315 research outputs found
Age-Related Differences in Motor Performance
The purpose of this work was to study the age effects on average performance and variability of movement responses in children, young adults, and older adults across multiple motor tasks. Optimal motor performance is observed in healthy young adults with declines observed at either end of the lifespan. This pattern has been represented as a U-shaped/inverted U-shaped curve. Little is known about if this pattern persists in chewing dynamics. While chewing has been found to improve aspects of attention, a cognitive function, research is limited on the relationship between chewing and other motor tasks.
The first aim of this research was to conduct a scoping systematic review to identify what measures of variability are reported for preferred performance of chewing and walking in children, young adults, and older adults and the age-related differences across these age groups. The available research was insufficient across these groups and does not support the perspective that children and older adults are more variable than young adults.
The second aim was to examine age-related differences in averages and variability of chewing, reaction time, balance, and walking responses across children, young adults, and older adults. A U-shaped curve was revealed for reaction time and postural sway with the young adults producing faster reaction times and decreased postural sway than the children and older adults. Chewing rates followed a similar curve but with children chewing at faster rates than young and older adults. No age-related differences were observed for normalized gait speed.
The final aim was to examine dual task relationships between chewing and secondary motor tasks in children. Sixteen healthy children completed finger tapping, reaction time, and walking while chewing at different speeds. Chewing rates varied when produced with a secondary motor task and the secondary motor tasks were differentially influenced by chewing. Reaction times slowed during chewing while walking rates increased/decreased with changes in chewing rates. This relationship was not as strong as previous reports in adults.
Overall, the anticipated patterns across the age groups were only partially revealed within this work. Understanding normal movement patterns is the foundation to identifying variations in atypical populations
Proceedings XXIII Congresso SIAMOC 2023
Il congresso annuale della Società Italiana di Analisi del Movimento in Clinica (SIAMOC), giunto quest’anno alla sua ventitreesima edizione, approda nuovamente a Roma.
Il congresso SIAMOC, come ogni anno, è l’occasione per tutti i professionisti che operano nell’ambito dell’analisi del movimento di incontrarsi, presentare i risultati delle proprie ricerche e rimanere aggiornati sulle più recenti innovazioni riguardanti le procedure e le tecnologie per l’analisi del movimento nella pratica clinica.
Il congresso SIAMOC 2023 di Roma si propone l’obiettivo di fornire ulteriore impulso ad una già eccellente attività di ricerca italiana nel settore dell’analisi del movimento e di conferirle ulteriore respiro ed impatto internazionale.
Oltre ai qualificanti temi tradizionali che riguardano la ricerca di base e applicata in ambito clinico e sportivo, il congresso SIAMOC 2023 intende approfondire ulteriori tematiche di particolare interesse scientifico e di impatto sulla società . Tra questi temi anche quello dell’inserimento lavorativo di persone affette da disabilità anche grazie alla diffusione esponenziale in ambito clinico-occupazionale delle tecnologie robotiche collaborative e quello della protesica innovativa a supporto delle persone con amputazione. Verrà infine affrontato il tema dei nuovi algoritmi di intelligenza artificiale per l’ottimizzazione della classificazione in tempo reale dei pattern motori nei vari campi di applicazione
Design and Development of Biofeedback Stick Technology (BfT) to Improve the Quality of Life of Walking Stick Users
Biomedical engineering has seen a rapid growth in recent times, where the aim to facilitate and equip humans with the latest technology has become widespread globally. From high-tech equipment ranging from CT scanners, MRI equipment, and laser treatments, to the design, creation, and implementation of artificial body parts, the field of biomedical engineering has significantly contributed to mankind. Biomedical engineering has facilitated many of the latest developments surrounding human mobility, with advancement in mobility aids improving human movement for people with compromised mobility either caused by an injury or health condition. A review of the literature indicated that mobility aids, especially walking sticks, and appropriate training for their use, are generally prescribed by allied health professionals (AHP) to walking stick users for rehabilitation and activities of daily living (ADL). However, feedback from AHP is limited to the clinical environment, leaving walking stick users vulnerable to falls and injuries due to incorrect usage. Hence, to mitigate the risk of falls and injuries, and to facilitate a routine appraisal of individual patient’s usage, a simple, portable, robust, and reliable tool was developed which provides the walking stick users with real-time feedback upon incorrect usage during their activities of daily living (ADL).
