Auditory Cue Effects on Gait-Phase-Dependent Electroencephalogram (EEG) Modulations during Overground and Treadmill Walking.

Walking rehabilitation following injury or disease involves voluntary gait modification, yet the specific brain signals underlying this process remains unclear. This aim of this study was to investigate the impact of an auditory cue on changes in brain activity when walking overground (O) and on a treadmill (T) using an electroencephalogram (EEG) with a 32-electrode montage. Employing a between-group repeated-measures design, 24 participants (age: 25.7 ± 3.8 years) were randomly allocated to either an O (n = 12) or T (n = 12) group to complete two walking conditions (self-selected speed control (sSC) and speed control (SC)). The differences in brain activities during the gait cycle were investigated using statistical non-parametric mapping (SnPM). The addition of an auditory cue did not modify cortical activity in any brain area during the gait cycle when walking overground (all p > 0.05). However, significant differences in EEG activity were observed in the delta frequency band (0.5-4 Hz) within the sSC condition between the O and T groups. These differences occurred at the central frontal (loading phase) and frontocentral (mid stance phase) brain areas (p < 0.05). Our data suggest auditory cueing has little impact on modifying cortical activity during overground walking. This may have practical implications in neuroprosthesis development for walking rehabilitation, sports performance optimization, and overall human quality-of-life improvement.

Validity and Reliability of Inertial Measurement Unit (IMU)-Derived 3D Joint Kinematics in Persons Wearing Transtibial Prosthesis.

BACKGROUND: A validity and reliability assessment of inertial measurement unit (IMU)-derived joint angular kinematics during walking is a necessary step for motion analysis in the lower extremity prosthesis user population. This study aimed to assess the accuracy and reliability of an inertial measurement unit (IMU) system compared to an optical motion capture (OMC) system in transtibial prosthesis (TTP) users. METHODS: Thirty TTP users were recruited and underwent simultaneous motion capture from IMU and OMC systems during walking. Reliability and validity were assessed using intra- and inter-subject variability with standard deviation (S.D.), average S.D., and intraclass correlation coefficient (ICC). RESULTS: The intra-subject S.D. for all rotations of the lower limb joints were less than 1° for both systems. The IMU system had a lower mean S.D. (o), as seen in inter-subject variability. The ICC revealed good to excellent agreement between the two systems for all sagittal kinematic parameters. CONCLUSION: All joint angular kinematic comparisons supported the IMU system's results as comparable to OMC. The IMU was capable of precise sagittal plane motion data and demonstrated validity and reliability to OMC. These findings evidence that when compared to OMC, an IMU system may serve well in evaluating the gait of lower limb prosthesis users.

Effects of repetitive transcranial magnetic stimulation combined with action-observation-execution on social interaction and communication in autism spectrum disorder: Feasibility study.

OBJECTIVE: To investigate the feasibility of a combined high-frequency rTMS (HF-rTMS) with action observation and execution (AOE) on social interaction and communication in children with Autistic Spectrum Disorder (ASD). MATERIALS AND METHODS: Fifteen children underwent 10 sessions of 5-Hz HF-rTMS on the right inferior frontal gyrus combined with AOE. An experimental group received the real HF-rTMS while the control group received the sham one. For the AOE protocol, they were instructed to watch and imitate a video showing the procedure, including reaching and grasping tasks, gustatory tasks, and facial expressions. Their behavioural outcomes were evaluated using the Vineland Adaptive Behaviour Scale (VABS) and electroencephalograms (EEGs) recorded at three time points: baseline, immediately after each treatment, and at the 1-week follow-up after the 10th treatment. RESULTS: There were increased VABS subitem scores in the experimental group, including the receptive, expressive, domestic, and community scores but no such increase was observed in the control group. For the EEG, the beta rhythm at C3 and C4 increased in the experimental group. Additionally, positive correlations were observed between changes in the scores for the expressive subitem and changes in the beta rhythm on the C4 electrode at baseline and immediately after treatment in the experimental group. The control group showed no significant differences in any items for both observation and imitation times. CONCLUSION: Ten sessions of HF-rTMS combined with AOE could improve both the subitems of communication and daily living skills domain in children aged 7-12 years with ASD. Although it is still inconclusive, this behavioural improvement may be partly attributable to increased cortical activity, as evidenced by beta rhythms.

Reliability and validation of the Thai version of the Cumberland Ankle Instability Tool (CAIT-THA).

PURPOSE: This study aimed to provide a version of Cumberland Ankle Instability Tool (CAIT) for the Thai younger adult population and examine psychometric properties and determine the cut-off score. METHODS: CAIT-Youth Thai version was modified to CAIT Thai version (CAIT-THA). To validate the CAIT-THA psychometric properties, 72 with chronic ankle instability (CAI) and 72 without (age 23.45 ± 4.45 years) were recruited. The validation was carried out by using internal consistency (Cronbach's alpha), concurrent validity (Spearman's rank correlation coefficient), discriminative validity (Receiver Operating Characteristic (ROC) curve), and test-retest reliability (intraclass correlation coefficient; ICC). A cut-off score was determined via Youden's index. RESULTS: Validation showed good internal consistency (Cronbach's alpha = 0.837), and concurrent validity (Spearman's rank correlation coefficient = 0.762 and 0.731 for right ankle and left ankle, respectively). Test-retest reliability was excellent with ICC (2,1) of 0.945 (95% CI = 0.93-0.96). A cut-off score of ≤ 25, determined by ROC curve and Youden's index, was distinguished between participants with and without CAI. CAIT-THA obtained 97.2% sensitivity, 94.4% specificity, 0.03 negative, and 17.5 positive likelihood ratios. CONCLUSION: CAIT-THA is a validated tool that can be used in Thai younger adults. Clinicians and researchers can confidently use a score of ≤ 25 to determine the presence of CAI.IMPLICATIONS FOR REHABILITATIONThe Cumberland Ankle Instability Tool Thai version (CAIT-THA) questionnaire is available for Thai young adults.The CAIT-THA had high sensitivity, specificity, and positive and negative likelihood cut-off ratio scores for discrimination between chronic ankle instability (CAI) and non-CAI.The CAIT-THA questionnaire may be used in rehabilitation and research settings for the identification and management of CAI conditions.

