59 research outputs found
Classification of degenerative parkinsonism subtypes by support-vector-machine analysis and striatal 123I-FP-CIT indices.
OBJECTIVES: To provide an automated classification method for degenerative parkinsonian syndromes (PS) based on semiquantitative 123I-FP-CIT SPECT striatal indices and support-vector-machine (SVM) analysis. METHODS: 123I-FP-CIT SPECT was performed at a single-center level on 370 individuals with PS, including 280 patients with Parkinson's disease (PD), 21 with multiple system atrophy-parkinsonian type (MSA-P), 41 with progressive supranuclear palsy (PSP) and 28 with corticobasal syndrome (CBS) (mean age 70.3Â years, 47% female, mean disease duration at scan 1.4Â year), as well as 208 age- and gender-matched control subjects. Striatal volumes-of-interest (VOIs) uptake, VOIs asymmetry indices (AIs) and caudate/putamen (C/P) ratio were used as input for SVM individual classification using fivefold cross-validation. RESULTS: Univariate analyses showed significantly lower VOIs uptake, higher striatal AI and C/P ratio for each PS in comparison to controls (all pââ70% accuracy. Overall, striatal AI and C/P ratio on the more affected side had the highest weighting factors. CONCLUSION: Semiquantitative 123I-FP-CIT SPECT striatal evaluation combined with SVM represents a promising approach to disentangle PD from non-degenerative conditions and from atypical PS at the early stage
Wide-pulse, high-frequency electrical stimulation" in humans : Combined investigations of neural and muscular function using electrophysiological and nuclear magnetic resonance techniques
L'ectrostimulation dite conventionnelle (CONV) est dĂ©livrĂ©e par des impulsions Ă©lectriques de basse frĂ©quence (†50 Hz), de courte durĂ©e (< 400 ÎŒs) et de haute intensitĂ©. Ce type d'ESNM permet ainsi d'Ă©voquer une contraction musculaire grĂące Ă l'activation directe des axones moteurs et est associĂ© Ă une fatigue musculaire exagĂ©rĂ©e par rapport aux contractions volontaires (VOL). Au contraire, lors de l'utilisation d'impulsions de longues durĂ©es (1 ms), de hautes frĂ©quences (â„ 80 Hz) et de faibles intensitĂ©s (i.e. protocole « Wide-Pulse, High-Frequency » (WPHF)), une partie de la force musculaire Ă©voquĂ©e aurait pour origine des mĂ©canismes centraux. En effet, une augmentation de la force produite en rĂ©ponse Ă WPHF a Ă©tĂ© rapportĂ©e alors que l'intensitĂ© de stimulation Ă©tait constante. Cette « extra force » (EF) reflĂ©terait le recrutement par voie rĂ©flexe des motoneurones spinaux. L'objectif de ce travail de thĂšse Ă©tait de mieux apprĂ©hender les mĂ©canismes neurophysiologiques Ă l'origine de l'EF et d'Ă©valuer les consĂ©quences mĂ©taboliques et corticales du protocole WPHF (1 ms - 100 Hz) par rapport Ă des protocoles d'exercices VOL et de type CONV (50 ÎŒs - 25 Hz). Les rĂ©ponses musculaires des flĂ©chisseurs plantaires et les rĂ©ponses cĂ©rĂ©brales ont Ă©tĂ© Ă©valuĂ© par rĂ©sonance magnĂ©tique nuclĂ©aire (la spectroscopie par rĂ©sonance magnĂ©tique du phosphore 31 du muscle et l'imagerie par rĂ©sonance magnĂ©tique fonctionnelle du cerveau) et Ă©lectrophysiologie (EMG). Ces rĂ©sultats constituent une premiĂšre Ă©tape importante vers une meilleure prise en charge des pathologies liĂ©es Ă des atteintes du neuromusculaire.Conventional neuromuscular electrical stimulation (CONV) is delivered via surface electrodes at short pulse duration (< 400 ÎŒs), low frequencies (†50 Hz) and high current intensities. The motor unit recruitment pattern of CONV, however, is different from the pattern of voluntary contractions (VOL) and leads to a hastened onset of muscle fatigue. The use of wide-pulses (1ms), high frequencies (100 Hz) (WPHF) and low current intensities might approach the natural activation pattern of VOL by enhancing the neural contribution to force production. Previous studies investigating WPHF reported progressive and unexpected force increments ("Extra Forces") despite a constant stimulation intensity which might reflect the more pronounced activation of sensory pathways within the central nervous system. The objective of this thesis was to investigate this "Extra Force" (EF) phenomenon and to evaluate the efficiency of WPHF (1 ms pulse duration at 100 Hz) in terms of metabolic demand and neural contribution to force production in comparison to CONV NMES (0.05 ms pulse duration at 25 Hz) and VOL. Our experiments comprised electrophysiological (EMG) and nuclear magnetic resonance techniques (31P spectroscopy of the muscle, functional imaging of the brain). The findings should be considered in future studies investigating the potential of NMES in a clinical context as a treatment for neuromuscular pathologies
"Move your baby" ::ein öffentliches Angebot zur Bewegungsförderung in der Schwangerschaft
Bouger, un défi pour les étudiant·es
Les étudiant·es font face à la réalité de la sédentarité dans leur parcours académique, alors que son impact négatif est reconnu. Pour questionner ce défi de santé publique, deux Hautes écoles romandes ont mené un sondage exploratoire
Move Your Baby ::promotion de lâactivitĂ© physique pendant la grossesse
