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The effectiveness of motor imagery (MI) training on sports performance is now well-documented. Recently, it has been proposed that a single session of MI combined with low frequency sound (LFS) might enhance muscle activation. However, the neural mechanisms underlying this effect remain unknown. We set up a test-retest intervention over the course of 2 consecutive days to evaluate the effect of (i) MI training (MI, n = 20), (ii) MI combined with LFS (MI + LFS, n = 20), and (iii) a control condition (CTRL, n = 20) on force torque produced across repeated maximal voluntary contractions of the quadriceps before (Pretest), after (Posttest) and at +12 h (Retention) post-intervention. We collected the integrated electromyograms of the quadriceps muscles, as well as brain electrical potentials during each experimental intervention. In the CTRL group, total force torque decreased from Pretest to Retention and from Posttest to Retention. By contrast, there was an increase between Posttest and Retention in both MI + LFS and MI groups (both ηP2 = 0.03, p < 0.05). Regression analyses further revealed a negative relationship between force performance and EEG activity in the MI + LFS group only. The data support a transient interference of LFS on cortical activity underlying the priming effects of MI practice on force performance. Findings are discussed in relation to the potential for motor reprogramming through MI combined with LFS.
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Eletromiografia , Músculo Quadríceps , Humanos , Masculino , Adulto , Adulto Jovem , Músculo Quadríceps/fisiologia , Eletroencefalografia , Imaginação/fisiologia , Feminino , Desempenho Psicomotor/fisiologia , Estimulação Acústica , TorqueRESUMO
BACKGROUND: With disease-modifying drugs in reach for cerebellar ataxias, fine-grained digital health measures are highly warranted to complement clinical and patient-reported outcome measures in upcoming treatment trials and treatment monitoring. These measures need to demonstrate sensitivity to capture change, in particular in the early stages of the disease. OBJECTIVE: Our aim is to unravel gait measures sensitive to longitudinal change in the-particularly trial-relevant-early stage of spinocerebellar ataxia type 2 (SCA2). METHODS: We performed a multicenter longitudinal study with combined cross-sectional and 1-year interval longitudinal analysis in early-stage SCA2 participants (n = 23, including nine pre-ataxic expansion carriers; median, ATXN2 CAG repeat expansion 38 ± 2; median, Scale for the Assessment and Rating of Ataxia [SARA] score 4.8 ± 4.3). Gait was assessed using three wearable motion sensors during a 2-minute walk, with analyses focused on gait measures of spatio-temporal variability that have shown sensitivity to ataxia severity (eg, lateral step deviation). RESULTS: We found significant changes for gait measures between baseline and 1-year follow-up with large effect sizes (lateral step deviation P = 0.0001, effect size rprb = 0.78), whereas the SARA score showed no change (P = 0.67). Sample size estimation indicates a required cohort size of n = 43 to detect a 50% reduction in natural progression. Test-retest reliability and minimal detectable change analysis confirm the accuracy of detecting 50% of the identified 1-year change. CONCLUSIONS: Gait measures assessed by wearable sensors can capture natural progression in early-stage SCA2 within just 1 year-in contrast to a clinical ataxia outcome. Lateral step deviation represents a promising outcome measure for upcoming multicenter interventional trials, particularly in the early stages of cerebellar ataxia. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Progressão da Doença , Ataxias Espinocerebelares , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Ataxias Espinocerebelares/fisiopatologia , Ataxias Espinocerebelares/genética , Estudos Longitudinais , Estudos Transversais , Marcha/fisiologia , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/diagnóstico , Ataxina-2/genéticaRESUMO
Each year, 15 million people worldwide suffer from strokes. Consequently, researchers face increasing pressure to develop reliable behavioural tests for assessing functional recovery after a stroke. Our aim was to establish a new motor performance index that can be used to evaluate post-stroke recovery in both young and aged animals. Furthermore, we validate the proposed procedure and recommend the necessary number of animals for experimental stroke studies. Young (n = 20) and aged (n = 27) Sprague-Dawley rats were randomly assigned to receive either sham or stroke surgery. The newly proposed performance index was calculated for the post-stroke acute, subacute and chronic phases. The advantage of using our test over current tests lies in the fact that the newly proposed motor index test evaluates not only the performance of the unaffected side in comparison to the affected one but also assesses overall performance by taking into account speed and coordination. Moreover, it reduces the number of animals needed to achieve a statistical power of 80%. This aspect is particularly crucial when studying aged rodents. Our approach can be used to monitor and assess the effectiveness of stroke therapies in experimental models using aged animals.
