RESUMO
A mixed-methods approach was used to study an individually-tailored community exercise program for people with a range of chronic neurological conditions (e.g., stroke, spinal cord injury, brain injury, multiple sclerosis, Parkinson's disease) and abilities. The program was delivered to older adults (mean age: 62 ± 9 years) with chronic neurological conditions across a 12-week and an 8-week term. Participants attended 88% of sessions and completed 89% of prescribed exercises in those sessions. There were no adverse events. Clinically important improvements were achieved by all evaluated participants (n = 8) in at least one testing domain (grip strength, lower-extremity strength, aerobic endurance, and balance). Interviews with participants identified key program elements as support through supervision, social connection, individualized programming, and experiential learning. Findings provide insight into elements that enable a community exercise program to meet the needs of a complex and varied group. Further study will support positive long-term outcomes for people aging with neurological conditions.
Assuntos
Terapia por Exercício , Doença de Parkinson , Humanos , Idoso , Terapia por Exercício/métodos , Exercício Físico , Força da Mão , Extremidade InferiorRESUMO
Acute cycling exercise can modulate motor cortical circuitry in the non-exercised upper-limb. Within the primary motor cortex, measures of intracortical inhibition are reduced and intracortical facilitation is enhanced following acute exercise. Further, acute cycling exercise decreases interhemispheric inhibition between the motor cortices and lowers cerebellar-to-motor cortex inhibition. Yet, investigations into the effects of acute exercise on sensorimotor integration, referring to the transfer of incoming afferent information from the primary somatosensory cortex to motor cortex, are lacking. The current work addresses this gap in knowledge with two experimental sessions. In the first session, we tested the exercise-induced changes in somatosensory and motor excitability by assessing somatosensory (SEP) and motor evoked potentials (MEPs). In the second session, we explored the effects of acute cycling exercise on short- (SAI) and long-latency afferent inhibition (LAI), and afferent facilitation. In both experimental sessions, neurophysiological measures were obtained from the non-exercised upper-limb muscle, tested at two time points pre-exercise separated by a 25-min period of rest. Next, a 25-min bout of moderate-intensity lower-limb cycling was performed with measures assessed at two time points post-exercise. Acute lower-limb cycling increased LAI, without modulation of SAI or afferent facilitation. Further, there were no exercise-induced changes to SEP or MEP amplitudes. Together, these results suggest that acute exercise has unique effects on sensorimotor integration, which are not accompanied by concurrent changes in somatosensory or motor cortical excitability.
Assuntos
Córtex Motor , Estimulação Magnética Transcraniana , Potencial Evocado Motor , Exercício Físico , Inibição NeuralRESUMO
Background: Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke. Objective: Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke. Methods: Paretic arm impairment (Fugl-Meyer upper limb, FM-UL) and function (Wolf Motor Function Test rate, WMFT-rate) were measured in 15 individuals with severe (FM-UL ≤ 30/66) and 14 with mild-moderate (FM-UL > 40/66) impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes at a single chronic (≥6 months) time point post stroke were performed. Results: Age (ΔR20.365, p = 0.017) and ipsilesional-transcallosal inhibition (ΔR20.182, p = 0.048) explained a 54.7% (p = 0.009) variance in paretic WMFT-rate. Prefrontal corpus callous fractional anisotropy (PF-CC FA) alone explained 49.3% (p = 0.007) variance in FM-UL outcome. The same models did not explain significant variance in mild-moderate stroke. In the severe group, k-means cluster analysis of PF-CC FA distinguished two subgroups, separated by a clinically meaningful and significant difference in motor impairment (p = 0.049) and function (p = 0.006) outcomes. Conclusion: Corpus callosum function and structure were identified as possible biomarkers of motor outcome in people with chronic and severe arm impairment.
Assuntos
Corpo Caloso/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Imagem de Difusão por Ressonância Magnética , Humanos , Pessoa de Meia-Idade , Vias Neurais/fisiopatologia , Tratos Piramidais/fisiopatologia , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico por imagem , Estimulação Magnética TranscranianaRESUMO
We present new evidence supporting the hypothesis that the effects of cardiovascular exercise on memory can be regulated in a time-dependent manner. When the exercise stimulus is coupled temporally with specific phases of the memory formation process, a single bout of cardiovascular exercise may be sufficient to improve memory.
