Motor Ability Of Patients Research Articles

Growth Factors and Their Application in the Therapy of Hereditary Neurodegenerative Diseases

Hereditary neurodegenerative diseases (hNDDs) such as Alzheimer’s, Parkinson’s, Huntington’s disease, and others are primarily characterized by their progressive nature, severely compromising both the cognitive and motor abilities of patients. The underlying genetic component in hNDDs contributes to disease risk, creating a complex genetic landscape. Considering the fact that growth factors play crucial roles in regulating cellular processes, such as proliferation, differentiation, and survival, they could have therapeutic potential for hNDDs, provided appropriate dosing and safe delivery approaches are ensured. This article presents a detailed overview of growth factors, and explores their therapeutic potential in treating hNDDs, emphasizing their roles in neuronal survival, growth, and synaptic plasticity. However, challenges such as proper dosing, delivery methods, and patient variability can hinder their clinical application.

Effects of combining rehabilitation training on the recovery of athletic ability after reconstruction of injured ligament

This paper aims to investigate the impact of conventional rehabilitation training and neuromuscular electrical stimulation (NMES) on the recovery of motor abilities in patients following ligament injury reconstruction. Forty postoperative patients who underwent surgery for anterior cruciate ligament reconstruction (ACLR) were randomly allocated to either the conventional rehabilitation group or the NMES group. The NMES group received NMES treatment in addition to the conventional rehabilitation program starting from eight weeks postoperatively. Various parameters, including knee joint function, stability, and balance, were compared between the two groups at eight weeks and 12 weeks postoperatively. Compared to the data at eight weeks postoperatively, both groups exhibited significant improvements in all measured indicators at 12 weeks postoperatively (p < 0.05). In the 12th week after the surgery, the NMES group demonstrated a Lysholm score of 93.18 ± 3.67 points, an IKDC score of 84.65 ± 2.33 points, a KT-2000 measurement of 0.88 ± 0.45 mm, a thigh circumference difference of −1.33 ± 0.55 cm, a knee flexion angle of 130.12 ± 4.21°, a single-leg standing time of 60.12 ± 9.33 s, a YBT score of 70.26 ± 2.68 points, and a Bulgarian split squat 1RM size of 58.07 ± 6.85 kg; all of these results were significantly superior to those observed in the conventional group (p < 0.05). NMES significantly enhances the recovery of athletic ability in patients following postoperative ACLR and can be effectively applied in clinical practice.

Imbalanced optimal feedback motor control system in spinocerebellar ataxia type 3.

Human motor planning and control depend highly on optimal feedback control systems, such as the neocortex-cerebellum circuit. Here, diffusion tensor imaging was used to verify the disruption of the neocortex-cerebellum circuit in spinocerebellar ataxia type 3 (SCA3), and the circuit's disruption correlation with SCA3 motor dysfunction was investigated. This study included 45 patients with familial SCA3, aged 17-67 years, and 49 age- and sex-matched healthy controls, aged 21-64 years. Tract-based spatial statistics and probabilistic tractography was conducted using magnetic resonance images of the patients and controls. The correlation between the local probability of probabilistic tractography traced from the cerebellum and clinical symptoms measured using specified symptom scales was also calculated. The cerebellum-originated probabilistic tractography analysis showed that structural connectivity, mainly in the subcortical cerebellar-thalamo-cortical tract, was significantly reduced and the cortico-ponto-cerebellar tract was significantly stronger in the SCA3 group than in the control group. The enhanced tract was extended to the right lateral parietal region and the right primary motor cortex. The enhanced neocortex-cerebellum connections were highly associated with disease progression, including duration and symptomatic deterioration. Tractography probabilities from the cerebellar to parietal and sensorimotor areas were significantly negatively correlated with motor abilities in patients with SCA3. To our knowledge, this study is the first to reveal that disrupting the neocortex-cerebellum loop can cause SCA3-induced motor dysfunctions. The specific interaction between the cerebellar-thalamo-cortical and cortico-ponto-cerebellar pathways in patients with SCA3 and its relationship with ataxia symptoms provides a new direction for future research.

The Impact of Early Rehabilitation and the Acceptance of the Disease on the Quality of Life of Patients after Hip Arthroplasty: An Observational Study.

