Motor Assessment Research Articles

Motor imagery brain-computer interface rehabilitation system enhances upper limb performance and improves brain activity in stroke patients: A clinical study.

This study compared the efficacy of Motor Imagery brain-computer interface (MI-BCI) combined with physiotherapy and physiotherapy alone in ischemic stroke before and after rehabilitation training. We wanted to explore whether the rehabilitation effect of MI-BCI is affected by the severity of the patient's condition and whether MI-BCI was effective for all patients. Forty hospitalized patients with ischemic stroke with motor deficits participated in this study. The patients were divided into MI and control groups. Functional assessments were performed before and after rehabilitation training. The Fugl-Meyer Assessment (FMA) was used as the primary outcome measure, and its shoulder and elbow scores and wrist scores served as secondary outcome measures. The motor assessment scale (MAS) was used to assess motor function recovery. We used non-contrast CT (NCCT) to investigate the influence of different types of middle cerebral artery high-density signs on the prognosis of ischemic stroke. Brain topographic maps can directly reflect the neural activity of the brain, so we used them to detect changes in brain function and brain topological power response after stroke. Compared the MI group and control group after rehabilitation training, better functional outcome was observed after MI-BCI rehabilitation, including a significantly higher probability of achieving a relevant increase in the Total FMA scores (MI = 16.70 ± 12.79, control = 5.34 ± 10.48), FMA shoulder and elbow scores (MI = 12.56 ± 6.37, control = 2.45 ± 7.91), FMA wrist scores (MI = 11.01 ± 3.48, control = 3.36 ± 5.79), the MAS scores (MI = 3.62 ± 2.48, control = 1.85 ± 2.89), the NCCT (MI = 21.94 ± 2.37, control = 17.86 ± 3.55). The findings demonstrate that MI-BCI rehabilitation training could more effectively improve motor function after upper limb motor dysfunction after stroke compared with routine rehabilitation training, which verifies the feasibility of active induction of neural rehabilitation. The severity of the patient's condition may affect the rehabilitation effect of the MI-BCI system.

FUNCTIONAL ASSESSMENT IN NEUROMOTOR REEDUCATION

ABSTRACT. Today’s neuromotor reeducation domain is filled up to the brim with all sorts of approaches. The only way of actually telling the good from the bad is conducting good and thorough studies, as well as having palpable evidence about the level of efficiency. The first step in doing that is having more specific tests that finely assess the motor function of a patient suffering from CNS lesions. This paper could be considered as a trial run for an even bigger step in terms of validating a supposed more specific tool of motor assessment. Two already validated and widely used tests in patients with stroke or in patients from the ICU are used, and the data collected is used to see if this new tool has a good, if any relationship with the previous. Apparently in all three circumstances primary, secondary and final assessment a strong relationship was found and the statistical significance was very promising. On a personal note, one specific and important difference between the already in clinical and scientific use and the new test was, that the new test could detect motor improvement when SIAS failed to do so, and even more so than DEMMI could. That for the therapist is a very important aspect being able to finely tune their means of approach. Also, for the patients it could have better and more positive pshycological outcomes, because now even if before when a regular test would not show them improvement at all, now even after a smaller amount of time but with targeted means of work, they have something to show for.

Analysis and Discussion on the Effect of Early Rehabilitation on Motor Dysfunction in Patients with Acute Cerebral Infarction

Objective: To analyze the effect of early rehabilitation on motor dysfunction in patients with acute cerebral infarction. Methods: A total of 70 patients with acute cerebral infarction admitted to Suqian Zhongwu Hospital (our hospital) from January 2020 to December 2021 were selected as research subjects. The participants were divided into two groups through envelopes. The patients of the reference group (n = 35) received conventional treatment whereas the observation group underwent early rehabilitation and conventional treatment (n = 35). The scores of limb motor function (Fugl-Meyer Assessment [FMA]), functional independence (Barthel Scale), and Motor Assessment Scale (MAS) of the two groups were compared. Results: There was no significant difference between the scores of the two groups before treatment (P > 0.05); after early rehabilitation, the FMA and Barthel scale scores of the observation group were higher than those of the reference group, and the MAS scores of the observation group were also better than the reference group (P < 0.05). Conclusion: Early rehabilitation treatment on the basis of conventional treatment for patients with acute cerebral infarction can promote the recovery of motor function and improve the ability to perform daily activities of patients, thus it should be popularized.

