scholarly journals Home-Based Therapy After Stroke Using the Hand Spring Operated Movement Enhancer (HandSOME II)

2021 ◽  
Vol 15 ◽  
Author(s):  
Rafael Casas ◽  
Melissa Sandison ◽  
Diane Nichols ◽  
Kaelin Martin ◽  
Khue Phan ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Real World ◽  
Brain Plasticity ◽  
Low Cost ◽  
Biomechanical Testing ◽  
Chronic Stroke ◽  
Reaching Task ◽  
Home Based ◽  
Before And After ◽  
Task Practice

We have developed a passive and lightweight wearable hand exoskeleton (HandSOME II) that improves range of motion and functional task practice in laboratory testing. For this longitudinal study, we recruited 15 individuals with chronic stroke and asked them to use the device at home for 1.5 h per weekday for 8 weeks. Subjects visited the clinic once per week to report progress and troubleshoot problems. Subjects were then given the HandSOME II for the next 3 months, and asked to continue to use it, but without any scheduled contact with the project team. Clinical evaluations and biomechanical testing was performed before and after the 8 week intervention and at the 3 month followup. EEG measures were taken before and after the 8 weeks of training to examine any recovery associated brain reorganization. Ten subjects completed the study. After 8 weeks of training, functional ability (Action Research Arm Test), flexor tone (Modified Ashworth Test), and real world use of the impaired limb (Motor Activity Log) improved significantly (p < 0.05). Gains in real world use were retained at the 3-month followup (p = 0.005). At both post-training and followup time points, biomechanical testing found significant gains in finger ROM and hand displacement in a reaching task (p < 0.05). Baseline functional connectivity correlated with gains in motor function, while changes in EEG functional connectivity paralleled changes in motor recovery. HandSOME II is a low-cost, home-based intervention that elicits brain plasticity and can improve functional motor outcomes in the chronic stroke population.

scholarly journals Integrated Outreach: Increasing Engagement in Computer Science and Cybersecurity

2020 ◽  
Vol 10 (12) ◽  
pp. 353
Author(s):  
Shaya Wolf ◽  
Andrea Carneal Burrows ◽  
Mike Borowczak ◽  
Mason Johnson ◽  
Rafer Cooley ◽  
...  
Keyword(s):  
Computer Science ◽  
Real World ◽  
Learning Experience ◽  
Low Cost ◽  
Outreach Programs ◽  
Integrated Stem ◽  
Hands On ◽  
Real World Applications ◽  
Before And After ◽  
Interest Level

Research on innovative, integrated outreach programs guided three separate week-long outreach camps held across two summers (2018 and 2019). These camps introduced computer science through real-world applications and hands-on activities, each dealing with cybersecurity principles. The camps utilized low-cost hardware and free software to provide a total of 84 students (aged 10 to 18 years) a unique learning experience. Based on feedback from the 2018 camp, a new pre/post survey was developed to assess changes in participant knowledge and interest. Student participants in the 2019 iteration showed drastic changes in their cybersecurity content recall (33% pre vs. 96% post), cybersecurity concept identification within real-world scenarios, and exhibited an increased ability to recognize potential cybersecurity threats in their every-day lives (22% pre vs. 69% post). Finally, students’ self-reported interest-level before and after the camp show a positive increase across all student participants, with the number of students who where highly interested in cybersecurity more than doubling from 31% pre-camp to 65% post-camp. Implications for educators are large as these activities and experiences can be interwoven into traditional schooling as well as less formal camps as pure computer science or through integrated STEM.

Effects of home-based telerehabilitation in patients with stroke

Neurology ◽  
2020 ◽  
Vol 95 (17) ◽  
pp. e2318-e2330 ◽  
Author(s):  
Jing Chen ◽  
Dalong Sun ◽  
Shufan Zhang ◽  
Yonghui Shi ◽  
Fenglei Qiao ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Motor Function ◽  
Primary Motor Cortex ◽  
Brain Plasticity ◽  
Analysis Of Covariance ◽  
Imaging Biomarkers ◽  
Motor Training ◽  
Neural Function ◽  
Resting State Functional Connectivity ◽  
Home Based

