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.
Benjaminse, Anne; Lemmink, Koen A P M; Diercks, Ron L; Otten, Bert
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. 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. 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 number NTR2250.
Preston, Nick; Magallón, Sara; Hill, Liam Jb; Andrews, Elizabeth; Ahern, Sara M; Mon-Williams, Mark
To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice. We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles. Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained. No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for 'high quality'. Nevertheless, not all included studies were adequately powered for determining an effect. Large effect sizes associated with 95 % confidence intervals suggest that 'Neuromotor Task Training', 'Task-oriented Motor Training' and 'Motor Imagery + Task Practice Training' are the most effective reported interventions for improving motor skills in children with developmental coordination disorder.
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
de Xivry J-J, Orban; de Xivry, Jean-Jacques Orban
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.
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.
Hartman, A.; Winkel, M.L. te; Beek, van R.; Keizer-Schrama, S.M.P.F.; Kemper, H.C.G.; Hop, W.C.; Heuvel-Eibrink, van den MM; Pieters, R.
once a week. CONCLUSIONS: The exercise program was not more beneficial than standard care in preventing reduction in BMD, motor performance and passive ankle dorsiflexion than standard care, most likely due to unsatisfactory compliance. Increased BMI and body fat in the intervention group normalized
Stinear, Cathy M; Byblow, Winston D; Ackerley, Suzanne J; Smith, Marie-Claire; Borges, Victor M; Barber, P Alan
Recovery of upper-limb motor impairment after first-ever ischemic stroke is proportional to the degree of initial impairment in patients with a functional corticospinal tract (CST). This study aimed to investigate whether proportional recovery occurs in a more clinically relevant sample including patients with intracerebral hemorrhage and previous stroke. Patients with upper-limb weakness were assessed 3 days and 3 months poststroke with the Fugl-Meyer scale. Transcranial magnetic stimulation was used to test CST function, and patients were dichotomized according to the presence of motor evoked potentials in the paretic wrist extensors. Linear regression modeling of Δ Fugl-Meyer score between 3 days and 3 months was performed, with predictors including initial impairment (66 - baseline Fugl-Meyer score), age, sex, stroke type, previous stroke, comorbidities, and upper-limb therapy dose. One hundred ninety-two patients were recruited, and 157 completed 3-month follow-up. Patients with a functional CST made a proportional recovery of 63% (95% confidence interval, 55%-70%) of initial motor impairment. The recovery of patients without a functional CST was not proportional to initial impairment and was reduced by greater CST damage. Recovery of motor impairment in patients with intact CST is proportional to initial impairment and unaffected by previous stroke, type of stroke, or upper-limb therapy dose. Novel interventions that interact with the neurobiological mechanisms of recovery are needed. The generalizability of proportional recovery is such that patients with intracerebral hemorrhage and previous stroke may usefully be included in interventional rehabilitation trials. URL: http://www.anzctr.org.au. Unique identifier: ANZCTR12611000755932. © 2017 American Heart Association, Inc.
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
Pugachev, A. A.; Kosmodamianskiy, A. S.
The relevance of thermal behavior investigation of traction induction motors is shown. The brief survey of techniques to monitor the temperature of an induction motors is carried out. The detailed multi-node equivalent thermal circuit of an induction motor is designed for steady state. The calculation technique of some units’ thermal resistances by using of construction features and geometric sizes of an induction motor is shown. Results of thermal processes calculation for 14 kWAO-63-4 induction motor are shown. The adequacy of proposed thermal model is proved by means of good convergence of calculated results with the results obtained by the experimental investigation on the same induction motor. As a result of investigation, it is established that the slot winding of the stator located about on 2/3 of its length from the cooling air entrance has the highest value of temperature.
Frandsen, Tommy; Rasmussen, Peter Omand
This paper presents an investigation of the eddycurrent 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 MIPMG is superior...
This study investigated the submaximal endurance levels of children with motor difficulties, using the six-minute walk test (6MWT). A prospective, cross-sectional study was conducted. Forty-eight children between ages seven and ten years were enrolled. They came from similar socio-economic backgrounds and attended ...
