Pub Date : 2024-07-02DOI: 10.1101/2024.06.30.24309742
Ines Vandekerckhove, Marleen Van den Hauwe, Tijl Dewit, Geert Molenberghs, Nathalie Goemans, Liesbeth De Waele, Anja Van Campenhout, Friedl De Groote, Kaat Desloovere
Background Insights into the progression of muscle impairments in growing boys with Duchenne muscular dystrophy (DMD) remains incomplete due to the frequent oversight of normal maturation as confounding factor, thereby restricting the delineation of sole pathological processes. Objective To establish longitudinal trajectories for a comprehensive integrated set of muscle impairments, including muscle weakness, contractures and muscle size alterations, whilst correcting for normal maturation, in DMD. Methods Thirty-five boys with DMD (aged 4.3-17 years) were included. Fixed dynamometry, goniometry and 3D freehand ultrasound were used to repeatedly asses lower limb muscle strength, passive range of motion (ROM) and muscle size, resulting in 165, 182 and 67 assessments for the strength, ROM and ultrasound dataset, respectively. To account for natural strength development, ROM reduction and muscle growth in growing children, muscle impairments were converted to unit-less z-scores calculated in reference to typically developing (TD) peers. This allows the interpretation of the muscle impairments as deficits or alterations with respect to TD. Mixed-effect models estimated the longitudinal change in muscle impairments. Results The pathological trajectories of most muscle impairments with age followed a similar non-linear, piecewise pattern, characterized by an initial phase of improvement or stability lasting until 6.6-9.5 years, and a subsequent decline after these ages. The muscle strength outcomes and several ROMs showed already initial deficits at young ages. General muscle weakness and plantar flexion contractures exhibited the steepest declines, resulting in large deficits at older ages. The muscle size alterations with age were muscle-specific. Conclusions The established longitudinal trajectories of muscle impairments will serve as the basis to enhance understanding of their relationship with the progressive gait pathology in DMD. Our study provides outcome measures, which will be useful for future clinical trials that assess the efficacy of novel therapeutic strategies.
{"title":"Longitudinal trajectories of muscle impairments in growing boys with Duchenne muscular dystrophy","authors":"Ines Vandekerckhove, Marleen Van den Hauwe, Tijl Dewit, Geert Molenberghs, Nathalie Goemans, Liesbeth De Waele, Anja Van Campenhout, Friedl De Groote, Kaat Desloovere","doi":"10.1101/2024.06.30.24309742","DOIUrl":"https://doi.org/10.1101/2024.06.30.24309742","url":null,"abstract":"Background Insights into the progression of muscle impairments in growing boys with Duchenne muscular dystrophy (DMD) remains incomplete due to the frequent oversight of normal maturation as confounding factor, thereby restricting the delineation of sole pathological processes.\u0000Objective To establish longitudinal trajectories for a comprehensive integrated set of muscle impairments, including muscle weakness, contractures and muscle size alterations, whilst correcting for normal maturation, in DMD.\u0000Methods Thirty-five boys with DMD (aged 4.3-17 years) were included. Fixed dynamometry, goniometry and 3D freehand ultrasound were used to repeatedly asses lower limb muscle strength, passive range of motion (ROM) and muscle size, resulting in 165, 182 and 67 assessments for the strength, ROM and ultrasound dataset, respectively. To account for natural strength development, ROM reduction and muscle growth in growing children, muscle impairments were converted to unit-less z-scores calculated in reference to typically developing (TD) peers. This allows the interpretation of the muscle impairments as deficits or alterations with respect to TD. Mixed-effect models estimated the longitudinal change in muscle impairments.\u0000Results The pathological trajectories of most muscle impairments with age followed a similar non-linear, piecewise pattern, characterized by an initial phase of improvement or stability lasting until 6.6-9.5 years, and a subsequent decline after these ages. The muscle strength outcomes and several ROMs showed already initial deficits at young ages. General muscle weakness and plantar flexion contractures exhibited the steepest declines, resulting in large deficits at older ages. The muscle size alterations with age were muscle-specific.\u0000Conclusions The established longitudinal trajectories of muscle impairments will serve as the basis to enhance understanding of their relationship with the progressive gait pathology in DMD. Our study provides outcome measures, which will be useful for future clinical trials that assess the efficacy of novel therapeutic strategies.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-28DOI: 10.1101/2024.06.21.24309202
