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Correction: Simulating space walking: a systematic review on anti-gravity technology in neurorehabilitation. 更正:模拟太空行走:反重力技术在神经康复中的应用系统综述。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-18 DOI: 10.1186/s12984-024-01472-0
Mirjam Bonanno, Maria Grazia Maggio, Angelo Quartarone, Alessandro Marco De Nunzio, Rocco Salvatore Calabrò
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引用次数: 0
Impact of chronic ankle instability on gait loading strategy in individuals with chronic ankle instability: a comparative study. 慢性踝关节不稳对慢性踝关节不稳患者步态负荷策略的影响:一项比较研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-18 DOI: 10.1186/s12984-024-01478-8
Omar M Elabd, Aliaa M Elabd, Mona S Abd El-Azez, Mohamed M Taha, Amira H Mohammed

Background: Lateral ankle sprains rank among the most prevalent musculoskeletal injuries, while chronic ankle instability (CAI) is its most common cascade. In addition to the conflicting results of the previous studies and their methodological flaws, the specific gait loading strategy is still not well studied.

Purpose: The study aimed to investigate the fluctuations in gait loading strategy in people with chronic ankle instability compared to health control.

Methods: A total of 56 male subjects participated in this study and were allocated into two groups: (A) CAI group: 28 subjects with unilateral CAI (age 24.79 ± 2.64 and BMI 26.25 ± 3.50); and (B) control group: 28 subjects without a history of ankle sprains (age 24.57 ± 1.17 and BMI 26.46 ± 2.597). Stance time, weight acceptance time, and load distribution were measured to investigate gait loading strategy.

Results: The study findings revealed that the CAI group had a significant higher load over the lateral rearfoot. However, MANOVA indicates that there was no overall significant difference in gait loading strategy between the CAI and control groups. Furthermore, in terms of stance time, time of weight acceptance phase, load over medial foot, and load over lateral foot, CAI and healthy controls seemed to walk similarly.

Conclusions: The findings revealed that individuals with CAI had the significant alteration in the lateral rearfoot loading, suggesting a potential compensatory mechanism to address instability during the weight acceptance phase. This could manifest a laterally deviated center of pressure and increased frontal plane inversion during the early stance phase. However, it is acknowledged that these alterations could be both the result and the origin of CAI. The study highlights the vulnerability of CAI during the early stance phase, emphasizing the need for gait reeducation as individuals return to walking as healthcare clinicians should focus on treatment modalities aimed at reducing rearfoot inversion in individuals with CAI.

背景:外侧踝关节扭伤是最常见的肌肉骨骼损伤之一,而慢性踝关节不稳定(CAI)则是其最常见的并发症。目的:本研究旨在调查慢性踝关节不稳定患者与健康对照组相比步态负荷策略的波动情况:共有 56 名男性受试者参加了此次研究,并被分为两组:(A) CAI 组:28 名单侧 CAI 受试者(年龄为 24.79 ± 2.64,体重指数为 26.25 ± 3.50);(B) 对照组:28 名无踝关节扭伤史的受试者(年龄为 24.57 ± 1.17,体重指数为 26.46 ± 2.597)。通过测量站立时间、体重接受时间和负荷分布来研究步态负荷策略:研究结果表明,CAI 组后脚外侧的负荷明显较高。然而,MANOVA 分析表明,CAI 组和对照组在步态负荷策略上总体上没有显著差异。此外,就站立时间、重心接受阶段时间、内侧脚负荷和外侧脚负荷而言,CAI 组和健康对照组的行走方式似乎相似:研究结果表明,CAI 患者的后脚外侧负荷发生了显著变化,这表明在体重接受阶段可能存在一种补偿机制来解决不稳定性问题。这可能表现为在早期站立阶段压力中心侧向偏离和额面内翻增加。不过,这些改变既可能是 CAI 的结果,也可能是 CAI 的起源。该研究强调了 CAI 在早期站立阶段的脆弱性,强调了在患者恢复行走时进行步态再教育的必要性,因为医疗临床医生应将重点放在旨在减少 CAI 患者后足内翻的治疗方法上。
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引用次数: 0
Acceptability, validity and responsiveness of inertial measurement units for assessing motor recovery after gene therapy in infants with early onset spinal muscular atrophy: a prospective cohort study. 用于评估早发脊髓性肌萎缩症婴儿基因治疗后运动恢复情况的惯性测量单元的可接受性、有效性和响应性:一项前瞻性队列研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-17 DOI: 10.1186/s12984-024-01477-9
R Barrois, B Tervil, M Cacioppo, C Barnerias, E Deladrière, V Leloup-Germa, A Hervé, L Oudre, D Ricard, P P Vidal, N Vayatis, S Quijano Roy, S Brochard, C Gitiaux, I Desguerre

Background: Onasemnogene abeparvovec gene replacement therapy (GT) has changed the prognosis of patients with spinal muscular atrophy (SMA) with variable outcome regarding motor development in symptomatic patients. This pilot study evaluates acceptability, validity and clinical relevance of Inertial Measurement Units (IMU) to monitor spontaneous movement recovery in early onset SMA patients after GT.

