Effect of music listening on hypertonia in neurologically impaired patients - systematic review

Background. As music listening is able to induce self-perceived and physiological signsof relaxation, it might be an interesting tool to induce muscle relaxation in patientswith hypertonia. To this date effective non-pharmacological rehabilitation strategies totreat hypertonia in neurologically impaired patients are lacking. Therefore the aim isto investigate the effectiveness of music listening on muscle activity and relaxation.Methodology. The search strategy was performed by the PRISMA guidelines andregistered in the PROSPERO database (no. 42019128511). Seven databases weresystematically searched until March 2019. Six of the 1,684 studies met the eligibilitycriteria and were included in this review. Risk of bias was assessed by the PEDro scale.In total 171 patients with a variety of neurological conditions were included assessinghypertonia with both clinicall and biomechanical measures.Results. The analysis showed that there was a large treatment effect of music listening onmuscle performance (SMD 0.96, 95% CI [0.29–1.63],I2=10%,Z=2.82,p=0.005).Music can be used as either background music during rehabilitation (dual-task) orduring rest (single-task) and musical preferences seem to play a major role in theobserved treatment effect.Conclusions. Although music listening is able to induce muscle relaxation, several gapsin the available literature were acknowledged. Future research is in need of an accurateand objective assessment of hypertonia

Управление деловой карьерой персонала в организации общественного питания

Проблема исследования заключается в необходимости управления деловой карьеры персонала в организации ООО «Бриз» для повышения качества ее работы в целом. Целью выпускной квалификационной работы является анализ управления деловой карьерой и разработка мероприятий по ее усовершенствованию деловой карьеры персонала в организации общественного питания ООО «Бриз».Объектом исследования является деловая карьера персонала в организации ООО «Бриз».Предметом исследования является управление деловой карьерой персонала в организации ООО «Бриз». Структура работы. Выпускная квалификационная работа состоит из: введения, двух глав, заключения, списка использованной литературы, приложений

The influence of a thoracolumbosacral orthosis on gait performance in healthy adults during walking

PURPOSE: Since the thorax and pelvis are primary determinants of normal and pathological walking, it is important to know how gait performance is influenced when the trunk is constraint. The objective of this study is to investigate the effect of a thoracolumbosacral orthosis (TLSO) on gait performance in healthy adults during overground walking. METHODS: Fourteen healthy volunteers walked with and without TLSO. Outcome measures consisted of spatiotemporal parameters and clinically important joint angular time profiles of the lower limbs. Joint angular time profiles were assessed in the sagittal, frontal and transversal plane. A paired t-test was used for discrete parameters and spm1d for assessing the joint angular time profiles. RESULTS: Walking with a constraint resulted in decreased stride time and step time, increased step width and cadence. In the sagittal plane, no significant differences were observed regarding joint kinematics in the hip, knee and ankle. In the frontal plane, decreased adduction during stance and abduction during swing was observed in the hip. In the transversal plane, increased external rotation of the hip and increased internal rotation of the ankle was seen when wearing a contstraint. CONCLUSIONS: Wearing a TLSO can already bring forth significant changes in gait performance, suggesting an important relationship between trunk movements and mobility.status: publishe

The Influence of Sound-Based Interventions on Motor Behavior After Stroke: A Systematic Review

Objective: To investigate the effects of sound-based interventions (SBIs) on biomechanical parameters in stroke patients. Methods: PubMed/Medline, Web of Science, the Physiotherapy Evidence Database (PEDro), and the Cochrane Library were searched until September 2019. Studies examining the effect of SBIs on kinematic, kinetic, and electromyographic outcome measures were included. Two independent reviewers performed the screening, and data extraction and risk-of-bias assessment were conducted with the PEDro and Newcastle-Ottawa scale. Disagreements were resolved by a third independent reviewer. Results: Of the 858 studies obtained from all databases, 12 studies and 240 participants met the inclusion and exclusion criteria. Six studies investigated the effect of SBI on upper limb motor tasks, while six examined walking. Concerning quality assessment (Newcastle-Ottawa Quality Assessment Scale and PEDro), the nine cross-sectional studies had a median score of seven, while the randomized controlled trials had a median score of five (fair to good quality). In relation to upper limb motor tasks, only one study found improvements in cortical reorganization and increased central excitability and motor control during reaching after SBI (results of the other five studies were too diverse and lacked quality to substantiate their findings). In relation to walking, results were clearer: SBI led to improvements in knee flexion and gastrocnemius muscle activity. Conclusion: Despite of the heterogeneity of the included studies, evidence was found demonstrating that SBI can induce biomechanical changes in motor behavior during walking in stroke patients. No conclusions could be formulated regarding reaching tasks. Additionally, directions for future research for understanding the underlying mechanism of the clinical improvements after SBI are: (1) using actual music pieces instead of rhythmic sound sequences and (2) examining sub-acute stroke rather than chronic stroke patients.status: publishe

Effect of music listening on hypertonia in neurologically impaired patients-systematic review