Cytokine profiles of plasma extracellular vesicles as progression biomarkers in Parkinson’s disease

Inflammation contributes substantially to the pathogenesis of Parkinson's disease (PD). Plasma extracellular vesicle (EV)-derived cytokines are emerging biomarkers of inflammation. We conducted a longitudinal study of the plasma EV-derived cytokine profiles of people with PD (PwP). A total of 101 people with mild to moderate PD and 45 healthy controls (HCs) were recruited, and they completed motor assessments (Unified Parkinson Disease Rating Scale [UPDRS]) and cognitive tests at baseline and 1-year follow-up. We isolated the participants' plasma EVs and analyzed their levels of cytokines, including interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β. We noted no significant changes in the plasma EV-derived cytokine profiles of the PwPs and HCs between baseline and the 1-year follow-up. Among the PwP, changes in plasma EV-derived IL-1β, TNF-α and IL-6 levels were significantly associated with changes in the severity of postural instability and gait disturbance (PIGD) and cognition. Baseline plasma EV-derived IL-1β, TNF-α, IL-6, and IL-10 levels were significantly associated with the severity of PIGD and cognitive symptoms at follow-up, and PwP with elevated IL-1β and IL-6 levels exhibited significant progression of PIGD over the study period. These results suggested the role of inflammation in PD progression. In addition, baseline levels of plasma EV-derived proinflammatory cytokines can be used to predict the progression of PIGD, the most severe motor symptom of PD. Additional studies with longer follow-up periods are necessary, and plasma EV-derived cytokines may serve as effective biomarkers of PD progression.

Tools for Objectifying Motor Assessment and Functional Adaptability of Children with SEN in Special Education

The motric activities for children who have special educational needs (SEN) are adapted and individualized to their deficiencies. It is also considered that the development of motor skills facilitates their participation in various educational activities carried out at school, thus providing some learning opportunities. The article analyzes the way motor abilities influence the children with SEN in the school adaptation. The research was conducted between January and February 2022 at the School Center for Inclusive Education Brașov (Romania). The study included 8 subjects with intellectual disabilities (ID) and associated disabilities, with an average age of 5.8 years (SD = 1.3). The motor skills test was performed by applying Movement Assessment Battery for Children, Second Edition (M ABC-2), using evaluation items for balance, manual dexterity and for throwing and catching objects. School functionality was assessed by the School Function Assessment (SFA), through which the ability to perform the physical and cognitive-behavioral tasks of the children concerned was determined. The results obtained showed a significant connection (r= .934) between the variable of motor skills and the variable of school functionality, which leads us to conclude that motor skills can improve the functional adaptation of children with SEN to activities in the school environment.

Assessing Bulbar Function in Spinal Muscular Atrophy Using Patient-Reported Outcomes.