Luke E Osborn, Breanne Christie, David P McMullen, Victoria Arriola, Tessy M Thomas, Ambarish S Pawar, Robert W Nickl, Manuel Alejandro Anaya, Brock A Wester, Charles M Greenspon, Gabriela L Cantarero, Pablo A Celnik, Sliman J Bensmaia, Jeffrey M Yau, Matthew S Fifer, Francesco V Tenore
Intracortical microstimulation (ICMS) of the somatosensory cortex activates neurons around the stimulating electrodes and can elicit tactile sensations. However, it is not clear how the direct activation of cortical neurons influences their ability to process additional tactile inputs originating from the skin. In a human implanted with chronic microelectrode arrays in both left and right somatosensory cortices, we presented mechanical vibration to the skin while simultaneously delivering ICMS and quantified the effects of combined mechanical and electrical stimulation on tactile perception. We found that subthreshold ICMS enhanced sensitivity to touch on the skin, as evidenced by a reduction in vibrotactile detection thresholds (median: -1.5 dB), but subthreshold vibration did not systematically impact the detectability of ICMS. Suprathreshold vibration led to an increase in ICMS thresholds (median: 2.4 dB) but suprathreshold ICMS had little impact on vibrotactile thresholds. The ICMS-induced enhancement of vibrotactile sensitivity was location dependent with the effect size decreasing as the projected field of the stimulating electrode and the locus of vibratory stimulation became farther apart. These results demonstrate that targeted microstimulation of cortex alone can focally enhance tactile sensitivity, potentially enabling restoration or strengthening of retained tactile sensations after injury.
{"title":"Subthreshold intracortical microstimulation of human somatosensory cortex enhances tactile sensitivity","authors":"Luke E Osborn, Breanne Christie, David P McMullen, Victoria Arriola, Tessy M Thomas, Ambarish S Pawar, Robert W Nickl, Manuel Alejandro Anaya, Brock A Wester, Charles M Greenspon, Gabriela L Cantarero, Pablo A Celnik, Sliman J Bensmaia, Jeffrey M Yau, Matthew S Fifer, Francesco V Tenore","doi":"10.1101/2024.06.21.24309202","DOIUrl":"https://doi.org/10.1101/2024.06.21.24309202","url":null,"abstract":"Intracortical microstimulation (ICMS) of the somatosensory cortex activates neurons around the stimulating electrodes and can elicit tactile sensations. However, it is not clear how the direct activation of cortical neurons influences their ability to process additional tactile inputs originating from the skin. In a human implanted with chronic microelectrode arrays in both left and right somatosensory cortices, we presented mechanical vibration to the skin while simultaneously delivering ICMS and quantified the effects of combined mechanical and electrical stimulation on tactile perception. We found that subthreshold ICMS enhanced sensitivity to touch on the skin, as evidenced by a reduction in vibrotactile detection thresholds (median: -1.5 dB), but subthreshold vibration did not systematically impact the detectability of ICMS. Suprathreshold vibration led to an increase in ICMS thresholds (median: 2.4 dB) but suprathreshold ICMS had little impact on vibrotactile thresholds. The ICMS-induced enhancement of vibrotactile sensitivity was location dependent with the effect size decreasing as the projected field of the stimulating electrode and the locus of vibratory stimulation became farther apart. These results demonstrate that targeted microstimulation of cortex alone can focally enhance tactile sensitivity, potentially enabling restoration or strengthening of retained tactile sensations after injury.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141503040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the association between depressive symptoms and time spent in unsupervised training among inpatients with subacute stroke. Design: This study was a secondary analysis of an unpublished dataset from 34 inpatients with subacute stroke (19 males; median age 65 [interquartile range, 55-75] years). Primary outcome was the median time spent in unsupervised training across three leg cycle sessions. Secondary outcomes included the Functional Independence Measure motor scores at discharge and the length of stay. Depressive symptoms were defined as the Japanese version of the Geriatric Depression Scale Short Form score of 7 or more. Results: Twelve participants (35.3%) had depressive symptoms. The median total time spent in unsupervised training was significantly lower in the group with depressive symptoms (367 [249-799] sec) than in the group without depressive symptoms (888 [579-901] sec), with a medium effect size (U = 57, p = 0.006, Cohen's r = 0.46). No significant differences were found in the secondary outcomes (p > 0.05). Conclusions: Depressive symptoms were associated with reduced participation in unsupervised training among inpatients after stroke. The findings highlight the importance of considering psychological factors in designing and implementing self-rehabilitation programs at the early stages of rehabilitation.
