scholarly journals Rehabilitation of Upper Limb in Children with Acquired Brain Injury: A Preliminary Comparative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Elena Beretta ◽  
Ambra Cesareo ◽  
Emilia Biffi ◽  
Carolyn Schafer ◽  
Sara Galbiati ◽  
...  
Keyword(s):  
Upper Limb ◽  
Brain Injuries ◽  
Motor Task ◽  
Clinical Decision ◽  
Positive Influence ◽  
The Body ◽  
Motor Tasks ◽  
Rehabilitation Treatment ◽  
Constraint Induced Movement Therapy ◽  
Wide Range

Acquired brain injuries (ABIs) can lead to a wide range of impairments, including weakness or paralysis on one side of the body known as hemiplegia. In hemiplegic patients, the rehabilitation of the upper limb skills is crucial, because the recovery has an immediate impact on patient quality of life. For this reason, several treatments were developed to flank physical therapy (PT) and improve functional recovery of the upper limbs. Among them, Constraint-Induced Movement Therapy (CIMT) and robot-aided therapy have shown interesting potentialities in the rehabilitation of the hemiplegic upper limb. Nevertheless, there is a lack of quantitative evaluations of effectiveness in a standard clinical setting, especially in children, as well as a lack of direct comparative studies between these therapeutic techniques. In this study, a group of 18 children and adolescents with hemiplegia was enrolled and underwent intensive rehabilitation treatment including PT and CIMT or Armeo®Spring therapy. The effects of the treatments were assessed using clinical functional scales and upper limb kinematic analysis during horizontal and vertical motor tasks. Results showed CIMT to be the most effective in terms of improved functional scales, while PT seemed to be the most significant in terms of kinematic variations. Specifically, PT resulted to have positive influence on distal movements while CIMT conveyed more changes in the proximal kinematics. Armeo treatment delivered improvements mainly in the vertical motor task, showing trends of progresses of the movement efficiency and reduction of compensatory movements of the shoulder with respect to other treatments. Therefore, every treatment gave advantages in a specific and different upper limb district. Therefore, results of this preliminary study may be of help to define the best rehabilitation treatment for each patient, depending on the goal, and may thus support clinical decision.

scholarly journals Awareness, Knowledge, and Utility of RCT Data vs RWE: Results From a Survey of US Cardiologists: Real-world Evidence in Clinical Decision Making

2020 ◽  
Vol 14 ◽  
pp. 117954682095341 ◽  
Author(s):  
Todd C Villines ◽  
Mark J Cziraky ◽  
Alpesh N Amin
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Real World ◽  
Randomized Clinical Trials ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Body ◽  
Representative Sampling ◽  
Real World Evidence ◽  
Wide Range

Real-world evidence (RWE) provides a potential rich source of additional information to the body of data available from randomized clinical trials (RCTs), but there is a need to understand the strengths and limitations of RWE before it can be applied to clinical practice. To gain insight into current thinking in clinical decision making and utility of different data sources, a representative sampling of US cardiologists selected from the current, active Fellows of the American College of Cardiology (ACC) were surveyed to evaluate their perceptions of findings from RCTs and RWE studies and their application in clinical practice. The survey was conducted online via the ACC web portal between 12 July and 11 August 2017. Of the 548 active ACC Fellows invited as panel members, 173 completed the survey (32% response), most of whom were board certified in general cardiology (n = 119, 69%) or interventional cardiology (n = 40, 23%). The survey results indicated a wide range of familiarity with and utilization of RWE amongst cardiologists. Most cardiologists were familiar with RWE and considered RWE in clinical practice at least some of the time. However, a significant minority of survey respondents had rarely or never applied RWE learnings in their clinical practice, and many did not feel confident in the results of RWE other than registry data. These survey findings suggest that additional education on how to assess and interpret RWE could help physicians to integrate data and learnings from RCTs and RWE to best guide clinical decision making.

scholarly journals Central Venous Oxygenation for Mixed Venous Oxygen Saturation

2018 ◽  
Vol 02 (02) ◽  
pp. 057-060
Author(s):  
Naresh Kumar Agarwal ◽  
Arun Subramanian
Keyword(s):  
Oxygen Saturation ◽  
Superior Vena ◽  
Vena Cava ◽  
Clinical Decision ◽  
Mixed Venous Oxygen Saturation ◽  
The Body ◽  
Wide Range ◽  
Venous Oxygen Saturation ◽  
Range Of Values ◽  
Mixed Venous

