RESUMEN
Perinatal stroke (PS), occurring between 20 weeks of gestation and 28 days of life, is a leading cause of hemiplegic cerebral palsy (HCP). Hallmarks of HCP are motor and sensory impairments on one side of the body-especially the arm and hand contralateral to the stroke (involved side). HCP is diagnosed months or years after the original brain injury. One effective early intervention for this population is constraint-induced movement therapy (CIMT), where the uninvolved arm is constrained by a mitt or cast, and therapeutic activities are performed with the involved arm. In this preliminary investigation, we used 3D motion capture to measure the spatiotemporal characteristics of pre-reaching upper extremity movements and any changes that occurred when constraint was applied in a real-time laboratory simulation. Participants were N = 14 full-term infants: N = six infants with typical development; and N = eight infants with PS (N = three infants with PS were later diagnosed with cerebral palsy (CP)) followed longitudinally from 2 to 6 months of age. We aimed to evaluate the feasibility of using 3D motion capture to identify the differences in the spatiotemporal characteristics of the pre-reaching upper extremity movements between the diagnosis group, involved versus uninvolved side, and with versus and without constraint applied in real time. This would be an excellent application of wearable sensors, allowing some of these measurements to be taken in a clinical or home setting.
Asunto(s)
Parálisis Cerebral , Accidente Cerebrovascular , Extremidad Superior , Parálisis Cerebral/diagnóstico , Humanos , Lactante , Movimiento , Modalidades de Fisioterapia , Resultado del TratamientoRESUMEN
Few studies in the literature have researched the use of surface electromyography (sEMG) for motor assessment post-stroke due to the complexity of this type of signal. However, recent advances in signal processing and machine learning have provided fresh opportunities for analyzing complex, non-linear, non-stationary signals, such as sEMG. This paper presents a method for identification of the upper limb movements from sEMG signals using a combination of digital signal processing, that is discrete wavelet transform, and the enhanced probabilistic neural network (EPNN). To explore the potential of sEMG signals for monitoring motor rehabilitation progress, this study used sEMG signals from a subset of movements of the Arm Motor Ability Test (AMAT) as inputs into a movement classification algorithm. The importance of a particular frequency domain feature, that is the ratio of the mean absolute values between sub-bands, was discovered in this work. An average classification accuracy of 75.5% was achieved using the proposed approach with a maximum accuracy of 100%. The performance of the proposed method was compared with results obtained using three other classification algorithms: support vector machine (SVM), k-Nearest Neighbors (k-NN), and probabilistic neural network (PNN) in terms of sEMG movement classification. The study demonstrated the capability of using upper limb sEMG signals to identify and distinguish between functional movements used in standard upper limb motor assessments for stroke patients. The classification algorithm used in the proposed method, EPNN, outperformed SVM, k-NN, and PNN.
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Movimiento , Procesamiento de Señales Asistido por Computador , Algoritmos , Electromiografía , Humanos , Extremidad Superior , Análisis de OndículasRESUMEN
Neurons in the pontomedullary reticular formation (PMRF) give rise to the reticulospinal tract. The motor output of the PMRF was investigated using stimulus-triggered averaging of electromyography (EMG) and force recordings in two monkeys (M. fascicularis). EMG was recorded from 12 pairs of upper limb muscles, and forces were detected using two isometric force-sensitive handles. Of 150 stimulation sites, 105 (70.0%) produced significant force responses, and 139 (92.5%) produced significant EMG responses. Based on the average flexor EMG onset latency of 8.3 ms and average force onset latency of 15.9 ms poststimulation, an electromechanical delay of â¼7.6 ms was calculated. The magnitude of force responses (â¼10 mN) was correlated with the average change in EMG activity (P < 0.001). A multivariate linear regression analysis was used to estimate the contribution of each muscle to force generation, with flexors and extensors exhibiting antagonistic effects. A predominant force output pattern of ipsilateral flexion and contralateral extension was observed in response to PMRF stimulation, with 65.3% of significant ipsilateral force responses directed medially and posteriorly (P < 0.001) and 78.6% of contralateral responses directed laterally and anteriorly (P < 0.001). This novel approach permits direct measurement of force outputs evoked by central nervous system microstimulation. Despite the small magnitude of poststimulus EMG effects, low-intensity single-pulse microstimulation of the PMRF evoked detectable forces. The forces, showing the combined effect of all muscle activity in the arms, are consistent with reciprocal pattern of force outputs from the PMRF detectable with stimulus-triggered averaging of EMG.