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
Namasivayam, Aravind Kumar; van Lieshout, Pascal
In this exploratory study, we investigated whether or not people who stutter (PWS) show motor practice and learning changes similar to those of people who do not stutter (PNS). To this end, five PWS and five PNS repeated a set of non-words at two different rates (normal and fast) across three test sessions (T1, T2 on the same day and T3 on a…
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
Subramanian, Leena; Morris, Monica Busse; Brosnan, Meadhbh; Turner, Duncan L; Morris, Huw R; Linden, David E J
Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient's own brain activity to self-regulate brain networks which in turn could lead to a change in behavior and clinical symptoms. The objective was to determine the effect of NF and motor training (MOT) alone on motor and non-motor functions in Parkinson's Disease (PD) in a 10-week small Phase I randomized controlled trial. Thirty patients with Parkinson's disease (PD; Hoehn and Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with MOT. Group 2 (MOT: 15 patients) received MOT alone. The primary outcome measure was the Movement Disorder Society-Unified PD Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention "off-medication". The secondary outcome measures were the "on-medication" MDS-UPDRS, the PD Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks. Patients in the NF group were able to upregulate activity in the supplementary motor area (SMA) by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the "off-medication" state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8). The improvement in the intervention group meets the minimal clinically important difference which is also on par with other non-invasive therapies such as repetitive Transcranial Magnetic Stimulation (rTMS). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group. This Phase I study suggests that NF combined with MOT is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions.
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
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.
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....
Lenzi, Tommaso; Vitiello, Nicola; McIntyre, Joseph; Roccella, Stefano; Carrozza, Maria Chiara
The role of the mechanical properties of the neuromuscular system in motor control has been investigated for a long time in both human and animal subjects, mainly through the application of mechanical perturbations to the limb during natural movements and the observation of its corrective responses. These methods have provided a wealth of insight into how the central nervous system controls the limb. They suffer, however, from the fact that it is almost impossible to separate the active and passive components of the measured arm stiffness and that the measurement may themselves alter the stiffness characteristic of the arm. As a complement to these analyses, the implementation of a given neuroscientific hypothesis on a real mechanical system could overcome these measurement artifact and provide a tool that is, under full control of the experimenter, able to replicate the relevant functional features of the human arm. In this article, we introduce the NEURARM platform, a robotic arm intended to test hypotheses on the human motor control system. As such, NEURARM satisfies two key requirements. First, its kinematic parameters and inertia are similar to that of the human arm. Second, NEURARM mimics the main physical features of the human actuation system, specifically, the use of tendons to transfer force, the presence of antagonistic muscle pairs, the passive elasticity of muscles in the absence of any neural feedback and the non-linear elastic behaviour. This article presents the design and characterization of the NEURARM actuation system. The resulting mechanical behaviour, which has been tested in joint and Cartesian space under static and dynamic conditions, proves that the NEURARM platform can be exploited as a robotic model of the human arm, and could thus represent a powerful tool for neuroscience investigations.
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.
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...... ring and shaft and the similarity of the stack actuators used. This paper investigates the electromechanical coupling of these factors into the motor current through experimental means...
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.
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.
Full Text Available We propose a framework for building electrophysiological predictors of single-trial motor performance variations, exemplified for SVIPT, a sequential isometric force control task suitable for hand motor rehabilitation after stroke.Electroencephalogram (EEG data of 20 subjects with mean age of 53 years was recorded prior to and during 400 trials of SVIPT. They were executed within a single session with the non-dominant left hand, while receiving continuous visual feedback of the produced force trajectories. The behavioral data showed strong trial-by-trial performance variations for five clinically relevant metrics, which accounted for reaction time as well as for the smoothness and precision of the produced force trajectory.18 out of 20 tested subjects remained after preprocessing and entered offline analysis. Source Power Comodulation (SPoC was applied on EEG data of a short time interval prior to the start of each SVIPT trial. For 11 subjects, SPoC revealed robust oscillatory EEG subspace components, whose bandpower activity are predictive for the performance of the upcoming trial. Since SPoC may overfit to non-informative subspaces, we propose to apply three selection criteria accounting for the meaningfulness of the features. Across all subjects, the obtained components were spread along the frequency spectrum and showed a variety of spatial activity patterns. Those containing the highest level of predictive information resided in and close to the alpha band. Their spatial patterns resemble topologies reported for visual attention processes as well as those of imagined or executed hand motor tasks. In summary, we identified subject-specific single predictors that explain up to 36 % of the performance fluctuations and may serve for enhancing neuroergonomics of motor rehabilitation scenarios.
