Limb Activity Research Articles

Thoracic limb activity of Simocephalus vetulus and its descendants is shaped by the combination of delafloxacin and calcium

Due to its robust antibacterial activity in acidic environments and effectiveness against old fluoroquinolone-resistant bacterial strains, the use of delafloxacin (DFX) is projected to increase in the coming years. Here, we investigated the effect on the thoracic limb rate (TLR) of the water flea Simocephalus vetulus under the combined exposure of DFX (0, 100, 200, and 400 µg L−1) and calcium (Ca) (26 and 78 mg L−1) using Bayesian statistics-based linear models. The findings showed unexpected increases and decreases in the TLR of maternal S. vetulus exposed to DFX in the 26 mg Ca L−1. In the 78 mg Ca L−1 condition, we found a clearer decrease in TLR during DFX treatments. In addition, in the 26 mg Ca L−1, elusive changes in the TLR of neonatal S. vetulus whose mothers were exposed to DFX were observed, whereas the reduced TLR of the neonate, whose mother was exposed to 400 µg DFX L−1, was apparent in the higher Ca condition. While the elevated Ca content did not appear to have a clear effect on organisms’ TLR, it acted as a synergist in conjunction with DFX, leading to a reduction in TLR, the underlying mechanism of which remains poorly understood. The results of our study indicate that DFX may pose an ecological risk as a xenobiotic; therefore, taking into account the abundance of Ca in specific aquatic environments, a comprehensive ecological risk assessment should be conducted. Moreover, the inclusion of Bayesian statistics in ecotoxicological studies is highly recommended to improve data analysis and interpretation.

Analysis of strength and electromyographic activity of lower limbs of individuals with down syndrome assisted in physiotherapy and hippotherapy

Introductionone of the characteristics of Down Syndrome (DS) is muscle hypotonia. Different therapeutic approaches have a positive influence, between them Physiotherapy applications with different therapeutic approaches such as Hippotherapy have a positive effect on the physical health and quality of live of individuals with DS. Objectiveto evaluate the effects of both treatments on the strength and electromyographic activity of the lower limbs of children and adolescents with DS. Methodsfourteen individuals, aged between 10 and 18 years, participated in two groups: Physiotherapy group (n = 5) and Hippotherapy group (n = 9). Thirty interventions were performed for each type of therapy, once a week, lasting 30 min. Pre and post-interventions, the 30-Second Chair Stand Test (30s-CST) was used to assess the strength of the lower limbs and the surface electromyography equipment (EMG 800RF) to assess the lower limb myoelectric activity. Resultsthere was a reduction in the post-intervention electromyographic values for both treatments (p˂0.001), with significantly less myoelectric activity in Hippotherapy compared to Physiotherapy for all evaluated muscles (p˂0.001) and a significant increase in muscle strength for the Hippotherapy, post-intervention group (p = 0.0007). ConclusionPhysiotherapy and Hippotherapy are interventions that promote positive changes in the myoelectric activities of individuals with DS. However, only hippotherapy promoted an increase in strength of the lower limbs.

Neuromuscular control strategies of the lower limb during a typical Tai Chi brush knee and twist step in practitioners with and without knee pain: a pilot study

ABSTRACT As a complex movement, Tai Chi (TC) could be challenging for knee control, and the compensatory changes in TC biomechanics of knee pain patients are unknown. The Brush Knee and Twist Step (BKTS) is a typical TC movement that involves basic leg motion repeated in the whole TC. This pilot study examined electromyography and retro-reflective marker trajectory data to investigate neuromuscular control strategies of the lower extremity during BKTS in TC practitioners with and without knee pain. Twelve experienced TC practitioners with (n = 6) and without knee pain (n = 6) participated. Our results revealed that knee pain practitioners presented muscle imbalance in the vastus medialis-vastus lateralis and vastus lateralis-biceps femoris, and poor alignment of the knee with the toes in TC lunge. Additionally, they adaptively developed rigid coordination strategies, showing higher levels of lower limb muscle co-contraction and activity compared to controls. Training programs for TC practitioners with knee pain should be designed to modify both abnormal muscle synergy patterns and incorrect lunge during TC, which may improve exercise safety.

