RESUMEN
Stroke is a medical condition characterized by the rapid loss of focal brain function. Post-stroke patients attend rehabilitation training to prevent the degeneration of physical function and improve upper limb movements and functional status after stroke. Promising rehabilitation therapies include functional electrical stimulation (FES), exergaming, and virtual reality (VR). This work presents a biomechanical assessment of 13 post-stroke patients with hemiparesis before and after rehabilitation therapy for two months with these three methods. Patients performed two tests (Maximum Forward Reach and Apley Scratching) where maximum angles, range of motion, angular velocities, and execution times were measured. A Wilcoxon test was performed (p = 0.05) to compare the variables before and after the therapy for paretic and non-paretic limbs. Significant differences were found in range of motion in flexion-extension, adduction-abduction, and internal-external rotation of the shoulder. Increases were found in flexion-extension, 17.98%, and internal-external rotation, 18.12%, after therapy in the Maximum Forward Reach Test. For shoulder adduction-abduction, the increase found was 20.23% in the Apley Scratching Test, supporting the benefits of rehabilitation therapy that combines FES, exergaming, and VR in the literature.
Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Realidad Virtual , Estimulación Eléctrica/métodos , Humanos , Recuperación de la Función , Rehabilitación de Accidente Cerebrovascular/métodos , Extremidad SuperiorRESUMEN
Brain-computer interface (BCI) remains an emerging tool that seeks to improve the patient interaction with the therapeutic mechanisms and to generate neuroplasticity progressively through neuromotor abilities. Motor imagery (MI) analysis is the most used paradigm based on the motor cortex's electrical activity to detect movement intention. It has been shown that motor imagery mental practice with movement-associated stimuli may offer an effective strategy to facilitate motor recovery in brain injury patients. In this sense, this study aims to present the BCI associated with visual and haptic stimuli to facilitate MI generation and control the T-FLEX ankle exoskeleton. To achieve this, five post-stroke patients (55-63 years) were subjected to three different strategies using T-FLEX: stationary therapy (ST) without motor imagination, motor imagination with visual stimulation (MIV), and motor imagination with visual-haptic inducement (MIVH). The quantitative characterization of both BCI stimuli strategies was made through the motor imagery accuracy rate, the electroencephalographic (EEG) analysis during the MI active periods, the statistical analysis, and a subjective patient's perception. The preliminary results demonstrated the viability of the BCI-controlled ankle exoskeleton system with the beta rebound, in terms of patient's performance during MI active periods and satisfaction outcomes. Accuracy differences employing haptic stimulus were detected with an average of 68% compared with the 50.7% over only visual stimulus. However, the power spectral density (PSD) did not present changes in prominent activation of the MI band but presented significant variations in terms of laterality. In this way, visual and haptic stimuli improved the subject's MI accuracy but did not generate differential brain activity over the affected hemisphere. Hence, long-term sessions with a more extensive sample and a more robust algorithm should be carried out to evaluate the impact of the proposed system on neuronal and motor evolution after stroke.
Asunto(s)
Interfaces Cerebro-Computador , Dispositivo Exoesqueleto , Accidente Cerebrovascular , Tobillo , Humanos , SobrevivientesRESUMEN
The bioenergetic status of fishes has been used to study their physiological responses to temporal changes at interannual scales. We evaluated the physiological responses of swordfish at an interannual scale from the El Niño Southern Oscillation (ENSO): warm phase "El Niño" in 2015 to the cold phase "La Niña" in 2017 and under neutral conditions as well in 2019. Herein, muscle samples from females and males were analyzed to evaluate the bioenergetic status from their biochemical constituents (L: lipids, P: proteins and G: glucose, E: total energy, and FAs: fatty acid profile), elemental composition (C: carbon, N: nitrogen, H: hydrogen), and nutritional indices (L:P, C:N, DHA/C18:1n-3, DHA/C16:0 and ω3/ω6 FAs). The physiological response of swordfish showed an interaction between the year and sex. Herein, the L and E showed similar trends, with the lowest female values found in 2015 and the highest in 2019. Contrary, males showed their highest values in 2015 and lowest in 2019. FA profile differed among years and highlighted significant differences between females and males in 2019. Although the female L:P and C:N ratios were lower in 2015 than in 2017, a decreasing trend in these ratios was found from 2017 to 2019. Moreover, DHA/C18:1n-3, DHA/C16:0 and ω3/ω6 showed higher ratios in females than males in 2019. Our results coincide with the beginning of the ENSO phases; it is therefore likely that the swordfish diet changed in response to the disturbances in environmental conditions. Furthermore, the degree of individual dietary specialization found under the neutral conditions could indicate differences in the feeding behaviors of males vs. females, which may be an adaptive strategy in this species. These findings will aid in understanding the bioenergetic status of swordfish under different climatic scenarios and the current global warming, providing relevant information for the management of this resource.
