Motor Activity Research Articles

The Effect of Metoclopramide on the Antinociceptive, Locomotor and Neurobehavioral Effects of Metamizole in Mice

Abstract Combining analgesic medications with distinct pharmacodynamics may result in effective analgesia and reduced adverse effects by lowering dosages of one or both medications. The objective was to investigate the nature of interactions of metoclopramide and metamizole by measuring the antinociceptive and neurobehavioral effects in mice. The drugs were administered intraperitoneally (ip) in mice. The antinociceptive effect was determined by the up-and-down method. Isobolographic analysis was performed by simultaneous injection of the two drugs at ED50 ratios of 1:1 and 0.5:0.5. The treated mice were also subjected to an open-field behavioral test as well as dorsal immobility and negative geotaxis behavioral paradigms. The ED50 of metoclopramide and metamizole were 33.71 and 43 mg/kg ip, respectively. Lower ED50 was established for metoclopramide and metamizole by 48.44% and 47.49%, respectively when given at a ratio of 0.5:0.5, and by 35.81% and 29.88%, respectively at a ratio of 1:1. The combined dose of metoclopramide and metamizole (8 and 10 mg/kg, ip, respectively) significantly decreased the open field-activity test in mice. This was observed by lower number of squares crossing compared to the control. Additionally, the drug combination resulted in a substantial increase in the duration of dorsal immobility response and delayed the negative geotaxis task when compared with the control group. The results indicated that the interaction between metoclopramide and metamizole in lower dose ratio with ED50 50:50, was synergistic in producing analgesia in mice with reduced risk for adverse reaction but with decreased behavioral and motor neuronal activity.

Effects of wearable device training on upper limb motor function in patients with stroke: a systematic review and meta-analysis.

To evaluate the effect of wearable device training on improving upper limb motor function in patients who experienced strokes. The PubMed, Embase, Cochrane Library, Web of Science, MEDLINE, SCOPUS, China National Knowledge Infrastructure, WanFang, and VIP databases were searched for randomized controlled trials (RCTs) that assessed the effectiveness of wearable device training in improving upper limb motor function in patients with stroke. Two investigators independently screened studies by their titles and abstracts and cross-checked, downloaded, and evaluated the results. Disagreements were resolved by a third highly experienced researcher. Risk of bias was evaluated using the Cochrane risk-of-bias tool. This meta-analysis was registered in PROSPERO (registration No. CRD42023421633). This study comprised 508 patients from 14 RCTs. The experimental group assessed various wearable devices, including 3D-printed dynamic orthoses, inertial measurement unit (IMU) sensors, electrical stimulation devices, and virtual reality (VR) devices for virtual interactive training. The control group received traditional rehabilitation therapies, including physical and conventional rehabilitation. The experimental group scored better on the Fugl-Meyer Assessment (FMA-UE) scale (standardized mean difference [SMD] 0.26, 95% confidence interval [CI] 0.07, 0.45) and Box and Block Test (BBT) (SMD 0.43, 95% CI 0.17, 0.69) versus controls. No significant intergroup differences were observed in the Action Research Arm Test (SMD 0.20, 95% CI -0.15, 0.55), motor activity log (mean difference [MD] 0.32, 95% CI -0.54, 0.33), and modified Ashworth scale (MD -0.08, 95% CI -0.81, 0.64). The probability rankings of wearable devices that improved FMA-UE scores in patients with stroke were: orthotic devices, with the highest probability ranking of 0.45, followed by sensor devices at 0.23, electrical stimulation devices at 0.21, and VR devices at 0.11. Wearable device training was found to significantly improve upper limb motor function in patients with stroke, particularly for large-range movements. Improvements in FMA-UE and BBT scores reflected reduced impairment and enhanced manual dexterity, respectively. However, the training had no significant effect on hand movement frequency, fine motor skills, or spasticity. Among the different wearable devices tested, orthoses produced the most effective results.

