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Métodos Terapéuticos y Terapias MTCI
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1.
Annu Rev Microbiol ; 75: 515-539, 2021 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-34348026

RESUMEN

To reproduce, prokaryotic viruses must hijack the cellular machinery of their hosts and redirect it toward the production of viral particles. While takeover of the host replication and protein synthesis apparatus has long been considered an essential feature of infection, recent studies indicate that extensive reprogramming of host primary metabolism is a widespread phenomenon among prokaryotic viruses that is required to fulfill the biosynthetic needs of virion production. In this review we provide an overview of the most significant recent findings regarding virus-induced reprogramming of prokaryotic metabolism and suggest how quantitative systems biology approaches may be used to provide a holistic understanding of metabolic remodeling during lytic viral infection.


Asunto(s)
Virus , Células Procariotas
2.
Ann Clin Transl Neurol ; 8(9): 1895-1905, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34415114

RESUMEN

BACKGROUND: High-intensity occupational therapy can improve arm function after stroke, but many people lack access to such therapy. Home-based therapies could address this need, but they don't typically address abnormal muscle co-activation, an important aspect of arm impairment. An earlier study using lab-based, myoelectric computer interface game training enabled chronic stroke survivors to reduce abnormal co-activation and improve arm function. Here, we assess feasibility of doing this training at home using a novel, wearable, myoelectric interface for neurorehabilitation training (MINT) paradigm. OBJECTIVE: Assess tolerability and feasibility of home-based, high-dose MINT therapy in severely impaired chronic stroke survivors. METHODS: Twenty-three participants were instructed to train with the MINT and game for 90 min/day, 36 days over 6 weeks. We assessed feasibility using amount of time trained and game performance. We assessed tolerability (enjoyment and effort) using a customized version of the Intrinsic Motivation Inventory at the conclusion of training. RESULTS: Participants displayed high adherence to near-daily therapy at home (mean of 82 min/day of training; 96% trained at least 60 min/day) and enjoyed the therapy. Training performance improved and co-activation decreased with training. Although a substantial number of participants stopped training, most dropouts were due to reasons unrelated to the training paradigm itself. INTERPRETATION: Home-based therapy with MINT is feasible and tolerable in severely impaired stroke survivors. This affordable, enjoyable, and mobile health paradigm has potential to improve recovery from stroke in a variety of settings. Clinicaltrials.gov: NCT03401762.


Asunto(s)
Videojuego de Ejercicio , Evaluación de Procesos y Resultados en Atención de Salud , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/terapia , Dispositivos Electrónicos Vestibles , Adulto , Anciano , Enfermedad Crónica , Electromiografía , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación de Accidente Cerebrovascular/instrumentación , Rehabilitación de Accidente Cerebrovascular/métodos , Sobrevivientes
3.
Neurorehabil Neural Repair ; 33(4): 284-295, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30888251

RESUMEN

BACKGROUND: Abnormal muscle co-activation contributes to impairment after stroke. We developed a myoelectric computer interface (MyoCI) training paradigm to reduce abnormal co-activation. MyoCI provides intuitive feedback about muscle activation patterns, enabling decoupling of these muscles. OBJECTIVE: To investigate tolerability and effects of MyoCI training of 3 muscle pairs on arm motor recovery after stroke, including effects of training dose and isometric versus movement-based training. METHODS: We randomized chronic stroke survivors with moderate-to-severe arm impairment to 3 groups. Two groups tested different doses of isometric MyoCI (60 vs 90 minutes), and one group tested MyoCI without arm restraint (90 minutes), over 6 weeks. Primary outcome was arm impairment (Fugl-Meyer Assessment). Secondary outcomes included function, spasticity, and elbow range-of-motion at weeks 6 and 10. RESULTS: Over all 32 subjects, MyoCI training of 3 muscle pairs significantly reduced impairment (Fugl-Meyer Assessment) by 3.3 ± 0.6 and 3.1 ± 0.7 ( P < 10-4) at weeks 6 and 10, respectively. Each group improved significantly from baseline; no significant differences were seen between groups. Participants' lab-based and home-based function also improved at weeks 6 and 10 ( P ≤ .01). Spasticity also decreased over all subjects, and elbow range-of-motion improved. Both moderately and severely impaired patients showed significant improvement. No participants had training-related adverse events. MyoCI reduced abnormal co-activation, which appeared to transfer to reaching in the movement group. CONCLUSIONS: MyoCI is a well-tolerated, novel rehabilitation tool that enables stroke survivors to reduce abnormal co-activation. It may reduce impairment and spasticity and improve arm function, even in severely impaired patients.


Asunto(s)
Brazo , Biorretroalimentación Psicológica , Movimiento , Rehabilitación de Accidente Cerebrovascular , Adulto , Anciano , Brazo/fisiopatología , Biorretroalimentación Psicológica/métodos , Fenómenos Biomecánicos , Enfermedad Crónica , Computadores , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Espasticidad Muscular , Músculo Esquelético/fisiopatología , Rango del Movimiento Articular , Recuperación de la Función , Accidente Cerebrovascular/fisiopatología , Rehabilitación de Accidente Cerebrovascular/métodos , Resultado del Tratamiento , Interfaz Usuario-Computador , Juegos de Video
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