Assuntos
Fenômenos Fisiológicos Cardiovasculares , Exercício Físico/psicologia , Memória/fisiologia , Encéfalo/fisiologia , Humanos , Fatores de TempoRESUMO
Acute aerobic exercise facilitated long-term potentiation-like plasticity in the human primary motor cortex (M1). Here, we investigated the effect of acute aerobic exercise on cerebellar circuits, and their potential contribution to altered M1 plasticity in healthy individuals (age: 24.8 ± 4.1 years). In Experimentâââ1, acute aerobic exercise reduced cerebellar inhibition (CBI) (n = 10, p = 0.01), elicited by dual-coil paired-pulse transcranial magnetic stimulation. In Experimentâââ2, we evaluated the facilitatory effects of aerobic exercise on responses to paired associative stimulation, delivered with a 25 ms (PAS25) or 21 ms (PAS21) interstimulus interval (n = 16 per group). Increased M1 excitability evoked by PAS25, but not PAS21, relies on trans-cerebellar sensory pathways. The magnitude of the aerobic exercise effect on PAS response was not significantly different between PAS protocols (interaction effect: p = 0.30); however, planned comparisons indicated that, relative to a period of rest, acute aerobic exercise enhanced the excitatory response to PAS25 (p = 0.02), but not PAS21 (p = 0.30). Thus, the results of these planned comparisons indirectly provide modest evidence that modulation of cerebellar circuits may contribute to exercise-induced increases in M1 plasticity. The findings have implications for developing aerobic exercise strategies to "prime" M1 plasticity for enhanced motor skill learning in applied settings.
Assuntos
Cerebelo/fisiologia , Potencial Evocado Motor/fisiologia , Exercício Físico/fisiologia , Rede Nervosa/fisiologia , Plasticidade Neuronal/fisiologia , Adulto , Estimulação Elétrica , Feminino , Humanos , Potenciação de Longa Duração/fisiologia , Masculino , Inibição Neural/fisiologia , Estimulação Magnética Transcraniana , Adulto JovemRESUMO
BACKGROUND: Multiple sclerosis (MS) is a degenerative disease of the central nervous system (CNS) that disrupts walking function and results in other debilitating symptoms. This study compares the effects of 'task-oriented exercise' against 'generalized resistance and aerobic exercise' and a 'stretching control' on walking and CNS function in people with MS (PwMS). We hypothesize that task-oriented exercise will enhance walking speed and related neural changes to a greater extent than other exercise approaches. METHODS: This study is a single-blinded, three-arm randomized controlled trial conducted in Saskatchewan, Canada. Eligible participants are those older than 18 years of age with a diagnosis of MS and an expanded Patient-Determined Disease Steps (PDDS) score between 3 ('gait disability') and 6 ('bilateral support'). Exercise interventions are delivered for 12 weeks (3 × 60-min per week) in-person under the supervision of a qualified exercise professional. Interventions differ in exercise approach, such that task-oriented exercise involves weight-bearing, walking-specific activities, while generalized resistance and aerobic exercise uses seated machine-based resistance training of major upper and lower body muscle groups and recumbent cycling, and the stretching control exercise involves seated flexibility and relaxation activities. Participants are allocated to interventions using blocked randomization that stratifies by PDDS (mild: 3-4; moderate: 5-6). Assessments are conducted at baseline, post-intervention, and at a six-week retention time point. The primary and secondary outcome measures are the Timed 25-Foot Walk Test and corticospinal excitability for the tibialis anterior muscles determined using transcranial magnetic stimulation (TMS), respectively. Tertiary outcomes include assessments of balance, additional TMS measures, blood biomarkers of neural health and inflammation, and measures of cardiorespiratory and musculoskeletal fitness. DISCUSSION: A paradigm shift in MS healthcare towards the use of "exercise as medicine" was recently proposed to improve outcomes and alleviate the economic burden of MS. Findings will support this shift by informing the development of specialized exercise programming that targets walking and changes in corticospinal excitability in PwMS. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05496881, Registered August 11, 2022. https://classic. CLINICALTRIALS: gov/ct2/show/NCT05496881 . Protocol amendment number: 01; Issue date: August 1, 2023; Primary reason for amendment: Expand eligibility to include people with all forms of MS rather than progressive forms of MS only.