Asunto(s)
El Niño Oscilación del Sur , Perciformes , Animales , Masculino , Femenino , Océano Pacífico , Calentamiento Global , PecesRESUMEN
Understanding the differences in ventilatory responses during exercise between patients with fibromyalgia and those with other chronic pain disorders is crucial for developing effective therapeutic interventions, especially in exercise to identify the better physical therapy prescription. Both populations face unique challenges that impact their ability to engage in physical activity; yet, the underlying physiological responses can vary significantly. In this context, the methodology of this study entailed conducting a comparative analysis of the ventilatory response during exercise in patients with fibromyalgia and those with other chronic pain disorders. The experimental protocol included a total of 31 participants (n = 13 diagnosed with fibromyalgia and n = 18 diagnosed with other chronic pain conditions). All participants completed a stress test, where the ventilatory parameters were measured in three stages (i.e., resting, incremental exercise, and recovery). The results revealed significant differences (p<0.05) in ventilatory responses between both groups. Patients with fibromyalgia exhibited reduced time for the aerobic threshold and a higher respiratory frequency in the anaerobic threshold compared to those with other chronic pain disorders. Furthermore, fibromyalgia patients demonstrated higher values in the ventilatory coefficient during the test and in the recovery stage. In conclusion, these differences underscore the need for tailored exercise programs that specifically address the unique ventilatory challenges faced by fibromyalgia patients to improve their physical function and overall quality of life.
RESUMEN
The temporal dynamics of energy reserves are associated with the physiological processes (i.e., reproduction) in marine fishes, in which storage organs play a key role for efficient energy investment. We evaluated the temporal (i.e., seasons) and intra-individual (i.e., organs) dynamics of adult female swordfish (Xiphias gladius) during its feeding period off the Chilean coast in the southeastern Pacific Ocean (SEPO). The biochemical composition (i.e., lipids, proteins, and glucose), energy content and fatty acid profile of the muscle, liver and gonad were evaluated during the austral autumn, winter, and spring. Our results showed principally an intra-individual effect in both the muscle and liver in the autumn and spring. Herein, a trend of higher amounts of lipids and total energy were found in the muscle, while the liver showed greater protein and glucose contents. Consequently, the muscle showed a higher saturated, monounsaturated, and polyunsaturated fatty acid contents than the liver. Although the gonad showed no significant temporal effect in the lipids and proteins contents, an increasing trend of each biochemical constituent, fatty acid group and gonadosomatic index were found from autumn to winter. Consistently, the glucose and total energy content as well Fulton's condition factor were significantly higher in winter. These findings reflect the spatial-temporal physiological dynamic of swordfish based on the storage of energy reserves in different organs during its feeding period. In this way, the products obtained from swordfish could have an added value depending on the season and capture zone, which could benefit the exploitation and regulation measures of this resource under an ecological approach of conservation and sustainability in the SEPO.
Asunto(s)
Perciformes , Animales , Femenino , Océano Pacífico , Peces , Lípidos , Ácidos Grasos , GlucosaRESUMEN
The integrated biochemical condition (IBC) of gonads is closely related to the reproductive success of highly migratory marine species. The IBC of gonads can be influenced not only by size and/or age, but also by environmental conditions. Here, female swordfish, Xiphias gladius, that migrate to temperate regions with a marked seasonality (e.g., the Southeastern Pacific Ocean, SEPO) were compared in relation to the IBCs (lipids, proteins, glucose and, fatty acid profiles) of their gonads; individuals with two body size ranges and distinct degrees of sexual maturity were evaluated, and considered as: small and/or virginal (SV: <170 cm lower jaw fork-length (LJFL), oocyte size (OS) <0.08 mm) vs large and/or maturing females (LM: >190 cm LJFL, OS >0.133 mm). This comparison was conducted in two environmentally contrasting seasons (winter vs spring). Our results showed that the gonadosomatic index (GSI) was significantly higher in LM than SV. Lipid contents varied significantly between seasons and body sizes. The highest lipid concentrations were recorded in the spring in large females. No significant differences were found when comparing the protein and glucose contents of the two evaluated seasons or body size ranges of the studied females. In turn, the fatty acid (FA) profiles of female gonads significantly varied for both seasons and body size ranges. A high content of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) and poly-unsaturated fatty acids (PUFAs) were recorded in female gonads in the spring. The SFAs C16:0 and C18:0, the MUFA C18:1n9, and the essential PUFA C22:6n3 were the main contributors to the observed differences between spring and winter. These results could be used as indicators of the nutritional condition and health status of swordfish individuals. Hence, the IBC of female swordfish gonads have great potential to aid in estimating survival rates and stock abundances of this species. The integration of this information constitutes an asset in fishery management models with an ecosystem approach.
