Effects of spastic cerebral palsy on multi-finger coordination during isometric force production tasks.

In this study, we quantified changes in finger interdependence (enslaving), multi-finger synergies, and feedforward modulation of synergy properties (i.e., anticipatory synergy adjustment) during single- and multi-finger force production tasks in individuals with cerebral palsy (CP). Spastic diplegic CP and healthy control subjects performed sets of finger force production tasks by each of the hands, including maximal force production and submaximal quick pulse force production in an isometric condition. The framework of the uncontrolled manifold hypothesis was used to quantify the indices of multi-finger synergies and the anticipatory synergy adjustment (ASA). The CP group showed lower maximal forces and higher indices of finger interdependence (enslaving), while the indices of multi-finger synergies stabilizing total finger forces during stable force production were not different significantly compared to the controls. Further, the time of ASA for the CP group was not delayed. The CP group showed a significantly less drop in the synergy indices during the anticipatory and quick pulse phase compared to the control group, which was accompanied by larger co-contraction indices of the forearm muscles. These findings suggest that the function of assembling motor synergies for stable force production is not affected by CP, while the ability to modulate synergy properties may be impaired with CP partially due to spasticity. The spasticity presumably hampers the purposeful feedforward destabilization of the performance. The results suggest that quantification of multi-digit synergies may provide an alternative tool for quantitative assessment of impaired coordination in the CP individuals.

Effect of Creative Dance on Fitness, Functional Balance, and Mobility Control in the Elderly.

BACKGROUND: In the literature on creativity in older adults, creative activities have been found to be an effective way of adapting to age-related psychological and physical changes, providing older adults with opportunities to think differently and be open to new ideas. On the other hand, physical activities play an important role in the prevention of physical decline. Thus, combining physical activity and certain creative activities, such as creative dance (CD), might help facilitate successful aging. Since the National Dance Association has expanded dance into educational and community facilities, CD programs have begun to be developed and widely used for all ages. OBJECTIVE: We investigated the effects of a CD program on fitness, functional balance, and mobility in the elderly. METHODS: Eighty-two community-dwelling older adults were randomly allocated to either a dance group (n = 41, age = 70.5 ± 7.89 years) or a stretching group (n = 41, age = 71.77 ± 7.78 years). Over 8 weeks, these groups participated in CD and stretching training (ST) classes, respectively, which lasted for 90 min and were held 2 days a week. The CD included tasks to explore movement elements (i.e., body, space, time, force), develop their own movement, and transform feelings or inner experiences into movement. The ST included several upper- and lower-body stretching poses. The outcome measures included the Senior Fitness Test (SFT), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Dynamic Gait Index (DGI), and 10-Meter Walking Test (gait speed). RESULTS: A significant group × time interaction was found for the 30-s stand and 30-s arm curl, and for the BBS, TUG, DGI, and gait speed. Post hoc paired t tests revealed significantly increased scores for the 30-s stand, 30-s arm curl, back stretching, and chair sit and reach tests, and for the TUG, BBS, TUG, DGI, and gait speed in the CD group. The 30-s arm curl and chair sit and reach test scores significantly increased in the ST group. CONCLUSION: CD and stretching may both benefit fitness and balance for older adults; however, CD may improve dynamic balance and mobility more than stretching. Therefore, CD may be a creative physical activity that contributes to successful aging.

Effect of adapted dance program on gait in adults with cerebral palsy: a pilot study.