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Bulbo Raquídeo/fisiología , Músculo Esquelético/fisiología , Neuronas/fisiología , Tegmento Pontino/fisiología , Animales , Estimulación Eléctrica , Electromiografía , Macaca fascicularis , Masculino , Fenómenos Mecánicos , Extremidad Superior/fisiologíaRESUMEN
The purposes of this pilot study were to create a model of focal cortical ischemia in Macaca fascicularis and to explore contributions of the reticulospinal system in recovery of reaching. Endothelin-1 was used to create a focal lesion in the shoulder/elbow representation of left primary motor cortex (M1) of two adult female macaques. Repetitive microstimulation was used to map upper limb motor outputs from right and left cortical motor areas and from the pontomedullary reticular formation (PMRF). In subject 1 with a small lesion and spontaneous recovery, reaching was mildly impaired. Changes were evident in the shoulder/elbow representations of both the lesioned and contralesional M1, and there appeared to be fewer than expected upper limb responses from the left (ipsilesional) PMRF. In subject 2 with a substantial lesion, reaching was severely impaired immediately after the lesion. After 12 weeks of intensive rehabilitative training, reach performance recovered to near-baseline levels, but movement times remained about 50% slower. Surprisingly, the shoulder/elbow representation in the lesioned M1 remained completely absent after recovery, and there was a little change in the contralesional M1. There was a definite difference in motor output patterns for left versus right PMRF for this subject, with an increase in right arm responses from right PMRF and a paucity of left arm responses from left PMRF. The results are consistent with increased reliance on PMRF motor outputs for recovery of voluntary upper limb motor control after significant cortical ischemic injury.
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Isquemia Encefálica/fisiopatología , Corteza Motora/patología , Trastornos de la Destreza Motora/etiología , Recuperación de la Función/fisiología , Formación Reticular/fisiopatología , Médula Espinal/fisiopatología , Vías Aferentes , Animales , Isquemia Encefálica/patología , Isquemia Encefálica/rehabilitación , Modelos Animales de Enfermedad , Estimulación Eléctrica , Endotelina-1/toxicidad , Femenino , Lateralidad Funcional , Macaca fascicularis , Corteza Motora/lesiones , Corteza Motora/fisiología , Proyectos Piloto , Formación Reticular/patología , Médula Espinal/patología , Extremidad Superior/fisiopatologíaRESUMEN
Early and accurate diagnosis of Parkinson's disease (PD) remains challenging. Neuropathological studies using brain bank specimens have estimated that a large percentages of clinical diagnoses of PD may be incorrect especially in the early stages. In this paper, a comprehensive computer model is presented for the diagnosis of PD based on motor, non-motor, and neuroimaging features using the recently-developed enhanced probabilistic neural network (EPNN). The model is tested for differentiating PD patients from those with scans without evidence of dopaminergic deficit (SWEDDs) using the Parkinson's Progression Markers Initiative (PPMI) database, an observational, multi-center study designed to identify PD biomarkers for diagnosis and disease progression. The results are compared to four other commonly-used machine learning algorithms: the probabilistic neural network (PNN), support vector machine (SVM), k-nearest neighbors (k-NN) algorithm, and classification tree (CT). The EPNN had the highest classification accuracy at 92.5% followed by the PNN (91.6%), k-NN (90.8%) and CT (90.2%). The EPNN exhibited an accuracy of 98.6% when classifying healthy control (HC) versus PD, higher than any previous studies.