ObjectiveTo determine the effects of a 12-week home-based motor training telerehabilitation program in patients with subcortical stroke by combining motor function assessments and multimodality MRI analysis methods.MethodsFifty-two patients with stroke and hemiplegia were randomly assigned to either a home-based motor training telerehabilitation (TR) group or a conventional rehabilitation (CR) group for 12 weeks. The Fugl-Meyer assessment (FMA) for upper and lower extremities and the modified Barthel Index were used as primary outcomes. The secondary outcomes included resting-state functional connectivity (rsFC) between the bilateral M1 areas, gray matter volumes of the primary motor cortex (M1) areas, and white matter integrity of the corticospinal tract. Analysis of covariance was applied to examine the effects of the home-based motor training TR program on neural function recovery and brain plasticity.ResultsCompared with the CR group, the TR group showed significant improvement in the FMA (p = 0.011) and significantly increased M1-M1 rsFC (p = 0.031) at the end of the rehabilitation. The M1-M1 rsFC change was significantly positively correlated with the FMA change in the TR group (p = 0.018).ConclusionThis study showed a beneficial effect of the home-based motor training telerehabilitation program on motor function in patients with stroke, which was accompanied by enhanced interhemispheric functional connectivity of the M1 areas. We inferred that it is feasible, safe, and efficacious for patients with stroke to receive professional rehabilitation training at home. The combined use of imaging biomarkers should be encouraged in motor training clinical studies in patients with stroke.Classification of evidenceThis study provides Class II evidence that for patients with stroke with hemiplegia, home-based telerehabilitation compared to conventional rehabilitation significantly improves some motor function tests.

scholarly journals Pilot Test of Dosage Effects in HEXORR II for Robotic Hand Movement Therapy in Individuals With Chronic Stroke

2021 ◽  
Vol 2 ◽  
Author(s):  
Ji Chen ◽  
Iian Black ◽  
Diane Nichols ◽  
Tianyao Chen ◽  
Melissa Sandison ◽  
...  
Keyword(s):  
Motion Capture ◽  
Hand Function ◽  
Hand Movement ◽  
Chronic Stroke ◽  
High Dose ◽  
Robotic Hand ◽  
Robotic Therapy ◽  
Before And After ◽  
Task Practice ◽  
Upper Extremity Impairment

Impaired use of the hand in functional tasks remains difficult to overcome in many individuals after a stroke. This often leads to compensation strategies using the less-affected limb, which allows for independence in some aspects of daily activities. However, recovery of hand function remains an important therapeutic goal of many individuals, and is often resistant to conventional therapies. In prior work, we developed HEXORR I, a robotic device that allows practice of finger and thumb movements with robotic assistance. In this study, we describe modifications to the device, now called HEXORR II, and a clinical trial in individuals with chronic stroke. Fifteen individuals with a diagnosis of chronic stroke were randomized to 12 or 24 sessions of robotic therapy. The sessions involved playing several video games using thumb and finger movement. The robot applied assistance to extension movement that was adapted based on task performance. Clinical and motion capture evaluations were performed before and after training and again at a 6-month followup. Fourteen individuals completed the protocol. Fugl-Meyer scores improved significantly at the 6 month time point compared to baseline, indicating reductions in upper extremity impairment. Flexor hypertonia (Modified Ashworth Scale) also decreased significantly due to the intervention. Motion capture found increased finger range of motion and extension ability after the intervention that continued to improve during the followup period. However, there was no change in a functional measure (Action Research Arm Test). At the followup, the high dose group had significant gains in hand displacement during a forward reach task. There were no other significant differences between groups. Future work with HEXORR II should focus on integrating it with functional task practice and incorporating grip and squeezing tasks.Trial Registration:ClinicalTrials.gov, NCT04536987. Registered 3 September 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT04536987.

scholarly journals The Exercising Brain: Changes in Functional Connectivity Induced by an Integrated Multimodal Cognitive and Whole-Body Coordination Training

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Traute Demirakca ◽  
Vita Cardinale ◽  
Sven Dehn ◽  
Matthias Ruf ◽  
Gabriele Ende
Keyword(s):  
Functional Connectivity ◽  
Brain Plasticity ◽  
Brain Regions ◽  
Posterior Cingulate Cortex ◽  
Whole Body ◽  
Before And After ◽  
Coordination Training ◽  
Brain Changes ◽  
The Impact ◽  
The Brain

