Beyond therapists: Technology-aided physical MS rehabilitation delivery

2019 ◽  
Vol 25 (10) ◽  
pp. 1387-1393 ◽  
Author(s):  
Peter Feys ◽  
Sofia Straudi
Keyword(s):  
Clinical Settings ◽  
Control Mechanisms ◽  
Key Factors ◽  
Massed Practice ◽  
Task Specificity ◽  
Upper Limb Function ◽  
Rehabilitation Technology ◽  
Good Movement ◽  
Optimal Rehabilitation ◽  
Available Technology

In the last decade, rehabilitation technology has been developed, investigated, and entered specialized clinical settings. In this chapter, we first discuss the potential of rehabilitation technology to support the achievement of key factors in motor recovery, such as delivering massed practice with good movement quality but also question task-specificity and cognitive motor control mechanisms. Second, we discuss available technology-supported rehabilitation methods for improving gait, balance and fitness, and upper limb function. Finally, we discuss considerations in relation to the professional workforce in order to deliver optimal rehabilitation.

Alzheimer's Electroencephalogram Event Scalp and Source Localization

2016 ◽  
pp. 33-49
Author(s):  
Pedro Miguel Rodrigues ◽  
João Paulo Teixeira ◽  
Diamantino R. S. Freitas
Keyword(s):  
Source Localization ◽  
The Elderly ◽  
Clinical Settings ◽  
New Approach ◽  
Brain Anomalies ◽  
Available Technology ◽  
Temporal Events ◽  
Near Future ◽  
Electroencephalogram Eeg ◽  
Irreversible Impairment

Alzheimer's disease is the most common cause of dementia which causes a progressive and irreversible impairment of several cognitive functions. The aging population has been increasing significantly in recent decades and this disease affects mainly the elderly. Its diagnostic accuracy is relatively low and there is not a biomarker able to detect AD without invasive tests. Despite the progress in better understanding the disease there remains no prospect of cure at least in the near future. The electroencephalogram (EEG) test is a widely available technology in clinical settings. It may help diagnosis of brain disorders, once it can be used in patients who have cognitive impairment involving a general decrease in overall brain function or in patients with a located deficit. This study is a new approach to improve the scalp localization and the detection of brain anomalies (EEG temporal events) sources associated with AD by using the EEG.

Detection of Alzheimer’s Disease Electroencephalogram Temporal Events

2013 ◽  
Vol 2 (3) ◽  
pp. 44-61 ◽  
Author(s):  
Pedro Miguel Rodrigues ◽  
Diamantino Rui Freitas ◽  
João Paulo Teixeira
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
The Elderly ◽  
Clinical Settings ◽  
Brain Disorder ◽  
New Approach ◽  
Self Organized ◽  
Available Technology ◽  
Temporal Events ◽  
Electroencephalogram Eeg

Alzheimer’s Disease (AD) is a chronic progressive and irreversible neurodegenerative brain disorder. The aging population has been increasing significantly in recent decades. Therefore, AD will continue to increase because the disease affects mainly the elderly. Its diagnostic accuracy is relatively low, and there is not a biomarker able to detect AD without invasive tests. The electroencephalogram (EEG) test is a widely available technology in clinical settings. It may help diagnosis of brain disorders, once it can be used in patients who have cognitive impairment involving a general decrease in overall brain function or in patients with a located deficit. This study is a new approach to detect EEG temporal events in order to improve the AD diagnosis. For that, K-means and Self-Organized Maps were used, and the results suggested that there are sequences of EEG energy variation that appear more frequently in AD patients than in healthy subjects.

scholarly journals A day in the life of third-year medical students: using an ethnographic method to understand information seeking and use

2017 ◽  
Vol 105 (1) ◽  
Author(s):  
Andrea B. Twiss-Brooks, MS, MLIS ◽  
Ricardo Andrade Jr., MLIS ◽  
Michelle B. Bass, PhD, MSI ◽  
Barbara Kern, MLIS ◽  
Jonna Peterson, MLIS ◽  
...  
Keyword(s):  
Medical Students ◽  
Time Management ◽  
Information Seeking ◽  
Information Resources ◽  
Clinical Settings ◽  
Structured Interviews ◽  
School Students ◽  
Desktop Computers ◽  
Available Technology