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Diagnóstico por Computador/métodos , Redes Neurales de la Computación , Enfermedad de Parkinson/diagnóstico , Algoritmos , Diagnóstico Diferencial , Reacciones Falso Positivas , Humanos , Examen Físico , Curva ROC , Máquina de Vectores de SoporteRESUMEN
CONTEXT: Video feedback is an expeditious method for improving athlete safety when performing activities with an inherent risk of injury. Providing appropriate and validated feedback during tackling training in American football may be a mechanism for athletes to learn safe tackling performance. OBJECTIVE: To determine the effect of video feedback in the instruction of tackling form. DESIGN: Controlled laboratory study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 32 youth football athletes (28 boys, 4 girls; age = 11.8 ± 0.8 years) participated in 1 day of training. Of those, 14 participants completed 2 additional days of training and a 48-hour retention and transfer test. INTERVENTION(S): Video feedback using self as model, expert as model, combined self and expert model, and oral feedback to promote safe tackling performance in a laboratory environment. MAIN OUTCOME MEASURE(S): Shoulder extension, cervical extension, trunk angle, pelvis height, and step length by training block and over time. RESULTS: For the 1-day training group, main effects for time were observed for shoulder extension (P < .01), cervical extension (P = .01), pelvis height (P < .01), and step length (P < .01), with better performance for pelvis height and step length after combined feedback. For the 3-day training group, main effects of time were identified in pelvis height (P < .01) and step length (P < .01), with combined feedback showing better performance than other methods in shoulder extension and pelvis height. Combined feedback resulted in better performance compared with its component parts and oral feedback alone. In the combined model, participants viewed both their performance and the expert model, enabling them to see the difference between current and required performance. CONCLUSIONS: Combined feedback may be superior to other forms of feedback in improving movement performance. This effect can be generalized across disciplines that provide instruction and feedback in movement.
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Fútbol Americano , Masculino , Femenino , Humanos , Adolescente , Niño , Fútbol Americano/lesiones , Retroalimentación , AtletasRESUMEN
It is well established that cortical motor stimulation results in contralateral upper limb (UL) activity. Motor responses are also elicited in the ipsilateral UL, though controversy surrounds the significance of these effects. Evidence suggests that ipsilateral muscle activity is more common following the stimulation of the supplementary motor area (SMA) and dorsal premotor area (PMd), compared to the primary motor cortex (M1), but none of these studies compared effects from all three areas in the same subjects. This has limited our understanding of how these three cortical motor areas influence ipsilateral UL muscle activity. The purpose of this study was to determine the contribution of each of three cortical areas to the production of ipsilateral and contralateral UL. To maximize sensitivity and allow comparison of the effects across cortical areas, we applied the same stimulation parameters (36 pulse stimulus train at 330 Hz) to M1, SMA, and PMd in three adult M. fascicularis and recorded electromyographic (EMG) activity from muscles in the trunk and both ULs. Of all muscle responses identified, 24 % were ipsilateral to the stimulation, mostly in proximal muscles. The highest percentage of ipsilateral responses occurred following SMA stimulation. We also observed that PMd stimulation elicited more suppression responses compared with stimulation of M1 and SMA. The results indicate that ipsilateral motor areas provide a significant contribution to cortical activation of the trunk and proximal UL muscles. These understudied pathways may represent a functional substrate for future strategies to shape UL recovery following injury or stroke.
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Potenciales Evocados Motores/fisiología , Lateralidad Funcional/fisiología , Corteza Motora/fisiología , Músculo Esquelético/fisiología , Extremidad Superior/inervación , Animales , Mapeo Encefálico , Estimulación Eléctrica , Electromiografía , Macaca fascicularis , Masculino , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
This preclinical study was conducted to develop discrete sonographic instrumentation settings and also safe contrast dosing that would consistently demonstrate perineural vascularity along the median nerve. This set of imaging studies was conducted with a convenience cohort of young adult female monkeys (Macaca fascicularis). Sonographic equipment settings and dosing were refined throughout the imaging series to ensure consistent contrast-enhanced ultrasound imaging. A mechanical index of 0.13 was consistently used for imaging. Perineural vessels were imaged with a suspension solution of 0.04 mL Definity/0.96 mL saline introduced over 5 minutes for a total dose of 0.8 mL of contrast solution. Blinded studies of high and low dose contrast, along with saline injections, were correctly identified by two experienced sonographers. This preclinical study established adequate equipment settings and dosing that allowed for a valid demonstration of vascularity surrounding the median nerve.