This study investigated the impact of “life kinetik” training on brain plasticity in terms of an increased functional connectivity during resting-state functional magnetic resonance imaging (rs-fMRI). The training is an integrated multimodal training that combines motor and cognitive aspects and challenges the brain by introducing new and unfamiliar coordinative tasks. Twenty-one subjects completed at least 11 one-hour-per-week “life kinetik” training sessions in 13 weeks as well as before and after rs-fMRI scans. Additionally, 11 control subjects with 2 rs-fMRI scans were included. The CONN toolbox was used to conduct several seed-to-voxel analyses. We searched for functional connectivity increases between brain regions expected to be involved in the exercises. Connections to brain regions representing parts of the default mode network, such as medial frontal cortex and posterior cingulate cortex, did not change. Significant connectivity alterations occurred between the visual cortex and parts of the superior parietal area (BA7). Premotor area and cingulate gyrus were also affected. We can conclude that the constant challenge of unfamiliar combinations of coordination tasks, combined with visual perception and working memory demands, seems to induce brain plasticity expressed in enhanced connectivity strength of brain regions due to coactivation.

scholarly journals MRI correlates of cognitive improvement after home-based EEG neurofeedback training in patients with multiple sclerosis: a pilot study

2021 ◽  
Author(s):  
Daniela Pinter ◽  
Silvia Erika Kober ◽  
Viktoria Fruhwirth ◽  
Lisa Berger ◽  
Anna Damulina ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Diffusion Tensor ◽  
Resting State Fmri ◽  
Neurofeedback Training ◽  
Cognitive Improvement ◽  
Home Based ◽  
Before And After ◽  
Eeg Neurofeedback ◽  
Brain Microstructure ◽  
Correlation Trend

Abstract Objective Neurofeedback training may improve cognitive function in patients with neurological disorders. However, the underlying cerebral mechanisms of such improvements are poorly understood. Therefore, we aimed to investigate MRI correlates of cognitive improvement after EEG-based neurofeedback training in patients with MS (pwMS). Methods Fourteen pwMS underwent ten neurofeedback training sessions within 3–4 weeks at home using a tele-rehabilitation system. Half of the pwMS (N = 7, responders) learned to self-regulate sensorimotor rhythm (SMR, 12–15 Hz) by visual feedback and improved cognitively after training, whereas the remainder (non-responders, n = 7) did not. Diffusion-tensor imaging and resting-state fMRI of the brain was performed before and after training. We analyzed fractional anisotropy (FA) and functional connectivity (FC) of the default-mode, sensorimotor (SMN) and salience network (SAL). Results At baseline, responders and non-responders were comparable regarding sex, age, education, disease duration, physical and cognitive impairment, and MRI parameters. After training, compared to non-responders, responders showed increased FA and FC within the SAL and SMN. Cognitive improvement correlated with increased FC in SAL and a correlation trend with increased FA was observed. Conclusions This exploratory study suggests that successful neurofeedback training may not only lead to cognitive improvement, but also to increases in brain microstructure and functional connectivity.

Effects of Interactive Technology on Home-Based Rehabilitation for Chronic Stroke Patient

2013 ◽  
Vol 831 ◽  
pp. 446-449
Author(s):  
Chien Yu Lin ◽  
Shu Ling Hsien
Keyword(s):  
Computer Animation ◽  
Visual Analysis ◽  
Low Cost ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Interactive Technology ◽  
Single Subject ◽  
Rehabilitation Training ◽  
Home Based ◽  
The Subject

This study aimed to apply low-cost interactive technology to home-based rehabilitation training for patients suffering from chronic stroke. It also focuses on discussing the results of the integration of interactive computer game training with home-based rehabilitation training in helping these patients. We conducted an experiment following the reversal design of single-subject research, in which a patient suffering with chronic stroke was given home-based rehabilitation training. In addition to interactive computer technology, the experiment also involved the adoption of a low-cost Wii Remote controller as an infrared receiver and a homemade infrared emitter supplemented by computer animation software to investigate the outcome of a home-based rehabilitation program. Data analysis is based on collection of points by the participant throughout the experiment and adopting visual analysis to discuss the outcome of interactive technology integrated with home-based rehabilitation. The results of this research show that the subject was able to stand on one leg for a few seconds longer than prior to the adoption of interactive technology integrated with home-based rehabilitation. Furthermore, parents of this patient and the therapists involved believe that the research and this innovative approach improved the patients performance in rehabilitation. The subject not only showed better motivation with regard to rehabilitation but also greater independence and enhanced capability of integrating into society.

