Mobile Applications for Resting Tremor Assessment in Parkinson’s Disease: A Systematic Review

(1) Background: Resting tremor is a motor manifestation present in most Parkinson’s disease (PD) patients. For its assessment, several scales have been created, but mobile applications could help in objectively assessing resting tremor in PD patients in person and/or remotely in a more ecological scenario. (2) Methods: a systematic review following the PRISMA recommendations was conducted in scientific databases (PubMed, Medline, Science Direct, Academic Search Premier, and Web of Science) and in the main mobile application markets (Google Play, iOS App Store, and Windows Store) to determine the applications available for the assessment of resting tremor in patients with PD using only the measurement components of the phone itself (accelerometers and gyroscopes). (3) Results: 14 articles that used mobile apps to assess resting tremor in PD were included, and 13 apps were identified in the mobile application markets for the same purpose. The risk of bias and of applicability concerns of the articles analyzed was low. Mobile applications found in the app markets met an average of 85.09% of the recommendations for the development of medical mobile applications. (4) Conclusions: the use of mobile applications for the evaluation of resting tremor in PD patients has great potential, but validation studies for this purpose are scarce.Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería)Fac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Predictive Factors and ACE-2 Gene Polymorphisms in Susceptibility to Long COVID-19 Syndrome.

Long COVID-19 syndrome is present in 5–10% of patients infected with SARS-CoV-2, and there is still little information on the predisposing factors that lead to its development. The purpose of the study was to evaluate the predictive factors in early symptoms, clinical features and the role of Angiotensin-Converting Enzyme-2 (ACE-2) c.513-1451G>A (rs2106806) and c.15643279T>C (rs6629110) polymorphisms in the susceptibility to developing Long COVID-19 syndrome subsequent to COVID-19 infectionA total of 29 patients who suffered COVID-19 were recruited in a descriptive longitudinal study of two groups: Long COVID-19 (n = 16) and non-Long COVID-19 (n = 13). Early symptoms and clinical features during COVID-19 were classified by a medical service. ACE-2 polymorphisms were genotyped by using a Single Nucleotide Primer Extension (SNPE). Of the early symptoms, fatigue, myalgia and headache showed a high risk of increasing Long COVID-19 susceptibility. Clinical features such as emergency care, SARS-CoV-2 reinfection, previous diseases, respiratory disease and brain fog also had a high risk of increasing Long COVID-19 susceptibility. The A allele in the rs2106806 variant was associated with an odds ratio (OR) of 4.214 (95% CI 2.521–8.853; p < 0.001), and the T allele in the rs6629110 variant was associated with an OR of 3.754 (95% CI 1.785–6.105; p = 0.002) of increasing Long COVID-19 susceptibility. This study shows the risk of ACE-2 polymorphisms, different early symptoms and clinical features during SARS-CoV-2 infection in susceptibility to Long COVID-19.post-print292 K

Effects of EMG-controlled video games on the upper limb functionality in patients with multiple sclerosis: a feasibility study and development description

Multiple sclerosis (MS) is the most common inflammatory neurological disease in young adults, with a high prevalence worldwide (2.8 million people). To aid in the MS treatment, using VR tools in cognitive and motor rehabilitation of such disease has been growing progressively in the last years. However, the role of VR as a rehabilitative tool in MS treatment is still under debate. This paper explores the effects of VR training using EMG activation in upper limb functionality. An experimental training protocol using video games controlled using an MYO armband sensor was conducted in a sample of patients with MS. Results support the use of EMG-commanded video games as a rehabilitative tool in patients with MS, obtaining favorable outcomes related to upper limb functionality and satisfaction.The authors would like to thank all the participants who collaborated in this study, as well as the staff of Association ALEM (Leganés, Spain). Also, the authors would like to thank Hugo Alonso Cámara for his collaboration and technical support. The research leading to these results received funding from the Spanish Ministry of Economy and Competitiveness as part of the project "ROBOASSET: Intelligent Robotic Systems for Assessment and Rehabilitation in Upper Limb Therapies" (PID2020-113508RB-I00), funded by AEI/10.13039/501100011033; from the Robocity2030-III-CM Project (S2013/MIT-2748) which is supported in part by Programas de Actividades I+D en la Comunidad de Madrid and in part by Structural Funds of the EU; and also from Spanish research project Discover2Walk "Sistema Robótico para Propiciar la Marcha en Niños Pequeños con Parálisis Cerebral" under Grant PID2019-105110RB-C32/AEI/10.13039/501100011033. This paper was part of the R&D and the authors' project PLEC2021-007819 funded by MCIN/AEI/10.13039/501100011033 and by the European Union NextGenerationEU/PRTR

Validity of a Fully-Immersive VR-Based Version of the Box and Blocks Test for Upper Limb Function Assessment in Parkinson's Disease