RESUMEN
The pontomedullary reticular formation (PMRF) of the monkey produces motor outputs to both upper limbs. EMG effects evoked from stimulus-triggered averaging (StimulusTA) were compared with effects from stimulus trains to determine whether both stimulation methods produced comparable results. Flexor and extensor muscles of scapulothoracic, shoulder, elbow, and wrist joints were studied bilaterally in two male M. fascicularis monkeys trained to perform a bilateral reaching task. The frequency of facilitation versus suppression responses evoked in the muscles was compared between methods. Stimulus trains were more efficient (94% of PMRF sites) in producing responses than StimulusTA (55%), and stimulus trains evoked responses from more muscles per site than from StimulusTA. Facilitation (72%) was more common from stimulus trains than StimulusTA (39%). In the overall results, a bilateral reciprocal activation pattern of ipsilateral flexor and contralateral extensor facilitation was evident for StimulusTA and stimulus trains. When the comparison was restricted to cases where both methods produced a response in a given muscle from the same site, agreement was very high, at 80%. For the remaining 20%, discrepancies were accounted for mainly by facilitation from stimulus trains when StimulusTA produced suppression, which was in agreement with the under-representation of suppression in the stimulus train data as a whole. To the extent that the stimulus train method may favor transmission through polysynaptic pathways, these results suggest that polysynaptic pathways from the PMRF more often produce facilitation in muscles that would typically demonstrate suppression with StimulusTA.
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Actividad Motora/fisiología , Músculo Esquelético/fisiología , Desempeño Psicomotor/fisiología , Formación Reticular/fisiología , Animales , Estimulación Eléctrica , Electromiografía , Macaca fascicularis , Masculino , Tiempo de Reacción/fisiología , Hombro/fisiología , Procesamiento de Señales Asistido por ComputadorRESUMEN
Pontomedullary reticular formation (PMRF) neurons (309) were recorded simultaneously with electromyographic activity from arm and shoulder muscles in four monkeys performing arm-reaching tasks. Spike-triggered averages (SpikeTAs) were compiled for 292 neurons (3836 neuron-muscle pairs). Fourteen PMRF neurons located in a region ventral to the abducens nucleus produced 42 significant SpikeTA effects in arm and shoulder muscles. Of these 14 PMRF neurons, nine produced SpikeTA effects bilaterally. Overall, PMRF neurons facilitated ipsilateral flexors and contralateral extensors, while suppressing ipsilateral extensors and contralateral flexors. Spike- and stimulus-triggered averaging effects obtained from the same recording site were similar. These findings indicate that single PMRF neurons can directly influence movements of both upper limbs.