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
Full Text Available A novel stator geometry for a linear switched reluctance motor (LSRM that improves the force profile is presented inthis paper. In the new geometry, pole shoes are affixed on the stator poles. Static characteristics for the proposed structurehave been highlighted using two dimensional (2-D finite element analyses (FEA. A detailed sensitivity analysis of the effectof several geometrical parameters on the performance of the proposed LSRM is presented. Further, motor performance forvariable load conditions is discussed. The 2-D FEA results and the experimental results of this paper prove that LSRMs areone of the strong candidates for linear propulsion drives.
Angulo-Barroso, Rosa M; Li, Ming; Santos, Denise C C; Bian, Yang; Sturza, Julie; Jiang, Yaping; Kaciroti, Niko; Richards, Blair; Lozoff, Betsy
Insufficient iron levels for optimal fetal and infant development is a concern during pregnancy and infancy. The goal of this study was to assess the effects of iron supplementation in pregnancy and/or infancy on motor development at 9 months. The study was a randomized controlled trial (RCT) of infancy iron supplementation linked to an RCT of pregnancy iron supplementation, conducted in Hebei, China. A total of 1482 infants were randomly assigned to receive placebo (n = 730) or supplemental iron (n = 752) from 6 weeks to 9 months. Gross motor development (assessed by using the Peabody Developmental Motor Scale, Second Edition, instrument) was the primary outcome. Neurologic integrity and motor quality were secondary outcomes. Motor outcome was available for 1196 infants, divided into 4 supplementation period groups: (1) placebo in pregnancy/placebo in infancy (n = 288); (2) placebo in pregnancy/iron in infancy (n = 305); (3) iron in pregnancy/placebo in infancy (n = 298); and (4) iron in pregnancy/iron in infancy (n = 305). Using the Peabody Developmental Motor Scale, instrument, iron supplementation in infancy but not pregnancy improved gross motor scores: overall, P motor scores by 0.3 SD compared with no supplementation or supplementation during pregnancy alone. Effects of iron supplementation in infancy alone were similar to effects with iron in both pregnancy and infancy. The RCT design supports the causal inference that iron supplementation in infancy, with or without iron supplementation in pregnancy, improved gross motor test scores at 9 months. Copyright © 2016 by the American Academy of Pediatrics.
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
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.
Lambert, Nadine M.
This investigation attempted to demonstrate the utility of standard item analysis procedures for selecting the most reliable and valid items for scoring Bender Visual Motor Gestalt Test test records. (Author)
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
Reus, Linda; Pelzer, Ben J; Otten, Barto J; Siemensma, Elbrich P C; van Alfen-van der Velden, Janielle A A E M; Festen, Dederieke A M; Hokken-Koelega, Anita C S; Nijhuis-van der Sanden, Maria W G
Although severe motor problems in infants with Prader-Willi syndrome (PWS) are striking, motor development has never been studied longitudinally and the results of growth hormone (GH) treatment on motor development are contradictory. The authors studied whether GH treatment can enhance the effect of physical training on motor development in infants with PWS. Twenty-two infants were followed for two years during a randomized controlled trial. The treatment and control groups began GH after baseline or following a control period, respectively. Both groups followed a child-specific physical training program. Motor performance was measured every three months. Multi-level regression analysis revealed that motor development differed significantly between infants (p<.001), and this could be partially explained by baseline motor developmental level (p<.01). GH treatment enhanced the effects of child-specific physical training on both motor developmental rate and motor developmental potential. Moreover, this effect was more pronounced when GH treatment was initiated at a younger age. Copyright © 2013 Elsevier Ltd. All rights reserved.