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Envelhecimento , Modelos Animais de Doenças , Ratos Sprague-Dawley , Animais , Masculino , Envelhecimento/fisiologia , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/complicações , Ratos , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Atividade Motora/fisiologiaRESUMO
This study investigates how the combination of robot-mediated haptic interaction and cerebellar neuromodulation can improve task performance and promote motor skill development in healthy individuals using a robotic exoskeleton worn on the index finger. The authors propose a leader-follower type of mirror game where participants can follow a leader in a two-dimensional virtual reality environment while the exoskeleton tracks the index finger motion using an admittance filter. The game requires two primary learning phases: the initial phase focuses on mastering the pinching interface, while the second phase centers on predicting the leader's movements. Cerebral transcranial direct current stimulation (tDCS) with anodal polarity is applied to the subjects during the game. It is shown that the subjects' performance improves as they play the game. The combination of tDCS with finger exoskeleton significantly enhances task performance. Our research indicates that modulation of the cerebellum during the mirror game improves the motor skills of healthy individuals. The results also indicate potential uses for motor neurorehabilitation in hemiplegia patients.
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INTRODUCTION: Treadmill training (TT) is a gait training technique that has commonly been used in neurorehabilitation, and has positive effects on gait, mobility, and related outcomes in stroke survivors. Transcranial direct current stimulation (tDCS) is a non-invasive approach for modulating brain cortex excitability. AIM: To evaluate the available scientific evidence on the effects of TT combined with tDCS on mobility, motor performance, balance function, and brain-related outcomes in stroke survivors. METHODS: Five databases namely the Cochrane library, PEDro, Web of Science, PubMed, and EMBASE, were searched for relevant studies from inception to March, 2024. Only randomized controlled trials were included, and their methodological quality and risk of bias (ROB) were evaluated using the PEDro scale and Cochrane ROB assessment tool respectively. Qualitative and quantitative syntheses (using fixed effects meta-analysis) were employed to analyze the data. RESULTS: The results revealed that TT combined with active tDCS had significant beneficial effects on some mobility parameters, some gait spatiotemporal parameters, some gait kinematic parameters, gait endurance, gait ability, and corticomotor excitability in stroke survivors, but no significant difference on gait speed (P > 0.05), functional mobility (P > 0.05), motor performance (P > 0.05), or some balance functions (P > 0.05), compared with the control conditions. CONCLUSIONS: TT combined with active tDCS significantly improves some gait/mobility outcomes and corticomotor excitability in stroke survivors.