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Potenciales de Acción/fisiología , Bulbo Raquídeo/fisiología , Músculo Esquelético/fisiología , Puente/fisiología , Formación Reticular/fisiología , Animales , Brazo/fisiología , Macaca fascicularis , Neuronas/fisiología , Hombro/fisiologíaRESUMEN
BACKGROUND: Many organizations have introduced frameworks to reduce the incidence of football related concussions through proper equipment fitting, coach education, and alteration of tackling technique. PURPOSE: The purpose of this study was to examine the effects of training in a vertical, head up tackling style on the number of head accelerations experienced while tackling in a controlled laboratory situation. The authors hypothesized that training in a head up tackling technique would reduce the severity of head acceleration experienced by participants. DESIGN: Controlled Laboratory Study. METHODS: Twenty-four participants (11.5 ± 0.6 years old, 60.5 ± 2.2 in, 110 ± 18.4 lbs.) with previous playing experience completed a one-day training session on tackling technique utilizing a tackling dummy. A subgroup of these participants completed an additional two days of training with a 48 hour retention test. Head accelerations were analyzed at baseline and end of training. Feedback consisted of verbal feedback utilizing the Qualitative Youth Tackling Scale (QYTS) and video tackling playback. RESULTS: A significant reduction in the number of peak linear head accelerations over 10 g and peak rotational head accelerations over 1885 deg/s2 were found in dummy tackling after training in both the one day and three day training regimens. A significant change in QYTS tackling form score was found between pretest and post-test (p = 0.004). Participants with larger steps had a 2.28, 4.42 and 4.14 increased odds ratio of sustaining head accelerations over 10, 15 and 20 g respectively. CONCLUSIONS: Training in a vertical, head up tackling style decreased the number of head accelerations over threshold values sustained while tackling; decreased step length may be the driving factor in the effectiveness of this tackling form. LEVEL OF EVIDENCE: Level 3b.
RESUMEN
BACKGROUND: Long term neurologic injury and concussion have been identified as risks from participation in American football. Altering tackling form has been recommended to reduce the risk of neurologic injury caused by head accelerations when tackling. The purpose of this research is to determine the inter-rater agreement and validity of the Qualitative Youth Tackling System (QYTS), a six-item feedback scale to correct tackling form, when utilized by novice and expert raters. HYPOTHESIS: Experienced raters will have higher levels of agreement with each other and with motion capture when compared to novice raters. METHODS: Both novice and experienced raters viewed video of youth athletes (ages 9-13) tackling a dummy in a laboratory setting along. The raters identified successful performance according to a binary rating scale for each component. Analysis of both the raters' agreement with each other and with an objective motion capture measure were completed. RESULTS: Fliess' Kappa measures between all raters were found to be moderate for head placement (k=.48), fair for cervical extension (k=.38), trunk inclination (k=.37), shoulder extension (k=.27) and step length (k=.29), and there was no agreement for pelvic height (k=.-16). When compared to the dichotomized validation measures of each of the five components provided by the motion capture system the average Cohen's Kappa agreement was substantial for pelvic height (k=.63), fair for step length (k=.34), cervical extension (k=.40), trunk inclination (k=.35), and slight for shoulder extension (k=.16). The experienced raters outperformed the novice raters in all categories. CONCLUSION: The results of this study indicate that skilled raters are better able to identify the movement patterns included in the QYTS when compared to a validation measure as well have higher rates of inter-rater agreement than novice raters. LEVEL OF EVIDENCE: 3b.
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This study investigated changes in median sensory nerve conduction velocity (SNCV) over several weeks of exposure to a voluntary, moderately forceful, repetitive pinching task performed for food rewards by a small sample of young adult female monkeys (Macaca fascicularis). SNCV, derived from peak latency, decreased significantly in the working hands of three of the four subjects. The overall decline in NCV was 25%-31% from baseline. There was no decrease in SNCV in the contralateral, nonworking hands. Several weeks after being removed from the task, SNCV returned to within 87%-100% of baseline. MRI showed enlargement of the affected nerves near the proximal end of the carpal tunnel, at the time of maximal SNCV slowing. This new animal model demonstrates a temporally unambiguous relationship between exposure to a moderately forceful, repetitive manual task and development of median mononeuropathy at the wrist, and recovery of SNCV following termination of task exposure. This study contributes to the pattern of evidence of a causal relationship between manual work, median mononeuropathy, and carpal tunnel syndrome in humans. In the future, this new animal model could be used to characterize dose-response relationships between risk factors and carpal tunnel syndrome.
