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1.
Medicine (Baltimore) ; 100(4): e23907, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530188

RESUMO

BACKGROUND: Infantile cerebral palsy refers to brain damage in infants and young children during their development, causing brain dysfunction, mainly manifested as dyskinesia, which may be complicated by mental retardation, epilepsy, and bone and joint developmental disorders. Clinical practice shows that acupuncture can effectively treat children with cerebral palsy, but it needs to be proven. This research will systematically evaluate the clinical effectiveness and safety of acupuncture and moxibustion in the treatment of children with cerebral palsy, and provide evidence-based evidence for it. METHOD: Search the following databases, including CNKI, WANFANG, China Biomedical Database, VIP, PubMed, Embase, the Cochrane Library, Web of Science. The retrieval time is from the establishment of the databases to October 2020, collecting all clinical randomized controlled studies of acupuncture and moxibustion treatment of children with cerebral palsy. Two investigators independently extract and evaluate the data of the included studies, and use RevMan V.5.3 software to conduct meta-analysis of the included literature. RESULT: This study evaluates the effectiveness and safety of acupuncture and moxibustion in the treatment of children with cerebral palsy through indicators such as Gross Motor Function Measure Scale, the Modified Ashworth Scale, and so on. CONCLUSION: This study will provide reliable evidence-based evidence for the clinical application of acupuncture and moxibustion in the treatment of children with cerebral palsy. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/7GUF5.


Assuntos
Terapia por Acupuntura , Paralisia Cerebral/reabilitação , Metanálise como Assunto , Moxibustão , Revisões Sistemáticas como Assunto , Terapia por Acupuntura/efeitos adversos , Paralisia Cerebral/fisiopatologia , Criança , Protocolos Clínicos , Humanos , Destreza Motora , Moxibustão/efeitos adversos , Projetos de Pesquisa
2.
Medicine (Baltimore) ; 100(6): e24718, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578615

RESUMO

BACKGROUND: Motor deficits are common after stroke and are a major contributor to stroke-related disability and the potential for long-lasting neurobiological consequences of stroke remains unresolved. There are only a few treatments available for the improvement of motor function in stroke patients. However, the mechanisms underlying stroke recovery remain poorly understood, and effective neurorehabilitation interventions remain insufficiently proven for widespread implementation. METHODS: Herein, we propose to enhance the effects of brain plasticity using a powerful noninvasive technique for brain modulation consisting of navigated transcranial magnetic stimulation (TMS) priming with transcranial direct current stimulation (tDCS) in combination with motor-training-like constraint-induced movement therapy (CIMT). Our hypothesis is that navigated low-frequency rTMS stimulus priming with precise location provided by neuronavigation on the healthy side of the brain and with anodal tDCS on the affected side combined with CIMT will induce a greater motor function improvement than that obtained with sham tDCS combined with CIMT alone. We predict that the application of this technique will result in a large reduction in cortical excitability and dis-inhibition in the affected hemisphere and lead to improvements in behavioral measures of hand function in stroke patients. DISCUSSION: The proposed study, therefore, is important for several reasons. The results could potentially lead to improved stroke therapeutics, and the approach makes use of 2 potential pathways to modulate brain function. TRIAL REGISTRATION: This study protocol was registered in Clinical Trials Registry (https://clinicaltrials.gov/ct2/show/NCT04646577). ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Human Research Ethics Committee of the King Fahad Specialist Hospital Dammam. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities.


Assuntos
Destreza Motora/fisiologia , Plasticidade Neuronal , Reabilitação do Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Humanos , Imagem por Ressonância Magnética , Neuroimagem , Recuperação de Função Fisiológica , Estimulação Magnética Transcraniana
3.
J Vasc Interv Radiol ; 32(2): 226-234, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33339678