Background: The early introduction of physiotherapy significantly shortens the time required for a patient to regain full mobility after hip arthroplasty. Obtaining the expected result is determined by cooperation with a physiotherapist and the patient's involvement in the rehabilitation process. The aim of this study was to assess the quality of life, life satisfaction, and motor ability of patients after hip arthroplasty. Methods: This study included 147 patients who underwent hip arthroplasty at the Orthopedic and Trauma Department. The research material was collected using questionnaires, and the study used the Barthel Index (BI), Harris Hip Score (HHS), Visual Analogue Scale (VAS), Acceptance of Illness Scale (AIS), and Quality of Life Assessment Questionnaire (WHOQOL-BREF). In the studied group of patients, the Excia cementless endoprosthesis was primarily used (69.39%), as well as the Metha Short Hip prosthesis (15.65%), AM hip prosthesis (10.20%), and bipolar hip prosthesis (4.76%). Results: The analyzed group of patients included 95 women (64.63%) and 52 men (35.37%); the average age was 67 years. Six weeks after hip arthroplasty, mild disability occurred in 53.74% of the patients, while the remaining 46.26% had no disability, and 95.24% of the patients achieved a high level of acceptance of the disease and quality of life. Conclusions: Early improvement after hip replacement surgery contributes to eliminating the disability of the hip joint in the following areas: pain sensation, functionality, lack of deformation, and range of motion. Each subsequent stage of treatment increased the level of acceptance of the disease in the study group. The applied surgical treatment increased satisfaction with overall health and quality of life.

The influence of hydrokinesitherapy on motor and cardiorespiratory functions in hereditary myopathy of childhood

To evaluate the impact of regular hydrokinesotherapy sessions and indicators of cardiorespiratory functions on the motor abilities of patients with hereditary myopathy of childhood. The study included 63 patients with genetically confirmed hereditary myopathy. Group 1 included 32 patients with Duchenne muscular dystrophy (DMD) who were in the early ambulatory stage. Group 2 included 15 patients at the late ambulatory stage. Group 3 included 16 patients with genetically confirmed forms of congenital myopathy. All patients performed a set of exercises, including dynamic aerobic exercises in the pool. The duration of the rehabilitation course was 4 months. At baseline and during follow-up after 2 and 4 months, we assessed: the distance of a 6-minute walk test (6-MWT) with fatigue assessment on a visual analogue scale (VAS) at the end of testing, time tests (running a distance of 10 m, climbing 4 steps) with determination of the functional class (FC) of test performance, spirometry indicators. Over 4 months of regular training, there were a positive dynamics in the results of a 6-MWT, a decrease in fatigue according to VAS, an improvement in running time of 10 meters' distance and the speed of climbing 4 steps, and an improvement in the FC of performing tasks (p≤0.01) in groups of patients with DMD at an early ambulatory stage and with congenital myopathies. An improvement in external respiratory function was found in all groups (p≤0.01). A significant correlations between body weight and BMI and a moderate correlation between the age of patients and indicators of motor abilities were revealed. There was a noticeable correlation between heart rate and the severity of fatigue when performing 6-MWT and running time of 10 meters' distance. When analyzing EchoCG data, the ejection fraction and shortening fraction were characterized by a noticeable correlations with the speed of climbing of 4 steps and a moderate correlations with the results of 6-MWT, fatigue during its implementation, running time of 10 meters' distance and its FC, as well as with the FC of climbing of 4 steps. Regular hydrokinesotherapy exercises can improve motor abilities, muscle endurance and speed in patients with DMD at the early ambulatory stage and in patients with congenital myopathies of childhood, as well as improve external respiratory function in patients with DMD and congenital myopathies in all ambulatory stages. In groups of patients with DMD, a significant relationship between indicators of speed, fatigue and endurance and the functional capabilities of the heart was revealed.