This thesis aimed to design and develop a smart walking stick technology: Biofeedback stick technology (BfT). The design incorporates the approach of patient and public involvement (PPI) in the development of BfT to ensure that BfT was developed as per the requirements of walking stick users and AHP recommendations. The newly developed system was tested quantitatively for; validity, reliability, and reproducibility against gold standard equipment such as the 3D motion capture system, force plates, optical measurement system for orientation, weight bearing, and step count. The system was also tested qualitatively for its usability by conducting semi-informal interviews with AHPs and walking stick users. The results of these studies showed that the newly developed system has good accuracy, reported above 95% with a maximum inaccuracy of 1°. The data reported indicates good reproducibility. The angles, weight, and steps recorded by the system during experiments are within the values published in the literature. From these studies, it was concluded that, BfT has the potential to improve the lives of walking stick users and that, with few additional improvements, appropriate approval from relevant regulatory bodies, and robust clinical testing, the technology has a huge potential to carve its way to a commercial market
Transcranial Direct Current Stimulation (tDCS) to Improve Lower Limb Motor Recovery Following Stroke: A Review and Study Proposal
Strokes are the result of restricted blood flow to particular areas of the brain classified by their cause. The neural damage they cause are of growing concern as the number of young adults experiencing strokes has increased by 11% in the last decade. Following stroke, there is an imbalance of inhibitory and excitatory neuronal activity, and disruption of neural networks. These changes lead to neuronal death and loss of synaptic connections that, depending on which part of the brain is affected, result in behavioral deficits such as weakness, limb hemiparesis, and loss of coordination, as well as speech and cognitive impairments. However, this loss of function can be partly recovered due to neuroplastic processes. Non-invasive brain stimulation (NIBS) is an approach that involves implanting electrodes into targeted areas of the brain which are connected to an implantable pulse generator on the skin that delivers chronic electric pulse. There are different forms of stimulation, but one with some established success in improving upper and lower limb mobility, as well as some cognitive symptoms, is transcranial direct current stimulation (tDCS). For the treatment of stroke, tDCS aims to increase excitability of the lesioned areas to improve contralesional mobility. While past research has focused on stimulating well established motor regions, such as the cerebellum, motor cortex, and basal ganglia, sensory systems also play a key role in sending information through the ascending dorsal column medial lemniscal pathway, posterior and anterior spinocerebellar tracts, and spinoreticular tracts. Here is a review of the current research on the integration of sensory and motor information in order to carry out desired movement, a discussion about how these networks are being targeted by tDCS after stroke to help patients regain lower limb movement, and finally, a proposed study in which improvements in balance, gait, and postural stability after anodal tDCS continue up to a year post-treatment in chronic ischemic stroke patients
Bilateral Prefrontal Cortex Activation During Ankle Sensorimotor Conditions in People with Subacute Stroke – an Exploratory fNIRS Study
The purpose of this exploratory study is to evaluate prefrontal cortex (PFC) activation patterns linked to active and passive paretic ankle dorsiflexion and plantarflexion and somatosensory stimulation (SS) using a reformed paperclip in people with subacute stroke. By using a neuroimaging tool called functional near-infrared spectroscopy (fNIRS) over the PFC, oxygenated and deoxygenated hemoglobin levels were collected in 9 participants. Objectives, including between-condition differences in PFC activation, interhemispheric asymmetry during conditions, and the relationship between interhemispheric asymmetry and clinical outcome measurement (Fugl-Meyer Lower Extremity Assessment, or FMLE), were evaluated using the fNIRS plots and Laterality Index (LI). Results showed that the active condition demonstrated the highest PFC activation, followed by the SS condition, then the passive condition. Two methods (LI and fNIRS plots) investigated interhemispheric asymmetry and divergent findings were found. Moreover, participants who have a higher score on the FMLE demonstrated bilateral PFC activation during active and SS conditions but contralesional activation during the passive condition. Overall, our study provided exploratory results that assist in understanding the role of PFC in ankle sensorimotor functions in people with subacute stroke
