80 research outputs found
Associating Frailty and Dynamic Dysregulation between Motor and Cardiac Autonomic Systems
Frailty is a geriatric syndrome associated with the lack of physiological
reserve and consequent adverse outcomes (therapy complications and death) in
older adults. Recent research has shown associations between heart rate (HR)
dynamics (HR changes during physical activity) with frailty. The goal of the
present study was to determine the effect of frailty on the interconnection
between motor and cardiac systems during a localized upper-extremity function
(UEF) test. Fifty-six older adults aged 65 or older were recruited and
performed the UEF task of rapid elbow flexion for 20-seconds with the right
arm. Frailty was assessed using the Fried phenotype. Wearable gyroscopes and
electrocardiography were used to measure motor function and HR dynamics. Using
convergent cross-mapping (CCM) the interconnection between motor (angular
displacement) and cardiac (HR) performance was assessed. A significantly weaker
interconnection was observed among pre-frail and frail participants compared to
non-frail individuals (p<0.01, effect size=0.810.08). Using logistic
models pre-frailty and frailty were identified with sensitivity and specificity
of 82% to 89%, using motor, HR dynamics, and interconnection parameters.
Findings suggested a strong association between cardiac-motor interconnection
and frailty. Adding CCM parameters in a multimodal model may provide a
promising measure of frailty.Comment: 16 pages, 3 tables, 4 figure
Low-rank representation of head impact kinematics: A data-driven emulator
Head motion induced by impacts has been deemed as one of the most important
measures in brain injury prediction, given that the majority of brain injury
metrics use head kinematics as input. Recently, researchers have focused on
using fast approaches, such as machine learning, to approximate brain
deformation in real-time for early brain injury diagnosis. However, those
requires large number of kinematic measurements, and therefore data
augmentation is required given the limited on-field measured data available. In
this study we present a principal component analysis-based method that emulates
an empirical low-rank substitution for head impact kinematics, while requiring
low computational cost. In characterizing our existing data set of 537 head
impacts, consisting of 6 degrees of freedom measurements, we found that only a
few modes, e.g. 15 in the case of angular velocity, is sufficient for accurate
reconstruction of the entire data set. Furthermore, these modes are
predominantly low frequency since over 70% to 90% of the angular velocity
response can be captured by modes that have frequencies under 40Hz. We compared
our proposed method against existing impact parametrization methods and showed
significantly better performance in injury prediction using a range of
kinematic-based metrics -- such as head injury criterion and rotational injury
criterion (RIC) -- and brain tissue deformation-metrics -- such as brain angle
metric, maximum principal strain (MPS) and axonal fiber strains (FS). In all
cases, our approach reproduced injury metrics similar to the ground truth
measurements with no significant difference, whereas the existing methods
obtained significantly different (p<0.01) values as well as poor injury
classification sensitivity and specificity. This emulator will enable us to
provide the necessary data augmentation to build a head impact kinematic data
set of any size.Comment: 20 pages, 13 figures, 4 table
Hyper-acute effects of sub-concussive soccer headers on brain function and hemodynamics
IntroductionSub-concussive head impacts in soccer are drawing increasing research attention regarding their acute and long-term effects as players may experience thousands of headers in a single season. During these impacts, the head experiences rapid acceleration similar to what occurs during a concussion, but without the clinical implications. The physical mechanism and response to repetitive impacts are not completely understood. The objective of this work was to examine the immediate functional outcomes of sub-concussive level impacts from soccer heading in a natural, non-laboratory environment.MethodsTwenty university level soccer athletes were instrumented with sensor-mounted bite bars to record impacts from 10 consecutive soccer headers. Pre- and post-header measurements were collected to determine hyper-acute changes, i.e., within minutes after exposure. This included measuring blood flow velocity using transcranial Doppler (TCD) ultrasound, oxyhemoglobin concentration using functional near infrared spectroscopy imaging (fNIRS), and upper extremity dual-task (UEF) neurocognitive testing.ResultsOn average, the athletes experienced 30.7 ± 8.9 g peak linear acceleration and 7.2 ± 3.1 rad/s peak angular velocity, respectively. Results from fNIRS measurements showed an increase in the brain oxygenation for the left prefrontal cortex (PC) (p = 0.002), and the left motor cortex (MC) (p = 0.007) following the soccer headers. Additional analysis of the fNIRS time series demonstrates increased sample entropy of the signal after the headers in the right PC (p = 0.02), right MC (p = 0.004), and left MC (p = 0.04).DiscussionThese combined results reveal some variations in brain oxygenation immediately detected after repetitive headers. Significant changes in balance and neurocognitive function were not observed in this study, indicating a mild level of head impacts. This is the first study to observe hemodynamic changes immediately after sub-concussive impacts using non-invasive portable imaging technology. In combination with head kinematic measurements, this information can give new insights and a framework for immediate monitoring of sub-concussive impacts on the head