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
Taylor, Paul N.; Gunzler, Douglas D.; Buurke, Jaap H.; IJzerman, Maarten J.; Chae, John
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 academic medical center Participants 110 chronic stroke survivors (> 12-wks post-stroke) with unilateral hemiparesis and dorsiflexion strength of ≤ 4/5 on the Medical Research Council scale Interventions Subjects were stratified by motor impairment level and then randomized to ambulation training with either a surface PNS device or usual care (ankle foot orthosis or no device) intervention. Subjects were treated for 12-wks and followed for 6-months post-treatment. Main Outcome Measures Lower limb portion of the Fugl-Meyer (FM) Assessment (motor impairment), the Modified Emory Functional Ambulation Profile (mEFAP) performed without a device (functional ambulation), and the Stroke Specific Quality of Life (SSQOL) scale. Results There was no significant treatment group main effect or treatment group by time interaction effect on FM, mEFAP, or SSQOL raw scores (p>0.05). The time effect was significant for the three raw scores (p<0.05). However, when comparing average change scores from baseline (T1) to end of treatment, (T2, 12-wks), and at 12-wks (T3) and 24-wks (T4) after end of treatment, significant differences were noted only for the mEFAP and SSQOL scores. The change in the average scores for both mEFAP and SSQOL occurred between T1 and T2, followed by relative stability thereafter. Conclusions There was no evidence of a motor relearning effect on lower limb motor impairment in either the PNS or usual care groups. However, both PNS and usual care groups demonstrated significant improvements in functional mobility and quality of life during the treatment period, which were maintained at 6-months follow-up. PMID:23399456
Full Text Available Abstract Background For brain computer interfaces (BCIs, which may be valuable in neurorehabilitation, brain signals derived from mental activation can be monitored by non-invasive methods, such as functional near-infrared spectroscopy (fNIRS. Single-trial classification is important for this purpose and this was the aim of the presented study. In particular, we aimed to investigate a combined approach: 1 offline single-trial classification of brain signals derived from a novel wireless fNIRS instrument; 2 to use motor imagery (MI as mental task thereby discriminating between MI signals in response to different tasks complexities, i.e. simple and complex MI tasks. Methods 12 subjects were asked to imagine either a simple finger-tapping task using their right thumb or a complex sequential finger-tapping task using all fingers of their right hand. fNIRS was recorded over secondary motor areas of the contralateral hemisphere. Using Fisher's linear discriminant analysis (FLDA and cross validation, we selected for each subject a best-performing feature combination consisting of 1 one out of three channel, 2 an analysis time interval ranging from 5-15 s after stimulation onset and 3 up to four Δ[O2Hb] signal features (Δ[O2Hb] mean signal amplitudes, variance, skewness and kurtosis. Results The results of our single-trial classification showed that using the simple combination set of channels, time intervals and up to four Δ[O2Hb] signal features comprising Δ[O2Hb] mean signal amplitudes, variance, skewness and kurtosis, it was possible to discriminate single-trials of MI tasks differing in complexity, i.e. simple versus complex tasks (inter-task paired t-test p ≤ 0.001, over secondary motor areas with an average classification accuracy of 81%. Conclusions Although the classification accuracies look promising they are nevertheless subject of considerable subject-to-subject variability. In the discussion we address each of these aspects, their
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.
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...... in the stator. The hub motor construction restricts the available conductive paths for heat dissipation from the stator to the ambient only through the shaft. In contrast to an internal rotor structure, where the stator winding losses are diffused via conduction, here convection plays a major role in loss...... dissipation. Therefore, a LP thermal model with improved convection modelling has been proposed to calculate the temperature of the components inside the hub motor. The developed model is validated with the FE thermal model and the test data. In addition, CFD tools has been used to accurately model...
