Lemmink Koen APM
Full Text Available Abstract Background Of all athletic knee injuries an anterior cruciate ligament (ACL rupture results in the longest time loss from sport. Regardless of the therapy chosen, conservative or reconstructive, athletes are often forced to reduce their level of physical activity and their involvement in sport. Moreover, a recent review reported prevalences of osteoarthritis ranging from 0% to 13% for patients with isolated ACL-deficient (ACL-D knees and respectively 21% to 48% in patients with combined injuries. The need for ACL injury prevention is clear. The identification of risk factors and the development of prevention strategies may therefore have widespread health and economic implications. The focus of this investigation is to assess the role of implicit and explicit motor learning in optimising the performance of a side-step-cutting task. Methods/design A randomized controlled laboratory study will be conducted. Healthy basketball players, females and males, 18 years and older, with no previous lower extremity injuries, playing at the highest recreational level will be included. Subjects will receive a dynamic feedback intervention. Kinematic and kinetic data of the hip, knee and ankle and EMG activity of the quadriceps, hamstrings and gastrocnemius will be recorded. Discussion Female athletes have a significantly higher risk of sustaining an ACL injury than male athletes. Poor biomechanical and neuromuscular control of the lower limb is suggested to be a primary risk factor of an ACL injury mechanism in females. This randomized controlled trial has been designed to investigate whether individual feedback on task performance appears to be an effective intervention method. Results and principles found in this study will be applied to future ACL injury prevention programs, which should maybe more focus on individual injury predisposition. Trial registration Trial registration number NTR2250.
Full Text Available Abstract Background Motor learning research has had little impact on clinical applications and rarely extended to research about how older adults learn motor skills. There is consistent evidence that motor skill performance and learning can be enhanced by giving learners instructions that direct their attention. The aim of this study was to test whether elderly individuals that receive an external focus instruction during training of dynamic balance skills would learn in a different manner compared to individuals that received an internal focus instruction. Methods This randomised trial included 26 older persons (81 ± 6 years that were training functional balance twice a week for the duration of 5 weeks. Learning outcomes were recorded after every training session. Weight shifting score and dynamic balance parameters (Biodex Balance System, components of the Extended Timed-Get-Up-and-Go test, five chair rises, and falls efficacy (FES-I was assessed at baseline and post-intervention. Results Participation for training sessions was 94%. No differences between groups were found following 5 weeks of training for weight shifting score, dynamic balance index and dynamic balance time (p p = 0.16, p Sit-to-stand, p = .036; Gait initiation, p = .039; Slow down, stop, turnaround, and sit down, p = 0.011 and the Fes-I (p = 0.014 showed improvements for the total group, indicating that function improved compared to baseline. Conclusion A 5-week balance training improved weight shifting scores and dynamic balance parameters as well as functional abilities. The observed improvements were independent from the type of attentional focus instructions. The findings provide support for the proposition of different motor learning principles in older adults compared to younger adults. Trial Registration ISRCTN44627088
Orban de Xivry J-J
Full Text Available Each task requires a specific motor behavior that is tuned to task demands. For instance, writing requires a lot of accuracy while clapping does not. It is known that the brain adjusts the motor behavior to different task demands as predicted by optimal control theory. In this study, the mechanism of this reoptimization process is investigated by varying the accuracy demands of a reaching task. In this task, the width of the reaching target (0.5 or 8 cm was varied either on a trial-to-trial basis (random schedule or in blocks (blocked schedule. On some trials, the hand of the subjects was clamped to a rectilinear trajectory that ended 2 cm on the left or right of the target center. The rejection of this perturbation largely varied with target width in the blocked schedule but not in the random schedule. That is, subjects exhibited different motor behavior in the different schedules despite identical accuracy demands. Therefore, while reoptimization has been considered immediate and automatic, the differences in motor behavior observed across schedules suggest that the reoptimization of the motor behavior is neither happening on a trial-by-trial basis nor obligatory. The absence of trial-to-trial mechanisms, the inability of the brain to adapt to two conflicting task demands and the existence of a switching cost are discussed as possible sources of the non-optimality of motor behavior during the random schedule.
Reilmann, Ralf; Schubert, Robin
Deficits in motor function are a hallmark of Huntington disease (HD). The Unified Huntington's Disease Rating Scale Total Motor Score (UHDRS-TMS) is a categoric clinical rating scale assessing multiple domains of motor disability in HD. The UHDRS-TMS or subsets of its items have served as primary or secondary endpoints in numerous clinical trials. In spite of a well-established video-based annual online certification system, intra- and interrater variability, subjective error, and rater-induced placebo effects remain a concern. In addition, the UHDRS-TMS was designed to primarily assess motor symptoms in manifest HD. Recently, advancement of technology resulted in the introduction of the objective Q-Motor (i.e., Quantitative-Motor) assessments in biomarker studies and clinical trials in HD. Q-Motor measures detected motor signs in blinded cross-sectional and longitudinal analyses of manifest, prodromal, and premanifest HD cohorts up to two decades before clinical diagnosis. In a multicenter clinical trial in HD, Q-Motor measures were more sensitive than the UHDRS-TMS and exhibited no placebo effects. Thus, Q-Motor measures are currently explored in several multicenter trials targeting both symptomatic and disease-modifying mechanisms. They may supplement the UHDRS-TMS, increase the sensitivity and reliability in proof-of-concept studies, and open the door for phenotype assessments in clinical trials in prodromal and premanifest HD. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Vaughan P Nicholson,1 Justin WL Keogh,2–4 Nancy L Low Choy1 1School of Physiotherapy, Australian Catholic University, Brisbane, QLD, Australia; 2Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia; 3Human Potential Centre, AUT University, Auckland, New Zealand; 4Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, QLD, Australia Purpose: To investigate the influence of a single session of locomotor-based motor imagery training on motor learning and physical performance. Patients and methods: Thirty independent adults aged >65 years took part in the randomized controlled trial. The study was conducted within an exercise science laboratory. Participants were randomly divided into three groups following baseline locomotor testing: motor imagery training, physical training, and control groups. The motor imagery training group completed 20 imagined repetitions of a locomotor task, the physical training group completed 20 physical repetitions of a locomotor task, and the control group spent 25 minutes playing mentally stimulating games on an iPad. Imagined and physical performance times were measured for each training repetition. Gait speed (preferred and fast, timed-up-and-go, gait variability and the time to complete an obstacle course were completed before and after the single training session. Results: Motor learning occurred in both the motor imagery training and physical training groups. Motor imagery training led to refinements in motor planning resulting in imagined movements better matching the physically performed movement at the end of training. Motor imagery and physical training also promoted improvements in some locomotion outcomes as demonstrated by medium to large effect size improvements after training for fast gait speed and timed-up-and-go. There were no training effects on gait variability. Conclusion: A single session
Bakshis, A. K.; Tamoshyunas, Y. K.
The vibration characteristics of electric motors were analyzed using mathematical statistics methods. The equipment used and the method of conducting the test are described. Curves are developed to show the visualization of the electric motor vibrations in the vertical direction. Additional curves are included to show the amplitude-phase frequency characteristic of dynamic rotor-housing vibrations at the first lug and the same data for the second lug of the electric motor. Mathematical models were created to show the transmission function of the dynamic rotor housing system.
Chollet, François; Tardy, Jean; Albucher, Jean-François; Thalamas, Claire; Berard, Emilie; Lamy, Catherine; Bejot, Yannick; Deltour, Sandrine; Jaillard, Assia; Niclot, Philippe; Guillon, Benoit; Moulin, Thierry; Marque, Philippe; Pariente, Jérémie; Arnaud, Catherine; Loubinoux, Isabelle
Hemiplegia and hemiparesis are the most common deficits caused by stroke. A few small clinical trials suggest that fluoxetine enhances motor recovery but its clinical efficacy is unknown. We therefore aimed to investigate whether fluoxetine would enhance motor recovery if given soon after an ischaemic stroke to patients who have motor deficits. In this double-blind, placebo-controlled trial, patients from nine stroke centres in France who had ischaemic stroke and hemiplegia or hemiparesis, had Fugl-Meyer motor scale (FMMS) scores of 55 or less, and were aged between 18 years and 85 years were eligible for inclusion. Patients were randomly assigned, using a computer random-number generator, in a 1:1 ratio to fluoxetine (20 mg once per day, orally) or placebo for 3 months starting 5-10 days after the onset of stroke. All patients had physiotherapy. The primary outcome measure was the change on the FMMS between day 0 and day 90 after the start of the study drug. Participants, carers, and physicians assessing the outcome were masked to group assignment. Analysis was of all patients for whom data were available (full analysis set). This trial is registered with ClinicalTrials.gov, number NCT00657163. 118 patients were randomly assigned to fluoxetine (n=59) or placebo (n=59), and 113 were included in the analysis (57 in the fluoxetine group and 56 in the placebo group). Two patients died before day 90 and three withdrew from the study. FMMS improvement at day 90 was significantly greater in the fluoxetine group (adjusted mean 34·0 points [95% CI 29·7-38·4]) than in the placebo group (24·3 points [19·9-28·7]; p=0·003). The main adverse events in the fluoxetine and placebo groups were hyponatraemia (two [4%] vs two [4%]), transient digestive disorders including nausea, diarrhoea, and abdominal pain (14 [25%] vs six [11%]), hepatic enzyme disorders (five [9%] vs ten [18%]), psychiatric disorders (three [5%] vs four [7%]), insomnia (19 [33%] vs 20 [36%]), and partial
Full Text Available In computational neuroscience it is generally accepted that human motor memory contains neural representations of the physics of the musculoskeletal system and the objects in the environment. These representations are called internal models. Force field studies, in which subjects have to adapt to dynamic perturbations induced by a robotic manipulandum, are an established tool to analyze the characteristics of such internal models. The aim of the current study was to investigate whether catch trials during force field learning could influence the consolidation of motor memory in more complex tasks. Thereby, the force field was more than double the force field of previous studies (35 Ns/m. Moreover, the arm of the subjects was not supported. A total of forty-six subjects participated in this study and performed center-out movements at a robotic manipulandum in two different force fields. Two control groups learned force field A on day 1 and were retested in the same force field on day 3 (AA. Two test groups additionally learned an interfering force field B (=-A on day 2 (ABA. The difference between the two test and control groups, respectively, was the absence (0% or presence (19% of catch trials, in which the force field was turned off suddenly. The results showed consolidation of force field A on day 3 for both control groups. Test groups showed no consolidation of force field A (19% catch trials and even poorer performance on day 3 (0% catch trials. In conclusion, it can be stated that catch trials seem to have a positive effect on the performance on day 3 but do not trigger a consolidation process as shown in previous studies that used a lower force field viscosity with supported arm. These findings indicate that the results of previous studies in which less complex tasks were analyzed, cannot be fully transferred to more complex tasks. Moreover, the effects of catch trials in these situations are insufficiently understood and further research
Sugimoto, H; Nishikawa, T; Tsuda, T; Hondou, Y; Akita, Y; Takeda, T; Okazaki, T; Ohashi, S; Yoshida, Y
We present a new high temperature superconductivity (HTS) synchronous motor using the liquid nitrogen as the refrigerant in this paper. This motor is designed to be used as the propulsion motor in ship. Because we use the liquid nitrogen as the refrigerant, it is possible to simplify the cooling equipments in the motor. And in our design, we apply the axial flux type of motor to simplify the cryostat of the HTS wires used to make the field coils. Here, the fields using the bismuth HTS wire for the HTS coils are fixed. Moreover, the cores used in the fields are separated from cryostat, and the armature applies the core-less structure. According to various the electromagnetic field analysis results, the new motor was designed and produced. The diameter of the motor is 650mm, and the width of the motor is 360mm. The motor's rated output is 8.8kW at 100rpm, while the overload output is 44kW, and the maximum efficiency is 97.7%. Also, in order to further miniaturize the motor, other magnetic field analysis have been done when the high-current-density type HTS wire was used and the permendur was used instead of magnetic steel plates. In this case, the motor's rated output is 12kW, and the overload output is 60kW
Sheffler, L.R.; Taylor, P.N.; Gunzler, D.D.; Buurke, Jaap; IJzerman, Maarten Joost; Chae, J.
Objective: To compare the motor relearning effect of a surface peroneal nerve stimulator (PNS) versus usual care on lower limb motor impairment, activity limitation, and quality of life among chronic stroke survivors. Design: Single-blinded randomized controlled trial. Setting: Teaching hospital of
Yoosefinejad, Amin Kordi; Motealleh, Alireza; Abbasalipur, Shekoofeh; Shahroei, Mahan; Sobhani, Sobhan
The aim of this study was to investigate the immediate effects of facilitatory and inhibitory kinesiotaping on motor neuron excitability. Randomized cross-over trial. Twenty healthy people received inhibitory and facilitatory kinesiotaping on two testing days. The H- and M-waves of the lateral gasterocnemius were recorded before and immediately after applying the two modes of taping. The Hmax/Mmax ratio (a measure of motor neuron excitability) was determined and analyzed. The mean Hmax/Mmax ratios were -0.013 (95% CI: -0.033 to 0.007) for inhibitory taping and 0.007 (95% CI: -0.013 to 0.027) for facilitatory taping. The mean difference between groups was -0.020 (95% CI: -0.048 to 0.008). The statistical model revealed no significant differences between the two interventions (P = 0.160). Furthermore, there were no within-group differences in Hmax/Mmax ratio for either group. Our findings did not disclose signs of immediate change in motor neuron excitability in the lateral gasterocnemius. Copyright © 2016. Published by Elsevier Ltd.
Dal-Ré, Rafael; Moher, David; Gluud, Christian
Rafael Dal-Ré and colleagues argue that the recruitment targets and performance of all site investigators in multi-centre clinical trials should be disclosed in trial registration sites before a trial starts, and when it ends.......Rafael Dal-Ré and colleagues argue that the recruitment targets and performance of all site investigators in multi-centre clinical trials should be disclosed in trial registration sites before a trial starts, and when it ends....
Full Text Available Perception in natural environments is inseparably linked to motor action. In fact, we consider action an essential component of perceptual representation. But these representations are inherently difficult to investigate: Traditional experimental setups are limited by the lack of flexibility in manipulating spatial features. To overcome these problems, virtual reality (VR experiments seem to be a feasible alternative, but these setups typically lack ecological realism due to the use of “unnatural” interface-devices (joystick. Thus, we propose an experimental apparatus which combines multisensory perception and action in an ecologically realistic way. The basis is a 10-foot hollow sphere (VirtuSphere placed on a platform that allows free rotation. A subject inside can walk in any direction for any distance immersed into virtual environment. Both the rotation of the sphere and movement of the subject's head are tracked to process the subject's view within the VR-environment presented on a head-mounted display. Moreover, auditory features are dynamically processed taking greatest care of exact alignment of sound-sources and visual objects using ambisonic-encoded audio processed by a HRTF-filterbank. We present empirical data that confirm ecological realism of this setup and discuss its suitability for multi-sensory-motor research.
Mueller, L R; Duke, G E; Evanson, O A
The motor correlate of the migrating myoelectric complex (MMC) was characterized in domestic turkeys, and feeding state, age, sex, and time of day were examined as possible factors influencing the motor activity observed. Strain gauge transducers, and in a few birds Ag-AgCl bipolar electrodes, were implanted on the caudoventral thin muscle of the muscular stomach, the duodenum, ileum, cecum, and colon. Contractility was recorded for 8-10 h per bird on alternating days for 2-3 wk, except in birds involved in four 24-h recording sessions during a 2-wk period. Intense motor activity characteristic of phase III of the MMC occurred only in the ileum; other phases could not be identified. The duration, propagation velocity, and percent of cyclic motor patterns propagating from one site to another were similar to those reported in other galliform species. The occurrence of cyclic motor activity appeared to be related to food consumption; the number of motor patterns occurring during an intense feeding session was less than the number observed 1.5-2 h after feeding. In addition, more motor patterns were recorded in fasted poults during the light period than in the dark; however, the reverse was observed in juveniles fed ad libitum. Cyclic motor activity recorded in fasted 18-wk-old birds was of longer duration than that in fasted 8-wk-old birds. No statistically significant differences were noted in the cyclic motor patterns of male vs. female poults.
Parkinson's disease is characterized by a heterogeneous combination of motor and non motor symptoms. The nigrostriatal dopamine deficit is one of its essential pathophysiologic features. Areas covered: This invited narrative review provides an overlook over current available and future promising non dopaminergic therapeutics to modulate altered dopaminergic neurotransmission in Parkinson's disease. Current research strategies aim to proof clinical efficacy by amelioration of motor symptoms and preponderant levodopa related movement fluctuations. These so-called motor complications are characterized by involuntary movements as a result of an overstimulation of the nigrostriatal dopaminergic system or by temporary recurrence of motor symptoms, when beneficial effects of dopamine substituting drugs vane. Expert opinion: Non dopaminergic modulation of dopamine replacement is currently mostly investigated in well defined and selected patients with motor complications to get approval. However, the world of daily maintenance of patients with its individually adapted, so-called personalised, therapy will determine the real value of these therapeutics. Here the clinical experience of the treating neurologists and the courage to use unconventional drug combinations are essential preconditions for successful treatments of motor and associated non motor complications in cooperation with the patients and their care giving surroundings.
Andrade, João; Cecílio, José; Simões, Marco; Sales, Francisco; Castelo-Branco, Miguel
We aimed to investigate the separability of the neural correlates of 2 types of motor imagery, self and third person (actions owned by the participant himself vs. another individual). If possible this would allow for the development of BCI interfaces to train disorders of action and intention understanding beyond simple imitation, such as autism. We used EEG recordings from 20 healthy participants, as well as electrocorticography (ECoG) in one, based on a virtual reality setup. To test feasibility of discrimination between each type of imagery at the single trial level, time-frequency and source analysis were performed and further assessed by data-driven statistical classification using Support Vector Machines. The main observed differences between self-other imagery conditions in topographic maps were found in Frontal and Parieto-Occipital regions, in agreement with the presence of 2 independent non μ related contributions in the low alpha frequency range. ECOG corroborated such separability. Source analysis also showed differences near the temporo-parietal junction and single-trial average classification accuracy between both types of motor imagery was 67 ± 1%, and raised above 70% when 3 trials were used. The single-trial classification accuracy was significantly above chance level for all the participants of this study (p Person MI use distinct electrophysiological mechanisms detectable at the scalp (and ECOG) at the single trial level, with separable levels of involvement of the mirror neuron system in different regions. These observations provide a promising step to develop new BCI training/rehabilitation paradigms for patients with neurodevelopmental disorders of action understanding beyond simple imitation, such as autism, who would benefit from training and anticipation of the perceived intention of others as opposed to own intentions in social contexts.
Long, Jeffrey D; Mills, James A; Leavitt, Blair R; Durr, Alexandra; Roos, Raymund A; Stout, Julie C; Reilmann, Ralf; Landwehrmeyer, Bernhard; Gregory, Sarah; Scahill, Rachael I; Langbehn, Douglas R; Tabrizi, Sarah J
Predictive genetic testing in Huntington disease (HD) enables therapeutic trials in HTT gene expansion mutation carriers prior to a motor diagnosis. Progression-free survival (PFS) is the composite of a motor diagnosis or a progression event, whichever comes first. To determine if PFS provides feasible sample sizes for trials with mutation carriers who have not yet received a motor diagnosis. This study uses data from the 2-phase, longitudinal cohort studies called Track and from a longitudinal cohort study called the Cooperative Huntington Observational Research Trial (COHORT). Track had 167 prediagnosis mutation carriers and 156 noncarriers, whereas COHORT had 366 prediagnosis mutation carriers and noncarriers. Track studies were conducted at 4 sites in 4 countries (Canada, France, England, and the Netherlands) from which data were collected from January 17, 2008, through November 17, 2014. The COHORT was conducted at 38 sites in 3 countries (Australia, Canada, and the United States) from which data were collected from February 14, 2006, through December 31, 2009. Results from the Track data were externally validated with data from the COHORT. The required sample size was estimated for a 2-arm prediagnosis clinical trial. Data analysis took place from May 1, 2016, to June 10, 2017. The primary end point is PFS. Huntington disease progression events are defined for the Unified Huntington's Disease Rating Scale total motor score, total functional capacity, symbol digit modalities test, and Stroop word test. Of Track's 167 prediagnosis mutation carriers, 93 (55.6%) were women, and the mean (SD) age was 40.06 (8.92) years; of the 156 noncarriers, 87 (55.7%) were women, and the mean (SD) age was 45.58 (10.30) years. Of the 366 COHORT participants, 229 (62.5%) were women and the mean (SD) age was 42.21 (12.48) years. The PFS curves of the Track mutation carriers showed good external validity with the COHORT mutation carriers after adjusting for initial progression. For
Experimentation and research of solid rocket motors are important subjects for aerospace engineering students. However, many institutes in Thailand rarely include experiments on solid rocket motors in research projects of aerospace engineering students, mainly because of the complexity of mixing the explosive propellants. This paper focuses on the design and construction of a solid rocket motor for total impulse in the class I-J that can be utilised as a small sounding rocket by researchers in the near future. Initially, the test stands intended for measuring the pressure in the combustion chamber and the thrust of the solid rocket motor were designed and constructed. The basic design of the propellant configuration was evaluated. Several formulas and ratios of solid propellants were compared for achieving the maximum thrust. The convenience of manufacturing and casting of the fabricated solid rocket motors were a critical consideration. The motor structural analysis such as the combustion chamber wall thickness was also discussed. Several types of nozzles were compared and evaluated for ensuring the maximum thrust of the solid rocket motors during the experiments. The theory of heat transfer analysis in the combustion chamber was discussed and compared with the experimental data.
Lv, Qibao; Yao, Zhiyuan; Li, Xiang
The effects of surface roughness are not considered in the traditional motor model which fails to reflect the actual contact mechanism between the stator and slider. An analytical model for calculating the tangential force of linear ultrasonic motor is proposed in this article. The presented model differs from the previous spring contact model, the asperities in contact between stator and slider are considered. The influences of preload and exciting voltage on tangential force in moving direction are analyzed. An experiment is performed to verify the feasibility of this proposed model by comparing the simulation results with the measured data. Moreover, the proposed model and spring model are compared. The results reveal that the proposed model is more accurate than spring model. The discussion is helpful for designing and modeling of linear ultrasonic motors. Copyright © 2017 Elsevier B.V. All rights reserved.
Jones, Rachel A; Okely, Anthony D; Hinkley, Trina; Batterham, Marijka; Burke, Claire
Educator-led programs for physical activity and motor skill development show potential but few have been implemented and evaluated using a randomized controlled design. Furthermore, few educator-led programs have evaluated both gross motor skills and physical activity. Therefore, the aim of this study was to evaluate a gross motor skill and physical activity program for preschool children which was facilitated solely by childcare educators. A six-month 2-arm randomized controlled trial was implemented between April and September 2012 in four early childhood centers in Tasmania, Australia. Educators participated in ongoing professional development sessions and children participated in structured physical activity lessons and unstructured physical activity sessions. In total, 150 children were recruited from four centers which were randomized to intervention or wait-list control group. Six early childhood educators from the intervention centers were trained to deliver the intervention. Gross motor skills were assessed using the Test of Gross Motor Development (2nd edition) and physical activity was measured objectively using GT3X+ Actigraph accelerometers. No statistically significant differences were identified. However, small to medium effect sizes, in favor of the intervention group, were evident for four of the five gross motor skills and the total gross motor skill score and small to medium effect sizes were reported for all physical activity outcomes. This study highlights the potential of educator-led physical activity interventions and supports the need for further translational trials within the early childhood sector. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Orihuela-Espina, Felipe; Roldán, Giovana Femat; Sánchez-Villavicencio, Israel; Palafox, Lorena; Leder, Ronald; Sucar, Luis Enrique; Hernández-Franco, Jorge
Evidence of superiority of robot training for the hand over classical therapies in stroke patients remains controversial. During the subacute stage, hand training is likely to be the most useful. To establish whether robot active assisted therapies provides any additional motor recovery for the hand when administered during the subacute stage (robot based therapies for hand recovery will show significant differences at subacute stages. A randomized clinical trial. A between subjects randomized controlled trial was carried out on subacute stroke patients (n = 17) comparing robot active assisted therapy (RT) with a classical occupational therapy (OT). Both groups received 40 sessions ensuring at least 300 repetitions per session. Treatment duration was (mean ± std) 2.18 ± 1.25 months for the control group and 2.44 ± 0.88 months for the study group. The primary outcome was motor dexterity changes assessed with the Fugl-Meyer (FMA) and the Motricity Index (MI). Both groups (OT: n = 8; RT: n = 9) exhibited significant improvements over time (Non-parametric Cliff's delta-within effect sizes: dwOT-FMA = 0.5, dwOT-MI = 0.5, dwRT-FMA = 1, dwRT-MI = 1). Regarding differences between the therapies; the Fugl-Meyer score indicated a significant advantage for the hand training with the robot (FMA hand: WRS: W = 8, p hand prehension for RT with respect to OT but failed to reach significance (MI prehension: W = 17.5, p = 0.080). No harm occurred. Robotic therapies may be useful during the subacute stages of stroke - both endpoints (FM hand and MI prehension) showed the expected trend with bigger effect size for the robotic intervention. Additional benefit of the robotic therapy over the control therapy was only significant when the difference was measured with FM, demanding further investigation with larger samples. Implications of this study are important for decision making during therapy administration and resource allocation. Copyright © 2016 Hanley
Fasil, Muhammed; Plesner, Daniel; Walther, Jens Honore
This paper investigates the heat dissipation in the hub motor of an electric two-wheeler using lumped parameter (LP), finite element (FE) and computational fluid dynamic (CFD) models. The motor uses external rotor permanent magnet brushless DC topology and nearly all of its losses are generated...
Frandsen, Tommy Vestergaard; Rasmussen, Peter Omand
This paper presents an investigation of 20% difference between the measured and calculated slip torque of a Motor Integrated Permanent Magnet Gear (MIPMG) prototype. The High Speed (HS) side of the Magnetic Gear (MG) was fixed by loading the motor when conducting the slip torque measurement. Susp...
Overdevest, Gijsbert M; Vleggeert-Lankamp, Carmen L A M; Jacobs, Wilco C H; Brand, Ronald; Koes, Bart W; Peul, Wilco C
In patients with sciatica due to a lumbar disc herniation, it is generally recommended to reserve surgical treatment for those who suffer from intolerable pain or those who demonstrate persistent symptoms after conservative management. Controversy exists about the necessity of early surgical intervention for those patients that have an additional motor deficit. The aim of this study was to compare the recovery of motor deficit among patients receiving early surgery to those receiving prolonged conservative treatment. Subgroup analysis of a randomized controlled trial. This subgroup analysis focuses on 150 (53%) of 283 patients with sciatica due to a lumbar disc herniation and whose symptoms at baseline (before randomization) were accompanied by a motor deficit. Motor deficit was assessed through manual muscle testing and graded according to the Medical Research Council (MRC) scale. In total, 150 patients with 6 to 12 weeks of sciatica due to a lumbar disc herniation and whose symptoms were accompanied by a moderate (MRC Grade 4) or severe (MRC Grade 3) motor deficit were randomly allocated to early surgery or prolonged conservative treatment. Repeated standardized neurologic examinations were performed at baseline and at 8, 26, and 52 weeks after randomization. This study was supported by a grant from the Netherlands Organization for Health Research and Development (ZonMW) and the Hoelen Foundation The Hague. Sciatica recovered among seven (10%) of the 70 patients assigned to early surgery before surgery could be performed, and of the 80 patients assigned to conservative treatment, 32 patients (40%) were treated surgically because of intolerable pain. Baseline severity of motor deficit was graded moderate in 84% of patients and severe in 16% of patients. Motor deficit recovered significantly faster among patients allocated to early surgery (p=.01), but the difference was no longer significant at 26 (p=.21) or 52 weeks (p=.92). At 1 year, complete recovery of motor
Peng, Taijiang; Shi, Hongyan; Liang, Xiong; Luo, Feng; Wu, Xiaoyu
This paper presents a manufacture method for a sandwich structure Ultrasonic Motor (USM) and experiment. Two pieces of rotor clamped on a stator, and a stainless steel disk-spring is bonded on the hollow rotor disk to provide the press by a nut assembled on the shaft. The stator is made of a double-side Printed-Circuit Board (PCB) which is sawed out the ring in the center and connected on the board with three legs. On each side of the ring surface, there are electrodes connected at the same position via through hole. The three layer drive circuit for sine, cosine, and ground signal is connected on the board through each leg. There are many piezoelectric components (PZT) bonded between two electrodes and fill soldering tin on each electrode. Then PZT is welded on PCB by reflow soldering. Finally, rub the gibbous soldering tin down to the position of PZT surface makes sure the surface contacts with rotor evenly. The welding process can also be completed by Surface Mounted Technology (SMT). A prototype motor is manufactured by this method. Two B03 model shapes of the stator are obtained by the finite element analysis and the optimal frequency of the motor is 56.375 kHz measured by impedance instrument. The theoretical analysis is conducted for the relationship between the revolving speed of the USM and thickness of stator ring, number of the travelling waves, PZT amplitude, frequency and the other parameters. The experiment result shows that the maximum revolving speed is 116 RPM and the maximum torque is 25 N mm, when the actuate voltage is 200 VAC. Copyright © 2014 Elsevier B.V. All rights reserved.
Baidak, Y.; Smyk, V.
Using as the base the differential equations system which was presented in relative units for generalized electric motor of hermetic refrigeration compressor, mathematical model of the software for dynamic performance calculation of refrigeration machine compressors drive low-power asynchronous motors was developed. Performed on its ground calculations of the basic model of two-phase electric motor drive of hermetic compressor and the proposed newly developed model of the motor with single-phase stator winding, which is an alternative to the industrial motor winding, have confirmed the benefits of the motor with innovative stator winding over the base engine. Given calculations of the dynamic characteristics of compressor drive motor have permitted to determine the value of electromagnetic torque swinging for coordinating compressor and motor mechanical characteristics, and for taking them into consideration in choosing compressor elements construction materials. Developed and used in the process of investigation of refrigeration compressor drive asynchronous single-phase motor mathematical and software can be considered as an element of computer-aided design system for design of the aggregate of refrigeration compression unit refrigerating machine.
Syaifuddin Mohd, M.; Aziz, A. Rashid A.; Syafiq Mohd, M.
An investigation of axial flux permanent magnet motor (AFPM) characteristics was conducted with a proposed mechanical field weakening control mechanisms (by means of stator-rotor force manipulation) on the motor through modeling and experimentation. By varying the air gap between at least two bistable positions, the peak torque and top speed of the motor can be extended. The motor high efficiency region can also be extended to cover greater part of the motor operating points. An analytical model of the motor had been developed to study the correlation between the total attraction force (between the rotor and the stator) and the operating parameters of the motor. The test results shows that the motor output complies with the prediction of the research hypothesis and it is likely that a spring locking mechanism can be built to dynamically adjust the air gap of the motor to increase the operating range and could be applied in electric drivetrain applications to improve overall efficiency of electric and hybrid electric vehicles.
Robinson, Leah E; Palmer, Kara K; Bub, Kristen L
Self-regulatory skills are broadly defined as the ability to manage emotions, focus attention, and inhibit some behaviors while activating others in accordance with social expectations and are an established indicator of academic success. Growing evidence links motor skills and physical activity to self-regulation. This study examined the efficacy of a motor skills intervention (i.e., the Children's Health Activity Motor Program, CHAMP) that is theoretically grounded in Achievement Goal Theory on motor skill performance and self-regulation in Head Start preschoolers. A sample of 113 Head Start preschoolers (Mage = 51.91 ± 6.5 months; 49.5% males) were randomly assigned to a treatment (n = 68) or control (n = 45) program. CHAMP participants engaged in 15, 40-min sessions of a mastery climate intervention that focused on the development of motor skills over 5 weeks while control participants engaged in their normal outdoor recess period. The Delay of Gratification Snack Task was used to measure self-regulation and the Test of Gross Motor Development-2nd Edition was used to assess motor skills. All measures were assessed prior to and following the intervention. Linear mixed models were fit for both self-regulation and motor skills. Results revealed a significant time × treatment interaction (p motor skills, post hoc comparisons found that all children improved their motor skills (p skills associated with healthy development in children (i.e., motor skills and self-regulation). This efficacy trial provided evidence that CHAMP helped maintain delay of gratification in preschool age children and significantly improved motor skills while participating in outdoor recess was not effective. CHAMP could help contribute to children's learning-related skills and physical development and subsequently to their academic success.
Robinson, Leah E.; Palmer, Kara K.; Bub, Kristen L.
Self-regulatory skills are broadly defined as the ability to manage emotions, focus attention, and inhibit some behaviors while activating others in accordance with social expectations and are an established indicator of academic success. Growing evidence links motor skills and physical activity to self-regulation. This study examined the efficacy of a motor skills intervention (i.e., the Children’s Health Activity Motor Program, CHAMP) that is theoretically grounded in Achievement Goal Theory on motor skill performance and self-regulation in Head Start preschoolers. A sample of 113 Head Start preschoolers (Mage = 51.91 ± 6.5 months; 49.5% males) were randomly assigned to a treatment (n = 68) or control (n = 45) program. CHAMP participants engaged in 15, 40-min sessions of a mastery climate intervention that focused on the development of motor skills over 5 weeks while control participants engaged in their normal outdoor recess period. The Delay of Gratification Snack Task was used to measure self-regulation and the Test of Gross Motor Development-2nd Edition was used to assess motor skills. All measures were assessed prior to and following the intervention. Linear mixed models were fit for both self-regulation and motor skills. Results revealed a significant time × treatment interaction (p motor skills, post hoc comparisons found that all children improved their motor skills (p skills associated with healthy development in children (i.e., motor skills and self-regulation). This efficacy trial provided evidence that CHAMP helped maintain delay of gratification in preschool age children and significantly improved motor skills while participating in outdoor recess was not effective. CHAMP could help contribute to children’s learning-related skills and physical development and subsequently to their academic success. PMID:27660751
Deserno, Thomas M; Keszei, András P
Background/aims Randomization is indispensable in clinical trials in order to provide unbiased treatment allocation and a valid statistical inference. Improper handling of allocation lists can be avoided using central systems, for example, human-based services. However, central systems are unaffordable for investigator-initiated trials and might be inaccessible from some places, where study subjects need allocations. We propose mobile access to virtual randomization, where the randomization lists are non-existent and the appropriate allocation is computed on demand. Methods The core of the system architecture is an electronic data capture system or a clinical trial management system, which is extended by an R interface connecting the R server using the Java R Interface. Mobile devices communicate via the representational state transfer web services. Furthermore, a simple web-based setup allows configuring the appropriate statistics by non-statisticians. Our comprehensive R script supports simple randomization, restricted randomization using a random allocation rule, block randomization, and stratified randomization for un-blinded, single-blinded, and double-blinded trials. For each trial, the electronic data capture system or the clinical trial management system stores the randomization parameters and the subject assignments. Results Apps are provided for iOS and Android and subjects are randomized using smartphones. After logging onto the system, the user selects the trial and the subject, and the allocation number and treatment arm are displayed instantaneously and stored in the core system. So far, 156 subjects have been allocated from mobile devices serving five investigator-initiated trials. Conclusion Transforming pre-printed allocation lists into virtual ones ensures the correct conduct of trials and guarantees a strictly sequential processing in all trial sites. Covering 88% of all randomization models that are used in recent trials, virtual randomization
Kwon, Jeong-Yi; Chang, Hyun Jung; Yi, Sook-Hee; Lee, Ji Young; Shin, Hye-Yeon; Kim, Yun-Hee
To examine whether hippotherapy has a clinically significant effect on gross motor function in children with cerebral palsy (CP). Randomized controlled trial. Outpatient therapy center. Ninety-two children with CP, aged 4-10 years, presenting variable function (Gross Motor Function Classification System [GMFCS] levels I-IV). Hippotherapy (30 minutes twice weekly for 8 consecutive weeks). Gross Motor Function Measure (GMFM)-88, GMFM-66, and Pediatric Balance Scale. Pre- and post-treatment measures were completed by 91 children (45 in the intervention group and 46 in the control group). Differences in improvement on all three measures significantly differed between groups after the 8-week study period. Dimensions of GMFM-88 improved significantly after hippotherapy varied by GMFCS level: dimension E in level I, dimensions D and E in level II, dimensions C and D in level III, and dimensions B and C in level IV. Hippotherapy positively affects gross motor function and balance in children with CP of various functional levels.
Macedo, Luciana G; Latimer, Jane; Maher, Chris G; Hodges, Paul W; Nicholas, Michael; Tonkin, Lois; McAuley, James H; Stafford, Ryan
Background Chronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded activity and motor control exercises. At present however, there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money are wasted on treatments which ultimately fail to help the patient. Methods This paper describes the protocol of a randomised clinical trial comparing the effects of motor control exercises with a graded activity program in the treatment of chronic non specific low back pain. Further analysis will identify clinical features that may predict a patient's response to each treatment. One hundred and seventy two participants will be randomly allocated to receive either a program of motor control exercises or graded activity. Measures of outcome will be obtained at 2, 6 and 12 months after randomisation. The primary outcomes are: pain (average pain intensity over the last week) and function (patient-specific functional scale) at 2 and 6 months. Potential treatment effect modifiers will be measured at baseline. Discussion This trial will not only evaluate which exercise approach is more effective in general for patients will chronic low back pain, but will also determine which exercise approach is best for an individual patient. Trial registration number ACTRN12607000432415 PMID:18454877
McAuley James H
Full Text Available Abstract Background Chronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded activity and motor control exercises. At present however, there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money are wasted on treatments which ultimately fail to help the patient. Methods This paper describes the protocol of a randomised clinical trial comparing the effects of motor control exercises with a graded activity program in the treatment of chronic non specific low back pain. Further analysis will identify clinical features that may predict a patient's response to each treatment. One hundred and seventy two participants will be randomly allocated to receive either a program of motor control exercises or graded activity. Measures of outcome will be obtained at 2, 6 and 12 months after randomisation. The primary outcomes are: pain (average pain intensity over the last week and function (patient-specific functional scale at 2 and 6 months. Potential treatment effect modifiers will be measured at baseline. Discussion This trial will not only evaluate which exercise approach is more effective in general for patients will chronic low back pain, but will also determine which exercise approach is best for an individual patient. Trial registration number ACTRN12607000432415
Kao, Ching-Chiu; Chiu, Huei-Ling; Liu, Doresses; Chan, Pi-Tuan; Tseng, Ing-Jy; Chen, Ruey; Niu, Shu-Fen; Chou, Kuei-Ru
Aging is a normal degenerative process that results in a decline in the gait and balance performance of older adults. Interactive cognitive motor training is an intervention that integrates cognitive and motor tasks to promote individuals' physical and cognitive fall risk factors. However, the additive effects of the interactive cognitive motor training on objective quantitative data and comprehensive descriptions of gait and balance warrants further investigation. To investigate the effect of interactive cognitive motor training on older adults' gait and balance from immediate to long-term time points. A double-blind randomized control trial. Four senior service centers and community service centers in Taiwan. 62 older adults who met the inclusion criteria. The study participants were older adults without cognitive impairment, and they were randomly allocated to the experimental group or active control group. In both groups, older adults participated in three sessions of 30-min training per week for a total of 8 weeks, with the total number of training sessions being 24. The primary outcome was gait performance, which was measured using objective and subjective indicators. iWALK was used as an objective indicator to measure pace and dynamic stability; the Functional Gait Assessment was employed as a subjective indicator. The secondary outcome was balance performance, which was measured using iSWAY. A generalized estimating equation was used to identify whether the results of the two groups differ after receiving different intervention measures; the results were obtained from immediate to long-term posttests. Stride length in the pace category of the experimental group improved significantly in immediate posttest (p = 0.01), 3-month follow-up (p = 0.01), and 6-month follow-up (p = 0.04). The range of motion of the leg exhibited significant improvement in immediate posttest (p = 0.04) and 3-month follow-up (p = 0.04). The Functional Gait
Schauer, Michael; Mauritz, Karl-Heinz
To demonstrate the effect of rhythmical auditory stimulation in a musical context for gait therapy in hemiparetic stroke patients, when the stimulation is played back measure by measure initiated by the patient's heel-strikes (musical motor feedback). Does this type of musical feedback improve walking more than a less specific gait therapy? The randomized controlled trial considered 23 registered stroke patients. Two groups were created by randomization: the control group received 15 sessions of conventional gait therapy and the test group received 15 therapy sessions with musical motor feedback. Inpatient rehabilitation hospital. Median post-stroke interval was 44 days and the patients were able to walk without technical aids with a speed of approximately 0.71 m/s. Gait velocity, step duration, gait symmetry, stride length and foot rollover path length (heel-on-toe-off distance). The test group showed more mean improvement than the control group: stride length increased by 18% versus 0%, symmetry deviation decreased by 58% versus 20%, walking speed increased by 27% versus 4% and rollover path length increased by 28% versus 11%. Musical motor feedback improves the stroke patient's walk in selected parameters more than conventional gait therapy. A fixed memory in the patient's mind about the song and its timing may stimulate the improvement of gait even without the presence of an external pacemaker.
Hestbaek, Lise; Andersen, Sarah Thurøe; Skovgaard, Thomas; Olesen, Line Groenholt; Elmose, Mette; Bleses, Dorthe; Andersen, Simon Calmar; Lauridsen, Henrik Hein
Good motor skills are considered important for children's physical, social, and psychological development, but the relationship is still poorly understood. Preschool age seems to be decisive for the development of motor skills and probably the most promising time-window in relation to preventive strategies based on improved motor skills. This research program has four overall aims: (1) investigation of the effect of a structured program aimed at improving motor skills in 3-6-year-old children on current and future motor skills, health, cognition, and wellbeing; (2) establish reference data on motor skills in 3-6-year-olds; (3) description of early development of musculoskeletal problems; and (4) establishment of a population-based cohort of 3-6-year-olds. Over a four-year period, all preschools in a Danish municipality, Svendborg, will implement a new program aimed at optimizing children's motor skills. By introducing the program into a subset of the preschools at onset and comparing these children to another subset (control) that will not receive the intervention the first three years, it is possible to document a potential effect of the intervention. At the same time, a cohort will be established including all children attending preschools in the municipality with extensive baseline data collection: gross and fine motor skills; movement patterns; musculoskeletal complaints; physical activity; anthropometry; general wellbeing; cognitive abilities; language status; medical history; demographic background; and more. The children are aged 3-6 years at baseline. A total of 1461 children have been invited into the cohort, 368 to the intervention arm and 359 to the control arm. Follow-up time for the trial is 2.5 years. The cohort is planned to run at least until the children leave school at age 15-16 years. Longer follow-up will depend on future funding. If the results of the trial are positive, the intervention can be implemented in other similar settings with
Kandel, Sonia; Perret, Cyril
Learning how to write involves the automation of grapho-motor skills. One of the factors that determine automaticity is "motor anticipation." This is the ability to write a letter while processing information on how to produce following letters. It is essential for writing fast and smoothly. We investigated how motor anticipation…
Leah Elizabeth Robinson
Full Text Available Self-regulatory skills are broadly defined as the ability to manage emotions, focus attention, and inhibit some behaviors while activating others in accordance with social expectations and are an established indicator of academic success. Growing evidence links motor skills and physical activity to self-regulation. This study examined the efficacy of a motor skills intervention (i.e., the Children’s Health Activity Motor Program, CHAMP that is theoretically grounded in Achievement Goal Theory on motor skill performance and self-regulation in Head Start preschoolers. A sample of 113 Head Start preschoolers (Mage = 51.91 + 6.5 months; 49.5% males were randomly assigned to a treatment (n = 68 or control (n = 45 program. CHAMP participants engaged in 15, 40-minute sessions of a mastery climate intervention that focused on the development of motor skills over 5 weeks while control participants engaged in their normal outdoor recess period. The Delay of Gratification Snack Task was used to measure self-regulation and the Test of Gross Motor Development - 2nd Edition was used to assess motor skills. All measures were assessed prior to and following the intervention. Linear mixed models were fit for both self-regulation and motor skills. Results revealed a significant time*treatment interaction (p < .001. In regards to motor skills, post hoc comparisons found that all children improved their motor skills (p < .05, but the CHAMP group improved significantly more than the control group (p < .001. Children in CHAMP maintained their self-regulation scores across time while children in the control group scored significantly lower than the CHAMP group at the posttest (p < .05. CHAMP is a mastery climate movement program that may be an approach to enhance skills associated with healthy development in children (i.e., motor skills and self-regulation. This efficacy trial provided evidence that CHAMP helped maintain delay of gratification in preschool age
On this base, the author offered to provide in the legislation of Ukraine requirements to inform in advance subjects about the presence or absence of post-trial access and to evaluate these provisions by ethics committees before and at the end of all trials in order to determine its real need in each individual case. The scope of the right on post-trial access to investigational treatment must be reasonably weighed in order to avoid, on the one hand, becoming an excessive stimulus for the subjects, and, on the other hand, not leading to a situation where on such regulation conducting of clinical trials in the country will no longer be appropriate.
Full Text Available Recently, electric vehicle motoring has become a topic of interest, due to the several problems caused by thermal engines such as pollution and high oil prices. Thus, electric motors are increasingly applied in vehicle’ applications and relevant research about these motors and their applications has been performed. Of particular interest are the improvements regarding torque production capability, the minimization of torque ripple and iron losses. The present work deals with the optimum design and the performance investigation of an outer rotor permanent magnet motor for in-wheel electric vehicle application. At first, and in order to find the optimum motor design, a new based particle-swarm multi-objective optimization procedure is applied. Three objective functions are used: efficiency maximization, weight and ripple torque minimization. Secondly, the effects of the permanent magnets segmentation, the stator slots opening, and the separation of adjacent magnets by air are outlined. The aim of the paper is the design of a topology with smooth output torque, low ripple torque, low iron losses and mechanical robustness.
Full Text Available Learning a motor task with temporally spaced presentations or with other tasks intermixed between presentations reduces performance during training, but can enhance retention post training. These two effects are known as the spacing and contextual interference effect, respectively. Here, we aimed at testing a unifying hypothesis of the spacing and contextual interference effects in visuomotor adaptation, according to which forgetting between trials due to either spaced presentations or interference by another task will promote between-trial forgetting, which will depress performance during acquisition, but will promote retention. We first performed an experiment with three visuomotor adaptation conditions: a short inter-trial-interval (ITI condition (SHORT-ITI; a long ITI condition (LONG-ITI; and an alternating condition with two alternated opposite tasks (ALT, with the same single-task ITI as in LONG-ITI. In the SHORT-ITI condition, there was fastest increase in performance during training and largest immediate forgetting in the retention tests. In contrast, in the ALT condition, there was slowest increase in performance during training and little immediate forgetting in the retention tests. Compared to these two conditions, in the LONG-ITI, we found intermediate increase in performance during training and intermediate immediate forgetting. To account for these results, we fitted to the data six possible adaptation models with one or two time scales, and with interference in the fast, or in the slow, or in both time scales. Model comparison confirmed that two time scales and some degree of interferences in either time scale are needed to account for our experimental results. In summary, our results suggest that retention following adaptation is modulated by the degree of between-trial forgetting, which is due to time-based decay in single adaptation task and interferences in multiple adaptation tasks.
Full Text Available Recent research on mental representation of complex action has revealed distinct differences in the structure of representational frameworks between experts and novices. More recently, research on the development of mental representation structure has elicited functional changes in novices' representations as a result of practice. However, research investigating if and how mental practice adds to this adaptation process is lacking. In the present study, we examined the influence of mental practice (i.e., motor imagery rehearsal on both putting performance and the development of one's representation of the golf putt during early skill acquisition. Novice golfers (N = 52 practiced the task of golf putting under one of four different practice conditions: mental, physical, mental-physical combined, and no practice. Participants were tested prior to and after a practice phase, as well as after a three day retention interval. Mental representation structures of the putt were measured, using the structural dimensional analysis of mental representation. This method provides psychometric data on the distances and groupings of basic action concepts in long-term memory. Additionally, putting accuracy and putting consistency were measured using two-dimensional error scores of each putt. Findings revealed significant performance improvements over the course of practice together with functional adaptations in mental representation structure. Interestingly, after three days of practice, the mental representations of participants who incorporated mental practice into their practice regime displayed representation structures that were more similar to a functional structure than did participants who did not incorporate mental practice. The findings of the present study suggest that mental practice promotes the cognitive adaptation process during motor learning, leading to more elaborate representations than physical practice only.
Lu, Kaiyuan; Rasmussen, Peter Omand; Ritchie, Ewen
Knowledge of actual flux linkage versus current profiles plays an important role in design verification and performance prediction for switched reluctance motors (SRM's) and permanent magnet motors (PMM's). Various measurement methods have been proposed and discussed so far but each method has its...
Park, Myoung-Ok; Lee, Sang-Heon
Preservation and enhancement of cognitive function are essential for the restoration of functional abilities and independence following stroke. While cognitive-motor dual-task training (CMDT) has been utilized in rehabilitation settings, many patients with stroke experience impairments in cognitive function that can interfere with dual-task performance. In the present study, we investigated the effects of CMDT combined with auditory motor synchronization training (AMST) utilizing rhythmic cues on cognitive function in patients with stroke. The present randomized controlled trial was conducted at a single rehabilitation hospital. Thirty patients with chronic stroke were randomly divided an experimental group (n = 15) and a control group (n = 15). The experimental group received 3 CMDT + AMST sessions per week for 6 weeks, whereas the control group received CMDT only 3 times per week for 6 weeks. Changes in cognitive function were evaluated using the trail making test (TMT), digit span test (DST), and stroop test (ST). Significant differences in TMT-A and B (P = .001, P = .001), DST-forward (P = .001, P = .001), DST-backward (P = .000, P = .001), ST-word (P = .001, P = .001), and ST-color (P = .002, P = .001) scores were observed in both the control and experimental groups, respectively. Significant differences in TMT-A (P = .001), DST-forward (P = .027), DST-backward (P = .002), and ST-word (P = .025) scores were observed between the 2 groups. Performance speed on the TMT-A was faster in the CMDT + AMST group than in the CMDT group. Moreover, DST-forward and DST-backward scores were higher in the CMDT + AMST group than in the CDMT group. Although ST-color results were similar in the 2 groups, ST-word scores were higher in the CMDT + AMST group than in the CMDT group. This finding indicates that the combined therapy CMDT and AMST can be used to increase attention, memory, and executive
Full Text Available Introduction: Vehicle engine id one of the main sources of noise which its level is influenced by various parameters. The aim of this study was to investigate the impact of motor oils quality before and after oil change on the variability of vehicle engine induced noise level. In this study it is tried to follow-up the efficacy of motor oil quality on engines sound level. Material and Method: First, engine noise of 94 vehicles were recorded for 30 seconds before and after oil change and all the vehicles technical information including mileage, type of motor oil, and type of vehicle were registered. Following, the recorded noises were calibrated in semi-anechoic chamber and the sound pressure levels were measured with A and C-weighting network and main octav bands, using a sound level meters. The obtained results analyzed using SPSS software version 17. Results: The effects of motor oil quality on different noise levels of engines were determined and a significant reduction in noise level of vehicles engine was observed. Investigation of the relationship between mileage and motor oil quality on various engines sound level manifested that vehicles with mileage ranged 100000-150000 miles had significant reduction in their sound pressure levels in comparison with other vehicles. Conclusion: The results revealed that engine oil is among factors reducing the vehicle engine induced noise level. Moreover, the engine oil type and the vehicle mileage are key variables which determine the impact of engine oil quality on reduction of the sound level of vehicles engine.
Full Text Available This article experimentally and numerically investigates the thermal performance of a 2350-kW completely enclosed motor, which is cooled through an air-to-air heat exchanger. The air in the heat exchanger includes external and internal flow paths. The external air driven by the rotation of the centrifugal fan goes through the heat exchanger mounted on the top of the frame. The internal air absorbs heat released from the stator and the rotor and then transfers the heat to the heat exchanger through the motion of two axial fans and the rotor. Several test rigs have been set up to measure the performance of the fan and the motor. The Fluent software package is adopted to analyze the complicated thermal-fluid interactions among the centrifugal fan, two axial fans, heat exchanger, stator, and rotor. The measured data, including the fan performance curves and the temperature profiles of the heat exchanger and the stator, show good agreement with the simulated results. The numerical calculations also show that the nonuniform external flow distribution through the heat exchanger and the air leakage between the axial fan and the rotor reduces the cooling ability of the motor. A detailed discussion is also included to improve the motor cooling performance.
Full Text Available Engineers think that pole embrace size of a PM BLDC motor affects directly the efficiency and the torque. Dealing with theexperimental research, in the studywe have investigated the effects of narrowing rotor pole embrace step by step by changing sizes parametrically. By doing so, high efficiency and low cogging torque would have been obtained for a 20 W PM BLDC motor. In order to do this,pole arc to pole pitch ratio of magnets at the rotor poles has been changed parametrically (0.5 to 1 by genetic algorithm methodfirst. Then the electromagnetic field dispersions, output parameters of the motor, new rotor constructions have been obtained; and new pole embrace has been derived from the variation of pole arc to pole pitch ratio. We have also calculatedthe magnetic flux distribution, output power, torque, cogging torque and efficiency values analytically and the effects of new pole embrace to motor efficiency and torque have been simulated. The developed 18 slots, 6 poles, surface mounted inner runner configuration rotor machine is proposed as to be used insmall dentistry apparatus.
Nana, B.; Fautso Kuiate, G.; Yamgoué, S. B.
This paper presents theoretical and experimental results on the investigation of the dynamics of a nonlinear electromechanical system made of a lever arm actuated by a DC motor and controlled through a repulsive magnetic force. We use the method of harmonic balance to derive oscillatory solutions. Theoretical tools such as, bifurcation diagrams, Lyapunov exponents, phase portraits, are used to unveil the rich nonlinear behavior of the system including chaos and hysteresis. The experimental results are in close accordance with the theoretical predictions.
A. Osman KURBAN
Full Text Available In this study, the slippers being the most effective on the performance of swash plate type axial piston pumps and motors, which is a good example of hydrodynamic-hydrostatic bearing applications, have been investigated. With respect to this, having derived the viscous moment loss, viscous flow leakage loss and power loss equations, the variations of these parameters under different operating conditions have been examined experimentally.
Causby, Ryan S; McDonnell, Michelle N; Reed, Lloyd; Hillier, Susan L
The process of using a scalpel, like all other motor activities, is dependent upon the successful integration of afferent (sensory), cognitive and efferent (motor) processes. During learning of these skills, even if motor practice is carefully monitored there is still an inherent risk involved. It is also possible that this strategy could reinforce high levels of anxiety experienced by the student and affect student self-efficacy, causing detrimental effects on motor learning. An alternative training strategy could be through targeting sensory rather than motor processes. Second year podiatry students who were about to commence learning scalpel skills were recruited. Participants were randomly allocated into sensory awareness training (Sensory), additional motor practice (Motor) or usual teaching only (Control) groups. Participants were then evaluated on psychological measures (Intrinsic Motivation Inventory) and dexterity measures (Purdue Pegboard, Grooved Pegboard Test and a grip-lift task). A total of 44 participants were included in the study. There were no baseline differences or significant differences between the three groups over time on the Perceived Competence, Effort/ Importance or Pressure/ Tension, psychological measures. All groups showed a significant increase in Perceived Competence over time (F 1,41 = 13.796, p = 0.001). Only one variable for the grip-lift task (Preload Duration for the non-dominant hand) showed a significant difference over time between the groups (F 2,41 = 3.280, p = 0.038), specifically, Motor and Control groups. The use of sensory awareness training, or additional motor practice did not provide a more effective alternative compared with usual teaching. Further research may be warranted using more engaged training, provision of supervision and greater participant numbers. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001428459 . Registered 13 th October 2016. Registered Retrospectively.
Silva, Adriana Teresa; Dias, Miqueline Pivoto Faria; Calixto, Ruanito; Carone, Antonio Luis; Martinez, Beatriz Bertolaccini; Silva, Andreia Maria; Honorato, Donizeti Cesar
The aim of this study was to investigate the acute effects of whole-body vibration on the motor function of patients with stroke. The present investigation was a randomized clinical trial studying 43 individuals with hemiparesis after stroke, with 33 subjects allocated to the intervention group and 10 subjects allocated to the control group. The intervention group was subjected to one session of vibration therapy (frequency of 50 Hz and amplitude of 2 mm) comprising four 1-min series with 1-min rest intervals between series in three body positions: bipedal stances with the knees flexed to 30 degrees and 90 degrees and a unipedal stance on the paretic limb. The analytical tests were as follows: simultaneous electromyography of the affected and unaffected tibialis anterior and rectus femoris muscles bilaterally in voluntary isometric contraction; the Six-Minute Walk Test; the Stair-Climb Test; and the Timed Get-Up-and-Go Test. The data were analyzed by independent and paired t tests and by analysis of covariance. There was no evidence of effects on the group and time interaction relative to variables affected side rectus femoris, unaffected side rectus femoris, affected side tibialis anterior, unaffected side tibialis anterior, and the Stair-Climb Test (P > 0.05). There was evidence of effects on the group interaction relative to variables Six-Minute Walk Test and Timed Get-Up-and-Go Test (P < 0.05). Whole-body vibration contributed little to improve the functional levels of stroke patients.
Zsurzsan, Tiberiu-Gabriel; Andersen, Michael A. E.; Zhang, Zhe
The Piezoelectric Actuator Drive (PAD) is an accurate, high-torque rotary piezoelectric motor that employs piezoelectric stack actuators and inverse hypocycloidal motion to generate rotation. Important factors that determine motor performance are the proper concentric alignment between the motor...
Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G
Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.
Ramirez, Agnese; Crisafulli, Sebastiano G; Rizzuti, Mafalda; Bresolin, Nereo; Comi, Giacomo P; Corti, Stefania; Nizzardo, Monica
Spinal muscular atrophy (SMA) is an autosomal-recessive childhood motor neuron disease and the main genetic cause of infant mortality. SMA is caused by deletions or mutations in the survival motor neuron 1 ( SMN1 ) gene, which results in SMN protein deficiency. Only one approved drug has recently become available and allows for the correction of aberrant splicing of the paralogous SMN2 gene by antisense oligonucleotides (ASOs), leading to production of full-length SMN protein. We have already demonstrated that a sequence of an ASO variant, Morpholino (MO), is particularly suitable because of its safety and efficacy profile and is both able to increase SMN levels and rescue the murine SMA phenotype. Here, we optimized this strategy by testing the efficacy of four new MO sequences targeting SMN2 . Two out of the four new MO sequences showed better efficacy in terms of SMN protein production both in SMA induced pluripotent stem cells (iPSCs) and SMAΔ7 mice. Further, the effect was enhanced when different MO sequences were administered in combination. Our data provide an important insight for MO-based treatment for SMA. Optimization of the target sequence and validation of a treatment based on a combination of different MO sequences could support further pre-clinical studies and the progression toward future clinical trials.
Frolov, Alexander A; Mokienko, Olesya; Lyukmanov, Roman; Biryukova, Elena; Kotov, Sergey; Turbina, Lydia; Nadareyshvily, Georgy; Bushkova, Yulia
Repeated use of brain-computer interfaces (BCIs) providing contingent sensory feedback of brain activity was recently proposed as a rehabilitation approach to restore motor function after stroke or spinal cord lesions. However, there are only a few clinical studies that investigate feasibility and effectiveness of such an approach. Here we report on a placebo-controlled, multicenter clinical trial that investigated whether stroke survivors with severe upper limb (UL) paralysis benefit from 10 BCI training sessions each lasting up to 40 min. A total of 74 patients participated: median time since stroke is 8 months, 25 and 75% quartiles [3.0; 13.0]; median severity of UL paralysis is 4.5 points [0.0; 30.0] as measured by the Action Research Arm Test, ARAT, and 19.5 points [11.0; 40.0] as measured by the Fugl-Meyer Motor Assessment, FMMA. Patients in the BCI group ( n = 55) performed motor imagery of opening their affected hand. Motor imagery-related brain electroencephalographic activity was translated into contingent hand exoskeleton-driven opening movements of the affected hand. In a control group ( n = 19), hand exoskeleton-driven opening movements of the affected hand were independent of brain electroencephalographic activity. Evaluation of the UL clinical assessments indicated that both groups improved, but only the BCI group showed an improvement in the ARAT's grasp score from 0 [0.0; 14.0] to 3.0 [0.0; 15.0] points ( p exoskeleton-assisted physical therapy can improve post-stroke rehabilitation outcomes. Both maximum and mean values of the percentage of successfully decoded imagery-related EEG activity, were higher than chance level. A correlation between the classification accuracy and the improvement in the upper extremity function was found. An improvement of motor function was found for patients with different duration, severity and location of the stroke.