Asunto(s)
Ecosistema , Perciformes , Femenino , Animales , Océano Pacífico , Gónadas , Ácidos Grasos , GlucosaRESUMEN
Introduction: The RobHand (Robot for Hand Rehabilitation) is a robotic neuromotor rehabilitation exoskeleton that assists in performing flexion and extension movements of the fingers. The present case study assesses changes in manual function and hand muscle strength of four selected stroke patients after completion of an established training program. In addition, safety and user satisfaction are also evaluated. Methods: The training program consisted of 16 sessions; two 60-minute training sessions per week for eight consecutive weeks. During each session, patients moved through six consecutive rehabilitation stages using the RobHand. Manual function assessments were applied before and after the training program and safety tests were carried out after each session. A user evaluation questionnaire was filled out after each patient completed the program. Results: The safety test showed the absence of significant adverse events, such as skin lesions or fatigue. An average score of 4 out of 5 was obtained on the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 Scale. Users were very satisfied with the weight, comfort, and quality of professional services. A Kruskal-Wallis test revealed that there were not statistically significant changes in the manual function tests between the beginning and the end of the training program. Discussion: It can be concluded that the RobHand is a safe rehabilitation technology and users were satisfied with the system. No statistically significant differences in manual function were found. This could be due to the high influence of the stroke stage on motor recovery since the study was performed with chronic patients. Hence, future studies should evaluate the rehabilitation effectiveness of the repetitive use of the RobHand exoskeleton on subacute patients. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05598892?id=NCT05598892&draw=2&rank=1, identifier NCT05598892.
RESUMEN
Physical activity can prevent many organic and mental pathologies. For people living in extreme southern high-latitude environments, weather conditions can affect these activities, altering their psychological well-being and favoring the prevalence of seasonal sensitivity (SS). This study aims to determine the relationships between the practice of physical activity, seasonal sensitivity and well-being in people living in high southern latitudes. A cross-sectional study was conducted, using the Seasonal Pattern Assessment Questionnaire (SPAQ), applying a psychological well-being scale, and determining sports practice according to the recommendations of the World Health Organization (WHO) for the 370 male (n = 209; 55%) and female (n = 173; 45%) participants. The main results indicated that 194 people (52 ± 7.7 years) reported physical activity. High-intensity physical activity practitioners recorded a significantly lower proportion of SS. In terms of psychological well-being, an adverse effect was found between the Seasonal Score Index (SSI) and five subcategories of the Ryff well-being scale. In conclusion, those who perform high-intensity physical activity have a lower SS, and those who have a higher SS have a lower psychological well-being.
Asunto(s)
Trastorno Afectivo Estacional , Humanos , Masculino , Femenino , Trastorno Afectivo Estacional/epidemiología , Trastorno Afectivo Estacional/prevención & control , Trastorno Afectivo Estacional/psicología , Estaciones del Año , Estudios Transversales , Bienestar Psicológico , Ejercicio FísicoRESUMEN
Nowadays, several strategies for treating neuropsychologic function loss in Parkinson's disease (PD) have been proposed, such as physical activity performance and developing games to exercise the mind. However, few studies illustrate the incidence of these therapies in neuronal activity. This work aims to study the feasibility of a virtual reality-based program oriented to the cognitive functions' rehabilitation of PD patients. For this, the study was divided into intervention with the program, acquisition of signals, data processing, and results analysis. The alpha and beta bands' power behavior was determined by evaluating the electroencephalography (EEG) signals obtained during the execution of control tests and games of the "Hand Physics Lab" Software, from which five games related to attention, planning, and sequencing, concentration, and coordination were taken. Results showed the characteristic performance of the cerebral bands during resting states and activity states. In addition, it was determined that the beta band increased its activity in all the cerebral lobes in all the tested games (p-value < 0.05). On the contrary, just one game exhibited an adequate performance of the alpha band activity of the temporal and frontal lobes (p-value < 0.02). Furthermore, the visual attention and the capacity to process and interpret the information given by the surroundings was favored during the execution of trials (p-value < 0.05); thus, the efficacy of the virtual reality program to recover cognitive functions was verified. The study highlights implementing new technologies to rehabilitate people with neurodegenerative diseases.