Objective: The authors undertook this project to learn how third-year medical students seek and use information in the course of daily activities, especially activities conducted in clinical settings in a variety of institutions.Methods: We recruited sixty-eight third-year undergraduate medical school students to create a mapping diary of a day that included clinical activities. We conducted semi-structured interviews based on the mapping diaries. Using content and thematic analyses of the resulting interview transcripts, we developed an ethnographic case study for each participant.Results: In the studied sample, we identified a broad range of information resources used for personal, clinical, and educational use. Participants relied heavily on technology throughout their day, including desktop computers, smart phones, handheld tablets, and laptops. Time management was a pervasive theme in the interviews, with participants squeezing in time to study for exams wherever and whenever they could. Selection of a particular information resource or technology to use was governed largely by the convenience of using that resource or technology. When obstacles were encountered, workarounds might be sought, but in many cases, the resource or technology would be abandoned in favor of a more convenient solution. Convenience was also a consideration in choosing spaces to use for clinical duties or for study, with specific considerations of available technology, proximity to clinical areas, and security for belongings contributing to choices made.Conclusions: Some of our results align with those of other recent studies of information use among medical students, residents, and practicing physicians. In particular, the fast-paced clinical setting favors use of information resources that are fast and easy to use. We demonstrated that the methods used are suitable to better understand clinicians’ discovery and use of information.

scholarly journals Factors Obscuring the Role of E. coli from Domestic Animals in the Global Antimicrobial Resistance Crisis: An Evidence-Based Review

2020 ◽  
Vol 17 (9) ◽  
pp. 3061 ◽  
Author(s):  
Fernanda Loayza ◽  
Jay P. Graham ◽  
Gabriel Trueba
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Species ◽  
Leading Edge ◽  
Domestic Animals ◽  
World Health ◽  
Clinical Settings ◽  
Key Factors ◽  
Animal Products ◽  
E Coli ◽  
Health Organization

Recent studies have found limited associations between antimicrobial resistance (AMR) in domestic animals (and animal products), and AMR in human clinical settings. These studies have primarily used Escherichia coli, a critically important bacterial species associated with significant human morbidity and mortality. E. coli is found in domestic animals and the environment, and it can be easily transmitted between these compartments. Additionally, the World Health Organization has highlighted E. coli as a “highly relevant and representative indicator of the magnitude and the leading edge of the global antimicrobial resistance (AMR) problem”. In this paper, we discuss the weaknesses of current research that aims to link E. coli from domestic animals to the current AMR crisis in humans. Fundamental gaps remain in our understanding the complexities of E. coli population genetics and the magnitude of phenomena such as horizontal gene transfer (HGT) or DNA rearrangements (transposition and recombination). The dynamic and intricate interplay between bacterial clones, plasmids, transposons, and genes likely blur the evidence of AMR transmission from E. coli in domestic animals to human microbiota and vice versa. We describe key factors that are frequently neglected when carrying out studies of AMR sources and transmission dynamics.

scholarly journals Associations Between Bipedal Stance Stability and Locomotor Stability Following a Trip in Unilateral Vestibulopathy

2017 ◽  
Vol 33 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Christopher McCrum ◽  
Katrin Eysel-Gosepath ◽  
Gaspar Epro ◽  
Kenneth Meijer ◽  
Hans H.C.M. Savelberg ◽  
...  
Keyword(s):  
Center Of Pressure ◽  
Force Plate ◽  
Clinical Settings ◽  
Control Mechanisms ◽  
Gait Stability ◽  
Eyes Open ◽  
Unilateral Vestibulopathy ◽  
Base Of Support ◽  
Dynamic Gait ◽  
Pearson Correlations

Posturography is used to assess balance in clinical settings, but its relationship to gait stability is unclear. We assessed if dynamic gait stability is associated with standing balance in 12 patients with unilateral vestibulopathy. Participants were unexpectedly tripped during treadmill walking and the change in the margin of stability (MoSchange) and base of support (BoSchange) relative to nonperturbed walking was calculated for the perturbed and first recovery steps. The center of pressure (COP) path during 30-s stance with eyes open and closed, and the distance between the most anterior point of the COP and the anterior BoS boundary during forward leaning (ADist), were assessed using a force plate. Pearson correlations were conducted between the static and dynamic variables. The perturbation caused a large decrease in the BoS, leading to a decrease in MoS. One of 12 correlations was significant (MoSchange at the perturbed step and ADist; r = −.595, P = .041; nonsignificant correlations: .068 ≤ P ≤ .995). The results suggest that different control mechanisms may be involved in stance and gait stability, as a consistent relationship was not found. Therefore, posturography may be of limited use in predicting stability in dynamic situations.

scholarly journals Reducing False Triggering Caused by Irrelevant Mental Activities in Brain-Computer Interface Based on Motor Imagery

2020 ◽  
Author(s):  
Lujia Zhou ◽  
Xuewen Tao ◽  
Feng He ◽  
Peng Zhou ◽  
Hongzhi Qi
Keyword(s):  
Steady State ◽  
Motor Imagery ◽  
Stroke Rehabilitation ◽  
Evoked Potential ◽  
Brain Computer Interface ◽  
Recognition Rate ◽  
Computer Interface ◽  
Task Specificity ◽  
Rehabilitation Technology ◽  
The Brain