{"title":"Depressive Symptoms Are Associated With Reduced Unsupervised Training Participation in Inpatients With Subacute Stroke: A Secondary Data Analysis Study","authors":"Kazuaki Oyake, Kaori Takahashi, Aiko Arikawa, Honoka Abe, Kunitsugu Kondo, Yohei Otaka, Satoshi Tanaka","doi":"10.1101/2024.06.21.24309324","DOIUrl":"https://doi.org/10.1101/2024.06.21.24309324","url":null,"abstract":"Objective: To investigate the association between depressive symptoms and time spent in unsupervised training among inpatients with subacute stroke. Design: This study was a secondary analysis of an unpublished dataset from 34 inpatients with subacute stroke (19 males; median age 65 [interquartile range, 55-75] years). Primary outcome was the median time spent in unsupervised training across three leg cycle sessions. Secondary outcomes included the Functional Independence Measure motor scores at discharge and the length of stay. Depressive symptoms were defined as the Japanese version of the Geriatric Depression Scale Short Form score of 7 or more.\u0000Results: Twelve participants (35.3%) had depressive symptoms. The median total time spent in unsupervised training was significantly lower in the group with depressive symptoms (367 [249-799] sec) than in the group without depressive symptoms (888 [579-901] sec), with a medium effect size (U = 57, p = 0.006, Cohen's r = 0.46). No significant differences were found in the secondary outcomes (p > 0.05).\u0000Conclusions: Depressive symptoms were associated with reduced participation in unsupervised training among inpatients after stroke. The findings highlight the importance of considering psychological factors in designing and implementing self-rehabilitation programs at the early stages of rehabilitation.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141528798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21DOI: 10.1101/2024.06.20.24309245
Jeremy Graber, Lauren Hinrichs-Kinney, Laura Churchill, Daniel D Matlock, Andrew J Kittelson, Adam Lutz, Michael Bade, Jennifer Stevens-Lapsley
Objective We piloted a decision support tool that promotes a people-like-me (PLM) approach to rehabilitation after total knee arthroplasty (TKA). The PLM approach encourages person centered care by using historical outcomes data from similar (past) patients as a template of what to expect for a new patient. In this study, we evaluated how successfully the PLM tool was implemented and examined contextual factors that may have influenced its implementation. Methods Two outpatient physical therapy clinics (Clinics A and B) piloted the PLM tool from September 2020 to December 2022. We gathered data related to its implementation from multiple sources including the electronic health record, the tool itself, and surveys and interviews with patients and clinicians. We based our primary outcomes on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), and we set pre-defined targets for a subset of these outcomes. We used an explanatory sequential mixed methods design to analyze the data overall and separately by each clinic. Results Overall, the clinics met implementation targets related to Reach, Effectiveness, Adoption, and fidelity, but did not use the tool as frequently as intended. Both clinics identified time, technology, and scheduling barriers to using the tool, but Clinic A scored higher in nearly every outcome. Clinic As success may have been related to its clinicians higher level of experience, more positive attitudes towards the tool, and more active approach to implementation compared to Clinic B clinicians. Conclusions The clinics met most of our pre-specified RE-AIM targets, but Clinic A experienced more implementation success than Clinic B. Future efforts to implement this PLM tool should (1) mitigate time, technology, and scheduling barriers, (2) engage clinicians as active implementation participants, (3) enhance or better communicate the tools usefulness to increase clinician uptake, and (4) refine the tools design to alter clinician behavior more effectively.