Case Report: Complex Treatment Using Korean Medicine, Including <italic>Jaeumkunbi-tang</italic>, Acupuncture, and Limb Activation Exercises for a Patient Suffering Unilateral Neglect due to Intraventricular Hemorrhage Accompanied by Intraventricular Hemorrhage

Objective: This study reports the effectiveness of the Korean medicine treatment of patients with intracerebral and intraventricular hemorrhages suffering unilateral neglect symptoms.Case presentation: The patient was treated using Korean medicine, including acupuncture, herbal medicine, moxibustion, and a limb activation exercise. We measured Unilateral Neglect Symptom progress with a numeric rating scale, Albert’s test, Line bisection test, Clock drawing test, and Catherine Bergego Scale. After eight days of combined Korean medicine and rehabilitation exercise, the Unilateral Neglect Symptom intensity reduced from NRS 8 to 6. In addition, Albert’s test score decreased from 2.5% to 0%. The Line bisection test score decreased from 19 mm to 12 mm, and the Clock drawing test score improved from 8 to 10. Last, the Catherine Bergego Scale decreased from 12 to 9. No adverse events were observed during treatment.Conclusion: This study suggested that a complex treatment including <i>Jaeumkunbi-tang</i>, acupuncture, moxibustion, and limb activation exercise can be effective for an intracerebral hemorrhage with intraventricular hemorrhage patient suffering from Unilateral Neglect Symptoms. Consequently, more research is needed in the future.

Cyanobacterial metabolites: Aeruginosin 98A, microginin-FR1, anabaenopeptin-A, cylindrospermopsin and their mixtures affect behavioral and physiological responses of Daphnia magna

We determined the effects influence of cyanobacterial products metabolites: aeruginosin-A (AER-A), microginin-FR1 (MG-FR1), anabaenopeptin-A (ANA-A), cylindrospermopsin (CYL) and their binary and quadruple mixtures on swimming behavior, heart rate, thoracic limb activity, oxygen consumption and in vivo cell health of Daphnia magna. The study showed that CYL induced mortality of daphnids at the highest concentrations, however three oligopeptides had no lethal effect. All the tested Each single metabolites inhibited swimming speed. The mixtures AER+MG-FR1 and AER-A+ANA-A induced antagonistic and the quadruple mixture synergistic effects. Physiological endpoints were depressed by CYL, however they were simulated by the oligopeptides and their binary mixtures. The quadruple mixture inhibited the physiological parameters with antagonistic interactions between the components were antagonistic. Single CYL, MG-FR1 and ANA-A induced cytotoxicity with synergistic interactions and the metabolites in mixtures showed. The study suggests that swimming behavior and physiological parameters may be affected by single cyanobacterial oligopeptides, however their mixtures may induce different total effects.

99mTc-MDP bone scintigraphy-based growth evaluation and prediction of epiphysis around the knee: a study of paediatric limb salvage for malignant bone tumours

To investigate the feasibility of bone scintigraphy in the assessment and prediction of bone growth potential after limb-salvage surgery in children with bone tumours. Fifty-five skeletally immature patients with primary bone malignancies in distal femur was enrolled. Thirty-two patients received epiphysis minimally invasive endoprosthesis (EMIE) reconstruction, seven received hemiarthroplasty, and 16 received adult-type rotation-hinged endoprosthesis (ATRHE) reconstruction. All enrolled patients underwent radiographic examination at regular intervals and followed-up for >12 months. The actual limb length discrepancy (LLDa) of the tibia was measured on the radiography image. The expected LLD of tibia (LLDp) was calculated according to multiplier method. The uptake ratio of the ipsilateral epiphysis to the contralateral epiphysis (Ri/c) was calculated at bone scintigraphy. The Ri/c value was accommodated in the formula of multiplier method for a modification. The difference and correlation between the modified expected LLD (LLDm), LLDp and LLDa were analysed. The growth potential of ipsilateral epiphysis was reserved in all patients who underwent hemiarthroplasty and one fourth of EMIE reconstruction. The Ri/c values in the hemiarthroplasty endoprosthesis group were significantly higher than the EMIE and ATRHE groups. There was no significant difference in Ri/c values between the EMIE and ATRHE group. Data from the 26 patients who reached bone maturation showed that there was a significant difference between LLDp and LLDa. LLDm showed a higher correlation with LLDa than LLDp. Bone scintigraphy is helpful to evaluate the growth potential of epiphysis after surgery. The multiplier method modified by Ri/c value improves prediction accuracy of bone growth.