Report and Abstracts of the 15th Congress of the Mediterranean Forum of Physical and Rehabilitation Medicine: Rome, July 6-8, 2023
The 15th Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM) Congress, held in Rome from 6 to 8 July 2023, brought together over 600 PRM specialists and residents from 51 countries and 5 continents to share knowledge, perspectives, and research findings. The Congress focused on the theme "Beyond COVID," highlighting the resilience and adaptability of PRM in the face of the pandemic. Presentations showcased the latest advancements in PRM across various subspecialties, including orthopedics and sports re-education, neurological disorders, pharmacotherapy and pain, pediatrics disorders, musculoskeletal disease, ergonomics and robotics, spasticity management, ICF and evaluation scales, spinal cord injury, musculoskeletal ultrasounds, rehabilitation of patients with cancers disease, post COVID-19 re-education, cardio-respiratory and urogynecological disorders, and traumatic brain injury. The congress successfully served as a platform for knowledge exchange, collaboration, and innovation in PRM, highlighting the importance of international cooperation and the resilience of PRM in adapting to emerging challenges
Contribution du cortex prémoteur à la locomotion entravée chez le chat
La locomotion est une composante fondamentale de la vie animale : elle permet l’accès continu aux ressources nécessaires à la survie ainsi que l’évitement de périls variés. Les milieux naturels comme anthropiques regorgent toutefois d’obstacles s’élevant contre notre progression. Pour l’humain et les autres mammifères terrestres naviguant principalement par la vision, le franchissement efficace de ces obstacles repose critiquement sur la capacité de modifier proactivement le positionnement et la trajectoire des pas en fonction des informations visuelles extraites durant leur approche.
Au niveau du système nerveux, cette capacité implique un processus complexe où le traitement des signaux visuels reflétant les paramètres de l’obstacle spécifie un cours d’action sécurisant son franchissement, lequel est ultimement exécuté par des altérations précises à l’activité musculaire. Des études approfondies chez le chat, l’un des modèles animaux les plus développés et investigués vis-à -vis du contrôle locomoteur, ont présentement impliqué deux structures corticales dans ce processus. Le cortex pariétal postérieur contribuerait ainsi à déterminer la position relative de l’obstacle et le cortex moteur primaire serait central à l’exécution des modifications de la démarche. Cependant, notre compréhension du substrat neural impliqué dans la transformation sensorimotrice joignant ces deux étapes est extrêmement limitée. Plusieurs lignes d’évidences, particulièrement dérivées de travaux chez le primate investiguant le contrôle des mouvements volontaires du bras, pointent cependant vers une contribution potentiellement majeure du cortex prémoteur à cette fonction.
Cette thèse entreprend de déterminer directement la contribution prémotrice aux modifications de la démarche. Deux études rapportent ainsi l’activité de neurones individuels enregistrés dans deux larges subdivisions du cortex prémoteur, les aires 6iffu et 4delta, chez le chat éveillé accomplissant librement une tâche de négociation d’obstacles sur tapis roulant. Ces études font état de changements d’activité distincts d’une subdivision à l’autre et corrélés à des aspects spécifiques de la tâche, incluant des changements préparatoires liés à l’approche finale de l’obstacle et d’autres liés à une ou plusieurs étapes des ajustements locomoteurs séquentiels entourant sa négociation. Une troisième étude investigue par microstimulation intracorticale la capacité des différentes subdivisions prémotrices du chat à modifier la démarche. Cette étude expose une variété de réponses électromyographiques complexes s’intégrant en phase avec la marche, où plusieurs subdivisions présentent des signatures distinctes d’effets multi-membres contrastant avec l’influence focale du cortex moteur primaire. Chacune de ces trois études est finalement complémentée d’investigations par traçage rétrograde de connexions anatomiques décisives à l’interprétation fonctionnelle des subdivisions investiguées.