Background: As music listening is able to induce self-perceived and physiological signs of relaxation, it might be an interesting tool to induce muscle relaxation in patients with hypertonia. To this date effective non-pharmacological rehabilitation strategies to treat hypertonia in neurologically impaired patients are lacking. Therefore the aim is to investigate the effectiveness of music listening on muscle activity and relaxation. Methodology: The search strategy was performed by the PRISMA guidelines and registered in the PROSPERO database (no. 42019128511). Seven databases were systematically searched until March 2019. Six of the 1,684 studies met the eligibility criteria and were included in this review. Risk of bias was assessed by the PEDro scale. In total 171 patients with a variety of neurological conditions were included assessing hypertonia with both clinicall and biomechanical measures. Results: The analysis showed that there was a large treatment effect of music listening on muscle performance (SMD 0.96, 95% CI [0.29-1.63], I2 = 10%, Z = 2.82, p = 0.005). Music can be used as either background music during rehabilitation (dual-task) or during rest (single-task) and musical preferences seem to play a major role in the observed treatment effect. Conclusions: Although music listening is able to induce muscle relaxation, several gaps in the available literature were acknowledged. Future research is in need of an accurate and objective assessment of hypertonia.status: publishe

Feasibility and effectiveness of repetitive gait training early after stroke: A systematic review and meta-analysis

Background: Pre-clinical evidence suggests a period early after stroke during which the brain is most receptive to rehabilitation, if it is provided as high-dose motor training. Objective: To evaluate the feasibility of repetitive gait training within the first 3 months post-stroke and the effects on gait-specific outcomes. Methods: PubMed, Web of Science, Cochrane Library, Rehab Data and PEDro databases were searched systematically. Randomized controlled trials were included to descriptively analyse the feasibility and quantitatively investigate the effectiveness of repetitive gait training compared with conventional therapy. Results: Fifteen randomized controlled trials were included. Repetitive training can safely be provided through body weight support and locomotor assistance from therapists or a robotic device. No difference in drop-out rates was reported despite the demanding nature of the intervention. The meta-analysis yielded significant, but small, effects on walking independence and endurance. Training with end-effector robots appears most effective. Conclusion: Robots enable a substantial, yet feasible, increase in the quantity of walking practice early post-stroke, which might enhance functional recovery. However, the mechanisms underlying these effects remain poorly understood

The influence of a thoracolumbosacral orthosis on gait performance in healthy adults during walking

Since the thorax and pelvis are primary determinants of normal and pathological walking, it is important to know how gait performance is influenced when the trunk is constraint. The objective of this study is to investigate the effect of a thoracolumbosacral orthosis (TLSO) on gait performance in healthy adults during overground walking. Methods: Fourteen healthy volunteers walked with and without TLSO. Outcome measures consisted of spatiotemporal parameters and clinically important joint angular time profiles of the lower limbs. Joint angular time profiles were assessed in the sagittal, frontal and transversal plane. A paired t-test was used for discrete parameters and spm1d for assessing the joint angular time profiles. Results: Walking with a constraint resulted in decreased stride time and step time, increased step width and cadence. In the sagittal plane, no significant differences were observed regarding joint kinematics in the hip, knee and ankle. In the frontal plane, decreased adduction during stance and abduction during swing was observed in the hip. In the transversal plane, increased external rotation of the hip and increased internal rotation of the ankle was seen when wearing a contstraint. Conclusions: Wearing a TLSO can already bring forth significant changes in gait performance, suggesting an important relationship between trunk movements and mobility

Age- and sex-related differences in trunk kinematics during walking in able-bodied adults

Abstract: Introduction Trunk motion during walking acts as a biomarker for decreased mobility and can difer between sexes. Knowing how age and sex afect trunk motion and energy conservation can help clinicians decide when and in whom to intervene with physiotherapy to prolong functional mobility. Methods A large sample of 138 able-bodied males and females in the age-categories 20\u201339 years, 40\u201359 years, 60\u201369 years, 70\u201379 years, and 80\u201389 years received a full-body 3D gait analysis. A two-factor ANOVA was performed to examine the efect of age and sex and their interaction on 3D trunk kinematics and positive mechanical work of the lower limbs, head-arms-trunk (HAT) segment and whole body. Results A signifcant decrease in walking speed was only found in those above 80 years (~.05 nm/s, p<.006), while changes in 3D trunk kinematics were observed earlier. From 60 years on, trunk rotations decreased (~2\u20133\ub0, p<.05), from 70-year frontal pelvic motion (~4\ub0, p<.001), and from the age of 80 years sagittal thorax motion (~1\u20136\ub0, p<.05). There were only small aging efects for mechanical energy demands that were more pronounced in females, showing decreased of HAT contributions (p=.020). Furthermore, age-related diferences in trunk kinematics are highly dependent on sex whereby age-related changes were observed sooner in females than males in all three planes of motion. Conclusions Age-related diferences in 3D trunk kinematics are observed from 60 years onward and increase with age. Age-related stifening of the trunk did not seem to afect the body\u2019s total mechanical work. Importantly, our data did show a stark contrast between males and females, indicating that training to prolong mobility should be tailored to sex. Future research should include sex-matched data when examining normal age and pathologic gait decline