RESUMO
Unilateral training involving voluntary contractions, neuromuscular electrical stimulation (NMES), or a combination of the two can increase the excitability of neural circuits bilaterally within the CNS. Many rehabilitation programs are designed to promote such "neuroplasticity" to improve voluntary movement following CNS damage. While much is known about this type of activity-dependent plasticity for the muscles that dorsi-flex the ankle, similar information is not available for the plantar-flexors. Presently, we assessed the excitability of corticospinal (CS) and spinal circuits for both soleus (SOL) muscles before and after voluntary contractions of the right plantar-flexors (VOL; 5 s on-5 s off, 40 min), NMES of the right tibial nerve (tnNMES; 5 s on-5 s off, 40 min), or both together (V + tnNMES). CS excitability for the right (rSOL) and left SOL (lSOL) muscles was assessed by quantifying motor evoked potentials elicited by transcranial magnetic stimulation. Spinal excitability was assessed using measures from the ascending limb of the M-wave versus H-reflex recruitment curve. CS excitability did not change for rSOL (the activated muscle) or lSOL following any condition. In contrast, there was a marked increase in spinal excitability for rSOL, but only following V + tnNMES; the slope of the M-wave versus H-reflex recruitment curve increased approximately twofold (pre = 7.9; post = 16.2) and H-reflexes collected when the M-wave was ~5 % of the maximal M-wave (M(max)) increased by ~1.5× (pre = 19 % M(max), post = 29 % M(max)). Spinal excitability for lSOL did not change following any condition. Thus, only voluntary contractions that were coupled with NMES increased CNS excitability, and this occurred only in the ipsilateral spinal circuitry. These results are in marked contrast to previous studies showing NMES-induced changes in CS excitability for every other muscle studied and suggest that the mechanisms that regulate activity-dependent neuroplasticity are different for SOL than other muscles. Further, while rehabilitation strategies involving voluntary training and/or NMES of the plantar-flexors may be beneficial for producing movement and reducing atrophy, a single session of low-intensity NMES and voluntary training may not be effective for strengthening CS pathways to the SOL muscle.
Assuntos
Córtex Cerebral/fisiologia , Contração Isométrica/fisiologia , Reflexo/fisiologia , Medula Espinal/fisiologia , Nervo Tibial/fisiologia , Adulto , Vias Aferentes/fisiologia , Estimulação Elétrica , Eletromiografia/métodos , Potencial Evocado Motor/fisiologia , Feminino , Humanos , Masculino , Recrutamento Neurofisiológico , Estatísticas não Paramétricas , Fatores de Tempo , Estimulação Magnética Transcraniana , Adulto JovemRESUMO
Cardiorespiratory or aerobic exercise immediately after practice of an upper-extremity motor skill task can facilitate skill consolidation, as demonstrated by enhanced performances at 24 h and 7-day retention tests. The purpose of this study was to examine the effect of acute cardiorespiratory exercise on motor skill consolidation when skill practice involved low and high levels of contextual interference introduced through repetitive and interleaved practice schedules, respectively. Forty-eight young healthy adults were allocated to one of four groups who performed either repetitive or interleaved practice of a pinch grip motor sequence task, followed by either a period of seated rest or a bout of high-intensity interval cycling. At pre- and post-practice and 24 h and 7-day retention tests, we assessed motor skill performance and ß-band (15-35 Hz) intermuscular coherence using surface electromyography (EMG) collected from the abductor pollicis brevis and first dorsal interosseous. At the 7-day retention test, off-line consolidation was enhanced in the cardiorespiratory exercise relative to the rest group, but only among individuals who performed interleaved motor skill practice (p = 0.02). Similarly, at the 7-day retention test, ß-band intermuscular coherence increased to a greater extent in the exercise group than in the rest group for those who performed interleaved practice (p = 0.02). Under the present experimental conditions, cardiorespiratory exercise preferentially supported motor skill consolidation and change in intermuscular coherence when motor skill practice involved higher rather than lower levels of contextual interference.