Methods: Clinical assessments including CHOPINTEND score (the gold standard motor score for infants with SMA) and IMU measurements were performed before (M0) and repeatedly after GT. Inertial data was recorded during a 25-min spontaneous movement task, the child lying on the back, without (10 min) and with a playset (15 min) wearing IMUs. Two commonly used parameters, norm acceleration 95th centile (||A||_95) and counts per minute (||A||_CPM) were computed for each wrist, elbow and foot sensors.

Results: 23 SMA-patients were included (mean age at diagnosis 8 months [min 2, max 20], 19 SMA type 1, three type 2 and one presymptomatic) and 104 IMU-measurements were performed, all well accepted by families and 84/104 with a good child participation (evaluated with Brazelton scale). ||A||_95 and ||A||_CPM showed high internal consistency (without versus with a playset) with interclass correlation coefficient for the wrist sensors of 0.88 and 0.85 respectively and for the foot sensors of 0.93 and 0.91 respectively. ||A||_95 and ||A||_CPM were strongly correlated with CHOPINTEND (r for wrist sensors 0.74 and 0.67 respectively and for foot sensors 0.61 and 0.68 respectively, p-values < 0.001). ||A||_95 for the foot, the wrist, the elbow sensors and ||A||_CPM for the foot, the wrist, the elbow sensors increased significantly between baseline and the 12 months follow-up visit (respective p-values: 0.004, < 0.001, < 0.001, 0.006, < 0.001, < 0.001).

Conclusion: IMUs were well accepted, consistent, concurrently valid, responsive and associated with unaided sitting acquisition especially for the elbow sensors. This study is the first reporting a large set of inertial sensor derived data after GT in SMA patients and paves the way for IMU-based follow-up of SMA patients after treatment.

背景:Onasemnogene abeparvovec基因替代疗法(GT)改变了脊髓性肌萎缩症(SMA)患者的预后,但无症状患者的运动发育情况却不尽相同。这项试验性研究评估了惯性测量单元(IMU)的可接受性、有效性和临床相关性,以监测GT治疗后早发性SMA患者的自发运动恢复情况:临床评估包括 CHOPINTEND 评分(SMA 婴儿的金标准运动评分)和惯性测量单元测量,分别在 GT 前(M0)和 GT 后重复进行。在25分钟的自发运动任务中记录惯性数据,患儿仰卧,不佩戴IMU(10分钟)和佩戴游戏装置(15分钟)。结果:共纳入 23 名 SMA 患者(诊断时平均年龄为 8 个月 [最小 2 个月,最大 20 个月],19 名 SMA 1 型患者,3 名 2 型患者和 1 名无症状患者),共进行了 104 次 IMU 测量,所有测量均得到了家属的认可,其中 84/104 次测量的儿童参与度较高(使用布拉泽尔顿量表进行评估)。||A||_95和||A||_CPM显示出较高的内部一致性(无游戏装置与有游戏装置),腕部传感器的类间相关系数分别为0.88和0.85,足部传感器的类间相关系数分别为0.93和0.91。||A||_95和||A||_CPM与CHOPINTEND密切相关(腕部传感器的r分别为0.74和0.67,足部传感器的r分别为0.61和0.68,p值为 结论:综测仪被广泛接受,具有一致性、并发有效性、响应性,并且与单人坐姿采集相关,尤其是肘部传感器。该研究首次报告了SMA患者GT治疗后的大量惯性传感器衍生数据,为基于IMU的SMA患者治疗后随访铺平了道路。
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引用次数: 0
Repetitive peripheral magnetic stimulation alone or in combination with repetitive transcranial magnetic stimulation in poststroke rehabilitation: a systematic review and meta-analysis. 重复性外周磁刺激单独或与重复性经颅磁刺激相结合用于中风后康复:系统综述和荟萃分析。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-16 DOI: 10.1186/s12984-024-01486-8
Yong Wang, Kenneth N K Fong, Youxin Sui, Zhongfei Bai, Jack Jiaqi Zhang

Objective: This study aimed to comprehensively review the effects of repetitive peripheral magnetic stimulation (rPMS) alone or in combination with repetitive transcranial magnetic stimulation (rTMS) on improving upper limb motor functions and activities of daily living (ADL) in patients with stroke, and to explore possible efficacy-related modulators.