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BACKGROUND: Mobility limitations (e.g., using wheelchair) have been closely linked to diminished functional independence and quality of life in older adults. The regulation of mobility is pertaining to multiple neurophysiologic and sociodemographic factors. We here aimed to characterize the relationships of these factors to the risk of restricted mobility in older adults. METHODS: In this longitudinal study, 668 older adults with intact mobility at baseline completed the baseline assessments of clinical characteristics, cognitive function, sleep quality, activities of daily living (ADL), walking performance, beat-to-beat blood pressure, and structural MRI of the brain. Then 506 of them (mean age = 70.7 ± 7.5 years) responded to the follow-up interview on the mobility limitation (as defined by if using wheelchair, cane, or walkers, or being disabled and lying on the bed) after 18 ± 3.5 months. Logistic regression analyses were performed to examine the relationships between the baseline characteristics and the follow-up mobility restriction. RESULTS: At baseline, compared to intact-mobility group (n = 475), restricted-mobility group (n = 31) were older, with lower score of ADL and the Montreal Cognitive Assessment (MoCA), greater score of Pittsburgh Sleep Quality Index (PSQI), poorer cardio- and cerebral vascular function, and slower walking speeds (ps < 0.05). The logistic regression analysis demonstrated that participants who were with history of falls, uncontrolled-hypertension, and/or greater Fazekas scale (odds ratios (ORs):1.3 ~ 13.9, 95% confidence intervals (CIs) = 1.1 ~ 328.2), walked slower, and/or with lower ADL score (ORs: 0.0026 ~ 0.9; 95%CI: 0.0001 ~ 0.99) at baseline, would have significantly greater risk of restricted mobility (p < 0.05; VIFs = 1.2 ~ 1.9). CONCLUSIONS: These findings provide novel profile of potential risk factors, including vascular characteristics, psycho-cognitive and motor performance, for the development of restricted mobility in near future in older adults, ultimately helping the design of appropriate clinical and rehabilitative programs for mobility in this population.
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Atividades Cotidianas , Limitação da Mobilidade , Humanos , Idoso , Masculino , Feminino , Estudos Longitudinais , Fatores de Risco , Atividades Cotidianas/psicologia , Idoso de 80 Anos ou mais , Avaliação Geriátrica/métodosRESUMO
BACKGROUND: Individuals (i.e. children/young adults) with developmental disabilities (DDs) and intellectual disabilities (IDs) often display a variety of physical and motor impairments. It is well known that participation in motor activities can positively impact the development of children's cognitive and social skills. Recently, virtual and digital technologies (e.g. video conferencing applications, virtual reality and video gaming) have been increasingly used to promote better physical/motor outcomes. The efficacy of digital technologies in improving motor outcomes for those with DD/ID varies depending on the technology and population, and the comparative effects of various technologies are unknown. The aim of our study is to conduct a systematic review to comprehensively examine the quantitative and qualitative results of current studies reporting the efficacy of digitally based motor interventions on motor outcomes in individuals with DD/ID. METHODS: Literature published from 1900 to 2024 was searched in four health sciences databases: PubMed, PsycINFO, Scopus and CINAHL. Articles that examined the effects of gross motor/physical activity training using technologies such as exergaming (i.e. exercise through video gaming such as the Wii and Xbox Kinect), virtual reality or telehealth video conferencing applications (i.e. Zoom, Webex or mobile health apps) on the standardised or game-specific gross motor performance of individuals with DD/ID diagnoses that do not typically experience significant walking challenges using experimental or quasi-experimental study designs were included. Thirty relevant articles were retrieved from a search of the databases PubMed (914), PsycINFO (1201), Scopus (1910) and CINAHL (948). RESULTS: Our quantitative synthesis of this published literature suggests strong and consistent evidence of small-to-large improvements in motor skill performance following digital movement interventions. CONCLUSIONS: Our review supports the use of digital motor interventions to support motor skill performance in individuals with DD without ID. Digital technologies can provide a more engaging option for therapists to promote motor skill development in individuals with DD or for caregivers to use as an adjunct to skilled therapy.