RESUMO
Although acute COVID-19 is known to cause cardiac damage in some cases, there is still much to learn about the duration and relative permanence of the damage that may occur. Long COVID is a condition that can occur when COVID-19 symptoms remain in the postviral acute period. Varying accounts of long COVID have been described across the literature, however, cardiac impairments are sustained in many individuals and cardiovascular assessment is now considered to be an expected follow-up examination. The purpose of this review and proof of concept is to summarize the current research related to the assessment of cardiac function, including echocardiography and blood biomarker data, during the follow-up period in patients who recovered from COVID-19. Following a literature review, it was found that right ventricular dysfunction along with global longitudinal strain and diastolic dysfunction are common findings. Finally, more severe acute myocardial injury during the index hospitalization appears to exacerbate cardiac function. The available literature implies that cardiac function must be monitored in patients recovered from COVID-19 who remain symptomatic and that the impairments and severity vary from person-to-person. The proof-of-concept analysis of patients with cardiac disease and respiratory disease in comparison to those with sustained symptoms from COVID-19 suggests elevated systolic time interval in those with sustained symptoms from COVID-19, thus reducing heart performance indices. Future research must consider the details of cardiac complications during the acute infection period and relate this to the cardiac function in patients with long COVID during mid- and long-term follow-up.
Assuntos
COVID-19 , Disfunção Ventricular Direita , COVID-19/complicações , Ecocardiografia , Humanos , Sístole , Síndrome de COVID-19 Pós-AgudaRESUMO
(1) Background: Cerebral autoregulation is altered during acute mild traumatic brain injury, or concussion. However, it is unknown how a history of concussion can impact cerebral haemodynamic activity during a task that elicits an autoregulatory response. (2) Methods: We assessed cerebral haemodynamic activity in those with a history of three or more concussions. The study included 44 retired athletes with concussion history and 25 control participants. We recorded participants' relative changes in right and left pre-frontal cortex oxygenation collected by near-infrared spectroscopy and continuous beat-to-beat blood pressure measured by finger photoplethysmography. Participants completed a 5-min seated rest followed by a 5-min repeated squat (10-s) stand (10-s) maneuver (0.05 Hz) to elicit a cerebral autoregulatory response. Wavelet transformation was applied to the collected signals, allowing separation into cardiac interval I (0.6 to 2 Hz), respiratory interval II (0.145 to 0.6 Hz), and smooth muscle cell interval III (0.052 to 0.145 Hz). (3) Results: Significant increases at cardiac interval I were found for the wavelet amplitude of oxy-haemoglobin and haemoglobin difference at the right pre-frontal cortex. No significant difference was found at the left pre-frontal cortex or the blood pressure wavelet amplitudes. (4) Conclusions: Contributions from cardiac activity to the pre-frontal cortex oxygenation are elevated when eliciting dynamic cerebral autoregulation in those with a history of three or more concussions.
RESUMO
The purpose was to investigate the effects of progressive resistance training (PRT) and creatine supplementation in stroke survivors. Participants were randomized to one of two groups: creatine (n = 5; 51 ± 16y) or placebo (n = 3; 73 ± 8y) during 10 weeks of supervised PRT. Prior to and following PRT and supplementation, assessments were made for body composition (lean tissue and fat mass), muscle thickness, muscle strength (1-repetition maximum), functional exercise capacity (6-minute walk test, Berg Balance Scale; BBS), cognition (Montreal Cognitive Assessment; MoCA), and symptoms of anxiety (Generalized Anxiety Disorder Assessment-7; GAD-7) and depression (Center for Epidemiological Studies Depression Scale; CES-D). There were time main effects for leg press strength (increased; p = 0.001), chest press strength (increased; p = 0.003), elbow flexor muscle thickness (increased; p = 0.007), BBS (increased; p = 0.002), MoCA (increased; p = 0.031) and CES-D (decreased; p = 0.045). There was a group x time interaction for the 6 minute walk test (p = 0.039). The creatine group significantly increased walking distance over time (p = 0.002) with no change in the placebo group (p = 0.120). Ten weeks of PRT had some positive effects on measures of muscle strength and size, balance, cognition and depression. The addition of creatine to PRT significantly improved walking performance in stroke survivors.