RESUMO

PURPOSE: To prospectively validate electromagnetic hand motion tracking in interventional radiology to detect differences in operator experience using simulation. METHODS: Sheath task: Six attending interventional radiologists (experts) and 6 radiology trainees (trainees) placed a wire through a sheath and performed a "pin-pull" maneuver, while an electromagnetic motion detection system recorded the hand motion. Radial task: Eight experts and 12 trainees performed palpatory radial artery access task on a radial access simulator. The trainees repeated the task with the nondominant hand. The experts were classified by their most frequent radial artery access technique as having either palpatory, ultrasound, or overall limited experience. The time, path length, and number of movements were calculated. Mann-Whitney U tests were used to compare the groups, and P < .05 was considered significant. RESULTS: Sheath task: The experts took less time, had shorter path lengths, and used fewer movements than the trainees (11.7 seconds ± 3.3 vs 19.7 seconds ± 6.5, P < .01; 1.1 m ± 0.3 vs 1.4 m ± 0.4, P < .01; and 19.5 movements ± 8.5 vs 31.0 movements ± 8.0, P < .01, respectively). Radial task: The experts took less time, had shorter path lengths, and used fewer movements than the trainees (24.2 seconds ± 10.6 vs 33.1 seconds ± 16.9, P < .01; 2.0 m ± 0.5 vs 3.0 m ± 1.9, P < .001; and 36.5 movements ± 15.0 vs 54.5 movements ± 28.0, P < .001, respectively). The trainees had a shorter path length for their dominant hand than their nondominant hand (3.0 m ± 1.9 vs 3.5 m ± 1.9, P < .05). The expert palpatory group had a shorter path length than the ultrasound and limited experience groups (1.8 m ± 0.4 vs 2.0 m ± 0.4 and 2.3 m ± 1.2, respectively, P < .05). CONCLUSIONS: Electromagnetic hand motion tracking can differentiate between the expert and trainee operators for simulated interventional tasks.


Assuntos
Cateterismo Periférico , Competência Clínica , Fenômenos Eletromagnéticos , Mãos , Destreza Motora , Artéria Radial , Radiografia Intervencionista , Radiologistas , Fenômenos Biomecânicos , Estudos de Viabilidade , Humanos , Projetos Piloto , Estudos Prospectivos , Punções , Fatores de Tempo
4.
J Vasc Interv Radiol ; 32(2): 235-241, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33358387

RESUMO

Ergonomic research in the field of interventional radiology remains limited. Existing literature suggests that operators are at increased risk for work-related musculoskeletal disorders related to the use of lead garments and incomplete knowledge of ergonomic principles. Data from existing surgical literature suggest that musculoskeletal disorders may contribute to physician burnout and female operators are at a higher risk of developing musculoskeletal disorders. This review article aims to summarize the existing ergonomic challenges faced by interventional radiologists, reiterate existing solutions to these challenges, and highlight the need for further ergonomic research in multiple areas, including burnout and gender.


Assuntos
Esgotamento Profissional/prevenção & controle , Ergonomia , Doenças Musculoesqueléticas/prevenção & controle , Radiografia Intervencionista , Radiologistas , Esgotamento Profissional/epidemiologia , Feminino , Humanos , Masculino , Destreza Motora , Doenças Musculoesqueléticas/epidemiologia , Saúde do Trabalhador , Postura , Radiografia Intervencionista/efeitos adversos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fluxo de Trabalho
5.
N Engl J Med ; 383(26): 2501-2513, 2020 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-33369354

RESUMO

BACKGROUND: The subthalamic nucleus is the preferred neurosurgical target for deep-brain stimulation to treat cardinal motor features of Parkinson's disease. Focused ultrasound is an imaging-guided method for creating therapeutic lesions in deep-brain structures, including the subthalamic nucleus. METHODS: We randomly assigned, in a 2:1 ratio, patients with markedly asymmetric Parkinson's disease who had motor signs not fully controlled by medication or who were ineligible for deep-brain stimulation surgery to undergo focused ultrasound subthalamotomy on the side opposite their main motor signs or a sham procedure. The primary efficacy outcome was the between-group difference in the change from baseline to 4 months in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score (i.e., part III) for the more affected body side (range, 0 to 44, with higher scores indicating worse parkinsonism) in the off-medication state. The primary safety outcome (procedure-related complications) was assessed at 4 months. RESULTS: Among 40 enrolled patients, 27 were assigned to focused ultrasound subthalamotomy (active treatment) and 13 to the sham procedure (control). The mean MDS-UPDRS III score for the more affected side decreased from 19.9 at baseline to 9.9 at 4 months in the active-treatment group (least-squares mean difference, 9.8 points; 95% confidence interval [CI], 8.6 to 11.1) and from 18.7 to 17.1 in the control group (least-squares mean difference, 1.7 points; 95% CI, 0.0 to 3.5); the between-group difference was 8.1 points (95% CI, 6.0 to 10.3; P<0.001). Adverse events in the active-treatment group were dyskinesia in the off-medication state in 6 patients and in the on-medication state in 6, which persisted in 3 and 1, respectively, at 4 months; weakness on the treated side in 5 patients, which persisted in 2 at 4 months; speech disturbance in 15 patients, which persisted in 3 at 4 months; facial weakness in 3 patients, which persisted in 1 at 4 months; and gait disturbance in 13 patients, which persisted in 2 at 4 months. In 6 patients in the active-treatment group, some of these deficits were present at 12 months. CONCLUSIONS: Focused ultrasound subthalamotomy in one hemisphere improved motor features of Parkinson's disease in selected patients with asymmetric signs. Adverse events included speech and gait disturbances, weakness on the treated side, and dyskinesia. (Funded by Insightec and others; ClinicalTrials.gov number, NCT03454425.).