Methods: A literature search from 1st January 2004 to 1st June 2024 was performed to identified studies that investigated the effects of rPMS on upper limb motor functions and ADL in poststroke patients.

Results: Seventeen studies were included. Compared with the control, both rPMS alone or rPMS in combination with rTMS significantly improved upper limb motor function (rPMS: Hedge's g = 0.703, p = 0.015; rPMS + rTMS: Hedge's g = 0.892, p < 0.001) and ADL (rPMS: Hedge's g = 0.923, p = 0.013; rPMS + rTMS: Hedge's g = 0.923, p < 0.001). However, rPMS combined with rTMS was not superior to rTMS alone on improving poststroke upper limb motor function and ADL (Hedge's g = 0.273, p = 0.123). Meta-regression revealed that the total pulses (p = 0.003) and the number of pulses per session of rPMS (p < 0.001) correlated with the effect sizes of ADL.

Conclusions: Using rPMS alone or in combination with rTMS appears to effectively improve upper extremity functional recovery and activity independence in patients after stroke. However, a simple combination of these two interventions may not produce additive benefits than the use of rTMS alone. Optimization of rPMS protocols, such as applying appropriate dosage, may lead to a more favourable recovery outcome in poststroke rehabilitation.

研究目的本研究旨在全面综述重复性外周磁刺激(rPMS)单独使用或与重复性经颅磁刺激(rTMS)联合使用对改善脑卒中患者上肢运动功能和日常生活活动(ADL)的影响,并探讨可能的疗效相关调节剂:方法:对 2004 年 1 月 1 日至 2024 年 6 月 1 日期间的文献进行检索,以确定有关经颅磁刺激对脑卒中后患者上肢运动功能和日常生活活动影响的研究:结果:共纳入17项研究。与对照组相比,单独使用经颅磁刺激(rPMS)或经颅磁刺激联合经颅磁刺激(rPMS)均能显著改善上肢运动功能(rPMS:Hedge's g = 0.703,p = 0.015;rPMS + rTMS:Hedge's g = 0.892,p 结论:经颅磁刺激联合经颅磁刺激(rPMS + rTMS)能显著改善上肢运动功能:单独使用经颅磁刺激或与经颅磁刺激联合使用似乎能有效改善中风后患者的上肢功能恢复和活动独立性。然而,这两种干预措施的简单结合可能不会比单独使用经颅磁刺激产生更多益处。优化经颅磁刺激方案,如使用适当的剂量,可能会为脑卒中后康复带来更有利的恢复结果。
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引用次数: 0
Inertial measurement units to evaluate the efficacity of Equino Varus Foot surgery in post stroke hemiparetic patients: a feasibility study. 用惯性测量装置评估中风后偏瘫患者 Equino 曲足手术的疗效:一项可行性研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-16 DOI: 10.1186/s12984-024-01469-9
Nicolas de l'Escalopier, Cyril Voisard, Sylvain Jung, Mona Michaud, Albane Moreau, Nicolas Vayatis, Philippe Denormandie, Alix Verrando, Claire Verdaguer, Alain Moussu, Aliénor Jequier, Christophe Duret, Laurence Mailhan, Laure Gatin, Laurent Oudre, Damien Ricard

Introduction: This study evaluates the gait analysis obtained by Inetial Measurement Units (IMU) before and after surgical management of Spastic Equino Varus Foot (SEVF) in hemiplegic post-stroke patients and to compare it with the functional results obtained in a monocentric prospective cohort.

Methods: Patients with post-stroke SEVF, who underwent surgery in a single hospital between November 2019 and December 2021 were included. The follow-up duration was 6 months and included a functional analysis using Goal Attainment Scaling (GAS) and a Gait analysis using an innovative Multidimensional Gait Evaluation using IMU: the semiogram.

Results: 20 patients had a gait analysis preoperatively and at 6 months postoperatively. 90% (18/20) patients had a functional improvement (GAS T score ≥ 50) and 50% (10/20) had an improvement in walking technique as evidenced by the cessation of the use of a walking aid (WA). In patients with functional improvement and modification of WA the change in the semiogram area was + 9.5%, sd = 27.5%, and it was + 15.4%, sd = 28%. In the group with functional improvement without change of WA. For the 3 experiences (two patients) with unfavorable results, the area under the curve changed by + 2.3%, -10.2% and - 9.5%. The measurement of the semiogram area weighted by average speed demonstrated very good reproducibility (ICC(1, 3) = 0.80).