In recent decades, gaming technology has been accepted as a feasible method for complementing traditional clinical practice, especially in neurorehabilitation; however, the viability of using 3D Virtual Reality (VR) for the assessment of upper limb motor function has not been fully explored. For that purpose, we developed a VR-based version of the Box and Blocks Test (BBT), a clinical test for the assessment of manual dexterity, as an automated alternative to the classical procedure. Our VR-based BBT (VR-BBT) integrates the traditional BBT mechanics into gameplay using the Leap Motion Controller (LMC) to capture the user’s hand motion and the Oculus Rift headset to provide a fully immersive experience. This paper focuses on evaluating the validity of our VR-BBT to reliably measure the manual dexterity in a sample of patients with Parkinson’s Disease (PD). For this study, a group of twenty individuals in a mild to moderate stage of PD were recruited. Participants were asked to perform the physical BBT (once) and our proposed VR-BBT (twice) system,separately. Correlation analysis of collected data was carried out. Statistical analysis proved that the performance data collected by the VR-BBT significantly correlated with the conventional assessment of the BBT. The VR-BBT scores have shown a significant association with PD severity measured by the Hoehn and Yahr scale. This fact suggests that the VR-BBT could be used as a reliable indicator for health improvements in patients with PD. Finally, the VR-BBT system presented high usability and acceptability rated by clinicians and patients.This work was supported in part by the Spanish Ministry of Economy and Competitiveness via the ROBOESPAS project (DPI2017-87562-C2-1-R), and in part by the RoboCity2030-DIH-CM, Madrid Robotics Digital Innovation Hub (S2018/NMT-4331), which is funded by the Programas de Actividades I+D Comunidad de Madrid and cofunded by the Structural Funds of the EU

Effects of virtual reality associated with serious games for upper limb rehabilitation inpatients with multiple sclerosis: randomized controlled trial

Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance. Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of 1 month without receiving any treatment. Results: In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance. Trial registration: This randomized controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908, Nov 2019.The research leading to these results has received funding from the ROBOHEALTH-A project (DPI2013-47944-C4-1-R) funded by the Spanish Ministry of Economy and Competitiveness

Construct Validity and Test–Retest Reliability of a Free Mobile Application to Evaluate Aerobic Capacity and Endurance in Post-COVID-19 Syndrome Patients—A Pilot Study.

Introduction: Disability associated with the symptoms of post-COVID-19 syndrome is one of its main features and can have a considerable impact on care and rehabilitation units. This, linked to a decreased aerobic capacity and endurance in post-COVID-19 syndrome patients, increases interest in studying the potential of mobile applications to assess performance capacity. The purpose of this research was to study how a free mobile application assesses aerobic capacity and endurance and its relationship with aerobic capacity, test-retest reliability, and endurance evaluated by a conventional test, along with fatigue and health-related quality of life. Methods: An observational study was conducted. RUNZI®, a free mobile application, was used by mounting a Samsung Galaxy S8 smartphone using a strap on the right forearm while all participants simultaneously performed a 6-Minute Walking Test (6MWT). Construct validity between the 6MWT and the total distance performed evaluated by RUNZI® was explored. Additionally, evaluation scales to assess fatigue (MFIS) and health-related quality of life (SF-36) were used to analyze the construct validity of RUNZI®. For test−retest reliability of the app, the same instructions about the 6MWT and procedure with the app were given to all participants at two different time periods. Results: A total of 16 post-COVID-19 syndrome patients (15 females and 1 male) completed the procedure. Distance measured with the RUNZI® showed an excellent correlation with the 6MWT assessed conventionally (p < 0.0001; r = 0.851). No statistical correlations were found between the distance assessed by the RUNZI® app with MFIS and the SF-36. Test−retest reliability was found to be close to statistical significance (p = 0.058) for distance (m) measured by RUNZI® with an ICC of 0.482. Conclusions: Instrumental 6MWT assessed by the RUNZI® app for the Android® operating system showed an excellent correlation with conventional 6MWT, indicating its construct validity in post-COVID-19 syndrome patients. Further, values for the test−retest reliability for the free mobile application were close to statistical significance with a reliability considered poor in an indoor setting.post-print953 K

The Impact of a Novel Immersive Virtual Reality Technology Associated with Serious Games in Parkinson’s Disease Patients on Upper Limb Rehabilitation: A Mixed Methods Intervention Study.

