Motor Function
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2021 ◽  
Vol 15 ◽  
Author(s):  
Xin Wang ◽  
LanLan Chen ◽  
Hongyu Zhou ◽  
Yao Xu ◽  
Hongying Zhang ◽  
...  

Background: Studies on non-pharmacological strategies for improving gait performance and cognition in Parkinson’s disease (PD) are of great significance. We aimed to investigate the effect of and mechanism underlying enriched rehabilitation as a potentially effective strategy for improving gait performance and cognition in early-stage PD.Methods: Forty participants with early-stage PD were randomly assigned to receive 12 weeks (2 h/day, 6 days/week) of enriched rehabilitation (ER; n = 20; mean age, 66.14 ± 4.15 years; 45% men) or conventional rehabilitation (CR; n = 20; mean age 65.32 ± 4.23 years; 50% men). In addition, 20 age-matched healthy volunteers were enrolled as a control (HC) group. We assessed the general motor function using the Unified PD Rating Scale—Part III (UPDRS-III) and gait performance during single-task (ST) and dual-task (DT) conditions pre- and post-intervention. Cognitive function assessments included the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), and the Trail Making Test (TMT), which were conducted pre- and post-intervention. We also investigated alteration in positive resting-state functional connectivity (RSFC) of the left dorsolateral prefrontal cortex (DLPFC) in participants with PD, mediated by ER, using functional magnetic resonance imaging (fMRI).Results: Compared with the HC group, PD participants in both ER and CR groups performed consistently poorer on cognitive and motor assessments. Significant improvements were observed in general motor function as assessed by the UPDRS-III in both ER and CR groups post-intervention. However, only the ER group showed improvements in gait parameters under ST and DT conditions post-intervention. Moreover, ER had a significant effect on cognition, which was reflected in increased MoCA, SDMT, and TMT scores post-intervention. MoCA, SDMT, and TMT scores were significantly different between ER and CR groups post-intervention. The RSFC analysis showed strengthened positive functional connectivity between the left DLPFC and other brain areas including the left insula and left inferior frontal gyrus (LIFG) post-ER.Conclusion: Our findings indicated that ER could serve as a potentially effective therapy for early-stage PD for improving gait performance and cognitive function. The underlying mechanism based on fMRI involved strengthened RSFC between the left DLPFC and other brain areas (e.g., the left insula and LIFG).


Author(s):  
Seyedeh Saeideh Babazadeh-Zavieh ◽  
Noureddin Nakhostin Ansari ◽  
Nastaran Ghotbi ◽  
Soofia Naghdi ◽  
Korosh Mansouri ◽  
...  

2021 ◽  
Vol 15 ◽  
Author(s):  
Liliana da Conceição Teixeira ◽  
Danielle Blacker ◽  
Carlos Campos ◽  
Carolina Garrett ◽  
Sophie Duport ◽  
...  

Purpose: The recommended way to assess consciousness in prolonged disorders of consciousness is to observe the patient’s responses to sensory stimulation. Multiple assessment sessions have to be completed in order to reach a correct diagnosis. There is, however, a lack of data on how many sessions are sufficient for validity and reliability. The aim of this study was to identify the number of Sensory Modality Assessment and Rehabilitation Technique (SMART) assessment sessions needed to reach a reliable diagnosis. A secondary objective was to identify which sensory stimulation modalities are more useful to reach a diagnosis.Materials and Methods: A retrospective analysis of all the adult patients (who received a SMART assessment) admitted to a specialist brain injury unit over the course of 4 years was conducted (n = 35). An independent rater analyzed the SMART levels for each modality and session and provided a suggestive diagnosis based on the highest SMART level per session.Results: For the vast majority of patients between 5 and 6 sessions was sufficient to reach the final clinical diagnosis. The visual, auditory, tactile, and motor function modalities were found to be more associated with the final diagnosis than the olfactory and gustatory modalities.Conclusion: These findings provide for the first time a rationale for optimizing the time spent on assessing patients using SMART.


Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1105
Author(s):  
Axel Horsch ◽  
Finja Hahne ◽  
Maher Ghandour ◽  
Hadrian Platzer ◽  
Merkur Alimusaj ◽  
...  