Discussion: IMUs appear to be a promising solution for the assessment of post-stroke hemiplegic patients who have undergone SEVF surgery. They can provide a quantified, objective, reliable in individual longitudinal follow up automated gait analysis solution for routine clinical use. Combined with a functional scale such as the GAS, they can provide a global analysis of the effect of surgery.

简介本研究对脑卒中后偏瘫患者痉挛性马蹄内翻足(SEVF)手术治疗前后的步态分析进行评估,并将其与单中心前瞻性队列中获得的功能结果进行比较:方法:纳入2019年11月至2021年12月期间在一家医院接受手术的卒中后SEVF患者。随访时间为 6 个月,包括使用目标达成量表(GAS)进行功能分析,以及使用 IMU 的创新多维步态评估方法:半图进行步态分析。90%(18/20)的患者功能有所改善(GAS T 评分≥ 50),50%(10/20)的患者通过停止使用助行器(WA)证明行走技术有所改善。在功能改善并改用助行器的患者中,半影面积的变化为 +9.5%,sd = 27.5%,而半影面积的变化为 +15.4%,sd = 28%。在功能改善但未改变 WA 的组别中。在结果不理想的 3 次经历(两名患者)中,曲线下面积的变化分别为 + 2.3%、-10.2% 和 -9.5%。按平均速度加权的半曲线面积的测量结果显示出很好的重现性(ICC(1, 3) = 0.80):讨论:IMU 似乎是对接受 SEVF 手术的卒中后偏瘫患者进行评估的一种很有前途的解决方案。它们可以为常规临床应用提供量化、客观、可靠的个体纵向随访自动步态分析解决方案。结合 GAS 等功能量表,它们可以对手术效果进行全面分析。
{"title":"Inertial measurement units to evaluate the efficacity of Equino Varus Foot surgery in post stroke hemiparetic patients: a feasibility study.","authors":"Nicolas de l'Escalopier, Cyril Voisard, Sylvain Jung, Mona Michaud, Albane Moreau, Nicolas Vayatis, Philippe Denormandie, Alix Verrando, Claire Verdaguer, Alain Moussu, Aliénor Jequier, Christophe Duret, Laurence Mailhan, Laure Gatin, Laurent Oudre, Damien Ricard","doi":"10.1186/s12984-024-01469-9","DOIUrl":"https://doi.org/10.1186/s12984-024-01469-9","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates the gait analysis obtained by Inetial Measurement Units (IMU) before and after surgical management of Spastic Equino Varus Foot (SEVF) in hemiplegic post-stroke patients and to compare it with the functional results obtained in a monocentric prospective cohort.</p><p><strong>Methods: </strong>Patients with post-stroke SEVF, who underwent surgery in a single hospital between November 2019 and December 2021 were included. The follow-up duration was 6 months and included a functional analysis using Goal Attainment Scaling (GAS) and a Gait analysis using an innovative Multidimensional Gait Evaluation using IMU: the semiogram.</p><p><strong>Results: </strong>20 patients had a gait analysis preoperatively and at 6 months postoperatively. 90% (18/20) patients had a functional improvement (GAS T score ≥ 50) and 50% (10/20) had an improvement in walking technique as evidenced by the cessation of the use of a walking aid (WA). In patients with functional improvement and modification of WA the change in the semiogram area was + 9.5%, sd = 27.5%, and it was + 15.4%, sd = 28%. In the group with functional improvement without change of WA. For the 3 experiences (two patients) with unfavorable results, the area under the curve changed by + 2.3%, -10.2% and - 9.5%. The measurement of the semiogram area weighted by average speed demonstrated very good reproducibility (ICC(1, 3) = 0.80).</p><p><strong>Discussion: </strong>IMUs appear to be a promising solution for the assessment of post-stroke hemiplegic patients who have undergone SEVF surgery. They can provide a quantified, objective, reliable in individual longitudinal follow up automated gait analysis solution for routine clinical use. Combined with a functional scale such as the GAS, they can provide a global analysis of the effect of surgery.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differing effectiveness of transcranial random noise stimulation and transcranial direct current stimulation for enhancing working memory in healthy individuals: a randomized controlled trial. 经颅随机噪声刺激和经颅直流电刺激对增强健康人工作记忆的不同效果:随机对照试验。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-14 DOI: 10.1186/s12984-024-01481-z
Yukina Tokikuni, Akihiro Watanabe, Hisato Nakazono, Hiroshi Miura, Ryuji Saito, Duan Miaowen, Kanako Fuyama, Keita Takahashi, Kazufumi Okada, Kazuhiro Sugawara, Harukazu Tohyama, Susumu Yoshida, Kenneth N K Fong, Daisuke Sawamura

Background: Transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex (DLPFC) is a promising technique for enhancing working memory (WM) performance in healthy and psychiatric populations. However, limited information is available about the effectiveness of transcranial random noise stimulation (tRNS) applied to the left DLPFC on WM. This study investigated the effectiveness of tRNS on WM compared with that of tDCS, which has established functional evidence.