A157: The Effect of Whole-Body Vibration Therapy on the Motor Abilities of Patients with Sarcopenia

Purpose: The highly morbid condition known as sarcopenia affects middle-aged and elderly people and is characterized by a progressive loss of whole-body muscle mass accelerated by aging. It is also accompanied by a decline in muscle strength and physiological function. These weakening functions manifest as impaired physical movement, increased risk of falls, disability, lower quality of life, and even death. Sarcopenia is progressively emerging as a new public health issue in China with a quickly aging population, making it vital to investigate effective exercise therapies for sarcopenic patients. Methods: Sixty sarcopenic patients (aged 60-75) from a local hospital in northeast China participated in the study. They were randomly divided into a test group and a control group, with 30 patients in each. The test group underwent a 40-minute whole-body vibration training session for 12 weeks, five times a week, while the control group kept regular routines. Data were collected at the end of the experiment, including muscle strength, muscle mass, muscle function, gait speed, berg balance scale (BBS), five sit-to-stand test (FTSST), activities of daily living (ADL), fall risk assessment scale (FRA), and Sarcopenia Quality of Life Scale (SarQoL) scores. Results: The 12-week whole-body vibration training intervention resulted in a significantly higher value of muscular strength, muscle mass, and muscle function among the test group compared to the control group. The former achieved substantially higher SPPB, ADL, FTSST, and BBS scores than the latter (p &lt; 0.01). With much lower FRA scores and significantly better SarQoL ratings compared to baseline, the test group also significantly outperformed the control group in terms of fall risk and quality of life (p &lt; 0.01). Conclusion: With whole-body vibration training, people with sarcopenia can increase their skeletal muscle strength, considerably enhance their motor function, lower their risk of falls and accidents, and generally improve their quality of life. Whole-body vibration training is worthy of therapeutic use since it is both feasible and practical.

Three weeks of exercise therapy altered brain functional connectivity in fibromyalgia inpatients

BackgroundFibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain, tenderness, and fatigue. Patients with FM have no effective medication so far, and their activity of daily living and quality of life are remarkably impaired. Therefore, new therapeutic approaches are awaited. Recently, exercise therapy has been gathering much attention as a promising treatment for FM. However, the underlying mechanisms are not fully understood, particularly, in the central nervous system, including the brain. Therefore, we investigated functional connectivity changes and their relationship with clinical improvement in patients with FM after exercise therapy to investigate the underlying mechanisms in the brain using resting-state fMRI (rs-fMRI) and functional connectivity (FC) analysis. MethodsSeventeen patients with FM participated in this study. They underwent a 3-week exercise therapy on in-patient basis and a 5-min rs-fMRI scan before and after the exercise therapy. We compared the FC strength of sensorimotor regions and the mesocortico-limbic system between two scans. We also performed a multiple regression analysis to examine the relationship between pre-post differences in FC strength and improvement of patients’ clinical symptoms or motor abilities. ResultsPatients with FM showed significant improvement in clinical symptoms and motor abilities. They also showed a significant pre-post difference in FC of the anterior cingulate cortex and a significant correlation between pre-post FC changes and improvement of clinical symptoms and motor abilities. Although sensorimotor regions tended to be related to the improvement of general disease severity and depression, brain regions belonging to the mesocortico-limbic system tended to be related to the improvement of motor abilities. ConclusionOur 3-week exercise therapy could ameliorate clinical symptoms and motor abilities of patients with FM, and lead to FC changes in sensorimotor regions and brain regions belonging to the mesocortico-limbic system. Furthermore, these changes were related to improvement of clinical symptoms and motor abilities. Our findings suggest that, as predicted by previous animal studies, spontaneous brain activities modified by exercise therapy, including the mesocortico-limbic system, improve clinical symptoms in patients with FM.

Effects of dual-task training on gait and motor ability in patients with Parkinson's disease: A systematic review and meta-analysis