Full Text Available Interactive cognitive-motor training (ICMT requires individuals to perform both gross motor movements and complex information processing. This study investigated the effectiveness of ICMT on cognitive functions associated with falls in older adults.A single-blinded randomized controlled trial was conducted in community-dwelling older adults (N = 90, mean age 81.5±7 without major cognitive impairment. Participants in the intervention group (IG played four stepping games that required them to divide attention, inhibit irrelevant stimuli, switch between tasks, rotate objects and make rapid decisions. The recommended minimum dose was three 20-minute sessions per week over a period of 16 weeks unsupervised at home. Participants in the control group (CG received an evidence-based brochure on fall prevention. Measures of processing speed, attention/executive function (EF, visuo-spatial ability, concerns about falling and depression were assessed before and after the intervention.Eighty-one participants (90% attended re-assessment. There were no improvements with respect to the Stroop Stepping Test (primary outcome in the intervention group. Compared to the CG, the IG improved significantly in measures of processing speed, visuo-spatial ability and concern about falling. Significant interactions were observed for measures of EF and divided attention, indicating group differences varied for different levels of the covariate with larger improvements in IG participants with poorer baseline performance. The interaction for depression showed no change for the IG but an increase in the CG for those with low depressive symptoms at baseline. Additionally, low and high-adherer groups differed in their baseline performance and responded differently to the intervention. Compared to high adherers, low adherers improved more in processing speed and visual scanning while high-adherers improved more in tasks related to EF.This study shows that unsupervised stepping
Arya, Kamal Narayan; Pandian, Shanta; Kumar, Dharmendra; Puri, Vinod
To establish the effect of the task-based mirror therapy (TBMT) on the upper limb recovery in stroke. A pilot, randomized, controlled, assessor-blinded trial was conducted in a rehabilitation institute. A convenience sample of 33 poststroke (mean duration, 12.5 months) hemiparetic subjects was randomized into 2 groups (experimental, 17; control, 16). The subjects were allocated to receive either TBMT or standard motor rehabilitation-40 sessions (5/week) for a period of 8 weeks. The TBMT group received movements using various goal-directed tasks and a mirror box. The movements were performed by the less-affected side superimposed on the affected side. The main outcome measures were Brunnstrom recovery stage (BRS) and Fugl-Meyer assessment (FMA)-FMA of upper extremity (FMA-UE), including upper arm (FMA-UA) and wrist-hand (FMA-WH). The TBMT group exhibited highly significant improvement on mean scores of FMA-WH (P hemiparesis. MT using tasks may be used as an adjunct in stroke rehabilitation. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Flower, Andrew; Witt, Claudia; Liu, Jian Ping; Ulrich-Merzenich, Gudrun; Yu, He; Lewith, George
ETHNOGRAPHIC RELEVANCE: Clinical trials investigating Chinese herbal medicine (CHM) have been frequently criticised for their lack of scientific rigour. As part of the GP-TCM project a team of experienced clinical researchers and CHM practitioners have developed clinical trial guidelines for CHM that combine an appreciation for traditional methods of practice with detailed and practical advice on research methodology. This paper presents an executive summary of this work. It introduces the practice of CHM and the key considerations that need to be addressed whilst researching this traditional medical system. These guidelines emphasise the importance of identifying best practice, and then developing and applying appropriate and rigorous research methodologies to investigate CHM as a whole system. It is hoped that this will encourage a thoughtful and meticulous process of investigation that will clarify the contribution that CHM can make to our future healthcare. Innovative new approaches are considered including the application of the new "omic" technologies and systems biology as a way of enhancing our understanding of traditional practice. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Zhang, Shuai; Hu, Fan; Zhang, Weihua
Although hybrid rocket motor is prospected to have distinct advantages over liquid and solid rocket motor, low regression rate and insufficient efficiency are two major disadvantages which have prevented it from being commercially viable. In recent years, complex fuel grain configurations are attractive in overcoming the disadvantages with the help of Rapid Prototyping technology. In this work, an attempt has been made to numerically investigate the flow field characteristics and local regression rate distribution inside the hybrid rocket motor with complex star swirl grain. A propellant combination with GOX and HTPB has been chosen. The numerical model is established based on the three dimensional Navier-Stokes equations with turbulence, combustion, and coupled gas/solid phase formulations. The calculated fuel regression rate is compared with the experimental data to validate the accuracy of numerical model. The results indicate that, comparing the star swirl grain with the tube grain under the conditions of the same port area and the same grain length, the burning surface area rises about 200%, the spatially averaged regression rate rises as high as about 60%, and the oxidizer can combust sufficiently due to the big vortex around the axis in the aft-mixing chamber. The combustion efficiency of star swirl grain is better and more stable than that of tube grain.
Wicklow, Brandy; Gallo, Sina; Majnemer, Annette; Vanstone, Catherine; Comeau, Kathryn; Jones, Glenville; L'Abbe, Mary; Khamessan, Ali; Sharma, Atul; Weiler, Hope; Rodd, Celia
In addition to benefits for bone health, vitamin D is implicated in muscle function in children and adults. To determine if vitamin D dosage positively correlated with gross motor development at 3 and 6 months of age. We hypothesized that higher doses would be associated with higher scores for gross motor skills. A consecutive sample of 55 healthy, term, and breastfed infants from Montreal, Canada were recruited from a randomized trial of vitamin D supplementation between 2009 and 2012. Infants were randomized to 400 International Units (IU) (n = 19), 800 IU (n = 18) or 1,200 IU (n = 18) vitamin D3/day. Motor performance at 3 and 6 months was quantified by the Alberta Infant Motor Scale (AIMS). Plasma vitamin D3 metabolites were measured by tandem mass spectrometry. AIMS scores did not differ at 3 months. However, total AIMS scores and sitting subscores were significantly higher at 6 months in infants receiving 400 IU/day compared to 800 IU/day and 1,200 IU/day groups (p gross motor achievements were significantly higher in infants receiving 400 IU/day vitamin D. Our findings also support longer infants being slightly delayed.
Liu, Yan-Ci; Yang, Yea-Ru; Tsai, Yun-An; Wang, Ray-Yau
This study investigated effects of cognitive and motor dual task gait training on dual task gait performance in stroke. Participants (n = 28) were randomly assigned to cognitive dual task gait training (CDTT), motor dual task gait training (MDTT), or conventional physical therapy (CPT) group. Participants in CDTT or MDTT group practiced the cognitive or motor tasks respectively during walking. Participants in CPT group received strengthening, balance, and gait training. The intervention was 30 min/session, 3 sessions/week for 4 weeks. Three test conditions to evaluate the training effects were single walking, walking while performing cognitive task (serial subtraction), and walking while performing motor task (tray-carrying). Parameters included gait speed, dual task cost of gait speed (DTC-speed), cadence, stride time, and stride length. After CDTT, cognitive-motor dual task gait performance (stride length and DTC-speed) was improved (p = 0.021; p = 0.015). After MDTT, motor dual task gait performance (gait speed, stride length, and DTC-speed) was improved (p = 0.008; p = 0.008; p = 0.008 respectively). It seems that CDTT improved cognitive dual task gait performance and MDTT improved motor dual task gait performance although such improvements did not reach significant group difference. Therefore, different types of dual task gait training can be adopted to enhance different dual task gait performance in stroke.
Frandsen, Tommy Vestergaard; Rasmussen, Peter Omand
to reduce 3D eddy currents in the machine. Material is removed and new parts are made in a non-conducting material. After the modifications of the prototype, the rotational losses have been measured and compared to the earlier measurements and the 2D based calculated losses. The rotational losses have been......This paper presents a practical investigation of the eddy current losses caused by 3D effects in a Motor Integrated Permanent Magnet Gear (MIPMG). Two prototypes of a MIPMG have been designed and build to be used as traction units for an electric vehicle. The measured efficiency of the prototype...
Hamilton, F; Rochester, L; Paul, L; Rafferty, D; O'Leary, C P; Evans, J J
Deficits in motor functioning, including walking, and in cognitive functions, including attention, are known to be prevalent in multiple sclerosis (MS), though little attention has been paid to how impairments in these areas of functioning interact. This study investigated the effects of performing a concurrent cognitive task when walking in people with MS. Level of task demand was manipulated to investigate whether this affected level of dual-task decrement. Eighteen participants with MS and 18 healthy controls took part. Participants completed walking and cognitive tasks under single- and dual-task conditions. Compared to healthy controls, MS participants showed greater decrements in performance under dual-task conditions in cognitive task performance, walking speed and swing time variability. In the MS group, the degree of decrement under dual-task conditions was related to levels of fatigue, a measure of general cognitive functioning and self-reported everyday cognitive errors, but not to measures of disease severity or duration. Difficulty with walking and talking in MS may be a result of a divided attention deficit or of overloading of the working memory system, and further investigation is needed. We suggest that difficulty with walking and talking in MS may lead to practical problems in everyday life, including potentially increasing the risk of falls. Clinical tools to assess cognitive-motor dual-tasking ability are needed.
GAME (Goals - Activity - Motor Enrichment): protocol of a single blind randomised controlled trial of motor training, parent education and environmental enrichment for infants at high risk of cerebral palsy.
Morgan, Catherine; Novak, Iona; Dale, Russell C; Guzzetta, Andrea; Badawi, Nadia
Cerebral palsy is the most common physical disability of childhood and early detection is possible using evidence based assessments. Systematic reviews indicate early intervention trials rarely demonstrate efficacy for improving motor outcomes but environmental enrichment interventions appear promising. This study is built on a previous pilot study and has been designed to assess the effectiveness of a goal - oriented motor training and enrichment intervention programme, "GAME", on the motor outcomes of infants at very high risk of cerebral palsy (CP) compared with standard community based care. A two group, single blind randomised controlled trial (n = 30) will be conducted. Eligible infants are those diagnosed with CP or designated "at high risk of CP" on the basis of the General Movements Assessment and/or abnormal neuroimaging. A physiotherapist and occupational therapist will deliver home-based GAME intervention at least fortnightly until the infant's first birthday. The intervention aims to optimize motor function and engage parents in developmental activities aimed at enriching the home learning environment. Primary endpoint measures will be taken 16 weeks after intervention commences with the secondary endpoint at 12 months and 24 months corrected age. The primary outcome measure will be the Peabody Developmental Motor Scale second edition. Secondary outcomes measures include the Gross Motor Function Measure, Bayley Scales of Infant and Toddler Development, Affordances in the Home Environment for Motor Development - Infant Scale, and the Canadian Occupational Performance Measure. Parent well-being will be monitored using the Depression Anxiety and Stress Scale. This paper presents the background, design and intervention protocol of a randomised trial of a goal driven, motor learning approach with customised environmental interventions and parental education for young infants at high risk of cerebral palsy. This trial is registered on the Australian
Garbarini, Francesca; Pia, Lorenzo
When humans move simultaneously both hands strong coupling effects arise and neither of the two hands is able to perform independent actions. It has been suggested that such motor constraints are tightly linked to action representation rather than to movement execution. Hence, bimanual tasks can represent an ideal experimental tool to investigate internal motor representations in those neurological conditions in which the movement of one hand is impaired. Indeed, any effect on the "moving" (healthy) hand would be caused by the constraints imposed by the ongoing motor program of the 'impaired' hand. Here, we review recent studies that successfully utilized the above-mentioned paradigms to investigate some types of productive motor behaviors in stroke patients. Specifically, bimanual tasks have been employed in left hemiplegic patients who report illusory movements of their contralesional limbs (anosognosia for hemiplegia). They have also been administered to patients affected by a specific monothematic delusion of body ownership, namely the belief that another person's arm and his/her voluntary action belong to them. In summary, the reviewed studies show that bimanual tasks are a simple and valuable experimental method apt to reveal information about the motor programs of a paralyzed limb. Therefore, it can be used to objectively examine the cognitive processes underpinning motor programming in patients with different delusions of motor behavior. Additionally, it also sheds light on the mechanisms subserving bimanual coordination in the intact brain suggesting that action representation might be sufficient to produce these effects.
Full Text Available When humans move simultaneously both hands strong coupling effects arise and neither of the two hands is able to perform independent actions. It has been suggested that such motor constraints are tightly linked to action representation rather than to movement execution. Hence, bimanual tasks can represent an ideal experimental tool to investigate internal motor representations in those neurological conditions in which the movement of one hand is impaired. Indeed, any effect on the ‘moving’ (healthy hand would be caused by the constraints imposed by the ongoing motor program of the ‘impaired’ hand. Here, we review recent studies that successfully utilized the above-mentioned paradigms to investigate some types of productive motor behaviors in stroke patients. Specifically, bimanual tasks have been employed in left hemiplegic patients who report illusory movements of their contralesional limbs (anosognosia for hemiplegia. They have also been administered to patients affected by a specific monothematic delusion of body ownership, namely the belief that another person’s arm and his/her voluntary action belong to them. In summary, the reviewed studies show that bimanual tasks are a simple and valuable experimental method apt to reveal information about the motor programs of a paralyzed limb. Therefore, it can be used to objectively examine the cognitive processes underpinning motor programming in patients with different delusions of motor behavior. Additionally, it also sheds light on the mechanisms subserving bimanual coordination in the intact brain suggesting that action representation might be sufficient to produce these effects.
Smits-Engelsman, Bouwien C M; Jelsma, Lemke Dorothee; Ferguson, Gillian D; Geuze, Reint H
Although Developmental Coordination Disorder (DCD) is often characterized as a skill acquisition deficit disorder, few studies have addressed the process of motor learning. This study examined learning of a novel motor task; the Wii Fit ski slalom game. The main objectives were to determine: 1) whether learning occurs over 100 trial runs of the game, 2) if the learning curve is different between children with and without DCD, 3) if learning is different in an easier or harder version of the task, 4) if learning transfers to other balance tasks. 17 children with DCD (6-10 years) and a matched control group of 17 typically developing (TD) children engaged in 20 minutes of gaming, twice a week for five weeks. Each training session comprised of alternating trial runs, with five runs at an easy level and five runs at a difficult level. Wii scores, which combine speed and accuracy per run, were recorded. Standardized balance tasks were used to measure transfer. Significant differences in initial performance were found between groups on the Wii score and balance tasks. Both groups improved their Wii score over the five weeks. Improvement in the easy and in the hard task did not differ between groups. Retention in the time between training sessions was not different between TD and DCD groups either. The DCD group improved significantly on all balance tasks. The findings in this study give a fairly coherent picture of the learning process over a medium time scale (5 weeks) in children novice to active computer games; they learn, retain and there is evidence of transfer to other balance tasks. The rate of motor learning is similar for those with and without DCD. Our results raise a number of questions about motor learning that need to be addressed in future research.
Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial.
Rascol, O.; Brooks, D.J.; Melamed, E.; Oertel, W.; Poewe, W.; Stocchi, F.; Tolosa, E.; LARGO study group
Lancet. 2005 Mar 12-18;365(9463):947-54. Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial. Rascol O, Brooks DJ, Melamed E, Oertel W, Poewe W, Stocchi F, Tolosa E; LARGO study group. Clinical Investigation Centre, Department of Clinical Pharmacology, University Hospital, Toulouse, France. ...
Mohandas K Mallath
Full Text Available India's success in producing food and milk for its population (Green Revolution and White Revolution happened because of scientific research and field trials. Likewise improving the health of Indians needs clinical research and clinical trials. A Large proportion of the sick Indians are poor, illiterate with no access to good health care. They are highly vulnerable to inducement and exploitation in clinical trials. The past two decades saw the rise and fall of clinical trials in India. The rise happened when our regulators created a favorable environment, and Indian investigators were invited to participate in global clinical trials. The gap between the demand and supply resulted in inadequate protection of the trial participants. Reports of abuses of the vulnerable trial participants followed by public interest litigations led to strengthening of regulations by the regulators. The stringent new regulations made the conduct of clinical trials more laborious and increased the cost of clinical trials in India. There was a loss of interest in sponsored clinical trials resulting in the fall in global clinical trials in India. Following repeated appeals by the investigators, the Indian regulators have recently relaxed some of the stringent regulations, while continuing to ensure the adequate patient protection. Clinical trials that are relevant to our population and conducted by well-trained investigators and monitored by trained and registered Ethics Committees will increase in the future. We must remain vigilant, avoid previous mistakes, and strive hard to protect the trial participants in the future trials.
Alexander A. Frolov
Full Text Available Repeated use of brain-computer interfaces (BCIs providing contingent sensory feedback of brain activity was recently proposed as a rehabilitation approach to restore motor function after stroke or spinal cord lesions. However, there are only a few clinical studies that investigate feasibility and effectiveness of such an approach. Here we report on a placebo-controlled, multicenter clinical trial that investigated whether stroke survivors with severe upper limb (UL paralysis benefit from 10 BCI training sessions each lasting up to 40 min. A total of 74 patients participated: median time since stroke is 8 months, 25 and 75% quartiles [3.0; 13.0]; median severity of UL paralysis is 4.5 points [0.0; 30.0] as measured by the Action Research Arm Test, ARAT, and 19.5 points [11.0; 40.0] as measured by the Fugl-Meyer Motor Assessment, FMMA. Patients in the BCI group (n = 55 performed motor imagery of opening their affected hand. Motor imagery-related brain electroencephalographic activity was translated into contingent hand exoskeleton-driven opening movements of the affected hand. In a control group (n = 19, hand exoskeleton-driven opening movements of the affected hand were independent of brain electroencephalographic activity. Evaluation of the UL clinical assessments indicated that both groups improved, but only the BCI group showed an improvement in the ARAT's grasp score from 0 [0.0; 14.0] to 3.0 [0.0; 15.0] points (p < 0.01 and pinch scores from 0.0 [0.0; 7.0] to 1.0 [0.0; 12.0] points (p < 0.01. Upon training completion, 21.8% and 36.4% of the patients in the BCI group improved their ARAT and FMMA scores respectively. The corresponding numbers for the control group were 5.1% (ARAT and 15.8% (FMMA. These results suggests that adding BCI control to exoskeleton-assisted physical therapy can improve post-stroke rehabilitation outcomes. Both maximum and mean values of the percentage of successfully decoded imagery-related EEG activity, were higher
Bibby, Anna C; Torgerson, David J; Leach, Samantha; Lewis-White, Helen; Maskell, Nick A
The 'trials within cohorts' (TwiC) design is a pragmatic approach to randomised trials in which trial participants are randomly selected from an existing cohort. The design has multiple potential benefits, including the option of conducting multiple trials within the same cohort. To date, the TwiC design methodology been used in numerous clinical settings but has never been applied to a clinical trial of an investigational medicinal product (CTIMP). We have recently secured the necessary approvals to undertake the first CTIMP using the TwiC design. In this paper, we describe some of the considerations and modifications required to ensure such a trial is compliant with Good Clinical Practice and international clinical trials regulations. We advocate using a two-stage consent process and using the consent stages to explicitly differentiate between trial participants and cohort participants who are providing control data. This distinction ensured compliance but had consequences with respect to costings, recruitment and the trial assessment schedule. We have demonstrated that it is possible to secure ethical and regulatory approval for a CTIMP TwiC. By including certain considerations at the trial design stage, we believe this pragmatic and efficient methodology could be utilised in other CTIMPs in future.
Okely, Anthony D; Hardy, Louise L; Batterham, Marijka; Pearson, Phillip; McKeen, Kim; Puglisi, Lauren
This study reports the long-term effects of a professional learning program for classroom teachers on fundamental motor skill (FMS) proficiency of primary school students from ethnically diverse backgrounds. A cluster non-randomized trial using a nested cross-sectional design. The study was conducted in 8 primary schools located in disadvantaged and culturally diverse areas in Sydney, Australia. The intervention used an action learning framework, with each school developing and implementing an action plan for enhancing the teaching of FMS in their school. School teams comprised 4-5 teachers and were supported by a member of the research team. The primary outcome was total proficiency score for 7 FMS (run, jump, catch, throw, kick, leap, side gallop). Outcome data were analyzed using mixed effects models. Eight-hundred and sixty-two students (82% response rate) were assessed at baseline in 2006 and 830 (82%) at follow-up in 2010. Compared with students in the control schools, there was a significantly greater increase in total motor skill proficiency among children in the intervention schools at follow-up (adjusted difference=5.2 components, 95%CI [1.65, 8.75]; p=0.01) and in four of the seven motor skills. Training classroom teachers to develop and implement units of work based around individual FMS is a promising strategy for increasing FMS among ethnically diverse children over an extended period of time. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Whitall, Jill; Waller, Sandy McCombe; Sorkin, John D; Forrester, Larry W; Macko, Richard F; Hanley, Daniel F; Goldberg, Andrew P; Luft, Andreas
This randomized controlled trial tests the efficacy of bilateral arm training with rhythmic auditory cueing (BATRAC) versus dose-matched therapeutic exercises (DMTEs) on upper-extremity (UE) function in stroke survivors and uses functional magnetic resonance imaging (fMRI) to examine effects on cortical reorganization. A total of 111 adults with chronic UE paresis were randomized to 6 weeks (3×/week) of BATRAC or DMTE. Primary end points of UE assessments of Fugl-Meyer UE Test (FM) and modified Wolf Motor Function Test Time (WT) were performed 6 weeks prior to and at baseline, after training, and 4 months later. Pretraining and posttraining, fMRI for UE movement was evaluated in 17 BATRAC and 21 DMTE participants. The improvements in UE function (BATRAC: FM Δ = 1.1 + 0.5, P = .03; WT Δ = -2.6 + 0.8, P frontal gyrus (P < .05). Activation change in the latter was correlated with improvement in the WMFT (P = .01). BATRAC is not superior to DMTE, but both rehabilitation programs durably improve motor function for individuals with chronic UE hemiparesis and with varied deficit severity. Adaptations in brain activation are greater after BATRAC than DMTE, suggesting that given similar benefits to motor function, these therapies operate through different mechanisms.
Veldman, Sanne L C; Okely, Anthony D; Jones, Rachel A
This study examined the feasibility, acceptability, and potential efficacy of a gross motor skill program for toddlers. An 8-wk. skills program in which children practiced three skills was implemented for 10 min. daily in two randomly designated childcare centers. Two other centers served as the control group. Recruitment and retention rates were collected for feasibility. Data on professional development, children's participation, program duration, and appropriateness of the lessons were collected for acceptability, and the Test of Gross Motor Development-2 and Get Skilled, Get Active (total of 28 points) were used to look at the potential efficacy. The participants were 60 toddlers (M age=2.5 yr., SD=0.4; n=29 boys), and the retention rate was 95%. Overall participation was 76%, and educators rated 98% of the lessons as appropriate. Compared with the control group, the intervention group showed significantly greater improvements in motor skills (pmotor skills among toddlers.
Full Text Available In this work we investigated the performance aspects of addition of used motor oils (UMO to neat and crumb rubber modified asphalts (CRMA and related that to the change of molecular size distribution of modified asphalt’s fractions; asphaltenes, saturates, naphthene aromatics, and polar aromatics. Based on the results of temperature sweep viscoelastic tests, addition of crumb rubber modifier (CRM alone or with UMO results in the formation of internal network within the modified asphalt. Based on the results of short and long term aged asphalts, the utilization of combination of UMO and CRM enhanced the aging behavior of asphalt. Bending beam rheometer was utilized to investigate the low temperature behavior of UMO modified asphalts. Based on those tests, the utilization of the UMO and CRM enhanced the low temperature properties of asphalts. Based on the results of the asphalt separation tests and the Gel Permeation Chromatography (GPC analysis, it was found that saturates and naphthene aromatics are the two asphalt fractions that have similar molecular size fractions as those of UMO. However, UMO only shifts the molecular sizes of saturates after interaction with asphalt. Results also show that polar aromatics pose higher molecular size structures than UMO.
Full Text Available Introduction: Although the survival rate of infants born preterm has increased, the prevalence of developmental problems and motor disorders among this population of infants remains the same. This study investigated the effect of physical activity programs in and out of water on motor performance and neuromuscular development of infants born preterm and had induced immobility by mechanical ventilation.Methods: This study was carried out in Al-Zahra hospital, Tabriz. 76 premature infants were randomly assigned into four groups. One group received daily passive range of motion to all extremities based on the Moyer-Mileur protocol. Hydrotherapy group received exercises for shoulders and pelvic area in water every other day. A combination group received physical activity programs in and out of water on alternating days. Infants in a containment group were held in a fetal position. Duration of study was two weeks ‘from 32 through 33 weeks post menstrual age (PMA. Motor outcomes were measured by the Test of Infant Motor Performance. Neuromuscular developmental was assessed by New Ballard scale and leg recoil and Ankle dorsiflexion items from Dubowitz scale. Data were analyzed using SPSS version 13.Results: TIMP and neuromuscular scores improved in all groups. Motor performance did not differ between groups at 34 weeks PMA. Postural tone of leg recoil was significantly higher in physical activity groups post intervention.Conclusion: Physical activities and containment didn’t have different effects on motor performance in infants born preterm. Leg recoil of neuromuscular development items was affected by physical activity programs.
Muhei-aldin, Othman; VanSwearingen, Jessie; Karim, Helmet; Huppert, Theodore; Sparto, Patrick J; Erickson, Kirk I; Sejdić, Ervin
Understanding complex brain networks using functional magnetic resonance imaging (fMRI) is of great interest to clinical and scientific communities. To utilize advanced analysis methods such as graph theory for these investigations, the stationarity of fMRI time series needs to be understood as it has important implications on the choice of appropriate approaches for the analysis of complex brain networks. In this paper, we investigated the stationarity of fMRI time series acquired from twelve healthy participants while they performed a motor (foot tapping sequence) learning task. Since prior studies have documented that learning is associated with systematic changes in brain activation, a sequence learning task is an optimal paradigm to assess the degree of non-stationarity in fMRI time-series in clinically relevant brain areas. We predicted that brain regions involved in a "learning network" would demonstrate non-stationarity and may violate assumptions associated with some advanced analysis approaches. Six blocks of learning, and six control blocks of a foot tapping sequence were performed in a fixed order. The reverse arrangement test was utilized to investigate the time series stationarity. Our analysis showed some non-stationary signals with a time varying first moment as a major source of non-stationarity. We also demonstrated a decreased number of non-stationarities in the third block as a result of priming and repetition. Most of the current literature does not examine stationarity prior to processing. The implication of our findings is that future investigations analyzing complex brain networks should utilize approaches robust to non-stationarities, as graph-theoretical approaches can be sensitive to non-stationarities present in data. Copyright © 2014 Elsevier B.V. All rights reserved.
Hestbaek, Lise; Andersen, Sara Thurøe; Skovgaard, Thomas
BACKGROUND: Good motor skills are considered important for children's physical, social, and psychological development, but the relationship is still poorly understood. Preschool age seems to be decisive for the development of motor skills and probably the most promising time-window in relation...... to preventive strategies based on improved motor skills. This research program has four overall aims: (1) investigation of the effect of a structured program aimed at improving motor skills in 3-6-year-old children on current and future motor skills, health, cognition, and wellbeing; (2) establish reference...... data on motor skills in 3-6-year-olds; (3) description of early development of musculoskeletal problems; and (4) establishment of a population-based cohort of 3-6-year-olds. METHODS: Over a four-year period, all preschools in a Danish municipality, Svendborg, will implement a new program aimed...
Cortes, Mar; Black-Schaffer, Randie M; Edwards, Dylan J
An improved understanding of motor dysfunction and recovery after stroke has important clinical implications that may lead to the design of more effective rehabilitation strategies for patients with hemiparesis. Transcranial magnetic stimulation (TMS) is a safe and painless tool that has been used in conjunction with other existing diagnostic tools to investigate motor pathophysiology in stroke patients. Since TMS emerged more than two decades ago, its application in clinical and basic neuroscience has expanded worldwide. TMS can quantify the corticomotor excitability properties of clinically affected and unaffected muscles and can probe local cortical networks as well as remote but functionally related areas. This provides novel insight into the physiology of neural circuits underlying motor dysfunction and brain reorganization during the motor recovery process. This important tool needs to be used with caution by clinical investigators, its limitations need to be understood, and the results should to be interpreted along with clinical evaluation in this patient population. In this review, we provide an overview of the rationale, implementation, and limitations of TMS to study stroke motor physiology. This knowledge may be useful to guide future rehabilitation treatments by assessing and promoting functional plasticity. © 2012 International Neuromodulation Society.
Prasad, Swati; Tan, Zheng-Hua; Prasad, Ramjee
Brain-Computer Interface (BCI) provides new means of communication for people with motor disabilities by utilizing electroencephalographic activity. Selection of features from Electroencephalogram (EEG) signals for classification plays a key part in the development of BCI systems. In this paper, we...
Verhagen Metman, L.; Blanchet, P. J.; van den Munckhof, P.; del Dotto, P.; Natté, R.; Chase, T. N.
The effects of the NMDA antagonist dextromethorphan (DM) on levodopa-associated dyskinesias and motor fluctuations were studied in patients with advanced Parkinson's disease. During initial open-label dose escalation, 6 of 18 patients reported a beneficial effect at their individually determined
Adams, I.L.; Steenbergen, B.; Lust, J.M.; Smits-Engelsman, B.C.
BACKGROUND: Previous studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements. Motor imagery paradigms have been used to test this internal modeling deficit.
Adams, I.L.J.; Steenbergen, B.; Lust, J.M.; Smits-Engelsman, B.C.M.
Background: Previous studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements. Motor imagery paradigms have been used to test this internal modeling deficit.
Mortensen, Jesper; Figlewski, Krystian; Andersen, Henning
To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH). A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT). Both groups improved JTT over time (p occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH. Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.
Peng, Taijiang; Wu, Xiaoyu; Liang, Xiong; Shi, Hongyan; Luo, Feng
A Langevin transducer can provide longitudinal vibration with larger amplitude while also possessing a greater fatigue life than other types of piezoelectric vibrators. A novel rotary Ultrasonic Motor (USM) was proposed based on the use of a longitudinal transducer (acting as the stator) and a spiral fin rotor: the front cover of the Langevin transducer was designed as a double-layer cup-shaped structure, with the rotor sustained by the inner-layer, and the bearing cover fixed to the outer-layer; the rotor consisted of a shaft and spiral fins which acted as the elastic coupler. It is different from a traditional traveling USM, because the stator provides longitudinal vibration and the rotor generates the elliptical motion. This paper analyzed the motion locus equation of the fin contact points. Additionally, a theoretical analysis was performed in regards to the mechanism and the motor's rotor motion characteristics, which demonstrates the relationships among the motor's driving force, the torque, the revolution speed, and the motor structure parameters. A motor prototype has been manufactured and surveyed to demonstrate the motor performance. The relationships between the amplitude and the preload on the rotor, the free revolution speed, and the torque of the motor have also been studied. Copyright © 2015 Elsevier B.V. All rights reserved.
Kuwabara, Satoshi; Misawa, Sonoko; Mori, Masahiro; Iwai, Yuta; Ochi, Kazuhide; Suzuki, Hidekazu; Nodera, Hiroyuki; Tamaoka, Akira; Iijima, Masahiro; Toda, Tatsushi; Yoshikawa, Hiroo; Kanda, Takashi; Sakamoto, Ko; Kusunoki, Susumu; Sobue, Gen; Kaji, Ryuji
Intravenous immunoglobulin (IVIg) therapy is currently the only established treatment in patients with multifocal motor neuropathy (MMN), and many patients have an IVIg-dependent fluctuation. We aimed to investigate the efficacy and safety of every 3 week IVIg (1.0 g/kg) for 52 weeks. This study was an open-label phase 3 clinical trial, enrolling 13 MMN patients. After an induction IVIg therapy (0.4 g/kg/d for 5 consecutive days), maintenance dose (1.0 g/kg) was given every 3 weeks for 52 weeks. The major outcome measures were the Medical Research Council (MRC) sum score and hand-grip strength at week 52. This trial is registered with ClinicalTrials.gov, number NCT01827072. At week 52, 11 of the 13 patients completed the study, and all 11 had a sustained improvement. The mean (SD) MRC sum score was 85.6 (8.7) at the baseline, and 90.6 (12.8) at week 52. The mean grip strength was 39.2 (30.0) kPa at the baseline and 45.2 (32.8) kPa at week 52. Two patients dropped out because of adverse event (dysphagia) and decision of an investigator, respectively. Three patients developed coronary spasm, dysphagia, or inguinal herniation, reported as the serious adverse events, but considered not related with the study drug. The other adverse effects were mild and resolved by the end of the study period. Our results show that maintenance treatment with 1.0 g/kg IVIg every 3 week is safe and efficacious for MMN patients up to 52 weeks. Further studies are required to investigate optimal dose and duration of maintenance IVIg for MMN. © 2018 The Authors. Journal of the Peripheral Nervous System published by Wiley Periodicals, Inc. on behalf of Peripheral Nerve Society.
Merriman, W J; Barnett, B E
This study was undertaken to explore the relationship between language skills and gross-motor skills of 28 preschool children from two private preschools in New York City. Pearson product-moment correlation coefficients were calculated for language (revised Preschool Language Scale) and gross motor (Test of Gross Motor Development) scores. Locomotor skills were significantly related to both auditory comprehension and verbal ability while object control scores did not correlate significantly with either language score. These results were discussed in terms of previous research and with reference to dynamical systems theory. Suggestions for research were made.
Pichierri, Giuseppe; Murer, Kurt; de Bruin, Eling D
Computer-based interventions have demonstrated consistent positive effects on various physical abilities in older adults. This study aims to compare two training groups that achieve similar amounts of strength and balance exercise where one group receives an intervention that includes additional dance video gaming. The aim is to investigate the different effects of the training programs on physical and psychological parameters in older adults. Thirty-one participants (mean age ± SD: 86.2 ± 4.6 years), residents of two Swiss hostels for the aged, were randomly assigned to either the dance group (n = 15) or the control group (n = 16). The dance group absolved a twelve-week cognitive-motor exercise program twice weekly that comprised progressive strength and balance training supplemented with additional dance video gaming. The control group performed only the strength and balance exercises during this period. Outcome measures were foot placement accuracy, gait performance under single and dual task conditions, and falls efficacy. After the intervention between-group comparison revealed significant differences for gait velocity (U = 26, P = .041, r = .45) and for single support time (U = 24, P = .029, r = .48) during the fast walking dual task condition in favor of the dance group. No significant between-group differences were observed either in the foot placement accuracy test or in falls efficacy. There was a significant interaction in favor of the dance video game group for improvements in step time. Significant improved fast walking performance under dual task conditions (velocity, double support time, step length) was observed for the dance video game group only. These findings suggest that in older adults a cognitive-motor intervention may result in more improved gait under dual task conditions in comparison to a traditional strength and balance exercise program. This trial has been registered under ISRCTN05350123 (www.controlled-trials.com)
Wang, Jun; Pei, Jian; Cui, Xiao; Sun, Kexing; Ni, Huanhuan; Zhou, Cuixia; Wu, Ji; Huang, Mei; Ji, Li
To compare the clinical efficacy on upper limb motor impairment in stroke between the interactive dynamic scalp acupuncture therapy and the traditional scalp acupuncture therapy. The randomized controlled trial and MINIMIZE layering randomization software were adopted. Seventy patients of upper limb with III to V grade in Brunnstrom scale after stroke were randomized into an interactive dynamic scalp acupuncture group and a traditional scalp acupuncture group, 35 cases in each one. In the interactive dynamic scalp acupuncture group, the middle 2/5 of Dingnieqianxiexian (anterior oblique line of vertex-temporal), the middle 2/5 of Dingniehouxiexian (posterior oblique line of vertex-temporal) and Dingpangerxian (lateral line 2 of vertex) on the affected side were selected as the stimulation areas. Additionally, the rehabilitation training was applied during scalp acupuncture treatment. In the traditional scalp acupuncture group, the scalp stimulation areas were same as the interactive dynamic scalp acupuncture group. But the rehabilitation training was applied separately. The rehabilitation training was applied in the morning and the scalp acupuncture was done in the afternoon. The results in Fugl-Meyer for the upper limb motor function (U-FMA), the Wolf motor function measure scale (WM- FT) and the modified Barthel index in the two groups were compared between the two groups before treatment and in 1 and 2 months of treatment, respectively. After treatment, the U-FMA score, WMFT score and the score of the modified Barthel index were all apparently improved as compared with those before treatment (all P acupuncture group was better than that in the traditional scalp acupuncture group (P acupuncture group were improved apparently as compared with those in the traditional scalp acupuncture group (P acupuncture group were not different significantly as compared with those in the traditional scalp acupuncture group (both P > 0.05). For the patients of IV to V grade in
Yavuzer, G; Senel, A; Atay, M B; Stam, H J
To evaluate the effects of ''Playstation EyeToy Games'' on upper extremity motor recovery and upper extremity-related motor functioning of patients with subacute stroke. The authors designed a randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 3 months. A total of 20 hemiparetic inpatients (mean age 61.1 years), all within 12 months post-stroke, received 30 minutes of treatment with ''Playstation EyeToy Games'' per day, consisting of flexion and extension of the paretic shoulder, elbow and wrist as well as abduction of the paretic shoulder or placebo therapy (watching the games for the same duration without physical involvement into the games) in addition to conventional program, 5 days a week, 2-5 hours/day for 4 weeks. Brunnstrom's staging and self-care sub-items of the functional independence measure (FIM) were performed at 0 month (baseline), 4 weeks (post-treatment), and 3 months (follow-up) after the treatment. The mean change score (95% confidence interval) of the FIM self-care score (5.5 [2.9-8.0] vs 1.8 [0.1-3.7], P=0.018) showed significantly more improvement in the EyeToy group compared to the control group. No significant differences were found between the groups for the Brunnstrom stages for hand and upper extremity. ''Playstation EyeToy Games'' combined with a conventional stroke rehabilitation program have a potential to enhance upper extremity-related motor functioning in subacute stroke patients.
Full Text Available This paper investigates of a kind of five-phase dual-rotor permanent-magnet synchronous motor (DRPMSM, which contains dual rotors and a single stator. This kind of motor has the potential advantages of high power density, high reliability and high efficiency, which make it more appropriate for using in electric vehicles (EVs. In order to evaluate the most suitable power level for this kind of structure, the electromagnetic, the thermal and the mechanical characteristics are investigated in this paper. The length to diameter ratio of motors is researched to obtain the highest power density and then the optimum ratio is obtained. Based on the optimum ratio, the thermal characteristics are researched under natural condition and forced-air cooling condition with different wind speeds. In addition, the mechanical characteristics are analyzed under no-load and different loads conditions, respectively. All of the results are analyzed by two-dimension (2-D and three-dimension (3-D finite element method (FEM simulation, which provide a good reference to select suitable power level for this kind of motor structure. Finally, a DRPMSM prototype is manufactured and tested. The experimental results effectively verify the FEM results.
Ostasevicius, Vytautas; Palevicius, Arvydas; Ragulskis, Minvydas; Janusas, Giedrius; Pilkauskas, Kestutis
Ultrasonic motors have seen application in areas needing compact, efficient, and intermittent motion. Such applications include: camera auto focus lenses, watch motors, compact paper handling, microrobots, medicine and etc.. They are characterized by high torque at low rotational speed, simple mechanical design and good controllability. Compared with electromagnetic actuators, there is no danger of interference due to electromagnetic induction because no magnetic field is used and ultrasonic motors are more quiet since speed-reduction gears are not required. A polarization vector of the piezoceramic element and location of excitation electrodes on its surface determine the resonance modes of the high frequency vibration exciter. In its turn the modes of vibration play a key role in the functionality of ultrasonic motor. There are analyzed two different regimes of operation--when the contact zone of the resonator performs elliptic and unidirectional motions. Though the mechanical characteristics of the ultrasonic motor in both cases are comparable, detailed analysis of the contact surface shows very different wears. Laser holography is used to identify and control the regimes of motion of actuator. Experimental results are compared with computer simulations. Contact surfaces are analyzed by atomic force microscope (AFM) before experiment, after 10 minutes and after 50 minutes of operation.
Full Text Available Permanent magnet motors have been considered for a variety of applications due to their features such as high power density and high efficiency. One of the issues that should be investigated in the design of these motors is the demagnetization problem. Usually, the demagnetization analysis is carried out in a steady state, while demagnetization effect in dynamic condition is more considerable due to pulse shaped of armature field. Based on this fact, in this paper, dynamic demagnetization is investigated for an IPM V‑shaped magnet. This study has been done for two types of magnet, each one in static & dynamic conditions and the results are compared. Moreover, the effect of flux weakening regime on demagnetization is investigated.
Amy Corneli, PhD, MPH
Full Text Available Concerns have been raised over the high turnover rate for clinical investigators. Using the U.S. Food and Drug Administration's (FDA Bioresearch Monitoring Information System database, we conducted an online survey to identify factors that affect principal investigators' (PIs decisions to conduct only a single FDA-regulated drug trial. Of the 201 PIs who responded, 54.2% were classified as “one-and-done.” Among these investigators, 28.9% decided for personal reasons to not conduct another trial, and 44.4% were interested in conducting another trial, but no opportunities were available. Three categories of broad barriers were identified as generally burdensome or challenging by the majority of investigators: 1 workload balance (balancing trial implementation with other work obligations and opportunities (63.8%; 2 time requirements (time to initiate and implement trial; investigator and staff time (63.4%; and 3 data and safety reporting (56.5%. Additionally, 46.0% of investigators reported being generally unsatisfied with finance-related issues. These same top three barriers also affected investigators' decisions to no longer conduct FDA-regulated trials. Our findings illuminate three key aspects of investigator turnover. First, they confirm that investigator turnover occurs, as more than half of respondents were truly “one-and-done.” Second, because a large proportion of respondents wanted to conduct more FDA-regulated trials but lacked opportunities to do so, mechanisms that match interested investigators with research sponsors are needed. Third, by focusing on the barriers we identified that affected investigators' decisions to no longer conduct FDA-regulated trials, future efforts to reduce investigator turnover can target issues that matter the most to investigators.
Full Text Available In this paper the magnetic flux density of tubular linear reluctance motor (TLRM in open type magnetic circuit is studied. Also, all magnetic flux density calculation methods in winding of tubular linear reluctance motor are described. The effect of structure parameters on magnetic flux density is also discussed. Electromagnetic finite-element analysis is used for simulation of magnetic field, and simulation results of the magnetic field analysis with DC voltage excitation are compared with results obtained from calculation methods. The comparison yields a good agreement.
Suellen M. Andrade
Full Text Available Objective. We compared the effects of transcranial direct current stimulation at different cortical sites (premotor and motor primary cortex combined with constraint-induced movement therapy for treatment of stroke patients. Design. Sixty patients were randomly distributed into 3 groups: Group A, anodal stimulation on premotor cortex and constraint-induced movement therapy; Group B, anodal stimulation on primary motor cortex and constraint-induced movement therapy; Group C, sham stimulation and constraint-induced movement therapy. Evaluations involved analysis of functional independence, motor recovery, spasticity, gross motor function, and muscle strength. Results. A significant improvement in primary outcome (functional independence after treatment in the premotor group followed by primary motor group and sham group was observed. The same pattern of improvement was highlighted among all secondary outcome measures regarding the superior performance of the premotor group over primary motor and sham groups. Conclusions. Premotor cortex can contribute to motor function in patients with severe functional disabilities in early stages of stroke. This study was registered in ClinicalTrials.gov database (NCT 02628561.
Full Text Available Abstract Background Computer-based interventions have demonstrated consistent positive effects on various physical abilities in older adults. This study aims to compare two training groups that achieve similar amounts of strength and balance exercise where one group receives an intervention that includes additional dance video gaming. The aim is to investigate the different effects of the training programs on physical and psychological parameters in older adults. Methods Thirty-one participants (mean age ± SD: 86.2 ± 4.6 years, residents of two Swiss hostels for the aged, were randomly assigned to either the dance group (n = 15 or the control group (n = 16. The dance group absolved a twelve-week cognitive-motor exercise program twice weekly that comprised progressive strength and balance training supplemented with additional dance video gaming. The control group performed only the strength and balance exercises during this period. Outcome measures were foot placement accuracy, gait performance under single and dual task conditions, and falls efficacy. Results After the intervention between-group comparison revealed significant differences for gait velocity (U = 26, P = .041, r = .45 and for single support time (U = 24, P = .029, r = .48 during the fast walking dual task condition in favor of the dance group. No significant between-group differences were observed either in the foot placement accuracy test or in falls efficacy. Conclusions There was a significant interaction in favor of the dance video game group for improvements in step time. Significant improved fast walking performance under dual task conditions (velocity, double support time, step length was observed for the dance video game group only. These findings suggest that in older adults a cognitive-motor intervention may result in more improved gait under dual task conditions in comparison to a traditional strength and balance exercise program
Pearce, Alan J; Hoy, Kate; Rogers, Mark A; Corp, Daniel T; Davies, Charlotte B; Maller, Jerome J; Fitzgerald, Paul B
This multimodal study investigated the motor, neurocognitive and neurophysiological responses following a sports related concussion injury in the acute-phase (up to 10 days) in sub-elite Australian football players. Between-group, repeated measures. Over the course of one season (six months), 43 male players from one football club (25.1 ± 4.5 years) were assessed for fine motor dexterity, visuomotor reaction time, implicit learning and attention. Motor cortex excitability and inhibition were assessed using transcranial magnetic stimulation. Of the 43 players, eight suffered concussion injuries, and were compared to 15 non-concussed players (active control) who returned for follow up testing. Post-concussion assessments using the aforementioned tests were carried out at 48 and 96 h, and 10 days. Compared to the non-concussed players, those who suffered concussion showed slowed fine dexterity (P = 0.02), response (P = 0.02) and movement times (P = 0.01) 48 h post-concussion. Similarly, attentional performance was reduced in the concussed group at all time points (48 h: P football players show abnormalities in motor, cognitive and neurophysiological measures with variable rates of recovery. These findings suggest that measuring the recovery of concussed athletes should incorporate a range of testing modalities rather than relying on one area of measurement in determining return to play. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Ross, Susan; Metcalf, Amanda; Bulger, Sean M.; Housner, Lynn D.
Purpose: As the scope of motor development and learning knowledge has successfully broadened over the years, there is an increased need to identify the content and learning experiences that are essential in preparing preservice physical educators. The purpose of this study was to generate expert consensus regarding the most critical motor…
Frost, Shawn B; Iliakova, Maria; Dunham, Caleb; Barbay, Scott; Arnold, Paul; Nudo, Randolph J
The purpose of the present study was to determine the feasibility of using a common laboratory rat strain for reliably locating cortical motor representations of the hindlimb. Intracortical microstimulation techniques were used to derive detailed maps of the hindlimb motor representations in 6 adult Fischer-344 rats. The organization of the hindlimb movement representation, while variable across individual rats in topographic detail, displayed several commonalities. The hindlimb representation was positioned posterior to the forelimb motor representation and posterolateral to the motor trunk representation. The areal extent of the hindlimb representation across the cortical surface averaged 2.00 ± 0.50 mm(2). Superimposing individual maps revealed an overlapping area measuring 0.35 mm(2), indicating that the location of the hindlimb representation can be predicted reliably based on stereotactic coordinates. Across the sample of rats, the hindlimb representation was found 1.25-3.75 mm posterior to the bregma, with an average center location approximately 2.6 mm posterior to the bregma. Likewise, the hindlimb representation was found 1-3.25 mm lateral to the midline, with an average center location approximately 2 mm lateral to the midline. The location of the cortical hindlimb motor representation in Fischer-344 rats can be reliably located based on its stereotactic position posterior to the bregma and lateral to the longitudinal skull suture at midline. The ability to accurately predict the cortical localization of functional hindlimb territories in a rodent model is important, as such animal models are being increasingly used in the development of brain-computer interfaces for restoration of function after spinal cord injury.
Full Text Available Abstract Conducting clinical trials in developing countries often presents significant ethical, organisational, cultural and infrastructural challenges to researchers, pharmaceutical companies, sponsors and regulatory bodies. Globally, these regions are under-represented in research, yet this population stands to gain more from research in these settings as the burdens on health are greater than those in developed resourceful countries. However, developing countries also offer an attractive setting for clinical trials because they often have larger treatment naive populations with higher incidence rates of disease and more advanced stages. These factors can present a reduction in costs and time required to recruit patients. So, balance needs to be found where research can be encouraged and supported in order to bring maximum public health benefits to these communities. The difficulties with such trials arise from problems with obtaining valid informed consent, ethical compensation mechanisms for extremely poor populations, poor health infrastructure and considerable socio-economic and cultural divides. Ethical concerns with trials in developing countries have received attention, even though many other non-ethical issues may arise. Local investigator initiated trials also face a variety of difficulties that have not been adequately reported in literature. This paper uses the example of the Cameroon Mobile Phone SMS trial to describe in detail, the specific difficulties encountered in an investigator-initiated trial in a developing country. It highlights administrative, ethical, financial and staff related issues, proposes solutions and gives a list of additional documentation to ease the organisational process.
Mbuagbaw, Lawrence; Thabane, Lehana; Ongolo-Zogo, Pierre; Lang, Trudie
Conducting clinical trials in developing countries often presents significant ethical, organisational, cultural and infrastructural challenges to researchers, pharmaceutical companies, sponsors and regulatory bodies. Globally, these regions are under-represented in research, yet this population stands to gain more from research in these settings as the burdens on health are greater than those in developed resourceful countries. However, developing countries also offer an attractive setting for clinical trials because they often have larger treatment naive populations with higher incidence rates of disease and more advanced stages. These factors can present a reduction in costs and time required to recruit patients. So, balance needs to be found where research can be encouraged and supported in order to bring maximum public health benefits to these communities. The difficulties with such trials arise from problems with obtaining valid informed consent, ethical compensation mechanisms for extremely poor populations, poor health infrastructure and considerable socio-economic and cultural divides. Ethical concerns with trials in developing countries have received attention, even though many other non-ethical issues may arise. Local investigator initiated trials also face a variety of difficulties that have not been adequately reported in literature. This paper uses the example of the Cameroon Mobile Phone SMS trial to describe in detail, the specific difficulties encountered in an investigator-initiated trial in a developing country. It highlights administrative, ethical, financial and staff related issues, proposes solutions and gives a list of additional documentation to ease the organisational process.
Poock, G. K.; Martin, B. J.
This was an applied investigation examining the ability of a speech recognition system to recognize speakers' inputs when the speakers were under different stress levels. Subjects were asked to speak to a voice recognition system under three conditions: (1) normal office environment, (2) emotional stress, and (3) perceptual-motor stress. Results indicate a definite relationship between voice recognition system performance and the type of low stress reference patterns used to achieve recognition.
Fatemeh Fakar Gharamaleki
Full Text Available Objective Stuttering is a developmental disorder of speech fluency with unknown causes. One of the proposed theories in this field is deficits in speech motor control that is associated with damaged control, timing, and coordination of the speech muscles. Fundamental frequency, fundamental frequency range, intensity, intensity range, and voice onset time are the most important acoustic components that are often used for indirect evaluation of physiological functions underlying the mechanisms of speech motor control. The purpose of this investigation was to compare some of the acoustic characteristics of speech motor control in children who stutter and children who do not stutter. Materials & Methods This research is a descriptive-analytic and cross-sectional comparative study. A total of 25 Azari-Persian bilingual boys who stutter (stutters group and 23 Azari-Persian bilinguals and 21 Persian monolingual boys who do not stutter (non-stutters group in the age range of 6 to 10 years participated in this study. Children participated in /a/ and /i/ vowels prolongation and carrier phrase repetition tasks for the analysis of some of their acoustic characteristics including fundamental frequency, fundamental frequency range, intensity, intensity range, and voice onset time. The PRAAT software was used for acoustic analysis. SPSS software (version 17, one-way ANOVA, and Kruskal-Wallis test were used for analyzing the data. Results The results indicated that there were no significant differences between the stutters and non-stutters groups (P>0.05 with respect to the acoustic features of speech motor control . Conclusion No significant group differences were observed in all of the dependent variables reported in this study. Thus, the results of this research do not support the notion of aberrant speech motor control in children who stutter.
Grabowski, P.Z.; Kazmierkowski, M.P. [Warsaw Univ. of Technology (Poland)
In this paper, the concept and implementation of a new simple Direct Torque Neuro-Fuzzy Control (DTNFC) scheme for PWM inverter-fed induction motor drive are presented. An Adaptive Neuro-Fuzzy Inference System (ANFIS) is applied to achieve high performance decoupled flux and torque control. The theoretical principle and tuning procedure of this method are discussed. A 3 kW induction motor experimental system with digital signal processor (DSP type) TMS 320C31 based controller has been built to verify this approach. The simulation and laboratory experimental results, which illustrate the performance of the proposed scheme, are presented. Also, nomograms for controller design are given. It has been shown that the simple DTNFC is characterised by very fast torque and flux response, very low speed operation and simple tuning capability. (orig.)
El-Deeb, G.; Nguon, B.; Tibi, A.; Rizzo-Padoin, N.
Recent revision of the legal environment for clinical research in France provided an opportunity to review what a hospital needs to carry out clinical trials using a radiopharmaceutical investigational drug. Legal measures concerning radiopharmaceutical investigational drugs are indeed more complex than those of classical clinical trials because of the additional legal provisions governing the use of ionizing radiation. Thus, requirements by the concerned staff (sponsor, pharmacist, person in charge of the nuclear activity) are described here. (authors) [fr
Benjaminse, Anne; Lemmink, Koen A. P. M.; Diercks, Ron L.; Otten, Bert
Background: Of all athletic knee injuries an anterior cruciate ligament (ACL) rupture results in the longest time loss from sport. Regardless of the therapy chosen, conservative or reconstructive, athletes are often forced to reduce their level of physical activity and their involvement in sport.
Anne Benjaminse; Ron L. Diercks; Bert Otten; Koen A.P.M. Lemmink
BACKGROUND: Of all athletic knee injuries an anterior cruciate ligament (ACL) rupture results in the longest time loss from sport. Regardless of the therapy chosen, conservative or reconstructive, athletes are often forced to reduce their level of physical activity and their involvement in sport.
Perez, Raymond; Archdeacon, Patrick; Roach, Nancy; Goodwin, Robert; Jarow, Jonathan; Stuccio, Nina; Forrest, Annemarie
Background/aims: The Food and Drug Administration’s final rule on investigational new drug application safety reporting, effective from 28 March 2011, clarified the reporting requirements for serious and unexpected suspected adverse reactions occurring in clinical trials. The Clinical Trials Transformation Initiative released recommendations in 2013 to assist implementation of the final rule; however, anecdotal reports and data from a Food and Drug Administration audit indicated that a majority of reports being submitted were still uninformative and did not result in actionable changes. Clinical Trials Transformation Initiative investigated remaining barriers and potential solutions to full implementation of the final rule by polling and interviewing investigators, clinical research staff, and sponsors. Methods: In an opinion-gathering effort, two discrete online surveys designed to assess challenges and motivations related to management of expedited (7- to 15-day) investigational new drug safety reporting processes in oncology trials were developed and distributed to two populations: investigators/clinical research staff and sponsors. Data were collected for approximately 1 year. Twenty-hour-long interviews were also conducted with Clinical Trials Transformation Initiative–nominated interview participants who were considered as having extensive knowledge of and experience with the topic. Interviewees included 13 principal investigators/study managers/research team members and 7 directors/vice presidents of pharmacovigilance operations from 5 large global pharmaceutical companies. Results: The investigative site’s responses indicate that too many individual reports are still being submitted, which are time-consuming to process and provide little value for patient safety assessments or for informing actionable changes. Fewer but higher quality reports would be more useful, and the investigator and staff would benefit from sponsors’“filtering” of
Perez, Raymond; Archdeacon, Patrick; Roach, Nancy; Goodwin, Robert; Jarow, Jonathan; Stuccio, Nina; Forrest, Annemarie
The Food and Drug Administration's final rule on investigational new drug application safety reporting, effective from 28 March 2011, clarified the reporting requirements for serious and unexpected suspected adverse reactions occurring in clinical trials. The Clinical Trials Transformation Initiative released recommendations in 2013 to assist implementation of the final rule; however, anecdotal reports and data from a Food and Drug Administration audit indicated that a majority of reports being submitted were still uninformative and did not result in actionable changes. Clinical Trials Transformation Initiative investigated remaining barriers and potential solutions to full implementation of the final rule by polling and interviewing investigators, clinical research staff, and sponsors. In an opinion-gathering effort, two discrete online surveys designed to assess challenges and motivations related to management of expedited (7- to 15-day) investigational new drug safety reporting processes in oncology trials were developed and distributed to two populations: investigators/clinical research staff and sponsors. Data were collected for approximately 1 year. Twenty-hour-long interviews were also conducted with Clinical Trials Transformation Initiative-nominated interview participants who were considered as having extensive knowledge of and experience with the topic. Interviewees included 13 principal investigators/study managers/research team members and 7 directors/vice presidents of pharmacovigilance operations from 5 large global pharmaceutical companies. The investigative site's responses indicate that too many individual reports are still being submitted, which are time-consuming to process and provide little value for patient safety assessments or for informing actionable changes. Fewer but higher quality reports would be more useful, and the investigator and staff would benefit from sponsors'"filtering" of reports and increased sponsor communication. Sponsors
Patsko, Emily; Godolphin, Peter J; Thomas, Kim S; Hepburn, Trish; Mitchell, Eleanor J; Craig, Fiona E; Bath, Philip M; Montgomery, Alan A
Blinding is the process of keeping treatment assignment hidden and is used to minimise the possibility of bias. Trials at high risk of bias have been shown to report larger treatment effects than low-risk studies. In dermatology, one popular method of blinding is to have independent outcome assessors who are unaware of treatment allocation assessing the endpoint using digital photographs. However, this can be complex, expensive and time-consuming. The objective of this study was to compare the effect of blinded and unblinded outcome assessment on the results of the STOP GAP trial. The STOP GAP trial compared prednisolone to ciclosporin in treating pyoderma gangrenosum. Participants' lesions were measured at baseline and at 6 weeks to calculate the primary outcome, speed of healing. Independent blinded assessors obtained measurements from digital photographs using specialist software. In addition, unblinded treating clinicians estimated lesion area by measuring length and width. The primary outcome was determined using blinded measurements where available, otherwise unblinded measurements were used (method referred to as trial measurements). In this study, agreement between the trial and unblinded measurements was determined using the intraclass correlation coefficient (ICC). The STOP GAP trial's primary analysis was repeated using unblinded measurements only. We introduced differential and nondifferential error in unblinded measurements and investigated the effect on the STOP GAP trial's primary analysis. Eighty-six (80%) of the 108 patients were assessed using digital images. Agreement between trial and unblinded measurements was excellent (ICC = 0.92 at baseline; 0.83 at 6 weeks). There was no evidence that the results of the trial primary analysis differed according to how the primary outcome was assessed (p value for homogeneity = 1.00). Blinded digital image assessment in the STOP GAP trial did not meaningfully alter trial conclusions compared with
Lei Hui; Tan Xun-Qiong
We report ab initio calculations of the transport behavior of a phenyl substituted molecular motor. The calculated results show that the transport behavior of the device is sensitive to the rotation degree of the rotor part. When the rotor part is parallel with the stator part, a better rectifying performance can be found in the current-voltage curve. However, when the rotor part revolves to vertical with the stator part, the currents in the positive bias region decrease slightly. More importantly, the rectifying performance disappears. Thus this offers us a new method to modulate the rectifying behavior in molecular devices. (condensed matter: electronic structure, electrical, magnetic, and optical properties)
Moene, F.C.; Spinhoven, P.; Hoogduin, C.A.L.; Dyck, R. van
This study tested whether a hypnosis-based intervention showed promise as a treatment for patients with conversion disorder, motor type. Forty-four outpatients with conversion disorder, motor type, or somatization disorder with motor conversion symptoms, were randomly assigned to a hypnosis or a
Full Text Available This paper presents a novel five-phase permanent magnet synchronous motor (PMSM, which contains dual rotors and a single stator, equivalent to two five-phase motors working together. Thus, this kind of motor has the potential of good fault tolerant capability and high torque density, which makes it appropriate for use in electric vehicles. In view of the different connection types, the inside and outside stator windings can be driven in series or parallel, which results in the different performances of the magnetomotive force (MMF and torque under open-circuit fault conditions. By decomposing the MMF, the reason that torque ripple increases after open-circuit faults is explained, and the relationship between MMF and torque is revealed. Then, the current control strategy is applied to adjust the open-circuit faults, and the electromagnetic analysis and MMF harmonics analysis are performed to interpret the phenomenon that the torque ripple is still larger than in the normal situation. The investigations are verified by finite element analysis results.
Kao, Chi-Yin; Huang, Guey-Shiun; Dai, Yu-Tzu; Pai, Ya-Ying; Hu, Wen-Yu
Clinical research nurses (CRNs) play an important role in improving the quality of clinical trials. In Taiwan, the increasing number of clinical trials has increased the number of practicing CRNs. Understanding the role responsibilities of CRNs is necessary to promote professionalism in this nursing category. This study investigates the role responsibilities of CRNs in conducting clinical trials / research. A questionnaire survey was conducted in a medical center in Taipei City, Taiwan. Eighty CRNs that were registered to facilitate and conduct clinical trials at this research site completed the survey. "Subject protection" was the CRN role responsibility most recognized by participants, followed by "research coordination and management", "subject clinical care", and "advanced professional nursing". Higher recognition scores were associated with higher importance scores and lower difficulty scores. Participants with trial training had significantly higher difficulty scores for "subject clinical care" and "research coordination and management" than their peers without this training (p research coordination and management" (p clinical practice.