Background: The gait function in adults with cerebral palsy (CP) deteriorates rapidly with age. Dance has been used as an effective intervention to improve balance, postural control, and gait. This study aimed to investigate the feasibility and effects of an adapted dance program (ADP) on the gait in adults with CP. The ADP, which consists of floor and barre workouts, was designed to be adapted for individuals with CP. Method: Ten female adults with spastic diplegic CP (mean age 52.3 ± 6.34, Gross Motor Function Classification System level II) participated in this study. Outcome measures, examined using 3D gait analysis, included spatiotemporal gait parameters and the Gait Deviation Index (GDI) based on nine kinematic variables in all planes of motion. To assess feasibility, we conducted post-questionnaires and a group interview. The ADP, each lasting 90 min, was held twice per week for 12 weeks. Results: A statistically significant improvement was observed in GDI (Δ5.74 points, p = 0.014), with a large effect size (d = 0.76). Foot off (Δ-0.72%), first double support (Δ-0.2%), second double support (Δ1.5%), and single support (Δ0.64%) showed no significant differences. Step length (Δ1.48 cm), cadence (Δ3.95 steps/min), and walking speed (Δ6.41 cm/s) tended to increase, though the differences were not statistically significant. Participants expressed high levels of physical and emotional satisfaction, suggesting a need for early intervention. Conclusion: The ADP may improve gait patterns in adults with spastic diplegic CP. The feasibility results indicated that the ADP is suitable for adults with spastic diplegic CP. This study provides evidence for improvement in gait patterns through dance, which has not been reported in previous dance studies on individuals with CP, offering additional information on the benefits of dance.

Effect of Dance on Balance, Mobility, and Activities of Daily Living in Adults With Cerebral Palsy: A Pilot Study.

The age-related decline in motor function with respect to balance and mobility may hamper the activities of daily living, quality of life, and social participation. Despite the importance of managing secondary conditions leading to premature aging, the literature regarding appropriate physical activity for adults with cerebral palsy (CP) is still scarce. Dance forms have emerged as an effective physical activity that improves balance and mobility in individuals with neurological conditions and boosts social engagement. However, its effect on adults with CP has yet to be examined. This pilot study aimed to examine the long-term effect of dance on improving balance and mobility in adults with CP. This single-cohort study included 10 adults with CP. They attended two 90-min-long creative dance sessions per week for 12 weeks. The outcomes measured effects on balance, mobility, balance confidence, and level of functional independence. These measurements were obtained at pre-intervention, post-intervention, and the 3-month follow-up. Outcome data of pre- to post-intervention and pre-intervention to 3-month follow-up were analyzed and compared. Statistically significant differences were found in the pre- and post-intervention displacement of the center of pressure (CoP) in the eyes-opened (EO) condition, timed up and go test (TUG), and Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and Korean-Activity of Balance Confidence (K-ABC) scores. Significant improvements were also observed for the CoP-EO, BBS, TUG, DGI, and K-ABC between the pre-intervention and 3-month follow-up assessments. However, there were no significant differences in the CoP in the eyes-closed condition and Korean modified Barthel Index score. Participants expressed enjoyment without any pain or fatigue. Our findings suggest that dance may have a positive impact in improving balance and mobility and may consequently contribute to healthy aging in adults with CP.

Effects of creative dance-based exercise on gait performance in adolescents with cerebral palsy.

The purpose of this study is to explore the feasibility and therapeutic potential of creative dance (CD) based exercise as a rehabilitation intervention for adolescents with cerebral palsy (CP). Participants were 10 adolescents with spastic CP (mean age, 17.5±2.12 years; Gross Motor Function Classification System levels I [n=3] and II [n=7]). Outcome measures included the Gross Motor Function Measure-88 (GMFM-88; dimensions D and E), spatiotemporal gait parameters, lower limb range of motion during walking, and body image, assessed using the Body Cathexis Scale (BCS). CD was provided in 2-hr classes, twice weekly, for 12 weeks, during which participants learned movement concepts and developed their own movement. All participants completed the intervention, with an attendance rate of 98% and high satisfaction rating. GMFM-88 dimensions D (P=0.01) and E (P=0.005); walking speed (P= 0.005), cadence (P=0.009), step (P=0.005), and stride length (P=0.005); and sagittal ranges of motions of hip (P=0.009) and ankle (P=0.03) during walking were significantly improved. The time of opposite foot off (P=0.028) and first double-limb support (P=0.028) significantly decreased, whereas the percentage of single-limb support time (P=0.02) increased. Additionally, BCS scores were significantly improved. In conclusions, CD-based exercise can improve gross motor function, gait performance, and body image in adolescents with CP.