AbstractVenous oxygen saturation has been traditionally used as a marker for tissue hypoxia. A wide range of factors can affect it. Literature abounds with articles on the use of the same in decision making and clinical management of patients in shock. Likewise, the application of venous saturation in patients undergoing cardiac and noncardiac surgery has been demonstrated. The controversy as to whether superior vena cava oxygen saturation can replace the traditional mixed venous oxygen saturation is never ending. Irrespective of the body of evidence, it is recommended that clinical decision should not be based on a single value, and a range of values needs to be incorporated to differentiate a critically ill from a noncritically ill patient.

scholarly journals Explanation Within Arm’s Reach: A Predictive Processing Framework for Single Arm Use in Octopuses

Erkenntnis ◽  
2021 ◽  
Author(s):  
Sidney Carls-Diamante
Keyword(s):  
Nervous System ◽  
Motor Control ◽  
Spatial Representation ◽  
Motor Task ◽  
The Body ◽  
Predictive Processing ◽  
Motor Tasks ◽  
Functional Characteristics ◽  
Somatotopic Map ◽  
Processing Framework

AbstractOctopuses are highly intelligent animals with vertebrate-like cognitive and behavioural repertoires. Despite these similarities, vertebrate-based models of cognition and behaviour cannot always be successfully applied to octopuses, due to the structural and functional characteristics that have evolved in their nervous system in response to the unique challenges posed by octopus morphology. For instance, the octopus brain does not support a somatotopic or point-for-point spatial map of the body—an important feature of vertebrate nervous systems. Thus, while octopuses are capable of motor tasks whose vertebrate counterparts require detailed interoceptive monitoring, these movements may not be explainable using motor control frameworks premised on internal spatial representation. One such motor task is the extension of a single arm. The ability of octopuses to select and use a single arm without the guidance of a somatotopic map has been regarded as a motor control puzzle. In an attempt at a solution, this paper develops a predictive processing account of single-arm extension in octopuses.

scholarly journals Motor Imagery EEG neurofeedback skill acquisition in the context of declarative interference and sleep

2020 ◽  
Author(s):  
Mareike Daeglau ◽  
Catharina Zich ◽  
Julius Welzel ◽  
Samira Kristina Saak ◽  
Jannik Florian Scheffels ◽  
...  
Keyword(s):  
Individual Differences ◽  
Motor Imagery ◽  
Skill Acquisition ◽  
Brain Injuries ◽  
Declarative Memory ◽  
Motor Task ◽  
Individual Variability ◽  
Control Group ◽  
Motor Abilities ◽  
Wide Range

AbstractMotor imagery (MI) practice in combination with neurofeedback (NF) is a promising supplement to facilitate the acquisition of motor abilities and the recovery of impaired motor abilities following brain injuries. However, the ability to control MI NF is subject to a wide range of inter-individual variability. A substantial number of users experience difficulties in achieving good results, which compromises their chances to benefit from MI NF in a learning or rehabilitation context. It has been suggested that context factors, that is, factors outside the actual motor task, can explain individual differences in motor skill acquisition. Retrospective declarative interference and sleep have already been identified as critical factors for motor execution (ME) and MI based practice. Here, we investigate whether these findings generalize to MI NF practice.Three groups underwent three blocks of MI NF practice each on two subsequent days. In two of the groups, MI NF blocks were followed by either immediate or delayed declarative memory tasks. The control group performed only MI NF and no specific interference tasks. Two of the MI NF blocks were run on the first day of the experiment, the third in the morning of the second day. Significant within-block NF gains in mu and beta frequency event-related desynchronization (ERD) where evident for all groups. However, effects of sleep on MI NF ERD were not found. Data did also not indicate an impact of immediate or delayed declarative interference on MI NF ERD.Our results indicate that effects of sleep and declarative interference context on ME or MI practice cannot unconditionally be generalized to MI NF skill acquisition. The findings are discussed in the context of variable experimental task designs, inter-individual differences, and performance measures.