The effect of motor imagery and action observation in the rehabilitation of lower limb injuries: A scoping review.

OBJECTIVE: To synthesize research literature, which has investigated the application of motor imagery and action observation in rehabilitation protocols. Specifically, we aimed to review the implementation of motor imagery and action observation in the rehabilitation of lower limb injuries. METHODS: This scoping review followed Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines for scoping reviews checklist. The Medline (PubMed), Cochrane Library, Scopus, and Web of Science databases were searched for controlled clinical trials published between 2010 and 2021 using key search terms. Primary articles were screened for inclusion based upon applying motor imagery and action observation as a rehabilitation protocol (independently or in combination) after sustaining an injury or undergoing surgery. Data were charted by extracting the exercise duration, frequency, and the number of weeks from the rehabilitative intervention protocols, and the measured clinical outcomes (pain, range of motion, muscle activity, and functional outcomes). RESULTS: The initial database search resulted in 1367 articles, with 1352 excluded after screening, resulting in a total of 15 articles eligible for inclusion in the review. Six of the included articles included an action observation intervention, eight studies a motor imagery intervention, and a single study included combined motor imagery and action observation approach. The motor imagery and action observation techniques were able to improve clinical outcomes, including daily activity, functional movement, rage of motion, pain, and muscle strength. CONCLUSION: Motor imagery and action observation interventions may be effective to improve rehabilitative outcomes of lower limb injuries, thus its application should be considered alongside standard treatment protocols.

Neuromuscular control of the ankle during pre-landing in athletes with chronic ankle instability: Insights from statistical parametric mapping and muscle co-contraction analysis.

OBJECTIVE: The present study aimed to compare the neuromuscular control of the muscles around the ankle between athletes with CAI and without history of any ankle sprain (Non-CAI) by using statistic parametric mapping (SPM) and co-contraction analyses. DESIGN: Cross-sectional study; Setting: Laboratory; Participants: 40 athletes (20 CAI, 20 Non-CAI) were pair-matched for age and gender. MAIN OUTCOME MEASURES: Neuromuscular control was examined using surface electromyography (EMG) amplitude and muscle co-contraction 200 ms before foot-contact with the ground during a jump-landing task. RESULTS: The EMG amplitude of tibialis anterior, peroneus longus, and gastrocnemius medialis were analyzed using statistic parametric mapping. The CAI group exhibited decreased EMG amplitude of peroneus longus during preparation for foot-contact. There were no significant co-contraction differences between groups. CONCLUSIONS: Our findings demonstrate that SPM combined with the co-contraction provides a comprehensive EMG analysis to detect the differences of neuromuscular control between athletes with and without chronic ankle instability. Additionally, this finding indicates that CAI contributed to altered neuromuscular control during the pre-landing phase, which may contribute to re-injury mechanisms.

Decreased supraspinal control and neuromuscular function controlling the ankle joint in athletes with chronic ankle instability.

PURPOSE: Chronic ankle instability (CAI) alters lower extremity neuromuscular function, associated with a change in corticomotor excitability. The aim of this study was to compare corticomotor excitability and neuromuscular function of the muscles around the ankle between athletes with CAI and without CAI (non-CAI). METHODS: Nineteen CAI athletes (15 men and 4 women) and 19 non-CAI athletes (15 men and 4 women) participated (age- and sex-matched). Corticomotor excitability was measured by transcranial magnetic stimulation for the following muscles: the tibialis anterior (TA), peroneus longus (PL) and gastrocnemius medialis (GM). The resting motor threshold (rMT), motor evoked potential (MEP), and latency (Lat) were subsequently measured. Neuromuscular function was assessed with a jump test, using the EMG activity before foot contact, peak torque, and joint position sense. RESULTS: The corticomotor excitability in CAI showed a lower normalized MEP in the TA (p = 0.026) and PL (p = 0.003), and longer latency in the TA (p = 0.049) and GM (p = 0.027) compared with non-CAI. The neuromuscular assessment showed CAI had less EMG activity of the PL (p < 0.001), less peak torque of the dorsiflexor (p = 0.019) muscle compared with non-CAI. CONCLUSION: Athletes with CAI had lower corticomotor excitability in the TA and PL and a longer latency in the TA and GM muscles. Additionally, CAI demonstrated functional neuromuscular deficits by decreasing EMG activity of the PL muscle and strength of the dorsiflexor muscle. Our findings indicated maladaptation at both cortical and peripheral levels among athletes with CAI.