Objective Parkinson's disease is one of the most common neurodegenerative diseases in the world, which seriously damages motor and balance ability. Dual-task training is discussed as an appropriate intervention. The aim of this review was to synthesize the existing research findings on the efficacy of dual-task training for people with Parkinson's disease. Data resources A systematic search on PubMed, CENTRAL, Embase, Web of Science, and PEDro, randomized-controlled trials (RCTs) of dual-task training for individuals with Parkinson's disease. Methods Articles published until 1 November 2022 were included. Our search identified 7 RCTs with a total of 406 subjects. Review Manager 5.4 software was used for bias evaluation and to process the results of the outcome measures collected from the investigations. Results Dual-task training was associated with significant improvement in most motor and balance outcomes including gait velocity (standard mean difference (SMD) = 0.62; 95% CI, 0.37–0.87; I2 = 31%; P = 0.21), cadence (SMD = 0.29; 95% CI, 0.05–0.53; I2 = 0%; P = 0.71), timed-up-and-go test (mean difference (MD) = -2.38; 95% CI, −3.93 to −0.84; I2 = 32%; P = 0.22) and mini-balance evaluation systems test (MD = 2.04; 95% CI, 1.05–3.03; I2 = 0%; P = 0.92). Conclusion Evidence from meta-analyses suggests that dual-task training may improve motor and balance abilities in Parkinson's disease patients. Future research should focus on finding the most appropriate dual-task treatment model for patients with different degrees, in order to further improve the rehabilitation treatment of Parkinson's disease.

Comprehensive rehabilitation for injuries to the medial collateral ligament of the knee in skiers and snowkiters

BACKGROUND: The main function of the medial collateral ligament is static stabilization when the tibia is deviated outward. Medial collateral ligament damage may result from the application of a sharp force to the tibia and knee joint in a valgus position, often leading to knee instability, recurrent synovitis and posttraumatic osteoarthritis. This often results in the development of functional disorders that sharply limit the motor abilities of patients, thereby affecting the performance (support ability) of the injured limb.&#x0D; AIM: The study aimed to conduct a comparative analysis of the efficiency of various current rehabilitation techniques providing a more patient-oriented approach in the conservative treatment of various degrees of medial collateral ligament injuries based on the assessment of the capabilities of magnetic resonance imaging in 38 patients.&#x0D; MATERIALS AND METHODS: Thirty-eight patients (27 men and 11 women, 71.05% and 28.95%, respectively) with partial medial collateral ligament injuries were followed up. The mean age was 28.5 years (1938 years). All subjects were involved in skiing and snowkiting in the alpine skiing discipline. The diagnosis was made based on clinical examination, patients complaints, and magnetic resonance imaging (MRI) of the knee joint. The examination was performed on a Vestra-2 magnetic resonance tomograph with a superconducting magnet and a magnetic field induction of 0.5 Tesla. Optimal for knee joint examination was a quadrature Surf-76 receiving and transmitting coil, which allowed the selection of a small field of view without artifacts or spatial distortion and increased the signal/noise ratio. The knee joints were examined twice: on the day of admission (maximum 1.5 days after injury) and at the end of the week 6 of conservative treatment.&#x0D; RESULTS: Using the rehabilitation treatment program proposed by the authors in patients with medial collateral ligament injuries, a decrease in the severity of clinical symptoms and an improvement of functional characteristics were observed. Inclusion of the kinesiotaping technique led to a reduction of the treatment recovery period.&#x0D; CONCLUSIONS: Current noninvasive diagnostic techniques (in particular, MRI) for bone tissues, articular cartilages, and periarticular soft tissues allow to determine the degree of damage to anatomical structures, choose the optimal conservative treatment method , and set the duration and extent of artificial immobilization and the terms of the onset of rehabilitation procedures for patients with partial injuries of the medial collateral ligaments. The results of the proposed rehabilitation treatment program for injuries of the medial knee ligament include a reduction of pain, synovitis and limping, and an improvement of muscle strength and elasticity and knee stability.

