Introduction
Insufficient literature exists regarding the clinimetric properties of the Upright Motor Control Test Knee Extension and Flexion subtests (UMCT‐KE and UMCT‐KF, respectively). This study ...examined the interrater and test‐retest reliability of these subtests, and determined the relationship between the UMCT‐KE and a clinical measure of muscle function in a sample of adults with chronic stroke.
Methods
Three raters independently administered the UMCT‐KE and UMCT‐KF on adults with chronic stroke with spasticity/abnormal movement patterns. Testing of each participant occurred on two occasions (T1 and T2) separated by a two‐week interval. A fourth rater independently administered the Five Times Sit to Stand Test (FTSST), a measure of lower extremity muscle function (power), on T2.
Results
Twenty‐nine adults aged 55 ± 8 years, comprising 21 men (72%), and who were 9 ± 5 years poststroke, completed the study. Most of the participants (66%, 19/29) did not require an assistive device during walking. The UMCT‐KE and UMCT‐KF demonstrated substantial interrater reliability (W = 0.63–0.67 and 0.72–0.75, respectively) and substantial to almost perfect test‐retest reliability across the raters (W = 0.75–0.82 and 0.85–0.87, respectively). The UMCT‐KE showed positive inverse correlation with the FTSST (ρ = −0.52, p = .003).
Conclusions
Scores on both subtests are reproducible within raters and across different raters. The relationship of UMCT‐KE scores with FTSST scores implies that the UMCT‐KE can provide information that relates with the construct of muscle function in a weight‐bearing position.
The UMCT‐KE and UMCT‐KF show substantial to almost perfect reliability in adults with chronic stroke. The UMCT‐KE can provide information that relates with the construct of muscle function in a weight‐bearing position. The feasibility of test administration in patients with lower extremity muscle spasticity, as shown in this study, enhances the clinical relevance of both tests.
All geminiviruses found in Brazil belong to the
Begomovirus genus with a bipartite genome that is split between two genomic components, DNA-A and DNA-B. The DNA-A of the bipartite begomovirus ...ToCMoV-MG-Bt (Tomato chlorotic mottle virus), however, possesses as a peculiar characteristic the capacity to systemically infect
Nicotiana benthamiana. Here we further characterize this variant DNA-A and show that it also infects
Solanum lycopersicum and other host plants, in the absence of DNA-B. The ToCMoV-MG-Bt-DNA-A encodes an additional ORF, designated
AC5, but otherwise its genome organization is similar to other DNA-A from Western Hemisphere begomoviruses. We showed that this
AC5 putative ORF is not essential for infection, as disruption of its coding capacity caused no effect on ToCMoV-MG-Bt-DNA-A-mediated infection process. Likewise, the ToCMoV-MG-Bt-DNA-A
ac4 mutant was indistinguishable from its wild type counterpart in all hosts tested. In contrast, an
av1 (coat protein) mutant was unable to infect systemically
N. benthamiana and
Chenopodium quinoa in the absence of DNA-B. However, inclusion of DNA-B in the infection assay fully rescued the movement defect of the ToCMoV-MG-Bt-DNA-A
av1 mutant. These results suggest that at suboptimal conditions for infection the coat protein is required for ToCMoV-MG-Bt systemic movement.
We have developed a quantitative analysis system, which is constructed on a personal computer and a transparent digitizer attached to a crystal display, for estimating functions of voluntary ...movements in the upper limb. We tried to identify parameters for distinguishing the movement functions of normal subjects and patients with spino-cerebellar degeneration (SCD), and normal ones and patients with Parkinson's disease (PD) using the visually guided tracking method in the system. The subject pursued a target moving on a circle at a fixed speed with a stylus pen, and the position of the pen was digitized and led to the computer. We decomposed the locus of pen into X and Y axes, and calculated the mean velocity (MV), the mean acceleration (MA), the sum of power spectrum of the acceleration waveform (SPS), coefficient of variation of the moving distance per each sampling time (CV), the distance and the delay from the target and the pen pressure. These parameters in normal subjects were statistically compared with those in SCD or PD patients. Parameters of MV, MA, SPS in both X and Y axes, CV and the distance from the target were significantly (p<0.001) larger in SCD patients than in normal subjects. While, PD patients were clearly distinguished from normal subjects by parameters of MA and SPS in the X axis, and CV. Also, we examined the recovery process in patients with normal pressure hydrocephalus (NPH) and patients with cerebral apoplexy (CA) as compared with a doctor's estimation. In NPH patients, it was found that the distance and the delay from the target, and SPS were very effective parameters as quantitative estimation of the recovery process. While, in CA patients, parameters of the delay from the target and SPS in the pen pressure were presented the recovery process similar to doctor's estimation. Thus, it is suggested that the analysis system may be useful to quantify voluntary movement disorders in the upper limb.
Aim
To explore the effects of brain–computer interface training combined with mindfulness therapy on Hemiplegic Patients with Stroke.
