Motor Function In Individuals Research Articles

Efficacy and Safety of Tetrabenazine in Reducing Chorea and Improving Motor Function in Individuals With Huntington's Disease: A Systematic Review

Efficacy and Safety of Tetrabenazine in Reducing Chorea and Improving Motor Function in Individuals With Huntington's Disease: A Systematic Review

Comprehensive assessment of heavy slow resistance training and high-dose therapeutic ultrasound in managing patellar tendinopathy, a randomized single-blind controlled trial

BackgroundPatellar tendinopathy (PT) is a common sport injury prone to recurrence. Heavy Slow Resistance Training (HSR) and High-Dose Therapeutic Ultrasound (TUS) are frequently used interventions for PT. However, the combined effectiveness of these therapies remains unclear. This study investigated the impact of combination therapy on functional outcomes in patients with PT.MethodsFifty-one college students aged 18–25, diagnosed with PT via musculoskeletal ultrasound, were randomly assigned to one of three groups (n = 17 per group): combined HSR and high-dose TUS, HSR training alone, or high-dose TUS alone. The eight-week intervention included assessments using the Victorian Institute of Sport Assessment-Patella (VISA-P), Visual Analogue Scale (VAS), Y-balance Test (YBT), Modified Thomas Test (MTT), Horizontal Jumping Distance, Maximum Isometric Muscle Strength Test, and musculoskeletal ultrasound for patellar tendon thickness and blood flow. Assessments were conducted at baseline and post-intervention, with a follow-up VISA-P assessment at week 16. This randomized, single-blind controlled trial was registered on ISRCTN11447397 (www.ISRCTN.com) on February 17, 2024 (retrospectively registered).ResultsAll groups demonstrated significant improvements in VISA-P scores at the end of the intervention compared to baseline (p < 0.01), with the combined group showing the greatest improvement (21 points). Follow-up at week 16 revealed continued improvement in VISA-P scores for the combined and HSR groups, while the TUS group showed a slight decrease (from 74 to 70). All groups displayed significantly reduced VAS scores post-intervention (p < 0.01) compared to baseline, indicating decreased pain. While no significant between-group differences were observed in pre-intervention VAS scores, post-intervention results revealed significant differences between the combined and HSR groups (p < 0.05), as well as between the combined and TUS groups (p < 0.01).ConclusionBoth exercise intervention and high-dose TUS appear effective in reducing pain and improving motor function in individuals with PT. However, the therapeutic effect of high-dose TUS alone seems limited compared to exercise intervention. The combined application of both methods yielded the most significant improvements in pain relief and motor function enhancement.

463P Longitudinal progression of motor function in individuals with myotonic dystrophy type 1: insights from the END-DM1 study

463P Longitudinal progression of motor function in individuals with myotonic dystrophy type 1: insights from the END-DM1 study

Spinal Cord Transcutaneous Stimulation in Cervical Spinal Cord Injury: A Review Examining Upper Extremity Neuromotor Control, Recovery Mechanisms, and Future Directions.

Cervical spinal cord injury (SCI) results in significant sensorimotor impairments below the injury level, notably in the upper extremities (UEs), impacting daily activities and quality of life. Regaining UE function remains the top priority for individuals post-cervical SCI. Recent advances in understanding adaptive plasticity within the sensorimotor system have led to the development of novel non-invasive neurostimulation strategies, such as spinal cord transcutaneous stimulation (scTS), to facilitate UE motor recovery after SCI. This comprehensive review investigates the neuromotor control of UE, the typical recovery trajectories following SCI, and the therapeutic potential of scTS to enhance UE motor function in individuals with cervical SCI. Although limited in number with smaller sample sizes, the included research articles consistently suggest that scTS, when combined with task-specific training, improves voluntary control of arm and hand function and sensation. Further, the reported improvements translate to the recovery of various UE functional tasks and positively impact the quality of life in individuals with cervical SCI. Several methodological limitations, including stimulation site selection and parameters, training strategies, and sensitive outcome measures, require further advancements to allow successful translation of scTS from research to clinical settings. This review also summarizes the current literature and proposes future directions to support establishing approaches for scTS as a viable neuro-rehabilitative tool.