Preparation and characterization of curcumin solid dispersion using HPMC.

Curcumin solid dispersions were prepared using hydroxypropyl methylcellulose (HPMC) to enhance water solubility of curcumin. The particle size of curcumin solid dispersions was in range from 371 to 528 nm and particles were shaped as spherical with wrinkles. The encapsulation efficiency was over 93% for all samples, and water solubility of curcumin was significantly improved to 238 µg/mL when the ratio of curcumin to HPMC was 20:80. The results of X-ray diffraction, differential scanning calorimeter, and Fourier transform infrared spectroscopy showed that crystalline form of curcumin changed to amorphous form. Curcumin solid dispersions showed improved dissolution behavior compared to pure curcumin and the curcumin release kinetic studies were applied to find best-fitting model. This study showed a great potential of solid dispersion using HPMC as curcumin delivery system with improved water solubility and oral absorption. PRACTICAL APPLICATION: Curcumin has limited applications in the food industry because of low water solubility. Dongoh water-soluble curcumin (DW-CURs) were prepared by solid dispersion method with HPMC. Our results indicated that curcumin solid dispersions improved the water solubility of curcumin and showed a sustained release, demonstrating its possibility of body application. Therefore, DW-CURs are a promising formulation for application as a functional ingredient in the food industry.

A Hydroxypropyl Methylcellulose-Based Solid Dispersion of Curcumin with Enhanced Bioavailability and its Hepatoprotective Activity.

Curcumin is a polyphenol compound derived from the rhizomes of Curcuma longa that exhibits antioxidant, anti-inflammatory, anticancer, and antimicrobial properties. However, its low solubility in aqueous solutions, low absorption following oral administration, and rapid degradation limit its use as a functional food material. In this study, a hydroxypropyl methylcellulose-based solid dispersion of curcumin (DW-CUR 20) was prepared and its bioavailability was evaluated. In addition, its therapeutic efficacy as a hepatoprotective agent was investigated using the model of tert-butyl hydroperoxide (t-BHP)-induced hepatocyte damage. The rat plasma pharmacokinetic study showed that the oral curcumin bioavailability of DW-CUR 20 significantly increased compared to that of non-formulated curcumin. DW-CUR 20 showed a concentration-dependent hepatocyte protective effect on t-BHP-induced HepG2 cells. DW-CUR 20 inhibited the release of lactate dehydrogenase and decreased apoptosis-related proteins such as Poly (ADP-ribose) polymerase, cleaved caspase-7 and cleaved caspase-8 on t-BHP-treated HepG2 cells. These findings suggest that DW-CUR 20 could be a promising formulation for enhancing the therapeutic efficiency of curcumin and for improving the safety.

Changes in body composition, blood lipid profile, and growth factor hormone in a patient with Prader-willi syndrome during 24 weeks of complex exercise: a single case study.

PURPOSE: Prader-Willi syndrome (PWS) is a genetic disorder characterized by excessive appetite with progressive obesity and growth hormone (GH) deficiency. Excessive eating causes progressive obesity with increased risk of morbidities and mortality. Although GH treatment has beneficial effects on patients with PWS, adverse events have occurred during GH treatment. Exercise potentially has a positive effect on obesity management. The purpose of this research was to examine the effects of 24-week complex exercise program on changes in body composition, blood lipid profiles, and growth factor hormone levels in a patient with PWS. METHODS: The case study participant was a 23-year-old man with PWS who also had type II diabetes mellitus because of extreme obesity. Complex exercises, including strength and aerobic exercises, were conducted 5 times one week for 60 minutes per session, over 24 weeks. Blood sampling was conducted five times: before and at 8, 16, 20, and 24 weeks after commencement of the exercise program. RESULTS: Weight, fat mass, triglycerides/high-density lipoprotein (TG/HDL) ratio, mean blood glucose, and GH decreased after training. Blood insulin and insulin-like growth factor (IGF-1) levels increased after training. At 15 and 20 weeks, insulin injection was discontinued. Insulin levels increased and average blood glucose decreased to normal levels; IGF-1 increased continuously during the 24-week exercise program. CONCLUSION: Conclusion] Twenty-four weeks of complex exercises had a positive effect on obesity and diabetes in the patient with PWS. Therefore, long-period complex exercises might be an effective intervention for improvement of metabolic factors in PWS patients.