Full Text Available Induction machines have a simple structure and are popular due to their wide range of use, however they have limited power factor and efficiency. Although the working principles of inductions machines have not changed for years, the materials and geometric structures used have undergone significant changes. In this study, slits were applied in the middle of the rotor teeth, rotor-stator teeth and stator teeth of a 7.5 kW induction motor. For these three situations, the torque ripple, iron losses, copper losses, inductance, phase current and voltage inducted in the windings and flux change were analyzed associated with the change in the slit width and slit height. Due to the fact that it is difficult to analytically calculate the slitted models created, they were analyzed by software which uses the finite elements method. The stator-rotor slitted structure determined as the optimum (the one with highest efficiency and the original motor were compared with 2D and 3D analyses. According to this comparison, a decrease in torque rupture and loss of copper is observed. The motor’s torque increased by 27%, and efficiency increased by 4%.
Invited commentary on comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial.
Kwakkel, Gert; van Wegen, Erwin E; Meskers, Carel M
In this issue of Archives of Physical Medicine and Rehabilitation, Jessica McCabe and colleagues report findings from their methodologically sound, dose-matched clinical trial in 39 patients beyond 6 months poststroke. In this phase II trial, the effects of 60 treatment sessions, each involving 3.5 hours of intensive practice plus either 1.5 hours of functional electrical stimulation (FES) or a shoulder-arm robotic therapy, were compared with 5 hours of intensive daily practice alone. Although no significant between-group differences were found on the primary outcome measure of Arm Motor Ability Test and the secondary outcome measure of Fugl-Meyer Arm motor score, 10% to 15% within-group therapeutic gains were on the Arm Motor Ability Test and Fugl-Meyer Arm. These gains are clinically meaningful for patients with stroke. However, the underlying mechanisms that drive these improvements remain poorly understood. The approximately $1000 cost reduction per patient calculated for the use of motor learning (ML) methods alone or combined with FES, compared with the combination of ML and shoulder-arm robotics, further emphasizes the need for cost considerations when making clinical decisions about selecting the most appropriate therapy for the upper paretic limb in patients with chronic stroke. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Kim, Kyuwon; Kim, Boemjun; Go, Youngil; Park, Jaeyong; Park, Joonhong; Suh, Insoo; Yi, Kyongsu
This paper describes a lateral disturbance compensation algorithm for an application to a motor-driven power steering (MDPS)-based driver assistant system. The lateral disturbance including wind force and lateral load transfer by bank angle reduces the driver's steering refinement and at the same time increases the possibility of an accident. A lateral disturbance compensation algorithm is designed to determine the motor overlay torque of an MDPS system for reducing the manoeuvreing effort of a human driver under lateral disturbance. Motor overlay torque for the compensation of driver's steering torque induced by the lateral disturbance consists of human torque feedback and feedforward torque. Vehicle-driver system dynamics have been investigated using a combined dynamic model which consists of a vehicle dynamic model, driver steering dynamic model and lateral disturbance model. The human torque feedback input has been designed via the investigation of the vehicle-driver system dynamics. Feedforward input torque is calculated to compensate additional tyre self-aligning torque from an estimated lateral disturbance. The proposed compensation algorithm has been implemented on a developed driver model which represents the driver's manoeuvreing characteristics under the lateral disturbance. The developed driver model has been validated with test data via a driving simulator in a crosswind condition. Human-in-the-loop simulations with a full-scale driving simulator on a virtual test track have been conducted to investigate the real-time performance of the proposed lateral disturbance compensation algorithm. It has been shown from simulation studies and human-in-the-loop simulation results that the driver's manoeuvreing effort and a lateral deviation of the vehicle under the lateral disturbance can be significantly reduced via the lateral disturbance compensation algorithm.
Kjemtrup, Lars; Cordtz, Rasmus Faurskov; Meyer, Martin
The work conducted in this paper presents a novel experimental setup to study sulfuric acid cold corrosion of cylinder liners in large two-stroke marine diesel engines. The process is simulated in a motored light duty BUKH DV24 diesel engine where the charge air contain known amounts of H2SO4 and H......2O vapor. Liner corrosion is measured as iron accumulation in the lubeoil. Similarly sulfuric acid condensation is assessed by measuring the accumulation of sulfur in the lube oil. To clarify the corrosive effect of sulfuric acid the lube oil utilized for experiments is a sulfur free neutral oil...... without alkaline additives (Chevron Neutral Oil 600R). Iron and sulfur accumulation in the lube oil is analyzed withan Energy Dispersive X-Ray Fluorescence (ED-XRF) apparatus. Three test cases with different H2SO4 concentrations are run. Results reveal good agreement between sulfuric acid injection flow...
-primary outcomes are the modified Roland score and pain numerical rating scale at 1 month. Discussion Although extensively utilized throughout North America for palliation of pain, vertebroplasty still has not undergone rigorous study. The study outlined above represents the first randomized, controlled study that can account for a placebo effect in the setting of vertebroplasty. Trial Registration Current Controlled Trials ISRCTN81871888
Müller, Sean; Vallence, Ann-Maree; Winstein, Carolee
A framework is presented of how theoretical predictions can be tested across the expert athlete to disabled patient skill continuum. Common-coding theory is used as the exemplar to discuss sensory and motor system contributions to perceptual-motor behavior. Behavioral and neural studies investigating expert athletes and patients recovering from cerebral stroke are reviewed. They provide evidence of bi-directional contributions of visual and motor systems to perceptual-motor behavior. Majority of this research is focused on perceptual-motor performance or learning, with less on transfer. The field is ripe for research designed to test theoretical predictions across the expert athlete to disabled patient skill continuum. Our view has implications for theory and practice in sports science, physical education, and rehabilitation.
Smits, Dirk-Wouter; Gorter, Jan Willem; Hanna, Steven E; Dallmeijer, Annet J; van Eck, Mirjam; Roebroeck, Marij E; Vos, Rimke C; Ketelaar, Marjolijn
The aim of this study was to describe patterns for gross motor development by level of severity in a Dutch population of individuals with cerebral palsy (CP). This longitudinal study included 423 individuals (260 males, 163 females) with CP. The mean age at baseline was 9 years 6 months (SD 6y 2mo, range 1-22y). The level of severity of CP among participants, according to the Gross Motor Function Classification System (GMFCS), was 50% level I, 13% level II, 14% level III, 13% level IV, and 10% level V. Participants had been assessed up to four times with the Gross Motor Function Measure (GMFM-66) at 1- or 2-year intervals between 2002 and 2009. Data were analysed using non-linear mixed effects modelling. For each GMFCS level, patterns were created by contrasting a stable limit model (SLM) with a peak and decline model (PDM), followed by estimating limits and rates of gross motor development. The SLM showed a better fit for all GMFCS levels than the PDM. Within the SLM, significant differences between GMFCS levels were found for both the limits (higher values for lower GMFCS levels) and the rates (higher values for GMFCS levels I-II vs level IV and for GMFCS levels I-IV vs level V) of gross motor development. The results validate the existence of five distinct patterns for gross motor development by level of severity of CP. ©The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.
Aoi, Shinya; Funato, Tetsuro
Humans and animals walk adaptively in diverse situations by skillfully manipulating their complicated and redundant musculoskeletal systems. From an analysis of measured electromyographic (EMG) data, it appears that despite complicated spatiotemporal properties, muscle activation patterns can be explained by a low dimensional spatiotemporal structure. More specifically, they can be accounted for by the combination of a small number of basic activation patterns. The basic patterns and distribution weights indicate temporal and spatial structures, respectively, and the weights show the muscle sets that are activated synchronously. In addition, various locomotor behaviors have similar low dimensional structures and major differences appear in the basic patterns. These analysis results suggest that neural systems use muscle group combinations to solve motor control redundancy problems (muscle synergy hypothesis) and manipulate those basic patterns to create various locomotor functions. However, it remains unclear how the neural system controls such muscle groups and basic patterns through neuromechanical interactions in order to achieve adaptive locomotor behavior. This paper reviews simulation studies that explored adaptive motor control in locomotion via sensory-motor coordination using neuromusculoskeletal models based on the muscle synergy hypothesis. Herein, the neural mechanism in motor control related to the muscle synergy for adaptive locomotion and a potential muscle synergy analysis method including neuromusculoskeletal modeling for motor impairments and rehabilitation are discussed. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Schneider, Lawrence W; Klinich, Kathleen D; Moore, Jamie L; MacWilliams, Joel B
In-depth investigations of motor-vehicle crashes involve detailed inspection, measurement, and photodocumentation of vehicle exterior and interior damage, evidence of belt-restraint use, and evidence of occupant contacts with the vehicle interior. Results of in-depth investigations thereby provide the most objective way to identify current and emerging injury problems and issues in occupant safety and crash protection, and provide important feedback on the real-world performance of the latest restraint-system and vehicle crashworthiness technologies. To provide an objective understanding of real-world transportation safety issues for wheelchair-seated travelers, the University of Michigan Transportation Research Institute (UMTRI) has been conducting and assembling data from in-depth investigations of motor-vehicle crashes and non-crash adverse moving-vehicle incidents, such as emergency vehicle braking, turning, and swerving, in which there was at least one vehicle occupant sitting in a wheelchair. The results of 39 investigations involving 42 wheelchair-seated occupants have been assembled and entered into a wheelchair-occupant crash/injury database. In addition, a biomechanical analysis of each case has been performed to identify key safety issues for wheelchair-seated travelers. The wheelchairs of 34 of the 42 occupants who were seated in wheelchairs while traveling in motor vehicles were effectively secured by either a four-point, strap-type tiedown system or a docking securement device, and all but one of these properly secured wheelchairs remained in place during the crash or non-collision event. However, 30 of the 42 occupants were improperly restrained, either because of non-use or incomplete use of available belt restraints, or because the belt restraints were improperly positioned on the occupant's body. Twenty-six of the 42 occupants sustained significant injuries and 10 of these occupants died as a direct result of injuries sustained, or from
Muhoozi, Grace K M; Atukunda, Prudence; Diep, Lien M; Mwadime, Robert; Kaaya, Archileo N; Skaare, Anne B; Willumsen, Tiril; Westerberg, Ane C; Iversen, Per O
Stunting is associated with impaired cognitive and motor function. The effect of an education intervention including nutrition, stimulation, sanitation, and hygiene on child growth and cognitive/language/motor development, delivered to impoverished mothers in Uganda, was assessed. In a community-based, open cluster-randomized trial, 511 mother/children dyads aged 6-8 months were enrolled to an intervention (n = 263) or control (n = 248) group. The primary outcome was change in length-for-age z-score at age 20-24 months. Secondary outcomes included anthropometry and scores on the 2 developmental scales: Bayley Scales of Infant and Toddler Development-III and the Ages and Stages Questionnaire. There was no evidence of a difference in mean length-for-age z-score at 20-24 months between the 2 study groups: 0.10, 95% CI [-0.17, 0.36], p = .49. The intervention group had higher mean composite development scores than the controls on Bayley Scales of Infant and Toddler Development-III, the mean difference being 15.6, 95% CI [10.9, 20.2], p = .0001; 9.9, 95% CI [6.4, 13.2], p = .0001; and 14.6, 95% CI [10.9, 18.2], p = .0001, for cognitive, language, and motor composite scores, respectively. The mean difference in scores from the Ages and Stages Questionnaire were 7.0, 95% CI [2.9, 11.3], p = .001; 5.9, 95% CI [1.2, 10.3], p = .01; 4.2, 95% CI [1.7, 6.7], p = .001; 8.9, 95% CI [5.3, 12.3], p = .0001; and 4.4, 95% CI [0.0, 8.8], p = .05, for communication, gross motor, fine motor, problem solving, and personal-social development, respectively. The intervention education delivered to mothers promoted early development domains in cognitive, language, and motor development but not linear growth of small children in impoverished rural communities in Uganda. Our study showed that child development may be improved with a relatively low cost intervention strategy. This trial was registered at ClinicalTrials.gov as NCT02098031. © 2017 John Wiley & Sons Ltd.
The Impact of Methylphenidate on Motor Performance in Children with both Attention Deficit Hyperactivity Disorder and Developmental Coordination Disorder: A Randomized Double-Blind Crossover Clinical Trial
Full Text Available Background: Children with attention deficit hyperactivity disorder/developmental coordination disorder (ADHD/DCD suffer from problems associated with gross and fine motor skills. There is no effective pharmacological therapy for such patients. We aimed to assess the impact of methylphenidate (MPH on motor performance of children with ADHD/DCD. Methods: In this double-blind placebo-controlled, 17 children (12 boys with ADHD/DCD with a mean age of 7 years 6 months were recruited in Shafa Hospital, Rasht, Iran. The response was defined as ≥25% reduction in the total score of ADHD rating scale-IV from the baseline. Sixteen boys entered phase 2 of the study in which the impact of MPH on motor function was determined through a crossover randomized clinical trial. Eligible individuals were scheduled for baseline and two assessment visits after a one-week period of intervention. We used the short form of Bruininks-Oseretsky test (BOT-2 to identify the disability of motor function. Children were randomly assigned to receive MPH or inert ingredients (placebo. In the second period, medication (MPH/placebo was crossed over. The effects of MPH were analyzed using χ2 test for related samples to compare the performance during baseline, placebo, and MPH trials. The results were analyzed using the SPSS software version 16.0. Results: The mean minimal effective dose of MPH per day was 17.3 mg (0.85 mg/kg. Children with higher ADHD rating scale had a significantly lower standard score in BOT-2 (P=0.03. Following MPH intake, 26.6% of the children showed clinically significant improvement in motor function. However, the improvement was not statistically different between the MPH and placebo. Conclusion: Although MPH improved ADHD symptoms, problems with motor performance still remained. Further work is required to determine the probable effects of MPH in a higher dosage or in different subtypes of ADHD. Trial Registration Number: IRCT201107071483N2
Trial Protocol: Cognitive functional therapy compared with combined manual therapy and motor control exercise for people with non-specific chronic low back pain: protocol for a randomised, controlled trial.
Belache, Fabiana Terra Cunha; Souza, Cíntia Pereira de; Fernandez, Jessica; Castro, Julia; Ferreira, Paula Dos Santos; Rosa, Elizana Rodrigues de Sousa; Araújo, Nathalia Cristina Gimenez de; Reis, Felipe José Jandre; Almeida, Renato Santos de; Nogueira, Leandro Alberto Calazans; Correia, Luís Cláudio Lemos; Meziat-Filho, Ney
Chronic low back pain is a public health problem, and there is strong evidence that it is associated with a complex interaction of biopsychosocial factors. Cognitive functional therapy is an intervention that deals with potentially modifiable multidimensional aspects of pain (eg, provocative cognitive, movement and lifestyle behaviours). There is evidence (from a single randomised, controlled trial) that cognitive functional therapy is better than combined manual therapy and motor control exercise. However, this study had significant methodological shortcomings including the failure to carry out an intention-to-treat analysis and a considerable loss of follow-up of participants. It is important to replicate this study in another domain through a randomised clinical trial with similar objectives but correcting these methodological shortcomings. To investigate the efficacy of cognitive functional therapy compared to combined manual therapy and exercise on pain and disability at 3 months in patients with chronic non-specific low back pain. Two-group, randomised, multicentre controlled trial with blinded assessors. One hundred and forty-eight participants with chronic low back pain that has persisted for >3months and no specific spinal pathology will be recruited from the school clinic of the Centro Universitário Augusto Motta and a private clinic in the city of Rio de Janeiro, Brazil. Four to 10 sessions of cognitive functional therapy. The physiotherapists who will treat the participants in the cognitive functional therapy group have previously attended 2 workshops with two different tutors of the method. Such physiotherapists have completed 106 hours of training, including workshops and patient examinations, as well as conducting a pilot study under the supervision of another physiotherapist with>3 years of clinical experience in cognitive functional therapy. Four to 10 sessions of combined manual therapy and motor control exercises. Participants in the combined
Full Text Available Abstract Background Evidence exist that motor observation activates the same cortical motor areas that are involved in the performance of the observed actions. The so called “mirror neuron system” has been proposed to be responsible for this phenomenon. We employ this neural system and its capability to re-enact stored motor representations as a tool for rehabilitating motor control. In our new neurorehabilitative schema (videotherapy we combine observation of daily actions with concomitant physical training of the observed actions focusing on the upper limbs. Following a pilot study in chronic patients in an ambulatory setting, we currently designed a new multicenter clinical study dedicated to patients in the sub-acute state after stroke using a home-based self-induced training. Within our protocol we assess 1 the capability of action observation to elicit rehabilitational effects in the motor system, and 2 the capacity of this schema to be performed by patients without assistance from a physiotherapist. The results of this study would be of high health and economical relevance. Methods/design A controlled, randomized, multicenter, paralleled, 6 month follow-up study will be conducted on three groups of patients: one group will be given the experimental treatment whereas the other two will participate in control treatments. All patients will undergo their usual rehabilitative treatment beside participation in the study. The experimental condition consists in the observation and immediate imitation of common daily hand and arm actions. The two parallel control groups are a placebo group and a group receiving usual rehabilitation without any trial-related treatment. Trial randomization is provided via external data management. The primary efficacy endpoint is the improvement of the experimental group in a standardized motor function test (Wolf Motor Function Test relative to control groups. Further assessments refer to subjective and
A new clinical trial is testing ONC201, an investigational drug that in laboratory studies has been shown to kill breast and endometrial cancer cells most likely by destroying mitochondria within the tumor cells. Mitochondria are the “powerhouse” of the cell, and blocking its activity may kill tumor cells and shrink tumors in human patients.
Gabbard, Carl; Caçola, Priscila; Bobbio, Tatiana
Theory and anatomical research suggest that the ability to mentally represent intended actions affect level of execution. This study presents preliminary data examining the association between children's ability to mentally represent action and general motor ability. Children aged 7- to 10 years were assessed for motor imagery ability using a simulation of reach task and motor ability via the Movement ABC-2. Motor ability values, based on percentile rank, ranged from 2 to 91, with a mean of 36. The overall correlation between mental representation and motor ability yielded a moderately positive relationship (r = .39). Interestingly, when looking at motor ability subcategories, only Balance was significant in the model, explaining 20% of the variance. These results provide preliminary evidence that children's motor ability and the ability to mentally represent action are associated in a positive direction. Furthermore, given the results for Balance, we speculate that there are clinical implications regarding work with potentially at-risk children. © 2011 Blackwell Publishing Ltd.
Hammond, J; Jones, V; Hill, E L; Green, D; Male, I
Children with Developmental Co-ordination Disorder (DCD) experience poor motor and psychosocial outcomes. Interventions are often limited within the healthcare system, and little is known about how technology might be used within schools or homes to promote the motor skills and/or psychosocial development of these children. This study aimed to evaluate whether short, regular school-based sessions of movement experience using a commercially available home video game console (Nintendo's Wii Fit) would lead to benefits in both motor and psychosocial domains in children with DCD. A randomized crossover controlled trial of children with movement difficulties/DCD was conducted. Children were randomly assigned to an intervention (n = 10) or comparison (n = 8) group. The intervention group spent 10 min thrice weekly for 1 month using Wii Fit during the lunch break, while the comparison group took part in their regular Jump Ahead programme. Pre- and post-intervention assessments considered motor proficiency, self-perceived ability and satisfaction and parental assessment of emotional and behavioural problems. Significant gains were seen in motor proficiency, the child's perception of his/her motor ability and reported emotional well-being for many, but not all children. This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support children's motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties. © 2013 John Wiley & Sons Ltd.
Monticone, Marco; Ambrosini, Emilia; Cazzaniga, Daniele; Rocca, Barbara; Motta, Lorenzo; Cerri, Cesare; Brayda-Bruno, Marco; Lovi, Alessio
To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression. 130 adults with idiopathic scoliosis (main curve rehabilitation programme consisting of active self-correction, task-oriented exercises and cognitive-behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society-22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome. Significant effects of time, group, and time by group interaction were found for all outcome measures (P cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year.
In recent years, several investigators have successfully regenerated axons in animal spinal cords without locomotor recovery. One explanation is that the animals were not trained to use the regenerated connections. Intensive locomotor training improves walking recovery after spinal cord injury (SCI) in people, and >90% of people with incomplete SCI recover walking with training. Although the optimal timing, duration, intensity, and type of locomotor training are still controversial, many investigators have reported beneficial effects of training on locomotor function. The mechanisms by which training improves recovery are not clear, but an attractive theory is available. In 1949, Donald Hebb proposed a famous rule that has been paraphrased as "neurons that fire together, wire together." This rule provided a theoretical basis for a widely accepted theory that homosynaptic and heterosynaptic activity facilitate synaptic formation and consolidation. In addition, the lumbar spinal cord has a locomotor center, called the central pattern generator (CPG), which can be activated nonspecifically with electrical stimulation or neurotransmitters to produce walking. The CPG is an obvious target to reconnect after SCI. Stimulating motor cortex, spinal cord, or peripheral nerves can modulate lumbar spinal cord excitability. Motor cortex stimulation causes long-term changes in spinal reflexes and synapses, increases sprouting of the corticospinal tract, and restores skilled forelimb function in rats. Long used to treat chronic pain, motor cortex stimuli modify lumbar spinal network excitability and improve lower extremity motor scores in humans. Similarly, epidural spinal cord stimulation has long been used to treat pain and spasticity. Subthreshold epidural stimulation reduces the threshold for locomotor activity. In 2011, Harkema et al. reported lumbosacral epidural stimulation restores motor control in chronic motor complete patients. Peripheral nerve or functional electrical
Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder
Straker Leon M
Full Text Available Abstract Background A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. Methods This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5. Discussion This is the first trial to
Byrne, Robert A; Capodanno, Davide; Mahfoud, Felix; Fajadet, Jean; Windecker, Stephan; Jüni, Peter; Baumbach, Andreas; Wijns, William; Haude, Michael
Cardiovascular medicine is one of the specialties that has relied most heavily on evidence from randomized clinical trials in determining best practice for the management of common disease conditions. When comparing treatment approaches, trials incorporating random allocation are the most appropriate method for protecting against treatment allocation bias. In order to protect against performance and ascertainment bias, trial designs including placebo control are preferable where feasible. In contrast to testing of medicines, treatments based on procedures or use of medical devices are more challenging to assess, as sham procedures are necessary to facilitate blinding of participants. However, in many cases, ethical concerns exist, as individual patients allocated to sham procedure are exposed only to risk without potential for benefit. Accordingly, the potential benefits to the general patient population must be carefully weighed against the risks of the exposed individuals. For this reason, trial design and study conduct are critically important to ensure that the investigation has the best chance of answering the study question at hand. In the current manuscript, we aim to review issues relating to the conduct of sham-controlled trials and discuss a number of recent examples in the field of interventional cardiology.
Full Text Available Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age and genotype were investigated. Clinical assessment scores for 38 girls and women with Rett syndrome who attended the Danish Center for Rett Syndrome were used to assess consistency of measurement. Principal components analysis enabled the calculation of three factor scores: Sitting, Standing and Walking, and Challenge. Motor scores were poorer with increasing age and those with the p.Arg133Cys, p.Arg294* or p.Arg306Cys mutation achieved higher scores than those with a large deletion. The repeatability of clinical assessment was excellent (intraclass correlation coefficient for total score 0.99, 95% CI 0.93-0.98. The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice and clinical trials.
Downs, Jenny; Stahlhut, Michelle; Wong, Kingsley; Syhler, Birgit; Bisgaard, Anne-Marie; Jacoby, Peter; Leonard, Helen
Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age and genotype were investigated. Clinical assessment scores for 38 girls and women with Rett syndrome who attended the Danish Center for Rett Syndrome were used to assess consistency of measurement. Principal components analysis enabled the calculation of three factor scores: Sitting, Standing and Walking, and Challenge. Motor scores were poorer with increasing age and those with the p.Arg133Cys, p.Arg294* or p.Arg306Cys mutation achieved higher scores than those with a large deletion. The repeatability of clinical assessment was excellent (intraclass correlation coefficient for total score 0.99, 95% CI 0.93-0.98). The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice and clinical trials.
Schnitzbauer, A A; Lamby, P E; Mutzbauer, I; von Hassel, J; Geissler, E K; Schlitt, H J
Transplantation medicine offers multiple translational questions which should preferably be transferred to clinical evidence. The current gold standard for testing such questions and hypotheses is by prospective randomized controlled trials (RCT). The trials should be performed independently from the medical industry to avoid conflicts of interests and to guarantee a strict scientific approach. A good model is an investigator initiated trial (IIT) in which academic institutions function as the sponsor and in which normally a scientific idea stands before marketing interests of a certain medical product. We present a model for an IIT which is sponsored and coordinated by Regensburg University Hospital at 45 sites in 13 nations (SiLVER study), highlight special pitfalls of this study and offer alternatives to this approach. Finances: financial support in clinical trials can be obtained from the medical industry. Alternatively in Germany the Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung) offers annual grants. The expansion of financial support through foundations is desirable. Infrastructure: sponsorship within the pharmaceutics act (Arzneimittelgesetz) demands excellent infrastructural conditions and a professional team to accomplish clinical, logistic, regulatory, legal and ethical challenges in a RCT. If a large trial has sufficient financial support certain tasks can be outsourced and delegated to contract research organizations, coordinating centers for clinical trials or partners in the medical industry. Clinical scientific advances to improve evidence are an enormous challenge when performed as an IIT. However, academic sponsors can perform (international) IITs when certain rules are followed and should be defined as the gold standard when scientific findings have to be established clinically.
Aşkın, Ayhan; Tosun, Aliye; Demirdal, Ümit Seçil
Repetitive transcranial magnetic stimulation (rTMS) was suggested as a preconditioning method that would increase brain plasticity and that it would be optimal to combine rTMS with intensive rehabilitation. To assess the efficacy of inhibitory rTMS on upper extremity motor recovery and functional outcomes in chronic ischemic stroke patients. In this randomized controlled trial, experimental group received low-frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT), and control group received PT. No statistically significant difference was found in baseline demographical and clinical characteristics of the subjects including stroke severity or severity of paralysis prior to intervention. There were statistically significant improvements in all clinical outcome measures except for the Brunnstrom Recovery Stages. Fugl-Meyer Assessment, Box and Block test, motor and total scores of Functional Independence Measurement (FIM), and Functional Ambulation Scale (FAS) scores were significantly increased in both groups, however, these changes were significantly greater in the rTMS group except for FAS score. FIM cognitive scores and standardized mini-mental test scores were significantly increased and distal and hand Modified Ashworth Scale scores were significantly decreased only in the rTMS group (p functional, and cognitive deficits in chronic stroke. Further studies with a larger number of patients with longer follow-up periods are needed to establish its effectiveness in stroke rehabilitation.
Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder.
Straker, Leon M; Campbell, Amity C; Jensen, Lyn M; Metcalf, Deborah R; Smith, Anne J; Abbott, Rebecca A; Pollock, Clare M; Piek, Jan P
A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile) will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5). This is the first trial to examine the impact of new virtual reality games on
Aktug, Zait Burak; Iri, Ruckan; Top, Elif
The aim of the study is to examine the relationship between children's 50 m freestyle swimming performances and motor performances. There were 32 swimmers (male = 21, female = 11), who had been swimming for at least one and a half year, participated in the study. The motor performances of the participating swimmers were determined through the…
Kvestad, Ingrid; Taneja, Sunita; Kumar, Tivendra; Hysing, Mari; Refsum, Helga; Yajnik, Chittaranjan S; Bhandari, Nita; Strand, Tor A
Deficiencies of vitamin B12 and folate are associated with delayed development and neurological manifestations. The objective of this study was to measure the effect of daily supplementation of vitamin B12 and/or folic acid on development in young North Indian children. In a randomized, double blind trial, children aged six to 30 months, received supplement with placebo or vitamin B12 and/or folic acid for six months. Children were allocated in a 1:1:1:1 ratio in a factorial design and in blocks of 16. We measured development in 422 children by the Ages and Stages Questionnaire 3rd ed. at the end of the intervention. Compared to placebo, children who received both vitamin B12 and folic acid had 0.45 (95% CI 0.19, 0.73) and 0.28 (95% CI 0.02, 0.54) higher SD-units in the domains of gross motor and problem solving functioning, respectively. The effect was highest in susceptible subgroups consisting of stunted children, those with high plasma homocysteine (> 10 μmol/L) or in those who were younger than 24 at end study. With the exception of a significant improvement on gross motor scores by vitamin B12 alone, supplementation of either vitamin alone had no effect on any of the outcomes. Our findings suggest that supplementation of vitamin B12 and folic acid benefit development in North Indian Children. ClinicalTrials.gov NCT00717730.
Mattern-Baxter, Katrin; McNeil, Stefani; Mansoor, Jim K
To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP). Quasi-randomized controlled trial. Homes of the participants. Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up. All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist. Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively. There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04). Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Ahn, Rosa; Woodbridge, Alexandra; Abraham, Ann; Saba, Susan; Korenstein, Deborah; Madden, Erin; Boscardin, W John; Keyhani, Salomeh
To examine the association between the presence of individual principal investigators' financial ties to the manufacturer of the study drug and the trial's outcomes after accounting for source of research funding. Cross sectional study of randomized controlled trials (RCTs). Studies published in "core clinical" journals, as identified by Medline, between 1 January 2013 and 31 December 2013. Random sample of RCTs focused on drug efficacy. Association between financial ties of principal investigators and study outcome. A total of 190 papers describing 195 studies met inclusion criteria. Financial ties between principal investigators and the pharmaceutical industry were present in 132 (67.7%) studies. Of 397 principal investigators, 231 (58%) had financial ties and 166 (42%) did not. Of all principal investigators, 156 (39%) reported advisor/consultancy payments, 81 (20%) reported speakers' fees, 81 (20%) reported unspecified financial ties, 52 (13%) reported honorariums, 52 (13%) reported employee relationships, 52 (13%) reported travel fees, 41 (10%) reported stock ownership, and 20 (5%) reported having a patent related to the study drug. The prevalence of financial ties of principal investigators was 76% (103/136) among positive studies and 49% (29/59) among negative studies. In unadjusted analyses, the presence of a financial tie was associated with a positive study outcome (odds ratio 3.23, 95% confidence interval 1.7 to 6.1). In the primary multivariate analysis, a financial tie was significantly associated with positive RCT outcome after adjustment for the study funding source (odds ratio 3.57 (1.7 to 7.7). The secondary analysis controlled for additional RCT characteristics such as study phase, sample size, country of first authors, specialty, trial registration, study design, type of analysis, comparator, and outcome measure. These characteristics did not appreciably affect the relation between financial ties and study outcomes (odds ratio 3.37, 1
Grigoryey, N. V.; Fedorovich, M. A.
The vibroacoustical characteristics of different types of electric motors are discussed. It is shown that the basic source of low frequency vibrations is rotor unbalance. A flexible damping support, with an antivibrator, is used to obtain the vibroacoustical effect of reduction in the basic harmonic of the electric motor. A model of the electric motor and the damping apparatus is presented. Mathematical models are developed to show the relationships of the parameters. The basic purpose in using a calculation model id the simultaneous replacement of the exciting force created by the rotor unbalance and its inertial rigidity characteristics by a limiting kinematic disturbance.
Full Text Available The present study presents an experimental investigation on the effect of condenser air inlet temperature and dimensionless parameter of X on the performance of automobile air-conditioning (AAC system using integrated brushless direct current motor-rotary compressor and electronic expansion valve. The other components of AAC system are from original component of AAC system used for medium size passenger car. The experimental results showed that the increment of the condenser air inlet temperature and X caused an increase in condensing temperature, cooling capacity and compressor work, while decreasing the coefficient of performance (COP. Meanwhile, the evaporating temperature increase with the increment of condenser air inlet temperature, but decrease with decrement of X. In general, AAC system have to work at higher value of X in order to produce more cooling capacity, thereby increment in compressor work also occurs due to energy balance. However, at higher value of X, the COP of the system dropped due to dominant increase in compressor power, as opposed to a rise in cooling capacity. Due to this reason, the best operation of this compressor occurs at X = 4.96 for constant T5 (35ºC, or at T5 = 30ºC for constant X (4.96.
Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial.
Rascol, O; Brooks, D J; Melamed, E; Oertel, W; Poewe, W; Stocchi, F; Tolosa, E
Rasagiline mesylate is a novel drug for Parkinson's disease with selective, irreversible monoamine oxidase B (MAO-B) inhibitor activity, and is effective as monotherapy in early disease. This study investigated rasagiline efficacy and safety in levodopa-treated patients with Parkinson's disease and motor fluctuations. In an 18-week, double-blind, multicentre (74 hospitals and academic centres in Israel, Argentina, and Europe) trial, 687 outpatients were randomly assigned to oral rasagiline (231 individuals; 1 mg once daily), entacapone (227; 200 mg with every levodopa dose), or placebo (229). Primary outcome was change in total daily off-time (intention-to-treat population). Other measures included the clinical global improvement (CGI) score and unified Parkinson's disease rating scale (UPDRS) scores. Analysis was by intention to treat. 88 (13%) patients who were assigned treatment did not complete the study (23 rasagiline, 30 entacapone, 35 placebo), mainly because of withdrawal of consent (n=34) and adverse events (n=34). Both rasagiline and entacapone reduced mean daily off-time (-1.18 h rasagiline and -1.2 h entacapone vs placebo -0.4 h; p=0.0001, prasagiline and -0.72 entacapone vs -0.37 placebo; prasagiline reduces mean daily off-time and improves symptoms of Parkinson's disease in levodopa-treated patients with motor fluctuations, an effect similar to that of entacapone.
Sheila M. Bird
Full Text Available The prison-based N-ALIVE pilot trial had undertaken to notify the Research Ethics Committee and participants if we had reason to believe that the N-ALIVE pilot trial would not proceed to the main trial. In this paper, we describe how external data for the third year of before/after evaluation from Scotland's National Naloxone Programme, a related public health policy, were anticipated by eliciting prior opinion about the Scottish results in the month prior to their release as official statistics. We summarise how deliberations by the N-ALIVE Trial Steering-Data Monitoring Committee (TS-DMC on N-ALIVE's own interim data, together with those on naloxone-on-release (NOR from Scotland, led to the decision to cease randomization in the N-ALIVE pilot trial and recommend to local Principal Investigators that NOR be offered to already-randomized prisoners who had not yet been released.
Conclusion: The results of this study showed that mirror neurons within the premotor cortex are an important neural mechanism in the brain activity pattern, which causes the effectiveness of imagery in the improvement of motor skills.
Full Text Available Three-phase voltage source inverter driven induction motor is used in many medium- and high-power applications. Precision in speed of the motor play vital role, i.e. popular methods of direct/indirect field-oriented control (FOC are applied. FOC is employed with proportional–integral (P-I or proportional–integral–derivative (P-I-D controllers and they are not adaptive, since gains are fixed at all operating conditions. Therefore, it needs a robust speed controlling in precision for induction motor drive application. This research paper articulates a novel speed control for FOC induction motor drive based on wavelet-fuzzy logic interface system. In specific, the P-I-D controller of IFOC which is actually replaced by the wavelet-fuzzy controller. The speed feedback (error signal is composed of multiple low and high frequency components. Further, these components are decomposed by the discrete wavelet transform and the fuzzy logic controller to generate the scaled gains for the indirect FOC induction motor. Complete model of the proposed ac motor drive is developed with numerical simulation Matlab/Simulink software and tested under different working conditions. For experimental verification, a hardware prototype was implemented and the control algorithm is framed using TMS320F2812 digital signal processor (dsp. Both simulation and hardware results presented in this paper are shown in close agreement and conformity about the suitability for industrial applications.
Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Diercks, Ron L; Lemmink, Koen A P M
Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during unexpected sidestep cutting in female and male athletes and how these effects remained over time. Ninety experienced basketball athletes performed sidestep cutting manoeuvres in three sessions (S1, S2 and S3). In this randomized controlled trial, athletes were allocated to three groups: visual (VIS), verbal (VER) and control (CTRL). Kinematics and kinetics were collected at the time of peak knee frontal plane moment. Males in the VIS group showed a larger vertical ground reaction force (S1: 25.4 ± 3.1 N/kg, S2: 25.8 ± 2.9 N/kg, S3: 25.2 ± 3.2 N/kg) and knee flexion moments (S1: -3.8 ± 0.9 Nm/kg, S2: -4.0 ± 1.2 Nm/kg, S3: -3.9 ± 1.3 Nm/kg) compared to the males in the VER and CTRL groups and to the females in the VIS group (p knee valgus moment and the females in the VER group reduced knee varus moment over time (n.s.). Male subjects clearly benefit from visual feedback. Females may need different feedback modes to learn a correct movement pattern. Sex-specific learning preferences may have to be acknowledged in day by day practice. Adding video instruction or feedback to regular training regimens when teaching athletes safe movement patterns and providing individual feedback might target suboptimal long-term results and optimize ACL injury prevention programmes. I.
Full Text Available Background The initial years of life particularly the first two years are regarded as the most important brain development period. This study attempted to determine the effect of care package on motor development in 12-month-old infants in Saqqez-Iran. Materials and Methods:This study was a clinical trial conducted in 2016 on 70 infants of 12 months of age selected randomly in intervention and control groups in Saqqez-Iran. The care package was taught to mothers of infants in intervention group by the researchers based on the book "Ages and Stages Learning Activities 0-5 years". These teachings for gross motor, included walking, pulling and pushing the toys, swinging, playing with ball, crawling, etc. and for fine motor skills included building towers, painting, filling a box with household items and emptying it, giving children books, stringing, etc. Motor skills (gross and fine were measured by Age and Stage Questionnaire (ASQ-2 screening tool before intervention, 4 and 8 weeks after the intervention. Data were analyzed using SPSS version 20.0 software. Results: In the intervention group, 56.2% and in the control group 51.4% were female, respectively. Results showed that 4 and 8 weeks after the intervention in gross movement, average scores in the intervention group were more than the control group (P = 0.02, and mean score in three times (before intervention, 4 and 8 weeks after the intervention was significant difference (P = 0.002. Also, for fine movement, results showed that in this area average scores in the intervention group were more than the control group (P=0.02; and the average score was a significant difference in that three times (P=0.01. Conclusion: Results revealed that the impact of care package in intervention group compared with control group in level of significance led to an improvement in motor skills domain (gross and fine movement in 12-month-old infants in this study.
Kaladjian, A; Adida, M; Simon, N; Belzeaux, R; Blin, O; Fakra, E; Azorin, J-M
As in the usual care of patients, paraclinical investigations have today only a very modest role in clinical trials in psychiatry, mainly to complete the pre-therapeutical assessments prior to inclusion of subjects or to monitor treatment tolerance. Yet, the accumulation of data in neurosciences suggests the next emergence of biomarkers, whose interest is that they are closely associated to the biological disturbances underlying psychiatric illnesses, and that they are accessible by means of technological tools such as imaging devices. These tools allow to explore the effects on brain of psychotropic medications, such as antidepressants, antipsychotics, or mood stabilizers, in relation to their therapeutic action. The obtained results allow to consider the use of such biomarkers in clinical trials in addition to more conventional approaches. In particular, they could be used as targets to measure brain response to treatment in association with clinical response, to predict a therapeutic response from the neurofunctional characteristics of patients, or to establish the safety profile of drugs on the nervous system. The use of such biomarkers in clinical trials would help to better define the explored populations and their characteristics, as well as the variables to assess, and to better measure the impact of the treatments and their potential harmful effects on the nervous system. © L’Encéphale, Paris, 2016.
Full Text Available The audition injury hinders some motor motions and the organised coordination at the higher level and may be a cause of disturbances and disorder in some motor abilities adoption. It was assumed that deafness including its aetiology and injury mechanism may significantly influence the motor development of human being. The study aimed in checking if the deafness, as a result of various unfavourable factors, determines the motor development of children and youngsters. Consequently the dependency between qualitative features i.e.: signed motor level and aetiology, audition injury mechanism and the deafness degree was examined. The mechanism and aetiology of hearing correlated with the motor abilities displayed statistically significant dependencies in few motor trials only. Revealed correlations regarded mostly the coordination trials excluding the flexibility one. Statistically significant dependencies between the audition diminution and the motor abilities level were not found.
Full Text Available Background: OnabotulinumtoxinA (BoNT-A can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. Methods: This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl–Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. Results: The ‘rehab’ group significantly improved on the Fugl–Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67 while the ‘no rehab’ group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006. This improvement was largely driven by the upper extremity “movement” subscale, which showed that the ‘rehab’ group was improving (Visit 1 = 33, Visit 5 = 37 while the ‘no rehab’ group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034. Conclusions: Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.
Devier, Deidre; Harnar, JoAnn; Lopez, Leandro; Brashear, Allison; Graham, Glenn
OnabotulinumtoxinA (BoNT-A) can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl-Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. The 'rehab' group significantly improved on the Fugl-Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67) while the 'no rehab' group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006). This improvement was largely driven by the upper extremity "movement" subscale, which showed that the 'rehab' group was improving (Visit 1 = 33, Visit 5 = 37) while the 'no rehab' group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034). Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.
Zhang, Zhen; Jiao, Xuejun; Xu, Fengang; Jiang, Jin; Yang, Hanjun; Cao, Yong; Fu, Jiahao
Functional near-infrared spectroscopy (fNIRS), which can measure cortex hemoglobin activity, has been widely adopted in brain-computer interface (BCI). To explore the feasibility of recognizing motor imagery (MI) and motor execution (ME) in the same motion. We measured changes of oxygenated hemoglobin (HBO) and deoxygenated hemoglobin (HBR) on PFC and Motor Cortex (MC) when 15 subjects performing hand extension and finger tapping tasks. The mean, slope, quadratic coefficient and approximate entropy features were extracted from HBO as the input of support vector machine (SVM). For the four-class fNIRS-BCI classifiers, we realized 87.65% and 87.58% classification accuracy corresponding to hand extension and finger tapping tasks. In conclusion, it is effective for fNIRS-BCI to recognize MI and ME in the same motion.
Gillian L. Fell
Full Text Available There are few evidence-based guidelines to inform optimal design of complex clinical trials, such as those assessing the safety and efficacy of intravenous drugs administered daily with infusion times over many hours per day and treatment durations that may span years. This study is a retrospective review of inpatient administration deviation reports for an investigational drug that is administered daily with infusion times of 8–24 h, and variable treatment durations for each patient. We report study design modifications made in 2007–2008 aimed at minimizing deviations from an investigational drug infusion protocol approved by an institutional review board and the United States Food and Drug Administration. Modifications were specifically aimed at minimizing errors of infusion rate, incorrect dose, incorrect patient, or wrong drug administered. We found that the rate of these types of administration errors of the study drug was significantly decreased following adoption of the specific study design changes. This report provides guidance in the design of clinical trials testing the safety and efficacy of study drugs administered via intravenous infusion in an inpatient setting so as to minimize drug administration protocol deviations and optimize patient safety.
Bruch, Anton; Kusminskiy, Silvia Viola; Refael, Gil; von Oppen, Felix
We present a field-theoretic treatment of an adiabatic quantum motor. We explicitly discuss a motor called the Thouless motor which is based on a Thouless pump operating in reverse. When a sliding periodic potential is considered to be the motor degree of freedom, a bias voltage applied to the electron channel sets the motor in motion. We investigate a Thouless motor whose electron channel is modeled as a Luttinger liquid. Interactions increase the gap opened by the periodic potential. For an infinite Luttinger liquid the coupling-induced friction is enhanced by electron-electron interactions. When the Luttinger liquid is ultimately coupled to Fermi liquid reservoirs, the dissipation reduces to its value for a noninteracting electron system for a constant motor velocity. Our results can also be applied to a motor based on a nanomagnet coupled to a quantum spin Hall edge.
The Food and Drug Administration (FDA) is amending the current good manufacturing practice (CGMP) regulations for human drugs, including biological products, to exempt most phase 1 investigational drugs from complying with the regulatory CGMP requirements. FDA will continue to exercise oversight of the manufacture of these drugs under FDA's general statutory CGMP authority and through review of the investigational new drug applications (IND). In addition, elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document entitled "Guidance for Industry: CGMP for Phase 1 Investigational Drugs" dated November 2007 (the companion guidance). This guidance document sets forth recommendations on approaches to compliance with statutory CGMP for the exempted phase 1 investigational drugs. FDA is taking this action to focus a manufacturer's effort on applying CGMP that is appropriate and meaningful for the manufacture of the earliest stage investigational drug products intended for use in phase 1 clinical trials while ensuring safety and quality. This action will also streamline and promote the drug development process.
Halliday, Mark H; Pappas, Evangelos; Hancock, Mark J; Clare, Helen A; Pinto, Rafael Z; Robertson, Gavin; Ferreira, Paulo H
Study Design Randomized clinical trial. Background Motor control exercises are believed to improve coordination of the trunk muscles. It is unclear whether increases in trunk muscle thickness can be facilitated by approaches such as the McKenzie method. Furthermore, it is unclear which approach may have superior clinical outcomes. Objectives The primary aim was to compare the effects of the McKenzie method and motor control exercises on trunk muscle recruitment in people with chronic low back pain classified with a directional preference. The secondary aim was to conduct a between-group comparison of outcomes for pain, function, and global perceived effect. Methods Seventy people with chronic low back pain who demonstrated a directional preference using the McKenzie assessment were randomized to receive 12 treatments over 8 weeks with the McKenzie method or with motor control approaches. All outcomes were collected at baseline and at 8-week follow-up by blinded assessors. Results No significant between-group difference was found for trunk muscle thickness of the transversus abdominis (-5.8%; 95% confidence interval [CI]: -15.2%, 3.7%), obliquus internus (-0.7%; 95% CI: -6.6%, 5.2%), and obliquus externus (1.2%; 95% CI: -4.3%, 6.8%). Perceived recovery was slightly superior in the McKenzie group (-0.8; 95% CI: -1.5, -0.1) on a -5 to +5 scale. No significant between-group differences were found for pain or function (P = .99 and P = .26, respectively). Conclusion We found no significant effect of treatment group for trunk muscle thickness. Participants reported a slightly greater sense of perceived recovery with the McKenzie method than with the motor control approach. Level of Evidence Therapy, level 1b-. Registered September 7, 2011 at www.anzctr.org.au (ACTRN12611000971932). J Orthop Sports Phys Ther 2016;46(7):514-522. Epub 12 May 2016. doi:10.2519/jospt.2016.6379.
Göksu, Ömer Can; Yüksek, Selami; Ölmez, Cengiz
This study was conducted to examine the effects of sports activities other than soccer on 10-15-year-old soccer players' motor skills. The sample included 146 registered soccer players in the U category (U10-U15) of the Turkish Football Federation's Aslantepe, Çeliktepe and Seyrantepe clubs. The players participated in this study on a voluntary…
Klíma, J.; Chomát, Miroslav; Schreier, Luděk
Roč. 2, č. 6 (2008), s. 341-352 ISSN 1751-8660 R&D Projects: GA ČR GA102/08/0424 Institutional research plan: CEZ:AV0Z20570509 Keywords : DC-link voltage pulsations * torque ripple * induction motor Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 0.660, year: 2008
D. S. Odnolko
Full Text Available The paper proposes an algorithm for online identification of active stator resistance. Algorithm synthesis has been developed on the basis of a recursive least squares method. The problem has been solved for induction motor model defined in the stationary stator frame α–β-coordinating system. An analysis of negative factors deteriorating the identifier operation has been made in the paper. The analysis has revealed the following: measured signals are noisy due to quantization and differentiation; dynamic model of an induction motor provides only approximate presentation about actual processes in the electromagnetic system of the machine. The paper presents results of a system simulation while applying the proposed algorithm that confirm the fact that the estimated value of the active stator resistance tends to a true value with high accuracy. The identification test assumes a fixed rotor and nominal parameters uncertainty, but the flexible structure of the algorithm allows to use it as for single-phase excitation so for full-phase control of the induction motor with freely rotating motor.
Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.
Kim, Grace J; Hinojosa, Jim; Rao, Ashwini K; Batavia, Mitchell; O'Dell, Michael W
To compare the long-term effects of external focus (EF) and internal focus (IF) of attention after 4 weeks of arm training. Randomized, repeated-measures, mixed analysis of variance. Outpatient clinic. Individuals with stroke and moderate-to-severe arm impairment living in the community (N=33; withdrawals: n=3). Four-week arm training protocol on a robotic device (12 sessions). Joint independence, Fugl-Meyer Assessment, and Wolf Motor Function Test measured at baseline, discharge, and 4-week follow-up. There were no between-group effects for attentional focus. Participants in both groups improved significantly on all outcome measures from baseline to discharge and maintained those changes at 4-week follow-up regardless of group assignment (joint independence EF condition: F 1.6,45.4 =17.74; P<.0005; partial η 2 =.39; joint independence IF condition: F 2,56 =18.66; P<.0005; partial η 2 =.40; Fugl-Meyer Assessment: F 2,56 =27.83; P<.0005; partial η 2 =.50; Wolf Motor Function Test: F 2,56 =14.05; P<.0005; partial η 2 =.35). There were no differences in retention of motor skills between EF and IF participants 4 weeks after arm training, suggesting that individuals with moderate-to-severe arm impairment may not experience the advantages of an EF found in healthy individuals. Attentional focus is most likely not an active ingredient for retention of trained motor skills for individuals with moderate-to-severe arm impairment, whereas dosage and intensity of practice appear to be pivotal. Future studies should investigate the long-term effects of attentional focus for individuals with mild arm impairment. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Rasagiline (n-propargyl-1[R]-aminoindan) mesylate is a novel irreversible selective monoamine oxidase type B inhibitor, previously demonstrated to improve symptoms in early Parkinson disease (PD). To determine the safety, tolerability, and efficacy of rasagiline in levodopa-treated patients with PD and motor fluctuations. Multicenter, randomized, placebo-controlled, double-blind, parallel-group study. Parkinson disease patients (N = 472) with at least 21/2 hours of daily "off" (poor motor function) time, despite optimized treatment with other anti-PD medications. Rasagiline, 1.0 or 0.5 mg/d, or matching placebo. Change from baseline in total daily off time measured by patients' home diaries during 26 weeks of treatment, percentage of patients completing 26 weeks of treatment, and adverse event frequency. During the treatment period, the mean adjusted total daily off time decreased from baseline by 1.85 hours (29%) in patients treated with 1.0 mg/d of rasagiline, 1.41 hours (23%) with 0.5 mg/d rasagiline, and 0.91 hour (15%) with placebo. Compared with placebo, patients treated with 1.0 mg/d rasagiline had 0.94 hour less off time per day, and patients treated with 0.5 mg/d rasagiline had 0.49 hour less off time per day. Prespecified secondary end points also improved during rasagiline treatment, including scores on an investigator-rated clinical global impression scale and the Unified Parkinson's Disease Rating Scale (activities of daily living in the off state and motor performance in the "on" state). Rasagiline was well tolerated. Rasagiline improves motor fluctuations and PD symptoms in levodopa-treated PD patients. In light of recently reported benefits in patients with early illness, rasagiline is a promising new treatment for PD.
Full Text Available An urgent need exists to develop new antibacterial drugs for children. We conducted research with investigators of pediatric antibacterial drug trials to identify facilitators and barriers in the conduct of these trials. Seventy-three investigators completed an online survey assessing the importance of 15 facilitators (grouped in 5 topical categories and the severity of 36 barriers (grouped in 6 topical categories to implementing pediatric antibacterial drug trials. Analysis focused on the identification of key factors that facilitate the successful implementation of pediatric antibacterial drug trials and the key barriers to implementation. Almost all investigators identified two factors as very important facilitators: having site personnel for enrollment and having adequate funding. Other top factors were related to staffing. Among the barriers, factors related to parent concerns and consent were prominent, particularly obtaining parental consent when there was disagreement between parents, concerns about the number of blood draws, and concerns about the number of invasive procedures. Having overly narrow eligibility criteria was also identified as a major barrier. The survey findings suggest three areas in which to focus efforts to help facilitate ongoing drug development: (1 improving engagement with parents of children who may be eligible to enroll in a pediatric antibacterial drug trial, (2 broadening inclusion criteria to allow more participants to enroll, and (3 ensuring adequate staffing and establishing sustainable financial strategies, such as funding pediatric trial networks. The pediatric antibacterial drug trials enterprise is likely to benefit from focused efforts by all stakeholders to remove barriers and enhance facilitation.
Yahaya Asizehi ENESI
Full Text Available In this paper, the input parameters of a single phase split-phase induction motor is taken to investigate and to study the output performance characteristics of capacitor start and capacitor run induction motor. The value of these input parameters are used in the design characteristics of capacitor run and capacitor start motor with each motor connected to rated or standard capacitor in series with auxiliary winding or starting winding respectively for the normal operational condition. The magnitude of capacitor that will develop maximum torque in capacitor start motor and capacitor run motor are investigated and determined by simulation. Each of these capacitors is connected to the auxiliary winding of split-phase motor thereby transforming it into capacitor start or capacitor run motor. The starting current and starting torque of the split-phase motor (SPM, capacitor run motor (CRM and capacitor star motor (CSM are compared for their suitability in their operational performance and applications.
Benninger-Döring, G; Boos, J
Non-commercial clinical trials may be of great benefit to the patients concerned. The 12th amendment to the German Drug Law (AMG) changed legal liability of the initiators of investigator-initiated clinical trials with extensive consequences for traditional project leaders. The central point under discussion is the sponsor's responsibility according to the AMG. Presently leading management divisions of university hospitals and universities are developing proceedings to assume sponsor responsibility by institutions (institutional sponsorship), which should enable investigator-initiated clinical trials to be conducted according to legal requirements in the future. Detailed problems and special questions can only be resolved in a single-minded fashion, and if necessary political processes should be catalyzed.
Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...
West, C; Bowen, A; Hesketh, A; Vail, A
Apraxia is a cognitive disorder that can occur after stroke. It prevents a person from carrying out a learned movement. Various interventions are used to treat apraxia but evidence of their benefit has been lacking. To determine which therapeutic interventions targeted at motor apraxia reduce disability. We searched the Cochrane Stroke Group Trials Register (last searched November 2006). In addition, we searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2006), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2006), CINAHL (1982 to November 2006), PsycINFO (1974 to November 2006), the Research Index of the Occupational Therapy Journal (searched November 2006), REHABDATA (1956 to November 2006), the National Research Register (searched November 2006) and Current Controlled Trials Register (searched November 2006). We reviewed the reference lists of all articles that we identified as relevant. We made efforts to find both published and unpublished trials by writing to key authors and journals. Randomised controlled trials of therapeutic intervention for motor apraxia in stroke. One review author searched the titles, abstracts and keywords. Four review authors extracted data and analysed trial quality. We contacted investigators for further details of trials if necessary. Three trials including a total of 132 participants were included in the review. There was evidence of a small and short-lived therapeutic effect in the two studies that reported change in activities of daily living (102 participants) but this was not considered clinically significant and did not persist at the longer-term follow up. There is insufficient evidence to support or refute the effectiveness of specific therapeutic interventions for motor apraxia after stroke. Further research of higher quality is required. As we did not review whether patients with apraxia benefit from rehabilitation input in general, they
Hashimoto, Hiroko; Takabatake, Shinichi; Miyaguchi, Hideki; Nakanishi, Hajime; Naitou, Yasuo
To examine the effectiveness of dance on motor functions, cognitive functions, and mental symptoms of Parkinson's disease (PD). This study employed a quasi-randomised, between-group design. Dance, PD exercise, and all assessments were performed in community halls in different regions of Japan. Forty-six mild-moderate PD patients participated. Six PD patient associations that agreed to participate in the study were randomly assigned to a dance group, PD exercise group, or non-intervention group. The dance and PD exercise groups performed one 60-min session per week for 12 weeks. Control group patients continued with their normal lives. All groups were assessed before and after the intervention. We used the Timed Up-and-Go Test (TUG) and Berg Balance Scale (BBS) to assess motor function, the Frontal Assessment Battery at bedside (FAB) and Mental Rotation Task (MRT) to assess cognitive function, and the Apathy Scale (AS) and Self-rating Depression Scale (SDS) to assess mental symptoms of PD. The Unified Parkinson's Disease Rating Scale (UPDRS) was used for general assessment of PD. When comparing results before and after intervention, the dance group showed a large effect in TUG time (ES=0.65, p=0.006), TUG step number (ES=0.66, p=0.005), BBS (ES=0.75, p=0.001), FAB (ES=0.77, p=0.001), MRT response time (ES=0.79, pmental symptoms in PD patients. General symptoms in PD also improved. Dance is an effective method for rehabilitation in PD patients. Copyright © 2015 Elsevier Ltd. All rights reserved.
Clohisy, John C; Kim, Young-Jo; Lurie, Jon
to be further defined. To date, clinical research reports have included primarily surgical case series. Future clinical investigations are needed to establish improved clinical evidence to guide patient care. Most urgent is the need to better understand the potential role of standardized nonsurgical treatment......Femoroacetabular impingement (FAI) represents a heterogeneous group of disorders that affect a diverse patient population. The natural history of the disease, the role of nonsurgical management, the indications for surgery, optimal surgical techniques, and the predictors of treatment outcomes need...... options for FAI and to define the predictors of surgical and nonsurgical outcomes. Future randomized controlled trials and large observational cohort studies targeted at these clinical research deficiencies will strengthen the evidence and improve informed decision making regarding the management...
Houssaïni, Allal; Assoumou, Lambert; Marcelin, Anne Geneviève; Molina, Jean Michel; Calvez, Vincent; Flandre, Philippe
Background. Many statistical models have been tested to predict phenotypic or virological response from genotypic data. A statistical framework called Super Learner has been introduced either to compare different methods/learners (discrete Super Learner) or to combine them in a Super Learner prediction method. Methods. The Jaguar trial is used to apply the Super Learner framework. The Jaguar study is an "add-on" trial comparing the efficacy of adding didanosine to an on-going failing regimen. Our aim was also to investigate the impact on the use of different cross-validation strategies and different loss functions. Four different repartitions between training set and validations set were tested through two loss functions. Six statistical methods were compared. We assess performance by evaluating R(2) values and accuracy by calculating the rates of patients being correctly classified. Results. Our results indicated that the more recent Super Learner methodology of building a new predictor based on a weighted combination of different methods/learners provided good performance. A simple linear model provided similar results to those of this new predictor. Slight discrepancy arises between the two loss functions investigated, and slight difference arises also between results based on cross-validated risks and results from full dataset. The Super Learner methodology and linear model provided around 80% of patients correctly classified. The difference between the lower and higher rates is around 10 percent. The number of mutations retained in different learners also varys from one to 41. Conclusions. The more recent Super Learner methodology combining the prediction of many learners provided good performance on our small dataset.
Differences in Investigator-Initiated Trials between Japan and Other Countries: Analyses of Clinical Trials Sponsored by Academia and Government in the ClinicalTrials.gov Registry and in the Three Japanese Registries.
Full Text Available Following the amendment of the Pharmaceutical Affairs Law in Japan in 2003 researchers were permitted to begin investigator-initiated trials (IITs. In subsequent years, however, the number of IITs remained low. In other countries in Asia as well as in Europe, North America, and South Africa, the number of IITs has increased over the past decade. The differences in the characteristics of IITs between Japan and other countries are unknown. Some studies have analyzed the characteristics of all clinical trials according to registry databases, but there has been less research focusing on IITs.The purpose of this study is to analyze the characteristics of IITs in the ClinicalTrials.gov registry and in the three Japanese registries, to identify differences in IITs between Japan and other countries.Using Thomson Reuters Pharma™, trials sponsored by academia and government as IITs in 2010 and registered in ClinicalTrials.gov were identified. IITs from 2004 to 2012 in Japan were identified in the three Japanese registries: the University Hospital Medical Information Network Clinical Trials Registry, the Japan Pharmaceutical Information Center Clinical Trials Information, and the Japan Medical Association Center for Clinical Trials, Clinical Trials Registry. Characterization was made of the trial purposes, phases, participants, masking, arms, design, controls, and other data.New and revised IITs registered in ClinicalTrials.gov during 2010 averaged about 40% of all sponsor-identified trials. IITs were nearly all early-phase studies with small numbers of participants. A total of 56 Japanese IITs were found over a period of 8 years, and these were also almost nearly all early-phase studies with small numbers of participants.There appear to be no great differences between Japan and other countries in terms of characteristics of IITs. These results should prompt a new review of the IIT environment in Japan.