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/cirurgia , Adulto , Idoso , Método Duplo-Cego , Discinesias/etiologia , Feminino , Transtornos Neurológicos da Marcha/etiologia , Ablação por Ultrassom Focalizado de Alta Intensidade/efeitos adversos , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Destreza Motora , Doença de Parkinson/fisiopatologia , Complicações Pós-Operatórias , Índice de Gravidade de Doença , Distúrbios da Fala/etiologia
6.
PLoS Med ; 17(12): e1003442, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33362221

RESUMO

BACKGROUND: Lipid-based nutrient supplements (LNS) and corn-soy blends (CSBs) with varying soy and milk content are used in treatment of moderate acute malnutrition (MAM). We assessed the impact of these supplements on child development. METHODS AND FINDINGS: We conducted a randomised 2 × 2 × 3 factorial trial to assess the effectiveness of 12 weeks' supplementation with LNS or CSB, with either soy isolate or dehulled soy, and either 0%, 20%, or 50% of protein from milk, on child development among 6-23-month-old children with MAM. Recruitment took place at 5 health centres in Province du Passoré, Burkina Faso between September 2013 and August 2014. The study was fully blinded with respect to soy quality and milk content, while study participants were not blinded with respect to matrix. This analysis presents secondary trial outcomes: Gross motor, fine motor, and language development were assessed using the Malawi Development Assessment Tool (MDAT). Of 1,609 children enrolled, 54.7% were girls, and median age was 11.3 months (interquartile range [IQR] 8.2-16.0). Twelve weeks follow-up was completed by 1,548 (96.2%), and 24 weeks follow-up was completed by 1,503 (93.4%); follow-up was similar between randomised groups. During the study, 4 children died, and 102 children developed severe acute malnutrition (SAM). There was no difference in adverse events between randomised groups. At 12 weeks, the mean MDAT z-scores in the whole cohort had increased by 0.33 (95% CI: 0.28, 0.37), p < 0.001 for gross motor; 0.26 (0.20, 0.31), p < 0.001 for fine motor; and 0.14 (0.09, 0.20), p < 0.001 for language development. Children had larger improvement in language z-scores if receiving supplements with milk (20%: 0.09 [-0.01, 0.19], p = 0.08 and 50%: 0.11 [0.01, 0.21], p = 0.02), although the difference only reached statistical significance for 50% milk. Post hoc analyses suggested that this effect was specific to boys (interaction p = 0.02). The fine motor z-scores were also improved in children receiving milk, but only when 20% milk was added to CSB (0.18 [0.03, 0.33], p = 0.02). Soy isolate over dehulled soy increased language z-scores by 0.07 (-0.01, 0.15), p = 0.10, although not statistically significant. Post hoc analyses suggested that LNS benefited gross motor development among boys more than did CSB (interaction p = 0.04). Differences between supplement groups did not persist at 24 weeks, but MDAT z-scores continued to increase post-supplementation. The lack of an unsupplemented control group limits us from determining the overall effects of nutritional supplementation for children with MAM. CONCLUSIONS: In this study, we found that child development improved during and after supplementation for treatment of MAM. Milk protein was beneficial for language and fine motor development, while suggested benefits related to soy quality and supplement matrix merit further investigation. Supplement-specific effects were not found post-intervention, but z-scores continued to improve, suggesting a sustained overall effect of supplementation. TRIAL REGISTRATION: ISRCTN42569496.