Construct Validity of the Both Hands Assessment Using Wrist-Worn Accelerometers

Aim The aim of this study was to evaluate the construct validity of the Both Hands Assessment (BoHA) using activity of the upper limbs as detected by accelerometry in children with bilateral cerebral palsy (CP). Methods Observational study of children with CP (n = 44, n = 27 boys, aged 9.1 ± 1.6 years; Manual Ability Classification Scale I: n = 15, II: n = 22, III: n = 7) completing a BoHA assessment while wearing a triaxial accelerometer on each wrist. BoHA Each-Hand sub-scores, BoHA percentage difference between hands, BoHA Units, mean activity for each hand, mean activity asymmetry index and total mean activity were calculated. Linear regressions were used to analyze associations between measures. Results There were significant, positive associations between BoHA Units and total mean activity (B = 0.86, 95%CI: 0.32, 1.40), BoHA Percentage difference between hands and mean activity asymmetry index (B = 0.95, 95%CI: 0.75,1.15), and BoHA Each-Hand sub-score and mean activity for the non-dominant hand (B = 1.71, 95%CI: 1.16, 2.28), but not the dominant hand (B = 0.50, 95%CI: −0.45, 1.45). Conclusions This study provides further evidence for the construct validity of the BoHA as a measure of upper limb performance. Wearable wrist sensors such as accelerometers capture and quantify gross upper limb movement in children with CP but cannot measure fine finger movements captured by the BoHA. Clinical trials registration Australian New Zealand Clinical Trials Registry (ACTRN12616001488493 and ACTRN12618000164291)

TWO CASES OF UPPER EXTREMITY DEEP VEIN THROMBOSIS IN ICU SETTING – A RARE CONDITION

Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget - Schroetter syndrome) or secondary to an underlying cause like thrombosis due to devices like central venous catheter. Primary and secondary UEDVT differs in long-term sequelae and mortality. It is less common phenomenon and accounts for approximately 5-10 percent of all cases of DVT. We are presenting two such cases of upper limb DVT encountered in our ICU. It is important that clinicians remain on high alert for prompt diagnosis and early recognition to provide early treatment and avoid potential complications such as pulmonary embolism.

필라테스 기구 운동 시 포지션에 따른 손목 과신전 자세가 상지와 어깨 근 활성도 및 통증에 미치는 영향

Purpose: This study compares and analyzes the effects of wrist hyper-extension posture on muscle activity and pain in upper limbs and shoulders when applying the Pilates exercise program to healthy adult women.BR Methods: The participants repeated hyper-extension posture and neutral posture of the wrist three times each using three instruments (cadillac, reformer, barrel). The activities of upper limbs muscles (post deltoid, anterior deltoid, lateral triceps, biceps brachii, and extensor carpi radialis brav is) were measured using surface electromyography. The pains of upper limbs (median wrist, lateral wrist, lateral elbow, and upper shoulder) were measured using electro algometer (FPX25).BR Result: The hyper-extension posture of the wrist revealed significant differences activities of post deltoid, lateral triceps, biceps brachii and extensor carpi radialis bravis muscles compared to neutral position of the wrist (p.05).BR The hyper-extension posture of the wrist elicited pain on median wrist, lateral wrist, lateral elbow, and upper shoulder more earlier that neutral posture of the wrist significantly (p.05).BR Conclusion: The hyper-extension posture of the wrist during the Pilates exercise program can reduce muscle activities and elicited pain on the upper limbs. Neutral posture of the wrist is important to improve muscle activities and reduce pain.