Load-relaxation properties of the human trunk in response to prolonged flexion: measuring and modeling the effect of flexion angle
Experimental studies suggest that prolonged trunk flexion reduces passive support of the spine. To understand alterations of the synergy between active and passive tissues following such loadings, several studies have assessed the time-dependent behavior of passive tissues including those within spinal motion segments and muscles. Yet, there remain limitations regarding load-relaxation of the lumbar spine in response to flexion exposures and the influence of different flexion angles. Ten healthy participants were exposed for 16 min to each of five magnitudes of lumbar flexion specified relative to individual flexion-relaxation angles (i.e., 30, 40, 60, 80, and 100%), during which lumbar flexion angle and trunk moment were recorded. Outcome measures were initial trunk moment, moment drop, parameters of four viscoelastic models (i.e., Standard Linear Solid model, the Prony Series, Schapery\u27s Theory, and the Modified Superposition Method), and changes in neutral zone and viscoelastic state following exposure. There were significant effects of flexion angle on initial moment, moment drop, changes in normalized neutral zone, and some parameters of the Standard Linear Solid model. Initial moment, moment drop, and changes in normalized neutral zone increased exponentially with flexion angle. Kelvin-solid models produced better predictions of temporal behaviors. Observed responses to trunk flexion suggest nonlinearity in viscoelastic properties, and which likely reflected viscoelastic behaviors of spinal (lumbar) motion segments. Flexion-induced changes in viscous properties and neutral zone imply an increase in internal loads and perhaps increased risk of low back disorders. Kelvin-solid models, especially the Prony Series model appeared to be more effective at modeling load-relaxation of the trunk
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The association between cognition and dual-tasking among older adults: the effect of motor function type and cognition task difficulty
Background: Dual-task actions challenge cognitive processing. The usefulness of objective methods based on dual-task actions to identify the cognitive status of older adults has been previously demonstrated. However, the properties of select motor and cognitive tasks are still debatable. We investigated the effect of cognitive task difficulty and motor task type (walking versus an upper-extremity function [UEF]) in identifying cognitive impairment in older adults. Methods: Older adults (>= 65 years) were recruited, and cognitive ability was measured using the Montreal Cognitive Assessment (MoCA). Participants performed repetitive elbow flexion under three conditions: 1) at maximum pace alone (Single-task); and 2) while counting backward by ones (Dual-task 1); and 3) threes (Dual-task 2). Similar single- and dual-task gait were performed at normal speed. Three-dimensional kinematics were measured for both motor functions using wearable sensors. Results: One-hundred older adults participated in this study. Based on MoCA score,20, 21 (21%) of the participants were considered cognitively impaired (mean age = 86 +/- 10 and 85 +/- 5 for cognitively impaired and intact participants, respectively). Within ANOVA models adjusted with demographic information, UEF dual-task parameters, including speed and range-of-motion variability were significantly higher by 52% on average, among cognitively impaired participant (p0.26). Conclusion: This study demonstrated that counting backward by threes within a UEF dual-task experiment was a pertinent and challenging enough task to detect cognitive impairment in older adults. Additionally, UEF was superior to gait as the motor task component of the dual-task. The UEF dual-task could be applied as a quick memory screen in a clinical setting.Centers for Disease Control and Prevention Healthy Brain Research Network (CDC-HBRN) - CDC Healthy Aging Program-Healthy Brain Initiative; National Institute of Aging (NIA) [1 R21 AG055852-01]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
Association between dual-task function and neuropsychological testing in older adults with cognitive impairment