RESUMO
Many people with neurological conditions experience challenges with movement. Although rehabilitation is often provided acutely and sub-acutely following the onset of a condition, motor deficits commonly persist in the long-term and are exacerbated by disuse and inactivity. Notably, motor rehabilitation approaches that incorporate exercise and physical activity can support gains in motor function even in the chronic stages of many neurological conditions. However, delivering motor rehabilitation on a long-term basis to people with chronic neurological conditions is a challenge within health care systems, and the onus is often placed on patients to find and pay for services. While neurological motor rehabilitation is largely the domain of physical and occupational therapists, kinesiologists may be able to complement existing care and support delivery of long-term neurological motor rehabilitation, specifically through provision of supported exercise and physical activity programs. In this perspective style review article, we discuss potential contributions of kinesiologists to advancing the field through exercise programming, focusing on community-based interventions that increase physical activity levels. We conclude with recommendations on how kinesiologists' role might be further optimized towards improving long-term outcomes for people with chronic neurological conditions, considering issues related to professional regulation and models of care.
RESUMO
CONTEXT: Sport-related concussion (SRC) often presents with multidimensional and subtle neurologic deficits that are difficult to detect with standard clinical tests. New assessment approaches that efficiently quantify deficits across multiple neurologic domains are needed. OBJECTIVE: To quantify impairments in postural movements during an assessment of rapid, bimanual motor ability in athletes within 10 days of experiencing an SRC and evaluate relationships between impairments in upper extremity and postural performance. DESIGN: Cohort study. SETTING: Sports medicine clinic. PATIENTS OR OTHER PARTICIPANTS: Initial baseline assessments were completed for 711 athletes. Seventy-five athletes (age = 15.8 ± 3.3 years at baseline) sustained SRCs and were reassessed within 10 days. Seventy-eight athletes (age = 15.5 ± 2.0 years) completed 2 assessments in a healthy state. MAIN OUTCOME MEASURE(S): Athletes stood on force plates and performed a rapid, bimanual motor task, termed the object-hit task, delivered using a Kinesiological Instrument for Normal and Altered Reaching Movements endpoint robot. Measures of postural stability that quantified center-of-pressure movements and measures of upper extremity performance were used to characterize task performance. RESULTS: Performance changes across assessments were converted to reliable change indices. We observed a difference in reliable change indices values between athletes with SRC and healthy control athletes on the combined postural measures (P = .01). Using measures to evaluate the change in postural movements from the early, easier portion of the task to the later, more difficult portion, we identified the highest levels of impairment (19%-25% of the sample impaired). We also noted a difference between individuals with concussion and healthy individuals on the combined upper extremity measures (P = .003), but these impairments were largely unrelated to those identified in the postural movements. CONCLUSIONS: Measurement of postural movements during the object-hit task revealed impairments in postural stability that were not related to impairments in upper extremity performance. The findings demonstrated the benefits of using assessments that simultaneously evaluate multiple domains of neurologic function (eg, upper extremity and postural control) after SRC.
Assuntos
Traumatismos em Atletas/fisiopatologia , Concussão Encefálica/fisiopatologia , Exame Neurológico/métodos , Equilíbrio Postural/fisiologia , Medicina Esportiva/métodos , Análise e Desempenho de Tarefas , Extremidade Superior , Adolescente , Traumatismos em Atletas/complicações , Concussão Encefálica/complicações , Estudos de Coortes , Feminino , Humanos , Masculino , Destreza Motora/fisiologia , Desempenho Psicomotor/fisiologiaRESUMO
When aerobic exercise is performed following skilled motor practice, it can enhance motor memory consolidation. Previous studies have suggested that dopamine may play a role in motor memory consolidation, but whether it is involved in the exercise effects on consolidation is unknown. Hence, we aimed to investigate the influence of dopaminergic pathways on the exercise-induced modulation of motor memory consolidation. We compared the effect of acute exercise on motor memory consolidation between the genotypes that are known to affect dopaminergic transmission and learning. By combining cluster analyses and fitting linear models with and without included polymorphisms, we provide preliminary evidence that exercise benefits the carriers of alleles that are associated with low synaptic dopamine content. In line with previous reports, our findings implicate dopamine as a modulator of the exercise-induced effects on motor memory consolidation, and suggest exercise as a potential clinical tool to counteract low endogenous dopamine bioavailability. Further experiments are needed to establish causal relations.