Background
The prevention and treatment of stroke still faces ...great challenges. Maximizing the improvement of patients’ ability to perform activities of daily living, limb motor function, and reducing anxiety, depression, and other social and psychological problems to improve patients’ overall quality of life is the focus and difficulty of clinical rehabilitation work.
Methods
Patients were recruited from December 2021 to November 2022, and assigned to either the intervention or control group following a simple randomization procedure (computer-generated random numbers). Both groups received conventional rehabilitation treatment, while patients in the intervention group additionally received brain–computer interface training and mindfulness therapy. The continuous treatment duration was 5 days per week for 8 weeks. Limb motor function, activities of daily living, mindfulness attention awareness level, sleep quality, and quality of life of the patients were measured (in T0, T1, and T2). Generalized estimated equation (GEE) were used to evaluate the effects. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2300070382).
Results
A total of 128 participants were randomized and 64 each were assigned to the intervention and control groups (of these, eight patients were lost to follow-up). At 6 months, compared with the control group, intervention group showed statistically significant improvements in limb motor function, mindful attention awareness, activities of daily living, sleep quality, and quality of life.
Conclusion
Brain–computer interface combined with mindfulness therapy training can improve limb motor function, activities of daily living, mindful attention awareness, sleep quality, and quality of life in hemiplegic patients with stroke.
Impact
This study provides valuable insights into post-stroke care. It may help improve the effect of rehabilitation nursing to improve the comprehensive ability and quality of life of patients after stroke.
Clinical review registration
https://www.chictr.org.cn/
, identifier ChiCTR2300070382.
The ankle kinematic characteristics of chronic ankle instability (CAI) at different gait phases and dimensions were not directly and overall explained. These characteristics have yet to be ...established. This study aimed to observe ankle kinematic changes of CAI, and explore their mechanisms, at different gait phases and dimensions in full gait cycle.
A three-dimensional (3D) motion capture system measured the 3D ankle movements of 53 individuals with CAI (meanage = 25.11 ± 6.01years, meanheight = 170.77 ± 7.80 cm, meanmass = 64.28 ± 9.28 kg) and 53 healthy controls (meanage = 24.66 ± 6.32 years, meanheight = 169.98 ± 9.00 cm, meanmass = 63.11 ± 9.62 kg) during barefoot walking overground at a self-selected speed. Once the acquisition results were processed with visual 3D software, the kinematics data were exported, and the eight phases of the gait cycle were identified.
As compared with the control group, individuals with CAI displayed a significantly smaller plantarflexion in toe off (P = 0.049, Cohen's d = 0.387), a significantly increased inversion in heel strike (P = 0.007, Cohen's d = 0.271) and initial swing (P = 0.035, Cohen's d = 0.233), mid-swing (P = 0.019, Cohen's d = 0.232) and end-swing (P = 0.021, Cohen's d = 0.214), and significantly smaller eversion in mid stance（P = 0.010, Cohen's d = 0.288）and heel off (P = 0.033, Cohen's d = 0.089). Significant between-group differences in ankle kinematics were observed in the sagittal and frontal planes, but not in the horizontal plane, during walking.
When walking, patients with CAI have altered sagittal- and frontal-plane kinematics during different stance and swing phases. These kinematic changes require multi-dimensional, dynamic, continuous functional assessment and specialized rehabilitation intervention.
The purposes of this study are to investigate the regional homogeneity (ReHo) of spontaneous brain activities in Parkinson's disease (PD) patients with freeze of gait (FOG) and to investigate the ...neural correlation of movement function through resting-state functional magnetic resonance imaging (RS-fMRI).
A total of 35 normal controls (NC), 33 PD patients with FOG (FOG+), and 35 PD patients without FOG (FOG-) were enrolled. ReHo was applied to evaluate the regional synchronization of spontaneous brain activities. Analysis of covariance (ANCOVA) was performed on ReHo maps of the three groups, followed by
two-sample
-tests between every two groups. Moreover, the ReHo signals of FOG+ and FOG- were extracted across the whole brain and correlated with movement scores (FOGQ, FOG questionnaire; GFQ, gait and falls questionnaire).
Significant ReHo differences were observed in the left cerebrum. Compared to NC subjects, the ReHo of PD subjects was increased in the left angular gyrus (AG) and decreased in the left rolandic operculum/postcentral gyrus (Rol/PostC), left inferior opercular-frontal cortex, left middle occipital gyrus, and supramarginal gyrus (SMG). Compared to that of FOG-, the ReHo of FOG+ was increased in the left caudate and decreased in the left Rol/PostC. Within the significant regions, the ReHo of FOG+ was negatively correlated with FOGQ in the left SMG/PostC (
= -0.39,
< 0.05). Negative correlations were also observed between ReHo and GFQ/FOGQ (
= -0.36/-0.38,
< 0.05) in the left superior temporal gyrus (STG) of the whole brain analysis based on AAL templates.