Novel Spinal Muscular Atrophy (SMA) treatments have demonstrated improvements on motor measures that are clearly distinct from the natural history of progressive decline. Comparable measures are needed to monitor bulbar function, which is affected in severe SMA. To assess bulbar function with patient-reported outcome measures (PROs) and determine their relationships with clinical characteristics. We recruited 47 non-ambulatory participants (mean (SD) age = 29.8 (13.7) years, range = 10.3-73.2) with SMA. PROs including Voice Handicap Index (VHI) and Eating Assessment Tool-10 (EAT-10) were collected alongside clinical characteristics and standardized motor assessments. Associations were assessed using Spearman correlation coefficients and group comparisons were performed using Wilcoxon rank sum tests. A majority of the 47 participants were SMA type 2 (70.2%), non-sitters (78.7%), 3 copies of SMN2 (77.5%), and using respiratory support (66.0%). A majority (94%) reported voice issues primarily in 8/30 VHI questions. Problems included: difficulty understanding me in a noisy room (87.2%); difficult for people to hear me (74.5%); and people ask me to repeat when speaking face-to-face (72.3%). A majority (85.1%) reported swallowing issues primarily in 3/10 EAT-10 questions: swallowing pills (68.1%); food sticks to my throat (66.0%); and swallowing solids (61.7%). The two PROs were moderately associated (rs = 0.66). Weaker individuals with SMA experience bulbar problems including difficulties with voice and swallowing. Further refinement and assessment of functional bulbar scales will help determine their relevance and responsiveness to changes in SMA. Additional study is needed to quantify bulbar changes caused by SMA and their response to disease-modifying treatments.

Comparing body posture and postural control in children with intellectual disability and dyslexia to typically developing children using technology‑based assessments

Background/Aims Children with intellectual disability and dyslexia have poor academic and behavioural skills related to social participation, as well as poor motor skills compared to typically developing children. Most training programmes for these children focus on the academic and behavioural aspects of special education, overlooking musculoskeletal and motor development needs. The aim of this study was to investigate body posture and postural control in children with intellectual disability and dyslexia compared to typically developing children using technology-based assessments. Methods A total of 77 children (36 with dyslexia, 21 with intellectual disability and 20 typically developing children) took part in the study. The PostureScreen Mobile app was used to evaluate body posture and the Fizyosoft Balance System was used to assess postural control. Results Significant postural differences were observed in children with intellectual disability when compared to typically developing children. Head, shoulder and knee translations in the sagittal plane were significantly higher in children with intellectual disability than typically developing children. Centre of pressure velocities were significantly higher in children with dyslexia. Centre of pressure displacements showed non-significant differences in the children with dyslexia compared to the children with intellectual disability and typically developing children. Conclusions The present study found that children with dyslexia had poor postural control and children with intellectual disability had poor quality of posture compared to typically developing children. The authors believe that motor and physical assessments with objective outcome measurements should be conducted for children with dyslexia and intellectual disability to help improve their motor development.

The relation between clinically diagnosed and parent-reported feeding difficulties in children with and without clefts

A cleft lip and/or palate (CL/P) is one of the most common craniofacial malformations, occurring worldwide in about one in 600–1000 newborn infants. CL/P is known to influence the feeding process negatively, causing feeding difficulties in 25–73% of all children with CL/P. Because there is a risk for serious complications in these children regarding feeding difficulties, there is often a need for intensive medical counseling and treatment. At this moment, adequate diagnosis and measurement remain a challenge and often lead to a delayed referral for professional help. Since parents play a big part in reporting feeding difficulties, it is important to help objectify parents’ experiences, as well as the use of a frontline screening instrument for routine check-ups during medical appointments. The aim of this study is to investigate the relationship between parent perspective and standardized observation by medical professionals on feeding difficulties in 60 children with and without clefts at the age of 17 months. We focus on the information from parents and health professionals by comparing the Observation List Spoon Feeding and the Schedule for Oral Motor Assessment with the validated Dutch translation of the Montreal Children’s Hospital Feeding Scale. Conclusion: There is a need for timely and adequate diagnosis and referral when it comes to feeding difficulties in children with CL/P. This study underscores the importance of combining both parental observations and measurements of oral motor skills by healthcare professionals to enable this.What is Known:• Early identification of feeding difficulties can prevent adversely affected growth and development.• Clefts increase the probability of feeding difficulties; however, the diagnostic trajectory is unclear.• The Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA) are validated to measure oral motor skills. The Montreal Children’s Hospital Feeding Scale Dutch version (MCH-FSD) has been validated for the parental perception of infant feeding difficulties.What is New:• Parents of children with CL/P experience relatively few feeding problems in their child on average.• Oral motor skills for spoon feeding are associated with oral motor skills for solid foods in children with CL/P.• The extent of the cleft is associated with experiencing more feeding difficulties in children with CL/P.