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
Bushnell, Cheryl; Bettger, Janet Prvu; Cockroft, Kevin M; Cramer, Steven C; Edelen, Maria Orlando; Hanley, Daniel; Katzan, Irene L; Mattke, Soeren; Nilsen, Dawn M; Piquado, Tepring; Skidmore, Elizabeth R; Wing, Kay; Yenokyan, Gayane
About half of survivors with stroke experience severe and significant long-term disability. The purpose of this article is to review the state of the science and to make recommendations for measuring patient-centric outcomes in interventions for motor improvement in the chronic stroke phase. A 9-member expert panel reviewed evidence to identify measures of upper and lower extremity function used to date as outcomes in trials with patients who experienced a stroke ≥6 months before assessment. Outcome measures were screened using StrokEDGE consensus panel recommendations, and evaluated for availability of a published minimal clinically important difference. Measures meeting these criteria were further evaluated with regard to their level of measurement, psychometric properties, and ability of minimal clinically important difference to capture gains associated with improved function and clinical relevance to patients, to arrive at recommendations. A systematic literature review yielded 115 clinical trials of upper and lower extremity function in chronic stroke that used a total of 34 outcome measures. Seven of these had published minimal clinically important differences and were recommended or highly recommended by StrokEDGE. Those are the Fugl-Meyer Upper Extremity and Lower Extremity scales, Wolf Motor Function Test, Action Research Arm Test, Ten-Meter and Six-Minute Walk Tests, and the Stroke Impact Scale. All had evidence for their psychometric performance, although the strength of evidence for validity varied, especially in populations with chronic stroke Fugl-Meyer Upper and Lower Extremity scales showing the strongest evidence for validity. The panel recommends that the Fugl-Meyer Upper and Lower Extremity scales be used as primary outcomes in intervention trials targeting motor function in populations with chronic stroke. The other 6 measures are recommended as secondary outcomes. © 2015 American Heart Association, Inc.
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 self-regulation scores across time, while children in the control group scored significantly lower than the CHAMP group at the posttest (p 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
Brach, Jennifer S; Van Swearingen, Jessie M; Perera, Subashan; Wert, David M; Studenski, Stephanie
To compare the effect of motor learning with that of standard exercise on measures of mobility and perceived function and disability. Single-blind randomized trial. University research center. Older adults (n = 40) with a mean age of 77.1 ± 6.0, normal walking speed (≥ 1.0 m/s), and impaired motor skills (Figure of 8 walk time >8 seconds). The motor learning program incorporated goal-oriented stepping and walking to promote timing and coordination within the phases of the gait cycle. The standard program employed endurance training by treadmill walking. Both included strength training and were offered twice weekly for 1 hour for 12 weeks. Primary outcomes were mobility performance (gait efficiency, motor skill in walking, gait speed, walking endurance); secondary outcomes were perceived function and disability (Late-Life Function and Disability Instrument). Thirty-eight of 40 participants completed the trial (motor learning, n = 18; standard, n = 20). The motor learning group improved more than the standard group in gait speed (0.13 vs 0.05 m/s, P = .008) and motor skill (-2.2 vs -0.89 seconds, P endurance (28.3 and 22.9 m, P = .14). Changes in gait efficiency and perceived function and disability were not different between the groups (P > .10). In older adults with subclinical gait dysfunction, motor learning exercise improved some parameters of mobility performance more than standard exercise. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.
Full Text Available In this study, the factors affecting change of the phase inductance in a switched reluctance motor (SRM have been investigated. The motor inductance is a function of both excitation current and rotor position and it depends on motor geometry, relative permeability, saturation and fringing and end-turn field. Non-linearity of SRM leads to difficulties for the development of analytical methods for predicting the flux linkages, co–energy change and inductance at all rotor positions these effects in the 6/4 SRM obtained from analytical way and predicted by 3D finite element method (Ansoft RMxprt, Ansoft Maxwell 3D have been investigated. Results of simulations and analytical solutions have been relatively compared.