Background: We conducted this study to compare postoperative radiological outcomes of two surgical procedures (femoral head resection (FHR) and femoral head cap plastic surgery (FCP)) in patients with CP and hip dislocation. Methods: CP patients with Gross Motor Function Classification Score (GMFCS) IV or V, who underwent either FHR or FCP between 2007 and 2018 at Heidelberg University Hospital in Germany, were included. Most participants underwent postoperative traction in an attempt to prevent telescoping. Besides the above-mentioned objectives, we examined the association between telescoping and spasmolytic use, traction weight, and traction duration. Results: Thirty-eight CP patients were included, of whom 15 (25 hips) underwent FHR and 23 (30 hips) underwent FCP. Heterotopic ossification (grades I, II, and III) occurred in 80% and 83.3% of patients in the FHR and FCP groups, respectively. Telescoping occurred in 18.68 and 31.99% of patients in the FHR and FCP groups, respectively (p = 0.999). Other complications were similar between both groups. Conclusions: The postoperative outcomes of FHR and FCP are similar in terms of telescoping, heterotopic ossification, and complications. Although telescoping was encountered more in the FCP group, no significant difference from the FHR group was found. We noted that the weight of traction could reduce the development of telescoping.


2021 ◽  
Vol 25 (Suppl 2) ◽  
pp. S55-62
Author(s):  
Sang-Hoon Kim ◽  
Lakkyong Hwang ◽  
Jun-Jang Jin ◽  
Il-Gyu Ko ◽  
Yong Bog Kim ◽  
...  

Purpose: Exercise is a representative noninvasive treatment that can be applied to various diseases. We studied the effect of resistance exercise on motor function and spatial learning ability in Parkinson disease (PD) mice.Methods: The rotarod test and beam walking test were conducted to evaluate the effect of resistance exercise on motor function, and the Morris water maze test was conducted to examine the effect of resistance exercise on spatial learning ability. The effect of resistance exercise on brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB) expression and 5’-adenosine monophosphate-activated protein kinase (AMPK) phosphorylation was investigated by Western blot analysis. New cell generation was confirmed by immunohistochemistry for 5-bromo-2’-deoxyuridine.Results: Resistance exercise improved coordination, balance, and spatial learning ability in PD mice. Resistance exercise enhanced new cell production, BDNF and TrkB expression, and AMPK phosphorylation in PD mice. The effect of such resistance exercise was similar to that of levodopa application.Conclusions: In PD-induced mice, resistance exercise enhanced AMPK phosphorylation to increase BDNF expression and new neuron generation, thereby improving spatial learning ability. Resistance exercise is believed to help improve symptoms of PD.


2021 ◽  
Vol 11 (12) ◽  
pp. 1563
Author(s):  
Faustyna Manikowska ◽  
Anna Krzyżańska ◽  
Paweł Chmara ◽  
Brian Po-Jung Chen ◽  
Marek Jóźwiak

Robotic-assisted therapy (RAT) is a task-specific approach for treating gait disorders in individuals with neurological impairments. However, the effectiveness of RAT is not clear for different severities of involvement, pathologies, and ages. This study aimed to assess the functional and clinical status outcomes after RAT in individuals with cerebral palsy (CP). Twenty-eight individuals with bilateral spastic CP were enrolled (female = 10; male = 18; age = 15.2 ± 2.0 years). The RAT program consisted of 30 sessions: five sessions weekly for six weeks. Gross Motor Function Measure (GMFM) and clinical physical examinations were evaluated before and after RAT. Our results suggested that the RAT program with the described protocol can improve the general gross motor functions of individuals with CP in Gross Motor Function Classification System (GMFCS) levels I and II, and primarily improves performance on less complex GMFM items for those in GMFCS levels III and IV. The lower baseline functional level was related to a greater functional improvement. Older individuals were noticed to improve more in GMFM dimension D. Regarding impairments evaluated by clinical examinations, no change was found after RAT intervention. It is worth mentioning that the strength of knee muscles was not affected either.


