WorldWideScience

Sample records for neuromuscular control ability

  1. Athletic background is related to superior trunk proprioceptive ability, postural control, and neuromuscular responses to sudden perturbations.

    Science.gov (United States)

    Glofcheskie, Grace O; Brown, Stephen H M

    2017-04-01

    Trunk motor control is essential for athletic performance, and inadequate trunk motor control has been linked to an increased risk of developing low back and lower limb injury in athletes. Research is limited in comparing relationships between trunk neuromuscular control, postural control, and trunk proprioception in athletes from different sporting backgrounds. To test for these relationships, collegiate level long distance runners and golfers, along with non-athletic controls were recruited. Trunk postural control was investigated using a seated balance task. Neuromuscular control in response to sudden trunk loading perturbations was measured using electromyography and kinematics. Proprioceptive ability was examined using active trunk repositioning tasks. Both athlete groups demonstrated greater trunk postural control (less centre of pressure movement) during the seated task compared to controls. Athletes further demonstrated faster trunk muscle activation onsets, higher muscle activation amplitudes, and less lumbar spine angular displacement in response to sudden trunk loading perturbations when compared to controls. Golfers demonstrated less absolute error and variable error in trunk repositioning tasks compared to both runners and controls, suggestive of greater proprioceptive ability. This suggests an interactive relationship between neuromuscular control, postural control, and proprioception in athletes, and that differences exist between athletes of various training backgrounds. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Eccentric Exercise to Enhance Neuromuscular Control.

    Science.gov (United States)

    Lepley, Lindsey K; Lepley, Adam S; Onate, James A; Grooms, Dustin R

    Neuromuscular alterations are a major causal factor of primary and secondary injuries. Though injury prevention programs have experienced some success, rates of injuries have not declined, and after injury, individuals often return to activity with functionality below clinical recommendations. Considering alternative therapies to the conventional concentric exercise approach, such as one that can target neuromuscular injury risk and postinjury alterations, may provide for more effective injury prevention and rehabilitation protocols. Peer-reviewed sources available on the Web of Science and MEDLINE databases from 2000 through 2016 were gathered using searches associated with the keywords eccentric exercise, injury prevention, and neuromuscular control. Eccentric exercise will reduce injury risk by targeting specific neural and morphologic alterations that precipitate neuromuscular dysfunction. Clinical review. Level 4. Neuromuscular control is influenced by alterations in muscle morphology and neural activity. Eccentric exercise beneficially modifies several underlying factors of muscle morphology (fiber typing, cross-sectional area, working range, and pennation angle), and emerging evidence indicates that eccentric exercise is also beneficial to peripheral and central neural activity (alpha motorneuron recruitment/firing, sarcolemma activity, corticospinal excitability, and brain activation). There is mounting evidence that eccentric exercise is not only a therapeutic intervention influencing muscle morphology but also targets unique alterations in neuromuscular control, influencing injury risk.

  3. NEUROMUSCULAR CONTROL IN LUMBAR DISORDERS

    Directory of Open Access Journals (Sweden)

    Ville Leinonen

    2004-03-01

    Full Text Available Impaired motor and sensory functions have been associated with low back pain (LBP. This includes disturbances in a wide range of sensorimotor control e.g. sensory dysfunctions, impaired postural responses and psychomotor control. However, the physiological mechanisms, clinical relevance and characteristics of these findings in different spinal pathologies require further clarification. The purposes of this study were to investigate postural control, lumbar muscle function, movement perception and associations between these findings in healthy volunteers (n=35, patients with lumbar disc herniation (n=20 and lumbar spinal stenosis (LSS, n=26. Paraspinal muscle responses for sudden upper limb loading and muscle activation during flexion-extension movement and the lumbar endurance test were measured by surface electromyography (EMG. Postural stability was measured on a force platform during two- and one-footed standing. Lumbar movement perception was assessed in a motorised trunk rotation unit in the seated position. In addition, measurements of motor-(MEP and somatosensory evoked potentials (SEP and needle EMG examination of lumbar multifidus muscles were performed in the LSS patients. Clinical and questionnaire data were also recorded. A short latency paraspinal muscle response (~50 ms for sudden upper limb loading was observed. The latency of the response was shortened by expectation (p=0.017. The response latency for unexpected loading was similar in healthy persons and disc herniation patients but the latency was not shortened by expectation in the patients (p = 0.014. Also impaired postural control (p < 0.05 and lumbar movement perception (p = 0.012 were observed in disc herniation patients. The impaired lumbar movement perception (p=0.054 and anticipatory muscle activation (p = 0.043 tended to be restored after successful surgery but postural control had still not recovered after 3 months of follow-up. The majority of LSS patients were unable

  4. Improvement in Offaxis Neuromuscular Control Under Slippery Conditions Following Six-Week Pivoting Leg Neuromuscular Training.

    Science.gov (United States)

    Lee, Song Joo; Ren, Yupeng; Press, Joel M; Lee, Jungwha; Zhang, Li-Qun

    2017-11-01

    Knee injuries are usually associated with offaxis loadings in the transverse and frontal planes. Thus, improvement of lower limb offaxis neuromuscular control is important in knee injury prevention and post-injury rehabilitation. The goal of this paper was to investigate the effects of six-week pivoting offaxis intensity adjustable neuromuscular control training (POINT) using a custom-made offaxis elliptical trainer on lower limb offaxis neuromuscular control performance in trained and untrained functional tasks under slippery conditions. Twenty-six subjects participated in 18 sessions of POINT (three sessions per week for six weeks) and 25 subjects served as controls who did a regular workout. Offaxis neuromuscular control performance measures in terms of pivoting instability, sliding instability, and time-to-peak offaxis EMG entropy were evaluated on both groups under slippery conditions including a trained free pivoting task and untrained free sliding task and free pivoting and sliding task. Compared with the control group, the training group significantly decreased pivoting instability and the time-to-peak offaxis EMG entropy in lower limb muscles, indicating improvement in offaxis neuromuscular control performance. Furthermore, the training group showed reduced pivoting instability and sliding instability during the untrained free pivoting and sliding task. This paper may help us develop more focused and effective offaxis training programs to reduce knee injuries associated with offaxis loadings.

  5. Effects of pivoting neuromuscular training on pivoting control and proprioception.

    Science.gov (United States)

    Lee, Song Joo; Ren, Yupeng; Chang, Alison H; Geiger, François; Zhang, Li-Qun

    2014-07-01

    Pivoting neuromuscular control and proprioceptive acuity may play an important role in anterior cruciate ligament injuries. The goal of this study was to investigate whether pivoting off-axis intensity adjustable neuromuscular control training (POINT) could improve pivoting neuromuscular control, proprioceptive acuity, and functional performance. Among 41 subjects, 21 subjects participated in 18 sessions of POINT (three sessions per week for 6 wk), and 20 subjects served as controls who did their regular workout. Both groups received pre-, mid-, and postintervention evaluations. Propensity score analysis with multivariable regression adjustment was used to investigate the effect of training on pivoting neuromuscular control (pivoting instability, leg pivoting stiffness, maximum internal, and external pivoting angles), proprioceptive acuity, and functional performance in both groups. Compared with the control group, the training group significantly improved pivoting neuromuscular control as reduced pivoting instability, reduced maximum internal and external pivoting angles, increased leg pivoting stiffness, and decreased entropy of time to peak EMG in the gluteus maximus and lateral gastrocnemius under pivoting perturbations. Furthermore, the training group enhanced weight-bearing proprioceptive acuity and improved the single leg hop distance. Improvement of pivoting neuromuscular control in functional weight-bearing activities and task performances after POINT may help develop lower limb injury prevention and rehabilitation methods to reduce anterior cruciate ligament and other musculoskeletal injuries associated with pivoting sports.

  6. Effects of Pivoting Neuromuscular Training on Pivoting Control and Proprioception

    Science.gov (United States)

    Lee, Song Joo; Ren, Yupeng; Chang, Alison H.; Geiger, François; Zhang, Li-Qun

    2014-01-01

    Purpose Pivoting neuromuscular control and proprioceptive acuity may play an important role in ACL injuries. The goal of this study was to investigate whether pivoting neuromuscular training on an offaxis elliptical trainer (POINT) could improve pivoting neuromuscular control, proprioceptive acuity, and functional performance. Methods Among 41 subjects, 21 subjects participated in 18 sessions of POINT (3 sessions/week for 6 weeks), and 20 subjects served as controls who did their regular workout. Both groups received pre-, mid-, and post-intervention evaluations. Propensity score analysis with multivariable regression adjustment was used to investigate the effect of training on pivoting neuromuscular control (pivoting instability, leg pivoting stiffness, maximum internal and external pivoting angles), proprioceptive acuity, and functional performance in both groups. Results Compared to the control group, the training group significantly improved pivoting neuromuscular control as reduced pivoting instability, reduced maximum internal and external pivoting angles, increased leg pivoting stiffness, and decreased entropy of time to peak EMG in the gluteus maximus and lateral gastrocnemius under pivoting perturbations. Furthermore, the training group enhanced weight-bearing proprioceptive acuity and improved the single leg hop distance. Conclusion Improvement of pivoting neuromuscular control in functional weight-bearing activities and task performances following POINT may help develop lower limb injury prevention and rehabilitation methods to reduce ACL and other musculoskeletal injuries associated with pivoting sports. PMID:24389517

  7. The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control.

    Science.gov (United States)

    Takacs, Judit; Carpenter, Mark G; Garland, S Jayne; Hunt, Michael A

    2013-04-01

    Knee osteoarthritis (OA) is a chronic joint condition, with 30% of those over the age of 75 exhibiting severe radiographic disease. Nearly 50% of those with knee OA have experienced a fall in the past year. Falls are a considerable public health concern, with a high risk of serious injury and a significant socioeconomic impact. The ability to defend against a fall relies on adequate dynamic postural control, and alterations in dynamic postural control are seen with normal aging. Neuromuscular changes associated with aging may be responsible for some of these alterations in dynamic postural control. Even greater neuromuscular deficits, which may impact dynamic postural control and the ability to defend against a fall, are seen in people with knee OA. There is little evidence to date on how knee OA affects the ability to respond to and defend against falls and the neuromuscular changes that contribute to balance deficits. As a result, this review will: summarize the key characteristics of postural responses to an external perturbation, highlight the changes in dynamic postural control seen with normal aging, review the neuromuscular changes associated with aging that have known and possible effects on dynamic postural control, and summarize the neuromuscular changes and balance problems in knee OA. Future research to better understand the role of neuromuscular changes in knee OA and their effect on dynamic postural control will be suggested. Such an understanding is critical to the successful creation and implementation of fall prevention and treatment programs, in order to reduce the excessive risk of falling in knee OA.

  8. Pivoting neuromuscular control and proprioception in females and males.

    Science.gov (United States)

    Lee, Song Joo; Ren, Yupeng; Kang, Sang Hoon; Geiger, François; Zhang, Li-Qun

    2015-04-01

    Noncontact ACL injuries occur most commonly in pivoting sports and are much more frequent in females than in males. However, information on sex differences in proprioceptive acuity under weight-bearing and leg neuromuscular control in pivoting is scarce. The objective of this study was to investigate sex differences in pivoting neuromuscular control during strenuous stepping tasks and proprioceptive acuity under weight-bearing. 21 male and 22 female subjects were recruited to evaluate pivoting proprioceptive acuity under weight-bearing, and pivoting neuromuscular control (in terms of leg pivoting instability, stiffness, maximum internal and external pivoting angles, and entropy of time-to-peak EMG in lower limb muscles) during strenuous stepping tasks performed on a novel offaxis elliptical trainer. Compared to males, females had significantly lower proprioceptive acuity under weight-bearing in both internal and external pivoting directions, higher pivoting instability, larger maximum internal pivoting angle, lower leg pivoting stiffness, and higher entropy of time-to-peak EMG in the gastrocnemius muscles during strenuous stepping tasks with internal and external pivoting perturbations. Results of this study may help us better understand factors contributing to ACL injuries in females and males, develop training strategies to improve pivoting neuromuscular control and proprioceptive acuity, and potentially reduce ACL and lower-limb musculoskeletal injuries.

  9. Stunted PFC activity during neuromuscular control under stress with obesity.

    Science.gov (United States)

    Mehta, Ranjana K

    2016-02-01

    Obesity is an established risk factor for impaired cognition, which is primarily regulated by the prefrontal cortex (PFC). However, very little is known about the neural pathways that underlie obesity-related declines in neuromuscular control, particularly under stress. The purpose of this study was to determine the role of the PFC on neuromuscular control during handgrip exertions under stress with obesity. Twenty non-obese and obese young adults performed submaximal handgrip exertions in the absence and presence of a concurrent stressful task. Primary dependent measures included oxygenated hemoglobin (HbO2: a measure of PFC activity) and force fluctuations (an indicator of neuromuscular control). Higher HbO2 levels in the PFC were observed in the non-obese compared to the obese group (P = 0.009). In addition, higher HbO2 levels were observed in the stress compared to the control condition in the non-obese group; however, this trend was reversed in the obese group (P = 0.043). In general, force fluctuations increased by 26% in the stress when compared to the control condition (P = 0.001) and obesity was associated with 39% greater force fluctuation (P = 0.024). Finally, while not significant, obesity-related decrements in force fluctuations were magnified under stress (P = 0.063). The current study provides the first evidence that neuromuscular decrements with obesity were associated with impaired PFC activity and this relationship was augmented in stress conditions. These findings are important because they provide new information on obesity-specific changes in brain function associated with neuromuscular control since the knowledge previously focused largely on obesity-specific changes in peripheral muscle capacity.

  10. Altered neuromuscular control mechanisms of the trapezius muscle in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Karlsson Stefan J

    2010-03-01

    Full Text Available Abstract Background fibromyalgia is a relatively common condition with widespread pain and pressure allodynia, but unknown aetiology. For decades, the association between motor control strategies and chronic pain has been a topic for debate. One long held functional neuromuscular control mechanism is differential activation between regions within a single muscle. The aim of this study was to investigate differences in neuromuscular control, i.e. differential activation, between myalgic trapezius in fibromyalgia patients and healthy controls. Methods 27 fibromyalgia patients and 30 healthy controls performed 3 minutes bilateral shoulder elevations with different loads (0-4 Kg with a high-density surface electromyographical (EMG grid placed above the upper trapezius. Differential activation was quantified by the power spectral median frequency of the difference in EMG amplitude between the cranial and caudal parts of the upper trapezius. The average duration of the differential activation was described by the inverse of the median frequency of the differential activations. Results the median frequency of the differential activations was significantly lower, and the average duration of the differential activations significantly longer in fibromyalgia compared with controls at the two lowest load levels (0-1 Kg (p Conclusion these findings illustrate a different neuromuscular control between fibromyalgia patients and healthy controls during a low load functional task, either sustaining or resulting from the chronic painful condition. The findings may have clinical relevance for rehabilitation strategies for fibromyalgia.

  11. Muscle synergies and complexity of neuromuscular control during gait in cerebral palsy.

    Science.gov (United States)

    Steele, Katherine M; Rozumalski, Adam; Schwartz, Michael H

    2015-12-01

    Individuals with cerebral palsy (CP) have impaired movement due to a brain injury near birth. Understanding how neuromuscular control is altered in CP can provide insight into pathological movement. We sought to determine if individuals with CP demonstrate reduced complexity of neuromuscular control during gait compared with unimpaired individuals and if changes in control are related to functional ability. Muscle synergies during gait were retrospectively analyzed for 633 individuals (age range 3.9-70y): 549 with CP (hemiplegia, n=122; diplegia, n=266; triplegia, n=73; quadriplegia, n=88) and 84 unimpaired individuals. Synergies were calculated using non-negative matrix factorization from surface electromyography collected during previous clinical gait analyses. Synergy complexity during gait was compared with diagnosis subtype, functional ability, and clinical examination measures. Fewer synergies were required to describe muscle activity during gait in individuals with CP compared with unimpaired individuals. Changes in synergies were related to functional impairment and clinical examination measures including selective motor control, strength, and spasticity. Individuals with CP use a simplified control strategy during gait compared with unimpaired individuals. These results were similar to synergies during walking among adult stroke survivors, suggesting similar neuromuscular control strategies between these clinical populations. © 2015 Mac Keith Press.

  12. Neuromuscular control and rehabilitation of the unstable ankle

    OpenAIRE

    Hung, You-jou

    2015-01-01

    Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. Howeve...

  13. Repeated sprint ability in soccer players: associations with physiological and neuromuscular factors.

    Science.gov (United States)

    Baldi, Marcelo; DA Silva, Juliano F; Buzzachera, Cosme F; Castagna, Carlo; Guglielmo, Luiz G

    2017-01-01

    The aim of this study was to examine the relationship between repeated sprint ability (RSA, 6×40 m [20+20 m] with 20-s recovery) and neuromuscular and aerobic fitness variables in male collegiate soccer players. Twenty-six players (age 22.5±3.6 years) were tested on separate days for countermovement jump (CMJ), squat jump (SJ), and standing long jump (LJ), and for maximal oxygen consumption (V̇O2max), velocity at onset of blood lactate accumulation (vOBLA), maximal aerobic speed (vV̇O2max), and peak blood lactate concentration (peak [La]). They were also tested for best and mean times on a repeated shuttle sprint ability test. RSA best time (r=-0.73 and r=-0.54) and RSA mean sprint time (r=-0.69 and r=-0.62) were significantly (Psoccer players. Given this finding, lower limbs' explosive-strength performance should be regarded as a relevant factor for male soccer.

  14. Neuromuscular control of trunk stability: clinical implications for sports injury prevention.

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    Zazulak, Bohdanna; Cholewicki, Jacek; Reeves, N Peter

    2008-09-01

    Recent prospective evidence supports the hypothesis that impaired trunk control is a contributing factor to sports injuries of the spine as well as to segments of the kinetic chain. The current concepts regarding neuromuscular control of trunk stability are best described from a systems engineering perspective. In the analysis of current neuromuscular training protocols for sports injury prevention, these principles are applied to identify components that optimize neuromuscular control of trunk stability. Current perspectives of neuromuscular learning can be applied clinically to aid in the formulation of injury prevention strategies.

  15. Contributions of rapid neuromuscular transmission to the fine control of acoustic parameters of birdsong.

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    Mencio, Caitlin; Kuberan, Balagurunathan; Goller, Franz

    2017-02-01

    Neural control of complex vocal behaviors, such as birdsong and speech, requires integration of biomechanical nonlinearities through muscular output. Although control of airflow and tension of vibrating tissues are known functions of vocal muscles, it remains unclear how specific muscle characteristics contribute to specific acoustic parameters. To address this gap, we removed heparan sulfate chains using heparitinases to perturb neuromuscular transmission subtly in the syrinx of adult male zebra finches (Taeniopygia guttata). Infusion of heparitinases into ventral syringeal muscles altered their excitation threshold and reduced neuromuscular transmission changing their ability to modulate airflow. The changes in muscle activation dynamics caused a reduction in frequency modulation rates and elimination of many high-frequency syllables but did not alter the fundamental frequency of syllables. Sound amplitude was reduced and sound onset pressure was increased, suggesting a role of muscles in the induction of self-sustained oscillations under low-airflow conditions, thus enhancing vocal efficiency. These changes were reversed to preinfusion levels by 7 days after infusion. These results illustrate complex interactions between the control of airflow and tension and further define the importance of syringeal muscle in the control of a variety of acoustic song characteristics. In summary, the findings reported here show that altering neuromuscular transmission can lead to reversible changes to the acoustic structure of song. Understanding the full extent of muscle involvement in song production is critical in decoding the motor program for the production of complex vocal behavior, including our search for parallels between birdsong and human speech motor control. It is largely unknown how fine motor control of acoustic parameters is achieved in vocal organs. Subtle manipulation of syringeal muscle function was used to test how active motor control influences acoustic

  16. Restoring standing capabilities with feedback control of functional neuromuscular stimulation following spinal cord injury.

    Science.gov (United States)

    Nataraj, Raviraj; Audu, Musa L; Triolo, Ronald J

    2017-04-01

    This paper reviews the field of feedback control for neuroprosthesis systems that restore advanced standing function to individuals with spinal cord injury. Investigations into closed-loop control of standing by functional neuromuscular stimulation (FNS) have spanned three decades. The ultimate goal for FNS standing control systems is to facilitate hands free standing and enabling the user to perform manual functions at self-selected leaning positions. However, most clinical systems for home usage currently only provide basic upright standing using preprogrammed stimulation patterns. To date, online modulation of stimulation to produce advanced standing functions such as balance against postural disturbances or the ability to assume leaning postures have been limited to simulation and laboratory investigations. While great technological advances have been made in biomechanical sensing and interfaces for neuromuscular stimulation, further progress is still required for finer motor control by FNS. Another major challenge is the development of sophisticated control schemes that produce the necessary postural adjustments, adapt against accelerating muscle fatigue, and consider volitional actions of the intact upper-body of the user. Model-based development for novel control schemes are proven and sensible approaches to prototype and test the basic operating efficacy of potentially complex and multi-faceted control systems. The major considerations for further innovation of such systems are summarized in this paper prior to describing the evolution of closed-loop FNS control of standing from previous works. Finally, necessary emerging technologies to for implementing FNS feedback control systems for standing are identified. These technological advancements include novel electrodes that more completely and selectively activate paralyzed musculature and implantable sensors and stimulation modules for flexible neuroprosthesis system deployment. Copyright © 2017 IPEM

  17. Neuromuscular function during stair descent in meniscectomized patients and controls

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Roos, Ewa M; Aagaard, Per

    2011-01-01

    The aim of this study was to identify differences in knee range of motion (ROM), movement speed, ground reaction forces (GRF) profile, neuromuscular activity, and muscle coactivation during the transition between stair descent and level walking in meniscectomized patients at high risk of knee...

  18. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

    Science.gov (United States)

    Zech, Astrid; Klahn, Philipp; Hoeft, Jon; zu Eulenburg, Christine; Steib, Simon

    2014-02-01

    Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

  19. Propiocepción y control neuromuscular en el fútblo infantil

    OpenAIRE

    Zarza, Cristían

    2014-01-01

    En el fútbol profesional la escasa utilización de la pierna no hábil hace que muchas situaciones de juego no se resuelvan eficazmente, además de predisponer a la aparición de lesiones. El presente estudio se concentró en determinar la influencia del entrenamiento propioceptivo y del control neuromuscular en las cualidades físicas y técnicas del miembro no hábil. Objetivo: Indagar el nivel propioceptivo y de control neuromuscular del miembro inferior no hábil en chicos que re...

  20. Innervation and neuromuscular control in ageing skeletal muscle.

    Science.gov (United States)

    Hepple, Russell T; Rice, Charles L

    2016-04-15

    Changes in the neuromuscular system affecting the ageing motor unit manifest structurally as a reduction in motor unit number secondary to motor neuron loss; fibre type grouping due to repeating cycles of denervation-reinnervation; and instability of the neuromuscular junction that may be due to either or both of a gradual perturbation in postsynaptic signalling mechanisms necessary for maintenance of the endplate acetylcholine receptor clusters or a sudden process involving motor neuron death or traumatic injury to the muscle fibre. Functionally, these changes manifest as a reduction in strength and coordination that precedes a loss in muscle mass and contributes to impairments in fatigue. Regular muscle activation in postural muscles or through habitual physical activity can attenuate some of these structural and functional changes up to a point along the ageing continuum. On the other hand, regular muscle activation in advanced age (>75 years) loses its efficacy, and at least in rodents may exacerbate age-related motor neuron death. Transgenic mouse studies aimed at identifying potential mechanisms of motor unit disruptions in ageing muscle are not conclusive due to many different mechanisms converging on similar motor unit alterations, many of which phenocopy ageing muscle. Longitudinal studies of ageing models and humans will help clarify the cause and effect relationships and thus, identify relevant therapeutic targets to better preserve muscle function across the lifespan. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  1. Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trial

    DEFF Research Database (Denmark)

    Claudius, C; Viby-Mogensen, J; Skovgaard, Lene Theil

    2009-01-01

    BACKGROUND: Acceleromyography (AMG) is increasingly being used in neuromuscular research, including in studies establishing the potency of neuromuscular blocking and reversal agents. However, AMG is insufficiently validated for use interchangeably with the gold standard, mechanomyography (MMG......) for this purpose. The aim of this study was to compare AMG and MMG for establishing dose-response relationship and potency, using rocuronium as an example. METHODS: We included 40 adult patients in this randomized-controlled single-dose response study. Anaesthesia was induced and maintained with propofol...... difference between AMG and MMG is so small that it justifies AMG to be used for establishing the potency of neuromuscular blocking agents. However, the wide CIs show that we cannot rule out a 13% higher ED(50) and a 26% higher ED(95) for AMG....

  2. Valoració i entrenament del control neuromuscular per a la millora del rendiment esportiu

    OpenAIRE

    Fort Vanmeerhaeghe, Azahara

    2010-01-01

    El control neuromuscular ha estat descrit com un important factor per a l'èxit en el rendiment esportiu. De la mateixa manera, també s'ha identificat com a clau en la prevenció i readaptació de les lesions esportives. El principal objectiu d'aquesta tesi doctoral és avaluar l'eficàcia de diferents tipus d'entrenament neuromuscular en esportistes.S'ha utilitzat una mostra de 81 esportistes sans entre els diferents estudis que s'hi presenten. Les diferents avaluacions realitzades han registrat ...

  3. Modified step aerobics training and neuromuscular function in osteoporotic patients: a randomized controlled pilot study.

    Science.gov (United States)

    Behrens, Martin; Müller, Karoline; Kilb, Jill-Isabel; Schleese, Lennart; Herlyn, Philipp K E; Bruhn, Sven; Mittlmeier, Thomas; Schober, Hans-Christof; Fischer, Dagmar-C

    2017-02-01

    Training programs directed to improve neuromuscular and musculoskeletal function of the legs are scarce with respect to older osteoporotic patients. We hypothesized that a modified step aerobics training program might be suitable for this purpose and performed a randomized controlled pilot study to assess the feasibility of conducting a large study. Here we report on the training-related effects on neuromuscular function of the plantar flexors. Twenty-seven patients with an age of at least 65 years were enrolled and randomized into control and intervention group. The latter received supervised modified step aerobics training (twice weekly, 1 h per session) over a period of 6 months. At baseline, and after 3 and 6 months neuromuscular function of the plantar flexors, i.e., isometric maximum voluntary torque, rate of torque development and twitch torque parameters were determined in detail in all patients of both groups. Twenty-seven patients (median age 75 years; range 66-84 years) were randomized (control group n = 14; intervention group n = 13). After 3 and 6 months of training, maximum voluntary contraction strength in the intervention group was significantly higher by 7.7 Nm (9.1%; 95% CI 3.3-12.2 Nm, P training program in a large randomized trial. However, a detailed neuromuscular assessment appears feasible only in a subset of participants.

  4. Electromyographic and neuromuscular variables in unstable postpolio subjects, stable postpolio subjects, and control subjects.

    Science.gov (United States)

    Rodriquez, A A; Agre, J C; Franke, T M

    1997-09-01

    To compare strength and endurance variables obtained in the quadriceps muscles of postpolio and control subjects over a 7-year interval with macro and single fiber electromyography (EMG) variables. A controlled inception cohort study. Neuromuscular research laboratory of a university hospital. A cohort of 23 postpolio and 14 control subjects. All postpolio subjects had a history, physical examination, and EMG consistent with previous poliomyelitis, and had greater than antigravity strength in the quadriceps muscle tested. Unstable postpolio subjects acknowledged new quadriceps weakness over the 7-year period of the study (n = 11), and stable postpolio subjects denied new weakness of the quadriceps over the same period (n = 12). All subjects had tests of neuromuscular function of the quadriceps muscles at the onset of this study and yearly over a 7-year period. EMG variables were determined on a separate day after the seventh year of neuromuscular measurements. Neuromuscular variables measured were isometric knee extension peak torque, isometric endurance (time to inability to maintain knee extensor contraction at 40% of maximal torque), tension time index (TTI) (product of isometric endurance time and 40% of maximal torque), and recovery of torque at 10 minutes after the endurance test. EMG variables were macro EMG and single fiber EMG (jitter, fiber density, and percent blocking). Unstable postpolio subjects did not lose strength more rapidly than stable postpolio subjects or control subjects. Unstable postpolio subjects were significantly weaker, had decreased TTI, larger macro EMG amplitude, greater jitter, blocking, and fiber density in comparison with stable postpolio subjects (all p postpolio group (p .05) with neuromuscular or EMG variables in control, stable, or unstable postpolio subjects.

  5. Integration of an adaptive swing control into a neuromuscular human walking model.

    Science.gov (United States)

    Song, Seungmoon; Desai, Ruta; Geyer, Hartmut

    2013-01-01

    Understanding the neuromuscular control underlying human locomotion has the potential to deliver practical controllers for humanoid and prosthetic robots. However, neurocontrollers developed in forward dynamic simulations are seldom applied as practical controllers due to their lack of robustness and adaptability. A key element for robust and adaptive locomotion is swing leg placement. Here we integrate a previously identified robust swing leg controller into a full neuromuscular human walking model and demonstrate that the integrated model has largely improved behaviors including walking on very rough terrain (±10 cm) and stair climbing (15 cm stairs). These initial results highlight the potential of the identified robust swing control. We plan to generalize it to a range of human locomotion behaviors critical in rehabilitation robotics.

  6. Effects of two neuromuscular training programs on running biomechanics with load carriage: a study protocol for a randomised controlled trial.

    Science.gov (United States)

    Liew, Bernard X W; Morris, Susan; Keogh, Justin W L; Appleby, Brendyn; Netto, Kevin

    2016-10-22

    In recent years, athletes have ventured into ultra-endurance and adventure racing events, which tests their ability to race, navigate, and survive. These events often require race participants to carry some form of load, to bear equipment for navigation and survival purposes. Previous studies have reported specific alterations in biomechanics when running with load which potentially influence running performance and injury risk. We hypothesize that a biomechanically informed neuromuscular training program would optimize running mechanics during load carriage to a greater extent than a generic strength training program. This will be a two group, parallel randomized controlled trial design, with single assessor blinding. Thirty healthy runners will be recruited to participate in a six weeks neuromuscular training program. Participants will be randomized into either a generic training group, or a biomechanically informed training group. Primary outcomes include self-determined running velocity with a 20 % body weight load, jump power, hopping leg stiffness, knee extensor and triceps-surae strength. Secondary outcomes include running kinetics and kinematics. Assessments will occur at baseline and post-training. To our knowledge, no training programs are available that specifically targets a runner's ability to carry load while running. This will provide sport scientists and coaches with a foundation to base their exercise prescription on. ANZCTR ( ACTRN12616000023459 ) (14 Jan 2016).

  7. Aging and limb alter the neuromuscular control of goal-directed movements.

    Science.gov (United States)

    Kwon, MinHyuk; Chen, Yen-Ting; Fox, Emily J; Christou, Evangelos A

    2014-06-01

    The purpose of this study was to determine whether the neuromuscular control of goal-directed movements is different for young and older adults with the upper and lower limbs. Twenty young (25.1 ± 3.9 years) and twenty older adults (71.5 ± 4.8 years) attempted to accurately match the displacement of their limb to a spatiotemporal target during ankle dorsiflexion or elbow flexion movements. We quantified neuromuscular control by examining the movement endpoint accuracy and variability, and the antagonistic muscle activity using surface electromyography (EMG). Our results indicate that older adults exhibit impaired endpoint accuracy with both limbs due to greater time variability. In addition, older adults exhibit greater EMG burst and lower EMG burst variability as well as lower coactivation of the antagonistic muscles. The impaired accuracy of older adults during upper limb movements was related to lower coactivation of the antagonistic muscles, whereas their impaired accuracy during lower limb movements was related to the amplified EMG bursts. The upper limb exhibited greater movement control than the lower limb, and different neuromuscular parameters were related to the accuracy and consistency for each limb. Greater endpoint error during upper limb movements was related to lower coactivation of the antagonistic muscles, whereas greater endpoint error during lower limb movements was related to the amplified EMG bursts. These findings indicate that the age-associated impairments in movement control are associated with altered activation of the involved antagonistic muscles. In addition, independent of age, the neuromuscular control of goal-directed movements is different for the upper and lower limbs.

  8. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Amy R. Wu

    2017-06-01

    settings for multiple walking speeds or adjustments for subjects of differing anthropometry and walking ability, NMC enabled SCI subjects to walk at several speeds, including near healthy speeds, in a healthy-like manner. These preliminary results are promising for future implementation of neuromuscular controllers on wearable prototypes for real-world walking conditions.

  9. Neuromuscular Control of Rapid Linear Accelerations in Fish

    Science.gov (United States)

    2016-06-22

    fish : Final Report Eric D. Tytell Department of Biology , Tufts University, eric.tytell@tufts.edu Abstract In this project, we measured muscle... important aspects of how rapid movements are controlled, but will have to be done using a negative stimulus such as a object accelerating toward the fish ...sunfish, Lepomis macrochirus. Animals with flexible bodies, like fishes , face a tradeoff for rapid movements. To produce high forces, they must

  10. Bioengineered novel robotic actuators for utilization in neuromuscular control

    Science.gov (United States)

    Paul, Eddie

    1998-07-01

    A linear motion-controlling or power-actuating cylinder can be found in virtually all types of machinery. In many applications, however, limitations in performance of longevity of operation exist due to a number of factors ranging from nature's environmental extremes to the demands of complex design and engineering requirements. Industry has come to accept the limited flexibility of current power- and motion-regulating mechanisms such as hydraulic valve-controlled actuators, and oftentimes chooses to design around the inherent flaws and drawbacks of these basic components. As a result, the level of maintenance and potential for mechanical failure are greater than necessary in many applications from routine road construction where hydraulic machinery is instrumental, to undersea operations where man relies heavily on hydraulic-cylinder devices during most scientific, geographic and biological research excursions. With ultimate flexibility and environmental adaptability providing the key motivation, E. P. Industries, Inc. has developed and prototyped a system of Novel Robotic Actuators to function where operational or environmental demands exceed the capabilities of conventional hydraulic-valve devices. The objective in developing the Robotic Muscle is to replace a typical hydraulic cylinder actuator with a relatively more compact `muscle-like' actuator exhibiting maximum flexibility and a superior strength-to-weight ratio while resisting the harsh temperatures and deterioration factors presented by unusual operating environments. Progressive development of the Robotic Muscle will be directed to use as an artificial biological replacement.

  11. Neuromuscular Control Deficits and the Risk of Subsequent Injury after a Concussion: A Scoping Review.

    Science.gov (United States)

    Howell, David R; Lynall, Robert C; Buckley, Thomas A; Herman, Daniel C

    2018-02-17

    An emerging area of research has identified that an increased risk of musculoskeletal injury may exist upon returning to sports after a sport-related concussion. The mechanisms underlying this recently discovered phenomenon, however, remain unknown. One theorized reason for this increased injury risk includes residual neuromuscular control deficits that remain impaired despite clinical recovery. Thus, the objectives of this review were: (1) to summarize the literature examining the relationship between concussion and risk of subsequent injury and (2) to summarize the literature for one mechanism with a theorized association with this increased injury risk, i.e., neuromuscular control deficits observed during gait after concussion under dual-task conditions. Two separate reviews were conducted consistent with both specified objectives. Studies published before 9 December, 2016 were identified using PubMed, Web of Science, and Academic Search Premier (EBSCOhost). Inclusion for the objective 1 search included dependent variables of quantitative measurements of musculoskeletal injury after concussion. Inclusion criteria for the objective 2 search included dependent variables pertaining to gait, dynamic balance control, and dual-task function. A total of 32 studies were included in the two reviews (objective 1 n = 10, objective 2 n = 22). According to a variety of study designs, athletes appear to have an increased risk of sustaining a musculoskeletal injury following a concussion. Furthermore, dual-task neuromuscular control deficits may continue to exist after patients report resolution of concussion symptoms, or perform normally on other clinical concussion tests. Therefore, musculoskeletal injury risk appears to increase following a concussion and persistent motor system and attentional deficits also seem to exist after a concussion. While not yet experimentally tested, these motor system and attentional deficits may contribute to the risk of sustaining a

  12. Changes in Balance Strategy and Neuromuscular Control during a Fatiguing Balance Task-A Study in Perturbed Unilateral Stance.

    Science.gov (United States)

    Ritzmann, Ramona; Freyler, Kathrin; Werkhausen, Amelie; Gollhofer, Albert

    2016-01-01

    Fatigue impairs sensorimotor performance, reduces spinal reflexes and affects the interaction of antagonistic muscles in complex motor tasks. Although there is literature dealing with the interference of fatigue and postural control, the interpretation is confounded by the variety of paradigms used to study it. This study aimed to evaluate the effects of postural fatigue on balance control and strategy, as well as on neuromuscular modulation, in response to postural perturbation (PERT) during a fatiguing balance task. A fatigue protocol consisting of continuous exposure to perturbations until exhaustion was executed in 24 subjects. Number of failed attempts, paths of center of pressure displacement (COP), ankle, knee, and hip joint kinematics, electromyographic activity of the soleus (SOL), tibialis anterior (TA), rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), and gluteus maximus muscles (GM) and spinal excitability of SOL at the peak of the short-latency responses (SLR) were recorded after posterior PERT. The co-contraction index (CCI) was calculated for TA_SOL, VL_BF and RF_GM. (1) The number of failed attempts significantly increased while COP amplitude and velocity, as well as angular excursion at the ankle, knee and hip joints, decreased with fatigue (P increased and spinal excitability in SOL declined. (3) Adaptations progressively augmented with progressing exhaustion and occurred in the distal prior to proximal segment. Distinctly deteriorated balance ability was accompanied by a modified neuromuscular control-the increase in co-contraction reflected by simultaneously activated antagonists is accompanied by smaller knee and hip joint excursions, indicating an elevated level of articular stiffness. These changes may be associated with an exaggerated postural rigidity and could have caused the delayed and reduced postural reactions that are reflected in the changes in COP displacement when compensating for sudden PERT. The reduction in

  13. Time-dependent postural control adaptations following a neuromuscular warm-up in female handball players: a randomized controlled trial.

    Science.gov (United States)

    Steib, Simon; Zahn, Peter; Zu Eulenburg, Christine; Pfeifer, Klaus; Zech, Astrid

    2016-01-01

    Female handball athletes are at a particular risk of sustaining lower extremity injuries. The study examines time-dependent adaptations of static and dynamic balance as potential injury risk factors to a specific warm-up program focusing on neuromuscular control. Fourty one (24.0 ± 5.9 years) female handball athletes were randomized to an intervention or control group. The intervention group implemented a 15-min specific neuromuscular warm-up program, three times per week for eleven weeks, whereas the control group continued with their regular warm-up. Balance was assessed at five time points. Measures included the star excursion balance test (SEBT), and center of pressure (COP) sway velocity during single-leg standing. No baseline differences existed between groups in demographic data. Adherence to neuromuscular warm-up was 88.7 %. Mean COP sway velocity decreased significantly over time in the intervention group (-14.4 %; p control group (-6.2 %; p = 0.056). However, these effects did not differ significantly between groups (p = .098). Mean changes over time in the SEBT score were significantly greater (p = .014) in the intervention group (+5.48) compared to the control group (+3.45). Paired t-tests revealed that the first significant balance improvements were observed after 6 weeks of training. A neuromuscular warm-up positively influences balance variables associated with an increased risk of lower extremity injuries in female handball athletes. The course of adaptations suggests that a training volume of 15 min, three times weekly over at least six weeks produces measurable changes. Retrospectively registered on 4th October 2016. Registry: clinicaltrials.gov. Trial number: NCT02925377.

  14. Control coordination abilities in shock combat sports

    Directory of Open Access Journals (Sweden)

    Natalya Boychenko

    2014-12-01

    Full Text Available Purpose: optimize the process control level of coordination abilities in martial arts. Material and Methods: analysis and compilation of scientific and methodological literature, interviews with coaches of drum martial arts, video analysis techniques, teacher observations. Results: identified specific types of coordination abilities in shock combat sports. Pod branny and offered specific and nonspecific tests to monitor the level of species athletes coordination abilities. Conclusion: it is determined that in order to achieve victory in the fight martial artists to navigate the space to be able to assess and manage dynamic and spatio-temporal parameters of movements, maintain balance, have a high coordination of movements. The proposed tests to monitor species coordination abilities athletes allow an objective assessment of not only the overall level of coordination, and the level of specific types of manifestations of this ability.

  15. Effects of regular Tai Chi practice and jogging on neuromuscular reaction during lateral postural control in older people.

    Science.gov (United States)

    Wang, Shao-Jun; Xu, Dong-Qing; Li, Jing-Xian

    2017-01-01

    This study examined the effects of regular Tai Chi practice and jogging on the neuromuscular activity of the trunk, hip, and ankle joint muscles of older people during lateral postural perturbation. A total of 42 older people participated in the study and formed the Tai Chi, jogging, and sedentary control groups. Electromyography signals were collected from the peroneus longus, anterior tibialis, gluteus medius, and erector spinae during unpredictable mediolateral perturbation. The Tai Chi group exhibited significantly faster latencies of the tibialis anterior and erector spinae than the control group. The jogging group showed a significantly shorter neuromuscular reaction time of the erector spinae than the control group. No significant difference was observed between the Tai Chi and jogging groups. Long-term regular Tai Chi practice enhanced the neuromuscular reaction of the erector spinae and tibialis anterior to lateral perturbation and will help timely posture correction when lateral postural distributions occur.

  16. Oscillations-free PID control of anesthetic drug delivery in neuromuscular blockade.

    Science.gov (United States)

    Medvedev, Alexander; Zhusubaliyev, Zhanybai T; Rosén, Olov; Silva, Margarida M

    2016-07-25

    The PID-control of drug delivery or the neuromuscular blockade (NMB) in closed-loop anesthesia is considered. The NMB system dynamics portrayed by a Wiener model can exhibit sustained nonlinear oscillations under realistic PID gains and for physiologically feasible values of the model parameters. Such oscillations, also repeatedly observed in clinical trials, lead to under- and over-dosing of the administered drug and undermine patient safety. This paper proposes a tuning policy for the proportional PID gain that via bifurcation analysis ensures oscillations-free performance of the control loop. Online estimates of the Wiener model parameters are needed for the controller implementation and monitoring of the closed-loop proximity to oscillation. The nonlinear dynamics of the PID-controlled NMB system are studied by bifurcation analysis. A database of patient models estimated under PID-controlled neuromuscular blockade during general anesthesia is utilized, along with the corresponding clinical measurements. The performance of three recursive algorithms is compared in the application at hand: an extended Kalman filter, a conventional particle filter (PF), and a PF making use of an orthonormal basis to estimate the probability density function from the particle set. It is shown that with a time-varying proportional PID gain, the type of equilibria of the closed-loop system remains the same as in the case of constant controller gains. The recovery time and frequency of oscillations are also evaluated in simulation over the database of patient models. Nonlinear identification techniques based on model linearization yield biased parameter estimates and thus introduce superfluous uncertainty. The bias and variance of the estimated models are related to the computational complexity of the identification algorithms, highlighting the superiority of the PFs in this safety-critical application. The study demonstrates feasibility of the proposed oscillation-free control

  17. Could Slackline Training Complement the FIFA 11+ Programme Regarding Training of Neuromuscular Control?

    Science.gov (United States)

    Jäger, Tobias; Kiefer, Julian; Werner, Inge; Federolf, Peter A

    2017-09-01

    The current study compared changes in neuromuscular control between slackline training and the stabilization training elements of the FIFA 11+ programme. Twenty-five students in 2 groups performed a 12-unit training programme. The slackline training group (n = 13) exclusively trained with a slackline. The stabilization training group (n = 12) practised exercises as described in the second part of the FIFA 11+ programme. Improvements in balance were assessed using three tests for dynamic, quasi-static, and perturbed postural control: the star excursion balance test (SEBT), the closed-eye single-leg stance, and the MFT S3-Check. Both groups significantly improved the stability and sensorimotor index of the MFT S3-Check (p FIFA 11+ warm-up programme. If compliance with the FIFA 11+ programme is declining, then slacklining might offer an alternative approach to reach the training goals of improved sensorimotor control.

  18. An adaptive neuromuscular controller for assistive lower-limb exoskeletons : A preliminary study on subjects with spinal cord injury

    NARCIS (Netherlands)

    Wu, Amy R.; Dzeladini, Florin; Brug, Tycho J.H.; Tamburella, Federica; Tagliamonte, Nevio L.; Van Asseldonk, Edwin H.F.; Van Der Kooij, Herman; IJspeert, Auke Jan

    2017-01-01

    Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI), where active recruitment of their own neuromuscular system could promote motor recovery.

  19. An adaptive neuromuscular controller for assistive lower-limb exoskeletons : A preliminary study on subjects with spinal cord injury

    NARCIS (Netherlands)

    Wu, Amy R.; Dzeladini, Florin; Brug, Tycho J.H.; Tamburella, Federica; Tagliamonte, Nevio L.; Van Asseldonk, Edwin H.F.; van der Kooij, H.; Ijspeert, Auke J.

    2017-01-01

    Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI), where active recruitment of their own neuromuscular system could promote motor recovery.

  20. Effects of footwear comfort perception on the neuromuscular control of balance.

    Science.gov (United States)

    Burke, Jeanmarie R

    2012-04-01

    The purpose of this research was to determine the effects of footwear comfort perception on the gain of the gastrocnemius H-reflex response during single leg balance tasks. Subjects performed single leg balance tasks while wearing aerobic sneakers with two different pairs of shoe insoles that were subjectively rated for comfort using a reliable 150 mm visual analog scale. The primary outcome was the consistency of decreasing the gain of the gastrocnemius H-reflex with increasing balance task complexity as a function of footwear comfort perception. Among the asymptomatic subjects (n = 11), H-reflex gain significantly decreased by 19% and 10% from balancing on a stable surface to an unstable surface for the shoe-brand and replacement insoles, respectively (p comfort perception may negatively impact the attenuation of gastrocnemius H-reflex gain that contributes to the neuromuscular control of challenging balance tasks.

  1. Neuromuscular Adaptations to Multimodal Injury Prevention Programs in Youth Sports: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Faude, Oliver; Rössler, Roland; Petushek, Erich J; Roth, Ralf; Zahner, Lukas; Donath, Lars

    2017-01-01

    Objective: Neuromuscular injury prevention programs (IPP) can reduce injury rate by about 40% in youth sport. Multimodal IPP include, for instance, balance, strength, power, and agility exercises. Our systematic review and meta-analysis aimed to evaluate the effects of multimodal IPP on neuromuscular performance in youth sports. Methods: We conducted a systematic literature search including selected search terms related to youth sports, injury prevention, and neuromuscular performance. Inclusion criteria were: (i) the study was a (cluster-)randomized controlled trial (RCT), and (ii) investigated healthy participants, up to 20 years of age and involved in organized sport, (iii) an intervention arm performing a multimodal IPP was compared to a control arm following a common training regime, and (iv) neuromuscular performance parameters (e.g., balance, power, strength, sprint) were assessed. Furthermore, we evaluated IPP effects on sport-specific skills. Results: Fourteen RCTs (comprising 704 participants) were analyzed. Eight studies included only males, and five only females. Seventy-one percent of all studies investigated soccer players with basketball, field hockey, futsal, Gaelic football, and hurling being the remaining sports. The average age of the participants ranged from 10 years up to 19 years and the level of play from recreational to professional. Intervention durations ranged from 4 weeks to 4.5 months with a total of 12 to 57 training sessions. We observed a small overall effect in favor of IPP for balance/stability (Hedges' g = 0.37; 95%CI 0.17, 0.58), leg power (g = 0.22; 95%CI 0.07, 0.38), and isokinetic hamstring and quadriceps strength as well as hamstrings-to-quadriceps ratio (g = 0.38; 95%CI 0.21, 0.55). We found a large overall effect for sprint abilities (g = 0.80; 95%CI 0.50, 1.09) and sport-specific skills (g = 0.83; 95%CI 0.34, 1.32). Subgroup analyses revealed larger effects in high-level (g = 0.34-1.18) compared to low-level athletes (g

  2. A Non-Linear Control Method to Compensate for Muscle Fatigue during Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Nitin Sharma

    2017-12-01

    Full Text Available Neuromuscular electrical stimulation (NMES is a promising technique to artificially activate muscles as a means to potentially restore the capability to perform functional tasks in persons with neurological disorders. A pervasive problem with NMES is that overstimulation of the muscle (among other factors leads to rapid muscle fatigue, which limits the use of clinical and commercial NMES systems. The objective of this article is to develop an NMES controller that incorporates the effects of muscle fatigue during NMES-induced non-isometric contraction of the human quadriceps femoris muscle. Our previous work that used the RISE class of non-linear controllers cannot accommodate fatigue and muscle activation dynamics. A totally new control design approach and associated stability proof is required to derive a new class of NMES control design that accounts for muscle fatigue dynamics and a first-order activation dynamics, in addition to the second-order musculoskeletal dynamics. Motivated from a control method for robotic systems in a strict-feedback form, a backstepping based-non-linear NMES controller was designed to accommodate for the additional muscle activation dynamics. Further, experimentally identified estimates of the fatigue and activation dynamics were incorporated in the control design. The developed controller uses a neural network-based estimate of the musculoskeletal dynamics and error due to fatigue estimation. A globally uniformly ultimately bounded stability is proven the new controller that accounts for an uncertain non-linear muscle model and bounded non-linear disturbances (e.g., spasticity and changing load dynamics. The developed controller was validated through experiments on the left and right legs of 3 able-bodied subjects and was compared with a proportional-derivative (PD controller and a PD augmented with a neural network. The statistical analysis showed improved control performance compared with the PD controller.

  3. Neuromuscular differences between volleyball players, middle distance runners and untrained controls.

    Science.gov (United States)

    Sleivert, G G; Backus, R D; Wenger, H A

    1995-08-01

    Volleyball players, middle distance runners and non-athletes (n = 10/group) were tested to determine whether neuromuscular differences existed between groups and to clarify the roles of factors involved in maximal power production. The runners were leaner than controls, while the volleyball players were taller, heavier and had larger thigh volumes than the other groups. The volleyball players had higher absolute cycle ergometer power than both middle distance (26%) and control (15%) groups, but differences disappeared when expressed relative to body mass or thigh volume. Volleyball athletes were also stronger than both middle distance (51, 52%) and control subjects (33, 35%) for isokinetic leg extension and plantar flexion respectively (0-4.19 rad.s-1). In leg press they were stronger than middle distance (32%) and control subjects (36%) for only the isometric and 1.05 rad.s-1 contraction. The volleyball players also had higher rates of isometric torque development than the other groups, however nerve conduction velocity did not vary. Vastus lateralis biopsy samples revealed no differences in percent Type II muscle fibers, or fiber cross-sectional area between groups, yet volleyball athletes had larger Type II/I fiber area ratio than controls (15%). Both strength, rate of torque development and power were related to muscle and muscle fiber size variables, but not fiber distribution or nerve conduction velocity. The size of type II muscle fibers seemed to be especially important since this was the only variable related to power when adjusted for body size.

  4. Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2011-12-01

    Full Text Available Abstract Background Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. Methods/Design 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis, pain, and self

  5. Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial.

    Science.gov (United States)

    Balcı, Nilay Comuk; Yuruk, Zeliha Ozlem; Zeybek, Aslican; Gulsen, Mustafa; Tekindal, Mustafa Agah

    2016-04-01

    [Purpose] The aim of our study was to compare the initial effects of scapular proprioceptive neuromuscular facilitation techniques and classic exercise interventions with physiotherapy modalities on pain, scapular dyskinesis, range of motion, and function in adhesive capsulitis. [Subjects and Methods] Fifty-three subjects were allocated to 3 groups: scapular proprioceptive neuromuscular facilitation exercies and physiotherapy modalities, classic exercise and physiotherapy modalities, and only physiotherapy modalities. The intervention was applied in a single session. The Visual Analog Scale, Lateral Scapular Slide Test, range of motion and Simple Shoulder Test were evaluated before and just after the one-hour intervention in the same session (all in one session). [Results] All of the groups showed significant differences in shoulder flexion and abduction range of motion and Simple Shoulder Test scores. There were statistically significant differences in Visual Analog Scale scores in the proprioceptive neuromuscular facilitation and control groups, and no treatment method had significant effect on the Lateral Scapular Slide Test results. There were no statistically significant differences between the groups before and after the intervention. [Conclusion] Proprioceptive neuromuscular facilitation, classic exercise, and physiotherapy modalities had immediate effects on adhesive capsulitis in our study. However, there was no additional benefit of exercises in one session over physiotherapy modalities. Also, an effective treatment regimen for shoulder rehabilitation of adhesive capsulitis patients should include scapular exercises.

  6. Delayed effect of Kinesio Taping on neuromuscular performance, balance, and lower limb function in healthy individuals: a randomized controlled trial

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    Caio A. A. Lins

    2016-01-01

    Full Text Available ABSTRACT Background Kinesio Taping (KT is an elastic bandage that aims to improve neuromuscular performance, although there is no consensus as to its benefits. Objective To analyze the immediate and delayed effects of KT on the neuromuscular performance of the femoral quadriceps, on balance, and lower limb function in healthy subjects. Method This is a randomized controlled trial. Thirty-six women with a mean age of 22.2±3.6 years and BMI of 22.5±2.3 Kg/m2 were divided into three groups: control, with ten minutes of rest (control, n=12, application of Kinesio Taping without tension (placebo, n=12 and with tension (KT, n=12 on the quadriceps. The primary outcome was isokinetic performance, while secondary outcomes were the single-hop test, one-footed static balance, and electromyographic activity. The evaluations were carried out in five stages: 1 before application of KT, 2 immediately after the application of KT, 3 after 24h, 4 after 48h, and 5 after 72h. Mixed ANOVA was used to determine differences between groups. Results There was no change in one-footed static balance, electromyographic activity of the VL in the lower limb function, nor in isokinetic performance between groups. Conclusion KT promotes neither immediate nor delayed changes in neuromuscular performance of the femoral quadriceps in healthy women.

  7. Delayed effect of Kinesio Taping on neuromuscular performance, balance, and lower limb function in healthy individuals: a randomized controlled trial.

    Science.gov (United States)

    Lins, Caio A A; Borges, Daniel T; Macedo, Liane B; Costa, Karinna S A; Brasileiro, Jamilson S

    2016-03-22

    Kinesio Taping (KT) is an elastic bandage that aims to improve neuromuscular performance, although there is no consensus as to its benefits. To analyze the immediate and delayed effects of KT on the neuromuscular performance of the femoral quadriceps, on balance, and lower limb function in healthy subjects. This is a randomized controlled trial. Thirty-six women with a mean age of 22.2±3.6 years and BMI of 22.5±2.3 Kg/m2 were divided into three groups: control, with ten minutes of rest (control, n=12), application of Kinesio Taping without tension (placebo, n=12) and with tension (KT, n=12) on the quadriceps. The primary outcome was isokinetic performance, while secondary outcomes were the single-hop test, one-footed static balance, and electromyographic activity. The evaluations were carried out in five stages: 1) before application of KT, 2) immediately after the application of KT, 3) after 24h, 4) after 48h, and 5) after 72h. Mixed ANOVA was used to determine differences between groups. There was no change in one-footed static balance, electromyographic activity of the VL in the lower limb function, nor in isokinetic performance between groups. KT promotes neither immediate nor delayed changes in neuromuscular performance of the femoral quadriceps in healthy women.

  8. Quality of Recovery After Low-Pressure Laparoscopic Donor Nephrectomy Facilitated by Deep Neuromuscular Blockade: A Randomized Controlled Study.

    Science.gov (United States)

    Özdemir-van Brunschot, Denise M D; Scheffer, Gert J; van der Jagt, Michel; Langenhuijsen, Hans; Dahan, Albert; Mulder, Janneke E E A; Willems, Simone; Hilbrands, Luuk B; Donders, Rogier; van Laarhoven, Cees J H M; d'Ancona, Frank A; Warlé, Michiel C

    2017-11-01

    The use of low intra-abdominal pressure (<10 mmHg) reduces postoperative pain scores after laparoscopic surgery. To investigate whether low-pressure pneumoperitoneum with deep neuromuscular blockade improves the quality of recovery after laparoscopic donor nephrectomy (LDN). In a single-center randomized controlled trial, 64 live kidney donors were randomly assigned to 6 or 12 mmHg insufflation pressure. A deep neuromuscular block was used in both groups. Surgical conditions were rated by the five-point Leiden-surgical rating scale (L-SRS), ranging from 5 (optimal) to 1 (extremely poor) conditions. If the L-SRS was insufficient, the pressure was increased stepwise. The primary outcome measure was the overall score on the quality of recovery-40 (QOR-40) questionnaire at postoperative day 1. The difference in the QOR-40 scores on day 1 between the low- and standard-pressure group was not significant (p = .06). Also the overall pain scores and analgesic consumption did not differ. Eight procedures (24%), initially started with low pressure, were converted to a standard pressure (≥10 mmHg). A L-SRS score of 5 was significantly more prevalent in the standard pressure as compared to the low-pressure group at 30 min after insufflation (p < .01). Low-pressure pneumoperitoneum facilitated by deep neuromuscular blockade during LDN does not reduce postoperative pain scores nor improve the quality of recovery in the early postoperative phase. The question whether the use of deep neuromuscular blockade during laparoscopic surgery reduces postoperative pain scores independent of the intra-abdominal pressure should be pursued in future studies. The trial was registered at clinicaltrial.gov before the start of the trial (NCT02146417).

  9. Fatiguing exercise intensity influences the relationship between parameters reflecting neuromuscular function and postural control variables.

    Directory of Open Access Journals (Sweden)

    Sébastien Boyas

    Full Text Available The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R(2≤0.82 of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R(2≤0.73 for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.

  10. Clinical evaluation of a simultaneous closed-loop anaesthesia control system for depth of anaesthesia and neuromuscular blockade*.

    Science.gov (United States)

    Janda, M; Simanski, O; Bajorat, J; Pohl, B; Noeldge-Schomburg, G F E; Hofmockel, R

    2011-12-01

    We developed a closed-loop system to control the depth of anaesthesia and neuromuscular blockade using the bispectral index and the electromyogram simultaneously and evaluated the clinical performance of this combined system for general anaesthesia. Twenty-two adult patients were included in this study. Anaesthesia was induced by a continuous infusion of remifentanil at 0.4 μg.kg(-1) .min(-1) (induction dose) and then 0.25 μg.kg(-1) .min(-1) (maintenance dose) and propofol at 2 mg.kg(-1) 3 min later. The combined automatic control was started 2 min after tracheal intubation. The depth of anaesthesia was recorded using bispectral index monitoring using a target value of 40. The target value of neuromuscular blockade, using mivacurium, was a T1/T1(0) twitch height of 10%. The precision of the system was calculated using internationally defined performance parameters. Twenty patients were included in the data analysis. The mean (SD) duration of simultaneous control was 129 (69) min. No human intervention was necessary during the computer-controlled administration of propofol and mivacurium. All patients assessed the quality of anaesthesia as 'good' to 'very good'; there were no episodes of awareness. The mean (SD) median performance error, median absolute performance error and wobble for the control of depth of anaesthesia and for neuromuscular blockade were -0.31 (1.78), 6.76 (3.45), 6.32 (2.93) and -0.38 (1.68), 3.75 (4.83), 3.63 (4.69), respectively. The simultaneous closed-loop system using propofol and mivacurium was able to maintain the target values with a high level of precision in a clinical setting. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  11. No Neuromuscular Side-Effects of Scopolamine in Sensorimotor Control and Force-Generating Capacity Among Parabolic Fliers

    Science.gov (United States)

    Ritzmann, Ramona; Freyler, Kathrin; Krause, Anne; Gollhofer, Albert

    2016-10-01

    Scopolamine is used to counteract motion sickness in parabolic flight (PF) experiments. Although the drug's anticholinergic properties effectively impede vomiting, recent studies document other sensory side-effects in the central nervous system that may considerably influence sensorimotor performance. This study aimed to quantify such effects in order to determine if they are of methodological and operational significance for sensorimotor control. Ten subjects of a PF campaign received a weight-sex-based dose of a subcutaneous scopolamine injection. Sensorimotor performance was recorded before medication, 20min, 2h and 4h after injection in four space-relevant paradigms: balance control in one-leg stance with eyes open (protocol 1) and closed as well as force-generating capacity in countermovement jumps and hops (protocol 2). Postural sway, forces and joint angles were recorded. Neuromuscular control was assessed by electromyography and peripheral nerve stimulation; H-reflexes and M-waves were used to monitor spinal excitability of the Ia afferent reflex circuitry and maximal motor output. (1) H-reflex amplitudes, latencies and functional reflexes remained unchanged after scopolamine injection. (2) M-waves, neuromuscular activation intensities and antagonistic muscle coordination did not change with scopolamine administration. (3) Balance performance and force-generating capacity were not impeded by scopolamine. We found no evidence for changes in sensorimotor control in response to scopolamine injection. Sensory processing of daily relevant reflexes, spinal excitability, maximal motor output and performance parameters were not sensitive to the medication. We conclude that scopolamine administration can be used to counteract motion sickness in PF without methodological and operational concerns or interference regarding sensorimotor skills associated with neuromuscular control.

  12. Controlled pilot study of the effects of neuromuscular therapy in patients with Parkinson's disease.

    Science.gov (United States)

    Craig, Lauren H; Svircev, Anna; Haber, Michael; Juncos, Jorge L

    2006-12-01

    The objectives of this study is to examine the effects of neuromuscular therapy (NMT) on motor and nonmotor symptoms in Parkinson's disease (PD). Thirty-six subjects with PD were randomly assigned to NMT or music relaxation (MR, or active control). Subjects received treatment twice a week for 4 weeks. Testing was conducted at baseline, after final treatment, and 8 days after final treatment. Primary outcome measures were the Motor subscale of the United Parkinson Disease Rating Scale (UPDRS) and the Clinical Global Impression scale (CGI-Change). Secondary outcome measures included a PD-specific quality of life scale (PDQ-39), quantitative measures of motor function, and severity scales for anxiety and depression symptoms. NMT resulted in a significant and sustained improvement in the Motor subscale of the UPDRS (P < or = 0.0001), most notable in the tremor scores. Also improved 1 week after the last treatment were the CGI scores (P = 0.007) and the finger-tapping speed (P = 0.001). The MR active control group had a slight improvement in tremor but evidenced no other change in motor function. Both groups exhibited a modest improvement in quality of life immediately after the last treatment. This effect was sustained for 8 days only in the MR group. In the nonmotor domains, the MR group evidenced improvements in mood (P = 0.001) and anxiety (P = 0.002), whereas NMT had no effect on mood (P = 0.09), and its initial effect on anxiety (P = 0.0009) dissipated after 8 days (P = 0.40). Group differences for UPDRS motor score and patient CGI-Change were superior in the NMT compared to the MR group. There was no group difference in PDQ-39 scores or in nonmotor measures. The findings suggest that NMT can improve motor and selected nonmotor symptoms in PD and that this effect is more durable for the motor symptoms. The results of this pilot study warrant larger controlled studies to examine dose range, durability, and mechanisms of NMT in PD function. Copyright 2006 Movement

  13. Neuromuscular disorders

    OpenAIRE

    Reed, Umbertina C.