Full Text Available Abstract Background We translated, modified, and extended a cognitive behavioral treatment (CBT protocol by Blanchard and Hickling (2003 for the purpose of treating survivors of MVA with full or subsyndromal posttraumatic stress disorder (PTSD whose native language is German. The treatment manual included some additional elements, e. g. cognitive procedures, imaginal reliving, and facilitating of posttraumatic growth. The current study was conducted in order to test the efficacy of the modified manual by administering randomized controlled trial in which a CBT was compared to a wait-list control condition. Methods Forty-two motor vehicle accident survivors with chronic or severe subsyndromal posttraumatic stress disorder (PTSD completed the treatment trial with two or three detailed assessments (pre, post, and 3-month follow-up. Results CAPS-scores showed significantly greater improvement in the CBT condition as compared to the wait list condition (group × time interaction effect size d = 1.61. Intent-to-treat analysis supported the outcome (d = 1.34. Categorical diagnostic data indicated clinical recovery of 67% (post-treatment and 76% (3 months FU in the treatment group. Additionally, patients of the CBT condition showed significantly greater reductions in co-morbid major depression than the control condition. At follow-up the improvements were stable in the active treatment condition. Conclusion The degree of improvement in our treatment group was comparable to that in previously reported treatment trials of PTSD with cognitive behavioral therapy. Trial registration ISRCTN66456536
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...... the described AC method on an SRM and on a PM motor. For these two motors, the measured flux-linkage-current curves are compared to those measured using other methods. The comparison results show good effectiveness of the proposed AC method for both the SRM and the PM motor....
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
Smits-Engelsman, Bouwien C M; Jelsma, Lemke Dorothee; Ferguson, Gillian D; Geuze, Reint H
OBJECTIVE: 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 versi...
Frandsen, Tommy Vestergaard; Rasmussen, Peter Omand
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...
Guberman, Guido; Cisek, Paul
Recent studies have shown that activity in sensorimotor structures varies depending on the speed-accuracy trade-off (SAT) context in which a decision is made. Here we tested the hypothesis that the same areas also reflect a more local adjustment of SAT established between individual trials, based on the outcome of the previous decision. Two monkeys performed a reaching decision task in which sensory evidence continuously evolves during the time course of a trial. In two SAT contexts, we compared neural activity in trials following a correct choice vs. those following an error. In dorsal premotor cortex (PMd), we found that 23% of cells exhibited significantly weaker baseline activity after error trials, and for ∼30% of these this effect persisted into the deliberation epoch. These cells also contributed to the process of combining sensory evidence with the growing urgency to commit to a choice. We also found that the activity of 22% of PMd cells was increased after error trials. These neurons appeared to carry less information about sensory evidence and time-dependent urgency. For most of these modulated cells, the effect was independent of whether the previous error was expected or unexpected. We found similar phenomena in primary motor cortex (M1), with 25% of cells decreasing and 34% increasing activity after error trials, but unlike PMd, these neurons showed less clear differences in their response properties. These findings suggest that PMd and M1 belong to a network of brain areas involved in SAT adjustments established using the recent history of reinforcement. NEW & NOTEWORTHY Setting the speed-accuracy trade-off (SAT) is crucial for efficient decision making. Previous studies have reported that subjects adjust their SAT after individual decisions, usually choosing more conservatively after errors, but the neural correlates of this phenomenon are only partially known. Here, we show that neurons in PMd and M1 of monkeys performing a reach decision task
Н. A. Mehdiyev
Full Text Available The paper considers a closed vector control system for induction motor rotation speed of a shipboard tow winch. Structural schemes and transfer functions of the system at control and disturbing influences are presented in the paper. The system with asynchronous motor drive parameters of a shipboard tow winch has been investigated in the paper. It has been revealed that transit process duration of the given system is insignificant. The fact is rather important to prevent accidents in case of vessel towing.