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Deficiências do Desenvolvimento , Adolescente , Criança , Humanos , Adulto Jovem , Deficiências do Desenvolvimento/fisiopatologia , Deficiências do Desenvolvimento/reabilitação , Terapia por Exercício/métodos , Deficiência Intelectual/fisiopatologia , Deficiência Intelectual/reabilitação , Destreza Motora/fisiologia , Jogos de VídeoRESUMO
BACKGROUND: Neural adaptions in response to sensorimotor tasks are impaired in those with untreated, recurrent mild-to-moderate neck pain (subclinical neck pain (SCNP)), due to disordered central processing of afferent information (e.g., proprioception). Neural adaption to force modulation, a sensorimotor skill reliant on accurate proprioception, is likely to be impaired in those with SCNP. This study examined changes in somatosensory evoked potential (SEP) peak amplitudes following the acquisition of a novel force matching tracking task (FMTT) in those with SCNP compared to non-SCNP. METHODS: 40 (20 female (F) & 20 male (M); average age (standard deviation, SD): 21.6 (3.01)) right-handed participants received controlled electrical stimulation at 2.47 Hz and 4.98 Hz (averaged 1000 sweeps/frequency) over the right-median nerve, to elicit SEPs before and after FMTT acquisition. Participants used their right thumb to match a series of force profiles that were calibrated to their right thumb (abductor pollicis brevis muscle) strength. To determine if motor learning was impacted, retention was assessed 24 to 48 hours later. Outliers were removed before running independent t-tests on normalized SEP peak amplitudes, and repeated measures analysis of variance (ANOVA) with planned contrasts on absolute and normalized motor performance accuracy. Benjamini-hochberg test was used to correct for multiple independent SEP comparisons. RESULTS: SEP peaks: N18 (t(29.058) = 2.031, p = 0.026), N20 (t(35) = -5.460, p < 0.001), and P25 (t(33) = -2.857, p = 0.004) had group differences. Motor performance: Absolute error (n = 38) had a main effect of time, and significant pre-and post-acquisition contrast for time (both p < 0.001). CONCLUSIONS: Group differences in the olivary-cerebellar pathway (N18), and cortical processing at the somatosensory cortex (N20 and P25), suggests that SCNP alters cortical and cerebellar processing compared to non-SCNP in response to FMTT acquisition. The sensory-motor integration differences in the SCNP group suggests that those with SCNP may rely more on feedback loops for discrete sensorimotor tasks dependent on proprioception. Early SEP changes may be used as a marker for altered neuroplasticity in the context of motor skill acquisition of a novel discrete FMTT in those with SCNP.
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Potenciais Somatossensoriais Evocados , Cervicalgia , Humanos , Masculino , Feminino , Potenciais Somatossensoriais Evocados/fisiologia , Destreza Motora , Músculo Esquelético/inervação , Mãos , Estimulação Elétrica , Córtex Somatossensorial/fisiologiaRESUMO
Many studies over the recent decades have attempted the modulation of motor learning using brain stimulation. Alternating currents allow for researchers not only to electrically stimulate the brain, but to further investigate the effects of specific frequencies, in and beyond the context of their endogenous associations. Transcranial alternating current stimulation (tACS) has therefore been used during motor learning to modulate aspects of acquisition, consolidation and performance of a learned motor skill. Despite numerous reviews on the effects of tACS, and its role in motor learning, there are few studies which synthesize the numerous frequencies and their respective theoretical mechanisms as they relate to motor and perceptual processes. Here we provide a short overview of the main stimulation frequencies used in motor learning modulation (e.g., alpha, beta, and gamma), and discuss the effect and proposed mechanisms of these studies. We summarize with the current state of the field, the effectiveness and variability in motor learning modulation, and novel mechanistic proposals from other fields.