The Perspectives of Preservice Kinesiology Students Concerning Autism and Physical Activity: Differences by Adapted Physical Activity Exposure.

This study investigated the effect of an adapted physical activity (APA) course on knowledge and perceptions of preservice trainees regarding physical activity (PA) and autism spectrum disorder in 3 areas: knowledge/perspectives, importance and ease of improving developmental domains, and importance and ease of improving motor skills. Four hundred upper-level undergraduate students were recruited to participate in this survey-based study (251 APA students and 149 non-APA students participated). Survey data were analyzed using multivariate analyses of variance. Participants estimated that the moderate to vigorous PA recommendations are 39.34minutes per day, that 46.65% of moderate to vigorous PA occurs during school, and that 61.03% of children have motor difficulties. Participants perceived activities of daily living, sleep habits, and heart health as the easiest domains to improve, and problem behaviors, social skills, and self-esteem as the most difficult domains to improve. Knowledge/perspectives regarding autism spectrum disorder and PA were different by APA exposure (F12,324 = 3.11, P < .001). Differences included self-efficacy in providing PA advice, knowledge of PA guidelines, and willingness to provide motor assessment referrals. Students differed by APA exposure in the importance of developmental domains (F8,381 = 4.37, P < .001) but not ease of improving those domains. Results suggest that APA education and contact with children with disabilities improves self-efficacy, perspectives, and knowledge of PA and motor concerns in children with autism spectrum disorder.

Validity and reliability of TGMD-2 Surakarta children aged 7-10 years

Motor assessment tests are widely used in many countries, including the Gross Motor Development Test 2 (TGMD-2). TGMD-2 is the most frequently used test to measure children's gross motor development in many countries. The purpose of this research is to be investigated whether TGMD-2 is suitable for measuring gross motor development in Surakarta boys aged 7-10 years. The participants involved in this study were 355 boys aged between 7-10 years, who attended state elementary school. Construct validity was calculated by Exploratory Factor Analysis, and reliability by Cronbach's Alpha. The result of the calculation is average Keyser-Meyer-Olkin (KMO) value is 0.837. This figure indicates that TGMD-2 is good for confirmation purposes. While the reliability is 0.743, categorized as medium. In conclusion, thus it can be concluded that TGMD-2 can used to assess gross motor development of the studied population.

Long-term neurodevelopmental follow-up of children exposed to pravastatin in utero

Preeclampsia, especially before term, increases the risk of child neurodevelopmental adverse outcomes. Biological plausibility, preclinical studies, and pilot clinical trials conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Obstetric-Fetal Pharmacology Research Centers Network support the safety and use of pravastatin to prevent preeclampsia. This study aimed to determine the effect of antenatal pravastatin treatment in high-risk pregnant individuals on their child's health, growth, and neurodevelopment. This was an ancillary follow-up cohort study of children born to mothers who participated in the Obstetric-Fetal Pharmacology Research Centers Network pilot trials of pravastatin vs placebo in individuals at high risk of preeclampsia (ClinicalTrials.gov; identifier NCT01717586). After obtaining written informed consent (and assent as appropriate), the parent was instructed to complete the Child Behavior Checklist. To assess the child's motor, cognitive, and developmental outcomes, a certified and blinded study psychologist completed child motor, cognitive, emotional, and behavioral assessments using validated tools. Given the small number of individuals in the studies, the 10- and 20-mg pravastatin groups were combined into 1 group, and the results of the pravastatin group were compared with that of the placebo group. Of 40 children born to mothers in the original trial, 30 (15 exposed in utero to pravastatin and 15 to placebo) were enrolled in this follow-up study. The time of follow-up, which was 4.7 years (interquartile range, 2.5-6.9), was not different between children in the pravastatin group and children in the placebo group. There was no difference in the child's body mass index percentiles per sex and corrected age, the rates of extremes of body mass index percentiles, or the report of any other medical or developmental complications between the 2 groups. No child born in the pravastatin group had any limitation in motor assessment compared with 2 children (13.3%) who walked with difficulty and 4 children (26.7%) who had reduced manual abilities in the placebo group. Moreover, children born to mothers who received pravastatin had a higher general mean conceptual ability score (98.2±16.7 vs 89.7±11.0; P=.13) and a lower frequency (15.4% vs 35.7%; P=.38) of having a score of <85 (ie, 1 standard deviation lower than the mean) compared with those in the placebo group. Finally, there was no difference in the parents' report on the Child Behavior Checklist between the 2 groups. This study reported on the long-term neuromotor, cognitive, and behavioral outcomes among children exposed to pravastatin in utero during the second and third trimesters of pregnancy. Although the data were limited by the original trial's sample size, no identifiable long-term neurodevelopmental safety signal was evident with the use of pravastatin during pregnancy. This favorable neonatal risk-benefit analysis justifies continued research using pravastatin in clinical trials.