Ang, Kai Keng; Chua, Karen Sui Geok; Phua, Kok Soon; Wang, Chuanchu; Chin, Zheng Yang; Kuah, Christopher Wee Keong; Low, Wilson; Guan, Cuntai
Electroencephalography (EEG)-based motor imagery (MI) brain-computer interface (BCI) technology has the potential to restore motor function by inducing activity-dependent brain plasticity. The purpose of this study was to investigate the efficacy of an EEG-based MI BCI system coupled with MIT-Manus shoulder-elbow robotic feedback (BCI-Manus) for subjects with chronic stroke with upper-limb hemiparesis. In this single-blind, randomized trial, 26 hemiplegic subjects (Fugl-Meyer Assessment of Motor Recovery After Stroke [FMMA] score, 4-40; 16 men; mean age, 51.4 years; mean stroke duration, 297.4 days), prescreened with the ability to use the MI BCI, were randomly allocated to BCI-Manus or Manus therapy, lasting 18 hours over 4 weeks. Efficacy was measured using upper-extremity FMMA scores at weeks 0, 2, 4 and 12. ElEG data from subjects allocated to BCI-Manus were quantified using the revised brain symmetry index (rBSI) and analyzed for correlation with the improvements in FMMA score. Eleven and 15 subjects underwent BCI-Manus and Manus therapy, respectively. One subject in the Manus group dropped out. Mean total FMMA scores at weeks 0, 2, 4, and 12 weeks improved for both groups: 26.3±10.3, 27.4±12.0, 30.8±13.8, and 31.5±13.5 for BCI-Manus and 26.6±18.9, 29.9±20.6, 32.9±21.4, and 33.9±20.2 for Manus, with no intergroup differences (P=.51). More subjects attained further gains in FMMA scores at week 12 from BCI-Manus (7 of 11 [63.6%]) than Manus (5 of 14 [35.7%]). A negative correlation was found between the rBSI and FMMA score improvement (P=.044). BCI-Manus therapy was well tolerated and not associated with adverse events. In conclusion, BCI-Manus therapy is effective and safe for arm rehabilitation after severe poststroke hemiparesis. Motor gains were comparable to those attained with intensive robotic therapy (1,040 repetitions/session) despite reduced arm exercise repetitions using EEG-based MI-triggered robotic feedback (136 repetitions/session). The
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.
Li, Lili; Xu, Guanghua; Zhang, Feng; Xie, Jun; Li, Min
Brain computer interfaces provide a novel channel for the communication between brain and output devices. The effectiveness of the brain computer interface is based on the classification accuracy of single trial brain signals. The common spatial pattern (CSP) algorithm is believed to be an effective algorithm for the classification of single trial brain signals. As the amplitude feature for spatial projection applied by this algorithm is based on a broad frequency bandpass filter (mainly 5-30 Hz) in which the frequency band is often selected by experience, the CSP is sensitive to noise and the influence of other irrelevant information in the selected broad frequency band. In this paper, to improve the CSP, a novel relevant feature integration and extraction algorithm is proposed. Before projecting, we integrated the motor relevant information to suppress the interference of noise and irrelevant information, as well as to improve the spatial difference for projection. The algorithm was evaluated with public datasets. It showed significantly better classification performance with single trial electroencephalography (EEG) data, increasing by 6.8% compared with the CSP.
Frank, Cornelia; Land, William M; Popp, Carmen; Schack, Thomas
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.
Pandian, Shanta; Arya, Kamal Narayan; Davidson, E W Rajkumar
Motor recovery of the hand usually plateaus in chronic stroke patients. Various conventional and contemporary approaches have been used to rehabilitate the hand post-stroke. However, the evidence for their effectiveness is still limited. To compare the hand therapy protocols based on Brunnstrom approach and motor relearning program in rehabilitation of the hand of chronic stroke patients. Randomized trial. Outpatients attending the occupational therapy department of a rehabilitation institute. 30 post-stroke subjects (35.06 ± 14.52 months) were randomly assigned into two equal groups (Group A and Group B), Outcome Measures: Brunnstrom recovery stages of hand (BRS-H), Fugl-Meyer assessment: wrist and hand (FMA-WH). Group A received Brunnstrom hand manipulation (BHM). BHM is the hand treatment protocol of the Brunnstrom movement therapy, which uses synergies and reflexes to develop voluntary motor control. Group B received the Motor Relearning Program (MRP) based hand protocol. MRP is the practice of specific motor skills, which results in the ability to perform a task. Active practice of context-specific motor task such as reaching and grasping helps regain the lost motor functions. Both the therapy protocols were effective in rehabilitation of the hand (BRS-H; p = 0.003 to 0.004, FMA-WH; p hand motor recovery) (p rehabilitation of the hand in chronic post-stroke patients. Copyright © 2011 Elsevier Ltd. All rights reserved.