目的我们试用了一种决策支持工具，该工具提倡在全膝关节置换术（TKA）后采用 "类人"（PLM）康复方法。PLM方法鼓励以人为本的护理，将类似（过去）患者的历史疗效数据作为新患者预期疗效的模板。在本研究中，我们评估了 PLM 工具的成功实施情况，并研究了可能影响其实施的背景因素。方法2020 年 9 月至 2022 年 12 月期间，两家门诊理疗诊所（诊所 A 和诊所 B）试用了 PLM 工具。我们从多个渠道收集了与该工具实施相关的数据，包括电子健康记录、工具本身以及对患者和临床医生的调查和访谈。我们的主要结果基于 RE-AIM 框架（覆盖、有效性、采用、实施和维护），并为这些结果的子集设定了预定义目标。我们采用了解释性顺序混合方法设计来分析整体数据和各诊所的单独数据。结果总体而言，诊所达到了与 "到达率"、"有效性"、"采用率 "和 "忠实度 "相关的实施目标，但工具的使用频率未达到预期。两家诊所都发现了使用该工具的时间、技术和日程安排障碍，但诊所 A 在几乎所有结果上都得分较高。与 B 诊所的临床医生相比，A 诊所的成功可能与其临床医生的经验水平更高、对工具的态度更积极、实施方法更主动有关。结论这些诊所达到了我们预先设定的 RE-AIM 目标中的大部分目标，但 A 诊所比 B 诊所的实施成功率更高。未来实施 PLM 工具的工作应：（1）减少时间、技术和日程安排方面的障碍；（2）让临床医生积极参与实施工作；（3）加强或更好地宣传工具的实用性，以提高临床医生的使用率；（4）完善工具设计，以更有效地改变临床医生的行为。
{"title":"Implementation of a people-like-me tool for personalized rehabilitation after total knee arthroplasty: A mixed methods pilot study","authors":"Jeremy Graber, Lauren Hinrichs-Kinney, Laura Churchill, Daniel D Matlock, Andrew J Kittelson, Adam Lutz, Michael Bade, Jennifer Stevens-Lapsley","doi":"10.1101/2024.06.20.24309245","DOIUrl":"https://doi.org/10.1101/2024.06.20.24309245","url":null,"abstract":"Objective\u0000We piloted a decision support tool that promotes a people-like-me (PLM) approach to rehabilitation after total knee arthroplasty (TKA). The PLM approach encourages person centered care by using historical outcomes data from similar (past) patients as a template of what to expect for a new patient. In this study, we evaluated how successfully the PLM tool was implemented and examined contextual factors that may have influenced its implementation. Methods\u0000Two outpatient physical therapy clinics (Clinics A and B) piloted the PLM tool from September 2020 to December 2022. We gathered data related to its implementation from multiple sources including the electronic health record, the tool itself, and surveys and interviews with patients and clinicians. We based our primary outcomes on the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), and we set pre-defined targets for a subset of these outcomes. We used an explanatory sequential mixed methods design to analyze the data overall and separately by each clinic. Results\u0000Overall, the clinics met implementation targets related to Reach, Effectiveness, Adoption, and fidelity, but did not use the tool as frequently as intended. Both clinics identified time, technology, and scheduling barriers to using the tool, but Clinic A scored higher in nearly every outcome. Clinic As success may have been related to its clinicians higher level of experience, more positive attitudes towards the tool, and more active approach to implementation compared to Clinic B clinicians. Conclusions\u0000The clinics met most of our pre-specified RE-AIM targets, but Clinic A experienced more implementation success than Clinic B. Future efforts to implement this PLM tool should (1) mitigate time, technology, and scheduling barriers, (2) engage clinicians as active implementation participants, (3) enhance or better communicate the tools usefulness to increase clinician uptake, and (4) refine the tools design to alter clinician behavior more effectively.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141528801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-20DOI: 10.1101/2024.06.19.24309068
Li-Juan Jie, Melanie Kleynen, Guus Rothuizen, Elmar Christiaan Kal, Andreas Rothgangel, Susy Braun
<strong>Introduction</strong>: Motor learning plays a central role in neurological and geriatric rehabilitation. The wide range of motor learning strategies and increase in evidence can make it difficult to make informed decisions about the use of motor learning strategies in practice. This review’s aim was to provide a broad overview of the current state of research regarding the effects of seven commonly used motor learning strategies to improve functional tasks within older neurological and geriatric populations.