Cerebral Small Vessel Disease Progression Increases Risk of Incident Parkinsonism.

Cerebral small vessel disease (SVD) is associated with motor impairments and parkinsonian signs cross-sectionally, however, there are little longitudinal data on whether SVD increases risk of incident parkinsonism itself. We investigated the relation between baseline SVD severity as well as SVD progression, and incident parkinsonism over a follow-up of 14 years. This study included 503 participants with SVD, and without parkinsonism at baseline, from the RUN DMC prospective cohort study. Baseline inclusion was performed in 2006 and follow-up took place in 2011, 2015, and 2020, including magnetic resonance imaging (MRI) and motor assessments. Parkinsonism was diagnosed according to the UK Brain Bank criteria, and stratified into vascular parkinsonism (VaP) and idiopathic Parkinson's disease (IPD). Linear mixed-effect models were constructed to estimate individual rate changes of MRI-characteristics. Follow-up for incident parkinsonism was near-complete (99%). In total, 51 (10.2%) participants developed parkinsonism (33 VaP, 17 IPD, and 1 progressive supranuclear palsy). Patients with incident VaP had higher SVD burden compared with patients with IPD. Higher baseline white matter hyperintensities (hazard ratio [HR]=1.46 per 1-SD increase, 95% confidence interval [CI]=1.21-1.78), peak width of skeletonized mean diffusivity (HR=1.66 per 1-SD increase, 95% CI=1.34-2.05), and presence of lacunes (HR=1.84, 95% CI=0.99-3.42) were associated with increased risk of all-cause parkinsonism. Incident lacunes were associated with incident VaP (HR=4.64, 95% CI=1.32-16.32). Both baseline SVD severity and SVD progression are independently associated with long-term parkinsonism. Our findings indicate a causal role of SVD in parkinsonism. Future studies are needed to examine the underlying pathophysiology of this relation. ANN NEUROL 2023;93:1130-1141.

Clinical utility of paced finger tapping assessment in idiopathic normal pressure hydrocephalus.

The Finger Tapping (F-T) test is useful for assessing motor function of the upper limbs in patients with idiopathic normal pressure hydrocephalus (iNPH). However, quantitative evaluation of F-T for iNPH has not yet been established. The purpose of this study was to investigate the usefulness of the quantitative F-T test and optimal measurement conditions as a motor evaluation and screening test for iNPH. Sixteen age-matched healthy controls (mean age 73 ± 5 years; 7/16 male) and fifteen participants with a diagnosis of definitive iNPH (mean age 76 ± 5 years; 8/15 male) completed the study (mean ± standard deviation). F-T performance of the index finger and thumb was quantified using a magnetic sensing device. The performance of repetitive F-T by participants was recorded in both not timing-regulated and timing-regulated conditions. The mean value of the maximum amplitude of F-T was defined as M-Amplitude, and the mean value of the maximum velocity of closure of F-T was defined as cl-Velocity. Finger Tapping in the iNPH group, with or without timing control, showed a decrease in M-Amplitude and cl-Velocity compared to the control group. We found the only paced F-T with 2.0 Hz auditory stimuli was found to improve both M-Amplitude and cl-Velocity after shunt surgery. The quantitative assessment of F-T with auditory stimuli at the rate of 2.0 Hz may be a useful and potentially supplemental screening method for motor assessment in patients with iNPH.