A Rehabilitation and Monitoring System for Upper Limb Stroke Based on The Combination of Mirror and Stationary Bicycle

The weakening of motor functions in individuals due to a stroke can impact daily life productivity, necessitating therapy or rehabilitation. One method for restoring the function of body parts, especially the upper limb affected by a stroke, is through mirror therapy on a bicycle. Mirror therapy provides visual stimulation to the brain, influencing the improvement of motor functions. To monitor the effectiveness and safety during therapy, a monitoring system is required to track progress and evaluate vital signs to prevent health issues arising from the exercise process. This research aims to design an integrated upper limb motor exercise system using a mirror therapy bicycle with a website to monitor the therapy process and evaluate the results. Observed parameters include heart rate, oxygen saturation, pedal rotations, and therapy duration. This is because the longer the duration and the more rotations of the static bicycle pedaled by post-stroke patients, the greater the likelihood of improving motor skills. Software reliability was tested for the website and data communication. The study involved 20 healthy subjects, analyzed statistically through descriptive statistics and normality tests using the Kolmogorov-Smirnov type. Then, data similarity was tested against a comparator using the Independent Sample T-Test. Heart rate (bpm) and oxygen saturation (SpO2%) data from the sensor were normally distributed with a p-value ≥ 0.05. MQTT demonstrated optimal performance at QoS 0 with a throughput value of 604.8 bits/s, delay of 3.4 ms, jitter of 2.152 ms, and no packet loss.

Utilizing Entropy of Cadence to Optimize Cycling Rehabilitation in Individuals With Parkinson’s Disease

Background Previous studies have established that increased Sample Entropy (SampEn) of cadence, a measure of non-linear variability, during dynamic cycling leads to greater improvements in motor function for individuals with Parkinson’s disease (PD). However, there is significant variability in responses among individuals with PD due to symptoms and disease progression. Objectives The aim of this study was to develop and test a paradigm for adapting a cycling exercise intervention using SampEn of cadence and rider effort to improve motor function. Methods Twenty-two participants were randomized into either patient-specific adaptive dynamic cycling (PSADC) or non-adaptive (NA) group. SampEn of cadence was calculated after each of the 12 sessions, and motor function was evaluated using the Kinesia test. Pearson’s correlation coefficient was used to analyze the relationship between SampEn of cadence and motor function improvement. Multiple linear regression (MLR) was used to identify the strongest predictors of motor function improvement. Results Pearson’s correlation coefficient revealed a significant correlation between SampEn of cadence and motor function improvements (R2 = −.545, P = .009), suggesting that higher SampEn of cadence led to greater motor function improvement. MLR demonstrated that SampEn of cadence was the strongest predictor of motor function improvement (β = −8.923, t = −2.632, P = .018) over the BMI, Levodopa equivalent daily dose, and effort. Conclusions The findings show that PSADC paradigm promoted a greater improvement in motor function than NA dynamic cycling. These data will be used to develop a predictive model to optimize motor function improvement after cycling in individuals with PD.

Exoskeleton-assisted upper limb rehabilitation after stroke: a randomized controlled trial

ABSTRACT Objectives The upper-limb exoskeleton training program which is repetetive and task-specific therapy can improve motor functions in patients with stroke. To compare the effect of an upper-limb exoskeleton training program with Bobath concept on upper limb motor functions in individuals with chronic stroke. Methods Participants were randomly assigned to exoskeleton group (EG, n = 12) or to Bobath group (BG, n = 12). Interventions were matched in terms of session duration and total number of sessions and performed 2 times per week for 6-weeks. Primary outcome was Fugl-Meyer- Upper Extremity (FMA-UE). Secondary outcomes were Modified Ashworth Scale (elbow and wrist flexor muscles), Motor Activity Log-30 which is consist of two parts as an amount of use (AOU) and quality of movement (QOM), and The Nottingham Extended Activities of Daily Living (NEADL) index. Results After 12-sessions of training, the mean (SD) FMA-UE score increased by 5.7 (2.9) in the EG, and 1.9 (1.5) points in the BG (p < .05). In total, 40% of participants (5/12) demonstrated a clinically meaningful improvement (≥5.25 points) in the FM-UE, while none of the participants reached MCID score in the bobath group. Changes in the AOU, QOM, and NEADL were significantly larger in the EG compared to BG (p < .05). 7/12 (58.33%) of participants for AOU and 5/12 (42%) of participants for QOM in the EG showed that clinically meaningful change. 5/12 of participants (42%) in the EG demonstrated ≥4.9-point increase in NEADL score. Discussion High-intensity repetitive arm and hand exercises with an exoskeleton device was safe and feasible. Exoskeleton-assisted training demonstrated significant benefits in improving upper limb functions and quality of life in individuals after stroke.