The ReHo analysis suggested that the regional signal synchronization of brain activities in FOG+ subjects was most active in the left caudate and most hypoactive in the left Rol/PostC. It also indicated that ReHo in the left caudate and left Rol/PostC was critical for discriminating the three groups. The correlation between ReHo and movement scores (GFQ/FOGQ) in the STG has the potential to differentiate FOG+ from FOG-. This study provided new insight into the understanding of PD with and without FOG.
The objective of this study was to explore the feasibility of using wearable devices to quantitatively measure the daily activity in patients with Parkinson’s disease (PD) and to monitor ...medication-induced motor fluctuations. In this case-controlled study, we used monitored daily movement function in 21 patients with Parkinson’s disease and 20 healthy volunteers. We analyzed the exercise types and sleep duration in the two groups and evaluated the correlation between daily movement function and age, gender, education, disease duration, Hohn-Yahr stage, UPDRS-II score, UPDRS-III score, and levodopa dose. We also determined the amount of exercise performed by PD patients at 1 h after taking levodopa and at 1 h before the next dose. The type of activity, average speed, and sleep duration in patients were significantly lower in PD patients than in healthy controls (
P
< 0.05). One hour after taking levodopa, patients were significantly more active than 1 h before the next dose (
P
< 0.05).Correlation analysis showed that age, gender, education, disease duration, Hohn-Yahr stage, UPDRS-II and UPDRS-III scores, and dosage of levodopa do not correlate with the daily movement function (
P
> 0.05) in patients with Parkinson’s disease. In the control group, age and education were associated with daily movement function (
P
< 0.05), while gender was unrelated (
P
> 0.05). Continuous monitoring of daily activity may be useful to reveal medication-induced motor fluctuations in Parkinson’s disease. The daily movement function may depend on age and education, but not on other parameters.
: Abnormalities of cognitive and movement functions are widely reported in Parkinson's disease (PD). The mechanisms therein are complicated and assumed to a coordination of various brain regions. ...This study explored the alterations of global synchronizations of brain activities and investigated the neural correlations of cognitive and movement function in PD patients.
: Thirty-five age-matched patients with PD and 35 normal controls (NC) were enrolled in resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Degree centrality (DC) was calculated to measure the global synchronizations of brain activity for two groups. Neural correlations between DC and cognitive function Frontal Assessment Battery (FAB), as well as movement function Unified Parkinson's Disease Rating Scale (UPDRS-III), were examined across the whole brain within Anatomical Automatic Labeling (AAL) templates.
: In the PD group, increased DC was observed in left fusiform gyrus extending to inferior temporal gyrus, left middle temporal gyrus (MTG) and angular gyrus, while it was decreased in right inferior opercular-frontal gyrus extending to superior temporal gyrus (STG). The DC in a significant region of the fusiform gyrus was positively correlated with UPDRS-III scores in PD (
= 0.41,
= 0.0145). Higher FAB scores were shown in NC than PD (
< 0.0001). Correlative analysis of PD between DC and FAB showed negative results (
< 0.05) in frontal cortex, whereas positive in insula and cerebellum. As for the correlations between DC and UPDRS-III, negative correlation (
< 0.05) was observed in bilateral inferior parietal lobule (IPL) and right cerebellum, whereas positive correlation (
< 0.05) in bilateral hippocampus and para-hippocampus gyrus (
< 0.01).
: The altered global synchronizations revealed altered cognitive and movement functions in PD. The findings suggested that the global functional connectivity in fusiform gyrus, cerebellum and hippocampus gyrus are critical regions in the identification of cognitive and movement functions in PD. This study provides new insights on the interactions among global coordination of brain activity, cognitive and movement functions in PD.
To explore the effects of predictive nursing intervention among patients with acute stroke.
One hundred and sixty participants were included. They were hospitalized in the Department of Neurology of ...a third-level first-class hospital in Changsha, Hunan Province, from January to August 2019. They were categorized into control group and intervention group by random number table, with 80 patients in each group. General nursing for patients in Neurology Department was offered to the control group. On the basis of general nursing, predictive nursing intervention was offered to the intervention group. The effectiveness of predictive nursing intervention were evaluated by disparity in neurologic function, movement function, daily life ability and sleep quality before intervention and 2 weeks after intervention. The neurologic function, movement function, daily life ability and sleep quality were evaluated by National Institute of Health acute stroke scale (NIHSS), Fugl-Meyer scale, Barthel indicator, and Pittsburgh sleep quality indicator (PSQI), respectively.
There was no significant difference in gender, age, complications and treatment methods between two groups. There was no significant difference in the scores of NIHSS, Fugl-Meyer scale, Barthel indicator, and PSQI before intervention. The scores of NIHSS and PSQI were significantly lower in the intervention group than those in the control group, and the scores of Fugl-Meyer scale and Barthel indicator were significantly higher in the intervention group than those in the control group (
<0.05).
Predictive nursing intervention could help improve not only neurologic function, movement function, and daily life ability, but also sleep quality among patients with acute stroke.
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