Features of the state of bone tissue in children with cerebral palsy. Part 1. Etiological aspects. A literature review

BACKGROUND: The growth of the human body is the most significant period of development of the bone tissue, because it is during this period that the size, shape, and architectonics of bone are formed against the background of increasing body weight and increasing physical exertion. Considering a number of pathological factors of the underlying disease (alimentary, neurological, hormonal, stress, and physical), bone tissue in children with cerebral palsy grows and develops with deviations from the norm. АIM: To present up-to-date generalized information about the features of bone tissue in children with cerebral palsy to orthopedic traumatologists, neurologists, and physical therapy specialists. MATERIALS AND METHODS: Studies on the problem of bone tissue condition in patients with cerebral palsy were analyzed. Data published over the past 20 years were searched in the scientific databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary without language restrictions. RESULTS: In the last 20 years, the number of studies about pediatric osteoporosis has increased. The gold standard for determining the level of bone mineral density is dual-energy X-ray absorptiometry. However, its use in children has presented some difficulties and limitations. In children, the relationship between bone mineral density values and the risk of fractures has not been well studied, which does not allow us to discuss about osteoporosis based on densitometric bone mineral density data alone. In patients with cerebral palsy, a decrease in bone mineral density and bone mass during growth was found. Previous studies showed that the main factors associated with a decrease in bone mineral density in this group of patients include neuroendocrine causes due to growth retardation against the background of CNS damage, alimentary factors, decreased calcium and vitamin D concentrations, systemic use of glucocorticoids, intake of antiepileptic drugs, decreased motor activity, and low muscle mass. Increasing serum vitamin D concentrations does not have a positive effect on bone mass, although increasing serum calcium concentrations is associated with an increase in bone mineral density. CONCLUSIONS: Identifying and correcting factors leading to decreased bone mineral density in children with cerebral palsy can improve bone health in this group of patients. The absence of a relationship between bone mineral density values and the risk of fractures in children with cerebral palsy does not allow us to discuss about osteoporosis based only on bone mineral density densitometric data. There may be more factors leading to an increased risk of bone fractures in children with cerebral palsy that require further study.

Influence of native thin filament type on the regulation of atrial and ventricular myosin motor activity

Ca2+-mediated activation of thin filaments is a crucial step in initiating striated muscle contraction. To gain mechanistic insight into this regulatory process, thin filament (TF) components and myosin motors from diverse species and tissue sources are often combined in minimal in vitro systems. The contribution of tissue-specific TF composition with native myosin motors in generating contraction speed remains unclear. To examine TF-mediated regulation, we established a procedure to purify native TFs (nTF) and myosin motors (M-II) from the same cardiac tissue samples as low as 10 mg and investigated their influence on gliding speeds and Ca2+ sensitivity. The rabbit atrial and ventricular nTFs and M-II were assessed in in vitro nTF motility experiments under varying Ca2+ concentrations. The speed-pCa relationship yielded a maximum TF speed of 2.58 μm/s for atrial (aM-II) and 1.51 μm/s for ventricular myosin (vM-II), both higher than the respective unregulated actin filament gliding speeds. The Ca2+ sensitivity was different for both protein sources. After swapping the nTFs, the ventricular TFs increased their gliding speed on atrial myosin, while the atrial nTFs reduced their gliding speed on ventricular myosin. Swapping of the nTFs decreased the calcium sensitivity for both vM-II and aM-II, indicating a strong influence of the thin filament source. These studies suggest that the nTF-myosin combination is critical to understanding the Ca2+ sensitivity of the shortening speed. Our approach is highly relevant to studying precious human cardiac samples, i.e., small myectomy samples, to address the alteration of contraction speed and Ca2+ sensitivity in cardiomyopathies.

Detection of semantic inconsistencies of motor actions: From language to praxis

Semantics of actions includes three types of knowledge: a) of the function of objects and tools, b) of the actions independently of the tools, and c) of the organization of simple actions in sequences. These types of knowledge might be structured as thematic roles into the semantics of actions. To test these hypothesis, 125 illustrations, divided into five conditions: i) Congruent (C), ii) Agent Inconsistent (AI), iii) Instrument Inconsistent (II), iv) Patient Inconsistent (PI), and v) Location Inconsistent (LI), were presented to 23 volunteers (50 % women), aged 20–25, who were asked to respond whether the image was congruent or incongruent. Electrical brain activity was recorded through 20 channels to obtain the event-related potentials (ERP) associated. Lower reaction times for II and PI than C, and a greater number of incorrect trials for C were found. A N300/N400 effect appeared for AI and LI conditions with respect to C. Finally, II and LI conditions present a deflected P600 in reference to C. These findings suggest semantic of actions is sensitive to thematic role manipulations and constitute evidence in favor of a semantic processing shared between visually observed praxis and words.

Potentiation of active locomotor state by spinal-projecting serotonergic neurons.