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Síndrome del Túnel Carpiano/etiología , Síndrome del Túnel Carpiano/fisiopatología , Modelos Animales de Enfermedad , Macaca fascicularis , Nervio Mediano/fisiología , Animales , Síndrome del Túnel Carpiano/diagnóstico , Enfermedad Crónica , Condicionamiento Psicológico , Citocinas/sangre , Electrodiagnóstico , Femenino , Fuerza de la Mano , Imagen por Resonancia Magnética , Actividad Motora , Conducción Nerviosa , VoliciónRESUMEN
The primary purpose of this study was to establish a methodology for determining and perhaps predicting (via regression analysis of anthropometric measures) Macaca fascicularis isometric pinch strength for a specific task. The larger purpose of this work was to properly scale a pinching task for the monkeys in order to study dose-response relationships in a non-human primate model for carpal tunnel syndrome. Three female and one male macaque (n=4) of varying size and age were trained to perform a left-handed pad-pad pinch. The task required 60 degrees of wrist flexion at a static pinching distance of 3 cm between the thumb and fingers. Subjects were trained for a period of 20-weeks. After that time, an analysis of performance gradients found that they had each reached a plateau in their force output. Pinch strength for the four animals ranged from 29.4 to 59.8 N. Regression analysis revealed that body mass (kg) and wrist circumference (cm) were both predictive of pinch strength, exhibiting adjusted R(2) values of 0.93 (p=0.024) and 0.96 (p=0.015), respectively. Thus, the results suggest that maximal pinch strength could be acceptably estimated in future subjects using either the wrist circumference or the body mass measures, as both were strong predictors of pad-pad pinch strength.
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Fuerza de Pellizco/fisiología , Animales , Fenómenos Biomecánicos , Peso Corporal , Retroalimentación , Femenino , Antebrazo/anatomía & histología , Predicción , Mano/anatomía & histología , Contracción Isométrica/fisiología , Macaca fascicularis , Masculino , Modelos Animales , Muñeca/anatomía & histología , Muñeca/fisiologíaRESUMEN
Researchers often rely on simple methods to identify involvement of neurons in a particular motor task. The historical approach has been to inspect large groups of neurons and subjectively separate neurons into groups based on the expertise of the investigator. In cases where neuron populations are small it is reasonable to inspect these neuronal recordings and their firing rates carefully to avoid data omissions. In this paper, a new methodology is presented for automatic objective classification of neurons recorded in association with behavioral tasks into groups. By identifying characteristics of neurons in a particular group, the investigator can then identify functional classes of neurons based on their relationship to the task. The methodology is based on integration of a multiple signal classification (MUSIC) algorithm to extract relevant features from the firing rate and an expectation-maximization Gaussian mixture algorithm (EM-GMM) to cluster the extracted features. The methodology is capable of identifying and clustering similar firing rate profiles automatically based on specific signal features. An empirical wavelet transform (EWT) was used to validate the features found in the MUSIC pseudospectrum and the resulting signal features captured by the methodology. Additionally, this methodology was used to inspect behavioral elements of neurons to physiologically validate the model. This methodology was tested using a set of data collected from awake behaving non-human primates.
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Potenciales de Acción/fisiología , Modelos Neurológicos , Neuronas/fisiología , Desempeño Psicomotor/fisiología , Detección de Señal Psicológica/fisiología , Algoritmos , Animales , Señales (Psicología) , Lateralidad Funcional/fisiología , Mano , Macaca fascicularis , Masculino , Distribución Normal , Análisis de Componente PrincipalRESUMEN
Constraint-induced movement therapy (CI therapy) is a well-researched intervention for treatment of upper limb function. Overall, CI therapy yields clinically meaningful improvements in speed of task completion and greatly increases use of the more affected upper extremity for daily activities. However, individual improvements vary widely. It has been suggested that intrinsic feedback from somatosensation may influence motor recovery from CI therapy. To test this hypothesis, an enhanced probabilistic neural network (EPNN) prognostic computational model was developed to identify which baseline characteristics predict extent of motor recovery, as measured by the Wolf Motor Function Test (WMFT). Individual characteristics examined were: proprioceptive function via the brief kinesthesia test, tactile sensation via the Semmes-Weinstein touch monofilaments, motor performance captured via the 15 timed items of the Wolf Motor Function Test, stroke affected side. A highly accurate predictive classification was achieved (100% accuracy of EPNN based on available data), but facets of motor functioning alone were sufficient to predict outcome. Somatosensation, as quantified here, did not play a large role in determining the effectiveness of CI therapy.