{"title":"Overview of effects of motor learning strategies in neurological and geriatric populations: a systematic mapping review","authors":"Li-Juan Jie, Melanie Kleynen, Guus Rothuizen, Elmar Christiaan Kal, Andreas Rothgangel, Susy Braun","doi":"10.1101/2024.06.19.24309068","DOIUrl":"https://doi.org/10.1101/2024.06.19.24309068","url":null,"abstract":"<strong>Introduction</strong>: Motor learning plays a central role in neurological and geriatric rehabilitation. The wide range of motor learning strategies and increase in evidence can make it difficult to make informed decisions about the use of motor learning strategies in practice. This review’s aim was to provide a broad overview of the current state of research regarding the effects of seven commonly used motor learning strategies to improve functional tasks within older neurological and geriatric populations.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141516030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-20DOI: 10.1101/2024.06.19.24308933
Nina Jacobs, Maud van den Bogaart, Ann Hallemans, Pieter Meyns
Background: The Joint Position Reproduction (JPR) approach has been commonly used to assess joint position sense (JPS), however, no prior study investigated its psychometric properties in children. This study aimed to assess the reliability and precision of a newly developed multi–joint JPR protocol for assessing lower limb JPS in school-aged typically developing (TD) children. Methods: Ankle, knee and hip JPS was assessed in TD children (aged 5–12 years), on two different days, by a single rater using a standardized JPR protocol (re–identification of a passively placed target position of the ipsilateral joint). The mean and best error(JRE,°) between target and reproduction angle were calculated from three–dimensional(3D) kinematics for each tested joint on both sides for three trials. Furthermore, total, joint– and limb–JRE scores were provided for clinical use. For JPR–reliability, the Intraclass Correlation Coefficient(ICC,2.1) was reported. For JPR–precision, the standard error of measurement (SEM) was calculated. Results: 270 JPR trials were assessed in 15 TD children (8.6±1.2 years,8boys). The mean and best JRE, summarized for all joints for test and retest, was 3.7° and 2.5°, respectively. The ICC were poor to fair(0.01–0.44) for mean JRE, but fair to very good(0.46–0.77) for best JRE. The SEM ranged from 0.8°–1.8°, depending on the joint and side being tested. Conclusion: Evaluating ankle, knee and hip JPS in children, using passive JPR, is more reliable and precise when using the best JRE. This study highlights the need for a multi–joint JPR approach in research and clinics, and provides joint- and limb-specific SEM values. Keywords: Assessment; Proprioception; Joint Position Sense; Reliability; Precision
{"title":"Multi-joint approach for assessing lower limb proprioception: reliability and precision in school-aged children","authors":"Nina Jacobs, Maud van den Bogaart, Ann Hallemans, Pieter Meyns","doi":"10.1101/2024.06.19.24308933","DOIUrl":"https://doi.org/10.1101/2024.06.19.24308933","url":null,"abstract":"Background: The Joint Position Reproduction (JPR) approach has been commonly used to assess joint position sense (JPS), however, no prior study investigated its psychometric properties in children. This study aimed to assess the reliability and precision of a newly developed multi–joint JPR protocol for assessing lower limb JPS in school-aged typically developing (TD) children. Methods: Ankle, knee and hip JPS was assessed in TD children (aged 5–12 years), on two different days, by a single rater using a standardized JPR protocol (re–identification of a passively placed target position of the ipsilateral joint). The mean and best error(JRE,°) between target and reproduction angle were calculated from three–dimensional(3D) kinematics for each tested joint on both sides for three trials. Furthermore, total, joint– and limb–JRE scores were provided for clinical use. For JPR–reliability, the Intraclass Correlation Coefficient(ICC,2.1) was reported. For JPR–precision, the standard error of measurement (SEM) was calculated. Results: 270 JPR trials were assessed in 15 TD children (8.6±1.2 years,8boys). The mean and best JRE, summarized for all joints for test and retest, was 3.7° and 2.5°, respectively. The ICC were poor to fair(0.01–0.44) for mean JRE, but fair to very good(0.46–0.77) for best JRE. The SEM ranged from 0.8°–1.8°, depending on the joint and side being tested. Conclusion: Evaluating ankle, knee and hip JPS in children, using passive JPR, is more reliable and precise when using the best JRE. This study highlights the need for a multi–joint JPR approach in research and clinics, and provides joint- and limb-specific SEM values. Keywords: Assessment; Proprioception; Joint Position Sense; Reliability; Precision","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141528803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1101/2024.05.29.24308150
Jo Armour Smith, Rongwen Tain, Isaac Chrisman, Kelli G. Sharp, Laura M Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer
Structural neuroplasticity in the brain may contribute to the persistence of low back pain (LBP) symptoms and the disability associated with them. It is not known if structural adaptations are evident early in the lifespan in young adults with LBP. This study compared gray matter in cortical sensorimotor regions in young adults with and without persistent LBP and identified gray matter and clinical predictors of pain-related disability. Eighty-two individuals with and without a history of LBP participated. Peak and average gray matter density in cortical sensorimotor regions of interest was quantified using voxel-based morphometry. Pain-related disability, pain intensity, pain duration, and pain-related fear were also assessed. Multiple linear regression was used to determine independent predictors of pain-related disability. We document significantly greater peak gray matter density in individuals with LBP in the primary somatosensory cortex, angular gyrus, and the midcingulate cortex. Pain-related disability positively correlated with average gray matter density in the posterior cingulate cortex. The most robust predictors of disability were average gray matter in the posterior cingulate, pain intensity, and pain-related fear. We demonstrate that in young adults, persistent LBP, and pain-related disability, are linked with structural neuroplasticity in regions forming part of the brain network termed the pain matrix. In contrast with studies of LBP in older adults, our findings of increased rather than decreased gray matter in young adults with LBP suggest that gray matter may increase initially in response to nociceptive pain.