Cet article donne suite Ă la prĂ©sentation du projet Move Your Baby par Franziska SchlĂ€ppy dans lâĂ©dition de dĂ©cembre 2019 dâObstetrica. Il prĂ©sente les rĂ©sultats de lâĂ©valuation du programme auprĂšs des femmes enceintes et des Ă©tudiantâeâs sages femmes. Les auteures proposent de continuer la discussion sur les ressources Ă disposition des sages-femmes pour la promotion de lâactivitĂ© physique, alimentĂ©e Ă©galement par les deux articles de Mbarga et al., 2021 et Rapp et al., parus dans les Ă©ditions de novembre et dĂ©cembre 2021 dâObstetrica
Strengthening competencies of future healthcare professionals to promote physical activity during pregnancy
Pregnancy is an opportune time to adopt healthy behaviors. Healthcare professionals from diverse disciplines play a crucial role in educating pregnant women on an active lifestyle. As a trusted source of information, they can promote physical activity and behavioral change during and beyond pregnancy. Consequently, they can increase well-being, reduce the risk of complications during the perinatal period and lower the rate of noncommunicable diseases in the future. Meaningful learning environments can support students in identifying with their role as future promoters of physical activity, understanding social determinants of health, and providing personalized counseling in physical activity. This chapter focuses on educational strategies (using the examples of women-centered education programs in Switzerland) and digital health to empower future healthcare professionals in the promotion of physical activity during the perinatal period
Pedagogical innovation to promote physical activity in pregnancy ::interprofessional and real-life settings on the example of the educational program Move Your Baby
Introduction:
Despite scientific evidence on health benefits of an active lifestyle during and after pregnancy, a gap still exists between current and recommended practice in physical activity counselling. Undergraduate education in midwifery is fundamental for physical activity promotion in professional practice. The aim of this article is to present pedagogical aspects, preliminary results and discuss the relevance of the educational program Move Your Baby.
Methods:
Between 2018 and 2020, 23 midwifery students (BSc) participated in the program at the School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Lausanne, Switzerland. Theoretical and practical workshops as well as adapted physical activity sessions, in direct contact with pregnant women, were offered and supervised by professional midwives and one expert in adapted physical activity. Data analysis based on an exploratory self-administered questionnaire was performed to rate pedagogical effectiveness, perceived skill level and identify barriers and facilitators to promote physical activity in their future profession.
Results:
Midwifery students perceived improvement in their knowledge, skills and confidence to promote physical activity during pregnancy. They rated the program as pedagogically effective. However, several barriers were identified such as lack of time and material resources to promote physical activity in professional practice.
Conclusions:
This community-oriented educational program based on interplay of theory, hands-on experience and interprofessional collaboration was rated successful. Teaching physical activity in real-life settings facilitates midwifery students to identify with their professional role in the field of health promotion. Midwifery students require more opportunities to promote physical activity in their professional practice
Education level affects dual-task gait after deep brain stimulation in Parkinson's disease
High cognitive reserve is associated with milder cognitive and motor deficits in Parkinson's disease (PD). We investigated whether educational status (as a proxy for cognitive reserve) could modulate dual-task (DT) related gait changes after subthalamic nucleus deep brain stimulation (STN-DBS) in PD
Can the fusion of motion capture and 3D medical imaging reduce the extrinsic variability due to marker misplacements?
In clinical gait analysis, measurement errors impede the reliability and repeatability of the measurements. This extrinsic variability can potentially mislead the clinical interpretation of the analysis and should thus be minimised. Skin marker misplacement has been identified as the largest source of extrinsic variability between measurements. The goal of this study was to test whether the fusion of motion capture and 3D medical imaging could reduce extrinsic variability due to skin marker misplacement. The fusion method consists in using anatomical landmarks identified with 3D medical imaging to correct marker misplacements. To assess the reduction of variability accountable to the fusion method, skin marker misplacements were voluntarily introduced in the measurement of the pelvis and hip kinematics during gait for two patients scheduled for unilateral hip arthroplasty and two patients that underwent unilateral hip arthroplasty. The root mean square deviation was reduced by -78 ± 15% and the range of variability by -80 ± 16% for the pelvis and hip kinematics in average. These results showed that the fusion method could significantly reduce the extrinsic variability due to skin marker misplacement and thus increase the reliability and repeatability of motion capture measurements. However, the identification of anatomical landmarks via medical imaging is a new source of extrinsic variability that should be assessed before considering the fusion method for clinical applications
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