scholarly journals Targeted Neuromodulation of Abnormal Interhemispheric Connectivity to Promote Neural Plasticity and Recovery of Arm Function after Stroke: A Randomized Crossover Clinical Trial Study Protocol

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Michael R. Borich ◽  
Steven L. Wolf ◽  
Andrew Q. Tan ◽  
Jacqueline A. Palmer
Keyword(s):  
Clinical Trial ◽  
Study Protocol ◽  
Motor Skill ◽  
Repeated Measures ◽  
Functional Disability ◽  
Early Stage ◽  
Stroke Survivors ◽  
Functional Connections ◽  
Interhemispheric Connectivity ◽  
Skill Performance

Background. Despite intensive rehabilitation efforts, most stroke survivors have persistent functional disability of the paretic arm and hand. These motor impairments may be due in part to maladaptive changes in structural and functional connections between brain regions. The following early stage clinical trial study protocol describes a noninvasive brain stimulation approach to target transcallosally mediated interhemispheric connections between the ipsi- and contralesional motor cortices (iM1 and cM1) using corticocortical paired associative stimulation (ihPAS). This clinical trial aims to characterize ihPAS-induced modulation of interhemispheric connectivity and the effect on motor skill performance and learning in chronic stroke survivors. Methods/Design. A repeated-measures, cross-over design study will recruit 20 individuals post-stroke with chronic mild–moderate paretic arm impairment. Each participant will complete an active ihPAS and control ihPAS session. Assessments of cortical excitability and motor skill performance will be conducted prior to and at four time points following the ihPAS intervention. The primary outcome measures will be: TMS-evoked interhemispheric motor connectivity, corticomotor excitability, and response time on a modified serial reaction time task. Discussion/Conclusion. The findings from this single-site early stage clinical trial will provide foundational results to inform the design of larger-scale, multisite clinical trials to evaluate the therapeutic potential of ihPAS-based neuromodulation for upper limb recovery after stroke. This trial is registered with NCT02465034.

Assessment of Energy Expenditure During Discrete Skill Performance Using Systematic Observation and Indirect Calorimetry

2021 ◽  
pp. 1-6
Author(s):  
Ryan S. Sacko ◽  
Cate A. Egan ◽  
Jenna Fisher ◽  
Chelsee Shortt ◽  
Kerry McIver
Keyword(s):  
Physical Activity ◽  
Energy Expenditure ◽  
Indirect Calorimetry ◽  
Motor Skill ◽  
Repeated Measures ◽  
Leisure Activity ◽  
National Standards ◽  
Systematic Observation ◽  
Paired Samples ◽  
Skill Performance

Purpose: To determine the accuracy of three systematic observation (SO) tools to estimate energy expenditure (EE) using different skill performance and observation intervals. Method: Three SO tools (Observational System for Recording Physical Activity in Children-Preschool, System for Observing Fitness Instruction Time, and System for Observing Play and Leisure Activity in Youth) were used to observe children (N = 42, Mage = 8.1 ± 0.7) during motor skill testing sessions. EE was measured using indirect calorimetry (COSMED K4b2). Results: Paired samples t tests, repeated-measures analysis of variance, and regression analyses were performed to compare the EE estimated from SO tools with EE measured by indirect calorimetry. The average mean difference between the estimated metabolic equivalence of task (METS) and actual METS ranged between −1.24 METS (SD = 1.62, p < .01) and −3.46 METS (SD = 1.31, p < .01) depending on skill performance interval or SO tool analyzed. Conclusions: SO tools did not accurately estimate EE during object control skill testing sessions. Physical educators should consider utilizing discrete motor skill practice to accumulate health-enhancing levels of physical activity while adhering to national standards.