Only problem gamblers spend less money when loot boxes are removed from a game: A before and after study of Heroes of the Storm

2019 ◽  
Author(s):  
David Zendle
Keyword(s):  
Video Games ◽  
Problem Gambling ◽  
Video Game ◽  
Real World ◽  
Complex Pattern ◽  
Problem Gamblers ◽  
Before And After ◽  
Gambling Severity ◽  
Reliable Correlation ◽  
Before And After Study

Loot boxes are items in video games that may be paid for with real-world money, but which contain randomised contents. There is a reliable correlation between loot box spending and problem gambling severity: The more money gamers spend on loot boxes, the more severe their problem gambling tends to be. However, it is unclear whether this link represents a case in which loot box spending causes problem gambling; a case in which the gambling-like nature of loot boxes cause problem gamblers to spend more money; or whether it simply represents a case in which there is a general dysregulation in in-game spending amongst problem gamblers, nonspecific to loot boxes.The multiplayer video game Heroes of the Storm recently removed loot boxes. In order to better understand links between loot boxes and problem gambling, we conducted an analysis of players of Heroes of the Storm (n=112) both before and after the removal of loot boxes.There were a complex pattern of results. In general, when loot boxes were removed from Heroes of the Storm, problem gamblers appeared to spend significantly less money in-game in contrast to other groups. These results suggest that the presence of loot boxes in a game may lead to problem gamblers spending more money in-game. It therefore seems possible that links between loot box spending and problem gambling are not due to a general dysregulation in in-game spending amongst problem gamblers, but rather are to do with specific features of loot boxes themselves.

Evidences of Brain Plasticity and Motor Control Modulation after Hemodialysis Session by Helixone Membrane: BOLD-fMRI Study

2020 ◽  
Vol 19 (6) ◽  
pp. 466-477
Author(s):  
Saïd Boujraf ◽  
Rachida Belaïch ◽  
Abdelkhalek Housni ◽  
Badreeddine Alami ◽  
Tariq Skalli ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Functional Activity ◽  
Brain Plasticity ◽  
Biological Assessment ◽  
Bold Fmri ◽  
Before And After ◽  
Total Antioxidant ◽  
Inflammatory State ◽  
Functional Control ◽  
The Impact

Objective: The aim of this paper is to demonstrate the impact of hemodialysis (HD) using synthetic Helixone membrane on brain functional control reorganization and plasticity in the cortical area generated while Oxidative Stress (OS) would be the main impacting agent. Methods: Indeed, 9 chronic HD patients underwent identical brain BOLD-fMRI assessment using the motor paradigm immediately before and after the same HD sessions. To assess the oxidative stress, the same patients underwent biological-assessment, including Malondialdehyde (MDA) and Total- Antioxidant-Activity (TAOA) reported in earlier papers. Results: BOLD-fMRI maps of motor areas obtained from HD-patients before and after HD sessions revealed a significant enhancement of activation volume of the studied motor cortex after HD reflecting brain plasticity. Results were correlated with OS assessed by the measurement of MDA and TAOA; this correlation was close to 1. Conclusion: Indeed, HD enhances the inflammatory state of brain tissues reflected by the increased OS. The functional brain reaction demonstrated a functional activity reorganization to overcome the inflammatory state and OS enhanced by HD process. This functional activity reorganization reveals brain plasticity induced by OS originated by HD.

scholarly journals POS1121 DEMOGRAPHICS, COMORBIDITIES, AND RENAL FUNCTION OF UNCONTROLLED GOUT PATIENTS WHO RECEIVED PEGLOTICASE: FINDING FROM A LARGE US CLAIMS DATABASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 839.2-840
Author(s):  
C. Vesel ◽  
A. Morton ◽  
M. Francis-Sedlak ◽  
B. Lamoreaux
Keyword(s):  
Kidney Function ◽  
Real World ◽  
Randomized Clinical Trials ◽  
Small Subset ◽  
Phase 3 ◽  
Claims Database ◽  
Medical Diagnoses ◽  
Ckd Stage ◽  
Before And After ◽  
The Impact