Effects Of Neurodynamics on Spasticity in Upper Extremity of Stroke Patients

Stroke leads to long term disability and spasticity is one of them. Neurodynamic is a movement which aimed to restore the electrical signal directed to the nerve and the spinal cord. The neural mobilization is used to restore the movement and improve elasticity of nervous system to improve the arm function and regain the motor ability in patients with stroke. Objective: To assess the effects of neurodynamics on spasticity in upper extremities of stroke patients. Methods: It is a Randomized controlled trial. Data was collected from 46 stroke Patients. Simple Random Sampling was done and data was collected from District headquarters hospital (DHQ) Jhelum. Patients with chronic stroke, age 40-60 years, Modified Ashworth Scale (MAS) ≥1 to 3 and both male and female were included in this study. For 6 weeks, the experimental group received conventional therapy with neurodynamics (10 reps/ set, 1 set/ day, 3 days/week), whereas the control group received conventional treatment (12 reps/ set, 1 set/ day, 3 days/week). The MAS, Fugl Meyer Upper Extremity Scale (FMUE), goniometry and Action Research Arm Test were used to examine the participants at zero, three, and six weeks (ARAT). The Shapiro-Wilk test was used to ensure that the data was normal, and statistical analysis was performed using SPSS 21. Results: Statistically significant improvement was found in between group analyses in MAS, FM-UE motor score and AROM as the p-value was &lt;0.05. There was no significant difference in ARAT, FM-UE sensation, joint pain, passive joint motion, coordination and PROM as p-value was &gt;0.05. Statistically significant improvement was found in within group analyses in MAS, FM-UE motor score, sensation, joint pain, AROM and PROM as the p-value was &lt;0.05 except in ARAT and FM-UE coordination. Conclusion: The result shows that neurodynamic combined with conventional treatment was more effective than conventional treatment alone to reduce spasticity, improve upper extremity function and AROM. The result also shows that there was significant improvement in upper extremity joint pain, sensation and PROM and no improvement occurred in coordination and fine task performance within groups. The study concludes that neurodynamic is effective for spasticity and has additional benefit in improving UE functional performance and active range of motion but the effects of neurodynamic combined with conventional treatment are no different than conventional treatment alone on passive range of motion, joint pain, coordination, fine task performance and sensation.

Occupational engagement, fatigue, and upper and lower extremity abilities in persons with melorheostosis.

Melorheostosis is a rare bone disorder with limited literature that describes the effect of this disease on functional and motor abilities. As part of a natural history study, four outcome measures were administered to better understand the burden this disease has on a person's ability to engage in basic and instrumental activities of daily living. To investigate the relationship between functional engagement, fatigue, and motor ability in patients with melorheostosis. Cross-sectional data gathered from a longitudinal natural history observational study. Rehabilitation department within a single institution. Forty-seven adult volunteers with melorheostosis were enrolled. Two participants were removed for failure to meet diagnosis eligibility. Thirty patients had lower extremity (LE) osteosclerotic bone lesions, 14 had upper extremity (UE) lesions, and one had lesions in both UEs and LEs. Not applicable. Activity Card Sort, Second Edition (ACS); Multi-Dimensional Fatigue Inventory; Lower Extremity Functional Scale; Upper Extremity Functional Index. On the ACS, high-demand leisure (HDL) activities were the least retained (p < .001). Of the activities rated most important, HDL activities were the most likely to have been given up (27%). General fatigue (μ=11.8) and physical fatigue (μ=11.0) were the two most limiting fatigue constructs. There were moderate negative correlations with HDL activities compared to physical fatigue (r=-0.524, p < .001) and reduced activity fatigue (r=-0.58, p=.001). LE lesions had a large effect on completing LE tasks (d=0.95) and UE lesions had a medium effect on completing tasks involving the UE (d=0.69). Patients with melorheostosis experience fatigue and low engagement in HDL activities. The results of this study underscore the importance of acknowledging activity domain, fatigue constructs, and lesion location to support and provide targeted evidence-based rehabilitative therapy. NCT02504879.

The Effect of Sensorimotor Exercises on Hand Mobility in Patients with Cerebral Palsy Hemiplegia Half of the Body