Associations Between Music and Dance Relationships, Rhythmic Proficiency, and Spatiotemporal Movement Modulation Ability in Adults with and without Mild Cognitive Impairment.

Personalized dance-based movement therapies may improve cognitive and motor function in individuals with mild cognitive impairment (MCI), a precursor to Alzheimer's disease. While age- and MCI-related deficits reduce individuals' abilities to perform dance-like rhythmic movement sequences (RMS)-spatial and temporal modifications to movement-it remains unclear how individuals' relationships to dance and music affect their ability to perform RMS. Characterize associations between RMS performance and music or dance relationships, as well as the ability to perceive rhythm and meter (rhythmic proficiency) in adults with and without MCI. We used wearable inertial sensors to evaluate the ability of 12 young adults (YA; age = 23.9±4.2 years; 9F), 26 older adults without MCI (OA; age = 68.1±8.5 years; 16F), and 18 adults with MCI (MCI; age = 70.8±6.2 years; 10F) to accurately perform spatial, temporal, and spatiotemporal RMS. To quantify self-reported music and dance relationships and rhythmic proficiency, we developed Music (MRQ) and Dance Relationship Questionnaires (DRQ), and a rhythm assessment (RA), respectively. We correlated MRQ, DRQ, and RA scores against RMS performance for each group separately. The OA and YA groups exhibited better MRQ and RA scores than the MCI group (p < 0.006). Better MRQ and RA scores were associated with better temporal RMS performance for only the YA and OA groups (r2 = 0.18-0.41; p < 0.045). DRQ scores were not associated with RMS performance in any group. Cognitive deficits in adults with MCI likely limit the extent to which music relationships or rhythmic proficiency improve the ability to perform temporal aspects of movements performed during dance-based therapies.

The effects of combining repetitive transcranial magnetic stimulation with task-specific training on gait performance in individuals with Parkinson's disease: A review article.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor impairments, especially in the area of gait disturbances. Physiotherapy, with a focus on task-specific training, has demonstrated a level of efficacy as regards alleviating symptoms and enhancing functional capabilities in individuals with PD. Repetitive Transcranial Magnetic Stimulation (rTMS) has emerged as a potential therapeutic intervention for improving motor functions in individuals with PD. This review article aims to investigate the effects of combining rTMS with task-specific training on gait performance in individuals with PD. PubMed, Physiotherapy Evidence Database (PEDro), and Scopus were all searched for relevant studies. The focus of the search was on studies that investigated the efficacy of combining rTMS with task-specific training to improve gait performance in individuals with PD. Four studies were identified as fulfilling the eligibility criteria and were included in the study. The combination of rTMS with specific treadmill training and weight-bearing exercises can significantly enhance walking efficiency, including improvements in walking speed, self-mobility, and step rate. In addition, the combination of rTMS and task-specific training, such as treadmill-based training, shows promise in enhancing gait performance in individuals with PD. High-frequency rTMS targeting the primary motor cortex (or M1) can result in improved walking speed, self-mobility, and step rate. However, limited research exists regarding low-frequency stimulation of the supplementary motor area (SMA) in individuals with gait issues. Further research is required to determine the optimal parameters of rTMS, such as strength, frequency, and duration of stimulation and it is worth considering the incorporation of additional training modalities, including cognitive exercises.

Associations between music and dance relationships, rhythmic proficiency, and spatiotemporal movement modulation ability in adults with and without mild cognitive impairment.