Asunto(s)
Enfermedad de Parkinson , Realidad Virtual , Adulto , Cognición/fisiología , Electroencefalografía , HumanosRESUMEN
This study examines the feasibility of using a robot-assisted therapy methodology based on the Bobath concept to perform exercises applied in conventional therapy for gait rehabilitation in stroke patients. The aim of the therapy is to improve postural control and movement through exercises based on repetitive active-assisted joint mobilization, which is expected to produce strength changes in the lower limbs. As therapy progresses, robotic assistance is gradually reduced and the patient's burden increases with the goal of achieving a certain degree of independence. The relationship between force and range of motion led to the analysis of both parameters of interest. The study included 23 volunteers who performed 24 sessions, 2 sessions per week for 12 weeks, each lasting about 1 h. The results showed a significant increase in hip abduction and knee flexion strength on both sides, although there was a general trend of increased strength in all joints. However, the range of motion at the hip and ankle joints was reduced. The usefulness of this platform for transferring exercises from conventional to robot-assisted therapies was demonstrated, as well as the benefits that can be obtained in muscle strength training. However, it is suggested to complement the applied therapy with exercises for the maintenance and improvement of the range of motion.
RESUMEN
In the Southeast Pacific Ocean, Xiphias gladius migrates through the Chilean coastal zone for feeding. Here, it forages for different prey items from autumn to spring, acquiring a great variety of energy and nutritional reserves. We evaluated seasonal variations in the biochemical reserves (i.e., contents of lipids, proteins, and glucose), total energy content and fatty acid profile of specimens captured during the austral autumn, winter, and spring. Our results show that higher amounts of lipids were found in the winter and spring, while protein and glucose were higher in the autumn. Thus, the energy content showed significant differences, with higher levels in winter and spring. Furthermore, the fatty acid profile was more diverse in the spring than the autumn and winter and was characterized by higher amounts of polyunsaturated fatty acids. These findings suggest that temporal changes in the biochemical reserves, total energy content and fatty acid profile support the idea of a "trophic migration" (i.e., the feeding period) established by the dynamics of fishery fleets. The high amounts of lipids and diverse fatty acid profile found in the spring could indicate the end of the trophic migration during this season. Thus, X. gladius may reach an optimum nutritional condition in the spring and make energetic adjustments to carry out its reproductive migration during the austral summer. Therefore, this species seems to meet the high energy demands of the reproductive season by foraging for a wide range of prey items from autumn to spring and storing an increased amount of lipids at the end of the feeding period. Overall, our data provides crucial baseline knowledge for future research on the ecophysiology of X. gladius, as well as for the management and conservation of this fishery resource under an ecosystem approach.
Asunto(s)
Ecosistema , Ácidos Grasos , Chile , Océano Pacífico , Estaciones del AñoRESUMEN
Robotic devices can provide physical assistance to people who have suffered neurological impairments such as stroke. Neurological disorders related to this condition induce abnormal gait patterns, which impede the independence to execute different Activities of Daily Living (ADLs). From the fundamental role of the ankle in walking, Powered Ankle-Foot Orthoses (PAFOs) have been developed to enhance the users' gait patterns, and hence their quality of life. Ten patients who suffered a stroke used the actuation system of the T-FLEX exoskeleton triggered by an inertial sensor on the foot tip. The VICONmotion capture system recorded the users' kinematics for unassisted and assisted gait modalities. Biomechanical analysis and usability assessment measured the performance of the system actuation for the participants in overground walking. The biomechanical assessment exhibited changes in the lower joints' range of motion for 70% of the subjects. Moreover, the ankle kinematics showed a correlation with the variation of other movements analyzed. This variation had positive effects on 70% of the participants in at least one joint. The Gait Deviation Index (GDI) presented significant changes for 30% of the paretic limbs and 40% of the non-paretic, where the tendency was to decrease. The spatiotemporal parameters did not show significant variations between modalities, although users' cadence had a decrease of 70% of the volunteers. Lastly, the satisfaction with the device was positive, the comfort being the most user-selected aspect. This article presents the assessment of the T-FLEX actuation system in people who suffered a stroke. Biomechanical results show improvement in the ankle kinematics and variations in the other joints. In general terms, GDI does not exhibit significant increases, and the Movement Analysis Profile (MAP) registers alterations for the assisted gait with the device. Future works should focus on assessing the full T-FLEX orthosis in a larger sample of patients, including a stage of training.
RESUMEN
Several challenges to guarantee medical care have been exposed during the current COVID-19 pandemic. Although the literature has shown some robotics applications to overcome the potential hazards and risks in hospital environments, the implementation of those developments is limited, and few studies measure the perception and the acceptance of clinicians. This work presents the design and implementation of several perception questionnaires to assess healthcare provider's level of acceptance and education toward robotics for COVID-19 control in clinic scenarios. Specifically, 41 healthcare professionals satisfactorily accomplished the surveys, exhibiting a low level of knowledge about robotics applications in this scenario. Likewise, the surveys revealed that the fear of being replaced by robots remains in the medical community. In the Colombian context, 82.9% of participants indicated a positive perception concerning the development and implementation of robotics in clinic environments. Finally, in general terms, the participants exhibited a positive attitude toward using robots and recommended them to be used in the current panorama.