Late integration of vision and proprioception during perturbed reaches.

The motor system corrects rapidly, but selectively, for perturbations to ongoing reaching movements, depending on the constraints of the task. To account for such sophistication, it has been postulated that corrections are based on an estimated limb state that integrates all sensory changes caused by the perturbation, taking into account their processing delays. Here, we asked if information from different sensory modalities is integrated immediately or processed separately in the early phase of a response. We perturbed the estimated state of the limb with both unimodal and bimodal visual and proprioceptive perturbations without changing the actual limb state. For visual perturbations, a cursor representing the hand was shifted to the left or the right relative to the true hand location. For proprioceptive perturbations, the biceps or triceps muscles were vibrated, which induced illusory limb-state changes to the right or the left. In the bimodal condition, the perturbations to vision and proprioception were either congruent or incongruent in their directions. Response latencies show that it takes ∼100 ms longer to respond to unimodal visual perturbations than to unimodal proprioceptive perturbations. Responses to bimodal perturbations show that it takes an additional ∼100 ms beyond the response to unimodal visual perturbations for intermodal consistency to impact the response. These results suggest that visual and proprioceptive signals are initially processed separately for state estimation and only combined at the level of the limb's motor output, instead of being immediately integrated into a single state estimate of the limb.NEW & NOTEWORTHY Both visual and proprioceptive signals provide information about arm state during reaching. By perturbing the perceived, but not the actual, position of the hand in both modalities using visual disturbances and muscle vibration, we examined multimodal integration and state estimation during reaching. Our results suggest that the early reach corrections are based on separate state estimates from the two sensory modalities and only later are based on a combined state estimate.

Role of Bobath and Task Specific Approach to Improve Upper Limb Activity of Daily Living among the Individual with Chronic Stroke - A Review Study

Role of Bobath and Task Specific Approach to Improve Upper Limb Activity of Daily Living among the Individual with Chronic Stroke - A Review Study

Laryngeal mask general anaesthesia versus spinal anaesthesia for promoting early recovery of cervical conisation: A randomised, controlled clinical study

BackgroundAlthough both spinal and general anaesthesia provides good anaesthesia for cervical conization, spinal anaesthesia delays the return of lower limb movements and urinary function, whereas general anaesthesia requires the patient to be unconscious. It is unclear which anaesthetic technique is more conducive to early postoperative recovery in patients undergoing cervical conization. Patients and methods140 patients undergoing cervical conization underwent either laryngeal mask general anaesthesia (LMA, n = 70) or spinal anaesthesia (SA, n = 70). In the LMA group, an i-gel mask was used for airway management. In the SA group, spinal anaesthesia was received with 0.75% ropivacaine (15 mg) in the L3-4 interval. The quality of recovery score (QoR-15) was the primary endpoint of the study. Secondary endpoints included incidence of adverse 24-h analgesia (NRS>3); return of lower limb activity; first bed activity and feeding; and the number of catheters removed at 6, 12 and 24 h postoperatively. ResultThe LMA group significantly improved QoR-15 scores (136.62 ± 11.02 vs 119.97 ± 12.75; P < 0.001); and reduced the incidence of poor analgesia (NRS >3) within 24 h postoperatively (20% vs 42.8%, P = 0.006); reduced time in bed (15.62 ± 3.83 h vs 18.27 ± 5.57 vs, P = 0.001); improved patient satisfaction (86% vs 27%; P < 0.001); and catheters removal within 24 h (70/70 vs 42/70, P < 0.001). ConclusionLMA general anaesthesia can facilitate early postoperative recovery in patients undergoing cervical conization compared with conventional spinal anaesthesia. Trial registrationChinese Clinical Trial Registry (ID: ChiCTR1800019384), http://www.chictr.org.cn/listbycreater.aspx (08/11/2018).