Background and Aim: Cerebral palsy is a very common sensory-motor disorders that can lead to functional hand disabilities and reduced participation; therefore, the aim of the present study was to investigate the effect of sensorimotor training on the motor ability of patients with cerebral palsy. Methods: In the present quasi-experimental study, the statistical population included all patients with cerebral palsy in Tabriz rehabilitation centers. 30 male and female hemiplegia patients aged 45 to 70 years were selected as the available sample and randomly divided into two groups of 15 test and control. Box and block tests were used to measure gross motor ability. The training program included the sensory and motor part, which was done for eight weeks and 3 sessions per week and 60 minutes per session. Statistical analysis of data was performed using SPSS software version 26. Independent and paired t-tests were used at a significance level of 0.05. Results: The results of the present study showed that after the application of simultaneous sensorimotor exercises, the motor function of the upper limb was significantly improved (p = 0.000). The mean change was observed in the experimental group from 9.12 ± 1.16 to 13.05 ± 2.56 and in the control group from 8.92± 1.27 to 9.02 ± 0.94. Conclusion: Using simultaneous sensorimotor exercises can lead to improved hand mobility if sensory-motor experiences are created. Therefore, this type of exercise can be used in the rehabilitation program of patients with cerebral palsy according to their needs. 53% of the changes in depression and 57% of the changes in anxiety were due to neurofeedback; but neurofeedback had no effect on stress. Neurofeedback was able to reduce depression and anxiety in women with abdominal pain but had no effect on their stress level. Keywords: Sensory motor exercises, motor ability, cerebral palsy, hemiplegia

Effects of sensory stimulation training on gross motor abilities in hemiplegic cerebral palsy

Background: Cerebral palsy is treated by various techniques but still more advancement is needed to find out the effects of sensory stimulation training on gross motor abilities in patients with hemiplegic cerebral palsy. Objectives: To determine the effect of sensory stimulation training on gross motor abilities in hemiplegic cerebral palsy. Methods: A single-blind randomized control trial was conducted at Al Rehman Hospital Phase II, Gulraiz Rawalpindi, spanning over 06 months from Feb 2019 to Jun 2019. The sampling technique was non-probability purposive sampling, Total sample size was 40, calculated through open epi, and randomly allocated into two groups equally by lottery method. Diagnosed hemiplegic cerebral palsy patients between 4 to 14 years of age, of both genders, did not receive special education and were not treated with sensory stimulation therapy, were included while any medical or surgical treatment before or during the study period was excluded. The Control group received Bobath Neurodevelopmental treatment, while the experimental group received sensory stimulation training by using Rody, swivel Cars, Foam Pogo Stick, Wobble Deck, Platform swing, trampoline, and Spooner board training five days a week for 6 weeks. Data was analyzed by SPSS 21, a Normality test was applied and results showed that data was normally distributed as the p-value of Shapiro-Wilk was &lt;0.05. Results: Out of 40 hemiplegic cerebral palsy patients, 20 were in the experimental while 20 were in the control group among them 23(57.5%) were females and 17(42.5%) were males. GMFCS before the training in the experimental group was 3.65 + 0. 67, while in the control group was 3.55 + 0.60 with the P-value of 0.62. After the exercise program, the experimental group was 3.60 + 0.75, and the control group was 3.60 + 0.50 with the P-value of 1.00. Within-group analysis showed before and after training P-value was &lt;0.01 in both experimental and control groups. Conclusion: It is concluded that sensory stimulation training improves gross motor abilities in hemiplegic cerebral palsy.

A Patient-Centered Evaluation of Meaningful Change on the 32-Item Motor Function Measure in Spinal Muscular Atrophy Using Qualitative and Quantitative Data.

The 32-item Motor Function Measure (MFM32) is an assessment of motor function used to evaluate fine and gross motor ability in patients with neuromuscular disorders, including spinal muscular atrophy (SMA). Reliability and validity of the MFM32 have been documented in individuals with SMA. Through semi-structured qualitative interviews (N = 40) and an online survey in eight countries (N = 217) with individuals with Types 2 and 3 SMA aged 2–59 years old and caregivers, the meaning of changes on a patient-friendly version of the MFM32 was explored. In an independent analysis of clinical trial data, anchor- and distribution-based analyses were conducted in a sample of individuals with Type 2 and non-ambulant Type 3 SMA to estimate patient-centered quantitative MFM32 meaningful change thresholds. The results from this study demonstrate that, based on patient and caregiver insights, maintaining functional ability as assessed by a patient-friendly version of the MFM32 is an important outcome. Quantitative analyses using multiple anchors (median age range of 5–8 years old across anchor groups) indicated that an ~3-point improvement in MFM32 total score represents meaningful change at the individual patient level. Overall, the qualitative and quantitative findings from this study support the importance of examining a range of meaningful change thresholds on the MFM32 including ≥0 points change reflecting stabilization or improvement and ≥3 points change reflecting a higher threshold of improvement. Future research is needed to explore quantitative differences in meaningful change on the MFM32 based on age and functional subgroups.