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  14. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton

    Science.gov (United States)

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    Brain-machine interface-controlled (BMI) neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion (ROM) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related ROM and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton) in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. NMES was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD) and electromyography (EMG) activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e., induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p = 0.028) or EMG (p = 0.021) modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related ROM (p = 0.009) and the movement-related brain modulation (p = 0.019). Combining a hybrid BMI with neuromuscular stimulation

  15. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton.

    Science.gov (United States)

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    Brain-machine interface-controlled (BMI) neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion (ROM) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related ROM and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton) in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. NMES was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD) and electromyography (EMG) activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e., induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p = 0.028) or EMG (p = 0.021) modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related ROM (p = 0.009) and the movement-related brain modulation (p = 0.019). Combining a hybrid BMI with neuromuscular stimulation

  16. Neuromuscular Scoliosis

    Science.gov (United States)

    ... to the optimal care of patients with spinal deformity Patients and Families Professionals About SRS Türkçe español ... unable to maintain appropriate balance / alignment of the spine and trunk. Neuromuscular curves are often associated with ...

  17. Static balance and function in children with cerebral palsy submitted to neuromuscular block and neuromuscular electrical stimulation: study protocol for prospective, randomized, controlled trial.

    Science.gov (United States)

    Kazon, Soráia; Grecco, Luanda A C; Pasini, Hugo; Corrêa, João C F; Christovão, Thaluanna C L; de Carvalho, Paulo de Tarsocamillo; Giannasi, Lilian Chrystiane; Lucareli, Paulo R G; de Oliveira, Luis Vicente Franco; Salgado, Afonso Shiguemi Inoue; Sampaio, Luciana M M; Oliveira, Claudia S

    2012-05-16

    The use of botulinum toxin A (BT-A) for the treatment of lower limb spasticity is common in children with cerebral palsy (CP). Following the administration of BT-A, physical therapy plays a fundamental role in potentiating the functionality of the child. The balance deficit found in children with CP is mainly caused by muscle imbalance (spastic agonist and weak antagonist). Neuromuscular electrical stimulation (NMES) is a promising therapeutic modality for muscle strengthening in this population. The aim of the present study is to describe a protocol for a study aimed at analyzing the effects of NMES on dorsiflexors combined with physical therapy on static and functional balance in children with CP submitted to BT- A. Protocol for a prospective, randomized, controlled trial with a blinded evaluator. Eligible participants will be children with cerebral palsy (Levels I, II and III of the Gross Motor Function Classification System) between five and 12 years of age, with independent gait with or without a gait-assistance device. All participants will receive BT-A in the lower limbs (triceps surae). The children will then be randomly allocated for either treatment with motor physical therapy combined with NMES on the tibialis anterior or motor physical therapy alone. The participants will be evaluated on three occasions: 1) one week prior to the administration of BT-A; 2) one week after the administration of BT-A; and 3) four months after the administration of BT-A (end of intervention). Spasticity will be assessed by the Modified Ashworth Scale and Modified Tardieu Scale. Static balance will be assessed using the Medicapteurs Fusyo pressure platform and functional balance will be assessed using the Berg Balance Scale. The aim of this protocol study is to describe the methodology of a randomized, controlled, clinical trial comparing the effect of motor physical therapy combined with NMES on the tibialis anterior muscle or motor physical therapy alone on static and

  18. Static balance and function in children with cerebral palsy submitted to neuromuscular block and neuromuscular electrical stimulation: Study protocol for prospective, randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Kazon Soráia

    2012-05-01

    Full Text Available Abstract Background The use of botulinum toxin A (BT-A for the treatment of lower limb spasticity is common in children with cerebral palsy (CP. Following the administration of BT-A, physical therapy plays a fundamental role in potentiating the functionality of the child. The balance deficit found in children with CP is mainly caused by muscle imbalance (spastic agonist and weak antagonist. Neuromuscular electrical stimulation (NMES is a promising therapeutic modality for muscle strengthening in this population. The aim of the present study is to describe a protocol for a study aimed at analyzing the effects of NMES on dorsiflexors combined with physical therapy on static and functional balance in children with CP submitted to BT- A. Methods/Design Protocol for a prospective, randomized, controlled trial with a blinded evaluator. Eligible participants will be children with cerebral palsy (Levels I, II and III of the Gross Motor Function Classification System between five and 12 years of age, with independent gait with or without a gait-assistance device. All participants will receive BT-A in the lower limbs (triceps surae. The children will then be randomly allocated for either treatment with motor physical therapy combined with NMES on the tibialis anterior or motor physical therapy alone. The participants will be evaluated on three occasions: 1 one week prior to the administration of BT-A; 2 one week after the administration of BT-A; and 3 four months after the administration of BT-A (end of intervention. Spasticity will be assessed by the Modified Ashworth Scale and Modified Tardieu Scale. Static balance will be assessed using the Medicapteurs Fusyo pressure platform and functional balance will be assessed using the Berg Balance Scale. Discussion The aim of this protocol study is to describe the methodology of a randomized, controlled, clinical trial comparing the effect of motor physical therapy combined with NMES on the tibialis anterior

  19. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population with and w......Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population...... with and without SIS (n=16, No-SIS=15). Surface electromyography was measured from Serratus anterior (SA) and Trapezius during bilateral arm elevation (no-load, 1kg, 3kg). Mean relative muscle activity was calculated for SA and the upper (UT) and lower part of trapezius (LWT), in addition to activation ratio...... and time to activity onset. In spite of a tendency to higher activity among SIS 0.10-0.30 between-group differences were not significant neither in ratio of muscle activation 0.80-0.98 nor time to activity onset 0.53-0.98. The hypothesized between-group differences in neuromuscular activity of Trapezius...

  20. Neuromuscular Control During the Bench Press Movement in an Elite Disabled and Able-Bodied Athlete

    Directory of Open Access Journals (Sweden)

    Gołaś Artur

    2017-12-01

    Full Text Available The disabled population varies significantly in regard to physical fitness, what is conditioned by the damage to the locomotor system. Recently there has been an increased emphasis on the role of competitive sport in enhancing health and the quality of life of individuals with disability. One of the sport disciplines of Paralympics is the flat bench press. The bench press is one of the most popular resistance exercises used for the upper body in healthy individuals. It is used not only by powerlifters, but also by athletes in most strength-speed oriented sport disciplines. The objective of the study was to compare neuromuscular control for various external loads (from 60 to 100% 1RM during the flat bench press performed by an elite able-bodied athlete and an athlete with lower limb disability. The research project is a case study of two elite bench press athletes with similar sport results: an able-bodied athlete (M.W., age 34 years, body mass 103 kg, body height 1.72 m, 1RM in the flat bench press 200 kg and a disabled athlete (M.T., age 31 years, body mass 92 kg, body height 1.70 m, 1RM in the flat bench press 190 kg. The activity was recorded for four muscles: pectoralis major (PM, anterior deltoid (AD, as well as for the lateral and long heads of the triceps brachii (TBlat and TBlong. The T-test revealed statistically significant differences between peak activity of all the considered muscles (AD with p = 0.001; PM with p = 0.001; TBlat with p = 0.0021 and TBlong with p = 0.002 between the 2 athletes. The analysis of peak activity differences of M.W and M.T. in relation to the load revealed statistically significant differences for load changes between: 60 to 100% 1RM (p = 0.007, 70 to 100% 1RM (p = 0.016 and 80 to 100% 1RM (p = 0.032. The flat bench press performed without legs resting firmly on the ground leads to the increased engagement of upper body muscles and to their greater activation. Isolated initial positions can be used to

  1. Neuromuscular Control During the Bench Press Movement in an Elite Disabled and Able-Bodied Athlete

    Science.gov (United States)

    Zwierzchowska, Anna; Maszczyk, Adam; Wilk, Michał; Stastny, Petr; Zając, Adam

    2017-01-01

    Abstract The disabled population varies significantly in regard to physical fitness, what is conditioned by the damage to the locomotor system. Recently there has been an increased emphasis on the role of competitive sport in enhancing health and the quality of life of individuals with disability. One of the sport disciplines of Paralympics is the flat bench press. The bench press is one of the most popular resistance exercises used for the upper body in healthy individuals. It is used not only by powerlifters, but also by athletes in most strength-speed oriented sport disciplines. The objective of the study was to compare neuromuscular control for various external loads (from 60 to 100% 1RM) during the flat bench press performed by an elite able-bodied athlete and an athlete with lower limb disability. The research project is a case study of two elite bench press athletes with similar sport results: an able-bodied athlete (M.W., age 34 years, body mass 103 kg, body height 1.72 m, 1RM in the flat bench press 200 kg) and a disabled athlete (M.T., age 31 years, body mass 92 kg, body height 1.70 m, 1RM in the flat bench press 190 kg). The activity was recorded for four muscles: pectoralis major (PM), anterior deltoid (AD), as well as for the lateral and long heads of the triceps brachii (TBlat and TBlong). The T-test revealed statistically significant differences between peak activity of all the considered muscles (AD with p = 0.001; PM with p = 0.001; TBlat with p = 0.0021 and TBlong with p = 0.002) between the 2 athletes. The analysis of peak activity differences of M.W and M.T. in relation to the load revealed statistically significant differences for load changes between: 60 to 100% 1RM (p = 0.007), 70 to 100% 1RM (p = 0.016) and 80 to 100% 1RM (p = 0.032). The flat bench press performed without legs resting firmly on the ground leads to the increased engagement of upper body muscles and to their greater activation. Isolated initial positions can be used to

  2. Neuromuscular Adaptations to Multimodal Injury Prevention Programs in Youth Sports: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Faude, Oliver; Rössler, Roland; Petushek, Erich J.; Roth, Ralf; Zahner, Lukas; Donath, Lars

    2017-01-01

    Objective: Neuromuscular injury prevention programs (IPP) can reduce injury rate by about 40% in youth sport. Multimodal IPP include, for instance, balance, strength, power, and agility exercises. Our systematic review and meta-analysis aimed to evaluate the effects of multimodal IPP on neuromuscular performance in youth sports. Methods: We conducted a systematic literature search including selected search terms related to youth sports, injury prevention, and neuromuscular performance. Inclusion criteria were: (i) the study was a (cluster-)randomized controlled trial (RCT), and (ii) investigated healthy participants, up to 20 years of age and involved in organized sport, (iii) an intervention arm performing a multimodal IPP was compared to a control arm following a common training regime, and (iv) neuromuscular performance parameters (e.g., balance, power, strength, sprint) were assessed. Furthermore, we evaluated IPP effects on sport-specific skills. Results: Fourteen RCTs (comprising 704 participants) were analyzed. Eight studies included only males, and five only females. Seventy-one percent of all studies investigated soccer players with basketball, field hockey, futsal, Gaelic football, and hurling being the remaining sports. The average age of the participants ranged from 10 years up to 19 years and the level of play from recreational to professional. Intervention durations ranged from 4 weeks to 4.5 months with a total of 12 to 57 training sessions. We observed a small overall effect in favor of IPP for balance/stability (Hedges' g = 0.37; 95%CI 0.17, 0.58), leg power (g = 0.22; 95%CI 0.07, 0.38), and isokinetic hamstring and quadriceps strength as well as hamstrings-to-quadriceps ratio (g = 0.38; 95%CI 0.21, 0.55). We found a large overall effect for sprint abilities (g = 0.80; 95%CI 0.50, 1.09) and sport-specific skills (g = 0.83; 95%CI 0.34, 1.32). Subgroup analyses revealed larger effects in high-level (g = 0.34–1.18) compared to low-level athletes (g

  3. Neuromuscular Adaptations to Multimodal Injury Prevention Programs in Youth Sports: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Oliver Faude

    2017-10-01

    Full Text Available Objective: Neuromuscular injury prevention programs (IPP can reduce injury rate by about 40% in youth sport. Multimodal IPP include, for instance, balance, strength, power, and agility exercises. Our systematic review and meta-analysis aimed to evaluate the effects of multimodal IPP on neuromuscular performance in youth sports.Methods: We conducted a systematic literature search including selected search terms related to youth sports, injury prevention, and neuromuscular performance. Inclusion criteria were: (i the study was a (cluster-randomized controlled trial (RCT, and (ii investigated healthy participants, up to 20 years of age and involved in organized sport, (iii an intervention arm performing a multimodal IPP was compared to a control arm following a common training regime, and (iv neuromuscular performance parameters (e.g., balance, power, strength, sprint were assessed. Furthermore, we evaluated IPP effects on sport-specific skills.Results: Fourteen RCTs (comprising 704 participants were analyzed. Eight studies included only males, and five only females. Seventy-one percent of all studies investigated soccer players with basketball, field hockey, futsal, Gaelic football, and hurling being the remaining sports. The average age of the participants ranged from 10 years up to 19 years and the level of play from recreational to professional. Intervention durations ranged from 4 weeks to 4.5 months with a total of 12 to 57 training sessions. We observed a small overall effect in favor of IPP for balance/stability (Hedges' g = 0.37; 95%CI 0.17, 0.58, leg power (g = 0.22; 95%CI 0.07, 0.38, and isokinetic hamstring and quadriceps strength as well as hamstrings-to-quadriceps ratio (g = 0.38; 95%CI 0.21, 0.55. We found a large overall effect for sprint abilities (g = 0.80; 95%CI 0.50, 1.09 and sport-specific skills (g = 0.83; 95%CI 0.34, 1.32. Subgroup analyses revealed larger effects in high-level (g = 0.34–1.18 compared to low-level athletes

  4. Hybrid neuroprosthesis for the upper limb: combining brain-controlled neuromuscular stimulation with a multi-joint arm exoskeleton

    Directory of Open Access Journals (Sweden)

    Florian Grimm

    2016-08-01

    Full Text Available Brain-machine interface-controlled (BMI neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related range of motion and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. Neuromuscular electrical stimulation was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD and electromyography (EMG activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e. induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p=0.028 or EMG (p=0.021 modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related range of motion (p=0.009 and the movement-related brain modulation (p=0

  5. Effects of respiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease: a randomized controlled trial.

    Science.gov (United States)

    Aslan, Goksen Kuran; Gurses, H Nilgun; Issever, Halim; Kiyan, Esen

    2014-06-01

    To investigate the effects of inspiratory and expiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease. Prospective randomized controlled double-blinded study. Chest diseases clinic of university hospital. Twenty-six patients with slowly progressive neuromuscular disease followed for respiratory problems were included in the study. Patients were randomly divided into two groups; experimental (n = 14; age 31.6 ±12.3 years) and sham (n = 12; age 26.5 ±8.6 years) groups. Spirometry, peak cough flow, maximal inspiratory pressure, maximal expiratory pressure, and sniff nasal inspiratory pressure were measured before the eighth week of study, and subsequently at end of it. Respiratory muscle training was performed by inspiratory (Threshold Inspiratory Muscle Trainer) and expiratory (Threshold Positive Expiratory Pressure) threshold loading methods. Training intensities were increased according to maximal inspiratory and expiratory pressures in the experimental group, while the lowest loads were used for training in the sham group. Patients performed 15 minutes inspiratory muscle training and 15 minutes expiratory muscle training, twice a day, five days/week, for a total of eight weeks at home. Training intensity was adjusted in the training group once a week. Maximal inspiratory and expiratory pressures (cmH2O, % predicted) (respectively p = 0.002, p = 0.003, p = 0.04, p = 0.03) and sniff nasal inspiratory pressure (p = 0.04) were improved in the experimental group when compared with the sham group. However, there was no improvement in spirometric measurements when groups were compared (p > 0.05). As a conclusion of our study, we found that respiratory muscle strength improved by inspiratory and expiratory muscle training in patients with slowly progressive neuromuscular disease. © The Author(s) 2013.

  6. Amelioration of Obstructive Sleep Apnea in REM Sleep Behavior Disorder: Implications for the Neuromuscular Control of OSA

    Science.gov (United States)

    Huang, Jixiong; Zhang, Jihui; Lam, Siu Ping; Li, Shirley Xin; Ho, Crover Kwok Wah; Lam, Venny; Yu, Mandy Wai Man; Wing, Yun-Kwok

    2011-01-01

    Objectives: The relationship between REM sleep behavior disorder (RBD) and obstructive sleep apnea (OSA) remains unclear. We aimed to (1) explore the association of REM-related EMG activity (REMREEA) with OSA in RBD patients; (2) compare the severity of OSA between RBD patients with OSA (RBD-OSA) and their age-, sex-, AHI-, and BMI- matched OSA controls. Design: a. Correlation study in consecutive RBD subjects and b. case-control study Setting: Sleep laboratory Participants: 71 RBD patients in the correlation study and 55 subjects (28 RBD-OSA cases and 27 OSA controls) in the case-control study. Intervention: N/A Methods: Polysomnographic assessment to document the sleep architecture, sleep apnea related parameters, and REMREEA. Results: (1) In the correlation study, increased REMREEA was associated with lower severity of OSA in RBD patients, including total AHI (r = −0.263), NREM AHI (r = −0.242), obstructive AHI (r = −0.265), and mean apnea duration (r = −0.353) (P sleep apnea parameters than OSA controls in terms of higher nadir SpO2 (85.7% ± 4.9% vs 80.8% ± 5.9%, P sleep exacerbation of sleep apneas was seen only in OSA controls but not in RBD subjects. Conclusions: This study demonstrated that excessive EMG activity in RBD might protect patients against severe OSA and suggests this may be a naturalistic model for understanding neuromuscular control of OSA. Citation: Huang J; Zhang J; Lam SP; Li SX; Ho CKW; Lam V; Yu MWM; Wing YK. Amelioration of obstructive sleep apnea in REM sleep behavior disorder: implications for the neuromuscular control of OSA. SLEEP 2011;34(7):909-915. PMID:21731141

  7. Ankles back in randomized controlled trial (ABrCt: braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Verhagen Evert ALM

    2011-09-01

    Full Text Available Abstract Background Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. Methods/Design This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. Discussion The ABrCt is the first randomized controlled trial to directly compare the secondary preventive

  8. Acute Neuromuscular Adaptations in the Postural Control of Patients with Parkinson’s Disease after Perturbed Walking

    Directory of Open Access Journals (Sweden)

    Cristian F. Pasluosta

    2017-09-01

    Full Text Available Patients suffering from Parkinson’s disease (PD present motor impairments reflected in the dynamics of the center of pressure (CoP adjustments during quiet standing. One method to study the dynamics of CoP adjustments is the entropic half-life (EnHL, which measures the short-term correlations of a time series at different time scales. Changes in the EnHL of CoP time series suggest neuromuscular adaptations in the control of posture. In this study, we sought to investigate the immediate changes in the EnHL of CoP adjustments of patients with PD during one session of perturbed (experimental group and unperturbed treadmill walking (control group. A total of 39 patients with PD participated in this study. The experimental group (n = 19 walked on a treadmill providing small tilting of the treadmill platform. The control group (n = 20 walked without perturbations. Each participant performed 5-min practice followed by three 5-min training blocks of walking with or without perturbation (with 3-min resting in between. Quiet standing CoP data was collected for 30 s at pre-training, after each training block, immediately post-training, and after 10 min retention. The EnHL was computed on the original and surrogates (phase-randomized CoP signals in the medio-lateral (ML and anterior–posterior (AP directions. Data was analyzed using four-way mixed ANOVA. Increased EnHL values were observed for both groups (Time effect, p < 0.001 as the intervention progressed, suggesting neuromuscular adaptations in the control of posture. The EnHL of surrogate signals were significantly lower than for original signals (p < 0.001, confirming that these adaptations come from non-random control processes. There was no Group effect (p = 0.622, however by analyzing the significant Group by Direction by Time interaction (p < 0.05, a more pronounced effect in the ML direction of the perturbed group was observed. Altogether, our findings show that treadmill walking decreases

  9. Effects of Hip Strengthening on Neuromuscular Control, Hip Strength, and Self-Reported Functional Deficits in Individuals With Chronic Ankle Instability.

    Science.gov (United States)

    Smith, Brent I; Docherty, Carrie L; Curtis, Denice

    2017-06-12

    Deficits in ankle and hip strength and lower extremity postural control are associated with chronic ankle instability (CAI). Following strength training, muscle groups demonstrate increased strength. This change is partially credited to improved neuromuscular control and many studies have investigated ankle protocols for subjects with CAI. The effects of isolating hip musculature in strength training protocols in this population is not well understood. Examine the effects of hip strengthening on clinical and self-reported outcomes in patients with CAI. Prospective randomized controlled clinical trial. Athletic Training facility. Twenty-six participants with CAI (12 males and 14 females, 20.9±1.5 years, 170.0±12.7 cm, 77.5±17.5 kg) were randomly assigned to training or control groups. The participants completed either four weeks of supervised hip strengthening (resistance bands 3x/week) or no intervention. Participants were assessed on four clinical measures (Star Excursion Balance Test (SEBT) in the anterior, posteromedial and posterolateral directions, Balance Error Scoring System (BESS), hip external rotation strength, hip abduction strength) and a patient reported measure (the Foot and Ankle Ability Measure (FAAM) activities of daily living and sports subscales) before and after the four-week training period. The training group displayed significantly improved post-test measures compared with the control group for: hip abduction strength (training 446.3±77.4 N, control 314.7±49.6 N, p control 169.4±34.6 N, p control 90.2±7.9%, p control 88.0±8.8 %, p control 86.6±9.6%, p control 21.2±6.3 errors, p control 84.8±10.9, p <.01). Improved clinical and patient-reported outcomes in the training group suggest hip strengthening is beneficial in the management and prevention of recurrent symptoms associated with CAI.

  10. Altered knee joint neuromuscular control during landing from a jump in 10-15year old children with Generalised Joint Hypermobility. A substudy of the CHAMPS-study Denmark

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, Niels; Thorlund, Jonas Bloch

    2015-01-01

    Generalised Joint Hypermobility (GJH) is considered an intrinsic risk factor for knee injuries. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability. The aim was to identify differences in knee neuromuscular control during landing of the Single-Leg-Hop-...

  11. Altered knee joint neuromuscular control during landing from a jump in 10-15 year old children with generalised joint hypermobility. A substudy of the CHAMPS-study Denmark

    DEFF Research Database (Denmark)

    Junge, Tina; Juul-Kristensen, B; Bloch Thorlund, Jonas

    Generalised Joint Hypermobility (GJH) is considered an intrinsic risk factor for knee injuries. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability. The aim was to identify differences in knee neuromuscular control during landing of the Single-Leg-Hop-...

  12. Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial

    National Research Council Canada - National Science Library

    Balcı, Nilay Comuk; Yuruk, Zeliha Ozlem; Zeybek, Aslican; Gulsen, Mustafa; Tekindal, Mustafa Agah

    2016-01-01

    [Purpose] The aim of our study was to compare the initial effects of scapular proprioceptive neuromuscular facilitation techniques and classic exercise interventions with physiotherapy modalities on pain...

  13. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton

    National Research Council Canada - National Science Library

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    ...) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop...

  14. Brain-controlled neuromuscular stimulation to drive neural plasticity and functional recovery.

    Science.gov (United States)

    Ethier, C; Gallego, J A; Miller, L E

    2015-08-01

    There is mounting evidence that appropriately timed neuromuscular stimulation can induce neural plasticity and generate functional recovery from motor disorders. This review addresses the idea that coordinating stimulation with a patient's voluntary effort might further enhance neurorehabilitation. Studies in cell cultures and behaving animals have delineated the rules underlying neural plasticity when single neurons are used as triggers. However, the rules governing more complex stimuli and larger networks are less well understood. We argue that functional recovery might be optimized if stimulation were modulated by a brain machine interface, to match the details of the patient's voluntary intent. The potential of this novel approach highlights the need for a better understanding of the complex rules underlying this form of plasticity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. THE RELAXOMETER - A COMPLETE AND COMPREHENSIVE COMPUTER-CONTROLLED NEUROMUSCULAR-TRANSMISSION MEASUREMENT SYSTEM DEVELOPED FOR CLINICAL RESEARCH ON MUSCLE-RELAXANTS

    NARCIS (Netherlands)

    ROWAAN, CJ; VANDENBROM, RHG; WIERDA, JMKH

    The Relaxometer is a computer-controlled system developed for reliable clinical experimental measurements on neuromuscular block. This system is based on an adapted personal computer (Atari 1040 ST) with a monochrome monitor (Atari SM 124), and a microcomputer-driven slave unit (stimulator). There

  16. Sports involvement following ACL reconstruction is related to lower extremity neuromuscular adaptations, subjective knee function and health locus of control.

    Science.gov (United States)

    Nyland, J; Mauser, N; Caborn, D N M

    2013-09-01

    This retrospective study compared the influence of perceived sports involvement on lower extremity neuromuscular adaptations during single-leg countermovement jumping (CMJ), perceived knee function and internal health locus of control (HLOC) scores at a minimum 2-year post-anterior cruciate ligament reconstruction. The hypothesis was that subjects with higher-level sports involvement would display significant differences compared to subjects with lower-level sports involvement. Uninvolved and involved lower extremity EMG amplitude (1,000 Hz), vertical ground reaction force (VGRF) (500 Hz) and kinematic (60 Hz) displacement differences were determined during single-leg CMJ. These data and International Knee Documentation Committee subjective knee survey scores, Multidimensional Health Locus of Control Survey internal HLOC subscale scores and sports activity characteristics were compared by sports involvement level. Subjects that regarded themselves as only sporting sometimes (Group 3, n = 26) had lower IKDC survey and internal HLOC scores, were more likely to decrease sports activities by two intensity levels than highly competitive (Group 1, n = 20) and well-trained/frequently sporting (Group 2, n = 24) subjects, and had greater peak landing VGRF differences suggesting decreased involved lower extremity loading compared to Group 2. During propulsion, Group 1 had greater gluteus maximus (GM) and gastrocnemius (G) EMG differences than Groups 2 and 3. Groups 1 and 2 had decreased vastus medialis (VM) EMG differences during propulsion than Group 3. During landing, Group 1 had greater GM and G EMG differences than Group 3. Subjects with higher-level sports involvement up-regulated involved lower extremity GM and G activation and down-regulated VM activation. This adaptation may enable continued higher-level sports participation while minimizing knee joint forces. Perceived higher-level sports involvement was related to neuromuscular adaptations, better subjective knee

  17. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

  18. Effects of weight management program on postural stability and neuromuscular function among obese children: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Sun, Fenghua; Wang, Li-Juan; Wang, Lin

    2015-04-10

    Childhood obesity is one of the most critical public health problems in the world. It is associated with low neuromuscular function and postural deformities. Whether weight loss can improve postural stability and neuromuscular control, benefit daily activities, or prevent injury is unknown. Therefore, this study attempts to investigate the effect of a 6 month weight management program on postural stability and neuromuscular control among obese children. We will conduct a prospective, single-blind, randomized controlled trial with 120 prepubescent obese children. Participants will be randomly assigned to a weight management group or a control group. The weight management group will participate in a dietary and exercise program. The control group will receive health education. After the intervention, participants will be followed for 6 months with no active intervention. The primary and secondary outcomes will be assessed at the baseline, and after 6 months and 12 months. Primary outcome measures will include body weight, body height, body mass index, waist circumference, hip circumference, and body fat percentage. Secondary outcome measures will include three-dimensional functional biomechanics in different tasks, proprioception tests of the knee and ankle, neuromuscular response of the leg muscles, and muscle strength tests of the knee and ankle. Furthermore, adverse events will be recorded and analyzed. An intention-to-treat analysis will be performed if any participants withdraw from the trial. The important features of this trial include the randomization procedures and large sample size. This study attempts to estimate the effect of weight loss intervention on outcomes, including daily life function, postural stability, and neuromuscular control in prepubescent obese children. Therefore, our results can be useful for obese children, medical staff, and healthcare decision makers. Chinese Clinical Trial Registry ChiCTR-IOB-15005874.

  19. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players

    DEFF Research Database (Denmark)

    Zebis, Mette K; Bencke, Jesper; Andersen, Lars

    2008-01-01

    and knee, and ground reaction forces were recorded during a sidecutting maneuver. Neuromuscular activity in the prelanding phase was obtained 10 and 50 ms before foot strike on a force plate and at 10 and 50 ms after foot strike on a force plate. RESULTS: Neuromuscular training markedly increased before...

  20. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players.

    Science.gov (United States)

    Zebis, Mette K; Bencke, Jesper; Andersen, Lars L; Døssing, Simon; Alkjaer, Tine; Magnusson, S Peter; Kjaer, Michael; Aagaard, Per

    2008-07-01

    The project aimed to implement neuromuscular training during a full soccer and handball league season and to experimentally analyze the neuromuscular adaptation mechanisms elicited by this training during a standardized sidecutting maneuver known to be associated with non-contact anterior cruciate ligament (ACL) injury. The players were tested before and after 1 season without implementation of the prophylactic training and subsequently before and after a full season with the implementation of prophylactic training. A total of 12 female elite soccer players and 8 female elite team handball players aged 26 +/- 3 years at the start of the study. The subjects participated in a specific neuromuscular training program previously shown to reduce non-contact ACL injury. Neuromuscular activity at the knee joint, joint angles at the hip and knee, and ground reaction forces were recorded during a sidecutting maneuver. Neuromuscular activity in the prelanding phase was obtained 10 and 50 ms before foot strike on a force plate and at 10 and 50 ms after foot strike on a force plate. Neuromuscular training markedly increased before activity and landing activity electromyography (EMG) of the semitendinosus (P < 0.05), while quadriceps EMG activity remained unchanged. Neuromuscular training increased EMG activity for the medial hamstring muscles, thereby decreasing the risk of dynamic valgus. This observed neuromuscular adaptation during sidecutting could potentially reduce the risk for non-contact ACL injury.

  1. The drop-jump video screening test: retention of improvement in neuromuscular control in female volleyball players.

    Science.gov (United States)

    Barber-Westin, Sue D; Smith, Stephanie T; Campbell, Thomas; Noyes, Frank R

    2010-11-01

    A valgus lower limb alignment is commonly documented during noncontact anterior cruciate ligament injuries. We previously developed a videographic drop-jump test to measure overall lower limb alignment in the coronal plane as a screening tool to detect such an abnormal (valgus) position on landing. A neuromuscular retraining program developed for female athletes was shown to be effective in improving lower limb alignment on this test immediately after completion of training. What remained unknown was whether these improvements would be retained for longer periods of time. Therefore, this study was undertaken to determine if these improvements in overall lower limb alignment would be retained up to 1 year after the training. Sixteen competitive, experienced female high-school volleyball players underwent the video drop-jump test and then completed the neuromuscular retraining program. The program consisted of a dynamic warm-up, jump training, speed and agility drills, strength training, and static stretching and was performed 3 times a week for 6 weeks. The athletes repeated the drop-jump test immediately upon completion of training and then 3- and 12-months later. Significant improvements were found in the mean normalized knee separation distance between the pre and posttrained values for all test sessions (p < 0.01). Immediately after training, 11 athletes (69%) displayed significant improvements in the mean normalized knee separation distance that were retained 12 months later. Five athletes failed to improve. The video drop-jump test, although not a risk indicator for a knee ligament injury, provides a cost-effective general assessment of lower limb position and depicts athletes who have poor control on landing and acceleration into a vertical jump.

  2. Effects of neuromuscular electrical stimulation and Kinesio Taping applications in children with cerebral palsy on postural control and sitting balance.

    Science.gov (United States)

    Elbasan, Bulent; Akaya, Kamile Uzun; Akyuz, Mufit; Oskay, Deran

    2018-02-06

    Neurodevelopmental treatment (NDT), neuromuscular electrical stimulation (NMES), and Kinesio Taping (KT) applications are separately used to improve postural control and sitting balance in children with cerebral palsy (CP). The aim of this study is to examine the combined effect of NDT, NMES and KT applications on postural control and sitting balance in children with CP. Forty five children, in 3 groups, between the ages 5-12 years were included in the study. Group 1 received NDT; group 2 received NDT + NMES; and the group 3 received NDT + NMES + KT for 6 weeks. Sitting function evaluated by the sitting section of the gross motor function measure (GMFM), and postural control assessed with the seated postural control measurement (SPCM). Seating section of GMFM was improved significantly in all the groups; however, increases in the group 3 were higher than groups 1 and 2 (p= 0.001). While significant differences were observed in all groups in the SPCM posture (pNDT improve the sitting posture, postural control, seating function, and gross motor function in children with CP.

  3. Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial.

    Science.gov (United States)

    Bruce-Brand, Robert A; Walls, Raymond J; Ong, Joshua C; Emerson, Barry S; O'Byrne, John M; Moyna, Niall M

    2012-07-03

    Quadriceps femoris muscle (QFM) weakness is a feature of knee osteoarthritis (OA) and exercise programs that strengthen this muscle group can improve function, disability and pain. Traditional supervised resistance exercise is however resource intensive and dependent on good adherence which can be challenging to achieve in patients with significant knee OA. Because of the limitations of traditional exercise programs, interest has been shown in the use of neuromuscular electrical stimulation (NMES) to strengthen the QFM. We conducted a single-blind, prospective randomized controlled study to compare the effects of home-based resistance training (RT) and NMES on patients with moderate to severe knee OA. 41 patients aged 55 to 75 years were randomised to 6 week programs of RT, NMES or a control group receiving standard care. The primary outcome was functional capacity measured using a walk test, stair climb test and chair rise test. Additional outcomes were self-reported disability, quadriceps strength and cross-sectional area. Outcomes were assessed pre- and post-intervention and at 6 weeks post-intervention (weeks 1, 8 and 14 respectively). There were similar, significant improvements in functional capacity for the RT and NMES groups at week 8 compared to week 1 (p ≤ 0.001) and compared to the control group (p knee OA, producing similar improvements in functional capacity. Current Controlled Trials ISRCTN85231954.

  4. Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.

    Science.gov (United States)

    Henchoz, Yves; Tétreau, Charles; Abboud, Jacques; Piché, Mathieu; Descarreaux, Martin

    2013-10-01

    Alterations of the neuromuscular control of the lumbar spine have been reported in patients with chronic low back pain (LBP). During trunk flexion and extension tasks, the reduced myoelectric activity of the low back extensor musculature observed during full trunk flexion is typically absent in patients with chronic LBP. To determine whether pain expectations could modulate neuromuscular responses to experimental LBP to a higher extent in patients with chronic LBP compared with controls. A cross-sectional, case-control study. Twenty-two patients with nonspecific chronic LBP and 22 age- and sex-matched control participants. Trunk flexion-extension tasks were performed under three experimental conditions: innocuous heat, noxious stimulation with low pain expectation, and noxious stimulation with high pain expectation. Noxious stimulations were delivered using a contact heat thermode applied on the skin of the lumbar region (L4-L5), whereas low or high pain expectations were induced by verbal and visual instructions. Surface electromyography of erector spinae at L2-L3 and L4-L5, as well as lumbopelvic kinematic variables were collected during the tasks. Pain was evaluated using a numerical rating scale. Pain catastrophizing, disability, anxiety, and fear-avoidance beliefs were measured using validated questionnaires. Two-way mixed analysis of variance revealed that pain was significantly different among the three experimental conditions (F2,84=317.5; plow back extensor musculature during full trunk flexion was observed in the high compared with low pain expectations condition at the L2-L3 level (F2,84=9.5; ppain catastrophizing in patients with chronic LBP (r=0.54; p=.012). Repeated exposure to pain appears to generate rigid and less variable patterns of muscle activation in patients with chronic LBP, which attenuate their response to pain expectations. Patients with high levels of pain catastrophizing show higher myoelectric activity of lumbar muscles in full flexion

  5. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Comparing joint kinematics and center of mass acceleration as feedback for control of standing balance by functional neuromuscular stimulation

    Directory of Open Access Journals (Sweden)

    Nataraj Raviraj

    2012-05-01

    Full Text Available Abstract Background The purpose of this study was to determine the comparative effectiveness of feedback control systems for maintaining standing balance based on joint kinematics or total body center of mass (COM acceleration, and assess their clinical practicality for standing neuroprostheses after spinal cord injury (SCI. Methods In simulation, controller performance was measured according to the upper extremity effort required to stabilize a three-dimensional model of bipedal standing against a variety of postural disturbances. Three cases were investigated: proportional-derivative control based on joint kinematics alone, COM acceleration feedback alone, and combined joint kinematics and COM acceleration feedback. Additionally, pilot data was collected during external perturbations of an individual with SCI standing with functional neuromuscular stimulation (FNS, and the resulting joint kinematics and COM acceleration data was analyzed. Results Compared to the baseline case of maximal constant muscle excitations, the three control systems reduced the mean upper extremity loading by 51%, 43% and 56%, respectively against external force-pulse perturbations. Controller robustness was defined as the degradation in performance with increasing levels of input errors expected with clinical deployment of sensor-based feedback. At error levels typical for body-mounted inertial sensors, performance degradation due to sensor noise and placement were negligible. However, at typical tracking error levels, performance could degrade as much as 86% for joint kinematics feedback and 35% for COM acceleration feedback. Pilot data indicated that COM acceleration could be estimated with a few well-placed sensors and efficiently captures information related to movement synergies observed during perturbed bipedal standing following SCI. Conclusions Overall, COM acceleration feedback may be a more feasible solution for control of standing with FNS given its

  7. Randomised controlled trial of non-invasive ventilation (NIV) for nocturnal hypoventilation in neuromuscular and chest wall disease patients with daytime normocapnia.

    Science.gov (United States)

    Ward, S; Chatwin, M; Heather, S; Simonds, A K

    2005-12-01

    Long term non-invasive ventilation (NIV) reduces morbidity and mortality in patients with neuromuscular and chest wall disease with hypercapnic ventilatory failure, but preventive use has not produced benefit in normocapnic patients with Duchenne muscular dystrophy. Individuals with nocturnal hypercapnia but daytime normocapnia were randomised to a control group or nocturnal NIV to examine whether nocturnal hypoventilation is a valid indication for NIV. Forty eight patients with congenital neuromuscular or chest wall disease aged 7-51 years and vital capacitytension (Tcco2) did not differ between the groups, but the mean (SD) percentage of the night during which Tcco2 was >6.5 kPa decreased in the NIV group (-57.7 (26.1)%) but not in controls (-11.75 (46.1)%; p=0.049, 95% CI -91.5 to -0.35). Mean (SD) arterial oxygen saturation increased in the NIV group (+2.97 (2.57)%) but not in controls (-1.12 (2.02)%; p=0.024, 95% CI 0.69 to 7.5). Nine of the 10 controls failed non-intervention by fulfilling criteria to initiate NIV after a mean (SD) of 8.3 (7.3) months. Patients with neuromuscular disease with nocturnal hypoventilation are likely to deteriorate with the development of daytime hypercapnia and/or progressive symptoms within 2 years and may benefit from the introduction of nocturnal NIV before daytime hypercapnia ensues.

  8. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

    Directory of Open Access Journals (Sweden)

    Hall Michelle

    2012-11-01

    Full Text Available Abstract Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home

  9. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Guilherme P. T. Areas

    2013-12-01

    Full Text Available BACKGROUND: Elastic resistance bands (ERB combined with proprioceptive neuromuscular facilitation (PNF are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. OBJECTIVES: The assessment of the effects of PNF combined with ERB on respiratory muscle strength. METHOD: Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10 or the control group (CG, n=10. Maximal expiratory pressure (MEP and inspiratory pressure (MIP were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. RESULTS: PNF combined with ERB showed significant increases in MIP and MEP (p<0.05. In addition, there were significant differences between the TG and CG regarding ∆MIP (p=0.01 and ∆MEP (p=0.04. CONCLUSIONS: PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength.

  10. Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial.

    Science.gov (United States)

    Stevens-Lapsley, Jennifer E; Balter, Jaclyn E; Wolfe, Pamela; Eckhoff, Donald G; Kohrt, Wendy M

    2012-02-01

    The recovery of quadriceps muscle force and function after total knee arthroplasty (TKA) is suboptimal, which predisposes patients to disability with increasing age. The purpose of this investigation was to evaluate the efficacy of quadriceps muscle neuromuscular electrical stimulation (NMES), initiated 48 hours after TKA, as an adjunct to standard rehabilitation. This was a prospective, longitudinal randomized controlled trial. Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation (control) or standard rehabilitation plus NMES applied to the quadriceps muscle (initiated 48 hours after surgery). The NMES was applied twice per day at the maximum tolerable intensity for 15 contractions. Data for muscle strength, functional performance, and self-report measures were obtained before surgery and 3.5, 6.5, 13, 26, and 52 weeks after TKA. At 3.5 weeks after TKA, significant improvements with NMES were found for quadriceps and hamstring muscle strength, functional performance, and knee extension active range of motion. At 52 weeks, the differences between groups were attenuated, but improvements with NMES were still significant for quadriceps and hamstring muscle strength, functional performance, and some self-report measures. Treatment volume was not matched for both study arms; NMES was added to the standard of care treatment. Furthermore, testers were not blinded during testing, but used standardized scripts to avoid bias. Finally, some patients reached the maximum stimulator output during at least one treatment session and may have tolerated more stimulation. The early addition of NMES effectively attenuated loss of quadriceps muscle strength and improved functional performance following TKA. The effects were most pronounced and clinically meaningful within the first month after surgery, but persisted through 1 year after surgery.

  11. Effects of Tai Chi versus Proprioception Exercise Program on Neuromuscular Function of the Ankle in Elderly People: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Jing Liu

    2012-01-01

    Full Text Available Background. Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people. Methods. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures included joint position sense and muscle strength of ankle. Subjects completed a satisfaction questionnaire upon study completion in Tai Chi and proprioception groups. Results. (1 Both Tai Chi group and proprioception exercise group were significantly better than control group in joint position sense of ankle, and there were no significant differences in joint position sense of ankle between TC group and PE group. (2 There were no significant differences in muscle strength of ankle among groups. (3 Subjects expressed more satisfaction with Tai Chi than with proprioception exercise program. Conclusions. None of the outcome measures on neuromuscular function at the ankle showed significant change posttraining in the two structured exercise groups. However, the subjects expressed more interest in and satisfaction with Tai Chi than proprioception exercise.

  12. Load Dependency of Postural Control--Kinematic and Neuromuscular Changes in Response to over and under Load Conditions.

    Directory of Open Access Journals (Sweden)

    Ramona Ritzmann

    Full Text Available Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL and under loading (UL used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms.Balance performance was recorded under normal loading (NL, 1 g, UL (0.16 g 0.38 g and OL (1.8 g in monopedal stance. Center of pressure (COP displacement and frequency distribution (low 0.15-0.5 Hz (LF, medium 0.5-2 Hz (MF, high 2-6 Hz (HF as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios.Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL.Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of

  13. Load Dependency of Postural Control--Kinematic and Neuromuscular Changes in Response to over and under Load Conditions.

    Science.gov (United States)

    Ritzmann, Ramona; Freyler, Kathrin; Weltin, Elmar; Krause, Anne; Gollhofer, Albert

    2015-01-01

    Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL) and under loading (UL) used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms. Balance performance was recorded under normal loading (NL, 1 g), UL (0.16 g 0.38 g) and OL (1.8 g) in monopedal stance. Center of pressure (COP) displacement and frequency distribution (low 0.15-0.5 Hz (LF), medium 0.5-2 Hz (MF), high 2-6 Hz (HF)) as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios). Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL. Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of

  14. Functional Neuromuscular Stimulation Controlled by Surface Electromyographic Signals Produced by Volitional Activation of the Same Muscle

    DEFF Research Database (Denmark)

    Sennels, Søren; Biering-Sørensen, Fin; Andersen, Ole Trier

    1997-01-01

    In order to use the volitional electromyography (EMG) as a control signal for the stimulation of the same muscle, it is necessary to eliminate the stimulation artifacts and the muscle responses caused by the stimulation. The stimulation artifacts, caused by the electric field in skin and tissue...... generated by the stimulation current, are relatively easy to eliminate by shutting down the EMG-amplifier at the onset of the stimulation pulses. The muscle response is a nonstationary signal, therefore, an adaptive linear prediction filter is proposed. The filter is implemented and for three filter lengths...... tested on both simulated and real data. The filter performance is compared with a conventional fixed comb filter. The simulations indicate that the adaptive filter is relatively insensitive to variations in amplitude of the muscle responses, and for all filter lengths produces a good filtering...

  15. Using the Hephaistos orthotic device to study countermeasure effectiveness of neuromuscular electrical stimulation and dietary lupin protein supplementation, a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Jochen Zange

    Full Text Available The present study investigated whether neuromuscular electrical stimulation for 20 min twice a day with an electrode placed over the soleus muscle and nutritional supplementation with 19 g of protein rich lupin seeds can reduce the loss in volume and strength of the human calf musculature during long term unloading by wearing an orthotic unloading device.Thirteen healthy male subjects (age of 26.4 ± 3.7 years wore a Hephaistos orthosis one leg for 60 days during all habitual activities. The leg side was randomly chosen for every subject. Six subjects only wore the orthosis as control group, and 7 subjects additionally received the countermeasure consisting of neuromuscular electrical stimulation of the soleus and lateral gastrocnemius muscles and lupin protein supplementation. Twenty-eight days before and on the penultimate day of the intervention cross-sectional images of the calf muscles were taken by magnetic resonance imaging (controls n = 5, and maximum voluntary torque (controls n = 6 of foot plantar flexion was estimated under isometric (extended knee, 90° knee flexion and isokinetic conditions (extended knee, respectively.After 58 days of wearing the orthosis the percentage loss of volume in the entire triceps surae muscle of the control subjects (-11.9 ± 4.4%, mean ± standard deviation was reduced by the countermeasure (-3.5 ± 7.2%, p = 0.032. Wearing the orthosis generally reduced plantar flexion torques values, however, only when testing isometric contraction at 90° knee ankle the countermeasure effected a significantly lower percentage decrease of torque (-9.7 ± 7.2%, mean ± SD in comparison with controls (-22.3 ± 11.2%, p = 0.032.Unloading of calf musculature by an orthotic device resulted in the expected loss of muscle volume and maximum of plantar flexion torque. Neuromuscular electrical muscle stimulation and lupin protein supplementation could significantly reduce the process of atrophy.ClinicalTrials.gov, identifier

  16. Using the Hephaistos orthotic device to study countermeasure effectiveness of neuromuscular electrical stimulation and dietary lupin protein supplementation, a randomised controlled trial.

    Science.gov (United States)

    Zange, Jochen; Schopen, Kathrin; Albracht, Kirsten; Gerlach, Darius A; Frings-Meuthen, Petra; Maffiuletti, Nicola A; Bloch, Wilhelm; Rittweger, Jörn

    2017-01-01

    The present study investigated whether neuromuscular electrical stimulation for 20 min twice a day with an electrode placed over the soleus muscle and nutritional supplementation with 19 g of protein rich lupin seeds can reduce the loss in volume and strength of the human calf musculature during long term unloading by wearing an orthotic unloading device. Thirteen healthy male subjects (age of 26.4 ± 3.7 years) wore a Hephaistos orthosis one leg for 60 days during all habitual activities. The leg side was randomly chosen for every subject. Six subjects only wore the orthosis as control group, and 7 subjects additionally received the countermeasure consisting of neuromuscular electrical stimulation of the soleus and lateral gastrocnemius muscles and lupin protein supplementation. Twenty-eight days before and on the penultimate day of the intervention cross-sectional images of the calf muscles were taken by magnetic resonance imaging (controls n = 5), and maximum voluntary torque (controls n = 6) of foot plantar flexion was estimated under isometric (extended knee, 90° knee flexion) and isokinetic conditions (extended knee), respectively. After 58 days of wearing the orthosis the percentage loss of volume in the entire triceps surae muscle of the control subjects (-11.9 ± 4.4%, mean ± standard deviation) was reduced by the countermeasure (-3.5 ± 7.2%, p = 0.032). Wearing the orthosis generally reduced plantar flexion torques values, however, only when testing isometric contraction at 90° knee ankle the countermeasure effected a significantly lower percentage decrease of torque (-9.7 ± 7.2%, mean ± SD) in comparison with controls (-22.3 ± 11.2%, p = 0.032). Unloading of calf musculature by an orthotic device resulted in the expected loss of muscle volume and maximum of plantar flexion torque. Neuromuscular electrical muscle stimulation and lupin protein supplementation could significantly reduce the process of atrophy. ClinicalTrials.gov, identifier NCT

  17. The Effects of Plyometric Type Neuromuscular Training on Postural Control Performance of Male Team Basketball Players.

    Science.gov (United States)

    Asadi, Abbas; Saez de Villarreal, Eduardo; Arazi, Hamid

    2015-07-01

    Anterior cruciate ligament injuries are common in basketball athletes; common preventive programs for decreasing these injures may be enhancing postural control (PC) or balance with plyometric training. This study investigated the efficiency of plyometric training program within basketball practice to improve PC performance in young basketball players. Sixteen players were recruited and assigned either to a plyometric + basketball training group (PT) or basketball training group (BT). All players trained twice per week, but the PT + BT followed a 6-week plyometric program implemented within basketball practice, whereas the BT followed regular practice. The star excursion balance test (SEBT) at 8 directions (anterior, A; anteromedial, AM; anterolateral, AL; medial, M; lateral, L; posterior, P; posteromedial, PM; and posterolateral, PL) was measured before and after the 6-week period. The PT group induced significant improvement (p ≤ 0.05) and small to moderate effect size in the SEBT (A = 0.95, AM = 0.62, AL = 0.61, M = 0.36, L = 0.47, P = 0.27, PM = 0.25, PL = 0.24). No significant improvements were found in the BT group. Also, there were significant differences between groups in all directions except PM and PL. An integrated plyometric program within the regular basketball practice can lead to significant improvements in SEBT and consequently PC. It can be recommended that strength and conditioning professionals use PT to enhance the athletes' joint awareness and PC to reduce possible future injuries in the lower extremity.

  18. The acute effects of targeted abdominal muscle activation training on spine stability and neuromuscular control.

    Science.gov (United States)

    Southwell, Daniel J; Hills, Nicole F; McLean, Linda; Graham, Ryan B

    2016-02-27

    Targeted activation of the transversus abdominis (TrA) muscle through the abdominal drawing-in maneuver (ADIM) is a frequently prescribed exercise for the prevention and rehabilitation of low back pain. However, there is still debate over the role the ADIM plays in maintaining a stable spine during movement. Thus, a single cohort pre/post-intervention protocol was used to examine whether 5 min of ADIM training prior to a dynamic movement task alters dynamic spine stability and control. Thirteen healthy participants performed a repetitive spine flexion task twice, once before and once after they received biofeedback training on how to correctly perform the ADIM in standing. Abdominal and back muscle activation (indwelling and surface electromyography, EMG) and 3D kinematic data were recorded during all trials. EMG activation (percent maximum) and local dynamic stability of spine movement [maximum finite-time Lyapunov exponent (λmax)] were compared before and after the training using Friedman's rank test and repeated-measures ANOVA, respectively. To assess the moderating effects of absolute changes in EMG (∆EMG) of each muscle after training on changes in stability, the ∆EMG (peak and mean) were added to the ANOVA as separate covariates (ANCOVA). Following ADIM training, there were greater peak and mean levels of activation in all tested abdominal muscles, including TrA, (p back muscles. The ANOVA showed no significant change in λmax following training (p = 0.633). However, after considering the moderating effects of the ∆EMG seen in each muscle with training, it was found that only changes in TrA EMG significantly influenced stability. The ANCOVA revealed a significant main effect of training on stability as well as a significant interaction effect between training and ∆EMG recorded from TrA (p < 0.05); those with larger increases in TrA activation demonstrated larger improvements in stability. As a group, 5 min of ADIM training did not change

  19. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2012-01-01

    Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential...... to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have...

  20. Genetic Control of Germination Ability under Cold Stress in Rice

    Directory of Open Access Journals (Sweden)

    Zhou-fei WANG

    2009-09-01

    Full Text Available An F9 recombinant inbred lines (RIL population, derived from a cross between IR28 (Oryza sativa L. spp. indica and Daguandao (O. sativa L. spp. japonica, was used to construct a molecular linkage map and to identify germination ability including the traits of imbibition rate, germination rate, germination index, root length, shoot length and seed vigor at 14°C for 23 d. A composite interval mapping approach was applied to conduct genetic analysis for germination ability. The frequency distributions of the germination ability traits under the cold stress in the RIL population showed continuous segregation, suggesting they were quantitative traits controlled by several genes. A total of seven QTLs were identified on chromosomes 4, 6 and 9, including two for imbibition rate (qIR-6, qIR-9, one for germination rate (qGR-4, two for germination index (qGI-4-1, qGI-4-2 and two for root length (qRL-4-1, qRL-4-2. There were no detected QTLs controlling shoot length and seed vigor. The phenotypic variance explained by a single QTL ranged from 9.1% to 37.0%, and two major QTLs, qIR-6 and qGI-4-2, accounted for over 30% of the phenotypic variance. The expressions of QTLs were developmentally regulated and growth stage-specific. Most of the QTLs observed here were located in the regions similar to the QTLs for rice cold tolerance reported previously, indicating that these QTLs were reliable. However, qRL-4-2 is not reported before.

  1. Effects of neuromuscular electrical stimulation on the wrist and finger flexor spasticity and hand functions in cerebral palsy.

    Science.gov (United States)

    Yıldızgören, Mustafa Turgut; Nakipoğlu Yüzer, Güldal Funda; Ekiz, Timur; Özgirgin, Neşe

    2014-09-01

    To evaluate the effects of neuromuscular electrical stimulation on wrist range of motion, wrist and finger flexor spasticity, and hand functions in patients with unilateral cerebral palsy. Twenty-four children with unilateral spastic cerebral palsy (14 boys and 10 girls) between the ages of 5 and 14 years were randomized into neuromuscular electrical stimulation and control groups. Conventional exercises were applied, and static volar wrist-hand orthosis was administered to all patients 5 days a week for 6 weeks. Additionally, 30-minute neuromuscular electrical stimulation sessions were applied to the wrist extensor muscles in the neuromuscular electrical stimulation group. Patients were evaluated by Zancolli Classification System, Manual Ability Classification System, and Abilhand-Kids Test. Compared with baseline, a significant increase was evident in active wrist extension angle at the fourth and sixth weeks in both groups (all P spasticity values in the neuromuscular electrical stimulation group at the fourth and sixth weeks (P = 0.002 and P = 0.001, respectively) and in the control group only at the sixth week (P = 0.008). Abilhand-Kids values improved only in the neuromuscular electrical stimulation group (P spasticity, and hand functions in cerebral palsy. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and anterior cruciate ligament injury risk: a systematic review.

    Science.gov (United States)

    Balachandar, Vivek; Marciniak, Jan-Luigi; Wall, Owen; Balachandar, Chandrika

    2017-01-01

    Anterior cruciate ligament (ACL) injury has a devastating impact on physical and psychological disability. Rates of ACL rupture are significantly greater in females than males during the same sports. Hormonal mechanisms have been proposed but are complex and poorly understood. This systematic review evaluates the effects of menstrual cycle on: 1) lower-limb biomechanics, 2) neuromuscular control, and 3) ACL injury risk. The MEDLINE, CINAHL, SPORTSDiscus, Web of Science, and Google Scholar databases were searched from inception to August 2016 for studies investigating the effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and ACL injury risk in females. Three independent reviewers assessed each paper for inclusion and two assessed for quality. Seventeen studies were identified. There is strong evidence that: 1) greatest risk of ACL injury is within the pre-ovulatory phase of the menstrual cycle, and 2) females with greater ACL laxity in the pre-ovulatory phase experience greater knee valgus and greater tibial external rotation during functional activity. Females are at greatest risk of ACL injury during the pre-ovulatory phase of the menstrual cycle through a combination of greater ACL laxity, greater knee valgus, and greater tibial external rotation during functional activity. Ib.

  3. Feedback Control of arm movements using Neuro-Muscular Electrical Stimulation (NMES combined with a lockable, passive exoskeleton for gravity compensation

    Directory of Open Access Journals (Sweden)

    Christian eKlauer

    2014-09-01

    Full Text Available Within the European project MUNDUS, an assistive framework was developed for the support of arm and hand functions during daily life activities in severely impaired people. Potential users of this system are patients with high-level spinal cord injury and neurodegenerative neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis. This contribution aims at designing a feedback control system for Neuro-Muscular Electrical Stimulation (NMES to enable reaching functions in people with no residual voluntary control of the arm due to upper motor neuron lesions after spinal cord injury. NMES is applied to the deltoids and the biceps muscles and integrated with a three degrees of freedom (DoFs passive exoskeleton, which partially compensates gravitational forces and allows to lock each DOF. The user is able to choose the target hand position and to trigger actions using an eyetracker system. The target position is selected by using the eyetracker and determined by a marker-based tracking system using Microsoft Kinect. A central controller, i.e. a finite state machine, issues a sequence of basic movement commands to the real-time arm controller. The NMES control algorithm sequentially controls each joint angle while locking the other DoFs. Daily activities, such as drinking, brushing hair, pushing an alarm button, etc., can be supported by the system. The robust and easily tunable control approach was evaluated with five healthy subjects during a drinking task. Subjects were asked to remain passive and to allow NMES to induce the movements. In all of them, the controller was able to perform the task, and a mean hand positioning error of less than five centimeters was achieved. The average total time duration for moving the hand from a rest position to a drinking cup, for moving the cup to the mouth and back, and for finally returning the arm to the rest position was 71 seconds.

  4. Doenças neuromusculares Neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Umbertina C. Reed

    2002-08-01

    Full Text Available Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo. Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de hipotonia muscular secundária ao comprometimento do sistema nervoso central ou a doenças sistêmicas não-neurológicas, são enfatizados, com base na experiência clínica vinda do atendimento a crianças com doenças neuromusculares durante os últimos 12 anos, no ambulatório de doenças neuromusculares do Hospital das Clínicas da Faculdade de Medicina, da Universidade de São Paulo. A revisão bibliográfica foi efetuada através do Medline e do periódico Neuromuscular Disorders, publicação oficial da World Muscle Society. Síntese dos dados: nas crianças, a maior parte destas afecções é geneticamente determinada, sendo as mais comuns a distrofia muscular progressiva ligada ao sexo, de Duchenne, a amiotrofia espinal infantil, a distrofia muscular congênita, a distrofia miotônica de Steinert, e as miopatias congênitas, estruturais e não estruturais. Polineuropatias hereditárias, síndrome miastênica congênita e miopatias metabólicas são menos comuns, porém mostram correlação geno-fenotípica cada vez mais precisa. Conclusões: na década passada, inúmeros avanços da genética molecular facilitaram imensamente o diagnóstico e o aconselhamento genético das doenças neuromusculares mais comuns das crianças, inclusive possibilitando diagnóstico fetal e, adicionalmente, vieram permitir melhor caracterização fenotípica e classificação mais objetiva.Objective: to discuss the most important aspects for performing a

  5. Learn About Neuromuscular Disease

    Science.gov (United States)

    ... for MDA Blog Donate Search MDA.org Close Learn About Neuromuscular Disease Muscular dystrophy, ALS and related ... power of a multiple-disease approach, MDA leverages learnings from one disease to accelerate progress in others ...

  6. ACL injury risk in elite female youth soccer: Changes in neuromuscular control of the knee following soccer-specific fatigue.

    Science.gov (United States)

    De Ste Croix, M B A; Priestley, A M; Lloyd, R S; Oliver, J L

    2015-10-01

    Fatigue is known to influence dynamic knee joint stability from a neuromuscular perspective, and electromechanical delay (EMD) plays an important role as the feedback activation mechanism that stabilizes the joint. The aim of this study was to investigate the influence of soccer-specific fatigue on EMD in U13-, U15-, and U17-year-old female soccer players. Thirty-six youth soccer players performed eccentric actions of the hamstrings in a prone position at 60, 120, and 180°/s before and after a soccer-specific fatigue trial. Surface electromyography was used to determine EMD from the semitendinosus, biceps femoris and gastrocnemius. A time × age × muscle × velocity repeated measures analysis of variance was used to explore the influence of fatigue on EMD. A significant main effect for time (P = 0.001) indicated that EMD was significantly longer post- compared with pre-fatigue (58.4% increase). A significant time × group interaction effect (P = 0.046) indicated EMD was significantly longer in the U13 age group compared with the U15 (P = 0.011) and U17 (P = 0.021) groups and greater post-fatigue. Soccer-specific fatigue compromised neuromuscular feedback mechanisms and the age-related effects may represent a more compliant muscle-tendon system in younger compared with older girls, increasing risk of injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Proximal Neuromuscular Control Protects Against Hamstring Injuries in Male Soccer Players: A Prospective Study With Electromyography Time-Series Analysis During Maximal Sprinting.

    Science.gov (United States)

    Schuermans, Joke; Danneels, Lieven; Van Tiggelen, Damien; Palmans, Tanneke; Witvrouw, Erik

    2017-05-01

    With their unremittingly high incidence rate and detrimental functional repercussions, hamstring injuries remain a substantial problem in male soccer. Proximal neuromuscular control ("core stability") is considered to be of key importance in primary and secondary hamstring injury prevention, although scientific evidence and insights on the exact nature of the core-hamstring association are nonexistent at present. The muscle activation pattern throughout the running cycle would not differ between participants based on injury occurrence during follow-up. Case-control study; Level of evidence, 3. Sixty amateur soccer players participated in a multimuscle surface electromyography (sEMG) assessment during maximal acceleration to full-speed sprinting. Subsequently, hamstring injury occurrence was registered during a 1.5-season follow-up period. Hamstring, gluteal, and trunk muscle activity time series during the airborne and stance phases of acceleration were evaluated and statistically explored for a possible causal association with injury occurrence and absence from sport during follow-up. Players who did not experience a hamstring injury during follow-up had significantly higher amounts of gluteal muscle activity during the front swing phase ( P = .027) and higher amounts of trunk muscle activity during the backswing phase of sprinting ( P = .042). In particular, the risk of sustaining a hamstring injury during follow-up lowered by 20% and 6%, with a 10% increment in normalized muscle activity of the gluteus maximus during the front swing and the trunk muscles during the backswing, respectively ( P < .024). Muscle activity of the core unit during explosive running appeared to be associated with hamstring injury occurrence in male soccer players. Higher amounts of gluteal and trunk muscle activity during the airborne phases of sprinting were associated with a lower risk of hamstring injuries during follow-up. Hence, the present results provide a basis for improved

  8. Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

    Science.gov (United States)

    Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

    2016-04-01

    Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  9. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: a randomised controlled trial.