Background:NHANES data indicate that approximately 9.2 million Americans have gout,1 with a small subset having uncontrolled disease.2 Pegloticase is a PEGylated recombinant uricase enzyme indicated for treating uncontrolled gout that markedly reduces serum uric acid levels (sUA)3 and resolves tophi in treatment responders.4 Despite pegloticase availability in the US for many years, real world demographics of pegloticase users in the treatment of uncontrolled gout have not been previously reported in a population-based cohort.Objectives:This study utilized a large US claims database to examine demographics and co-morbidities of uncontrolled gout patients treated with pegloticase. Kidney function before and after pegloticase treatment and concomitant therapy with immunomodulators were also examined.Methods:The TriNetX Diamond database includes de-identified data from 4.3 million US patients with gout (as of September 2019), including demographics, medical diagnoses, laboratory values, procedures (e.g. infusions, surgeries), and pharmacy data. Patients who had received ≥1 pegloticase infusion were included in these analyses. The number of infusions was evaluated for a subgroup of patients who were in the database ≥3 months before and ≥2 years after the first pegloticase infusion (i.e. first infusion prior to September 2017) to ensure only complete courses of therapy were captured. In this subpopulation, kidney function before and after pegloticase therapy was examined, along with the presence of immunomodulation prescriptions (methotrexate, mycophenolate mofetil, azathioprine, leflunomide) within 60 days prior to and 14 days after the first pegloticase infusion.Results:1494 patients treated with pegloticase were identified. Patients were 63.1 ± 14.0 years of age (range: 23–91), mostly male (82%), and white (76%). Mean sUA prior to pegloticase was 8.7 ± 2.4 mg/dL (n=50), indicating uncontrolled gout in the identified population. The most commonly reported comorbidities were chronic kidney disease (CKD, 48%), essential hypertension (71%), type 2 diabetes (39%), and cardiovascular disease (38%), similar to pegloticase pivotal Phase 3 trial populations. In patients with pre-therapy kidney function measures (n=134), pre-treatment eGFR averaged 61.2 ± 25.7 ml/min/1.73 m2, with 44% having Stage 3-5 CKD. In patients with complete therapy course capture and pre- and post-therapy eGFR measures (n=48), kidney function remained stable (change in eGFR: -2.9 ± 18.2 ml/min/1.73 m2) and CKD stage remained the same or improved in 81% of patients. In 791 patients with complete treatment course capture, patients had received 8.7 ± 13.8 infusions (median: 3, IQR: 2-10). Of these, 189 (24%) patients received only 1 pegloticase infusion and 173 (22%) received ≥12 infusions. As the data cut-off for this analysis pre-dated emerging data on the use of immunomodulation as co-therapy, only 19 of 791 (2%) patients received immunomodulation co-therapy with pegloticase.Conclusion:This relatively large group of patients with uncontrolled gout treated with pegloticase had similar patient characteristics of those studied in the phase 3 randomized clinical trials. Patients with uncontrolled gout are significantly burdened with systemic co-morbid diseases. The majority of patients had stable or improved kidney function following pegloticase treatment. As these results reflect patients initiating treatment prior to 2018, before co-treatment with immunomodulation was introduced, this cohort only included a small percentage of patients who were co-treated with an immunomodulator. Future studies using more current datasets are needed to evaluate real world outcomes in patients treated with pegloticase/immunomodulator co-therapy and to evaluate the impact of systemic co-morbid diseases.References:[1]Chen-Xu M, et al. Arthritis Rheumatol 2019 71:991-999.[2]Fels E, Sundy JS. Curr Opin Rheumatol 2008;20:198-202.[3]Sundy J, et al. JAMA 2011;306:711-720.[4]Mandell BF, et al. Arthritis Res Ther 2018;20:286.Disclosure of Interests:Claudia Vesel Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Allan Morton Speakers bureau: Sanofi, Amgen, and Horizon, Megan Francis-Sedlak Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Brian LaMoreaux Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc.

scholarly journals Network robustness improvement via long-range links

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Vincenza Carchiolo ◽  
Marco Grassia ◽  
Alessandro Longheu ◽  
Michele Malgeri ◽  
Giuseppe Mangioni
Keyword(s):  
Complex Networks ◽  
Long Range ◽  
Real World ◽  
Network Robustness ◽  
Scale Free ◽  
Area Of Interest ◽  
Before And After ◽  
Significant Area ◽  
Better Than

AbstractMany systems are today modelled as complex networks, since this representation has been proven being an effective approach for understanding and controlling many real-world phenomena. A significant area of interest and research is that of networks robustness, which aims to explore to what extent a network keeps working when failures occur in its structure and how disruptions can be avoided. In this paper, we introduce the idea of exploiting long-range links to improve the robustness of Scale-Free (SF) networks. Several experiments are carried out by attacking the networks before and after the addition of links between the farthest nodes, and the results show that this approach effectively improves the SF network correct functionalities better than other commonly used strategies.

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