Methods: This randomized, double-blind, sham-controlled trial enrolled 120 healthy right-handed adults who were randomly allocated to four stimulation groups: tRNS + direct current (DC) offset, tRNS, tDCS, or sham. Each stimulus was placed over the left DLPFC and had a current intensity of 2 mA applied for 20 min during the dual n-back task. The dual n-back task was repeated thrice: pre-stimulation, during stimulation, and post-stimulation. The d-prime scores, and response times were calculated as the main outcome measures. A linear mixed model was created to identify the main effects and interactions between the groups and times, with the group and time as fixed effects, and baseline performance and the subject as a covariate and random effect, respectively. The relationships between the benefit of each stimulus and baseline WM performance were also examined.

Results: For the d-prime score during stimulation, the tRNS group significantly performed better than the sham group at online assessment (β = 0.310, p = 0.001). In the relationships between the benefit of each stimulus and baseline WM performance, the tRNS group had significantly larger negative line slopes than the sham group for the d-prime score (β = -0.233, p = 0.038).

Conclusions: tRNS applied to the left DLPFC significantly improved WM performance and generated greater benefits for healthy individuals with lower WM performance. These findings highlight the potential utility of tRNS for enhancing WM performance in individuals with lower WM performance and contribute evidence for clinical application to patients with cognitive decline.

Trial registration: This study was registered in the University Hospital Medical Information Network Clinical Trial Registry in Japan (UMIN000047365) on April 1, 2022; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054021 .

背景:对左侧背外侧前额叶皮层(DLPFC)进行经颅直流电刺激(tDCS)是一种很有前途的技术,可提高健康和精神病患者的工作记忆(WM)能力。然而,关于经颅随机噪声刺激(tRNS)应用于左侧前额叶皮层对工作记忆效果的信息却很有限。本研究调查了经颅随机噪声刺激(tRNS)与已有功能性证据的 tDCS 相比对 WM 的有效性:这项随机、双盲、假对照试验招募了 120 名健康的右利手成人,他们被随机分配到四个刺激组:tRNS + 直流偏移、tRNS、tDCS 或假刺激。每组刺激均置于左侧 DLPFC 上,电流强度为 2 mA,刺激时间为 20 分钟,刺激过程中进行双 N 向后任务。在刺激前、刺激中和刺激后重复三次双N-回任务。主要结果指标为 d-prime 分数和反应时间。我们建立了一个线性混合模型,以确定各组和时间之间的主效应和交互作用,其中组和时间为固定效应,基线表现和受试者分别为协变量和随机效应。研究还考察了每种刺激的益处与基线 WM 表现之间的关系:结果:就刺激期间的 d-prime 评分而言,tRNS 组在在线评估中的表现明显优于假组(β = 0.310,p = 0.001)。在每种刺激的益处与基线 WM 性能之间的关系中,tRNS 组在 d-prime 分数上的负线斜率明显大于假体组(β = -0.233,p = 0.038)。结论:应用于左侧 DLPFC 的 tRNS 能明显改善 WM 性能,并为 WM 性能较低的健康人带来更大益处。这些发现凸显了tRNS在提高WM性能较低个体的WM性能方面的潜在作用,并为临床应用于认知能力下降患者提供了证据:本研究于2022年4月1日在日本大学医院医疗信息网临床试验注册中心注册(UMIN000047365);https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054021 。
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引用次数: 0
Impact of the combination of virtual reality and noninvasive brain stimulation on the upper limb motor function of stroke patients: a systematic review and meta-analysis. 虚拟现实与非侵入性脑部刺激相结合对中风患者上肢运动功能的影响:系统回顾与荟萃分析。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-05 DOI: 10.1186/s12984-024-01474-y
Nuo Zhang, Hujun Wang, Hanming Wang, Shuyan Qie

Background: Stroke frequently results in upper limb motor dysfunction, with traditional therapies often failing to yield sufficient improvements. Emerging technologies such as virtual reality (VR) and noninvasive brain stimulation (NIBS) present promising new rehabilitation possibilities.

Objectives: This study systematically reviews and meta-analyses the effectiveness of VR and NIBS in improving upper limb motor function in stroke patients.