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study.

Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6-10 years with SLD/DCD. A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers' perceived notion of need and received two 45-60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD.

Experience and perception of utilizing virtual clinic in neurological assessment in Saudi Arabia.

The World Health Organization defined electronic health as "the unified usage of information technology and electronic communications in the health sector." In the Kingdom of Saudi Arabia, outpatient encounters were largely shifted to virtual clinics due to the crisis caused by COVID-19. This study aimed to evaluate the neurology consultants', specialists', and residents' experience and perception of utilizing virtual services for neurological assessment in Saudi Arabia. This cross-sectional study was conducted by sending an anonymous online survey to neurologists and neurology residents in Saudi Arabia. The survey was developed by the authors and contained three main sections: demographics, subspecialty and years of experience after residency, and virtual clinics during the coronavirus disease 2019 (COVID-19) pandemic. A total of 108 neurology-practicing physicians in Saudi Arabia responded to the survey. Overall, 75% experienced virtual clinics, and 61% of them used phones for consultation. In neurology clinical practice, there was a significant difference (P < 0.001) regarding the teleconsultations for follow-up patients compared to the newly referred patients, being more suitable for the follow-up cases. Additionally, most neurology practicing physicians showed more confidence in performing history-taking tasks virtually (82.4%) than in physical examination. However, it was found that consultants were significantly (P < 0.03) more confident to virtually perform the cranial nerve, motor, coordination, and extrapyramidal assessments than the neurology residents. Physicians deemed it more suitable to conduct teleconsultations for patients with headaches and epilepsy than for those with neuromuscular and demyelinating diseases/multiple sclerosis. Furthermore, they agreed that patients' experiences (55.6%) and physicians' acceptance (55.6%) were the two main limitations to implementing virtual clinics. This study revealed that neurologists were more confident in performing history-taking in virtual clinics than in physical exams. On the contrary, consultants were more confident in handling the physical examination virtually than the neurology residents. Moreover, the most accepted clinics to be handled electronically were the headache and epilepsy clinics in comparison to the other subspecialties, being mainly diagnosed using history. Further studies with larger sample sizes are warranted to observe the level of confidence in performing different duties in neurology virtual clinics.

Randomized clinical trial comparing pericapsular nerve group (PENG) block and periarticular local anesthetic infiltration for total hip arthroplasty

BackgroundThis randomized trial compared pericapsular nerve group block and periarticular local anesthetic infiltration in patients undergoing primary total hip arthroplasty. We hypothesized that, compared with pericapsular nerve group block, periarticular...

Music, movement and mood in Parkinson’s: A transdisciplinary study to develop a new protocol to measure functional mobility in people with Parkinson’s by integrating motion capture with a pressure sensitive gait mat