{"title":"Gray matter morphology and pain-related disability in young adults with low back pain","authors":"Jo Armour Smith, Rongwen Tain, Isaac Chrisman, Kelli G. Sharp, Laura M Glynn, Linda R. Van Dillen, Jesse V. Jacobs, Steven C. Cramer","doi":"10.1101/2024.05.29.24308150","DOIUrl":"https://doi.org/10.1101/2024.05.29.24308150","url":null,"abstract":"Structural neuroplasticity in the brain may contribute to the persistence of low back pain (LBP) symptoms and the disability associated with them. It is not known if structural adaptations are evident early in the lifespan in young adults with LBP. This study compared gray matter in cortical sensorimotor regions in young adults with and without persistent LBP and identified gray matter and clinical predictors of pain-related disability. Eighty-two individuals with and without a history of LBP participated. Peak and average gray matter density in cortical sensorimotor regions of interest was quantified using voxel-based morphometry. Pain-related disability, pain intensity, pain duration, and pain-related fear were also assessed. Multiple linear regression was used to determine independent predictors of pain-related disability. We document significantly greater peak gray matter density in individuals with LBP in the primary somatosensory cortex, angular gyrus, and the midcingulate cortex. Pain-related disability positively correlated with average gray matter density in the posterior cingulate cortex. The most robust predictors of disability were average gray matter in the posterior cingulate, pain intensity, and pain-related fear. We demonstrate that in young adults, persistent LBP, and pain-related disability, are linked with structural neuroplasticity in regions forming part of the brain network termed the pain matrix. In contrast with studies of LBP in older adults, our findings of increased rather than decreased gray matter in young adults with LBP suggest that gray matter may increase initially in response to nociceptive pain.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141256632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-29DOI: 10.1101/2024.05.28.24307964
Raul C. Sîmpetru, Daniela Souza de Oliveira, Matthias Ponfick, Alessandro Del Vecchio
The loss of bilateral hand function is a debilitating challenge for millions of individuals that suffered a motorcomplete spinal cord injury (SCI). We have recently demonstrated in eight tetraplegic individuals the presence of highly functional spared spinal motor neurons in the extrinsic muscles of the hand that are still capable of generating proportional flexion and extension signals. In this work, we hypothesized that an artificial intelligence (AI) system could automatically learn the spared electromyographic (EMG) patterns that encode the attempted movements of the paralyzed digits. We constrained the AI to continuously output the attempted movements in the form of a digital hand so that this signal could be used to control any assistive system (e.g., exoskeletons, electrical stimulation). We trained a convolutional neural network using data from 13 uninjured (control) participants and 8 motor-complete tetraplegic participants to study the latent space learned by the AI. Our model can automatically differentiate between eight different hand movements, including individual finger flexions, grasps, and pinches, achieving a mean accuracy of 98.3% within the SCI group. Moreover, the model could distinguish with 100% accuracy whether a participant had an injury or not, and it could also facilitate proportional control of certain movements after the injury. Analysis of the latent space of the model revealed that proportionally controllable movements exhibited an elliptical path, while movements lacking proportional control followed a chaotic trajectory. We found that proportional control of a movement can only be correctly estimated if the latent space embedding of the movement follows an elliptical path (correlation = 0.73; p < 0.001). These findings emphasize the reliability of the proposed system for closed-loop applications that require an accurate estimate of the spinal cord motor output.
