Early sleep after action observation plus motor imagery improves gait and balance abilities in older adults.

Action observation plus motor imagery (AOMI) is a rehabilitative approach to improve gait and balance performance. However, limited benefits have been reported in older adults. Early sleep after motor practice represents a strategy to enhance the consolidation of trained skills. Here, we investigated the effects of AOMI followed by early sleep on gait and balance performance in older adults. Forty-five older adults (mean age: 70.4 ± 5.2 years) were randomized into three groups performing a 3-week training. Specifically, AOMI-sleep and AOMI-control groups underwent observation and motor imagery of gait and balance tasks between 8:00 and 10:00 p.m. or between 8:00 and 10:00 a.m. respectively, whereas Control group observed landscape video-clips. Participants were assessed for gait performance, static and dynamic balance and fear of falling before and after training and at 1-month follow-up. The results revealed that early sleep after AOMI training sessions improved gait and balance abilities in older adults compared to AOMI-control and Control groups. Furthermore, these benefits were retained at 1-month after the training end. These findings suggested that early sleep after AOMI may represent a safe and easy-applicable intervention to minimize the functional decay in older adults.

Early sleep after action observation and motor imagery training boosts improvements in manual dexterity.

The systematic observation and imagination of actions promotes acquisition of motor skills. Furthermore, studies demonstrated that early sleep after practice enhances motor learning through an offline stabilization process. Here, we investigated behavioral effects and neurodynamical correlates of early sleep after action observation and motor imagery training (AO + MI-training) on motor learning in terms of manual dexterity. Forty-five healthy participants were randomized into three groups receiving a 3 week intervention consisting of AO + MI-training immediately before sleeping or AO + MI-training at least 12 h before sleeping or a control stimulation. AO + MI-training implied the observation and motor imagery of transitive manual dexterity tasks, whereas the control stimulation consisted of landscape video-clips observation. Manual dexterity was assessed using functional tests, kinematic and neurophysiological outcomes before and after the training and at 1-month follow-up. AO + MI-training improved manual dexterity, but subjects performing AO + MI-training followed by early sleep had significantly larger improvements than those undergoing the same training at least 12 h before sleeping. Behavioral findings were supported by neurodynamical correlates during motor performance and additional sleep-dependent benefits were also detected at 1 month follow-up. These findings introduce a new approach to enhance the acquisition of new motor skills or facilitate recovery in patients with motor impairments.

Efficacy and characteristics of physiotherapy interventions in patients with lumbar spinal stenosis: a systematic review.

PURPOSE: To determine the efficacy of physiotherapy approaches used in the treatment of LSS and compare their delivery characteristics. METHODS: A systematic search was conducted using MEDLINE/PubMed, EMBASE, Scopus, PEDro, CINAHL and Web of Science databases, from inception until March 2021. Inclusion criteria were clinical diagnosis of LSS confirmed through imaging techniques, RCTs written in English comparing physiotherapy interventions among them or versus placebo or usual care without restrictions on treatment and follow-up duration, outcomes related to pain, physical function, disability and quality of life. Two independent reviewers assessed records for eligibility and methodological quality (PEDro scale) and extracted participants' characteristics, interventions details and outcome measures at each timepoint. Pooled or un-pooled findings were reported as mean difference with 95% confidence interval, depending on heterogeneity. Evidence quality was rated using the GRADE approach. RESULTS: Twelve studies (944 patients, mean PEDro score 7.6, range 5-9) were included. Three weeks of weight-supported walking improved pain and disability, while 8 weeks of aquatic exercises improved pain and walking tolerance (very low evidence). Six weeks of cycling reduced disability compared to weight-supported walking (low evidence). Six weeks of manual therapy plus exercise was not superior to supervised exercises (low evidence), but improved pain, walking tolerance, disability and quality of life compared to home/group exercises (moderate to very low evidence). Very low evidence supported 2 weeks of electromagnetic fields, whereas TENS (low evidence) and ultrasounds (very low evidence) revealed no effects. CONCLUSIONS: These findings may assist clinicians in delivering effective physiotherapy interventions in LSS patients.