Animals produce diverse motor actions that enable expression of context-appropriate behaviors. Neuromodulators facilitate behavioral flexibility by altering the temporal dynamics and output of neural circuits. Discrete populations of serotonergic (5-HT) neurons target circuits in the brainstem and spinal cord, but their role in the control of motor behavior is unclear. Here we define the pre- and post-synaptic organization of the spinal-projecting serotonergic system and define a role in locomotor control. We show that while forebrain-targeting 5-HT neurons decrease their activity during locomotion, subpopulations of spinal projecting neurons increase their activity in a context-dependent manner. Optogenetic activation of ventrally projecting 5-HT neurons does not trigger initiation of movement, but rather enhances the speed and duration of ongoing locomotion over extended time scales. These findings indicate that the descending serotonergic system potentiates locomotor output and demonstrate a role for serotonergic neurons in modulating the temporal dynamics of motor circuits.

Examination of sex differences in fatigability and neuromuscular responses during continuous, maximal, isometric leg extension

Objective.This study examined sex-related differences in fatigability and neuromuscular responses using surface electromyographic (sEMG) and mechanomyographic (sMMG) amplitude (AMP) and frequency (MPF) during fatiguing, maximal, bilateral isometric leg extensions.Approach.Twenty recreationally active males and females with resistance training experience performed continuous, maximal effort, bilateral isometric leg extensions until their force reduced by 50%. Linear mixed effect models analyzed patterns of force, sEMG, and sMMG AMP and MPF responses in the dominant limb. An independent samples t-test compared time-to-task failure (TTF) between sexes.Main Results.There were no significant differences in TTF between males and females. However, males experienced a greater rate of force loss compared to females. Furthermore, sEMG AMP and MPF and sMMG AMP responses followed similar linear trends for both sexes, while sMMG MPF showed non-linear responses with sex-dependent differences.Significance.These data suggest that although TTF was similar, males had a higher rate of force reduction, likely due to greater absolute strength. Furthermore, despite parallel changes in sEMG AMP and MPF, as well as sMMG AMP, the divergent responses observed in sMMG MPF highlight sex-dependent differences in how males and females experience changes in the firing rates of active motor units during sustained maximal contractions.

Влияние регуляторного пептида тафтцин-pro-gly-pro на показатели вариабельности ритма сердца крыс в условиях различной физической активности

Background: The cardiotropic effects of a synthetic peptide with the anxiolytic activity of taftsinPro-Gly-Pro (taftsin-PGP) under stress was investigated. Previously, the effect of this peptide on the state of the cardiovascular system, which plays an important role in the adaptive reactions of the body under stress, has not been studied. The aim of the study: To study the effect of the regulatory peptide taftsin-Pro-Gly-Pro on the heart rate variability (HRV) indices of rats under conditions of various motor activity. Materials and methods: The study was performed on 48 Wistar rats. HRV indices were recorded using the Physiobelt 2.5.1 complex (Neurobotics, Russia) and analyzed by statistical, geometric and spectral indicators. Taftsin-PGP was administered intraperitoneally at doses of 80, 250 and 750 μg/kg once in a volume of 1 μg/kg. The study was performed in 4 stages: 1 – after adaptation to the device (before the introduction of the peptide), 2 – 15 minutes after the introduction of the peptide, 3 – after physical exertion (2-minute treadmill run), 4 – after a 15-minute rest. Results: At a dose of 80 μg/kg, taftsin-PGP had a pronounced adaptogenic effect in the form of maintaining the initial level of functioning of regulatory mechanisms both during physical exertion and during recovery. At a dose of 250 μg/kg, taftcin-PGP led to disorganization of autonomic regulation at the level of the autonomous and central circuits of heart rate regulation. The introduction of the peptide at a dose of 750 μg/kg stabilized the mechanisms of regulation of heart rate with increased physical activity, but caused an imbalance in the regulation of heart rate during recovery. Conclusion: Intraperitoneal administration of taftsin-PGP to Wistar rats had a dose-dependent and multidirectional effect on the regulation of heart rate at all stages of the experiment: at rest (15 minutes after administration), after physical exertion and during recovery.

