Temporarily Abled: How Exoskeleton Experience Reinvents Bodies in Spinal Cord Injury and Cerebrovascular Accidents

Recent achievements in rehabilitative robotics modify essential parameters of the human body, such as motility. Exoskeletons used for persons with neurological impairments like spinal cord injury and stroke enter this category by rehabilitating and assisting damaged motor patterns, achievements thought impossible until not long ago. Unlike other examples leading to similar dysfunctions, such as diseases or tumors, the experience of an accident causing a spinal cord injury or the occurrence of a cerebrovascular accident is sudden and perceived as a radical event. This often leads to deep consequences for one’s own body capacities. Exoskeletons attempt to alter this condition, contributing to forge a temporary abled body, although this currently happens in the restricted space of a clinic or a lab and under very controlled conditions for the predominance of users. Using qualitative empirical material from an ongoing study in sociology, including expert and narrative interviews as well as ethnographic visits in labs and centers that design and test exoskeletons, this article addresses the challenges and gains that people with stroke and spinal cord injury experience during their training with exoskeletons. The discussed cases contribute to reassess categories from the phenomenological paradigm, disability studies, and the role medical technologies play in contemporary body worlds.

Therapeutic Exercise to Improve Motor Function Among Children with Down Syndrome Aged 0 to 3 Years: A Systematic Literature Review

Objective: To determine the effect of therapeutic exercises on the motor function of children with Down syndrome (DS) aged 0 to 3 years.Data Sources: A search was carried out on PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library without publication date restrictions for the terms.Study Selection: The search yielded 1384 eligible articles, which were screened by 2 reviewers. RCTs that would have evaluated the effectiveness of therapeutic exercise were selected, and that would have reported the effectiveness in the outcomes.Data Extraction: The methodology and results of the studies were critically appraised in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. Data Synthesis: Six studies were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. A therapeutic aerobic exercise was performed using the treadmill, while a neuromuscular exercise was done using unstable surfaces. The exercise frequency ranged from three days to five days a week, and the duration of each session was between six and 15 minutes. Conclusion: There is moderate to high evidence to support that therapeutic exercise promotes the occurrence of motor patterns such as gait patterns and enhances the motor skills of children with DS aged 0 to 3 years.

Territorial Displays of the Ctenophorus decresii Complex: A Story of Local Adaptations

Closely related species make for interesting model systems to study the evolution of signaling behavior because they share evolutionary history but have also diverged to the point of reproductive isolation. This means that while they may have some behavioral traits in common, courtesy of a common ancestor, they are also likely to show local adaptations. The Ctenophorus decresii complex is such a system, and comprises six closely related agamid lizard species from Australia: C. decresii, C. fionni, C. mirrityana, C. modestus, C. tjanjalka, and C. vadnappa. In this study, we analyze the motion displays of five members of the C. decresii complex in the context of their respective habitats by comparing signal structure, habitat characteristics and signal contrast between all species. Motor pattern use and the temporal sequence of motor patterns did not differ greatly, but the motion speed distributions generated during the displays were different for all species. There was also variation in the extent to which signals contrasted with plant motion, with C. vadnappa performing better than the other species at all habitats. Overall, this study provides evidence that members of the C. decresii complex exhibit local adaptations in signaling behavior to their respective habitat, but they also maintain some morphological and behavioral traits in common, which is likely a consequence from the ancestral state.

Faecal incontinence is associated with an impaired rectosigmoid brake and improved by sacral neuromodulation

Background and aims: The rectosigmoid brake, characterized by retrograde cyclic motor patterns on high-resolution colonic manometry has been postulated as a contributor to the maintenance of bowel continence. Sacral neuromodulation (SNM) is an effective therapy for faecal incontinence, but its mechanism of action is unclear. This study aims to investigate the colonic motility patterns in the distal colon of patients with faecal incontinence, and how these are modulated by SNM. Methods: A high-resolution fibre-optic colonic manometry catheter, containing 36 sensors spaced at 1-cm intervals, was positioned in patients with faecal incontinence undergoing Stage 1 SNM. One hour of pre-meal and post-meal recordings were obtained followed by pre- and post-meal recordings with suprasensory SNM. A 700-kcal meal was given. Data were analysed to identify propagating contractions. Results: Fifteen patients with faecal incontinence were analysed. Patients had an abnormal meal response (fewer retrograde propagating contractions compared to controls; p=0.027) and failed to show a postmeal increase in propagating contractions (mean 17 +/- 6/h pre-meal vs 22 +/- 9/h post-meal, p = 0.438). Compared to baseline, SNM significantly increased the number of retrograde propagating contractions in the distal colon (8 +/- 3/h pre-meal vs 14 +/- 3/h pre-meal with SNM, p = 0.028). Consuming a meal did not further increase the number of propagating contractions beyond the baseline upregulating effect of SNM. Conclusion: The rectosigmoid brake was suppressed in this cohort of patients with faecal incontinence. SNM may exert a therapeutic effect by modulating this rectosigmoid brake.