Assuntos
Suplementos Nutricionais , Transtornos da Nutrição do Lactente/dietoterapia , Fenômenos Fisiológicos da Nutrição do Lactente , Desnutrição/dietoterapia , Proteínas do Leite/administração & dosagem , Estado Nutricional , Proteínas de Soja/administração & dosagem , Doença Aguda , Fatores Etários , Burkina Faso , Desenvolvimento Infantil , Linguagem Infantil , Feminino , Humanos , Lactente , Transtornos da Nutrição do Lactente/diagnóstico , Transtornos da Nutrição do Lactente/fisiopatologia , Masculino , Desnutrição/diagnóstico , Desnutrição/fisiopatologia , Destreza Motora , Fatores de Tempo , Resultado do Tratamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-33375134

RESUMO

Lack of physical activity is a global public health problem causing not only morbidity and premature mortality, but it is also a major economic burden worldwide. One of the cornerstones of a physically active lifestyle is Motor Competence (MC). MC is a complex biocultural attribute and therefore, its study requires a multi-sectoral, multi-, inter- and transdisciplinary approach. MC is a growing area of research, especially in children and adolescents due to its positive association with a plethora of health and developmental outcomes. Many questions, however, remain to be answered in this field of research, with regard to: (i) Health and Developmental-related Associations of MC; (ii) Assessment of MC; (iii) Prevalence and Trends of MC; (iv) Correlates and Determinants of MC; (v) MC Interventions, and (vi) Translating MC Research into Practice and Policy. This paper presents a narrative review of the literature, summarizing current knowledge, identifying key research gaps and presenting questions for future investigation on MC in children and adolescents. This is a collaborative effort from the International Motor Competence Network (IMCNetwork) a network of academics and researchers aiming to promote international collaborative research and knowledge translation in the expansive field of MC. The knowledge and deliverables generated by addressing and answering the aforementioned research questions on MC presented in this review have the potential to shape the ways in which researchers and practitioners promote MC and physical activity in children and adolescents across the world.


Assuntos
Exercício Físico , Destreza Motora , Adolescente , Criança , Promoção da Saúde , Humanos , Estilo de Vida , Prevalência
8.
Lancet Child Adolesc Health ; 4(11): 828-836, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33068549

RESUMO

BACKGROUND: Acute flaccid myelitis (AFM) is characterised by rapid onset of limb weakness with spinal cord grey-matter abnormalities on MRI scan. We aimed to assess whether detection of enterovirus in respiratory or other specimens can help predict prognosis in children with AFM. METHODS: In this nationwide, longitudinal study, we evaluated the significance of detection of enterovirus in any sample in predicting outcomes in a cohort of Canadian children younger than 18 years presenting with AFM to tertiary paediatric hospitals in Canada in 2014 and 2018. All patients fulfilled the 2015 US Centers for Disease Control and Prevention case definition for definite AFM or probable AFM. Clinical data, laboratory findings, treatment, and neuroimaging results were collected (follow up period up to 5 years). We assessed neurological function and motor outcomes using Kurtzke's Expanded Disability Status Scale (EDSS) and a Weakest Limb Score. FINDINGS: 58 children with AFM (median age 5·1 years, IQR 3·8-8·3) were identified across five of Canada's ten provinces and three territories. 25 (43%) children had enterovirus detected in at least one specimen: 16 (64%) with EV-D68, two (8%) with EV-A71, two (8%) with coxsackievirus, 10 (40%) with untyped enterovirus. Children who were enterovirus positive were more likely than those that were negative to have had quadriparesis (12 [48%] of 25 vs four [13%] of 30; p=0·028), bulbar weakness (11 [44%] of 25 vs two [7%] of 30; p=0·028), bowel or bladder dysfunction (14 [56%] of 25 vs seven [23%] of 30; p=0·040), cardiovascular instability (nine [36%] of 25 vs one [3%] of 30; p=0·028), and were more likely to require intensive care unit admission (13 [52%] of 25 vs 5 [17%] of 30; p=0·028). On MRI, most children who were enterovirus positive showed brainstem pontine lesions (14 [61%] of 23), while other MRI parameters did not correlate with enterovirus status. Median EDSS of enterovirus positive (EV+) and enterovirus negative (EV-) groups was significantly different at all timepoints: baseline (EDSS 8·5, IQR 4·1-9·5 vs EDSS 4·0, IQR 3·0-6·0; p=0·0067), 3 months (EDSS 4·0, IQR 3·0-7·4 vs EDSS 3·0, IQR 1·5-4·3; p=0·0067), 6 months (EDSS 3·5, IQR 3·0-7·0 vs EDSS 3·0, IQR 1·0-4·0; p=0·029), and 12 months (EDSS 3·0, IQR 3·0-6·9 vs EDSS 2·5 IQR 0·3-3·0; p=0·0067). Kaplan-Meier survival analysis of a subgroup of patients showed significantly poorer motor recovery among children who tested positive for enterovirus than for those who tested negative (p=0·037). INTERPRETATION: Detection of enterovirus in specimens from non-sterile sites at presentation correlated with more severe acute motor weakness, worse overall outcomes and poorer trajectory for motor recovery. These results have implications for rehabilitation planning as well as counselling of families of children with these disorders. The findings of this study support the need for early testing for enterovirus in non-CNS sites in all cases of AFM. FUNDING: None.