RESUMO
There is a need for better tools to objectively, reliably, and precisely assess neurological function after sport-related concussion (SRC). The aim of this study was to use a robotic device (Kinesiological Instrument for Normal and Altered Reaching Movements; KINARM) to quantify neurological impairments in athletes acutely and when clinically asymptomatic post-SRC. Robotic assessments included five KINARM standard tasks that evaluate aspects of motor, sensory, and cognitive function. We hypothesized that acutely concussed athletes would demonstrate significant rates of impairment on the robotic assessment, and that impairments would be associated with acute symptom severity. Pre-season assessments were conducted from 2011 to 2016 on 1051 athletes. Eighty-four athletes were reassessed acutely (≤10 days post-injury) and while symptomatic post-SRC and 89 when clinically asymptomatic. Forty-four parameters were measured from the KINARM assessment to characterize neurological function. Reliable change indices (80% confidence interval) identified impairments in healthy and concussed individuals for each parameter. In concussed individuals, impairment rate varied across parameters from 4% to 27% at the acute time point and from 2% to 18% when clinically asymptomatic. Healthy athlete impairment rates were between 2% and 16% across all testing time points. We identified relationships between acute symptom severity and task performance for only two parameters, both of which evaluated attributes of motor function. Overall, the KINARM identified impairments in motor, sensory, and cognitive function in athletes with SRC; however, impairment rates were low and largely did not relate to symptom severity. More complex tasks may be necessary to identify potentially subtle neurological impairments post-SRC.
Assuntos
Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Exame Neurológico/instrumentação , Robótica , Adolescente , Traumatismos em Atletas/complicações , Concussão Encefálica/complicações , Cognição/fisiologia , Feminino , Humanos , Masculino , Desempenho Psicomotor/fisiologia , Recuperação de Função Fisiológica , Distúrbios Somatossensoriais/diagnóstico , Distúrbios Somatossensoriais/etiologia , Adulto JovemRESUMO
BACKGROUND: Current assessment tools for sport-related concussion are limited by a reliance on subjective interpretation and patient symptom reporting. Robotic assessments may provide more objective and precise measures of neurological function than traditional clinical tests. OBJECTIVE: To determine the reliability of assessments of sensory, motor and cognitive function conducted with the KINARM end-point robotic device in young adult elite athletes. METHODS: Sixty-four randomly selected healthy, young adult elite athletes participated. Twenty-five individuals (25 M, mean age±SD, 20.2±2.1 years) participated in a within-season study, where three assessments were conducted within a single season (assessments labeled by session: S1, S2, S3). An additional 39 individuals (28M; 22.8±6.0 years) participated in a year-to-year study, where annual pre-season assessments were conducted for three consecutive seasons (assessments labeled by year: Y1, Y2, Y3). Forty-four parameters from five robotic tasks (Visually Guided Reaching, Position Matching, Object Hit, Object Hit and Avoid, and Trail Making B) and overall Task Scores describing performance on each task were quantified. RESULTS: Test-retest reliability was determined by intra-class correlation coefficients (ICCs) between the first and second, and second and third assessments. In the within-season study, ICCs were ≥0.50 for 68% of parameters between S1 and S2, 80% of parameters between S2 and S3, and for three of the five Task Scores both between S1 and S2, and S2 and S3. In the year-to-year study, ICCs were ≥0.50 for 64% of parameters between Y1 and Y2, 82% of parameters between Y2 and Y3, and for four of the five Task Scores both between Y1 and Y2, and Y2 and Y3. CONCLUSIONS: Overall, the results suggest moderate-to-good test-retest reliability for the majority of parameters measured by the KINARM robot in healthy young adult elite athletes. Future work will consider the potential use of this information for clinical assessment of concussion-related neurological deficits.