Personalized dance-based movement therapies may improve cognitive and motor function in individuals with mild cognitive impairment (MCI), a precursor to Alzheimer's disease. While age- and MCI-related deficits reduce individuals' abilities to perform dance-like rhythmic movement sequences (RMS)-spatial and temporal modifications to movement-it remains unclear how individuals' relationships to dance and music affect their ability to perform RMS. Characterize associations between RMS performance and music or dance relationships, as well as the ability to perceive rhythm and meter (rhythmic proficiency) in adults with and without MCI. We used wearable inertial sensors to evaluate the ability of 12 young adults (YA; age=23.9±4.2 yrs; 9F), 26 older adults without MCI (OA; age=68.1±8.5 yrs; 16F), and 18 adults with MCI (MCI; age=70.8±6.2 yrs; 10F) to accurately perform spatial, temporal, and spatiotemporal RMS. To quantify self-reported music and dance relationships and rhythmic proficiency, we developed Music (MRQ) and Dance Relationship Questionnaires (DRQ), and a rhythm assessment (RA), respectively. We correlated MRQ, DRQ, and RA scores against RMS performance for each group separately. The OA and YA groups exhibited better MRQ and RA scores than the MCI group (p<0.006). Better MRQ and RA scores were associated with better temporal RMS performance for only the YA and OA groups (r2=0.18-0.41; p<0.045). DRQ scores were not associated with RMS performance in any group. Cognitive deficits in adults with MCI likely limit the extent to which music relationships or rhythmic proficiency improve the ability to perform temporal aspects of movements performed during dance-based therapies.

Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease.

Long-term physical exercise has been shown to benefit patients with Parkinson disease (PD), but there is a lack of evidence regarding the underlying mechanism. A better understanding of how such benefits are induced by exercise might contribute to the development of therapeutic targets for improving the motor function in individuals with PD. The purpose of this study was therefore to investigate the possible association between exercise-induced motor improvements and the changes in serum microRNA (miRNA) levels of PD patients through small RNA sequencing for the first time. Thirteen PD patients completed our 3-month home-and-community-based exercise program, while 6 patients were assigned to the control group. Motor functions were measured, and small RNA sequencing with data analysis was performed on serum miRNAs both before and after the program. The results were further validated by quantitative real-time polymerase chain reaction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were then conducted to determine the role of differentially expressed miRNAs. The 3-month home-and-community-based exercise program induced significant motor improvements in PD patients in terms of Unified Parkinson's Disease Rating Scale activities of daily living and Motor Subscale (P < .05), comfortable walking speed (P = .003), fast walking speed (P = .028), Six-Minute Walk Test (P = .004), Berg Balance Scale (P = .039), and Timed Up and Go (P = .002). A total of 11 miRNAs (10 upregulated and one downregulated) were identified to be remarkably differentially expressed after intervention in the exercise group, but not in the control group. The results of miRNA sequencing were further validated by quantitative real-time polymerase chain reaction. It was found that the targets of altered miRNAs were mostly enriched in the mitogen-activated protein kinase, Wnt, and Hippo signaling pathways and the GO annotations mainly included binding, catalytic activity, and transcription regulator activity. The exercise-induced motor improvements were possibly associated with changes in circulating miRNA levels in PD patients. These miRNAs, as well as the most enriched pathways and GO terms, may play a critical role in the mechanism of exercise-induced benefits in PD and serve as novel treatment targets for the disease, although further investigations are needed.

Effectiveness of Focal Vibration on Muscle Tone, Kinematic Parameters, and Motor Function in Individuals with Stroke, Parkinson’ Disease and Multiple Sclerosis: A Systematic Review, Meta- Analysis and Meta-Regression

This systematic review aimed to investigate the effect of focal vibration (FV) on muscle tone, kinematic parameters and motor functions in individuals with stroke, Parkinson’ disease and multiple sclerosis. It also determined the influence of vibration parameters such as frequency and amplitude, stimulation session duration, and the total number of intervention sessions on the outcome measures. PubMed, Scopus, Cochrane, Web of Science, and EBSCO were searched, yielding 21 qualifying articles. Within a week post-treatment, FV effectively reduced elbow spasticity (P = 0.04), improved upper limb kinematic parameters (SMD = -0.75, 95% CI: -1.50 to -0.01), and enhanced upper limb motor function (P = 0.05) in stroke patients. FV significantly improved lower limb kinematic parameters of Parkinson’s disease patients (P = 0.03). Over a week post-treatment, the effect of FV was not significant in reducing spasticity for upper limb in stroke (P = 0.25) and improving kinematic parameters for lower limb in Parkinson’s disease (SMD = 0.38, 95% CI: -0.58 to 1.35). The total therapy sessions significantly associated with the effect size (p = 0.042) for upper limb motor function outcome measure. Conclusion, integrating FV into rehabilitation may benefit patients with neurological disorders such as stroke, Parkinson’s disease, and multiple sclerosis.

