Relative fascicle excursion effects on dynamic strength generation during gait in children with cerebral palsy

Evaluation of muscle structure gives us a better understanding of how muscles contribute to force generation which is significantly altered in children with cerebral palsy (CP). While most muscle structure parameters have shown to be significantly correlated to different expressions of strength development in children with CP and typically developing (TD) children, conflicting results are found for muscle fascicle length. Muscle fascicle length determines muscle excursion and velocity, and contrary to what might be expected, correlations of fascicle length to rate of force development have not been found for children with CP. The lack of correlation between muscle fascicle length and rate of force development in children with CP could be due, on the one hand, to the non-optimal joint position adopted for force generation on the isometric strength tests as compared to the position of TD children. On the other hand, the lack of correlation could be due to the erroneous assumption that muscle fascicle length is representative of sarcomere length. Thus, the relationship between muscle architecture parameters reflecting sarcomere length, such as relative fascicle excursions and dynamic power generation, should be assessed. Understanding of the underlying mechanisms of weakness in children with CP is key for individualized prescription and assessment of muscle-targeted interventions. Findings could imply the detection of children operating on the descending limb of the sarcomere length–tension curve, which in turn might be at greater risk of developing crouch gait. Furthermore, relative muscle fascicle excursions could be used as a predictive variable of outcomes related to crouch gait prevention treatments such as strength training

Automatic real-time monitoring and assessment of tremor parameters in the upper limb from orientation data

Upper limb tremor is the most prevalent movement disorder and, unfortunately, it is not effectively managed in a large proportion of the patients. Neuroprostheses that stimulate the sensorimotor pathways are one of the most promising alternatives although they are still under development. To enrich the interpretation of data recorded during long-term tremor monitoring and to increase the intelligence of tremor suppression neuroprostheses we need to be aware of the context. Context awareness is a major challenge for neuroprostheses and would allow these devices to react more quickly and appropriately to the changing demands of the user and/or task. Traditionally kinematic features are used to extract context information, with most recently the use of joint angles as highly potential features. In this paper we present two algorithms that enable the robust extraction of joint angle and related features to enable long-term continuous monitoring of tremor with context awareness. First, we describe a novel relative sensor placement identification technique based on orientation data. We focus on relative rather than absolute sensor location, because in many medical applications magnetic and inertial measurement units (MIMU) are used in a chain stretching over adjacent segments, or are always placed on a fixed set of locations. Subsequently we demonstrate how tremor parameters can be extracted from orientation data using an adaptive estimation algorithm. Relative sensor location was detected with an accuracy of 94.12% for the 4 MIMU configuration, and 100% for the 3 MIMU configurations. Kinematic tracking error values with an average deviation of 8% demonstrate our ability to estimate tremor from orientation data. The methods presented in this study constitute an important step toward more user-friendly and context-aware neuroprostheses for tremor suppression and monitoring

One central oscillatory drive is compatible with experimental motor unit behaviour in essential and Parkinsonian tremor

Pathological tremors are symptomatic to several neurological disorders that are difficult to differentiate and the way by which central oscillatory networks entrain tremorogenic contractions is unknown. We considered the alternative hypotheses that tremor arises from one oscillator (at the tremor frequency) or, as suggested by recent findings from the superimposition of two separate inputs (at the tremor frequency and twice that frequency). Approach. Assuming one central oscillatory network we estimated analytically the relative amplitude of the harmonics of the tremor frequency in the motor neuron output for different temporal behaviors of the oscillator. Next, we analyzed the bias in the relative harmonics amplitude introduced by superimposing oscillations at twice the tremor frequency. These findings were validated using experimental measurements of wrist angular velocity and surface electromyography (EMG) from 22 patients (11 essential tremor, 11 Parkinson’s disease). The ensemble motor unit action potential trains identified from the EMG represented the neural drive to the muscles. Main results. The analytical results showed that the relative power of the tremor harmonics in the analytical models of the neural drive was determined by the variability and duration of the tremor bursts and the presence of the second oscillator biased this power towards higher values. The experimental findings accurately matched the analytical model assuming one oscillator, indicating a negligible functional role of secondary oscillatory inputs. Furthermore, a significant difference in the relative power of harmonics in the neural drive was found across the patient groups, suggesting a diagnostic value of this measure (classification accuracy: 86%). This diagnostic power decreased substantially when estimated from limb acceleration or the EMG. Signficance. The results indicate that the neural drive in pathological tremor is compatible with one central network providing neural oscillations at the tremor frequency. Moreover, the regularity of this neural oscillation varies across tremor pathologies, making the relative amplitude of tremor harmonics a potential biomarker for diagnostic use