Background&#x0D; Parkinson’s disease (PD) is a neurodegenerative brain disorder associated with early-onset functional motor impairments (Rana et al., 2012). There are several assessment scales for the evaluation of PD, but many motor measurement protocols lack reference to the qualitative assessment of functional mobility in everyday life (Opara et al., 2017). Moreover, previous studies have shown that pharmaceutical treatments in combination with physical therapy play an important role in improving motor symptoms, but the benefits do not seem to extend to mental well-being (Fox et al., 2018). Growing evidence suggest that an interdisciplinary approach by integrating musical activity with exercises may have the potential to improve both functional mobility and psychological wellbeing (Barnish &amp; Barran, 2020).&#x0D; Methods&#x0D; The first phase of this mixed methods study includes a Patient and Public Involvement (PPI) consultation process (workshops and interviews; Rose et al., 2022) to develop a context-appropriate new group-based intervention program for and with PwP and health professionals. The focus will lie on music activity and the use music imagery to develop individual jukeboxes of musical cues to combat motor symptoms such as rigidity and freeze of gait. To evaluate the efficacy and the generalisability of the program, a 12-week within-subject repeated measures controlled trial will be conducted in Switzerland and the UK. An accurate and reliable quantitative measurement protocol will be developed to enable assessment of disease progression, and evaluation of interventions alongside qualitative observations of mobility in PwP. Moreover, we aim to provide fine-grained assessment of clinical measures (such as the Timed Up and Go) using an integrated motion capture (MoCap) and gait mat analysis system.&#x0D; Expected Outcomes and Perspectives&#x0D; This project lays the foundation for the development of non-pharmaceutical and low-cost intervention programs. Our PPI approach will provide better individualised and targeted prevention strategies to counteract the increasing financial and personal burden of PD worldwide. A unique aspect of the study is to develop a new quantitative functional mobility measurement protocol to assess PwP over time. This research approach will contribute to our understanding of functional mobility symptoms and the use of music in PD to reduce symptom severity and improve quality of life.&#x0D; References&#x0D; Barnish, M. S., &amp; Barran, S. M. (2020). A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson’s disease. BMC Neurology, 20(1), Article 371. https://doi.org/10.1186/s12883-020-01938-3&#x0D; Fox, S. H., Katzenschlager, R., Lim, S. Y., Barton, B., de Bie, R. M. A., Seppi, K., Coelho, M., &amp; Sampaio, C. (2018). International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson’s disease. Movement Disorders, 33(8),1248-1266. https://doi.org/10.1002/mds.27372&#x0D; Opara, J., Małecki, A., Małecka, E., &amp; Socha, T. (2017). Motor assessment in Parkinson’s disease. Annals of Agricultural and Environment Medicine, 24(3), 411-415. https://doi.org/10.5604/12321966.1232774&#x0D; Rana, A. Q., Siddiqui, I., &amp; Yousuf, M. S. (2012). Challenges in diagnosis of young onset Parkinson’s disease. Journal of the Neurological Sciences, 323(1-2), 113-116. https://doi.org/10.1016/j.jns.2012.08.029&#x0D; Rose, D. C., Poliakoff, E., Hadley, R., Guérin, S. M. R., Phillips, M., &amp; Young, W. R. (2022) Levelling the playing field: The role of workshops to explore how people with Parkinson’s use music for mood and movement management as part of a patient and public involvement strategy. Frontiers in Rehabilitation Sciences, 3, Article 873216. https://doi.org/10.3389/fresc.2022.873216

Association of GBA genotype with motor and cognitive decline in Chinese Parkinson's disease patients.

Variants in the glucocerebrosidase (GBA) gene are the most common and significant risk factor for Parkinson's disease (PD). However, the impact of GBA variants on PD disease progression in the Chinese population remains unclear. This study aimed to explore the significance of GBA status on motor and cognitive impairment in a longitudinal cohort of Chinese patients with PD. The entire GBA gene was screened by long-range polymerase chain reaction (LR-PCR) and next generation sequencing (NGS). A total of 43 GBA-related PD (GBA-PD) and 246 non-GBA-mutated PD (NM-PD) patients with complete clinical data at baseline and at least one follow-up were recruited for this study. The associations of GBA genotype with rate of motor and cognitive decline, as measured by Unified PD Rating Scale (UPDRS) motor and Montreal Cognitive Assessment (MoCA), were assessed by linear mixed-effect models. The estimated (standard error, SE) UPDRS motor [2.25 (0.38) points/year] and MoCA [-0.53 (0.11) points/year] progression rates in the GBA-PD group were significantly faster than those in the NM-PD group [1.35 (0.19); -0.29 (0.04) points/year; respectively]. In addition, the GBA-PD group showed significantly faster estimated (SE) bradykinesia [1.04 (0.18) points/year], axial impairment [0.38 (0.07) points/year], and visuospatial/executive [-0.15 (0.03) points/year] progression rates than the NM-PD group [0.62 (0.10); 0.17 (0.04); -0.07 (0.01) points/year; respectively]. GBA-PD is associated with faster motor and cognitive decline, specifically greater disability in terms of bradykinesia, axial impairment, and visuospatial/executive function. Better understanding of GBA-PD progression may help predict prognosis and improve clinical trial design.