Methods: Registered with PROSPERO (CRD42023494220) and adhering to the PRISMA guidelines, this study conducted a thorough search of databases including PubMed, MEDLINE, PEDro, REHABDATA, EMBASE, Web of Science, Cochrane, CNKI, Wanfang, and VIP from 2000 to December 1, 2023, to identify relevant studies. The inclusion criterion was stroke patients receiving combined VR and NIBS treatment, while exclusion criteria were studies with incomplete articles and data. The risk of bias was assessed using the Cochrane Collaboration tool. Statistical analysis was performed using Stata SE 15.0, employing either a fixed-effects model or a random-effects model based on the level of heterogeneity.

Results: A total of 11 studies involving 493 participants were included, showing a significant improvement in Fugl-Meyer Assessment Upper Extremity (FMA-UE) scores in the combined treatment group compared to the control group (SMD = 0.85, 95% CI [0.40, 1.31], p = 0.017). The Modified Ashworth Scale (MAS) scores significantly decreased (SMD = - 0.51, 95% CI [- 0.83, - 0.20], p = 0.032), the Modified Barthel Index (MBI) scores significantly increased (SMD = 0.97, 95% CI [0.76, 1.17], p = 0.004), and the Wolf Motor Function Test (WMFT) scores also significantly increased (SMD = 0.36, 95% CI [0.08, 0.64], p = 0.021). Subgroup analysis indicated that the duration of treatment influenced the outcomes in daily living activities.

Conclusions: The combination of VR and NIBS demonstrates significant improvements in upper limb motor function in stroke patients. The duration of treatment plays a critical role in influencing the outcomes, particularly in activities of daily living. This systematic review has limitations, including language bias, unclear randomization descriptions, potential study omissions, and insufficient follow-up periods. Future studies should focus on exploring long-term effects and optimizing treatment duration to maximize the benefits of combined VR and NIBS therapy.

背景:脑卒中经常导致上肢运动功能障碍,传统疗法往往无法充分改善这一症状。虚拟现实(VR)和非侵入性脑部刺激(NIBS)等新兴技术为康复提供了新的可能:本研究系统回顾并荟萃分析了 VR 和 NIBS 在改善中风患者上肢运动功能方面的有效性:方法:本研究在 PROSPERO(CRD42023494220)注册,并遵循 PRISMA 指南,对 2000 年至 2023 年 12 月 1 日期间的 PubMed、MEDLINE、PEDro、REHABDATA、EMBASE、Web of Science、Cochrane、CNKI、万方和 VIP 等数据库进行了全面检索,以确定相关研究。纳入标准为接受 VR 和 NIBS 联合治疗的脑卒中患者,排除标准为文章和数据不完整的研究。使用 Cochrane 协作工具评估偏倚风险。统计分析使用 Stata SE 15.0 进行,根据异质性程度采用固定效应模型或随机效应模型:结果显示,与对照组相比,联合治疗组的 Fugl-Meyer 评估上肢(FMA-UE)评分有显著改善(SMD = 0.85,95% CI [0.40,1.31],p = 0.017)。改良阿什沃斯量表(MAS)评分显著下降(SMD = - 0.51,95% CI [- 0.83, - 0.20],p = 0.032),改良巴特尔指数(MBI)评分显著上升(SMD = 0.97,95% CI [0.76, 1.17],p = 0.004),沃尔夫运动功能测试(WMFT)评分也显著上升(SMD = 0.36,95% CI [0.08, 0.64],p = 0.021)。分组分析表明,治疗持续时间影响了日常生活活动的结果:结论:VR 和 NIBS 联合治疗可显著改善中风患者的上肢运动功能。结论:VR 和 NIBS 联合治疗可显著改善中风患者的上肢运动功能,治疗持续时间对疗效,尤其是日常生活活动的疗效有重要影响。本系统综述存在一定的局限性,包括语言偏差、随机化描述不清晰、潜在的研究遗漏以及随访时间不足。未来的研究应侧重于探索长期效果和优化治疗持续时间,以最大限度地发挥 VR 和 NIBS 联合疗法的益处。
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引用次数: 0
Multibody dynamics-based musculoskeletal modeling for gait analysis: a systematic review. 基于多体动力学的步态分析肌肉骨骼建模:系统综述。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-05 DOI: 10.1186/s12984-024-01458-y
Muhammad Abdullah, Abdul Aziz Hulleck, Rateb Katmah, Kinda Khalaf, Marwan El-Rich