Background: Parkinson’s disease is a neurodegenerative disorder that causes impaired motor functions. Virtual reality technology may be recommended to optimize motor learning in a safe environment. The objective of this paper was to evaluate the e ects of a novel immersive virtual reality technology used for serious games (Oculus Rift 2 plus leap motion controller—OR2-LMC) for upper limb outcomes (muscle strength, coordination, speed of movements, fine and gross dexterity). Another objective was to obtain qualitative data for participants’ experiences related to the intervention. Methods: A mixed methods intervention (embedded) study was used, with a qualitative design after a technology intervention (quantitative design). The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings. Results: Significant improvements were observed in strength (p = 0.028), fine (p = 0.026 to 0.028) and gross coordination dexterity, and speed movements (p = 0.039) in the a ected side, with excellent compliance (100%) and a high level of satisfaction (3.66 0.18 points out of the maximum of 4). No adverse side e ects were observed. Qualitative findings described patients’ perspectives regarding OR2-LMC treatment, facilitators and barriers for adherence, OR2-LMC applications, and treatment improvements. Conclusions: The intervention showed positive results for the upper limbs, with elements of discordance, expansion, and confirmation between qualitative and quantitative results.post-print1.962 K

Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study

A corrigendum on Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study by Ibáñez, J., Monge-Pereira, E., Molina-Rueda, F., Serrano, J. I., del Castillo, M. D., Cuesta-Gómez, A., et al. (2017). Front. Neurosci. 11:126. doi: 10.3389/fnins.2017.00126. In the recently published article, there were incorrect and missing contents in the Acknowledgments section

Proverbs and Aphorisms in Neurorehabilitation: A Literature Review

Introduction: Brain plasticity is not limited to childhood or adolescence, as originally assumed, but continues into adulthood. Understanding this conceptual evolution about the nervous system, neuroscience and neurorehabilitation, researchers have left different proverbs and aphorisms derived of their investigations that are still used in university and postgraduate training. A proverb is defined as a phrase of popular origin traditionally repeated invariably, in which a moral thought, advice or teaching is expressed. On the other hand, an aphorism is understood as a brief and doctrinal phrase or sentence that is proposed as a rule in some science or art. The aim of this paper is to present a compilation of proverbs and aphorisms related to neuroscience and neurorehabilitation, classified chronologically, to illustrate the conceptual evolution about the brain and to improve our understanding about the management of neurological patients through the methods and techniques developed during the 19th, 20th and 21st centuries, as many therapies are based on them. Methods: A literature review was conducted based on the recommendations for Systematic Reviews guidelines for scoping reviews. A computerized search was conducted in the following electronic databases: CINAHL Medical Science, Medline through EBSCO, PubMed, Physiotherapy Evidence Database (PEDro) and Scopus, limiting the search to papers published until April 2021 in English and Spanish. Inverse searches were also carried out based on papers found in the databases. The following data were extracted: technique or approach; author; date of birth and death; proverbs and aphorisms; clinical interpretation. Results: Proverbs and aphorisms linked to authors such as Charles Edward Beevor (1854–1908), Heinrich Sebastian Frenkel (1860–1931), Rudolf Magnus (1873–1927), Nikolai Bernstein (1896–1966), Donald O. Hebb (1904–1985), Elwood Henneman (1915–1996), Wilder Graves Penfield (1891–1976), Humberto Augusto Maturana Romesín (1928), Edward Taub (1931), Janet Howard Carr (1933–2014), Roberta Barkworth Shepherd (1934), Brown &amp; Hardman (1987), Jeffrey A. Kleim and Theresa A. Jones (2008) were compiled. Conclusion: Different authors have developed throughout history a series of proverbs and aphorisms related to neurosciences and neurorehabilitation that have helped to better our understanding of the nervous system and, therefore, in the management of the neurological patient through the methods and techniques developed throughout the 19th, 20th and 21st centuries

Influential Women in the Field of Neurological Rehabilitation: A Literature Review

Background: Medicine requires the brightest minds, regardless of gender. Women working in the health sciences have time and again demonstrated the value of their technical training, communication skills, emotional support, and ability to provide understandable explanations to their patients. The objective of this work was to carry out a historical review of the main female authors linked to classic sensorimotor neurorehabilitation techniques throughout the nineteenth and twentieth centuries, as well as female authors linked to eponymous tests or assessments, exposing their scientific trajectory and main contributions to the field of neurological rehabilitation. A literature review was conducted. The databases of Physiotherapy Evidence Database (PEDro), Scopus, CINAHL Medical Science, Medline through EBSCO and PubMed were used to obtain the biographical information of each author, searches of papers were limited until August 2021 in English and Spanish languages. Seventeen female authors were identified who linked to the main rehabilitation techniques or approaches described for neurological rehabilitation and for scales or tests with an eponymous origin as an example of female contribution on neurorehabilitation. Biographical information based on the computerized search in the electronic databases showed 57 potentially relevant articles. Of those articles, 43 were subsequently excluded. Fourteen articles were used to show their contribution to neurorehabilitation. This paper demonstrates the influential role of women in the history of sensorimotor neurorehabilitation throughout the nineteenth and twentieth centuries, linked to the methods, techniques, concepts, or approaches used in physical therapy or occupational therapy