Limb immobilization for the treatment of focal occupational dystonia

Neurology ◽  
2001 ◽  
Vol 57 (3) ◽  
pp. 405-409 ◽  
Author(s):  
A. Priori ◽  
A. Pesenti ◽  
A. Cappellari ◽  
G. Scarlato ◽  
S. Barbieri
Keyword(s):  
Upper Limb ◽  
Social Impact ◽  
Motor Task ◽  
Musical Instrument ◽  
Base Line ◽  
Motor Tasks ◽  
Rating Score ◽  
Self Rating ◽  
Disability Scale ◽  
Limb Immobilization

Background: Occupational focal upper-limb dystonia is characterized by involuntary muscle contractions that selectively interfere with the execution of specific motor tasks such as writing or playing a musical instrument. Occupational dystonias have a severe social impact, especially in certain professions. The available medical treatments offer little benefit.Methods: In eight patients with idiopathic occupational focal dystonia of the upper limb, the dystonic forearm and hand were immobilized with a plastic splint for mean (±SD) 4.5 ± 0.75 weeks. Before splinting (base line) and at various intervals afterwards (4, 12, and 24 weeks), the authors assessed the severity of dystonia and the patients’ motor performance objectively (Arm Dystonia Disability Scale and Tubiana and Chamagne Score) and subjectively (Self-Rating Score).Results: Assessment 4 weeks after splint removal, when patients had regained normal voluntary movements, showed that the severity of dystonia and the patients’ performance of the impaired motor task had improved; the benefit persisted unchanged at later follow-up visits (Arm Dystonia Disability Scale: base line 20.6 ± 30.2%; after 4 weeks 83.9 ± 23.8%, p = 0.007; after 12 weeks 83.9 ± 23.8%, p = 0.007; after 24 weeks 79.7 ± 29.5%, p = 0.015. Tubiana and Chamagne Score: base line 28.6 ± 22.7%; after 4 weeks 80.0 ± 23.1%, p = 0.015; after 12 weeks 80.0 ± 23.1%, p = 0.015; after 24 weeks 74.3 ± 32.1%, p = 0.031. Self-Rating Score: base line 20.6 ± 19.3%; after 4 weeks 63.7 ± 25.2%, p = 0.015; after 12 weeks 66.9 ± 28.1%, p = 0.015; after 24 weeks 70.6 ± 31.8%, p = 0.015). At the 24-week visit the improvement disappeared in one patient, was moderate in three, and marked in four.Conclusions: Limb immobilization can be a simple, effective, safe, and inexpensive treatment for focal occupational upper-limb dystonia.

Motor Training-Induced Neuroplasticity

GeroPsych ◽  
2012 ◽  
Vol 25 (4) ◽  
pp. 189-197 ◽  
Author(s):  
Ladina Bezzola ◽  
Susan Mérillat ◽  
Lutz Jäncke
Keyword(s):  
Physical Activity ◽  
Brain Aging ◽  
Motor Task ◽  
Motor Training ◽  
Motor Tasks ◽  
Cross Sectional ◽  
Functional Changes ◽  
Age Cohorts ◽  
Applied Study ◽  
Wide Range

The present lab-review presents and discusses our previous and current research into motor training-induced neuroplasticity by classifying our work on the basis of two broad aspects: (1) the applied study design (i.e., cross-sectional vs. longitudinal) and (2) the complexity of the motor task subjected to training (i.e., elementary finger movements vs. highly complex physical activity). Together with others we demonstrate that training-induced anatomic and functional changes are evident for a wide range of motor tasks and for several age cohorts. Finally, we discuss our findings from a lifespan perspective and embed them in the context of research investigating the beneficial effect of motor training-induced neuroplasticity on brain aging.

scholarly journals The inferior vena cava: anatomical variants and acquired pathologies

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Simon J. Li ◽  
Jean Lee ◽  
Jonathan Hall ◽  
Tom R. Sutherland
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Clinical Decision Making ◽  
Vena Cava ◽  
Clinical Decision ◽  
The Body ◽  
Embryological Development ◽  
Anatomical Variants ◽  
Pictorial Review ◽  
Wide Range

AbstractThe inferior vena cava (IVC) is the largest vein in the body, draining blood from the abdomen, pelvis and lower extremities. This pictorial review summarises normal anatomy and embryological development of the IVC. In addition, we highlight a wide range of anatomical variants, acquired pathologies and a common pitfall in imaging of the IVC. This information is essential for clinical decision making and to reduce misdiagnosis.