Cheng, J; East, P; Blanco, E; Sim, E Kang; Castillo, M; Lozoff, B; Gahagan, S
Poor motor skills have been consistently linked with a higher body weight in childhood, but the causal direction of this association is not fully understood. This study investigated the temporal ordering between children's motor skills and weight status at 5 and 10 years. Participants were 668 children (54% male) who were studied from infancy as part of an iron deficiency anaemia preventive trial and follow-up study in Santiago, Chile. All were healthy, full-term and weighing 3 kg or more at birth. Cross-lagged panel modelling was conducted to understand the temporal precedence between children's weight status and motor proficiency. Analyses also examined differences in gross and fine motor skills among healthy weight, overweight, and obese children. A higher BMI at 5 years contributed to declines in motor proficiency from 5 to 10 years. There was no support for the reverse, that is, poor motor skills at 5 years did not predict increases in relative weight from 5 to 10 years. Obesity at 5 years also predicted declines in motor proficiency. When compared with normal weight children, obese children had significantly poorer total and gross motor skills at both 5 and 10 years. Overweight children had poorer total and gross motor skills at 10 years only. The differences in total and gross motor skills among normal weight, overweight and obese children appear to increase with age. There were small differences in fine motor skill between obese and non-obese children at 5 years only. Obesity preceded declines in motor skills and not the reverse. Study findings suggest that early childhood obesity intervention efforts might help prevent declines in motor proficiency that, in turn, may positively impact children's physical activity and overall fitness levels. © 2016 John Wiley & Sons Ltd.
Rabadi, Meheroz H; Aston, Christopher E
The aim of this article was to determine whether cathodal transcranial direct current stimulation (c-tDCS) to unaffected primary motor cortex (PMC) plus conventional occupational therapy (OT) improves functional motor recovery of the affected arm hand in patients after an acute ischemic stroke compared with sham transcranial direct current stimulation plus conventional OT. In this prospective, randomized, double-blinded, sham-controlled trial of 16 severe, acute ischemic stroke patients with severe arm-hand weakness were randomly assigned to either experimental (c-tDCS plus OT; n = 8) or control (sham transcranial direct current stimulation plus OT; n = 8) groups. All patients received a standard 3-hr in-patient rehabilitation therapy, plus an additional ten 30-min sessions of tDCS. During each session, 1 mA of cathodal stimulation to the unaffected PMC is performed followed by the patient's scheduled OT. The primary outcome measure was change in Action Research Arm Test (ARAT) total and subscores on discharge. Application of c-tDCS to unaffected PMC resulted in a clinically relevant 10-point improvement in the affected arm-hand function based on ARAT total score compared with a 2-point improvement in the control group. Application of 30-min of c-tDCS to the unaffected PMC showed a 10-point improvement in the ARAT score. This corresponds to a large effect size in improvement of affected arm-hand function in patients with severe, acute ischemic stroke. Although not statistically significant, this suggests that larger studies, enrolling at least 25 patients in each group, and with a longer follow-up are warranted.
McCabe, Jessica; Monkiewicz, Michelle; Holcomb, John; Pundik, Svetlana; Daly, Janis J
To compare response to upper-limb treatment using robotics plus motor learning (ML) versus functional electrical stimulation (FES) plus ML versus ML alone, according to a measure of complex functional everyday tasks for chronic, severely impaired stroke survivors. Single-blind, randomized trial. Medical center. Enrolled subjects (N=39) were >1 year postsingle stroke (attrition rate=10%; 35 completed the study). All groups received treatment 5d/wk for 5h/d (60 sessions), with unique treatment as follows: ML alone (n=11) (5h/d partial- and whole-task practice of complex functional tasks), robotics plus ML (n=12) (3.5h/d of ML and 1.5h/d of shoulder/elbow robotics), and FES plus ML (n=12) (3.5h/d of ML and 1.5h/d of FES wrist/hand coordination training). Primary measure: Arm Motor Ability Test (AMAT), with 13 complex functional tasks; secondary measure: upper-limb Fugl-Meyer coordination scale (FM). There was no significant difference found in treatment response across groups (AMAT: P≥.584; FM coordination: P≥.590). All 3 treatment groups demonstrated clinically and statistically significant improvement in response to treatment (AMAT and FM coordination: P≤.009). A group treatment paradigm of 1:3 (therapist/patient) ratio proved feasible for provision of the intensive treatment. No adverse effects. Severely impaired stroke survivors with persistent (>1y) upper-extremity dysfunction can make clinically and statistically significant gains in coordination and functional task performance in response to robotics plus ML, FES plus ML, and ML alone in an intensive and long-duration intervention; no group differences were found. Additional studies are warranted to determine the effectiveness of these methods in the clinical setting. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Min, Yang Won; Min, Byung-Hoon; Kim, Seonwoo; Choi, Dongil; Rhee, Poong-Lyul
Improving gastric accommodation and gastric emptying is an attractive physiological treatment target in patients with functional dyspepsia (FD). We evaluated the effect of DA-9701, a new drug for FD, on gastric motor function after a meal in healthy volunteers using magnetic resonance imaging (MRI). Forty healthy volunteers were randomly allocated to receive either DA-9701 or placebo. After 5 days of treatment, subjects underwent gastric MRI (60 min before and 15, 30, 45, 60, 90, and 120 min after a liquid test meal). Gastric volume was measured through 3-dimensional reconstruction from MRI data. We analyzed 4 outcome variables including changes in total gastric volume (TGV), proximal TGV, and proximal to distal TGV ratio after a meal and gastric emptying rates after adjusting values at the pre-test meal. Changes in TGV and proximal TGV after a meal did not differ between the DA-9701 and placebo groups (difference between groups -25.9 mL, 95% confidence interval [CI] -54.0 to 2.3 mL, P = 0.070 and -2.9 mL, 95% CI -30.3 to 24.5 mL, P = 0.832, respectively). However, pre-treatment with DA-9701 increased postprandial proximal to distal TGV ratio more than placebo (difference between groups 0.93, 95% CI 0.08 to 1.79, P = 0.034). In addition, pre-treatment with DA-9701 significantly increased gastric emptying as compared with placebo (mean difference between groups 3.41%, 95% CI 0.54% to 6.29%, P = 0.021, by mixed model for repeated measures). Our results suggested that DA-9701 enhances gastric emptying and does not significantly affect gastric accommodation in healthy volunteers. Further studies to confirm whether DA-9701 enhances these gastric motor functions in patients with FD are warranted. ClinicalTrials.gov NCT02091635.
Yang Won Min
Full Text Available Improving gastric accommodation and gastric emptying is an attractive physiological treatment target in patients with functional dyspepsia (FD. We evaluated the effect of DA-9701, a new drug for FD, on gastric motor function after a meal in healthy volunteers using magnetic resonance imaging (MRI.Forty healthy volunteers were randomly allocated to receive either DA-9701 or placebo. After 5 days of treatment, subjects underwent gastric MRI (60 min before and 15, 30, 45, 60, 90, and 120 min after a liquid test meal. Gastric volume was measured through 3-dimensional reconstruction from MRI data. We analyzed 4 outcome variables including changes in total gastric volume (TGV, proximal TGV, and proximal to distal TGV ratio after a meal and gastric emptying rates after adjusting values at the pre-test meal.Changes in TGV and proximal TGV after a meal did not differ between the DA-9701 and placebo groups (difference between groups -25.9 mL, 95% confidence interval [CI] -54.0 to 2.3 mL, P = 0.070 and -2.9 mL, 95% CI -30.3 to 24.5 mL, P = 0.832, respectively. However, pre-treatment with DA-9701 increased postprandial proximal to distal TGV ratio more than placebo (difference between groups 0.93, 95% CI 0.08 to 1.79, P = 0.034. In addition, pre-treatment with DA-9701 significantly increased gastric emptying as compared with placebo (mean difference between groups 3.41%, 95% CI 0.54% to 6.29%, P = 0.021, by mixed model for repeated measures.Our results suggested that DA-9701 enhances gastric emptying and does not significantly affect gastric accommodation in healthy volunteers. Further studies to confirm whether DA-9701 enhances these gastric motor functions in patients with FD are warranted.ClinicalTrials.gov NCT02091635.
Schenkman, Margaret; Moore, Charity G; Kohrt, Wendy M; Hall, Deborah A; Delitto, Anthony; Comella, Cynthia L; Josbeno, Deborah A; Christiansen, Cory L; Berman, Brian D; Kluger, Benzi M; Melanson, Edward L; Jain, Samay; Robichaud, Julie A; Poon, Cynthia; Corcos, Daniel M
Parkinson disease is a progressive neurologic disorder. Limited evidence suggests endurance exercise modifies disease severity, particularly high-intensity exercise. To examine the feasibility and safety of high-intensity treadmill exercise in patients with de novo Parkinson disease who are not taking medication and whether the effect on motor symptoms warrants a phase 3 trial. The Study in Parkinson Disease of Exercise (SPARX) was a phase 2, multicenter randomized clinical trial with 3 groups and masked assessors. Individuals from outpatient and community-based clinics were enrolled from May 1, 2012, through November 30, 2015, with the primary end point at 6 months. Individuals with idiopathic Parkinson disease (Hoehn and Yahr stages 1 or 2) aged 40 to 80 years within 5 years of diagnosis who were not exercising at moderate intensity greater than 3 times per week and not expected to need dopaminergic medication within 6 months participated in this study. A total of 384 volunteers were screened by telephone; 128 were randomly assigned to 1 of 3 groups (high-intensity exercise, moderate-intensity exercise, or control). High-intensity treadmill exercise (4 days per week, 80%-85% maximum heart rate [n = 43]), moderate-intensity treadmill exercise (4 days per week, 60%-65% maximum heart rate [n = 45]), or wait-list control (n = 40) for 6 months. Feasibility measures were adherence to prescribed heart rate and exercise frequency of 3 days per week and safety. The clinical outcome was 6-month change in Unified Parkinson's Disease Rating Scale motor score. A total of 128 patients were included in the study (mean [SD] age, 64  years; age range, 40-80 years; 73 [57.0%] male; and 108 [84.4%] non-Hispanic white). Exercise rates were 2.8 (95% CI, 2.4-3.2) days per week at 80.2% (95% CI, 78.8%-81.7%) maximum heart rate in the high-intensity group and 3.2 (95% CI, 2.8-3.6; P = .13) days per week at 65.9% (95% CI, 64.2%-67.7%) maximum heart rate in the
Motor neurons translate synaptic input from widely distributed premotor networks into patterns of action potentials that orchestrate motor unit force and motor behavior. Intercalated between the CNS and muscles, motor neurons add to and adjust the final motor command. The identity and functional...... in in vitro preparations is far from complete. Nevertheless, a foundation has been provided for pursuing functional significance of intrinsic response properties in motoneurons in vivo during motor behavior at levels from molecules to systems....
Andrade, Suellen Marinho; de Brito Aranha, Renata Emanuela Lyra; de Oliveira, Eliane Araújo; de Mendonça, Camila Teresa Ponce Leon; Martins, Wanessa Kallyne Nascimento; Alves, Nelson Torro; Fernández-Calvo, Bernardino
Although transcranial direct current stimulation (tDCS) represents a therapeutic option for the prophylaxis of chronic migraine, the target area for application of the electrical current to the cortex has not yet been well established. Here we sought to determine whether a treatment protocol involving 12 sessions of 2mA, 20min anodal stimulation of the left primary motor (M1) or dorsolateral prefrontal cortex (DLPFC) could offer clinical benefits in the management of pain from migraine. Thirteen participants were assessed before and after treatment, using the Headache Impact Test-6, Visual Analogue Scale and Medical Outcomes Study 36 - Item Short - Form Health Survey. After treatment, group DLPFC exhibited a better performance compared with groups M1 and sham. On intragroup comparison, groups DLPFC and M1 exhibited a greater reduction in headache impact and pain intensity and a higher quality of life after treatment. No significant change was found in group sham. The participants in group M1 exhibited more adverse effects, especially headache, heartburn, and sleepiness, than did those in the other two groups. Transcranial direct current stimulation is a safe and efficacious technique for treating chronic migraine. However, it should be kept in mind that the site of cortical stimulation might modulate the patient's response to treatment. Copyright © 2017 Elsevier B.V. All rights reserved.
Jokstad, Asbjørn; Winnett, Brenton; Fava, Joseph; Powell, David; Somogyi-Ganss, Eszter
New digital technologies enable real-time computer-aided (CA) three-dimensional (3D) guidance during dental implant surgery. The aim of this investigational clinical trial was to demonstrate the safety and effectiveness of a prototype optoelectronic CA-navigation device in comparison with the conventional approach for planning and effecting dental implant surgery. Study participants with up to four missing teeth were recruited from the pool of patients referred to the University of Toronto Graduate Prosthodontics clinic. The first 10 participants were allocated to either a conventional or a prototype device study arm in a randomized trial. The next 10 participants received implants using the prototype device. All study participants were restored with fixed dental prostheses after 3 (mandible) or 6 (maxilla) months healing, and monitored over 12 months. The primary outcome was the incidence of any surgical, biologic, or prosthetic adverse events or device-related complications. Secondary outcomes were the incidence of positioning of implants not considered suitable for straightforward prosthetic restoration (yes/no); the perception of the ease of use of the prototype device by the two oral surgeons, recorded by use of a Likert-type questionnaire; and the clinical performance of the implant and superstructure after 1 year in function. Positioning of the implants was appraised on periapical radiographs and clinical photographs by four independent blinded examiners. Peri-implant bone loss was measured on periapical radiographs by a blinded examiner. No adverse events occurred related to placing any implants. Four device-related complications led to a switch from using the prototype device to the conventional method. All implants placed by use of the prototype device were in a position considered suitable for straightforward prosthetic restoration (n = 21). The qualitative evaluation by the surgeons was generally positive, although ergonomic challenges were identified
Li, Da; Jiao, Yu-Ming; Wang, Liang; Lin, Fu-Xin; Wu, Jun; Tong, Xian-Zeng; Wang, Shuo; Cao, Yong
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent). The study enrolled 23 patients who underwent preoperative DTI/DTT and 24 patients who did not (the control group). The pre- and postoperative muscle strength of both limbs and modified Rankin Scale (mRS) scores were evaluated. Muscle strength of any limb at 12 months after surgery at the clinic visit was the primary outcome; worsened muscle strength was considered to be a poor outcome. Outcome assessors were blinded to patient management. This study reports the preliminary results of the interim analysis. RESULTS The cohort included 47 patients (22 women) with a mean age of 35.7 years. The clinical baselines between these 2 groups were not significantly different. In the DTI/DTT group, the corticospinal tract was affected in 17 patients (73.9%): it was displaced, deformed/partially interrupted, or completely interrupted in 6, 7, and 4 patients, respectively. The surgical approach and brainstem entry point were adjusted in 3 patients (13.0%) based on DTI/DTT data. The surgical morbidity of the DTI/DTT group (7/23, 30.4%) was significantly lower than that of the control group (19/24, 79.2%, p = 0.001). At 12 months, the mean mRS score (1.1, p = 0.034) and percentage of patients with worsened motor deficits (4.3%, p = 0.006) were significantly lower in the DTI/DTT group than in the control group (1.7% and 37.5%). Multivariate logistic regression identified the absence of preoperative DTI/DTT (OR 0.06, 95% CI 0.01-0.73, p = 0
Curatolo, Massimiliano; La Bianca, Giuseppe; Cosentino, Giuseppe; Baschi, Roberta; Salemi, Giuseppe; Talotta, Rossella; Romano, Marcello; Triolo, Giovanni; De Tommaso, Marina; Fierro, Brigida; Brighina, Filippo
Fibromyalgia (FM) is a clinical syndrome characterised by widespread musculoskeletal pain, chronic fatigue, cognitive deficits, and sleep and mood disorders. The effectiveness of most pharmacological treatments is limited, and there is a need for new, effective and well-tolerated therapies. It has recently been shown that transcranial direct-current stimulation (tDCS) of the motor cortex reduces pain, and that tDCS of the dorso-lateral prefrontal cortex (DLPFC) improves anxiety, depression and cognitive impairment in FM patients. The new technique of transcranial random noise stimulation (tRNS) using randomly changing alternating currents has very recently been shown to improve working memory and pain in limited series of patients with FM or neuropathic pain. The aim of this study was to investigate the clinical effects of primary motor cortex (M1) tRNS in FM patients. Twenty female FM patients aged 26-67 years were randomised to undergo active (real) or placebo (sham) tRNS sessions on five days a week (Monday-Friday) for two weeks. Each patient was evaluated before and after treatment using a visual analogue scale (VAS), the Fibromyalgia Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT), the Forward and Backward Digit Span test, and the FAS verbal fluency test. In comparison with sham treatment, active tRNS of M1 induced a general improvement in the clinical picture of FM, with a significant reduction in pain, depression, anxiety and FIQ scores and a significant improvement in TMT (A), RAVLT and FAS scores. These findings suggest that tRNS of M1 can be very effective in relieving FM symptoms. Unlike motor cortex tDCS, it seems to counteract both pain and cognitive disturbances, possibly because the invoked mechanism of stochastic resonance synchronises neural firing and thus leads to more widespread and lasting effects.
Full Text Available Little is known of how to involve families in physical activity (PA interventions for children. In this cluster randomized controlled trial, we recruited families with four- to seven-year-old children to participate in a year-long study where parents in the intervention group families (n = 46 received tailored counseling to increase children’s PA. Structured PA was not served. Control group families (n = 45 did not receive any counseling. PA in all children (n = 91; mean age 6.16 ± 1.13 years at the baseline was measured by accelerometers at the baseline and after three, six, nine and 12 months. Motor competence (MC (n = 89 was measured at the baseline and after six and 12 months by a KTK (KörperkoordinationsTest für Kinder and throwing and catching a ball (TCB protocols. The effect of parental counseling on study outcomes was analyzed by a linear mixed-effects model fit by REML and by a Mann-Whitney U test in the case of the TCB. As season was hypothesized to affect counseling effect, an interaction of season on the study outcomes was examined. The results show significant decrease of MVPA in the intervention group when compared to the control group (p < .05. The TCB showed a nearly significant improvement at six months in the intervention group compared to the controls (p = .051, but not at 12 months. The intervention group had a steadier development of the KTK when the interaction of season was taken into account. In conclusion, more knowledge of family constructs associating with the effectiveness of counseling is needed for understanding how to enhance PA in children by parents. However, a hypothesis may be put forward that family-based counseling during an inactive season rather than an active season may provide a more lasting effect on the development of KTK in children.Controlled-Trials.com ISRCTN28668090.
Full Text Available Double-motor drive tracked vehicles (2MDTV are widely used in the tracked vehicle industry due to the development of electric vehicle drive systems. The aim of this paper is to solve the problem of insufficient propulsion motor torque in low-speed, small-radius steering and insufficient power in high-speed large-radius steering. In order to do this a new type of steering system with a coupling device is designed and a closed-loop control strategy based on speed is adopted to improve the lateral stability of the vehicle. The work done entails modeling and simulating the 2MDTV and the proposed control strategy in RecurDyn and Matlab/Simulink. The simulation results show that the 2MDTV with the coupling device outputs more torque and power in both steering cases compared to the 2MDTV without the coupling device, and the steering stability of the vehicle is improved by using the strategy based on speed.
Choung, R S; Talley, N J; Peterson, J; Camilleri, M; Burton, D; Harmsen, W S; Zinsmeister, A R
Itopride, a dopamine D2 antagonist and acetylcholinesterase inhibitor, significantly improved symptoms in patients with functional dyspepsia in one phase II randomized trial. However, the mechanisms by which itopride may improve symptoms are unknown. We aimed to compare the effects of two doses of itopride and placebo on gastric volumes, gastric emptying, small bowel transit and satiation in female and male healthy volunteers. Randomized, double-blind, placebo-controlled study evaluated gastric function before and after 7 days of itopride 100 mg (n = 16) or 200 mg (n = 15) or placebo (n = 15) t.i.d. Validated methods were used to study gastric accommodation (single photon emission computed tomography), gastric emptying and orocecal transit and satiation postnutrient challenge. The three arms were comparable with regard to age, gender and body mass index. There were no statistically significant effects of itopride on gastric emptying, orocecal transit, fasting gastric volume, maximum tolerated volume or aggregate symptom score with nutrient drink challenge. Postprandial (PP) change in gastric volume differed in the three groups (P = 0.019): 625[+/-28 (SEM)], 555(+/-26) and 512(+/-33) in placebo, itopride 100 and 200 mg groups, respectively. In healthy subjects, itopride reduced total PP gastric volume without accelerating gastric emptying or significantly altering gastric motor and sensory function in healthy individuals.
Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson's disease with early motor complications (EARLYSTIM trial): secondary analysis of an open-label randomised trial.
Lhommée, Eugénie; Wojtecki, Lars; Czernecki, Virginie; Witt, Karsten; Maier, Franziska; Tonder, Lisa; Timmermann, Lars; Hälbig, Thomas D; Pineau, Fanny; Durif, Franck; Witjas, Tatiana; Pinsker, Marcus; Mehdorn, Maximilian; Sixel-Döring, Friederike; Kupsch, Andreas; Krüger, Rejko; Elben, Saskia; Chabardès, Stephan; Thobois, Stéphane; Brefel-Courbon, Christine; Ory-Magne, Fabienne; Regis, Jean-Marie; Maltête, David; Sauvaget, Anne; Rau, Jörn; Schnitzler, Alfons; Schüpbach, Michael; Schade-Brittinger, Carmen; Deuschl, Gunther; Houeto, Jean-Luc; Krack, Paul
Although subthalamic stimulation is a recognised treatment for motor complications in Parkinson's disease, reports on behavioural outcomes are controversial, which represents a major challenge when counselling candidates for subthalamic stimulation. We aimed to assess changes in behaviour in patients with Parkinson's disease receiving combined treatment with subthalamic stimulation and medical therapy over a 2-year follow-up period as compared with the behavioural evolution under medical therapy alone. We did a parallel, open-label study (EARLYSTIM) at 17 surgical centres in France (n=8) and Germany (n=9). We recruited patients with Parkinson's disease who were disabled by early motor complications. Participants were randomly allocated (1:1) to either medical therapy alone or bilateral subthalamic stimulation plus medical therapy. The primary outcome was mean change in quality of life from baseline to 2 years. A secondary analysis was also done to assess behavioural outcomes. We used the Ardouin Scale of Behavior in Parkinson's Disease to assess changes in behaviour between baseline and 2-year follow-up. Apathy was also measured using the Starkstein Apathy Scale, and depression was assessed with the Beck Depression Inventory. The secondary analysis was done in all patients recruited. We used a generalised estimating equations (GEE) regression model for individual items and mixed model regression for subscores of the Ardouin scale and the apathy and depression scales. This trial is registered with ClinicalTrials.gov, number NCT00354133. The primary analysis has been reported elsewhere; this report presents the secondary analysis only. Between July, 2006, and November, 2009, 251 participants were recruited, of whom 127 were allocated medical therapy alone and 124 were assigned bilateral subthalamic stimulation plus medical therapy. At 2-year follow-up, the levodopa-equivalent dose was reduced by 39% (-363·3 mg/day [SE 41·8]) in individuals allocated bilateral
Full Text Available Self-controlled augmented feedback enhances learning of simple motor tasks. Thereby, learners tend to request feedback after trials that were rated as good by themselves. Feedback after good trials promotes positive reinforcement, which enhances motor learning. The goal of this study was to investigate when naïve learners request terminal visual feedback in a complex motor task, as conclusions drawn on simple tasks can hardly be transferred to complex tasks. Indeed, seven of nine learners stated to have intended to request feedback predominantly after good trials, but in contrast to their intention, kinematic analysis showed that feedback was rather requested randomly (23% after good, 44% after intermediate, 33% after bad trials. Moreover, requesting feedback after good trials did not correlate with learning success. It seems that self-estimation of performance in complex tasks is challenging. As a consequence, learners might have focused on certain movement aspects rather than on the overall movement. Further studies should assess the current focus of the learner in detail to gain more insight in self-estimation capabilities during complex motor task learning.
Straker, L; Howie, E; Smith, A; Jensen, L; Piek, J; Campbell, A
Impaired motor development can significantly affect a child's life and may result in an increased risk of a range of physical and psychological disorders. Active video game (AVG) interventions have been demonstrated to enhance motor skills in children with Developmental Coordination Disorder (DCD); however a home-based intervention has not been assessed. The primary aim of this study was to compare the changes in motor coordination between a 16 week period of AVG use, with 16 weeks of normal activities (NAG). The secondary aim was to compare the child and parent perceptions of their physical performance between the AVG and NAG conditions. Twenty-one 9-12 year olds (10 males) were confirmed to be at risk of DCD (⩽ 16th percentile Movement Assessment Battery for Children-2nd edition (MABC-2) and ⩽ 15th percentile Developmental Coordination Disorder Questionnaire (DCDQ)) and participated in this crossover randomised and controlled trial. Data was collected at study entry, after the first 16 week condition and following the final 16 week condition, including; (1) the MABC-2, (2) three-dimensional motion analysis of single leg balance and finger-nose tasks, and (3) parent perception of physical skills. Participant perception of physical skills was collected only after the first and second conditions. There was no significant difference between AVG and NAG for any of the primary variables including the MABC-2, balance centre-of-mass path distance and finger-nose path distance. There was no significant intervention effect for secondary measures of motor coordination; however the children perceived their motor skills to be significantly enhanced as a result of the AVG intervention in comparison to the period of no intervention. A 16 week home based AVG intervention did not enhance motor skills in children with DCD, although they perceived their physical skills to be significantly improved. Australia and New Zealand Clinical trials Registry (ACTRN 12611000400965
Perez, Raymond P; Finnigan, Shanda; Patel, Krupa; Whitney, Shanell; Forrest, Annemarie
Use of electronic clinical trial portals has increased in recent years to assist with sponsor-investigator communication, safety reporting, and clinical trial management. Electronic portals can help reduce time and costs associated with processing paperwork and add security measures; however, there is a lack of information on clinical trial investigative staff's perceived challenges and benefits of using portals. The Clinical Trials Transformation Initiative (CTTI) sought to (1) identify challenges to investigator receipt and management of investigational new drug (IND) safety reports at oncologic investigative sites and coordinating centers and (2) facilitate adoption of best practices for communicating and managing IND safety reports using electronic portals. CTTI, a public-private partnership to improve the conduct of clinical trials, distributed surveys and conducted interviews in an opinion-gathering effort to record investigator and research staff views on electronic portals in the context of the new safety reporting requirements described in the US Food and Drug Administration's final rule (Code of Federal Regulations Title 21 Section 312). The project focused on receipt, management, and review of safety reports as opposed to the reporting of adverse events. The top challenge investigators and staff identified in using individual sponsor portals was remembering several complex individual passwords to access each site. Also, certain tasks are time-consuming (eg, downloading reports) due to slow sites or difficulties associated with particular operating systems or software. To improve user experiences, respondents suggested that portals function independently of browsers and operating systems, have intuitive interfaces with easy navigation, and incorporate additional features that would allow users to filter, search, and batch safety reports. Results indicate that an ideal system for sharing expedited IND safety information is through a central portal used by
Sindrup, Søren Hein; Konder, R; Lehmann, R
with tramadol. During 4-week treatment periods, daily oral doses of either GRT9906 120-240 mg, or placebo, or tramadol 200-400 mg were given. These were separated by 1-week washout periods. The primary endpoint was the average pain intensity (average of daily current pain intensity over the last 3 days of each......GRT9906 is an investigational novel compound with μ-opioid receptor agonism and inhibition of noradrenalin/serotonin re-uptake. In this randomized, double-blind, placebo-controlled, three-way cross-over trial in painful polyneuropathy, the efficacy and safety of GRT9906 was assessed and compared...... treatment period rated on a 0 to 10-point numeric rating scale). One hundred seventeen patients were enrolled and 64 were randomized to one of six treatment sequences. Forty-seven patients qualified for the per protocol analysis. GRT9906 reduced average pain intensity by 2.1 points compared with a reduction...
Ruiping Xia; Zhi-Hong Mao
Parkinson's disease (PD) is a chronic progressive neurodegenerative disease that is clinically manifested by a triad of cardinal motor symptoms - rigidity,bradykinesia and tremor - due to loss of dopaminergic neurons.The motor symptoms of PD become progressively worse as the disease advances.PD is also a heterogeneous disease since rigidity and bradykinesia are the major complaints in some patients whereas tremor is predominant in others.In recent years,many studies have investigated the progression of the hallmark symptoms over time,and the cardinal motor symptoms have different rates of progression,with the disease usually progressing faster in patients with rigidity and bradykinesia than in those with predominant tremor.The current treatment regime of dopamine-replacement therapy improves motor symptoms and alleviates disability.Increasing the dosage of dopaminergic medication is commonly used to combat the worsenirtg symptoms.However,the drug-induced involuntary body movements and motor comphcations can significantly contribute to overall disability.Further,none of the currently-available therapies can slow or halt the disease progression.Significant research efforts have been directed towards developing neuroprotective or disease-modifying agents that are intended to slow the progression.In this article,the most recent clinical studies investigating disease progression and current progress on the development of disease-modifying drug trials are reviewed.
Full Text Available Abstract Background Patients with sepsis syndromes in comparison to general intensive care patients can have worse outcomes for physical function, quality of life and survival. Early intensive care rehabilitation can improve the outcome in general Intensive Care Unit (ICU patients, however no investigations have specifically looked at patients with sepsis syndromes. The 'i-PERFORM Trial' will investigate if early targeted rehabilitation is both safe and effective in patients with sepsis syndromes admitted to ICU. Methods/Design A single-centred blinded randomized controlled trial will be conducted in Brisbane, Australia. Participants (n = 252 will include those ≥ 18 years, mechanically ventilated for ≥ 48 hours and diagnosed with a sepsis syndrome. Participants will be randomised to an intervention arm which will undergo an early targeted rehabilitation program according to the level of arousal, strength and cardiovascular stability and a control group which will receive normal care. The primary outcome measures will be physical function tests on discharge from ICU (The Acute Care Index of Function and The Physical Function ICU Test. Health-related quality of life will be measured using the Short Form-36 and the psychological component will be tested using The Hospital Anxiety and Depression Scale. Secondary measures will include inflammatory biomarkers; Interleukin-6, Interleukin-10 and Tumour Necrosis Factor-α, peripheral blood mitochondrial DNA content and lactate, fat free muscle mass, tissue oxygenation and microcirculatory flow. Discussion The 'i-PERFORM Trial' will determine whether early rehabilitation for patients with sepsis is effective at improving patient outcomes with functional and physiological parameters reflecting long and short-term effects of early exercise and the safety in its application in critical illness. Trial Registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12610000808044
Slater, Rebeccah; Hartley, Caroline; Moultrie, Fiona; Adams, Eleri; Juszczak, Ed; Rogers, Richard; Norman, Jane E; Patel, Chetan; Stanbury, Kayleigh; Hoskin, Amy; Green, Gabrielle
Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia. 156 infants between 34 and 42 weeks' gestational age who require a clinical heel lance and ROP screening on the same test occasion will be included in the trial. Infants will be randomised to receive either a single dose of morphine sulphate (100 μg/kg) or placebo. Each infant will be monitored for 48 hours and safety data will be collected during the 24 hours following drug administration. The primary outcome will be the Premature Infant Pain Profile-revised (PIPP-R) score 30 seconds after ROP screening. The co-primary outcome will be the magnitude of nociceptive-specific brain activity evoked by a clinically-required heel lance. Infant clinical stability will be assessed by comparing the number of episodes of bradycardia, tachycardia, desaturation and apnoea, and changes in respiratory support requirements in the 24-hour periods before and after the clinical intervention. In addition, drug safety will be assessed by considering the occurrence of apnoeic and hypotensive episodes requiring intervention in the 24-hour period following drug administration. This study has been published as an Accepted Protocol Summary by The Lancet .
Full Text Available Preventing obesity is an international health priority. In Australia, young women who live in rural communities are at high risk of unhealthy weight gain. Interventions which engage young women and support sustainable behaviour change are needed and comprehensive evaluation of such interventions generates knowledge for population scale-up. This qualitative sub-study aims to identify enablers and barriers to behaviour change initiation and continuation within a community weight gain prevention program.In-depth semi-structured interviews were conducted with program participants 6 months after baseline. All interviews were audio-taped and transcribed verbatim. Transcripts were analysed independently by two investigators via thematic analysis.A total of 28 women with a mean age of 39.9±6.2years and a BMI of 28.6±5.2kg/m2 were purposively recruited from the larger cohort (n = 649 that participated in the prevention trial.Four behaviour change groups emerged were identified from participant interviews: (i no change, (ii relapse, (iii intermittent and (iv continued change. Factors influencing behaviour change initiation and continuation included realistic program expectations and the participant's ability to apply the core program elements including: setting small, achievable behaviour change goals, problem solving and using self-management techniques. Personal knowledge, skills, motivation, self-efficacy, accountability and perceived social and environmental barriers also affected behaviour change. Satisfaction with personal program progress and the perceived amount of program supports required to achieve ongoing behaviour change varied amongst participants. Women who relapsed expressed a desire for more intensive and regular support from health professionals, identified more barriers unrelated to the program, anticipated significant weight loss and had lower satisfaction with their progress.Initiating and continuing behaviour change is a complex
Kozica, Samantha; Lombard, Catherine; Teede, Helena; Ilic, Dragan; Murphy, Kerry; Harrison, Cheryce
Preventing obesity is an international health priority. In Australia, young women who live in rural communities are at high risk of unhealthy weight gain. Interventions which engage young women and support sustainable behaviour change are needed and comprehensive evaluation of such interventions generates knowledge for population scale-up. This qualitative sub-study aims to identify enablers and barriers to behaviour change initiation and continuation within a community weight gain prevention program. In-depth semi-structured interviews were conducted with program participants 6 months after baseline. All interviews were audio-taped and transcribed verbatim. Transcripts were analysed independently by two investigators via thematic analysis. A total of 28 women with a mean age of 39.9±6.2years and a BMI of 28.6±5.2kg/m2 were purposively recruited from the larger cohort (n = 649) that participated in the prevention trial. Four behaviour change groups emerged were identified from participant interviews: (i) no change, (ii) relapse, (iii) intermittent and (iv) continued change. Factors influencing behaviour change initiation and continuation included realistic program expectations and the participant's ability to apply the core program elements including: setting small, achievable behaviour change goals, problem solving and using self-management techniques. Personal knowledge, skills, motivation, self-efficacy, accountability and perceived social and environmental barriers also affected behaviour change. Satisfaction with personal program progress and the perceived amount of program supports required to achieve ongoing behaviour change varied amongst participants. Women who relapsed expressed a desire for more intensive and regular support from health professionals, identified more barriers unrelated to the program, anticipated significant weight loss and had lower satisfaction with their progress. Initiating and continuing behaviour change is a complex process. Our
Paller, Channing J.; Bradbury, Penelope A.; Ivy, S. Percy; Seymour, Lesley; LoRusso, Patricia M.; Baker, Laurence; Rubinstein, Larry; Huang, Erich; Collyar, Deborah; Groshen, Susan; Reeves, Steven; Ellis, Lee M.; Sargent, Daniel J.; Rosner, Gary L.; LeBlanc, Michael L.; Ratain, Mark J.
Anticancer drugs are combined in an effort to treat a heterogeneous tumor or to maximize the pharmacodynamic effect. The development of combination regimens, while desirable, poses unique challenges. These include the selection of agents for combination therapy that may lead to improved efficacy while maintaining acceptable toxicity, the design of clinical trials that provide informative results for individual agents and combinations, and logistical and regulatory challenges. The phase 1 trial is often the initial step in the clinical evaluation of a combination regimen. In view of the importance of combination regimens and the challenges associated with developing them, the Clinical Trial Design (CTD) Task Force of the National Cancer Institute (NCI) Investigational Drug Steering Committee developed a set of recommendations for the phase 1 development of a combination regimen. The first two recommendations focus on the scientific rationale and development plans for the combination regimen; subsequent recommendations encompass clinical design aspects. The CTD Task Force recommends that selection of the proposed regimens be based on a biological or pharmacological rationale supported by clinical and/or robust and validated preclinical evidence, and accompanied by a plan for subsequent development of the combination. The design of the phase 1 clinical trial should take into consideration the potential pharmacokinetic and pharmacodynamic interactions as well as overlapping toxicity. Depending on the specific hypothesized interaction, the primary endpoint may be dose optimization, pharmacokinetics, and/or pharmacodynamic (i.e., biomarker). PMID:25125258
Benjaminse, Anne; Otten, Bert; Gokeler, Alli; Diercks, Ron L.; Lemmink, Koen A. P. M.
Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during
Sparaci, Laura; Formica, Domenico; Lasorsa, Francesca Romana; Mazzone, Luigi; Valeri, Giovanni; Vicari, Stefano
Numerous studies have underscored prevalence of motor impairments in children with autism spectrum disorders (ASD), but only few of them have analyzed motor strategies exploited by ASD children when learning a new motor procedure. To evaluate motor procedure learning and performance strategies in both ASD and typically developing (TD) children, we built a virtual pursuit rotor (VPR) task, requiring tracking a moving target on a computer screen using a digitalized pen and tablet. Procedural learning was measured as increased time on target (TT) across blocks of trials on the same day and consolidation was assessed after a 24-hour rest. The program and the experimental setting (evaluated in a first experiment considering two groups of TD children) allowed also measures of continuous time on target (CTT), distance from target (DT) and distance from path (DP), as well as 2D reconstructions of children's trajectories. Results showed that the VPR was harder for children with ASD than for TD controls matched for chronological age and intelligence quotient, but both groups displayed comparable motor procedure learning (i.e., similarly incremented their TT). However, closer analysis of CTT, DT, and DP as well as 2D trajectories, showed different motor performance strategies in ASD, highlighting difficulties in overall actions planning. Data underscore the need for deeper investigations of motor strategies exploited by children with ASD when learning a new motor procedure. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
Malfliet, Anneleen; Kregel, Jeroen; Coppieters, Iris; De Pauw, Robby; Meeus, Mira; Roussel, Nathalie; Cagnie, Barbara; Danneels, Lieven; Nijs, Jo
Effective treatments for chronic spinal pain are essential to reduce the related high personal and socioeconomic costs. To compare pain neuroscience education combined with cognition-targeted motor control training with current best-evidence physiotherapy for reducing pain and improving functionality, gray matter morphologic features, and pain cognitions in individuals with chronic spinal pain. Multicenter randomized clinical trial conducted from January 1, 2014, to January 30, 2017, among 120 patients with chronic nonspecific spinal pain in 2 outpatient hospitals with follow-up at 3, 6, and 12 months. Participants were randomized into an experimental group (combined pain neuroscience education and cognition-targeted motor control training) and a control group (combining education on back and neck pain and general exercise therapy). Primary outcomes were pain (pressure pain thresholds, numeric rating scale, and central sensitization inventory) and function (pain disability index and mental health and physical health). There were 22 men and 38 women in the experimental group (mean [SD] age, 39.9 [12.0] years) and 25 men and 35 women in the control group (mean [SD] age, 40.5 [12.9] years). Participants in the experimental group experienced reduced pain (small to medium effect sizes): higher pressure pain thresholds at primary test site at 3 months (estimated marginal [EM] mean, 0.971; 95% CI, -0.028 to 1.970) and reduced central sensitization inventory scores at 6 months (EM mean, -5.684; 95% CI, -10.589 to -0.780) and 12 months (EM mean, -6.053; 95% CI, -10.781 to -1.324). They also experienced improved function (small to medium effect sizes): significant and clinically relevant reduction of disability at 3 months (EM mean, -5.113; 95% CI, -9.994 to -0.232), 6 months (EM mean, -6.351; 95% CI, -11.153 to -1.550), and 12 months (EM mean, -5.779; 95% CI, -10.340 to -1.217); better mental health at 6 months (EM mean, 36.496; 95% CI, 7.998-64.995); and better physical
Wu, Kitty K; Li, Frendi W; Cho, Valda W
Motor vehicle crashes (MVCs) are leading contributors to the global burden of disease. Patients attending accident and emergency (A&E) after an MVC may develop symptoms of posttraumatic stress disorder (PTSD). There is evidence that brief cognitive behavioural therapy (B-CBT) can be effective in treating PTSD; however, there are few studies of the use of B-CBT to treat PTSD in MVC survivors. This study examined the effects of B-CBT and a self-help program on the severity of psychological symptoms in MVC survivors at risk of developing PTSD. Sixty participants who attended A&E after a MVC were screened for PTSD symptoms and randomized to a 4-weekly session B-CBT or a 4-week self-help program (SHP) booklet treatment conditions. Psychological assessments were completed at baseline (1-month post-MVC) and posttreatment (3- and 6-month follow-ups) by utilizing Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). There were significant improvements in the measures of anxiety, depression, and PTSD symptoms over time. Participants treated with B-CBT showed greater reductions in anxiety at 3-month and 6-month follow-ups, and in depression at 6-month follow-up. A comparison of effect size favoured B-CBT for the reduction of anxiety and depression symptoms measured by HADS. A high level of pretreatment anxiety and depression were predictive of negative outcome at 6-month follow-up in the SHP condition. There was no differential effect on PTSD symptoms measured by IES-R. This trial supports the efficacy of providing B-CBT as a preventive strategy to improve psychological symptoms after an MVC.
Manno, Daniela; Kowa, Priscilla K.; Bwalya, Hellen K.; Siame, Joshua; Grantham-McGregor, Sally; Baisley, Kathy; De Stavola, Bianca L.; Jaffar, Shabbar; Filteau, Suzanne
It is uncertain whether multiple micronutrients benefit the mental and psychomotor development of young children in developing countries. We conducted a randomised double-blind controlled trial to evaluate the effect of a richly micronutrient-fortified v. a basal fortified porridge on mental and psychomotor development in Zambian infants. Infants (n 743) were randomised at age 6 months to receive either the richly fortified or the basal fortified infant food and were followed up until 18 months of age. All the infants were evaluated monthly for achievement of a series of developmental milestones. The Bayley scales of infant development II were administered to a subsample of 502 infants at 6, 12 and 18 months. Rich micronutrient fortification had no significant benefit on the following: (a) number of developmental milestones achieved (rate ratio at 12 months = 1·00; 95 % CI 0·96, 1·05; P=0·81, adjusted for sex, socio-economic status and maternal education, with similar results at 15 and 18 months); (b) ages of walking unsupported (hazard ratio (HR) 1·04; 95 % CI 0·88, 1·24; P=0·63, adjusted for the above covariates) and of speaking three or four clear words (HR 1·01; 95 % CI 0·84, 1·20; P=0·94, adjusted for the above covariates); (c) mental development index (MDI) and psychomotor development index (PDI) of the Bayley scales (scores difference adjusted for baseline scores, age at the assessment, sex, socio-economic status, maternal education, language, age and HIV status: MDI 0·3 (95 % CI −0·5, 1·1), P=0·43; PDI −0·1 (95 % CI −0·9, 0·7), P=0·78). In conclusion, the results do not support the hypothesis that rich micronutrient fortification improves Zambian infants’ mental and motor development. PMID:21733297
Papadopoulos, Nicole; McGinley, Jennifer; Tonge, Bruce J.; Bradshaw, John L.; Saunders, Kerryn; Rinehart, Nicole J.
There is now a growing body of research examining movement difficulties in children diagnosed with high functioning autism (HFA) and Asperger's disorder (AD). Despite this, few studies have investigated the kinematic components of movement that may be disrupted in children diagnosed with these disorders. The current study investigated rapid aiming…
Meaney, K S; Edwards, R
This study investigated the effects of modeling and verbal rehearsal on the motor performance of English-speaking and limited English proficient (LEP) children. Children (N = 64) in 4th-grade classes were randomly assigned to conditions in a 2 x 2 x 2 x 2 (Gender x Primary Language x Model Type x Rehearsal) factorial design. Boys and girls whose primary language was English or Spanish were assigned to either a verbal model or no-model condition as well as to a verbal rehearsal or no-rehearsal condition of the motor skills required to be performed. Analysis of variance revealed a significant Model Type x Primary Language interaction as well as a significant Rehearsal x Primary Language interaction. Follow-up analyses revealed that English-speaking children provided with a verbal rehearsal strategy recalled significantly more skills than English-speaking children in the no-rehearsal condition; for LEP children, there were no differences due to rehearsal. Moreover, LEP children presented with a verbal model recalled significantly more skills than LEP children in the no-model condition; for English-speaking children, there were no differences attributed to model type. These results indicate that effective modeling conditions that are provided with verbal cues in English are related to children's primary language.
Fokas, Emmanouil; Spezi, Emiliano; Patel, Neel; Hurt, Chris; Nixon, Lisette; Chu, Kwun-Ye; Staffurth, John; Abrams, Ross; Mukherjee, Somnath
We performed a retrospective central review of tumour outlines in patients undergoing radiotherapy in the SCALOP trial. The planning CT scans were reviewed retrospectively by a central review team, and the accuracy of investigators' GTV (iGTV) and PTV (iPTV) was compared to the trials team-defined gold standard (gsGTV and gsPTV) using the Jaccard Conformity Index (JCI) and Geographical Miss Index (GMI). The prognostic value of JCI and GMI was also assessed. The RT plans were also reviewed against protocol-defined constraints. 60 patients with diagnostic-quality planning scans were included. The median whole volume JCI for GTV was 0.64 (IQR: 0.43-0.82), and the median GMI was 0.11 (IQR: 0.05-0.22). For PTVs, the median JCI and GMI were 0.80 (IQR: 0.71-0.88) and 0.04 (IQR: 0.02-0.12) respectively. Tumour was completely missed in 1 patient, and⩾50% of the tumour was missed in 3. Patients with JCI for GTV⩾0.7 had 7.12 (95% CIs: 1.83-27.67, p=0.005) higher odds of progressing by 9months in multivariate analysis. Major deviations in RT planning were noted in 4.5% of cases. Radiotherapy workshops and real-time central review of contours are required in RT trials of pancreatic cancer. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Lucas, Barbara R; Elliott, Elizabeth J; Coggan, Sarah; Pinto, Rafael Z; Jirikowic, Tracy; McCoy, Sarah Westcott; Latimer, Jane
Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention
Johari, Sahar; Rassafiani, Mehdi; Dalvand, Hamid; Ahmadi Kahjoogh, Mina; Daemi, Mostafa
Cerebral palsy (CP) is the most common physical disability in children. These children require long-term therapy for achieving better motor function. It seems that treatment and training at home is necessary. The purpose of this study was to determine the impact of handling training of mothers at home on fine motor skill development of children…
Bossers, Willem J. R.; van der Woude, Lucas H. V.; Boersma, Froukje; Hortobagyi, Tibor; Scherder, Erik J. A.; van Heuvelen, Marieke J. G.
Objective: To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function. Methods: Using
Wajda, Douglas A; Mirelman, Anat; Hausdorff, Jeffrey M; Sosnoff, Jacob J
Individuals with neurodegenerative disease (NDD) commonly have elevated cognitive-motor interference, change in either cognitive or motor performance (or both) when tasks are performed simultaneously, compared to healthy controls. Given that cognitive-motor interference is related to reduced community ambulation and elevated fall risk, it is a target of rehabilitation interventions. Areas covered: This review details the collective findings of previous dual task interventions in individuals with NDD. A total of 21 investigations focusing on 4 different neurodegenerative diseases and one NDD precursor (Parkinson's disease, multiple sclerosis, Alzheimer's disease (AD), dementia other than AD, and mild cognitive impairment) consisting of 721 participants were reviewed. Expert commentary: Preliminary evidence from interventions targeting cognitive-motor interference, both directly and indirectly, show promising results for improving CMI in individuals with neurodegenerative diseases. Methodological limitations, common to pilot investigations preclude firm conclusions. Well-designed randomized control trials targeting cognitive motor interference are warranted.
Full Text Available The aim is to establish intergroup multivariant and univariant investigated differences in specific motor space between respondents juniors and seniors members of the Macedonian karate team. The sample of 30 male karate respondents covers juniors on 16,17 and seniors over 18 years.In the research were applied 20 specific motor tests. Based on Graph 1 where it is presented multivariant analysis of variance Manova and Anova can be noted that respondents juniors and seniors, although not belonging to the same population are not different in multivariant understudied area.W. lambda of .19, Rao-wool R - Approximation of 1.91 degrees of freedom df 1 = 20 and df 2 = 9 provides the level of significance of p =, 16. Based on univariant analysis for each variable separately can be seen that has been around intergroup statistically significant difference in seven SMAEGERI (kick in the sack with favoritism leg mae geri for 10 sec., SMAVASI (kick in the sack with favoritism foot mavashi geri by 10 sec., SUSIRO (kick in the sack with favoritism leg ushiro geri for 10 sec., SKIZAME (kick in the sack with favoritism hand kizame cuki for 10 sec., STAPNSR (taping with foot in sagital plane for 15 sec. SUDMNR (hitting a moving target with weaker hand and SUDMPN (hitting a moving target with favoritism foot of twenty applied manifest variables. There are no intergroup differences in multivariant investigated specific - motor space among the respondents juniors and seniors members of the Macedonian karate team. Based on univariant analysis for each variable separately can be seen that has been around intergroup statistically significant difference in seven SMAEGERI (kick in the sack with favoritism leg mae geri for 10 sec., SMAVASI (kick in the sack with favoritism foot mavashi geri by 10 sec., SUSIRO (kick in the sack with favoritism leg ushiro geri for 10 sec., SKIZAME (kick in the sack with favoritism hand kizame cuki for 10 sec., STAPNSR (taping with foot in
Yahaya Asizehi ENESI; Jacob TSADO; Mark NWOHU; Usman Abraham USMAN; Odu Ayo IMORU
In this paper, the input parameters of a single phase split-phase induction motor is taken to investigate and to study the output performance characteristics of capacitor start and capacitor run induction motor. The value of these input parameters are used in the design characteristics of capacitor run and capacitor start motor with each motor connected to rated or standard capacitor in series with auxiliary winding or starting winding respectively for the normal operational condition. The ma...
Asım Gökhan Yetgin
Full Text Available Induction motors are used in many areas from the past to the present and in different fields with the development of technology has continued to be used. It is obvious that induction motors as an improvement to the efficiency in terms of energy saving would cause great benefit. In that context, induction motor manufacturers and designers are constantly trying out new methods to improve motor performance and efficiency. In this study, what would be the optimum diameter of the shaft in order to increase the efficiency of the induction motor were investigated. In the study, 5.5 kW, 7.5 kW and 11 kW motors analyzes were also performed. Obtained shaft diameter values were compared with the manufacturer values. In addition, critical points such as the magnetic flux values, weight values and performances of the motors were examined and optimal shaft diameter values for each motor have been determined.
Hwang, Thomas J
For biopharmaceutical companies, investments in research and development are risky, and the results from clinical trials are key inflection points in the process. Few studies have explored how and to what extent the public equity market values clinical trial results. Our study dataset matched announcements of clinical trial results for investigational compounds from January 2011 to May 2013 with daily stock market returns of large United States-listed pharmaceutical and biotechnology companies. Event study methodology was used to examine the relationship between clinical research events and changes in stock returns. We identified public announcements for clinical trials of 24 investigational compounds, including 16 (67%) positive and 8 (33%) negative events. The majority of announcements were for Phase 3 clinical trials (N = 13, 54%), and for oncologic (N = 7, 29%) and neurologic (N = 6, 24%) indications. The median cumulative abnormal returns on the day of the announcement were 0.8% (95% confidence interval [CI]: -2.3, 13.4%; P = 0.02) for positive events and -2.0% (95% CI: -9.1, 0.7%; P = 0.04) for negative events, with statistically significant differences from zero. In the day immediately following the announcement, firms with positive events were associated with stock price corrections, with median cumulative abnormal returns falling to 0.4% (95% CI: -3.8, 12.3%; P = 0.33). For firms with negative announcements, the median cumulative abnormal returns were -1.7% (95% CI: -9.5, 1.0%; P = 0.03), and remained significantly negative over the two day event window. The magnitude of abnormal returns did not differ statistically by indication, by trial phase, or between biotechnology and pharmaceutical firms. The release of clinical trial results is an economically significant event and has meaningful effects on market value for large biopharmaceutical companies. Stock return underperformance due to negative events is greater in magnitude and persists longer than
Full Text Available The sensorimotor timing is recalibrated after a brief exposure to a delayed feedback of voluntary actions (temporal recalibration effect: TRE (Heron et al., 2009; Stetson et al., 2006; Sugano et al., 2010. We introduce a new paradigm, namely ‘synchronous tapping’ (ST which allows us to investigate how the TRE builds up during adaptation. In each experimental trial, participants were repeatedly exposed to a constant lag (∼150 ms between their voluntary action (pressing a mouse and a feedback stimulus (a visual flash / an auditory click 10 times. Immediately after that, they performed a ST task with the same stimulus as a pace signal (7 flashes / clicks. A subjective ‘no-delay condition’ (∼50 ms served as control. The TRE manifested itself as a change in the tap-stimulus asynchrony that compensated the exposed lag (eg, after lag adaptation, the tap preceded the stimulus more than in control and built up quickly (∼3–6 trials, ∼23–45 sec in both the visuo- and audio-motor domain. The audio-motor TRE was bigger and built-up faster than the visuo-motor one. To conclude, the TRE is comparable between visuo- and audio-motor domain, though they are slightly different in size and build-up rate.
Visser, Kirsten; Greaves-Lord, Kirstin; Tick, Nouchka T; Verhulst, Frank C; Maras, Athanasios; van der Vegt, Esther J M
Previous research shows that adolescents with autism spectrum disorder (ASD) run several risks in their psychosexual development and that these adolescents can have limited access to reliable information on puberty and sexuality, emphasizing the need for specific guidance of adolescents with ASD in their psychosexual development. Few studies have investigated the effects of psychosexual training programs for adolescents with ASD and to date no randomized controlled trials are available to study the effects of psychosexual interventions for this target group. The randomized controlled trial (RCT) described in this study protocol aims to investigate the effects of the Tackling Teenage Training (TTT) program on the psychosexual development of adolescents with ASD. This parallel clinical trial, conducted in the South-West of the Netherlands, has a simple equal randomization design with an intervention and a waiting-list control condition. Two hundred adolescents and their parents participate in this study. We assess the participants in both conditions using self-report as well as parent-report questionnaires at three time points during 1 year: at baseline (T1), post-treatment (T2), and for follow-up (T3). To our knowledge, the current study is the first that uses a randomized controlled design to study the effects of a psychosexual training program for adolescents with ASD. It has a number of methodological strengths, namely a large sample size, a wide range of functionally relevant outcome measures, the use of multiple informants, and a standardized research and intervention protocol. Also some limitations of the described study are identified, for instance not making a comparison between two treatment conditions, and no use of blinded observational measures to investigate the ecological validity of the research results. Dutch Trial Register NTR2860. Registered on 20 April 2011.
Miroslav D. Demić
Full Text Available Dynamic simulation, based on modeling, has a significant role during the process of vehicle development. It is especially important in the first stages of vehicle design, when relevant vehicle parameters are to be defined. Shock absorbers as executive parts of vehicle semi-active suspension systems suffer thermal loads, which may result in damage and degradation of ther characteristics. Therefore,this paper shows an attempt to analyze converting of mechanical work into heat by using the dynamic simulation method. Introduction Shock absorbers are integral elements of semi-active suspension systems for vehicles (hereinafter SASS. They directly affect the active vehicle safety. The role of shock absorbers is to absorb mechanical vibrations transferred from the road and to ensure the safety of passengers in a vehicle. The kinetic energy of vehicle vibrations transforms into mechanical work or heat in shock absorbers. In practice, in the first stage of vehicle development, the shock absorber parameters are chosen from the condition of damping vibrations of vehicles, but their thermal shock loads should be also taken into account. Motor vehicles have complex dynamic characteristics manifested by spatial movement, parameters change during operation, a number of disturbing influences, backlash, friction, hysteresis, etc. The above-mentioned dynamic phenomena, especially vibration, lead to fatigue of driver and users, reduce the life of the vehicle and its systems, etc. The main objective of the system is to reduce the reliance of the above-mentioned negative effects, improving the vehicle behavior on the road and allow the exploitation of vehicles in a wide range of service conditions. Classical systems cannot satisfiy these conditions, so there was a need to introduce new suspension systems with controlled characteristics (briefly called "semi-active", or "active" systems. Oscillatory model of vehicle The differential equations of vibratory motion of
Seebacher, Barbara; Kuisma, Raija; Glynn, Angela; Berger, Thomas
Motor imagery (MI) is increasingly used in neurorehabilitation to facilitate motor performance. Our previous study results demonstrated significantly improved walking after rhythmic-cued MI in people with multiple sclerosis (pwMS). The present feasibility study was aimed to obtain preliminary information of changes in walking, fatigue, quality of life (QoL) and MI ability following cued and non-cued MI in pwMS. The study further investigated the feasibility of a larger study and examined the reliability of a two-dimensional gait analysis system. At the MS-Clinic, Department of Neurology, Medical University of Innsbruck, Austria, 15 adult pwMS (1.5-4.5 on the Expanded Disability Status Scale, 13 females) were randomised to one of three groups: 24 sessions of 17 min of MI with music and verbal cueing (MVMI), with music alone (MMI), or non-cued (MI). Descriptive statistics were reported for all outcomes. Primary outcomes were walking speed (Timed 25-Foot Walk) and walking distance (6-Minute Walk Test). Secondary outcomes were recruitment rate, retention, adherence, acceptability, adverse events, MI ability (Kinaesthetic and Visual Imagery Questionnaire, Time-Dependent MI test), fatigue (Modified Fatigue Impact Scale) and QoL (Multiple Sclerosis Impact Scale-29). The reliability of a gait analysis system used to assess gait synchronisation with music beat was tested. Participants showed adequate MI abilities. Post-intervention, improvements in walking speed, walking distance, fatigue, QoL and MI ability were observed in all groups. Success of the feasibility criteria was demonstrated by recruitment and retention rates of 8.6% (95% confidence interval, CI 5.2, 13.8%) and 100% (95% CI 76.4, 100%), which exceeded the target rates of 5.7% and 80%. Additionally, the 83% (95% CI 0.42, 0.99) adherence rate surpassed the 67% target rate. Intra-rater reliability analysis of the gait measurement instruments demonstrated excellent Intra-Class Correlation coefficients for step
Protocol study for a randomised, controlled, double-blind, clinical trial involving virtual reality and anodal transcranial direct current stimulation for the improvement of upper limb motor function in children with Down syndrome.
Lopes, Jamile Benite Palma; Grecco, Luanda André Collange; Moura, Renata Calhes Franco de; Lazzari, Roberta Delasta; Duarte, Natalia de Almeida Carvalho; Miziara, Isabela; Melo, Gileno Edu Lameira de; Dumont, Arislander Jonathan Lopes; Galli, Manuela; Santos Oliveira, Claudia
Down syndrome results in neuromotor impairment that affects selective motor control, compromising the acquisition of motor skills and functional independence. The aim of the proposed study is to evaluate and compare the effects of multiple-monopolar anodal transcranial direct current stimulation and sham stimulation over the primary motor cortex during upper limb motor training involving virtual reality on motor control, muscle activity, cerebral activity and functional independence. A randomised, controlled, double-blind, clinical trial is proposed. The calculation of the sample size will be defined based on the results of a pilot study involving the same methods. The participants will be randomly allocated to two groups. Evaluations will be conducted before and after the intervention as well as 1 month after the end of the intervention process. At each evaluation, three-dimensional analysis of upper limb movement muscle activity will be measured using electromyography, cerebral activity will be measured using an electroencephalogram system and intellectual capacity will be assessed using the Wechsler Intelligence Scale for Children. Virtual reality training will be performed three times a week (one 20 min session per day) for a total of 10 sessions. During the protocol, transcranial stimulation will be administered concomitantly to upper limb motor training. The results will be analysed statistically, with a p value≤0.05 considered indicative of statistical significance. The present study received approval from the Institutional Review Board of Universidade Nove de Julho (Sao Paulo,Brazil) under process number 1.540.113 and is registered with the Brazilian Registry of Clinical Trials (N° RBR3PHPXB). The participating institutions have presented a declaration of participation. The volunteers will be permitted to drop out of the study at any time with no negative repercussions. The results will be published and will contribute evidence regarding the use of
Full Text Available The paper deals with determination of losses of two-stage power electronic system with two-phase variable orthogonal output. The simulation is focused on the investigation of losses in the converter during one period in steady-state operation. Modeling and simulation of two matrix converters with R-L load is shown in the paper. The simulation results confirm a very good time-waveform of the phase current and the system seems to be suitable for low-cost application in automotive/aerospace industries and in application with high frequency voltage sources.
Noordstar, J.J.; van der Net, J.; Jak, S.; Helders, P.J.M.; Jongmans, M.J.