Validation of a modified version of the gross motor function measure in PPPR5D related neurodevelopmental disorder

BackgroundProtein phosphatase 2 regulatory subunit B’ Delta (PPP2R5D)-related neurodevelopmental disorder is a rare genetic condition caused by pathogenic variants in the PPP2R5D gene. Clinical signs include hypotonia, gross motor delay, intellectual disability (ID), epilepsy, speech delays, and abnormal gait among other impairments. As this disorder was recognized within the last decade, there are only 103 people published diagnoses to date. A thorough understanding of the motor manifestations of this disorder has not yet been established. Knowledge of the natural history of PPP2R5D related neurodevelopmental disorder will lead to improved standard of care treatments as well as serve as a baseline foundation for future clinical trials. Appropriate outcome measures are necessary for use in clinical trials to uniformly measure function and monitor potential for change. The aim of this study was to validate the gross motor function measure (GMFM) in children and adults with PPP2R5D-related neurodevelopmental disorder in order to better characterize the disorder.ResultsThirty-eight individuals with PPP2R5D pathogenic variants, median age 8.0 years (range 1–27) were evaluated. Gross motor, upper limb and ambulatory function were assessed using the GMFM-66, six-minute walk test (6MWT), 10-meter walk run (10MWR), timed up and go (TUG), and revised upper limb module (RULM). The pediatric disability inventory computer adapted test (PEDI-CAT) captured caregiver reported assessment. Median GMFM-66 score was 60.6 (SD = 17.3, range 21.1–96.0). There were strong associations between the GMFM-66 and related mobility measures, 10MWR (rs = −0.733; p < 0.001), TUG (rs= −0.747; p = 0.003), 6MWT (r = 0.633; p = 0.006), RULM (r = 0.763; p < 0.001), PEDICAT-mobility (r = 0.855; p < 0.001), and daily activities (r = 0.822; p < 0.001) domains.ConclusionsThe GMFM is a valid measure for characterizing motor function in individuals with PPP2R5D related neurodevelopmental disorder. The GMFM-66 had strong associations with the RULM and timed function tests which characterized gross motor, upper limb and ambulatory function demonstrating concurrent validity. The GMFM-66 was also able to differentiate between functional levels in PPP2R5D related neurodevelopmental disorder demonstrating discriminant validity. Future studies should examine its sensitivity to change over time, ability to identify sub-phenotypes, and suitability as an outcome measure in future clinical trials in individuals with PPP2R5D variants.

Myoelectric, Myo-Oxygenation, and Myotonometry Changes during Robot-Assisted Bilateral Arm Exercises with Varying Resistances.

Robot-assisted bilateral arm training has demonstrated its effectiveness in improving motor function in individuals post-stroke, showing significant enhancements with increased repetitions. However, prolonged training sessions may lead to both mental and muscle fatigue. We conducted two types of robot-assisted bimanual wrist exercises on 16 healthy adults, separated by one week: long-duration, low-resistance workouts and short-duration, high-resistance exercises. Various measures, including surface electromyograms, near-infrared spectroscopy, heart rate, and the Borg Rating of Perceived Exertion scale, were employed to assess fatigue levels and the impacts of exercise intensity. High-resistance exercise resulted in a more pronounced decline in electromyogram median frequency and recruited a greater amount of hemoglobin, indicating increased muscle fatigue and a higher metabolic demand to cope with the intensified workload. Additionally, high-resistance exercise led to increased sympathetic activation and a greater sense of exertion. Conversely, engaging in low-resistance exercises proved beneficial for reducing post-exercise muscle stiffness and enhancing muscle elasticity. Choosing a low-resistance setting for robot-assisted wrist movements offers advantages by alleviating mental and physiological loads. The reduced training intensity can be further optimized by enabling extended exercise periods while maintaining an approximate dosage compared to high-resistance exercises.

Abstract TMP28: Forced-Rate Aerobic Cycling Enhances Motor Recovery in Persons With Chronic Stroke: A Randomized Clinical Trial