Author(s):  
Vandana Gudhe ◽  
Moh´d Irshad Qureshi ◽  
Rakesh Krishna Kovela

Introduction: Telephysiotherapy (TPT) is provision of physiotherapy services using telecommunication technology such as audio call or video call to facilitate the physiotherapy management of patients within their own homes. In the absence of which the patients may have to discontinue physiotherapy treatment that may result into poor motor outcomes leading to deterioration of the quality of life (QoL). Methodology: This is a study protocol designed to study the effectiveness of TPT intervention in Stroke patients. The objective is to study whether TPT is effective for Stroke Rehabilitation in improving motor function and quality of life. An exercise protocol will be administered to patients suffering from mild to moderate stroke those grading less than or equal to 4 on a Modified Rankin Scale (mRS=<4). A total 40 patients will be recruited in the study, divided into 2 groups –Group A and Group B, where Group A will receive the exercise therapy through Tele Physiotherapy & Group B will receive Out-Patient-Based (OPD-based) Physiotherapy. Participants of both the groups will be called to the OPD at the baseline and at the end of 6 weeks intervention. The patients shall be assessed at the baseline and at the end of intervention using Fugl-Meyer Assessment (FMA), Dynamic Gait Index (DGI), Functional Independence Measure (FIM) and Stroke Specific Quality Of Life scale (SS-QOL) to evaluate their motor function, gait, functional status and quality of life respectively. Ethical Considerations: Approval from the Institutional Ethics committee of the institute is obtained. Participation in study will be voluntary and only the patients willing to give the written informed consent will be recruited for the study. Results: The results of the study will be published and disseminated in peer-reviewed journals.


2021 ◽  
Vol 10 (23) ◽  
pp. 5540
Author(s):  
Andrada Mirea ◽  
Elena-Silvia Shelby ◽  
Mihaela Axente ◽  
Mihaela Badina ◽  
Liliana Padure ◽  
...  

Background: Spinal muscular atrophy (SMA) is a neuromuscular progressive disease, characterized by decreased amounts of survival motor neuron (SMN) protein, due to an autosomal recessive genetic defect. Despite recent research, there is still no cure. Nusinersen, an antisense oligonucleotide acting on the SMN2 gene, is intrathecally administered all life long, while onasemnogene abeparvovec-xioi, a gene therapy, is administered intravenously only once. Both therapies have proven efficacy, with best outcomes obtained when administered presymptomatically. In recent years, disease-modifying therapies such as nusinersen and onasemnogene abeparvovec-xioi have changed the natural history of SMA. Methods: We observed seven SMA type I patients, who received both therapies. We compared their motor function trajectories, ventilation hours and cough assist sessions to a control group of patients who received one therapy, in order to investigate whether combination therapy may be more effective than a single intervention alone. Results: Patients who received both therapies, compared to the monotherapy cohort, had the same motor function trajectory. Moreover, it was observed that the evolution of motor function was better in the 6 months following the first therapy than in the first 6 months after adding the second treatment. Conclusions: Our results suggest that early treatment is more important than combined therapy.


2021 ◽  
Vol 12 ◽  
Author(s):  
Chen Dai ◽  
Bin Liu ◽  
Bibo Peng ◽  
Bo Qu ◽  
Jiezhi Lin ◽  
...  

Background: Spinal cord injury (SCI), a major public health problem, has no effective treatment. A large number of studies have confirmed that histone deacetylases (HDACs) are involved in the physiologic processes that occur following SCI. We tried to uncover the potential neuroprotective role of entinostat (a class I HDAC inhibitor) in SCI.Methods: We conducted a study on a preclinical mouse model of SCI and OGD-induced neuronal damage to present the role of entinostat by the analysis of motor function, histopathologic damage, local NLRP3 inflammasome activation, and neuronal damage.Results: The results showed that entinostat suppressed HDAC activation (including HDAC1 and HDAC3 expression), improved the grip strength and BMS score, spinal edema, cell death, and local NLRP3 inflammasome activation in the spinal cord following SCI. Furthermore, entinostat significantly increased OGD-inhibited neuronal activity and decreased PI-positive cells, HDAC activation, caspase-1 activation, IL-1β and IL-18 levels, and NLRP3 expression.Conclusion: In summary, we first documented that entinostat improved the motor function, histopathologic damage, and local inflammatory response and NLRP3 inflammasome activation in the spinal cord following SCI and also presented the neuroprotective role of OGD-induced neuronal damage via the NLRP3 inflammasome. Thus, our study has the potential to reveal the interaction between the HDAC and NLRP3 inflammasome in the pathologic process as well as SCI and further promote the clinical indications of HDACi entinostat and clinical treatment for the inflammatory response after SCI.


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