Arthrogenic muscle inhibition after anterior cruciate ligament injury: Injured and uninjured limb recovery over time.

It is well documented that marked weakness of the quadriceps is present after knee joint injury. This joint trauma induces a presynaptic reflex inhibition of musculature surrounding the joint, termed arthrogenic muscle inhibition (AMI). The extent to which anterior cruciate ligament (ACL) injury affects thigh musculature motor unit activity, which may affect restoration of thigh muscle strength after injury, is undetermined. A randomized protocol of knee flexion and extension isometric contractions (10%-50% maximal voluntary isometric contraction) were performed for each leg on 54 subjects with electromyography array electrodes placed on the vastus medialis, vastus lateralis, semitendinosus, and biceps femoris. Longitudinal assessments for motor unit recruitment and average firing rate were acquired at 6-month intervals for 1 year post ACL injury. The ACL-injured population demonstrated smaller quadriceps and hamstrings motor unit size (assessed via motor unit action potential peak-to-peak amplitude) and altered firing rate activity in both injured and uninjured limbs compared to healthy controls. Motor unit activity remained altered compared to healthy controls at 12 months post ACL reconstruction (ACLR). Motor unit activity was altered after ACLR up to 12 months post-surgery. Further research is warranted to optimize rehabilitation interventions that adequately address altered motor unit activity and improve safety and success with return to sport after ACLR. In the interim, evidence based clinical reasoning with a focus on development of muscular strength and power capacity should be the impetus behind rehabilitation programming to address motor control deficits.

Mirror movements – A simple algorithm for mirror activity signal processing and normative values

Mirror activity is an involuntary activation of a muscle when the respective contralateral muscle is contracting. This phenomenon has been described primarily in children and in disease states, and, more recently, also in healthy adults. Different ways of assessing mirror activity have been described.In this work we propose a simple protocol for quantifying the amount of mirror activity during a brief isolated full force isometric contraction of a given muscle. The signal was analyzed by a custom-built algorithm that detects the beginning and the end of muscle contraction. The amount of EMG signal on the mirror muscle in relation to the amount of EMG signal of the active muscle is then calculated.We studied 57 right-handed healthy subjects. Mirror activity was evaluated in the Abductor digiti minimi (ADM) and Tibialis anterior (TA) muscles during a 2–3 s full force isometric contraction. The intensity of mirror movement was represented as a percentage of the signal from maximal voluntary contraction.The performance of the algorithm for the detection of the beginning of muscle contraction was very good, when compared to 2 human operators. Intraclass correlation coefficient was excellent (0.998). The Bland-Altman plots showed similar performances of the algorithm and the human operators.We found a significant correlation of mirror activity with intensity and age. There was significantly more intense mirror activity in the left limbs (non-dominant) when compared to the right limbs.The upper limits of normality for mirror EMG signal was 27.4% for right ADM, 15.4% for left ADM, 10.4% for right TA and 2.1% for left TA.This simple protocol allows for an objective measurement of the amount of mirror activity. We propose this technique for investigation of neurological disorders.

From The Ground Up: Expert Perceptions of Lower Limb Activity Monitoring in Tennis

Understanding on-court movement in tennis allows for enhanced preparation strategies to improve player readiness and performance. Here, we explore expert physical preparation coaches' perceptions of elite training strategies for preparation and performance in tennis, with special reference to lower limb activity. Thirteen world renowned tennis strength and conditioning coaches were interviewed in a semi-structured method that explored four key topic areas of physical preparation for tennis: i) the physical demands; ii) load monitoring practice; iii) the direction of ground reaction forces application during match-play; and iv) the application of strength and conditioning for tennis. Three higher-order themes emerged from these discussions: i) off-court training for tennis should be specific to the demands of the sport, ii) the mechanical understanding of tennis lags our physiological approach, and iii) our understanding of the lower limb's contribution to tennis performance is limited. These findings provide valuable insights into the importance of improving our knowledge relevant to the mechanical demands of tennis movement, whilst highlighting important practical considerations from leading tennis conditioning experts.