Ensemble, ces travaux soutiennent et précisent une contribution centrale du cortex prémoteur aux modifications de la démarche sous guidage visuel. D’une part, ils rapportent pour la première fois que l’activité neuronale de multiples subdivisions du cortex prémoteur reflète différentes étapes de la planification locomotrice stipulant les altérations à entreprendre à l’approche d’un obstacle et durant son franchissement. D’autre part, ils révèlent complémentairement que l’activation de ces subdivisions a le pouvoir d’influencer profondément la marche. Les données collectées soulignent finalement plusieurs points de comparaison entre les aires prémotrices du chat et du primate, suggérant un degré d’analogie fonctionnelle extensible à la locomotion humaine.Locomotion is a fundamental component of animal life: it provides continuous access to the resources necessary for survival as well as the means to elude potential perils. However, both natural and built environments teem with obstacles impeding one’s progress. For humans and other terrestrial mammals navigating primarily through vision, efficiently negotiating these obstacles critically requires the capacity to proactively adapt the positioning and trajectory of each step on the basis of visual information extracted during their approach.
In the nervous system, this capacity involves a complex process through which the integration of visual signals reflecting the parameters and location of an obstacle specifies a course of action to ensure its negotiation, Extensive studies in the cat, one of the most common models used to study the neural mechanisms involved in the control of locomotion, have currently implicated two cortical structures to this process. The posterior parietal cortex is suggested to contribute to the determination of the obstacle’s relative position (with respect to the body) while the primary motor cortex is central to the execution of the gait modifications. However, our comprehension of the neural substrate implicated in the sensorimotor transformation linking these defined stages is extremely limited. Several lines of evidence, predominantly derived from work in the primate investigating the voluntary control of arm movements, nonetheless point towards a potentially major contribution of the premotor cortex to this function.
This thesis sets out to directly determine the premotor contribution to the control of gait modifications. Two studies report the activity of individual neurons recorded in two large subdivisions of premotor cortex, areas 6iffu and 4delta, in awake cats freely performing an obstacle negotiation task on treadmill. These studies describe distinct changes in activity across subdivisions that correlate with specific aspects of the task, including preparatory changes related to the final approach of the obstacle and others related to one or more stages of the sequential locomotor adjustments surrounding its negotiation. A third study used intracortical microstimulation to investigate the capacity of different premotor subdivisions of the cat to modify gait. This study reveals a variety of complex electromyographic responses that are integrated into the gait cycle. Moreover, several subdivisions show distinct signatures of multi-limb effects that contrast with the focal influence of the primary motor cortex. Each of these three studies is finally complemented by retrograde tracing investigations of anatomical connections critical to the functional interpretation of the subdivisions examined.