    Science.gov (United States)

    Zebis, Mette K; Andersen, Lars L; Brandt, Mikkel; Myklebust, Grethe; Bencke, Jesper; Lauridsen, Hanne Bloch; Bandholm, Thomas; Thorborg, Kristian; Hölmich, Per; Aagaard, Per

    2016-05-01

    Adolescent female football and handball players are among the athletes with the highest risk of sustaining anterior cruciate ligament (ACL) injuries. This study evaluated the effects of evidence-based lower extremity injury prevention training on neuromuscular and biomechanical risk factors for non-contact ACL injury. 40 adolescent female football and handball players (15-16 years) were randomly allocated to a control group (CON, n=20) or neuromuscular training group (NMT, n=20). The NMT group performed an injury prevention programme as a warm-up before their usual training 3 times weekly for 12 weeks. The CON group completed their regular warm-up exercise programme before training. Players were tested while performing a side cutting movement at baseline and 12-week follow-up, using surface electromyography (EMG) and three-dimensional movement analysis. We calculated: (1) EMG amplitude from vastus lateralis (VL), semitendinosus (ST) and biceps femoris 10 ms prior to initial contact (IC) normalised to peak EMG amplitude recorded during maximal voluntary isometric contraction and (2) VL-ST EMG preactivity difference during the 10 ms prior to foot contact (primary outcome). We measured maximal knee joint valgus moment and knee valgus angle at IC. There was a difference between groups at follow-up in VL-ST preactivity (43% between-group difference; 95% CI 32% to 55%). No between-group differences were observed for kinematic and kinetic variables. A 12-week injury prevention programme in addition to training and match play in adolescent females altered the pattern of agonist-antagonist muscle preactivity during side cutting. This may represent a more ACL-protective motor strategy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Effects of neuromuscular electrical stimulation and low-level laser therapy on the muscle architecture and functional capacity in elderly patients with knee osteoarthritis: a randomized controlled trial.

    Science.gov (United States)

    Melo, Mônica de Oliveira; Pompeo, Klauber Dalcero; Brodt, Guilherme Auler; Baroni, Bruno Manfredini; da Silva Junior, Danton Pereira; Vaz, Marco Aurélio

    2015-06-01

    To determine the effects of low-level laser therapy in combination with neuromuscular electrical stimulation on the muscle architecture and functional capacity of elderly patients with knee osteoarthritis. A randomized, evaluator-blinded clinical trial with sequential allocation of patients to three different treatment groups. Exercise Research Laboratory. A total of 45 elderly females with knee osteoarthritis, 2-4 osteoarthritis degrees, aged 66-75 years. Participants were randomized into one of the following three intervention groups: electrical stimulation group (18-32 minutes of pulsed current, stimulation frequency of 80 Hz, pulse duration of 200 μs and stimulation intensity fixed near the maximal tolerated), laser group (low-level laser therapy dose of 4-6 J per point, six points at the knee joint) or combined group (electrical stimulation and low-level laser therapy). All groups underwent a four-week control period (without intervention) followed by an eight-week intervention period. The muscle thickness, pennation angle and fascicle length were assessed by ultrasonography, and the functional capacity was assessed using the 6-minute walk test and the Timed Up and Go Test. After intervention, only the electrical stimulation and combined groups exhibited significant increases in the muscle thickness (27%-29%) and pennation angle (24%-34%) values. The three groups exhibited increased performance on the walk test (5%-9%). However, no significant differences in terms of functional improvements were observed between the groups. Neuromuscular electrical stimulation reduced the deleterious effects of osteoarthritis on the quadriceps structure. Low-level laser therapy did not potentiate the effects of electrical stimulation on the evaluated parameters. © The Author(s) 2014.

  11. Short-Term effects of neuromuscular electrical stimulation on muscle architecture of the tibialis anterior and gastrocnemius in children with cerebral palsy: preliminary results of a prospective controlled study.

    Science.gov (United States)

    Karabay, İlkay; Öztürk, Gökhan Tuna; Malas, Fevziye Ünsal; Kara, Murat; Tiftik, Tülay; Ersöz, Murat; Özçakar, Levent

    2015-09-01

    The aim of this study was to explore the short-term effects of neuromuscular electrical stimulation application on tibialis anterior (stimulated muscle) and gastrocnemius (antagonist) muscles' size and architecture in children with cerebral palsy by using ultrasound. This prospective, controlled study included 28 children diagnosed with spastic diplegic cerebral palsy. Participants were treated either with neuromuscular electrical stimulation application and conventional physiotherapy (group A) or with conventional physiotherapy alone (group B). Outcome was evaluated by clinical (gross motor function, selective motor control, range of motion, spasticity) and ultrasonographic (cross-sectional area, pennation angle, fascicle length of tibialis anterior and gastrocnemius muscles) measurements before and after treatment in both groups. Cross-sectional area values of tibialis anterior (238.7 ± 61.5 vs. 282.0 ± 67.1 mm) and gastrocnemius (207.9 ± 48.0 vs. 229.5 ± 52.4 mm) (P muscles were increased after treatment in group A. Cross-sectional area values of tibialis anterior muscle were decreased (257.3 ± 64.7 vs. 239.7 ± 60.0 mm) after treatment in group B (P muscles increased after 20 sessions of neuromuscular electrical stimulation treatment. Future studies with larger samples and longer follow-up are definitely awaited for better evaluation of neuromuscular electrical stimulation application on muscle architecture and its possible correlates in clinical/functional outcome.

  12. Modified Newton-Raphson method to tune feedback gains of control system for standing by functional neuromuscular stimulation following spinal cord injury.

    Science.gov (United States)

    Nataraj, Raviraj; Audu, Musa L; Triolo, Ronald J

    2014-11-01

    Functional neuromuscular stimulation (FNS) can restore standing capabilities following spinal cord injury. Feedback control of these systems can optimize performance by reducing the required upper extremity support. However, tuning these control systems can be intensive and clinically inconvenient. This case study investigated a clinical method to efficiently tune feedback gains for a control system utilizing feedback of total body center of mass acceleration to modulate stimulation levels to targeted paralyzed musculature of the lower extremities and trunk. Gains for this control system were tuned to minimize the stabilization loading by one arm against internal postural perturbations volitionally-generated during manipulation of an object using the other arm. An algorithm based on a modified form of the Newton-Raphson method was employed to find the optimal feedback gains with lower subject effort than that to determine the original tuning curves. This method accurately (<6.2% error) approximated the optimal gains with 70% fewer manipulations by the subject. These results suggest that optimal feedback gains for the specific FNS control system can be determined systematically with considerably less effort than heuristic gain tuning. This demonstrates the potential for devising simple, convenient methods for effective system re-tuning during clinical usage.

  13. Hereditary neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Oezsarlak, O. E-mail: ozkan.ozsarlak@uza.be; Schepens, E.; Parizel, P.M.; Goethem, J.W. van; Vanhoenacker, F.; Schepper, A.M. de; Martin, J.J

    2001-12-01

    This article presents the actual classification of neuromuscular diseases based on present expansion of our knowledge and understanding due to genetic developments. It summarizes the genetic and clinical presentations of each disorder together with CT findings, which we studied in a large group of patients with neuromuscular diseases. The muscular dystrophies as the largest and most common group of hereditary muscle diseases will be highlighted by giving detailed information about the role of CT and MRI in the differential diagnosis. The radiological features of neuromuscular diseases are atrophy, hypertrophy, pseudohypertrophy and fatty infiltration of muscles on a selective basis. Although the patterns and distribution of involvement are characteristic in some of the diseases, the definition of the type of disease based on CT scan only is not always possible.

  14. Adaptation of neuromuscular activation patterns during treadmill walking after long-duration space flight

    Science.gov (United States)

    Layne, C. S.; Lange, G. W.; Pruett, C. J.; McDonald, P. V.; Merkle, L. A.; Mulavara, A. P.; Smith, S. L.; Kozlovskaya, I. B.; Bloomberg, J. J.

    The precise neuromuscular control needed for optimal locomotion, particularly around heel strike and toe off, is known to be compromised after short duration (8- to 15-day) space flight. We hypothesized here that longer exposure to weightlessness would result in maladaptive neuromuscular activation during postflight treadmill walking. We also hypothesized that space flight would affect the ability of the sensory-motor control system to generate adaptive neuromuscular activation patterns in response to changes in visual target distance during postflight treadmill walking. Seven crewmembers, who completed 3- to 6-month missions, walked on a motorized treadmill while visually fixating on a target placed 30 cm (NEAR) or 2 m (FAR) from the subject's eyes. Electronic foot switch data and surface electromyography were collected from selected muscles of the right lower limb. Results indicate that the phasic features of neuromuscular activation were moderately affected and the relative amplitude of activity in the tibialis anterior and rectus femoris around toe off changed after space flight. Changes also were evident after space flight in how these muscles adapted to the shift in visual target distance.

  15. Preliminary observations on the ability of goats to control post ...

    African Journals Online (AJOL)

    Discusses drought, stocking rate and plant tolerance in relation to management objectives; A ten hectare block which had been burned with an intense surface head fire was stocked at the rate of one goat per hectare to control the woody regrowth. After one year the block was subdivided and in one half the stocking rate ...

  16. Neuromuscular blockade in cardiac surgery: An update for clinicians

    Directory of Open Access Journals (Sweden)

    Hemmerling Thomas

    2008-01-01

    Full Text Available There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary sufficiently profound neuromuscular blockade during surgery and immediate re-establishment of normal neuromuscular transmission at the end of surgery. Postoperative residual muscle paralysis is one of the major hurdles for immediate or early extubation after cardiac surgery. Nondepolarising neuromuscular blocking drugs for cardiac surgery should therefore be easy to titrate, of rapid onset and short duration of action with a pathway of elimination independent from hepatic or renal dysfunction, and should equally not affect haemodynamic stability. The difference between repetitive bolus application and continuous infusion is outlined in this review, with the pharmacodynamic and pharmacokinetic characteristics of vecuronium, pancuronium, rocuronium, and cisatracurium. Kinemyography and acceleromyography are the most important currently used neuromuscular monitoring methods. Whereas monitoring at the adductor pollicis muscle is appropriate at the end of surgery, monitoring of the corrugator supercilii muscle better reflects neuromuscular blockade at more central, profound muscles, such as the diaphragm, larynx, or thoraco-abdominal muscles. In conclusion, cisatracurium or rocuronium is recommended for neuromuscular blockade in modern cardiac surgery.

  17. Cognitive Abilities, Monitoring Confidence, and Control Thresholds Explain Individual Differences in Heuristics and Biases

    OpenAIRE

    Jackson, Simon A.; Kleitman, Sabina; Howie, Pauline; Stankov, Lazar

    2016-01-01

    In this paper, we investigate whether individual differences in performance on heuristic and biases tasks can be explained by cognitive abilities, monitoring confidence, and control thresholds. Current theories explain individual differences in these tasks by the ability to detect errors and override automatic but biased judgments, and deliberative cognitive abilities that help to construct the correct response. Here we retain cognitive abilities but disentangle error detection, proposing tha...

  18. Cognitive abilities, monitoring, and control explain individual differences in heuristics and biases

    OpenAIRE

    Simon Anthony Jackson; Sabina Kleitman; Pauline Howie; Lazar Stankov

    2016-01-01

    In this paper, we investigate whether individual differences in performance on heuristic and biases tasks can be explained by cognitive abilities, monitoring confidence and control thresholds. Current theories explain individual differences in these tasks by the ability to detect errors and override automatic but biased judgements, and deliberative cognitive abilities that help to construct the correct response. Here we retain cognitive abilities but disentangle error detection, proposing tha...

  19. The role of multisensor data fusion in neuromuscular control of a sagittal arm with a pair of muscles using actor-critic reinforcement learning method.

    Science.gov (United States)

    Golkhou, V; Parnianpour, M; Lucas, C

    2004-01-01

    In this study, we consider the role of multisensor data fusion in neuromuscular control using an actor-critic reinforcement learning method. The model we use is a single link system actuated by a pair of muscles that are excited with alpha and gamma signals. Various physiological sensor information such as proprioception, spindle sensors, and Golgi tendon organs have been integrated to achieve an oscillatory movement with variable amplitude and frequency, while achieving a stable movement with minimum metabolic cost and coactivation. The system is highly nonlinear in all its physical and physiological attributes. Transmission delays are included in the afferent and efferent neural paths to account for a more accurate representation of the reflex loops. This paper proposes a reinforcement learning method with an Actor-Critic architecture instead of middle and low level of central nervous system (CNS). The Actor in this structure is a two layer feedforward neural network and the Critic is a model of the cerebellum. The Critic is trained by the State-Action-Reward-State-Action (SARSA) method. The Critic will train the Actor by supervisory learning based on previous experiences. The reinforcement signal in SARSA is evaluated based on available alternatives concerning the concept of multisensor data fusion. The effectiveness and the biological plausibility of the present model are demonstrated by several simulations. The system showed excellent tracking capability when we integrated the available sensor information. Addition of a penalty for activation of muscles resulted in much lower muscle coactivation while keeping the movement stable.

  20. Effect of whole-body vibration on neuromuscular performance and body composition for females 65 years and older: a randomized-controlled trial.

    Science.gov (United States)

    von Stengel, S; Kemmler, W; Engelke, K; Kalender, W A

    2012-02-01

    We examined whether the effect of multipurpose exercise can be enhanced by whole-body vibration (WBV). One hundred and fifty-one post-menopausal women (68.5 ± 3.1 years) were randomly assigned to three groups: (1) a training group (TG); (2) training including vibration (VTG); and (3) a wellness control group (CG). TG and VTG performed the same training program twice weekly (60 min), consisting of aerobic and strength exercises, with the only difference that leg strength exercises (15 min) were performed with (VTG) or without (TG) vibration. CG performed a low-intensity "wellness" program. At baseline and after 18 months, body composition was determined using dual-X-ray-absorptiometry. Maximum isometric strength was determined for the legs and the trunk region. Leg power was measured by countermovement jumps using a force-measuring plate. In the TG lean body mass, total body fat, and abdominal fat were favorably affected, but no additive effects were generated by the vibration stimulus. However, concerning muscle strength and power, there was a tendency in favor of the VTG. Only vibration training resulted in a significant increase of leg and trunk flexion strength compared with CG. In summary, WBV embedded in a multipurpose exercise program showed minor additive effects on body composition and neuromuscular performance. © 2010 John Wiley & Sons A/S.

  1. Effects of two neuromuscular training programs on running biomechanics with load carriage: a study protocol for a randomised controlled trial

    OpenAIRE

    Liew, Bernard X. W.; Morris, Susan; Keogh, Justin W.L.; Appleby, Brendyn; Netto , Kevin

    2016-01-01

    Background In recent years, athletes have ventured into ultra-endurance and adventure racing events, which tests their ability to race, navigate, and survive. These events often require race participants to carry some form of load, to bear equipment for navigation and survival purposes. Previous studies have reported specific alterations in biomechanics when running with load which potentially influence running performance and injury risk. We hypothesize that a biomechanically informed neurom...

  2. Assessment of the interaction between atracurium and suxamethonium at 50% neuromuscular block using closed-loop feedback control of infusion of atracurium.

    Science.gov (United States)

    Olkkola, K T; Tammisto, T

    1994-08-01

    We have studied the effect of prior administration of suxamethonium on the infusion requirements of atracurium at 50% neuromuscular block in patients undergoing elective general surgery. Anaesthesia was maintained with nitrous oxide in oxygen, propofol and fentanyl. Of 20 patients given atracurium, only 10 were given prior administration of suxamethonium 1 mg kg-1. At the beginning of the infusion, atracurium 0.3 mg kg-1 was given by bolus administration. Interaction between the two drugs was assessed by determining the steady state rate of infusion necessary to produce a constant 50% neuromuscular block. This was accomplished by applying non-linear curve fitting to data on the cumulative dose requirements during anaesthesia. The neuromuscular blocking effect was found to be similar with or without prior administration of suxamethonium. The mean steady-state rate of infusion for atracurium was 0.19 (SD 0.03) mg kg-1 h-1 for patients given suxamethonium and 0.18 (0.09) mg kg-1 h-1 for those who were not given suxamethonium. Thus prior administration of suxamethonium did not affect the infusion requirements of atracurium at 50% neuromuscular block, unlike the situation at constant 90% neuromuscular block.

  3. Implementation of a neuromuscular training programme in female adolescent football: 3-year follow-up study after a randomised controlled trial.

    Science.gov (United States)

    Lindblom, Hanna; Waldén, Markus; Carlfjord, Siw; Hägglund, Martin

    2014-10-01

    Neuromuscular training (NMT) has been shown to reduce anterior cruciate ligament injury rates in highly structured clinical trials. However, there is a paucity of studies that evaluate implementation of NMT programmes in sports. To evaluate the implementation of an NMT programme in female adolescent football 3 years after a randomised controlled trial (RCT). Cross-sectional follow-up after an RCT using the Reach, Effectiveness, Adoption, Implementation, and Maintenance Sports Setting Matrix (RE-AIM SSM) framework. Questionnaires were sent to the Swedish Football Association (FA), to eight district FAs and coaches (n=303) that participated in the RCT in 2009, and coaches who did not participate in the RCT but were coaching female adolescent football teams during the 2012 season (n=496). Response rates were 100% among the FAs, 57% among trial coaches and 36% among currently active coaches. The reach of the intervention was high, 99% of trial coaches (control group) and 91% of current coaches were familiar with the programme. The adoption rate was 74% among current coaches, but programme modifications were common among coaches. No district FA had formal policies regarding implementation, and 87% of current coaches reported no club routines for programme use. Maintenance was fairly high; 82% of trial coaches from the intervention group and 68% from the control group still used the programme. Reach and adoption of the programme was high among coaches. However, this study identified low programme fidelity and lack of formal policies for its implementation and use in clubs and district FAs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Neuromuscular Training Improves Lower Extremity Biomechanics Associated with Knee Injury during Landing in 11–13 Year Old Female Netball Athletes: A Randomized Control Study

    Science.gov (United States)

    Hopper, Amanda J.; Haff, Erin E.; Joyce, Christopher; Lloyd, Rhodri S.; Haff, G. Gregory

    2017-01-01

    The purpose of this study was to examine the effects of a neuromuscular training (NMT) program on lower-extremity biomechanics in youth female netball athletes. The hypothesis was that significant improvements would be found in landing biomechanics of the lower-extremities, commonly associated with anterior cruciate ligament (ACL) injury, following NMT. Twenty-three athletes (age = 12.2 ± 0.9 years; height = 1.63 ± 0.08 m; mass = 51.8 ± 8.5 kg) completed two testing sessions separated by 7-weeks and were randomly assigned to either a experimental or control group. Thirteen athletes underwent 6-weeks of NMT, while the remaining 10 served as controls and continued their regular netball training. Three-dimensional lower-extremity kinematics and vertical ground reaction force (VGRF) were measured during two landing tasks, a drop vertical jump and a double leg broad jump with a single leg landing. The experimental group significantly increased bilateral knee marker distance during the bilateral landing task at maximum knee-flexion range of motion. Knee internal rotation angle during the unilateral landing task at maximum knee flexion-extension range of motion was significantly reduced (p ≤ 0.05, g > 1.00). The experimental group showed large, significant decreases in peak vertical ground reaction force in both landing tasks (p ≤ 0.05, g > −1.30). Control participants did not demonstrate any significant pre-to-post-test changes in response to the 6-week study period. Results of the study affirm the hypothesis that a 6-week NMT program can enhance landing biomechanics associated with ACL injury in 11–13 year old female netball athletes. PMID:29163219

  5. Neuromuscular Training Improves Lower Extremity Biomechanics Associated with Knee Injury during Landing in 11–13 Year Old Female Netball Athletes: A Randomized Control Study

    Directory of Open Access Journals (Sweden)

    Amanda J. Hopper

    2017-11-01

    Full Text Available The purpose of this study was to examine the effects of a neuromuscular training (NMT program on lower-extremity biomechanics in youth female netball athletes. The hypothesis was that significant improvements would be found in landing biomechanics of the lower-extremities, commonly associated with anterior cruciate ligament (ACL injury, following NMT. Twenty-three athletes (age = 12.2 ± 0.9 years; height = 1.63 ± 0.08 m; mass = 51.8 ± 8.5 kg completed two testing sessions separated by 7-weeks and were randomly assigned to either a experimental or control group. Thirteen athletes underwent 6-weeks of NMT, while the remaining 10 served as controls and continued their regular netball training. Three-dimensional lower-extremity kinematics and vertical ground reaction force (VGRF were measured during two landing tasks, a drop vertical jump and a double leg broad jump with a single leg landing. The experimental group significantly increased bilateral knee marker distance during the bilateral landing task at maximum knee-flexion range of motion. Knee internal rotation angle during the unilateral landing task at maximum knee flexion-extension range of motion was significantly reduced (p ≤ 0.05, g > 1.00. The experimental group showed large, significant decreases in peak vertical ground reaction force in both landing tasks (p ≤ 0.05, g > −1.30. Control participants did not demonstrate any significant pre-to-post-test changes in response to the 6-week study period. Results of the study affirm the hypothesis that a 6-week NMT program can enhance landing biomechanics associated with ACL injury in 11–13 year old female netball athletes.

  6. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

    Directory of Open Access Journals (Sweden)

    João Fernando Lourenço de Almeida

    2000-06-01

    Full Text Available Neuromuscular blocking agents (NMBAs have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000 and active search of articles were the mechanisms used in this review.Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisar a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000 associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão.

  7. The role of proprioception and neuromuscular stability in carpal instabilities.

    Science.gov (United States)

    Hagert, E; Lluch, A; Rein, S

    2016-01-01

    Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities. © The Author(s) 2015.

  8. Patient-controlled positive end-expiratory pressure with neuromuscular disease: effect on speech in patients with tracheostomy and mechanical ventilation support.

    Science.gov (United States)

    Garguilo, Marine; Leroux, Karl; Lejaille, Michèle; Pascal, Sophie; Orlikowski, David; Lofaso, Frédéric; Prigent, Hélène

    2013-05-01

    Communication is a major issue for patients with tracheostomy who are supported by mechanical ventilation. The use of positive end-expiratory pressure (PEEP) may restore speech during expiration; however, the optimal PEEP level for speech may vary individually. We aimed to improve speech quality with an individually adjusted PEEP level delivered under the patient's control to ensure optimal respiratory comfort. Optimal PEEP level (PEEPeff), defined as the PEEP level that allows complete expiration through the upper airways, was determined for 12 patients with neuromuscular disease who are supported by mechanical ventilation. Speech and respiratory parameters were studied without PEEP, with PEEPeff, and for an intermediate PEEP level. Flow and airway pressure were measured. Microphone speech recordings were subjected to both quantitative and qualitative assessments of speech, including an intelligibility score, a perceptual score, and an evaluation of prosody determined by two speech therapists blinded to PEEP condition. Text reading time, phonation flow, use of the respiratory cycle for phonation, and speech comfort significantly improved with increasing PEEP, whereas qualitative parameters remained unchanged. This resulted mostly from the increase of the expiratory volume through the upper airways available for speech for all patients combined, with a rise in respiratory rate for nine patients. Respiratory comfort remained stable despite high levels of PEEPeff (median, 10.0 cm H2O; interquartile range, 9.5-12.0 cm H₂O). Patient-controlled PEEP allowed for the use of high levels of PEEP with good respiratory tolerance and significant improvement in speech (enabling phonation during the entire respiratory cycle in most patients). The device studied could be implemented in home ventilators to improve speech and, therefore, autonomy of patients with tracheostomy. ClinicalTrials.gov; No.: NCT01479959; URL: clinicaltrials.gov.

  9. Plyometric type neuromuscular exercise is a treatment to postural control deficits of volleyball players: A case study

    Directory of Open Access Journals (Sweden)

    A. Asadi

    2016-06-01

    Conclusions: It can be recommend that strength and conditioning professionals in the field of volleyball do not perform other type of landing exercise in plyometric training sessions because of postural control impaired and consequently the probability of lower extremity injuries will increase.

  10. Design of pilot-assisted load control valve with load velocity control ability and fast opening feature

    Directory of Open Access Journals (Sweden)

    Haibo Xie

    2015-11-01

    Full Text Available This article presents a design of pilot-assisted load control valve with load velocity control ability and fast opening feature based on static and dynamic modeling. Traditional load control valves do not have the load velocity control ability and its opening feature is very poor because the high spring stiffness comes along with the pressure–spring balance–based principle. Some improvement has been done by employing a two-stage pressure–pressure balance principle to make a load control valve to achieve load velocity control ability while the opening feature was not improved much. In this design, another pressure–pressure balance principle is proposed to make the load control valve achieve load velocity control ability and fast opening closing feature at the same time. Static modeling method based on force balance and Bernoulli orifice pressure-flow equation is used to design the load velocity control ability of the valve. Dynamic modeling method based on Newton’s second law and fluid continuity equation is used to optimize the parameters to give the proposed load control valve a fast opening feature. An actual load control valve was developed according to the above methods and the test results show both good load velocity control ability and fast opening feature of the design, which validates the potentiality of the proposed design in many applications.

  11. Augmented effects of EMG biofeedback interfaced with virtual reality on neuromuscular control and movement coordination during reaching in children with cerebral palsy.

    Science.gov (United States)

    Yoo, Ji Won; Lee, Dong Ryul; Cha, Young Joo; You, Sung Hyun

    2017-01-01

    The purpose of the present study was to compare therapeutic effects of an electromyography (EMG) biofeedback augmented by virtual reality (VR) and EMG biofeedback alone on the triceps and biceps (T:B) muscle activity imbalance and elbow joint movement coordination during a reaching motor taskOBJECTIVE: To compare therapeutic effects of an electromyography (EMG) biofeedback augmented by virtual reality (VR) and EMG biofeedback alone on the triceps and biceps muscle activity imbalance and elbow joint movement coordination during a reaching motor task in normal children and children with spastic cerebral palsy (CP). 18 children with spastic CP (2 females; mean±standard deviation = 9.5 ± 1.96 years) and 8 normal children (3 females; mean ± standard deviation = 9.75 ± 2.55 years) were recruited from a local community center. All children with CP first underwent one intensive session of EMG feedback (30 minutes), followed by one session of the EMG-VR feedback (30 minutes) after a 1-week washout period. Clinical tests included elbow extension range of motion (ROM), biceps muscle strength, and box and block test. EMG triceps and biceps (T:B) muscle activity imbalance and reaching movement acceleration coordination were concurrently determined by EMG and 3-axis accelerometer measurements respectively. Independent t-test and one-way repeated analysis of variance (ANOVA) were performed at p EMG biofeedback when augmented by virtual reality exercise games in children with spastic CP. The augmented EMG and VR feedback produced better neuromuscular balance control in the elbow joint than the EMG biofeedback alone.

  12. Increasing compliance with neuromuscular training to prevent ankle sprain in sport: does the 'Strengthen your ankle' mobile App make a difference? A randomised controlled trial.

    Science.gov (United States)

    Van Reijen, M; Vriend, I; Zuidema, V; van Mechelen, W; Verhagen, E A

    2016-10-01

    E-health has the potential to facilitate implementation of effective measures to prevent sports injuries. We evaluated whether an interactive mobile application containing a proven effective exercise programme to prevent recurrent ankle sprains resulted in higher compliance as compared with regular written exercise materials. 220 athletes participated in this randomised controlled trial with a follow-up of 8 weeks; 110 athletes received a booklet explaining an 8-week neuromuscular training programme; 110 athletes participated in the same programme in an interactive mobile App (Strengthen your ankle). The primary outcome was compliance with the exercise programme. Secondary outcome measure was the incidence density of self-reported recurrent ankle sprains. The mean compliance to the exercise scheme was 73.3% (95% CI 67.7% to 78.1%) in the App group, compared with 76.7% (95% CI 71.9% to 82.3%) in the Booklet group. No significant difference in compliance was found between groups. The incidence densities of self-reported time-loss recurrences were not significantly different between both groups (HR 3.07; 95% CI 0.62 to 15.20). This study shows that the method of implementing the exercises by using an App or a Booklet does not lead to different compliance rates. The use of a mobile App or a Booklet lead to similar compliance and injury rates in the short term. The Netherlands National Trial Register NTR 4027. The NTR is part of the WHO Primary Registries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Short-term microcurrent electrical neuromuscular stimulation to improve muscle function in the elderly: A randomized, double-blinded, sham-controlled clinical trial.

    Science.gov (United States)

    Kwon, Dong Rak; Kim, Jihoon; Kim, Yongmin; An, Sungho; Kwak, Jinmyoung; Lee, Sungjae; Park, Suyeon; Choi, Yoon Hee; Lee, Yang Kyun; Park, Ji Woong

    2017-06-01

    Microcurrent electrical neuromuscular stimulation (MENS) has been suggested to improve muscle function and restore damaged muscle. However, current evidence is insufficient to determine the effectiveness of this therapy in age-dependent muscle weakness. Therefore, a prospective, randomized, double-blinded, sham-controlled clinical trial was designed to evaluate the effects of short-term MENS on muscle function in the elderly. A total of 38 healthy elderly participants aged 65 years and above were enrolled and randomly divided into 2 stimulation groups: real or sham MENS group. Real or sham MENS were applied to the 8 anatomical points of the dominant arm and leg during the course of 40 minutes. We performed muscle function tests at baseline and after the intervention: the handgrip strength tests (HGS, kg), the root mean square values (RMS, μV), and the single leg heel-rise tests (HRT) to determine changes in the strength, activity, and endurance of the elderly muscle, respectively. In the real MENS group, the mean values of the HGS and the number of plantar flexions were significantly increased, but the RMS value of the electromyography signal was significantly decreased after the real intervention (P < .05). However, the sham MENS group showed a significant decrease in the number of plantar flexions and the total time for HRT after the sham stimulation (P < .05). The mean difference in the RMS value was significantly lower, but the number of plantar flexions and the total time for HRT was significantly higher in the real MENS group than in the sham MENS group (P < .05). The findings suggest that short-term application of MENS may play a partial role in enhancing physical activities of the elderly, as it can improve some muscle function.

  14. The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis: a randomized, single-blind, controlled trial.

    Science.gov (United States)

    Holsgaard-Larsen, A; Clausen, B; Søndergaard, J; Christensen, R; Andriacchi, T P; Roos, E M

    2017-04-01

    To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Ninety three participants (57% women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index -0.07 [-0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  15. Neuromuscular blocking agents in patients with acute respiratory distress syndrome: a summary of the current evidence from three randomized controlled trials

    NARCIS (Netherlands)

    Serpa Neto, Ary; Pereira, Victor Galvão Moura; Espósito, Daniel Crepaldi; Damasceno, Maria Cecília Toledo; Schultz, Marcus J.

    2012-01-01

    Background: Acute respiratory distress syndrome (ARDS) is a potentially fatal disease with high mortality. Our aim was to summarize the current evidence for use of neuromuscular blocking agents (NMBA) in the early phase of ARDS. Methods: Systematic review and meta-analysis of publications between

  16. Functional Neuromuscular Stimulation Controlled by Surface Electromyographic Signals Produced by the Volitional Activation of the Same Muscle:

    DEFF Research Database (Denmark)

    Sennels, Søren; Fin, Biering-Sørensen; Andersen, Ole Trier

    1997-01-01

    Using the voluntary EMG as a control signal for the stimulation of the same muscle necessitates elimination of stimulus artifacts and the muscle response caused by the stimulation. The stimulus artifacts are easily eliminated by shutting down the amplifier during stimulation. The muscle response...... is a non-stationary signal, therefore an adaptive linear prediction filter is proposed. The filter is derived and tested for three filter lengths on both simulated and real data. The performance is compared with a conventional fixed comb filter. The simulations indicate that the adaptive filter...... comparable with the background noise. It is thus possible to extract the voluntary EMG from a partly paralysed muscle and use it for controlling the stimulation of the same muscle....

  17. Locus of Control, Academic Self-Concept, and Academic Dishonesty among High Ability College Students

    Science.gov (United States)

    Rinn, Anne N.; Boazman, Janette

    2014-01-01

    The purposes of the current study were to evaluate a measure of academic dishonesty and examine high ability college students' loci of control and its effect on behaviors of academic dishonesty, as moderated by academic self-concept. A total of 357 high ability college students enrolled at two universities in the southwestern United States took…

  18. Non-invasive neuromuscular electrical stimulation in patients with central nervous system lesions: an educational review

    National Research Council Canada - National Science Library

    Schuhfried, Othmar; Crevenna, Richard; Fialka-Moser, Veronika; Paternostro-Sluga, Tatjana

    2012-01-01

    ...) functional electrical stimulation. Therapeutic electrical stimulation improves neuromuscular functional condition by strengthening muscles, increasing motor control, reducing spasticity, decreasing pain and increasing range of motion...

  19. Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial.

    Science.gov (United States)

    Janssen, Kasper W; van Mechelen, Willem; Verhagen, Evert A L M

    2014-08-01

    Ankle sprain is the most common sports-related injury with a high rate of recurrence and associated costs. Recent studies have emphasised the effectiveness of both neuromuscular training and bracing for the secondary prevention of ankle sprains. To evaluate the effectiveness of combined bracing and neuromuscular training, or bracing alone, against the use of neuromuscular training on recurrences of ankle sprain after usual care. 384 athletes, aged 18-70, who had sustained a lateral ankle sprain, were included (training group n=120; brace group n=126; combi group n=138). The training group received an 8-week home-based neuromuscular training programme, the brace group received a semirigid ankle brace to be worn during all sports activities for 12 months, and the combi group received both the training programme, as well as the ankle brace, to be worn during all sports activities for 8 weeks. The main outcome measure was self-reported recurrence of the ankle sprain. During the 1-year follow-up, 69 participants (20%) reported a recurrent ankle sprain: 29 (27%) in the training group, 17 (15%) in the brace group and 23 (19%) in the combi group. The relative risk for a recurrent ankle sprain in the brace group versus the training group was 0.53 (95% CI 0.29 to 0.97). No significant differences were found for time losses or costs due to ankle sprains between the intervention groups. Bracing was superior to neuromuscular training in reducing the incidence but not the severity of self-reported recurrent ankle sprains after usual care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. The effect of shoe design and lateral wedges on knee load and neuromuscular control in healthy subjects during walking

    DEFF Research Database (Denmark)

    Mølgaard, Carsten; Kersting, Uwe G.

    2014-01-01

    design/type on the effectiveness of lateral wedging has not been investigated so far. The Purpose of the present study was to explore alterations in knee loading due to lateral foot wedges in three different shoes. Methods: Thirteen healthy participants with no history of knee pain were tested using...... wedging is effective regardless of shoe design. Differences between the three neutral walking conditions underline the importance of footwear choice in individuals. It is safe to apply lateral wedges without jeopardising muscular control during walking regardless of shoe type. Possible effects of altering...... three-dimensional gait analysis. Barefoot walking, walking in a running shoe, an Oxford-type leather shoe, and a rocker shoe were analysed. The shoes were tested both with and without a 10-degree full-length laterally wedged insole. Results: There were significant shoe wedge interactions on the first...

  1. ANS acuity and mathematics ability in preschoolers from low-income homes: contributions of inhibitory control.

    Science.gov (United States)

    Fuhs, Mary Wagner; McNeil, Nicole M

    2013-01-01

    Recent findings by Libertus, Feigenson, and Halberda (2011) suggest that there is an association between the acuity of young children's approximate number system (ANS) and their mathematics ability before exposure to instruction in formal schooling. The present study examined the generalizability and validity of these findings in a sample of preschoolers from low-income homes. Children attending Head Start (N = 103) completed measures to assess ANS acuity, mathematics ability, receptive vocabulary, and inhibitory control. Results showed only a weak association between ANS acuity and mathematics ability that was reduced to non-significance when controlling for a direct measure of receptive vocabulary. Results also revealed that inhibitory control plays an important role in the relation between ANS acuity and mathematics ability. Specifically, ANS acuity accounted for significant variance in mathematics ability over and above receptive vocabulary, but only for ANS acuity trials in which surface area conflicted with numerosity. Moreover, this association became non-significant when controlling for inhibitory control. These results suggest that early mathematical experiences prior to formal schooling may influence the strength of the association between ANS acuity and mathematics ability and that inhibitory control may drive that association in young children. © 2012 Blackwell Publishing Ltd.

  2. Coping with examinations: exploring relationships between students' coping strategies, implicit theories of ability, and perceived control.

    Science.gov (United States)

    Doron, Julie; Stephan, Yannick; Boiché, Julie; Le Scanff, Christine

    2009-09-01

    Relatively little is known about the contribution of students' beliefs regarding the nature of academic ability (i.e. their implicit theories) on strategies used to deal with examinations. This study applied Dweck's socio-cognitive model of achievement motivation to better understand how students cope with examinations. It was expected that students' implicit theories of academic ability would be related to their use of particular coping strategies to deal with exam-related stress. Additionally, it was predicted that perceived control over exams acts as a mediator between implicit theories of ability and coping. Four hundred and ten undergraduate students (263 males, 147 females), aged from 17 to 26 years old (M=19.73, SD=1.46) were volunteers for the present study. Students completed measures of coping, implicit theories of academic ability, and perception of control over academic examinations during regular classes in the first term of the university year. Multiple regression analyses revealed that incremental beliefs of ability significantly and positively predicted active coping, planning, venting of emotions, seeking social support for emotional and instrumental reasons, whereas entity beliefs positively predicted behavioural disengagement and negatively predicted active coping and acceptance. In addition, analyses revealed that entity beliefs of ability were related to coping strategies through students' perception of control over academic examinations. These results confirm that exam-related coping varies as a function of students' beliefs about the nature of academic ability and their perceptions of control when approaching examinations.

  3. Cognitive abilities, monitoring, and control explain individual differences in heuristics and biases

    Directory of Open Access Journals (Sweden)

    Simon Anthony Jackson

    2016-10-01

    Full Text Available In this paper, we investigate whether individual differences in performance on heuristic and biases tasks can be explained by cognitive abilities, monitoring confidence and control thresholds. Current theories explain individual differences in these tasks by the ability to detect errors and override automatic but biased judgements, and deliberative cognitive abilities that help to construct the correct response. Here we retain cognitive abilities but disentangle error detection, proposing that lower monitoring confidence and higher control thresholds promote error checking. Participants (N = 250 completed tasks assessing their fluid reasoning abilities, stable monitoring confidence levels, and the control threshold they impose on their decisions. They also completed seven typical heuristic and biases tasks such as the cognitive reflection test and resistance to framing. Using structural equation modelling, we found that individuals with higher reasoning abilities, lower monitoring confidence and higher control threshold performed significantly and, at times, substantially better on the heuristic and biases tasks. Individuals with higher control thresholds also showed lower preferences for risky alternatives in a gambling task. Furthermore, residual correlations among the heuristic and biases tasks were reduced to null, indicating that cognitive abilities, monitoring confidence and control thresholds accounted for their shared variance. Implications include the proposal that the capacity to detect errors does not differ between individuals. Rather, individuals might adopt varied strategies that promote error checking to different degrees, regardless of whether they have made a mistake or not. The results support growing evidence that decision making involves cognitive abilities that construct actions and monitoring and control processes that manage their initiation.

  4. Cognitive Abilities, Monitoring Confidence, and Control Thresholds Explain Individual Differences in Heuristics and Biases.

    Science.gov (United States)

    Jackson, Simon A; Kleitman, Sabina; Howie, Pauline; Stankov, Lazar

    2016-01-01

    In this paper, we investigate whether individual differences in performance on heuristic and biases tasks can be explained by cognitive abilities, monitoring confidence, and control thresholds. Current theories explain individual differences in these tasks by the ability to detect errors and override automatic but biased judgments, and deliberative cognitive abilities that help to construct the correct response. Here we retain cognitive abilities but disentangle error detection, proposing that lower monitoring confidence and higher control thresholds promote error checking. Participants ( N = 250) completed tasks assessing their fluid reasoning abilities, stable monitoring confidence levels, and the control threshold they impose on their decisions. They also completed seven typical heuristic and biases tasks such as the cognitive reflection test and Resistance to Framing. Using structural equation modeling, we found that individuals with higher reasoning abilities, lower monitoring confidence, and higher control threshold performed significantly and, at times, substantially better on the heuristic and biases tasks. Individuals with higher control thresholds also showed lower preferences for risky alternatives in a gambling task. Furthermore, residual correlations among the heuristic and biases tasks were reduced to null, indicating that cognitive abilities, monitoring confidence, and control thresholds accounted for their shared variance. Implications include the proposal that the capacity to detect errors does not differ between individuals. Rather, individuals might adopt varied strategies that promote error checking to different degrees, regardless of whether they have made a mistake or not. The results support growing evidence that decision-making involves cognitive abilities that construct actions and monitoring and control processes that manage their initiation.

  5. Relationship between neuromuscular body functions and upper extremity activity in children with cerebral palsy.

    Science.gov (United States)

    Braendvik, Siri M; Elvrum, Ann-Kristin G; Vereijken, Beatrix; Roeleveld, Karin

    2010-02-01

    Our aim was to investigate the relationship between the dimensions of neuromuscular body function and elbow, forearm, and hand activity in the upper extremities in children/adolescents with spastic cerebral palsy (CP), within the framework of the World Health Organization International Classification of Functioning, Disability and Health. Twenty-three participants (10 males, 13 females, mean age 13y, SD 3y, range 8-18y) with spastic CP (21 with hemiplegia, two with diplegia) at Manual Ability Classification System levels I to III participated in the study. Neuromuscular body function measures were (1) muscle strength in the elbow, forearm, and grip, (2) muscle tone in elbow flexors and forearm supinators, (3) active supination range and elbow extension range, and (4) force control at submaximal level in elbow flexion. Activity measures were actual use of the affected hand in bimanual activities (Assisting Hand Assessment) and instructed use of the affected hand (Melbourne Assessment of Unilateral Upper Limb Function). Nearly all the neuromuscular body function variables were significantly correlated with activity. The combination of active supination range and strength explained 74% of the variance in actual use, and the combination of active supination range and force control explained 74% of the variance in instructed use. In high-functioning children and adolescents with CP, limited active supination range and difficulties in generating and modulating force are strongly related to limitations in hand activity. Further studies are needed to establish cause and effect in this relationship.

  6. Effects of avoiding neuromuscular blocking agents during maintenance of anaesthesia on recovery characteristics in patients undergoing craniotomy for supratentorial lesions: A randomised controlled study

    Directory of Open Access Journals (Sweden)

    Ruchi A Jain

    2017-01-01

    Full Text Available Background and Aims: Neuromuscular blocking agents have been one of the cornerstones of anaesthesia. With the advent of newer surgical, anaesthetic and neurological monitoring techniques, their utility in neuroanaesthesia practice seems dispensable. The aim of this prospective, comparative, randomised study was to determine whether neuromuscular blocking agents are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used. Methods: Sixty patients with the American Society of Anesthesiologists physical status I or II, aged between 18 and 60 years were included in the study. All patients received anaesthesia including desflurane, dexmedetomidine and scalp block. The patients were randomly allocated to receive no neuromuscular blocking agent (Group A or atracurium infusion to keep train-of-four count 2 (Group B. The two groups were compared with respect to haemodynamic stability, brain relaxation scores and recovery characteristics. Haemodynamic parameters and time taken to achieve Aldrete score >9 and other secondary outcomes were analysed using Student's t-test. Non-parametric data were analysed using the Mann–Whitney test. Results: The mean arterial pressure was comparable between the groups. The intraoperative heart rate was comparable; however, in the post-operative period, it remained higher in Group B for 30 min after extubation (P = 0.02. The brain relaxation scores were comparable among the two groups (P = 0.27. Tracheal extubation time, time taken for orientation and time required to reach Aldrete score ≥9 were comparable among the two groups. Conclusion: The present study suggests that balanced anaesthesia using desflurane, dexmedetomidine and scalp block can preclude the use of neuromuscular blocking agents in patients undergoing supratentorial surgery under intense haemodynamic monitoring.

  7. Effect of EMG-triggered neuromuscular electrical stimulation with bilateral arm training on hemiplegic shoulder pain and arm function after stroke: a randomized controlled trial.

    Science.gov (United States)

    Chuang, Li-Ling; Chen, You-Lin; Chen, Chih-Chung; Li, Yen-Chen; Wong, Alice May-Kuen; Hsu, An-Lun; Chang, Ya-Ju

    2017-11-28

    Hemiplegic shoulder pain is a frequent complication after stroke, leading to limited use of the affected arm. Neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS) are two widely used interventions to reduce pain, but the comparative efficacy of these two modalities remains uncertain. The purpose of this research was to compare the immediate and retained effects of EMG-triggered NMES and TENS, both in combination with bilateral arm training, on hemiplegic shoulder pain and arm function of stroke patients. A single-blind, randomized controlled trial was conducted at two medical centers. Thirty-eight patients (25 males and 13 females, 60.75 ± 10.84 years old, post stroke duration 32.68 ± 53.07 months) who had experienced a stroke more than 3 months ago at the time of recruitment and hemiplegic shoulder pain were randomized to EMG-triggered NMES or TENS. Both groups received electrical stimulation followed by bilateral arm training 3 times a week for 4 weeks. The primary outcome measures included a vertical Numerical Rating Scale supplemented with a Faces Rating Scale, and the short form of the Brief Pain Inventory. The secondary outcome measures were the upper-limb subscale of the Fugl-Meyer Assessment, and pain-free passive shoulder range of motion. All outcomes were measured pretreatment, post-treatment, and at 1-month after post-treatment. Two-way mixed repeated measures ANOVAs were used to examine treatment effects. Compared to TENS with bilateral arm training, the EMG-triggered NMES with bilateral arm training was associated with lower pain intensity during active and passive shoulder movement (P =0.007, P =0.008), lower worst pain intensity (P = 0.003), and greater pain-free passive shoulder abduction (P =0.001) and internal rotation (P =0.004) at follow-up. Both groups improved in pain at rest (P =0.02), pain interference with daily activities, the Fugl-Meyer Assessment, and pain-free passive

  8. Measures of Dogs' Inhibitory Control Abilities Do Not Correlate across Tasks

    Directory of Open Access Journals (Sweden)

    Désirée Brucks

    2017-05-01

    Full Text Available Inhibitory control, the ability to overcome prepotent but ineffective behaviors, has been studied extensively across species, revealing the involvement of this ability in many different aspects of life. While various different paradigms have been created in order to measure inhibitory control, only a limited number of studies have investigated whether such measurements indeed evaluate the same underlying mechanism, especially in non-human animals. In humans, inhibitory control is a complex construct composed of distinct behavioral processes rather than of a single unified measure. In the current study, we aimed to investigate the validity of inhibitory control paradigms in dogs. Sixty-seven dogs were tested in a battery consisting of frequently used inhibitory control tests. Additionally, dog owners were asked to complete an impulsivity questionnaire about their dog. No correlation of dogs' performance across tasks was found. In order to understand whether there are some underlying behavioral aspects explaining dogs' performance across tests, we performed principle component analyses. Results revealed that three components (persistency, compulsivity and decision speed explained the variation across tasks. The questionnaire and dogs' individual characteristics (i.e., age and sex provided only limited information for the derived components. Overall, results suggest that no unique measurement for inhibitory control exists in dogs, but tests rather measure different aspects of this ability. Considering the context-specificity of inhibitory control in dogs and most probably also in other non-human animals, extreme caution is needed when making conclusions about inhibitory control abilities based on a single test.

  9. Teachers' voice disorders and loss of work ability: a case-control study.

    Science.gov (United States)

    Giannini, Susana Pimentel Pinto; Latorre, Maria do Rosário Dias de Oliveira; Fischer, Frida Marina; Ghirardi, Ana Carolina de Assis Moura; Ferreira, Léslie Piccolotto

    2015-03-01

    Teachers constitute a profession with a high occurrence of voice disorders due to the occupation's intense vocal demands and unfavorable work environment. To identify the association between voice disorders and work ability among teachers from public schools in São Paulo, Brazil. This is a case-control study. The case group comprised teachers with voice disorder complaints, vocal quality deviations in speech pathology evaluations, and vocal fold lesions according to an evaluation by an otorhinolaryngologist. The control group was randomly selected from the same schools as those in the case group. Both groups answered the following questionnaires: sociodemographic, lifestyles, working conditions, work organization, conditions of vocal production-teacher (CVP-T), and Work Ability Index (WAI). The analysis used the chi-square association test and univariate and multivariate regression models. The analyses of both groups showed comparable populations with no significant differences in the demographic and control variables. The groups differed, as expected, in vocal symptoms. Analyzing associations with the WAI, there was an association between decreased work ability and voice disorder (P voice disorders. Analyzing the ability to work, age, and acoustics; decreased (OR = 12.2, P voice disorders. The occurrence of voice disorders is significantly associated with work ability, which may eventually compromise teachers' ability to continue working. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. Why are they late? Timing abilities and executive control among students with learning disabilities.

    Science.gov (United States)

    Grinblat, Nufar; Rosenblum, Sara

    2016-12-01

    While a deficient ability to perform daily tasks on time has been reported among students with learning disabilities (LD), the underlying mechanism behind their 'being late' is still unclear. This study aimed to evaluate the organization in time, time estimation abilities, actual performance time pertaining to specific daily activities, as well as the executive functions of students with LD in comparison to those of controls, and to assess the relationships between these domains among each group. The participants were 27 students with LD, aged 20-30, and 32 gender and age-matched controls who completed the Time Organization and Participation Scale (TOPS) and the Behavioral Rating Inventory of Executive Function-Adult version (BRIEF-A). In addition, their ability to estimate the time needed to complete the task of preparing a cup of coffee as well as their actual performance time were evaluated. The results indicated that in comparison to controls, students with LD showed significantly inferior organization in time (TOPS) and executive function abilities (BRIEF-A). Furthermore, their time estimation abilities were significantly inferior and they required significantly more time to prepare a cup of coffee. Regression analysis identified the variables that predicted organization in time and task performance time among each group. The significance of the results for both theoretical and clinical implications are discussed. What this paper adds? This study examines the underlying mechanism of the phenomena of being late among students with LD. Following a recent call for using ecologically valid assessments, the functional daily ability of students with LD to prepare a cup of coffee and to organize time were investigated. Furthermore, their time estimation and executive control abilities were examined as a possible underlying mechanism for their lateness. Although previous studies have indicated executive control deficits among students with LD, to our knowledge, this

  11. Autoantibodies in neuromuscular transmission disorders

    National Research Council Canada - National Science Library

    Vincent, Angela

    2008-01-01

    .... The neuromuscular junction (NMJ) is the site of a number of different autoimmune and genetic disorders, and it is also the target of many neurotoxins from venomous snakes, spiders, scorpions and other species...

  12. Balance ability and postural stability among patients with painful shoulder disorders and healthy controls.

    Science.gov (United States)

    Baierle, Tobias; Kromer, Thilo; Petermann, Carmen; Magosch, Petra; Luomajoki, Hannu

    2013-10-02

    In therapeutic settings, patients with shoulder pain often exhibit deficient coordinative abilities in their trunk and lower extremities. The aim of the study was to investigate 1) if there is a connection between shoulder pain and deficits in balance ability and postural stability, 2) if pain intensity is related to balance ability and postural stability, and 3) if there is a connection between body mass index (BMI) and balance ability and postural stability. In this case-control study, patients (n = 40) with pathological shoulder pain (> 4 months) were matched with a healthy controls (n = 40) and were compared with regard to their balance ability and postural stability. Outcome parameters were postural stability, balance ability and symmetry index which were measured using the S3-Check system. In addition, the influence of shoulder pain intensity and BMI on the outcome parameters was analysed. Patients with shoulder pain showed significantly worse results in measurements of postural stability right/left (p shoulder pain group. There was no correlation between pain intensity and measurements of balance ability or postural stability. Likewise, no correlation between BMI and deficiencies in balance ability and postural stability was established. Patients with pathological shoulder pain (> 4 months) have deficiencies in balance ability and postural stability; however the underlying mechanisms for this remain unclear. Neither pain intensity nor BMI influenced the outcome parameters. Patients with shoulder pain shift their weight to the affected side. Further research is needed to determine if balance training can improve rehabilitation results in patients with shoulder pathologies.

  13. ECHNOLOGICAL PROVISIONING OF TEST CONTROL OF SPECIAL HEALTH GROUP STUDENTS’ POWER ABILITIES

    Directory of Open Access Journals (Sweden)

    Koryahin V.M.

    2016-02-01

    Full Text Available Purpose: to substantiate and realize modern electronic technological means for perfection of test control of students’ power abilities in special health groups. Material: materials of students’ test control have been used in the research. Results: we have developed electronic system for test monitoring of students’ power abilities. Besides, we showed possibilities of innovative automated methodic application for test monitoring of students’ power abilities. Strict regulation of monitoring significantly decreases dispersion of error and raises reliability of test. The mentioned monitoring system removes dependence of result on teacher’s subjective perception of information. Conclusions: Implementation of the offered system of monitoring of students’ power abilities’ functional state ensures promptness of confident testing results’ reception. It will facilitate effectiveness of control in students’ physical education.

  14. The effects of a strength and neuromuscular exercise programme for the lower extremity on knee load, pain and function in obese children and adolescents: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Horsak, Brian; Artner, David; Baca, Arnold; Pobatschnig, Barbara; Greber-Platzer, Susanne; Nehrer, Stefan; Wondrasch, Barbara

    2015-12-23

    Childhood obesity is one of the most critical and accelerating health challenges throughout the world. It is a major risk factor for developing varus/valgus misalignments of the knee joint. The combination of misalignment at the knee and excess body mass may result in increased joint stresses and damage to articular cartilage. A training programme, which aims at developing a more neutral alignment of the trunk and lower limbs during movement tasks may be able to reduce knee loading during locomotion. Despite the large number of guidelines for muscle strength training and neuromuscular exercises that exist, most are not specifically designed to target the obese children and adolescent demographic. Therefore, the aim of this study is to evaluate a training programme which combines strength and neuromuscular exercises specifically designed to the needs and limitations of obese children and adolescents and analyse the effects of the training programme from a biomechanical and clinical point of view. A single assessor-blinded, pre-test and post-test randomised controlled trial, with one control and one intervention group will be conducted with 48 boys and girls aged between 10 and 18 years. Intervention group participants will receive a 12-week neuromuscular and quadriceps/hip strength training programme. Three-dimensional (3D) gait analyses during level walking and stair climbing will be performed at baseline and follow-up sessions. The primary outcome parameters for this study will be the overall peak external frontal knee moment and impulse during walking. Secondary outcomes include the subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS), frontal and sagittal kinematics and kinetics for the lower extremities during walking and stair climbing, ratings of change in knee-related well-being, pain and function and adherence to the training programme. In addition, the training programme will be evaulated from a clinical and health status perspective by

  15. Effects of carbohydrates-BCAAs-caffeine ingestion on performance and neuromuscular function during a 2-h treadmill run: a randomized, double-blind, cross-over placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Peltier Sébastien L

    2011-12-01

    Full Text Available Abstract Background Carbohydrates (CHOs, branched-chain amino acids (BCAAs and caffeine are known to improve running performance. However, no information is available on the effects of a combination of these ingredients on performance and neuromuscular function during running. Methods The present study was designed as a randomized double-blind cross-over placebo-controlled trial. Thirteen trained adult males completed two protocols, each including two conditions: placebo (PLA and Sports Drink (SPD: CHOs 68.6 g.L-1, BCAAs 4 g.L-1, caffeine 75 mg.L-1. Protocol 1 consisted of an all-out 2 h treadmill run. Total distance run and glycemia were measured. In protocol 2, subjects exercised for 2 h at 95% of their lowest average speeds recorded during protocol 1 (whatever the condition. Glycemia, blood lactate concentration and neuromuscular function were determined immediately before and after exercise. Oxygen consumption (V˙O2, heart rate (HR and rate of perceived exertion (RPE were recorded during the exercise. Total fluids ingested were 2 L whatever the protocols and conditions. Results Compared to PLA, ingestion of SPD increased running performance (p = 0.01, maintained glycemia and attenuated central fatigue (p = 0.04, an index of peripheral fatigue (p = 0.04 and RPE (p = 0.006. Maximal voluntary contraction, V˙O2, and HR did not differ between the two conditions. Conclusions This study showed that ingestion of a combination of CHOs, BCAAs and caffeine increased performance by about 2% during a 2-h treadmill run. The results of neuromuscular function were contrasted: no clear cut effects of SPD were observed. Trial registration ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT00799630

  16. Relationships between mind-wandering and attentional control abilities in young adults and adolescents.

    Science.gov (United States)

    Stawarczyk, David; Majerus, Steve; Catale, Corinne; D'Argembeau, Arnaud

    2014-05-01

    Recent findings suggest that mind-wandering-the occurrence of thoughts that are both stimulus-independent and task-unrelated-corresponds to temporary failures in attentional control processes involved in maintaining constant task-focused attention. Studies supporting this proposal are, however, limited by a possible confound between mind-wandering episodes and other kinds of conscious experiences, such as external distractions (i.e., interoceptive sensations and exteroceptive perceptions). In the present study, we addressed this issue by examining, in adolescents and young adults, the relations between tasks measuring attentional control abilities and a measure of mind-wandering that is distinct from external distractions. We observed (1) that adolescents experienced more frequent external distractions, but not more mind-wandering, than young adults during the Sustained Attention to Response Task (SART) and (2) that, in young adults, the influence of external distractions on SART performance was fully accounted for by attentional control abilities, whereas mind-wandering was associated with decreases in SART performance above and beyond what was explained by attentional control abilities. These results show that mind-wandering cannot be entirely reduced to failures in the ability to maintain one's attention focused on task, and suggest that external distractions rather than mind-wandering are due to attentional control failures. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Cognitive predictors of a common multitasking ability: Contributions from working memory, attention control, and fluid intelligence.

    Science.gov (United States)

    Redick, Thomas S; Shipstead, Zach; Meier, Matthew E; Montroy, Janelle J; Hicks, Kenny L; Unsworth, Nash; Kane, Michael J; Hambrick, D Zachary; Engle, Randall W

    2016-11-01

    Previous research has identified several cognitive abilities that are important for multitasking, but few studies have attempted to measure a general multitasking ability using a diverse set of multitasks. In the final dataset, 534 young adult subjects completed measures of working memory (WM), attention control, fluid intelligence, and multitasking. Correlations, hierarchical regression analyses, confirmatory factor analyses, structural equation models, and relative weight analyses revealed several key findings. First, although the complex tasks used to assess multitasking differed greatly in their task characteristics and demands, a coherent construct specific to multitasking ability was identified. Second, the cognitive ability predictors accounted for substantial variance in the general multitasking construct, with WM and fluid intelligence accounting for the most multitasking variance compared to attention control. Third, the magnitude of the relationships among the cognitive abilities and multitasking varied as a function of the complexity and structure of the various multitasks assessed. Finally, structural equation models based on a multifaceted model of WM indicated that attention control and capacity fully mediated the WM and multitasking relationship. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Comparison of effects of static, proprioceptive neuromuscular facilitation and Mulligan stretching on hip flexion range of motion: a randomized controlled trial

    OpenAIRE

    MS Yıldırım; S Ozyurek; OÇ Tosun; Uzer, S; Gelecek, N.

    2016-01-01

    The aim of this study was to compare the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching and Mulligan technique on hip flexion range of motion (ROM) in subjects with bilateral hamstring tightness. A total of 40 students (mean age: 21.5±1.3 years, mean body height: 172.8±8.2 cm, mean body mass index: 21.9±3.0 kg • m-2) with bilateral hamstring tightness were enrolled in this randomized trial, of whom 26 completed the study. Subjects were divided into 4 ...

  19. Neuromuscular disease classification system

    Science.gov (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M.; Serrano, Carmen

    2013-06-01

    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns.

  20. Singing ability is rooted in vocal-motor control of pitch.

    Science.gov (United States)

    Hutchins, Sean; Larrouy-Maestri, Pauline; Peretz, Isabelle

    2014-11-01

    The inability to vocally match a pitch can be caused by poor pitch perception or by poor vocal-motor control. Although previous studies have tried to examine the relationship between pitch perception and vocal production, they have failed to control for the timbre of the target to be matched. In the present study, we compare pitch-matching accuracy with an unfamiliar instrument (the slider) and with the voice, designed such that the slider plays back recordings of the participant's own voice. We also measured pitch accuracy in singing a familiar melody ("Happy Birthday") to assess the relationship between single-pitch-matching tasks and melodic singing. Our results showed that participants (all nonmusicians) were significantly better at matching recordings of their own voices with the slider than with their voice, indicating that vocal-motor control is an important limiting factor on singing ability. We also found significant correlations between the ability to sing a melody in tune and vocal pitch matching, but not pitch matching on the slider. Better melodic singers also tended to have higher quality voices (as measured by acoustic variables). These results provide important evidence about the role of vocal-motor control in poor singing ability and demonstrate that single-pitch-matching tasks can be useful in measuring general singing abilities.

  1. The Effects of Control for Ability Level on EFL Reading of Graded Readers

    Science.gov (United States)

    Wan-a-rom, Udorn

    2012-01-01

    The study was aimed to examine how EFL learners of English reacted to graded readers in terms of reading strategy use, comprehension, speed, and attitude as well as motivation when control for ability level was determined. Eighty Thai high school students placed into their own reading level of graded readers by the scores gained from the graded…

  2. Impaired Synaptic Development, Maintenance, and Neuromuscular Transmission in LRP4-Related Myasthenia.

    Science.gov (United States)

    Selcen, Duygu; Ohkawara, Bisei; Shen, Xin-Ming; McEvoy, Kathleen; Ohno, Kinji; Engel, Andrew G

    2015-08-01

    Congenital myasthenic syndromes (CMS) are heterogeneous disorders. Defining the phenotypic features, genetic basis, and pathomechanisms of a CMS is relevant to prognosis, genetic counseling, and therapy. To characterize clinical, structural, electrophysiologic, and genetic features of a CMS and to search for optimal therapy. Two sisters with CMS affecting the limb-girdle muscles were investigated between 2012 and 2014 at an academic medical center by clinical observation, in vitro analysis of neuromuscular transmission, cytochemical and electron microscopy studies of the neuromuscular junction, exome sequencing, expression studies in HEK293 and COS7 cells, and for response to therapy, and they were compared with 15 historical control participants. We identified the disease gene and mutation, confirmed pathogenicity of the mutation by expression studies, and instituted optimal pharmacotherapy. Quantitative analysis of single EP regions was done for all 15 control participants and microelectrode studies of neuromuscular transmission and α-bgt binding sites per EP was conducted for 13 control participants. Examination of the older sister's intercostal muscle end plates (EPs) showed them to be abnormally small, with attenuated reactivities for the acetylcholine receptor and acetylcholinesterase. Most EPs had poorly differentiated or degenerate junctional folds, and some appeared denuded of nerve terminals. The amplitude of the EP potential (EPP), the miniature EPP, and the quantal content of the EPP were all markedly reduced. Exome sequencing identified a novel homozygous p.Glu1233Ala mutation in low-density lipoprotein receptor-related protein 4 (LRP4), a coreceptor for agrin to activate muscle-specific tyrosine kinase (MuSK), which is required for EP development and maintenance. Expression studies indicate that the mutation compromises the ability of LRP4 to bind to, phosphorylate, and activate MuSK. Treatment with albuterol sulfate improved the patients' symptoms

  3. Neuromuscular Activity and Knee Kinematics in Adolescents with Patellofemoral Pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

  4. Relationship between static postural control and the level of functional abilities in children with cerebral palsy

    Science.gov (United States)

    Pavão, Sílvia L.; Nunes, Gabriela S.; Santos, Adriana N.; Rocha, Nelci A. C. F.