Predicting later categories of upper limb activity from earlier clinical assessments following stroke: an exploratory analysis

BackgroundAccelerometers allow for direct measurement of upper limb (UL) activity. Recently, multi-dimensional categories of UL performance have been formed to provide a more complete measure of UL use in daily life. Prediction of motor outcomes after stroke have tremendous clinical utility and a next step is to explore what factors might predict someone’s subsequent UL performance category.PurposeTo explore how different machine learning techniques can be used to understand how clinical measures and participant demographics captured early after stroke are associated with the subsequent UL performance categories.MethodsThis study analyzed data from two time points from a previous cohort (n = 54). Data used was participant characteristics and clinical measures from early after stroke and a previously established category of UL performance at a later post stroke time point. Different machine learning techniques (a single decision tree, bagged trees, and random forests) were used to build predictive models with different input variables. Model performance was quantified with the explanatory power (in-sample accuracy), predictive power (out-of-bag estimate of error), and variable importance.ResultsA total of seven models were built, including one single decision tree, three bagged trees, and three random forests. Measures of UL impairment and capacity were the most important predictors of the subsequent UL performance category, regardless of the machine learning algorithm used. Other non-motor clinical measures emerged as key predictors, while participant demographics predictors (with the exception of age) were generally less important across the models. Models built with the bagging algorithms outperformed the single decision tree for in-sample accuracy (26–30% better classification) but had only modest cross-validation accuracy (48–55% out of bag classification).ConclusionsUL clinical measures were the most important predictors of the subsequent UL performance category in this exploratory analysis regardless of the machine learning algorithm used. Interestingly, cognitive and affective measures emerged as important predictors when the number of input variables was expanded. These results reinforce that UL performance, in vivo, is not a simple product of body functions nor the capacity for movement, instead being a complex phenomenon dependent on many physiological and psychological factors. Utilizing machine learning, this exploratory analysis is a productive step toward the prediction of UL performance.Trial registration NA

Ground reaction force and electromyograms of lower limb muscles during fast walking.

Physically active status is an important contributor to individual health. Walking is regarded as commonly accepted exercise for exercise promotion. Particularly, interval fast walking (FW), consisting of alternating between fast and slow walking speeds, has gained popularity from practical viewpoints. Although previous studies have determined the short- and long-term effects of FW programs on endurance capacity and cardiovascular variables, factors affecting these outcomes have not been clarified. In addition to physiological variables, understanding of mechanical variables and muscle activity during FW would be a help to understand characteristics of FW. In the present study, we compared the ground reaction force (GRF) and lower limb muscle activity between fast walking (FW) and running at equivalent speeds. Eight healthy men performed slow walking (45% of the maximum walking speed; SW, 3.9 ± 0.2 km/h), FW (85% of the maximum walking speed, 7.4 ± 0.4 km/h), and running at equivalent speeds (Run) for 4 min each. GRF and average muscle activity (aEMG) were evaluated during the contact, braking, and propulsive phases. Muscle activities were determined for seven lower limb muscles: gluteus maximus (GM), biceps femoris (BF), rectus femoris (RF), vastus lateralis (VL), gastrocnemius medialis (MG), soleus (SOL), and tibialis anterior (TA). The anteroposterior GRF was greater in FW than in Run during the propulsive phase (p < 0.001), whereas the impact load (peak and average vertical GRF) was lower in FW than in Run (p < 0.001). In the braking phase, lower leg muscle aEMGs were higher during Run than during SW and FW (p < 0.001). However, in the propulsive phase, soleus muscle activity was greater during FW than during Run (p < 0.001). aEMG of tibialis anterior was higher during FW than during SW and Run in the contact phase (p < 0.001). No significant difference between FW and Run was observed for HR and RPE. These results suggest that the average muscle activities of lower limbs (e.g., gluteus maximus, rectus femoris, and soleus) during the contact phase were comparable between FW and running, however, the activity patterns of lower limb muscles differed between FW and running, even at equivalent speeds. During running, muscles were mainly activated in the braking phase related to impact. In contrast, during FW, soleus muscle activity during the propulsive phase was increased. Although cardiopulmonary response was not different between FW and running, exercise using FW might be useful for health promotion among individuals who cannot exercise at high-intensity.