Assuntos
Viroses do Sistema Nervoso Central , Enterovirus/isolamento & purificação , Debilidade Muscular , Mielite , Doenças Neuromusculares , Medula Espinal/diagnóstico por imagem , Canadá/epidemiologia , Viroses do Sistema Nervoso Central/diagnóstico , Viroses do Sistema Nervoso Central/epidemiologia , Viroses do Sistema Nervoso Central/microbiologia , Viroses do Sistema Nervoso Central/terapia , Pré-Escolar , Enterovirus/classificação , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Destreza Motora , Debilidade Muscular/diagnóstico , Debilidade Muscular/etiologia , Debilidade Muscular/reabilitação , Mielite/diagnóstico , Mielite/epidemiologia , Mielite/microbiologia , Mielite/terapia , Doenças Neuromusculares/diagnóstico , Doenças Neuromusculares/epidemiologia , Doenças Neuromusculares/microbiologia , Doenças Neuromusculares/terapia , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Recuperação de Função Fisiológica
9.
PLoS One ; 15(10): e0239155, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33044967

RESUMO

Training in elite sport aims at the optimization of the athletic performance, and to control the athletes`progress in physiological, anthropometrical and motor performance prerequisites. However, in most sports, the value of longitudinal testing is unclear. This study evaluates the longitudinal development and the influence of intense training over 2-years on specific physiological performance prerequisites, as well as certain body dimensions and motor abilities in elite youth athletes. Recruited between 11-13 years of age at Shanghai Elite Sport school, the sample of student-athletes (N = 21) was categorized as the swimming group (10 athletes), and the racket sports group (11 players: 7 table tennis and 4 badminton players). The performance monitoring took place over two years between September 2016 and September 2018 and included 5 test waves. In all the test waves, the athletes were assessed by means of three physiological measurements (vital capacity, hemoglobin concentration, heart rate at rest), three anthropometric parameters (body height, body weight, chest girth), and two motor tests (back strength, complex reaction speed). Seven out of eight diagnostic methods exhibit medium to high validity to discriminate between the different levels of performance development in the two sports groups. The investigated development of the performance characteristics is attributed partly to the inherited athletic disposition as well as to the different sport-specific training regimens of the two sports groups.


Assuntos
Atletas , Desempenho Atlético/fisiologia , Esportes com Raquete/fisiologia , Natação/fisiologia , Adolescente , Antropometria , Criança , China , Seguimentos , Frequência Cardíaca , Hemoglobinas/metabolismo , Humanos , Estudos Longitudinais , Masculino , Destreza Motora , Força Muscular , Tempo de Reação , Capacidade Vital
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3166-3169, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018677

RESUMO

Haptic virtual environments have been used to assess cognitive and fine motor function. For tasks performed in physical environments, upper extremity movement is usually separated into reaching and object manipulation phases using fixed velocity thresholds. However, these thresholds can result in premature segmentation due to additional trajectory adjustments common in virtual environments. In this work, we address the issues of premature segmentation and the lack of a measure to characterize the spatial distribution of a trajectory while targeting an object. We propose a combined relative distance and velocity segmentation procedure and use principal component analysis (PCA) to capture the spatial distribution of the participant's targeting phase. Synthetic data and 3D motion data from twenty healthy adults were used to evaluate the methods with positive results. We found that these methods quantify motor skill improvement of healthy participants performing repeated trials of a haptic virtual environment task.