Beyond qualitative assessment, gait analysis involves the quantitative evaluation of various parameters such as joint kinematics, spatiotemporal metrics, external forces, and muscle activation patterns and forces. Utilizing multibody dynamics-based musculoskeletal (MSK) modeling provides a time and cost-effective non-invasive tool for the prediction of internal joint and muscle forces. Recent advancements in the development of biofidelic MSK models have facilitated their integration into clinical decision-making processes, including quantitative diagnostics, functional assessment of prosthesis and implants, and devising data-driven gait rehabilitation protocols. Through an extensive search and meta-analysis of over 116 studies, this PRISMA-based systematic review provides a comprehensive overview of different existing multibody MSK modeling platforms, including generic templates, methods for personalization to individual subjects, and the solutions used to address statically indeterminate problems. Additionally, it summarizes post-processing techniques and the practical applications of MSK modeling tools. In the field of biomechanics, MSK modeling provides an indispensable tool for simulating and understanding human movement dynamics. However, limitations which remain elusive include the absence of MSK modeling templates based on female anatomy underscores the need for further advancements in this area.

除定性评估外,步态分析还涉及对各种参数的定量评估,如关节运动学、时空指标、外力以及肌肉激活模式和力量。利用基于多体动力学的肌肉骨骼(MSK)建模为预测内部关节和肌肉力提供了一种省时、经济的非侵入性工具。最近在开发生物保真 MSK 模型方面取得的进展促进了这些模型与临床决策过程的整合,包括定量诊断、假肢和植入物的功能评估以及设计数据驱动的步态康复方案。通过对超过 116 项研究的广泛搜索和荟萃分析,这篇基于 PRISMA 的系统综述全面概述了现有的不同多体 MSK 建模平台,包括通用模板、针对个体受试者的个性化方法以及用于解决静态不确定问题的解决方案。此外,它还总结了 MSK 建模工具的后处理技术和实际应用。在生物力学领域,MSK 建模为模拟和理解人体运动动力学提供了不可或缺的工具。然而,由于缺乏基于女性解剖学的 MSK 建模模板等限制因素,该领域仍有待进一步发展。
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引用次数: 0
Analysis of electrode locations on limb condition effect for myoelectric pattern recognition. 电极位置对肌电模式识别的肢体条件效应分析
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-03 DOI: 10.1186/s12984-024-01466-y
Hai Wang, Na Li, Xiaoyao Gao, Ning Jiang, Jiayuan He

Background: Gesture recognition using surface electromyography (sEMG) has garnered significant attention due to its potential for intuitive and natural control in wearable human-machine interfaces. However, ensuring robustness remains essential and is currently the primary challenge for practical applications.

Methods: This study investigates the impact of limb conditions and analyzes the influence of electrode placement. Both static and dynamic limb conditions were examined using electrodes positioned on the wrist, elbow, and the midpoint between them. Initially, we compared classification performance across various training conditions at these three electrode locations. Subsequently, a feature space analysis was conducted to quantify the effects of limb conditions. Finally, strategies for group training and feature selection were explored to mitigate these effects.

Results: The results indicate that with the state-of-the-art method, classification performance at the wrist was comparable to that at the middle position, both of which outperformed the elbow, consistent with the findings from the feature space analysis. In inter-condition classification, training under dynamic limb conditions yielded better results than training under static conditions, especially at the positions covered by dynamic training. Additionally, fast and slow movement speeds produced similar performance outcomes. To mitigate the effects of limb conditions, adding more training conditions reduced classification errors; however, this reduction plateaued after four conditions, resulting in classification errors of 22.72%, 22.65%, and 26.58% for the wrist, middle, and elbow, respectively. Feature selection further improved classification performance, reducing errors to 19.98%, 19.75%, and 27.14% at the respective electrode locations, using three optimal features derived from single-condition training.

Conclusions: The study demonstrated that the impact of limb conditions was mitigated when electrodes were placed near the wrist. Dynamic limb condition training, combined with feature optimization, proved to be an effective strategy for reducing this effect. This work contributes to enhancing the robustness of myoelectric-controlled interfaces, thereby advancing the development of wearable intelligent devices.