scholarly journals THU0566 THE EFFECT OF KINESIO-TAPING ON CHRONIC NONSPECIFIC LOW BACK PAIN: PRELIMINARY RESULTS OF A DOUBLE BLINDED RANDOMIZED CLINICAL TRIAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 524.1-525
Author(s):  
I. Aachari ◽  
K. Samia ◽  
T. Latifa ◽  
T. Fatima Zahrae ◽  
S. Afilal ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Placebo Group ◽  
Back Pain ◽  
Randomized Clinical Trial ◽  
Clinical Characteristics ◽  
Functional Disability ◽  
Low Back ◽  
Kinesio Taping ◽  
Secondary Outcomes

Background:The technique of Kinesio-Taping is a method of adhesive bandage exerting traction on the skin which would favorably influence the muscular and articular systems by reducing the pressure exerted on the subcutaneous mechanoreceptors thus reducing pain and muscle tension.Objectives:The aim of this study is to assess the effectiveness of Kinesio-Taping in the short and medium term on pain and function in patients with chronic nonspecific low back pain compared to a placebo.Methods:We conducted a double-blind, two-arm randomized clinical trial. The study should include a total of 70 patients randomized into 2 groups: Kinesio-Taping (n = 35) and control group (n = 35). To this date we have included 46 patients.All patients receives four I-shaped adhesive strips arranged in a star-like shape and applied to the most painful region of the lower back with a tension between 25% to 30% in the taping group. The placebo group received a taping procedure with no tension.Taping is applied three times (at baseline, fourth and eighth day). Patients are assessed at baseline, on day 14 and at 4 weeks by the Arabic version of the Oswestry Physical and Functional Disability Index (ODI) which is the primary outcome. The secondary outcomes are the assessment of pain and functional disability according to the visual analog scale (VAS) evaluated on a scale of 0 to 10, as well as Rolland-Morris score.Results:Both groups were comparable at baseline concerning the demographical and clinical characteristics (P > 0.05) (table 1). The result of repeated measures ANOVA showed a significant change in ODI score and in VAS for pain and functional disability as well as Rolland-Morris score in both groups. Using the ANCOVA, controlling for pre-test scores, a significant difference was found between the two groups (table 2).Table 1. Clinical characteristics of study population.Conclusion:Our clinical trial offers preliminary evidence on the superiority of Kinesio-Taping in the treatment chronic back pain compared to placebo concerning the reduction of pain and disability. Thus, it can be used as a complementary method in chronic non-specific low back pain.Table 2. Primary and secondary outcomes in the Kinesio-Taping and placebo group.Disclosure of Interests:None declared

scholarly journals EEG Fractal Analysis Reflects Brain Impairment after Stroke

Entropy ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 592
Author(s):  
Maria Rubega ◽  
Emanuela Formaggio ◽  
Franco Molteni ◽  
Eleonora Guanziroli ◽  
Roberto Di Marco ◽  
...  
Keyword(s):  
Early Stage ◽  
Brain Activity ◽  
Phase 1 ◽  
Behavioral Changes ◽  
Stroke Survivors ◽  
Eeg Signals ◽  
Novel Treatments ◽  
Fractal Measures ◽  
Underlying Mechanisms ◽  
Random Fluctuations

Stroke is the commonest cause of disability. Novel treatments require an improved understanding of the underlying mechanisms of recovery. Fractal approaches have demonstrated that a single metric can describe the complexity of seemingly random fluctuations of physiological signals. We hypothesize that fractal algorithms applied to electroencephalographic (EEG) signals may track brain impairment after stroke. Sixteen stroke survivors were studied in the hyperacute (<48 h) and in the acute phase (∼1 week after stroke), and 35 stroke survivors during the early subacute phase (from 8 days to 32 days and after ∼2 months after stroke): We compared resting-state EEG fractal changes using fractal measures (i.e., Higuchi Index, Tortuosity) with 11 healthy controls. Both Higuchi index and Tortuosity values were significantly lower after a stroke throughout the acute and early subacute stage compared to healthy subjects, reflecting a brain activity which is significantly less complex. These indices may be promising metrics to track behavioral changes in the very early stage after stroke. Our findings might contribute to the neurorehabilitation quest in identifying reliable biomarkers for a better tailoring of rehabilitation pathways.

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