Preparation of Chitosan-Coated Nanostructured Lipid Carriers (CH-NLCs) to Control Iron Delivery and Their Potential Application to Food Beverage System.

Nanostructured lipid carriers (NLCs) and chitosan-coated NLCs (CH-NLCs) were prepared by a combined double emulsion and melt dispersion method. The physicochemical properties of them were investigated to determine the optimum conditions. At 3% emulsifier concentration, the NLCs showed about 191.0 ± 4.1 nm mean particle size and low polydispersity index value compared to those observed under other conditions. The encapsulation efficiency of CH-NLCs was 83.9% which was about 10% higher than that of NLCs. In vitro release test showed that low release amount of iron from the NLCs (11%) and CH-NLCs (5%) in simulated gastric condition within 3 h, whereas the iron release amounts of the NLCs and CH-NLCs were high (over 77%) in simulated intestinal condition because both NLCs and CH-NLCs were totally destructed in the intestinal condition after 3 h. In the thiobarbituric acid test, the absorbance of milk-fortified NLC and CH-NLCs was lower than that of original milk. Based on these results, CH-NLCs showed great potential for iron fortification in milk.

Development of Food-Grade Curcumin Nanoemulsion and its Potential Application to Food Beverage System: Antioxidant Property and In Vitro Digestion.

Curcumin nanoemulsions (Cur-NEs) were developed with various surfactant concentrations by using high pressure homogenization and finally applied to the commercial milk system. Characterization of Cur-NEs was performed by measuring the droplet size and polydispersity index value at different Tween 20 concentrations. The morphology of the Cur-NEs was observed by confocal laser scanning microscopy and transmission electron microscopy. Antioxidant activity and in vitro digestion ability were tested using 2,2-diphenyl-1-picrylhydrazyl, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt, pH-stat method, and thiobarbituric acid reactive substances assays. Cur-NEs were found to be physically stable for 1 mo at room temperature. The surfactant concentration affects particle formation and droplet size. The mean droplet size decreased from 122 to 90 nm when surfactant concentration increased 3 times. Cur-NEs had shown an effective oxygen scavenging activity. Cur-NEs-fortified milk showed significantly lower lipid oxidation than control (unfortified) milk and milk containing curcumin-free nanoemulsions. These properties make Cur-NEs suitable systems for the beverage industry.

Preparation of chitosan-coated nanoliposomes for improving the mucoadhesive property of curcumin using the ethanol injection method.

Chitosan-coated curcumin nanoliposomes (CS-Cur-NLs) were fabricated by the ethanol injection method (EIM), and their physicochemical properties were compared with the properties of those fabricated by the dry thin film method (DTFM). The mean size and zeta potential of CS-Cur-NLs gradually increased with CS concentration. The encapsulation efficiency of Cur-NLs prepared by EIM was 54.70%, which was significantly improved compared to that (42.60%) of Cur-NLs prepared by DTFM. Further improvement of encapsulation efficiency was attained (up to 64.93%) by EIM with 0.1% CS coating. The mucoadhesive property of Cur-NLs improved from 33.60 to 56.47% with CS coating. The results indicate that the encapsulated curcumin will show prolonged adsorption in the gastrointestinal tract because of higher mucoadhesion. Thus, EIM can be considered to be effective for food-grade delivery carriers with higher encapsulation efficiency and absence of harmful solvents. EIM-generated CS-Cur-NLs showed higher bioavailability, with enhanced high mucoadhesive property, storage stability, and encapsulation efficiency.