Together, these studies support and clarify a central contribution of the premotor cortex to the modification of gait under visual guidance. We report for the first time that the neural activity of multiple subdivisions of the premotor cortex reflects different stages of the locomotor plan specifying the gait alterations to perform during the approach and crossing of an obstacle. In addition, we reveal that activation of these subdivisions has the power to profoundly influence walking. The data collected finally highlight several points of comparison between the premotor areas of the cat and the primate, suggesting a degree of functional analogy extensible to human locomotion
Methodological considerations for the assessment of postural stability and lower limb bilateral asymmetry
Purpose: There are currently no agreed methods for the assessment of postural stability using centre of pressure (CoP) analysis of quiet standing nor assessment of lower limb bilateral asymmetry measured during a countermovement jump (CMJ). Much of the existing literature surrounding both of these biomechanical assessments are varied and inconclusive in the determination of a criterion methodology. There is also a dearth of information regarding the reliability of both measures or expected outcomes. Therefore, the purpose of the current study was twofold. Firstly, to assess the methodology and reliability of postural stability measures obtained from a force-platform. Secondly, to investigate the methodology and reliability of measuring lower limb bilateral asymmetry using a dual-force-platform set-up. Methodology: Using a repeated measures design of test-retest reliability, postural stability and CMJ performance was assessed for male (n = 10, age = 32.7 ± 9.5 yrs., height = 1.797 ± 0.060 m, mass = 88.2 ± 14.4 kg) and female (n = 9, age = 32.4 ± 8.7 yrs., height = 1.662 ± 0.055 m, mass = 70.8 ± 13.5 kg) recreationally active individuals divided into three populations, female-only (FEM), male-only (MALE) and combined (ALL). For postural stability measurement, path length (Lp), sway area (As) and mean velocity (Vm) were reported from 8 trials for six epochs derived from 100 s of quiet standing. Four trials of each condition, were conducted on each of the two separate testing days. Reliability of bilateral CMJ performance was assessed from ten maximal CMJ trials using five kinetic and two temporal neuromuscular variables: peak force (Fmax), impulse due to eccentric and concentric contraction (Jecc and Jcon), peak instantaneous mechanical power (PPO), take-off velocity (Vto), percentage of jump duration that changeover from eccentric to concentric phases occurs (tecN) and percentage of jump duration that peak force occurs (tFmaxN). Lower limb bilateral asymmetry was then calculated for Fmax, Jecc, Jcon and tFmaxN using two SIs; sided, left leg vs right leg (LvsR) and un-sided, higher vs lower limb value (HvsL) to give asymmetry irrespective of limb side. Differences between conditions and SI methods were identified using paired-samples t-tests and test-retest reliability was assessed using ICC and Bland and Altman (B&A) plot analysis. Postural Stability Results: Lp and Vm were significantly higher (p ≤ 0.05) in the EC condition for all epochs. As demonstrated differences between the two conditions, however, not always significant; in all cases of significance, As was greater in the EC condition. Absolute ICC values for Lp and Vm were indicative of excellent reliability (>0.90) however, 95% CI ranged from poor (0.75) to excellent across conditions and epochs. B&A plot analysis showed As was the most variable. In general, results showed that EC had the higher test-retest reliability, however differences between ICC values and the magnitude of the bias and LOA between conditions were small. It was not clear which epoch provided the most, or least, reliable results for Lp or Vm. For As, the 1st 30 s had the most variability, while for all variables, 90 s was one of the most reliable epochs. Cumulative moving average analysis showed a trend toward increased precision as number of repetitions increased for all epochs. Bilateral Asymmetry Results: Kinematic variables derived from analysis of a CMJ resulted in high test-retest reliability and agreement (ICC > 0.9) for Fmax, Jecc, Jcon, PPO, Vto and tecN. LvsR and HvsL methods of SI calculation were significantly different (p ≤ 0.05) for 3/4 variables. Fmax (ALL: LvsR - 0.72 ± 6.96%, HvsL 6.22 ± 3.89%), Jecc (ALL: LvsR 4.99 ± 23.47%, HvsL 25.29 ± 12.33%), Jcon (ALL: LvsR -6.93 ± 26.87%, HvsL 25.47 ± 13.80%), tFmaxN (ALL: LvsR -2.10 ± 7.87%, HvsL 5.67 ± 6.83%). Overall, the absolute ICCs of Jecc and tFmaxN ranged from poor to excellent, while Fmax and Jcon showed better agreement, although 95% CI ranges and magnitude of B&A LOAs were still large, particularly in LvsR (e.g., Fmax, ALL LvsR: Bias = 32%, LOA = 352%). B&A plot analysis demonstrated far smaller bias and LOA in HvsL than LvsR for all variables and populations. In both postural stability and bilateral asymmetry, there was no substantial differences noted between the reliability of FEM and MALE populations. For both