Positive and negative motor signs of head motion in cerebral palsy: assessment of impairment and task performance

This paper analyzes the presence of positive and negative motor signs in people with cerebral palsy (CP). Positive motor signs are those that lead to involuntarily increased frequency or magnitude of muscle activity. Negative motor signs describe insufficient muscle activity or insufficient control of muscle activity. In this paper, a head-mounted alternative computer interface based on inertial technology was used to assess motor signs in seven users with CP. Task performance and control of posture was related to the impairment. There are no significant differences between users with CP and healthy control participants in the frequency domain of the head movement. Results suggest that this kind of motor disorders is not related to positive motor signs. Moreover, a control mode based on posture more than on movements is not optimum; an alternative control mode must be specially designed for users with poor postural control

Study of resting state cortico-cortical synchronization aimed to accurately discriminate Parkinson and essential tremor patients: A MEG source-space connectivity study

Motor tremor-related syndromes like essential tremor (ET) and Parkinson's disease (PD) have a common symptomatology in early stages: the presence of tremor. Even when both diseases have a different aetiology and, thus, different prognosis and treatment, the symptoms in early stages are quite similar. This usually leads to misdiagnosis, with the associated risks and limitations. A PD patient with an ET treatment will continue developing the disease, loosing an important window of action. On the other hand, an ET patient with a PD treatment will suffer strong side effects. A correct diagnosis is in both cases mandatory for the well-being of the patients. In this experiment we tried to find a biomarker based in magneto-physiological data that allows clinicians a faster and easier diagnosis of ET and PD patients, saving time and money to both patients and hospitals

Study of resting state cortico-cortical synchronization aimed to accurately discriminate Parkinson and essential tremor patients: A MEG signal-space connectivity study

Motor tremor-related syndromes like essential tremor (ET) and Parkinson?s disease (PD) have a common symptomatology in early stages: the presence of tremor. Even when both diseases have a different aetiology and, thus, different prognosis and treatment, the symptoms in early stages are quite similar. This usually leads to misdiagnosis, with the associated risks and limitations. A PD patient with an ET treatment will continue developing the disease, loosing an important window of action. On the other hand, an ET patient with a PD treatment will suffer strong side effects. A correct diagnosis is in both cases mandatory for the well-being of the patients. In this experiment we tried to find a biomarker based in magneto-physiological data that allows clinicians a faster and easier diagnosis of ET and PD patients, saving time and money to both patients and hospitals

Altered functional connectivity in essential tremor

Essential tremor (ET) has been associated with a spectrum of clinical features, with both motor and nonmotor elements, including cognitive deficits. We employed resting-state functional magnetic resonance imaging (fMRI) to assess whether brain networks that might be involved in the pathogenesis of nonmotor manifestations associated with ET are altered, and the relationship between abnormal connectivity and ET severity and neuropsychological function. Resting-state fMRI data in 23 ET patients (12 women and 11 men) and 22 healthy controls (HC) (12 women and 10 men) were analyzed using independent component analysis, in combination with a ‘‘dualregression’’ technique, to identify the group differences of resting-state networks (RSNs) (default mode network [DMN] and executive, frontoparietal, sensorimotor, cerebellar, auditory/language, and visual networks). All participants underwent a neuropsychological and neuroimaging session, where resting-state data were collected. Relative to HC, ET patients showed increased connectivity in RSNs involved in cognitive processes (DMN and frontoparietal networks) and decreased connectivity in the cerebellum and visual networks. Changes in network integrity were associated not only with ET severity (DMN) and ET duration (DMN and left frontoparietal network), but also with cognitive ability.Moreover, in at least 3 networks (DMN and frontoparietal networks), increased connectivity was associated with worse performance on different cognitive domains (attention, executive function, visuospatial ability, verbal memory, visual memory, and language) and depressive symptoms. Further, in the visual network, decreased connectivity was associated with worse performance on visuospatial ability. ET was associated with abnormal brain connectivity in major RSNs that might be involved in both motor and nonmotor symptoms