Participation in motor activities is essential for social interaction and life satisfaction in children. Self-perceptions and task values have a central position in why children do or do not participate in (motor) activities. Investigating developmental changes in motor self-perceptions and motor
Ana L. Faria
Full Text Available Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. Virtual Reality (VR based methods for stroke rehabilitation have mainly focused on motor rehabilitation but there is increasing interest toward the integration of cognitive training for providing more effective solutions. Here we investigate the feasibility for stroke recovery of a virtual cognitive-motor task, the Reh@Task, which combines adapted arm reaching, and attention and memory training. 24 participants in the chronic stage of stroke, with cognitive and motor deficits, were allocated to one of two groups (VR, Control. Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the VR group underwent training with the Reh@Task and the control group performed time-matched conventional occupational therapy. Motor and cognitive competences were assessed at baseline, end of treatment (1 month and at a 1-month follow-up through the Montreal Cognitive Assessment, Single Letter Cancelation, Digit Cancelation, Bells Test, Fugl-Meyer Assessment Test, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale, and Barthel Index. Our results show that both groups improved in motor function over time, but the Reh@Task group displayed significantly higher between-group outcomes in the arm subpart of the Fugl-Meyer Assessment Test. Improvements in cognitive function were significant and similar in both groups. Overall, these results are supportive of the viability of VR tools that combine motor and cognitive training, such as the Reh@Task. Trial Registration: This trial was not registered because it is a small clinical study that addresses the feasibility of a prototype device.
management of the disease. Manual muscle testing (MMT) is performed as part of a routine neurological exam. Manual muscle testing (MMT) was found to be...dynamometry in spinal muscular atrophy. Muscle Nerve. 2002;26(1):64-70. Mostert & Kesselring. Effects of a short-term exercise training program on aerobic...dictated by the diseased motor neuron. The surviving muscles have more viable hypertrophied type 1 motor units possibly resulting in a lower MPF. Our
Gorgon, Edward James R
Caregiver-provided physical therapy home programs (PTHP) play an important role in enhancing motor outcomes in pediatric patient populations. This scoping review systematically mapped clinical trials of caregiver-provided PTHP that were aimed at enhancing motor outcomes in children who have or who are at risk for motor delay, with the purpose of (1) describing trial characteristics; (2) assessing methodologic quality; and (3) examining the reporting of caregiver-related components. Physiotherapy Evidence Database (PEDro), Cochrane CENTRAL, PubMed, Scopus, ScienceDirect, ProQuest Central, CINAHL, LILACS, and OTseeker were searched up to July 31, 2017. Two reviewers independently assessed study eligibility. Randomized or quasi-randomized controlled trials on PTHP administered by parents, other family members, friends, or informal caregivers to children who had or who were at risk for motor delay were included. Two reviewers independently appraised trial quality on the PEDro scale and extracted data. Twenty-four articles representing 17 individual trials were identified. Populations and interventions investigated were heterogeneous. Most of the trials had important research design limitations and methodological issues that could limit usefulness in ascertaining the effectiveness of caregiver-provided PTHP. Few (4 of 17) trials indicated involvement of caregivers in the PTHP planning, assessed how the caregivers learned from the training or instructions provided, or carried out both. Included studies were heterogeneous, and unpublished data were excluded. Although caregiver-provided PTHP are important in addressing motor outcomes in this population, there is a lack of evidence at the level of clinical trials to guide practice. More research is urgently needed to determine the effectiveness of care-giver-provided PTHP. Future studies should address the many important issues identified in this scoping review to improve the usefulness of the trial results.
Butchard-MacDonald, Emma; Paul, Lorna; Evans, Jonathan J
People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance. This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined. A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measured via the Modified Fatigue Index Scale. No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p=.007), but not a stable surface (p=.679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho=0.527; p=.001) and depression (rho=0.451; p=.007). RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties. (JINS, 2018, 24, 247-258).
Wang, S Keisin; Green, Linden A; Gutwein, Ashley R; Drucker, Natalie A; Motaganahalli, Raghu L; Fajardo, Andres; Babbey, Clifford M; Murphy, Michael P
Abdominal aortic aneurysms (AAAs) are a major source of morbidity and mortality despite continuing advances in surgical technique and care. Although the inciting factors for AAA development continue to be elusive, accumulating evidence suggests a significant periaortic inflammatory response leading to degradation and dilation of the aortic wall. Previous human trials have demonstrated safety and efficacy of mesenchymal stem cells (MSCs) in the treatment of inflammation-related pathologies such as rheumatoid arthritis, graft versus host disease, and transplant rejection. Therefore, herein, we describe the Aortic Aneurysm Repression with Mesenchymal Stem Cells (ARREST) trial, a phase I investigation into the safety of MSC infusion for patients with small AAA and the cells' effects on modulation of AAA-related inflammation. ARREST is a phase I, single-center, double-blind, randomized controlled trial (RCT) investigating infusion both dilute and concentrated MSCs compared to placebo in 36 small AAA (35-45 mm) patients. Subjects will be followed by study personnel for 12 months to ascertain incidence of adverse events, immune cell phenotype expression, peripheral cytokine profile, and periaortic inflammation. Maximum transverse aortic diameter will be assessed regularly for 5 years by a combination of computed tomography and duplex sonography. Four patients have thus far been enrolled, randomized, and treated per protocol. We anticipate the conclusion of the treatment phase within the next 24 months with ongoing long-term follow-up. ARREST will be pivotal in assessing the safety of MSC infusion and provide preliminary data on the ability of MSCs to favorably modulate the pathogenic AAA host immune response. The data gleaned from this phase I trial will provide the groundwork for a larger, phase III RCT which may provide the first pharmaceutical intervention for AAA. Copyright © 2017 Elsevier Inc. All rights reserved.
Increased GABA-A receptor binding and reduced connectivity at the motor cortex in children with hemiplegic cerebral palsy: a multimodal investigation using 18F-fluoroflumazenil PET, immunohistochemistry, and MR imaging.
Park, Hae-Jeong; Kim, Chul Hoon; Park, Eun Sook; Park, Bumhee; Oh, So Ra; Oh, Maeng-Keun; Park, Chang Il; Lee, Jong Doo
γ-aminobutyric acid (GABA)-A receptor-mediated neural transmission is important to promote practice-dependent plasticity after brain injury. This study investigated alterations in GABA-A receptor binding and functional and anatomic connectivity within the motor cortex in children with cerebral palsy (CP). We conducted (18)F-fluoroflumazenil PET on children with hemiplegic CP to investigate whether in vivo GABA-A receptor binding is altered in the ipsilateral or contralateral hemisphere of the lesion site. To evaluate changes in the GABA-A receptor subunit after prenatal brain injury, we performed GABA-A receptor immunohistochemistry using rat pups with a diffuse hypoxic ischemic insult. We also performed diffusion tensor MR imaging and resting-state functional MR imaging on the same children with hemiplegic CP to investigate alterations in anatomic and functional connectivity at the motor cortex with increased GABA-A receptor binding. In children with hemiplegic CP, the (18)F-fluoroflumazenil binding potential was increased within the ipsilateral motor cortex. GABA-A receptors with the α1 subunit were highly expressed exclusively within cortical layers III, IV, and VI of the motor cortex in rat pups. The motor cortex with increased GABA-A receptor binding in children with hemiplegic CP had reduced thalamocortical and corticocortical connectivity, which might be linked to increased GABA-A receptor distribution in cortical layers in rats. Increased expression of the GABA-A receptor α1 subunit within the ipsilateral motor cortex may be an important adaptive mechanism after prenatal brain injury in children with CP but may be associated with improper functional connectivity after birth and have adverse effects on the development of motor plasticity.
Flynn, Charles Joseph [QM Power, Inc., Kansas City, MO (United States)
The objective of this project was to design and build a cost competitive, more efficient heating, ventilation, and air conditioning (HVAC) motor than what is currently available on the market. Though different potential motor architectures among QMP’s primary technology platforms were investigated and evaluated, including through the building of numerous prototypes, the project ultimately focused on scaling up QM Power, Inc.’s (QMP) Q-Sync permanent magnet synchronous motors from available sub-fractional horsepower (HP) sizes for commercial refrigeration fan applications to larger fractional horsepower sizes appropriate for HVAC applications, and to add multi-speed functionality. The more specific goal became the research, design, development, and testing of a prototype 1/2 HP Q-Sync motor that has at least two operating speeds and 87% peak efficiency compared to incumbent electronically commutated motors (EC or ECM, also known as brushless direct current (DC) motors), the heretofore highest efficiency HVACR fan motor solution, at approximately 82% peak efficiency. The resulting motor prototype built achieved these goals, hitting 90% efficiency and .95 power factor at full load and speed, and 80% efficiency and .7 power factor at half speed. Q-Sync, developed in part through a DOE SBIR grant (Award # DE-SC0006311), is a novel, patented motor technology that improves on electronically commutated permanent magnet motors through an advanced electronic circuit technology. It allows a motor to “sync” with the alternating current (AC) power flow. It does so by eliminating the constant, wasteful power conversions from AC to DC and back to AC through the synthetic creation of a new AC wave on the primary circuit board (PCB) by a process called pulse width modulation (PWM; aka electronic commutation) that is incessantly required to sustain motor operation in an EC permanent magnet motor. The Q-Sync circuit improves the power factor of the motor by removing all
Hurst, R.W.; Feltham, P. (eds.)
This handbook outlines the important role that electric motors play in modern society. It covers the field of motor applications from various motor types to their use and repair. It also presents practical applications of electric motors and methods on motor efficiency. More than half of all electricity generated, and 75 per cent of all industrial electricity consumption is consumed by electric motors. Electrical personnel must be aware of all factors involved in electric motors in order to choose and apply the appropriate size of electric motor. These factors include efficiency, sizing and proper application. The efficient use and maximum life expectancy of electric motors depends on proper motor protection, control and maintenance. This handbook includes articles from leading experts on electric motors in modern electrical systems. The content includes: design considerations; proper electric motor sizing techniques; optimal electric motor application; electric motor protection technology; electric motor control principles; electric motor maintenance and troubleshooting; induction electric motors; electric motor bearing currents; electric motor bearing lubrication; electromagnetism; electric motor enclosures; electric motor testing; electric motor repair; DC electric motor; electric motor starters; electric motor brushes; industrial electric motors; electric motor diagrams; AC electric motors; electric motor wiring; electric motor service; electric motor rewinding; electric motor winding; diagram of electric motor wiring; electric motor kit; and, troubleshooting electric motors. A directory of motor manufacturers and suppliers was also included. refs., tabs., figs.
Brookshire, Geoffrey; Ivry, Richard; Casasanto, Daniel
We investigated the extent to which emotionally valenced words automatically cue spatio-motor representations. Participants made speeded button presses, moving their hand upward or downward while viewing words with positive or negative valence. Only the color of the words was relevant to the response; on target trials, there was no requirement to read the words or process their meaning. In Experiment 1, upward responses were faster for positive words, and downward for negative words. This eff...
Bunce, D.; MacDonald, S.W.S.; Hultsch, D.F.
Intraindividual variability (inconsistency) in reaction time (RT) latencies was investigated in a group of younger (M=25.46 years) and older (M=69.29 years) men. Both groups performed 300 trials in 2-, 4-, and 8-choice RT conditions where RTs for decision and motor components of the task were recorded separately. A dissociation was evident in that…
Clarke Simon D
Full Text Available Abstract Background The ACTION study (Attention deficit hyperactivity disorder Controlled Trial Investigation Of a Non-stimulant is a multi-center, double-blind, randomized cross-over trial of the non-stimulant medication, Atomoxetine, in children and adolescents with attention deficit hyperactivity disorder (ADHD. The primary aims are to examine the efficacy of atomoxetine for improving cognition and emotional function in ADHD and whether any improvements in these outcomes are more pronounced in participants with comorbid anxiety; and to determine if changes in these outcomes after atomoxetine are more reliable than changes in diagnostic symptoms of ADHD. This manuscript will describe the methodology and rationale for the ACTION study. Methods Children and adolescents aged 6 - 17 y with ADHD will be enrolled. Clinical interview and validated scales will be used to confirm diagnosis and screen for exclusion criteria, which include concurrent stimulant use, and comorbid psychiatric or neurological conditions other than anxiety. Three assessment sessions will be conducted over the 13-week study period: Session 1 (Baseline, pre-treatment, Session 2 (six weeks, atomoxetine or placebo, and Session 3 (13 weeks, cross-over after one-week washout period. The standardized touch-screen battery, "IntegNeuro™", will be used to assess cognitive and emotional function. The primary measure of response will be symptom ratings, while quality of life will be a secondary outcome. Logistic regression will be used to determine predictors of treatment response, while repeated measures of analysis will determine any differences in effect of atomoxetine and placebo. Results The methodology for the ACTION study has been detailed. Conclusions The ACTION study is the first controlled trial to investigate the efficacy of atomoxetine using objective cognitive and emotional function markers, and whether these objective measures predict outcomes with atomoxetine in ADHD
Mann, Eva; Meyer, Gabriele
Without transparent reporting of how a randomised controlled trial was designed and conducted and of the methods used, its internal validity cannot be assessed by the reader. A congress abstract is often the only source providing information about a trial. In January 2008, an extended CONSORT statement on abstract reporting was published. Its impact has yet to be evaluated. Using a slightly modified CONSORT checklist comprising 17 items, we thus investigated the reporting quality of randomised controlled trials published in the book of abstracts presented at the World Congress of Geriatrics and Gerontology in Paris in July 2009. A total of n=4,416 abstracts was screened for inclusion; n=129 met the inclusion criteria. The overall quality of the abstracts was remarkably poor. The primary outcome was mentioned in 34/129 abstracts (26%), none of the abstracts reported on the procedure of random allocation of participants or clusters, 21/129 abstracts (16%) reported some kind of blinding, and the attrition rate was mentioned in only 12/129 abstracts (9%). The majority of abstracts fulfilled two items: description of intended intervention for each group (102/129; 79%) and general interpretation of results (107/129; 83%). Trial status was reported in all abstracts. Both journal editors and committees organising congresses are requested to define the use of the CONSORT statement as a prerequisite in their guidelines for authors and to instruct reviewers to conduct compliance checks. Medical associations should finally endorse the indispensability of the CONSORT statement and publish it in their journals. Otherwise the intended benefits cannot be fully generated. Copyright © 2010. Published by Elsevier GmbH.
Investigation of the Association Between Motor Stereotypy Behavior With Fundamental Movement Skills, Adaptive Functioning, and Autistic Spectrum Disorder Symptomology in Children With Intellectual Disabilities.
Powell, Joanne L; Pringle, Lydia; Greig, Matt
Motor stereotypy behaviors are patterned, coordinated, repetitive behaviors that are particularly evident in those with an autistic spectrum disorder and intellectual disabilities. The extent to which motor stereotypy behavior severity is associated with motor skills and maladaptive behavior, measures of adaptive functioning, along with fundamental movement skills and degree of autistic spectrum disorder symptomology is assessed in this preliminary report. Twelve participants, aged 7 to 16 years, with a reported motor stereotypy behavior and either mild or severe intellectual disability comprising developmental or global delay took part in the study. Spearman rho correlational analysis showed that severity of motor stereotypy behavior was significantly positively correlated with autistic spectrum disorder symptomology ( P = .008) and maladaptive behavior ( P = .008) but not fundamental movement skills ( P > .05). An increase in fundamental movement skills score was associated with a decrease in autistic spectrum disorder symptomology ( P = .01) and an increase in motor skills ( P = .002). This study provides evidence showing a significant relationship between motor stereotypy behavior severity with degree of autistic spectrum disorder symptomology and maladaptive behavior.
Full Text Available Objective. A new, novel product, Cynatine HNS, was evaluated for its effects as a supplement for improving various aspects of hair and nails in a randomized, double-blind, placebo-controlled clinical trial. Methods. A total of 50 females were included and randomized into two groups. The active group (n=25 received 2 capsules containing Cynatine HNS, comprised of Cynatine brand keratin (500 mg plus vitamins and minerals, per day, and the placebo group (n=25 received 2 identical capsules of maltodextrin per day for 90 days. End points for hair loss, hair growth, hair strength, amino acid composition, and hair luster were measured. End points were also measured for nail strength and the appearance of nails. Results. The results show that subjects taking Cynatine HNS showed statistically significant improvements in their hair and nails when compared to placebo. Conclusion. Cynatine HNS is an effective supplement for improving hair and nails in 90 days or less. EudraCT number is 2014-002645-22.
von Niederhäusern, Belinda; Fabbro, Thomas; Pauli-Magnus, Christiane
Six multidisciplinary competence centres (Clinical Trial Units, CTUs) in Basel, Berne, Geneva, Lausanne, St. Gallen and Zurich provide professional support to clinical researchers in the planning, implementation, conduct and evaluation of clinical studies. Through their coordinated network, these units promote high-quality, nationally harmonised and internationally standardised clinical research conduct in Switzerland. We will describe why this network has been established, how it has been successful in stilling the growing need for clinical research support, which training and education opportunities it offers, and how it created national awareness for the still-existing hurdles towards clinical research excellence in Switzerland. Taking the CTU Basel as an example, we show that a considerable number (25%) of the studies submitted for regulatory approval in 2013 were supported by the CTU, decreasing the number of findings in ethics reviews by about one-third. We conclude that these achievements, together with a Swiss national funding model for clinical research, and improved national coordination, will be critical factors to successfully position Swiss clinical research at the international forefront.
Martín Muñoz, Agustín
Mostramos la construcción de un modelo de motor homopolar, uno de los más antiguos tipos de motores eléctricos. Se caracterizan porque el campo magnético del imán mantiene siempre la misma polaridad (de ahí su nombre, del griego homos, igual), de modo que, cuando una corriente eléctrica atraviesa el campo magnético, aparece una fuerza que hace girar los elementos no fijados mecánicamente. En el sencillísimo motor homopolar colgado (Schlichting y Ucke 2004), el imán puede girar ...
Lahav, Orit; Apter, Alan; Ratzon, Navah Z.
This study evaluates how much the effects of intervention programs are influenced by pre-existing psychological adjustment and self-esteem levels in kindergarten and first grade children with poor visual-motor integration skills, from low socioeconomic backgrounds. One hundred and sixteen mainstream kindergarten and first-grade children, from low…
Lee, So Young; Han, Eun Young; Kim, Bo Ryun; Im, Sang Hee
The aim of this study was to assess the effects of a motorized aquatic treadmill exercise program improve the isometric strength of the knee muscles, cardiorespiratory fitness, arterial stiffness, motor function, balance, functional outcomes and quality of life in subacute stroke patients. Thirty-two patients were randomly assigned to 4-week training sessions of either aquatic therapy(n=19) or land-based aerobic exercise(n=18). Isometric strength was measured using an isokinetic dynamometer. Cardiopulmonary fitness was evaluated using a symptom-limited exercise tolerance test and by measuring brachial ankle pulse wave velocity. Moreover, motor function(Fugl-Meyer Assessment[FMA] and FMA-lower limb[FMA-LL]), balance(Berg Balance Scale[BBS]), Activities of daily living(Korean version of the Modified Barthel Index [K-MBI]), and Quality of life(EQ-5D index) were examined. There were no inter-group differences between demographic and clinical characteristics at baseline(p>0.05). The results shows significant improvements in peak oxygen consumption (p=0.02), maximal isometric strength of the bilateral knee extensors (paquatic therapy group. However, only significant improvements in maximal isometric strength in the knee extensors (p=0.03) and flexors (p=0.04) were found within the aquatic therapy group and control group. Water-based aerobic exercise performed on a motorized aquatic treadmill had beneficial effect on isometric muscle strength in the lower limb.
Abbott, J Dawn; Lombardero, Manuel S; Barsness, Gregory W; Pena-Sing, Ivan; Buitrón, L Virginia; Singh, Premranjan; Woodhead, Gail; Tardif, Jean-Claude; Kelsey, Sheryl F
Peripheral arterial disease increases cardiovascular risk in many patient populations. The risks associated with an abnormal ankle-brachial index (ABI) in patients with type 2 diabetes and stable coronary artery disease have not been well described with respect to thresholds and types of cardiovascular events. We examined 2,368 patients in the BARI 2D trial who underwent ABI assessment at baseline. Death and major cardiovascular events (death, myocardial infarction and stroke) during follow-up (average 4.3 years) were assessed across the ABI spectrum and by categorized ABI: low (≤0.90), normal (0.91-1.3), high (>1.3), or noncompressible. A total of 12,568 person-years were available for mortality analysis. During follow-up, 316 patients died, and 549 had major cardiovascular events. After adjustment for potential confounders, with normal ABI as the referent group, a low ABI conferred an increased risk of death (relative risk [RR] 1.6, CI 1.2-2.2, P = .0005) and major cardiovascular events (RR 1.4, CI 1.1-1.7, P = .004). Patients with a high ABI had similar outcomes as patients with a normal ABI, but risk again increased in patients with a noncompressible ABI with a risk of death (RR 1.9, CI 1.3-2.8, P = .001) and major cardiovascular event (RR 1.5, CI 1.1-2.1, P = .01). In patients with coronary artery disease and type 2 diabetes, ABI screening and identification of ABI abnormalities including a low ABI (<1.0) or noncompressible artery provide incremental prognostic information. Copyright © 2012 Mosby, Inc. All rights reserved.
This book is divided into three parts, which is about practical using of stepping motor. The first part has six chapters. The contents of the first part are about stepping motor, classification of stepping motor, basic theory og stepping motor, characteristic and basic words, types and characteristic of stepping motor in hybrid type and basic control of stepping motor. The second part deals with application of stepping motor with hardware of stepping motor control, stepping motor control by microcomputer and software of stepping motor control. The last part mentions choice of stepping motor system, examples of stepping motor, measurement of stepping motor and practical cases of application of stepping motor.
Saig, Avraham; Gordon, Goren; Assa, Eldad; Arieli, Amos; Ahissar, Ehud
Perception involves motor control of sensory organs. However, the dynamics underlying emergence of perception from motor-sensory interactions are not yet known. Two extreme possibilities are as follows: (1) motor and sensory signals interact within an open-loop scheme in which motor signals determine sensory sampling but are not affected by sensory processing and (2) motor and sensory signals are affected by each other within a closed-loop scheme. We studied the scheme of motor-sensory interactions in humans using a novel object localization task that enabled monitoring the relevant overt motor and sensory variables. We found that motor variables were dynamically controlled within each perceptual trial, such that they gradually converged to steady values. Training on this task resulted in improvement in perceptual acuity, which was achieved solely by changes in motor variables, without any change in the acuity of sensory readout. The within-trial dynamics is captured by a hierarchical closed-loop model in which lower loops actively maintain constant sensory coding, and higher loops maintain constant sensory update flow. These findings demonstrate interchangeability of motor and sensory variables in perception, motor convergence during perception, and a consistent hierarchical closed-loop perceptual model.
Full Text Available Polycystic ovary syndrome (PCOS is associated with increased risk of venous thromboembolism (VTE and cardiovascular disease (CVD in later life. We aimed to study the effect of liraglutide intervention on markers of VTE and CVD risk, in PCOS. In a double-blind, placebo-controlled, randomized trial, 72 overweight and/or insulinresistant women with PCOS were randomized, in a 2:1 ratio, to liraglutide or placebo 1.8 mg/day. Endpoints included between-group difference in change (baseline to follow-up in plasminogen activator inhibitor-1 levels and in thrombin generation test parameters: endogenous thrombin potential, peak thrombin concentration, lag time and time to peak. Mean weight loss was 5.2 kg (95% CI 3.0–7.5 kg, P < 0.001 in the liraglutide group compared with placebo. We detected no effect on endogenous thrombin potential in either group. In the liraglutide group, peak thrombin concentration decreased by 16.71 nmol/L (95% CI 2.32–31.11, P < 0.05 and lag time and time to peak increased by 0.13 min (95% CI 0.01–0.25, P < 0.05 and 0.38 min (95% CI 0.09–0.68, P < 0.05, respectively, but there were no between-group differences. There was a trend toward 12% (95% CI 0–23, P = 0.05 decreased plasminogen activator inhibitor-1 in the liraglutide group, and there was a trend toward 16% (95% CI −4 to 32, P = 0.10 reduction, compared with placebo. In overweight women with PCOS, liraglutide intervention caused an approximate 5% weight loss. In addition, liraglutide affected thrombin generation, although not significantly differently from placebo. A concomitant trend toward improved fibrinolysis indicates a possible reduction of the baseline thrombogenic potential. The findings point toward beneficial effects of liraglutide on markers of VTE and CVD risk, which should be further pursued in larger studies.
Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain.
Ortiz-Catalan, Max; Guðmundsdóttir, Rannveig A; Kristoffersen, Morten B; Zepeda-Echavarria, Alejandra; Caine-Winterberger, Kerstin; Kulbacka-Ortiz, Katarzyna; Widehammar, Cathrine; Eriksson, Karin; Stockselius, Anita; Ragnö, Christina; Pihlar, Zdenka; Burger, Helena; Hermansson, Liselotte
Phantom limb pain is a debilitating condition for which no effective treatment has been found. We hypothesised that re-engagement of central and peripheral circuitry involved in motor execution could reduce phantom limb pain via competitive plasticity and reversal of cortical reorganisation. Patients with upper limb amputation and known chronic intractable phantom limb pain were recruited at three clinics in Sweden and one in Slovenia. Patients received 12 sessions of phantom motor execution using machine learning, augmented and virtual reality, and serious gaming. Changes in intensity, frequency, duration, quality, and intrusion of phantom limb pain were assessed by the use of the numeric rating scale, the pain rating index, the weighted pain distribution scale, and a study-specific frequency scale before each session and at follow-up interviews 1, 3, and 6 months after the last session. Changes in medication and prostheses were also monitored. Results are reported using descriptive statistics and analysed by non-parametric tests. The trial is registered at ClinicalTrials.gov, number NCT02281539. Between Sept 15, 2014, and April 10, 2015, 14 patients with intractable chronic phantom limb pain, for whom conventional treatments failed, were enrolled. After 12 sessions, patients showed statistically and clinically significant improvements in all metrics of phantom limb pain. Phantom limb pain decreased from pre-treatment to the last treatment session by 47% (SD 39; absolute mean change 1·0 [0·8]; p=0·001) for weighted pain distribution, 32% (38; absolute mean change 1·6 [1·8]; p=0·007) for the numeric rating scale, and 51% (33; absolute mean change 9·6 [8·1]; p=0·0001) for the pain rating index. The numeric rating scale score for intrusion of phantom limb pain in activities of daily living and sleep was reduced by 43% (SD 37; absolute mean change 2·4 [2·3]; p=0·004) and 61% (39; absolute mean change 2·3 [1·8]; p=0·001), respectively. Two of four
Full Text Available Background: The aim of this study was to determine the efficacy of two methods of colon preparation for colon cleansing in a randomized controlled trial. Methods: In this prospective randomized investigator-blinded trial, consecutive outpatients indicated for elective colonoscopy were randomized into two groups. Patients in Senna group took 24 tablets of 11 mg Senna in two divided doses 24 hour before colonoscopy. In Poly Ethylene Glycol (PEG group they solved 4 sachets in 4 liters of water the day before the procedure and were asked to drink 250 ml every 15 minutes. The overall quality of colon cleansing was evaluated using the Aronchick scoring scale. Difficulty of the procedure, patients′ tolerance and compliance and adverse events were also evaluated. Results: 322 patients were enrolled in the study. There was no significant difference in the quality of colon cleansing, patients′ tolerance, compliance and the difficulty of the procedure between two groups (p > 0.05. The incidence of adverse effects was similar between two groups except for abdominal pain that was more severe in Senna group (p < 0.05 and nausea and vomiting that was more common in PEG group (p < 0.05 Conclusions: In conclusion we deduce that Senna has the same efficacy and patient′s acceptance as Polyethylene glycol-electrolyte solution (PEG-ES and it could be prescribed as an alternative method for bowel preparation.
Full Text Available Abstract Background Late onset sepsis is a frequent complication of prematurity associated with increased mortality and morbidity. The commensal bacteria of the gastrointestinal tract play a key role in the development of healthy immune responses. Healthy term infants acquire these commensal organisms rapidly after birth. However, colonisation in preterm infants is adversely affected by delivery mode, antibiotic treatment and the intensive care environment. Altered microbiota composition may lead to increased colonisation with pathogenic bacteria, poor immune development and susceptibility to sepsis in the preterm infant. Probiotics are live microorganisms, which when administered in adequate amounts confer health benefits on the host. Amongst numerous bacteriocidal and nutritional roles, they may also favourably modulate host immune responses in local and remote tissues. Meta-analyses of probiotic supplementation in preterm infants report a reduction in mortality and necrotising enterocolitis. Studies with sepsis as an outcome have reported mixed results to date. Allergic diseases are increasing in incidence in "westernised" countries. There is evidence that probiotics may reduce the incidence of these diseases by altering the intestinal microbiota to influence immune function. Methods/Design This is a multi-centre, randomised, double blinded, placebo controlled trial investigating supplementing preterm infants born at Bifidobacterium infantis, Streptococcus thermophilus and Bifidobacterium lactis. A total of 1,100 subjects are being recruited in Australia and New Zealand. Infants commence the allocated intervention from soon after the start of feeds until discharge home or term corrected age. The primary outcome is the incidence of at least one episode of definite (blood culture positive late onset sepsis before 40 weeks corrected age or discharge home. Secondary outcomes include: Necrotising enterocolitis, mortality, antibiotic usage, time to
Palsbo, Susan E; Hood-Szivek, Pamela
We explored the efficacy of robotic technology in improving handwriting in children with impaired motor skills. Eighteen participants had impairments arising from cerebral palsy (CP), autism spectrum disorder (ASD), attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), or other disorders. The intervention was robotic-guided three-dimensional repetitive motion in 15-20 daily sessions of 25-30 min each over 4-8 wk. Fine motor control improved for the children with learning disabilities and those ages 9 or older but not for those with CP or under age 9. All children with ASD or ADHD referred for slow writing speed were able to increase speed while maintaining legibility. Three-dimensional, robot-assisted, repetitive motion training improved handwriting fluidity in children with mild to moderate fine motor deficits associated with ASD or ADHD within 10 hr of training. This dosage may not be sufficient for children with CP. Copyright © 2012 by the American Occupational Therapy Association, Inc.
Fathy Abdelazim Awwad Elshazly
Full Text Available Osteoarthritis is a common rheumatologic disease. Several non operative interventions have been described for the treatment. But the available evidences of comparing the effectiveness of Virtual reality training over sensory motor training are very few. So, the purpose of this study is to compare the effectiveness of Virtual reality training over sensory motor training in the treatment of Osteoarthritis. 60 subjects who fulfilled the inclusion and exclusion criteria were divided into three Groups (1, 2 & 3 with randomized sampling method. Group 1 treated with Virtual reality training (VRT, Group 2 treated with sensory motor training (SMT and Group 3 (control treated with conventional exercise training (CET. The duration of the treatment was three times per week for 8 weeks in all the three groups. Subjects were assessed at baseline, at 4th and 8th week. Pain Intensity by Visual Analog scale (VAS, Joint Proprioception by Perception Sense, Functional Disability by WOMAC Score, and Quality of Life by HRQOL score were measured. A statistically significant (p ≤ 0.05 difference between all the 3 groups were noted at the period of 8 week for pain intensity, joint proprioception, functional disability and quality of life. Group-1 treated with (VRT shows more significant improvement in all parameters compared with Group-2 (SMT and Group-3 (CET. In conclusion, the addition of virtual reality training to conventional training exercises could improve pain and proprioception which subsequently improve the functional level and quality of life of OA patients
The world's most expensive motor fuel (gasoline, diesel and LPG) is sold most likely in the Republic of Turkey. This paper investigates the key issues related to the motor fuel prices in Turkey. First of all, the paper analyses the main reason behind high prices, namely motor fuel taxes in Turkey. Then, it estimates the elasticity of motor fuel demand in Turkey using an econometric analysis. The findings indicate that motor fuel demand in Turkey is quite inelastic and, therefore, not responsive to price increases caused by an increase in either pre-tax prices or taxes. Therefore, fuel market in Turkey is open to opportunistic behavior by firms (through excessive profits) and the government (through excessive taxes). Besides, the paper focuses on the impact of high motor fuel prices on road transport associated activities, including the pattern of passenger transportation, motorization rate, fuel use, total kilometers traveled and CO 2 emissions from road transportation. The impact of motor fuel prices on income distribution in Turkey and Turkish public opinion about high motor fuel prices are also among the subjects investigated in the course of the study. - Highlights: • The key issues (e.g. taxes) related to motor fuel prices in Turkey are explored. • Their impact on transport activities and income distribution is also investigated. • An econometric analysis is performed to estimate motor fuel demand in Turkey. • Motor fuel demand in Turkey is found to be quite inelastic. • Turkish fuel market is open to opportunistic behavior by firms and the government
Schmidt, Barbara; Roberts, Robin S; Anderson, Peter J; Asztalos, Elizabeth V; Costantini, Lorrie; Davis, Peter G; Dewey, Deborah; D'Ilario, Judy; Doyle, Lex W; Grunau, Ruth E; Moddemann, Diane; Nelson, Harvey; Ohlsson, Arne; Solimano, Alfonso; Tin, Win
Caffeine citrate therapy for apnea of prematurity reduces the rates of bronchopulmonary dysplasia, severe retinopathy, and neurodevelopmental disability at 18 months and may improve motor function at 5 years. To evaluate whether neonatal caffeine therapy is associated with improved functional outcomes 11 years later. A follow-up study was conducted at 14 academic hospitals in Canada, Australia, and the United Kingdom from May 7, 2011, to May 27, 2016, of English- or French-speaking children who had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between October 11, 1999, and October 22, 2004. A total of 1202 children with birth weights of 500 to 1250 g were eligible for this study; 920 (76.5%) had adequate data for the main outcome. Caffeine citrate or placebo until drug therapy for apnea of prematurity was no longer needed. Functional impairment was a composite of poor academic performance (defined as at least 1 standard score greater than 2 SD below the mean on the Wide Range Achievement Test-4), motor impairment (defined as a percentile rank of ≤5 on the Movement Assessment Battery for Children-Second Edition), and behavior problems (defined as a Total Problem T score ≥2 SD above the mean on the Child Behavior Checklist). Among the 920 children (444 females and 476 males; median age, 11.4 years [interquartile range, 11.1-11.8 years]), the combined rates of functional impairment were not significantly different between the 457 children assigned to receive caffeine compared with the 463 children assigned to receive placebo (145 [31.7%] vs 174 [37.6%]; adjusted odds ratio, 0.78; 95% CI, 0.59-1.02; P = .07). With all available data, including those from up to 24 Swedish trial participants, the rates of poor academic performance on 1 or more of 4 subtests (66 of 458 [14.4%] vs 61 of 462 [13.2%]; adjusted odds ratio, 1.11; 95% CI, 0.77-1.61; P = .58) and behavior problems (52 of 476 [10.9%] vs 40 of 481 [8
Full Text Available Bearingless induction motors combining functions of both torque generation and noncontact magnetic suspension together have attracted more and more attention in the past decades due to their definite advantages of compactness, simple structure, less maintenance, no wear particles, high rotational speed, and so forth. This paper overviews the key technologies of the bearingless induction motors, with emphasis on motor topologies, mathematical models, and control strategies. Particularly, in the control issues, the vector control, independent control, direct torque control, nonlinear decoupling control, sensorless control, and so forth are investigated. In addition, several possible development trends of the bearingless induction motors are also discussed.
Verwey, L J; Edwards, T M
Gap junctions are important to how the brain functions but are relatively under-investigated with respect to their contribution towards behaviour. In the present study a single trial discrimination avoidance task was used to investigate the effect of the gap junction inhibitor 18-alpha-glycyrrhetinic acid (alphaGA) on retention. Past studies within our research group have implied a potential role for gap junctions during the short-term memory (STM) stage which decays by 15 min post-training. A retention function study comparing 10 microM alphaGA and vehicle given immediately post-training demonstrated a significant main effect for drug with retention loss at all times of test (10-180 min post-training). Given that the most common gap junction in the brain is that forming the astrocytic network it is reasonable to conclude that alphaGA was acting upon these. To confirm this finding and interpretation two additional investigations were undertaken using endothelin-1 (ET-1) and ET-1+tolbutamide. Importantly, a retention function study using 10nM ET-1 replicated the retention loss observed for alphaGA. In order to confirm that ET-1 was acting on astrocytic gap junctions the amnestic action of ET-1 was effectively challenged with increasing concentrations of tolbutamide. The present findings suggest that astrocytic gap junctions are important for memory processing. Copyright 2009 Elsevier Inc. All rights reserved.
The Belgian trial with azithromycin for acute COPD exacerbations requiring hospitalization: an investigator-initiated study protocol for a multicenter, randomized, double-blind, placebo-controlled trial
Full Text Available Kristina Vermeersch,1 Maria Gabrovska,2 Griet Deslypere,3 Ingel K Demedts,4 Hans Slabbynck,5 Joseph Aumann,3 Vincent Ninane,2 Geert M Verleden,1 Thierry Troosters,1,6 Kris Bogaerts,7,8 Guy G Brusselle,9 Wim Janssens1 On behalf of the BACE Trial Investigators 1KU Leuven, Laboratory of Respiratory Diseases, Department of Clinical and Experimental Medicine, Faculty of Medicine, Leuven, Belgium; 2Department of Pneumology, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium; 3Department of Pneumology, Jessa Ziekenhuis, Hasselt, Belgium; 4Department of Respiratory Medicine, AZ Delta Roeselare-Menen, Roeselare, Belgium; 5Department of Respiratory Medicine, ZNA Middelheim, Antwerpen, Belgium; 6KU Leuven, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium; 7KU Leuven, Department of Public Health and Primary Care, I-BioStat, Leuven, Belgium; 8Hasselt University, Hasselt, Belgium; 9Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium Background: Long-term use of macrolide antibiotics is effective to prevent exacerbations in chronic obstructive pulmonary disease (COPD. As risks and side effects of long-term intervention outweigh the benefits in the general COPD population, the optimal dose, duration of treatment, and target population are yet to be defined. Hospitalization for an acute exacerbation (AE of COPD may offer a targeted risk group and an obvious risk period for studying macrolide interventions.Methods/design: Patients with COPD, hospitalized for an AE, who have a smoking history of ≥10 pack-years and had ≥1 exacerbation in the previous year will be enrolled in a multicenter, randomized, double-blind, placebo-controlled trial (NCT02135354. On top of a standardized treatment of systemic corticosteroids and antibiotics, subjects will be randomized to receive either azithromycin or placebo during 3 months, at an uploading dose of 500 mg once a day for
Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: enhancing minority participation in clinical trials (EMPaCT).
Durant, Raegan W; Wenzel, Jennifer A; Scarinci, Isabel C; Paterniti, Debora A; Fouad, Mona N; Hurd, Thelma C; Martin, Michelle Y
The study of disparities in minority recruitment to cancer clinical trials has focused primarily on inquiries among minority populations. Yet very little is known about the perceptions of individuals actively involved in minority recruitment to clinical trials within cancer centers. Therefore, the authors assessed the perspectives of cancer center clinical and research personnel on barriers and facilitators to minority recruitment. In total, 91 qualitative interviews were conducted at 5 US cancer centers among 4 stakeholder groups: cancer center leaders, principal investigators, research staff, and referring clinicians. All interviews were recorded and transcribed. Qualitative analyses of response data was focused on identifying prominent themes related to barriers and facilitators to minority recruitment. The perspectives of the 4 stakeholder groups were largely overlapping with some variations based on their unique roles in minority recruitment. Four prominent themes were identified: 1) racial and ethnic minorities are influenced by varying degrees of skepticism related to trial participation, 2) potential minority participants often face multilevel barriers that preclude them from being offered an opportunity to participate in a clinical trial, 3) facilitators at both the institutional and participant level potentially encourage minority recruitment, and 4) variation between internal and external trial referral procedures may limit clinical trial opportunities for racial and ethnic minorities. Multilevel approaches are needed to address barriers and optimize facilitators within cancer centers to enhance minority recruitment for cancer clinical trials. © 2014 American Cancer Society.
Boa Sorte Silva, Narlon C; Gregory, Michael A; Gill, Dawn P; Petrella, Robert J
The effects of multiple-modality exercise on arterial stiffening and cardiovascular fitness has not been fully explored. To explore the influence of a 24-week multiple-modality exercise program associated with a mind-motor training in cardiovascular health and fitness in community-dwelling older adults, compared to multiple-modality exercise (M2) alone. Participants (n=127, aged 67.5 [7.3] years, 71% females) were randomized to either M4 or M2 groups. Both groups received multiple-modality exercise intervention (60min/day, 3days/week for 24-weeks); however, the M4 group underwent additional 15min of mind-motor training, whereas the M2 group received 15min of balance training. Participants were assessed at 24-weeks and after a 28-week non-contact follow-up (52-weeks). at 52-weeks, the M4 group demonstrated a greater VO2max (ml/kg/min) compared to the M2 group (mean difference: 2.39, 95% CI: 0. 61 to 4.16, p=0.009). Within-group analysis indicated that the M4 group demonstrated a positive change in VO2max at 24-weeks (mean change: 1.93, 95% CI: 0.82 to 3.05, p=0.001) and 52-weeks (4.02, 95% CI: 2.71 to 5.32, p=0.001). Similarly, the M2 group increased VO2max at 24-weeks (2.28, 95% CI: 1.23 to 3.32, pMind-motor training associated with multiple-modality exercise can positively impact cardiovascular fitness to the same extent as multiple-modality exercise alone. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Caramiaux, Baptiste; Bevilacqua, Frédéric; Wanderley, Marcelo M; Palmer, Caroline
Motor skill acquisition inherently depends on the way one practices the motor task. The amount of motor task variability during practice has been shown to foster transfer of the learned skill to other similar motor tasks. In addition, variability in a learning schedule, in which a task and its variations are interweaved during practice, has been shown to help the transfer of learning in motor skill acquisition. However, there is little evidence on how motor task variations and variability schedules during practice act on the acquisition of complex motor skills such as music performance, in which a performer learns both the right movements (motor skill) and the right time to perform them (timing skill). This study investigated the impact of rate (tempo) variability and the schedule of tempo change during practice on timing and motor skill acquisition. Complete novices, with no musical training, practiced a simple musical sequence on a piano keyboard at different rates. Each novice was assigned to one of four learning conditions designed to manipulate the amount of tempo variability across trials (large or small tempo set) and the schedule of tempo change (randomized or non-randomized order) during practice. At test, the novices performed the same musical sequence at a familiar tempo and at novel tempi (testing tempo transfer), as well as two novel (but related) sequences at a familiar tempo (testing spatial transfer). We found that practice conditions had little effect on learning and transfer performance of timing skill. Interestingly, practice conditions influenced motor skill learning (reduction of movement variability): lower temporal variability during practice facilitated transfer to new tempi and new sequences; non-randomized learning schedule improved transfer to new tempi and new sequences. Tempo (rate) and the sequence difficulty (spatial manipulation) affected performance variability in both timing and movement. These findings suggest that there is a
Ercan, Zülfiye Gül; Ahmetoglu, Emine; Aral, Neriman
This study aims to define whether age creates any differences in the visual-motor integration skills of 60-72 months old children at low and high socio-economic status. The study was conducted on a total of 148 children consisting of 78 children representing low socio-economic status and 70 children representing high socio-economic status in the…
Preconception Micronutrient Supplementation with Iron and Folic Acid Compared with Folic Acid Alone Affects Linear Growth and Fine Motor Development at 2 Years of Age: A Randomized Controlled Trial in Vietnam.
Nguyen, Phuong H; Gonzalez-Casanova, Ines; Young, Melissa F; Truong, Truong Viet; Hoang, Hue; Nguyen, Huong; Nguyen, Son; DiGirolamo, Ann M; Martorell, Reynaldo; Ramakrishnan, Usha
Background: Maternal health and nutrition play a crucial role in early child growth and development. However, little is known about the benefits of preconception micronutrient interventions beyond the role of folic acid (FA) and neural tube defects. Objective: We evaluated the impact of weekly preconception multiple micronutrient (MM) or iron and folic acid (IFA) supplementation on child growth and development through the age of 2 y compared with FA alone. Methods: We followed 1599 offspring born to women who participated in a randomized controlled trial of preconception supplementation in Vietnam. Women received weekly supplements that contained either 2800 μg FA, 60 mg Fe and 2800 μg FA, or 15 MMs including IFA, from baseline until conception followed by daily prenatal IFA supplements until delivery. Child anthropometry was measured at birth and at 3, 6, 12, 18, and 24 mo. Child development was measured with the use of the Bayley Scales for Infant Development III at 24 mo. Results: The groups were similar for baseline maternal and offspring birth characteristics. At 24 mo of age, the offspring in the IFA group had significantly higher length-for-age z scores (LAZs) (0.14; 95% CI: 0.03, 0.26), reduced risk of being stunted (0.87; 95% CI: 0.76, 0.99), and smaller yearly decline in LAZs (0.10; 95% CI: 0.04, 0.15) than the offspring in the FA group. Similar trends were found for the offspring in the MM group compared with the FA group for LAZs (0.10; 95% CI: -0.02, 0.22) and the risk of being stunted (0.88; 95% CI: 0.77, 1.01). Offspring in the IFA group had improved motor development ( P = 0.03), especially fine motor development (0.41; 95% CI: 0.05, 0.77), at the age of 24 mo, but there were no differences for measures of cognition or language. Conclusions: Preconception supplementation with IFA improved linear growth and fine motor development at 2 y of age compared with FA. Future studies should examine whether these effects persist and improve child health and
Barkman, W.E.; Adams, W.Q.; Berrier, B.R.
A linear induction motor has been operated on a test bed with a feedback pulse resolution of 5 nm (0.2 μin). Slewing tests with this slide drive have shown positioning errors less than or equal to 33 nm (1.3 μin) at feedrates between 0 and 25.4 mm/min (0-1 ipm). A 0.86-m (34-in)-stroke linear motor is being investigated, using the SPACO machine as a test bed. Initial results were encouraging, and work is continuing to optimize the servosystem compensation
Rakopoulos, C.D.; Kosmadakis, G.M.; Pariotis, E.G.
The present work investigates the effect of varying the combustion chamber geometry and engine rotational speed on the gas flow and temperature field, using a new quasi-dimensional engine simulation model in conjunction with an in-house developed computational fluid dynamics (CFD) code served to validate the predicted in-cylinder flow field and gas temperature distribution calculated by the quasi-dimensional model, for three alternative piston bowl geometries and three rotational speeds. This CFD code can simulate three-dimensional curvilinear domains using the finite volume method in a collocated grid; it solves the generalized transport equation for the conservation of mass, momentum and energy, and incorporates the standard k-ε turbulence model with some slight modifications to introduce the compressibility of a fluid in generalized coordinates. On the other hand, the quasi-dimensional model solves the general transport equation for the conservation of mass and energy by a finite volume method throughout the entire in-cylinder volume, while for the estimation of the flow field a new simplified three dimensional air motion model is used. To compare these two models the in-cylinder spatial and temporal temperature distribution, the mean cylinder pressure diagram, as well as the mean in-cylinder radial and axial velocity are examined, for the three piston bowl geometries and the three speeds, for a high speed direct injection (HSDI) diesel engine operating under motoring conditions. From the comparison of calculated results, it becomes apparent that the two models predict similar in-cylinder temperature distributions and mean air velocity fields at each crank angle, for all cases examined. Thus, it is shown that the quasi-dimensional model with the proposed simplified air motion model is capable of capturing the physical effect of combustion chamber geometry and speed on the in-cylinder velocity and temperature field, while needing significantly lower computing
Fokas, Emmanouil; Clifford, Charlotte; Spezi, Emiliano; Joseph, George; Branagan, Jennifer; Hurt, Chris; Nixon, Lisette; Abrams, Ross; Staffurth, John; Mukherjee, Somnath
To evaluate the variation in investigator-delineated volumes and assess plans from the radiotherapy trial quality assurance (RTTQA) program of SCALOP, a phase II trial in locally advanced pancreatic cancer. Participating investigators (n=25) outlined a pre-trial benchmark case as per RT protocol, and the accuracy of investigators' GTV (iGTV) and PTV (iPTV) was evaluated, against the trials team-defined gold standard GTV (gsGTV) and PTV (gsPTV), using both qualitative and geometric analyses. The median Jaccard Conformity Index (JCI) and Geographical Miss Index (GMI) were calculated. Participating RT centers also submitted a radiotherapy plan for this benchmark case, which was centrally reviewed against protocol-defined constraints. Twenty-five investigator-defined contours were evaluated. The median JCI and GMI of iGTVs were 0.57 (IQR: 0.51-0.65) and 0.26 (IQR: 0.15-0.40). For iPTVs, these were 0.75 (IQR: 0.71-0.79) and 0.14 (IQR: 0.11-0.22) respectively. Qualitative analysis showed largest variation at the tumor edges and failure to recognize a peri-pancreatic lymph node. There were no major protocol deviations in RT planning, but three minor PTV coverage deviations were identified. . SCALOP demonstrated considerable variation in iGTV delineation. RTTQA workshops and real-time central review of delineations are needed in future trials. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Croonen, E.A.; Essink, M.; Burgt, I. van der; Draaisma, J.M.; Noordam, C.; Nijhuis-Van der Sanden, M.W.G.
Although problems with motor performance in daily life are frequently mentioned in Noonan syndrome, the motor performance profile has never been systematically investigated. The aim of this study was to examine whether a specific profile in motor performance in children with Noonan syndrome was seen
Ioana A Cristea
Full Text Available The influence of factors related to the background of investigators conducting trials comparing psychotherapy and pharmacotherapy has remained largely unstudied. Specializations emphasizing biological determinants of mental disorders, like psychiatry, might favor pharmacotherapy, while others stressing psychosocial factors, like psychology, could promote psychotherapy. Yet financial conflict of interest (COI could be a confounding factor as authors with a medical specialization might receive more sponsoring from the pharmaceutical industry.We conducted a meta-analysis with subgroup and meta-regression analysis examining whether the specialization and affiliation of trial authors were associated to outcomes in the direct comparison of psychotherapy and pharmacotherapy for the acute treatment of depression. Meta-regression analysis also included trial risk of bias and author conflict of interest in relationship to the pharmaceutical industry.We included 45 trials. In half, the first author was psychologist. The last author was psychiatrist/MD in half of the trials, and a psychologist or statistician/other technical in the rest. Most lead authors had medical affiliations. Subgroup analysis indicated that studies with last authors statisticians favored pharmacotherapy. Univariate analysis showed a negative relationship between the presence of statisticians and outcomes favoring psychotherapy. Multivariate analysis showed that trials including authors with financial COI reported findings more favorable to pharmacotherapy.We report the first detailed overview of the background of authors conducting head to head trials for depression. Trials co-authored by statisticians appear to subtly favor pharmacotherapy. Receiving funding from the industry is more closely related to finding better outcomes for the industry's elective treatment than are factors related to authors' background.For a minority of authors we could not retrieve background information
Lee, Jae Jin; Lee, Dong Ryul; Shin, Yoon Kyum; Lee, Nam Gi; Han, Bong S; You, Sung Joshua Hyun
The purpose of this study was to compare topographical maps using a novel EEG-based brain mapping system with fMRI in normal and children with cerebral palsy (CP) during a grasping motor task. A normal child (mean ± SD = 13 ± 0 yrs) and four children with CP (mean ± SD = 10.25 ± 2.86 yrs) were recruited from a local community school and medical center. A novel EEG-based brain mapping system with 30 scalp sites (an extension of the 10-20 system) and a 3T MR scanner were used to observe cortical activation patterns during a grasping motor task. Descriptive analysis. In the EEG brain mapping data, the sensorimotor cortex (SMC) and inferior parietal cortex (IPC) were activated in all of the children. The children with CP showed additional activation areas in the premotor cortex (PMC), superior parietal cortex (SPC), and prefrontal cortex (PFC). In the fMRI brain mapping data, SMC activation was observed in all of the children, and the children with CP showed additional activation areas in the PMC and primary somatosensory cortex (PSC). The EEG-based topographical maps were equivalent to the maps obtained from fMRI during the grasping motor task. The results indicate that our novel EEG-based brain mapping system is useful for probing cortical activation patterns in normal children and children with CP.
Ebert, Jay R; Joss, Brendan; Jardine, Berit; Wood, David J
To investigate the efficacy of manual lymphatic drainage (MLD) in the early postoperative period after total knee arthroplasty (TKA) to reduce edema and pain and improve knee range of motion. Prospective randomized controlled trial. Private hospital and functional rehabilitation clinic. Consecutive sample of patients (N=43; 53 knees) scheduled for TKA. MLD (vs no MLD) on days 2, 3, and 4 postoperatively. Both groups underwent conventional, concomitant physical therapy. Clinical assessment was undertaken pre- and postoperatively prior to and after the designated postoperative MLD sessions (days 2, 3, and 4) and at 6 weeks postsurgery. This included active knee flexion and extension range of motion, lower limb girths (ankle, midpatella, thigh, and calf), and knee pain using a numeric rating scale and the Knee Injury and Osteoarthritis Outcome Score. A significant group effect was observed for active knee flexion, with post hoc tests demonstrating a significantly greater active knee flexion in the MLD group when compared with the control (no MLD) group at the final measure prior to hospital discharge (day 4 postsurgery) and at 6 weeks postsurgery. There were no further group effects observed for the remaining patient-reported and functional outcomes. MLD in the early postoperative stages after TKA appears to improve active knee flexion up to 6 weeks postsurgery, in addition to conventional care. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Tupper-Carey, Darell Alexander; Fathil, Shahridan Mohd; Tan, Yin Kiat Glenn; Kan, Yuk Man; Cheong, Chern Yuen; Siddiqui, Fahad Javaid; Assam, Pryseley Nkouibert
We conducted a single-centre, prospective randomised clinical trial to investigate the analgesic efficacy of transversus abdominis plane (TAP) block in adult patients undergoing laparoscopic appendicectomy. Patients undergoing urgent laparoscopic appendicectomy under general anaesthesia alone (control group) and general anaesthesia supplemented by TAP block (TAP intervention group) were compared. All patients received a multimodal analgesia regime, which included postoperative morphine via a patient-controlled analgesia device. The primary endpoints were morphine consumption at 12 hours and 24 hours postoperatively. Secondary endpoints included pain scores, incidence of nausea and vomiting, and time to hospital discharge. A total of 58 patients were recruited, with 29 patients in each group. Mean postoperative morphine consumption at 12 hours (control group: 11.45 ± 7.64 mg, TAP intervention group: 9.79 ± 8.09 mg; p = 0.4264) and 24 hours (control group: 13.38 ± 8.72 mg, TAP intervention group: 11.31 ± 8.66 mg; p = 0.3686) for the control and TAP intervention groups were not statistically different. Secondary outcomes were also not different between the two groups. Length of stay in the post-anaesthesia care unit was significantly shorter for the TAP intervention group, with a trend toward faster hospital discharge being observed. TAP block, a regional anaesthetic procedure performed immediately prior to skin incision for laparoscopic appendicectomy, did not significantly improve postoperative analgesia outcomes. Copyright: © Singapore Medical Association
Shirakawa Okuma, Rosely; Calderón Orejuela, Javier
La tesis narra la situación de una empresa concesionaria de vehículos nuevos, Jidosha's Motors, perteneciente a una corporación japonesa que cuenta con una cultura muy arraigada de ética y de cumplimiento. Se plantean respuestas, se identifican problemas y sus alternativas de solución para una toma adecuada de decisiones por parte de los directivos, siguiendo una estructura de análisis de situaciones de negocios (ASN). Tesis
Griffith, Garett; Klaren, Rachel E; Motl, Robert W; Baynard, Tracy; Fernhall, Bo
This randomized controlled trial (RCT) will investigate the effects of a home-based aerobic exercise training regimen (i.e., cycle ergometry) on subclinical atherosclerosis and walking mobility in persons with multiple sclerosis (MS) and minimal disability. This RCT will recruit 54 men and women who have an Expanded Disability Status Scale characteristic of the 1st stage of MS (i.e., 0-4.0) to participate in a 3 month exercise or stretching intervention, with assessments of subclinical atherosclerosis and walking mobility conducted at baseline, week 6 (midpoint), and week 12 (conclusion) of the program. The exercise intervention will consist of 3 days/week of cycling, with a gradual increase of duration followed by an increase in intensity across the 3 month period. The attention-control condition will incorporate stretching activities and will require the same contact time commitment as the exercise condition. Both study groups will participate in weekly video chat sessions with study personnel in order to monitor and track program adherence. Primary outcomes will consist of assessments of vascular structure and function, as well as several walking tasks. Additional outcomes will include questionnaires, cardiorespiratory fitness assessment, and a 1-week free-living physical activity assessment. This investigation will increase understanding of the role of aerobic exercise as part of a treatment plan for managing subclinical atherosclerosis and improving walking mobility persons in the 1st stage of MS. Overall, this study design has the potential to lead to effective aerobic exercise intervention strategies for this population and improve program adherence. Copyright © 2015 Elsevier Inc. All rights reserved.
Kozica, Samantha L; Teede, Helena J; Harrison, Cheryce L; Klein, Ruth; Lombard, Catherine B
The prevalence of obesity in rural and remote areas is elevated in comparison to urban populations, highlighting the need for interventions targeting obesity prevention in these settings. Implementing evidence-based obesity prevention programs is challenging. This study aimed to investigate factors influencing the implementation of obesity prevention programs, including adoption, program delivery, community uptake, and continuation, specifically within rural settings. Nested within a large-scale randomized controlled trial, a qualitative exploratory approach was adopted, with purposive sampling techniques utilized, to recruit stakeholders from 41 small rural towns in Australia. In-depth semistructured interviews were conducted with clinical health professionals, health service managers, and local government employees. Open coding was completed independently by 2 investigators and thematic analysis undertaken. In-depth interviews revealed that obesity prevention programs were valued by the rural workforce. Program implementation is influenced by interrelated factors across: (1) contextual factors and (2) organizational capacity. Key recommendations to manage the challenges of implementing evidence-based programs focused on reducing program delivery costs, aided by the provision of a suite of implementation and evaluation resources. Informing the scale-up of future prevention programs, stakeholders highlighted the need to build local rural capacity through developing supportive university partnerships, generating local program ownership and promoting active feedback to all program partners. We demonstrate that the rural workforce places a high value on obesity prevention programs. Our results inform the future scale-up of obesity prevention programs, providing an improved understanding of strategies to optimize implementation of evidence-based prevention programs. © 2015 National Rural Health Association.
Zhou, Zhong-xing; Wan, Bai-kun; Ming, Dong; Qi, Hong-zhi
In this study, we proposed and evaluated the use of the empirical mode decomposition (EMD) technique combined with phase synchronization analysis to investigate the human brain synchrony of the supplementary motor area (SMA) and primary motor area (M1) during complex motor imagination of combined body and limb action. We separated the EEG data of the SMA and M1 into intrinsic mode functions (IMFs) using the EMD method and determined the characteristic IMFs by power spectral density (PSD) analysis. Thereafter, the instantaneous phases of the characteristic IMFs were obtained by the Hilbert transformation, and the single-trial phase-locking value (PLV) features for brain synchrony measurement between the SMA and M1 were investigated separately. The classification performance suggests that the proposed approach is effective for phase synchronization analysis and is promising for the application of a brain-computer interface in motor nerve reconstruction of the lower limbs.
DeWall, K.G.; Watkins, J.C.; Bramwell, D. [Idaho National Engineering Lab., Idaho Falls, ID (United States); Weidenhamer, G.H.
Researchers at the Idaho National Engineering Laboratory recently conducted tests investigating the operating efficiency of the power train (gearbox) in motor-operators typically used in nuclear power plants to power motor-operated valves. Actual efficiency ratios were determined from in-line measurements of electric motor torque (input to the operator gearbox) and valve stem torque (output from the gearbox) while the operators were subjected to gradually increasing loads until the electric motor stalled. The testing included parametric studies under reduced voltage and elevated temperature conditions. As part of the analysis of the results, the authors compared efficiency values determined from testing to the values published by the operator manufacturer and typically used by the industry in calculations for estimating motor-operator capabilities. The operators they tested under load ran at efficiencies lower than the running efficiency (typically 50%) published by the operator manufacturer.
DeWall, K.G.; Watkins, J.C.; Bramwell, D.; Weidenhamer, G.H.
Researchers at the Idaho National Engineering Laboratory recently conducted tests investigating the operating efficiency of the power train (gearbox) in motor-operators typically used in nuclear power plants to power motor-operated valves. Actual efficiency ratios were determined from in-line measurements of electric motor torque (input to the operator gearbox) and valve stem torque (output from the gearbox) while the operators were subjected to gradually increasing loads until the electric motor stalled. The testing included parametric studies under reduced voltage and elevated temperature conditions. As part of the analysis of the results, the authors compared efficiency values determined from testing to the values published by the operator manufacturer and typically used by the industry in calculations for estimating motor-operator capabilities. The operators they tested under load ran at efficiencies lower than the running efficiency (typically 50%) published by the operator manufacturer
DeWall, K.G.; Watkins, J.C.; Bramwell, D.