    2014-01-01

    Background: Postural control deficits can impair functional performance in children with cerebral palsy (CP) in daily living activities. Objective: To verify the relationship between standing static postural control and the functional ability level in children with CP. Method: The postural control of 10 children with CP (gross motor function levels I and II) was evaluated during static standing on a force platform for 30 seconds. The analyzed variables were the anteroposterior (AP) and mediolateral (ML) displacement of the center of pressure (CoP) and the area and velocity of the CoP oscillation. The functional abilities were evaluated using the mean Pediatric Evaluation of Disability Inventory (PEDI) scores, which evaluated self-care, mobility and social function in the domains of functional abilities and caregiver assistance. Results: Spearman's correlation test found a relationship between postural control and functional abilities. The results showed a strong negative correlation between the variables of ML displacement of CoP, the area and velocity of the CoP oscillation and the PEDI scores in the self-care and caregiver assistance domains. Additionally, a moderate negative correlation was found between the area of the CoP oscillation and the mobility scores in the caregiver assistance domain. We used a significance level of 5% (p <0.05). Conclusions: We observed that children with cerebral palsy with high CoP oscillation values had lower caregiver assistance scores for activities of daily living (ADL) and consequently higher levels of caregiver dependence. These results demonstrate the repercussions of impairments to the body structure and function in terms of the activity levels of children with CP such that postural control impairments in these children lead to higher requirements for caregiver assistance. PMID:25054383

  5. Faces presenting sadness enhance self-control abilities in gifted adolescents.

    Science.gov (United States)

    Urben, Sébastien; Camos, Valérie; Habersaat, Stéphanie; Stéphan, Philippe

    2018-02-23

    Self-regulation skills refer to processes allowing emotional and cognitive adaptation of the individual. Some gifted adolescents are known for their imbalance between high intellectual abilities and low emotional skills. Thus, this study aimed at examining the interplay between emotion and cognition in gifted and non-gifted adolescents. A stop-signal task, a response inhibition task including neutral, happy, or sad faces as signal triggering inhibition, was administered to 19 gifted and 20 typically developing male adolescents (12-18 years old). Gifted adolescents showed lower response inhibition abilities than non-gifted adolescents in the neutral and happy face conditions. Sad faces in gifted adolescents were associated with higher response inhibition compared to happy condition. In typically developing adolescents, emotional information (happy or sad faces) was related to lower response inhibition compared to neutral face condition. This study highlights that gifted adolescents present different self-regulation skills than their typically developing peers. Statement of contribution What is already known on this subject? Some gifted adolescents present higher intellectual abilities alongside with lower socio-emotional skills. Self-regulation skills refer to processes allowing emotional and cognitive adaptation. Self-regulation skills might help to understand gifted adolescents, but remain scarcely studied. What does this study adds? Task-relevant emotional information impaired cognitive control in typically developing adolescents. Gifted adolescents are able to use sad faces to enhance their cognitive control abilities. © 2018 The British Psychological Society.

  6. The trAPP-study: cost-effectiveness of an unsupervised e-health supported neuromuscular training program for the treatment of acute ankle sprains in general practice: design of a randomized controlled trial.

    Science.gov (United States)

    Mailuhu, Adinda K E; Verhagen, Evert A L M; van Ochten, John M; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

    2015-04-09

    Ankle sprains are one of the most frequent injuries of the musculoskeletal system, with yearly around 680.000 new sprains in The Netherlands. Of these, about 130.000 people will visit the general practitioner (GP) each year. In addition, patients have an increased risk of a recurrent ankle sprain and about a third report at least one re-sprain. No optimal treatment strategy has proven to be effective in general practice, however promising results were achieved in a preventive trial among athletes. Therefore, the objective is to examine the (cost)-effectiveness of an unsupervised e-health supported neuromuscular training program in combination with usual care in general practice compared to usual care alone in patients with acute ankle sprains in general practice. This study is a multi-center, open-label randomized controlled trial, with a one-year follow-up. Patients with an acute lateral ankle sprain, aged between 14 and 65 years and visiting the GP within three weeks of injury are eligible for inclusion. Patients will be randomized in two study groups. The intervention group will receive, in addition to usual care, a standardized eight-week neuromuscular training program guided by an App. The control group will receive usual care in general practice alone. The primary outcome of this study is the total number of ankle sprain recurrences reported during one year follow-up. Secondary outcomes are subjective recovery after one year follow-up, pain at rest and during activity, function, return to sport, cost-effectiveness and compliance of the intervention. Measurements will take place monthly for the study period of 12 months after baseline measurement. For general practitioners the treatment of acute ankle sprains is a challenge. A neuromuscular training program that has proven to be effective for athletes might be a direct treatment tool for acute ankle sprains in general practice. Positive results of this randomized controlled trial can lead to changes in

  7. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  8. Doenças neuromusculares

    OpenAIRE

    Reed,Umbertina C.

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  9. Temporal parameter change of human postural control ability during upright swing using recursive least square method

    Science.gov (United States)

    Goto, Akifumi; Ishida, Mizuri; Sagawa, Koichi

    2010-01-01

    The purpose of this study is to derive quantitative assessment indicators of the human postural control ability. An inverted pendulum is applied to standing human body and is controlled by ankle joint torque according to PD control method in sagittal plane. Torque control parameters (KP: proportional gain, KD: derivative gain) and pole placements of postural control system are estimated with time from inclination angle variation using fixed trace method as recursive least square method. Eight young healthy volunteers are participated in the experiment, in which volunteers are asked to incline forward as far as and as fast as possible 10 times over 10 [s] stationary intervals with their neck joint, hip joint and knee joint fixed, and then return to initial upright posture. The inclination angle is measured by an optical motion capture system. Three conditions are introduced to simulate unstable standing posture; 1) eyes-opened posture for healthy condition, 2) eyes-closed posture for visual impaired and 3) one-legged posture for lower-extremity muscle weakness. The estimated parameters Kp, KD and pole placements are applied to multiple comparison test among all stability conditions. The test results indicate that Kp, KD and real pole reflect effect of lower-extremity muscle weakness and KD also represents effect of visual impairment. It is suggested that the proposed method is valid for quantitative assessment of standing postural control ability.

  10. A game-based training approach to enhance human hand motor learning and control abilities

    OpenAIRE

    Asadipour, Ali; Debattista, Kurt; Chalmers, Alan

    2015-01-01

    This work presents a serious game designed to improve the performance in users’ control abilities applied to pressure sensitivity. In particular, the aim of this work is part of a larger goal of providing medical students with further opportunities of palpation experiences and assistance as part of their education. Typically medical students are limited by the number of volunteers they can practice on and the amount of time they can interact with more experienced practitioners to further deve...

  11. REHABILITATION PROGRAMS FOR PEOPLE WITH NEUROMUSCULAR DISORDERS

    OpenAIRE

    Anton Zupan

    2004-01-01

    Neuromuscular diseases are inherited, chronic, degenerative and progressive. The main characteristics of neuromuscular diseases are: muscular weakness, contractures, scoliosis, respiratory insufficiency, cardiac affection, nutrition disturbances, dependence on the help of others, possible social isolation and physiological problems. Appropriate rehabilitation programs should influence all mentioned characteristics. A special unit for rehabilitation of patients with neuromuscular diseases with...

  12. Academic abilities and glycaemic control in children and young people with Type 1 diabetes mellitus.

    Science.gov (United States)

    Semenkovich, K; Patel, P P; Pollock, A B; Beach, K A; Nelson, S; Masterson, J J; Hershey, T; Arbeláez, A M

    2016-05-01

    To determine if children and young people aged diabetes differ in academic ability from age-matched control subjects without Type 1 diabetes and whether academic scores are related to glycaemic control. Using a cross-sectional study design, we administered cognitive and academic tests (Woodcock-Johnson III Spatial Relations, General Information, Letter-Word Recognition, Calculation and Spelling tests) to young people with Type 1 diabetes (n=61) and control subjects (n=26) aged 9-22 years. The groups did not differ in age or gender. Participants with Type 1 diabetes had a disease duration of 5-17.7 years. History of glycaemic control (HbA1c , diabetic ketoacidosis and severe hypoglycaemic episodes) was obtained via medical records and interviews. The participants with Type 1 diabetes had a lower mean estimated verbal intelligence (IQ) level compared with those in the control group (P=0.04). Greater exposure to hyperglycaemia over time was associated with lower spelling abilities within the group with Type 1 diabetes (P=0.048), even after controlling for age, gender, socio-economic status, blood glucose level at time of testing and verbal IQ (P=0.01). History of severe hypoglycaemia or ketoacidosis was not associated with differences in academic abilities. In children and young people, Type 1 diabetes was associated with a lower verbal IQ. Moreover, increased exposure to hyperglycaemia was associated with lower spelling performance. These results imply that hyperglycaemia can affect cognitive function and/or learning processes that may affect academic achievement. © 2015 Diabetes UK.

  13. Bilateral deficits in fine motor control ability and manual dexterity in women with fibromyalgia syndrome.

    Science.gov (United States)

    Pérez-de-Heredia-Torres, Marta; Martínez-Piédrola, Rosa M; Cigarán-Méndez, Margarita; Ortega-Santiago, Ricardo; Fernández-de-Las-Peñas, César

    2013-04-01

    The aim of the current study was to investigate fine motor control ability and manual dexterity women with fibromyalgia syndrome (FMS) without symptoms in the upper extremity compared to healthy women. Subtests of the Purdue Pegboard Test (one-hand, bilateral and assembly) and of the Jebsen-Taylor hand-function test (writing, turning cards, picking up small, light and large heavy objects, simulated feeding and stacking checkers) were evaluated bilaterally in 20 women with FMS (aged 35-55 years) without symptoms in the upper limb and 20 age- and hand dominance-matched healthy women. Differences between sides and groups were analysed with several analysis of variance (ANOVA). The ANOVA revealed significant differences between groups (P controls. Patients also exhibited significantly lower scores in bilateral pin placement and assembly subtests when compared to healthy controls (P motor control ability and manual dexterity in patients with FMS without symptoms in the upper extremity. These deficits are not related to the clinical features of the symptoms supporting an underlying central mechanism of altered motor control.

  14. Muscle ultrasound in neuromuscular disorders.

    NARCIS (Netherlands)

    Pillen, S.; Arts, I.M.P.; Zwarts, M.J.

    2008-01-01

    Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in

  15. Palliative care in neuromuscular diseases

    NARCIS (Netherlands)

    de Visser, Marianne; Oliver, David J.

    2017-01-01

    Purpose of review Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. Neuromuscular disorders (NMDs) are characterized by progressive muscle weakness, leading to pronounced and incapacitating

  16. Vocational perspectives and neuromuscular disorders

    NARCIS (Netherlands)

    Andries, F.; Wevers, C. W.; Wintzen, A. R.; Busch, H. F.; Höweler, C. J.; de Jager, A. E.; Padberg, G. W.; de Visser, M.; Wokke, J. H.

    1997-01-01

    The present study analyses the actual occupational situation, vocational handicaps and past labour career of a group of about 1000 Dutch patients suffering from a neuromuscular disorder (NMD). On the basis of the likelihood of a substantial employment history and sufficient numbers of patients, four

  17. Influence of inhibitory control on planning abilities in children with mild intellectual disability

    Directory of Open Access Journals (Sweden)

    Gligorović Milica

    2016-01-01

    Full Text Available With regard to the fact that the tendency toward unsophisticated strategies is often related to difficulties with basic components of executive functions, the aim of this research was to determine the relation between planning abilities and inhibitory control in children with mild intellectual disability (MID. The sample included 56 children with idiopathic MID (IQ 50-69, M=61.13, SD=7.14, of both genders (26/46.3% of girls, between 9.11 and 14.03 years of age (M=11.61; SD=1.29. Go no Go Task and Day/Night Stroop Task were used for the assessment of inhibitory control (delayed response to the agreed signal, conflict provoking motor responses, and inhibition of arrogant verbal responses, while Tower of London Test (ToL was used for the assessment of planning abilities. Multivariate analysis of covariance (MANCOVA, paired samples t-test, Pearson's correlation, and partial correlation coefficients were used in statistical analysis of the results. The results showed that the mistakes in Response delay set of Go-no-Go task were the only significant factor of primary Total move score variable (ToL. The influence of the ability to delay motor activity, assessed by Response delay set, on all ToL variables was statistically significant (p=0.003. The results lead to a conclusion that, during the processes of planning and executing activities, children with MID primarily rely on simple inhibitory mechanisms.

  18. The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis: study protocol for a randomized, single-blind, controlled trial (the EXERPHARMA trial).

    Science.gov (United States)

    Clausen, Brian; Holsgaard-Larsen, Anders; Søndergaard, Jens; Christensen, Robin; Andriacchi, Thomas P; Roos, Ewa M

    2014-11-15

    Knee osteoarthritis (OA) is a mechanically driven disease, and it is suggested that medial tibiofemoral knee-joint load increases with pharmacologic pain relief, indicating that pharmacologic pain relief may be positively associated with disease progression. Treatment modalities that can both relieve pain and reduce knee-joint load would be preferable. The knee-joint load is influenced by functional alignment of the trunk, pelvis, and lower-limb segments with respect to the knee, as well as the ground-reaction force generated during movement. Neuromuscular exercise can influence knee load and decrease knee pain. It includes exercises to improve balance, muscle activation, functional alignment, and functional knee stability. The primary objective of this randomized controlled trial (RCT) is to investigate the efficacy of a NEuroMuscular EXercise (NEMEX) therapy program, compared with optimized analgesics and antiinflammatory drug use, on the measures of knee-joint load in people with mild to moderate medial tibiofemoral knee osteoarthritis. One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical practices and randomly allocated (1:1) to one of two 8-week treatments, either (a) NEMEX therapy twice a week or (b) information on the recommended use of analgesics and antiinflammatory drugs (acetaminophen and oral NSAIDs) via a pamphlet and video materials. The primary outcome is change in knee load during walking (the Knee Index, a composite score of the first external peak total reaction moment on the knee joint from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes include changes in the external peak knee-adduction moment and impulse and functional performance measures, in addition to changes in self-reported pain, function, health status, and quality of life. These findings will help determine whether 8 weeks of neuromuscular exercise is superior to optimized use

  19. Effects of electromyography-driven robot-aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke.

    Science.gov (United States)

    Rong, Wei; Tong, Kai Yu; Hu, Xiao Ling; Ho, Sze Kit

    2015-03-01

    An electromyography-driven robot system integrated with neuromuscular electrical stimulation (NMES) was developed to investigate its effectiveness on post-stroke rehabilitation. The performance of this system in assisting finger flexion/extension with different assistance combinations was evaluated in five stroke subjects. Then, a pilot study with 20-sessions training was conducted to evaluate the training's effectiveness. The results showed that combined assistance from the NMES-robot could improve finger movement accuracy, encourage muscle activation of the finger muscles and suppress excessive muscular activities in the elbow joint. When assistances from both NMES and the robot were 50% of their maximum assistances, finger-tracking performance had the best results, with the lowest root mean square error, greater range of motion, higher voluntary muscle activations of the finger joints and lower muscle co-contraction in the finger and elbow joints. Upper limb function improved after the 20-session training, indicated by the increased clinical scores of Fugl-Meyer Assessment, Action Research Arm Test and Wolf Motor Function Test. Muscle co-contraction was reduced in the finger and elbow joints reflected by the Modified Ashworth Scale. The findings demonstrated that an electromyography-driven NMES-robot used for chronic stroke improved hand function and tracking performance. Further research is warranted to validate the method on a larger scale. Implications for Rehabilitation The hand robotics and neuromuscular electrical stimulation (NMES) techniques are still separate systems in current post-stroke hand rehabilitation. This is the first study to investigate the combined effects of the NMES and robot on hand rehabilitation. The finger tracking performance was improved with the combined assistance from the EMG-driven NMES-robot hand system. The assistance from the robot could improve the finger movement accuracy and the assistance from the NMES could reduce the

  20. Wheel Slip Control for Improving Traction-Ability and Energy Efficiency of a Personal Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Kanghyun Nam

    2015-07-01

    Full Text Available In this paper, a robust wheel slip control system based on a sliding mode controller is proposed for improving traction-ability and reducing energy consumption during sudden acceleration for a personal electric vehicle. Sliding mode control techniques have been employed widely in the development of a robust wheel slip controller of conventional internal combustion engine vehicles due to their application effectiveness in nonlinear systems and robustness against model uncertainties and disturbances. A practical slip control system which takes advantage of the features of electric motors is proposed and an algorithm for vehicle velocity estimation is also introduced. The vehicle velocity estimator was designed based on rotational wheel dynamics, measurable motor torque, and wheel velocity as well as rule-based logic. The simulations and experiments were carried out using both CarSim software and an experimental electric vehicle equipped with in-wheel-motors. Through field tests, traction performance and effectiveness in terms of energy saving were all verified. Comparative experiments with variations of control variables proved the effectiveness and practicality of the proposed control design.

  1. Cognitive ability and self-control in relation to dietary habits, physical activity and bodyweight in adolescents

    Directory of Open Access Journals (Sweden)

    van Kampen Margit

    2010-03-01

    Full Text Available Abstract Background Previous studies showed that cognitive ability is related to health and mortality. The cause of this relationship remains largely unknown. One plausible explanation is that cognitive ability is related to behaviours that affect health. This study investigates whether cognitive ability is related to healthy dietary habits, physical activity and appropriate bodyweight in adolescents and examines whether self-control mediates the relationship between cognitive ability and health behaviour. Methods In total 201 high-school students aged between 15 and 20 participated in the study. They completed three cognitive tests, measuring cognitive ability, reaction time and memory span, and completed a questionnaire on self-control, dietary habits, physical activity and bodyweight. Results Results show that adolescents scoring high on the cognitive ability test have healthier dietary habits and engage more often in physical activity. Adolescents with high self-control have a healthier eating pattern, are more often physically active and have lower BMI's. Both reaction time and memory span were not related to dietary habits and physical activity. Self-control was not related to cognitive ability and could not, therefore, mediate the relationship between cognitive ability and health in this study. Conclusion In conclusion, the link between cognitive ability and health behaviour could explain - in part - the relationship between cognitive ability and health. Self-control cannot explain this link.

  2. Cognitive ability and self-control in relation to dietary habits, physical activity and bodyweight in adolescents.

    Science.gov (United States)

    Junger, Marianne; van Kampen, Margit

    2010-03-23

    Previous studies showed that cognitive ability is related to health and mortality. The cause of this relationship remains largely unknown. One plausible explanation is that cognitive ability is related to behaviours that affect health. This study investigates whether cognitive ability is related to healthy dietary habits, physical activity and appropriate bodyweight in adolescents and examines whether self-control mediates the relationship between cognitive ability and health behaviour. In total 201 high-school students aged between 15 and 20 participated in the study. They completed three cognitive tests, measuring cognitive ability, reaction time and memory span, and completed a questionnaire on self-control, dietary habits, physical activity and bodyweight. Results show that adolescents scoring high on the cognitive ability test have healthier dietary habits and engage more often in physical activity. Adolescents with high self-control have a healthier eating pattern, are more often physically active and have lower BMI's. Both reaction time and memory span were not related to dietary habits and physical activity. Self-control was not related to cognitive ability and could not, therefore, mediate the relationship between cognitive ability and health in this study. In conclusion, the link between cognitive ability and health behaviour could explain - in part - the relationship between cognitive ability and health. Self-control cannot explain this link.

  3. Ability to control emotions of nurses in relation to their jobs

    OpenAIRE

    Kalandyk, Halina; Krajewska-Kułak, Elzbieta; Guty, Edyta

    2017-01-01

    Kalandyk Halina, Krajewska-Kułak Elzbieta, Guty Edyta. Ability to control emotions of nurses in relation to their jobs. Journal of Education, Health and Sport. 2017;7(3):86-96. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.265676 http://ojs.ukw.edu.pl/index.php/johs/article/view/4213 https://pbn.nauka.gov.pl/sedno-webapp/works/789568       The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.201...

  4. Comparison of effects of static, proprioceptive neuromuscular facilitation and Mulligan stretching on hip flexion range of motion: a randomized controlled trial.

    Science.gov (United States)

    Yıldırım, M S; Ozyurek, S; Tosun, Oç; Uzer, S; Gelecek, N

    2016-03-01

    The aim of this study was to compare the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching and Mulligan technique on hip flexion range of motion (ROM) in subjects with bilateral hamstring tightness. A total of 40 students (mean age: 21.5±1.3 years, mean body height: 172.8±8.2 cm, mean body mass index: 21.9±3.0 kg · m(-2)) with bilateral hamstring tightness were enrolled in this randomized trial, of whom 26 completed the study. Subjects were divided into 4 groups performing (I) typical static stretching, (II) PNF stretching, (III) Mulligan traction straight leg raise (TSLR) technique, (IV) no intervention. Hip flexion ROM was measured using a digital goniometer with the passive straight leg raise test before and after 4 weeks by two physiotherapists blinded to the groups. 52 extremities of 26 subjects were analyzed. Hip flexion ROM increased in all three intervention groups (pstatic stretching (p=0.016 and p=0.02, respectively). No significant difference was found between Mulligan TSLR technique and PNF stretching (p=0.920). The initial-final assessment difference of hip flexion ROM was similar in typical static stretching and no intervention (p=0.491). A 4-week stretching intervention is beneficial for increasing hip flexion ROM in bilateral hamstring tightness. However, PNF stretching and Mulligan TSLR technique are superior to typical static stretching. These two interventions can be alternatively used for stretching in hamstring tightness.

  5. Locomotor Adaptation Improves Balance Control, Multitasking Ability and Reduces the Metabolic Cost of Postural Instability

    Science.gov (United States)

    Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Miller, C. A.; Ploutz-Snyder, R. J.; Guined, J. R.; Buxton, R. E.; Cohen, H. S.

    2011-01-01

    During exploration-class missions, sensorimotor disturbances may lead to disruption in the ability to ambulate and perform functional tasks during the initial introduction to a novel gravitational environment following a landing on a planetary surface. The overall goal of our current project is to develop a sensorimotor adaptability training program to facilitate rapid adaptation to these environments. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene. It provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. Greater metabolic cost incurred during balance instability means more physical work is required during adaptation to new environments possibly affecting crewmembers? ability to perform mission critical tasks during early surface operations on planetary expeditions. The goal of this study was to characterize adaptation to a discordant sensory challenge across a number of performance modalities including locomotor stability, multi-tasking ability and metabolic cost. METHODS: Subjects (n=15) walked (4.0 km/h) on a treadmill for an 8 -minute baseline walking period followed by 20-minutes of walking (4.0 km/h) with support surface motion (0.3 Hz, sinusoidal lateral motion, peak amplitude 25.4 cm) provided by the treadmill/motion-base system. Stride frequency and auditory reaction time were collected as measures of locomotor stability and multi-tasking ability, respectively. Metabolic data (VO2) were collected via a portable metabolic gas analysis system. RESULTS: At the onset of lateral support surface motion, subj ects walking on our treadmill showed an increase in stride frequency and auditory reaction time indicating initial balance and multi-tasking disturbances. During the 20-minute adaptation period, balance control and multi-tasking performance improved. Similarly, throughout the 20-minute adaptation period, VO2 gradually

  6. Rehabilitation interventions for foot drop in neuromuscular disease.

    Science.gov (United States)

    Sackley, Catherine; Disler, Peter B; Turner-Stokes, Lynne; Wade, Derick T; Brittle, Nicola; Hoppitt, Thomas

    2009-07-08

    "Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases. To conduct a systematic review of randomised trials for the treatment of foot drop resulting from neuromuscular disease. In this update, we searched the Cochrane Neuromuscular Disease Group Trials Register (April 2009), MEDLINE (January 1966 to April 24 2009), EMBASE January 1980 to April 24 2009), CINAHL (January 1982 to May 6 2009), AMED (January 1985 to April 24 2009), the British Nursing Index (January 1985 to January 2008) and Royal College of Nursing Journal of Databases (January 1985 to January 2008). Randomised and quasi-randomised trials of physical, orthotic and surgical treatments for foot drop resulting from lower motor neuron or muscle disease and related contractures were included. People with primary joint disease were excluded. Interventions included a 'wait and see' approach, physiotherapy, orthoses, surgery and pharmacological therapy. The primary outcome measure was quantified ability to walk whilst secondary outcome measures included range of movement, dorsiflexor torque and strength, measures of activity and participation, quality of life and adverse effects. Methodological quality was evaluated by two authors using the van Tulder criteria. Four studies with a total of n = 152 participants were included in the update to the original review. Heterogeneity of the studies precluded pooling the data. Early surgery did not significantly affect walking speed in a trial including 20 children with Duchenne muscular dystrophy. Both groups deteriorated during the 12 months follow-up. After one year, the mean difference (MD) of the 28 feet walking time was 0.00 seconds (95% confidence interval (CI) -0.83 to 0.83) and the MD of the 150 feet walking time was -2.88 seconds, favouring the control group (95% CI -8.18 to 2.42). Night splinting of the ankle did not significantly

  7. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    Science.gov (United States)

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  8. Neuromuscular dressing effects: a literature review

    Directory of Open Access Journals (Sweden)

    Calero PA

    2012-05-01

    Full Text Available The kinesio taping is a technique that was created in 1979 by Doctor Kenzo Kase I’m looking through it that could generate a new therapeutic option to control pain, improve athletic performance and reduce the impact of musculoskeletal disorders. From the Sydney 2000 Olympic Games, this technique as a therapeutic alternative PTO and is composed of health professionals in the field of sport and physical rehabilitation.Objetive: This article aims to identify theoretical approaches on the bandage neuromuscular. Material and methods: held today, for which conducted a literature search of databases such as como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs.The paper proposes a scheme of contextualization of the current landscape of the use and effects of kinesio taping in the management of different pathologies of the musculo-skeletal system in sports. Conclusion: it is concluded that currently many health professionals, and take the neuromuscular bandage a good therapeutic option in the management of diseases affecting the human body is investigated and every day more about the subject, which makes these new therapeutic methods to acquire a scientific value and transcends knowledge.

  9. [Respiratory treatments in neuromuscular disease].

    Science.gov (United States)

    Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

    2014-10-01

    In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  10. Neuromuscular fatigue in racquet sports.

    Science.gov (United States)

    Girard, Olivier; Millet, Grégoire P

    2008-02-01

    This article describes the physiologic and neural mechanisms that cause neuromuscular fatigue in racquet sports: table tennis, tennis, squash, and badminton. In these intermittent and dual activities, performance may be limited as a match progresses because of a reduced central activation, linked to changes in neurotransmitter concentration or in response to afferent sensory feedback. Alternatively, modulation of spinal loop properties may occur because of changes in metabolic or mechanical properties within the muscle. Finally, increased fatigue manifested by mistimed strokes, lower speed, and altered on-court movements may be caused by ionic disturbances and impairments in excitation-contraction coupling properties. These alterations in neuromuscular function contribute to decrease in racquet sports performance observed under fatigue.

  11. Wrist range of motion and motion frequency during toy and game play with a joint-specific controller specially designed to provide neuromuscular therapy: A proof of concept study in typically developing children.

    Science.gov (United States)

    Crisco, Joseph J; Schwartz, Joel B; Wilcox, Bethany; Brideau, Holly; Basseches, Benjamin; Kerman, Karen

    2015-08-20

    Upper extremities affected by hemiplegic cerebral palsy (CP) and other neuromuscular disorders have been demonstrated to benefit from therapy, and the greater the duration of the therapy, the greater the benefit. A great motivator for participating in and extending the duration of therapy with children is play. Our focus is on active motion therapy of the wrist and forearm. In this study we examine the wrist motions associated with playing with two toys and three computer games controlled by a specially-designed play controller. Twenty children (ages 5-11) with no diagnosis of a muscular disorder were recruited. The play controller was fitted to the wrist and forearm of each child and used to measure and log wrist flexion and extension. Play activity and enjoyment were quantified by average wrist range of motion (ROM), motion frequency measures, and a discrete visual scale. We found significant differences in the average wrist ROM and motion frequency among the toys and games, yet there were no differences in the level of enjoyment across all toys and games, which was high. These findings indicate which toys and games may elicit the greater number of goal-directed movements, and lay the foundation for our long-term goal to develop and evaluate innovative motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with CP. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Ketogenic diet does not impair spatial ability controlled by the hippocampus in male rats.

    Science.gov (United States)

    Fukushima, Atsushi; Ogura, Yuji; Furuta, Miyako; Kakehashi, Chiaki; Funabashi, Toshiya; Akema, Tatsuo

    2015-10-05

    A ketogenic diet was recently shown to reduce glutamate accumulation in synaptic vesicles, decreasing glutamate transmission. We questioned whether a ketogenic diet affects hippocampal function, as glutamate transmission is critically involved in visuospatial ability. In the present study, male Wistar rats were maintained on a ketogenic diet containing 10% protein and 90% fat with complements for 3 weeks to change their energy expenditure from glucose-dependent to fat-dependent. Control rats were fed a diet containing 10% protein, 10% fat, and 80% carbohydrates. The fat-dependent energy expenditure induced by the ketogenic diet led to decreased body weight and increased blood ketone production, though the rats in the two groups consumed the same number of calories. The ketogenic diet did not alter food preferences for the control or high-fat diet containing 10% protein, 45% fat, and 45% carbohydrates. Anxiety in the open field was not altered by ingestion the ketogenic diet. However, rats fed the ketogenic diet performed better in the Y-maze test than rats fed the control diet. No difference was observed between the two groups in the Morris water maze test. Finally, Western blot revealed that the hippocampal expression of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-type glutamate receptor subunit 1 (GluR1) was significantly increased in mice fed a ketogenic diet. These results suggest that hippocampal function is not impaired by a ketogenic diet and we speculate that the fat-dependent energy expenditure does not impair visuospatial ability. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Low eddy loss axial hybrid magnetic bearing with gimballing control ability for momentum flywheel

    Science.gov (United States)

    Tang, Jiqiang; Sun, Jinji; Fang, Jiancheng; Shuzhi Sam, Ge

    2013-03-01

    For a magnetically suspended momentum flywheel (MSMF), the spinning rotor can be tilted by a pair of the presented axial hybrid magnetic bearing (AHMB) with eight poles and rotates around the radial axes to generate a large torque to maneuver the spacecraft. To improve the control performance and gimballing control ability of the AHMB, characteristics such as magnetic suspension force, angular stiffness and tilting momentum are researched. These segmented stator poles cause the magnetic density in the thrust rotor plate to be uneven unavoidably and the rotational loss is large at high speed, but we optimized the stator poles configuration and caused the thrust rotor plate formed by bulk DT4C and laminated material to make the magnetic density in the thrust rotor plate change less and be smoother. Laminated material such as 1J50 film with a thickness of 0.1 mm can make the variation of the magnetic density in DT4C become very small and the eddy loss of it be negligible, but the stress produced in the “O” shape stacks by reeling has a bad effect on its power loss. Nanocrystalline can reduce eddy losses and is not affected by the reeling process. Based on the AHBM consisting of the stator with eight improved poles and the presented thrust rotor plate with DT4 and nanocrystalline, the rotational loss of 5-DOF magnetically suspended momentum flywheel with angular momentum of 15 N m s at 5000 rpm has reduced from 23.4 W to 3.2 W, which proved that this AHMB has low eddy loss for the gimballing control ability.

  14. Myths and facts in neuromuscular pharmacology - New developments in reversing neuromuscular blockade

    NARCIS (Netherlands)

    Fink, H.; Hollmann, M. W.

    2012-01-01

    Pharmacologic reversal of neuromuscular blockade is a topic nor very well acknowledged and controversially discussed. Reasons for this are numerous and include missing perception of the potential complications of residual neuromuscular paralysis including an increased morbidity and mortality, as

  15. The undesirable effects of neuromuscular blocking drugs

    DEFF Research Database (Denmark)

    Claudius, C; Garvey, L H; Viby-Mogensen, J

    2009-01-01

    Neuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor...... in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect...... of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking...

  16. Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.

    NARCIS (Netherlands)

    Cup, E.H.C.; Pieterse, A.J.; Broek-Pastoor, J.M. Ten; Munneke, M.; Engelen, B.G.M. van; Hendricks, H.T.; Wilt, G.J. van der; Oostendorp, R.A.B.

    2007-01-01

    OBJECTIVE: To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL,

  17. Professional Soccer Player Neuromuscular Responses and Perceptions to Acute Whole Body Vibration Differ from Amateur Counterparts.

    Science.gov (United States)

    Cloak, Ross; Lane, Andrew; Wyon, Matthew

    2016-03-01

    Acute whole body vibration (WBV) is an increasingly popular training technique amongst athletes immediately prior to performance and during scheduled breaks in play. Despite its growing popularity, evidence to demonstrate its effectiveness on acute neuromuscular responses is unclear, and suggestions that athlete ability impacts effectiveness warrant further investigation. The purpose of this study was to compare the neuromuscular effects of acute WBV and perceptions of whether WBV is an effective intervention between amateur and professional soccer players. Participants were 44 male soccer players (22 professional and 22 amateur; age: 23.1 ± 3.7 years, body mass: 75.6 ± 8.8 kg and height: 1.77 ± 0.05 m). Participants in each group were randomly assigned to either an intervention of 3 x 60 s of WBV at 40 Hz (8mm peak-to-peak displacement) or control group. Peak knee isometric force, muscle activation and post activation potentiation (PAP) of the knee extensors along with self-report questionnaire of the perceived benefits of using the intervention were collected. A three-way ANOVA with repeated measures revealed professional players demonstrated a significant 10.6% increase (p amateur players. A significant difference (p amateur players were reported across measurements. Results also indicated professional players reported significantly stronger positive beliefs in the effectiveness of the WBV intervention (p amateur players. Acute WBV elicited a positive neuromuscular response amongst professional players identified by PAP and improvements in knee isometric peak force as well as perceived benefits of the intervention, benefits not found among amateur players. Key pointsAcute WBV improves knee extensor peak isometric force output and PAP amongst professional and not amateur soccer playersProfessional players perceived acute WBV as more beneficial to performance than amateur playersIsometric strength,vibration intensity and duration appear to influence results

  18. Professional Soccer Player Neuromuscular Responses and Perceptions to Acute Whole Body Vibration Differ from Amateur Counterparts

    Directory of Open Access Journals (Sweden)

    Ross Cloak, Andrew Lane, Matthew Wyon

    2016-03-01

    Full Text Available Acute whole body vibration (WBV is an increasingly popular training technique amongst athletes immediately prior to performance and during scheduled breaks in play. Despite its growing popularity, evidence to demonstrate its effectiveness on acute neuromuscular responses is unclear, and suggestions that athlete ability impacts effectiveness warrant further investigation. The purpose of this study was to compare the neuromuscular effects of acute WBV and perceptions of whether WBV is an effective intervention between amateur and professional soccer players. Participants were 44 male soccer players (22 professional and 22 amateur; age: 23.1 ± 3.7 years, body mass: 75.6 ± 8.8 kg and height: 1.77 ± 0.05 m. Participants in each group were randomly assigned to either an intervention of 3 x 60 s of WBV at 40 Hz (8mm peak-to-peak displacement or control group. Peak knee isometric force, muscle activation and post activation potentiation (PAP of the knee extensors along with self-report questionnaire of the perceived benefits of using the intervention were collected. A three-way ANOVA with repeated measures revealed professional players demonstrated a significant 10.6% increase (p < 0.01, Partial Eta2 = 0.22 in peak knee isometric force following acute WBV with no significant differences among amateur players. A significant difference (p < 0.01, Partial Eta2 = 0.16 in PAP amongst professional players following acute WBVT was also reported. No significant differences amongst amateur players were reported across measurements. Results also indicated professional players reported significantly stronger positive beliefs in the effectiveness of the WBV intervention (p < 0.01, Partial Eta2 = 0.27 compared to amateur players. Acute WBV elicited a positive neuromuscular response amongst professional players identified by PAP and improvements in knee isometric peak force as well as perceived benefits of the intervention, benefits not found among amateur players.

  19. No differences in visual theory of mind abilities between euthymic bipolar patients and healthy controls.

    Science.gov (United States)

    Haag, Silvia; Haffner, Paula; Quinlivan, Esther; Brüne, Martin; Stamm, Thomas

    2016-12-01

    Research on theory of mind (ToM) abilities in patients with bipolar disorder has yielded conflicting results. Meta-analyses point to a stable moderate impairment in remitted patients, but factors such as subsyndromal symptoms, illness severity, and deficits in basic neurocognitive functions might act as confounders. Also, differences in deficits depending on task area (cognitive or affective) or task modality (visual or verbal) have been observed. This study aimed to test the hypothesis that euthymic bipolar patients would perform more poorly than healthy subjects on visual cognitive and visual affective ToM tasks. Furthermore, we aimed to explore the relationship between ToM performance and basic neurocognitive functions, subsyndromal symptom severity, and illness burden. Twenty-nine clinically stable outpatients with bipolar disorder and 29 healthy comparison subjects completed a measure of visual cognitive ToM (Mental State Attribution Task, MSAT), a measure of visual affective ToM (Reading the Mind in the Eyes Test, RMET), and a battery of tests assessing neurocognitive functioning (attention, verbal memory, executive functions, and intelligence). Patients did not differ significantly from healthy controls for the ToM tasks or any of the neurocognitive measures, suggesting a high level of neurocognitive functioning in the bipolar group. On average, patients were slower than controls to complete the ToM tasks. Within the bipolar group, ToM performance was moderately correlated with attention, verbal memory and reasoning abilities. Performance on the RMET was positively correlated with clinician-rated depressive symptoms with a small effect. Number of years of illness was weakly and negatively correlated with performance on the MSAT. Overall, no moderate or strong correlations were found between ToM performance, subsyndromal depressive or manic symptoms, illness duration, and number of depressive or (hypo)manic episodes. Moderate correlations between To

  20. Cognitive style and the acquisition and transfer of the ability to control variables

    Science.gov (United States)

    Strawitz, Barbara M.

    This study examined the effects of an instructional procedure designed to teach both field-dependent and field-independent sixth graders to control variables and to transfer this ability to novel tasks. Students were randomly assigned to either a treatment group taught with a special instructional procedure adapted from Case or a group where students freely explored science equipment without receiving feedback. Three posttest tasks administered approximately four weeks after the last training session served as retention and transfer measures. Results indicated that students receiving the special instructional treatment correctly tested significantly more variables on the posttest tasks than did students in the other group. Within-group analyses revealed that the special treatment was effective for field-dependent as well as field-independent students, while the other treatment was effective for only field-independent students.

  1. Set-shifting abilities, mood and loss of control over eating in binge eating disorder: An experimental study.

    Science.gov (United States)

    Dingemans, Alexandra E; Visser, Hiske; Paul, Linda; van Furth, Eric F

    2015-12-15

    Executive functions play an important role in problem-solving and self-control. Set-shifting is an aspect of executive functioning and represents cognitive flexibility. The inability to control eating in Binge Eating Disorder (BED) may imply deficits in set-shifting which could be exacerbated by negative mood and depressive symptoms. The aim of the study was to test whether there is a causal relationship between set-shifting ability, changes in mood and loss of control over eating in BED. Seventy-five participants diagnosed with BED were randomly assigned to a negative or neutral mood induction. Set-shifting abilities, depressive symptoms, current mood and loss of control over eating were assessed. Having depressive symptoms and poorer set-shifting abilities resulted in a more negative mood after a negative mood induction, whereas this was not observed in the neutral mood induction. Post-hoc analyses revealed that individuals with poorer set-shifting abilities and more changes in negative mood, experienced more feelings of loss of control over eating than individuals whose set-shifting abilities were better and whose mood did not change. The results suggest that both depressive symptoms and deficits in set-shifting abilities may decrease an individual's ability to handle negative affect and increase loss of control over eating in individuals with BED. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Reactive Balance Control in Response to Perturbation in Unilateral Stance: Interaction Effects of Direction, Displacement and Velocity on Compensatory Neuromuscular and Kinematic Responses.

    Directory of Open Access Journals (Sweden)

    Kathrin Freyler

    Full Text Available Unexpected sudden perturbations challenge postural equilibrium and require reactive compensation. This study aimed to assess interaction effects of the direction, displacement and velocity of perturbations on electromyographic (EMG activity, centre of pressure (COP displacement and joint kinematics to detect neuromuscular characteristics (phasic and segmental and kinematic strategies of compensatory reactions in an unilateral balance paradigm. In 20 subjects, COP displacement and velocity, ankle, knee and hip joint excursions and EMG during short (SLR, medium (MLR and long latency response (LLR of four shank and five thigh muscles were analysed during random surface translations varying in direction (anterior-posterior (sagittal plane, medial-lateral (frontal plane, displacement (2 vs. 3 cm and velocity (0.11 vs. 0.18 m/s of perturbation when balancing on one leg on a movable platform. Phases: SLR and MLR were scaled to increased velocity (P<0.05; LLR was scaled to increased displacement (P<0.05. Segments: phasic interrelationships were accompanied by segmental distinctions: distal muscles were used for fast compensation in SLR (P<0.05 and proximal muscles to stabilise in LLR (P<0.05. Kinematics: ankle joints compensated for both increasing displacement and velocity in all directions (P<0.05, whereas knee joint deflections were particularly sensitive to increasing displacement in the sagittal (P<0.05 and hip joint deflections to increasing velocity in the frontal plane (P<0.05. COP measures increased with increasing perturbation velocity and displacement (P<0.05. Interaction effects indicate that compensatory responses are based on complex processes, including different postural strategies characterised by phasic and segmental specifications, precisely adjusted to the type of balance disturbance. To regain balance after surface translation, muscles of the distal segment govern the quick regain of equilibrium; the muscles of the proximal limb

  3. Rolling revisado: utilización del rolling para valorar y tratar la coordinación y control neuromuscular del core y extremidades en atletas

    Directory of Open Access Journals (Sweden)

    Barbara J. Hoogenboom

    2017-05-01

    Full Text Available Rolling es un patrón de movimiento raramente utilizado por los fisioterapeutas para la evaluación e intervención de pacientes con función neurológica normal. El Rolling, como destreza motriz adulta, combina el uso de las extremidades superiores, core y extremidades inferiores con el movimiento coordinado en el paso de una postura a otra. El Rolling se lleva a cabo partiendo de la posición prona a posición supina y viceversa, aunque el método utilizado varía entre adultos. Desde la perspectiva de la habilidad de completar tareas o la simetría bilateral, el Rolling puede ser beneficioso para el uso de atletas que realizan deportes de rotación parcial tales como el golf, el lanzamiento, el tenis, y los deportes con torsión como la danza, la gimnasia, y el patinaje artístico. Además, cuando es usado como técnica de intervención, los patrones del Rolling tienen la capacidad de influir en disfunciones de la parte superior del cuerpo, core y parte inferior. Aplicando los principios de la facilitación neuromuscular propioceptiva (FNP, el terapeuta puede asistir a pacientes y clientes que son incapaces de completar un patrón de Rolling. Algunos ejemplos citados en el artículo incluyen separación/elongación, compresión, y contacto manual para facilitar el propio Rolling. Los autores defienden que el uso terapéutico de los patrones de desarrollo del Rolling con las técnicas derivadas de FNP es un distintivo en la rehabilitación de pacientes con disfunciones neurológicas que pueden ser también utilizados en la rehabilitación músculo-esquelética de forma creativa y efectiva. Se han obtenido los resultados preliminares de una exploración del mecanismo por el que el Rolling puede influir en la estabilidad y existen evidencias recientes disponibles. El propósito de este comentario clínico es describir las técnicas de análisis, evaluación y tratamiento de disfunción, usando casos ejemplos que incorporan el Rolling.

  4. Low eddy loss axial hybrid magnetic bearing with gimballing control ability for momentum flywheel

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Jiqiang, E-mail: tjq_72@163.com [School of Instrument Science and Opto-electronics Engineering, Beihang University, Beijing 100191 (China); Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117576 (Singapore); Sun, Jinji; Fang, Jiancheng [School of Instrument Science and Opto-electronics Engineering, Beihang University, Beijing 100191 (China); Shuzhi Sam, Ge [Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117576 (Singapore)

    2013-03-15

    For a magnetically suspended momentum flywheel (MSMF), the spinning rotor can be tilted by a pair of the presented axial hybrid magnetic bearing (AHMB) with eight poles and rotates around the radial axes to generate a large torque to maneuver the spacecraft. To improve the control performance and gimballing control ability of the AHMB, characteristics such as magnetic suspension force, angular stiffness and tilting momentum are researched. These segmented stator poles cause the magnetic density in the thrust rotor plate to be uneven unavoidably and the rotational loss is large at high speed, but we optimized the stator poles configuration and caused the thrust rotor plate formed by bulk DT4C and laminated material to make the magnetic density in the thrust rotor plate change less and be smoother. Laminated material such as 1J50 film with a thickness of 0.1 mm can make the variation of the magnetic density in DT4C become very small and the eddy loss of it be negligible, but the stress produced in the 'O' shape stacks by reeling has a bad effect on its power loss. Nanocrystalline can reduce eddy losses and is not affected by the reeling process. Based on the AHBM consisting of the stator with eight improved poles and the presented thrust rotor plate with DT4 and nanocrystalline, the rotational loss of 5-DOF magnetically suspended momentum flywheel with angular momentum of 15 N m s at 5000 rpm has reduced from 23.4 W to 3.2 W, which proved that this AHMB has low eddy loss for the gimballing control ability. - Highlights: Black-Right-Pointing-Pointer Control methods of rotor driven by AHMBs and their characteristics are researched. Black-Right-Pointing-Pointer Optimized stator and rotor of AHMB reduce its eddy losses greatly. Black-Right-Pointing-Pointer Presented the factors affecting the eddy losses of AHMBs. Black-Right-Pointing-Pointer The good performances of AHMB with low eddy loss are proved by experiments.

  5. Individual differences in control of language interference in late bilinguals are mainly related to general executive abilities

    OpenAIRE

    Münte Thomas F; Rodriguez-Fornells Antoni; Festman Julia

    2010-01-01

    Abstract Background Recent research based on comparisons between bilinguals and monolinguals postulates that bilingualism enhances cognitive control functions, because the parallel activation of languages necessitates control of interference. In a novel approach we investigated two groups of bilinguals, distinguished by their susceptibility to cross-language interference, asking whether bilinguals with strong language control abilities ("non-switchers") have an advantage in executive function...

  6. Individual differences in control of language interference in late bilinguals are mainly related to general executive abilities

    OpenAIRE

    Festman, J.; Rodríguez Fornells, Antoni; Münte, Thomas F.

    2010-01-01

    Background: Recent research based on comparisons between bilinguals and monolinguals postulates that bilingualism enhances cognitive control functions, because the parallel activation of languages necessitates control of interference. In a novel approach we investigated two groups of bilinguals, distinguished by their susceptibility to cross-language interference, asking whether bilinguals with strong language control abilities ('non-switchers") have an advantage in executive functions (inhib...

  7. Impact of Comprehensive Rehabilitation Therapy on Trunk Controlling Ability of Children with Cerebral Palsy.

    Science.gov (United States)

    Wu, J-X; Shi, S-X; Wang, B; Kan, X-L

    2015-05-06

    This study aims to investigate the impact of comprehensive treatment on the trunk controlling ability (TCA) of children with cerebral palsy (CPC). Twenty children with spastic cerebral palsy had truncal stability parameters in the sitting posture and the symmetry parameters of left-right-forward-backward centre of pressure evaluated by the stationary stability assessment module of the PK 254 P balance training instrument. After a six-month trunk control training with physical therapy technology and balancing instrument, the above indicators were re-evaluated, and the evaluations before and after the treatment were analysed to assess the therapeutic effect. The difference in the truncal stability parameters before and after the treatment was statistically significant ( p < 0.05); the difference in the symmetry parameters of forward-backward centre of pressure was significant ( p < 0.05). The balancing instrument training, combined with physical therapy technology training, could effectively improve the TCA of CPC, and the balancing instrument could also provide the objective and quantitative efficacy assessment toward the TCA of CPC.

  8. Neuromuscular interactions around the knee in children, adults and elderly

    National Research Council Canada - National Science Library

    Kellis, Eleftherios; Mademli, Lida; Patikas, Dimitrios; Kofotolis, Nikolaos

    2014-01-01

    Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly...

  9. Ancestral genes can control the ability of horizontally acquired loci to confer new traits.

    Directory of Open Access Journals (Sweden)

    H Deborah Chen

    2011-07-01

    Full Text Available Horizontally acquired genes typically function as autonomous units conferring new abilities when introduced into different species. However, we reasoned that proteins preexisting in an organism might constrain the functionality of a horizontally acquired gene product if it operates on an ancestral pathway. Here, we determine how the horizontally acquired pmrD gene product activates the ancestral PmrA/PmrB two-component system in Salmonella enterica but not in the closely related bacterium Escherichia coli. The Salmonella PmrD protein binds to the phosphorylated PmrA protein (PmrA-P, protecting it from dephosphorylation by the PmrB protein. This results in transcription of PmrA-dependent genes, including those conferring polymyxin B resistance. We now report that the E. coli PmrD protein can activate the PmrA/PmrB system in Salmonella even though it cannot do it in E. coli, suggesting that these two species differ in an additional component controlling PmrA-P levels. We establish that the E. coli PmrB displays higher phosphatase activity towards PmrA-P than the Salmonella PmrB, and we identified a PmrB subdomain responsible for this property. Replacement of the E. coli pmrB gene with the Salmonella homolog was sufficient to render E. coli resistant to polymyxin B under PmrD-inducing conditions. Our findings provide a singular example whereby quantitative differences in the biochemical activities of orthologous ancestral proteins dictate the ability of a horizontally acquired gene product to confer species-specific traits. And they suggest that horizontally acquired genes can potentiate selection at ancestral loci.

  10. Patients’ ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial

    Science.gov (United States)

    Umasunthar, T; Procktor, A; Hodes, M; Smith, J G; Gore, C; Cox, H E; Marrs, T; Hanna, H; Phillips, K; Pinto, C; Turner, P J; Warner, J O; Boyle, R J

    2015-01-01

    Background Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices. Methods We allocated mothers of food-allergic children prescribed an AAI for the first time to Anapen or EpiPen using a computer-generated randomization list, with optimal training according to manufacturer's instructions. After one year, participants were randomly allocated a new device (EpiPen, Anapen, new EpiPen, JEXT or Auvi-Q), without device-specific training. We assessed ability to deliver adrenaline using their AAI in a simulated anaphylaxis scenario six weeks and one year after initial training, and following device switch. Primary outcome was successful adrenaline administration at six weeks, assessed by an independent expert. Secondary outcomes were success at one year, success after switching device, and adverse events. Results We randomized 158 participants. At six weeks, 30 of 71 (42%) participants allocated to Anapen and 31 of 73 (43%) participants allocated to EpiPen were successful – RR 1.00 (95% CI 0.68–1.46). Success rates at one year were also similar, but digital injection was more common at one year with EpiPen (8/59, 14%) than Anapen (0/51, 0%, P = 0.007). When switched to a new device without specific training, success rates were higher with Auvi-Q (26/28, 93%) than other devices (39/80, 49%; P adrenaline administration. Success rates were low with several devices, but were high using the audio-prompt device Auvi-Q. PMID:25850463

  11. Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial.

    Science.gov (United States)

    Umasunthar, T; Procktor, A; Hodes, M; Smith, J G; Gore, C; Cox, H E; Marrs, T; Hanna, H; Phillips, K; Pinto, C; Turner, P J; Warner, J O; Boyle, R J

    2015-07-01

    Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices. We allocated mothers of food-allergic children prescribed an AAI for the first time to Anapen or EpiPen using a computer-generated randomization list, with optimal training according to manufacturer's instructions. After one year, participants were randomly allocated a new device (EpiPen, Anapen, new EpiPen, JEXT or Auvi-Q), without device-specific training. We assessed ability to deliver adrenaline using their AAI in a simulated anaphylaxis scenario six weeks and one year after initial training, and following device switch. Primary outcome was successful adrenaline administration at six weeks, assessed by an independent expert. Secondary outcomes were success at one year, success after switching device, and adverse events. We randomized 158 participants. At six weeks, 30 of 71 (42%) participants allocated to Anapen and 31 of 73 (43%) participants allocated to EpiPen were successful - RR 1.00 (95% CI 0.68-1.46). Success rates at one year were also similar, but digital injection was more common at one year with EpiPen (8/59, 14%) than Anapen (0/51, 0%, P = 0.007). When switched to a new device without specific training, success rates were higher with Auvi-Q (26/28, 93%) than other devices (39/80, 49%; P < 0.001). AAI device design is a major determinant of successful adrenaline administration. Success rates were low with several devices, but were high using the audio-prompt device Auvi-Q. © 2015 The Authors Allergy Published by John Wiley & Sons Ltd.

  12. Kinship and interaction in neuromuscular pharmacology

    NARCIS (Netherlands)

    Schiere, Sjouke

    2006-01-01

    The background of this thesis is presented in the introductory chapters and stafts with a brief history of neuromuscular relaxants. It is followed by a short description of the neuromuscular physiology and pharmacology in chapters 2 and 3, respectively. In chapter 4 the aim of the thesis is

  13. Sugammadex Improves Neuromuscular Function in Patients ...

    African Journals Online (AJOL)

    2018-02-23

    Feb 23, 2018 ... with a modified gamma-cyclodextrin structure offers a viable alternative to the traditional decurarization by cholinesterase inhibitors in the context of the use of steroidal neuromuscular blocking agents. Sugammadex shows its effects through encapsulation of the steroidal neuromuscular blockers, its effects ...

  14. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten.

    Science.gov (United States)

    Blair, Clancy; Razza, Rachel Peters

    2007-01-01

    This study examined the role of self-regulation in emerging academic ability in one hundred and forty-one 3- to 5-year-old children from low-income homes. Measures of effortful control, false belief understanding, and the inhibitory control and attention-shifting aspects of executive function in preschool were related to measures of math and literacy ability in kindergarten. Results indicated that the various aspects of child self-regulation accounted for unique variance in the academic outcomes independent of general intelligence and that the inhibitory control aspect of executive function was a prominent correlate of both early math and reading ability. Findings suggest that curricula designed to improve self-regulation skills as well as enhance early academic abilities may be most effective in helping children succeed in school.

  15. Biologic control ability of plant growth-promoting Paenibacillus lentimorbus NRRL B-30488 isolated from milk.

    Science.gov (United States)

    DasGupta, S M; Khan, N; Nautiyal, C S

    2006-12-01

    A plant growth-promoting Paenibacillus lentimorbus NRRL B-30488 (B-30488) was isolated from cows' milk. Bacterial colonization and growth responses of different plant species after inoculation with B-30488 were evaluated in a controlled environment and in microplot assays. Survival and colonization of B-30488 in the phytosphere of plants and soil was monitored using a chromosomally located rifampicin-marked mutant B-30488 (B-30488R). The strain showed variable ability to invade plants. The interaction between B-30488R and Fusarium oxysporum f. sp. ciceri was studied by scanning electron microscopy. Chitinase and beta-1,3-glucanase enzymes were produced when B-30488R was grown in the presence of colloidal chitin as sole carbon source. Deliberate dilution of B-30488R with field soil offers a reliable process for decreasing the cost of bacterial inoculants in developing countries. Seed treatment of chickpea demonstrated significantly (P = 0.05) greater seedling mortality in nonbacterized compared with bacterized seedlings. Bacterization significantly (P = 0.05) improved seed germination, plant height, number of pods/plant(-1), and seed dry weight.

  16. Long-term effects of controllability or the lack of it on coping abilities and stress resilience in the rat.

    Science.gov (United States)

    Lucas, Morgan; Ilin, Yana; Anunu, Rachel; Kehat, Orli; Xu, Lin; Desmedt, Aline; Richter-Levin, Gal

    2014-09-01

    Findings suggest that stress-induced impaired learning and coping abilities may be attributed more to the psychological nature of the stressor, rather than its physical properties. It has been proposed that establishing controllability over stressors can ameliorate some of its effects on cognition and behavior. Gaining controllability was suggested to be associated with the development of stress resilience. Based on repeated exposure to the two-way shuttle avoidance task, we previously developed and validated a behavioral task that leads to a strict dissociation between gaining controllability (to the level that the associated fear is significantly reduced) and a fearful state of uncontrollability. Employing this protocol, we investigated here the impact of gaining or failing to gain emotional controllability on indices of anxiety and depression and on subsequent abilities to cope with positively or negatively reinforcing learning experiences. In agreement with previous studies, rats exposed to the uncontrollable protocol demonstrated high concentration of sera corticosterone, increased immobility, reduced duration of struggling in the forced swim test and impaired ability to acquire subsequent learning tasks. Achieving emotional controllability resulted in resilience to stress as was indicated by longer duration of struggling in the forced swim test, and enhanced learning abilities. Our prolonged training protocol, with the demonstrated ability of rats to gain emotional controllability, is proposed as a useful tool to study the neurobiological mechanisms of stress resilience.

  17. The importance of job control for workers with decreased work ability to remain productive at work

    NARCIS (Netherlands)

    T.I.J. van den Berg (Tilja); S.J.W. Robroek (Suzan); J.F. Plat (Jan); M.A. Koopmanschap (Marc); A. Burdorf (Alex)

    2011-01-01

    textabstractPurpose: Workers with decreased work ability are at greater risk of reduced productivity at work. We hypothesized that work-related characteristics play an important role in supporting workers to remain productive despite decreased work ability. Methods: The study population consisted of

  18. Effect of in-season neuromuscular and proprioceptive training on postural stability in male youth basketball players

    Directory of Open Access Journals (Sweden)

    Ondra Lukáš

    2017-10-01

    Full Text Available Background: Poor balance ability is a predictor of injuries of the lower extremity. Multi-intervention proprioception preventive programs, comprising balance training, strength, plyometric, agility, running, and stretching exercises, are effective in improving balance ability and reducing the risk of lower extremity injuries in athletes.Objective: The aim of the study was to examine the effect of a 20-week in-season multi-intervention proprioceptive neuromuscular training program on postural stability in male youth basketball players.Methods: Twenty-one elite male youth basketball players were divided into an intervention group (n = 10, age 17.3 ± 1.3 years and a control group (n = 11, age 16.5 ± 1.8 years. During the in-season period (20 weeks, the intervention group followed a proprioceptive and neuromuscular training program, three times per week and 20 minutes per session. Balance was tested in a quiet unipedal stance (on both the dominant and non-dominant leg on a foam mat with eyes open, before and after a 20-week period in both groups. The mean velocities in the medial-lateral and anterior-posterior directions and the mean total velocity of the centre of pressure (COP displacement were obtained with a force platform.Results: The combined effect (pre-post test × group showed that intervention resulted in significant improvement in the mean COP velocity for both the dominant and non-dominant limb in the anterior-posterior direction (p = .013 and p < .001, respectively and in the medial-lateral direction (p = .007 and p < .001, respectively as well as in the total COP velocity (p = .009 and p < .001, respectively. Conclusions: The specific proprioceptive and neuromuscular training had a positive effect on postural stability for both the dominant and non-dominant limb in basketball players.

  19. Effectiveness of Proprioceptive Neuromuscular Facilitation Techniques as Compared to Traditional Strength Training in Gait Training Among Transtibial Amputees.

    Science.gov (United States)

    Anjum, Hadeya; Amjad, Imran; Malik, Arshad Nawaz

    2016-06-01

    To determine the effects of proprioceptive neuromuscular facilitation (PNF) techniques as compared with the traditional prosthetic strength training (TPT), in improving ambulatory function in subjects with transtibial amputation. Randomized control trial. Artificial Limb Centre of Fauji Foundation Hospital, Rawalpindi, from July to December 2014. Patients with lower-limb amputation was selected through purposive sampling and randomly assigned into PNF group (n=31) and traditional group (n=32). The baseline and follow-up of 04 weeks treatment session was provided and measurement was noted through the locomotor capabilities index. The locomotor capabilities index abilities had significant difference in both groups. The mean index was 23.93 for PNF and 18.18 for TPT(p > 0.05), and the knee muscle strength was also significantly different (p > 0.05). There was no significant difference in gait parameters. Proprioceptive neuromuscular facilitation technique is better in improving the locomotor abilities and knee muscle strength as compared to traditional training. The basic gait parameters have same effect in both groups.

  20. Coping with examinations: Exploring relationships between students' coping strategies, implicit theories of ability, and perceived control

    OpenAIRE

    Doron, Julie; Stephan, Yannick; Boiché, Julie; Scanff, Christine Le

    2009-01-01

    International audience; Background: Relatively little is known about the contribution of students' beliefs regarding the nature of academic ability (i.e. their implicit theories) on strategies used to deal with examinations.Aims: This study applied Dweck's socio-cognitive model of achievement motivation to better understand how students cope with examinations. It was expected that students' implicit theories of academic ability would be related to their use of particular coping strategies to ...

  1. Autoantibodies in neuromuscular transmission disorders

    Directory of Open Access Journals (Sweden)

    Vincent Angela

    2008-01-01

    Full Text Available It is a great pleasure to be asked to honour the memory of Dr. Baldev Singh by reviewing the field of autoantibodies in myasthenia gravis and other neurotransmission disorders. The neuromuscular junction (NMJ is the site of a number of different autoimmune and genetic disorders, and it is also the target of many neurotoxins from venomous snakes, spiders, scorpions and other species. The molecular organization of the NMJ is graphically represented in [Figure 1A], where different ion channels, receptors and other proteins are shown. Four of the ion channels or receptors are directly involved in autoimmune diseases. This brief review will not only concentrate on these conditions but also illustrate how their study is helping us to understand the etiology of rare but treatable neurological syndromes of the central nervous system.