Introduction: The potential for intensive aerobic exercise to enhance neuroplasticity post-stroke has been theorized but not systematically investigated. Our aim was to determine the effects of forced-rate aerobic exercise paired with an abbreviated session of upper extremity (UE) repetitive task practice (FE+RTP) compared to time-matched UE repetitive task practice (RTP only) on the recovery of motor function in individuals with chronic stroke. Hypothesis: We hypothesized that FE+RTP would yield greater improvements in UE motor recovery compared to time-matched RTP only. Methods: A randomized clinical trial was conducted in which participants (N=60) completed 24 sessions of FE followed by RTP (FE+RTP) or time-matched RTP alone. The FE+RTP group exercised at 60-80% of heart rate reserve on a motorized stationary semi-recumbent cycle ergometer for 45 minutes followed by 45 minutes of RTP. The control group completed 90 minutes of RTP. The primary UE outcomes were the Fugl-Meyer Assessment (FMA) and the Action Research Arm Test (ARAT). The Six-minute Walk Test (6MWT) assessed walking capacity. Results: Sixty individuals 60.5 (±10.6) years of age were enrolled, and 56 completed the study. The RTP only group completed more RTP in terms of repetitions (411.8±44.4 versus 222.8±28.4, P&lt;0.001) and time (72.7±6.7 versus 37.8±2.4 minutes, P&lt;0.001) compared to FE+RTP. Both groups improved on the FMA (FE+RTP, 36.2±10.1 to 44.0±11.8 and RTP only, 34.4±11.0 to 41.2±13.4, P&lt;0.001) and ARAT (FE+RTP, 32.5±16.6 to 37.7±17.9 and RTP only, 32.8±18.6 to 36.4±18.5, P&lt;0.001). A group main effect was not observed. The FE+RTP group demonstrated greater improvements on the 6MWT (274.9±122.0 to 327.1±141.2 meters) compared to the RTP only group (285.5±160.3 to 316.9±170.0, P=0.004). Conclusions: While both interventions elicited comparable improvements in UE motor recovery, the summative value of FE+RTP in improving UE and lower extremity function was demonstrated.

Avatar embodiment prior to motor imagery training in VR does not affect the induced event-related desynchronization: a pilot study

Motor-imagery brain-computer interfaces (MI-BCIs) have the potential to improve motor function in individuals with neurological disorders. Their effectiveness relies on patients’ ability to generate reliable MI-related electroencephalography (EEG) patterns, which can be influenced by the quality of neurofeedback. Virtual Reality (VR) has emerged as a promising tool for enhancing proprioceptive feedback due to its ability to induce a sense of embodiment (SoE), where individuals perceive a virtual body as their own. Although prior research has highlighted the importance of SoE in enhancing MI skills and BCI performance, to date, no study has successfully isolated nor manipulated the SoE in VR before MI training, creating a gap in our understanding of the precise role of the priming effect of embodiment in MI-BCIs. In this study, we aimed to examine whether the virtual SoE when induced, as priming of avatar embodiment, and assessed before MI training, could enhance MI-induced EEG patterns. To achieve this, we divided 26 healthy participants into two groups: the embodied group, which experienced SoE with an avatar before undergoing VR-based MI training, and the non-embodied group, which underwent the same MI training without a prior embodiment phase, serving as a control. We analyzed subjective measures of embodiment, the event-related desynchronization (ERD) power of the sensorimotor rhythms, lateralization of ERD, and offline classification BCI accuracy. Although the embodiment phase effectively induced SoE in the embodied group, both groups exhibited similar MI-induced ERD patterns and BCI classification accuracy. This suggests that the induction of SoE prior to MI training may not significantly influence the training outcomes. Instead, it appears that the integration of embodied VR feedback during MI training itself is sufficient to induce appropriate ERD, as evidenced by previous research.

Beyond pediatrics: noninvasive spinal neuromodulation improves motor function in an adult with cerebral palsy.

Regaining motor function in individuals with cerebral palsy (CP) has been predominantly studied in children, resulting in an underrepresentation of adults in research efforts. We tested the efficacy of noninvasive spinal neuromodulation with neurorehabilitation (Spinal Cord Innovation in Pediatrics; SCiP™ therapy). A 60-year-old CP participant underwent 8 weeks of SCiP™ therapy, resulting in significant motor recovery measured by 14.2-points increase in gross motor function measure (GMFM-88) score, ~ three times the Minimal Clinically Important Difference (MCID) of 5-points. This represented gains in kneeling, sitting, and walking functions. The improvement in GMFM-88 score was maintained above the MCID at the follow up visit (10.3 points above the baseline), twenty weeks following the last therapy session, indicating a persistent effect of the therapy. Our preliminary findings support the therapeutic promise of SCiP™ therapy for enhancing motor function in CP adults. Broader investigations are needed to establish its wider applicability.

Spiral strapping for improving upper extremity motor functions in individuals with stroke: A randomized controlled trial.

