The Effect of Locomotor Assisted Therapy on Lower Extremity Motor Performance in Typically Developing Children and Children with Cerebral Palsy

Indiana University-Purdue University Indianapolis (IUPUI)Background: Ambulation is critical to a child’s participation, development of selfconcept, and quality of life. Children with cerebral palsy (CP) frequently exhibit limitation in walking proficiency which has been identified as the primary physical disability. Traditional rehabilitative treatment techniques to improve ambulation for children with CP reveal inconsistent results. Driven gait orthosis (DGO) training is a novel approach focusing on motor learning principles that foster cortical neural plasticity. Objective: The objectives are to determine if: (i) the lower extremity muscle activation patterns of children with CP are similar to age-matched TD children in overground (OG) walking, (ii) DGO training replicates muscle activation patterns in OG ambulation in TD children, (iii) the lower extremity muscle activation patterns in OG walking of children with CP are similar to their muscle activation patterns with DGO assistance, and (iv) DGO training promotes unimpaired muscle activation patterns in children with CP. Methods: Muscle activity patterns of the rectus femoris, semitendinosus, gluteus maximus and gluteus medius were recorded in the OG and DGO walking conditions of children with CP and age-matched TD. The gait cycles were identified and the data was averaged to produce final average gait cycle time normalized values. Results: In comparing the variability of the muscle activation patterns within the subject groups, CP DGO walking was considerably lower than CP OG. In comparing the muscle activation patterns in each condition, consistent differences (p < .05) were noted in terminal stance, pre-swing and initial swing phases of gait with the DGO condition consistently revealing greater muscle unit recruitment. Conclusion: The results indicate that training in the DGO provided the ability to practice with measurably repetitive movement as evidenced by decreased variability. Consistent differences were noted in muscle activation patterns in the terminal stance, pre-swing and initial swing phases of gait when most of these muscles are primarily inactive. The alteration in ground reaction force within the DGO environment may play a role in this variance. With the goal of normalizing gait, it is important that the effect of these parameters on ground reaction forces be considered in the use of DGO rehabilitation

The Support Problem and Its Elliptic Analogue

AbstractLetFbe a number field, Supposex,y∈F* have the property that for alln∈Zand almost all prime ideals p of the ring of integers ofF* one has thatyn≡1 (modp) wheneverxn≡1 (modp). We show that thenyis a power ofx. This answers a question of Erdős. We also prove an elliptic analogue of this result

Eletriptan in the management of acute migraine. An update on the evidence for efficacy, safety, and consistent response

Migraine is a multifactorial, neurological and disabling disorder, also characterized by several autonomic symptoms. Triptans, selective serotonin 5-HT1B/1D agonists, are the first-line treatment option for moderate-to-severe headache attacks. In this paper, we review the recent data on eletriptan clinical efficacy, safety, and tolerability, and potential clinically relevant interactions with other drugs. Among triptans, eletriptan shows a consistent and significant clinical efficacy and a good tolerability profile in the treatment of migraine, especially for patients with cardiovascular risk factors without coronary artery disease. It shows the most favorable clinical response, together with sumatriptan injections, zolmitriptan and rizatriptan. Additionally, eletriptan shows the most complex pharmacokinetic/dynamic profile compared with the other triptans. It is metabolized primarily by the CYP3A4 hepatic enzyme and therefore the concomitant administration of CYP3A4-potent inhibitors should be carefully evaluated. A relatively low risk of serotonin syndrome is given by the co-administration with serotoninergic drugs. No clinically relevant interaction has been found with drugs used for migraine prophylactic treatment or other acute drugs, with the exception of ergot derivatives that should not be co-administered with eletriptan

Robot motion generation and navigation : What we can learn from rats

研究成果の概要 (和文) : 実環境で自律的に移動する移動ロボットの能力は非常に重要である。技術の進歩にも関わらず、複雑な環境でのロボットの自己推定、目標位置への移動は依然として途上の課題である。ラットは、周囲の環境の情報を手がかりに自分自身をローカライズすることによって、複雑な空間で正確かつ迅速に移動することがよく知られている。我々は、これらに基づき、ラットの脳信号をそれ自身の行動にマッピングすることによってラットの意思決定を模倣することをロボットが学習するアルゴリズムを開発した。アルゴリズムを実装 されたロボットは、複雑な環境で位置推定し移動するために、内部状態と外部センサ情報を統合することを学習できることを確認した。研究成果の概要 (英文) : The mobile robot ability to navigate autonomously in its environment is very important. Even though the advances in technology, robot self-localization and goal directed navigation in complex environments are still challenging tasks. It has been well known that rats accurately and rapidly navigate in a complex space by localizing themselves about the surrounding environmental cues. We developed an algorithm by which the robot learned to imitate the rat’s decision-making by mapping the rat’s brain signals into its own actions. Finally, the robot learned to integrate the internal states as well as external sensors to localize and navigate in the complex environment

An Artificial Neural Network Based Robot Controller that Uses Rat’s Brain Signals

Brain machine interface (BMI) has been proposed as a novel technique to control prosthetic devices aimed at restoring motor functions in paralyzed patients. In this paper, we propose a neural network based controller that maps rat’s brain signals and transforms them into robot movement. First, the rat is trained to move the robot by pressing the right and left lever in order to get food. Next, we collect brain signals with four implanted electrodes, two in the motor cortex and two in the somatosensory cortex area. The collected data are used to train and evaluate different artificial neural controllers. Trained neural controllers are employed online to map brain signals and transform them into robot motion. Offline and online classification results of rat’s brain signals show that the Radial Basis Function Neural Networks (RBFNN) outperforms other neural networks. In addition, online robot control results show that even with a limited number of electrodes, the robot motion generated by RBFNN matched the motion generated by the left and right lever position

Development of \u27\u27Bonten-Maru\u27\u27humanoid robot

This paper presents the status and research results of the ”Bonten-Maru” humanoid robot project. The main contributions of this project are on CORBA based control of humanoid robot,real time optimal gait generation, control of humanoid robot in a long distance using teleoperation system, operation of humanoid robot in emergency environments, and various humanoid robot motions. In order to verify our research results, we developed the ”Bonten-Maru” humanoid robot. Another important objective is to cooperate with different researchers on humanoid robots by:(1)making the control platform open;(2)easy to be extended;(3)easy to integrate programs in developed in different programming languages. We present the main of the ”Bonten-Maru” humanoid robot project published in more than 20 papers in international journals and conference proceedings

Changing the approach to anticoagulant therapy in older patients with multimorbidity using a precision medicine approach

The ageing of the world population has resulted in an increase in the number of older patients with multimorbid conditions receiving multiple therapies. This emerging clinical scenario poses new challenges, which are mostly related to the increased incidence of adverse effects. This translates into poor clinical care, reduced cost-effectiveness of drug therapies, and social isolation of multimorbid patients due to reduced autonomy. A strategy to address these emerging challenges could involve the personalization of therapies based on the clinical, molecular, and genetic characterization of multimorbid patients. Anticoagulation therapy is a feasible model to implement personalized medicine since it generally involves older multimorbid patients receiving multiple drugs. In this study, in patients with atrial fibrillation, the use of the new generation of anticoagulation therapy, i.e., direct oral anti-coagulants (DOACs), is based on a preliminary assessment of the molecular targets of DOACS and any possible drug–drug interactions. Then, the genetic polymorphism of enzymes metabolizing DOACs is studied. After DOAC prescription, its circulating levels are measured. Clinical data are being collected to assess whether this personalized approach improves the safety and efficacy profiles of anticoagulation therapy using DOACs, thereby reducing the costs of healthcare for ageing multimorbid patients