  2. Improvement of Upper Extremity Deficit after Constraint-Induced Movement Therapy Combined with and without Preconditioning Stimulation Using Dual-hemisphere Transcranial Direct Current Stimulation and Peripheral Neuromuscular Stimulation in Chronic Stroke Patients: A Pilot Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Takashi Takebayashi

    2017-10-01

    Full Text Available In this study, we investigated the effects of dual-hemisphere transcranial direct current stimulation (dual-tDCS of both the affected (anodal tDCS and non-affected (cathodal tDCS primary motor cortex, combined with peripheral neuromuscular electrical stimulation (PNMES, on the effectiveness of constraint-induced movement therapy (CIMT as a neurorehabilitation intervention in chronic stroke. We conducted a randomized controlled trial of feasibility, with a single blind assessor, with patients recruited from three outpatient clinics. Twenty chronic stroke patients were randomly allocated to the control group, receiving conventional CIMT, or the intervention group receiving dual-tDCS combined with PNMES before CIMT. Patients in the treatment group first underwent a 20-min period of dual-tDCS, followed immediately by PNMES, and subsequent CIMT for 2 h. Patients in the control group only received CIMT (with no pretreatment stimulation. All patients underwent two CIMT sessions, one in the morning and one in the afternoon, each lasting 2 h, for a total of 4 h of CIMT per day. Upper extremity function was assessed using the Fugl-Meyer Assessment (primary outcome, as well as the amount of use (AOU and quality of movement (QOM scores, obtained via the Motor Activity Log (secondary outcome. Nineteen patients completed the study, with one patient withdrawing after allocation. Compared to the control group, the treatment improvement in upper extremity function and AOU was significantly greater in the treatment than control group (change in upper extremity score, 9.20 ± 4.64 versus 4.56 ± 2.60, respectively, P < 0.01, η2 = 0.43; change in AOU score, 1.10 ± 0.65 versus 0.62 ± 0.85, respectively, P = 0.02, η2 = 0.52. There was no significant effect of the intervention on the QOM between the intervention and control groups (change in QOM score, 1.00 ± 0.62 versus 0.71 ± 0.72, respectively, P = 0.07, η2

  3. FUNCTIONS OF A NEUROMUSCULAR CENTRE

    Directory of Open Access Journals (Sweden)

    Janez Zidar

    2004-12-01

    Full Text Available Main functions of a neuromuscular (NM centre are making diagnosis, treatment and counselling. Some other functions, e. g. forming a register and epidemiological endeavours, could be added. All these activities are expected to be achieved by multidisciplinary approach with the idea that members use the same guidelines and share the same knowledge.NM diseases affect lower levels of the nervous system that is motor units (motor cells in the brainstem and spinal cord, nerve roots, cranial and peripheral nerves, neuromuscular junction, and muscles. There are many such diseases; a few are more common others are rare.Rational approach in making a diagnosis can be divided into several steps. The process begins with a person with clinical symptoms and signs which raise the suspicion of NM disease. The first step is the description of the predominant pattern of muscular wasting and weakness (e. g. limb-girdle, distal, ocular, facio-scapulo-humeral. Each of these syndromes require a differential diagnosis within the motor unit territory what is achieved by means of EMG and muscle biopsy. The latter is even more important to define the nature of the abnormality. Disease nature can also be determined biochemically and, as NM disorders are commonly genetically determined, at the molecular genetic level. Treatment modalities include drugs (causative and symptomatic and other measures such as promoting and maintaining good general health, preventing skeletal deformities, physiotherapy, orthoses, surgery, and prevention of respiratory and cardiac functions. Counselling is mainly by social workers that focus on the practical aspects of coping with illness and disability and by genetic counsellors who gave advise on family planning.

  4. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis

    Science.gov (United States)

    Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E

    2017-01-01

    Objective The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Design Systematic review and meta-regression. Data sources The literature search was performed in PubMed and EBSCO. Eligibility criteria Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. Results The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2–17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Conclusions Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. PMID:27251898

  5. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis.

    Science.gov (United States)

    Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E

    2016-10-01

    The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Systematic review and meta-regression. The literature search was performed in PubMed and EBSCO. Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2-17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  6. Does chess instruction improve mathematical problem-solving ability? Two experimental studies with an active control group.

    Science.gov (United States)

    Sala, Giovanni; Gobet, Fernand

    2017-12-01

    It has been proposed that playing chess enables children to improve their ability in mathematics. These claims have been recently evaluated in a meta-analysis (Sala & Gobet, 2016, Educational Research Review, 18, 46-57), which indicated a significant effect in favor of the groups playing chess. However, the meta-analysis also showed that most of the reviewed studies used a poor experimental design (in particular, they lacked an active control group). We ran two experiments that used a three-group design including both an active and a passive control group, with a focus on mathematical ability. In the first experiment (N = 233), a group of third and fourth graders was taught chess for 25 hours and tested on mathematical problem-solving tasks. Participants also filled in a questionnaire assessing their meta-cognitive ability for mathematics problems. The group playing chess was compared to an active control group (playing checkers) and a passive control group. The three groups showed no statistically significant difference in mathematical problem-solving or metacognitive abilities in the posttest. The second experiment (N = 52) broadly used the same design, but the Oriental game of Go replaced checkers in the active control group. While the chess-treated group and the passive control group slightly outperformed the active control group with mathematical problem solving, the differences were not statistically significant. No differences were found with respect to metacognitive ability. These results suggest that the effects (if any) of chess instruction, when rigorously tested, are modest and that such interventions should not replace the traditional curriculum in mathematics.

  7. REHABILITATION PROGRAMS FOR PEOPLE WITH NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    Anton Zupan

    2004-12-01

    Full Text Available Neuromuscular diseases are inherited, chronic, degenerative and progressive. The main characteristics of neuromuscular diseases are: muscular weakness, contractures, scoliosis, respiratory insufficiency, cardiac affection, nutrition disturbances, dependence on the help of others, possible social isolation and physiological problems. Appropriate rehabilitation programs should influence all mentioned characteristics. A special unit for rehabilitation of patients with neuromuscular diseases within the Institute for rehabilitation of the Republic of Slovenia was established in 1993 at the initiative of the Muscular Dystrophy Association of Slovenia. The main aim of this establishment was to try to guide the patient and his family through the course of the disease. The article describes the work of the mentioned unit. Different clinical rehabilitation programs for people with neuromuscular diseases are presented and some research results of the unit are mentioned.

  8. Cambios en el control neuromuscular de seis músculos de miembro inferior durante CMJ máximos realizados con fatiga

    Directory of Open Access Journals (Sweden)

    Gabriel Fábrica

    2013-06-01

    Full Text Available Hay diferentes opiniones respecto a si existen cambios en el control muscular cuando saltos con contramovimiento (CMJ son realizados en condición de fatiga. Este trabajo evalúa si la actividad y la secuencia temporal de activación de seis músculos de miembro inferior durante CMJ cambian por causa de la fatiga. El nivel de actividad varió principalmente en los músculos biarticulares. Los tiempos de los picos de actividad eléctrica sugieren la existencia de grupos de acción muscular, si bien ocurren cambios en la secuencia de activación dentro de cada grupo. Fue posible establecer que existe un patrón general de control muscular durante el apoyo en los CMJ, con ajustes del nivel y tiempo de activación que dependen del periodo temporal analizado y el músculo considerado.

  9. Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography.

    Science.gov (United States)

    Yin, Guo-ping; Ye, Jing-ying; Han, De-min; Wang, Xiao-yi; Zhang, Yu-huan; Li, Yan-ru

    2013-01-01

    It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis. Currently, there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea. This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition. The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea. The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value, where the percent compensated electromyography value = (normal breath surface electromyography - apnea surface electromyography)/normal breath surface electromyography, and the percent compensated electromyography values among subjects were compared. The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined. The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R(2) = 0.382, P electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea. The neuromuscular contribution is different among subjects with obstructive sleep apnea.

  10. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function.

    Science.gov (United States)

    Hindle, Kayla B; Whitcomb, Tyler J; Briggs, Wyatt O; Hong, Junggi

    2012-03-01

    Proprioceptive neuromuscular facilitation (PNF) is common practice for increasing range of motion, though little research has been done to evaluate theories behind it. The purpose of this study was to review possible mechanisms, proposed theories, and physiological changes that occur due to proprioceptive neuromuscular facilitation techniques. Four theoretical mechanisms were identified: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory. The studies suggest that a combination of these four mechanisms enhance range of motion. When completed prior to exercise, proprioceptive neuromuscular facilitation decreases performance in maximal effort exercises. When this stretching technique is performed consistently and post exercise, it increases athletic performance, along with range of motion. Little investigation has been done regarding the theoretical mechanisms of proprioceptive neuromuscular facilitation, though four mechanisms were identified from the literature. As stated, the main goal of proprioceptive neuromuscular facilitation is to increase range of motion and performance. Studies found both of these to be true when completed under the correct conditions. These mechanisms were found to be plausible; however, further investigation needs to be conducted. All four mechanisms behind the stretching technique explain the reasoning behind the increase in range of motion, as well as in strength and athletic performance. Proprioceptive neuromuscular facilitation shows potential benefits if performed correctly and consistently.

  11. Sign and Symptom and Ability to Control Violent Behaviour with Music Therapy and Rational Emotive Cognitive Behaviour Therapy

    Directory of Open Access Journals (Sweden)

    Heri Setiawan

    2015-10-01

    Full Text Available Introduction: Prevalence of violence is highly occur in mental disorders clients at psychiatric hospitals. The impact is injure to others. This research aims to examine the effectiveness of music therapy and RECBT to sign and symptom and ability to control violent behaviour. Methods: Quasi-experimental research design with a sample of 64 respondents. Result: The study found a decrease symptoms of violent behaviour, ability to control violent behavior include relaxation, change negative thingking, irational belief, and negative behavior have increased significantly than the clients that did not receiving therapy. Discussion: Music therapy and RECBT is recommended as a therapeutic nursing at the client’s violent behaviour. Key Word: violent, sign and simptom, ability, music therapy, RECBT

  12. Grade Inflation Rates among Different Ability Students, Controlling for Other Factors.

    Science.gov (United States)

    Mc Spirit, Stephanie; Jones, Kirk E.

    1999-01-01

    Compared grade inflation rates among students of different abilities at an open-admissions public university by examining trends in graduating grade point average from 1983 to 1996. The higher grade inflation rates among low aptitude students suggest that faculty might be using grades to encourage learning among marginal students. (SLD)

  13. Cambios en el control neuromuscular de seis músculos de miembro inferior durante CMJ máximos realizados con fatiga

    OpenAIRE

    Fábrica,Gabriel; González Rodríguez,Paula; Loss,Jefferson Fagundes

    2013-01-01

    Hay diferentes opiniones respecto a si existen cambios en el control muscular cuando saltos con contramovimiento (CMJ) son realizados en condición de fatiga. Este trabajo evalúa si la actividad y la secuencia temporal de activación de seis músculos de miembro inferior durante CMJ cambian por causa de la fatiga. El nivel de actividad varió principalmente en los músculos biarticulares. Los tiempos de los picos de actividad eléctrica sugieren la existencia de grupos de acción muscular, si bien o...

  14. Phonological Memory, Attention Control, and Musical Ability: Effects of Individual Differences on Rater Judgments of Second Language Speech

    Science.gov (United States)

    Isaacs, Talia; Trofimovich, Pavel

    2011-01-01

    This study examines how listener judgments of second language speech relate to individual differences in listeners' phonological memory, attention control, and musical ability. Sixty native English listeners (30 music majors, 30 nonmusic majors) rated 40 nonnative speech samples for accentedness, comprehensibility, and fluency. The listeners were…

  15. Changes in Frontal EEG Coherence across Infancy Predict Cognitive Abilities at Age 3: The Mediating Role of Attentional Control

    Science.gov (United States)

    Whedon, Margaret; Perry, Nicole B.; Calkins, Susan D.; Bell, Martha Ann

    2016-01-01

    Theoretical perspectives of cognitive development have maintained that functional integration of the prefrontal cortex across infancy underlies the emergence of attentional control and higher cognitive abilities in early childhood. To investigate these proposed relations, we tested whether functional integration of prefrontal regions across the…

  16. Effectiveness of Functional Progressive Resistance Exercise Training on Walking Ability in Children with Cerebral Palsy: A Randomized Controlled Trial

    Science.gov (United States)

    Scholtes, Vanessa A.; Becher, Jules G.; Janssen-Potten, Yvonne J.; Dekkers, Hurnet; Smallenbroek, Linda; Dallmeijer, Annet J.

    2012-01-01

    The objective of the study was to evaluate the effectiveness of functional progressive resistance exercise (PRE) training on walking ability in children with cerebral palsy (CP). Fifty-one ambulant children with spastic CP (mean age 10 years 5 months, 29 boys) were randomized to an intervention (n=26) or control group (n=25, receiving usual care).…

  17. Virtual Reality-Based Wii Fit Training in Improving Muscle Strength, Sensory Integration Ability, and Walking Abilities in Patients with Parkinson's Disease: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Ying-Yi Liao

    2015-12-01

    Conclusion: VRWii training is as beneficial as TE in improving walking abilities, sensory integration ability, and muscle strength in patients with PD, and such improvements persisted for at least for 1 month. VRWii training is thus suggested to be implemented in patients with PD.

  18. Motor ability in children treated for idiopathic clubfoot. A controlled pilot study.

    Science.gov (United States)

    Andriesse, Hanneke; Westbom, Lena; Hägglund, Gunnar

    2009-12-15

    To study motor ability at seven years of age in children treated for idiopathic clubfoot and its relation to clubfoot laterality, foot status and the amount of surgery performed. Twenty children (mean age 7.5 years, SD 3.2 months) from a consecutive birth cohort from our hospital catchments area (300.000 inhabitants from southern Sweden) were assessed with the Movement Assessment Battery for Children (MABC) and the Clubfoot Assessment Protocol (CAP). Compared to typically developing children an increased prevalence of motor impairment was found regarding both the total score for MABC (p Children with idiopathic clubfoot appear to have an increased risk of motor activity limitations and it is possible that other factors, independent of the clinical status, might be involved. The ability to keep balance on one leg may be a sufficient tool for determining which children in the orthopedic setting should be more thoroughly evaluated regarding their neuromotor functioning.

  19. Motor ability in children treated for idiopathic clubfoot. A controlled pilot study

    Directory of Open Access Journals (Sweden)

    Westbom Lena

    2009-12-01

    Full Text Available Abstract Background To study motor ability at seven years of age in children treated for idiopathic clubfoot and its relation to clubfoot laterality, foot status and the amount of surgery performed. Methods Twenty children (mean age 7.5 years, SD 3.2 months from a consecutive birth cohort from our hospital catchments area (300.000 inhabitants from southern Sweden were assessed with the Movement Assessment Battery for Children (MABC and the Clubfoot Assessment Protocol (CAP. Results Compared to typically developing children an increased prevalence of motor impairment was found regarding both the total score for MABC (p Conclusions Children with idiopathic clubfoot appear to have an increased risk of motor activity limitations and it is possible that other factors, independent of the clinical status, might be involved. The ability to keep balance on one leg may be a sufficient tool for determining which children in the orthopedic setting should be more thoroughly evaluated regarding their neuromotor functioning.

  20. Motor ability in children treated for idiopathic clubfoot. A controlled pilot study

    OpenAIRE

    Westbom Lena; Andriesse Hanneke; Hägglund Gunnar

    2009-01-01

    Abstract Background To study motor ability at seven years of age in children treated for idiopathic clubfoot and its relation to clubfoot laterality, foot status and the amount of surgery performed. Methods Twenty children (mean age 7.5 years, SD 3.2 months) from a consecutive birth cohort from our hospital catchments area (300.000 inhabitants from southern Sweden) were assessed with the Movement Assessment Battery for Children (MABC) and the Clubfoot Assessment Protocol (CAP). Results Compar...

  1. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.

    2016-01-01

    BACKGROUND: Female adolescents with patellofemoral pain are characterized by altered neuromuscular knee control and reduced maximal quadriceps torque. The purpose of this study is to investigate whether exercise therapy and patient education are associated with larger improvements in neuromuscular...... knee control and maximal quadriceps torque compared with patient education alone. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education and exercise therapy on self-reported recovery in 121 adolescents with patellofemoral pain...... flexion/extension kinematics and maximal quadriceps torque. FINDINGS: There was an 8-15% greater decrease in the complexity of surface electromyography suggesting an improvement in neuromuscular knee control among those randomized to exercise therapy (0.08

  2. Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability: a randomized controlled trial

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus D; Brandt, Mikkel

    2014-01-01

    OBJECTIVE: Imbalance between work demands and individual resources can lead to musculoskeletal disorders and reduced work ability. The aim of this study was to evaluate the effect of two contrasting interventions on work ability among slaughterhouse workers with chronic pain and work disability....... METHODS: Sixty-six slaughterhouse workers with upper-limb chronic pain and work disability were randomly allocated to 10 weeks of either strength training for the shoulder, arm, and hand muscles (3 times per week, 10 minutes per session) or ergonomic training (usual care control group) from September...... (mental resources) increased following strength training compared with ergonomic training (Ppain and disability exposed to forceful and repetitive job tasks...

  3. Neuromuscular paralysis for newborn infants receiving mechanical ventilation.

    Science.gov (United States)

    Cools, F; Offringa, M

    2005-04-18

    Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome. Neuromuscular paralysis, which eliminates spontaneous breathing efforts of the infant, has potential advantages in this respect. However, a number of complications have been reported with muscle relaxation in infants, so that concerns exist regarding the safety of prolonged neuromuscular paralysis in newborn infants. To determine whether routine neuromuscular paralysis of newborn infants receiving mechanical ventilation compared with no routine paralysis results in clinically important benefits or harms. The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2004), MEDLINE (from 1966 to April 2004) and EMBASE (from 1988 to April 2004) were searched. References of review articles were hand searched. Language restriction was not imposed. All trials using random or quasi-random patient allocation, in which the routine use of neuromuscular blocking agents during mechanical ventilation was compared to no paralysis or selective paralysis in newborn infants. Methodological quality was assessed blindly and independently by the two authors. Data were abstracted using standard methods of the Cochrane Collaboration and its Neonatal Review Group, with independent evaluation of trial quality, and abstraction and synthesis of data by both authors. Treatment effect was analysed using relative risk, risk difference and weighted mean difference. Ten possibly eligible trials were identified, of which six were included in the review. All the included trials studied preterm infants ventilated for respiratory distress syndrome, and used pancuronium as the neuromuscular blocking agent. In the analysis of the results of all trials, no significant difference was found in

  4. Neuromuscular blocking properties of dioxonium.

    Science.gov (United States)

    Tammisto, T; Salmenperä, M

    1980-12-01

    The characteristics of the myoneural block caused by a new neuromuscular blocking agent, dioxonium (Dx), were evaluated in surgical patients. The force and the corresponding electromyogram (EMG) of the thumb adduction evoked by various modes of ulnar nerve stimuli were measured. Onset, maintenance and disappearance of blockade after sequential administration of Dx were compared with results obtained with d-tubocurarine (dTc) or suxamethonium (Sx). Initially the Dx block was shown to be depolarizing with a negligible fade in the 2 Hz train of four stimuli with a single twitch suppression of 90%. On a weight basis, Dx was found to be about 15 times as potent as dTc in suppressing twitch to the 90% level. During maintenance, the block gained nondepolarizing characteristics with profound fades in the 2 and 50 Hz trains. The transition was associated with tachyphylaxis and with a more pronounced suppression of EMG amplitude than that measured in the twitch force. After a total dose of about 100 microgram/kg of Dx, the sensitivity to Dx again increased and the discrepancy between twitch tension and EMG disappeared. This pattern of changes was also seen with Sx. Spontaneous recovery occurred slightly faster than after dTc blocks of corresponding duration. With neostigmine, reversal was hastened and a full recovery with restitution of prerelaxant twitch and disappearance of fades was reached in about 20 min. Some discrepancy in EMG amplitude and twitch force persisted, however.

  5. Neuromuscular function in healthy occlusion.

    Science.gov (United States)

    Forrester, S E; Allen, S J; Presswood, R G; Toy, A C; Pain, M T G

    2010-09-01

    This study aimed to measure neuromuscular function for the masticatory muscles under a range of occlusal conditions in healthy, dentate adults. Forty-one subjects conducted maximum voluntary clenches under nine different occlusal loading conditions encompassing bilateral posterior teeth contacts with the mandible in different positions, anterior teeth contacts and unilateral posterior teeth contacts. Surface electromyography was recorded bilaterally from the anterior temporalis, superficial masseter, sternocleidomastoid, anterior digastric and trapezius muscles. Clench condition had a significant effect on muscle function (P = 0.0000) with the maximum function obtained for occlusions with bilateral posterior contacts and the mandible in a stable centric position. The remaining contact points and moving the mandible to a protruded position, whilst keeping posterior contacts, resulted in significantly lower muscle activities. Clench condition also had a significant effect on the per cent overlap, anterior-posterior and torque coefficients (P = 0.0000-0.0024), which describe the degree of symmetry in these muscle activities. Bilateral posterior contact conditions had significantly greater symmetry in muscle activities than anterior contact conditions. Activity in the sternocleidomastoid, anterior digastric and trapezius was consistently low for all clench conditions, i.e. centric position, whilst with anterior teeth contacts, both the muscle activity and the degree of symmetry in muscle activity are significantly reduced.

  6. Visuo-motor coordination ability predicts performance with brain-computer interfaces controlled by modulation of sensorimotor rhythms (SMR

    Directory of Open Access Journals (Sweden)

    Eva Maria Hammer

    2014-08-01

    Full Text Available Modulation of sensorimotor rhythms (SMR was suggested as a control signal for brain-computer interfaces (BCI. Yet, there is a population of users estimated between 10 to 50% not able to achieve reliable control and only about 20% of users achieve high (80-100% performance. Predicting performance prior to BCI use would facilitate selection of the most feasible system for an individual, thus constitute a practical benefit for the user, and increase our knowledge about the correlates of BCI control. In a recent study, we predicted SMR-BCI performance from psychological variables that were assessed prior to the BCI sessions and BCI control was supported with machine-learning techniques. We described two significant psychological predictors, namely the visuo-motor coordination ability and the ability to concentrate on the task. The purpose of the current study was to replicate these results thereby validating these predictors within a neurofeedback based SMR-BCI that involved no machine learning. Thirty-three healthy BCI novices participated in a calibration session and three further neurofeedback training sessions. Two variables were related with mean SMR-BCI performance: (1 A measure for the accuracy of fine motor skills, i.e. a trade for a person’s visuo-motor control ability and (2 subject’s attentional impulsivity. In a linear regression they accounted for almost 20% in variance of SMR-BCI performance, but predictor (1 failed significance. Nevertheless, on the basis of our prior regression model for sensorimotor control ability we could predict current SMR-BCI performance with an average prediction error of M = 12.07%. In more than 50% of the participants, the prediction error was smaller than 10%. Hence, psychological variables played a moderate role in predicting SMR-BCI performance in a neurofeedback approach that involved no machine learning. Future studies are needed to further consolidate (or reject the present predictors.

  7. Systematic review of the evidence on orthotic devices for the management of knee instability related to neuromuscular and central nervous system disorders.

    Science.gov (United States)

    McDaid, Catriona; Fayter, Debra; Booth, Alison; O'Connor, Joanne; Rodriguez-Lopez, Rocio; McCaughan, Dorothy; Bowers, Roy; Iglesias, Cynthia P; Lalor, Simon; O'Connor, Rory J; Phillips, Margaret; Ramdharry, Gita

    2017-09-05

    To assess the effectiveness of orthotic devices for the management of instability of the knee in adults with a neuromuscular disorder or central nervous system disorder. A systematic review of primary studies. Community. Adults with a neuromuscular disorder or central nervous system disorder and impaired walking ability due to instability of the knee. Orthoses with the clinical aim of controlling knee instability, for example, knee-ankle-foot orthoses, ankle-foot orthoses and knee orthoses or mixed design with no restrictions in design or material. Condition-specific or generic patient-reported outcome measures assessing function, disability, independence, activities of daily living, quality of life or psychosocial outcomes; pain; walking ability; functional assessments; biomechanical analysis; adverse effects; usage; patient satisfaction and the acceptability of a device; and resource utilisation data. Twenty-one studies including 478 patients were included. Orthotic devices were evaluated in patients with postpolio syndrome, poststroke syndrome, inclusion body myositis and spinal cord injury. The review included 2 randomised controlled trials (RCTs), 3 non-randomised controlled studies and 16 case series. Most were small, single-centre studies with only 6 of 21 following patients for 1 year or longer. They met between one and five of nine quality criteria and reported methods and results poorly. They mainly assessed outcomes related to gait analysis and energy consumption with limited use of standardised, validated, patient-reported outcome measures. There was an absence of evidence on outcomes of direct importance to patients such as reduction in pain and falls. There is a need for high-quality research, particularly RCTs, of orthotic devices for knee instability related to neuromuscular and central nervous system conditions. This research should address outcomes important to patients. There may also be value in developing a national registry. PROSPERO (CRD

  8. Systematic review of the evidence on orthotic devices for the management of knee instability related to neuromuscular and central nervous system disorders

    Science.gov (United States)

    Fayter, Debra; Booth, Alison; O'Connor, Joanne; Rodriguez-Lopez, Rocio; McCaughan, Dorothy; Bowers, Roy; Iglesias, Cynthia P; Lalor, Simon; O'Connor, Rory J; Phillips, Margaret; Ramdharry, Gita

    2017-01-01

    Objectives To assess the effectiveness of orthotic devices for the management of instability of the knee in adults with a neuromuscular disorder or central nervous system disorder. Design A systematic review of primary studies. Setting Community. Participants Adults with a neuromuscular disorder or central nervous system disorder and impaired walking ability due to instability of the knee. Interventions Orthoses with the clinical aim of controlling knee instability, for example, knee-ankle-foot orthoses, ankle-foot orthoses and knee orthoses or mixed design with no restrictions in design or material. Primary and secondary outcome measures Condition-specific or generic patient-reported outcome measures assessing function, disability, independence, activities of daily living, quality of life or psychosocial outcomes; pain; walking ability; functional assessments; biomechanical analysis; adverse effects; usage; patient satisfaction and the acceptability of a device; and resource utilisation data. Results Twenty-one studies including 478 patients were included. Orthotic devices were evaluated in patients with postpolio syndrome, poststroke syndrome, inclusion body myositis and spinal cord injury. The review included 2 randomised controlled trials (RCTs), 3 non-randomised controlled studies and 16 case series. Most were small, single-centre studies with only 6 of 21 following patients for 1 year or longer. They met between one and five of nine quality criteria and reported methods and results poorly. They mainly assessed outcomes related to gait analysis and energy consumption with limited use of standardised, validated, patient-reported outcome measures. There was an absence of evidence on outcomes of direct importance to patients such as reduction in pain and falls. Conclusions There is a need for high-quality research, particularly RCTs, of orthotic devices for knee instability related to neuromuscular and central nervous system conditions. This research should

  9. Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy: A New Strategy for Improving Upper Extremity Function in Patients with Hemiparesis following Stroke

    OpenAIRE

    Fujiwara, Toshiyuki; Kawakami, Michiyuki; Honaga, Kaoru; Tochikura, Michi; Abe, Kaoru

    2017-01-01

    Hybrid Assistive Neuromuscular Dynamic Stimulation (HANDS) therapy is one of the neurorehabilitation therapeutic approaches that facilitates the use of the paretic upper extremity (UE) in daily life by combining closed-loop electromyography- (EMG-) controlled neuromuscular electrical stimulation (NMES) with a wrist-hand splint. This closed-loop EMG-controlled NMES can change its stimulation intensity in direct proportion to the changes in voluntary generated EMG amplitudes recorded with surfa...

  10. Study protocol: effect of playful training on functional abilities of older adults - a randomized controlled trial

    DEFF Research Database (Denmark)

    Jessen, Jari Due; Lund, Henrik Hautop

    2017-01-01

    Background: Loss of functional capabilities due to inactivity is one of the most common reasons for fall accidents, and it has been well established that loss of capabilities can be effectively reduced by physical activity. Pilot studies indicate a possible improvement in functional abilities......). Secondary outcomes related to adherence, motivation and acceptability will be investigated through semi-structured interviews. Data will be collected from pre-and post-tests. Data will be analyzed for statistically significant differences by checking that there is a Gaussian distribution and then using...

  11. The effects of inhibitory control training for preschoolers on reasoning ability and neural activity

    DEFF Research Database (Denmark)

    Liu, Qian; Zhu, Xinyi; Ziegler, Albert

    2015-01-01

    Inhibitory control (including response inhibition and interference control) develops rapidly during the preschool period and is important for early cognitive development. This study aimed to determine the training and transfer effects on response inhibition in young children. Children in the trai......Inhibitory control (including response inhibition and interference control) develops rapidly during the preschool period and is important for early cognitive development. This study aimed to determine the training and transfer effects on response inhibition in young children. Children....... Furthermore, gender differences in the training-induced changes in neural activity were found in preschoolers....

  12. Ability of independently ambulant children with cerebral palsy to ride a two-wheel bicycle: a case-control study.

    Science.gov (United States)

    Toovey, Rachel; Reid, Susan M; Rawicki, Barry; Harvey, Adrienne R; Watt, Kerrianne

    2017-04-01

    Limited information exists on the ability of children with cerebral palsy (CP) to ride a two-wheel bicycle, an activity that may improve health and participation. We aimed to describe bicycle-riding ability and variables associated with ability to ride in children with CP (Gross Motor Functional Classification System [GMFCS] levels I-II) compared with children with typical development. This case-control study surveyed parents of 114 children with CP and 87 children with typical development aged 6 to 15 years (115 males, mean age 9y 11mo, standard deviation [SD] 2y 10mo). Kaplan-Meier methods were used to compare proportions able to ride at any given age between the two groups. Logistic regression was used to assess variables associated with ability to ride for children with CP and typical development separately. The proportion of children with CP able to ride at each level of bicycle-riding ability was substantially lower at each age than peers with typical development (pchildren with typical development were able to ride independently by 10 years of age, 51% of children with CP classified as GMFCS level I and 3% of those classified as GMFCS level II had obtained independent riding in the community by 15 years of age. Variables associated with ability to ride for children classified as GMFCS level I were age and parent-rated importance of their child being able to ride. Some independently ambulant children with CP can learn to ride a bicycle, in particular if they are classified as GMFCS level I. Variables associated with ability to ride deserve consideration in shaping future efforts for the majority of this population who are not yet able to ride. © 2016 Mac Keith Press.

  13. Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke.

    Science.gov (United States)

    Park, Yu-Hyung; Lee, Chi-Ho; Lee, Byoung-Hee

    2013-01-01

    This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (Pvirtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.

  14. Plasticity of Decision-Making Abilities Among Maltreated Adolescents: Evidence From a Random Controlled Trial

    Science.gov (United States)

    Weller, Joshua A.; Leve, Leslie D.; Kim, Hyoun K.; Bhimji, Jabeene; Fisher, Philip A.

    2014-01-01

    Childhood maltreatment has lasting negative effects throughout the lifespan. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls’ ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n = 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and non-maltreated age and SES-matched girls living with their biological parent(s) (n = 80), completed a decision-making task (at age 15–17) that assessed risk-taking and sensitivity to expected value, an index of advantageous decision-making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to non-maltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects. PMID:25997770

  15. Individual differences in control of language interference in late bilinguals are mainly related to general executive abilities

    Directory of Open Access Journals (Sweden)

    Münte Thomas F

    2010-01-01

    Full Text Available Abstract Background Recent research based on comparisons between bilinguals and monolinguals postulates that bilingualism enhances cognitive control functions, because the parallel activation of languages necessitates control of interference. In a novel approach we investigated two groups of bilinguals, distinguished by their susceptibility to cross-language interference, asking whether bilinguals with strong language control abilities ("non-switchers" have an advantage in executive functions (inhibition of irrelevant information, problem solving, planning efficiency, generative fluency and self-monitoring compared to those bilinguals showing weaker language control abilities ("switchers". Methods 29 late bilinguals (21 women were evaluated using various cognitive control neuropsychological tests [e.g., Tower of Hanoi, Ruff Figural Fluency Task, Divided Attention, Go/noGo] tapping executive functions as well as four subtests of the Wechsler Adult Intelligence Scale. The analysis involved t-tests (two independent samples. Non-switchers (n = 16 were distinguished from switchers (n = 13 by their performance observed in a bilingual picture-naming task. Results The non-switcher group demonstrated a better performance on the Tower of Hanoi and Ruff Figural Fluency task, faster reaction time in a Go/noGo and Divided Attention task, and produced significantly fewer errors in the Tower of Hanoi, Go/noGo, and Divided Attention tasks when compared to the switchers. Non-switchers performed significantly better on two verbal subtests of the Wechsler Adult Intelligence Scale (Information and Similarity, but not on the Performance subtests (Picture Completion, Block Design. Conclusions The present results suggest that bilinguals with stronger language control have indeed a cognitive advantage in the administered tests involving executive functions, in particular inhibition, self-monitoring, problem solving, and generative fluency, and in two of the

  16. Individual differences in control of language interference in late bilinguals are mainly related to general executive abilities.

    Science.gov (United States)

    Festman, Julia; Rodriguez-Fornells, Antoni; Münte, Thomas F

    2010-01-13

    Recent research based on comparisons between bilinguals and monolinguals postulates that bilingualism enhances cognitive control functions, because the parallel activation of languages necessitates control of interference. In a novel approach we investigated two groups of bilinguals, distinguished by their susceptibility to cross-language interference, asking whether bilinguals with strong language control abilities ("non-switchers") have an advantage in executive functions (inhibition of irrelevant information, problem solving, planning efficiency, generative fluency and self-monitoring) compared to those bilinguals showing weaker language control abilities ("switchers"). 29 late bilinguals (21 women) were evaluated using various cognitive control neuropsychological tests [e.g., Tower of Hanoi, Ruff Figural Fluency Task, Divided Attention, Go/noGo] tapping executive functions as well as four subtests of the Wechsler Adult Intelligence Scale. The analysis involved t-tests (two independent samples). Non-switchers (n = 16) were distinguished from switchers (n = 13) by their performance observed in a bilingual picture-naming task. The non-switcher group demonstrated a better performance on the Tower of Hanoi and Ruff Figural Fluency task, faster reaction time in a Go/noGo and Divided Attention task, and produced significantly fewer errors in the Tower of Hanoi, Go/noGo, and Divided Attention tasks when compared to the switchers. Non-switchers performed significantly better on two verbal subtests of the Wechsler Adult Intelligence Scale (Information and Similarity), but not on the Performance subtests (Picture Completion, Block Design). The present results suggest that bilinguals with stronger language control have indeed a cognitive advantage in the administered tests involving executive functions, in particular inhibition, self-monitoring, problem solving, and generative fluency, and in two of the intelligence tests. What remains unclear is the direction of the

  17. Automated optimal coordination of multiple-DOF neuromuscular actions in feedforward neuroprostheses.

    Science.gov (United States)

    Lujan, J Luis; Crago, Patrick E

    2009-01-01

    This paper describes a new method for designing feedforward controllers for multiple-muscle, multiple-DOF, motor system neural prostheses. The design process is based on experimental measurement of the forward input/output properties of the neuromechanical system and numerical optimization of stimulation patterns to meet muscle coactivation criteria, thus resolving the muscle redundancy (i.e., overcontrol) and the coupled DOF problems inherent in neuromechanical systems. We designed feedforward controllers to control the isometric forces at the tip of the thumb in two directions during stimulation of three thumb muscles as a model system. We tested the method experimentally in ten able-bodied individuals and one patient with spinal cord injury. Good control of isometric force in both DOFs was observed, with rms errors less than 10% of the force range in seven experiments and statistically significant correlations between the actual and target forces in all ten experiments. Systematic bias and slope errors were observed in a few experiments, likely due to the neuromuscular fatigue. Overall, the tests demonstrated the ability of a general design approach to satisfy both control and coactivation criteria in multiple-muscle, multiple-axis neuromechanical systems, which is applicable to a wide range of neuromechanical systems and stimulation electrodes.

  18. Employment profiles in neuromuscular diseases.

    Science.gov (United States)

    Fowler, W M; Abresch, R T; Koch, T R; Brewer, M L; Bowden, R K; Wanlass, R L

    1997-01-01

    Consumer and rehabilitation provider factors that might limit employment opportunities for 154 individuals with six slowly progressive neuromuscular diseases (NMD) were investigated. The NMDs were spinal muscular atrophy (SMA), hereditary motor sensory neuropathy (HMSN), Becker's muscular dystrophy (BMD), facioscapulohumeral muscular dystrophy (FSHD), myotonic muscular dystrophy (MMD), and limb-girdle syndrome (LGS). Forty percent were employed in the competitive labor market at the time of the study, 50% had been employed in the past, and 10% had never been employed. The major consumer barrier to employment was education. Other important factors were type of occupation, intellectual capacity, psychosocial adjustment, and the belief by most individuals that their physical disability was the only or major barrier to obtaining a job. Psychological characteristics were associated with level of unemployment. However, physical impairment and disability were not associated with level of unemployment. There also were differences among the types of NMDs. Compared with the SMA, HMSN, BMD, and FSHD groups, the MMD and LGS groups had significantly higher levels of unemployment, lower educational levels, and fewer employed professional, management, and technical workers. Nonphysical impairment factors such as a low percentage of college graduates, impaired intellectual function in some individuals, and poor psychological adjustment were correlated with higher unemployment levels in the MMD group. Unemployment in the LGS group was correlated with a failure to complete high school. Major provider barriers to employment were the low level of referrals to Department of Rehabilitation by physicians and the low percentage of acceptance into the State Department of Rehabilitation. The low rate of acceptance was primarily attributable to the low number of referrals compounded by a lack of counselor experience with individuals with NMD. Both consumer and provider barriers may

  19. Protein defects in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Vainzof M.

    2003-01-01

    Full Text Available Muscular dystrophies are a heterogeneous group of genetically determined progressive disorders of the muscle with a primary or predominant involvement of the pelvic or shoulder girdle musculature. The clinical course is highly variable, ranging from severe congenital forms with rapid progression to milder forms with later onset and a slower course. In recent years, several proteins from the sarcolemmal muscle membrane (dystrophin, sarcoglycans, dysferlin, caveolin-3, from the extracellular matrix (alpha2-laminin, collagen VI, from the sarcomere (telethonin, myotilin, titin, nebulin, from the muscle cytosol (calpain 3, TRIM32, from the nucleus (emerin, lamin A/C, survival motor neuron protein, and from the glycosylation pathway (fukutin, fukutin-related protein have been identified. Mutations in their respective genes are responsible for different forms of neuromuscular diseases. Protein analysis using Western blotting or immunohistochemistry with specific antibodies is of the utmost importance for the differential diagnosis and elucidation of the physiopathology of each genetic disorder involved. Recent molecular studies have shown clinical inter- and intra-familial variability in several genetic disorders highlighting the importance of other factors in determining phenotypic expression and the role of possible modifying genes and protein interactions. Developmental studies can help elucidate the mechanism of normal muscle formation and thus muscle regeneration. In the last fifteen years, our research has focused on muscle protein expression, localization and possible interactions in patients affected by different forms of muscular dystrophies. The main objective of this review is to summarize the most recent findings in the field and our own contribution.

  20. Effects of Swiss ball exercise and resistance exercise on respiratory function and trunk control ability in patients with scoliosis

    OpenAIRE

    Kim, Jwa Jun; Song, Gui Bin; Park, Eun Cho

    2015-01-01

    [Purpose] This study compared the effects of Swiss ball exercise and resistance exercise on the respiratory function and trunk control ability of patients with scoliosis. [Subjects] Forty scoliosis patients were randomly divided into the Swiss ball exercise group (n= 20) and resistance exercise group (n = 20). [Methods] The Swiss ball and resistance exercise groups performed chest expansion and breathing exercises with a Swiss ball and a therapist?s resistance, respectively. Both groups recei...

  1. Effects of Swiss ball exercise and resistance exercise on respiratory function and trunk control ability in patients with scoliosis.

    Science.gov (United States)

    Kim, Jwa Jun; Song, Gui Bin; Park, Eun Cho

    2015-06-01

    [Purpose] This study compared the effects of Swiss ball exercise and resistance exercise on the respiratory function and trunk control ability of patients with scoliosis. [Subjects] Forty scoliosis patients were randomly divided into the Swiss ball exercise group (n= 20) and resistance exercise group (n = 20). [Methods] The Swiss ball and resistance exercise groups performed chest expansion and breathing exercises with a Swiss ball and a therapist's resistance, respectively. Both groups received training 30 min per day, 5 times per week for 8 weeks. [Results] Both groups exhibited significant changes in forced vital capacity, forced expiratory volume in one second, and trunk impairment scale after the intervention. However, there was no significant change in the forced expiratory volume in one second/forced vital capacity ratio after the intervention in either group. Meanwhile, forced expiratory volume in one second and trunk impairment scale were significantly greater in the resistance exercise group after the intervention. [Conclusion] Both Swiss ball exercise and resistance exercise are effective for improving the respiratory function and trunk control ability of patients with scoliosis. However, resistance exercise is more effective for increasing the forced expiratory volume in one second and trunk control ability.

  2. Emotional and effortful control abilities in 42-month-old very preterm and full-term children.

    Science.gov (United States)

    Witt, Arnaud; Theurel, Anne; Tolsa, Cristina Borradori; Lejeune, Fleur; Fernandes, Lisa; de Jonge, Laurence van Hanswijck; Monnier, Maryline; Bickle Graz, Myriam; Barisnikov, Koviljka; Gentaz, Edouard; Hüppi, Petra S

    2014-10-01

    Very preterm (VP) infants are at greater risk for cognitive difficulties that may persist during school-age, adolescence and adulthood. Behavioral assessments report either effortful control (part of executive functions) or emotional reactivity/regulation impairments. The aim of this study is to examine whether emotional recognition, reactivity, and regulation, as well as effortful control abilities are impaired in very preterm children at 42 months of age, compared with their full-term peers, and to what extent emotional and effortful control difficulties are linked. Children born very preterm (VP; children (n=47) participated in a series of specific neuropsychological tests assessing their level of emotional understanding, reactivity and regulation, as well as their attentional and effortful control abilities. VP children exhibited higher scores of frustration and fear, and were less accurate in naming facial expressions of emotions than their aged-matched peers. However, VP children and FT children equally performed when asked to choose emotional facial expression in social context, and when we assessed their selective attention skills. VP performed significantly lower than full terms on two tasks of inhibition when correcting for verbal skills. Moreover, significant correlations between cognitive capacities (effortful control) and emotional abilities were evidenced. Compared to their FT peers, 42 month-olds who were born very preterm are at higher risk of exhibiting specific emotional and effortful control difficulties. The results suggest that these difficulties are linked. Ongoing behavioral and emotional impairments starting at an early age in preterms highlight the need for early interventions based on a better understanding of the relationship between emotional and cognitive difficulties. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Effects of Aldrin-transdiol on neuromuscular facilitation and depression

    NARCIS (Netherlands)

    Akkermans, L.M.A.; Bercken, J. van den; Zalm, J.M. van der

    The effects of aldrin-transdiol, one of the active metabolites of the insecticide dieldrin, on evoked transmitter release, neuromuscular facilitation and neuromuscular depression have been studied in frog sartorius nerve-muscle preparations. Conventional techniques of intracellular recordings were

  4. Quantitative skeletal muscle ultrasonography in children with suspected neuromuscular disease.

    NARCIS (Netherlands)

    Pillen, S.; Scholten, R.R.; Zwarts, M.J.; Verrips, A.

    2003-01-01

    We determined prospectively the diagnostic value of quantitative ultrasonography in detecting neuromuscular disorders in children. Ultrasonographic scans of four muscles were made in 36 children with symptoms or signs suggestive of neuromuscular disease, such as muscle weakness and hypotonia. The

  5. The Importance of Postural Control in Relation to Technical Abilities in Small-Sided Soccer Games.

    Science.gov (United States)

    Edis, Çağlar; Vural, Faik; Vurgun, Hikmet

    2016-12-01

    Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3) small-sided games (SSGs). Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg). Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior-posterior and medial-lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman's rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776), 2:2 (rvalues ranging from 0.511 to 0.740) and 3:3 (r-values ranging from 0.502 to 0.834) SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game.

  6. Neuromuscular Junction Dismantling in Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Valentina Cappello

    2017-10-01

    Full Text Available Neuromuscular junction assembly and plasticity during embryonic, postnatal, and adult life are tightly regulated by the continuous cross-talk among motor nerve endings, muscle fibers, and glial cells. Altered communications among these components is thought to be responsible for the physiological age-related changes at this synapse and possibly for its destruction in pathological states. Neuromuscular junction dismantling plays a crucial role in the onset of Amyotrophic Lateral Sclerosis (ALS. ALS is characterized by the degeneration and death of motor neurons leading to skeletal muscle denervation, atrophy and, most often, death of the patient within five years from diagnosis. ALS is a non-cell autonomous disease as, besides motor neuron degeneration, glial cells, and possibly muscle fibers, play a role in its onset and progression. Here, we will review the recent literature regarding the mechanisms leading to neuromuscular junction disassembly and muscle denervation focusing on the role of the three players of this peripheral tripartite synapse.

  7. Process control and risky decision-making : moderation by general mental ability and need for cognition

    NARCIS (Netherlands)

    Burkolter, Dina; Kluge, Annette

    2012-01-01

    Human factors and ergonomics research could benefit from focusing more strongly on individual differences especially trait variables. The present study suggests the analysis of moderator effects as a promising way to enhance understanding of trait variables and process control performance. Process

  8. Control beliefs can predict the ability to up-regulate sensorimotor rhythm during neurofeedback training

    Directory of Open Access Journals (Sweden)

    Matthias eWitte

    2013-08-01

    Full Text Available Technological progress in computer science and neuroimaging has resulted in many approaches that aim to detect brain states and translate them to an external output. Studies from the field of brain-computer interfaces and neurofeedback have validated the coupling between brain signals and computer devices; however a cognitive model of the processes involved remains elusive. Psychological parameters usually play a moderate role in predicting the performance of brain-computer interface (BCI and neurofeedback (NF users. The concept of a locus of control, i.e. whether one’s own action is determined by internal or external causes, may help to unravel inter-individual performance capacities. Here, we present data from twenty healthy participants who performed a feedback task based on EEG recordings of the sensorimotor rhythm (SMR. One group of ten participants underwent ten training sessions where the amplitude of the SMR was coupled to a vertical feedback bar. The other group of ten participants participated in the same task but relied on sham feedback. Our analysis revealed that a locus of control score focusing on control beliefs with regard to technology negatively correlated with the power of SMR. These preliminary results suggest that participants whose confidence in control over technical devices is high might consume additional cognitive resources. This higher effort in turn may interfere with brain states of relaxation as reflected in the SMR. As a consequence, one way to improve control over brain signals in neurofeedback paradigms may be to explicitly instruct users not to force mastery but instead to aim at a state of effortless relaxation.

  9. The Importance of Postural Control in Relation to Technical Abilities in Small-Sided Soccer Games

    Directory of Open Access Journals (Sweden)

    Edis Çağlar

    2016-12-01

    Full Text Available Making assessments regarding postural control and balance is very important for injury prevention in soccer. However, there has been no study that has associated postural control variables with branch-specific technical properties in a game. The aim of the present study was to determine the relationships between variables designating postural control levels and technical performance variables in different (1:1, 2:2 and 3:3 small-sided games (SSGs. Sixteen trained male amateur soccer players volunteered to take part in the study (age 17.2 ± 1.02 years, body height 176.25 ± 0.07 m, body mass 67.67 ± 13.27 kg. Following familiarization sessions, postural control was evaluated using one-leg and both-leg quiet-stance positions by measuring postural sway with a Tekscan HR Mat™ in anterior–posterior and medial–lateral directions. Later, 1:1, 2:2 and 3:3 SSGs were performed at two-day intervals and the technical variables specified for each game were analyzed. A Spearman’s rank-order correlation analysis demonstrated the relationship between postural control and soccer-specific technical variables in 1:1 (r-values ranging from 0.582 to 0.776, 2:2 (rvalues ranging from 0.511 to 0.740 and 3:3 (r-values ranging from 0.502 to 0.834 SSGs. In addition, a Wilcoxon signed rank test revealed differences between SSGs in terms of several variables. The results of the study showed that higher postural control levels are among the important variables that affect success in the performance of technical skills under rival pressure and suddenly changing conditions. Therefore, it is recommended that in addition to its use for injury prevention purposes, balance training should be conducted to improve branch-specific technical skills and to increase the levels of their successful performance in a game.

  10. [Electrodiagnosis in disorders of neuromuscular transmission].

    Science.gov (United States)

    Chumillas, M J; Cortés, V

    Electrophysiological studies are of recognized use in the confirmation of alterations of neuromuscular transmission in further determining their physiopathological characteristics, helping to differentiate them from other conditions with secondary effects on their function. In our study we review the physiopathology of these disorders which compromise the safety factor of the neuromuscular junction, by presynaptic or postsynaptic alterations, and forms the basis of the results of electrophysiological studies. We describe the techniques currently most used: repetitive stimulation and single fibre electromyography complemented by conventional electromyography. Their application and findings in the commonest syndromes are discussed. Finally, their sensitivity, specificity and difficulties are considered.

  11. Research highlights of partial neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Cheng ZHANG

    2014-05-01

    Full Text Available In order to understand the latest progression on neuromuscular disorders for clinicians, this review screened and systemized the papers on neuromuscular disorders which were collected by PubMed from January 2013 to February 2014. This review also introduced the clinical diagnosis and treatment hightlights on glycogen storage disease type Ⅱ (GSD Ⅱ, Duchenne muscular dystrophy (DMD, amyotrophic lateral sclerosis (ALS and spinal muscular atrophy (SMA. The important references will be useful for clinicians. doi: 10.3969/j.issn.1672-6731.2014.05.004

  12. Early inhibitory control and working memory abilities of children prenatally exposed to methadone.

    Science.gov (United States)

    Levine, Terri A; Woodward, Lianne J

    2018-01-01

    Methadone maintenance is the most common method of treating opioid-dependent pregnant women. However, little is known about the impact of prenatal methadone exposure on child neurocognitive development. To examine the early executive functioning of children born to methadone-maintained mothers, and to assess relations between executive functioning and later emotional and behavioral adjustment. Prospective longitudinal study. The sample consisted of 68 methadone-exposed children and 88 non-methadone-exposed children. At age 2years, children's inhibitory control and working memory were assessed using the Snack Delay and Three Boxes tasks. At 2 and 4.5years, their emotional and behavioral adjustment was assessed using the caregiver-completed Strengths and Difficulties Questionnaire. Methadone-exposed children had poorer inhibitory control than non-exposed children (p<0.0001). These differences were explained by maternal education and prenatal benzodiazepine use. With respect to working memory, although both groups performed similarly on the first trial set, non-exposed children significantly improved their performance on the second trial set (p=0.002), while methadone-exposed children did not (p=0.92). Inhibitory control at age 2years was predictive of higher conduct (p=0.001), hyperactivity (p=0.0001), peer relationship (p=0.02), and total (p<0.0001) problems at 4.5years even after adjustment for behavioral problems at 2years. Methadone-exposed children demonstrate difficulties with inhibitory control and possibly sustained attention/learning. These difficulties were explained by factors correlated with maternal prenatal methadone use. Longer-term follow-up of these children is needed to understand the effects of prenatal methadone exposure and related maternal factors on executive functioning and behavioral adjustment. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. 21 CFR 882.5860 - Implanted neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted neuromuscular stimulator. 882.5860... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5860 Implanted neuromuscular stimulator. (a) Identification. An implanted neuromuscular stimulator is a device that provides...

  14. Segmental spinal instrumentation in the management of neuromuscular spinal deformity.

    Science.gov (United States)

    Taddonio, R F

    1982-01-01

    Seventeen patients with progressive neuromuscular spinal deformity were critically analyzed. All patients were surgically managed by employing segmental spinal instrumentation with Luque rods accompanied by posterior spinal fusion to sacrum. Satisfactory correction of scoliosis, kyphosis, and lordosis was achieved. Furthermore, maintainence and production of physiologic postural curves was possible with this method of instrumentation. Head and trunk decompensation and pelvic obliquity were not well controlled in this series. Respiratory complications in this high-risk group were minimal. Partial postoperative immobilization with bivalved thoraco-lumbosacral orthoses (TLSO) was employed in the majority of patients. Segmental spinal instrumentation provides significant benefits to justify its continued use and development.

  15. Acute and chronic neuromuscular adaptations to local vibration training.

    Science.gov (United States)

    Souron, Robin; Besson, Thibault; Millet, Guillaume Y; Lapole, Thomas

    2017-10-01

    Vibratory stimuli are thought to have the potential to promote neural and/or muscular (re)conditioning. This has been well described for whole-body vibration (WBV), which is commonly used as a training method to improve strength and/or functional abilities. Yet, this technique may present some limitations, especially in clinical settings where patients are unable to maintain an active position during the vibration exposure. Thus, a local vibration (LV) technique, which consists of applying portable vibrators directly over the tendon or muscle belly without active contribution from the participant, may present an alternative to WBV. The purpose of this narrative review is (1) to provide a comprehensive overview of the literature related to the acute and chronic neuromuscular changes associated with LV, and (2) to show that LV training may be an innovative and efficient alternative method to the 'classic' training programs, including in the context of muscle deconditioning prevention or rehabilitation. An acute LV application (one bout of 20-60 min) may be considered as a significant neuromuscular workload, as demonstrated by an impairment of force generating capacity and LV-induced neural changes. Accordingly, it has been reported that a training period of LV is efficient in improving muscular performance over a wide range of training (duration, number of session) and vibration (frequency, amplitude, site of application) parameters. The functional improvements are principally triggered by adaptations within the central nervous system. A model illustrating the current research on LV-induced adaptations is provided.

  16. A two-dimensional semiconductor transistor with boosted gate control and sensing ability

    Science.gov (United States)

    Xu, Jing; Chen, Lin; Dai, Ya-Wei; Cao, Qian; Sun, Qing-Qing; Ding, Shi-Jin; Zhu, Hao; Zhang, David Wei

    2017-01-01

    Transistors with exfoliated two-dimensional (2D) materials on a SiO2/Si substrate have been applied and have been proven effective in a wide range of applications, such as circuits, memory, photodetectors, gas sensors, optical modulators, valleytronics, and spintronics. However, these devices usually suffer from limited gate control because of the thick SiO2 gate dielectric and the lack of reliable transfer method. We introduce a new back-gate transistor scheme fabricated on a novel Al2O3/ITO (indium tin oxide)/SiO2/Si “stack” substrate, which was engineered with distinguishable optical identification of exfoliated 2D materials. High-quality exfoliated 2D materials could be easily obtained and recognized on this stack. Two typical 2D materials, MoS2 and ReS2, were implemented to demonstrate the enhancement of gate controllability. Both transistors show excellent electrical characteristics, including steep subthreshold swing (62 mV dec−1 for MoS2 and 83 mV dec−1 for ReS2), high mobility (61.79 cm2 V−1 s−1 for MoS2 and 7.32 cm2 V−1 s−1 for ReS2), large on/off ratio (~107), and reasonable working gate bias (below 3 V). Moreover, MoS2 and ReS2 photodetectors fabricated on the basis of the scheme have impressively leading photoresponsivities of 4000 and 760 A W−1 in the depletion area, respectively, and both have exceeded 106 A W−1 in the accumulation area, which is the best ever obtained. This opens up a suite of applications of this novel platform in 2D materials research with increasing needs of enhanced gate control. PMID:28560330

  17. [Deep versus moderate neuromuscular block during one-lung ventilation in lung resection surgery].

    Science.gov (United States)

    Casanova, Javier; Piñeiro, Patricia; De La Gala, Francisco; Olmedilla, Luis; Cruz, Patricia; Duque, Patricia; Garutti, Ignacio

    Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in one-lung ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during one-lung ventilation is not deleterious. A prospective, longitudinal observational study was made in which each patient served as both treated subject and control. 76 consecutive patients programmed for lung resection surgery in Gregorio Marañon Hospital along the year of 2013 who required one-lung ventilation in lateral decubitus were included. Ventilator data, hemodynamic parameters were registered in different moments according to train-of-four response (intense, deep and moderate blockade) during one-lung ventilation. Peak, plateau and mean pressures were significantly lower during the intense and deep blockade. Besides, compliance and peripheral oxygen saturation were significantly higher in those moments. Heart rate was significantly higher during deep blockade. No mechanical ventilation parameters were modified during measurements. Deep neuromuscular blockade attenuates the poor lung mechanics observed during one-lung ventilation. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Regulation and restoration of motoneuronal synaptic transmission during neuromuscular regeneration in the pulmonate snail Helisoma trivolvis.

    Science.gov (United States)

    Turner, M B; Szabo-Maas, T M; Poyer, J C; Zoran, M J

    2011-08-01

    Regeneration of motor systems involves reestablishment of central control networks, reinnervation of muscle targets by motoneurons, and reconnection of neuromodulatory circuits. Still, how these processes are integrated as motor function is restored during regeneration remains ill defined. Here, we examined the mechanisms underlying motoneuronal regeneration of neuromuscular synapses related to feeding movements in the pulmonate snail Helisoma trivolvis. Neurons B19 and B110, although activated during different phases of the feeding pattern, innervate similar sets of muscles. However, the percentage of muscle fibers innervated, the efficacy of excitatory junction potentials, and the strength of muscle contractions were different for each cell's specific connections. After peripheral nerve crush, a sequence of transient electrical and chemical connections formed centrally within the buccal ganglia. Neuromuscular synapse regeneration involved a three-phase process: the emergence of spontaneous synaptic transmission (P1), the acquisition of evoked potentials of weak efficacy (P2), and the establishment of functional reinnervation (P3). Differential synaptic efficacy at muscle contacts was recapitulated in cell culture. Differences in motoneuronal presynaptic properties (i.e., quantal content) were the basis of disparate neuromuscular synapse function, suggesting a role for retrograde target influences. We propose a homeostatic model of molluscan motor system regeneration. This model has three restoration events: (1) transient central synaptogenesis during axonal outgrowth, (2) intermotoneuronal inhibitory synaptogenesis during initial neuromuscular synapse formation, and (3) target-dependent regulation of neuromuscular junction formation.

  19. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning

    DEFF Research Database (Denmark)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel

    2017-01-01

    . A neuromuscular monitoring e-learning module might support consistent use of neuromuscular monitoring devices. OBJECTIVE: The aim of the study is to assess the effect of a neuromuscular monitoring e-learning module on anesthesia staff's use of objective neuromuscular monitoring and the incidence of residual...... as well as a multiple-choice test to assess knowledge. The e-learning module was developed based on a needs assessment process, including focus group interviews, surveys, and expert opinions. RESULTS: The e-learning module was implemented in 6 anesthesia departments on 21 November 2016. Currently, we...... are collecting postintervention data. The final dataset will include data from more than 10,000 anesthesia procedures. We expect to publish the results in late 2017 or early 2018. CONCLUSIONS: With a dataset consisting of thousands of general anesthesia procedures, the INVERT study will assess whether an e-learning...

  20. Mirror Therapy with Neuromuscular Electrical Stimulation for improving motor function of stroke survivors: A pilot randomized clinical study.

    Science.gov (United States)

    Lee, DongGeon; Lee, GyuChang; Jeong, JiSim

    2016-07-27

    This study was to investigate the effects of Mirror Therapy (MT) combined with Neuromuscular Electrical Stimulation (NMES) on muscle strength and tone, motor function, balance, and gait ability in stroke survivors with hemiplegia. This study was a randomized controlled trial. Twenty-seven hemiplegic stroke survivors from a rehabilitation center participated in the study. The participants were randomly assigned to either an experimental or a control group. The experimental group (n = 14) underwent MT combined with NMES and conventional physical therapy, and the control group (n = 13) underwent conventional physical therapy alone. Muscle strength and tone, balance, and gait ability were examined at baseline and after 4 weeks of intervention. A hand-held dynamometer was used to assess muscle strength, the Modified Ashworth Scale (MAS) was used to assess muscle tone, the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) were used to ascertain balance, and the 6-m Walk Test (6mWT) was used to examine gait ability. After the intervention, compared to baseline values, there were significant improvements in muscle strength and MAS, BBS, TUG, and 6mWT values in the experimental group (Pstroke survivors. However, further studies are necessary to demonstrate brain reorganization after MT combined with NMES.

  1. Neuromuscular stimulation therapy after incomplete spinal cord injury promotes recovery of interlimb coordination during locomotion

    Science.gov (United States)

    Jung, R.; Belanger, A.; Kanchiku, T.; Fairchild, M.; Abbas, J. J.

    2009-10-01

    The mechanisms underlying the effects of neuromuscular electrical stimulation (NMES) induced repetitive limb movement therapy after incomplete spinal cord injury (iSCI) are unknown. This study establishes the capability of using therapeutic NMES in rodents with iSCI and evaluates its ability to promote recovery of interlimb control during locomotion. Ten adult female Long Evans rats received thoracic spinal contusion injuries (T9; 156 ± 9.52 Kdyne). 7 days post-recovery, 6/10 animals received NMES therapy for 15 min/day for 5 days, via electrodes implanted bilaterally into hip flexors and extensors. Six intact animals served as controls. Motor function was evaluated using the BBB locomotor scale for the first 6 days and on 14th day post-injury. 3D kinematic analysis of treadmill walking was performed on day 14 post-injury. Rodents receiving NMES therapy exhibited improved interlimb coordination in control of the hip joint, which was the specific NMES target. Symmetry indices improved significantly in the therapy group. Additionally, injured rodents receiving therapy more consistently displayed a high percentage of 1:1 coordinated steps, and more consistently achieved proper hindlimb touchdown timing. These results suggest that NMES techniques could provide an effective therapeutic tool for neuromotor treatment following iSCI.

  2. Neuromuscular rate of force development deficit in Parkinson disease.

    Science.gov (United States)

    Hammond, Kelley G; Pfeiffer, Ronald F; LeDoux, Mark S; Schilling, Brian K

    2017-06-01

    Bradykinesia and reduced neuromuscular force exist in Parkinson disease. The interpolated twitch technique has been used to evaluate central versus peripheral manifestations of neuromuscular strength in healthy, aging, and athletic populations, as well as moderate to advanced Parkinson disease, but this method has not been used in mild Parkinson disease. This study aimed to evaluate quadriceps femoris rate of force development and quantify potential central and peripheral activation deficits in individuals with Parkinson disease. Nine persons with mild Parkinson Disease (Hoehn & Yahr≤2, Unified Parkinson Disease Rating Scale total score=mean 19.1 (SD 5.0)) and eight age-matched controls were recruited in a cross-sectional investigation. Quadriceps femoris voluntary and stimulated maximal force and rate of force development were evaluated using the interpolated twitch technique. Thirteen participants satisfactorily completed the protocol. Individuals with early Parkinson disease (n=7) had significantly slower voluntary rate of force development (p=0.008; d=1.97) and rate of force development ratio (p=0.004; d=2.18) than controls (n=6). No significant differences were found between groups for all other variables. Persons with mild-to-moderate Parkinson disease display disparities in rate of force development, even without deficits in maximal force. The inability to produce force at a rate comparable to controls is likely a downstream effect of central dysfunction of the motor pathway in Parkinson disease. Copyright © 2017. Published by Elsevier Ltd.

