Quality of Residual Neuromuscular Control and Functional Deficits in Patients with Spinal Cord Injury

Study Design: Prospective cohort study. Objective: This study examined the relationship between motor control and clinical function outcomes after spinal cord injury (SCI). Setting: University of Louisville, Louisville, KY, USA. Materials: Eleven persons with SCI and 5 non-injured subjects were included in this study. Methods: The ASIA Impairment Scale (AIS) was used to categorize injury level and severity. Multi-muscle, surface EMG (sEMG) recording, was carried out using a protocol of reflex and volitional motor tasks and was analyzed using a vector-based tool that calculates index values that relate a distribution of multi-muscle activation pattern of each SCI subject to the prototype obtained from non-injured subject group and presents overall magnitude as a separate value. Functional Independence Measure motor sub-scale, Spinal Cord Injury Independence Measure (SCIM-III), and Walking Index for Spinal Cord Injury (WISCI) scale scores were compared to neurophysiological parameters. Results: AIS category and injury level correlated significantly with the WISCI and SCIM mobility sub-scales. sEMG-derived parameters were significantly correlated with SCIM and WISCI scores but only for examinations carried out 48 or more days post-injury. Conclusion: These results supported the hypothesis that clinically relevant function after SCI is related to the degree to which functional organization within the central nervous system is disrupted. Further, due likely to the constraints placed on the expression of functional ability by early post-injury immobilization and hospitalization, neurophysiological assessment of motor function may provide better sensitivity and reliability than can be obtained using the clinical function scales examined here within the early period after injury

Prediction of Maximal Oxygen Consumption from Rating of Perceived Exertion (RPE) using a Modified Total-body Recumbent Stepper

International Journal of Exercise Science 8(4): 414-424, 2015. Exercise training is crucial to improve cardiovascular health and quality of life in people with spinal cord injuries (SCI). A key limitation is the lack of validated submaximal tests to evaluate and predict cardiovascular fitness in this population. The purpose of this study was to validate a submaximal test to predict maximal oxygen consumption for individuals with SCI. Ten able-bodied participants and two individuals with SCI completed a rating of perceived exertion (RPE)-based submaximal oxygen consumption test and a graded maximal oxygen consumption test on a NuStep T4 recumbent stepper. Prediction of VO2max from an RPE-based protocol is feasible and can produce reliable predicted VO2max values in the able bodied population. This study is a proof of concept to the implementation of a submaximal test protocol using a total body recumbent stepper to predict VO2max in able-bodied individuals. Additionally, this study shows evidence of feasibility of performing this test in SCI individuals

Incorporation of a physical activity program Minds in Motion in a Spanish-immersion elementary school. Effects on classroom behavior and academic performance.

“Minds in motion” is an intense physical activity program with the goal of targeting vestibular, proprioceptive and sensory systems with the purpose of facilitate the integration of internal and external cues resulting in a more accurate motor response that may result in better balance, coordination and reading skills. The school-based approach of Minds in Motion is called the “MAZE,” which blends developmental gymnastics, balance exercises, and complex movements through a rotating set of protocols. These activities, range from full-body exercises to isolated eye movements with the purpose of improve eye tracking and reading. The purpose of this study was to determine if the incorporation of Minds in Motion approach before school hours results in better academic performance (i.e. reading and math), classroom behavior and agility, balance and coordination in children enrolled in 4th and 5th in a local Spanish immersion elementary school

Mental Imagery and Virtual Reality’s Impact on Blood Pressure Regulation For People with Spinal Cord Injury

Mental Imagery and Virtual Reality’s Impact on Blood Pressure Regulation For People with Spinal Cord Injury Kaden Kozlowski1 ; Rachel Torres2; Camilo Castillo MD3; Addie Wanner BS1; Daniela Terson de Paleville PhD1,2,4 INTRODUCTION: People with spinal cord injuries (SCI) often suffer from orthostatic intolerance with symptoms of dizziness, syncope, cognitive slowing, nausea and headache. Mental imagery has been successfully used to modulate blood pressure (BP) and other of these symptoms in people with autonomic dysfunction. Our goal is to determine if immersive virtual reality (VR) is an effective non-pharmaceutical, non-invasive intervention to improve orthostatic intolerance in people with SCI. OBJECTIVES: Determine the effects of immersive and mental imagery on BP and heart rate (HR) of people with SCI and non-injured controls for practical application of non-pharmaceutical orthostatic hypotension management. SETTING: University of Louisville Novak Lab in Health and Sport Sciences Department METHODS: A convenience sample of six (n=6) people with SCI, 3 men, 3 women, mean height 171 cm (± 11.5), weight 86.9 Kg (± 24.7) and five (n=5) non-injured volunteers, height 170 cm (± 12.3), weight 70.2 Kg (± 16) participated in this study. Participants completed the conditions in 2 separate visits and were randomly assigned to receive either mental imagery or VR conditions first, to avoid familiarization responses. Each participant engaged in a seated immersive VR session as well as a seated mental imagery session. Cardiovascular parameters (i.e., HR, BP, electrocardiogram activity) were continuously recorded using a telemetry (Caretaker, city) throughout the session. Participants were instructed in either increase or decrease mean arterial pressure (MAP) by 5 mmHg. Verbal feedback regarding the attainment of goal was given at the end of each cycle. RESULTS: Both, VR and mental imagery were effective on modulate BP during relaxing or arousing conditions. However, VR was more effective in modulating MAP than mental imagery in participants with and without SCI. CONCLUSIONS: Immersive VR is an effective non-pharmaceutical intervention for managing orthostatic hypotension among people with SCI. Affiliations: 1- UofL Health and Sport Sciences 2- UofL Interdisciplinary Program in Translational Neurosciences 3- UofL Division of Physical Medicine & Rehabilitation 4- UofL Department of Physiology & Biophysic

Quality of residual neuromuscular control and functional deficits in patients with spinal cord injury

Materials: Eleven persons with SCI and 5 non-injured subjects were included in this study. Methods: The ASIA Impairment Scale (AIS) was used to categorize injury level and severity. Multi-muscle, surface EMG (sEMG) recording, was carried out using a protocol of reflex and volitional motor tasks and was analyzed using a vector-based tool that calculates index values that relate a distribution of multi-muscle activation pattern of each SCI subject to the prototype obtained from non-injured subject group and presents overall magnitude as a separate value. Functional Independence Measure motor sub-scale, Spinal Cord Injury Independence Measure (SCIM-III), and Walking Index for Spinal Cord Injury (WISCI) scale scores were compared to neurophysiological parameters. Results: AIS category and injury level correlated significantly with the WISCI and SCIM mobility sub-scales. sEMG-derived parameters were significantly correlated with SCIM and WISCI scores but only for examinations carried out 48 or more days post-injury. Conclusion: These results supported the hypothesis that clinically relevant function after SCI is related to the degree to which functional organization within the central nervous system is disrupted. Further, due likely to the constraints placed on the expression of functional ability by early post-injury immobilization and hospitalization, neurophysiological assessment of motor function may provide better sensitivity and reliability than can be obtained using the clinical function scales examined here within the early period after injury