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Diagnóstico por Computador/métodos , Terapia Pasiva Continua de Movimiento/métodos , Actividad Motora/fisiología , Recuperación de la Función/fisiología , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
STUDY DESIGN: Prospective test-retest, intrarater reliability study. OBJECTIVES: To estimate the intrarater reliability, asymmetry, and associated error with measurement of the cross-sectional area (CSA) of the bilateral S1 multifidi when measured by a physical therapist following a short course of self-directed training in ultrasound imaging. BACKGROUND: There is increasing interest in the assessment of the lumbar multifidus during the recovery from low back injury. It is important to know the error associated with the CSA measurements obtained by a physical therapist with limited experience in ultrasound imaging when using a portable unit. METHODS AND MEASURES: Thirty healthy females (mean +/- SD age, 23 +/- 2 years; mean +/- SD mass, 63.1 +/- 9.2 kg; mean +/- SD height, 1.63 +/- 0.06 m) participated. Fourteen subjects returned within 1 to 4 days for repeated measurements. RESULTS: For all 30 subjects, the average (+/- SD) CSA of the left S1 multifidus (4.18 +/- 0.55 cm2) was larger (P<.05) than the right (4.11 +/- 0.57 cm2), with a standard error of the measurement (SEM) of 0.13 cm2 and average +/- SD asymmetry of 3.5% +/- 3.4%. For a subset of 14 subjects, the between-day intrarater reliability for the right S1 multifidus muscle was ICC3,1 = 0.80 (95% CI, 0.49-0.93), while the ICC for the left side was 0.72 (95% CI, 0.34-0.90). The day-to-day average differences for the left and right side were 0.02 cm2 and 0.04 cm2, respectively. For the most conservative estimate, the between-day SEM was 0.37cm2. CONCLUSIONS: A physical therapist, newly trained in ultrasound imaging, obtained reasonable between-day intrarater reliability when imaging the S1 multifidus. A high degree of symmetry was found between the bilateral S1 multifidi in a sample of healthy subjects, which is consistent with previous reports from measurements by skilled ultrasonographers.
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Región Lumbosacra/diagnóstico por imagen , Adulto , Femenino , Humanos , Dolor de la Región Lumbar/rehabilitación , Región Lumbosacra/anatomía & histología , Manipulaciones Musculoesqueléticas , Ohio , Evaluación de Procesos y Resultados en Atención de Salud/normas , Especialidad de Fisioterapia , Estudios Prospectivos , UltrasonografíaRESUMEN
This study evaluated the role of spared axons on structural and behavioral neuroplasticity in the lumbar enlargement after a thoracic spinal cord injury (SCI). Previous work has demonstrated that recovery in the presence of spared axons after an incomplete lesion increases behavioral output after a subsequent complete spinal cord transection (TX). This suggests that spared axons direct adaptive changes in below-level neuronal networks of the lumbar cord. In response to spared fibers, we postulate that lumbar neuron networks support behavioral gains by preventing aberrant plasticity. As such, the present study measured histological and functional changes in the isolated lumbar cord after complete TX or incomplete contusion (SCI). To measure functional plasticity in the lumbar cord, we used an established instrumental learning paradigm (ILP). In this paradigm, neural circuits within isolated lumbar segments demonstrate learning by an increase in flexion duration that reduces exposure to a noxious leg shock. We employed this model using a proof-of-principle design to evaluate the role of sparing on lumbar learning and plasticity early (7 days) or late (42 days) after midthoracic SCI in a rodent model. Early after SCI or TX at 7 days, spinal learning was unattainable regardless of whether the animal recovered with or without axonal substrate. Failed learning occurred alongside measures of cell soma atrophy and aberrant dendritic spine expression within interneuron populations responsible for sensorimotor integration and learning. Alternatively, exposure of the lumbar cord to a small amount of spared axons for 6 weeks produced near-normal learning late after SCI. This coincided with greater cell soma volume and fewer aberrant dendritic spines on interneurons. Thus, an opportunity to influence activity-based learning in locomotor networks depends on spared axons limiting maladaptive plasticity. Together, this work identifies a time dependent interaction between spared axonal systems and adaptive plasticity in locomotor networks and highlights a critical window for activity-based rehabilitation.