  3. A neuromuscular monitoring system based on a personal computer.

    Science.gov (United States)

    White, D A; Hull, M

    1992-07-01

    We have developed a computerized neuromuscular monitoring system (NMMS) using commercially available subsystems, i.e., computer equipment, clinical nerve stimulator, force transducer, and strip-chart recorder. This NMMS was developed for acquisition and analysis of data for research and teaching purposes. Computer analysis of the muscle response to stimulation allows graphic and numeric presentation of the twitch response and calculated ratios. Since the system can store and recall data, research data can be accessed for analysis and graphic presentation. An IBM PC/AT computer is used as the central controller and data processor. The computer controls timing of the nerve stimulator output, initiates data acquisition, and adjusts the paper speed of the strip chart recorder. The data processing functions include establishing control response values (when no neuromuscular blockade is present), displaying force versus time and calculated data graphically and numerically, and storing these data for further analysis. The general purpose nature of the computer and strip chart recording equipment allow modification of the system primarily by changes in software. For example, new patterns of nerve stimulation, such as the posttetanic count, can be programmed into the computer system along with appropriate data display and analysis routines. The NMMS has functioned well in the operating room environment. We have had no episodes of electrocautery interference with the computer functions. The automated features have enhanced the utility of the NMMS.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2015-01-01

    : In patients 3-12 months following a medial arthroscopic partial meniscectomy, a neuromuscular exercise program did not alter the peak knee adduction moment, a key predictor of osteoarthritis structural disease progression. Australia and New Zealand Clinical Trials Registry (#ACTRN12612000542897)....

  5. Experienced and physiological fatigue in neuromuscular disorders.

    NARCIS (Netherlands)

    Schillings, M.L.; Kalkman, J.S.; Janssen, H.M.; Engelen, B.G.M. van; Bleijenberg, G.; Zwarts, M.J.

    2007-01-01

    OBJECTIVE: Fatigue has been described as a typical symptom of neurological diseases. It might be caused both by changes at the peripheral and at the central level. This study measured the level of experienced fatigue and physiological correlates of fatigue in three genetically defined neuromuscular

  6. Postoperative neuromuscular function following non-depolarising ...

    African Journals Online (AJOL)

    2016-07-03

    Jul 3, 2016 ... speaking, difficulty swallowing, unsteady gait and sensations of fatigue and muscle weakness.8,10,24–26 These newer studies have resulted in a recovery to a TOF of 0.9 or greater prior to extubation becoming widely adopted as a standard of anaesthetic practice following non-depolarising neuromuscular ...

  7. Neuromuscular dysfunction associated with delayed weaning from ...

    African Journals Online (AJOL)

    Yehia Khalil

    2012-03-21

    Mar 21, 2012 ... Neuromuscular dysfunction associated with delayed weaning from mechanical ventilation in patients with respiratory failure. Yehia Khalil a. , Emad El Din Mustafa a. , Ahmed Youssef a. ,. Mohamed Hassan Imam b,. *, Amni Fathy El Behiry a a Department of Chest, Faculty of Medicine, Alexandria University, ...

  8. Effects of a short proprioceptive neuromuscular facilitation stretching bout on quadriceps neuromuscular function, flexibility, and vertical jump performance.

    Science.gov (United States)

    Place, Nicolas; Blum, Yannick; Armand, Stéphane; Maffiuletti, Nicola A; Behm, David G

    2013-02-01

    The inclusion of relatively long bouts of stretching (repeated static stretches of ∼30 seconds) in the warm-up is usually associated with a drop in muscle performance. The purpose of this study was to assess the effect of a novel self-administered proprioceptive neuromuscular facilitation (PNF) paradigm with short periods of stretching and contraction on quadriceps neuromuscular function, vertical jump performance, and articular range of motion (ROM). Twelve healthy men (age: 27.7 ± 7.3 years, height: 178.4 ± 10.4 cm, weight: 73.8 ± 16.9 kg) volunteered to participate in a PNF session and a control session separated by 2-7 days. The PNF stretching lasted 2 minutes and consisted of 4 sets of 5-second isometric hamstring contraction immediately followed by 5 seconds of passive static stretch of the quadriceps immediately followed by 5 seconds isometric quadriceps contraction for each leg. For the control session, the participants were asked to walk at a comfortable speed for 2 minutes. Active ROM of knee flexion, vertical jump performance, and quadriceps neuromuscular function were tested before, immediately after, and 15 minutes after the intervention. The PNF stretching procedure did not affect ROM, squat jump, and countermovement jump performances. Accordingly, we did not observe any change in maximal voluntary contraction force, voluntary activation level, M-wave and twitch contractile properties that could be attributed to PNF stretching. The present self-administered PNF stretching of the quadriceps with short (5-second) stretches is not recommended before sports where flexibility is mandatory for performance.

  9. Rapid synthesis of acetylcholine receptors at neuromuscular junctions.

    Science.gov (United States)

    Ramsay, D A; Drachman, D B; Pestronk, A

    1988-10-11

    The rate of acetylcholine receptor (AChR) degradation in mature, innervated mammalian neuromuscular junctions has recently been shown to be biphasic; up to 20% are rapidly turned over (RTOs; half life less than 1 day) whereas the remainder are lost more slowly ('stable' AChRs; half life 10-12 days). In order to maintain normal junctional receptor density, synthesis and insertion of AChRs should presumably be sufficiently rapid to replace both the RTOs and the stable receptors. We have tested this prediction by blocking pre-existing AChRs in the mouse sternomastoid muscle with alpha-bungarotoxin (alpha-BuTx), and monitoring the subsequent appearance of 'new' junctional AChRs at intervals of 3 h to 20 days by labeling them with 125I-alpha-BuTx. The results show that new receptors were initially inserted rapidly (16% at 24 h and 28% at 48 h). The rate of increase of 'new' 125I-alpha-BuTx binding sites gradually slowed down during the remainder of the time period studied. Control observations excluded possible artifacts of the experimental procedure including incomplete blockade of AChRs, dissociation of toxin-receptor complexes, or experimentally induced alteration of receptor synthesis. The present demonstration of rapid synthesis and incorporation of AChRs at innervated neuromuscular junctions provides support for the concept of a subpopulation of rapidly turned over AChRs. The RTOs may serve as precursors for the larger population of stable receptors and have an important role in the metabolism of the neuromuscular synapse.

  10. Vibration or balance training on neuromuscular performance in osteopenic women.

    Science.gov (United States)

    Stolzenberg, N; Belavý, D L; Rawer, R; Felsenberg, D

    2013-11-01

    Maintaining neuromuscular function in older age is an important topic for aging societies, especially for older women with low bone density who may be at risk of falls and bone fracture. This randomized controlled trial investigated the effect of resistive exercise with either whole-body vibration training (VIB) or coordination/balance training (BAL) on neuromuscular function (countermovement jump, multiple 1-leg hopping, sit-to-stand test). 68 postmenopausal women with osteopenia or osteoporosis were recruited for the study. 57 subjects completed the 9-month, twice weekly, intervention period. All subjects conducted 30 min of resistance exercise each training day. The VIB-group performed additional training on the Galileo vibration exercise device. The BAL-group performed balance training. An "intent-to-treat" analysis showed greater improvement in the VIB-group for peak countermovement power (p=0.004). The mean [95% confidence interval] effect size for this parameter was a  + 0.9[0.3 to 1.5] W/kg greater change in VIB than BAL after 9 months. In multiple 1-leg hopping, a significantly better performance in the VIB-group after the intervention period was seen on a "per-protocol" analysis only. Both groups improved in the sit-to-stand test. The current study provides evidence that short-duration whole-body vibration exercise can have a greater impact on some aspects of neuromuscular function in post-menopausal women with low bone density than proprioceptive training. © Georg Thieme Verlag KG Stuttgart · New York.

  11. O uso de bloqueadores neuromusculares no Brasil El uso de bloqueadores neuromusculares en Brasil Neuromuscular blockers in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Simões de Almeida

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Dados estatísticos referentes ao uso de bloqueadores neuromusculares no Brasil são desconhecidos. Este trabalho se propõe a análise estatística desse tópico. MÉTODO: Foram compiladas 831 respostas de um questionário preenchido em parte por anestesiologistas presentes ao 48º Congresso Brasileiro de Anestesiologia em Recife, 2001 e em parte via Internet, por anestesiologistas cujos endereços eletrônicos constam na página da Sociedade Brasileira de Anestesiologia (www.sba.com.br. Foram analisados os seguintes dados: tempo de contato com a especialidade, região onde atuam os anestesiologistas, uso de bloqueadores neuromusculares (BNM em ordem de preferência, indicações do uso de succinilcolina, uso do monitor da transmissão neuromuscular, critérios para se considerar o paciente descurarizado, uso de neostigmina, forma de administração dos BNM e descrição de complicações observadas. RESULTADOS: A maioria dos anestesiologistas em questão exerce a profissão há mais de 11 anos e o maior número de respostas foi proveniente da região sudeste do Brasil. O BNM mais empregado é o atracúrio, seguido de pancurônio e succinilcolina. A succinilcolina é mais empregada na indução rápida e em crianças (80% e 25% respectivamente. Monitores da transmissão neuromuscular, 53% dos anestesiologistas nunca usam, e como critério de recuperação, 92% consideram o paciente descurarizado mediante sinais clínicos. Em 45% das vezes os profissionais empregam a neostigmina de forma rotineira, e 94% administra os BNM sob forma de bolus. Cerca de 30% registra ter havido complicação decorrente do uso de BNM. As complicações mais apontadas foram o bloqueio prolongado, o broncoespasmo grave e a curarização residual. CONCLUSÕES: O atracúrio é o bloqueador neuromuscular mais empregado no Brasil, há percentual alto de uso da succinilcolina em situações não emergenciais, o uso de monitores da transmiss

  12. Genetic control and combining ability of agronomic attributes and northern leaf blight-related attributes in popcorn.

    Science.gov (United States)

    Santos, J S; Amaral Júnior, A T; Vivas, M; Mafra, G S; Pena, G F; Silva, F H L; Guimarães, A G

    2017-09-27

    The present study was conducted to investigate the genetic control and to estimate the general and specific combining abilities of popcorn for agronomic attributes and attributes related to resistance to northern leaf blight (NLB). The 56 hybrids (F1 and reciprocals), together with the eight parent lines and six controls, were evaluated in two harvests, in a randomized-block design with four replications. Dominance components were more expressive than the additive components for grain yield and expression of resistance, and hybridization was the most suitable option for obtaining resistant and productive genotypes. For grain yield, popping expansion, and resistance to NLB, there was no significance for reciprocal effects, which indicates that the direction in which the cross is performed does not interfere with the hybrid's performance. Then, the superior hybrids recommended for more profitable growth were P8 x L61, L61 x L76, and L61 x L77.

  13. The Structure of Human Neuromuscular Junctions: Some Unanswered Molecular Questions

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    Clarke R. Slater

    2017-10-01

    Full Text Available The commands that control animal movement are transmitted from motor neurons to their target muscle cells at the neuromuscular junctions (NMJs. The NMJs contain many protein species whose role in transmission depends not only on their inherent properties, but also on how they are distributed within the complex structure of the motor nerve terminal and the postsynaptic muscle membrane. These molecules mediate evoked chemical transmitter release from the nerve and the action of that transmitter on the muscle. Human NMJs are among the smallest known and release the smallest number of transmitter “quanta”. By contrast, they have the most deeply infolded postsynaptic membranes, which help to amplify transmitter action. The same structural features that distinguish human NMJs make them particularly susceptible to pathological processes. While much has been learned about the molecules which mediate transmitter release and action, little is known about the molecular processes that control the growth of the cellular and subcellular components of the NMJ so as to give rise to its mature form. A major challenge for molecular biologists is to understand the molecular basis for the development and maintenance of functionally important aspects of NMJ structure, and thereby to point to new directions for treatment of diseases in which neuromuscular transmission is impaired.

  14. Family Stress with Chronic Childhood Illness: Cystic Fibrosis, Neuromuscular Disease, and Renal Disease.

    Science.gov (United States)

    Holroyd, Jean; Guthrie, Donald

    1986-01-01

    Parents of children with neuromuscular disease, cystic fibrosis, and renal disease were compared with parents of control subjects matched by age to the clinical cases. The three clinical groups exhibited different patterns of stressful response, consistent with the nature of their illnesses and the requirements for care imposed on the families.…

  15. Neuromuscular Adaptations to Eccentric Strength Training in Children and Adolescents with Cerebral Palsy

    Science.gov (United States)

    Reid, Siobhan; Hamer, Peter; Alderson, Jacqueline; Lloyd, David

    2010-01-01

    Aim: To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP). Method: In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11y, SD 2y range 9-15y), diagnosed with upper-limb spasticity were…

  16. The Preparation Period in Basketball: Training Load and Neuromuscular Adaptations.

    Science.gov (United States)

    Ferioli, Davide; Bosio, Andrea; Bilsborough, Johann C; Torre, Antonio La; Tornaghi, Michele; Rampinini, Ermanno

    2018-01-18

    To investigate the 1) effect of the preparation period on the neuromuscular characteristics of 12 professional (PRO) and 16 semi-professional (SEMI-PRO) basketball players; 2) relationships between training load indices and changes in neuromuscular physical performance. Prior to and following the preparation period, players underwent a counter-movement jump (CMJ) test, followed by a repeated change of direction (COD) test consisting of 4 levels with increasing intensities. The peripheral neuromuscular functions of the knee extensors (peak torque, PT) were measured using electrical stimulations after each level (PT1, PT2, PT3 and PT4). Furthermore, PT Max (the highest value of PT) and PT Dec (PT decrement from PT Max to PT4) were calculated. Trivial-to-small (effect size, ES: -0.17 to 0.46) improvements were found in CMJ variables, regardless of the competitive levels. After the preparation period, peripheral fatigue induced by a COD test was similarly reduced in both PRO (PT Dec: from 27.8±21.3% to 11.4±13.7%, ES±90%CI= -0.71±0.30) and SEMI-PRO (PT Dec: from 26.1±21.9% to 10.2±8.2%, ES±90%CI= -0.69±0.32). Moderate-to-large relationships were found between session rating of perceived exertion training load and changes in PPO measured during the CMJs (r s ±90%CI: PPOabs, -0.46±0.26; PPOrel, -0.53±0.23) and in some PTs measured during the COD test (PT1, -0.45±0.26; PT2, -0.44±0.26; PT3, -0.40±0.27 and PT Max, -0.38±0.28). Preparation period induced minimal changes in the CMJ, while the ability to sustain repeated COD efforts was improved. Reaching high session rating of perceived exertion training loads might partially and negatively affect the ability to produce strength and power.

  17. Variation in Dube3a expression affects neurotransmission at the Drosophila neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Colleen Valdez

    2015-07-01

    Full Text Available Changes in UBE3A expression levels in neurons can cause neurogenetic disorders ranging from Angelman syndrome (AS (decreased levels to autism (increased levels. Here we investigated the effects on neuronal function of varying UBE3A levels using the Drosophila neuromuscular junction as a model for both of these neurogenetic disorders. Stimulations that evoked excitatory junction potentials (EJPs at 1 Hz intermittently failed to evoke EJPs at 15 Hz in a significantly higher proportion of Dube3a over-expressors using the pan neuronal GAL4 driver C155-GAL4 (C155-GAL4>UAS-Dube3a relative to controls (C155>+ alone. However, in the Dube3a over-expressing larval neurons with no failures, there was no difference in EJP amplitude at the beginning of the train, or the rate of decrease in EJP amplitude over the course of the train compared to controls. In the absence of tetrodotoxin (TTX, spontaneous EJPs were observed in significantly more C155-GAL4>UAS-Dube3a larva compared to controls. In the presence of TTX, spontaneous and evoked EJPs were completely blocked and mEJP amplitude and frequency did not differ among genotypes. These data suggest that over-expression of wild type Dube3a, but not a ubiquitination defective Dube3a-C/A protein, compromises the ability of motor neuron axons to support closely spaced trains of action potentials, while at the same time increasing excitability. EJPs evoked at 15 Hz in the absence of Dube3a (Dube3a15b homozygous mutant larvae decayed more rapidly over the course of 30 stimulations compared to w1118 controls, and Dube3a15b larval muscles had significantly more negative resting membrane potentials (RMP. However, these results could not be recapitulated using RNAi knockdown of Dube3a in muscle or neurons alone, suggesting more global developmental defects contribute to this phenotype. These data suggest that reduced UBE3A expression levels may cause global changes that affect RMP and neurotransmitter release from

  18. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  19. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  20. Man-machine interface system for neuromuscular training and evaluation based on EMG and MMG signals.

    Science.gov (United States)

    de la Rosa, Ramon; Alonso, Alonso; Carrera, Albano; Durán, Ramon; Fernández, Patricia

    2010-01-01

    This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System), a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES) and, as a novelty, the myomechanic signals (MMS). In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  1. Man-Machine Interface System for Neuromuscular Training and Evaluation Based on EMG and MMG Signals

    Directory of Open Access Journals (Sweden)

    Patricia Fernández

    2010-12-01

    Full Text Available This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System, a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES and, as a novelty, the myomechanic signals (MMS. In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  2. Neuromuscular adaptations to training, injury and passive interventions: implications for running economy.

    Science.gov (United States)

    Bonacci, Jason; Chapman, Andrew; Blanch, Peter; Vicenzino, Bill

    2009-01-01

    Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling

  3. Among three different executive functions, general executive control ability is a key predictor of decision making under objective risk

    Directory of Open Access Journals (Sweden)

    Johannes eSchiebener

    2014-12-01

    Full Text Available Executive functioning is supposed to have an important role in decision making under risk. Several studies reported that more advantageous decision-making behavior was accompanied by better performance in tests of executive functioning and that the decision-making process was accompanied by activations in prefrontal and subcortical brain regions associated with executive functioning. However, to what extent different components of executive functions contribute to decision making is still unclear. We tested direct and indirect effects of three executive functions on decision-making performance in a laboratory gambling task, the Game of Dice Task (GDT. Using Brand’s model of decisions under risk (2006 we tested seven structural equation models with three latent variables that represent executive functions supposed to be involved in decision making. The latent variables were general control (represented by the general ability to exert attentional and behavioral self-control that is in accordance with task goals despite interfering information, concept formation (represented by categorization, rule detection, and set maintenance, and monitoring (represented by supervision of cognition and behavior. The seven models indicated that only the latent dimension general control had a direct effect on decision making under risk. Concept formation and monitoring only contributed in terms of indirect effects, when mediated by general control. Thus, several components of executive functioning seem to be involved in decision making under risk. However, general control functions seem to have a key role. They may be important for implementing the calculative and cognitively controlled processes involved in advantageous decision making under risk.

  4. Fundamental Molecules and Mechanisms for Forming and Maintaining Neuromuscular Synapses

    Directory of Open Access Journals (Sweden)

    Steven J. Burden

    2018-02-01

    Full Text Available The neuromuscular synapse is a relatively large synapse with hundreds of active zones in presynaptic motor nerve terminals and more than ten million acetylcholine receptors (AChRs in the postsynaptic membrane. The enrichment of proteins in presynaptic and postsynaptic membranes ensures a rapid, robust, and reliable synaptic transmission. Over fifty years ago, classic studies of the neuromuscular synapse led to a comprehensive understanding of how a synapse looks and works, but these landmark studies did not reveal the molecular mechanisms responsible for building and maintaining a synapse. During the past two-dozen years, the critical molecular players, responsible for assembling the specialized postsynaptic membrane and regulating nerve terminal differentiation, have begun to be identified and their mechanism of action better understood. Here, we describe and discuss five of these key molecular players, paying heed to their discovery as well as describing their currently understood mechanisms of action. In addition, we discuss the important gaps that remain to better understand how these proteins act to control synaptic differentiation and maintenance.

  5. Sarcocystis fayeri in skeletal muscle of horses with neuromuscular disease.

    Science.gov (United States)

    Aleman, Monica; Shapiro, Karen; Sisó, Silvia; Williams, Diane C; Rejmanek, Daniel; Aguilar, Beatriz; Conrad, Patricia A

    2016-01-01

    Recent reports of Sarcocystis fayeri-induced toxicity in people consuming horse meat warrant investigation on the prevalence and molecular characterization of Sarcocystis spp. infection in horses. Sarcocysts in skeletal muscle of horses have been commonly regarded as an incidental finding. In this study, we investigated the prevalence of sarcocysts in skeletal muscle of horses with neuromuscular disease. Our findings indicated that S. fayeri infection was common in young mature horses with neuromuscular disease and could be associated with myopathic and neurogenic processes. The number of infected muscles and number of sarcocysts per muscle were significantly higher in diseased than in control horses. S. fayeri was predominantly found in low oxidative highly glycolytic myofibers. This pathogen had a high glycolytic metabolism. Common clinical signs of disease included muscle atrophy, weakness with or without apparent muscle pain, gait deficits, and dysphagia in horses with involvement of the tongue and esophagus. Horses with myositis were lethargic, apparently painful, stiff, and reluctant to move. Similar to humans, sarcocystosis and cardiomyopathy can occur in horses. This study did not establish causality but supported a possible association (8.9% of cases) with disease. The assumption of Sarcocysts spp. being an incidental finding in every case might be inaccurate. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. [Six-minute walk test in children with neuromuscular disease.

    Science.gov (United States)

    Cruz-Anleu, Israel Didier; Baños-Mejía, Benjamín Omar; Galicia-Amor, Susana

    2013-01-01

    Background: neuromuscular diseases affect the motor unit. When they evolve, respiratory complications are common; the six-minute walk test plays an important role in the assessment of functional capacity. Methods: prospective, transversal, descriptive and observational study. We studied seven children with a variety of neuromuscular diseases and spontaneous ambulation. We tested their lung function, and administered a six-minute walk test and a test of respiratory muscle strength to these children. Results: the age was 9.8 ± 2.4 years. All patients were males. Forced vital capacity decreased in three patients (42.8 %), forced expiratory volume during the first second (2.04 ± 1.4 L) and peak expiratory flow (4.33 ± 3.3 L/s) were normal. The maximum strength of respiratory muscles was less than 60 % of predicted values. The distance covered in the six-minute walk test was lower when compared with healthy controls (29.9 %). Conclusions: the six-minute walk test can be a useful tool in early stages of this disease, since it is easy to perform and well tolerated by the patients.

  7. Neuromuscular blockade during laparoscopic ventral herniotomy

    DEFF Research Database (Denmark)

    Medici, Roar; Madsen, Matias V; Asadzadeh, Sami

    2015-01-01

    's rating of surgical conditions during suturing, duration of surgery and duration of the suturing of the hernia. CONCLUSION: This randomised cross-over study investigated a potential effect on the surgical workspace in laparoscopic ventral herniotomy using deep NMB compared with no NMB. The study may......INTRODUCTION: Laparoscopic herniotomy is the preferred technique for some ventral hernias. Several factors may influence the surgical conditions, one being the depth of neuromuscular blockade (NMB) applied. We hypothesised that deep neuromuscular blockade defined as a post-tetanic count below eight...... would provide a better surgical workspace. METHODS: This was an investigator-initiated, assessor- and patient-blinded randomised cross-over study. A total of 34 patients with planned laparoscopic umbilical, incisional and linea alba herniotomy were studied. Patients would be randomised to receive deep...

  8. Neuromuscular blockade during laparoscopic ventral herniotomy

    DEFF Research Database (Denmark)

    Medici, Roar; Madsen, Matias V; Asadzadeh, Sami

    2015-01-01

    INTRODUCTION: Laparoscopic herniotomy is the preferred technique for some ventral hernias. Several factors may influence the surgical conditions, one being the depth of neuromuscular blockade (NMB) applied. We hypothesised that deep neuromuscular blockade defined as a post-tetanic count below eight......'s rating of surgical conditions during suturing, duration of surgery and duration of the suturing of the hernia. CONCLUSION: This randomised cross-over study investigated a potential effect on the surgical workspace in laparoscopic ventral herniotomy using deep NMB compared with no NMB. The study may...... provide knowledge relevant to other laparoscopic techniques. FUNDING: The study is funded by a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme Corp. TRIAL REGISTRATION: NCT02247466....

  9. Progressive inhibition of neuromuscular structures (PINS) technique.

    Science.gov (United States)

    Dowling, D J

    2000-05-01

    Progressive inhibition of neuromuscular structures (PINS) is a technique that can be included in the osteopathic manipulative treatment repertoire. It relies on knowledge of anatomy and neuromuscular physiologic features as well as on standard forms of osteopathic palpatory diagnosis and treatment. It is a variant of the inhibition technique that has been taught as an osteopathic manipulative technique for many years, and it bears some resemblance to other manual medicine techniques. The emphasis of the approach is the determination of the alteration of the tissues due to dysfunction, delivering treatment based on palpatory evaluation and patient feedback. Two related points are initially chosen, followed by a progression from one to the other. Relationships to similar techniques are also discussed. Theoretical as well as selected practical applications are presented.

  10. Options for mechanical ventilation in neuromuscular diseases.

    Science.gov (United States)

    Unterborn, J N; Hill, N S

    1994-12-01

    A variety of mechanical devices may be used to provide assistance when ventilation and cough are severely impaired by progressive respiratory weakness caused by neuromuscular disease. Traditionally, positive pressure ventilation via a tracheostomy has been used, but if upper airway function is adequate, a variety of noninvasive devices also may be considered. Although positive pressure ventilation is the preferred noninvasive mode for assisting ventilation, other modes may be selected depending on patient needs, preferences, and physical characteristics.

  11. Neuromuscular adaptation to actual and simulated weightlessness

    Science.gov (United States)

    Edgerton, V. R.; Roy, R. R.

    1994-01-01

    The chronic "unloading" of the neuromuscular system during spaceflight has detrimental functional and morphological effects. Changes in the metabolic and mechanical properties of the musculature can be attributed largely to the loss of muscle protein and the alteration in the relative proportion of the proteins in skeletal muscle, particularly in the muscles that have an antigravity function under normal loading conditions. These adaptations could result in decrements in the performance of routine or specialized motor tasks, both of which may be critical for survival in an altered gravitational field, i.e., during spaceflight and during return to 1 G. For example, the loss in extensor muscle mass requires a higher percentage of recruitment of the motor pools for any specific motor task. Thus, a faster rate of fatigue will occur in the activated muscles. These consequences emphasize the importance of developing techniques for minimizing muscle loss during spaceflight, at least in preparation for the return to 1 G after spaceflight. New insights into the complexity and the interactive elements that contribute to the neuromuscular adaptations to space have been gained from studies of the role of exercise and/or growth factors as countermeasures of atrophy. The present chapter illustrates the inevitable interactive effects of neural and muscular systems in adapting to space. It also describes the considerable progress that has been made toward the goal of minimizing the functional impact of the stimuli that induce the neuromuscular adaptations to space.

  12. Multicategory classification of 11 neuromuscular diseases based on microarray data using support vector machine.

    Science.gov (United States)

    Choi, Soo Beom; Park, Jee Soo; Chung, Jai Won; Yoo, Tae Keun; Kim, Deok Won

    2014-01-01

    We applied multicategory machine learning methods to classify 11 neuromuscular disease groups and one control group based on microarray data. To develop multicategory classification models with optimal parameters and features, we performed a systematic evaluation of three machine learning algorithms and four feature selection methods using three-fold cross validation and a grid search. This study included 114 subjects of 11 neuromuscular diseases and 31 subjects of a control group using microarray data with 22,283 probe sets from the National Center for Biotechnology Information (NCBI). We obtained an accuracy of 100%, relative classifier information (RCI) of 1.0, and a kappa index of 1.0 by applying the models of support vector machines one-versus-one (SVM-OVO), SVM one-versus-rest (OVR), and directed acyclic graph SVM (DAGSVM), using the ratio of genes between categories to within-category sums of squares (BW) feature selection method. Each of these three models selected only four features to categorize the 12 groups, resulting in a time-saving and cost-effective strategy for diagnosing neuromuscular diseases. In addition, a gene symbol, SPP1 was selected as the top-ranked gene by the BW method. We confirmed relationships between the gene (SPP1) and Duchenne muscular dystrophy (DMD) from a previous study. With our models as clinically helpful tools, neuromuscular diseases could be classified quickly using a computer, thereby giving a time-saving, cost-effective, and accurate diagnosis.

  13. Neuromuscular interactions around the knee in children, adults and elderly

    OpenAIRE

    Kellis, Eleftherios; Mademli, Lida; Patikas, Dimitrios; Kofotolis, Nikolaos

    2014-01-01

    Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly. The purpose of this study is to review recent evidence on age differences in neural activation and muscle balances around the knee when performing single joint movements. Particularly, current evidence indicates that there are some interesting similarities in the neuromuscular mechanisms by...

  14. Cognitive ability and self-control in relation to dietary habits, physical activity and bodyweight in adolescents

    NARCIS (Netherlands)

    Junger, Marianne; van Kampen, Margit

    2010-01-01

    Background Previous studies showed that cognitive ability is related to health and mortality. The cause of this relationship remains largely unknown. One plausible explanation is that cognitive ability is related to behaviours that affect health. This study investigates whether cognitive ability is

  15. A New Mother-Child Play Activity Program to Decrease Parenting Stress and Improve Child Cognitive Abilities: A Cluster Randomized Controlled Trial: e38238

    National Research Council Canada - National Science Library

    Yoshiyuki Tachibana; Ai Fukushima; Hitomi Saito; Satoshi Yoneyama; Kazuo Ushida; Susumu Yoneyama; Ryuta Kawashima

    2012-01-01

    .... To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial...

  16. A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial

    National Research Council Canada - National Science Library

    Tachibana, Yoshiyuki; Fukushima, Ai; Saito, Hitomi; Yoneyama, Satoshi; Ushida, Kazuo; Yoneyama, Susumu; Kawashima, Ryuta

    2012-01-01

    .... To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial...

  17. Ação neuro-muscular do veneno crotálico: dados preliminares Neuromuscular action of crotalid venom: preliminar data

    Directory of Open Access Journals (Sweden)

    Maria Dorvalina Silva

    1996-03-01

    Full Text Available Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores admite que veneno crotálico determina síndrome miastênica. Nossos achados indicam que ptose palpebral, facies miastênico e fraqueza muscular observados após acidente crotálico, correspondem provavelmente a miopatia mitocondrial, muitas vezes transitória e reversível.We studied 6 patients and 2 dogs that have been bitten by South American rattlesnake Crotalus durissus terrificus and one rabbit inoculated with crotalid venom. We analized sensory and motor peripheral nerve conduction, repetitive stimulation for studying neuromuscular transmission and electromyographies. Muscle biopsies were processed by histochemistry. All patients had peripheral mononeuropathy of the closest sensitive nerve to the area of snakebite. The neuromuscular transmission alterations were minimal. Muscle histochemistry of 4 patients, 2 dogs and 1 rabbit showed findings of mitochondrial myopathy. The majority of authors admit that crotalid venom causes myastenic syndrome. Our findings suggest that palpebral ptosis, myastenic facies and muscular weakness observed after crotalid poisoning are, probably, due to transient and reversible mitochondrial myopathy. As far as we know, this is the first report on the ability of the venom of this rattlesnake to cause local sensitive mononeuropathy and the first muscle histochemistry showing mitochondrial myopathy in humans poisoned by crotalid venom.

  18. Urgencias en patología neuromuscular Emergencies in neuromuscular pathology

    OpenAIRE

    T. Ayuso; I. Jericó

    2008-01-01

    La debilidad muscular aguda (DMA) es el síntoma predominante de las urgencias neuromusculares, especialmente si afecta a la musculatura respiratoria u orofaríngea. La DMA es un síndrome plurietiológico y con distintos niveles lesionales en la unidad motora. Dentro del amplio grupo de enfermedades neuromusculares, las que con mayor frecuencia provocan DMA e insuficiencia respiratoria son el síndrome de Guillain-Barré (SGB) y la miastenia gravis (MG). El SGB constituye la causa más frecuente de...

  19. Impact of soil salinity on the plant-growth – promoting and biological control abilities of root associated bacteria

    Directory of Open Access Journals (Sweden)

    Dilfuza Egamberdieva

    2017-11-01

    Full Text Available The effectiveness of plant growth – promoting bacteria is variable under different biotic and abiotic conditions. Abiotic factors may negatively affect the beneficial properties and efficiency of the introduced PGPR inoculants. The aim of this study was to evaluate the effect of plant growth – promoting rhizobacteria on plant growth and on the control of foot and root rot of tomatoes caused by Fusarium solani under different soil salinity conditions. Among the five tested strains, only Pseudomonas chlororaphis TSAU13, and Pseudomonas extremorientalis TSAU20 were able to stimulate plant growth and act as biological controls of foot and root rot disease of tomato. The soil salinity did not negatively affect the beneficial impacts of these strains, as they were able to colonize and survive on the roots of tomato plants under both saline and non-saline soil conditions. The improved plant height and fruit yield of tomato was also observed for plants inoculated with P. extremorientalis TSAU20. Our results indicated that, saline condition is not crucial factor in obtaining good performance with respect to the plant growth stimulating and biocontrol abilities of PGPR strains. The bacterial inoculant also enhanced antioxidant enzymes activities thereby preventing ROS induced oxidative damage in plants, and the proline concentrations in plant tissue that play an important role in plant stress tolerance.

  20. Effects of bench step exercise intervention on work ability in terms of cardiovascular risk factors and oxidative stress: a randomized controlled study.

    Science.gov (United States)

    Ohta, Masanori; Eguchi, Yasumasa; Inoue, Tomohiro; Honda, Toru; Morita, Yusaku; Konno, Yoshimasa; Yamato, Hiroshi; Kumashiro, Masaharu

    2015-01-01

    Work ability is partly determined by physical and mental fitness. Bench step exercise can be practiced anywhere at any time. The aim of this study was to determine the effects of a bench step exercise on work ability by examining cardiovascular risk factors and oxidative stress. Thirteen volunteers working in a warehousing industry comprised the bench step exercise group (n=7) and the control group (n=6). The participants in the step exercise group were encouraged to practice the step exercise at home for 16 weeks. The step exercise improved glucose metabolism and antioxidative capacity and increased work ability by reducing absences from work and improving the prognosis of work ability. The improvement in work ability was related to a reduction in oxidative stress. These results suggest that a bench step exercise may improve work ability by reducing cardiovascular risk factors and oxidative stress.

  1. Autophagy Impairment in Muscle Induces Neuromuscular Junction Degeneration and Precocious Aging

    Directory of Open Access Journals (Sweden)

    Silvia Carnio

    2014-09-01

    Full Text Available The cellular basis of age-related tissue deterioration remains largely obscure. The ability to activate compensatory mechanisms in response to environmental stress is an important factor for survival and maintenance of cellular functions. Autophagy is activated both under short and prolonged stress and is required to clear the cell of dysfunctional organelles and altered proteins. We report that specific autophagy inhibition in muscle has a major impact on neuromuscular synaptic function and, consequently, on muscle strength, ultimately affecting the lifespan of animals. Inhibition of autophagy also exacerbates aging phenotypes in muscle, such as mitochondrial dysfunction, oxidative stress, and profound weakness. Mitochondrial dysfunction and oxidative stress directly affect acto-myosin interaction and force generation but show a limited effect on stability of neuromuscular synapses. These results demonstrate that age-related deterioration of synaptic structure and function is exacerbated by defective autophagy.

  2. Efficacy of brain-computer interface-driven neuromuscular electrical stimulation for chronic paresis after stroke.

    Science.gov (United States)

    Mukaino, Masahiko; Ono, Takashi; Shindo, Keiichiro; Fujiwara, Toshiyuki; Ota, Tetsuo; Kimura, Akio; Liu, Meigen; Ushiba, Junichi

    2014-04-01

    Brain computer interface technology is of great interest to researchers as a potential therapeutic measure for people with severe neurological disorders. The aim of this study was to examine the efficacy of brain computer interface, by comparing conventional neuromuscular electrical stimulation and brain computer interface-driven neuromuscular electrical stimulation, using an A-B-A-B withdrawal single-subject design. A 38-year-old male with severe hemiplegia due to a putaminal haemorrhage participated in this study. The design involved 2 epochs. In epoch A, the patient attempted to open his fingers during the application of neuromuscular electrical stimulation, irrespective of his actual brain activity. In epoch B, neuromuscular electrical stimulation was applied only when a significant motor-related cortical potential was observed in the electroencephalogram. The subject initially showed diffuse functional magnetic resonance imaging activation and small electro-encephalogram responses while attempting finger movement. Epoch A was associated with few neurological or clinical signs of improvement. Epoch B, with a brain computer interface, was associated with marked lateralization of electroencephalogram (EEG) and blood oxygenation level dependent responses. Voluntary electromyogram (EMG) activity, with significant EEG-EMG coherence, was also prompted. Clinical improvement in upper-extremity function and muscle tone was observed. These results indicate that self-directed training with a brain computer interface may induce activity- dependent cortical plasticity and promote functional recovery. This preliminary clinical investigation encourages further research using a controlled design.

  3. Non-invasive neuromuscular electrical stimulation in patients with central nervous system lesions: an educational review.

    Science.gov (United States)

    Schuhfried, Othmar; Crevenna, Richard; Fialka-Moser, Veronika; Paternostro-Sluga, Tatjana

    2012-02-01

    The aim of this educational review is to provide an overview of the clinical application of transcutaneous electrical stimulation of the extremities in patients with upper motor neurone lesions. In general two methods of electrical stimulation can be distinguished: (i) therapeutic electrical stimulation, and (ii) functional electrical stimulation. Therapeutic electrical stimulation improves neuromuscular functional condition by strengthening muscles, increasing motor control, reducing spasticity, decreasing pain and increasing range of motion. Transcutaneous electrical stimulation may be used for neuromuscular electrical stimulation inducing repetitive muscle contraction, electromyography-triggered neuromuscular electrical stimulation, position-triggered electrical stimulation and subsensory or sensory transcutaneous electric stimulation. Functional electrical stimulation provokes muscle contraction and thereby produces a functionally useful movement during stimulation. In patients with spinal cord injuries or stroke, electrical upper limb neuroprostheses are applied to enhance upper limb and hand function, and electrical lower limb neuroprostheses are applied for restoration of standing and walking. For example, a dropped foot stimulator is used to trigger ankle dorsiflexion to restore gait function. A review of the literature and clinical experience of the use of therapeutic electrical stimulation as well as of functional electrical stimulation in combination with botulinum toxin, exercise therapy and/or splinting are presented. Although the evidence is limited we conclude that neuromuscular electrical stimulation in patients with central nervous system lesions can be an effective modality to improve function, and that combination with other treatments has an additive therapeutic effect.

  4. Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks.

    Science.gov (United States)

    Chappell, Jonathan D; Limpisvasti, Orr

    2008-06-01

    Altered motor control strategies are a proposed cause of the female athlete's increased risk for noncontact anterior cruciate ligament injury. Injury prevention programs have shown promising results in decreasing the incidence of anterior cruciate ligament injury. To evaluate the effect of the Kerlan-Jobe Orthopaedic Clinic Modified Neuromuscular Training Program on the biomechanics of select jumping tasks in the female collegiate athlete. Controlled laboratory study. Thirty female National Collegiate Athletic Association Division I soccer and basketball players performed vertical jump, hopping tests, and 2 jumping tasks (drop jump and stop jump). All subjects completed a 6-week neuromuscular training program with core strengthening and plyometric training. Three-dimensional motion analysis and force plate data were used to compare the kinetics and kinematics of jumping tasks before and after training. Dynamic knee valgus moment during the stance phase of stop jump tasks decreased after completion of the neuromuscular training program (P = .04), but differences were not observed for the drop jump. Initial knee flexion (P = .003) and maximum knee flexion (P = .006) angles increased during the stance phase of drop jumps after training, but differences were not observed for the stop jump. The athletes showed improved performance in vertical jump (P < .001), right 1-legged hop (P < .001), and left 1-legged hop (P < .001). Completion of a 6-week neuromuscular training program improved select athletic performance measures and changed movement patterns during jumping tasks in the subject population. The use of this neuromuscular training program could potentially modify the collegiate athlete's motion strategies, improve performance, and lower the athlete's risk for injury.

  5. Immunoglobulins from Animal Models of Motor Neuron Disease and from Human Amyotrophic Lateral Sclerosis Patients Passively Transfer Physiological Abnormalities to the Neuromuscular Junction

    Science.gov (United States)

    Apel, Stanley H.; Engelhardt, Jozsef I.; Garcia, Jesus; Stefani, Enrico

    1991-01-01

    Amyotrophic lateral sclerosis (ALS) is a devastating human disease of upper and lower motoneurons of unknown etiology. In support of the potential role of autoimmunity in ALS, two immune-mediated animal models of motoneuron disease have been developed that resemble ALS with respect to the loss of motoneurons, the presence of IgG within motoneurons and at the neuromuscular junction, and with respect to altered physiology of the motor nerve terminal. To provide direct evidence for the primary role of humoral immunity, passive transfer with immunoglobulins from the two animal models and human ALS was carried out. Mice injected with serum or immunoglobulins from the animal disease models and human ALS but not controls demonstrated IgG in motoneurons and at the neuromuscular junction. The mice also demonstrated an increase in miniature end-plate potential (mepp) frequency, with normal amplitude and time course and normal resting membrane potential, indicating an increased resting quantal release of acetylcholine from the nerve terminal. The ability to transfer motoneuron dysfunction with serum immunoglobulins provides evidence for autoimmune mechanisms in the pathogenesis of both the animal models and human ALS.

  6. [From joint to neuromuscular, from mechanics to electronics: the concept of neuromuscular compatibility].

    Science.gov (United States)

    Toubol, J P; Duret, F

    1989-06-01

    The development of devices to record the functional mandibular kinetics, has permitted the physiological analysis of the masticatory cycles. Therefore, it is possible to consider a functional integration of the corrections, by addition or subtraction to the occlusal surfaces of the teeth. For this purpose, we have established the conditions of a physiological concept of occlusion taking into account the efficiency of the masticatory apparatus through a velocity analysis. This is the N.M.C. concept or concept of Neuro-Muscular Compatibility. This concept has led us to define the ISCA (Intra-Cuspid Spatial Angle), represented by the angle defined in the three spatial planes, by the trajectory of the occlusal contact point of a cusp liding over its opposite, in any excursive opportunity. We have shortly reported the studies by Levin on the SIROGNATOGRAPH and the prospects resulting from these studies. Then, we have studied in greater details the Saphon VISI TRAINER III developed by HOBO and described the various potentials of its use in the GBM Laboratory in Vienna (France), with François DURET. We have also analyzed the specific points which seem to represent the weaknesses of this device and have outlined some solutions to this problem. This approach, within a clinical context, may at term give rise to a complex analyser-expert-system intends to facilitate the establishment of a reliable diagnosis and to control the physiological integration of our procedures. The establishment, at term, of parameters and constants of this function, will guide this progression towards success.

  7. A novel neuromuscular syndrome associated with clenbuterol-tainted heroin.

    Science.gov (United States)

    Manini, Alex; Labinson, Robert M; Kirrane, Barbara; Hoffman, Robert S; Rao, Rama; Stajic, Marina; Nelson, Lewis S

    2008-12-01

    Clenbuterol is a potent, long-acting beta-adrenergic agonist that has been reported as an adulterant of heroin. We describe an atypical syndrome in five users of clenbuterol-tainted heroin. All cases were referred to a regional Poison Control Center. Urine and blood were analyzed using gas and liquid chromatography as well as mass spectrometry. Five heroin users presented with a syndrome characterized by muscular spasm, tremor, hyperreflexia, and elevated serum creatine phosphokinase concentrations. All patients lacked findings of acute clenbuterol toxicity but tested positive for clenbuterol and negative for strychnine and a battery of common potential adulterants. We report five cases of a novel neuromuscular syndrome in users of clenbuterol-adulterated heroin. It is unclear whether these reactions represent an atypical response to clenbuterol or another unidentified contaminant.

  8. Deep neuromuscular blockade and low insufflation pressure during laparoscopic hysterectomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Istre, Olav; Springborg, Henrik Halvor

    2017-01-01

    . The gynaecologists registered increasing abdominal tensions in no versus eight procedures (p = 0.006) in the deep and standard NMB group, respectively. CONCLUSION: Deep NMB in combination with 8 mmHg pneumoperitoneum prevented sudden abdominal contractions during laparoscopic hysterectomy. FUNDING: This work......INTRODUCTION: Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB...... reduces the incidence of sudden abdominal contractions as compared with standard NMB. METHODS: This was a pre-planned secondary analysis of a randomized, controlled study. A total of 110 patients scheduled for laparoscopic hysterectomy were randomized to either deep NMB and 8 mmHg pneumoperitoneum (deep...

  9. DMRT3 is associated with gait type in Mangalarga Marchador horses, but does not control gait ability.

    Science.gov (United States)

    Patterson, L; Staiger, E A; Brooks, S A

    2015-04-01

    The Mangalarga Marchador (MM) is a Brazilian horse breed known for a uniquely smooth gait. A recent publication described a mutation in the DMRT3 gene that the authors claim controls the ability to perform lateral patterned gaits (Andersson et al. 2012). We tested 81 MM samples for the DMRT3 mutation using extracted DNA from hair bulbs using a novel RFLP. Horses were phenotypically categorized by their gait type (batida or picada), as recorded by the Brazilian Mangalarga Marchador Breeders Association (ABCCMM). Statistical analysis using the plink toolset (Purcell, 2007) revealed significant association between gait type and the DMRT3 mutation (P = 2.3e-22). Deviation from Hardy-Weinberg equilibrium suggests that selective pressure for gait type is altering allele frequencies in this breed (P = 1.00e-5). These results indicate that this polymorphism may be useful for genotype-assisted selection for gait type within this breed. As both batida and picada MM horses can perform lateral gaits, the DMRT3 mutation is not the only locus responsible for the lateral gait pattern. © 2015 Stichting International Foundation for Animal Genetics.

  10. Neuromuscular Manifestations of West Nile Virus Infection

    Directory of Open Access Journals (Sweden)

    A. Arturo eLeis

    2012-03-01

    Full Text Available The most common neuromuscular manifestation of West Nile virus (WNV infection is a poliomyelitis syndrome with asymmetric paralysis variably involving one (monoparesis to four limbs (quadriparesis, with or without brainstem involvement and respiratory failure. This syndrome of acute flaccid paralysis may occur without overt fever or meningoencephalitis. Although involvement of anterior horn cells in the spinal cord and motor neurons in the brainstem are the major sites of pathology responsible for neuromuscular signs, inflammation also may involve skeletal or cardiac muscle (myositis, myocarditis, motor axons (polyradiculitis, peripheral nerve (Guillain-Barré syndrome, brachial plexopathy. In addition, involvement of spinal sympathetic neurons and ganglia provides a plausible explanation for autonomic instability seen in some patients. Many patients also experience prolonged subjective generalized weakness and disabling fatigue. Despite recent evidence that WNV may persist long term in the central nervous system or periphery in animals, the evidence in humans is controversial. WNV persistence would be of great concern in immunosuppressed patients or in those with prolonged or recurrent symptoms. Support for the contention that WNV can lead to autoimmune disease arises from reports of patients presenting with various neuromuscular diseases that presumably involve autoimmune mechanisms (GBS, other demyelinating neu¬ropathies, myasthenia gravis, brachial plexopathies, stiff-person syndrome, and delayed or recurrent symptoms. Although there is no specific treatment or vaccine currently approved in humans, and the standard remains supportive care, drugs that can alter the cascade of immunobiochemical events leading to neuronal death may be potentially useful (high-dose corticosteroids, interferon preparations, and intravenous immune globulin containing WNV-specific antibodies. Human experience with these agents seems promising based on anecdotal

  11. Neuromuscular training for sports injury prevention: a systematic review.

    Science.gov (United States)

    Hübscher, Markus; Zech, Astrid; Pfeifer, Klaus; Hänsel, Frank; Vogt, Lutz; Banzer, Winfried

    2010-03-01

    The aim of this systematic review was to assess the effectiveness of proprioceptive/neuromuscular training in preventing sports injuries by using the best available evidence from methodologically well-conducted randomized controlled trials and controlled clinical trials without randomization. Two independent researchers performed a literature search in various electronic databases and reference lists. The reviewers independently assessed trials for inclusion criteria and methodological quality and extracted the data. Focusing on studies of high methodological quality, relative risks (RR) and 95% confidence intervals (CI) were used to estimate treatment effects. From a total of 32 relevant studies, 7 methodologically well-conducted studies were considered for this review. Pooled analysis revealed that multi-intervention training was effective in reducing the risk of lower limb injuries (RR = 0.61, 95% CI = 0.49-0.77, P injuries (RR = 0.46, 95% CI = 0.28-0.76, P injuries (RR = 0.50, 95% CI = 0.31-0.79, P training alone resulted in a significant risk reduction of ankle sprain injuries (RR = 0.64, 95% CI = 0.46-0.9, P injuries overall (RR = 0.49, 95% CI = 0.13-1.8, P = 0.28). Exercise interventions were more effective in athletes with a history of sports injury than in those without. On the basis of the results of seven high-quality studies, this review showed evidence for the effectiveness of proprioceptive/neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports. Future research should focus on the conduct of comparative trials to identify the most appropriate and effective training components for preventing injuries in specific sports and populations.

  12. Medical back belt with integrated neuromuscular electrical stimulation

    NARCIS (Netherlands)

    Bottenberg, E. (Eliza); Brinks, G.J. (Ger); Hesse, J. (Jenny)

    2014-01-01

    The medical back belt with integrated neuromuscular electrical stimulation is anorthopedic device, which has two main functions. The first function is to stimulate the backmuscles by using a neuromuscular electrical stimulation device that releases regular,electrical impulses. The second function of

  13. Motoneuron and sensory neuron plasticity to varying neuromuscular activity levels

    Science.gov (United States)

    Ishihara, Akihiko; Roy, Roland R.; Ohira, Yoshinobu; Edgerton, V. Reggie

    2002-01-01

    The size and phenotypic properties of the neural and muscular elements of the neuromuscular unit are matched under normal conditions. When subjected to chronic decreases or increases in neuromuscular activity, however, the adaptations in these properties are much more limited in the neural compared with the muscular elements.

  14. ATRACURIUM-INDUCED NEUROMUSCULAR BLOCK IN THE ISOLATED ARM

    NARCIS (Netherlands)

    ERIKSSON, LI; VANDENBROM, RHG; LENNMARKEN, C; AGOSTON, S

    1992-01-01

    A modification of the isolated arm technique was applied in 10 females under opioid-based i.v. anaesthesia for comparison of the offset of an atracurium-induced neuromuscular block in an isolated arm to an arm with maintained circulation. The neuromuscular blocking effect of a bolus dose of

  15. High-Achieving High School Students and Not so High-Achieving College Students: A Look at Lack of Self-Control, Academic Ability, and Performance in College

    Science.gov (United States)

    Honken, Nora B.; Ralston, Patricia A. S.

    2013-01-01

    This study investigated the relationship among lack of self-control, academic ability, and academic performance for a cohort of freshman engineering students who were, with a few exceptions, extremely high achievers in high school. Structural equation modeling analysis led to the conclusion that lack of self-control in high school, as measured by…

  16. Cross-disease comparison of amyotrophic lateral sclerosis and spinal muscular atrophy reveals conservation of selective vulnerability but differential neuromuscular junction pathology.

    Science.gov (United States)

    Comley, Laura H; Nijssen, Jik; Frost-Nylen, Johanna; Hedlund, Eva

    2016-05-01

    Neuromuscular junctions are primary pathological targets in the lethal motor neuron diseases spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS). Synaptic pathology and denervation of target muscle fibers has been reported prior to the appearance of clinical symptoms in mouse models of both diseases, suggesting that neuromuscular junctions are highly vulnerable from the very early stages, and are a key target for therapeutic intervention. Here we examined neuromuscular pathology longitudinally in three clinically relevant muscle groups in mouse models of ALS and SMA in order to assess their relative vulnerabilities. We show for the first time that neuromuscular junctions of the extraocular muscles (responsible for the control of eye movement) were resistant to degeneration in endstage SMA mice, as well as in late symptomatic ALS mice. Tongue muscle neuromuscular junctions were also spared in both animal models. Conversely, neuromuscular junctions of the lumbrical muscles of the hind-paw were vulnerable in both SMA and ALS, with a loss of neuronal innervation and shrinkage of motor endplates in both diseases. Thus, the pattern of selective vulnerability was conserved across these two models of motor neuron disease. However, the first evidence of neuromuscular pathology occurred at different timepoints of disease progression, with much earlier evidence of presynaptic involvement in ALS, progressing to changes on the postsynaptic side. Conversely, in SMA changes appeared concomitantly at the neuromuscular junction, suggesting that mechanisms of neuromuscular disruption are distinct in these diseases. J. Comp. Neurol. 524:1424-1442, 2016. © 2015 The Authors The Journal of Comparative Neurology Published by Wiley Periodicals, Inc. © 2015 The Authors The Journal of Comparative Neurology Published by Wiley Periodicals, Inc.

  17. Electrophysiological study in neuromuscular junction disorders

    Directory of Open Access Journals (Sweden)

    Ajith Cherian

    2013-01-01

    Full Text Available This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS, congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS. SFEMG requires skill and patience and its availability is limited to a few centers. For RNS supramaximal stimulation is essential and so is display of the whole waveform of each muscle response at maximum amplitude. The amplitudes of the negative phase of the first and fourth responses are measured from baseline to negative peak, and the percent change of the fourth response compared with the first represents the decrement or increment. A decrement greater than 10% is accepted as abnormal and smooth progression of response amplitude train and reproducibility form the crux. In suspected LEMS the effect of fast rates of stimulation should be determined after RNS response to slow rates of stimulation. Caution is required to avoid misinterpretation of potentiation and pseudofacilitation.

  18. Cardiorespiratory and neuromuscular responses to motocross riding.

    Science.gov (United States)

    Konttinen, Tomi; Kyröläinen, Heikki; Häkkinen, Keijo

    2008-01-01

    The aim of the present study was to examine physiological and neuromuscular responses during motocross riding at individual maximal speed together with the riding-induced changes in maximal isometric force production. Seven A-level (group A) and 5 hobby-class (group H) motocross-riders performed a 30-minute riding test on a motocross track and maximal muscle strength and oxygen uptake (VO2max) tests in a laboratory. During the riding the mean (+/-SD) VO2 reduced in group A from 86 +/- 10% to 69 +/- 6% of the maximum (P physical stress and demands on both skill and physical capacity of the rider. Physical stress occurs as the result of handling of the bike when receiving continuous impacts in the situation requiring both aerobic and anaerobic metabolism. Our data suggest that both maximal capacity and strain during the ride should be measured to analyze the true physiological and neuromuscular demands of motocross ride. For the practice, this study strongly suggests to train not only aerobic and anaerobic capacity but also to use strength and power training for successful motocross riding.

  19. Neuromuscular imaging in inherited muscle diseases

    Energy Technology Data Exchange (ETDEWEB)

    Wattjes, Mike P. [VU University Medical Center, Department of Radiology, De Boelelaan 1117, HV, Amsterdam (Netherlands); Kley, Rudolf A. [Klinken Bergmannsheil, Ruhr-University, Department of Neurology, Neuromuscular Centre Ruhrgebiet, Bochum (Germany); Fischer, Dirk [University Hospital of Basel, Department of Neurology, Basel (Switzerland); University Children' s Hospital Basel, Department of Neuropaediatrics, Basel (Switzerland)

    2010-10-15

    Driven by increasing numbers of newly identified genetic defects and new insights into the field of inherited muscle diseases, neuromuscular imaging in general and magnetic resonance imaging (MRI) in particular are increasingly being used to characterise the severity and pattern of muscle involvement. Although muscle biopsy is still the gold standard for the establishment of the definitive diagnosis, muscular imaging is an important diagnostic tool for the detection and quantification of dystrophic changes during the clinical workup of patients with hereditary muscle diseases. MRI is frequently used to describe muscle involvement patterns, which aids in narrowing of the differential diagnosis and distinguishing between dystrophic and non-dystrophic diseases. Recent work has demonstrated the usefulness of muscle imaging for the detection of specific congenital myopathies, mainly for the identification of the underlying genetic defect in core and centronuclear myopathies. Muscle imaging demonstrates characteristic patterns, which can be helpful for the differentiation of individual limb girdle muscular dystrophies. The aim of this review is to give a comprehensive overview of current methods and applications as well as future perspectives in the field of neuromuscular imaging in inherited muscle diseases. We also provide diagnostic algorithms that might guide us through the differential diagnosis in hereditary myopathies. (orig.)

  20. Prevalence of complications in neuromuscular scoliosis surgery

    DEFF Research Database (Denmark)

    Sharma, Shallu; Wu, Chunsen; Andersen, Thomas

    2013-01-01

    PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: PubMed and Em......PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: Pub......Med and Embase databases were searched for studies reporting the outcomes and complications of NMS surgery, published from 1997 to May 2011. We focused on NMS as defined by the Scoliosis Research Society's classification. We measured the pooled estimate of the overall complication rates (PR) using a random....... In regard to surgical complications affiliated with various surgical techniques in NMS, the level of evidence of published literature ranges between 2+ to 2-; the subsequent recommendations are level C. CONCLUSION: NMS patients have diverse and high complication rates after scoliosis surgery. High PRs...

  1. LRP4 is critical for neuromuscular junction maintenance.

    Science.gov (United States)

    Barik, Arnab; Lu, Yisheng; Sathyamurthy, Anupama; Bowman, Andrew; Shen, Chengyong; Li, Lei; Xiong, Wen-cheng; Mei, Lin

    2014-10-15

    The neuromuscular junction (NMJ) is a synapse between motor neurons and skeletal muscle fibers, and is critical for control of muscle contraction. Its formation requires neuronal agrin that acts by binding to LRP4 to stimulate MuSK. Mutations have been identified in agrin, MuSK, and LRP4 in patients with congenital myasthenic syndrome, and patients with myasthenia gravis develop antibodies against agrin, LRP4, and MuSK. However, it remains unclear whether the agrin signaling pathway is critical for NMJ maintenance because null mutation of any of the three genes is perinatal lethal. In this study, we generated imKO mice, a mutant strain whose LRP4 gene can be deleted in muscles by doxycycline (Dox) treatment. Ablation of the LRP4 gene in adult muscle enabled studies of its role in NMJ maintenance. We demonstrate that Dox treatment of P30 mice reduced muscle strength and compound muscle action potentials. AChR clusters became fragmented with diminished junctional folds and synaptic vesicles. The amplitude and frequency of miniature endplate potentials were reduced, indicating impaired neuromuscular transmission and providing cellular mechanisms of adult LRP4 deficiency. We showed that LRP4 ablation led to the loss of synaptic agrin and the 90 kDa fragments, which occurred ahead of other prejunctional and postjunctional components, suggesting that LRP4 may regulate the stability of synaptic agrin. These observations demonstrate that LRP4 is essential for maintaining the structural and functional integrity of the NMJ and that loss of muscle LRP4 in adulthood alone is sufficient to cause myasthenic symptoms. Copyright © 2014 the authors 0270-6474/14/3413892-14$15.00/0.

  2. Training Cognitive Control in Older Adults with the Space Fortress Game: The Role of Training
    Instructions and Basic Motor Ability

    Directory of Open Access Journals (Sweden)

    Helena M Blumen

    2010-11-01

    Full Text Available This study examined if and how cognitively-healthy older adults can learn to play a complex computer-based action game called the Space Fortress (SF as a function of training instructions (Standard vs. Emphasis Change (EC; e.g. Gopher, Weil & Siegel, 1989 and basic motor ability. A total of 35 cognitively-healthy older adults completed a 3-month SF training program with three SF sessions weekly. Twelve 3-minute games were played during each session. Basic motor ability was assessed with an aiming task, which required rapidly rotating a spaceship to shoot targets. Older adults showed improved performance on the SF task over time, but did not perform at the same level as younger adults. Unlike studies of younger adults, overall SF performance in older adults was greater following standard instructions than following EC instructions. However, this advantage was primarily due to collecting more bonus points and not – the primary goal of the game – shooting and destroying the fortress, which in contrast benefitted from EC instructions. Basic motor ability was low and influenced many different aspects of SF game learning, often interacted with learning rate, and influenced overall SF performance. These findings show that older adults can be trained to deal with the complexity of the SF task but that overall SF performance, and the ability to capitalize on EC instructions, differs when a basic ability such as motor control is low. Hence, the development of this training program as a cognitive intervention that can potentially compensate for age-related cognitive decline should consider that basic motor ability can interact with the efficiency of training instructions that promote the use of cognitive control (e.g. EC instructions – and the confluence between such basic abilities and higher-level cognitive control abilities should be further examined.

  3. Design of low-cost general purpose microcontroller based neuromuscular stimulator.

    Science.gov (United States)

    Koçer, S; Rahmi Canal, M; Güler, I

    2000-04-01

    In this study, a general purpose, low-cost, programmable, portable and high performance stimulator is designed and implemented. For this purpose, a microcontroller is used in the design of the stimulator. The duty cycle and amplitude of the designed system can be controlled using a keyboard. The performance test of the system has shown that the results are reliable. The overall system can be used as the neuromuscular stimulator under safe conditions.

  4. Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade?

    DEFF Research Database (Denmark)

    Pedersen, T; Viby-Mogensen, J; Bang, U

    1990-01-01

    evaluated the degree of neuromuscular blockade solely by clinical criteria. The use of a nerve stimulator was found to have no effect on the dose of relaxant given during anesthesia, on the need for supplementary doses of anticholinesterase in the recovery room, on the time from end of surgery to end......The authors conducted a randomized controlled clinical trial to evaluate the usefulness of perioperative manual evaluation of the response to train-of-four (TOF) nerve stimulation. A total of 80 patients were divided into four groups of 20 each. For two groups (one given vecuronium and one...... pancuronium), the anesthetists assessed the degree of neuromuscular blockade during operation and during recovery from neuromuscular blockade by manual evaluation of the response to TOF nerve stimulation. In the other two groups, one of which received vecuronium and the other pancuronium, the anesthetists...