Assuntos
Movimento , Extremidade Superior , Adulto , Humanos , Destreza Motora
11.
PLoS One ; 15(10): e0239139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33001994

RESUMO

Studies have documented that traditional motor skills (i.e. motor habits) are part of the cultural way of life that characterises each society. Yet, it is still unclear to what extent motor skills are inherited through culture. Drawing on ethnology and motor behaviour, we addressed this issue through a detailed description of traditional pottery skills. Our goal was to quantify the influence of three kinds of constraints: the transcultural constraints of wheel-throwing, the cultural constraints induced via cultural transmission, and the potters' individual constraints. Five expert Nepalese potters were invited to produce three familiar pottery types, each in five specimens. A total of 31 different fashioning hand positions were identified. Most of them (14) were cross-cultural, ten positions were cultural, five positions were individual, and two positions were unique. Statistical tests indicated that the subset of positions used by the participants in this study were distinct from those of other cultural groups. Behaviours described in terms of fashioning duration, number of gestures, and hand position repertoires size highlighted both individual and cross-cultural traits. We also analysed the time series of the successive hand positions used throughout the fashioning of each vessel. Results showed, for each pottery type, strong reproducible sequences at the individual level and a clearly higher level of variability between potters. Overall, our findings confirm the existence of a cultural transmission in craft skills but also demonstrated that the skill is not fully determined by a cultural marking. We conclude that the influence of culture on craft skills should not be overstated, even if its role is significant given the fact that it reflects the socially transmitted part of the skill. Such research offers insights into archaeological problems in providing a representative view of how cultural constraints influence the motor skills implied in artefact manufacturing.


Assuntos
Arte , Características Culturais , Destreza Motora , Adulto , Comparação Transcultural , Gestos , Mãos , Hinduísmo , Humanos , Masculino , Pessoa de Meia-Idade , Nepal
12.
Med Probl Perform Art ; 35(3): 130-137, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32870964

RESUMO

AIMS: The musician's hand represents a complex system, which requires important motor skills. Although several studies have already investigated rehabilitation outcomes and techniques in musicians after hand lesions, none have been addressed specifically to objectively quantifiable functional parameters. The purpose of our study was to study hand functionality in violinists in order to provide foundations on which to establish and develop more appropriate rehabilitation protocols. STUDY DESIGN: An observational cross-sectional cohort study consisting of 34 subjects, including 23 students and 11 professional violinists who were either studying or working at a conservatory. Results were compared to a data set of a non-musician control group. METHODS: Nine-hole peg test and hand test system (HTS) were used to perform the study. A hand-held dynamometer was used to measure hand grip and tripod pinch maximal isometric voluntary contraction of both hands. RESULTS: Hand strength did not significantly differ on either side between professional and student violinists. A significant difference was seen when comparing violinists as a whole versus the non-musician control group. HTS highlighted significant differences in dexterity. CONCLUSION: Violinists develop better overall motor performances of the left hand, and their performance is better than normal "non-musician" controls. Dexterity and precision of execution positively correlate to years of practice. We conclude that rehabilitation of a violinist's hand should be aimed at enhancing motor performance of the left hand and should be focused to maximize dexterity of both hands.


Assuntos
Força da Mão , Destreza Motora , Música , Estudos Transversais , Mãos , Humanos , Modalidades de Fisioterapia , Estudantes
13.
Proc Natl Acad Sci U S A ; 117(38): 23886-23897, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32900934

RESUMO

Motor skill learning involves a complex process of generating novel movement patterns guided by evaluative feedback, such as a reward. Previous literature has suggested anteroposteriorly separated circuits in the striatum to be implicated in early goal-directed and later automatic stages of motor skill learning, respectively. However, the involvement of these circuits has not been well elucidated in human de novo motor skill learning, which requires learning arbitrary action-outcome associations and value-based action selection. To investigate this issue, we conducted a human functional MRI (fMRI) experiment in which participants learned to control a computer cursor by manipulating their right fingers. We discovered a double dissociation of fMRI activity in the anterior and posterior caudate nucleus, which was associated with performance in the early and late learning stages. Moreover, cognitive and sensorimotor cortico-caudate interactions predicted individual learning performance. Our results suggest parallel cortico-caudate networks operating in different stages of human de novo motor skill learning.