Phytochemical and Toxicity Evaluation of Methanol Extracts of Leaves and Fruits of Zanthoxylum rhetsa (Rutaceae)

Zanthoxylum rhetsa is extensively utilized in the realm of gastronomy and therapeutics. However, existing literature lacks any documentation concerning the systematic assessment of the toxicity characteristics of the foliage and produce of Z.rhetsa. Consequently, the present inquiry was executed to appraise the immediate toxicity examinations of the methanol extract derived from the leaves and fruits in mice, in accordance with the regulations delineated by the Organization for Economic Cooperation and Development (OECD 420, 2001). In this investigation, a solitary dosage of 5000 mg/kg body mass of the specimen was administered to female mice, as stipulated by the OECD guidelines. Daily surveillance ensued for a total of fourteen days, with the objective of detecting any indications of toxicity or fatality. Upon the culmination of this two-week period, a comprehensive analysis involving hematological, biochemical, and histopathological evaluations was conducted. The outcomes of the immediate toxicity investigations evinced that neither the leaves nor the fruits extract exhibited any morbidity, conspicuous alterations in corporeal mass, nor any discernible impairment in behavioral or motor neural activities in the mice. The haematological and serum biochemical parameters did not exhibit significant disparities from the control groups. These findings were corroborated by histopathological investigations, wherein no abnormalities or pathological alterations were detected in the vital organs. The LD 50 (oral lethal dose) of the samples was determined to exceed 5000 mg/kg body weight. Consequently, the methanol extract of leaf and fruit extract of Z.rhetsa can be regarded as non-toxic and demonstrated a broad margin of safety for its therapeutic application.

A Review of Myoelectric Prosthetic Arm Designs from 2011 to 2022

Prosthetic arms are worn by people whose arms have been amputated. Amputation involves surgical removal of the muscle, neurosensory system, and skeletal system. Myoelectric prosthetics make use of the signals generated by the intact muscles for the limb movement. Prosthetic limbs are designed using mechanical parts with suitable gear and motors. Users of prosthetic arms can carry out tasks associated with everyday living and their jobs almost exactly like they would with a natural arm. Prosthetic arms come in a variety of designs based on the needs of the user. The current research reviews the goals, plans, and trials conducted on prosthetic elbows, wrists, and hands between 2011 and 2022 from reputable conferences and journals. In this work, the design of two prosthetic hands with one degree of freedom and thirteen degrees of freedom, respectively, in the 3D simulation tool SolidWorks is described. Prosthetic elbow and a wrist with one degree of freedom were designed as well. The fine motor activities can be performed with the prosthetic fingers designed in this work.

Managing the rehabilitation of patients following joint replacement using remote support tools

The article considers the approach to the development of an intelligent decision support system based on artificial intelligence technologies to manage the rehabilitation process in patients who have undergone joint endoprosthetic surgery. The paper focuses on the advantages of using complex intelligent systems in various industries requiring personalised approaches to the object, including medicine. The prospects for their further development are considered. The creation of a digital twin reflecting the key parameters of the object and its development trajectory from the moment of the first interaction with the system is proposed. The system, developed on the basis of software and instrumental environments, provides the possibility of remote observation and correction of the recovery plan by specialists, which represents a significant advantage compared to traditional methods. In order to ensure the adaptability of the system and the actualisation of the proposed solutions, control over the patient's condition and adaptation of treatment programmes is achieved by means of periodic and unscheduled checking of the object indicators. This is achieved by comparing the indicators obtained as a result of video data analysis with the normalised indicators of the system. The developed system analyses video recordings, performs movement analysis and adapts rehabilitation measures depending on the obtained data on the patient's motor activity in real time. The proposed method offers the potential to enhance the precision and personalisation of rehabilitation approaches, thereby facilitating greater accessibility and efficacy in treatment. The integration of artificial intelligence elements into clinical practice presents a promising avenue for optimising rehabilitation processes.

Evaluating Users’ Perception of Biologically Inspired Involuntary Behavior in Human–Robot Interaction

Multimodal communication is a human feature that enables diverse interactions. In human–robot interaction (HRI), robots have to communicate using human skills so that they can seem natural and assist effectively. Most research uses predefined gestures to equip robots with social abilities. However, researchers scarcely consider generating bioinspired involuntary behavior to improve a robot's expressiveness and communication. Human studies revealed that involuntary behavior affects how others perceive communicative intentions. Therefore, mimicking human involuntary behavior may positively affect HRI. This article extends our previous work on equipping robots with involuntary behavior with a user study that evaluates the use of bioinspiration for complementing gestures. A preliminary test is conducted with 15 participants to determine if they can perceive the intensities of the involuntary processes heart rate, pupil size, blink rate, breathing rate, and motor activity. 63 new participants interacted with a robot with bioinspired behaviors or a robot only showing predefined gestures to evaluate the robots’ warmth, competence, and discomfort. The results show that the preliminary test participants differentiated the intensities of the involuntary processes. Participants in the second study find the robot with bioinspired behaviors significantly warmer and more competent than the robot with predefined gestures, with no discomfort difference.