Chair squat performance as a potential predictor of nurses’ physical capabilities in ergonomic patient transfers

Muscle activation and movements performed during occupational work can lead to musculoskeletal disorders, one of the nursing profession's most significant health hazards. However, physical activity like exercise training tailored to the exposure and physical ability offers health prevention and rehabilitation. Professional nursing associations have advised squat training to promote occupational health because it strengthens lower limb and back muscles. Given that squatting is a fundamental part of many daily activities and various actions in caregiving processes, we hypothesized that chair squat performance is a potential predictor of nurses’ physical capabilities to perform occupational tasks. We conducted kinetic and electromyographic assessments of 289 chair squat repetitions and compared them to ergonomic patient transfer tasks. In this task, nurses transferred a supine patient to a lateral position in a care bed using similar movement characteristics of the squat task. This cross-sectional pilot study provides initial insights into nurses’ kinetic and muscle activation patterns of health-enhancing and compensational strategies. Highly asymmetric movements corresponded to distinct extremes in lower limb and spine muscle activity data—e.g., increased activity of the rectus femoris indicates increased hip flexion, including postural sway and, therefore, high torsional forces affecting the sacroiliac joints. The potential of the chair squat performance as a predictor of nurses’ physical capabilities in ergonomic patient transfers was quantified by a 2 × 2 contingency table resulting in an accuracy rate of 73%.

Flexible and Wearable Photonic-Crystal Fiber Interferometer for Physiological Monitoring and Healthcare

Utilization of flexible optical systems for real-time comprehensive physiological monitoring has been restricted by their low mechanical robustness and reconfigurability. Here we report a mechanically robust, reconfigurable, flexible, and wearable photonic interferometer system for real-time precision tracking of limb activities, facial motions, respiration, and pulse rate with significant temporal stability and repeatability. Vital health diagnostic parameters have been measured by virtue of a highly sensitive response of the system. The proposed system features curvature sensitivity of 3.1 nm/m–1 over the range of 0–1.71 m–1, temperature sensitivity of 284 pm/°C between 30 and 60 °C, and physical strain sensitivity of 540 pm/1% tensile strain. Such a robust, reconfigurable, and sensitive system would have a wide practical and sustainable utility for real-time dynamic activity monitoring in health, industrial, and various other sectors.

Upper Limb Function Recovery by Combined Repetitive Transcranial Magnetic Stimulation and Occupational Therapy in Patients with Chronic Stroke According to Paralysis Severity.

Repetitive transcranial magnetic stimulation (rTMS) with intensive occupational therapy improves upper limb motor paralysis and activities of daily living after stroke; however, the degree of improvement according to paralysis severity remains unverified. Target activities of daily living using upper limb functions can be established by predicting the amount of change after treatment for each paralysis severity level to further aid practice planning. We estimated post-treatment score changes for each severity level of motor paralysis (no, poor, limited, notable, and full), stratified according to Action Research Arm Test (ARAT) scores before combined rTMS and intensive occupational therapy. Motor paralysis severity was the fixed factor for the analysis of covariance; the delta (post-pre) of the scores was the dependent variable. Ordinal logistic regression analysis was used to compare changes in ARAT subscores according to paralysis severity before treatment. We implemented a longitudinal, prospective, interventional, uncontrolled, and multicenter cohort design and analyzed a dataset of 907 patients with stroke hemiplegia. The largest treatment-related changes were observed in the Limited recovery group for upper limb motor paralysis and the Full recovery group for quality-of-life activities using the paralyzed upper limb. These results will help predict treatment effects and determine exercises and goal movements for occupational therapy after rTMS.