Assuntos
Concussão Encefálica/diagnóstico , Cognição/fisiologia , Destreza Motora/fisiologia , Robótica/instrumentação , Sensação/fisiologia , Adolescente , Atletas , Concussão Encefálica/fisiopatologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Estudos Prospectivos , Desempenho Psicomotor , Reprodutibilidade dos Testes , Adulto JovemRESUMO
BACKGROUND: Conventionally, change in motor performance is quantified with discrete measures of behavior taken pre- and postpractice. As a high degree of movement variability exists in motor performance after stroke, pre- and posttesting of motor skill may lack sensitivity to predict potential for motor recovery. OBJECTIVE: Evaluate the use of predictive models of motor learning based on individual performance curves and clinical characteristics of motor function in individuals with stroke. METHODS: Ten healthy and fourteen individuals with chronic stroke performed a continuous joystick-based tracking task over 6 days, and at a 24-hour delayed retention test, to assess implicit motor sequence learning. RESULTS: Individuals with chronic stroke demonstrated significantly slower rates of improvements in implicit sequence-specific motor performance compared with a healthy control (HC) group when root mean squared error performance data were fit to an exponential function. The HC group showed a positive relationship between a faster rate of change in implicit sequence-specific motor performance during practice and superior performance at the delayed retention test. The same relationship was shown for individuals with stroke only after accounting for overall motor function by including Wolf Motor Function Test rate in our model. CONCLUSION: Nonlinear information extracted from multiple time points across practice, specifically the rate of motor skill acquisition during practice, relates strongly with changes in motor behavior at the retention test following practice and could be used to predict optimal doses of practice on an individual basis.
Assuntos
Aprendizagem , Atividade Motora , Acidente Vascular Cerebral/psicologia , Idoso , Análise de Variância , Braço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Dinâmica não Linear , Análise de Regressão , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular CerebralRESUMO
The objective of the current work was to evaluate whether the effects of acute aerobic exercise on motor learning were dependent on genetic variants impacting brain-derived neurotrophic factor (BDNF val66met polymorphism) and the dopamine D2 receptor (DRD2/ANKK1 glu713lys polymorphism) in humans. A retrospective analysis was performed to determine whether these polymorphisms influence data from our two previous studies, which both demonstrated that a single bout of aerobic exercise prior to motor practice enhanced implicit motor learning. Here, our main finding was that the effect of acute aerobic exercise on motor learning was dependent on DRD2/ANKK1 genotype. Motor learning was enhanced when aerobic exercise was performed prior to skill practice in glu/glu homozygotes, but not lys allele carriers. In contrast, the BDNF val66met polymorphism did not impact the exercise effect. The results suggest that the dopamine D2 receptor may be involved in acute aerobic exercise effects on motor learning. Such genetic information could inform the development of individualized aerobic exercise strategies to promote motor learning.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Exercício Físico , Destreza Motora , Polimorfismo de Nucleotídeo Único , Receptores de Dopamina D2/genética , Adulto , Feminino , Genótipo , Humanos , Masculino , Análise e Desempenho de Tarefas , Adulto JovemRESUMO
INTRODUCTION: There is evidence for beneficial effects of acute and long-term exercise interventions on several forms of memory, including procedural motor learning. In the present study we examined how performing a single bout of continuous moderate intensity aerobic exercise would impact motor skill acquisition and retention in young healthy adults, compared to a period of rest. We hypothesized that exercise would improve motor skill acquisition and retention, compared to motor practice alone. MATERIALS AND METHODS: Sixteen healthy adults completed sessions of aerobic exercise or seated rest that were immediately followed by practice of a novel motor task (practice). Exercise consisted of 30 minutes of continuous cycling at 60% peak O2 uptake. Twenty-four hours after practice, we assessed motor learning with a no-exercise retention test (retention). We also quantified changes in offline motor memory consolidation, which occurred between practice and retention (offline). Tracking error was separated into indices of temporal precision and spatial accuracy. RESULTS: There were no differences between conditions in the timing of movements during practice (p = 0.066), at retention (p = 0.761), or offline (p = 0.966). However, the exercise condition enabled participants to maintain spatial accuracy during practice (p = 0.477); whereas, following rest performance diminished (p = 0.050). There were no significant differences between conditions at retention (p = 0.532) or offline (p = 0.246). DISCUSSION: An acute bout of moderate-intensity aerobic exercise facilitated the maintenance of motor performance during skill acquisition, but did not influence motor learning. Given past work showing that pairing high intensity exercise with skilled motor practice benefits learning, it seems plausible that intensity is a key modulator of the effects of acute aerobic exercise on changes in complex motor behavior. Further work is necessary to establish a dose-response relationship between aerobic exercise and motor learning.