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Aprendizagem , Destreza Motora , Estimulação Transcraniana por Corrente Contínua , Humanos , Estimulação Transcraniana por Corrente Contínua/métodos , Aprendizagem/fisiologia , Destreza Motora/fisiologia , Córtex Motor/fisiologiaRESUMO
The deleterious consequences of mental fatigue (MF) on athletes in diverse sporting domains have been subject to extensive inquiry. However, the efficacy of interventions to counteract the effects of MF remains largely elusive. This review aims to evaluate the effects of counteractive interventions on the sport-specific performance of mentally fatigued athletes. Moreover, synthesizes the current evidence on which sports effectively counter the detrimental effects of MF with interventions, highlighting potential avenues for upcoming research. A systematic search was executed via Web of Science, Scopus, PubMed, and EBSCOhost, in addition to Google Scholar and references for grey literature. A meta-analysis was executed to compute effect sizes for different interventions with 13 qualified papers. Interventions include transcranial direct current stimulation, person-fit, mindfulness, glucose supplementation, caffeine mouth rinsing, and nature exposure showed potential to mitigate the detrimental effects on sport-specific performance, particularly in shooting accuracy (ES = 0.591; p = 0.001), decision-making accuracy (ES = 0.553; p = 0.006), and reaction time (ES = -0.871; p < 0.001), however, not in completion time (ES = -0.302; p = 0.182). This review underscores the unique roles of self-regulatory resources and directed attention. Nonetheless, a cautious interpretation of the findings is warranted given the paucity of investigations involving potential interventions in numerous other sports, such as volleyball, Australian football, cricket, and boxing.
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INTRODUCTION: Transitional care interventions have emerged as a promising method of ensuring treatment continuity and health care coordination when patients are discharged from hospital to home. However, few studies have investigated the frequency and duration of interventions and the effects of interventions on physical function. Therefore, this study aimed to determine the efficacy of transitional care for patients with stroke. METHODS: Six databases and the grey literature were searched to obtain relevant articles from October 1, 2022 to March 10, 2023. The primary outcomes studied were motor performance, walking speed, activities of daily living (ADLs) and caregiver burden following hospital-to-home transitional care. The quality of the studies was assessed with Cochrane risk of bias version 2. The quality and sensitivity of the evidence were assessed to ensure rigour of the findings. Meta-analyses were performed using stata 17.0. RESULTS: A total of 2966 patients were identified from 23 studies. Transitional care improved post-stroke motor performance, walking speed and ADLs, and reduced caregiver burden. CONCLUSION: The findings suggest that provision of transitional care model implementation in patients with stroke is important because it reduces disability in stroke patients and helps to decrease caregivers' burden. IMPACT: The findings of the study emphasize the importance of transitional care programmes for stroke patients after they are discharged from the hospital and returned to their homes. To meet the needs of patients, all levels of health professionals including nurses should be aware of the discharge process and care plan.
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Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Cuidado Transicional , Humanos , Atividades Cotidianas , Acidente Vascular Cerebral/terapia , Alta do PacienteRESUMO
In some patients with unilateral spatial neglect, symptoms reflect impaired lateralized spatial attention and representation (perceptual bias) whereas in others the inability to respond to stimuli located in contralesional space (response bias). Here, we investigated whether prismatic adaptation (PA) and visual scanning training (VST) differentially affect perceptual and response bias and whether rehabilitation outcome depends on the type of bias underlying symptoms. Two groups of neglect patients in the subacute phase were evaluated before, immediately after, and two weeks following 10 days of PA (n = 9) or VST (n = 9). Standard neuropsychological tests (i.e., Behavioural Inattentional Test, Diller cancellation test, and Line Bisection test) were administered to assess neglect symptoms, while the Landmark task was used to disentangle perceptual and response biases. Performance on the Landmark task revealed that PA was more effective in improving the perceptual bias, while VST mainly modulated the response bias. Neuropsychological tests performance suggested that VST is better suited to modulate neglect in patients with response bias, while PA may be effective in patients with both types of bias. These findings may offer novel insights into the efficacy of PA and VST in the rehabilitation of perceptual and response biases in patients with neglect.