Effectiveness of robotic exoskeletons for improving gait in children with cerebral palsy: A systematic review

The Hybrid Assistive Limb® (HAL®, CYBERDYNE) is a wearable robot that provides assistance to a patient while they are walking, standing, and performing leg movements based on the wearer’s intended movement. The effect of robot-assisted training using HAL® for cerebral palsy (CP) is unknown. Therefore, we assessed the effect of robot-assisted training using HAL® on patients with CP, and compared walking and gross motor abilities between pre-intervention and post-intervention.Six subjects with CP were included (mean age: 16.8 years; range: 13–24 years; Gross Motor Function Classification System levels II–IV: n = 1, 4, 1). Robot-assisted training using HAL® were performed 2–4 sessions per week, 20 min per session, within a 4 weeks period, 12 times in total. Outcome measures included gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle, 6-minute walking distance (6 MD), physiological cost index (PCI), knee-extension strength, and Gross Motor Function Measure (GMFM).There were significant increases in self-selected walking speed (SWS), cadence during SWS and maximum walking speed (MWS), single-leg support per gait cycle, hip joint angle in the swing phase, 6 MD, and GMFM. In contrast, gait speed during MWS, step length during SWS and MWS, hip and knee joint angle in the stance phase, knee joint angle in the swing phase, PCI, and knee-extension strength generally improved, but not significantly.Robot-assisted training using HAL® may improve walking and gross motor abilities of patients with CP.

Decoding of Motor Coordination Imagery Involving the Lower Limbs by the EEG‐Based Brain Network

Compared with the efficacy of traditional physical therapy, a new therapy utilizing motor imagery can induce brain plasticity and allows partial recovery of motor ability in patients with hemiplegia after stroke. Here, we proposed an updated paradigm utilizing motor coordination imagery involving the lower limbs (normal gait imagery and hemiplegic gait imagery after stroke) and decoded such imagery via an electroencephalogram- (EEG-) based brain network. Thirty subjects were recruited to collect EEGs during motor coordination imagery involving the lower limbs. Time-domain analysis, power spectrum analysis, time-frequency analysis, brain network analysis, and statistical analysis were used to explore the neural mechanisms of motor coordination imagery involving the lower limbs. Then, EEG-based brain network features were extracted, and a support vector machine was used for decoding. The results showed that the two employed motor coordination imageries mainly activated sensorimotor areas; the frequency band power was mainly concentrated within theta and alpha bands, and brain functional connections mainly occurred in the right forehead. The combination of the network attributes of the EEG-based brain network and the spatial features of the adjacency matrix had good separability for the two kinds of gait imagery (p < 0.05), and the average classification accuracy of the combination feature was 92.96% ± 7.54%. Taken together, our findings suggest that brain network features can be used to identify normal gait imagery and hemiplegic gait imagery after stroke.

Collagen nanomaterial in the recovery of motor ability of patients with peripheral nerve transection injury

Objective: The combination of neurotrophic factors and ordered collagen material can promote the regeneration of nerve fibres in the injured area, which has a good effect on the recovery of motor ability in patients with peripheral nerve transection. In this paper, the collagen composite scaffolds were used to repair peripheral nerve defects, and then the collagen scaffolds combined with neurotrophic factors were used to promote axon regeneration and motor function recovery in rats with total transection of peripheral nerve. The experimental results show that the fusion of neurotrophic factors with collagen binding domain can specifically bind to collagen-based biomaterials, prevent rapid diffusion of factors in vivo, thus maintaining a more uniform release efficiency in vivo, which can be widely used in the study of motor ability recovery of peripheral nerve transection patients.

Identification of an Identical de Novo SCAMP5 Missense Variant in Four Unrelated Patients With Seizures and Severe Neurodevelopmental Delay.