Assuntos
Núcleo Caudado/diagnóstico por imagem , Núcleo Caudado/fisiologia , Aprendizagem/fisiologia , Imagem por Ressonância Magnética , Destreza Motora/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
14.
Proc Natl Acad Sci U S A ; 117(38): 23898-23903, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32900965

RESUMO

Recent evidence suggests that gains in performance observed while humans learn a novel motor sequence occur during the quiet rest periods interleaved with practice (micro-offline gains, MOGs). This phenomenon is reminiscent of memory replay observed in the hippocampus during spatial learning in rodents. Whether the hippocampus is also involved in the production of MOGs remains currently unknown. Using a multimodal approach in humans, here we show that activity in the hippocampus and the precuneus increases during the quiet rest periods and predicts the level of MOGs before asymptotic performance is achieved. These functional changes were followed by rapid alterations in brain microstructure in the order of minutes, suggesting that the same network that reactivates during the quiet periods of training undergoes structural plasticity. Our work points to the involvement of the hippocampal system in the reactivation of procedural memories.


Assuntos
Hipocampo/fisiologia , Aprendizagem/fisiologia , Destreza Motora/fisiologia , Adolescente , Adulto , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Memória , Adulto Jovem
15.
PLoS One ; 15(9): e0239362, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960905

RESUMO

Ceramics are quintessential indicators of human culture and its evolution across generations of social learners. Cultural transmission and evolution theory frequently emphasizes apprentices' need for accurate imitation (high-fidelity copying) of their mentors' actions. However, the ensuing prediction of standardized fashioning patterns within communities of practice has not been directly addressed in handicraft traditions such as pottery throwing. To fill this gap, we analysed variation in vessel morphogenesis amongst and within traditional potters from culturally different workshops producing for the same market. We demonstrate that, for each vessel type studied, individual potters reliably followed distinctive routes through morphological space towards a much-less-variable common final shape. Our results indicate that mastering the pottery handicraft does not result from accurately reproducing a particular model behaviour specific to the community's cultural tradition. We provide evidence that, at the level of the elementary clay-deforming gestures, individual learning rather than simple imitation is required for the acquisition of a complex motor skill such as throwing pottery.


Assuntos
Aprendizado Social , Conferências de Consenso como Assunto , Cultura , Humanos , Destreza Motora
16.
J Sports Sci ; 38(20): 2314-2320, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32965184

RESUMO

This study was designated to investigate the kinematical differences between successful and faulty spikes, in order to identify the best strategies leading to better spike performance. Simulating a real-game condition, 13 elite youth attackers performed 6 spikes in the presence of 2 blocks. The kinematic variables of the spike performances were recorded using 6 optoelectronic cameras (Vicon Motion systems, Oxford, UK). The paired sample t-test was used to compare the kinematic variables recorded during the delivery of successful and faulty spikes. Among the successful trials, both the angular velocities of the knees (≈12.4%) and hips (≈13.3%), and the vertical velocity of the centre of mass at take-off (≈6.5%) and arm swing (≈8.2%) were considerably higher during the plant phase. Consequently, the jump (≈4.3%) and spike (≈1.5%) heights, as well as the wrist velocity (≈5.5%), were significantly higher during the jump phase of successful spikes. In successful spike performances, the attackers adopted higher hip and knee angular velocities, combined with efficient arm swings, to produce higher take-off velocities and reach higher jump heights. This approach provides them with the better position regarding the ball and the blockers to find the best path and hit the ball with higher arm velocities.


Assuntos
Destreza Motora/fisiologia , Voleibol/fisiologia , Adolescente , Braço/fisiologia , Desempenho Atlético/fisiologia , Fenômenos Biomecânicos , Cotovelo/fisiologia , Quadril/fisiologia , Humanos , Joelho/fisiologia , Ombro/fisiologia , Estudos de Tempo e Movimento , Punho/fisiologia
17.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32938777