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Agnosia , Transtornos da Percepção , Humanos , Transtornos da Percepção/reabilitação , Resultado do Tratamento , Testes Neuropsicológicos , Adaptação Fisiológica/fisiologia , Lateralidade Funcional/fisiologia , Percepção Espacial/fisiologiaRESUMO
Excessive stride variability is a characteristic feature of cerebellar ataxias, even in pre-ataxic or prodromal disease stages. This study explores the relation of variability of arm swing and trunk deflection in relationship to stride length and gait speed in previously described cohorts of cerebellar disease and healthy elderly: we examined 10 patients with spinocerebellar ataxia type 14 (SCA), 12 patients with essential tremor (ET), and 67 healthy elderly (HE). Using inertial sensors, recordings of gait performance were conducted at different subjective walking speeds to delineate gait parameters and respective coefficients of variability (CoV). Comparisons across cohorts and walking speed categories revealed slower stride velocities in SCA and ET patients compared to HE, which was paralleled by reduced arm swing range of motion (RoM), peak velocity, and increased CoV of stride length, while no group differences were found for trunk deflections and their variability. Larger arm swing RoM, peak velocity, and stride length were predicted by higher gait velocity in all cohorts. Lower gait velocity predicted higher CoV values of trunk sagittal and horizontal deflections, as well as arm swing and stride length in ET and SCA patients, but not in HE. These findings highlight the role of arm movements in ataxic gait and the impact of gait velocity on variability, which are essential for defining disease manifestation and disease-related changes in longitudinal observations.
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Braço , Marcha , Velocidade de Caminhada , Humanos , Masculino , Marcha/fisiologia , Feminino , Idoso , Braço/fisiopatologia , Braço/fisiologia , Velocidade de Caminhada/fisiologia , Pessoa de Meia-Idade , Tronco/fisiopatologia , Tronco/fisiologia , Movimento/fisiologia , Doenças Cerebelares/fisiopatologia , Caminhada/fisiologia , Fenômenos Biomecânicos/fisiologia , Amplitude de Movimento Articular/fisiologia , Tremor Essencial/fisiopatologiaRESUMO
BACKGROUND: This study tested the agreement between a markerless motion capture system and force-plate system ("gold standard") to quantify stability control and motor performance during gait initiation. METHODS: Healthy adults (young and elderly) and patients with Parkinson's disease performed gait initiation series at spontaneous and maximal velocity on a system of two force-plates placed in series while being filmed by a markerless motion capture system. Signals from both systems were used to compute the peak of forward center-of-mass velocity (indicator of motor performance) and the braking index (indicator of stability control). RESULTS: Descriptive statistics indicated that both systems detected between-group differences and velocity effects similarly, while a Bland-Altman plot analysis showed that mean biases of both biomechanical indicators were virtually zero in all groups and conditions. Bayes factor 01 indicated strong (braking index) and moderate (motor performance) evidence that both systems provided equivalent values. However, a trial-by-trial analysis of Bland-Altman plots revealed the possibility of differences >10% between the two systems. CONCLUSION: Although non-negligible differences do occur, a markerless motion capture system appears to be as efficient as a force-plate system in detecting Parkinson's disease and velocity condition effects on the braking index and motor performance.
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Doença de Parkinson , Adulto , Humanos , Idoso , Captura de Movimento , Teorema de Bayes , Fenômenos Biomecânicos , MarchaRESUMO
INTRODUCTION: Age-related sensory and motor impairment are associated with risk of dementia. No study has examined the joint associations of multiple sensory and motor measures on prevalence of early cognitive impairment (ECI). METHODS: Six hundred fifty participants in the Baltimore Longitudinal Study of Aging completed sensory and motor function tests. The association between sensory and motor function and ECI was examined using structural equation modeling with three latent factors corresponding to multisensory, fine motor, and gross motor function. RESULTS: The multisensory, fine, and gross motor factors were all correlated (r = 0.74 to 0.81). The odds of ECI were lower for each additional unit improvement in the multisensory (32%), fine motor (30%), and gross motor factors (12%). DISCUSSION: The relationship between sensory and motor impairment and emerging cognitive impairment may guide future intervention studies aimed at preventing and/or treating ECI. HIGHLIGHTS: Sensorimotor function and early cognitive impairment (ECI) prevalence were assessed via structural equation modeling. The degree of fine and gross motor function is associated with indicators of ECI. The degree of multisensory impairment is also associated with indicators of ECI.