Objective: To establish and broaden the phenotypic spectrum of secretory carrier membrane protein (SCAMP5) associated with epilepsy and neurodevelopmental delay. Methods: A Chinese patient was identified at the First Hospital of Peking University, and the three unrelated patients were recruited from two different countries (Italy and United States) through GeneMatcher. SCAMP5 pathogenic variants were identified by whole exome sequencing; clinical data of the patients were retrospectively collected and analyzed. Result: The onset age of seizures was ranged from 6 to 15 months. Patients had different types of seizures, including focal seizures, generalized tonic-clonic seizures and tonic seizure. One patient showed typical autism spectrum disorder (ASD) symptoms. Electroencephalogram (EEG) findings presented as focal or multifocal discharges, sometimes spreading to generalization. Brain magnetic resonance imaging (MRI) abnormalities were present in each patient. Severe intellectual disability and language and motor developmental disorders were found in our patients, with all patients having poor language development and were nonverbal at last follow-up. All but one of the patients could walk independently in childhood, but the ability to walk independently in one patient had deteriorated with age. All patients had abnormal neurological exam findings, mostly signs of extrapyramidal system involvement. Dysmorphic features were found in 2/4 patients, mainly in the face and trunk. All four unrelated patients were found to have the same heterozygous pathogenic SCAMP5 de novo variant (p. Gly180Trp). Conclusion: Epilepsy, severe developmental delay, abnormal neurological exam findings, with or without ASD or variably dysmorphic features and were common in patients with SCAMP5 variant. The onset time and type of seizure varied greatly. The EEG and brain MRI findings were not consistent, but diverse and nonspecific. The motor ability of patients with heterozygous SCAMP5 variant might have a regressive course; language development was more severely affected.

The Relationships Between Ataxia and Cognition in Spinocerebellar Ataxia Type 2.

The clinical spectrum of spinocerebellar ataxia type 2 includes motor manifestations and cognitive disturbances in executive functions, memory, and visuoconstructive skills. The relationships between severity of motor disturbances and altered cognition are poorly known. In this study, we assessed patients with spinocerebellar ataxia type 2 and age- and sex-matched healthy control subjects by a test battery including the Mini-mental State Examination, the Wisconsin Card Sorting test, and the Wechsler Memory Scale-Revised. The correlation between severity of motor ataxia (as assessed by a validated and widely used severity scale, the SARA scale, and by an objective automated computerized system of gait analysis) and altered cognition was then evaluated by Spearman correlation analysis. Patients performed worse than healthy controls in almost all administered neuropsychological tests. Nevertheless, only global intellectual abilities and executive functions significantly correlated with the overall severity of ataxia as assessed by the SARA scale, and impaired executive functions alone correlated with performance on several spatio-temporal gait analysis parameters. Our findings would probably suggest a prominent influence of executive functions on motor abilities in patients with spinocerebellar ataxia type 2 and raise the possibility that cognitive pharmaceutical or rehabilitative interventions may be of benefit in the management of motor problems in these patients.

Robot-assisted training using Hybrid Assistive Limb® for cerebral palsy

PurposeThe Hybrid Assistive Limb® (HAL®, CYBERDYNE) is a wearable robot that provides assistance to a patient while they are walking, standing, and performing leg movements based on the wearer’s intended movement. The effect of robot-assisted training using HAL® for cerebral palsy (CP) is unknown. Therefore, we assessed the effect of robot-assisted training using HAL® on patients with CP, and compared walking and gross motor abilities between pre-intervention and post-intervention. MethodsSix subjects with CP were included (mean age: 16.8 years; range: 13–24 years; Gross Motor Function Classification System levels II–IV: n = 1, 4, 1). Robot-assisted training using HAL® were performed 2–4 sessions per week, 20 min per session, within a 4 weeks period, 12 times in total. Outcome measures included gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle, 6-minute walking distance (6 MD), physiological cost index (PCI), knee-extension strength, and Gross Motor Function Measure (GMFM). ResultsThere were significant increases in self-selected walking speed (SWS), cadence during SWS and maximum walking speed (MWS), single-leg support per gait cycle, hip joint angle in the swing phase, 6 MD, and GMFM. In contrast, gait speed during MWS, step length during SWS and MWS, hip and knee joint angle in the stance phase, knee joint angle in the swing phase, PCI, and knee-extension strength generally improved, but not significantly. ConclusionRobot-assisted training using HAL® may improve walking and gross motor abilities of patients with CP.