背景:利用表面肌电图(sEMG)进行手势识别因其在可穿戴人机界面中实现直观自然控制的潜力而备受关注。然而,确保鲁棒性仍是至关重要的,也是目前实际应用的主要挑战:本研究调查了肢体条件的影响,并分析了电极位置的影响。本研究调查了肢体条件的影响,并分析了电极位置对其影响。我们使用腕部、肘部和两者之间中点的电极对静态和动态肢体条件进行了研究。最初,我们比较了这三个电极位置在不同训练条件下的分类性能。随后,我们进行了特征空间分析,以量化肢体条件的影响。最后,我们探索了分组训练和特征选择策略,以减轻这些影响:结果表明,采用最先进的方法,腕部的分类性能与中间位置相当,均优于肘部,这与特征空间分析的结果一致。在条件间分类中,动态肢体条件下的训练结果优于静态条件下的训练结果,尤其是在动态训练所覆盖的位置。此外,快速和慢速运动也产生了相似的性能结果。为了减轻肢体条件的影响,增加更多的训练条件可减少分类误差;然而,这种减少在四个条件之后就趋于稳定,结果是手腕、中段和肘部的分类误差分别为 22.72%、22.65% 和 26.58%。特征选择进一步提高了分类性能,使用从单一条件训练中获得的三个最佳特征,将相应电极位置的误差分别降低到 19.98%、19.75% 和 27.14%:该研究表明,当电极放置在手腕附近时,肢体条件的影响会得到缓解。动态肢体条件训练与特征优化相结合,被证明是减少这种影响的有效策略。这项工作有助于增强肌电控制界面的稳健性,从而推动可穿戴智能设备的发展。
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引用次数: 0
Automatic gait evoking in healthy adults through Vojta's peripheric somatosensory stimulation: a double-blind randomized controlled trial. 通过 Vojta 的外周体感刺激唤起健康成年人的自动步态:双盲随机对照试验。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-01 DOI: 10.1186/s12984-024-01470-2
Luis Perales-López, Ismael Sanz-Esteban, Camen Jiménez-Antona, J Ignacio Serrano, Ana San-Martín-Gómez, Xisca Vives-Gelabert, Roberto Cano-de-la-Cuerda

Background: To study the effects of different interventions on automatic gait processing in contrast with voluntary gait processing in healthy subjects.

Methods: A double-blind randomised controlled trial was designed (120 able-body persons between 18 and 65 years old entered and completed the study), with pre-intervention and post-intervention assessments using the 6-Minute Walk Test (6MWT). The participants were randomly distributed into four groups. Prior to intervention, all participants performed voluntary gait on the ground (VoG) in a calibrated circuit following the 6MWT. The presence of automatic gait (AG) was explored post-intervention without a voluntary demand in the same circuit following the 6MWT. Each group received a different intervention for 30 min: Vojta stimulation, MOTOMED® at no less than 60 revolutions/minute, treadmill walking at 3 km/h, and resting in a chair (control). The main assessment, conducted by a blinded rater, was the difference in distance covered (in meters) during the 6MWT between pre- and post-intervention. Surface electromyography (sEMG) average root mean square (RMS) signals in the right tibialis anterior, right soleus, right rectus femoris, and right biceps femoris were also considered outcome measures.

Results: The Vojta group was the only one that initiated AG after the intervention (476.4 m ± 57.1 in VoG versus 9.0 m ± 8.9 in AG, p < 0.001) with comparable kinematics and EMG parameters during voluntary gait, except for ankle dorsal flexion. Within the Vojta group, high variability in kinematics, sEMG activity, and distance covered was observed.

Conclusions: AG isolation is approachable through Vojta at only one session measurable with the 6MWT without any voluntary gait demand. No automatic gait effects were observed post-intervention in the other groups.

Trial registration: NCT04689841 (ClinicalTrials.gov).

背景:研究不同干预措施对健康受试者自动步态处理和自主步态处理的影响:研究不同干预措施对健康受试者自动步态处理和自主步态处理的影响:设计了一项双盲随机对照试验(120 名 18 至 65 岁的健全人参加并完成了研究),使用 6 分钟步行测试(6MWT)进行干预前和干预后评估。参与者被随机分为四组。在干预前,所有参与者都在 6MWT 之后的校准回路中进行了地面自主步态(VoG)。干预后,在 6MWT 之后的同一回路中,在无自主要求的情况下,探讨是否存在自动步态(AG)。每组接受不同的干预 30 分钟:Vojta 刺激、不低于 60 转/分钟的 MOTOMED®、时速 3 公里的跑步机行走以及在椅子上休息(对照组)。主要评估由一名盲人评定员进行,评估内容是干预前和干预后在 6MWT 中行走距离(以米为单位)的差异。右胫骨前肌、右比目鱼肌、右股直肌和右股二头肌的表面肌电图(sEMG)平均均方根(RMS)信号也被视为结果测量指标:结果:Vojta 组是唯一一个在干预后启动 AG 的组(VoG 为 476.4 米±57.1,AG 为 9.0 米±8.9,P通过 Vojta,只需进行一次 6MWT 测量,就能接近 AG 隔离,而无需任何自主步态要求。其他组在干预后未观察到自动步态效应:NCT04689841(ClinicalTrials.gov)。
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引用次数: 0
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Journal of NeuroEngineering and Rehabilitation
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