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Disfunção Cognitiva , Humanos , Estudos Longitudinais , Disfunção Cognitiva/epidemiologia , Envelhecimento , BaltimoreRESUMO
OBJECTIVE: Four web-based experiments investigated flexibility of disembodiment of a virtual object that is no longer actively controlled. Emphasis was on possibilities to modify the timescale of this process. BACKGROUND: Interactions with virtual objects are commonplace in settings like teleoperation, rehabilitation, and computer-aided design. These objects are quickly integrated into the operator's body schema (embodiment). Less is known about how long such embodiment lasts. Understanding the dynamics of this process is crucial because different applied settings either profit from fast or slow disembodiment. METHOD: To induce embodiment, participants moved a 2D virtual hand through operating a computer mouse or touchpad. After initial embodiment, participants either stopped or continued moving for a fixed period of time. Embodiment ratings were collected continuously during each trial. RESULTS: Results across all experiments indicated that embodiment for the virtual hand gradually increased during active use and gradually decreased after stopping to use it. Disembodiment unfolded nearly twice as fast as embodiment and showed a curved decay pattern. These dynamics remained unaffected by anticipation of active control that would be required in an upcoming task. CONCLUSION: The results highlight the importance of continuously experiencing active control in virtual interactions if aiming at inducing stable embodiment of a virtual object. APPLICATION: Our findings suggest that applications of virtual disembodiment such as virtual tools or interventions to affect a person's body representation critically depend on continuous updating of sensorimotor experience. However, if switching between virtual objects, for example, during teleoperation or video gaming, after-effects are unlikely to affect performance.
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The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23 years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26-74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive-motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults.
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Cognição , Depressão , Avaliação Geriátrica , Humanos , Estudos Transversais , Idoso , Feminino , Masculino , Depressão/psicologia , Cognição/fisiologia , Avaliação Geriátrica/métodos , Idoso de 80 Anos ou mais , Vida Independente , Análise e Desempenho de Tarefas , Testes de Estado Mental e Demência , Pessoa de Meia-IdadeRESUMO
Recent studies suggest an important role of the principal inhibitory neurotransmitter GABA for motor performance in the context of aging. Nonetheless, as previous magnetic resonance spectroscopy (MRS) studies primarily reported resting-state GABA levels, much less is known about transient changes in GABA levels during motor task performance and how these relate to behavior and brain activity patterns. Therefore, we investigated GABA+ levels of left primary sensorimotor cortex (SM1) acquired before, during, and after execution of a unimanual/bimanual action selection task in 30 (human) young adults (YA; age 24.5 ± 4.1, 15 male) and 30 older adults (OA; age 67.8 ± 4.9, 14 male). In addition to task-related MRS data, task-related functional magnetic resonance imaging (fMRI) data were acquired. Behavioral results indicated lower motor performance in OA as opposed to YA, particularly in complex task conditions. MRS results demonstrated lower GABA+ levels in OA as compared with YA. Furthermore, a transient task-related decrease of GABA+ levels was observed, regardless of age. Notably, this task-induced modulation of GABA+ levels was linked to task-related brain activity patterns in SM1 such that a more profound task-induced instantaneous lowering of GABA+ was related to higher SM1 activity. Additionally, higher brain activity was related to better performance in the bimanual conditions, despite some age-related differences. Finally, the modulatory capacity of GABA+ was positively related to motor performance in OA but not YA. Together, these results underscore the importance of transient dynamical changes in neurochemical content for brain function and behavior, particularly in the context of aging.SIGNIFICANCE STATEMENT Emerging evidence designates an important role to regional GABA levels in motor control, especially in the context of aging. However, it remains unclear whether changes in GABA levels emerge when executing a motor task and how these changes relate to brain activity patterns and performance. Here, we identified a transient decrease of sensorimotor GABA+ levels during performance of an action selection task across young adults (YA) and older adults (OA). Interestingly, whereas a more profound GABA+ modulation related to higher brain activity across age groups, its association with motor performance differed across age groups. Within OA, our results highlighted a functional merit of a task-related release from inhibitory tone, i.e. lowering regional GABA+ levels was associated with task-relevant brain activity.