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Condicionamiento Operante/fisiología , Interneuronas/fisiología , Plasticidad Neuronal/fisiología , Recuperación de la Función/fisiología , Traumatismos de la Médula Espinal , Médula Espinal/patología , Análisis de Varianza , Animales , Espinas Dendríticas/patología , Espinas Dendríticas/ultraestructura , Modelos Animales de Enfermedad , Conducta Exploratoria/fisiología , Femenino , Esponja de Gelatina Absorbible/uso terapéutico , Hemostáticos/uso terapéutico , Procesamiento de Imagen Asistido por Computador , Interneuronas/patología , Interneuronas/ultraestructura , Neuroimagen , Ratas , Ratas Sprague-Dawley , Tinción con Nitrato de Plata , Traumatismos de la Médula Espinal/tratamiento farmacológico , Traumatismos de la Médula Espinal/patología , Traumatismos de la Médula Espinal/fisiopatología , Traumatismos de la Médula Espinal/terapia , Factores de TiempoRESUMEN
For neuroscience, memorable demonstrations of principles in action are crucial. Neural control of walking is particularly difficult to understand because the interaction of the cerebral cortex with a central pattern generator (CPG) makes the mode of control context-dependent. Beginning students tend to consider corticospinal control the basis of all movement, so they may not distinguish the limited circumstances in which the cerebral cortex bypasses the CPG to control leg movements directly for walking. The demonstration described here is designed to show that cortical involvement in normal walking is minimal unless visual control of foot placement is required. Cortical involvement in motor control is assessed by probing for spare attention while a student volunteer performs three different tasks: sitting, walking down a hallway, and walking through an obstacle course. Simple math quizzes with 20 oral questions are the probes. The class observes the demonstration and discusses the results. To evaluate learning, a multiple-choice question was administered two months after the demonstration, as well as 14 months later to cohorts from the previous year's class. The demonstration succeeded: quiz scores were similar for sitting and level walking, but lower for the obstacle course. Two months later, 86% of students correctly answered the multiple choice question; 42% of the previous year's cohorts answered correctly after 14 months. The demonstration shows that the cortex is engaged by walking through an obstacle course, not walking on a flat indoor surface. Initially, most students learned this distinction well, but after a year, many reverted to the idea that the corticospinal tract controls details of leg movements during walking. Thus this result emphasizes the need for review of advanced concepts. Overall, the experience was fun and could easily fit into basic or clinical neuroscience courses.
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The proper isolation of action potentials recorded extracellularly from neural tissue is an active area of research in the fields of neuroscience and biomedical signal processing. This paper presents an isolation methodology for neural recordings using the wavelet transform (WT), a statistical thresholding scheme, and the principal component analysis (PCA) algorithm. The effectiveness of five different mother wavelets was investigated: biorthogonal, Daubachies, discrete Meyer, symmetric, and Coifman; along with three different wavelet coefficient thresholding schemes: fixed form threshold, Stein's unbiased estimate of risk, and minimax; and two different thresholding rules: soft and hard thresholding. The signal quality was evaluated using three different statistical measures: mean-squared error, root-mean squared, and signal to noise ratio. The clustering quality was evaluated using two different statistical measures: isolation distance, and L-ratio. This research shows that the selection of the mother wavelet has a strong influence on the clustering and isolation of single unit neural activity, with the Daubachies 4 wavelet and minimax thresholding scheme performing the best.