Do not blame bats and pangolins! Global consequences for wildlife conservation after the SARS-CoV-2 pandemic.

This pandemic situation requests a correct understanding of our impacts on wildlife conservation, which would also provide benefits for our species. In this commentary we revised and discussed some of the repercussions that SARS-CoV-2 pandemic may have to wildlife. We propose four actions that should be taken into account to protect and conserve wildlife in this pandemic era: wildlife "wet" markets must close; human interference with wildlife must be reduced; bats and pangolins must be conserved and not blamed; and Chinese traditional medicine must be more controlled.

Certified "sustainable" palm oil took the place of endangered Bornean and Sumatran large mammals habitat and tropical forests in the last 30 years.

Tropical forests inhabited by endangered orangutans, rhinos, tigers, and elephants in South-east Asia are threatened by deforestation, including oil palm expansion. Certification has been proposed to label sustainable palm oil production. However, from a remotely sensed time-series and imagery analysis (1984-2020), we discovered that most of the currently certified grower supply bases and concessions in Sumatra and Borneo are located in the 1990s large mammals habitat and in areas that were biodiverse tropical forests less than 30 years ago. In light of this dramatic evidence, we suggest that certification schemes claim for the "sustainable" production of palm oil just because they neglect a very recent past of deforestation and habitat degradation.

Sustainable palm oil may not be so sustainable.

The globalization of the palm oil trade poses a menace to the ecosystem integrity of Southeast Asia. In this short communication, we briefly discuss why palm oil certifications may have failed as an effective means to halt forest degradation and biodiversity loss. From a comparison of multiple new datasets, we analysed recent tree loss in Indonesia, Malaysia, and Papua New Guinea, and discovered that, from 2001 to 2016, about 40% of the area located in certified concessions suffered from habitat degradation, deforestation, fires, or other tree damages. Certified concessions have been subject to more tree removals than non-certified ones. We also detect significant tree loss before and after the start of certification schemes. Beyond non-governmental organisations' concern that Roundtable on Sustainable Palm Oil (RSPO) and Palm Oil Innovation Group (POIG) certifications allow ongoing clearance of any forest not identified as of high conservation values (HCV) or high carbon stock (HCS), we suggest an alarming and previously overlooked situation, such as that current "sustainable palm oil" is often associated with recent habitat degradation and forest loss. In other words, certified palm oil production may not be so sustainable.

Cognitive training with action-related verbs induces neural plasticity in the action representation system as assessed by gray matter brain morphometry.

Embodied cognition theories of semantic memory still face the need for multiple sources of converging evidence in support of the involvement of sensory-motor systems in action-related knowledge. Previous studies showed that training manual actions improves semantic processing of verbs referring to the trained actions. The present work aimed to provide complementary evidence by measuring the brain plasticity effects of a cognitive training requiring sustained lexical-semantic processing of action-related verbs. We included two groups of participants, namely the Proximal Group (PG) and the Distal Group (DG), which underwent a 3-week training with verbs referring to actions involving the proximal and the distal upper limb musculature, respectively. Before and after training, we measured gray matter voxel brain morphometry based on T1 structural magnetic resonance imaging. By means of this 2 (Group: PG, DG) × 2 (Time: pre-, post-training) factorial design, we tested whether sustained cognitive experience with specific action-related verbs induces congruent brain plasticity modifications in target regions of interest pertaining to the action representation system. We found significant post- versus pre-training gray matter volume increases, specifically for PG in the left dorsal precentral gyrus, and for DG in the right cerebellar lobule VIIa. These preliminary results suggest that a cognitive training can induce structural plasticity modifications in brain regions specifically coding for the distal and proximal motor actions the trained verbs refer to.

Improving hand functional use in subjects with multiple sclerosis using a musical keyboard: a randomized controlled trial.