The rehabilitation process for the upper extremities of individuals with stroke requires therapists to use splints for supportive and corrective purposes. The aim of this study was to assess the effectiveness of spiral strapping in inhibiting spasticity and improving the upper extremity motor functions of individuals with chronic stroke. Forty Saudi individuals aged 50-60 years with chronic stroke participated in this study. Their degrees of spasticity according to the Modified Ashworth Scale ranged across grades 1, 1+, and 2. Participants were randomly assigned to experimental and control groups. Participants in both groups received 1 h of conventional physical therapy for 3 d/wk to improve the motor functions of their upper extremities. In addition, participants in the experimental group wore an upper-limb spiral strapping with a hand splint 10 h/d for 6 d/wk. The treatment program for both groups was delivered for 4 weeks. Changes in the scores of Action Research Arm Test for elbow joint spasticity, active range of motion of the shoulder, elbow, and forearm joints, and hand grip strength were evaluated before and after treatment in both groups. Significant improvements in all measured variables after treatment were reported in both groups, except for elbow joint spasticity in the control group. The experimental group showed significant post-treatment improvement in the scores for all measured variables compared with the control group. Spiral strapping was beneficial in inhibiting mild degrees of spasticity and improving the motor functions of the upper extremities of stroke patients.

Ab. No. 65 The Effect of Motor Imagery and Virtual Reality on Motor Functions in Individuals With Parkinson’s Disease – A Systematic Review

Introduction: Parkinson’s disease is a neuro-degenerative disorder, characterized by degeneration of dopaminergic neurons. Motor imagery practice uses the imagery of a motor act to learn and Improve outcome. Virtual reality can provide patients with sensory stimulation, immersive environment, feedback during motor task, reflecting motor learning and neuroplasticity. The purpose is to investigate effectiveness of motor imagery and virtual reality on motor functions in individuals with Parkinson’s disease. Methods: 10 articles were included with 287 participants. 9 were RCT and one was case study. A search of literature was conducted by using following keywords: Parkinson’s disease, Virtual reality, motor imagery. A search was undertaken via google scholar, PubMed and research gate. Out of 287 articles, 28 studies were reviewed. 10 studies met the inclusion criteria. UPDRS was the outcome measure used to assess motor functions. These articles were analyzed using PRISMA 2020 checklist and PEDro. Cochrane risk of bias tool was used to check the bias. Three articles studied the combined effect of virtual reality and motor imagery, two motor imagery alone and five virtual realities alone. Result: Combining VR with MI showed statistically significant difference. Motor imagery alone showed significant difference in one article and no difference in the other. Articles about VR alone showed statistically significant difference. Conclusion: Virtual reality and motor imagery are effective rehabilitation tool for improving motor function in individuals with Parkinson’s disease. Implications: Virtual reality and motor imagery can be used in designing more effective and engaging rehabilitation program leading to improved outcomes and quality of life.

A Gait Imagery-Based Brain-Computer Interface with Visual feedback for Spinal Cord Injury Rehabilitation on Lokomat.

Motor Imagery (MI)-based Brain-Computer Interfaces (BCIs) have been proposed for the rehabilitation of people with disabilities, being a big challenge their successful application to restore motor functions in individuals with Spinal Cord Injury (SCI). This work proposes an Electroencephalography (EEG) gait imagery-based BCI to promote motor recovery on the Lokomat platform, in order to allow a clinical intervention by acting simultaneously on both central and peripheral nervous mechanisms. As a novelty, our BCI system accurately discriminates gait imagery tasks during walking and further provides a multi-channel EEG-based Visual Neurofeedback (VNFB) linked to μ (8-12 Hz) and β (15-20 Hz) rhythms around Cz. VNFB is carried out through a cluster analysis strategy-based Euclidean distance, where the weighted mean MI feature vector is used as a reference to teach individuals with SCI to modulate their cortical rhythms. The developed BCI reached an average classification accuracy of 74.4%. In addition, feature analysis demonstrated a reduction in cluster variance after several sessions, whereas metrics associated with self-modulation indicated a greater distance between both classes: passive walking with gait MI and passive walking without MI. The results suggest that intervention with a gait MI-based BCI with VNFB may allow the individuals to appropriately modulate their rhythms of interest around Cz. This work contributes to the development of advanced systems for gait rehabilitation by integrating Machine Learning and neurofeedback techniques, to restore lower-limb functions of SCI individuals.