Researchers at the Idaho National Engineering Laboratory recently conducted tests investigating the operating efficiency of the power train (gearbox) in motor-operators typically used in nuclear power plants to power motor-operated valves. Actual efficiency ratios were determined from in-line measurements of electric motor torque (input to the operator gearbox) and valve stem torque (output from the gearbox) while the operators were subjected to gradually increasing loads until the electric motor stalled. The testing included parametric studies under reduced voltage and elevated temperature conditions. As part of the analysis of the results, we compared efficiency values determined from testing to the values published by the operator manufacturer and typically used by the industry in calculations for estimating motor-operator capabilities. The operators we tested under load ran at efficiencies lower than the running efficiency (typically 50%) published by the operator manufacturer
Wolz, Martin; Schleiffer, Christine; Klingelhöfer, Lisa; Schneider, Christine; Proft, Florian; Schwanebeck, Uta; Reichmann, Heinz; Riederer, Peter; Storch, Alexander
A previous questionnaire study suggests an increased chocolate consumption in Parkinson's disease (PD). The cacao ingredient contains caffeine analogues and biogenic amines, such as β-phenylethylamine, with assumed antiparkinsonian effects. We thus tested the effects of 200 g of chocolate containing 80 % of cacao on UPDRS motor score after 1 and 3 h in 26 subjects with moderate non-fluctuating PD in a mono-center, single-dose, investigator-blinded crossover study using cacao-free white chocolate as placebo comparator. At 1 h after chocolate intake, mean UPDRS motor scores were mildly decreased compared to baseline in both treatments with significant results only for dark chocolate [-1.3 (95 % CI 0.18-2.52, RMANOVA F = 4.783, p = 0.013¸ Bonferroni p = 0.021 for 1 h values)]. A 2 × 2-cross-over analysis revealed no significant differences between both treatments [-0.54 ± 0.47 (95 % CI -1.50 to 0.42), p = 0.258]. Similar results were obtained at 3 h after intake. β-phenylethylamine blood levels were unaltered. Together, chocolate did not show significant improvement over white cacao-free chocolate in PD motor function.
Massetti, Thais; Fávero, Francis Meire; Menezes, Lilian Del Ciello de; Alvarez, Mayra Priscila Boscolo; Crocetta, Tânia Brusque; Guarnieri, Regiani; Nunes, Fátima L S; Monteiro, Carlos Bandeira de Mello; Silva, Talita Dias da
To evaluate whether people with Duchenne muscular dystrophy (DMD) practicing a task in a virtual environment could improve performance given a similar task in a real environment, as well as distinguishing whether there is transference between performing the practice in virtual environment and then a real environment and vice versa. Twenty-two people with DMD were evaluated and divided into two groups. The goal was to reach out and touch a red cube. Group A began with the real task and had to touch a real object, and Group B began with the virtual task and had to reach a virtual object using the Kinect system. ANOVA showed that all participants decreased the movement time from the first (M = 973 ms) to the last block of acquisition (M = 783 ms) in both virtual and real tasks and motor learning could be inferred by the short-term retention and transfer task (with increasing distance of the target). However, the evaluation of task performance demonstrated that the virtual task provided an inferior performance when compared to the real task in all phases of the study, and there was no effect for sequence. Both virtual and real tasks promoted improvement of performance in the acquisition phase, short-term retention, and transfer. However, there was no transference of learning between environments. In conclusion, it is recommended that the use of virtual environments for individuals with DMD needs to be considered carefully.
Yang, Peilan; Wang, Jie; Wu, Yingen; Zi, Suna; Tang, Jie; Wang, Zhenwei
Purpose To compare the efficacy of individualized herbal decoction with standard decoction for patients with stable bronchiectasis through N-of-1 trials. Methods We conducted a single center N-of-1 trials in 17 patients with stable bronchiectasis. Each N-of-1 trial contains three cycles. Each cycle is divided into two 4-week intervention including individualized decoction and fixed decoction (control). The primary outcome was patient self-reported symptoms scores on a 1–7 point Likert scale. Secondary outcomes were 24-hour sputum volume and CAT scores. Results Among 14 completed trials, five showed that the individualized decoction was statistically better than the control decoction on symptom scores (P traditional Chinese medicine individual diagnosis and treatment. PMID:29552084
Seyed Ali Hosseini
Full Text Available Background: Centre of pressure displacement is an indicator of postural control. Children with cerebral palsy have poor postural control. One common intervention to enhance their balance is vestibular stimulation. The aim of this research was to investigate the effect of vestibular stimulation on COP parameters in children with cerebral palsy (3-10 years old. Methods: This study was a randomized double-blind controlled clinical trial. Twenty children with cerebral palsy received vestibular stimulation, two sessions per week with a course of twelve sessions, based on vestibular stimulation protocol including anteroposterior, lateral, ascending–descending movements and spinning. One cerebral palsy group experienced current and conventional occupational therapy while the other received a period of vestibular stimulation during treatment. Force plate outcome measures were center of pressure displacement parameters as well as velocity, area, displacement in X and Y axes. Results: According to Mann-Whitney U test, means in post-tests in two groups with both conditions of eyes open and closed were significant in velocity parameter (eyes open P=0.036; eyes closed P=0.021 while Area parameter, COP displacement in X axis (Rang fore after, COP displacement in Y axis (Rang side way were not significant (P>0.05. Wilcoxon Test showed significant difference in the velocity parameter; eyes open (P=0.012 and eyes closed (P=0.018. Conclusion: Children who received vestibular stimulation are able to change and control COP displacement faster (according to changes in velocity parameters. So we suggest rehabilitation team members especially occupational therapist to apply vestibular stimulation during their treatment.
Piek Jan P
Full Text Available Abstract Background Many children are reported to have insufficient physical activity (PA placing them at greater risk of poor health outcomes. Participating in sedentary activities such as playing electronic games is widely believed to contribute to less PA. However there is no experimental evidence that playing electronic games reduces PA. There is also no evidence regarding the effect of different types of electronic games (traditional sedentary electronic games versus new active input electronic games on PA. Further, there is a poor understanding about how characteristics of children may moderate the impact of electronic game access on PA and about what leisure activities are displaced when children play electronic games. Given that many children play electronic games, a better understanding of the effect of electronic game use on PA is critical to inform child health policy and intervention. Methods This randomised and controlled trial will examine whether PA is decreased by access to electronic games and whether any effect is dependent on the type of game input or the child's characteristics. Children aged 10–12 years (N = 72, 36 females will be recruited and randomised to a balanced ordering of 'no electronic games', 'traditional' electronic games and 'active' electronic games. Each child will participate in each condition for 8 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is PA, assessed by Actical accelerometers worn for 7 days on the wrist and hip. Energy expenditure will be assessed by the doubly labelled water technique and motor coordination, adiposity, self-confidence, attitudes to technology and PA and leisure activities will also be assessed. A sample of 72 will provide a power of > 0.9 for detecting a 15 mins difference in PA (sd = 30 mins. Discussion This is the first such trial and will provide critical information to understand whether access to electronic games affects
OBJECTIVE: To summarize and analyze the factors and theories related to the attack of motor neuron disease, and comprehensively investigate the pathogenesis of motor neuron disease.DATA SOURCES: A search of Pubmed database was undertaken to identify articles about motor neuron disease published in English from January 1994 to June 2006 by using the keywords of "neurodegenerative diseases". Other literatures were collected by retrieving specific journals and articles.STUDY SELECTION: The data were checked primarily, articles related to the pathogenesis of motor neuron disease were involved, and those obviously irrelated to the articles were excluded.DATA EXTRACTION: Totally 54 articles were collected, 30 of them were involved, and the other 24 were excluded.DATA SYNTHESIS: The pathogenesis of motor neuron disease has multiple factors, and the present related theories included free radical oxidation, excitotoxicity, genetic and immune factors, lack of neurotrophic factor,injury of neurofilament, etc. The studies mainly come from transgenic animal models, cell culture in vitro and patients with familial motor neuron disease, but there are still many restrictions and disadvantages.CONCLUSION: It is necessary to try to find whether there is internal association among different mechanisms,comprehensively investigate the pathogenesis of motor neuron diseases, in order to provide reliable evidence for the clinical treatment.
Damiano, Diane L; Stanley, Christopher J; Ohlrich, Laurie; Alter, Katharine E
Locomotor training using treadmills or robotic devices is commonly utilized to improve gait in cerebral palsy (CP); however, effects are inconsistent and fail to exceed those of equally intense alternatives. Possible limitations of existing devices include fixed nonvariable rhythm and too much limb or body weight assistance. To quantify and compare effectiveness of a motor-assisted cycle and a novel alternative, an elliptical, in CP to improve interlimb reciprocal coordination through intensive speed-focused leg training. A total of 27 children with bilateral CP, 5 to 17 years old, were randomized to 12 weeks of 20 minutes, 5 days per week home-based training (elliptical = 14; cycle = 13) at a minimum of 40 revolutions per minute, with resistance added when speed target was achieved. Primary outcomes were self-selected and fastest voluntary cadence on the devices and gait speed. Secondary outcomes included knee muscle strength, and selective control and functional mobility measures. Cadence on trained but not nontrained devices increased, demonstrating task specificity of training and increased exercise capability. Mean gait speed did not increase in either group, nor did parent-reported functional mobility. Knee extensor strength increased in both. An interaction between group and time was seen in selective control with scores slightly increasing for the elliptical and decreasing for the cycle, possibly related to tighter limb coupling with cycling. Task-specific effects were similarly positive across groups, but no transfer was seen to gait or function. Training dose was low (≤20 hours) compared with intensive upper-limb training recommendations and may be insufficient to produce appreciable clinical change.
Full Text Available Abstract Background Randomised, placebo-controlled trials are needed to provide evidence demonstrating safe, effective interventions that reduce falls and fractures in the elderly. The quality of a clinical trial is dependent on successful recruitment of the target participant group. This paper documents the successes and failures of recruiting over 2,000 women aged at least 70 years and at higher risk of falls or fractures onto a placebo-controlled trial of six years duration. The characteristics of study participants at baseline are also described for this study. Methods The Vital D Study recruited older women identified at high risk of fracture through the use of an eligibility algorithm, adapted from identified risk factors for hip fracture. Participants were randomised to orally receive either 500,000 IU vitamin D3 (cholecalciferol or placebo every autumn for five consecutive years. A variety of recruitment strategies were employed to attract potential participants. Results Of the 2,317 participants randomised onto the study, 74% (n = 1716/2317 were consented onto the study in the last five months of recruiting. This was largely due to the success of a targeted mail-out. Prior to this only 541 women were consented in the 18 months of recruiting. A total of 70% of all participants were recruited as a result of targeted mail-out. The response rate from the letters increased from 2 to 7% following revision of the material by a public relations company. Participant demographic or risk factor profile did not differ between those recruited by targeted mail-outs compared with other methods. Conclusion The most successful recruitment strategy was the targeted mail-out and the response rate was no higher in the local region where the study had extensive exposure through other recruiting strategies. The strategies that were labour-intensive and did not result in successful recruitment include the activities directed towards the GP medical centres
Landau, Sabine; Emsley, Richard; Dunn, Graham
Random allocation avoids confounding bias when estimating the average treatment effect. For continuous outcomes measured at post-treatment as well as prior to randomisation (baseline), analyses based on (A) post-treatment outcome alone, (B) change scores over the treatment phase or (C) conditioning on baseline values (analysis of covariance) provide unbiased estimators of the average treatment effect. The decision to include baseline values of the clinical outcome in the analysis is based on precision arguments, with analysis of covariance known to be most precise. Investigators increasingly carry out explanatory analyses to decompose total treatment effects into components that are mediated by an intermediate continuous outcome and a non-mediated part. Traditional mediation analysis might be performed based on (A) post-treatment values of the intermediate and clinical outcomes alone, (B) respective change scores or (C) conditioning on baseline measures of both intermediate and clinical outcomes. Using causal diagrams and Monte Carlo simulation, we investigated the performance of the three competing mediation approaches. We considered a data generating model that included three possible confounding processes involving baseline variables: The first two processes modelled baseline measures of the clinical variable or the intermediate variable as common causes of post-treatment measures of these two variables. The third process allowed the two baseline variables themselves to be correlated due to past common causes. We compared the analysis models implied by the competing mediation approaches with this data generating model to hypothesise likely biases in estimators, and tested these in a simulation study. We applied the methods to a randomised trial of pragmatic rehabilitation in patients with chronic fatigue syndrome, which examined the role of limiting activities as a mediator. Estimates of causal mediation effects derived by approach (A) will be biased if one of
Violet N Chihota
Full Text Available 40 primary health clinics (PHCs in four provinces in South Africa, June 2012 -February 2013.To determine whether health care worker (HCW practice in investigating people with TB symptoms was altered when the initial test for TB was changed from smear microscopy to Xpert MTB/RIF.Cross-sectional substudy at clinics participating in a pragmatic cluster randomised trial, Xpert for TB: Evaluating a New Diagnostic "XTEND", which evaluated the effect of Xpert MTB/RIF implementation in South Africa.Consecutive adults exiting PHCs reporting at least one TB symptom (defined as any of cough, weight loss, night sweats and fever were enrolled. The main outcome was the proportion who self-reported having sputum requested by HCW during the clinic encounter just completed.3604 adults exiting PHCs (1676 in Xpert arm, 1928 in microscopy arm were enrolled (median age 38 years, 71.4% female, 38.8% reported being HIV-positive, 70% reported cough. For 1267 participants (35.2% the main reason for attending the clinic was TB symptom(s. Overall 2130/3604 (59.1% said they reported their symptom(s to HCW. 22.7% (818/3604 reported having been asked to give sputum for TB investigation. Though participants in the Xpert vs. microscopy arm were more likely to have sputum requested by HCW, this was not significantly different: overall (26.0% [436/1676] vs 19.8% [382/1928]; adjusted prevalence ratio [aPR] 1.31, [95% CI 0.78-2.20] and when restricted to those presenting at clinics due to symptoms (49.1% [260/530] vs 29.9% [220/737]; aPR 1.38 [0.89-2.13] and those reporting being HIV-positive (29.4% [190/647] vs 20.8% [156/749]; aPR 1.38[0.88-2.16]. Those attending clinic due to TB symptoms, were more likely to have sputum requested if they had increasing number of symptoms; longer duration of cough, unintentional weight loss and night sweats and if they reported symptoms to HCW.A large proportion of people exiting PHCs reporting TB symptoms did not get tested. Implementation of
Mcbrien, E. F.; Tryon, H. B.
The differences in the performance of dc motors are evaluated when operating with chopper type controllers, and when operating on direct current. The interactions between the motor and the controller which cause these differences are investigated. Motor-controlled tests provided some of the data the quantified motor efficiency variations for both ripple free and chopper modes of operation.
Hansen, R.B.; Hattel, T.; Bork, J
Sliding mode control of induction motor phase currents are investigated through development of two control concepts.......Sliding mode control of induction motor phase currents are investigated through development of two control concepts....
Golubeva, Natalia; Imparato, Alberto
, as compared to the non-interacting system, in a wide range of biologically compatible scenarios. We furthermore consider the case where the motor-motor interaction directly affects the internal chemical cycle and investigate the effect on the system dynamics and thermodynamics.......We study the mechanical and thermodynamic properties of different traffic models for kinesin which are relevant in biological and experimental contexts. We find that motor-motor interactions play a fundamental role by enhancing the thermodynamic efficiency at maximum power of the motors...
Beran, Roy G
Most multi-centre trials are both financed and sponsored by the pharmaceutical company involved. What follows will map the path adopted for an investigator initiated and sponsored study for a new indication of an established medication. The chief investigators of a company-sponsored, investigator-initiated, multi-centre, placebo-controlled study of an established medication, Pharmaceutical Benefit Scheme (PBS) listed for treatment of one condition but trialled in the management of another condition (trial of off-label use), were approached to submit a protocol to repeat the type of study with a different compound. The new study would test a different agent, also PBS listed, for the same condition as in the initial study and with the same off-licence application. The company would finance the study, provide the medication and matched placebo but only review the investigator-initiated protocol which would be sponsored by the principal investigator. This required the investigator to implement the trial, as would normally be done by the pharmaceutical company, yet also act as its principal investigator. The principal investigator, with colleagues and a Clinical Research Organisation (CRO), developed a protocol, adapted for the new agent, and submitted it for approval. Upon acceptance a contract was negotiated with the pharmaceutical company which had to overcome jurisdictional conflicts between common law and civil law legal systems. A CRO was contracted to undertake administrative functions which dictated special contractual agreements to overcome possible conflicts of interest for a sponsor/investigator to protect patient interests. There was need to find indemnification insurance with jurisdictional problems, co-investigators, ethics committee approvals and finance management as just some of the difficulties encountered. The paper will outline how these obstacles were overcome and how ethical and legal issues were respected through compromise. The ethical and legal
Christine E Watson
Full Text Available Neuroimaging studies have found that sensorimotor systems are engaged when participants observe actions or comprehend action language. However, most of these studies have asked the binary question of whether action concepts are embodied or not, rather than whether sensory and motor areas of the brain contain graded amounts of information during putative action simulations. To address this question, we used repetition suppression (RS functional magnetic resonance imaging to determine if functionally-localized motor movement and visual motion regions-of-interest (ROI and two anatomical ROIs (inferior frontal gyrus, IFG; left posterior middle temporal gyrus were sensitive to changes in the exemplar (e.g., two different people kicking or representational format (e.g., photograph or schematic drawing of someone kicking within pairs of action images. We also investigated whether concrete versus more symbolic depictions of actions (i.e., photographs versus schematic drawings yielded different patterns of activation throughout the brain. We found that during a conceptual task, sensory and motor systems represent actions at different levels of specificity. While the visual motion ROI did not exhibit RS to different exemplars of the same action or to the same action depicted by different formats, the motor movement ROI did. These effects are consistent with person-specific action simulations: if the motor system is recruited for action understanding, it does so by activating one’s own motor program for an action. We also observed significant repetition enhancement within the IFG ROI to different exemplars or formats of the same action, a result that may indicate additional cognitive processing on these trials. Finally, we found that the recruitment of posterior brain regions by action concepts depends on the format of the input: left lateral occipital cortex and right supramarginal gyrus responded more strongly to symbolic depictions of actions than
Juan-Juan Du; Sheng-Di Chen
Objective:The aim of this study was to summarize recent studies on nondopaminergic options for the treatment of motor symptoms in Parkinson's disease (PD).Data Sources:Papers in English published in PubMed,Cochrane,and Ovid Nursing databases between January 1988 and November 2016 were searched using the following keywords:PD,nondopaminergic therapy,adenosine,glutamatergic,adrenergic,serotoninergic,histaminic,and iron chelator.We also reviewed the ongoing clinical trials in the website of clinicaltrials.gov.Study Selection:Articles related to the nondopaminergic treatment of motor symptoms in PD were selected for this review.Results:PD is conventionally treated with dopamine replacement strategies,which are effective in the early stages of PD.Long-term use oflevodopa could result in motor complications.Recent studies revealed that nondopaminergic systems such as adenosine,glutamatergic,adrenergic,serotoninergic,histaminic,and iron chelator pathways could include potential therapeutic targets for motor symptoms,including motor fluctuations,levodopa-induced dyskinesia,and gait disorders.Some nondopaminergic drugs,such as istradefylline and amantadine,are currently used clinically,while most such drugs are in preclinical testing stages.Transitioning of these agents into clinically beneficial strategies requires reliable evaluation since several agents have failed to show consistent results despite positive findings at the preclinical level.Conclusions:Targeting nondopaminergic transmission could improve some motor symptoms in PD,especially the discomfort ofdyskinesia.Although nondopaminergic treatments show great potential in PD treatment as an adjunct therapy to levodopa,further investigation is required to ensure their success.
Noordstar, Johannes J; van der Net, Janjaap; Jak, Suzanne; Helders, Paul J M; Jongmans, Marian J
Participation in motor activities is essential for social interaction and life satisfaction in children. Self-perceptions and task values have a central position in why children do or do not participate in (motor) activities. Investigating developmental changes in motor self-perceptions and motor
Sanders, Kerrie M; Stuart, Amanda L; Merriman, Elizabeth N; Read, Meaghan L; Kotowicz, Mark A; Young, Doris; Taylor, Roderick; Blair-Holt, Ian; Mander, Alistair G; Nicholson, Geoffrey C
Randomised, placebo-controlled trials are needed to provide evidence demonstrating safe, effective interventions that reduce falls and fractures in the elderly. The quality of a clinical trial is dependent on successful recruitment of the target participant group. This paper documents the successes and failures of recruiting over 2,000 women aged at least 70 years and at higher risk of falls or fractures onto a placebo-controlled trial of six years duration. The characteristics of study participants at baseline are also described for this study. The Vital D Study recruited older women identified at high risk of fracture through the use of an eligibility algorithm, adapted from identified risk factors for hip fracture. Participants were randomised to orally receive either 500,000 IU vitamin D3 (cholecalciferol) or placebo every autumn for five consecutive years. A variety of recruitment strategies were employed to attract potential participants. Of the 2,317 participants randomised onto the study, 74% (n = 1716/2317) were consented onto the study in the last five months of recruiting. This was largely due to the success of a targeted mail-out. Prior to this only 541 women were consented in the 18 months of recruiting. A total of 70% of all participants were recruited as a result of targeted mail-out. The response rate from the letters increased from 2 to 7% following revision of the material by a public relations company. Participant demographic or risk factor profile did not differ between those recruited by targeted mail-outs compared with other methods. The most successful recruitment strategy was the targeted mail-out and the response rate was no higher in the local region where the study had extensive exposure through other recruiting strategies. The strategies that were labour-intensive and did not result in successful recruitment include the activities directed towards the GP medical centres. Comprehensive recruitment programs employ overlapping strategies
Full Text Available Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP screening and heel lancing provides effective analgesia. 156 infants between 34 and 42 weeks’ gestational age who require a clinical heel lance and ROP screening on the same test occasion will be included in the trial. Infants will be randomised to receive either a single dose of morphine sulphate (100 μg/kg or placebo. Each infant will be monitored for 48 hours and safety data will be collected during the 24 hours following drug administration. The primary outcome will be the Premature Infant Pain Profile–revised (PIPP-R score 30 seconds after ROP screening. The co-primary outcome will be the magnitude of nociceptive-specific brain activity evoked by a clinically-required heel lance. Infant clinical stability will be assessed by comparing the number of episodes of bradycardia, tachycardia, desaturation and apnoea, and changes in respiratory support requirements in the 24-hour periods before and after the clinical intervention. In addition, drug safety will be assessed by considering the occurrence of apnoeic and hypotensive episodes requiring intervention in the 24-hour period following drug administration. This study has been published as an Accepted Protocol Summary by The Lancet.
Edwardson, C L; Harrington, D M; Yates, T; Bodicoat, D H; Khunti, K; Gorely, T; Sherar, L B; Edwards, R T; Wright, C; Harrington, K; Davies, M J
Despite the health benefits of physical activity, data from the UK suggest that a large proportion of adolescents do not meet the recommended levels of moderate-to-vigorous physical activity (MVPA). This is particularly evident in girls, who are less active than boys across all ages and may display a faster rate of decline in physical activity throughout adolescence. The 'Girls Active' intervention has been designed by the Youth Sport Trust to target the lower participation rates observed in adolescent girls. 'Girls Active' uses peer leadership and marketing to empower girls to influence decision making in their school, develop as role models and promote physical activity to other girls. Schools are provided with training and resources to review their physical activity, sport and PE provision, culture and practices to ensure they are relevant and attractive to adolescent girls. This study is a two-arm cluster randomised controlled trial (RCT) aiming to recruit 20 secondary schools. Clusters will be randomised at the school level (stratified by school size and proportion of Black and Minority Ethnic (BME) pupils) to receive either the 'Girls Active' intervention or carry on with usual practice (1:1). The 20 secondary schools will be recruited from state secondary schools within the Midlands area. We aim to recruit 80 girls aged 11-14 years in each school. Data will be collected at three time points; baseline and seven and 14 months after baseline. Our primary aim is to investigate whether 'Girls Active' leads to higher objectively measured (GENEActiv) moderate-to-vigorous physical activity in adolescent girls at 14 months after baseline assessment compared to the control group. Secondary outcomes include other objectively measured physical activity variables, adiposity, physical activity-related psychological factors and the cost-effectiveness of the 'Girls Active' intervention. A thorough process evaluation will be conducted during the course of the intervention
Borckardt, Jeffrey J; Nahas, Ziad; Koola, Jejo; George, Mark S
Resting motor threshold is the basic unit of dosing in transcranial magnetic stimulation (TMS) research and practice. There is little consensus on how best to estimate resting motor threshold with TMS, and only a few tools and resources are readily available to TMS researchers. The current study investigates the accuracy and efficiency of 5 different approaches to motor threshold assessment for TMS research and practice applications. Computer simulation models are used to test the efficiency and accuracy of 5 different adaptive parameter estimation by sequential testing (PEST) procedures. For each approach, data are presented with respect to the mean number of TMS trials necessary to reach the motor threshold estimate as well as the mean accuracy of the estimates. A simple nonparametric PEST procedure appears to provide the most accurate motor threshold estimates, but takes slightly longer (on average, 3.48 trials) to complete than a popular parametric alternative (maximum likelihood PEST). Recommendations are made for the best starting values for each of the approaches to maximize both efficiency and accuracy. In light of the computer simulation data provided in this article, the authors review and suggest which techniques might best fit different TMS research and clinical situations. Lastly, a free user-friendly software package is described and made available on the world wide web that allows users to run all of the motor threshold estimation procedures discussed in this article for clinical and research applications.
... gross (large, general) motor control. An example of gross motor control is waving an arm in greeting. Problems ... out the child's developmental age. Children develop fine motor skills over time, by practicing and being taught. To ...
Kutner, Nancy G; Zhang, Rebecca; Butler, Andrew J; Wolf, Steven L; Alberts, Jay L
At 6 months poststroke, most patients cannot incorporate their affected hand into daily activities, which in turn is likely to reduce their perceived quality of life. This preliminary study explored change in patient-reported, health-related quality of life associated with robotic-assisted therapy combined with reduced therapist-supervised training. A single-blind, multi-site, randomized clinical trial was conducted. Seventeen individuals who were 3 to 9 months poststroke participated. Sixty hours of therapist-supervised repetitive task practice (RTP) was compared with 30 hours of RTP combined with 30 hours of robotic-assisted therapy. Participants completed the Stroke Impact Scale (SIS) at baseline, immediately postintervention, and 2 months postintervention. Change in SIS score domains was assessed in a mixed model analysis. The combined therapy group had a greater increase in rating of mood from preintervention to postintervention, and the RTP-only group had a greater increase in rating of social participation from preintervention to follow-up. Both groups had statistically significant improvement in activities of daily living and instrumental activities of daily living scores from preintervention to postintervention. Both groups reported significant improvement in hand function postintervention and at follow-up, and the magnitude of these changes suggested clinical significance. The combined therapy group had significant improvements in stroke recovery rating postintervention and at follow-up, which appeared clinically significant; this also was true for stroke recovery rating from preintervention to follow-up in the RTP-only group. LIMITATIONS OUTCOMES: of 30 hours of RTP in the absence of robotic-assisted therapy remain unknown. Robotic-assisted therapy may be an effective alternative or adjunct to the delivery of intensive task practice interventions to enhance hand function recovery in patients with stroke.
Full Text Available Abstract Background Generalised Anxiety Disorder (GAD is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD trial aims to evaluate the effectiveness of an evidence-based online prevention website for GAD. Methods/Design The principal clinical question under investigation is the effectiveness of an online GAD intervention (E-couch using a community-based sample. We examine whether the effect of the intervention can be maximised by either human support, in the form of telephone calls, or by automated support through emails. The primary outcome will be a reduction in symptoms on the GAD-7 in the active arms relative to the non active intervention arms. Discussion The WebGAD trial will be the first to evaluate the use of an internet-based cognitive behavioural therapy (CBT program contrasted with a credible control condition for the prevention of GAD and the first formal RCT evaluation of a web-based program for GAD using community recruitment. In general, internet-based CBT programs have been shown to be effective for the treatment of other anxiety disorders such as Post Traumatic Stress Disorder, Social Phobia, Panic Disorder and stress in clinical trials; however there is no evidence for the use of internet CBT in the prevention of GAD. Given the severe shortage of therapists identified in Australia and overseas, and the low rates of treatment seeking in those with a mental illness, the successful implementation of this protocol has important practical outcomes. If found to be effective, WebGAD will provide those experiencing GAD with an easily accessible, free, evidence-based prevention tool which can be promoted and disseminated immediately. Trial Registration Controlled-trials.com: ISRCTN76298775
Stark, C.; Herkenrath, P.; Hollmann, H.; Waltz, S.; Becker, I.; Hoebing, L.; Semler, O.; Hoyer-Kuhn, H.; Duran, I.; Hero, B.; Hadders-Algra, M.; Schoenau, E.
OBJECTIVES: to investigate feasibility, safety and efficacy of home-based side-alternating whole body vibration (sWBV) to improve motor function in toddlers with cerebral palsy (CP). METHODS: Randomized controlled trial including 24 toddlers with CP (mean age 19 months (SD±3.1); 13 boys).
Downs, Jenny; Stahlhut, Michelle; Wong, Kingsley
.93-0.98). The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice......Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated...... the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age...
Piek, J P; McLaren, S; Kane, R; Jensen, L; Dender, A; Roberts, C; Rooney, R; Packer, T; Straker, L
The Animal Fun program was designed to enhance the motor ability of young children by imitating the movements of animals in a fun, inclusive setting. The efficacy of this program was investigated through a randomized controlled trial using a multivariate nested cohort design. Pre-intervention scores were recorded for 511 children aged 4.83 years to 6.17 years (M=5.42 years, SD=3.58 months). Six control and six intervention schools were compared 6 months later following the intervention, and then again at 18 months after the initial testing when the children were in their first school year. Changes in motor performance were examined using the Bruininks-Oseretsky Test of Motor Proficiency short form. Data were analyzed using multi-level-mixed effects linear regression. A significant Condition×Time interaction was found, F(2,1219)=3.35, p=.035, demonstrating that only the intervention group showed an improvement in motor ability. A significant Sex×Time interaction was also found, F(2,1219)=3.84, p=.022, with boys improving over time, but not girls. These findings have important implications for the efficacy of early intervention of motor skills and understanding the differences in motor performance between boys and girls. Copyright © 2012 Elsevier B.V. All rights reserved.
Peterson, William J. (Inventor); Faulkner, Dennis T. (Inventor)
This invention relates to a motor control system for a brushless DC motor having an inverter responsively coupled to the motor control system and in power transmitting relationship to the motor. The motor control system includes a motor rotor speed detecting unit that provides a pulsed waveform signal proportional to rotor speed. This pulsed waveform signal is delivered to the inverter to thereby cause an inverter fundamental current waveform output to the motor to be switched at a rate proportional to said rotor speed. In addition, the fundamental current waveform is also pulse width modulated at a rate proportional to the rotor speed. A fundamental current waveform phase advance circuit is controllingly coupled to the inverter. The phase advance circuit is coupled to receive the pulsed waveform signal from the motor rotor speed detecting unit and phase advance the pulsed waveform signal as a predetermined function of motor speed to thereby cause the fundamental current waveform to be advanced and thereby compensate for fundamental current waveform lag due to motor winding reactance which allows the motor to operate at higher speeds than the motor is rated while providing optimal torque and therefore increased efficiency.
Johnson, Casey; Monath, Thomas P; Kanesa-Thasan, Niranjan; Mathis, Danell; Miller, Chuck; Shapiro, Seth; Nichols, Richard; McCarthy, Karen; Deary, Alison; Bedford, Philip
Two subjects developed marked elevations in creatine kinase and other serum enzymes associated with mild myalgia during a randomized, double-blind, controlled Phase 1 clinical trial of an investigational live, attenuated vaccine against West Nile virus (ChimeriVax-WN02). One subject had received ChimeriVax-WN02 while the other subject was enrolled in an active control group and received licensed yellow fever 17D vaccine (YF-VAX). Subsequently, the clinical trial was interrupted, and an investigation was begun to evaluate the enzyme abnormalities. As daily serum samples were collected for determination of quantitative viremia, it was possible to define the enzyme elevations with precision and to relate these elevations to physical activity of the subjects, symptoms, and virological and serological measurements. Evaluation of both subjects clearly showed that skeletal muscle injury, and not cardiac or hepatic dysfunction, was responsible for the biochemical abnormalities. This investigation also implicated strenuous exercise as the cause of the apparent muscle injury rather than the study vaccines. As a result of this experience, subjects engaged in future early-stage trials of these live, attenuated viral vaccines will be advised not to engage in contact sports or new or enhanced exercise regimens for which they are not trained or conditioned. The inclusion of placebo control arm (in lieu of or addition to an active vaccine control) will also be useful in differentiating causally related serum enzyme elevations.
Screw compressors use electric motors to drive the male screw rotor. They are cooled by the suction refrigerant vapor that flows around the motor. The thermal conditions of the motor can dramatically influence the performance and reliability of the compressor. The more optimized this flow path is, the better the motor performance. For that reason it is important to understand the flow characteristics around the motor and the motor temperatures. Computational fluid dynamics (CFD) can be used to provide a detailed analysis of the refrigerant’s flow behavior and motor temperatures to identify the undesirable hot spots in the motor. CFD analysis can be used further to optimize the flow path and determine the reduction of hot spots and cooling effect. This study compares the CFD solutions of a motor cooling model to a motor installed with thermocouples measured in the lab. The compressor considered for this study is an R134a screw compressor. The CFD simulation of the motor consists of a detailed breakdown of the stator and rotor components. Orthotropic thermal conductivity material properties are used to represent the simplified motor geometry. In addition, the analysis includes the motor casings of the compressor to draw heat away from the motor by conduction. The study will look at different operating conditions and motor speeds. Finally, the CFD study will investigate the predicted motor temperature change by varying the vapor mass flow rates and motor speed. Recommendations for CFD modeling of such intricate heat transfer phenomenon have thus been proposed.
Ma, Li-Xin; Liu, Jian-Ping
To investigate whether the power of the effect size was based on adequate sample size in randomized controlled trials (RCTs) for the treatment of patients with type 2 diabetes mellitus (T2DM) using Chinese medicine. China Knowledge Resource Integrated Database (CNKI), VIP Database for Chinese Technical Periodicals (VIP), Chinese Biomedical Database (CBM), and Wangfang Data were systematically recruited using terms like "Xiaoke" or diabetes, Chinese herbal medicine, patent medicine, traditional Chinese medicine, randomized, controlled, blinded, and placebo-controlled. Limitation was set on the intervention course > or = 3 months in order to identify the information of outcome assessement and the sample size. Data collection forms were made according to the checking lists found in the CONSORT statement. Independent double data extractions were performed on all included trials. The statistical power of the effects size for each RCT study was assessed using sample size calculation equations. (1) A total of 207 RCTs were included, including 111 superiority trials and 96 non-inferiority trials. (2) Among the 111 superiority trials, fasting plasma glucose (FPG) and glycosylated hemoglobin HbA1c (HbA1c) outcome measure were reported in 9% and 12% of the RCTs respectively with the sample size > 150 in each trial. For the outcome of HbA1c, only 10% of the RCTs had more than 80% power. For FPG, 23% of the RCTs had more than 80% power. (3) In the 96 non-inferiority trials, the outcomes FPG and HbA1c were reported as 31% and 36% respectively. These RCTs had a samples size > 150. For HbA1c only 36% of the RCTs had more than 80% power. For FPG, only 27% of the studies had more than 80% power. The sample size for statistical analysis was distressingly low and most RCTs did not achieve 80% power. In order to obtain a sufficient statistic power, it is recommended that clinical trials should establish clear research objective and hypothesis first, and choose scientific and evidence
Amy D Rodriguez
Full Text Available Embodied/modality-specific theories of semantic memory propose that sensorimotor representations play an important role in perception and action. A large body of evidence supports the notion that concepts involving human motor action (i.e., semantic-motor representations are processed in both language and motor regions of the brain. However, most studies have focused on perceptual tasks, leaving unanswered questions about language-motor interaction during production tasks. Thus, we investigated the effects of shared semantic-motor representations on concurrent language and motor production tasks in healthy young adults, manipulating the semantic task (motor-related vs. nonmotor-related words and the motor task (i.e., standing still and finger-tapping. In Experiment 1 (n = 20, we demonstrated that motor-related word generation was sufficient to affect postural control. In Experiment 2 (n = 40, we demonstrated that motor-related word generation was sufficient to facilitate word generation and finger tapping. We conclude that engaging semantic-motor representations can have a reciprocal influence on motor and language production. Our study provides additional support for functional language-motor interaction, as well as embodied/modality-specific theories.
Li, Junhua; Zhang, Liqing
Brain-computer interface (BCI) allows the use of brain activities for people to directly communicate with the external world or to control external devices without participation of any peripheral nerves and muscles. Motor imagery is one of the most popular modes in the research field of brain-computer interface. Although motor imagery BCI has some advantages compared with other modes of BCI, such as asynchronization, it is necessary to require training sessions before using it. The performance of trained BCI system depends on the quality of training samples or the subject engagement. In order to improve training effect and decrease training time, we proposed a new paradigm where subjects participated in training more actively than in the traditional paradigm. In the traditional paradigm, a cue (to indicate what kind of motor imagery should be imagined during the current trial) is given to the subject at the beginning of a trial or during a trial, and this cue is also used as a label for this trial. It is usually assumed that labels for trials are accurate in the traditional paradigm, although subjects may not have performed the required or correct kind of motor imagery, and trials may thus be mislabeled. And then those mislabeled trials give rise to interference during model training. In our proposed paradigm, the subject is required to reconfirm the label and can correct the label when necessary. This active training paradigm may generate better training samples with fewer inconsistent labels because it overcomes mistakes when subject's motor imagination does not match the given cues. The experiments confirm that our proposed paradigm achieves better performance; the improvement is significant according to statistical analysis.
Zhang, Jiang; Li, Yuyao; Chen, Huafu; Ding, Jurong; Yuan, Zhen
In this study, small-world network analysis was performed to identify the similarities and differences between functional brain networks for right- and left-hand motor imageries (MIs). First, Pearson correlation coefficients among the nodes within the functional brain networks from healthy subjects were calculated. Then, small-world network indicators, including the clustering coefficient, the average path length, the global efficiency, the local efficiency, the average node degree, and the small-world index, were generated for the functional brain networks during both right- and left-hand MIs. We identified large differences in the small-world network indicators between the functional networks during MI and in the random networks. More importantly, the functional brain networks underlying the right- and left-hand MIs exhibited similar small-world properties in terms of the clustering coefficient, the average path length, the global efficiency, and the local efficiency. By contrast, the right- and left-hand MI brain networks showed differences in small-world characteristics, including indicators such as the average node degree and the small-world index. Interestingly, our findings also suggested that the differences in the activity intensity and range, the average node degree, and the small-world index of brain networks between the right- and left-hand MIs were associated with the asymmetry of brain functions.
Uranga Favela, Ivan Jaime [Energia Controlada de Mexico, S. A. de C. V., Mexico, D. F. (Mexico)
This paper is a technical-financial study of the high efficiency and super-premium motors. As it is widely known, more than 60% of the electrical energy generated in the country is used for the operation of motors, in industry as well as in commerce. Therefore the importance that the motors have in the efficient energy use. [Espanol] El presente trabajo es un estudio tecnico-financiero de los motores de alta eficiencia y los motores super premium. Como es ampliamente conocido, mas del 60% de la energia electrica generada en el pais, es utilizada para accionar motores, dentro de la industria y el comercio. De alli la importancia que los motores tienen en el uso eficiente de la energia.
Uranga Favela, Ivan Jaime [Energia Controlada de Mexico, S. A. de C. V., Mexico, D. F. (Mexico)
This paper is a technical-financial study of the high efficiency and super-premium motors. As it is widely known, more than 60% of the electrical energy generated in the country is used for the operation of motors, in industry as well as in commerce. Therefore the importance that the motors have in the efficient energy use. [Espanol] El presente trabajo es un estudio tecnico-financiero de los motores de alta eficiencia y los motores super premium. Como es ampliamente conocido, mas del 60% de la energia electrica generada en el pais, es utilizada para accionar motores, dentro de la industria y el comercio. De alli la importancia que los motores tienen en el uso eficiente de la energia.
Full Text Available Background Shared Decision Making (SDM is regarded as the best practice model for the communicative challenge of decision making about treatment or diagnostic options. However, randomized controlled trials focusing the effectiveness of SDM trainings are rare and existing measures of SDM are increasingly challenged by the latest research findings. This study will 1 evaluate a new physicians' communication training regarding patient involvement in terms of SDM, 2 validate SDMMASS, a new compound measure of SDM, and 3 evaluate the effects of SDM on the perceived quality of the decision process and on the elaboration of the decision. Methods In a multi-center randomized controlled trial with a waiting control group, 40 physicians from 7 medical fields are enrolled. Each physician contributes a sequence of four medical consultations including a diagnostic or treatment decision. The intervention consists of two condensed video-based individual coaching sessions (15min. supported by a manual and a DVD. The interventions alternate with three measurement points plus follow up (6 months. Realized patient involvement is measured using the coefficient SDMMASS drawn from the Multifocal Approach to the Sharing in SDM (MAPPIN'SDM which includes objective involvement, involvement as perceived by the patient, and the doctor-patient concordance regarding their judges of the involvement. For validation purposes, all three components of SDMMASS are supplemented by similar measures, the OPTION observer scale, the Shared Decision Making Questionnaire (SDM-Q and the dyadic application of the Decisional Conflict Scale (DCS. Training effects are analyzed using t-tests. Spearman correlation coefficients are used to determine convergent validities, the influence of involvement (SDMMASS on the perceived decision quality (DCS and on the elaboration of the decision. The latter is operationalised by the ELAB coefficient from the UP24 (Uncertainty Profile, 24 items version
Reissfelder, Christoph; Büchler, Markus W; Beckhove, Philipp; Huber, Peter E; Weitz, Jürgen; Timke, Carmen; Schmitz-Winnenthal, Hubertus; Rahbari, Nuh N; Koch, Moritz; Klug, Felix; Roeder, Falk; Edler, Lutz; Debus, Jürgen
Insufficient migration and activation of tumor specific effector T cells in the tumor is one of the main reasons for inadequate host anti-tumor immune response. External radiation seems to induce inflammation and activate the immune response. This phase I/II clinical trial aims to evaluate whether low dose single fraction radiotherapy can improve T cell associated antitumor immune response in patients with colorectal liver metastases. This is an investigator-initiated, prospective randomised, 4-armed, controlled Phase I/II trial. Patients undergoing elective hepatic resection due to colorectal cancer liver metastasis will be enrolled in the study. Patients will receive 0 Gy, 0.5 Gy, 2 Gy or 5 Gy radiation targeted to their liver metastasis. Radiation will be applied by external beam radiotherapy using a 6 MV linear accelerator (Linac) with intensity modulated radiotherapy (IMRT) technique two days prior to surgical resection. All patients admitted to the Department of General-, Visceral-, and Transplantion Surgery, University of Heidelberg for elective hepatic resection are consecutively screened for eligibility into this trial, and written informed consent is obtained before inclusion. The primary objective is to assess the effect of active local external beam radiation dose on, tumor infiltrating T cells as a surrogate parameter for antitumor activity. Secondary objectives include radiogenic treatment toxicity, postoperative morbidity and mortality, local tumor control and recurrence patterns, survival and quality of life. Furthermore, frequencies of systemic tumor reactive T cells in blood and bone marrow will be correlated with clinical outcome. This is a randomized controlled patient blinded trial to assess the safety and efficiency of low dose radiotherapy on metastasis infiltrating T cells and thus potentially enhance the antitumor immune response. ClinicalTrials.gov: http://www.clinicaltrials.gov/ct2/show/NCT01191632
Eisinger, Robert S; Hess, Christopher W; Martinez-Ramirez, Daniel; Almeida, Leonardo; Foote, Kelly D; Okun, Michael S; Gunduz, Aysegul
Distinct motor subtypes of Parkinson's disease (PD) have been described through both clinical observation and through data-driven approaches. However, the extent to which motor subtypes change during disease progression remains unknown. Our objective was to determine motor subtypes of PD using an unsupervised clustering methodology and evaluate subtype changes with disease duration. The Parkinson's Progression Markers Initiative database of 423 newly diagnosed PD patients was utilized to retrospectively identify unique motor subtypes through a data-driven, hierarchical correlational clustering approach. For each patient, we assigned a subtype to each motor assessment at each follow-up visit (time points) and by using published criteria. We examined changes in PD subtype with disease duration using both qualitative and quantitative methods. Five distinct motor subtypes were identified based on the motor assessment items and these included: Tremor Dominant (TD), Axial Dominant, Appendicular Dominant, Rigidity Dominant, and Postural and Instability Gait Disorder Dominant. About half of the patients had consistent subtypes at all time points. Most patients met criteria for TD subtype soon after diagnosis. For patients with inconsistent subtypes, there was an overall trend to shift away from a TD phenotype with disease duration, as shown by chi-squared test, p motor subtypes in PD can shift with increasing disease duration. Shifting subtypes is a factor that should be accounted for in clinical practice or in clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.
Henderson, Robert D; McCombe, Pamela A
The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.
Full Text Available While neuroplasticity changes measured by transcranial magnetic stimulation have been proved to be highly correlated to motor recovery and have been tested in various forms of interventions, it has not been applied to investigate the neurophysiologic mechanism of acupuncture therapy. The aim of this study is to investigate neuroplasticity changes induced by a single session of acupuncture therapy in healthy adults, regarding the excitability change on bilateral primary motor cortex and interhemispheric inhibition. Ten subjects took a 30-minute acupuncture therapy and the same length relaxing phase in separate days. Transcranial magnetic stimulation measures, including resting motor threshold, amplitudes of motor-evoked potential, and interhemispheric inhibition, were assessed before and 10 minutes after intervention. Acupuncture treatment showed significant changes on potential amplitude from both ipsilateral and contralateral hemispheres to acupuncture compared to baseline. Also, interhemispheric inhibition from the contralateral motor cortex to the opposite showed a significant decline. The results indicated that corticomotoneuronal excitability and interhemispheric competition could be modulated by acupuncture therapy on healthy subjects. The following question about whether these changes will be observed in the same way on stroke patients and whether they correlate with the therapeutic effect on movement need to be answered by following studies. This trial is registered with ISRCTN13074245.
.... We investigate the gross acoustic signature of a notional stationary field synchronous motor utilized as a marine propulsion motor in a naval combatant using the following methodology: (1) model the forces...
Pollok, B; Latz, D; Krause, V; Butz, M; Schnitzler, A
Motor learning results from practice but also between practice sessions. After skill acquisition early consolidation results in less interference with other motor tasks and even improved performance of the newly learned skill. A specific significance of the primary motor cortex (M1) for early consolidation has been suggested. Since synchronized oscillatory activity is assumed to facilitate neuronal plasticity, we here investigate alterations of motor-cortical oscillations by means of event-related desynchronization (ERD) at alpha (8-12 Hz) and beta (13-30 Hz) frequencies in healthy humans. Neuromagnetic activity was recorded using a 306-channel whole-head magnetoencephalography (MEG) system. ERD was investigated in 15 subjects during training on a serial reaction time task and 10 min after initial training. The data were compared with performance during a randomly varying sequence serving as control condition. The data reveal a stepwise decline of alpha-band ERD associated with faster reaction times replicating previous findings. The amount of beta-band suppression was significantly correlated with reduction of reaction times. While changes of alpha power have been related to lower cognitive control after initial skill acquisition, the present data suggest that the amount of beta suppression represents a neurophysiological marker of early cortical reorganization associated with motor learning. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.
Takiyama, Ken; Shinya, Masahiro
Most motor learning experiments have been conducted in a laboratory setting. In this type of setting, a huge and expensive manipulandum is frequently used, requiring a large budget and wide open space. Subjects also need to travel to the laboratory, which is a burden for them. This burden is particularly severe for patients with neurological disorders. Here, we describe the development of a novel application based on Unity3D and smart devices, e.g., smartphones or tablet devices, that can be used to conduct motor learning experiments at any time and in any place, without requiring a large budget and wide open space and without the burden of travel on subjects. We refer to our application as POrtable Motor learning LABoratory, or PoMLab. PoMLab is a multiplatform application that is available and sharable for free. We investigated whether PoMLab could be an alternative to the laboratory setting using a visuomotor rotation paradigm that causes sensory prediction error, enabling the investigation of how subjects minimize the error. In the first experiment, subjects could adapt to a constant visuomotor rotation that was abruptly applied at a specific trial. The learning curve for the first experiment could be modeled well using a state space model, a mathematical model that describes the motor leaning process. In the second experiment, subjects could adapt to a visuomotor rotation that gradually increased each trial. The subjects adapted to the gradually increasing visuomotor rotation without being aware of the visuomotor rotation. These experimental results have been reported for conventional experiments conducted in a laboratory setting, and our PoMLab application could reproduce these results. PoMLab can thus be considered an alternative to the laboratory setting. We also conducted follow-up experiments in university physical education classes. A state space model that was fit to the data obtained in the laboratory experiments could predict the learning curves
Full Text Available Most motor learning experiments have been conducted in a laboratory setting. In this type of setting, a huge and expensive manipulandum is frequently used, requiring a large budget and wide open space. Subjects also need to travel to the laboratory, which is a burden for them. This burden is particularly severe for patients with neurological disorders. Here, we describe the development of a novel application based on Unity3D and smart devices, e.g., smartphones or tablet devices, that can be used to conduct motor learning experiments at any time and in any place, without requiring a large budget and wide open space and without the burden of travel on subjects. We refer to our application as POrtable Motor learning LABoratory, or PoMLab. PoMLab is a multiplatform application that is available and sharable for free. We investigated whether PoMLab could be an alternative to the laboratory setting using a visuomotor rotation paradigm that causes sensory prediction error, enabling the investigation of how subjects minimize the error. In the first experiment, subjects could adapt to a constant visuomotor rotation that was abruptly applied at a specific trial. The learning curve for the first experiment could be modeled well using a state space model, a mathematical model that describes the motor leaning process. In the second experiment, subjects could adapt to a visuomotor rotation that gradually increased each trial. The subjects adapted to the gradually increasing visuomotor rotation without being aware of the visuomotor rotation. These experimental results have been reported for conventional experiments conducted in a laboratory setting, and our PoMLab application could reproduce these results. PoMLab can thus be considered an alternative to the laboratory setting. We also conducted follow-up experiments in university physical education classes. A state space model that was fit to the data obtained in the laboratory experiments could predict the
Gao, Yan; Luquez, Cecilia; Lynggaard, Helle; Andersen, Henning; Saboo, Banshi
The study aimed to confirm the efficacy, through non-inferiority, of patient-driven versus investigator-driven titration of biphasic insulin aspart 30 (BIAsp 30) in terms of glycemic control assessed by HbA1c change. SimpleMix was a 20 week, open-label, randomized, two-armed, parallel-group, multicenter study in five countries (Argentina, China, India, Poland, and the UK). Patients with type 2 diabetes were randomized into either patient-driven or investigator-driven BIAsp 30 titration groups. Non-inferiority of patient-driven vs. investigator-driven titration based on change in HbA1c from baseline to week 20 could not be demonstrated. Mean (SE) estimated change from baseline to week 20 was -0.72 (0.08)% in the patient-driven group and -0.97 (0.08)% in the investigator-driven group; estimated difference 0.25% (95% CI: 0.04; 0.46). Estimated mean change (SE) in fasting plasma glucose from baseline to week 20 was similar between groups: -0.94 (0.21) mmol/L for patient-driven and -1.07 (0.22) mmol/L for investigator-driven (difference non-significant). Both treatment arms were well tolerated, and hypoglycemic episode rates were similar between groups, with a rate ratio of 0.77 (95% CI: 0.54; 1.09; p = 0.143) for all hypoglycemic episodes and 0.78 (95% CI: 0.42; 1.43; p = 0.417) for nocturnal hypoglycemic episodes. Non-inferiority of patient-driven versus investigator-driven titration with regard to change from baseline to end-of-treatment HbA1c could not be confirmed. It is possible that a clinic visit 12 weeks after intensification of treatment with BIAsp 30 in patients with type 2 diabetes inadequately treated with basal insulin may benefit patient-driven titration of BIAsp 30. A limitation of the study was the relatively small number of patients recruited in each country, which does not allow country-specific analyses to be performed. Overall, treatment with BIAsp 30 was well tolerated in both treatment groups.
Full Text Available Rewards associated with actions are critical for motivation and learning about the consequences of one's actions on the world. The motor cortices are involved in planning and executing movements, but it is unclear whether they encode reward over and above limb kinematics and dynamics. Here, we report a categorical reward signal in dorsal premotor (PMd and primary motor (M1 neurons that corresponds to an increase in firing rates when a trial was not rewarded regardless of whether or not a reward was expected. We show that this signal is unrelated to error magnitude, reward prediction error, or other task confounds such as reward consumption, return reach plan, or kinematic differences across rewarded and unrewarded trials. The availability of reward information in motor cortex is crucial for theories of reward-based learning and motivational influences on actions.
Stalmans, Ingeborg; Oddone, Francesco; Cordeiro, Maria Francesca; Hommer, Anton; Montesano, Giovanni; Ribeiro, Luisa; Sunaric-Mégevand, Gordana; Rossetti, Luca
The aim of this study was to investigate the efficacy and safety of Bimatoprost Unit Dose Preservative Free (BUDPF) and Latanoprost Unit Dose Preservative Free (LUDPF). A prospective, randomized, investigator-masked, cross-over comparison was used. Inclusion criteria were ocular hypertension (OHT) or open-angle glaucoma (OAG) with a maximum intraocular pressure (IOP) of 21 mmHg on a preserved prostaglandin monotherapy. After 6 weeks washout, patients were randomized to BUDPF or LUDPF for 3 months and then switched to the other treatment for 3 months. IOP curves were performed at baseline and after each treatment period. Statistical analysis was performed in a R programming environment. Linear mixed modeling was used to account for repeated measures on the same subject and clustering of observations from the same center. Safety outcomes included visual acuity, adverse events, slit-lamp biomicroscopy, ocular tolerability, and optic nerve assessment. Analysis at 6 months (primary outcome) showed a 1.6 ± 0.5-mmHg difference in IOP values between LUDPF and BUDPF (p < 0.01). A mean intra-subject IOP difference of 0.9 ± 0.2 mmHg (LUDPF - BUDPF) was observed (p < 0.01).. Significant differences in IOP were observed for both drugs at 3 and at 6 months compared to baseline: -4,0 ± 0.5 mmHg for both BUDPF and LUDPF at 3 months (p < 0.01 for both drugs; p = 0.32 between the two drugs); -5.2 ± 0.5 and -3.4 ± 0.5 mmHg for BUDPF and LUDPF, respectively (both p < 0.01), at 6 months. Both drugs were tolerated well, the only statistically significant difference being lower hyperemia scores for LUDPF (albeit low for both drugs). This study demonstrates a superior efficacy of BUDPF over LUDPF in lowering IOP. The results are consistent both in the parallel comparison between the two treatment groups at 6 months as well as in the intra-subject pressure comparison.
Background Motor skill learning (MSL) is the persistent increase in performance of a skill obtained through practice. This process is associated with changes throughout the central nervous system. One of these is a change in corticospinal excitability (CSE) assessable with Transcranial Magnetic...... a novel visuomotor skill. I hypothesized that changes in CSE accompanying long-term motor practice relate to the process of learning rather than repetitive practice on an acquired skill and investigated this by incrementally increasing task difficulty and thus postponing saturation of learning....... Furthermore, we aimed to investigate the feasibility of applying paired associative stimulation to the investigation of learning-dependent motor cortical plasticity by comparing the transient increase in CSE accompanying motor skill learning to the associative plasticity induced by pairing electrical motor...
Pierce, Jordan E; McDowell, Jennifer E
Cognitive control optimizes responses to relevant task conditions by balancing bottom-up stimulus processing with top-down goal pursuit. It can be investigated using the ocular motor system by contrasting basic prosaccades (look toward a stimulus) with complex antisaccades (look away from a stimulus). Furthermore, the amount of time allotted between trials, the need to switch task sets, and the time allowed to prepare for an upcoming saccade all impact performance. In this study the relative probabilities of anti- and pro-saccades were manipulated across five blocks of interleaved trials, while the inter-trial interval and trial type cue duration were varied across subjects. Results indicated that inter-trial interval had no significant effect on error rates or reaction times (RTs), while a shorter trial type cue led to more antisaccade errors and faster overall RTs. Responses following a shorter cue duration also showed a stronger effect of trial type probability, with more antisaccade errors in blocks with a low antisaccade probability and slower RTs for each saccade task when its trial type was unlikely. A longer cue duration yielded fewer errors and slower RTs, with a larger switch cost for errors compared to a short cue duration. Findings demonstrated that when the trial type cue duration was shorter, visual motor responsiveness was faster and subjects relied upon the implicit trial probability context to improve performance. When the cue duration was longer, increased fixation-related activity may have delayed saccade motor preparation and slowed responses, guiding subjects to respond in a controlled manner regardless of trial type probability. Copyright © 2016 Elsevier B.V. All rights reserved.
Fontaine, Patricia; Mendenhall, Tai J; Peterson, Kevin; Speedie, Stuart M
The electronic Primary Care Research Network (ePCRN) enrolled PBRN researchers in a feasibility trial to test the functionality of the network's electronic architecture and investigate error rates associated with two data entry strategies used in clinical trials. PBRN physicians and research assistants who registered with the ePCRN were eligible to participate. After online consent and randomization, participants viewed simulated patient records, presented as either abstracted data (short form) or progress notes (long form). Participants transcribed 50 data elements onto electronic case report forms (CRFs) without integrated field restrictions. Data errors were analyzed. Ten geographically dispersed PBRNs enrolled 100 members and completed the study in less than 7 weeks. The estimated overall error rate if field restrictions had been applied was 2.3%. Participants entering data from the short form had a higher rate of correctly entered data fields (94.5% vs 90.8%, P = .004) and significantly more error-free records (P = .003). Feasibility outcomes integral to completion of an Internet-based, multisite study were successfully achieved. Further development of programmable electronic safeguards is indicated. The error analysis conducted in this study will aid design of specific field restrictions for electronic CRFs, an important component of clinical trial management systems.
Grogan, Mary; Jenkins, Margaret; Sansing, Veronica V; MacGregor, Joan; Brooks, Maria Mori; Julien-Williams, Patricia; Amendola, Angela; Abbott, J Dawn
The purpose of this study was to examine measures of chronic disease severity and treatment according to insurance status in a clinical trial setting. Baseline insurance status of 776 patients with type 2 diabetes and stable coronary artery disease (CAD) enrolled in the United States in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial was analyzed with regard to measures of metabolic and cardiovascular risk factor control. Compared with patients with private or public insurance, the uninsured were younger, more often female, and less often white non-Hispanic. Uninsured patients had the greatest burden of CAD. Patients with public insurance were treated with the greatest number of medications, had the greatest self-reported functional status, and the lowest mean glycosylated hemoglobin and low-density lipoprotein (LDL) cholesterol values. Overall, for 5 measured risk factor targets, the mean number above goal was 2.49 ± 1.18. After adjustment for demographic and clinical variables, insurance status was not associated with a difference in risk factor control. In the BARI 2D trial, we did not observe a difference in baseline cardiovascular risk factor control according to insurance status. An important observation, however, was that risk factor control overall was suboptimal, which highlights the difficulty in treating type 2 diabetes and CAD irrespective of insurance status.
Gnacinski, P.; Mindykowski, J.; Tarasiuk, T.
This paper deals with the effect of lowered voltage quality in ship power systems on windings temperature of low-power induction cage machines. The results of investigations carried out with experimental and analytical methods are presented. The thermal impact of power quality disturbances permitted by ship classification societies is discussed. A proposal of new power quality regulations for ship classification societies is made.
Full Text Available Abstract Background The largest single cause of death among people with severe mental disorders is cardiovascular disease (CVD. The majority of people with schizophrenia and bipolar disorder smoke and many are also overweight, considerably increasing their risk of CVD. Treatment for smoking and other health risk behaviours is often not prioritized among people with severe mental disorders. This protocol describes a study in which we will assess the effectiveness of a healthy lifestyle intervention on smoking and CVD risk and associated health behaviours among people with severe mental disorders. Methods/Design 250 smokers with a severe mental disorder will be recruited. After completion of a baseline assessment and an initial face-to-face intervention session, participants will be randomly assigned to either a multi-component intervention for smoking cessation and CVD risk reduction or a telephone-based minimal intervention focusing on smoking cessation. Randomisation will be stratified by site (Newcastle, Sydney, Melbourne, Australia, Body Mass Index (BMI category (normal, overweight, obese and type of antipsychotic medication (typical, atypical. Participants will receive 8 weekly, 3 fortnightly and 6 monthly sessions delivered face to face (typically 1 hour or by telephone (typically 10 minutes. Assessments will be conducted by research staff blind to treatment allocation at baseline, 15 weeks, and 12-, 18-, 24-, 30- and 36-months. Discussion This study will provide comprehensive data on the effect of a healthy lifestyle intervention on smoking and CVD risk among people with severe mental disorders. If shown to be effective, this intervention can be disseminated to treating clinicians using the treatment manuals. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR identifier: ACTRN12609001039279
Spedden, Meaghan E; Malling, Anne Sofie B; Andersen, Ken K
The objective was to examine associations between motor and executive function across the adult lifespan and to investigate the role of motor complexity in these associations. Young, middle-aged and older adults (n = 82; 19-83y) performed two gross-motor tasks with different levels of complexity...... and a Stroop-like computer task. Performance was decreased in older adults. The association between motor and cognitive performance was significant for older adults in the complex motor task (p = 0.03, rs = -0.41), whereas no significant associations were found for young or middle-aged groups, suggesting...... that the link between gross-motor and executive function emerges with age and depends on motor complexity....