cases, greater reliability could be seen for the majority of variables when FEM and MALE were combined in the ALL population. Conclusions: Lp and Vm had better reliability and lower variability than As. As is not recommended as a reliable postural stability performance parameter. There was a significant difference between visual conditions, indicating the impact of visual acuity on human postural control. Both EO and EC showed good reliability for all epochs, although B&A plots revealed variability in the data that should be considered in future research. Although EC appeared to be the slightly more reliable condition, it cannot be recommended over EO as they are representative of different requirements of human postural control. Bilateral CMJ performance showed good test-retest reliability, however, normalised temporal variables should be used with caution; tFmaxN was the least reliable variable. LvsR and HvsL methods of SI calculation were significantly different and have the ability to quantify very different inherent characteristics of bilateral CMJ performance. Results identify the importance of determining a suitable set of reference values and the consideration of the directionality of asymmetries on an individual basis. In a bilateral CMJ, the differences in the force generating capacity between limbs does not necessarily determine the variation in the magnitude of VGRF generated during the jump. Instead, variations in VGRF symmetry should be considered to represent bilateral variations in limb loading that stem from differing jumping and compensatory strategies adopted by individuals
Utilisation of Cryotherapy in Sport: Understanding the Multifaceted Response
Cryotherapy is commonly used in sport for injury, rehabilitation, and recovery in readiness to perform. The principal aim of this thesis was to examine the effects of cryotherapy on several responses that underpin the optimisation of its application in sport. A substantial evidence base investigates the effects of various modes of cryotherapy across different populations and protocols, yet no body of literature examines multiple responses across several domains (biomechanical, biochemical, physiological, psychological) with an emphasis on contemporary in-field applied practices of cryotherapy in sport. This approach defines the originality of the thesis. Fifteen peer reviewed publications represent the body of work, structured by five themes:
Theme 1: KINEMATIC RESPONSES TO CRYOTHERAPY
Theme 2: MUSCLE STRENGTH RESPONSES TO CRYOTHERAPY
Theme 3: THERMOGRAPHY AND SKIN SURFACE RESPONSES TO CRYOTHERAPY
Theme 4: CONTEMPORARY CRYOTHERAPY APPLICATIONS AND RESPONSES
Theme 5: MULTIFACETED RESPONSES TO CRYOTHERAPY AS A RECOVERY STRATEGY IN ELITE SPORT
The studies representing several underpinning concepts from which key research questions evolved, adopted several methodologies and styles, presented in a conceptual arrangement within the five themes as opposed to chronological order. The purpose being to demonstrate synergy between concepts that might be considered important for the development of optimal cryotherapeutic applications in sport. This is an expression of the author’s interest in and evolution of research over several years working in sport rather than a pre-determined plan of studies which allowed adaptability to contemporary issues in practice as they emerged. Populations ranged from amateur to elite professional athletes, with data collection protocols developed from laboratory-based to high-performance sports environments within mid-competitive seasons.
Key findings note the ability to reduce skin surface temperature for optimising intended physiological response differs between dose, modality type, compression adjunct and physical positional characteristics in team sport. Further, consensus on optimal protocols for cryo-compression is lacking, despite compression being known to increase the magnitude of cooling. Sports practitioners should appreciate the potentially detrimental biomechanical responses to local cooling at the lower limb when considering the multidirectional demands of sport. Consequently, several variables can influence the optimisation of cryotherapeutic protocols seen in biomechanical and perceptual responses over rewarming periods. Further, where cold-water immersion may be useful to ameliorate potential deficits in eccentric hamstring strength, differences in neuromuscular performance suggest periodisation and individualisation of cryotherapy protocols in these environments is important to negate responses that may be inhibiting readiness to perform. The progression of advantageous cooling protocols in sport are inherent to the understanding of the response and relationship between key variables that underpin the effected output and response in the working context of the cryotherapeutic application. Considerations for applied practitioners to optimise cryotherapy protocols are illustrated (Table 10. pg. 227) and an infographic (Figure 23. pg. 231) to provide recommendations for future applied research demonstrates the originality of the work
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