Gender Differences, Motor Skills and Physical Fitness Heterogeneity in Adults with Down’s Syndrome

Background-Adults with Down's syndrome (DS) present lower physical fitness associated with heightened sedentary behaviors and motor skills impairments. Their etiologies and determinants seem to be heterogeneous. This study aims to evaluate physical fitness in adults with DS and to identify specific physical fitness profiles depending on gender and physical activity levels. Methods-Forty adults with DS (16 women, 24 men, 29.7 ± 7.5 years) performed six tests from the EUROFIT Battery and Motor Assessment Battery for Children (MAB-C). Their maximal aerobic capacity was assessed using an incremental treadmill test to assess (VO2peak). Ecological, physical activity, and sedentary levels were evaluated subjectively (Global Physical Activity Questionnaire) and objectively using an Actigraph GT9X® accelerometer over a seven-day period. Results-VO2peak and isometric strength were significantly lower for women (p < 0.01), whereas men had significantly lower flexibility than women (p < 0.05). Using a principal component analysis and an agglomerative hierarchical analysis, we identified three clusters. Cluster 1 (n = 14; 50% men; Body Mass index = 28.3 ± 4.3) was characterized by significantly poorer physical fitness variables (VO2peak (p < 0.01), strength (p < 0.01) and balance (p < 0.05)) compared to Clusters 2 and 3. Cluster 2 (n = 19; 58% men; Body Mass index = 22.9 ± 2.0) and Cluster 3 (n = 19; 58% men; BMI = 22.9 ± 1.9) were characterized by subjects with comparable physical fitness profiles, except for the balance capacities, which were significantly lower in Cluster 3 (p < 0.05). Conclusions-DS subjects exhibited high heterogeneity in terms of physical fitness, PA, and sedentary levels, with a significant gender effect. The present findings are important to identify subjects at higher risk of sedentary behaviors and impaired motor capacities to develop personalized PA programs.

Eye-tracking visual patterns of sonographers with and without fetal motor assessment expertise

ObjectivesFetal motor assessment (FMA) in addition to structural anomaly scan enhances prenatal detection of arthrogryposis multiplex congenita (AMC). In the Amsterdam UMC, sonographers are trained to perform FMA. We examined the effect of motor assessment training by comparing sonographers with (SMA) and without this training (S) on their qualitative motor assessment in fetuses with normal (FNM) and abnormal motility (FAM) and their visual processing by eye-tracking. MethodsThe study was performed from 2019 to 2020. Five SMA and five S observed five FNM and five FAM videos. Qualitative FMA consisted of six aspects of the general movement and the overall conclusion normal or abnormal. The visual processing aspects examined through eye-tracking were fixation duration, number of revisits per region of interest (ROI) and scanpaths of saccades between fixation points. ResultsQuality assessment by SMA revealed more correct aspects in FNM than in FAM but overall conclusions were equally correct (92–96 %). S scored aspects of FNM better than in FAM, but overall conclusion correct only in half of FNM and three quarters of FAM. Eye-tracking of SMA and S showed fixation duration and revisits with similar distributions per ROIs for FNM and FAM, but SMA perform more trunk revisits in FNM. Scanpaths had smaller circumference, less outliers and more consistency in SMA than S. ConclusionThis modest population of qualified sonographers showed that additional FMA training improved qualitative motor assessment. Eye-tracking revealed differences in visual processing and stimulates continuous education for professionals active in the detection of these rare diseases.