Sarah Nadine Meissner
Full Text Available Although implicit motor sequence learning is rather well understood in young adults, effects of aging on this kind of learning are controversial. There is first evidence that working memory (WM might play a role in implicit motor sequence learning in young adults as well as in adults above the age of 65. However the knowledge about the development of these processes across the adult life span is rather limited. As the average age of our population continues to rise, a better understanding of age-related changes in motor sequence learning and potentially mediating cognitive processes takes on increasing significance. Therefore, we investigated aging effects on implicit motor sequence learning and WM. Sixty adults (18-71 years completed verbal and visuospatial n-back tasks and were trained on a serial reaction time task. Randomly varying trials served as control condition. To further assess consolidation indicated by off-line improvement and reduced susceptibility to interference, reaction times (RTs were determined 1 h after initial learning. Young and older but not middle-aged adults showed motor sequence learning. Nine out of 20 older adults (compared to one young/one middle-aged exhibited some evidence of sequence awareness. After 1 h, young and middle-aged adults showed off-line improvement. However, RT facilitation was not specific to sequence trials. Importantly, susceptibility to interference was reduced in young and older adults indicating the occurrence of consolidation. Although WM performance declined in older participants when load was high, it was not significantly related to sequence learning. The data reveal a decline in motor sequence learning in middle-aged but not in older adults. The use of explicit learning strategies in older adults might account for the latter result.
Gnacinski, P.; Mindykowski, J.; Tarasiuk, T. [Gdynia Maritime Univ., Dept. of Ship Electrical Power Engineering, Morska Str. 83, 81-225 Gdynia (Poland)
This paper deals with the effect of lowered voltage quality in ship power systems on windings temperature of low-power induction cage machines. The results of investigations carried out with experimental and analytical methods are presented. The thermal impact of power quality disturbances permitted by ship classification societies is discussed. A proposal of new power quality regulations for ship classification societies is made. (author)
Chalmers, B J
Electric Motor Handbook aims to give practical knowledge in a wide range of capacities such as plant design, equipment specification, commissioning, operation and maintenance. The book covers topics such as the modeling of steady-state motor performance; polyphase induction, synchronous, and a.c. commutator motors; ambient conditions, enclosures, cooling and loss dissipation; and electrical supply systems and motor drives. Also covered are topics such as variable-speed drives and motor control; materials and motor components; insulation types, systems, and techniques; and the installation, sit
Braun, Daniel A.; Aertsen, Ad; Paz, Rony; Vaadia, Eilon; Rotter, Stefan; Mehring, Carsten
When faced with unpredictable environments, the human motor system has been shown to develop optimized adaptation strategies that allow for online adaptation during the control process. Such online adaptation is to be contrasted to slower over-trial learning that corresponds to a trial-by-trial update of the movement plan. Here we investigate the interplay of both processes, i.e., online adaptation and over-trial learning, in a visuomotor experiment performed by macaques. We show that simple non-adaptive control schemes fail to perform in this task, but that a previously suggested adaptive optimal feedback control model can explain the observed behavior. We also show that over-trial learning as seen in learning and aftereffect curves can be explained by learning in a radial basis function network. Our results suggest that both the process of over-trial learning and the process of online adaptation are crucial to understand visuomotor learning. PMID:21720526
Weinstein, A; Brickner, O; Lerman, H; Greemland, M; Bloch, M; Lester, H; Chisin, R; Sarne, Y; Mechoulam, R; Bar-Hamburger, R; Freedman, N; Even-Sapir, E
Heavy use of marijuana is claimed to damage critical skills related to short-term memory, visual scanning and attention. Motor skills and driving safety may be compromised by the acute effects of marijuana. The aim of this study was to investigate the acute effects of 13 mg and 17 mg Delta 9-tetrahydrocannabinol (THC) on skills important for coordinated movement and driving and on subjective and autonomic measures in regular users of marijuana. Fourteen regular users of marijuana were enrolled. Each subject was tested on two separate days. On each test day, subjects smoked two low-nicotine cigarettes, one with and the other without THC. Seventeen mg THC was included in the cigarette on one test day and 13 mg on the other day. The sequence of cigarette types was unknown to the subject. During smoking, heart rate and blood pressure were monitored, and the subjects performed a virtual reality maze task requiring attention and motor coordination, followed by 3 other cognitive tasks (Wisconsin Card Sorting Test (WCST), a "gambling" task and estimation of time and distance from an approaching car). After smoking a cigarette with 17 mg THC, regular marijuana users hit the walls more often on the virtual maze task than after smoking cigarettes without THC; this effect was not seen in patients after they smoked cigarettes with 13 mg THC. Performance in the WCST was affected with 17 mg THC and to a lesser extent with the use of 13 mg THC. Decision making in the gambling task was affected after smoking cigarettes with 17 mg THC, but not with 13 m THC. Smoking cigarettes with 13 and 17 mg THC increased subjective ratings of pleasure and satisfaction, drug "effect" and drug "high". These findings imply that smoking of 17 mg THC results in impairment of cognitive-motor skills that could be important for coordinated movement and driving, whereas the lower dose of 13 mg THC appears to cause less impairment of such skills in regular users of marijuana.
This book guides the application for Linear motor. It lists classification and speciality of Linear Motor, terms of linear-induction motor, principle of the Motor, types on one-side linear-induction motor, bilateral linear-induction motor, linear-DC Motor on basic of the motor, linear-DC Motor for moving-coil type, linear-DC motor for permanent-magnet moving type, linear-DC motor for electricity non-utility type, linear-pulse motor for variable motor, linear-pulse motor for permanent magneto type, linear-vibration actuator, linear-vibration actuator for moving-coil type, linear synchronous motor, linear electromagnetic motor, linear electromagnetic solenoid, technical organization and magnetic levitation and linear motor and sensor.
Full Text Available O presente estudo investigou se a aprendizagem motora de crianças pode ser beneficiada pelo "feedback" (conhecimento de resultados -CR fornecido após tentativas relativamente boas de prática, ao invés de após tentativas ruins. A tarefa requeriu que os participantes arremessassem saquinhos de feijão em um alvo circular fixo, posicionado no chão, a uma distância de 3 m. Vinte e oito crianças do ensino fundamental (idade média: 10,6 anos participaram deste experimento. A fase de prática consistiu de 10 blocos de seis tentativas. Após cada bloco de tentativas, um grupo (KR "good" recebeu CR relacionado aos três arremessos mais precisos, enquanto ao outro grupo (KR "poor" foi fornecido CR relacionado aos três arremessos menos precisos. Os participantes não foram informados sobre as tentativas nas quais o "feedback" seria fornecido. Imediatamente após a fase de prática, os participantes preencheram o questionário de motivação intrínseca. Um dia após a fase de prática, foi conduzido um teste de retenção composto por 10 tentativas, sem CR. Os resultados demonstraram que a aprendizagem foi melhorada através do fornecimento de CR após as boas tentativas de prática. Ainda, os resultados do questionário revelaram que a motivação intrínseca dos aprendizes foi aumentada pelo "feedback" positivo. Os presentes achados adicionam evidências de que os efeitos motivacionais do "feedback" possuem um impacto direto sobre a aprendizagem.The present study investigated whether children would benefit from feedback (knowledge of results, KR provided after relatively good as opposed to poor trials. The task required participants to throw beanbags at a circular target that was placed on the floor at a distance of 3 m. Twenty-eight elementary school children (mean age: 10.6 years participated in this experiment. The practice phase consisted of 10 blocks of 6 trials. After each 6-trial block, one group (KR good received KR on the 3 most
Arakawa, Reiko; Arakawa, Masayuki; Kaneko, Kaori; Otsuki, Noriko; Aoki, Ryoko; Saito, Kayoko
Spinal muscular atrophy is a neurodegenerative disorder caused by the deficient expression of survival motor neuron protein in motor neurons. A major goal of disease-modifying therapy is to increase survival motor neuron expression. Changes in survival motor neuron protein expression can be monitored via peripheral blood cells in patients; therefore we tested the sensitivity and utility of imaging flow cytometry for this purpose. After the immortalization of peripheral blood lymphocytes from a human healthy control subject and two patients with spinal muscular atrophy type 1 with two and three copies of SMN2 gene, respectively, we used imaging flow cytometry analysis to identify significant differences in survival motor neuron expression. A bright detail intensity analysis was used to investigate differences in the cellular localization of survival motor neuron protein. Survival motor neuron expression was significantly decreased in cells derived from patients with spinal muscular atrophy relative to those derived from a healthy control subject. Moreover, survival motor neuron expression correlated with the clinical severity of spinal muscular atrophy according to SMN2 copy number. The cellular accumulation of survival motor neuron protein was also significantly decreased in cells derived from patients with spinal muscular atrophy relative to those derived from a healthy control subject. The benefits of imaging flow cytometry for peripheral blood analysis include its capacities for analyzing heterogeneous cell populations; visualizing cell morphology; and evaluating the accumulation, localization, and expression of a target protein. Imaging flow cytometry analysis should be implemented in future studies to optimize its application as a tool for spinal muscular atrophy clinical trials. Copyright © 2016 Elsevier Inc. All rights reserved.
Teo, James T H; Swayne, Orlando B C; Cheeran, Binith; Greenwood, Richard J; Rothwell, John C
Intermittent theta burst stimulation (iTBS) transiently increases motor cortex excitability in healthy humans by a process thought to involve synaptic long-term potentiation (LTP), and this is enhanced by nicotine. Acquisition of a ballistic motor task is likewise accompanied by increased excitability and presumed intracortical LTP. Here, we test how iTBS and nicotine influences subsequent motor learning. Ten healthy subjects participated in a double-blinded placebo-controlled trial testing the effects of iTBS and nicotine. iTBS alone increased the rate of learning but this increase was blocked by nicotine. We then investigated factors other than synaptic strengthening that may play a role. Behavioral analysis and modeling suggested that iTBS increased performance variability, which correlated with learning outcome. A control experiment confirmed the increase in motor output variability by showing that iTBS increased the dispersion of involuntary transcranial magnetic stimulation-evoked thumb movements. We suggest that in addition to the effect on synaptic plasticity, iTBS may have facilitated performance by increasing motor output variability; nicotine negated this effect on variability perhaps via increasing the signal-to-noise ratio in cerebral cortex.
Full Text Available Objective. This study synthesized literature concerning casual evidence of effects of various physical activity programs on motor skills and cognitive development in typically developed preschool children. Methods. Electronic databases were searched through July 2017. Peer-reviewed randomized controlled trials (RCTs examining the effectiveness of physical activity on motor skills and cognitive development in healthy young children (4–6 years were screened. Results. A total of 15 RCTs were included. Of the 10 studies assessing the effects of physical activity on motor skills, eight (80% reported significant improvements in motor performance and one observed mixed findings, but one failed to promote any beneficial outcomes. Of the five studies investigating the influence of physical activity on cognitive development, four (80% showed significant and positive changes in language learning, academic achievement, attention, and working memory. Notably, one indicated no significant improvements were observed after the intervention. Conclusions. Findings support causal evidence of effects of physical activity on both motor skills and cognitive development in preschool children. Given the shortage of available studies, future research with large representative samples is warranted to explore the relationships between physical activity and cognitive domains as well as strengthen and confirm the dose-response evidence in early childhood.
Zeng, Nan; Ayyub, Mohammad; Sun, Haichun; Wen, Xu; Xiang, Ping; Gao, Zan
This study synthesized literature concerning casual evidence of effects of various physical activity programs on motor skills and cognitive development in typically developed preschool children. Electronic databases were searched through July 2017. Peer-reviewed randomized controlled trials (RCTs) examining the effectiveness of physical activity on motor skills and cognitive development in healthy young children (4-6 years) were screened. A total of 15 RCTs were included. Of the 10 studies assessing the effects of physical activity on motor skills, eight (80%) reported significant improvements in motor performance and one observed mixed findings, but one failed to promote any beneficial outcomes. Of the five studies investigating the influence of physical activity on cognitive development, four (80%) showed significant and positive changes in language learning, academic achievement, attention, and working memory. Notably, one indicated no significant improvements were observed after the intervention. Findings support causal evidence of effects of physical activity on both motor skills and cognitive development in preschool children. Given the shortage of available studies, future research with large representative samples is warranted to explore the relationships between physical activity and cognitive domains as well as strengthen and confirm the dose-response evidence in early childhood.
Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...
Nishigaki, Kaori; Yoneyama, Akira; Ishii, Mitsuko; Kamibeppu, Kiyoko
Limited time away from the child is cited as the main factor that increases the burden for the primary caregiver of severely disabled children. The aim of this study was to quantitatively elucidate the factors related to the desire to use social services and the actual use of respite care services by the primary caregivers of severely disabled children in Japan. In this study, we investigated the use of respite care services in accordance with the primary caregivers' wishes by examining inhibiting or promoting factors associated with respite care service use only among those who wished to use social services. A total of 169 Japanese mothers participated and answered the questionnaires. We conducted a logistic regression analysis and a multiple regression analysis to investigate the factors related to respite care service use. The most important factors affecting a primary caregiver's desire to use social services were the belief that the child would enjoy using social services and the family's approval of the social service use. The most important factors affecting respite care service use were the family's approval of the use and a large care burden on the primary caregiver. Respite care services should be sought out before the care burden becomes too great to enable the primary caregiver to more easily contribute to the continuation of home care. A background of mother-child separation anxiety disrupted the use of respite care. However, believing that the child enjoys using social services may reduce primary caregivers' psychological resistance to being separated from their child, which is supported by tradition. Thus, it is also important for respite care service providers to provide information about the children to their primary caregivers and families while they are using respite care services. © 2016 John Wiley & Sons Ltd.
Karl Spanner; Burhanettin Koc
Piezoelectric motors are used in many industrial and commercial applications. Various piezoelectric motors are available in the market. All of the piezoelectric motors use the inverse piezoelectric effect, where microscopically small oscillatory motions are converted into continuous or stepping rotary or linear motions. Methods of obtaining long moving distance have various drive and functional principles that make these motors categorized into three groups: resonance-drive (piezoelectric ult...
Electric motor performance is vital to the reliable and efficient operation of power plants. The failure of one or more critical motors could cause lost capacity and excessive repair and maintenance cost. However, existing maintenance recommendations proposed by vendors for electric motors have sometimes encouraged many overly conservative maintenance practices. These practices have lead to excessive maintenance activities and costs which have provided no extra margin of operability. EPRI has sponsored RP2814-35 to develop a guide which provides power plants with information and guidance for establishing an effective maintenance program which will aid in preventing unexpected motor failures and assist in planning motor maintenance efforts. The guide includes a technical description which summarizes technical data relative to the four basic types of motors and their components in general use in power plants. The significant causes of motor failures are investigated and described in detail and methods to optimize service life and minimize maintenance cost through appropriate preventive maintenance and conditioning program are presented. This guide provides a foundation for an effective electric motor maintenance program and simplifies the selection of predictive and preventive maintenance tasks. Its use will enable maintenance personnel in nuclear and fossil plants to plan motor repairs during scheduled outages and avoid costly unexpected failures
Nonis, Karen P.; Jernice, Tan Sing Yee
Many international studies have examined the gross motor skills of children studying in special schools while local studies of such nature are limited. This study investigated the gross motor skills of children with Mild Learning Disabilities (MLD; n = 14, M age = 8.93 years, SD = 0.33) with the Test of Gross Motor Development-2 (TGMD-2, Ulrich,…
Worobey, Lynn A; Rigot, Stephanie K; Hogaboom, Nathan S; Venus, Chris; Boninger, Michael L
To determine the efficacy of a web-based transfer training module at improving transfer technique across 3 groups: web-based training, in-person training (current standard of practice), and a waitlist control group (WLCG); and secondarily, to determine subject factors that can be used to predict improvements in transfer ability after training. Randomized controlled trials. Summer and winter sporting events for disabled veterans. A convenience sample (N=71) of manual and power wheelchair users who could transfer independently. An individualized, in-person transfer training session or a web-based transfer training module. The WLCG received the web training at their follow-up visit. Transfer Assessment Instrument (TAI) part 1 score was used to assess transfers at baseline, skill acquisition immediately posttraining, and skill retention after a 1- to 2-day follow-up period. The in-person and web-based training groups improved their median (interquartile range) TAI scores from 7.98 (7.18-8.46) to 9.13 (8.57-9.58; P.05). A lower initial TAI score was found to be the only significant predictor of a larger percent change in TAI score after receiving training. Transfer training can improve technique with changes retained within a short follow-up window, even among experienced wheelchair users. Web-based transfer training demonstrated comparable improvements to in-person training. With almost half of the United States population consulting online resources before a health care professional, web-based training may be an effective method to increase knowledge translation. Copyright © 2017 American Congress of Rehabilitation Medicine. All rights reserved.
Bennion, Kevin S [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
Thermal management enables more efficient and cost-effective motors. This Annual Merit Review presentation describes the technical accomplishments and progress in electric motor thermal management R&D over the last year. This project supports a broad industry demand for data, analysis methods, and experimental techniques to improve and better understand motor thermal management.
Hopwood, J. E.
A portable programmable dc motor controller, with features not available on commercial instruments was developed for controlling fixtures during welding processes. The controller can be used to drive any dc motor having tachometer feedback and motor requirements not exceeding 30 volts, 3 amperes. Among the controller's features are delayed start time, upslope time, speed, and downslope time.
St John, Tanya; Estes, Annette M; Dager, Stephen R; Kostopoulos, Penelope; Wolff, Jason J; Pandey, Juhi; Elison, Jed T; Paterson, Sarah J; Schultz, Robert T; Botteron, Kelly; Hazlett, Heather; Piven, Joseph
Existing evidence suggests executive functioning (EF) deficits may be present in children with autism spectrum disorder (ASD) by 3 years of age. It is less clear when, prior to 3 years, EF deficits may emerge and how EF unfold over time. The contribution of motor skill difficulties to poorer EF in children with ASD has not been systematically studied. We investigated the developmental trajectory of EF in infants at high and low familial risk for ASD (HR and LR) and the potential associations between motor skills, diagnostic group, and EF performance. Participants included 186 HR and 76 LR infants. EF (A-not-B), motor skills (Fine and Gross Motor), and cognitive ability were directly assessed at 12 months and 24 months of age. Participants were directly evaluated for ASD at 24 months using DSM-IV-TR criteria and categorized as HR-ASD, HR-Negative, and LR-Negative. HR-ASD and HR-Negative siblings demonstrated less improvement in EF over time compared to the LR-Negative group. Motor skills were associated with group and EF performance at 12 months. No group differences were found at 12 months, but at 24 months, the HR-ASD and HR-Negative groups performed worse than the LR-Negative group overall after controlling for visual reception and maternal education. On reversal trials, the HR-ASD group performed worse than the LR-Negative group. Motor skills were associated with group and EF performance on reversal trials at 24 months. Findings suggest that HR siblings demonstrate altered EF development and that motor skills may play an important role in this process.
St. John, Tanya; Estes, Annette M.; Dager, Stephen R.; Kostopoulos, Penelope; Wolff, Jason J.; Pandey, Juhi; Elison, Jed T.; Paterson, Sarah J.; Schultz, Robert T.; Botteron, Kelly; Hazlett, Heather; Piven, Joseph
Existing evidence suggests executive functioning (EF) deficits may be present in children with autism spectrum disorder (ASD) by 3 years of age. It is less clear when, prior to 3 years, EF deficits may emerge and how EF unfold over time. The contribution of motor skill difficulties to poorer EF in children with ASD has not been systematically studied. We investigated the developmental trajectory of EF in infants at high and low familial risk for ASD (HR and LR) and the potential associations between motor skills, diagnostic group, and EF performance. Participants included 186 HR and 76 LR infants. EF (A-not-B), motor skills (Fine and Gross Motor), and cognitive ability were directly assessed at 12 months and 24 months of age. Participants were directly evaluated for ASD at 24 months using DSM-IV-TR criteria and categorized as HR-ASD, HR-Negative, and LR-Negative. HR-ASD and HR-Negative siblings demonstrated less improvement in EF over time compared to the LR-Negative group. Motor skills were associated with group and EF performance at 12 months. No group differences were found at 12 months, but at 24 months, the HR-ASD and HR-Negative groups performed worse than the LR-Negative group overall after controlling for visual reception and maternal education. On reversal trials, the HR-ASD group performed worse than the LR-Negative group. Motor skills were associated with group and EF performance on reversal trials at 24 months. Findings suggest that HR siblings demonstrate altered EF development and that motor skills may play an important role in this process. PMID:27458411
Tanja H. Kakebeeke
Full Text Available According to the Constrained Action Hypothesis, motor learning is believed to be more efficient when an external focus (EF of motor control is given to the performer instead of an internal focus (IF of motor control. This systematic review investigated whether findings of studies focusing on the Constrained Action Hypothesis may be transferred to rehabilitation settings by assessing the methodological quality and risk of bias (ROB of available randomized controlled trials (RCTs. Of the 18 selected reports representing 20 RCTs, the methodological quality was rather low, and the majority of the reports appeared to have a high ROB. The 18 reports included 68 patients tested in a rehabilitation setting and 725 healthy participants. The time scale of the motor learning processes presented in the selected articles was heterogenic. The results of this systematic review indicate that the assumption that an external focus of control is to be preferred during motor learning processes is not sufficiently substantiated. The level of available evidence is not large enough to warrant transfer to patient populations (including children and the elderly and raises doubts about research with healthy individuals. This implies that based on the methodology used so far, there seems to be insufficient evidence for the superiority of an external focus of control, neither in healthy individuals nor in clinical populations. The relationship between EF instructions and motor learning research and its effect in both patient rehabilitation settings and healthy populations requires further exploration. Future adequately powered studies with low ROB and with rehabilitation populations that are followed over extended time periods should, therefore, be performed to substantiate or refute the assumption of the superiority of an EF in motor learning.
Adams, Kirkwood F.; Butler, Javed; Patterson, J. Herbert; Stough, Wendy Gattis; Bauman, Jerry L.; van Veldhuisen, Dirk J.; Schwartz, Todd A.; Sabbah, Hani; Mackowiak, John I.; Ventura, Hector O.; Ghali, Jalal K.
AimsMany patients with heart failure and reduced EF remain at high risk for hospitalization despite evidence-based therapy. Digoxin may decrease hospitalization; however, uncertainty persists concerning its proper administration and effect on mortality. This study investigated whether using dose
Mizuguchi, N; Nakata, H; Kanosue, K
To elucidate the neural substrate associated with capabilities for kinesthetic motor imagery of difficult whole-body movements, we measured brain activity during a trial involving both kinesthetic motor imagery and action observation as well as during a trial with action observation alone. Brain activity was assessed with functional magnetic resonance imaging (fMRI). Nineteen participants imagined three types of whole-body movements with the horizontal bar: the giant swing, kip, and chin-up during action observation. No participant had previously tried to perform the giant swing. The vividness of kinesthetic motor imagery as assessed by questionnaire was highest for the chin-up, less for the kip and lowest for the giant swing. Activity in the primary visual cortex (V1) during kinesthetic motor imagery with action observation minus that during action observation alone was significantly greater in the giant swing condition than in the chin-up condition within participants. Across participants, V1 activity of kinesthetic motor imagery of the kip during action observation minus that during action observation alone was negatively correlated with vividness of the kip imagery. These results suggest that activity in V1 is dependent upon the capability of kinesthetic motor imagery for difficult whole-body movements. Since V1 activity is likely related to the creation of a visual image, we speculate that visual motor imagery is recruited unintentionally for the less vivid kinesthetic motor imagery of difficult whole-body movements. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Hickam, Christopher Dale [Glasford, IL
A motor/generator is provided for connecting between a transmission input shaft and an output shaft of a prime mover. The motor/generator may include a motor/generator housing, a stator mounted to the motor/generator housing, a rotor mounted at least partially within the motor/generator housing and rotatable about a rotor rotation axis, and a transmission-shaft coupler drivingly coupled to the rotor. The transmission-shaft coupler may include a clamp, which may include a base attached to the rotor and a plurality of adjustable jaws.
Full Text Available Abstract Background Whiplash is the most common injury following a motor vehicle accident. Approximately 60% of people suffer persistent pain and disability six months post injury. Two forms of exercise; specific motor relearning exercises and graded activity, have been found to be effective treatments for this condition. Although the effect sizes for these exercise programs, individually, are modest, pilot data suggest much larger effects on pain and disability are achieved when these two treatments are combined. The aim of this study is to investigate the effectiveness and cost-effectiveness of this comprehensive exercise approach for chronic whiplash. Methods/Design A multicentre randomised controlled trial will be conducted. One hundred and seventy-six participants with chronic grade I to II whiplash will be recruited in Sydney and Brisbane, Australia. All participants will receive an educational booklet on whiplash and in addition, those randomised to the comprehensive exercise group (specific motor relearning and graded activity exercises will receive 20 progressive and individually-tailored, 1 hour exercise sessions over a 12 week period (specific motor relearning exercises: 8 sessions over 4 weeks; graded activity: 12 sessions over 8 weeks. The primary outcome to be assessed is pain intensity. Other outcomes of interest include disability, health-related quality of life and health service utilisation. Outcomes will be measured at baseline, 14 weeks, 6 months and 12 months by an assessor who is blinded to the group allocation of the subjects. Recruitment is due to commence in late 2009. Discussion The successful completion of this trial will provide evidence on the effectiveness and cost-effectiveness of a simple treatment for the management of chronic whiplash. Trial registration ACTRN12609000825257
Keser, Zafer; Francisco, Gerard E
Almost 7 million adult Americans have had a stroke. There is a growing need for more effective treatment options as add-ons to conventional therapies. This article summarizes the published literature for pharmacologic agents used for the enhancement of motor and speech recovery after stroke. Amphetamine, levodopa, selective serotonin reuptake inhibitors, and piracetam were the most commonly used drugs. Pharmacologic augmentation of stroke motor and speech recovery seems promising but systematic, adequately powered, randomized, and double-blind clinical trials are needed. At this point, the use of these pharmacologic agents is not supported by class I evidence. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Piezoelectric motors are used in many industrial and commercial applications. Various piezoelectric motors are available in the market. All of the piezoelectric motors use the inverse piezoelectric effect, where microscopically small oscillatory motions are converted into continuous or stepping rotary or linear motions. Methods of obtaining long moving distance have various drive and functional principles that make these motors categorized into three groups: resonance-drive (piezoelectric ultrasonic motors, inertia-drive, and piezo-walk-drive. In this review, a comprehensive summary of piezoelectric motors, with their classification from initial idea to recent progress, is presented. This review also includes some of the industrial and commercial applications of piezoelectric motors that are presently available in the market as actuators.
Arnold, J.R.; Kelly, J.F.; Delzingaro, M.J.
Motor Operated Valve (MOV) squirrel cage AC motor rotors are susceptible to degradation under certain conditions. Premature failure can result due to high humidity/temperature environments, high running load conditions, extended periods at locked rotor conditions (i.e. > 15 seconds) or exceeding the motor`s duty cycle by frequent starts or multiple valve stroking. Exposure to high heat and moisture due to packing leaks, pressure seal ring leakage or other causes can significantly accelerate the degradation. ComEd and Liberty Technologies have worked together to provide and validate a non-intrusive method using motor power diagnostics to evaluate MOV rotor condition and predict failure. These techniques have provided a quick, low radiation dose method to evaluate inaccessible motors, identify degradation and allow scheduled replacement of motors prior to catastrophic failures.
Jensen, Jesper Lundbye
Practice of a new motor task is usually associated with an improvement in performance. Indeed, if we stop practicing and return the next day to the same task, we find that our performance has been maintained and may even be better than it was at the start of the first day. This improvement...... is a measure of our ability to form and store a motor memory of the task. However, the initial memory of the task is labile and may be subject to interference. During and following motor learning plastic changes occur within the central nervous system. On one hand these changes are driven by motor practice......, on the other hand the changes underlie the formation of motor memory and the retention of improved motor performance. During motor learning changes may occur at many different levels within the central nervous system dependent on the type of task and training. Here, we demonstrate different studies from our...
Allegra, Adolfo; Marino, Angelo; Volpes, Aldo; Coffaro, Francesco; Scaglione, Piero; Gullo, Salvatore; La Marca, Antonio
The number of oocytes retrieved is a relevant intermediate outcome in women undergoing IVF/intracytoplasmic sperm injection (ICSI). This trial compared the efficiency of the selection of the FSH starting dose according to a nomogram based on multiple biomarkers (age, day 3 FSH, anti-Müllerian hormone) versus an age-based strategy. The primary outcome measure was the proportion of women with an optimal number of retrieved oocytes defined as 8-14. At their first IVF/ICSI cycle, 191 patients underwent a long gonadotrophin-releasing hormone agonist protocol and were randomized to receive a starting dose of recombinant (human) FSH, based on their age (150 IU if ≤35 years, 225 IU if >35 years) or based on the nomogram. Optimal response was observed in 58/92 patients (63%) in the nomogram group and in 42/99 (42%) in the control group (+21%, 95% CI = 0.07 to 0.35, P = 0.0037). No significant differences were found in the clinical pregnancy rate or the number of embryos cryopreserved per patient. The study showed that the FSH starting dose selected according to ovarian reserve is associated with an increase in the proportion of patients with an optimal response: large trials are recommended to investigate any possible effect on the live-birth rate. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Althouse, Andrew D; Abbott, J Dawn; Sutton-Tyrrell, Kim; Forker, Alan D; Lombardero, Manuel S; Buitrón, L Virginia; Pena-Sing, Ivan; Tardif, Jean-Claude; Brooks, Maria Mori
The aim of this manuscript was to report the risk of incident peripheral arterial disease (PAD) in a large randomized clinical trial that enrolled participants with stable coronary artery disease and type 2 diabetes and compare the risk between assigned treatment arms. The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial randomly assigned participants to insulin sensitization (IS) therapy versus insulin-providing (IP) therapy for glycemic control. Results showed similar 5-year mortality in the two glycemic treatment arms. In secondary analyses reported here, we examine the effects of treatment assignment on the incidence of PAD. A total of 1,479 BARI 2D participants with normal ankle-brachial index (ABI) (0.91-1.30) were eligible for analysis. The following PAD-related outcomes are evaluated in this article: new low ABI≤0.9, a lower-extremity revascularization, lower-extremity amputation, and a composite of the three outcomes. During an average 4.6 years of follow-up, 303 participants experienced one or more of the outcomes listed above. Incidence of the composite outcome was significantly lower among participants assigned to IS therapy than those assigned to IP therapy (16.9 vs. 24.1%; Pdiabetes who are free from PAD, a glycemic control strategy of insulin sensitization may be the preferred therapeutic strategy to reduce the incidence of PAD and subsequent outcomes.
Cele, Emmanuel Nkosinathi; Maboeta, Mark
An iron ore mine site in Swaziland is currently (2015) in a derelict state as a consequence of past (1964-1988) and present (2011 - current) iron ore mining operations. In order to control problems associated with mine wastes, the Swaziland Water Services Corporation (SWSC) recently (2013) proposed the application of biosolids in sites degraded by mining operations. It is thought that this practice could generally improve soil conditions and enhance plant reestablishment. More importantly, the SWSC foresees this as a potential solution to the biosolids disposal problems. In order to investigate the effects of biosolids and plants in soil physicochemical conditions of iron mine soils, we conducted two plant growth trials. Trial 1 consisted of tailings that received biosolids and topsoil (TUSB mix) while in trial 2, tailings received biosolids only (TB mix). In the two trials, the application rates of 0 (control), 10, 25, 50, 75 and 100 t ha(-1) were used. After 30 days of equilibration, 25 seeds of Cynodon dactylon were sown in each pot and thinned to 10 plants after 4 weeks. Plants were watered twice weekly and remained under greenhouse conditions for 12 weeks, subsequent to which soils were subjected to chemical analysis. According to the results obtained, there were significant improvements in soil parameters related to fertility such as organic matter (OM), water holding capacity (WHC), cation exchange capacity (CEC), ammonium [Formula: see text] , magnesium (Mg(2+)), calcium (Ca(2+)) and phosphorus ( [Formula: see text] ). With regard to heavy metals, biosolids led to significant increases in soil total concentrations of Cu, Zn, Cd, Hg and Pb. The higher concentrations of Zn and Cu in treated tailings compared to undisturbed adjacent soils are a cause for concern because in the field, this might work against the broader objectives of mine soil remediation, which include the recolonization of reclaimed sites by soil-dwelling organisms. Therefore, while
Taylor Nicholas F
Full Text Available Abstract Background Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome. Methods A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry, muscle strength (1 repetition maximum for chest and leg press and physical activity (frequency, duration, intensity over 7-days will be assessed at baseline (Week 0, following the intervention (Week 11, and at 3 months post intervention (Week 24 by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates. Discussion This paper outlines the study protocol for a randomised controlled trial on the
The Effects of Rhythm and Robotic Interventions on the Imitation/Praxis, Interpersonal Synchrony, and Motor Performance of Children with Autism Spectrum Disorder (ASD): A Pilot Randomized Controlled Trial
Srinivasan, Sudha M.; Kaur, Maninderjit; Park, Isabel K.; Gifford, Timothy D.; Marsh, Kerry L.; Bhat, Anjana N.
We assessed the effects of three interventions, rhythm, robotic, and standard-of-care, on the imitation/praxis, interpersonal synchrony, and overall motor performance of 36 children with Autism Spectrum Disorder (ASD) between 5 and 12 years of age. Children were matched on age, level of functioning, and services received, prior to random assignment to one of the three groups. Training was provided for 8 weeks with 4 sessions provided each week. We assessed generalized changes in motor skills from the pretest to the posttest using a standardized test of motor performance, the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2). We also assessed training-specific changes in imitation/praxis and interpersonal synchrony during an early and a late session. Consistent with the training activities practiced, the rhythm and robot groups improved on the body coordination composite of the BOT-2, whereas the comparison group improved on the fine manual control composite of the BOT-2. All three groups demonstrated improvements in imitation/praxis. The rhythm and robot groups also showed improved interpersonal synchrony performance from the early to the late session. Overall, socially embedded movement-based contexts are valuable in promoting imitation/praxis, interpersonal synchrony, and motor performance and should be included within the standard-of-care treatment for children with ASD. PMID:26793394
Priming With 1-Hz Repetitive Transcranial Magnetic Stimulation Over Contralesional Leg Motor Cortex Does Not Increase the Rate of Regaining Ambulation Within 3 Months of Stroke: A Randomized Controlled Trial.
Huang, Ying-Zu; Lin, Li-Fong; Chang, Kwang-Hwa; Hu, Chaur-Jong; Liou, Tsan-Hon; Lin, Yen-Nung
The potential benefits of repetitive transcranial magnetic stimulation (rTMS), applied either alone or as a combination treatment, on recovery of lower limbs after stroke have been insufficiently studied. The aim of the study was to evaluate the effect of priming with 1-Hz repetitive transcranial magnetic stimulation over contralesional leg motor area with a double-cone coil before physical therapy on regaining ambulation. Thirty-eight subacute stroke patients with significant leg disabilities were randomly assigned into the experimental group or control group to receive a 15-min real or sham 1-Hz repetitive transcranial magnetic stimulation, respectively, over the contralesional motor cortex representing the quadriceps muscle followed by 45-min physical therapy for 15 sessions for 3 wks. Functional measures, motor evoked potentials, and quality of life were assessed. There was no significant difference between experimental group and control group regarding the recovery in ambulation, balance, motor functions, and activity of daily living. No significant difference was found in other functional measures and the quality of life. Only the control group displayed significantly increased cortical excitability of the contralesional hemisphere after the intervention. The present study found that insufficient evidence that contralesional priming with 1-Hz repetitive transcranial magnetic stimulation improves ambulatory and other motor functions among patients with a severe leg dysfunction in subacute stroke.
The Effects of Rhythm and Robotic Interventions on the Imitation/Praxis, Interpersonal Synchrony, and Motor Performance of Children with Autism Spectrum Disorder (ASD: A Pilot Randomized Controlled Trial
Sudha M. Srinivasan
Full Text Available We assessed the effects of three interventions, rhythm, robotic, and standard-of-care, on the imitation/praxis, interpersonal synchrony, and overall motor performance of 36 children with Autism Spectrum Disorder (ASD between 5 and 12 years of age. Children were matched on age, level of functioning, and services received, prior to random assignment to one of the three groups. Training was provided for 8 weeks with 4 sessions provided each week. We assessed generalized changes in motor skills from the pretest to the posttest using a standardized test of motor performance, the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2. We also assessed training-specific changes in imitation/praxis and interpersonal synchrony during an early and a late session. Consistent with the training activities practiced, the rhythm and robot groups improved on the body coordination composite of the BOT-2, whereas the comparison group improved on the fine manual control composite of the BOT-2. All three groups demonstrated improvements in imitation/praxis. The rhythm and robot groups also showed improved interpersonal synchrony performance from the early to the late session. Overall, socially embedded movement-based contexts are valuable in promoting imitation/praxis, interpersonal synchrony, and motor performance and should be included within the standard-of-care treatment for children with ASD.
Langhammer, Birgitta; Stanghelle, Johan K
The primary aim of the present study was to investigate, based on data from our study in 2000, whether the Bobath approach enhanced quality of movement better than the Motor Relearning Programme (MRP) during rehabilitation of stroke patients. A randomized controlled stratified trial of acute stroke patients. The patients were treated according to Motor Relearning Programme and Bobath approach and assessed with Motor Assessment Scale, Sødring Motor Evaluation Scale, Nottingham Health Profile and the Barthel Index. A triangulation of the test scores was made in reference to the Movement Quality Model and biomechanical, physiological, psycho-socio-cultural, and existential themes. The items arm (p = 0.02-0.04) sitting (p = 0.04) and hand (p = 0.01-0.03) were significantly better in the Motor Relearning Programme group than in the Bobath group, in both Sødring Motor Evaluation Scale and Motor Assessment Scale. Leg function, balance, transfer, walking and stair climbing did not differ between the groups. The Movement Quality Model and the movement qualities biomechanical, physiological and psycho-socio-cultural showed higher scoring in the Motor Relearning Programme group, indicating better quality of movement in all items. Regression models established the relationship with significant models of motor performance and self reported physical mobility (adjusted R(2) 0.30-0.68, p < 0.0001), energy (adjusted R(2) 0.13-0.14, p = 0.03-0.04, emotion (adjusted R(2) 0.30-0.38, p < 0.0001) and social interaction (arm function, adjusted R(2) 0.25, p = 0.0001). These analyses confirm that task oriented exercises of the Motor Relearning Programme type are preferable regarding quality of movement in the acute rehabilitation of patients with stroke. Copyright © 2010 John Wiley & Sons, Ltd.
Full Text Available The present study investigated the relationship between individual differences in timing movements at the level of milliseconds and performance on selected cognitive and fine motor skills. For this purpose, young adult participants (N = 100 performed a repetitive movement task paced by an auditory metronome at different rates. Psychometric measures included the digit-span and symbol search subtasks from the Wechsler battery as well as the Raven SPM. Fine motor skills were assessed with the Purdue Pegboard test. Motor timing performance was significantly related (mean r = .3 to cognitive measures, and explained both unique and shared variance with information-processing speed of Raven's scores. No significant relations were found between motor timing measures and fine motor skills. These results show that individual differences in cognitive and motor timing performance is to some extent dependent upon shared processing not associated with individual differences in manual dexterity.
Full Text Available StartReact is the acceleration of reaction time by a startling acoustic stimulus (SAS. The SAS is thought to release a pre-prepared motor program. Here, we investigated whether the StartReact effect is applicable to the very first trial in a series of repeated unpractised single-joint movements.Twenty healthy young subjects were instructed to perform a rapid ankle dorsiflexion movement in response to an imperative stimulus. Participants were divided in two groups of ten. Both groups performed 17 trials. In one group a SAS (116 dB was given in the first trial, whereas the other group received a non-startling sound (70 dB as the first imperative stimulus. In the remaining 16 trials, the SAS was given as the imperative stimulus in 25% of the trials in both groups. The same measurement was repeated one week later, but with the first-trial stimuli counterbalanced between groups.When a SAS was given in the very first trial, participants had significantly shorter onset latencies compared to first-trial responses to a non-startling stimulus. Succeeding trials were significantly faster compared to the first trial, both for trials with and without a SAS. However, the difference between the first and succeeding trials was significantly larger for responses to a non-startling stimulus compared to responses triggered by a SAS. SAS-induced acceleration in the first trial of the second session was similar to that in succeeding trials of session 1.The present results confirm that the StartReact phenomenon also applies to movements that have not yet been practiced in the experimental context. The excessive SAS-induced acceleration in the very first trial may be due to the absence of integration of novel context-specific information with the existing motor memory for movement execution. Our findings demonstrate that StartReact enables a rapid release of motor programs in the very first trial also without previous practice, which might provide a behavioural
Rosenkilde, Mads; Petersen, Martin Bæk; Gram, Anne Sofie
represents a promising alternative to increase physical activity, but it has yet to be established whether active commuting conveys health benefits on par with leisure time physical activity (LTPA). A 6-month randomized controlled trial was designed to investigate the effects of increased physical activity......Regular physical activity is efficacious for improving metabolic health in overweight and obese individuals, yet, many adults lead sedentary lives. Most exercise interventions have targeted leisure time, but physical activity also takes place in other domains of everyday life. Active commuting...... in transport (bicycling) or leisure time domains (moderate or vigorous intensity endurance exercise). We included 188 overweight and class 1 obese sedentary women and men (20-45years) of which 130 were randomized to either sedentary controls (n=18), active commuting (n=35) or moderate (n=39) or vigorous (n=38...
Terband, H.; Maassen, B.; Guenther, F.H.; Brumberg, J.
Background/Purpose Differentiating the symptom complex due to phonological-level disorders, speech delay and pediatric motor speech disorders is a controversial issue in the field of pediatric speech and language pathology. The present study investigated the developmental interaction between neurological deficits in auditory and motor processes using computational modeling with the DIVA model. Method In a series of computer simulations, we investigated the effect of a motor processing deficit alone (MPD), and the effect of a motor processing deficit in combination with an auditory processing deficit (MPD+APD) on the trajectory and endpoint of speech motor development in the DIVA model. Results Simulation results showed that a motor programming deficit predominantly leads to deterioration on the phonological level (phonemic mappings) when auditory self-monitoring is intact, and on the systemic level (systemic mapping) if auditory self-monitoring is impaired. Conclusions These findings suggest a close relation between quality of auditory self-monitoring and the involvement of phonological vs. motor processes in children with pediatric motor speech disorders. It is suggested that MPD+APD might be involved in typically apraxic speech output disorders and MPD in pediatric motor speech disorders that also have a phonological component. Possibilities to verify these hypotheses using empirical data collected from human subjects are discussed. PMID:24491630
Firdaus Fabrice Hannanu
In subacute stroke, fMRI brain activity related to passive movement measured in a sensorimotor network defined by activity during voluntary movement predicted motor recovery better than baseline motor-FMS alone. Furthermore, fMRI sensorimotor network activity measures considered alone allowed excellent clinical recovery prediction and may provide reliable biomarkers for assessing new therapies in clinical trial contexts. Our findings suggest that neural reorganization related to motor recovery from moderate to severe stroke results from balanced changes in ipsilesional MI (BA4a and a set of phylogenetically more archaic sensorimotor regions in the ventral sensorimotor trend, in which OP1 and OP4 processes may complement the ipsilesional dorsal motor cortex in achieving compensatory sensorimotor recovery.
Terband, H; Maassen, B; Guenther, F H; Brumberg, J
Differentiating the symptom complex due to phonological-level disorders, speech delay and pediatric motor speech disorders is a controversial issue in the field of pediatric speech and language pathology. The present study investigated the developmental interaction between neurological deficits in auditory and motor processes using computational modeling with the DIVA model. In a series of computer simulations, we investigated the effect of a motor processing deficit alone (MPD), and the effect of a motor processing deficit in combination with an auditory processing deficit (MPD+APD) on the trajectory and endpoint of speech motor development in the DIVA model. Simulation results showed that a motor programming deficit predominantly leads to deterioration on the phonological level (phonemic mappings) when auditory self-monitoring is intact, and on the systemic level (systemic mapping) if auditory self-monitoring is impaired. These findings suggest a close relation between quality of auditory self-monitoring and the involvement of phonological vs. motor processes in children with pediatric motor speech disorders. It is suggested that MPD+APD might be involved in typically apraxic speech output disorders and MPD in pediatric motor speech disorders that also have a phonological component. Possibilities to verify these hypotheses using empirical data collected from human subjects are discussed. The reader will be able to: (1) identify the difficulties in studying disordered speech motor development; (2) describe the differences in speech motor characteristics between SSD and subtype CAS; (3) describe the different types of learning that occur in the sensory-motor system during babbling and early speech acquisition; (4) identify the neural control subsystems involved in speech production; (5) describe the potential role of auditory self-monitoring in developmental speech disorders. Copyright © 2014 Elsevier Inc. All rights reserved.
Wu, Tao; Hallett, Mark; Chan, Piu
Bradykinesia is the most important feature contributing to motor difficulties in Parkinson’s disease (PD). However, the pathophysiology underlying bradykinesia is not fully understood. One important aspect is that PD patients have difficulty in performing learned motor skills automatically, but this problem has been generally overlooked. Here we review motor automaticity associated motor deficits in PD, such as reduced arm swing, decreased stride length, freezing of gait, micrographia and reduced facial expression. Recent neuroimaging studies have revealed some neural mechanisms underlying impaired motor automaticity in PD, including less efficient neural coding of movement, failure to shift automated motor skills to the sensorimotor striatum, instability of the automatic mode within the striatum, and use of attentional control and/or compensatory efforts to execute movements usually performed automatically in healthy people. PD patients lose previously acquired automatic skills due to their impaired sensorimotor striatum, and have difficulty in acquiring new automatic skills or restoring lost motor skills. More investigations on the pathophysiology of motor automaticity, the effect of L-dopa or surgical treatments on automaticity, and the potential role of using measures of automaticity in early diagnosis of PD would be valuable. PMID:26102020
Duque, Julie; Petitjean, Charlotte; Swinnen, Stephan P.
Motor behaviors often require refraining from selecting options that may be part of the repertoire of natural response tendencies but that are in conflict with ongoing goals. The presence of sensory conflict has a behavioral cost but the latter can be attenuated in contexts where control processes are recruited because conflict is expected in advance, producing a behavioral gain compared to contexts where conflict occurs in a less predictable way. In the present study, we investigated the corticospinal correlates of these behavioral effects (both conflict-driven cost and context-related gain). To do so, we measured motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) of young and healthy older adults performing the Eriksen Flanker Task. Subjects performed button-presses according to a central arrow, flanked by irrelevant arrows pointing in the same (congruent trial) or opposite direction (incongruent trial). Conflict expectation was manipulated by changing the probability of congruent and incongruent trials in a given block. It was either high (mostly incongruent blocks, MIB, 80% incongruent trials) or low (mostly congruent blocks, MCB, 80% congruent). The MEP data indicate that the conflict-driven behavioral cost is associated with a strong increase in inappropriate motor activity regardless of the age of individuals, as revealed by larger MEPs in the non-responding muscle in incongruent than in congruent trials. However, this aberrant facilitation disappeared in both groups of subjects when conflict could be anticipated (i.e., in the MIBs) compared to when it occurred in a less predictably way (MCBs), probably allowing the behavioral gain observed in both the young and the older individuals. Hence, the ability to overcome and anticipate conflict was surprisingly preserved in the older adults. Nevertheless, some control processes are likely to evolve with age because the behavioral gain observed in
Full Text Available Background: Two previous studies, which investigated transcranial direct current stimulation (tDCS use in motor recovery after acute ischemic stroke, did not show tDCS to be effective in this regard. We speculated that additional left dorsolateral prefrontal cortex (DLPFC stimulation may enhance post stroke motor recovery. Methods: In the present randomized clinical trial, 20 acute ischemic stroke patients were recruited. Patients received real motor cortex (M1 stimulation in both arms of the trial. The two arms differed in terms of real vs. sham stimulation over the left DLPFC. Motor component of the Fugl-Meyer upper extremity assessment (FM and Action Research Arm Test (ARAT scores were used to assess primary outcomes, and non-linear mixed effects models were used for data analyses. Results: Primary outcome measures improved more and faster among the real stimulation group. During the first days of stimulations, sham group’s FM scores increased 1.2 scores per day, while real group’s scores increased 1.7 scores per day (P = 0.003. In the following days, FM improvement decelerated in both groups. Based on the derived models, a hypothetical stroke patient with baseline FM score of 15 improves to 32 in the sham stimulation group and to 41 in the real stimulation group within the first month after stroke. Models with ARAT scores yielded nearly similar results. Conclusion: The current study results showed that left DLPFC stimulation in conjunction with M1 stimulation resulted in better motor recovery than M1 stimulation alone.
Malhotra, Neha; Poolton, Jamie M; Wilson, Mark R; Fan, Joe K M; Masters, Rich S W
Identifying personality factors that account for individual differences in surgical training and performance has practical implications for surgical education. Movement-specific reinvestment is a potentially relevant personality factor that has a moderating effect on laparoscopic performance under time pressure. Movement-specific reinvestment has 2 dimensions, which represent an individual's propensity to consciously control movements (conscious motor processing) or to consciously monitor their 'style' of movement (movement self-consciousness). This study aimed at investigating the moderating effects of the 2 dimensions of movement-specific reinvestment in the learning and updating (cross-handed technique) of laparoscopic skills. Medical students completed the Movement-Specific Reinvestment Scale, a psychometric assessment tool that evaluates the conscious motor processing and movement self-consciousness dimensions of movement-specific reinvestment. They were then trained to a criterion level of proficiency on a fundamental laparoscopic skills task and were tested on a novel cross-handed technique. Completion times were recorded for early-learning, late-learning, and cross-handed trials. Propensity for movement self-consciousness but not conscious motor processing was a significant predictor of task completion times both early (p = 0.036) and late (p = 0.002) in learning, but completion times during the cross-handed trials were predicted by the propensity for conscious motor processing (p = 0.04) rather than movement self-consciousness (p = 0.21). Higher propensity for movement self-consciousness is associated with slower performance times on novel and well-practiced laparoscopic tasks. For complex surgical techniques, however, conscious motor processing plays a more influential role in performance than movement self-consciousness. The findings imply that these 2 dimensions of movement-specific reinvestment have a differential influence in the learning and updating
Transcranial Direct Current Stimulation Targeting Primary Motor Versus Dorsolateral Prefrontal Cortices: Proof-of-Concept Study Investigating Functional Connectivity of Thalamocortical Networks Specific to Sensory-Affective Information Processing.
Sankarasubramanian, Vishwanath; Cunningham, David A; Potter-Baker, Kelsey A; Beall, Erik B; Roelle, Sarah M; Varnerin, Nicole M; Machado, Andre G; Jones, Stephen E; Lowe, Mark J; Plow, Ela B
The pain matrix is comprised of an extensive network of brain structures involved in sensory and/or affective information processing. The thalamus is a key structure constituting the pain matrix. The thalamus serves as a relay center receiving information from multiple ascending pathways and relating information to and from multiple cortical areas. However, it is unknown how thalamocortical networks specific to sensory-affective information processing are functionally integrated. Here, in a proof-of-concept study in healthy humans, we aimed to understand this connectivity using transcranial direct current stimulation (tDCS) targeting primary motor (M1) or dorsolateral prefrontal cortices (DLPFC). We compared changes in functional connectivity (FC) with DLPFC tDCS to changes in FC with M1 tDCS. FC changes were also compared to further investigate its relation with individual's baseline experience of pain. We hypothesized that resting-state FC would change based on tDCS location and would represent known thalamocortical networks. Ten right-handed individuals received a single application of anodal tDCS (1 mA, 20 min) to right M1 and DLPFC in a single-blind, sham-controlled crossover study. FC changes were studied between ventroposterolateral (VPL), the sensory nucleus of thalamus, and cortical areas involved in sensory information processing and between medial dorsal (MD), the affective nucleus, and cortical areas involved in affective information processing. Individual's perception of pain at baseline was assessed using cutaneous heat pain stimuli. We found that anodal M1 tDCS and anodal DLPFC tDCS both increased FC between VPL and sensorimotor cortices, although FC effects were greater with M1 tDCS. Similarly, anodal M1 tDCS and anodal DLPFC tDCS both increased FC between MD and motor cortices, but only DLPFC tDCS modulated FC between MD and affective cortices, like DLPFC. Our findings suggest that M1 stimulation primarily modulates FC of sensory networks
Hotton, Matthew; Derakshan, Nazanin; Fox, Elaine
The process of worry has been associated with reductions in working memory capacity and availability of resources necessary for efficient attentional control. This, in turn, can lead to escalating worry. Recent investigations into working memory training have shown improvements in attentional control and cognitive performance in high trait-anxious individuals and individuals with sub-clinical depression. The current randomised controlled trial investigated the effects of 15 days of adaptive n-back working memory training, or an active control task, on working memory capacity, attentional control and worry in a sample of high worriers. Pre-training, post-training and one-month follow-up measures of working memory capacity were assessed using a Change Detection task, while a Flanker task was used to assess attentional control. A breathing focus task was used as a behavioural measure of worry in addition to a number of self-report assessments of worry and anxiety. Overall there was no difference between the active training and the active control condition with both groups demonstrating similar improvements in working memory capacity and worry, post-training and at follow-up. However, training-related improvements on the n-back task were associated with gains in working memory capacity and reductions in worry symptoms in the active training condition. These results highlight the need for further research investigating the role of individual differences in working memory training. Copyright © 2017. Published by Elsevier Ltd.
Shibata, E; Kaneko, F
The perceptual integration of afferent inputs from two antagonistic muscles, or the perceptual integration of afferent input and motor imagery are related to the generation of a kinesthetic sensation. However, it has not been clarified how, or indeed whether, a kinesthetic perception would be generated by motor imagery if afferent inputs from two antagonistic muscles were simultaneously induced by tendon vibration. The purpose of this study was to investigate how a kinesthetic perception would be generated by motor imagery during co-vibration of the two antagonistic muscles at the same frequency. Healthy subjects participated in this experiment. Illusory movement was evoked by tendon vibration. Next, the subjects imaged wrist flexion movement simultaneously with tendon vibration. Wrist flexor and extensor muscles were vibrated according to 4 patterns such that the difference between the two vibration frequencies was zero. After each trial, the perceived movement sensations were quantified on the basis of the velocity and direction of the ipsilateral hand-tracking movements. When the difference in frequency applied to the wrist flexor and the extensor was 0Hz, no subjects perceived movements without motor imagery. However, during motor imagery, the flexion velocity of the perceived movement was higher than the flexion velocity without motor imagery. This study clarified that the afferent inputs from the muscle spindle interact with motor imagery, to evoke a kinesthetic perception, even when the difference in frequency applied to the wrist flexor and extensor was 0Hz. Furthermore, the kinesthetic perception resulting from integrations of vibration and motor imagery increased depending on the vibration frequency to the two antagonistic muscles. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Lukina, Elena; Watman, Nora; Dragosky, Marta; Pastores, Gregory M; Arreguin, Elsa Avila; Rosenbaum, Hanna; Zimran, Ari; Angell, Jennifer; Ross, Leorah; Puga, Ana Cristina; Peterschmitt, Judith M
Eliglustat is an investigational, oral substrate reduction therapy for Gaucher disease type 1 (GD1). Nineteen treatment-naïve patients have now completed 4years of an open-label study (NCT00358150). Mean hemoglobin level and platelet count increased by 2.3±1.5g/dL (baseline: 11.3±1.5g/dL) and 95% (baseline: 68,700±21,200/mm(3)), respectively. Mean spleen and liver volumes (multiples of normal, MN) decreased by 63% (baseline: 17.3±9.5 MN) and 28% (baseline: 1.7±0.4 MN), respectively. Median chitotriosidase and CCL-18 each decreased by 82%; plasma glucosylceramide and GM3 normalized. Mean bone mineral density T-score for the lumbar spine increased by 0.8 (60%) (baseline: -1.6±1.1). Femur dark marrow, a reflection of Gaucher cell infiltration into bone marrow, was reduced or stable in 17/18 patients. There were no bone crises. Most adverse events were mild and unrelated to treatment. These results extend the safety and efficacy of eliglustat reported at 1 and 2 years to 4 years. Copyright © 2014. Published by Elsevier Inc.
Rozental, Alexander; Shafran, Roz; Wade, Tracey; Egan, Sarah; Nordgren, Lise Bergman; Carlbring, Per; Landström, Andreas; Roos, Stina; Skoglund, Malin; Thelander, Elisabet; Trosell, Linnéa; Örtenholm, Alexander; Andersson, Gerhard
Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.
Alleva, Jessica M; Diedrichs, Phillippa C; Halliwell, Emma; Martijn, Carolien; Stuijfzand, Bobby G; Treneman-Evans, Georgia; Rumsey, Nichola
Focusing on body functionality is a promising technique for improving women's body image. This study replicates prior research in a large novel sample, tests longer-term follow-up effects, and investigates underlying mechanisms of these effects (body complexity and body-self integration). British women (N = 261) aged 18-30 who wanted to improve their body image were randomised to Expand Your Horizon (three online body functionality writing exercises) or an active control. Trait body image was assessed at Pretest, Posttest, 1-week, and 1-month Follow-Up. To explore whether changes in body complexity and body-self integration 'buffer' the impact of negative body-related experiences, participants also completed beauty-ideal media exposure. Relative to the control, intervention participants experienced improved appearance satisfaction, functionality satisfaction, body appreciation, and body complexity at Posttest, and at both Follow-Ups. Neither body complexity nor body-self integration mediated intervention effects. Media exposure decreased state body satisfaction among intervention and control participants, but neither body complexity nor body-self integration moderated these effects. The findings underscore the value of focusing on body functionality for improving body image and show that effects persist one month post-intervention. Copyright © 2018 Elsevier Ltd. All rights reserved.
Cho, Hohyun; Ahn, Minkyu; Ahn, Sangtae; Kwon, Moonyoung; Jun, Sung Chan
Most investigators of brain-computer interface (BCI) research believe that BCI can be achieved through induced neuronal activity from the cortex, but not by evoked neuronal activity. Motor imagery (MI)-based BCI is one of the standard concepts of BCI, in that the user can generate induced activity by imagining motor movements. However, variations in performance over sessions and subjects are too severe to overcome easily; therefore, a basic understanding and investigation of BCI performance variation is necessary to find critical evidence of performance variation. Here we present not only EEG datasets for MI BCI from 52 subjects, but also the results of a psychological and physiological questionnaire, EMG datasets, the locations of 3D EEG electrodes, and EEGs for non-task-related states. We validated our EEG datasets by using the percentage of bad trials, event-related desynchronization/synchronization (ERD/ERS) analysis, and classification analysis. After conventional rejection of bad trials, we showed contralateral ERD and ipsilateral ERS in the somatosensory area, which are well-known patterns of MI. Finally, we showed that 73.08% of datasets (38 subjects) included reasonably discriminative information. Our EEG datasets included the information necessary to determine statistical significance; they consisted of well-discriminated datasets (38 subjects) and less-discriminative datasets. These may provide researchers with opportunities to investigate human factors related to MI BCI performance variation, and may also achieve subject-to-subject transfer by using metadata, including a questionnaire, EEG coordinates, and EEGs for non-task-related states. © The Authors 2017. Published by Oxford University Press.
Full Text Available Chronic pain is a complex physiological and psychological phenomenon. Implicit learning mechanisms contribute to the development of chronic pain and to persistent changes in the central nervous system. We hypothesized that these central abnormalities can be remedied with Cognitive Behavioral Therapy (CBT. Specifically, since regions of the anterior Default Mode Network (DMN are centrally involved in emotional regulation via connections with limbic regions, such as the amygdala, remediation of maladaptive behavioral and cognitive patterns as a result of CBT for chronic pain would manifest itself as a change in the intrinsic functional connectivity (iFC between these prefrontal and limbic regions. Resting-state functional neuroimaging was performed in patients with chronic pain before and after 11-week CBT (n = 19, as well as a matched (ages 19–59, both sexes active control group of patients who received educational materials (n = 19. Participants were randomized prior to the intervention. To investigate the differential impact of treatment on intrinsic functional connectivity (iFC, we compared pre–post differences in iFC between groups. In addition, we performed exploratory whole brain analyses of changes in fractional amplitude of low frequency fluctuations (fALFF. The course of CBT led to significant improvements in clinical measures of pain and self-efficacy for coping with chronic pain. Significant group differences in pre–post changes in both iFC and fALFF were correlated with clinical outcomes. Compared to control patients, iFC between the anterior DMN and the amygdala/periaqueductal gray decreased following CBT, whereas iFC between the basal ganglia network and the right secondary somatosensory cortex increased following CBT. CBT patients also had increased post-therapy fALFF in the bilateral posterior cingulate and the cerebellum. By delineating neuroplasticity associated with CBT-related improvements, these results add to
Arnold, J.R.; Kelly, J.F.; Delzingaro, M.J.