Deep Learning for Parkinson’s Disease Diagnosis: A Graph Neural Network (GNN) Based Classification Approach with Graph Wavelet Transform (GWT) Using Protein–Peptide Datasets

Abstract: Background: An important neurological disorder of Parkinson’s Disease (PD) is characterized by motor and non-motor activity of the patients. Empirical condition of the patient: PD assessment uses the Movement Disorder Society Unified Parkinson’s Rating Scale part III (MDS-UPDRS-III) measures for identifying the prediction of PD. Due to the unstable value of the measurement, the PD prediction and tracking lead to a lower prediction rate. Methods: To overcome this limitation, this paper proposed the Graph Wavelet Transform (GWT) based weighted feature extraction along with the Graph Neutral Network (GNN) classification. The main contribution of this research is (i) The weighted correlation between the data is calculated by GWT for effective prediction of PD. (ii) Machine learning algorithms were trained to predict Parkinson’s disease based on these patterns. In this research, we developed a new model called Graph Neural Network (GNN) to predict PD tremors’ MDS-UPDRS-III score using input data. To strengthen PD research and enable the construction of individualized treatment plans, these linked networks work together to methodically examine the data and find significant discoveries. Results: The proposed approach for predicting PD severity (motor- and MDS_UPDRS) has a mean squared error of 0.1796 and a root mean squared error of 0.2845, according to the experimental data. The prediction accuracy is increased by 27.66%, 54.11%, and 0.71%, correspondingly, when compared with the most effective State-of-the-Art methods of DNN, ANFIS + SVR, and Mixed MLP models. Conclusion: In conclusion, this proves that the proposed strategy is more effective at making predictions.

Analysis of Electroencephalographic Signals Using the Root Mean Square (RMS) Fluctuation Function: Applicable Sample Test

Brain signals extracted through brain-computer interface systems (BCI2000- http://www.bci2000.org) allow researchers and computer scientists to cooperate with techniques, mathematical models and statistical inferences that allow the interpretation of a variety of signals provided by people with conditions that significantly affect the ability to move or perform motor activities due to limitations in muscles, bones or nervous system. For this study, we propose a preliminary test with the root mean square (rms) fluctuation function, with EEG data, whose task was the response given to real/imaginary motor stimulus. To validate the model and all the steps up to the configuration of the rms function, we chose the information contained in the EEG of subject S003, available in the public database https://physionet.org/content/eegmmidb/1.0.0/. Considering the distribution of electrodes in the brain (lobes: frontal, parietal, temporal and occipital) and given the data availability conditions (10 - 10 system, EDF format and 160 samples per second), we analyzed 12 of the 64 channels and four stimuli, namely: opening and closing the left or right fist, imagining opening and closing the left or right fist, opening and closing both fists or both feet and imagining opening and closing both fists or both feet. We evaluated their fluctuations individually and the amplitudes of channels 32 and 37 in relation to the others (11, 22, 24, 43, 44, 49, 54, 61, 63 and 64). We observed quantitative similarities when the brain performs the same real/imaginary motor task and that the time of the amplitude changes with the increase of the scale n (time scales). In all experiments (S003_R3, S003_R4, S003_R5, S003_R6), channel 32 x 24, for n > 20 (15 seconds) was smaller than the others, showing that channel 32 (left hemisphere) has the largest fluctuation. From data processing (.EDF) to visualization of F<SUB>DFA</SUB>/∆log curves, we conclude that it is possible to replicate the study for more channels, as well as to investigate other types of activities in the human brain adapted to potential variations (DDP) generated by neurons via signals extracted from the EEG device.