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Envelhecimento/fisiologia , Desempenho Psicomotor/fisiologia , Córtex Sensório-Motor/metabolismo , Ácido gama-Aminobutírico/metabolismo , Adulto , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , MasculinoRESUMO
BACKGROUND: Prediction of poststroke outcome using the degree of subacute deficit or magnetic resonance imaging is well studied in humans. While mice are the most commonly used animals in preclinical stroke research, systematic analysis of outcome predictors is lacking. METHODS: We intended to incorporate heterogeneity into our retrospective study to broaden the applicability of our findings and prediction tools. We therefore analyzed the effect of 30, 45, and 60 minutes of arterial occlusion on the variance of stroke volumes. Next, we built a heterogeneous cohort of 215 mice using data from 15 studies that included 45 minutes of middle cerebral artery occlusion and various genotypes. Motor function was measured using a modified protocol for the staircase test of skilled reaching. Phases of subacute and residual deficit were defined. Magnetic resonance images of stroke lesions were coregistered on the Allen Mouse Brain Atlas to characterize stroke topology. Different random forest prediction models that either used motor-functional deficit or imaging parameters were generated for the subacute and residual deficits. RESULTS: Variance of stroke volumes was increased by 45 minutes of arterial occlusion compared with 60 minutes. The inclusion of various genotypes enhanced heterogeneity further. We detected both a subacute and residual motor-functional deficit after stroke in mice and different recovery trajectories could be observed. In mice with small cortical lesions, lesion volume was the best predictor of the subacute deficit. The residual deficit could be predicted most accurately by the degree of the subacute deficit. When using imaging parameters for the prediction of the residual deficit, including information about the lesion topology increased prediction accuracy. A subset of anatomic regions within the ischemic lesion had particular impact on the prediction of long-term outcomes. Prediction accuracy depended on the degree of functional impairment. CONCLUSIONS: For the first time, we developed and validated a robust tool for the prediction of functional outcomes after experimental stroke in mice using a large and genetically heterogeneous cohort. These results are discussed in light of study design and imaging limitations. In the future, using outcome prediction can improve the design of preclinical studies and guide intervention decisions.
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Neurofeedback training (NFT) refers to a training where the participants voluntarily aim to manipulate their own brain activity using the sensory feedback abstracted from their brain activity. NFT has attracted attention in the field of motor learning due to its potential as an alternative or additional training method for general physical training. In this study, a systematic review of NFT studies for motor performance improvements in healthy adults and a meta-analysis on the effectiveness of NFT were conducted. A computerized search was performed using the databases Web of Science, Scopus, PubMed, JDreamIII, and Ichushi-Web to identify relevant studies published between January 1st, 1990, and August 3rd, 2021. Thirty-three studies were identified for the qualitative synthesis and 16 randomized controlled trials (374 subjects) for the meta-analysis. The meta-analysis, including all trials found in the search, revealed significant effects of NFT for motor performance improvement examined at the timing after the last NFT session (standardized mean difference = 0.85, 95% CI [0.18-1.51]), but with the existence of publication biases and substantial heterogeneity among the trials. Subsequent meta-regression analysis demonstrated the dose-response gradient between NFTs and motor performance improvements; more than 125 min of cumulative training time may benefit for the subsequent motor performance. For each motor performance measure (e.g., speed, accuracy, and hand dexterity), the effectiveness of NFT remains inconclusive, mainly due to its small sample sizes. More empirical NFT studies for motor performance improvement may be needed to show beneficial effects on motor performance and to safely incorporate NFT into real-world scenarios.