Motor Operated Valve (MOV) squirrel cage AC motor rotors are susceptible to degradation under certain conditions. Premature failure can result due to high humidity/temperature environments, high running load conditions, extended periods at locked rotor conditions (i.e. > 15 seconds) or exceeding the motor's duty cycle by frequent starts or multiple valve stroking. Exposure to high heat and moisture due to packing leaks, pressure seal ring leakage or other causes can significantly accelerate the degradation. ComEd and Liberty Technologies have worked together to provide and validate a non-intrusive method using motor power diagnostics to evaluate MOV rotor condition and predict failure. These techniques have provided a quick, low radiation dose method to evaluate inaccessible motors, identify degradation and allow scheduled replacement of motors prior to catastrophic failures
Roig, Marc; Skriver, Kasper Christen; Lundbye-Jensen, Jesper
Regular physical activity has a positive impact on cognition and brain function. Here we investigated if a single bout of exercise can improve motor memory and motor skill learning. We also explored if the timing of the exercise bout in relation to the timing of practice has any impact on the acq...... exercise on long-term motor memory....... that exercised before practice, the subjects that exercised after practice showed a better retention of the motor skill 7 days after practice. These findings indicate that one bout of intense exercise performed immediately before or after practicing a motor task is sufficient to improve the long-term retention......Regular physical activity has a positive impact on cognition and brain function. Here we investigated if a single bout of exercise can improve motor memory and motor skill learning. We also explored if the timing of the exercise bout in relation to the timing of practice has any impact...
Brown, Gerald V.
Technology for pollution-free "electric flight" is being evaluated in a number of NASA Glenn Research Center programs. One approach is to drive propulsive fans or propellers with electric motors powered by fuel cells running on hydrogen. For large transport aircraft, conventional electric motors are far too heavy to be feasible. However, since hydrogen fuel would almost surely be carried as liquid, a propulsive electric motor could be cooled to near liquid hydrogen temperature (-423 F) by using the fuel for cooling before it goes to the fuel cells. Motor windings could be either superconducting or high purity normal copper or aluminum. The electrical resistance of pure metals can drop to 1/100th or less of their room-temperature resistance at liquid hydrogen temperature. In either case, super or normal, much higher current density is possible in motor windings. This leads to more compact motors that are projected to produce 20 hp/lb or more in large sizes, in comparison to on the order of 2 hp/lb for large conventional motors. High power density is the major goal. To support cryogenic motor development, we have designed and built in-house a small motor (7-in. outside diameter) for operation in liquid nitrogen.
Levin, Michael Benjamin
A rotor of an electric motor for a motor vehicle is aligned to an axis of rotation for a crankshaft of an internal combustion engine having an internal combustion engine and an electric motor. A locator is provided on the crankshaft, a piloting tool is located radially by the first locator to the crankshaft. A stator of the electric motor is aligned to a second locator provided on the piloting tool. The stator is secured to the engine block. The rotor is aligned to the crankshaft and secured thereto.
Full Text Available Brain-computer interfacing (BCI has recently been applied as a rehabilitation approach for patients with motor disorders, such as stroke. In these closed-loop applications, a brain switch detects the motor intention from brain signals, e.g. scalp EEG, and triggers a neuroprosthetic device, either to deliver sensory feedback or to mimic real movements, thus re-establishing the compromised sensory-motor control loop and promoting neural plasticity. In this context, single trial detection of motor intention with short latency is a prerequisite. The performance of the event detection from EEG recordings is mainly determined by three factors: the type of motor imagery (e.g., repetitive, ballistic, the frequency band (or signal modality used for discrimination (e.g., alpha, beta, gamma, and MRCP, i.e. movement-related cortical potential, and the processing technique (e.g., time-series analysis, sub-band power estimation. In this study, we investigated single trial EEG traces during movement imagination on healthy individuals, and provided a comprehensive analysis of the performance of a short-latency brain switch when varying these three factors. The morphological investigation showed a cross-subject consistency of a prolonged negative phase in MRCP, and a delayed beta rebound in sensory-motor rhythms during repetitive tasks. The detection performance had the greatest accuracy when using ballistic MRCP with time-series analysis. In this case, the true positive rate was ~70% for a detection latency of ~200 ms. The results presented here are of practical relevance for designing BCI systems for motor function rehabilitation.
Nieschlag, Eberhard; Bouloux, Pierre-Marc G; Stegmann, Barbara J; Shankar, R Ravi; Guan, Yanfen; Tzontcheva, Anjela; McCrary Sisk, Christine; Behre, Hermann M
Hypogonadotropic hypogonadism (HH) in men results in insufficient testicular function and deficiencies in testosterone and spermatogenesis. Combinations of human chorionic gonadotropin (hCG) and recombinant follicle-stimulating hormone (recFSH) have been successful in the treatment of HH. Corifollitropin alfa is a long-acting FSH-analog with demonstrated action in women seeking infertility care. The aim of this study was to investigate the efficacy and safety of corifollitropin alfa combined with hCG to increase testicular volume and induce spermatogenesis in men with HH. This was a Phase III, multi-center, open-label, single-arm trial of corifollitropin alfa in azoospermic men aged 18 to 50 years with HH. After 16 weeks of pretreatment of 23 subjects with hCG alone, 18 subjects with normalized testosterone (T) levels who remained azoospermic entered the 52-week combined treatment phase with hCG twice-weekly and 150 μg corifollitropin alfa every other week. The increase in testicular volume (primary efficacy endpoint) and induction of spermatogenesis resulting in a sperm count ≥1 × 10 6 /mL (key secondary efficacy endpoint) during 52 weeks of combined treatment were assessed. Safety was evaluated by the presence of anti-corifollitropin alfa antibodies and the occurrence of adverse events (AEs). Mean (±SD) testicular volume increased from 8.6 (±6.09) mL to 17.8 (±8.93) mL (geometric mean fold increase, 2.30 [95% CI: 2.03, 2.62]); 14 (77.8%) subjects reached a sperm count ≥1 × 10 6 /mL. No subject developed confirmed anti-corifollitropin alfa antibodies during the trial. Treatment was generally well tolerated. Corifollitropin alfa 150 μg administrated every other week combined with twice-weekly hCG for 52 weeks increased testicular volume significantly, and induced spermatogenesis in >75% of men with HH who had remained azoospermic after hCG treatment alone. ClinicalTrials.gov: NCT01709331 .
Full Text Available ... Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, or ... humans. What Are Clinical Trials? Clinical trials are research studies that explore whether a medical strategy, treatment, or ...
David F. Putrino
Full Text Available Neurons in the Primary Motor Cortex (MI are known to form functional ensembles with one another in order to produce voluntary movement. Neural network changes during skill learning are thought to be involved in improved fluency and accuracy of motor tasks. Unforced errors during skilled tasks provide an avenue to study network connections related to motor learning. In order to investigate network activity in MI, microwires were implanted in the MI of cats trained to perform a reaching task. Spike trains from eight groups of simultaneously recorded cells (95 neurons in total were acquired. A point process generalized linear model (GLM was developed to assess simultaneously recorded cells for functional connectivity during reaching attempts where unforced errors or no errors were made. Whilst the same groups of neurons were often functionally connected regardless of trial success, functional connectivity between neurons was significantly different at fine time scales when the outcome of task performance changed. Furthermore, connections were shown to be significantly more robust across multiple latencies during successful trials of task performance. The results of this study indicate that reach-related neurons in MI form dynamic spiking dependencies whose temporal features are highly sensitive to unforced movement errors.
Peters, Jan; Schaal, Stefan; Schölkopf, Bernhard
Autonomous robots that can adapt to novel situations has been a long standing vision of robotics, artificial intelligence, and cognitive sciences. Early approaches to this goal during the heydays of artificial intelligence research in the late 1980s, however, made it clear that an approach purely based on reasoning or human insights would not be able to model all the perceptuomotor tasks that a robot should fulfill. Instead, new hope was put in the growing wake of machine learning that promised fully adaptive control algorithms which learn both by observation and trial-and-error. However, to date, learning techniques have yet to fulfill this promise as only few methods manage to scale into the high-dimensional domains of manipulator robotics, or even the new upcoming trend of humanoid robotics, and usually scaling was only achieved in precisely pre-structured domains. In this paper, we investigate the ingredients for a general approach to motor skill learning in order to get one step closer towards human-like performance. For doing so, we study two major components for such an approach, i.e., firstly, a theoretically well-founded general approach to representing the required control structures for task representation and execution and, secondly, appropriate learning algorithms which can be applied in this setting.
Muhammad Khan Burdi
Full Text Available A detailed investigation of the universal motor is developed and used for various dynamic steady state and transient operating conditions of loads. In the investigation, output torque, motor speed, input current, input/output power and efficiency are computed, compared and analyzed for different loads. While this paper discusses the steady-state behavior of the universal motor, another companion paper, ?Transient dynamic behavior of universal motor?, will discuss its transient behavior in detail. A non-linear generalized electric machine model of the motor is considered for the analysis. This study was essential to investigate effect of output load on input current, power, speed and efficiency of the motor during operations. Previously such investigation is not known
Nélio Silva de Souza
Full Text Available The motor imagery (MI has been proposed as a treatment in the complex regional pain syndrome type 1 (CRPS-1, since it seems to promote a brain reorganization effect on sensory- motor areas of pain perception. The aim of this paper is to investigate, through an integrative critical review, the influence of MI on the CRPS-1, correlating their evidence to clinical practice. Research in PEDro, Medline, Bireme and Google Scholar databases was conducted. Nine randomized controlled trials (level 2, 1 non-controlled clinical study (level 3, 1 case study (level 4, 1 systematic review (level 1, 2 review articles and 1 comment (level 5 were found. We can conclude that MI has shown effect in reducing pain and functionality that remains after 6 months of treatment. However, the difference between the MI strategies for CRPS-1 is unknown as well as the intensity of mental stress influences the painful response or effect of MI or other peripheral neuropathies.
Nicholas, Christian L; Bei, Bei; Worsnop, Christopher; Malhotra, Atul; Jordan, Amy S; Saboisky, Julian P; Chan, Julia K M; Duckworth, Ella; White, David P; Trinder, John
single motor unit recordings of the genioglossus (GG) muscle indicate that GG motor units have a variety of discharge patterns, including units that have higher discharge rates during inspiration (inspiratory phasic and inspiratory tonic), or expiration (expiratory phasic and expiratory tonic), or do not modify their rate with respiration (tonic). Previous studies have shown that an increase in GG muscle activity is a consequence of increased activity in inspiratory units. However, there are differences between studies as to whether this increase is primarily due to recruitment of new motor units (motor unit recruitment) or to increased discharge rate of already active units (rate coding). Sleep-wake state studies in humans have suggested the former, while hypercapnia experiments in rats have suggested the latter. In this study, we investigated the effect of hypercapnia on GG motor unit activity in humans during wakefulness. sleep research laboratory. sixteen healthy men. each participant was administered at least 6 trials with P(et)CO(2) being elevated 8.4 (SD = 1.96) mm Hg over 2 min following a 30-s baseline. Subjects were instrumented for GG EMG and respiratory measurements with 4 fine wire electrodes inserted subcutaneously into the muscle. One hundred forty-one motor units were identified during the baseline: 47% were inspiratory modulated, 29% expiratory modulated, and 24% showed no respiratory related modulation. Sixty-two new units were recruited during hypercapnia. The distribution of recruited units was significantly different from the baseline distribution, with 84% being inspiratory modulated (P units active during baseline, nor new units recruited during hypercapnia, increased their discharge rate as P(et)CO(2) increased (P > 0.05 for all comparisons). increased GG muscle activity in humans occurs because of recruitment of previously inactive inspiratory modulated units.
Thürer, Benjamin; Stockinger, Christian; Focke, Anne; Putze, Felix; Schultz, Tanja; Stein, Thorsten
The retrieval of motor memory requires a previous memory encoding and subsequent consolidation of the specific motor memory. Previous work showed that motor memory seems to rely on different memory components (e.g., implicit, explicit). However, it is still unknown if explicit components contribute to the retrieval of motor memories formed by dynamic adaptation tasks and which neural correlates are linked to memory retrieval. We investigated the lower and higher gamma bands of subjects' electroencephalography during encoding and retrieval of a dynamic adaptation task. A total of 24 subjects were randomly assigned to a treatment and control group. Both groups adapted to a force field A on day 1 and were re-exposed to the same force field A on day 3 of the experiment. On day 2, treatment group learned an interfering force field B whereas control group had a day rest. Kinematic analyses showed that control group improved their initial motor performance from day 1 to day 3 but treatment group did not. This behavioral result coincided with an increased higher gamma band power in the electrodes over prefrontal areas on the initial trials of day 3 for control but not treatment group. Intriguingly, this effect vanished with the subsequent re-adaptation on day 3. We suggest that improved re-test performance in a dynamic motor adaptation task is contributed by explicit memory and that gamma bands in the electrodes over the prefrontal cortex are linked to these explicit components. Furthermore, we suggest that the contribution of explicit memory vanishes with the subsequent re-adaptation while task automaticity increases. Copyright © 2015 Elsevier Inc. All rights reserved.
Ajimsha, M S; Majeed, Nisar A; Chinnavan, Elanchezhian; Thulasyammal, Ramiah Pillai
Relaxation training can be an important adjunct in reducing symptoms associated with Parkinson's disease (PD). Autogenic Training (AT) is a simple, easily administered and inexpensive technique for retraining the mind and the body to be able to relax. AT uses visual imagery and body awareness to promote a state of deep relaxation. To investigate whether AT when used as an adjunct to Physiotherapy (PT) improves motor performances in PD in comparison with a control group receiving PT alone. Randomized, controlled, single blinded trial. Movement Disorder Clinic and Department of Physiotherapy, Sree Chithira Thirunal Institute of Medical Sciences and Technology in Trivandrum, Kerala, India. Patients with PD of grade 2 or 3 of Hoehn & Yahr (H&Y) scale (N = 66). AT group or control group. The techniques were administered by Physiotherapists trained in AT and consisted of 40 sessions per patient over 8 weeks. Motor score subscale of Unified Parkinson's Disease Rating Scale (UPDRS) was used to measure the motor performances. The primary outcome measure was the difference in Motor score subscale of UPDRS scores between Week 1 (pretest score), Week 8 (posttest score), and follow-up at Week 12 after randomization. The simple main effects analysis showed that the AT group performed better than the control group in weeks 8 and 12 (P < .005). Patients in the AT and control groups reported a 51.78% and 35.24% improvement, respectively, in their motor performances in Week 8 compared with that in Week 1, which persisted, in the follow-up (Week 12) as 30.82% in the AT group and 21.42% in the control group. This study provides evidence that AT when used as an adjunct to PT is more effective than PT alone in improving motor performances in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.
Bunce, D; MacDonald, SWS; Hultsch, DF
Intraindividual variability (inconsistency) in reaction time (RT) latencies was investigated in a group of younger (M = 25.46 years) and older (M = 69.29 years) men. Both groups performed 300 trials in 2-, 4-, and 8-choice RT conditions where RTs for decision and motor components of the task were recorded separately. A dissociation was evident in that inconsistency was greater in older adults for decision RTs when task demands relating to the number of choices and fatigue arising from time-on...
Brown, Rachel M; Palmer, Caroline
In two experiments, we investigated how auditory-motor learning influences performers' memory for music. Skilled pianists learned novel melodies in four conditions: auditory only (listening), motor only (performing without sound), strongly coupled auditory-motor (normal performance), and weakly coupled auditory-motor (performing along with auditory recordings). Pianists' recognition of the learned melodies was better following auditory-only or auditory-motor (weakly coupled and strongly coupled) learning than following motor-only learning, and better following strongly coupled auditory-motor learning than following auditory-only learning. Auditory and motor imagery abilities modulated the learning effects: Pianists with high auditory imagery scores had better recognition following motor-only learning, suggesting that auditory imagery compensated for missing auditory feedback at the learning stage. Experiment 2 replicated the findings of Experiment 1 with melodies that contained greater variation in acoustic features. Melodies that were slower and less variable in tempo and intensity were remembered better following weakly coupled auditory-motor learning. These findings suggest that motor learning can aid performers' auditory recognition of music beyond auditory learning alone, and that motor learning is influenced by individual abilities in mental imagery and by variation in acoustic features.
Full Text Available ABSTRACT Introduction: Fine motor skills are important for children not only in the activities of daily living, but also for learning activities. In the present study, the effects of supervised physical training were investigated in normal children. Objective: To evaluate the effects of supervised training by combining full-body exercise and the eye-hand coordination activities to improve fine motor skills in a group of five-year-old normal children. Methods: Fifty-two children were selected and randomized in exercise and control groups. The exercise group participated in three 30-minute training sessions per week for 24 weeks. Results: The fine motor skills and hand grip strength of the exercise group were significantly increased, while there was no significant change in the control group during the experimental period. Conclusion: The results indicate that the current exercise training program is effective and can be applied to 5-year-old normal children to improve their fine motor skills. In addition, this program has simple physical activities that are appropriate to the physical and mental level of child development. The 30-minute training session would be easily implemented in the kindergarten program. Level of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.
Nishiyori, Ryota; Bisconti, Silvia; Ulrich, Beverly
Assessments of brain activity during motor task performance have been limited to fine motor movements due to technological constraints presented by traditional neuroimaging techniques, such as functional magnetic resonance imaging. Functional near-infrared spectroscopy (fNIRS) offers a promising method by which to overcome these constraints and investigate motor performance of functional motor tasks. The current study used fNIRS to quantify hemodynamic responses within the primary motor cortex in twelve healthy adults as they performed unimanual right, unimanual left, and bimanual reaching, and stepping in place. Results revealed that during both unimanual reaching tasks, the contralateral hemisphere showed significant activation in channels located approximately 3 cm medial to the C3 (for right-hand reach) and C4 (for left-hand reach) landmarks. Bimanual reaching and stepping showed activation in similar channels, which were located bilaterally across the primary motor cortex. The medial channels, surrounding Cz, showed significantly higher activations during stepping when compared to bimanual reaching. Our results extend the viability of fNIRS to study motor function and build a foundation for future investigation of motor development in infants during nascent functional behaviors and monitor how they may change with age or practice.
Meyer, Denny; Blamey, Peter J; Pipingas, Andrew; Bhar, Sunil
Background Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. Objective This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. Methods This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive
Watanabe, E.; Kikukawa, K.; Satoh, Y.; Torii, S.
We have developed and produced a superconducting claw-pole motor for a trial purpose as a method to make the best use of the characteristic of superconductivity without collector rings or rotating superconducting coils that need to be cryocooled, and made some examinations. The unique feature in this motor is to have the mechanism that supports the reaction magnetic force generated in the axial direction
Babl, Anna; Grosse Holtforth, Martin; Heer, Sara; Lin, Mu; Stähli, Annabarbara; Holstein, Dominique; Belz, Martina; Egenolf, Yvonne; Frischknecht, Eveline; Ramseyer, Fabian; Regli, Daniel; Schmied, Emma; Flückiger, Christoph; Brodbeck, Jeannette; Berger, Thomas; Caspar, Franz
This currently recruiting randomized controlled trial investigates the effects of integrating components of Emotion-Focused Therapy (EFT) into Psychological Therapy (PT), an integrative form of cognitive-behavioral therapy in a manner that is directly mirroring common integrative practice in the sense of assimilative integration. Aims of the study are to understand how both, an existing therapy approach as well as the elements to be integrated, are affected by the integration and to clarify the role of emotional processing as a mediator of therapy outcome. A total of 130 adults with a diagnosed unipolar depressive, anxiety or adjustment disorder (seeking treatment at a psychotherapy outpatient clinic) are randomized to either treatment as usual (PT) with integrated emotion-focused components (TAU + EFT) or PT (TAU). Primary outcome variables are psychopathology and symptom severity at the end of therapy and at follow up; secondary outcome variables are interpersonal problems, psychological wellbeing, quality of life, attainment of individual therapy goals, and emotional competency. Furthermore, process variables such as the quality of the therapeutic relationship are studied as well as aptitude-treatment interactions. Variables are assessed at baseline, after 8 and 16 sessions, at the end of therapy, after 25 ± 3 sessions, and at 6, 12 and 36 month follow-up. Underlying mechanisms of change are investigated. Statistical analyses will be conducted using the appropriate multilevel approaches, mainly two-level regression and growth analysis. The results of this study will indicate whether the integration of emotion-focused elements into treatment as usual increases the effectiveness of Psychological Therapy. If advantages are found, which may be limited to particular variables or subgroups of patients, recommendations for a systematic integration, and caveats if also disadvantages are detected, can be formulated. On a more abstract level, a cognitive
Armah, Kabenla; Jouffroy, Jerome; Duggen, Lars
This paper gives a study into the development of a generalized model for a three-phase induction motor that offers flexibility of simulating balanced and unbalanced parameter scenarios. By analyzing the interaction of forces within the motor, we achieve our main objective of deriving the system d...
Kassem, Salma; van Leeuwen, Thomas; Lubbe, Anouk S.; Wilson, Miriam R.; Feringa, Ben L.; Leigh, David A.
Motor proteins are nature's solution for directing movement at the molecular level. The field of artificial molecular motors takes inspiration from these tiny but powerful machines. Although directional motion on the nanoscale performed by synthetic molecular machines is a relatively new
Differential activation of brain regions involved with error-feedback and imitation based motor simulation when observing self and an expert's actions in pilots and non-pilots on a complex glider landing task.
Callan, Daniel E; Terzibas, Cengiz; Cassel, Daniel B; Callan, Akiko; Kawato, Mitsuo; Sato, Masa-Aki
In this fMRI study we investigate neural processes related to the action observation network using a complex perceptual-motor task in pilots and non-pilots. The task involved landing a glider (using aileron, elevator, rudder, and dive brake) as close to a target as possible, passively observing a replay of one's own previous trial, passively observing a replay of an expert's trial, and a baseline do nothing condition. The objective of this study is to investigate two types of motor simulation processes used during observation of action: imitation based motor simulation and error-feedback based motor simulation. It has been proposed that the computational neurocircuitry of the cortex is well suited for unsupervised imitation based learning, whereas, the cerebellum is well suited for error-feedback based learning. Consistent with predictions, pilots (to a greater extent than non-pilots) showed significant differential activity when observing an expert landing the glider in brain regions involved with imitation based motor simulation (including premotor cortex PMC, inferior frontal gyrus IFG, anterior insula, parietal cortex, superior temporal gyrus, and middle temporal MT area) than when observing one's own previous trial which showed significant differential activity in the cerebellum (only for pilots) thought to be concerned with error-feedback based motor simulation. While there was some differential brain activity for pilots in regions involved with both Execution and Observation of the flying task (potential Mirror System sites including IFG, PMC, superior parietal lobule) the majority was adjacent to these areas (Observation Only Sites) (predominantly in PMC, IFG, and inferior parietal loblule). These regions showing greater activity for observation than for action may be involved with processes related to motor-based representational transforms that are not necessary when actually carrying out the task. Copyright © 2013 Elsevier Inc. All rights reserved.
Sobierajewicz, Jagna; Szarkiewicz, Sylwia; Prekoracka-Krawczyk, Anna; Jaskowski, Wojciech; van der Lubbe, Robert Henricus Johannes
Motor imagery is generally thought to share common mechanisms with motor execution. In the present study, we examined to what extent learning a fine motor skill by motor imagery may substitute physical practice. Learning effects were assessed by manipulating the proportion of motor execution and
Investigation of the Study Characteristics Affecting Clinical Trial Quality Using the Protocol Deviations Leading to Exclusion of Subjects From the Per Protocol Set Data in Studies for New Drug Application: A Retrospective Analysis.
Kohara, Norihito; Kaneko, Masayuki; Narukawa, Mamoru
The concept of the risk-based approach has been introduced as an effort to secure the quality of clinical trials. In the risk-based approach, identification and evaluation of risk in advance are considered important. For recently completed clinical trials, we investigated the relationship between study characteristics and protocol deviations leading to the exclusion of subjects from Per Protocol Set (PPS) efficacy analysis. New drugs approved in Japan in the fiscal year 2014-2015 were targeted in the research. The reasons for excluding subjects from the PPS efficacy analysis were described in 102 trials out of 492 in the summary of new drug application documents, which was publicly disclosed after the drug's regulatory approval. The author extracted these reasons along with the numbers of the cases and the study characteristics of each clinical trial. Then, the direct comparison, univariate regression analysis, and multivariate regression analysis was carried out based on the exclusion rate. The study characteristics for which exclusion of subjects from the PPS efficacy analysis were frequently observed was multiregional clinical trials in study region; inhalant and external use in administration route; Anti-infective for systemic use; Respiratory system, Dermatologicals, and Nervous system in therapeutic drug under the Anatomical Therapeutic Chemical Classification. In the multivariate regression analysis, the clinical trial variables of inhalant, Respiratory system, or Dermatologicals were selected as study characteristics leading to a higher exclusion rate. The characteristics of the clinical trial that is likely to cause protocol deviations that will affect efficacy analysis were suggested. These studies should be considered for specific attention and priority observation in the trial protocol or its monitoring plan and execution, such as a clear description of inclusion/exclusion criteria in the protocol, development of training materials to site staff, and
Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi
[Purpose] The purpose of this study was to investigate reliability of the test of gross motor development second edition (TGMD-2) for Kindergarten children in Myanmar. [Subjects and Methods] Fifty healthy Kindergarten children (23 males, 27 females) whose parents/guardians had given written consent were participated. The subjects were explained and demonstrated all 12 gross motor skills of TGMD-2 before the assessment. Each subject individually performed two trials for each gross motor skill and the performance was video recorded. Three raters separately watched the video recordings and rated for inter-rater reliability. The second assessment was done one month later with 25 out of 50 subjects for test-rest reliability. The video recordings of 12 subjects were randomly selected from the first 50 recordings for intra-rater reliability six weeks after the first assessment. The agreement on the locomotor and object control raw scores and the gross motor quotient (GMQ) were calculated. [Results] The findings of all the reliability coefficients for the locomotor and object control raw scores and the GMQ were interpreted as good and excellent reliability. [Conclusion] The results represented that TGMD-2 is a highly reliable and appropriate assessment tool for assessing gross motor skill development of Kindergarten children in Myanmar.
Kheradmand, Afshin; Nayebi, Alireza M; Jorjani, Masoumeh; Khalifeh, Solmaz; Haddadi, Rasool
Over production of reactive oxygen species (ROS) is postulated to be the main contributor in degeneration of nigrostriatal dopaminergic neurons. In this study we investigated the effects of WR1065, a free radical scavenger, on motor imbalance, oxidative stress parameters and inflammatory cytokines in CSF and brain of hemi-parkinsonian rats. Lesion of dopaminergic neurons was done by unilateral infusion of 6-hydroxydopamine into the central region of the substentia nigra pars compacta (SNc) to induce hemi-parkinsonism and motor imbalance in rats. WR1065 (20, 40 and 80μg/2μl/rat) was administered three days before 6-OHDA administration. After three weeks behavioral study was performed and then brain and CSF samples were collected to assess tumor necrosis factor (TNFα), interlukin (IL-1β), reduced glutathione (GSH), and malondialdehyde (MDA). WR1065 pre-treatment in rats before receiving 6-OHDA, improved significantly motor impairment and caused reduction of MDA and inflammatory cytokines TNFα and IL-1β levels, while GSH level significantly increased when compared with lesioned rats. Our study indicated that WR1065 could improve 6-OHDA-induced motor imbalance. Furthermore, it decreased lipid peroxidation and inflammatory cytokines and restored the level of GSH up to normal range. We suggest that WR1065 can be proposed as a potential neuroprotective agent in motor impairments of PD. However to prove this hypothesis more clinical trial studies should be done. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Volker R Zschorlich
Full Text Available The present study shows evidence for conscious motor intention in motor preparation prior to movement execution. We demonstrate that conscious motor intention of directed movement, combined with minimally supra-threshold transcranial magnetic stimulation (TMS of the motor cortex, determines the direction and the force of resulting movements, whilst a lack of intention results in weak and omni-directed muscle activation. We investigated changes of consciously intended goal directed movements by analyzing amplitudes of motor-evoked potentials of the forearm muscle, flexor carpi radialis (FCR, and extensor carpi radialis (ECR, induced by transcranial magnetic stimulation over the right motor cortex and their motor outcome. Right-handed subjects were asked to develop a strong intention to move their left wrist (flexion or extension, without any overt motor output at the wrist, prior to brain stimulation. Our analyses of hand acceleration and electromyography showed that during the strong motor intention of wrist flexion movement, it evoked motor potential responses that were significantly larger in the FCR muscle than in the ECR, whilst the opposite was true for an extension movement. The acceleration data on flexion/extension corresponded to this finding. Under no-intention conditions again, which served as a reference for motor evoked potentials, brain stimulation resulted in undirected and minimally simultaneous extension/flexion innervation and virtually no movement. These results indicate that conscious intentions govern motor function, which in turn shows that a neuronal activation representing an "intention network" in the human brain pre-exists, and that it functionally represents target specific motor circuits. Until today, it was unclear whether conscious motor intention exists prior to movement, or whether the brain constructs such an intention after movement initiation. Our study gives evidence that motor intentions become aware before
Zschorlich, Volker R.; Köhling, Rüdiger
The present study shows evidence for conscious motor intention in motor preparation prior to movement execution. We demonstrate that conscious motor intention of directed movement, combined with minimally supra-threshold transcranial magnetic stimulation (TMS) of the motor cortex, determines the direction and the force of resulting movements, whilst a lack of intention results in weak and omni-directed muscle activation. We investigated changes of consciously intended goal directed movements by analyzing amplitudes of motor-evoked potentials of the forearm muscle, flexor carpi radialis (FCR), and extensor carpi radialis (ECR), induced by transcranial magnetic stimulation over the right motor cortex and their motor outcome. Right-handed subjects were asked to develop a strong intention to move their left wrist (flexion or extension), without any overt motor output at the wrist, prior to brain stimulation. Our analyses of hand acceleration and electromyography showed that during the strong motor intention of wrist flexion movement, it evoked motor potential responses that were significantly larger in the FCR muscle than in the ECR, whilst the opposite was true for an extension movement. The acceleration data on flexion/extension corresponded to this finding. Under no-intention conditions again, which served as a reference for motor evoked potentials, brain stimulation resulted in undirected and minimally simultaneous extension/flexion innervation and virtually no movement. These results indicate that conscious intentions govern motor function, which in turn shows that a neuronal activation representing an “intention network” in the human brain pre-exists, and that it functionally represents target specific motor circuits. Until today, it was unclear whether conscious motor intention exists prior to movement, or whether the brain constructs such an intention after movement initiation. Our study gives evidence that motor intentions become aware before any motor
Gholam Reza Arab Markadeh
Full Text Available The lack of variable-speed drives for two (single induction motor is a reality. This article attempts mainly to investigate the reasons for this lack of variable – speed drives. This paper deals with literature survey of various existing converter topologies, which have been proposed for adjustable speed single phase induction motor drives. Various converter topologies have been compared in this paper. Among these converter topologies, the adjustable frequency PWM inverter is the best choice for single-phase induction motor drives. However, adjustable-frequency drives have not been widely used with single-phase Induction motors. The open-loop constant V/F control law cannot be used with the single-phase induction motor drives as it is used with three phase motors. The variation of the operating frequency at lower speed range with constant load torque causes variation in motor's slip. A constant V/F control is suitable only over the upper speed range.
Diana A Liao
Full Text Available Working memory (WM involves the ability to maintain and manipulate information held in mind. Neuroimaging studies have shown that secondary motor areas activate during WM for verbal content (e.g., words or letters, in the absence of primary motor area activation. This activation pattern may reflect an inner speech mechanism supporting online phonological rehearsal. Here, we examined the causal relationship between motor system activity and WM processing by using transcranial magnetic stimulation (TMS to manipulate motor system activity during WM rehearsal. We tested WM performance for verbalizable (words and pseudowords and non-verbalizable (Chinese characters visual information. We predicted that disruption of motor circuits would specifically affect WM processing of verbalizable information. We found that TMS targeting motor cortex slowed response times on verbal WM trials with high (pseudoword vs. low (real word phonological load. However, non-verbal WM trials were also significantly slowed with motor TMS. WM performance was unaffected by sham stimulation or TMS over visual cortex. Self-reported use of motor strategy predicted the degree of motor stimulation disruption on WM performance. These results provide evidence of the motor system’s contributions to verbal and non-verbal WM processing. We speculate that the motor system supports WM by creating motor traces consistent with the type of information being rehearsed during maintenance.
An ironless linear motor (5) comprising a magnet track (53) and a coil assembly (50) operating in cooperation with said magnet track (53) and having a plurality of concentrated multi-turn coils (31 a-f, 41 a-d, 51 a-k), wherein the end windings (31E) of the coils (31 a-f, 41 a-e) are substantially
Kassandra Nunes Amaro
Full Text Available The objective of this study was to investigate the motor performance of school chil-dren aged 6 to 10 years without learning difficulties (n=101, and to analyze the reliability of the Motor Development Scale (MDS (Rosa Neto, 2002. Descriptive statistics with calculation of the mean, standard deviation, and range was used for data analysis. The internal consistency of the MDS was assessed using Cronbach’s alpha coefficient, and the correlation between variables was determined by Pearson’s linear correlation, with p<0.05. The results showed (1 that motor development was within normal limits in 96% of the children, and (2 a high correlation betwe-en chronological age and general motor age, indicating good internal consistency. These data demonstrate the logic and structured design of the MDS, confirming its reliability.
Rezania, Kourosh; Roos, Raymond P
Spinal cord motor neuron diseases affect lower motor neurons in the ventral horn. This article focuses on the most common spinal cord motor neuron disease, amyotrophic lateral sclerosis, which also affects upper motor neurons. Also discussed are other motor neuron diseases that only affect the lower motor neurons. Despite the identification of several genes associated with familial amyotrophic lateral sclerosis, the pathogenesis of this complex disease remains elusive. Copyright © 2013 Elsevier Inc. All rights reserved.
Stephenson, Jennifer L.; Maluf, Katrina S.
The paired motor unit analysis provides in vivo estimates of the magnitude of persistent inward currents (PIC) in human motoneurons by quantifying changes in the firing rate (ΔF) of an earlier recruited (reference) motor unit at the time of recruitment and derecruitment of a later recruited (test) motor unit. This study assessed the variability of ΔF estimates, and quantified the dependence of ΔF on the discharge characteristics of the motor units selected for analysis. ΔF was calculated for 158 pairs of motor units recorded from nine healthy individuals during repeated submaximal contractions of the tibialis anterior muscle. The mean (SD) ΔF was 3.7 (2.5) pps (range −4.2 to 8.9 pps). The median absolute difference in ΔF for the same motor unit pair across trials was 1.8 pps, and the minimal detectable change in ΔF required to exceed measurement error was 4.8 pps. ΔF was positively related to the amount of discharge rate modulation in the reference motor unit (r2=0.335; Precruitment of the reference and test motor units (r2=0.229, Pmotor unit activity (r2=0.110, Precruitment threshold of the test motor unit (r2=0.237, Pmotor unit analysis. PMID:21459110
MacKinnon David P
Full Text Available Abstract Background Worksites are important locations for interventions to promote health. However, occupational programs with documented efficacy often are not used, and those being implemented have not been studied. The research in this report was funded through the American Reinvestment and Recovery Act Challenge Topic 'Pathways for Translational Research,' to define and prioritize determinants that enable and hinder translation of evidenced-based health interventions in well-defined settings. Methods The IGNITE (investigation to guide new insights for translational effectiveness trial is a prospective cohort study of a worksite wellness and injury reduction program from adoption to final outcomes among 12 fire departments. It will employ a mixed methods strategy to define a translational model. We will assess decision to adopt, installation, use, and outcomes (reach, individual outcomes, and economic effects using onsite measurements, surveys, focus groups, and key informant interviews. Quantitative data will be used to define the model and conduct mediation analysis of each translational phase. Qualitative data will expand on, challenge, and confirm survey findings and allow a more thorough understanding and convergent validity by overcoming biases in qualitative and quantitative methods used alone. Discussion Findings will inform worksite wellness in fire departments. The resultant prioritized influences and model of effective translation can be validated and manipulated in these and other settings to more efficiently move science to service.
Frederix, Ines; Vandenberk, Thijs; Janssen, Leen; Geurden, Anne; Vandervoort, Pieter; Dendale, Paul
Cardiac telerehabilitation includes, in its most comprehensive format, telemonitoring, telecoaching, social interaction, and eLearning. The specific role of eLearning, however, was seldom assessed. The aim of eEduHeart I is to investigate the medium-term effectiveness of the addition of a cardiac web-based eLearing platform to conventional cardiac care. In this prospective, multicenter randomized, controlled trial, 1,000 patients with coronary artery disease will be randomized 1:1 to an intervention group (receiving 1-month unrestricted access to the cardiac eLearning platform in addition to conventional cardiac care) or to conventional cardiac care alone. The primary endpoint is health-related quality of life, assessed by the HeartQoL questionnaire at the 1- and 3-month follow-ups. Secondary endpoints include pathology-specific knowledge and self-reported eLearning platform user experience. Data on the eLearning platform usage will be gathered through web logging during the study period. eEduHeart I will be one of the first studies to report on the added value of eLearning. If the intervention is proven effective, current cardiac telerehabilitation programs can be augmented by including eLearning, too. The platform can then be used as a model for other chronic diseases in which patient education plays a key role. © 2016 S. Karger AG, Basel.
Singh, Premranjan P; Abbott, J Dawn; Lombardero, Manuel S; Sutton-Tyrrell, Kim; Woodhead, Gail; Venkitachalam, Lakshmi; Tsapatsaris, Nicholas P; Piemonte, Thomas C; Lago, Rodrigo M; Rutter, Martin K; Nesto, Richard W
To examine ankle-brachial index (ABI) abnormalities in patients with type 2 diabetes and coronary artery disease (CAD). An ABI was obtained in 2,240 patients in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial. ABIs were classified as: normal, 0.91-1.3; low, ≤ 0.9; high, >1.3; or noncompressible artery (NC). Baseline characteristics were examined according to ABI and by multivariate analysis. RESULTS ABI was normal in 66%, low in 19%, and high in 8% of patients, and 6% of patients had NC. Of the low ABI patients, 68% were asymptomatic. Using normal ABI as referent, low ABI was independently associated with smoking, female sex, black race, hypertension, age, C-reactive protein, diabetes duration, and lower BMI. High ABI was associated with male sex, nonblack race, and higher BMI; and NC artery was associated with diabetes duration, higher BMI, and hypertension. ABI abnormalities are common and often asymptomatic in patients with type 2 diabetes and CAD.
Full Text Available A repetitive movement practice by motor imagery (MI can inﬂuence motor cortical excitability in the electroencephalogram (EEG. The feedback and the feedback environment should be inherently motivating and relevant for the learner and should have an appeal of novelty, real-world relevance or aesthetic value (Ryan and Deci, 2000; Merrill, 2007. This study investigated if a realistic visualization in 3D of upper and lower limb movements can amplify motor related potentials during motor imagery. We hypothesized that a richer sensory visualization might be more effective during instrumental conditioning, resulting in a more pronounced event related desynchronisation (ERD of the upper alpha band (10-12 Hz over the sensorimotor cortices thereby potentially improving MI based BCI protocols for motor rehabilitation. The results show a strong increase of the characteristic patterns of ERD of the upper alpha band components for left and right limb motor imagery present over the sensorimotor areas in both visualization conditions. Overall, significant differences were observed as a function of visualization modality (2D vs. 3D. The largest upper alpha band power decrease was obtained during motor imagery after a 3-dimensional visualization. In total in 12 out of 20 tasks the end-user of the 3D visualization group showed an enhanced upper alpha ERD relative to 2D visualization modality group, with statistical significance in nine tasks.With a realistic visualization of the limb movements, we tried to increase motor cortex activation during MI. Realistic visual feedback, consistent with the participant’s motor imagery, might be helpful for accomplishing successful motor imagery and the use of such feedback may assist in making BCI a more natural interface for motor imagery based BCI rehabilitation.
Decloe, Rebecca; Obhi, Sukhvinder S
Motor activity during vicarious experience of actions is a widely reported and studied phenomenon, and motor system activity also accompanies observation of graspable objects in the absence of any actions. Such motor activity is thought to reflect simulation of the observed action, or preparation to interact with the object, respectively. Here, in an initial exploratory study, we ask whether motor activity during observation of object directed actions is involved in processes related to recognition of the object after initial exposure. Single pulse Transcranial Magnetic Stimulation (TMS) was applied over the thumb representation of the motor cortex, or over the vertex, during observation of a model thumb typing on a cell-phone, and performance on a phone recognition task at the end of the trial was assessed. Disrupting motor processing over the thumb representation 100 ms after the onset of the typing video impaired the ability to recognize the phone in the recognition test, whereas there was no such effect for TMS applied over the vertex and no TMS trials. Furthermore, this effect only manifested for videos observed from the first person perspective. In an additional control condition, there was no evidence for any effects of TMS to the thumb representation or vertex when observing and recognizing non-action related shape stimuli. Overall, these data provide evidence that motor cortical processing during observation of object-directed actions from a first person perspective is causally linked to the formation of enduring representations of objects-of-action.
Background Motor activity during vicarious experience of actions is a widely reported and studied phenomenon, and motor system activity also accompanies observation of graspable objects in the absence of any actions. Such motor activity is thought to reflect simulation of the observed action, or preparation to interact with the object, respectively. Results Here, in an initial exploratory study, we ask whether motor activity during observation of object directed actions is involved in processes related to recognition of the object after initial exposure. Single pulse Transcranial Magnetic Stimulation (TMS) was applied over the thumb representation of the motor cortex, or over the vertex, during observation of a model thumb typing on a cell-phone, and performance on a phone recognition task at the end of the trial was assessed. Disrupting motor processing over the thumb representation 100 ms after the onset of the typing video impaired the ability to recognize the phone in the recognition test, whereas there was no such effect for TMS applied over the vertex and no TMS trials. Furthermore, this effect only manifested for videos observed from the first person perspective. In an additional control condition, there was no evidence for any effects of TMS to the thumb representation or vertex when observing and recognizing non-action related shape stimuli. Conclusion Overall, these data provide evidence that motor cortical processing during observation of object-directed actions from a first person perspective is causally linked to the formation of enduring representations of objects-of-action. PMID:24330638
Meldrum, Suzanne; Dunstan, Janet A; Foster, Jonathan K; Simmer, Karen; Prescott, Susan L
A number of trials have been undertaken to assess whether the intake of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) during pregnancy can influence the neurological development of the offspring, yet no consensus from these trials has been reached. We aimed to investigate the long-term effects (12 years) of fish oil supplementation in pregnancy on neurodevelopment, including cognition, language and fine motor skills. In a follow up of a previously published randomised controlled trial of 98 pregnant women, their children were assessed at 12 years of age using a battery of neurodevelopmental assessments. Fifty participants were assessed at 12 years, with 25 participant's mothers receiving fish oil supplementation, and 25 receiving control capsules. There were no significant differences for any of the assessment measures completed. Our data indicate that fish oil supplementation during pregnancy does not influence the cognition, language or fine motor skills of children in late primary school (12 years of age).
Pirila, Sija; van der Meere, Jaap; Pentikainen, Taina; Ruusu-Niemi, Pirjo; Korpela, Raija; Kilpinen, Jenni; Nieminen, Pirkko; Ruusu-Niemin, P; Kilpinen, R
The aim of the study was to investigate associations between the severity of motor limitations, cognitive difficulties, language and motor speech problems in children with cerebral palsy. Also, the predictive power of neonatal cranial ultrasound findings on later outcome was investigated. For this
G. Ganesh; A. Takagi; R. Osu; T. Yoshioka; M. Kawato; E. Burdet
How do physical interactions with others change our own motor behavior? Utilizing a novel motor learning paradigm in which the hands of two - individuals are physically connected without their conscious awareness, we investigated how the interaction forces from a partner adapt the motor behavior in physically interacting humans. We observed the motor adaptations during physical interactions to be mutually beneficial such that both the worse and better of the interacting partners improve motor...
Hardiono D. Pusponegoro; Pustika Efar; Soedjatmiko; Amanda Soebadi; Agus Firmansyah; Hui-Ju Chen; Kun-Long Hung
While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and sociali...
Min, Seonguk; Park, Seon Yong; Yoon, Ji Young; Suh, Dae Hun
Fractional microneedling radiofrequency (FMR) is one of the promising methods in acne treatment. Moreover, bipolar radiofrequency (BR) generates heat thereby which induces neocollagenosis. FMR may have the potential to be a safe and effective treatment for the patients both with acne and acne scar. This study was performed to compare the efficacy and safety of FMR and BR in acne and acne scar treatment. Furthermore, mechanism of the FMR treatment was investigated through skin tissues obtained from subjects. Twenty subjects with mild-to-moderate acne and acne scars were treated in a split-face manner with FMR and BR. Two sessions of treatment was done 4 weeks apart in a total 12-week prospective single-blind, randomized clinical trial. Clinical assessment and sebum measurement were carried out for the evaluation of efficacy and safety. Skin tissues were acquired for investigation of molecular changes. FMR was more effective for acne scar especially in icepick and boxcar scar compared to BR. Both inflammatory and non-inflammatory acne lesions decreased by 80 and 65 % in the FMR-treated side at the final visit of 12 weeks, respectively. FMR treatment resulted in significant reduction of sebum excretion. Both treatments showed no severe adverse effects other than erythema. The FMR showed superior efficacy in acne and acne scar compared with BR. Increased expression of TGFβ and collagen I and decreased expression of NF-κB, IL-8 are suggested to involve in the improvement of acne scar and acne lesion by FMR.
Zaman, Jonas; Van den Bergh, Omer; Fannes, Stien; Van Diest, Ilse
Claims have been made that breathing is in part controlled by feedforward regulation. In a classical conditioning paradigm, we investigated anticipatory increases in the inspiratory motor drive as measured by inspiratory occlusion pressure (P100). In an acquisition phase, an experimental group (N=13) received a low-intensity resistive load (5 cmH2O/l/s) for three consecutive inspirations as Conditioned Stimulus (CS), preceding a load of a stronger intensity (20 cmH2O/l/s) for three subsequent inspirations as unconditioned stimulus (US). The control group (N=11) received the low-intensity load for six consecutive inspirations. In a post-acquisition phase both groups received the low-intensity load for six consecutive inspirations. Responses to the CS-load only differed between groups during the first acquisition trials and a strong increase in P100 during the US-loads was observed, which habituated across the experiment. Our results suggest that the disruption caused by adding low to moderate resistive loads to three consecutive inspirations results in a short-lasting anticipatory increase in inspiratory motor drive. Copyright © 2014 Elsevier B.V. All rights reserved.
Fox, Susan H; Katzenschlager, Regina; Lim, Shen-Yang; Ravina, Bernard; Seppi, Klaus; Coelho, Miguel; Poewe, Werner; Rascol, Olivier; Goetz, Christopher G; Sampaio, Cristina
The objective was to update previous evidence-based medicine reviews of treatments for motor symptoms of Parkinson's disease published between 2002 and 2005. Level I (randomized, controlled trial) reports of pharmacological, surgical, and nonpharmacological interventions for the motor symptoms of Parkinson's disease between January 2004 (2001 for nonpharmacological) and December 2010 were reviewed. Criteria for inclusion, clinical indications, ranking, efficacy conclusions, safety, and implications for clinical practice followed the original program outline and adhered to evidence-based medicine methodology. Sixty-eight new studies qualified for review. Piribedil, pramipexole, pramipexole extended release, ropinirole, rotigotine, cabergoline, and pergolide were all efficacious as symptomatic monotherapy; ropinirole prolonged release was likely efficacious. All were efficacious as a symptomatic adjunct except pramipexole extended release, for which there is insufficient evidence. For prevention/delay of motor fluctuations, pramipexole and cabergoline were efficacious, and for prevention/delay of dyskinesia, pramipexole, ropinirole, ropinirole prolonged release, and cabergoline were all efficacious, whereas pergolide was likely efficacious. Duodenal infusion of levodopa was likely efficacious in the treatment of motor complications, but the practice implication is investigational. Entacapone was nonefficacious as a symptomatic adjunct to levodopa in nonfluctuating patients and nonefficacious in the prevention/delay of motor complications. Rasagiline conclusions were revised to efficacious as a symptomatic adjunct, and as treatment for motor fluctuations. Clozapine was efficacious in dyskinesia, but because of safety issues, the practice implication is possibly useful. Bilateral subthalamic nucleus deep brain stimulation, bilateral globus pallidus stimulation, and unilateral pallidotomy were updated to efficacious for motor complications. Physical therapy was revised
The study identifies the industrial decision makers, investigated the information they needed to know, how they can best be reached, and the motivating factors for purchasing energy-efficient electric motors. A survey was conducted of purchasers of integral horsepower polyphase motors. The survey measured current knowledge of and awareness of energy-efficient motors, decision-making criteria, information sources, purchase and usage patterns, and related factors. The survey data were used for the electric motor market penetration analysis. Additionally, a telephone survey was made. The study also provides analyses of distribution channels, commercialization constraints, and the impacts of government programs and rising energy prices. A description of study findings, conclusions, and recommendations is presented. Sample questionnaires and copies of letters to respondents are presented in 3 appendices. Appendices D and E contain descriptions of the methods used. (MCW)
Sigmundsson, H; Haga, M
Recently, the topic of motor competence has figured prominently in the media. The claims made are many, but the research that support the statements is seldom cited. The aim of this review article is to address that deficiency by documenting what is really known about the motor competence of children. Motor competence not only allows children to carry out everyday practical tasks, but it is also an important determinant of their level of self-esteem and of their popularity and status in their peer group. While many studies have shown a significant correlation between motor problems and other problems in the social sphere, it has been difficult to establish causal relationships with any degree of confidence, as there appear to be several interactions which need to be taken into account. Research has shown that 6-10% of Norwegian children in the 7 to 10 year age group have a motor competence well below the norm. It is unusual for motor problems to simply disappear over time. In the absence of intervention the syndrome is likely to continue to manifest itself. More recent research points to some of the circularity in this causal network, children with motor problems having been shown to be less physically active than their peers. In a larger health perspective this in itself can have very serious consequences for the child.
Krainick-Strobel, Ute E; Lichtenegger, Werner; Wallwiener, Diethelm; Tulusan, Augustinus H; Jänicke, Fritz; Bastert, Gunther; Kiesel, Ludwig; Wackwitz, Birgit; Paepke, Stefan
In recent years, preoperative volume reduction of locally advanced breast cancers, resulting in higher rates of breast-conserving surgery (BCS), has become increasingly important also in postmenopausal women. Clinical interest has come to center on the third-generation nonsteroidal aromatase inhibitors (AIs), including letrozole, for such neoadjuvant endocrine treatment. This usually lasts 3–4 months and has been extended to up to 12 months, but optimal treatment duration has not been fully established. This study was designed as a multicenter, open-label, single-arm, exploratory phase IIb/III clinical trial of letrozole 2.5 mg, one tablet daily, for 4–8 months. The primary objective was to investigate the effect of neoadjuvant treatment duration on tumor regression and BCS eligibility to identify optimal treatment duration. Tumor regression (by clinical examination, mammography, and ultrasound), shift towards BCS eligibility, and safety assessments were the main outcome measures. Standard parametric and nonparametric descriptive statistics were performed. Letrozole treatment was received by 32 of the enrolled 33 postmenopausal women (median (range): 67.0 (56–85) years) with unilateral, initially BCS-ineligible primary breast cancer (clinical stage ≥ T2, N0, M0). Letrozole treatment duration in the modified intent-to-treat (ITT; required 4 months' letrozole treatment) analysis population (29 patients) was 4 months in 14 patients and > 4 months in 15 patients. The respective per-protocol (PP) subgroup sizes were 14 and 11. The majority of partial or complete responses were observed at 4 months, though some beneficial responses occurred during prolonged letrozole treatment. Compared with baseline, median tumor size in the ITT population was reduced by 62.5% at Month 4 and by 70.0% at final study visit (Individual End). Similarly, in the PP population, respective reductions were 64.0% and 67.0%. Whereas initially all patients were mastectomy candidates
McKenzie, Joanne E; Herbison, G Peter; Roth, Paul; Paul, Charlotte
Recent cohort studies of randomised controlled trials have provided evidence of within-study selective reporting bias; where statistically significant outcomes are more likely to be more completely reported compared to non-significant outcomes. Bias resulting from selective reporting can impact on meta-analyses, influencing the conclusions of systematic reviews, and in turn, evidence based clinical practice guidelines.In 2006 we received funding to investigate if there was evidence of within-study selective reporting in a cohort of RCTs submitted to New Zealand Regional Ethics Committees in 1998/99. This research involved accessing ethics applications, their amendments and annual reports, and comparing these with corresponding publications. We did not plan to obtain informed consent from trialists to view their ethics applications for practical and scientific reasons. In November 2006 we sought ethical approval to undertake the research from our institutional ethics committee. The Committee declined our application on the grounds that we were not obtaining informed consent from the trialists to view their ethics application. This initiated a seventeen month process to obtain ethical approval. This publication outlines what we planned to do, the issues we encountered, discusses the legal and ethical issues, and presents some potential solutions. Methodological research such as this has the potential for public benefit and there is little or no harm for the participants (trialists) in undertaking it. Further, in New Zealand, there is freedom of information legislation, which in this circumstance, unambiguously provided rights of access and use of the information in the ethics applications. The decision of our institutional ethics committee defeated this right and did not recognise the nature of this observational research. Methodological research, such as this, can be used to develop processes to improve quality in research reporting. Recognition of the potential
Full Text Available Non-motor symptoms are increasingly recognized as important features of Parkinson's disease (PD. LRRK2 mutations are common causes of familial and sporadic PD. Non-motor features have not been yet comprehensively evaluated in LRRK2 transgenic mouse models.Using a transgenic mouse model overexpressing the R1441G mutation of the human LRRK2 gene, we have investigated the longitudinal correlation between motor and non-motor symptoms and determined if specific non-motor phenotypes precede motor symptoms.We investigated the onset of motor and non-motor phenotypes on the LRRK2(R1441G BAC transgenic mice and their littermate controls from 4 to 21 month-old using a battery of behavioral tests. The transgenic mutant mice displayed mild hypokinesia in the open field from 16 months old, with gastrointestinal dysfunctions beginning at 6 months old. Non-motor features such as depression and anxiety-like behaviors, sensorial functions (pain sensitivity and olfaction, and learning and memory abilities in the passive avoidance test were similar in the transgenic animals compared to littermate controls.LRRK2(R1441G BAC transgenic mice displayed gastrointestinal dysfunction at an early stage but did not have abnormalities in fine behaviors, olfaction, pain sensitivity, mood disorders and learning and memory compared to non-transgenic littermate controls. The observations on olfaction and gastrointestinal dysfunction in this model validate findings in human carriers. These mice did recapitulate mild Parkinsonian motor features at late stages but compensatory mechanisms modulating the progression of PD in these models should be further evaluated.
Mokienko, Olesya A.; Chervyakov, Alexander V.; Kulikova, Sofia N.; Bobrov, Pavel D.; Chernikova, Liudmila A.; Frolov, Alexander A.; Piradov, Mikhail A.
Background: Motor imagery (MI) is the mental performance of movement without muscle activity. It is generally accepted that MI and motor performance have similar physiological mechanisms. Purpose: To investigate the activity and excitability of cortical motor areas during MI in subjects who were previously trained with an MI-based brain-computer interface (BCI). Subjects and Methods: Eleven healthy volunteers without neurological impairments (mean age, 36 years; range: 24–68 years) were either trained with an MI-based BCI (BCI-trained, n = 5) or received no BCI training (n = 6, controls). Subjects imagined grasping in a blocked paradigm task with alternating rest and task periods. For evaluating the activity and excitability of cortical motor areas we used functional MRI and navigated transcranial magnetic stimulation (nTMS). Results: fMRI revealed activation in Brodmann areas 3 and 6, the cerebellum, and the thalamus during MI in all subjects. The primary motor cortex was activated only in BCI-trained subjects. The associative zones of activation were larger in non-trained subjects. During MI, motor evoked potentials recorded from two of the three targeted muscles were significantly higher only in BCI-trained subjects. The motor threshold decreased (median = 17%) during MI, which was also observed only in BCI-trained subjects. Conclusion: Previous BCI training increased motor cortex excitability during MI. These data may help to improve BCI applications, including rehabilitation of patients with cerebral palsy. PMID:24319425
Full Text Available Background: Motor imagery (MI is the mental performance of movement without muscle activity. It is generally accepted that MI and motor performance have similar physiological mechanisms.Purpose: To investigate the activity and excitability of cortical motor areas during MI in subjects who were previously trained with an MI-based brain-computer interface (BCI.Subjects and methods: Eleven healthy volunteers without neurological impairments (mean age, 36 years; range: 24–68 years were either trained with an MI-based BCI (BCI-trained, n = 5 or received no BCI training (n = 6, controls. Subjects imagined grasping in a blocked paradigm task with alternating rest and task periods. For evaluating the activity and excitability of cortical motor areas we used functional MRI and navigated transcranial magnetic stimulation (nTMS.Results: fMRI revealed activation in Brodmann areas 3 and 6, the cerebellum, and the thalamus during MI in all subjects. The primary motor cortex was activated only in BCI-trained subjects. The associative zones of activation were larger in non-trained subjects. During MI, motor evoked potentials recorded from two of the three targeted muscles were significantly higher only in BCI-trained subjects. The motor threshold decreased (median = 17% during MI, which was also observed only in BCI-trained subjects.Conclusion: Previous BCI training increased motor cortex excitability during MI. These data may help to improve BCI applications, including rehabilitation of patients with cerebral palsy.
Vinoth Kumar, K.; Sony, Kevin; Achenkunju John, Alan; Kuriakose, Anto; John, Ano P.
This paper investigates the stator short winding failure of asynchronous motor also their effects on motor current spectrums. A fuzzy logic approach i.e., model based technique possibly will help to detect the asynchronous motor failure. Actually, fuzzy logic similar to humanoid intelligent methods besides expected linguistic empowering inferences through vague statistics. The dynamic model is technologically advanced for asynchronous motor by means of fuzzy logic classifier towards investigate the stator inter turn failure in addition open phase failure. A hardware implementation was carried out with LabVIEW for the online-monitoring of faults.
Nkyekyer, Joanna; Meyer, Denny; Blamey, Peter J; Pipingas, Andrew; Bhar, Sunil
Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training-formal listening activities designed to optimize speech perception-are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for
Togo, Shunta; Imamizu, Hiroshi
Humans perform various motor tasks by coordinating the redundant motor elements in their bodies. The coordination of motor outputs is produced by motor commands, as well properties of the musculoskeletal system. The aim of this study was to dissociate the coordination of motor commands from motor outputs. First, we conducted simulation experiments where the total elbow torque was generated by a model of a simple human right and left elbow with redundant muscles. The results demonstrated that muscle tension with signal-dependent noise formed a coordinated structure of trial-to-trial variability of muscle tension. Therefore, the removal of signal-dependent noise effects was required to evaluate the coordination of motor commands. We proposed a method to evaluate the coordination of motor commands, which removed signal-dependent noise from the measured variability of muscle tension. We used uncontrolled manifold analysis to calculate a normalized index of synergy. Simulation experiments confirmed that the proposed method could appropriately represent the coordinated structure of the variability of motor commands. We also conducted experiments in which subjects performed the same task as in the simulation experiments. The normalized index of synergy revealed that the subjects coordinated their motor commands to achieve the task. Finally, the normalized index of synergy was applied to a motor learning task to determine the utility of the proposed method. We hypothesized that a large part of the change in the coordination of motor outputs through learning was because of changes in motor commands. In a motor learning task, subjects tracked a target trajectory of the total torque. The change in the coordination of muscle tension through learning was dominated by that of motor commands, which supported the hypothesis. We conclude that the normalized index of synergy can be used to evaluate the coordination of motor commands independently from the properties of the
Riedel-Heller Steffi G
Full Text Available Abstract Background Regarding demographic changes in Germany it can be assumed that the number of elderly and the resulting need for long term care is increasing in the near future. It is not only an individual's interest but also of public concern to avoid a nursing home admission. Current evidence indicates that preventive home visits can be an effective way to reduce the admission rate in this way making it possible for elderly people to stay longer at home than without home visits. As the effectiveness and cost-effectiveness of preventive home visits strongly depends on existing services in the social and health system existing international results cannot be merely transferred to Germany. Therefore it is necessary to investigate the effectiveness and cost-effectiveness of such an intervention in Germany by a randomized controlled trial. Methods The trial is designed as a prospective multi-center randomized controlled trial in the cities of Halle and Leipzig. The trial includes an intervention and a control group. The control group receives usual care. The intervention group receives three additional home visits by non-physician health professionals (1 geriatric assessment, (2 consultation,