CONSTRUÇÃO DE UM INSTRUMENTO PARA ESTUDAR ACADEMIAS AO AR LIVRE: RESULTADOS DA APLICAÇÃO EM QUATRO CIDADES

Outdoor gyms are a democratic space to promote the health and social inclusion of their users. Thus, motor activities can be extended to people with disabilities. The question that guided this study is: do these gyms have equipment adapted for people with disabilities to perform motor activities? Therefore, the objective was to identify and classify the equipment present in outdoor gyms in four cities. It is framed as an exploratory and descriptive study, with qualitative and quantitative analysis. To begin the collection, outdoor gyms were visited in four cities, in three different states and all available equipment was photographed for later analysis. At the same time, an internet search was conducted to find the companies that sell this equipment and to identify which of them had the seal for use by people with disabilities. The results indicated the existence of 28 equipment intended for wheelchair users. The variables chosen for the collection were: 1) access to the gyms; 2) equipment present; 3) equipment intended for people with disabilities; 4) condition of the equipment; 5) written instructions for using the equipment. The data collection took place in 29 outdoor gyms and 198 pieces of equipment were analyzed, making it possible to adequately measure the variables assessed. The results of the applications indicated the need for maintenance of access points and equipment and, mainly, the installation of signs indicating how the population should use them. Received: 2024/09/03 Reformulated: 2024/09/25 Accepted: 2024/09/27

Investigating the link between temperamental and motor development: a longitudinal study of infants aged 6–42 months

BackgroundSince the 1920s, motor development has been a strong research theme, focusing on infants' acquisition of motor skills, such as turning over and crawling. In the 1980s, a dynamic systems approach began emphasizing children's own motivation, which helped explain individual differences in the emergence of motor skills. However, few studies have examined factors contributing to individual differences in early motor development. In response, we investigated directional associations between temperament and motor development in children aged 6 months to 3 years.MethodThe Japan Environment and Children’s Study (JECS-A) recruited mothers between January 2011 and March 2014. 2,639 mothers were sent a questionnaire at 6 months, and responses were received from 1,657 of them, with full data for children aged 6 months, 2 years, and 3 years, including from three mothers of twins, were analyzed through structural equation modeling. Question items regarding fine and gross motor activities at each age were selected by pediatric neurologists specializing in developmental disorders. The Japanese version of the Little Developmental Coordination Disorder Questionnaire was administered at 42 months. Temperament was assessed through the parent-reported Behavior Questionnaire (short version) for infants, toddlers, and children. In all three measures, Surgency and Negative Affectivity were extracted, and Effortful Control, a major form of self-regulation, was found from toddlerhood onward, as in previous studies.ResultsA path diagram reveals that at 6 months, Surgency and Orienting/Regulation interacted positively with the motor function (respectively, r = .57; r = 40, ps < .001). Up to about 3 years, Effortful Control plays a role in facilitating the motor function, resulting in positive effects on Control During Movement (CDM), General Coordination (GC), and Fine Motor Movement (FMM) (β = 14; β = 30; β = 37, ps < .001). Surgency had a positive effect on CDM and GC (β = 18; β = 06, ps < .001), whereas Negative Affect had a negative influence on FMM and GC (β = -.08; β = -.08, ps < .001).ConclusionWhile Surgency may be a key reactive factor in early motor development, Effortful Control and Movement develop in an interactive manner.Trial registrationUMIN000030786.Scientific Title: The Japan Environment and Children’s Study.Date of disclosure of the study: 2018/01/15.Only questionnaires were administered in the study.

Cost-effectiveness of TOMAC therapy for medication-refractory restless legs syndrome: an updated analysis based on Extension study data

Aims Patients with medication-refractory restless legs syndrome (RLS) have limited therapeutic options available for symptom relief. Tonic motor activation (TOMAC) presents a novel, non-invasive therapy for this patient population. The aim of this study was to conduct an updated cost-effectiveness analysis of TOMAC therapy based on recently available longer-term follow-up data. Materials and Methods A previously published decision-analytic Markov model was utilized to project strategy-specific costs and outcomes over three-years and lifetime for TOMAC compared to status quo treatment (control). Cohort characteristics were based on 24-week clinical data from the extension cohort of the RESTFUL study, which included longer-term follow-up of RESTFUL completers who were assigned to continue or discontinue TOMAC use (TOMAC and control, respectively). The primary analysis outcome was the incremental cost-effectiveness ratio (ICER) in $ per quality-adjusted life year (QALY) gained, calculated using change in International RLS Study Group Rating Scale (IRLS) score as the effect measure. Extensive sensitivity analyses were performed. Results TOMAC treatment improved IRLS by 5.9 versus control, resulting in estimated utility improvement of +0.05. Over three-years and lifetime, TOMAC added 0.14 and 0.73 QALYs, at incremental costs of $6,751 and $27,440, resulting in projected ICERs of $47,609 and $37,823 per QALY gained, respectively. TOMAC was found to be cost-effective across all tested sensitivity analyses. Limitations and Conclusion The inclusion of longer follow-up data in the current analysis confirms earlier exploratory cost-effectiveness findings and suggest TOMAC therapy may provide a high-value treatment option for patients with medication-refractory RLS.