Challenge 4: Intelligent robotics

Accés lliure al text del llibre a la web de l'editorIntelligent robotics are called to be the next revolution by providing AI with the capability of interacting with the physical world. Robots are overpassing their cages in the industry to become intelligent machines that can live among us, helping in the service sector, as tools in rehabilitation and assistive tasks, and also as companions. Robotics poses especial problems and AI research must be reshaped and redefined to meet robotics special needs in areas like perception and scene understanding, decision making and learning, and actuation. Besides these classical robotics areas, modern robots need to take into account the central role of human-robot interaction : unstructured environments, unforeseen situations, user preferences, and safety. The challenges to frame this revolution are multiple. We highlight the seven where we identify CSIC has a strategic advantage and thus can cause a better impact. Modern robotics implies robots in human environments, what we called here robots for everyone : easy reprogramming and continuous learning. Deployment can include big-scale mobile robots and cars for autonomous navigation for cities, or small-scale robots for intelligent manipulation for new applications, possibly making use of effective and adaptive coordination of robot fleets. Robots in human environments require safe and ethical human-robot interaction, that can take advantage of seamless cooperative and everywhere localization solutions and dexterity and efficiency through bio-inspired and parallel mechanisms. Advances on intelligent robotics will have a great impact on science, industry, and society in general. Robots have the potential to change people’s lifestyle and thus, require special attention from rule bodies and policymakers. However, robotics is highly experimental and requires special efforts in physically building the prototypes. To make this possible, we believe a new joint lab or infrastructure must be established to facilitate research and testing, foster collaboration and involve industry and policy-makers.Postprint (published version

Essential tremor severity and anatomical changes in brain areas controlling movement sequencing

Objective: Although the cerebello-thalamo-cortical network has often been suggested to be of importance in the pathogenesis of essential tremor (ET), the origins of tremorgenic activity in this disease are not fully understood. We used a combination of cortical thickness imaging and neurophysiological studies to analyze whether the severity of tremor was associated with anatomical changes in the brain in ET patients. Methods: Magnetic resonance imaging (MRI) and a neurophysiological assessment were performed in 13 nondemented ET patients. High field structural brain MRI images acquired in a 3T scanner and analyses of cortical thickness and surface were carried out. Cortical reconstruction and volumetric segmentation was performed with the FreeSurfer image analysis software. We used high-density surface electromyography (hdEMG) and inertial measurement units (IMUs) to quantify the tremor severity in upper extrimities of patients. In particular, advanced computer tool was used to reliably identify discharge patterns of individual motor units from surface hdEMG and quantify motor unit synchronization. Results: We found significant association between increased motor unit synchronization (i.e., more severe tremor) and cortical changes (i.e., atrophy) in widespread cerebral cortical areas, including the left medial orbitofrontal cortex, left isthmus of the cingulate gyrus, right paracentral lobule, right lingual gyrus, as well as reduced left supramarginal gyrus (inferior parietal cortex), right isthmus of the cingulate gyrus, left thalamus, and left amygdala volumes. Interpretation: Given that most of these brain areas are involved in controlling movement sequencing, ET tremor could be the result of an involuntary activation of a program of motor behavior used in the genesis of voluntary repetitive movements