  5. Habilidades pragmáticas em crianças deficientes auditivas: estudo de casos e controles Pragmatic abilities in hearing impaired children: a case-control study

    Directory of Open Access Journals (Sweden)

    Luana Curti

    2010-01-01

    Full Text Available OBJETIVO: Avaliar as habilidades pragmáticas de um grupo de crianças deficientes auditivas e compará-las a seus pares normo-ouvintes. MÉTODOS: Estudo de casos e controles composto por 32 crianças de ambos os gêneros com idades entre dois e seis anos. Dentre estas, 16 deficientes auditivas de grau moderadamente severo a profundo sem outros comprometimentos orgânicos (casos e 16 crianças normo-ouvintes sem queixas fonoaudiológicas (controle pareadas por idade. A avaliação e a análise da pragmática foram realizadas a partir do Teste ABFW-Pragmática, seguindo as instruções do protocolo. RESULTADOS: A média de idade das crianças estudadas foi quatro anos (DP=1,3; houve diferença significativa em relação ao número de atos comunicativos por minuto entre casos e controles (p=0,001. As crianças deficientes auditivas apresentaram menos iniciativas comunicativas do que as crianças normo-ouvintes e o meio comunicativo gestual foi utilizado por 13 (81, 3% destas e por cinco (32,2% das crianças normo-ouvintes (p=0,004. Não houve diferença entre os grupos em relação às intenções comunicativas (p=0,465. CONCLUSÃO: As crianças deficientes auditivas foram capazes de interagir em situações contextualizadas utilizando-se de funções comunicativas semelhantes às das ouvintes, e se diferiram destas quanto ao meio comunicativo mais utilizado.PURPOSE: To evaluate the pragmatic abilities of a group of hearing impaired children, and compare them with normal-listener peers. METHODS: Case-control study composed by 32 children of both genders with ages between two and six years, paired by age: 16 hearing impaired with moderately severe to profound hearing loss without other organic dysfunctions (cases, and 16 children with normal hearing with no Speech-Language Pathology complaints (control. The evaluation and analysis of pragmatic abilities were carried out based on the ABFW-Pragmatics Test, following instructions of its own protocol

  6. Controlling the Formation of Ionic-Liquid-based Aqueous Biphasic Systems by Changing the Hydrogen Bonding Ability of Polyethylene Glycol End Groups

    Science.gov (United States)

    Pereira, Jorge F. B.; Kurnia, Kiki A.; Freire, Mara G.; Coutinho, João A. P.; Rogers, Robin D.

    2017-01-01

    The formation of aqueous biphasic systems (ABS) when mixing aqueous solutions of polyethylene glycol (PEG) and an ionic liquid (IL) can be controlled by modification of the hydrogen bond ability of the polymer’s end groups. It is shown that the miscibility/immiscibility on these systems stems from both the solvation of the ether groups in the oxygen chain and the ability of the PEG terminal groups to preferably hydrogen bond with water or the salt anion. The reduction of even one hydrogen bond in PEG can noticeably affect the phase behavior, especially in those regions of the phase diagram where all the ethylene oxide (EO) units of the polymeric chain are completely solvated. In this region, removing or weakening the hydrogen bond donating ability of PEG results in greater immiscibility, i.e., in a higher ability to form ABS, as a result of the much weaker interactions between the IL anion and the PEG end groups. PMID:25943332

  7. Influence of Resistance Training on Neuromuscular Function and Physical Capacity in ALS Patients

    Directory of Open Access Journals (Sweden)

    L. Jensen

    2017-01-01

    Full Text Available Objectives. The present study aimed to explore the effect of resistance training in patients with amyotrophic lateral sclerosis (ALS, a disease characterized by progressive motor neuron loss and muscle weakness. Materials and Methods. Following a 12-week “lead-in” control period, a population of ALS patients from Funen, Denmark, completed a 12-week resistance training program consisting of 2-3 sessions/week. Neuromuscular function (strength and power and voluntary muscle activation (superimposed twitch technique were evaluated before and after both control and training periods. Physical capacity tests (chair rise and timed up and go, the revised ALS functional rating scale (ALSFRS-R scores, and muscle cross sectional area (histology were also assessed. Results. Of twelve ALS patients assessed for eligibility, six were included and five completed the study. Training did not significantly affect the ALSFRS-R score, and loss of neuromuscular function (strength and power increased following the training period. However, an improved functionality (chair rise and an increase in greatly hypertrophied type II fibres combined with an increase in atrophied fibres following the training period compared to the control period were observed. Conclusion. In this small study, the present form of resistance training was unable to attenuate progressive loss of neuromuscular function in ALS, despite some changes in physical capacity and morphology.

  8. Evaluation of the effectiveness of neuromuscular electrical stimulation after total knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Bistolfi, Alessandro; Zanovello, Jessica; Ferracini, Riccardo; Allisiardi, Fabrizio; Lioce, Elisa; Magistroni, Ernesta; Berchialla, Paola; Da Rold, Ilaria; Massazza, Giuseppe

    2017-10-07

    to evaluate the efficacy of the use of the neuromuscular electrical stimulation (NMES) after total knee arthroplasty (TKA). a systematic review of randomized controlled trials (MEDLINE, PubMed, Cochrane Library, and PEDro) using PICOS approach to formulate the research question, Controlled terms and Boolean operators. Inclusion and exclusion criteria were defined in advance. "Neuromuscular electrical stimulation" and "total knee arthroplasty" were used as keywords. The overall risk of bias was determined according to: random sequence generation, concealment, blinding mass of participants and staff, commissioning blind assessment results, incomplete data and loans received. out of the 36 identified studies, six were included in the review (496 participants). In these studies, one group of patients followed a rehabilitation protocol (control-group) and the other followed a rehabilitation program plus a session of neuromuscular electrical stimulation (NMES-group). Patients of NMES-groups got the best scores (Timed Up and Go Test, Stair-Climbing Test and Walk Test). NMES benefits were strong in the first postoperative weeks/months and gradually diminished. NMES allows a slightly better functional recovery following TKA, especially in the first period, with more evident benefits in patients with a severe lack of muscular activation. Nevertheless, there is no difference at medium-long term.

  9. Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial

    Science.gov (United States)

    Lee, Kyeongjin; Lee, Yong Woo

    2017-01-01

    [Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults. PMID:28931994

  10. Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial.

    Science.gov (United States)

    Lee, Kyeongjin; Lee, Yong Woo

    2017-09-01

    [Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults.

  11. The immediate effects of soft tissue mobilization with proprioceptive neuromuscular facilitation on glenohumeral external rotation and overhead reach.

    Science.gov (United States)

    Godges, Joseph J; Mattson-Bell, Melodie; Thorpe, Donna; Shah, Drashti

    2003-12-01

    Randomized controlled 2-group. pretest-posttest, multivariate study of patients with shoulder musculoskeletal disorders. The purpose of this study was to evaluate the immediate effect of soft tissue mobilization (STM) with proprioceptive neuromuscular facilitation (PNF) to increase glenohumeral external rotation at 45 degrees of shoulder abduction and overhead reach. It is postulated that limitation in glenohumeral external rotation, when measured at 45 degrees of shoulder abduction, represents subscapularis muscle flexibility deficits and is associated with the inability to fully reach overhead. No research, however, is available to demonstrate whether intervention strategies intended to improve subscapularis flexibility and glenohumeral external rotation range of motion at 45 degrees of shoulder abduction will improve a patient's ability to reach overhead. Twenty patients (10 males, 10 females; age range, 21-83 years) with limited glenohumeral external rotation and overhead reach of 1 year duration or less served as subjects. The subjects were randomly assigned to a treatment group, which consisted of soft tissue mobilization to the subscapularis and proprioceptive neuromuscular facilitation to the shoulder rotators, or a control group. Goniometric measurements of glenohumeral external rotation at 45 degrees abduction and overhead reach were taken preintervention and immediately postintervention for the treatment group or at prerest and postrest periods for the control group. The treatment group improved by a mean of 16.4 degrees (95% confidence interval [CI, 12.5 degrees-20.3 degrees) of glenohumeral external rotation, as compared to less than a 1 degree gain (95% CI, -0.2 degrees-2.0 degrees) in the control group (P < .0005). Overhead reach in the treatment group improved by a mean of 9.6 cm (95% CI, 5.2-14.0 cm) in comparison to a mean gain of 2.4 cm (95% CI, -0.8-5.6 cm) for the control group (P = .009). These findings suggest that a single intervention

  12. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    Hg; 'standard') insufflation pressure in a 2 × 2 factorial design. Primary endpoint was surgeon's overall satisfaction with surgical conditions, rated at end of surgery using an 11-point numerical scale. Post-operative pain scores were also evaluated. Data were analyzed using analysis of covariance. RESULTS......INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic......: Of 127 randomized patients, 120 had evaluable data for the primary endpoint. Surgeon's score of overall satisfaction with surgical conditions was significantly higher with deep versus moderate NMB indicated by a least-square mean difference of 1.1 points (95% confidence interval 0.1-2.0; P = 0...

  13. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic......Hg; 'standard') insufflation pressure in a 2 × 2 factorial design. Primary endpoint was surgeon's overall satisfaction with surgical conditions, rated at end of surgery using an 11-point numerical scale. Post-operative pain scores were also evaluated. Data were analyzed using analysis of covariance. RESULTS......: Of 127 randomized patients, 120 had evaluable data for the primary endpoint. Surgeon's score of overall satisfaction with surgical conditions was significantly higher with deep versus moderate NMB indicated by a least-square mean difference of 1.1 points (95% confidence interval 0.1-2.0; P = 0...

  14. Monitoring strength training: neuromuscular and hormonal profile.

    Science.gov (United States)

    Bosco, C; Colli, R; Bonomi, R; von Duvillard, S P; Viru, A

    2000-01-01

    This study investigated changes induced by a single heavy resistance training session on neuromuscular and endocrine systems in trained athletes, using the same exercises for training and testing. Five different groups volunteered: track and field male sprinters (MS, N = 6), track and field female sprinters (FS, N = 6), body builders (BB, N = 6), and weight lifters performing low-repetition exercise (WLL, N = 4) and high-repetition exercise (WLH, N = 4). In training, the work performed during half and full squat exercise was monitored for mechanical power output as well as EMG analysis on leg extensor muscles of the subjects belonging to the MS, FS, and BB groups. Just before and immediately after the training session, venous blood samples were obtained for RIA determination of testosterone (T), cortisol (C), lutropin (LH), human prolactin (PRL), and follitropin (FSH) in FS and MS. In the other three groups (BB, WLH, and WLL), the hormonal profile was limited to T and human growth hormone (hGH) only. After training the power developed in full squat demonstrated a statistically significant decrease (P training session. Consequently, the EMG/Power ratio increased in both MS and FS, although only in MS a statistical significance was noted (P < 0.05). In MS immediately after the session the levels of C, T, and LH were significantly lower (P < 0.05). No changes were found in FS. In both groups and in BB significant negative correlation was found between changes in T level and EMG/Power ratio in half squat performance. It is likely that adequate T level may compensate the effect of fatigue in FT fibers by ensuring a better neuromuscular efficiency.

  15. The ability of the biological control agent Bacillus subtilis, strain BB, to colonise vegetable brassicas endophytically following seed inoculation

    NARCIS (Netherlands)

    Wulff, E.G.; Vuurde, van J.W.L.; Hockenhull, J.

    2003-01-01

    The ability of Bacillus subtilis, strain BB, to colonise cabbage seedlings endophytically was examined following seed inoculation. Strain BB was recovered from different plant parts including leaves (cotyledons), stem (hypocotyl) and roots. While high bacterial populations persisted in the roots and

  16. Relationships between Task-Oriented Postural Control and Motor Ability in Children and Adolescents with Down Syndrome

    Science.gov (United States)

    Wang, Hui-Yi; Long, I-Man; Liu, Mei-Fang

    2012-01-01

    Individuals with Down syndrome (DS) have been characterized by greater postural sway in quiet stance and insufficient motor ability. However, there is a lack of studies to explore the properties of dynamic postural sway, especially under conditions of task-oriented movement. The purpose of this study was to investigate the relationships between…

  17. Effectiveness of functional progressive resistance exercise training on walking ability in children with cerebral palsy: A randomized controlled trial

    NARCIS (Netherlands)

    Scholtes, V.A.; Becher, J.G.; Janssen-Potten, Y.J.; Dekkers, H.; Smallenbroek, L.; Dallmeijer, A.J.

    2012-01-01

    The objective of the study was to evaluate the effectiveness of functional progressive resistance exercise (PRE) training on walking ability in children with cerebral palsy (CP).Fifty-one ambulant children with spastic CP (mean age 10 years 5 months, 29 boys) were randomized to an intervention (n=

  18. A neuromuscular exercise programme versus standard care for patients with traumatic anterior shoulder instability

    DEFF Research Database (Denmark)

    Eshoj, Henrik; Rasmussen, Sten; Frich, Lars Henrik

    2017-01-01

    -based exercise programmes. In similar, high-impact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL. Thus, the objective of this trial is to compare a nonoperative neuromuscular exercise shoulder programme......BACKGROUND: Anterior shoulder dislocation is a common injury and may have considerable impact on shoulder-related quality of life (QoL). If not warranted for initial stabilising surgery, patients are mostly left with little to no post-traumatic rehabilitation. This may be due to lack of evidence...... with standard care in patients with traumatic anterior shoulder dislocations (TASD). METHODS/DESIGN: Randomised, assessor-blinded, controlled, multicentre trial. Eighty patients with a TASD will be recruited from three orthopaedic departments in Denmark. Patients with primary or recurrent anterior shoulder...

  19. An 8-Week Neuromuscular Exercise Program for Patients With Mild to Moderate Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Clausen, Brian; Holsgaard-Larsen, Anders; Roos, Ewa M

    2017-01-01

    OBJECTIVE:   To describe the feasibility of a neuromuscular exercise (NEMEX) program in patients with mild to moderate knee osteoarthritis (KOA). BACKGROUND:   Neuromuscular exercise has been increasingly used in patients with osteoarthritis to achieve sensorimotor control and improved daily...... to increased (n = 2) or persisting (n = 1) knee pain. However, their pain ratings did not show worsening symptoms. UNIQUENESS:   This NEMEX-KOA program was designed for physically active middle-aged patients with mild to moderate KOA; therefore, it involved exercises and difficulty levels that were more...... challenging than a previously described NEMEX program for patients eligible for total joint replacement. CONCLUSIONS:   In patients with baseline mild to severe pain with activity, the NEMEX-KOA program was feasible. Progression was achieved with few incidents of clinically relevant increases in pain...

  20. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    ). An 8-week preoperative neuromuscular supervised exercise programme was delivered twice a week for 1 h as adjunct treatment to the standard arthroplasty procedure and compared with the standard arthroplasty procedure alone. The primary outcome was self-reported physical function measured......OBJECTIVE: To investigate the postoperative efficacy of a supervised programme of neuromuscular exercise prior to hip or knee arthroplasty. METHODS: In this assessor-blinded randomised controlled trial, we included 165 patients scheduled for hip or knee arthroplasty due to severe osteoarthritis (OA...... on the activities of daily living (ADL) subscale in the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires for patients with hip and knee OA, respectively. Primary endpoint was 3 months after surgery. RESULTS: 165 patients randomised...

  1. A GO intervention program for enhancing elementary school children's cognitive functions and control abilities of emotion and behavior: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tachibana Yoshiyuki

    2012-01-01

    Full Text Available Abstract Background Executive function is critical for children's healthy development. We propose an intervention program to enhance children's executive function using the game, GO. Many neuroimaging studies have revealed that playing GO is related to executive function. In addition, previous studies also revealed that executive function can be enhanced by training. We will perform a randomized controlled trial to investigate the effectiveness of a GO intervention group and a control group without intervention. Methods/Design 35 elementary school children aged 8 to 10 were recruited from Edogawa elementary school in Tokyo, Japan. They will be randomized into two groups; either the 5-week GO intervention group or no-intervention control group. We will ask the participants of the intervention group to join the GO course which will be held once every week for five weeks (total: six times. In the GO course, the children will be taught GO by the GO masters of the Nihon Ki-in and enjoy it for an hour. Besides the course, the participants will perform GO problems about twenty minutes a day, three times a week during the intervention period. We will use the Stroop task, the digit span, the Raven's colored progressive matrices, the Span-board task, and the Behavioral inhibition/behavioral activation scale for the outcome measures. Outcomes will be measured at a baseline (Assessment 1 and 5 weeks after the intervention program started (Assessment 2. The intervention group will be compared with the control group using one-way analyses of covariance with the difference between Assessment 1 and Assessment 2 measures as dependent variables and pretest scores as covariates. Discussion To our knowledge, this study will be the first RCT to investigate the efficacy of a GO intervention program for elementary school children. If this intervention is effective, we will be able to take the next steps in making an educational program to enhance children's executive

  2. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke

    OpenAIRE

    Sharma, Vishal; Kaur, Jaskirat

    2017-01-01

    The purpose of this study was to evaluate the effects of core strengthening combined with pelvic proprioceptive neuromuscular facilitation (PNF) on trunk impairment, balance, gait, and functional ability of chronic stroke patients. Twenty-three participants with chronic stroke were recruited and randomly allocated to one of the two groups: core strengthening combined with pelvic PNF (group 1, n=13), and pelvic PNF with trunk flexibility exercises (group 2, n=10). Intervention was given to bot...

  3. Effect of Family Empowerment Modified Model to a Family???s Ability in Controlling Life Style and Physical Activity of Children with Overweight and Obesity

    OpenAIRE

    Kadek Ayu Erika, Elly Nurachmah Yeni Rustina, Suryani As`ad and Werna Nontji

    2016-01-01

    - Overeating and physical inactivity has led to an increase in the prevalence of overweight and obese children in developing countries which lead to Non Communicable Disease (NCD). Family???s role is important in controlling children lifestyle by developing and implementing a Family Empowerment Modified Model (FEMM) through the health promotion and family maintenance. This study aims to determine differences in the family???s ability controlling the lifestyle and physical activity of obesi...

  4. Two- and 6-minute walk tests assess walking capability equally in neuromuscular diseases.

    Science.gov (United States)

    Andersen, Linda Kahr; Knak, Kirsten Lykke; Witting, Nanna; Vissing, John

    2016-02-02

    This methodologic study investigates if the 2-minute walk test (2MWT) can be a valid alternative to the 6-minute walk test (6MWT) to describe walking capability in patients with neuromuscular diseases. Patients (n = 115) with different neuromuscular diseases were invited to participate on 2 test days, each consisting of 1 2MWT and 1 6MWT separated by a minimum 30-minute period of rest. The order of the walk tests was randomly assigned via sealed envelopes. A group of 38 healthy controls completed 1 6MWT. The mean walking distance for the 2MWT was 142.8 meters and for the 6MWT 405.3 meters. The distance walked in the 2MWT was highly correlated to the distance walked in the 6MWT (r = 0.99, p walking speed from the first to last minute in the 6MWT, both among patients and healthy controls, which was not evident in the 2MWT. Results were consistent across diagnoses and levels of disease severity. The 2MWT is a potential alternative to the 6MWT to describe walking capability among patients with neuromuscular diseases during clinical trials. © 2016 American Academy of Neurology.

  5. Effectiveness of neuromuscular taping on painful hemiplegic shoulder: a randomised clinical trial.

    Science.gov (United States)

    Pillastrini, Paolo; Rocchi, Giulia; Deserri, Deborah; Foschi, Paola; Mardegan, Michele; Naldi, Maria Teresa; Villafañe, Jorge Hugo; Bertozzi, Lucia

    2016-08-01

    The purpose of this trial was to investigate changes in pain, the range of motion (ROM) and spasticity in people with painful hemiplegic shoulder (PHS) after the application of an upper limb neuromuscular taping (NMT). We conducted a randomised clinical trial. The study included 32 people, 31% female (mean ± SD age: 66 ± 9 years), with PHS after stroke with pain at rest and during functional movements. The experimental group received the application of NMT and a standard physical therapy programme (SPTP), whereas the control group received SPTP. The groups received four 45-minute long sessions over four weeks. The VAS, ROM and spasticity were assessed before and after the intervention with follow-up at four weeks. The experimental group had a greater reduction in pain compared to the control group at the end of the intervention, as well as at one month after the intervention (p shoulder flexion (95% CI: 37.3-22.7) at 4 weeks and by 24.8° (95% CI: 32.1-17.6) at 8 weeks as well as in abduction by 30.6° (95% CI: 37.5-23.7) at 4 weeks and 25.1° (95% CI: 33.8-16.3) at 8 weeks. Our study demonstrates that NMT decreases pain and increases the ROM in subjects with shoulder pain after a stroke. Implications for Rehabilitation Painful hemiplegic shoulder is a frequent complication after stroke with negative impacts on functional activities and on quality of life of people, moreover restricts rehabilitation intervention. Neuromuscular taping is a technique introduced by David Blow for the treatment of neuromuscoloskeletal problems. This study shows the reduction of pain and the improvement of range of motion after the application of an upper limb neuromuscular taping. Rehabilitation professionals who are involved in the management of painful hemiplegic shoulder may like to consider the benefits that neuromuscular taping can produce on upper limb.

  6. Seeking a better landscape for therapy development in neuromuscular disorders.

    Science.gov (United States)

    Larkindale, Jane; Porter, John D

    2018-01-01

    Although the neuromuscular field has seen accelerated approval of a drug for Duchenne muscular dystrophy (DMD) and full approval of one for spinal muscular atrophy, these experiences have shown that objective data and an adequate level of effect are essential for drug approval and reimbursement. The appropriateness and validity of biomarkers and clinically meaningful endpoints and an understanding of disease progression rates all played essential roles in the levels of evidence for these drugs. Such tools are best developed through integration of clinical data. The siloing of clinical data for rare neuromuscular diseases represents a considerable barrier to achieving better care and novel therapies for patients living with neuromuscular diseases. We discuss a data-sharing model implemented for DMD and urge cultural changes in the ways natural history and clinical trial data are collected and shared across all neuromuscular diseases in order to benefit the primary stakeholder, the patient. Muscle Nerve 57: 16-19, 2018. © 2017 Wiley Periodicals, Inc.

  7. Neuromuscular training for sports injury prevention: a systematic review

    National Research Council Canada - National Science Library

    Hübscher, Markus; Zech, Astrid; Pfeifer, Klaus; Hänsel, Frank; Vogt, Lutz; Banzer, Winfried

    2010-01-01

    The aim of this systematic review was to assess the effectiveness of proprioceptive/neuromuscular training in preventing sports injuries by using the best available evidence from methodologically well...

  8. Quantitative skeletal muscle ultrasound: diagnostic value in childhood neuromuscular disease.

    NARCIS (Netherlands)

    Pillen, S.; Verrips, A.; Alfen, N. van; Arts, I.M.P.; Sie, L.T.L.; Zwarts, M.J.

    2007-01-01

    In this study we investigated the diagnostic value of quantitative skeletal muscle ultrasonography in 150 consecutively referred children with symptoms suspect for a neuromuscular disorder. Muscle thickness and quantitatively determined echo intensity of four muscles and the distribution of these

  9. Effects of napping on neuromuscular fatigue in myasthenia gravis.

    Science.gov (United States)

    Kassardjian, Charles D; Murray, Brian J; Kokokyi, Seint; Jewell, Dana; Barnett, Carolina; Bril, Vera; Katzberg, Hans D

    2013-11-01

    The relationship between sleep and neuromuscular fatigue is understood poorly. The goal of this study was to evaluate the effects of napping on quantitative measures of neuromuscular fatigue in patients with myasthenia gravis (MG). Eight patients with mild to moderate MG were recruited. Patients underwent maintenance of wakefulness tests (MWT) and multiple sleep latency tests (MSLT). The Quantitative Myasthenia Gravis Score (QMGS) was measured before nap and after each nap to examine the effects of napping and sleep on neuromuscular weakness. Results showed that QMGS improves only after naps where patients slept more than 5 min but not where patients did not sleep or slept less than 5 min. Daytime napping mitigates neuromuscular fatigue in patients with MG, especially if patients slept for more than 5 min. Copyright © 2013 Wiley Periodicals, Inc.

  10. Genetics of Pediatric-Onset Motor Neuron and Neuromuscular Diseases

    Science.gov (United States)

    2015-08-24

    Spinal Muscular Atrophy; Charcot-Marie-Tooth Disease; Muscular Dystrophy; Spinal Muscular Atrophy With Respiratory Distress 1; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Neuromuscular Disease; Peroneal Muscular Atrophy; Fragile X Syndrome

  11. [Neuromuscular relaxation and CCMDP. The Zilgrei and Feldenkrais methods 2].

    Science.gov (United States)

    Santoro, F; Maiorana, C; Faccin, C

    1989-10-31

    The Authors show two neuromuscular release methods employed in the treatment of cranio-cervico-mandibular syndrome; these methods work at the place of origin of the pathology resolving the symptoms in different districts of the body.

  12. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Minis, M.A.H; Cup, E.H.C.; Heerkens, Y.H.; Engels, J.A.; Engelen, B.G.M. van; Oostendorp, R.A.B.

    2012-01-01

    Minis MA, Cup EH, Heerkens YF, Engels JA, van Engelen BG, Oostendorp RA. Exploring employment in consultation reports of patients with neuromuscular diseases. OBJECTIVES: To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients

  13. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona

    2015-01-01

    endotracheally intubated, mechanically ventilated, anesthetized with propofol and fentanyl, and randomized into two groups in a cross-over assessor-blinded design. Neuromuscular block was established with rocuronium. Artificial laparotomy for ileus was performed. We investigated the influence of intense......PURPOSE: Intense neuromuscular block may improve surgical conditions in ileus laparotomies; however, it is difficult to evaluate. The aim of this study was to investigate if neuromuscular block improved surgical conditions in pigs with artificial ileus laparotomy. METHODS: Six pigs were...... neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while...

  14. Lower limb neuromuscular function and blood flow characteristics in AFO-using survivors of stroke.

    Science.gov (United States)

    Sherk, Kyle A; Sherk, Vanessa D; Anderson, Mark A; Bemben, Debra A; Bemben, Michael G

    2015-01-01

    Ankle-foot orthoses (AFOs) and gait aids are commonly used by survivors of stroke to ambulate, but they have not been used as inclusion or exclusion criteria for physiological studies. The purpose of this study was to examine differences in neuromuscular function and blood flow characteristics between the lower limbs of ambulatory, AFO-using survivors of stroke (n = 9). The subjects were, on average, 14 years poststroke and had used an AFO for about 7 years. We used the following measures to assess both lower limbs: quadriceps muscular strength (manual muscle testing, 1RM), calf muscular endurance (single-leg heel raises), lower limb soft tissue composition and muscle cross-sectional area, calf resting blood flow (strain gauge plethysmography), and central neural drive of the plantar flexors (nerve stimulation). The sound limb was defined as the control. Quadriceps strength, triceps surae endurance, and calf cross-sectional area all were greater in the sound limb than in the affected limb (relative differences: 76.3% ± 16.6%, 146.4% ± 24.6%, and 25.6% ± 5.7%, respectively). In addition, resting blood flow, peak torque, and central neural drive of the plantar flexors were significantly greater (relative differences: 38.7% ± 5.9%, 94.4% ± 17.9%, and 43.6% ± 12.0%, respectively) in the sound calf. Our findings confirm that significant decrements in muscle performance, size, and blood flow persist in the affected limb many years after stroke despite a resumption of ambulation. This cohort of ambulatory AFO users exhibited large variations in functional abilities. We recommend that future studies in stroke survivors consider AFO use in their research designs.

  15. Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students' critical thinking ability: A randomized controlled trial.

    Science.gov (United States)

    Hong, Shaohua; Yu, Ping

    2017-03-01

    To explore and compare the effectiveness of two styles of case-based learning methods, unfolding nursing case and usual nursing case, implemented in lectures for developing nursing students' critical thinking ability. 122 undergraduate nursing students in four classes were taught the subject of medical nursing for one year. Two classes were randomly assigned as the experimental group and the other two the control group. The experimental group received the lectures presenting unfolding nursing cases and the control group was taught the usual cases. Nineteen case-based lectures were provided in 8 months in two semesters to each group. The two groups started with a similar level of critical thinking ability as tested by the instrument of Critical Thinking Disposition Inventory-Chinese version (CTDI-CV). After receiving 19 case-based learning lectures for 8 months, both groups of students significantly improved their critical thinking ability. The improvement in the experimental group was significantly higher than that in the control group (with the average total score of 303.77±15.24 vs. 288.34±13.94, pnursing cases appear to be significantly more effective than the usual nursing cases in developing undergraduate nursing students' critical thinking ability in the subject of medical nursing. Further research can implement the unfolding nursing cases in other nursing subjects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. EFFECT OF NEUROMUSCULAR TRAINING ON BALANCE AMONG UNIVERSITY ATHLETES

    OpenAIRE

    Mohansundar Sankaravel; Jeffrey Low Fook Lee; Ong Kuan Boon; Sanmuganathan Jeganathan

    2016-01-01

    Background: Proprioceptive deficiency followed by lateral ankle sprain leads to poor balance is not uncommon. It has been linked with increased injury risk among young athletes. Introducing neuromuscular training programs for this have been believed as one of the means of injury prevention. Hence, this study was aimed to determine the effects of six weeks progressive neuromuscular training (PNM Training) on static balance gains among the young athletes with a previous history of ankle sprains...

  17. Improvement of balance control ability and flexibility in the elderly Tai Chi Chuan (TCC) practitioners: a systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Yijun; Liu, Xuemei

    2015-01-01

    Falls are the main cause of accidental death in the elderly people, which is associated with balance control ability and flexibility of the older adults. The purpose of this study was to evaluate the effect of TCC on the balance control and flexibility of the older adults. We searched the PubMed, Embase and Cochrane library with the deadline of May 15th, 2014. This meta-analysis was performed using RevMan5.0 software. The overall weighted mean difference (WMD) and its 95% confidence interval (CI) were calculated. A total of 7 randomized controlled trials including 1088 participants (544 TCC practitioners and 544 participants with other interventions) were considered in this meta-analysis. The pooled estimate of Get up and Go test (WMD=1.04; 95%CI: 0.67-1.41; PTCC significantly shorten the completion time of Get up and Go test of the older adults, indicating flexibility of older adults was improved by practicing TCC. The overall estimates of the single-leg stand test (WMD=5.33; 95%CI: 3.35-7.32; PTCC could significantly prolong the time of single-leg stand and improve the balance control ability of older adults. In conclusion, TCC practice was beneficial to improve the balance control ability and flexibility of older adults, which may be the reason of preventing falls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Lumbopelvic neuromuscular training and injury rehabilitation: a systematic review.

    Science.gov (United States)

    Briggs, Matthew S; Givens, Deborah L; Best, Thomas M; Chaudhari, Ajit M

    2013-05-01

    The aim of this systematic review was to assess the evidence for lumbopelvic neuromuscular training (LNMT) in individuals after musculoskeletal (MSK) injury. A literature search of PubMed and EMBASE databases was performed for English studies from January 1990 to March 2012. Search terms including and related to trunk, core, stability, injury, and LNMT were used. All studies directly involving LNMT for MSK injuries were reviewed by 2 authors. These articles were assessed based on the inclusion criteria and if appropriate selected for further analysis. Expert opinion, review articles, and articles involving non-MSK injuries were excluded. Four authors then scored the selected articles for methodological quality. A total of 2312 articles were initially identified. Twenty-nine articles met the inclusion criteria for review and were divided into categories of lower extremity (LE), lumbar, and upper extremity (UE). No trials involving the UE met the inclusion criteria. Data including subject demographics (age, height, weight, gender, etc), injury type, intervention type, and outcome measurements were extracted from the relevant articles. A variety of baseline and follow-up scores were extracted including pain levels, patient satisfaction, disability questionnaires, and other functional outcomes. Two out of 3 LE randomized controlled trials (RCTs) and 9/26 lumbar RCTs were rated with high methodological quality based on the scoring system described by van Tulder et al. The average quality score for the LE RCTs was 6.3 (range = 4-9) and for the lumbar RCTs was 5.1 (range = 2-9). The evidence for the effectiveness of the 3 LE studies was rated as conflicting, whereas 24 lumbar studies demonstrated moderate-to-strong evidence. Unfortunately, heterogeneity of populations, interventions, and outcomes precluded a quantitative meta-analysis and specific clinical recommendations. High-quality evidence is lacking to make specific clinical recommendations for or against the use of

  19. The effectiveness of neuromuscular facial retraining combined with electromyography in facial paralysis rehabilitation.

    Science.gov (United States)

    Cronin, Gaye W; Steenerson, Ronald Leif

    2003-04-01

    The study goal was to present the effectiveness of neuromuscular facial retraining techniques used in combination with electromyography for improving facial function even in cases of longstanding paralysis. We conducted a retrospective case review in a tertiary neurotology clinic. Twenty-four patients with facial paralysis received neuromuscular facial retraining between April 1999 and April 2001. The patient sample included 6 males and 18 females, with an average age of 44 years. A control group consisted of 6 patients (4 females and 2 males). All patient groups made significant improvements in function with improved symmetry in dual-channel electromyographic readings and increased facial movement percentages. Some of the percentages of posttreatment facial function were as follows: acoustic neuromas, 93%; Bell's palsy/Ramsay Hunt syndrome, 80%; and facial nerve anastomosis, 71%. Synkinesis was reduced by at least 2 levels in patients who initially demonstrated synkinesis. Neuromuscular facial retraining exercises and electromyography are effective for improving facial movements. Facial retraining is an excellent example of the plasticity of the central nervous system to reorganize, even in cases of longstanding paralysis.

  20. Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique.

    Science.gov (United States)

    Ibáñez-García, Jordi; Alburquerque-Sendín, Francisco; Rodríguez-Blanco, Cleofás; Girao, Didac; Atienza-Meseguer, Albert; Planella-Abella, Sergi; Fernández-de-Las Peñas, César

    2009-01-01

    The aim of this study was to compare the immediate effects, on pressure pain sensitivity and active mouth opening, following the application of neuromuscular or strain/counter-strain technique in latent myofascial trigger points (MTrPs) in the masseter muscle. Seventy-one subjects, 34 men and 37 women, aged 20-65 years old, participated in this study. Subjects underwent a screening process to establish the presence of MTrPs in the masseter muscle. Subjects were divided randomly into three groups: group A which was treated with a neuromuscular intervention, group B treated with the strain/counter-strain technique, and group C as control group. Each treatment group received a weekly treatment session during 3 consecutive weeks. Outcomes measures were pressure pain thresholds (PPTs), active mouth opening and local pain (visual analogue scale, VAS) elicited by the application of 2.5kg/cm(2) of pressure over the MTrP. They were captured at baseline and 1 week after discharge by an assessor blinded to the treatment allocation of the subject. The ANOVA found a significant groupxtime interaction (F=25.3; pactive mouth opening (F=10.5; p1) for PPT and mouth opening, and moderate for local pain (d0.8). Our results suggest that neuromuscular or strain/counter-strain technique might be employed in the management of latent MTrPs in the masseter muscle.

  1. Comparing targeted exome and whole exome approaches for genetic diagnosis of neuromuscular disorders.

    Science.gov (United States)

    Gorokhova, Svetlana; Cerino, Mathieu; Mathieu, Yves; Courrier, Sébastien; Desvignes, Jean-Pierre; Salgado, David; Béroud, Christophe; Krahn, Martin; Bartoli, Marc

    2015-12-01

    Massively parallel sequencing is rapidly becoming a widely used method in genetic diagnostics. However, there is still no clear consensus as to which approach can most efficiently identify the pathogenic mutations carried by a given patient, while avoiding false negative and false positive results. We developed a targeted exome approach (MyoPanel2) in order to optimize genetic diagnosis of neuromuscular disorders. Using this approach, we were able to analyse 306 genes known to be mutated in myopathies as well as in related disorders, obtaining 98.8% target sequence coverage at 20 ×. Moreover, MyoPanel2 was able to detect 99.7% of 11,467 known mutations responsible for neuromuscular disorders. We have then used several quality control parameters to compare performance of the targeted exome approach with that of whole exome sequencing. The results of this pilot study of 140 DNA samples suggest that targeted exome sequencing approach is an efficient genetic diagnostic test for most neuromuscular diseases.

  2. The knockdown of αkap alters the postsynaptic apparatus of neuromuscular junctions in living mice.

    Science.gov (United States)

    Martinez-Pena Y Valenzuela, Isabel; Aittaleb, Mohamed; Chen, Po-Ju; Akaaboune, Mohammed

    2015-04-01

    A muscle-specific nonkinase anchoring protein (αkap), encoded within the calcium/calmodulin kinase II (camk2) α gene, was recently found to control the stability of acetylcholine receptor (AChR) clusters on the surface of cultured myotubes. However, it remains unknown whether this protein has any effect on receptor stability and the maintenance of the structural integrity of neuromuscular synapses in vivo. By knocking down the endogenous expression of αkap in mouse sternomastoid muscles with shRNA, we found that the postsynaptic receptor density was dramatically reduced, the turnover rate of receptors at synaptic sites was significantly increased, and the insertion rates of both newly synthesized and recycled receptors into the postsynaptic membrane were depressed. Moreover, we found that αkap shRNA knockdown impaired synaptic structure as postsynaptic AChR clusters and their associated postsynaptic scaffold proteins within the neuromuscular junction were completely eliminated. These results provide new mechanistic insight into the role of αkap in regulating the stability of the postsynaptic apparatus of neuromuscular synapses. Copyright © 2015 the authors 0270-6474/15/355118-10$15.00/0.

  3. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

    Science.gov (United States)

    Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

    2015-07-01

    Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.

    Science.gov (United States)

    Garguilo, Marine; Lejaille, Michèle; Vaugier, Isabelle; Orlikowski, David; Terzi, Nicolas; Lofaso, Frédéric; Prigent, Hélène

    2016-01-01

    Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order. NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort. ClinicalTrials.gov NCT01519388.

  5. Investigating Prospective Teachers' Perceived Problem-Solving Abilities in Relation to Gender, Major, Place Lived, and Locus of Control

    Science.gov (United States)

    Çakir, Mustafa

    2017-01-01

    The purpose of this study is to investigate prospective teachers' perceived personal problem-solving competencies in relation to gender, major, place lived, and internal-external locus of control. The Personal Problem-Solving Inventory and Rotter's Internal-External Locus of Control Scale were used to collect data from freshman teacher candidates…

  6. Reflex postural control of patients with cerebral palsy for odontological assistance

    OpenAIRE

    Aguiar, Sandra Maria Herondina Coelho Ávila de [UNESP; Rezende, Maria Cristina Rosifini Alves [UNESP

    2013-01-01

    Cerebral palsy (CP) describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.A child with cerebral palsy may have impairments in motor control, which contributes to loss of functional abilities in posture and mobility. The severity of the impairment on the neuromuscular system determines the variations of functional mobility in chil...

  7. Attention control and ability level in a complex cognitive skill: attention shifting and second-language proficiency.

    Science.gov (United States)

    Segalowitz, Norman; Frenkiel-Fishman, Sarah

    2005-06-01

    In this study, we investigated the relationship between attention control and proficiency in a complex cognitive skill. The participants were English-French bilinguals with varying degrees of second-language (French) proficiency. Proficiency was operationalized as efficiency of lexical access in an animacy judgment task, as reflected in the coefficient of variability of response time adjusted for first-language performance on the same task. Attention control was operationalized as the shift cost obtained in a linguistic version of the alternating runs task-switching paradigm. Hierarchical regression revealed that, overall, attention control accounted for 59% of the variance of proficiency and that second-language attention control alone accounted for 32% of the unique variance of proficiency, indicating a high degree of skill domain (second language) specificity in the relationship between attention control and proficiency. The results speak to issues regarding the development of expertise, second-language acquisition, and a cognitive linguistic approach to language and attention.

  8. Monitoring intraoperative neuromuscular blockade and blood pressure with one device (TOF-Cuff): A comparative study with mechanomyography and invasive blood pressure.

    Science.gov (United States)

    Veiga Ruiz, G; García Cayuela, J; Orozco Montes, J; Parreño Caparrós, M; García Rojo, B; Aguayo Albasini, J L

    2017-12-01

    The overall objective of the study is to determine the ability of TOF-Cuff device (blood-pressure modified cuff, including stimulation electrodes) to monitor with the same device the non-invasive blood pressure (NIBP) and the depth of a neuromuscular blockade (NMB) induced pharmacologically, by stimulation of the brachial plexus at the humeral level and recording evoked changes in arterial pressure. Clinical, single-centre, open-controlled study with 32 adult patients ASA I-III for scheduled elective surgery under general anaesthesia in supine position, for the validation of neuromuscular monitoring, comparing the values obtained from neuromuscular relaxation TOF-Cuff with those obtained by mechanomyography (MMG) (control method) during the recovery phase of NMB, when a TOF ratio>0.7 and>0.9 (primary endpoint) were reached respectively. And an additional consecutive study of 17 patients for validation of NIBP monitoring with TOF-Cuff device vs invasive blood pressure measured by an intra-arterial catheter. All data were analyzed using the Bland-Altman method. Recovery from NMB measured with the TOF-Cuff was earlier compared to MMG. Comparing TOF-ratio>0.9 measured with TOF-Cuff vs TOF-ratio>0.7 with MMG, a specificity of 91% and a positive predictive value of 84% were obtained. In NIBP measurement, the mean error and standard deviation of both systolic blood pressure (1.6±7mmHg) and diastolic blood pressure (-3.4±6.3) were within the European accuracy requirements for medical devices. The TOF-Cuff device has been shown to be valid and safe in the monitoring of NMB and in the measurement of NIBP, with no patient presenting any adverse events, skin-level lesions or residual pain. It is not interchangeable with MMG, having a TOF-ratio>0.9 quantified by the TOF-Cuff device, a good correlation with a TOF-ratio>0.7 on MMG. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights

  9. Sleep polygraphic parameters in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Márcia Pradella

    1994-12-01

    Full Text Available In a polysomnography study of 32 neuromuscular patients - 22 with a form of muscular dystrophy, 3 with a form of congenital myopathy, 4 with a form of spinal muscular atrophy, 1 with a recurrent form of polymyositis and 1 with osteogenesis imperfecta syndrome - of which 21 were nonambulatory, we observed sleep related respiratory disturbances represented by: drops in oxygen saturation (SaO2, cardiac arrythmia, sleep disruption, apneas, tachypnea, tachycardia and snoring. Nine out of the cohort of 32 patients presented with significant desaturations periods. These patients presented with an associated restrictive syndrome and thoracic deformities, some with tachypnea and/or SaO2 below 90% during wakefulness. In this group, snoring was observed in those patients with a form of muscular dystrophy while tachypnea was observed in patients who presented the highest desaturations levels. Sleep quantification revealed an increase of stage 1 sleep coupled with a decrease or even total absence of REM sleep. This is, we believe, a likely consequence of episodic desaturations that may accompany sleep hypoventilation which is potentialised during REM sleep stage.

  10. Neuromuscular disorders in chronic alcohol intoxication

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  11. Neuromuscular Fatigue During 200 M Breaststroke

    Directory of Open Access Journals (Sweden)

    Ana Conceição

    2014-03-01

    Full Text Available The aims of this study were: i to analyze activation patterns of four upper limb muscles (duration of the active and non-active phase in each lap of 200m breaststroke, ii quantify neuromuscular fatigue, with kinematics and physiologic assessment. Surface electromyogram was collected for the biceps brachii, deltoid anterior, pectoralis major and triceps brachii of nine male swimmers performing a maximal 200m breaststroke trial. Swimming speed, SL, SR, SI decreased from the 1st to the 3rd lap. SR increased on the 4th lap (35.91 ± 2.99 stroke·min-1. Peak blood lactate was 13.02 ± 1.72 mmol·l-1 three minutes after the maximal trial. The EMG average rectified value (ARV increased at the end of the race for all selected muscles, but the deltoid anterior and pectoralis major in the 1st lap and for biceps brachii, deltoid anterior and triceps brachii in the 4th lap. The mean frequency of the power spectral density (MNF decreased at the 4th lap for all muscles. These findings suggest the occurrence of fatigue at the beginning of the 2nd lap in the 200m breaststroke trial, characterized by changes in kinematic parameters and selective changes in upper limb muscle action. There was a trend towards a non-linear fatigue state.

  12. Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls.

    Science.gov (United States)

    Paast, Negin; Khosravi, Zohreh; Memari, Amir Hossein; Shayestehfar, Monir; Arbabi, Mohammad

    2016-02-25

    Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified from the university staff and local community residents. All participants were administered the 28-item version of the General Health Questionnaire (GHQ-28), the Wisconsin Card Sorting Test (WCST), and the Tower of London (TOL) test. Two measures of the WCTS (number of perseverative errors and number of categories completed) were used to assess cognitive flexibility and three measures of the TOL (total number of moves in 12 trials, total response time, and planning time) were used to assess planning ability. The level of current psychological distress in the two patient groups was significantly greater than that in the control group. After adjusting for demographic variables and the level of psychological distress, both OCD patients and OCPD patients made more perseverative errors on the WCST than control subjects, and the OCD patients (but not the OCPD patients) completed significantly fewer categories than the control subjects. Both the OCD patients and OCPD patients required significantly more moves than control subjects to complete the 12 TOL tasks and OCD patients took significantly longer than both OCPD patients and control subjects to complete the tasks. Individuals with OCD and OCPD have impaired cognitive flexibility and planning ability compared to healthy controls, and there are some differences in these measures of cognitive functioning between OCD and OCPD. Long term follow-up studies of OCD and OCPD that assess changes in cognitive measures as the severity of obsessive compulsive

  13. Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised controlled trial among cleaners

    DEFF Research Database (Denmark)

    Jørgensen, Marie B.; Faber, Anne; Hansen, Jørgen V.

    2011-01-01

    Only a few workplace initiatives among cleaners have been reported, even though they constitute a job group in great need of health promotion. The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain...... or CBTr compared with REF was found in conservative ITT analyses. However, explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT. People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF (p = 0.05). The PCT...... intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners. It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability...

  14. Design of Factor XIII V34X Activation Peptides to Control Ability to Interact With Thrombin Mutants

    Science.gov (United States)

    Jadhav, Madhavi A.; Lucas, R. Cory; Goldsberry, Whitney N.; Maurer, Muriel C.

    2011-01-01

    Thrombin helps to activate Factor XIII (FXIII) by hydrolyzing the R37-G38 peptide bond. The resultant transglutaminase introduces cross-links into the fibrin clot. With the development of therapeutic coagulation factors, there is a need to better understand interactions involving FXIII. Such knowledge will help predict ability to activate FXIII and thus ability to promote/hinder the generation of transglutaminase activity. Kinetic parameters have been determined for a series of thrombin species hydrolyzing the FXIII (28′41) V34X activation peptides (V34, V34L, V34F, and V34P). The V34P substitution introduces PAR4 character into the FXIII, and the V34F exhibits important similarities to the cardioprotective V34L. FXIII activation peptides containing V34, V34L, or V34P could each be accommodated by alanine mutants of thrombin lacking either the W60d or Y60a residue in the 60-insertion loop. By contrast, FXIII V34F AP could be cleaved by thrombin W60dA but not by Y60aA. FXIII V34P is highly reliant on the thrombin W215 platform for its strong substrate properties whereas FXIII V34F AP becomes the first segment that can maintain its Km upon loss of the critical thrombin W215 residue. Interestingly, FXIII V34F AP could also be readily accommodated by thrombin L99A and E217A. Hydrolysis of FXIII V34F AP by thrombin W217A/E217A (WE) was similar to that of FXIII V34L AP whereas WE could not effectively cleave FXIII V34P AP. FXIII V34F and V34P AP show promise for designing FXIII activation systems that are either tolerant of or greatly hindered by the presence of anticoagulant thrombins. PMID:21798378

  15. Thought Control Ability Is Different from Rumination in Explaining the Association between Neuroticism and Depression: A Three-Study Replication

    OpenAIRE

    Feng-Ying Lu; Wen-Jing Yang; Qing-Lin Zhang; Jiang Qiu

    2017-01-01

    Neuroticism is the most common vulnerability factor of depression. However, the mechanism underlying this vulnerability is still unclear. Previous studies suggested that rumination intensifies the negative effect of neuroticism on depression. However, whether cognitive control could explain the association between neuroticism and depression remains unclear to date. Therefore, this study evaluated the indirect effects of rumination and thought control on the relationship between neuroticism an...

  16. Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls

    OpenAIRE

    PAAST, Negin; Khosravi, Zohreh; Memari, Amir Hossein; Shayestehfar, Monir; Arbabi, Mohammad

    2016-01-01

    Background Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Aim Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Methods Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified ...

  17. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: preliminary report.

    Science.gov (United States)

    McGibbon, Chris A; Krebs, David E; Parker, Stephen W; Scarborough, Donna M; Wayne, Peter M; Wolf, Steven L

    2005-02-18

    Vestibular rehabilitation (VR) is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC), have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width), lower extremity sagittal plane mechanical energy expenditures (MEE), and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity), were measured. Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster gait and reduced excessive hip compensation. The VR group

  18. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

    Directory of Open Access Journals (Sweden)

    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster

  19. Cognitive style and the effects of two instructional treatments on the acquisition and transfer of the ability to control variables: A longitudinal study

    Science.gov (United States)

    Strawitz, Barbara M.

    Long-term retention effects of two methods of instruction used one year earlier to teach field-dependent (FD) and field-independent (FI) sixth-grade students to control variables and to transfer this ability to novel tasks were investigated. The study also examined whether or not uninstructed seventh-grade students had acquired this ability on their own. Results indicated that Treatment I produced better retention over time for both FD and FI students than did Treatment II. Treatment II was more effective for FI students than for FD students. Significant main effects for treatment and cognitive style were found on each controlling variables task when the abilities of instructed and uninstructed seventh-grade students were compared. Field-dependent students who had received Treatment I significantly outperformed FD students who had received Treatment II and FD students who had received no instruction on how to control variables. Field-dependent students who had received Treatment II performed about as well as their counterparts who had received no instruction. Field-independent students who had received Treatment I significantly outperformed FI students who had received Treatment II on two of three measures and FI students who had received no instruction on all measures. Field-independent student who had received Treatment II significantly outperformed FI students who had received no instruction on two of three measures.

  20. Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee.

    Science.gov (United States)

    Becker, Roland; Berth, Alexander; Nehring, Markus; Awiszus, Friedemann

    2004-07-01

    Decreased maximal quadriceps strength and voluntary activation has been observed in patients with osteoarthritis in previous studies, but those results do not allow any conclusions to be drawn as to whether quadriceps dysfunction precedes or follows osteoarthritis. Thirty-two patients (group a) who underwent partial meniscectomy 48+/-9 month prior to the study were matched according to their weight and body mass index with a control group (group b). The twitch interpolation technique was used to determine maximal voluntary contraction (MVC) and voluntary activation (VA) of the quadriceps muscle of both legs. Subjective assessment of the knee was performed using the Lysholm-Score. AP and lateral X-rays of the operated knee were obtained. None of the participants showed any evidence of characteristic radiological or clinical signs for osteoarthritis. A significantly lower MVC was noticed in both the affected and the contralateral knee of group a in comparison to group b (p weakness as already described in patients with manifest osteoarthritis. The authors hypothesise that muscle dysfunction may be an etiologic factor underlying the pathologic changes of osteoarthritis. Whether muscle dysfunction occurs also at other sites, e.g. in the upper extremity, remains unclear but would be of interest in order to detect a generalized neuromuscular dysfunction.

  1. Neuromuscular transmission and muscle fatigue changes by nanostructured oxygen.

    Science.gov (United States)

    Ivannikov, Maxim V; Sugimori, Mutsuyuki; Llinás, Rodolfo R

    2017-04-01

    Oxygen (O 2 ) nanobubbles offer a new method for tissue oxygenation. The effects of O 2 nanobubbles on transmission at neuromuscular junctions (NMJs) and muscle function were explored in murine diaphragm. Electrophysiological parameters, NMJ ultrastructure, muscle force, and muscle fatigue were studied during superfusion with solutions with different oxygen levels or oxygen nanobubbles. High frequency nerve stimulation of muscles superfused with O 2 nanobubble solution slowed neurotransmission decline over those with either control or hyperoxic solution. O 2 nanobubble solution increased the amplitude of evoked end plate potentials and quantal content but did not affect spontaneous activity. Electron microscopy of stimulated O 2 nanobubble treated NMJs showed accumulation of large synaptic vesicles and endosome-like structures. O 2 nanobubble solution had no effects on isometric muscle force, but it significantly decreased fatigability and maximum force recovery time in nerve stimulated muscles. O 2 nanobubbles increase neurotransmission and reduce the probability of neurotransmission failure in muscle fatigue. Muscle Nerve 55: 555-563, 2017. © 2016 Wiley Periodicals, Inc.

  2. Limited ability of humoral immune responses in control of viremia during infection with SIVsmmD215 strain

    Energy Technology Data Exchange (ETDEWEB)

    Ribiero, Ruy M [Los Alamos National Laboratory

    2009-01-01

    To investigate the impact of humoral immunity on SIV replication, 11 rhesus macaques (RMs) were inoculated with the neutralization-sensitive strain SIVsmmD215. Seven RMs were treated every three weeks, with 50 mglkg of an anti-CD20 antibody (Rituxan, gift from Genentech) starting from day -7 p.i., as follows: four RMs were treated for two months, and three were treated for five months. The remaining four RMs were used as controls. Three RMs were completely depleted of CD20 cells. Four RMs only partially depleted CD20 cells in the LNs and intestine. The efficacy of tissue CD20 depletion predicted the ablation of antibody production, with SIVsmm seroconversion being delayed in the animals with complete tissue CD20 depletion, and neutralizing antibody production being significantly delayed and at low levels in all CD20-depleted RMs. There was no significant difference in acute or chronic VLs between CD20-depleted RMs and control monkeys, with a tendency for lower set-point VLs in CD20-depleted RMs. At 6 weeks p.i., cellular immune responses were significantly stronger in CD20 depleted RMs than in controls. After two years p.i., there was no significant difference in survival between CD20-depleted and control RMs. We concluded that CD20 depletion plays no significant role in the control of SIV replication or disease progression in SIVsmmD215-infected RMs.

  3. Recovery of central and peripheral neuromuscular fatigue after exercise.

    Science.gov (United States)

    Carroll, T J; Taylor, J L; Gandevia, S C

    2017-05-01

    Sustained physical exercise leads to a reduced capacity to produce voluntary force that typically outlasts the exercise bout. This "fatigue" can be due both to impaired muscle function, termed "peripheral fatigue," and a reduction in the capacity of the central nervous system to activate muscles, termed "central fatigue." In this review we consider the factors that determine the recovery of voluntary force generating capacity after various types of exercise. After brief, high-intensity exercise there is typically a rapid restitution of force that is due to recovery of central fatigue (typically within 2 min) and aspects of peripheral fatigue associated with excitation-contraction coupling and reperfusion of muscles (typically within 3-5 min). Complete recovery of muscle function may be incomplete for some hours, however, due to prolonged impairment in intracellular Ca(2+) release or sensitivity. After low-intensity exercise of long duration, voluntary force typically shows rapid, partial, recovery within the first few minutes, due largely to recovery of the central, neural component. However, the ability to voluntarily activate muscles may not recover completely within 30 min after exercise. Recovery of peripheral fatigue contributes comparatively little to the fast initial force restitution and is typically incomplete for at least 20-30 min. Work remains to identify what factors underlie the prolonged central fatigue that usually accompanies long-duration single joint and locomotor exercise and to document how the time course of neuromuscular recovery is affected by exercise intensity and duration in locomotor exercise. Such information could be useful to enhance rehabilitation and sports performance. Copyright © 2017 the American Physiological Society.

  4. Neuromuscular fatigue after maximal exercise in patients with cystic fibrosis.

    Science.gov (United States)

    Vallier, J M; Gruet, M; Mely, L; Pensini, M; Brisswalter, J

    2011-04-01

    The aim of this study was to determine whether patients with cystic fibrosis (CF), despite their ventilatory limitation, would develop neuromuscular fatigue of quadriceps muscles following a maximal cycling exercise. Eleven adults with CF (age=26.8±6.9years; forced expiratory volume in 1s=54.1±12.8% predicted) and 11 age-matched healthy subjects performed a maximal incremental cycle test with respiratory gas exchange measurements. Maximal voluntary contraction (MVC) and electromyographic (EMG) activity of the vastus medialis muscle were recorded before and after exercise. Neural and contractile properties of the quadriceps were also investigated using femoral nerve electrical stimulation. Patients had lower exercise capacity, peak oxygen uptake and MVC than controls. MVC fell significantly postexercise in both groups (CF: -20±10%, controls: -19±6%; pdevelopment (-50.3±13.8%) and relaxation (-35.2±19.5%) were all reduced after exercise in CF patients. The control group followed the same pattern (-38.4±14.4%, -42.1±14.7% and -15±20.4%) but the statistical significance was not reached for the maximal rate of twitch torque relaxation. In conclusion, CF patients demonstrated lower limb fatigue following symptom-limited cycle exercise, which was comparable to that exhibited by healthy controls. This fatigue may be due to contractile impairments and not to transmission failure. Further studies should be conducted in a larger sample to confirm these preliminary results. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Does peer learning or higher levels of e-learning improve learning abilities? A randomized controlled trial

    Science.gov (United States)

    Worm, Bjarne Skjødt; Jensen, Kenneth

    2013-01-01

    Background and aims The fast development of e-learning and social forums demands us to update our understanding of e-learning and peer learning. We aimed to investigate if higher, pre-defined levels of e-learning or social interaction in web forums improved students’ learning ability. Methods One hundred and twenty Danish medical students were randomized to six groups all with 20 students (eCases level 1, eCases level 2, eCases level 2+, eTextbook level 1, eTextbook level 2, and eTextbook level 2+). All students participated in a pre-test, Group 1 participated in an interactive case-based e-learning program, while Group 2 was presented with textbook material electronically. The 2+ groups were able to discuss the material between themselves in a web forum. The subject was head injury and associated treatment and observation guidelines in the emergency room. Following the e-learning, all students completed a post-test. Pre- and post-tests both consisted of 25 questions randomly chosen from a pool of 50 different questions. Results All students concluded the study with comparable pre-test results. Students at Level 2 (in both groups) improved statistically significant compared to students at level 1 (p>0.05). There was no statistically significant difference between level 2 and level 2+. However, level 2+ was associated with statistically significant greater student's satisfaction than the rest of the students (p>0.05). Conclusions This study applies a new way of comparing different types of e-learning using a pre-defined level division and the possibility of peer learning. Our findings show that higher levels of e-learning does in fact provide better results when compared with the same type of e-learning at lower levels. While social interaction in web forums increase student satisfaction, learning ability does not seem to change. Both findings are relevant when designing new e-learning materials. PMID:24229729

  6. The Effect of Whole Body Vibration Training and Detraining Periods on Neuromuscular Performance in Male Older People

    Directory of Open Access Journals (Sweden)

    Ali Abbasi

    2011-07-01

    Full Text Available Objectives: This study aimed to evaluatethe the effect of eight weeks whole body vibration training (WBVT and detraining periods on neuromuscular performance male healthy older people. Methods & Materials: Thirty male subjects (70±9.6 years old were randomly allocated into two groups of WBVT and control (n=15 per group. Timed Up & Go and 5-Chair stand tests, as indicators of neuromuscular performance in older subjects, were taken as pretest and posttest and also after four, six, and eight weeks of detraining. Results: Results of Repeated-measure ANOVA and one-way ANOVA showed that neuromuscular performance improved significantly in WBVT group (P<0.05. There were also significant differences between posttest and six and eight weeks of detraining periods in WBVTgroup (P<0.05. Conclusion: WBVT could affect neuromuscular performance in healthy subjects and reduce the probability of falling among them. However, the effects of this training are not persistent, goes back to the early levels after six weeks of detraining. Hence, it is possible that WBVT can be recommended as a safe balance training to older people.

  7. Ability to Gain Control Over One’s Own Brain Activity and its Relation to Spiritual Practice: A Multimodal Imaging Study

    Directory of Open Access Journals (Sweden)

    Silvia E. Kober

    2017-05-01

    Full Text Available Spiritual practice, such as prayer or meditation, is associated with focusing attention on internal states and self-awareness processes. As these cognitive control mechanisms presumably are also important for neurofeedback (NF, we investigated whether people who pray frequently (N = 20 show a higher ability of self-control over their own brain activity compared to a control group of individuals who rarely pray (N = 20. All participants underwent structural magnetic resonance imaging (MRI and one session of sensorimotor rhythm (SMR, 12–15 Hz based NF training. Individuals who reported a high frequency of prayer showed improved NF performance compared to individuals who reported a low frequency of prayer. The individual ability to control one’s own brain activity was related to volumetric aspects of the brain. In the low frequency of prayer group, gray matter volumes in the right insula and inferior frontal gyrus were positively associated with NF performance, supporting prior findings that more general self-control networks are involved in successful NF learning. In contrast, participants who prayed regularly showed a negative association between gray matter volume in the left medial orbitofrontal cortex (Brodmann’s area (BA 10 and NF performance. Due to their regular spiritual practice, they might have been more skillful in gating incoming information provided by the NF system and avoiding task-irrelevant thoughts.

  8. Ability of Stress, Sense of Control, and Self-Theories to Predict Swedish High School Students' Final Grades

    Science.gov (United States)

    Ollfors, Marianne; Andersson, Sven Ingmar

    2007-01-01

    The aim of this study was to investigate self-theories (theories of intelligence, confidence in one's intelligence, internal attribution of failure, academic self-efficacy), specific control, and experiencing of stress by means of a questionnaire for 915 Swedish high school students. Factor analysis yielded 6 stress domains (Workload, Psychosocial…

  9. Controlling the Formation of Ionic-Liquid-based Aqueous Biphasic Systems by Changing the Hydrogen-Bonding Ability of Polyethylene Glycol End Groups.

    Science.gov (United States)

    Pereira, Jorge F B; Kurnia, Kiki A; Freire, Mara G; Coutinho, João A P; Rogers, Robin D

    2015-07-20

    The formation of aqueous biphasic systems (ABS) when mixing aqueous solutions of polyethylene glycol (PEG) and an ionic liquid (IL) can be controlled by modifying the hydrogen-bond-donating/-accepting ability of the polymer end groups. It is shown that the miscibility/immiscibility in these systems stems from both the solvation of the ether groups in the oxygen chain and the ability of the PEG terminal groups to preferably hydrogen bond with water or the anion of the salt. The removal of even one hydrogen bond in PEG can noticeably affect the phase behavior, especially in the region of the phase diagram in which all the ethylene oxide (EO) units of the polymeric chain are completely solvated. In this region, removing or weakening the hydrogen-bond-donating ability of PEG results in greater immiscibility, and thus, in a higher ability to form ABS, as a result of the much weaker interactions between the IL anion and the PEG end groups. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Comparison of canal transportation and centering ability of Twisted Files, HyFlex controlled memory, and Wave One using computed tomography scan: An in vitro study.