RESUMO

BACKGROUND AND OBJECTIVES: Genetic testing is recommended for individuals with autism spectrum disorder (ASD). Pathogenic yield varies by clinician and/or patient characteristics. Our objectives were to determine the pathogenic yield of genetic testing, the variability in rate of pathogenic results based on subject characteristics, and the percentage of pathogenic findings resulting in further medical recommendations in toddlers with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of ASD. METHODS: We conducted a retrospective chart review of 500 toddlers, 18 to 36 months, diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ASD (mean age: 25.8 months, 79% male). Subject demographics, medical and neuropsychological characteristics, and genetic test results were abstracted. Genetic results were divided into negative or normal, variants of unknown significance, and pathogenic. Subject characteristics were compared across results. Manual chart review determined if further recommendations were made after pathogenic results. RESULTS: Over half of subjects (59.8%, n = 299) completed genetic testing, and of those, 36 (12.0%) had pathogenic findings. There were no significant differences in Bayley Scales of Infant Development cognitive (P = .112), language (P = .898), or motor scores (P = .488) among children with negative or normal findings versus a variant of unknown significance versus pathogenic findings. Medical recommendations in response to the genetic finding were made for 72.2% of those with pathogenic results. CONCLUSIONS: Our findings reinforce the importance of genetic testing for toddlers diagnosed with ASD given the 12% yield and lack of phenotypic differences between subjects with and without pathogenic findings. The majority of pathogenic results lead to further medical recommendations.


Assuntos
Transtorno do Espectro Autista/genética , Testes Genéticos/estatística & dados numéricos , Transtorno do Espectro Autista/diagnóstico , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/genética , Pré-Escolar , Cromossomos Humanos 13-15 , Cognição , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Proteína do X Frágil de Retardo Mental/genética , Deleção de Genes , Duplicação Gênica , Testes Genéticos/métodos , Humanos , Lactente , Desenvolvimento da Linguagem , Masculino , Análise em Microsséries , Mosaicismo , Destreza Motora , Mutação , Fenótipo , Encaminhamento e Consulta , Estudos Retrospectivos
18.
PLoS One ; 15(9): e0237575, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915793

RESUMO

Handwriting is a complex skill to acquire and it requires years of training to be mastered. Children presenting dysgraphia exhibit difficulties automatizing their handwriting. This can bring anxiety and can negatively impact education. 280 children were recruited in schools and specialized clinics to perform the Concise Evaluation Scale for Children's Handwriting (BHK) on digital tablets. Within this dataset, we identified children with dysgraphia. Twelve digital features describing handwriting through different aspects (static, kinematic, pressure and tilt) were extracted and used to create linear models to investigate handwriting acquisition throughout education. K-means clustering was performed to define a new classification of dysgraphia. Linear models show that three features only (two kinematic and one static) showed a significant association to predict change of handwriting quality in control children. Most kinematic and statics features interacted with age. Results suggest that children with dysgraphia do not simply differ from ones without dysgraphia by quantitative differences on the BHK scale but present a different development in terms of static, kinematic, pressure and tilt features. The K-means clustering yielded 3 clusters (Ci). Children in C1 presented mild dysgraphia usually not detected in schools whereas children in C2 and C3 exhibited severe dysgraphia. Notably, C2 contained individuals displaying abnormalities in term of kinematics and pressure whilst C3 regrouped children showing mainly tilt problems. The current results open new opportunities for automatic detection of children with dysgraphia in classroom. We also believe that the training of pressure and tilt may open new therapeutic opportunities through serious games.


Assuntos
Agrafia/diagnóstico , Escrita Manual , Agrafia/fisiopatologia , Agrafia/psicologia , Fenômenos Biomecânicos , Criança , Feminino , Humanos , Masculino , Destreza Motora
19.
Artigo em Inglês | MEDLINE | ID: mdl-32882872

RESUMO

Irish adolescents have been found to possess high perceptions of motor competence. However, there is an evidential value to investigating the strength of the relationship between adolescent perceptions of motor competence and their low levels of actual motor competence. The purpose of this research was to gather data on the fundamental, functional, and perceived motor competence in adolescents, differentiated by year group, to discern if participants could assess their perceptions of ability. Data were collected on adolescents (N = 373; mean age: 14.38 ± 0.87 years; 47.7% female) across six second-level schools in Ireland, including measurements of fundamental movement skills, functional movement, and perceived motor competence. Poor levels of fundamental and functional movement were observed, with significant differences between year groups detected. Participants in 1st year scored the highest in overall fundamental movement skills; however, for overall functional movement, 3rd-year participants scored highest. High levels of perceived motor competence were reported across the entire sample. These scores did not align with actual motor competence, nor did any alignment between these measurements improve with aging, countering theorized age-related associations. Future research should target low levels of actual motor competence while emphasizing the cognitive aspects of movement to ensure greater accuracy between actual and perceived motor competence.


Assuntos
Destreza Motora , Instituições Acadêmicas , Autoimagem , Adolescente , Envelhecimento , Feminino , Humanos , Irlanda , Masculino , Movimento
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