Creating the Wind

2020 ◽  
Vol 2 (4) ◽  
pp. 14-31
Author(s):  
Élodie Dupey García
Keyword(s):  
Indigenous Communities ◽  
The Body ◽  
Historical Sources ◽  
Natural Behavior ◽  
Sensory Experiences ◽  
Identity And Agency ◽  
Wide Range ◽  
Late Postclassic ◽  
Comparative Examination ◽  
Meteorological Phenomenon

This article explores how the Nahua of late Postclassic Mesoamerica (1200–1521 CE) created living and material embodiments of their wind god constructed on the basis of sensory experiences that shaped their conception of this divinized meteorological phenomenon. In this process, they employed chromatic and design devices, based on a wide range of natural elements, to add several layers of meaning to the human, painted, and sculpted supports dressed in the god’s insignia. Through a comparative examination of pre-Columbian visual production—especially codices and sculptures—historical sources mainly written in Nahuatl during the viceregal period, and ethnographic data on indigenous communities in modern Mexico, my analysis targets the body paint and shell jewelry of the anthropomorphic “images” of the wind god, along with the Feathered Serpent and the monkey-inspired embodiments of the deity. This study identifies the centrality of other human senses beyond sight in the conception of the wind god and the making of its earthly manifestations. Constructing these deity “images” was tantamount to creating the wind because they were intended to be visual replicas of the wind’s natural behavior. At the same time, they referred to the identity and agency of the wind god in myths and rituals.

Neural Stem Cells to Glial Cells an Important Factor for Brain Injury

2020 ◽  
Author(s):  
Prithiv K R Kumar
Keyword(s):  
Stem Cells ◽  
Central Nervous System ◽  
Nervous System ◽  
Neural Stem Cells ◽  
Glial Cells ◽  
Brain Injuries ◽  
The Body ◽  
The Central Nervous System ◽  
Near Future

Stem cells have the capacity to differentiate into any type of cell or organ. Stems cell originate from any part of the body, including the brain. Brain cells or rather neural stem cells have the capacitive advantage of differentiating into the central nervous system leading to the formation of neurons and glial cells. Neural stem cells should have a source by editing DNA, or by mixings chemical enzymes of iPSCs. By this method, a limitless number of neuron stem cells can be obtained. Increase in supply of NSCs help in repairing glial cells which in-turn heal the central nervous system. Generally, brain injuries cause motor and sensory deficits leading to stroke. With all trials from novel therapeutic methods to enhanced rehabilitation time, the economy and quality of life is suppressed. Only PSCs have proven effective for grafting cells into NSCs. Neurons derived from stem cells is the only challenge that limits in-vitro usage in the near future.

Structure, Function and Interactions of Tau: Particular Focus on Potential Drug Targets for the Treatment of Tauopathies

2018 ◽  
Vol 17 (5) ◽  
pp. 325-337 ◽  
Author(s):  
Hojjat Borna ◽  
Kasim Assadoulahei ◽  
Gholamhossein Riazi ◽  
Asghar Beigi Harchegani ◽  
Alireza Shahriary
Keyword(s):  
Tau Protein ◽  
Drug Targets ◽  
Brain Injuries ◽  
Potential Drug ◽  
Microtubule Network ◽  
Wide Range ◽  
Potential Risk Factors ◽  
Range Of Functions ◽  
Potential Drug Targets

Background & Objective: Neurodegenrative diseases are among the most widespread lifethreatening disorders around the world in elderly ages. The common feature of a group of neurodegenerative disorders, called tauopathies, is an accumulation of microtubule associated protein tau inside the neurons. The exact mechanism underlying tauopathies is not well-understood but several factors such as traumatic brain injuries and genetics are considered as potential risk factors. Although tau protein is well-known for its key role in stabilizing and organization of axonal microtubule network, it bears a broad range of functions including DNA protection and participation in signaling pathways. Moreover, the flexible unfolded structure of tau facilitates modification of tau by a wide range of intracellular enzymes which in turn broadens tau function and interaction spectrum. The distinctive properties of tau protein concomitant with the crucial role of tau interaction partners in the progression of neurodegeneration suggest tau and its binding partners as potential drug targets for the treatment of neurodegenerative diseases. Conclusion: This review aims to give a detailed description of structure, functions and interactions of tau protein in order to provide insight into potential therapeutic targets for treatment of tauopathies.

Sign in / Sign up

Export Citation Format

Share Document