Genetically defined neuron types underlying visuomotor transformation in the superior colliculus.

The superior colliculus (SC) is a conserved midbrain structure that is important for transforming visual and other sensory information into motor actions. Decades of investigations in numerous species have made the SC and its nonmammalian homologue, the optic tectum, one of the best studied structures in the brain, with rich information now available regarding its anatomical organization, its extensive inputs and outputs and its important functions in many reflexive and cognitive behaviours. Excitingly, recent studies using modern genomic and physiological approaches have begun to reveal the diverse neuronal subtypes in the SC, as well as their unique functions in visuomotor transformation. Studies have also started to uncover how subtypes of SC neurons form intricate circuits to mediate visual processing and visually guided behaviours. Here, we review these recent discoveries on the cell types and neuronal circuits underlying visuomotor transformations mediated by the SC. We also highlight the important future directions made possible by these new developments.

Effects of a Wearable-Based Intervention on the Hemiparetic Upper Limb in Persons With Stroke: A Randomized Controlled Trial.

Wearables have emerged as a transformative rehabilitation tool to provide self-directed training in the home. Objective. In this study, we examined the efficacy of a novel wearable device, "Smart Reminder" (SR), to provide home-based telerehabilitation for hemiparetic upper limb (UL) training in persons with stroke. Forty stroke survivors from community support groups were randomized (stratified by the period after stroke onset and impairment severity) to either the SR group or the sham device group. Participants received either 20 hours of telerehabilitation using the SR device or training with pictorial handouts and a sham device over 4 weeks. In addition, all participants wore a standard accelerometer for 3 hours each day, 5 times a week, outside the prescribed training. Participants were assessed by a masked assessor at baseline, post-intervention (week 4), and follow-up (week 8). The outcome measures included Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test, Motor Activity Log, muscle strength, active range of motion and amount of movement of the UL, and compliance rate of training. The SR group improved substantially in their FMA-UE scores after treatment (mean difference = 2.05, P = .036) compared to the sham group. Also, adherence to the training using the SR device was significantly higher, 97%, than the sham group, 82.3% (P = .038). The 4-week telerehabilitation program using a "SR" device demonstrated potential efficacy in improving FMA-UE scores of the hemiparetic upper limb. However, it did not significantly enhance the performance of the affected limb in daily activities. The trial was registered on ClinicalTrial.gov (URL: http://www.clinicaltrials.gov) with the identifier NCT05877183.

INNOVATIVE APPROACHES TO PHYSICAL EDUCATION OF YOUNG CHILDREN: METHODS AND PRACTICES

The article highlights modern approaches to physical education of young children in modern preschool educational institutions, in particular, traditional forms of activities and innovative methods. The main forms of physical education, such as morning gymnastics, physical culture classes, mobile games and hardening procedures, are complemented by author’s and non-traditional methods, such as self-massage using Su-jok technology. Special attention is paid to the game methods proposed by M. Yefimenko and the introduction of information and communication technologies increasing the effectiveness and interest of classes. Particular attention is paid to the use of baby yoga for the physical and emotional development of young children. The importance of creating favorable conditions for independent motor activity of children is also emphasized. The article contains practical recommendations for the implementation of these methods into the educational process of preschool educational institutions. The purpose of the article is to distinguish the peculiarities of the organization of physical education in groups of young children. Among the research methods a scientific analysis of psychological and pedagogical sources, priority documents of the Ukrainian state educational policy is presented, where various problems related to the organization of physical education of young children in preschool educational institutions are outlined, its meaning and role of modern forms and methods of physical education of children are revealed in early age groups. Findings of the results indicated the need for further search for modern technologies and methods of physical development of young children in order to improve the quality of the educational process in preschool educational institutions. The conclusions emphasize that the introduction of original and non-traditional methods, such as self-massage using Su-jok technology, as well as game methods proposed by M. Yefimenko, significantly increase the effectiveness and interest of classes. The use of information and communication technologies and baby yoga helps in the development of children’s physical and emotional skills, makes classes diverse and attractive for children.