Impacto de la actividad física programada sobre el rendimiento motor de preescolares (Impact of scheduled physical activity on motor performance in preschoolers)

El estudio de la relación entre el desarrollo de patrones motores y los niveles de actividad física en la infancia, ha tomado un renovado interés con el objetivo de reorientar las prácticas en este grupo etario. El objetivo de la presente investigación fue comparar el efecto de una intervención de 12 semanas, mediante la ejecución de circuitos de actividad física, sobre el rendimiento motor en preescolares, la muestra seleccionada fue un grupo de niños y niñas de entre 4-6 años, que para efectos de la investigación se dividieron en dos grupos de acuerdo a su estado nutricional: normopeso (n=12) y sobrepeso/obesidad (n=9).Corresponde a un estudio cuantitativo, en el que se evaluó IMC/edad, circunferencia de cintura y rendimiento motor. De acuerdo con los resultados se logró evidenciar que existen mejoras significativas en el rendimiento motor del grupo normopeso, específicamente en el equilibrio, salto y carrera y en el grupo con sobrepeso/obesidad, solo hubo una mejora en la carrera. En conclusión, una intervención de actividad física, mediante circuitos, mejoró el rendimiento motor en la muestra de preescolares, principalmente en el grupo con estado nutricional normal. Abstract: The study of the relationship between the development of motor patterns and levels of physical activity in childhood has taken a renewed interest with the aim of reorienting practices in this age group. The objective of this research was to compare the effect of a 12-week intervention, through the execution of physical activity circuits, on motor performance in preschoolers, the selected sample was a group of boys and girls between 4-6 years old, that for research purposes were divided into two groups according to their nutritional status: normal weight (n = 12) and overweight / obesity (n = 9). It corresponds to a quantitative study, in which BMI / age, circumference waist and motor performance. According to the results, it was possible to show that there are significant improvements in motor performance in the normal weight group, specifically in balance, jumping and running and in the overweight / obese group, there was only one improvement in running. In conclusion, a physical activity intervention, using circuits, improved motor performance in the preschool sample, mainly in the group with normal nutritional status.

Feeding State-Dependent Modulation of Feeding-Related Motor Patterns

Studies elucidating modulation of microcircuit activity in isolated nervous systems have revealed numerous insights regarding neural circuit flexibility, but this approach limits the link between experimental results and behavioral context. To bridge this gap, we studied feeding behavior-linked modulation of microcircuit activity in the isolated stomatogastric nervous system (STNS) of male Cancer borealis crabs. Specifically, we removed hemolymph from a crab that was unfed for ≥24 h ('unfed' hemolymph) or fed 15 min - 2 h before hemolymph removal ('fed' hemolymph). After feeding, the first significant foregut emptying occurred >1 h later and complete emptying required ≥6 h. We applied the unfed or fed hemolymph to the stomatogastric ganglion (STG) in an isolated STNS preparation from a separate, unfed crab to determine its influence on the VCN (ventral cardiac neuron)-triggered gastric mill (chewing)- and pyloric (filtering of chewed food) rhythms. Unfed hemolymph had little influence on these rhythms, but fed hemolymph from each examined time-point (15 min, 1- or 2 h post-feeding) slowed one or both rhythms without weakening circuit neuron activity. There were also distinct parameter changes associated with each time-point. One change unique to the 1 h time-point (i.e. reduced activity of one circuit neuron during the transition from the gastric mill retraction to protraction phase) suggested the fed hemolymph also enhanced the influence of a projection neuron which innervates the STG from a ganglion isolated from the applied hemolymph. Hemolymph thus provides a feeding state-dependent modulation of the two feeding-related motor patterns in the C. borealis STG.

Interstitial cells of Cajal and human colon motility in health and disease

Our understanding of human colonic motility, and autonomic reflexes that generate motor patterns, has increased markedly through high-resolution manometry. Details of the motor patterns are emerging related to frequency and propagation characteristics that allow linkage to interstitial cells of Cajal (ICC) networks. In studies on colonic motor dysfunction requiring surgery, ICC are almost always abnormal or significantly reduced. However, there are still gaps in our knowledge about the role of ICC in the control of colonic motility and there is little understanding of a mechanistic link between ICC abnormalities and colonic motor dysfunction. This review will outline the various ICC networks in the human colon and their proven and likely associations with the enteric and extrinsic autonomic nervous systems. Based on our extensive knowledge of the role of ICC in the control of gastrointestinal motility of animal models and the human stomach and small intestine, we propose how ICC networks are underlying the motor patterns of the human colon. The role of ICC will be reviewed in the autonomic neural reflexes that evoke essential motor patterns for transit and defecation. Mechanisms underlying ICC injury, maintenance, and repair will be discussed. Hypotheses are formulated as to how ICC dysfunction can lead to motor abnormalities in slow transit constipation, chronic idiopathic pseudo-obstruction, Hirschsprung's disease, fecal incontinence, diverticular disease, and inflammatory conditions. Recent studies on ICC repair after injury hold promise for future therapies.