BACKGROUND AND PURPOSE: Playing an instrument implies neuroplasticity in different cerebral regions. This phenomenon has been described in subjects with stroke, suggesting that it could play a role in hand rehabilitation. The aim of this study is to analyse the effectiveness of playing a musical keyboard in improving hand function in subjects with multiple sclerosis. METHODS: Nineteen hospitalized subjects were randomized in two groups: nine played a turned-on musical keyboard by sequences of fingers movements (audio feedback present) and 10 performed the same exercises on a turned-off musical keyboard (audio feedback absent). Training duration was half an hour per day for 15 days. Primary outcome was the perceived hand functional use measured by ABILHAND Questionnaire. Secondary outcomes were hand dexterity, measured by Nine-Hole Peg Test, and hand strength, measured by Jamar and Pinch dynamometers. Two-way analysis of variance was used for data analysis. RESULTS: The interaction time × group was significant (p = 0.003) for ABILHAND Questionnaire in favour of experimental group (mean between-group difference 0.99 logit [IC95%: 0.44; 1.54]). The two groups showed a significant time effect for all outcomes except for Jamar measure. DISCUSSION: Playing a musical keyboard seems a valid method to train the functional use of hands in subjects with multiple sclerosis.

Action observation and motor imagery in performance of complex movements: evidence from EEG and kinematics analysis.

Motor imagery (MI) and action observation (AO) are considered effective cognitive tools for motor learning, but little work directly compared their cortical activation correlate in relation with subsequent performance. We compared AO and MI in promoting early learning of a complex four-limb, hand-foot coordination task, using electroencephalographic (EEG) and kinematic analysis. Thirty healthy subjects were randomly assigned into three groups to perform a training period in which AO watched a video of the task, MI had to imagine it, and Control (C) was involved in a distracting computation task. Subjects were then asked to actually perform the motor task with kinematic measurement of error time with respect to the correct motor performance. EEG was recorded during baseline, training and task execution, with task-related power (TRPow) calculation for sensorimotor (alpha and beta) rhythms reactive with respect to rest. During training, the AO group had a stronger alpha desynchronization than the MI and C over frontocentral and bilateral parietal areas. However, during task execution, AO group had greater beta synchronization over bilateral parietal regions than MI and C groups. This beta synchrony furthermore demonstrated the strongest association with kinematic errors, which was also significantly lower in AO than in MI. These data suggest that sensorimotor activation elicited by action observation enhanced motor learning according to motor performance, corresponding to a more efficient activation of cortical resources during task execution. Action observation may be more effective than motor imagery in promoting early learning of a new complex coordination task.

Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients.

Because chronic L-arginine supplementation improves insulin sensitivity and endothelial function in nonobese type 2 diabetic patients, the aim of this study was to evaluate the effects of a long-term oral L-arginine therapy on adipose fat mass (FM) and muscle free-fat mass (FFM) distribution, daily glucose levels, insulin sensitivity, endothelial function, oxidative stress, and adipokine release in obese type 2 diabetic patients with insulin resistance who were treated with a combined period of hypocaloric diet and exercise training. Thirty-three type 2 diabetic patients participated in a hypocaloric diet plus an exercise training program for 21 days. Furthermore, they were divided into two groups in randomized order: the first group was also treated with L-arginine (8.3 g/day), and the second group was treated with placebo. Although in the placebo group body weight, waist circumference, daily glucose profiles, fructosamine, insulin, and homeostasis model assessment index significantly decreased, L-arginine supplementation further decreased FM (P < 0.05) and waist circumference (P < 0.0001), preserving FFM (P < 0.03), and improved mean daily glucose profiles (P < 0.0001) and fructosamine (P < 0.03). Moreover, change in area under the curve of cGMP (second messenger of nitric oxide; P < 0.001), superoxide dismutase (index of antioxidant capacity; P < 0.01), and adiponectin levels (P < 0.02) increased, whereas basal endothelin-1 levels (P < 0.01) and leptin-to-adiponectin ratio (P < 0.05) decreased in the L-arginine group. Long-term oral L-arginine treatment resulted in an additive effect compared with a diet and exercise training program alone on glucose metabolism and insulin sensitivity. Furthermore, it improved endothelial function, oxidative stress, and adipokine release in obese type 2 diabetic patients with insulin resistance.