{"title":"Identification of Spared and Proportionally Controllable Hand Motor Dimensions in Motor Complete Spinal Cord Injuries Using Latent Manifold Analysis","authors":"Raul C. Sîmpetru, Daniela Souza de Oliveira, Matthias Ponfick, Alessandro Del Vecchio","doi":"10.1101/2024.05.28.24307964","DOIUrl":"https://doi.org/10.1101/2024.05.28.24307964","url":null,"abstract":"The loss of bilateral hand function is a debilitating challenge for millions of individuals that suffered a motorcomplete spinal cord injury (SCI). We have recently demonstrated in eight tetraplegic individuals the presence of highly functional spared spinal motor neurons in the extrinsic muscles of the hand that are still capable of generating proportional flexion and extension signals. In this work, we hypothesized that an artificial intelligence (AI) system could automatically learn the spared electromyographic (EMG) patterns that encode the attempted movements of the paralyzed digits. We constrained the AI to continuously output the attempted movements in the form of a digital hand so that this signal could be used to control any assistive system (e.g., exoskeletons, electrical stimulation). We trained a convolutional neural network using data from 13 uninjured (control) participants and 8 motor-complete tetraplegic participants to study the latent space learned by the AI. Our model can automatically differentiate between eight different hand movements, including individual finger flexions, grasps, and pinches, achieving a mean accuracy of 98.3% within the SCI group. Moreover, the model could distinguish with 100% accuracy whether a participant had an injury or not, and it could also facilitate proportional control of certain movements after the injury. Analysis of the latent space of the model revealed that proportionally controllable movements exhibited an elliptical path, while movements lacking proportional control followed a chaotic trajectory. We found that proportional control of a movement can only be correctly estimated if the latent space embedding of the movement follows an elliptical path (correlation = 0.73; p <em><</em> 0.001). These findings emphasize the reliability of the proposed system for closed-loop applications that require an accurate estimate of the spinal cord motor output.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141195838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.1101/2024.05.09.24307158
Dominik Schröder, Andrea Stölting, Christina Müllenmeister, Georg M.N. Behrens, Sandra Klawitter, Frank Klawonn, Aisha Cook, Nadja Wegner, Martin Wetzke, Tim Schmachtenberg, Alexandra Dopfer-Jablonka, Frank Müller, Christine Happle
Background Post-COVID-Syndrome (PCS) poses enormous clinical challenges. Occupational therapy (OT) is recommended in PCS, but structural validation of this concept is pending.
{"title":"Improvement in quality of life and cognitive function in Post Covid Syndrome after online occupational therapy: results from a randomized controlled pilot study","authors":"Dominik Schröder, Andrea Stölting, Christina Müllenmeister, Georg M.N. Behrens, Sandra Klawitter, Frank Klawonn, Aisha Cook, Nadja Wegner, Martin Wetzke, Tim Schmachtenberg, Alexandra Dopfer-Jablonka, Frank Müller, Christine Happle","doi":"10.1101/2024.05.09.24307158","DOIUrl":"https://doi.org/10.1101/2024.05.09.24307158","url":null,"abstract":"<strong>Background</strong> Post-COVID-Syndrome (PCS) poses enormous clinical challenges. Occupational therapy (OT) is recommended in PCS, but structural validation of this concept is pending.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140931400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.1101/2024.05.07.24306570
Kathleen M. Weden, Elizabeth A. Barstow, Robert A. Oster, Dawn K. DeCarlo
Background Cerebral Visual Impairment (CVI) is the most common cause of low vision in children. Standardized, quantifiable measures of visual function are needed.
{"title":"A QUANTITATIVE ASSESSMENT OF VISUAL FUNCTION FOR YOUNG AND MEDICALLY COMPLEX CHILDREN WITH CEREBRAL VISUAL IMPAIRMENT: DEVELOPMENT AND INTER-RATER RELIABILITY","authors":"Kathleen M. Weden, Elizabeth A. Barstow, Robert A. Oster, Dawn K. DeCarlo","doi":"10.1101/2024.05.07.24306570","DOIUrl":"https://doi.org/10.1101/2024.05.07.24306570","url":null,"abstract":"<strong>Background</strong> Cerebral Visual Impairment (CVI) is the most common cause of low vision in children. Standardized, quantifiable measures of visual function are needed.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140931006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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