    Science.gov (United States)

    Kishore, Abhinav; Gurtu, Anuraag; Bansal, Rashmi; Singhal, Anurag; Mohan, Sumit; Mehrotra, Anmol

    2017-01-01

    The aim of the present study was to compare the canal transportation and centering ability of three rotary nickel-titanium (NiTi) systems (Twisted Files [TF], HyFlex controlled memory [CM], and Wave One [WO]) in curved root canals using computed tomography (CT). Sixty freshly extracted single-rooted teeth having curved root canals with at least 25-35 degrees of curvature were selected. The teeth were randomly divided into three experimental groups of twenty each. After preparation with TF, HyFlex CM, and WO, all teeth were scanned using CT to determine the root canal shape. Pre- and post-instrumentation images were obtained at three levels, 3 mm apical, 9 mm middle, and 15 mm coronal above the apical foramen were compared using CT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and post hoc Tukey's honestly significant difference test. Least apical transportation and higher centering ability were seen in HyFlex CM file system in all the three sections followed by TF. WO file system showed maximum transportation. The canal preparation with HyFlex CM file system showed lesser transportation and better centering ability than TF, WO file system.

  11. Genome Editing of Monogenic Neuromuscular Diseases: A Systematic Review.

    Science.gov (United States)

    Long, Chengzu; Amoasii, Leonela; Bassel-Duby, Rhonda; Olson, Eric N

    2016-11-01

    Muscle weakness, the most common symptom of neuromuscular disease, may result from muscle dysfunction or may be caused indirectly by neuronal and neuromuscular junction abnormalities. To date, more than 780 monogenic neuromuscular diseases, linked to 417 different genes, have been identified in humans. Genome-editing methods, especially the CRISPR (clustered regularly interspaced short palindromic repeats)-Cas9 (CRISPR-associated protein 9) system, hold clinical potential for curing many monogenic disorders, including neuromuscular diseases such as Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1. To provide an overview of genome-editing approaches; to summarize published reports on the feasibility, efficacy, and safety of current genome-editing methods as they relate to the potential correction of monogenic neuromuscular diseases; and to highlight scientific and clinical opportunities and obstacles toward permanent correction of disease-causing mutations responsible for monogenic neuromuscular diseases by genome editing. PubMed and Google Scholar were searched for articles published from June 30, 1989, through June 9, 2016, using the following keywords: genome editing, CRISPR-Cas9, neuromuscular disease, Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1. The following sources were reviewed: 341 articles describing different approaches to edit mammalian genomes; 330 articles describing CRISPR-Cas9-mediated genome editing in cell culture lines (in vitro) and animal models (in vivo); 16 websites used to generate single-guide RNA; 4 websites for off-target effects; and 382 articles describing viral and nonviral delivery systems. Articles describing neuromuscular diseases, including Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1, were also reviewed. Multiple proof

  12. Neuromuscular Fatigue during Prolonged Exercise in Hypoxia.

    Science.gov (United States)

    Jubeau, Marc; Rupp, Thomas; Temesi, John; Perrey, Stéphane; Wuyam, Bernard; Millet, Guillaume Y; Verges, Samuel

    2017-03-01

    Prolonged cycling exercise performance in normoxia is limited because of both peripheral and central neuromuscular impairments. It has been reported that cerebral perturbations are greater during short-duration exercise in hypoxia compared with normoxia. The purpose of this study was to test the hypothesis that central deficits are accentuated in hypoxia compared with normoxia during prolonged (three bouts of 80 min separated by 25 min) whole-body exercise at the same relative intensity. Ten subjects performed two sessions consisting of three 80-min cycling bouts at 45% of their relative maximal aerobic power in normoxia and hypoxia (FiO2 = 0.12). Before exercise and after each bout, maximal voluntary force, voluntary activation assessed with nerve stimulation and transcranial magnetic stimulation, corticospinal excitability (motor evoked potential), intracortical inhibition (cortical silent period), and electrical (M-wave) and contractile (twitch and doublet peak forces) properties of the knee extensors were measured. Prefrontal and motor cortical oxygenation was also recorded during each cycling bout in both conditions. A significant but similar force reduction (≈-22%) was observed at the end of exercise in normoxia and hypoxia. The modifications of voluntary activation assessed with transcranial magnetic stimulation and nerve stimulation, motor evoked potential, cortical silent period, and M-wave were also similar in both conditions. However, cerebral oxygenation was reduced in hypoxia compared with normoxia. These findings show that when performed at the same relative low intensity, prolonged exercise does not induce greater supraspinal fatigue in hypoxia compared with normoxia. Despite lower absolute exercise intensities in hypoxia, reduced brain O2 availability might contribute to similar amounts of central fatigue compared with normoxia.

  13. Ramadan fasting does not adversely affect neuromuscular performances and reaction times in trained karate athletes.

    Science.gov (United States)

    Zarrouk, Nidhal; Hammouda, Omar; Latiri, Imed; Adala, Hela; Bouhlel, Ezzedine; Rebai, Haithem; Dogui, Mohamed

    2016-01-01

    The present study aimed to investigate the concomitant effects of Ramadan intermittent fast (RIF) and muscle fatigue on neuromuscular performances and reaction times in young trained athletes. Eight karate players (17.2 ± 0.5 years) were tested on three sessions: during a control period (S1: one week before Ramadan), and during the first (S2) and the fourth week of RIF (S3). Dietary intake and anthropometric measurements were assessed before each session. During each test session, participants performed maximal voluntary isometric contractions (MVC) and a submaximal contraction at 75 % MVC until exhaustion (T lim ) of the right elbow flexors. Surface electromyography was recorded from biceps brachii muscle during MVC and T lim . Simple (SRT) and choice (CRT) reaction times were evaluated at rest and just after T lim in a random order. The total daily energy (S2: +19.5 %, p < 0.05; S3: +27.4 %, p < 0.01) and water (S2: +26.8 %, p < 0.01; S3: +23.2 %, p < 0.05) intake were significantly increased during RIF. However, neither body mass nor body mass index was altered by RIF (F (2,14) = 0.80, p = 0.47 and F (2,14) = 0.78, p = 0.48, respectively). In addition, T lim (F (2,14) = 2.53, p = 0.12), MVC (F (2,14) = 0.51, p = 0.61) and associated electrical activity (F (2,14) = 0.13, p = 0.88) as well as neuromuscular efficiency (F (2,14) = 0.27, p = 0.76) were maintained during RIF. Moreover, neither SRT nor CRT was affected by RIF (F (2,14) = 1.82, p = 0.19 and F (2,14) = 0.26, p = 0.78, respectively) or neuromuscular fatigue (F (1,7) = 0.0002, p = 0.98 and F (1,7) = 3.78, p = 0.09, respectively). The present results showed that RIF did not adversely affect the neuromuscular performances and anthropometric parameters of elite karate athletes who were undertaking their usual training schedule. In addition, neither RIF nor neuromuscular fatigue poorly affects reaction

  14. Neuromuscular and Blood Lactate Response After a Motocross Training Session in Amateur Riders.

    Science.gov (United States)

    Simões, Vinicius Radenzev; Crisp, Alex Harley; Verlengia, Rozangela; Pellegrinotti, Idico Luiz

    2016-06-01

    Motocross is one of the most popular motorized off-road sports, characterized by riding on irregular natural terrain of hard earth and/or sand with various obstacles throughout the course. This study evaluated the influence of a motocross training session on neuromuscular response and blood lactate in amateur riders. Nine motocross riders (22.7 ± 2.8 years) participating in amateur competitions at the state level conducted a training session of 20 minutes duration at a motocross track (1.6 km) with a 250-cc four-stroke motorcycle. Metabolic demand was measured with blood lactate concentrations before and immediately, 3, 5, 8, and 10 minutes after the training session. To measure neuromuscular response, riders completed handgrip strength and horizontal jump tests before and 10 minutes after the training session. Student's t-test and analysis of variance one-way repeated measures were used to compare the changes before and after the motocross training session. Significant decreases in handgrip strength were observed for both hands (left: P = 0.010 and right: P = 0.004). However, no significant difference (P = 0.241) in horizontal jump ability was observed. Significant blood lactate values were observed immediately (P = 0.001), 3 (P = 0.001), 5 (P = 0.001), and 8 (P = 0.01) minutes after training when compared to the value before training. The peak blood lactate value was 6.5 ± 2.7 mM at 8 minutes after the training session. Amateur motocross riders had significant anaerobic metabolism demands and had reduced handgrip strength following a training session. These data suggest an importance of physical training aimed at improving anaerobic and neuromuscular performance of the upper limbs in amateur motocross riders.

  15. Impaired Synaptic Development, Maintenance, and Neuromuscular Transmission in LRP4 Myasthenia

    Science.gov (United States)

    Selcen, Duygu; Ohkawara, Bisei; Shen, Xin-Ming; McEvoy, Kathleen; Ohno, Kinji; Engel, Andrew G.

    2015-01-01

    IMPORTANCE Congenital myasthenic syndromes (CMS) are heterogeneous disorders. Defining the phenotypic features, genetic basis, and pathomechanisms of a CMS is relevant to prognosis, genetic counseling, and therapy. OBJECTIVE To characterize clinical, structural, electrophysiologic, and genetic features of a CMS and search for optimal therapy. DESIGN, SETTINGS, AND PARTICIPANTS Two sisters, 34 and 20 years of age suffering from a CMS affecting the limb-girdle muscles were investigated at an academic medical center by clinical observation, in vitro analysis of neuromuscular transmission, cytochemical and electron microscopy studies of the neuromuscular junction, exome sequencing, expression studies in HEK293 and COS-7 cells, and for response to therapy. MAIN OUTCOMES AND MEASURES We identified the disease gene and mutation, confirmed pathogenicity of the mutation by expression studies, and instituted optimal pharmacotherapy. RESULTS Intercostal muscle endplates (EPs) were abnormally small with attenuated reactivities for the acetylcholine receptor and acetylcholine esterase. Most EPs had poorly differentiated or degenerate junctional folds and some appeared denuded of nerve terminals. The amplitude of the EP potential (EPP), the miniature EPP, and the quantal content of the EPP were all markedly reduced. Exome sequencing identified a novel homozygous p.Glu1233Ala mutation in LRP4, a coreceptor for agrin to activate MuSK, required for EP development and maintenance. Expression studies indicate the mutation compromises ability of LRP4 to bind to, phosphorylate, and activate MuSK. Albuterol improved the patients’ symptoms. CONCLUSIONS AND RELEVANCE We identify a second CMS kinship harboring mutations in LRP4, identify the mechanisms that impair neuromuscular transmission, and mitigate the disease by appropriate therapy. PMID:26052878

  16. Effects of hindlimb unloading on neuromuscular development of neonatal rats

    Science.gov (United States)

    Huckstorf, B. L.; Slocum, G. R.; Bain, J. L.; Reiser, P. M.; Sedlak, F. R.; Wong-Riley, M. T.; Riley, D. A.

    2000-01-01

    We hypothesized that hindlimb suspension unloading of 8-day-old neonatal rats would disrupt the normal development of muscle fiber types and the motor innervation of the antigravity (weightbearing) soleus muscles but not extensor digitorum longus (EDL) muscles. Five rats were suspended 4.5 h and returned 1.5 h to the dam for nursing on a 24 h cycle for 9 days. To control for isolation from the dam, the remaining five littermates were removed on the same schedule but not suspended. Another litter of 10 rats housed in the same room provided a vivarium control. Fibers were typed by myofibrillar ATPase histochemistry and immunostaining for embryonic, slow, fast IIA and fast IIB isomyosins. The percentage of multiple innervation and the complexity of singly-innervated motor terminal endings were assessed in silver/cholinesterase stained sections. Unique to the soleus, unloading accelerated production of fast IIA myosin, delayed expression of slow myosin and retarded increases in standardized muscle weight and fiber size. Loss of multiple innervation was not delayed. However, fewer than normal motor nerve endings achieved complexity. Suspended rats continued unloaded hindlimb movements. These findings suggest that motor neurons resolve multiple innervation through nerve impulse activity, whereas the postsynaptic element (muscle fiber) controls endplate size, which regulates motor terminal arborization. Unexpectedly, in the EDL of unloaded rats, transition from embryonic to fast myosin expression was retarded. Suspension-related foot drop, which stretches and chronically loads EDL, may have prevented fast fiber differentiation. These results demonstrate that neuromuscular development of both weightbearing and non-weightbearing muscles in rats is dependent upon and modulated by hindlimb loading.

  17. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training.

    Science.gov (United States)

    Behrens, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance.

  18. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

    Directory of Open Access Journals (Sweden)

    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave, peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue

  19. Effects of Neuromuscular Fatigue on Quadriceps Strength and Activation and Knee Biomechanics in Individuals Post-Anterior Cruciate Ligament Reconstruction and Healthy Adults.

    Science.gov (United States)

    Thomas, Abbey C; Lepley, Lindsey K; Wojtys, Edward M; McLean, Scott G; Palmieri-Smith, Riann M

    2015-12-01

    Laboratory-based experiment using a pretest/posttest design. To determine the effects of neuromuscular fatigue on quadriceps strength and activation and sagittal and frontal plane knee biomechanics during dynamic landing following anterior cruciate ligament reconstruction (ACLR). Impaired quadriceps central activation occurs post-ACLR, likely altering lower extremity biomechanics. Neuromuscular fatigue similarly reduces volitional muscle activation and impairs neuromuscular control. Upon return to full activity post-ACLR, individuals likely concurrently experience quadriceps central activation deficits and neuromuscular fatigue, though the effects of fatigue on muscle strength and activation and biomechanics post-ACLR are unknown. Seventeen individuals 7 to 10 months post-ACLR and 16 controls participated. Quadriceps strength and central activation ratio were recorded prefatigue and postfatigue, which was induced via sets of double-leg squats. Knee biomechanics were recorded during a dynamic landing activity prefatigue and postfatigue. Both groups demonstrated smaller knee flexion (initial contact, P = .017; peak, P = .004) and abduction (initial contact, P = .005; peak, P = .009) angles postfatigue. The ACLR group had smaller peak knee flexion angles (Pbiomechanics were present postfatigue in both groups, suggesting that neuromuscular fatigue may increase noncontact ACL injury risk. However, these changes were not exaggerated in those post-ACLR, likely because they already demonstrated a stiff-legged landing strategy prefatigue.

  20. Movement-Related Cortical Potential Amplitude Reduction after Cycling Exercise Relates to the Extent of Neuromuscular Fatigue.

    Science.gov (United States)

    Spring, Jérôme Nicolas; Place, Nicolas; Borrani, Fabio; Kayser, Bengt; Barral, Jérôme

    2016-01-01

    Exercise-induced fatigue affects the motor control and the ability to generate a given force or power. Surface electroencephalography allows researchers to investigate movement-related cortical potentials (MRCP), which reflect preparatory brain activity 1.5 s before movement onset. Although the MRCP amplitude appears to increase after repetitive single-joint contractions, the effects of large-muscle group dynamic exercise on such pre-motor potential remain to be described. Sixteen volunteers exercised 30 min at 60% of the maximal aerobic power on a cycle ergometer, followed by a 10-km all-out time trial. Before and after each of these tasks, knee extensor neuromuscular function was investigated using maximal voluntary contractions (MVC) combined with electrical stimulations of the femoral nerve. MRCP was recorded during 60 knee extensions after each neuromuscular sequence. The exercise resulted in a significant decrease in the knee extensor MVC force after the 30-min exercise (-10 ± 8%) and the time trial (-21 ± 9%). The voluntary activation level (VAL; -6 ± 8 and -12 ± 10%), peak twitch (Pt; -21 ± 16 and -32 ± 17%), and paired stimuli (P100 Hz; -7 ± 11 and -12 ± 13%) were also significantly reduced after the 30-min exercise and the time trial. The first exercise was followed by a decrease in the MRCP, mainly above the mean activity measured at electrodes FC1-FC2, whereas the reduction observed after the time trial was related to the FC1-FC2 and C2 electrodes. After both exercises, the reduction in the late MRCP component above FC1-FC2 was significantly correlated with the reduction in P100 Hz (r = 0.61), and the reduction in the same component above C2 was significantly correlated with the reduction in VAL (r = 0.64). In conclusion, large-muscle group exercise induced a reduction in pre-motor potential, which was related to muscle alterations and resulted in the inability to produce a maximal voluntary contraction.

  1. Attitude, complications, ability of fasting and glycemic control in fasting Ramadan by children and adolescents with type 1 diabetes mellitus.

    Science.gov (United States)

    Deeb, Asma; Al Qahtani, Nabras; Akle, Mariette; Singh, Himanshi; Assadi, Rifah; Attia, Salima; Al Suwaidi, Hana; Hussain, Tara; Naglekerke, Nico

    2017-04-01

    Sick individuals and children are exempted from fasting Ramadan. Fasting by type 1 diabetes patients might predispose to acute complications. There are no guidelines on fasting safety or its impact on diabetes control in children and adolescents. We aim to assess patients' attitude towards fasting, frequency of complications and impact on glycemic control in children with type 1 diabetes. 65 children with type 1 diabetes were enrolled. The study involved 2 hospital visits. Questionnaires were filled in each visit and HbA1c was recorded. Log books indicating symptomatic hypoglycemia and hyperglycemia leading to breaking fast were obtained. Majority of subjects were willing to fast and 75% were encouraged by parents to do. 57% and 26% fasted more than half and all through the month respectively. 52% had, at least, one episode of hypoglycemia and 29% had hyperglycemia with one episode of ketoacidosis. All patients broke fast in response to symptomatic hypoglycemia/hyperglycemia. There was no significant difference between the frequency of complications in the pump or the Multiple Daily Injection (MDI) groups. Mean HbA1c increased from 70mmol/mol to 73mmol/mol. The difference was not statistically significant. Children and adolescents with type 1 diabetes are keen to fast Ramadan and they are able to fast a significant number of days. Hypoglycemia and hyperglycemia are not uncommon with no difference between Pump or in MDI users. Breaking fast on occurrence of complications makes fasting safe. Glycemic control might deteriorate during the month and the following Eid. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Measuring Creative Imagery Abilities

    Directory of Open Access Journals (Sweden)

    Dorota M. Jankowska

    2015-10-01

    Full Text Available Over the decades, creativity and imagination research developed in parallel, but they surprisingly rarely intersected. This paper introduces a new theoretical model of creative imagination, which bridges creativity and imagination research, as well as presents a new psychometric instrument, called the Test of Creative Imagery Abilities (TCIA, developed to measure creative imagery abilities understood in accordance with this model. Creative imagination is understood as constituted by three interrelated components: vividness (the ability to create images characterized by a high level of complexity and detail, originality (the ability to produce unique imagery, and transformativeness (the ability to control imagery. TCIA enables valid and reliable measurement of these three groups of abilities, yielding the general score of imagery abilities and at the same time making profile analysis possible. We present the results of eight studies on a total sample of more than 1,700 participants, showing the factor structure of TCIA using confirmatory factor analysis, as well as provide data confirming this instrument’s validity and reliability. The availability of TCIA for interested researchers may result in new insights and possibilities of integrating the fields of creativity and imagination science.

  3. Measuring creative imagery abilities

    Science.gov (United States)

    Jankowska, Dorota M.; Karwowski, Maciej

    2015-01-01

    Over the decades, creativity and imagination research developed in parallel, but they surprisingly rarely intersected. This paper introduces a new theoretical model of creative visual imagination, which bridges creativity and imagination research, as well as presents a new psychometric instrument, called the Test of Creative Imagery Abilities (TCIA), developed to measure creative imagery abilities understood in accordance with this model. Creative imagination is understood as constituted by three interrelated components: vividness (the ability to create images characterized by a high level of complexity and detail), originality (the ability to produce unique imagery), and transformativeness (the ability to control imagery). TCIA enables valid and reliable measurement of these three groups of abilities, yielding the general score of imagery abilities and at the same time making profile analysis possible. We present the results of nine studies on a total sample of more than 1700 participants, showing the factor structure of TCIA using confirmatory factor analysis, as well as provide data confirming this instrument's validity and reliability. The availability of TCIA for interested researchers may result in new insights and possibilities of integrating the fields of creativity and imagination science. PMID:26539140

  4. On the validity of self-report assessment of cognitive abilities: Attentional control scale associations with cognitive performance, emotional adjustment, and personality.

    Science.gov (United States)

    Williams, Paula G; Rau, Holly K; Suchy, Yana; Thorgusen, Sommer R; Smith, Timothy W

    2017-05-01

    Individual differences in attentional control involve the ability to voluntarily direct, shift, and sustain attention. In studies of the role of attentional control in emotional adjustment, social relationships, and vulnerability to the effects of stress, self-report questionnaires are commonly used to measure this construct. Yet, convincing evidence of the association between self-report scales and actual cognitive performance has not been demonstrated. Across 2 independent samples, we examined associations between self-reported attentional control (Attentional Control Scale; ACS), self-reported emotional adjustment, Five-Factor Model personality traits (NEO Personality Inventory-Revised) and performance measures of attentional control. Study 1 examined behavioral performance on the Attention Network Test (ANT; Fan, McCandliss, Sommer, Raz, & Posner, 2002) and the Modified Switching Task (MST; Suchy & Kosson, 2006) in a large sample (n = 315) of healthy young adults. Study 2 (n = 78) examined behavioral performance on standardized neuropsychological tests of attention, including Conner's Continuous Performance Test-II and subtests from the Wechsler Adult Intelligence Scales, Third Edition (WAIS-III; Psychological Corporation, 1997) and Delis-Kaplan Executive Function System (D-KEFS; Delis, Kaplan, & Kramer, 2001). Results indicated that the ACS was largely unrelated to behavioral performance measures of attentional control but was significantly associated with emotional adjustment, neuroticism, and conscientiousness. These findings suggest that although self-reported attentional control may be a useful construct, researchers using the ACS should exercise caution in interpreting it as a proxy for actual cognitive ability or performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Pharmacokinetic studies of neuromuscular blocking agents: Good Clinical Research Practice (GCRP)

    DEFF Research Database (Denmark)

    Viby-Mogensen, J.; Østergaard, D.; Donati, F.

    2000-01-01

    Good Clinical Research Practice (GCRP), neuromuscular blocking agents, pharmacokinetics, pharmacokinetic/pharmacodynamic modeling, population pharmacokinetics, statistics, study design......Good Clinical Research Practice (GCRP), neuromuscular blocking agents, pharmacokinetics, pharmacokinetic/pharmacodynamic modeling, population pharmacokinetics, statistics, study design...

  6. Vertebral column resection in children with neuromuscular spine deformity.

    Science.gov (United States)

    Sponseller, Paul D; Jain, Amit; Lenke, Lawrence G; Shah, Suken A; Sucato, Daniel J; Emans, John B; Newton, Peter O

    2012-05-15

    Retrospective analysis. To determine, in pediatric patients with neuromuscular deformity undergoing vertebral column resection (VCR), the (1) characteristics of the surgery performed; (2) amount of pelvic obliquity restoration, and coronal and sagittal correction achieved; (3) associated blood loss and complications; and (4) extent to which curve type and VCR approach influenced correction, blood loss, and complications. VCR allows for correction of severe, rigid spinal deformity. This technique has not been previously reported in children with neuromuscular disorders. We retrospectively reviewed the records of 23 children with neuromuscular disorders (mean age, 15 years) and spinal deformities (severe scoliosis, 9; global kyphosis or angular kyphosis, 4; kyphoscoliosis, 10) who underwent VCR. The Student t test was used to compare correction differences (statistical significance, P deformity. However, this challenging procedure involves the potential for major complications.

  7. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade

    DEFF Research Database (Denmark)

    Brueckmann, B; Sasaki, N; Grobara, P

    2015-01-01

    by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual...... measured at PACU entry. Zero out of 74 sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch® SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], Pcare patients, 2 also had clinical evidence of partial...... paralysis. Time between reversal agent administration and operating room discharge-readiness was shorter for sugammadex vs usual care (14.7 vs 18.6 min respectively; P=0.02). CONCLUSIONS: After abdominal surgery, sugammadex reversal eliminated residual neuromuscular blockade in the PACU, and shortened...

  8. Altered knee joint neuromuscular control during landing from a jump in 10-15year old children with Generalised Joint Hypermobility. A substudy of the CHAMPS-study Denmark

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, Niels; Thorlund, Jonas Bloch

    2015-01-01

    -Leg-Hop-for-Distance test (SLHD) in 25 children with GJH compared to 29 children without GJH (controls), all 10-15years. Inclusion criteria for GJH: Beighton score⩾5/9 and minimum one hypermobile knee. EMG was recorded from the quadriceps, the hamstring and the calf muscles, presented relative to Maximum Voluntary...

  9. A neuromuscular test battery for osteoporotic women: a pilot study.

    Science.gov (United States)

    Kerschan-Schindl, K; Uher, E; Grampp, S; Kaider, A; Ghanem, A H; Fialka-Moser, V; Preisinger, E

    2001-05-01

    To examine the efficacy of a short neuromuscular test battery in elderly women suffering from osteoporosis in accordance with the World Health Organization criteria, with and without a history of fractures. Reduced bone mass and a high likelihood of falling increase the risk of osteoporotic fractures. There is a need for neuromuscular tests to identify individuals at risk for falls and fractures. The women were assessed twice. Forty-two women, with a mean age of 70.0 +/- 5.1 (SD) yr, completed the first assessment. The number of postmenopausal fractures and the women's history with regard to agility and falls were assessed. The women performed neuromuscular tests (one-leg stance, tandem walk, and body sway); bone mineral density of the spine and femoral neck were measured. For the follow-up assessment, 13.2 +/- 1.3 mo later, 39 women were studied. The same outcome measurements were obtained at both evaluations. During the observation period, five women fell once and one woman fell twice; there were only two vertebral fractures and no nonvertebral fracture. Neuromuscular performance did not change during this observation period. The median changes in bone mineral density between the two assessments were clinically not relevant. A comparison between patients suffering from established osteoporosis and osteoporotic patients without a history of postmenopausal fractures showed that both groups of patients did not differ with respect to age, neuromuscular performance, bone mineral density, and fear of falling. This neuromuscular test battery is a feasible and practical tool because it is brief and economical to perform. However, its efficacy as a predictor of fractures must be tested in additional studies with a long-term follow-up and a larger group of subjects.

  10. Efectos del vendaje neuromuscular sobre la flexibilidad del raquis lumbar

    OpenAIRE

    A.M. Labrador-Cerrato; P. Ortega Sánchez-Diezma; G. Lanzas Melendo; C. Gutiérrez-Ortega

    2015-01-01

    Introducción: El vendaje neuromuscular es una técnica que produce una estimulación muy selectiva sobre la piel a través de la aplicación de unas vendas elásticas especiales con el fin de lograr cambios propioceptivos, aumento o inhibición del tono muscular y mitigación de algias, entre otros. Objetivos: Comprobar si la aplicación del vendaje neuromuscular permite aumentar la flexión del raquis lumbar comparándola con otras técnicas de vendaje placebo (esparadrapo rígido convencional; Omniplas...

  11. Miller Fisher syndrome with presynaptic neuromuscular transmission disorder.

    Science.gov (United States)

    Ehler, Edvard; Latta, Jan

    2014-11-01

    Miller Fisher syndrome is defined by a triad of symptoms, namely areflexia, ataxia, and ophthalmoparesis. The ophthalmoparesis is mostly severe, undulating weakness of eye movements with ptosis and increased fatigability resembling a neuromuscular transmission disorder. We present a 52-year-old man with severe Miller Fisher syndrome with a high level of anti-GQ1b antibodies and a presynaptic type of neuromuscular transmission disorder. The diagnosis was confirmed by stimulated single-fiber electromyography with the use of a concentric needle electrode and various stimulation rates. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Exercise Therapy in Spinobulbar Muscular Atrophy and Other Neuromuscular Disorders

    DEFF Research Database (Denmark)

    Dahlqvist, Julia Rebecka; Vissing, John

    2016-01-01

    There is no curative treatment for most neuromuscular disorders. Exercise, as a treatment for these diseases, has therefore received growing attention. When executed properly, exercise can maintain and improve health and reduce the risk of cardiovascular disease, obesity, and diabetes. In persons...... in patients with neuromuscular diseases associated with weakness and wasting. We review studies that have investigated different types of exercise in both myopathies and motor neuron diseases, with particular emphasis on training of persons affected by spinobulbar muscular atrophy (SBMA). Finally, we provide...

  13. Association, characterisation and meta-analysis of SNPs linked to general reading ability in a German dyslexia case-control cohort.

    Science.gov (United States)

    Müller, Bent; Wilcke, Arndt; Czepezauer, Ivonne; Ahnert, Peter; Boltze, Johannes; Kirsten, Holger

    2016-06-17

    Dyslexia is a severe disorder in the acquisition of reading and writing. Several studies investigated the role of genetics for reading, writing and spelling ability in the general population. However, many of the identified SNPs were not analysed in case-control cohorts. Here, we investigated SNPs previously linked to reading or spelling ability in the general population in a German case-control cohort. Furthermore, we characterised these SNPs for functional relevance with in silico methods and meta-analysed them with previous studies. A total of 16 SNPs within five genes were included. The total number of risk alleles was higher in cases than in controls. Three SNPs were nominally associated with dyslexia: rs7765678 within DCDC2, and rs2038137 and rs6935076 within KIAA0319. The relevance of rs2038137 and rs6935076 was further supported by the meta-analysis. Functional profiling included analysis of tissue-specific expression, annotations for regulatory elements and effects on gene expression levels (eQTLs). Thereby, we found molecular mechanistical implications for 13 of all 16 included SNPs. SNPs associated in our cohort showed stronger gene-specific eQTL effects than non-associated SNPs. In summary, our results validate SNPs previously linked to reading and spelling in the general population in dyslexics and provide insights into their putative molecular pathomechanisms.

  14. Neuromuscular exercise improves functional performance in patients with severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Larsen, Anders Holsgaard

    Purpose. Exercise is regarded a cornerstone in the treatment of mild to moderate osteoarthritis (OA). However, little is known of the effects in patients with advanced and end-stage OA. The purpose was to evaluate the effect of neuromuscular exercise in patients with severe hip OA. Methods. Design....... Randomized controlled trial (Clinicaltrials.gov identifier: NCT01003756). 84 patients, 51% female, mean age 68.6±7.8 years, BMI 28.7±4.7 scheduled for total hip replacement at Svendborg Community Hospital, Odense University Hospital, Denmark were included. Intervention. Participants were randomized...

  15. Comparison of canal transportation and centering ability of Twisted Files, HyFlex controlled memory, and Wave One using computed tomography scan: An in vitro study

    OpenAIRE

    Kishore, Abhinav; Gurtu, Anuraag; Bansal, Rashmi; Singhal, Anurag; Mohan, Sumit; Mehrotra, Anmol

    2017-01-01

    Aim: The aim of the present study was to compare the canal transportation and centering ability of three rotary nickel-titanium (NiTi) systems (Twisted Files [TF], HyFlex controlled memory [CM], and Wave One [WO]) in curved root canals using computed tomography (CT). Materials and Methods: Sixty freshly extracted single-rooted teeth having curved root canals with at least 25–35 degrees of curvature were selected. The teeth were randomly divided into three experimental groups of twenty each. A...

  16. Priming Ability Emotional Intelligence

    Science.gov (United States)

    Schutte, Nicola S.; Malouff, John M.

    2012-01-01

    Two studies examined whether priming self-schemas relating to successful emotional competency results in better emotional intelligence performance. In the first study participants were randomly assigned to a successful emotional competency self-schema prime condition or a control condition and then completed an ability measure of emotional…

  17. Genetic control and combining ability of flag leaf area and relative water content traits of bread wheat cultivars under drought stress condition

    Directory of Open Access Journals (Sweden)

    Golparvar Ahmad Reza

    2013-01-01

    Full Text Available In order to compare mode of inheritance, combining ability, heterosis and gene action in genetic control of traits flag leaf area, relative water content and grain filling rate of bread wheat under drought stress, a study was conducted on 8 cultivars using of Griffing’s method2 in fixed model. Mean square of general combining ability was significant also for all traits and mean square of specific combining ability was significant also for all traits except relative water content of leaf which show importance of both additive and dominant effects of genes in heredity of these traits under stress. GCA to SCA mean square ratio was significant for none of traits. Results of this study showed that non additive effects of genes were more important than additive effect for all traits. According to results we can understand that genetic improvement of mentioned traits will have low genetic efficiency by selection from the best crosses of early generations. Then it is better to delay selection until advanced generations and increase in heritability of these traits.

  18. Effects of concentric and eccentric control exercise on gross motor function and balance ability of paretic leg in children with spastic hemiplegia.

    Science.gov (United States)

    Park, Su-Ik; Kim, Mi-Sun; Choi, Jong-Duk

    2016-07-01

    [Purpose] This study examines the effect of concentric and eccentric control training of the paretic leg on balance and gross motor function in children with spastic hemiplegia. [Subjects and Methods] Thirty children with spastic hemiplegia were randomly divided into experimental and control groups. In the experimental group, 20 min of neurodevelopmental therapy and 20 min of concentric and eccentric control exercise were applied to the paretic leg. In the control group, 40 min of neurodevelopmental therapy was applied. The Pediatric Balance Scale test and standing and gait items of the Gross Motor Function Measure were evaluated before and after intervention. [Results] In the experimental group, Gross Motor Function Measure and Pediatric Balance Scale scores statistically significantly increased after the intervention. The control group showed no statistically significant difference in either score after the intervention. [Conclusion] Concentric and eccentric control exercise therapy in children with spastic hemiplegia can be effective in improving gross motor function and balance ability, and can be used to solve functional problems in a paretic leg.

  19. Neuromuscular Adaptations to Combined Strength and Endurance Training: Order and Time-of-Day.

    Science.gov (United States)

    Küüsmaa-Schildt, Maria; Eklund, Daniela; Avela, Janne; Rytkönen, Tuomas; Newton, Robert; Izquierdo, Mikel; Häkkinen, Keijo

    2017-09-01

    The present study examined the effects of 24 weeks of morning vs. evening same-session combined strength (S) and endurance (E) training on neuromuscular and endurance performance. Fifty-one men were assigned to the morning (m) or evening (e) training group, where S preceded E or vice versa (SEm, ESm, SEe and ESe), or to the control group. Isometric force, voluntary activation, EMG and peak wattage during the maximal cycling test were measured. Training time did not significantly affect the adaptations. Therefore, data are presented for SEm+e (SEm+SEe) and ESm+e (ESm+ESe). In the morning, no order specific gains were observed in neuromuscular performance. In the evening, the changes in isometric force (SEm+e 15.9±16.7%, p=0.001; ESm+e 4.1±12.2%, p=0.615) and EMG (SEm+e 38.3±31.7%, p=0.001; ESm+e 14.67±36.44%, p=0.486) were larger (p=0.014) in SEm+e than in ESm+e and in voluntary activation larger (p=0.026) in SEm+e compared to controls. Peak wattage increased in the morning (SEm+e 15.9±9.2%, ESm+e 22.0±7.0%; ptraining program led to greater neuromuscular adaptations when SE-training was performed in the evening, whereas the ES-training provided more optimal conditions for endurance performance adaptations both in the morning and evening. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy

    Science.gov (United States)

    Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold’s Tyson de Sousa; Moreira dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra

    2015-01-01

    [Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care. PMID:26157261

  1. Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy.

    Science.gov (United States)

    Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold's Tyson de Sousa; Moreira Dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra

    2015-05-01

    [Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care.

  2. A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Yoshiyuki Tachibana

    Full Text Available BACKGROUND: We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. METHODOLOGY/PRINCIPAL FINDINGS: Participants were 238 pairs of mothers and typically developing preschool children (ages 4-6 years old from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI (for mothers, the Goodenough Draw-a-Man intelligence test (DAM, and the new S-S intelligence test (NS-SIT (for children were administered prior to and 3 months after the intervention period. Pre-post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress, Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress, and the score on the DAM (for child cognitive abilities. The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed. CONCLUSIONS/SIGNIFICANCE: Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities. TRIAL REGISTRATION: UMIN Clinical Trials Registry UMIN000002265.

  3. A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial.

    Science.gov (United States)

    Tachibana, Yoshiyuki; Fukushima, Ai; Saito, Hitomi; Yoneyama, Satoshi; Ushida, Kazuo; Yoneyama, Susumu; Kawashima, Ryuta

    2012-01-01

    We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. Participants were 238 pairs of mothers and typically developing preschool children (ages 4-6 years old) from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI) (for mothers), the Goodenough Draw-a-Man intelligence test (DAM), and the new S-S intelligence test (NS-SIT) (for children) were administered prior to and 3 months after the intervention period. Pre-post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress), Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress), and the score on the DAM (for child cognitive abilities). The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed. Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities. UMIN Clinical Trials Registry UMIN000002265.

  4. Deep neuromuscular blockade and low insufflation pressure during laparoscopic hysterectomy.

    Science.gov (United States)

    Madsen, Matias Vested; Istre, Olav; Springborg, Henrik Halvor; Staehr-Rye, Anne Kathrine; Rosenberg, Jacob; Lund, Jørgen; Gätke, Mona Ring

    2017-05-01

    Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. This was a pre-planned secondary analysis of a randomized, controlled study. A total of 110 patients scheduled for laparoscopic hysterectomy were randomized to either deep NMB and 8 mmHg pneumoperitoneum (deep NMB group) or single-bolus NMB and 12 mmHg pneumoperitoneum (standard NMB group). NMB was established with rocuronium and reversed with sugammadex. Two gynaecologists registered episodes of sudden abdominal contractions, alarms from the insufflator due to increased intraabdominal pressure and incidences with tightness of the abdominal wall. No sudden abdominal contractions were detected in the deep NMB group as compared with 12 episodes in the standard NMB group (p deep and standard NMB group, respectively. The gynaecologists registered increasing abdominal tensions in no versus eight procedures (p = 0.006) in the deep and standard NMB group, respectively. Deep NMB in combination with 8 mmHg pneumoperitoneum prevented sudden abdominal contractions during laparoscopic hysterectomy. This work was funded in part by a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme Corp, USA. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. The study was assigned with EudraCT number 2012-003787-51 and registered with clinicaltrials.gov (NCT01722097). Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any

  5. An experimental model to measure the ability of headphones with active noise control to reduce patient's exposure to noise in an intensive care unit.

    Science.gov (United States)

    Gallacher, Stuart; Enki, Doyo; Stevens, Sian; Bennett, Mark J

    2017-10-17

    Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce patient's exposure to noise. Active noise control devices may prove to be useful adjuncts but there is currently little to quantify their ability to reduce noise in this complex environment. Sound meters were embedded in the auditory meatus of three polystyrene model heads with no headphones (control), with headphones alone and with headphones using active noise control and placed in patient bays in a cardiac ICU. Ten days of recording sound levels at a frequency of 1 Hz were performed, and the noise levels in each group were compared using repeated measures MANOVA and subsequent pairwise testing. Multivariate testing demonstrated that there is a significant difference in the mean noise exposure levels between the three groups (p headphones and active noise control. The mean reduction in noise exposure between the control and this group over 24 h is 6.8 (0.66) dB. The use of active noise control was also associated with a reduction in the exposure to high-intensity sound events over the course of the day. The use of active noise cancellation, as delivered by noise-cancelling headphones, is associated with a significant reduction in noise exposure in our model of noise exposure in a cardiac ICU. This is the first study to look at the potential effectiveness of active noise control in adult patients in an intensive care environment and shows that active noise control is a candidate technology to reduce noise exposure levels the patients experience during stays on intensive care.

  6. The drop height determines neuromuscular adaptations and changes in jump performance in stretch-shortening cycle training

    OpenAIRE

    Taube, Wolfgang; Leukel, Christian; Lauber, B.; Gollhofer, Albert

    2012-01-01

    There is an ongoing discussion about how to improve jump performance most efficiently with plyometric training. It has been proposed that drop height influences the outcome, although longitudinal studies are missing. Based on cross-sectional drop jump studies showing height-dependent Hoffmann (H)-reflex activities, we hypothesized that the drop height should influence the neuromuscular activity and thus, the training result. Thirty-three subjects participated as a control or in one of two str...

  7. A new self-report quality of life questionnaire for children with neuromuscular disorders: presentation of the instrument, rationale for its development, and some preliminary results.

    Science.gov (United States)

    Orcesi, Simona; Ariaudo, Giada; Mercuri, Eugenio; Beghi, Ettore; Rezzani, Cristiana; Balottin, Umberto

    2014-02-01

    Improvement of quality of life in neuromuscular disorders is a primary objective, both in management of affected children and in the context of therapeutic trials. Quality of life is a subjective concept and it is crucial to gather information directly from patients. We created the SOLE Questionnaire for NMDs, a new instrument designed to investigate quality of life in children with neuromuscular disorders, and tested it in a study population of 78 patients and in 81 healthy children aged 5 to 13 years. The SOLE Questionnaire, characterized by a visual and neutral approach, was well received, practical, rapid to administer, and able to discriminate between patients and controls. We also confirmed the presence of disagreement about children's quality of life between children and their parents. We suggest that our new approach could help to improve understanding of quality of life in children with neuromuscular disorders.

  8. Roles of neuro-exocytotic proteins at the neuromuscular junction

    NARCIS (Netherlands)

    Sons-Michel, Michèle S.

    2011-01-01

    The aim of the studies described in the thesis was to elucidate the roles of several neuro-exocytotic proteins at the motor nerve terminal in neuromuscular synaptic transmission, making use of genetic knockout (KO) mice, each missing one (or more) neuro-exocytotic proteins. In addition, it was

  9. [Neuro-muscular apparatus state in lumbosacral radiculopathy in miners].

    Science.gov (United States)

    Battakova, Sh B; Amanbekov, U A; Otarbaeva, M B; Fazylova, M D; Sraĭmanov, K S; Miianova, G A; Kozhakhmetova, K M

    2008-01-01

    Based on clinical and electrophysiologic studies, the authors analysed neuro-muscular apparatus of "spinal center--periphery" axis for miners with radicular pain caused by occupational lumbosacral radiculopathy. Findings are that constantly irritated receptors in lumbar motor segment during occupational activities alter habitual motor stereotype and cause specific compensatory muscular reactions, rearrangement of motor activity in segmental apparatus.

  10. Imaging of respiratory muscles in neuromuscular disease: A review.

    Science.gov (United States)

    Harlaar, L; Ciet, P; van der Ploeg, A T; Brusse, E; van der Beek, N A M E; Wielopolski, P A; de Bruijne, M; Tiddens, H A W M; van Doorn, P A

    2017-11-24

    Respiratory muscle weakness frequently occurs in patients with neuromuscular disease. Measuring respiratory function with standard pulmonary function tests provides information about the contribution of all respiratory muscles, the lungs and airways. Imaging potentially enables the study of different respiratory muscles, including the diaphragm, separately. In this review, we provide an overview of imaging techniques used to study respiratory muscles in neuromuscular disease. We identified 26 studies which included a total of 573 patients with neuromuscular disease. Imaging of respiratory muscles was divided into static and dynamic techniques. Static techniques comprise chest radiography, B-mode (brightness mode) ultrasound, CT and MRI, and are used to assess the position and thickness of the diaphragm and the other respiratory muscles. Dynamic techniques include fluoroscopy, M-mode (motion mode) ultrasound and MRI, used to assess diaphragm motion in one or more directions. We discuss how these imaging techniques relate with spirometric values and whether these can be used to study the contribution of the different respiratory muscles in patients with neuromuscular disease. Copyright © 2017. Published by Elsevier B.V.

  11. Neuromuscular stimulation after stroke: from technology to clinical deployment

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; Renzenbrink, Gerbert J.; Geurts, Alexander C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  12. Neuromuscular stimulation after stroke: from technology to clinical deployment.

    NARCIS (Netherlands)

    IJzerman, M.J.; Renzenbrink, G.J.; Geurts, A.C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  13. Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation.

    Science.gov (United States)

    Rozand, Vianney; Grosprêtre, Sidney; Stapley, Paul J; Lepers, Romuald

    2015-09-13

    Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, spinal and peripheral levels). The present protocol describes how this method can be used to stimulate the posterior tibial nerve that activates plantar flexor muscles. Percutaneous electrical nerve stimulation consists of inducing an electrical stimulus to a motor nerve to evoke a muscular response. Direct (M-wave) and/or indirect (H-reflex) electrophysiological responses can be recorded at rest using surface electromyography. Mechanical (twitch torque) responses can be quantified with a force/torque ergometer. M-wave and twitch torque reflect neuromuscular transmission and excitation-contraction coupling, whereas H-reflex provides an index of spinal excitability. EMG activity and mechanical (superimposed twitch) responses can also be recorded during maximal voluntary contractions to evaluate voluntary activation level. Percutaneous nerve stimulation provides an assessment of neuromuscular function in humans, and is highly beneficial especially for studies evaluating neuromuscular plasticity following acute (fatigue) or chronic (training/detraining) exercise.

  14. [New surgical treatment of late-stage neuromuscular ureteral dysplasia].

    Science.gov (United States)

    Lopatkin, N A; Zhitnikova, L H; Berestennikov, K A

    1999-01-01

    A surgical treatment of neuromuscular ureteral, dysplasia (NUD) is proposed which provides development of restenosis in vesicoureteral anastomosis and vesicoureteral reflux in maintenance of normal urodynamics of the upper urinary tracts. This organ-saving method can be applied at late disease. Multichannel impedance ureterography proved useful in definition of the operation's scope.

  15. Radiation fibrosis syndrome: neuromuscular and musculoskeletal complications in cancer survivors.

    Science.gov (United States)

    Stubblefield, Michael D

    2011-11-01

    Radiation-induced toxicity is a major cause of long-term disability after cancer treatment. Radiation fibrosis describes the insidious pathologic fibrotic tissue sclerosis that can occur in response to radiation exposure. Radiation fibrosis syndrome describes the myriad clinical manifestations of progressive fibrotic tissue sclerosis resulting from radiation treatment. Radiation-induced damage can include "myelo-radiculo-plexo-neuro-myopathy," causing muscle weakness and dysfunction and contributing to neuromuscular injury. Similarly, radiation damage to neuromuscular structures contributes to radiation-induced trismus and cervical dystonia in head and neck cancer survivors. This narrative review discusses the pathophysiology, anatomy, evaluation, and treatment of neuromuscular, musculoskeletal, and functional disorders that can result as late effects of radiation treatment. Rehabilitation medicine physicians with extensive training in neuromuscular and musculoskeletal medicine as well as in the principles of functional restoration are uniquely positioned to help lead efforts to improve the quality of life for cancer survivors with radiation fibrosis syndrome. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. Intraorbital neuromuscular choristoma adjacent to the optic nerve

    Directory of Open Access Journals (Sweden)

    Arie Perry, M.D.

    2017-03-01

    Full Text Available Neuromuscular choristoma is a rare tumor that incorporates mature skeletal muscle within fascicles of peripheral nerve. The etiology is poorly understood, yet most present in large nerves of children, with a tight link to post-operative fibromatosis recently appreciated. Herein, we report an exceptional intra-orbital example in a 53-year-old man with optic nerve compression.

  17. Comparison of the Effect of Neuromuscular Electrical Stimulation ...

    African Journals Online (AJOL)

    Children with cerebral palsy (CP) often demonstrate poor hand function due to spasticity. Thus spasticity in the wrist and finger flexors poses a great deal of functional limitations. This study was therefore designed to compare the effectiveness of Cryotherapy and Neuromuscular Electrical Stimulation (NMES) on spasticity ...

  18. Neuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?

    NARCIS (Netherlands)

    Driessen, J.J.

    2008-01-01

    PURPOSE OF REVIEW: The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported. RECENT FINDINGS: The findings include the mechanisms of the hyperkalemia

  19. Is deep neuromuscular blockade beneficial in laparoscopic surgery?

    DEFF Research Database (Denmark)

    Madsen, M. V.; Staehr-Rye, A K; Claudius, C

    2016-01-01

    this in narrative form. We have shared our analysis and text with the authors of the 'Con-' side of these paired position papers during the preparation of the manuscripts. RESULTS: There are a few low risk of bias studies indicating that use of deep neuromuscular blockade improve surgical conditions and improve...

  20. Effects of electromyostimulation training and volleyball practice on jumping ability.

    Science.gov (United States)

    Malatesta, Davide; Cattaneo, Fabio; Dugnani, Sergio; Maffiuletti, Nicola A

    2003-08-01

    The aim of this study was to investigate the influence of a 4-week electromyostimulation (EMS) training program on the vertical jump performance of 12 volleyball players. EMS sessions were incorporated into volleyball sessions 3 times weekly. EMS consisted of 20-22 concomitant stimulations of the knee extensor and plantar flexor muscles and lasted approximately 12 minutes. No significant changes were observed after EMS training for squat jump (SJ) and counter movement jump (CMJ) performance, while the mean height and the mean power maintained during 15 seconds of consecutive CMJs significantly increased by approximately 4% (p < 0.05). Ten days after the end of EMS training, the jumping height significantly (p < 0.05) increased compared with baseline also for single jumps (SJ +6.5%, CMJ +5.4%). When the aim of EMS resistance training is to enhance vertical jump ability, sport-specific workouts following EMS would enable the central nervous system to optimize the control to neuromuscular properties.

  1. Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Ageberg, Eva; Nilsdotter, Anna; Kosek, Eva

    2013-01-01

    The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled...... before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee....

  2. Improvements in Orientation and Balancing Abilities in Response to One Month of Intensive Slackline-Training. A Randomized Controlled Feasibility Study.

    Science.gov (United States)

    Dordevic, Milos; Hökelmann, Anita; Müller, Patrick; Rehfeld, Kathrin; Müller, Notger G

    2017-01-01

    Background: Slackline-training has been shown to improve mainly task-specific balancing skills. Non-task specific effects were assessed for tandem stance and preferred one-leg stance on stable and perturbed force platforms with open eyes. It is unclear whether transfer effects exist for other balancing conditions and which component of the balancing ability is affected. Also, it is not known whether slackline-training can improve non-visual-dependent spatial orientation abilities, a function mainly supported by the hippocampus. Objective: To assess the effect of one-month of slackline-training on different components of balancing ability and its transfer effects on non-visual-dependent spatial orientation abilities. Materials and Methods: Fifty subjects aged 18-30 were randomly assigned to the training group (T) (n = 25, 23.2 ± 2.5 years; 12 females) and the control group (C) (n = 25, 24.4 ± 2.8 years; 11 females). Professional instructors taught the intervention group to slackline over four consecutive weeks with three 60-min-trainings in each week. Data acquisition was performed (within 2 days) by blinded investigators at the baseline and after the training. Main outcomes Improvement in the score of a 30-item clinical balance test (CBT) developed at our institute (max. score = 90 points) and in the average error distance (in centimeters) in an orientation test (OT), a triangle completion task with walking and wheelchair conditions for 60°, 90°, and 120°. Results: Training group performed significantly better on the closed-eyes conditions of the CBT (1.6 points, 95% CI: 0.6 to 2.6 points vs. 0.1 points, 95% CI: -1 to 1.1 points; p = 0.011, [Formula: see text] = 0.128) and in the wheelchair (vestibular) condition of the OT (21 cm, 95% CI: 8-34 cm vs. 1 cm, 95% CI: -14-16 cm; p = 0.049, [Formula: see text] = 0.013). Conclusion: Our results indicate that one month of intensive slackline training is a novel approach for enhancing clinically relevant balancing

  3. Functional ability and muscle force in healthy children and ambulant Duchenne muscular dystrophy patients

    NARCIS (Netherlands)

    Beenakker, EAC; Maurits, NM; Fock, JM; Brouwer, OF; van der Hoeven, JH

    2005-01-01

    Neuromuscular disorders are characterised by progressive muscle weakness, which in time causes functional impairment. To quantify the extent of disease progression, muscle force and functional ability can be measured. Which of these parameters changes most depends on the disease stage. In a previous

  4. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus

    Directory of Open Access Journals (Sweden)

    Ford KR

    2015-08-01

    Full Text Available Kevin R Ford,1 Anh-Dung Nguyen,2 Steven L Dischiavi,1 Eric J Hegedus,1 Emma F Zuk,2 Jeffrey B Taylor11Department of Physical Therapy, High Point University, High Point, NC, USA; 2Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USAAbstract: Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.Keywords: dynamic lower extremity valgus, hip neuromuscular control, ACL injury rehabilitation, patellofemoral pain, hip muscular activation

  5. Mechanical insufflation-exsufflation for people with neuromuscular disorders.

    Science.gov (United States)

    Morrow, Brenda; Zampoli, Marco; van Aswegen, Helena; Argent, Andrew

    2013-12-30

    People with neuromuscular disorders (NMDs) may have weak respiratory (breathing) muscles which makes it difficult for them to effectively cough and clear mucus from the lungs. This places them at risk of recurrent chest infections and chronic lung disease. Mechanical insufflation-exsufflation (MI-E) is one of a number of techniques available to improve cough efficacy and mucus clearance. To determine the efficacy and safety of MI-E in people with NMDs. On 7 October 2013, we searched the following databases from inception: the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL (The Cochrane Library), MEDLINE, and EMBASE. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform for ongoing trials. We conducted handsearches of reference lists and conference proceedings. We considered randomised or quasi-randomised clinical trials, and randomised cross-over trials of MI-E used to assist airway clearance in people with a NMD and respiratory insufficiency. We considered comparisons of MI-E with no treatment, or alternative cough augmentation techniques. Two authors independently assessed trial eligibility, extracted data, and assessed risk of bias in included studies according to standard Cochrane methodology. The primary outcome was mortality throughout follow-up or at six months follow-up. Five studies with a total of 105 participants were found to be eligible for inclusion in this review. All included trials were short-term studies (two days or less), measuring immediate effects of the interventions. There was insufficient detail in the reports to assess methods of randomisation and allocation concealment. All five studies were at a high risk of bias from lack of blinding. The studies did not report on mortality, morbidity, quality of life, serious adverse events or any of the other prespecified outcomes. One study was a randomised cross-over trial conducted over two days, in which investigators applied two

  6. Neuromuscular Activity of Micrurus laticollaris (Squamata: Elapidae Venom in Vitro

    Directory of Open Access Journals (Sweden)

    Alejandro Carbajal-Saucedo

    2014-01-01

    Full Text Available In this work, we have examined the neuromuscular activity of Micrurus laticollaris (Mexican coral snake venom (MLV in vertebrate isolated nerve-muscle preparations. In chick biventer cervicis preparations, the MLV induced an irreversible concentration- and time-dependent (1–30 µg/mL neuromuscular blockade, with 50% blockade occurring between 8 and 30 min. Muscle contractures evoked by exogenous acetylcholine were completely abolished by MLV, whereas those of KCl were also significantly altered (86% ± 11%, 53% ± 11%, 89% ± 5% and 89% ± 7% for one, three, 10 and 30 µg of venom/mL, respectively; n = 4; p < 0.05. In mouse phrenic nerve-diaphragm preparations, MLV (1–10 µg/mL promoted a slight increase in the amplitude of twitch-tension (3 µg/mL, followed by neuromuscular blockade (n = 4; the highest concentration caused complete inhibition of the twitches (time for 50% blockade = 26 ± 3 min, without exhibiting a previous neuromuscular facilitation. The venom (3 µg/mL induced a biphasic modulation in the frequency of miniature end-plate potentials (MEPPs/min, causing a significant increase after 15 min, followed by a decrease after 60 min (from 17 ± 1.4 (basal to 28 ± 2.5 (t15 and 12 ± 2 (t60. The membrane resting potential of mouse diaphragm preparations pre-exposed or not to d-tubocurarine (5 µg/mL was also significantly less negative with MLV (10 µg/mL. Together, these results indicate that M. laticollaris venom induces neuromuscular blockade by a combination of pre- and post-synaptic activities.

  7. Endomicroscopy and electromyography of neuromuscular junctions in situ

    Science.gov (United States)

    Brown, Rosalind; Dissanayake, Kosala N; Skehel, Paul A; Ribchester, Richard R

    2014-01-01

    Objective Electromyography (EMG) is used routinely to diagnose neuromuscular dysfunction in a wide range of peripheral neuropathies, myopathies, and neuromuscular degenerative diseases including motor neuron diseases such as amyotrophic lateral sclerosis (ALS). Definitive neurological diagnosis may also be indicated by the analysis of pathological neuromuscular innervation in motor-point biopsies. Our objective in this study was to preempt motor-point biopsy by combining live imaging with electrophysiological analysis of slow degeneration of neuromuscular junctions (NMJs) in vivo. Methods We combined conventional needle electromyography with fiber-optic confocal endomicroscopy (CEM), using an integrated hand-held, 1.5-mm-diameter probe. We utilized as a test bed, various axotomized muscles in the hind limbs of anaesthetized, double-homozygous thy1.2YFP16: WldS mice, which coexpress the Wallerian-degeneration Slow (WldS) protein and yellow fluorescent protein (YFP) in motor neurons. We also tested exogenous vital stains, including Alexa488-α-bungarotoxin; the styryl pyridinium dye 4-Di-2-Asp; and a GFP conjugate of botulinum toxin Type A heavy chain (GFP-HcBoNT/A). Results We show that an integrated EMG/CEM probe is effective in longitudinal evaluation of functional and morphological changes that take place over a 7-day period during axotomy-induced, slow neuromuscular synaptic degeneration. EMG amplitude declined in parallel with overt degeneration of motor nerve terminals. EMG/CEM was safe and effective when nerve terminals and motor endplates were selectively stained with vital dyes. Interpretation Our findings constitute proof-of-concept, based on live imaging in an animal model, that combining EMG/CEM may be useful as a minimally invasive precursor or alternative to motor-point biopsy in neurological diagnosis and for monitoring local administration of potential therapeutics. PMID:25540801

  8. Neuromuscular and perceptual fatigue responses to consecutive tag football matches.

    Science.gov (United States)

    Hogarth, Luke W; Burkett, Brendan J; McKean, Mark R

    2015-07-01

    To examine the neuromuscular and perceptual fatigue responses to consecutive tag football matches played on the same day and determine the relationship between fatigue and match running performance. Neuromuscular and perceptual fatigue responses of 15 national tag football players were assessed before and during the 2014 State of Origin tournament. Global positioning systems (GPS) provided data on players' match running performance, and a vertical-jump test and subjective questionnaire were used to assess players' neuromuscular and perceptual fatigue, respectively. There were small to moderate reductions in the majority of match-running-performance variables over consecutive matches, including distance (ES=-0.81), high-speed-running (HSR) distance (ES=-0.51), HSR efforts (ES=-0.64), and maximal accelerations (ES=-0.76). Prematch vertical jump was initially below baseline values before the first match (ES=0.68-0.88). There were no substantial reductions in vertical-jump performance from baseline values over consecutive matches, although there was a small decline from after match 2 to after match 3 (3.3%; ES=-0.45±0.62). There were progressive reductions in perceived well-being scores after matches 1 (ES=-0.38), 2 (ES=-0.70), and 3 (ES=-1.14). There were small to moderate associations between changes in fatigue measures and match running performance. Perceptual fatigue accumulates over consecutive tag football matches, although there were only marginal increases in neuromuscular fatigue. However, both neuromuscular and perceptual fatigue measures were found to contribute to reduced match running performance in the final match.

  9. Effect of inherited abnormalities of calcium regulation on human neuromuscular transmission.

    Science.gov (United States)

    Maselli, Ricardo A; Books, Wendy; Dunne, Vanessa

    2003-09-01

    Synaptotagmins are abundant synaptic proteins that represent the best candidate for the calcium sensor at the nerve terminal. The pore-forming, voltage-sensing transmembrane alpha-1 subunit of the P/Q voltage-gated calcium channel (or Ca(v)2.1) encoded by the CACNA1A gene is another major component of the process of action potential-evoked exocytosis at the adult mammalian neuromuscular junction. Defects of these proteins, in nonhuman species, result in severe disruption of rapid synaptic transmission. This paper investigates the molecular bases of inherited presynaptic deficits of neuromuscular transmission in humans. Patients with congenital presynaptic failure, including two patients with episodic ataxia type 2 (EA-2) due to CACNA1A mutations, were studied with muscle biopsy, microelectrode studies, electron microscopy, DNA amplification, and sequencing. All patients, including EA-2 patients, showed selective failure of the action potential-dependent release without reduction of the spontaneous release of neurotransmitter. In addition, patients with EA-2 showed partial blockade of neuromuscular transmission with the N-type blocker omega-conotoxin not seen in controls. The EM showed a varied degree of increased complexity of postsynaptic folds. Mutational analysis in candidate genes, including human synaptotagmin II, syntaxin 1A, synaptobrevin I, SNAP 25, CACNA1A, CACNB2, and Rab3A, was unrevealing. Although no mutations in candidate genes were found in patients with inborn presynaptic failure, functional and structural similarities between this group and patients with EA-2 due to CACNA1A mutations suggest a common pathogenic mechanism.

  10. Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy.

    Science.gov (United States)

    Ravindra, Vijay M; Christensen, Michael T; Onwuzulike, Kaine; Smith, John T; Halvorson, Kyle; Brockmeyer, Douglas L; Walker, Marion L; Bollo, Robert J

    2017-11-01

    OBJECTIVE Selective dorsal rhizotomy (SDR) via limited laminectomy is an effective treatment of lower-extremity spasticity in the pediatric population. Children with spasticity are also at risk for neuromuscular scoliosis; however, specific risk factors for progressive spinal deformity requiring posterior spinal fusion (PSF) after SDR are unknown. The authors' goal was to identify potential risk factors. METHODS The authors performed a retrospective cohort study of patients who underwent SDR via limited laminectomy between 2003 and 2014 and who had at least 1 year of follow-up. They analyzed demographic, clinical, and radiographic variables to elucidate risk factors for progressive neuromuscular scoliosis. The primary outcome was need for PSF. RESULTS One hundred thirty-four patients underwent SDR and had at least 12 months of follow-up (mean 65 months); 48 patients (36%) had detailed pre- and postoperative radiographic data available. The mean age at surgery was 10 years (SD 5.1 years). Eighty-four patients (63%) were ambulatory before SDR, 109 (82%) underwent a single-level laminectomy, and a mean of 53% of the dorsal rootlets from L-1 to S-1 were sectioned. Fifteen patients (11.2%) subsequently required PSF for progressive deformity. Nonambulatory status (p 30° (p = 0.003) were significantly associated with PSF on univariate analysis, but no statistically significant correlation was found with any clinical or radiographic variable and PSF after SDR on multivariate regression analysis. CONCLUSIONS Patients with preoperative nonambulatory status and Cobb angle > 30° may be at risk for progressive spinal deformity requiring PSF after SDR. These are well-known risk factors for progressive deformity in children with spasticity in general. Although our analysis suggests SDR via limited laminectomy may not significantly accelerate the development of neuromuscular scoliosis, further case-control studies are critical to elucidate the impact of SDR on spinal deformity.

  11. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  12. Family environment and the malleability of cognitive ability: a Swedish national home-reared and adopted-away cosibling control study.