Abstract Background: In recent years, the brain-computer interface (BCI) based on motor imagery (MI) has been considered as a potential post-stroke rehabilitation technology. However, the recognition of MI relies on the event-related desynchronization (ERD) feature, which has poor task specificity. Further, there is the problem of false triggering (irrelevant mental activities recognized as the MI of the target limb). Methods: In this paper, we discuss the feasibility of reducing the false triggering rate using a novel paradigm, in which the steady-state somatosensory evoked potential (SSSEP) is combined with the MI (MI-SSSEP). Data from the target (right hand MI) and nontarget task (rest) were used to establish the recognition model, and three kinds of interference tasks were used to test the false triggering performance. In the MI-SSSEP paradigm, ERD and SSSEP features modulated by MI could be used for recognition, while in the MI paradigm, only ERD features could be used. Results: The results showed that the false triggering rate of interference tasks with SSSEP features was reduced to 29.3%, which was far lower than the 55.5% seen under the MI paradigm with ERD features. Moreover, in the MI-SSSEP paradigm, the recognition rate of the target and nontarget task was also significantly improved. Further analysis showed that the specificity of SSSEP was significantly higher than that of ERD (p<0.05), but the sensitivity was not significantly different. Conclusions: These results indicated that SSSEP modulated by MI could more specifically decode the target task MI, and thereby may have potential in achieving more accurate rehabilitation training.

scholarly journals Mitochondrial Stress Signalling: HTRA2 and Parkinson's Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Enrico Desideri ◽  
L. Miguel Martins
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Quality Control ◽  
Free Radicals ◽  
Oxygen Free Radicals ◽  
Control Mechanisms ◽  
Cyclin Dependent Kinase ◽  
Key Factors ◽  
Mitochondrial Stress ◽  
Stress Kinase

Mitochondria are cellular energy generators whose activity requires a continuous supply of oxygen. Recent genetic analysis has suggested that defects in mitochondrial quality control may be key factors in the development of Parkinson’s disease (PD). Mitochondria have a crucial role in supplying energy to the brain, and their deterioration can affect the function and viability of neurons, contributing to neurodegeneration. These organelles can sow the seeds of their own demise because they generate damaging oxygen-free radicals as a byproduct of their intrinsic physiological functions. Mitochondria have therefore evolved specific molecular quality control mechanisms to compensate for the action of damaging agents such as oxygen-free radicals. PTEN-induced putative kinase 1 (PINK1) and high-temperature-regulated A2 (HTRA2), a mitochondrial protease, have recently been proposed to be key modulators of mitochondrial molecular quality control. Here, we review some of the most recent advances in our understanding of mitochondria stress-control pathways, focusing on how signalling by the p38 stress kinase pathway may regulate mitochondrial stress by modulating the activity of HTRA2 via PINK1 and cyclin-dependent kinase 5 (CDK5). We also propose how defects in this pathway may contribute to PD.

scholarly journals Experiences of Using Pathways and Resources for Engagement and Participation (PREP) Intervention for Children with Acquired Brain Injury: A Knowledge Translation Study

2020 ◽  
Vol 17 (23) ◽  
pp. 8736
Author(s):  
Melanie Burrough ◽  
Clare Beanlands ◽  
Paul Sugarhood
Keyword(s):  
Brain Injury ◽  
Knowledge Translation ◽  
Real Life ◽  
Acquired Brain Injury ◽  
Successful Implementation ◽  
Clinical Settings ◽  
Ripple Effect ◽  
Key Factors ◽  
Social Opportunities ◽  
Family Readiness

Background: Children with acquired brain injury experience participation restrictions. Pathways and Resources for Engagement and Participation (PREP) is an innovative, participation focused intervention. Studies have examined PREP in Canadian research contexts, however little is known about implementation in real-life clinical settings. This study aimed to understand experiences of clinicians implementing PREP in a UK clinical context, with a focus on implementation processes and key factors for successful implementation. Methods: A qualitative single-site 8-week knowledge translation intervention study, guided by an action research framework, explored clinicians’ experiences of implementation. Six occupational therapists (OTs) working in a neurorehabilitation setting participated. The therapists provided two intervention sessions per week, over four weeks for one child on their caseload. Planning, implementation and evaluation were explored through two focus groups. Thematic analysis was used to analyse data. Results: Two themes, “key ingredients before you start” and “PREP guides the journey”, were identified before introducing PREP to practice. Four additional themes were related to PREP implementation: “shifting to a participation perspective”, “participation moves beyond the OT”, “environmental challengers and remedies” and “whole family readiness”. A participation ripple effect was observed by building capacity across the multi-disciplinary team and families. The involvement of peers, social opportunities and acknowledging family readiness were key factors for successful implementation. Conclusions: The findings illustrate practical guidance to facilitate the uptake of participation-based evidence in clinical practice. Further research is required to understand aspects of knowledge translation when implementing participation interventions in other UK clinical settings.

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