Introduction: Despite the current high prevalence of dementia, more than half of older adult patients never receive an evaluation. Current evaluation methods are lengthy, cumbersome, and not viable for busy clinics. This indicates that, despite recent improvements, a quick and objective routine test for screening cognitive decline in older adults is still needed. Poor dual-task gait performance has been previously associated with decreased executive and neuropsychological function. However, gait tests are not always viable for clinics or older patients. Methods: The aim of this study was to assess the relationship between a novel upper-extremity function (UEF) dual-task performance and neuropsychological test results in older adults. For UEF dual-tasks, participants performed a consistent elbow flexion and extension, while counting backwards in increments of threes or ones. Wearable motion sensors were attached to the forearm and upper-arm to measure accuracy and speed of elbow flexion kinematics to calculate a UEF cognitive score. Results: We recruited older adults at three stages: cognitively normal (CN) (n = 35), mild cognitively impaired (MCI) of the Alzheimer's type (n = 34), and Alzheimer's disease (AD) (n = 22). The results demonstrate significant correlations between UEF cognitive score and mini-mental state examination (MMSE), Mini-Cog, Category fluency, Benson complex figure copy, Trail making test, and Montreal cognitive assessment (MOCA) (r values between −0.2355 and −0.6037 and p < 0.0288). Discussion: UEF dual-task was associated with executive function, orientation, repetition, abstraction, verbal recall, attention and calculation, language and visual construction. Of the associated brain domains, UEF dual-task was most significantly associated with executive function, visual construction, and delayed recall. The results from this study convey potential for UEF dual-task as a safe and convenient cognitive impairment screening method
Proprioceptive impairments in high fall risk older adults: the effect of mechanical calf vibration on postural balance
Background: Impairments in proprioceptive mechanism with aging has been observed and associated with fall risk. The purpose of the current study was to assess proprioceptive deficits among high fall risk individuals in comparison with healthy participants, when postural performance was disturbed using low-frequency mechanical gastrocnemius vibratory stimulation. Methods: Three groups of participants were recruited: healthy young (n = 10; age = 23 +/- 2 years), healthy elders (n = 10; age = 73 +/- 3 years), and high fall risk elders (n = 10; age = 84 +/- 9 years). Eyes-open and eyes-closed upright standing balance performance was measured with no vibration, and 30 and 40 Hz vibration of both calves. Vibration-induced changes in balance behaviors, compared to baseline (no vibratory stimulation) were compared between three groups using multivariable repeated measures analysis of variance models. Results: Overall, similar results were observed for two vibration frequencies. However, changes in body sway due to vibration were more obvious within the eyes-closed condition, and in the medial-lateral direction. Within the eyes-closed condition high fall risk participants showed 83% less vibration-induced change in medial-lateral body sway, and 58% less sway velocity, when compared to healthy participants (p < 0.001; effect size = 0.45-0.64). Conclusions: The observed differences in vibration effects on balance performance may be explained by reduced sensitivity in peripheral nervous system among older adults with impaired balance.University of Arizona, Arizona Center on Aging (ACOA)Open access journal.UA Open Access Publishing Fund.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
Low intensity vibration of ankle muscles improves balance in elderly persons at high risk of falling
<div><p>In our study we examined postural performance of young healthy persons (HY), elderly healthy persons (HE), and elderly persons at high risk of falling (FR). Anterio-posterior (AP) and medio-lateral (ML) ankle and hip angular deviations, as well as linear displacements of the center of mass (COM) were assessed in persons standing with eyes either open or closed, while none, and 40 and 30 Hz vibrations were applied bilaterally to the ankle muscle gastrocnemius. During quiet standing with eyes open, balance parameters in FR group differed from those in healthy groups. ML ankle and hip angular deviations, as well as COM linear displacements were noticeably larger in FR group. During quiet standing with eyes closed, all balance parameters in participants of all groups had a clear trend to increase. During standing with eyes open, 40 Hz vibration increased all but one balance parameter within HY group, ankle angular deviations in HE group, but none in FR group. In response to 30 Hz vibration, only ankle angular deviations and COM linear displacements increased in HY group. There were no changes in both elderly groups. During standing with eyes closed, 40 and 30 Hz vibrations did not produce consistent changes in balance parameters in HY and HE groups. In FR persons, 40 Hz vibration did not change balance parameters. However, in FR groups, 30 Hz vibration decreased ankle and hip angular deviations, and COM linear displacements. The major result of the study is a finding that low intensity vibration of ankle muscles makes balance better in elderly persons at high risk of falling. This result is clinically relevant because it suggests that applying mild vibration to ankle muscles while standing and walking might benefit elderly persons, improving their postural performance and reducing a risk of unexpected falls.</p></div
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