Full Text Available OBJECTIVE: To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden. DESIGN: This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms. SETTING: The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly. SUBJECTS: Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences. INTERVENTIONS: Aerobic exercises (flexibility, strength, and agility and functional balance exercises were conducted over six months for 60 minutes three times per week. MAIN MEASURES: Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA was applied to observe interactions (pre- vs. post-intervention; participants vs. controls. RESULTS: Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F: 11.12; p = 0.01; Cornell Depression scale: F: 11.97; p = 0.01. The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01. CONCLUSIONS: Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study.
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 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 Time is a fundamental dimension of our behavior and enables us to guide our actions and to experience time such as predicting collisions or listening to music. In this study, we investigate the regulation and covariation of motor timing and time perception functions in left- and right-handers who are characterized by distinct brain processing mechanisms for cognitive-motor control. To this purpose, we use a combination of tasks that assess the timed responses during movements and the perception of time intervals. The results showed a positive association across left- and right-handers between movement-driven timing and perceived interval duration when adopting a preferred tempo, suggesting cross-domain coupling between both abilities when an intrinsic timescale is present. Handedness guided motor timing during externally-driven conditions that required cognitive intervention, which specifies the relevance of action expertise for the performance of timed-based motor activities. Overall, our results reveal that individual variation across domain-general and domain-specific levels of organization plays a steering role in how one predicts, perceives and experiences time, which accordingly impacts on cognition and behavior.
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.
Zhang, Xin; Yong, Xinyi; Menon, Carlo
Electroencephalography (EEG) has recently been considered for use in rehabilitation of people with motor deficits. EEG data from the motor imagery of different body movements have been used, for instance, as an EEG-based control method to send commands to rehabilitation devices that assist people to perform a variety of different motor tasks. However, it is both time and effort consuming to go through data collection and model training for every rehabilitation task. In this paper, we investigate the possibility of using an EEG model from one type of motor imagery (e.g.: elbow extension and flexion) to classify EEG from other types of motor imagery activities (e.g.: open a drawer). In order to study the problem, we focused on the elbow joint. Specifically, nine kinesthetic motor imagery tasks involving the elbow were investigated in twelve healthy individuals who participated in the study. While results reported that models from goal-oriented motor imagery tasks had higher accuracy than models from the simple joint tasks in intra-task testing (e.g., model from elbow extension and flexion task was tested on EEG data collected from elbow extension and flexion task), models from simple joint tasks had higher accuracies than the others in inter-task testing (e.g., model from elbow extension and flexion task tested on EEG data collected from drawer opening task). Simple single joint motor imagery tasks could, therefore, be considered for training models to potentially reduce the number of repetitive data acquisitions and model training in rehabilitation applications.
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.
Matta, Lawrence Mark
The goal of this study was to improve the understanding of the flow turning loss, which contributes to the damping of axial acoustic instabilities in solid propellant rocket motors. This understanding is needed to develop practical methods for designing motors that do not exhibit such instabilities. The flow turning loss results from the interaction of the flow of combustion products leaving the surface of the propellant with the acoustic field in an unstable motor. While state of the art solid rocket stability models generally account for the flow turning loss, its magnitude and characteristics have never been fully investigated. This thesis describes a combined theoretical, numerical, and experimental investigation of the flow turning loss and its dependence upon various motor design and operating parameters. First, a one dimensional acoustic stability equation that verifies the existence of the flow turning loss was derived for a chamber with constant mean pressure and temperature. The theoretical development was then extended to include the effects of mean temperature gradients to accommodate combustion systems in which mean temperature gradients and heat losses are significant. These analyses provided the background and expressions necessary to guide an experimental study. The relevant equations were then solved for the developed experimental setup to predict the behavior of the flow turning loss and the other terms of the developed acoustic stability equation. This was followed by and experimental study in which the flow turning region of an unstable solid propellant rocket motor was simulated. The setup was used, with and without combustion, to determine the dependence of the flow turning loss upon operating conditions. These studies showed that the flow turning loss strongly depends upon the gas velocity at the propellant surface and the location of the flow turning region relative to the standing acoustic wave. The flow turning loss measured in the
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.
Halliday, Mark H; Ferreira, Paulo H; Hancock, Mark J; Clare, Helen A
To investigate if McKenzie exercises when applied to a cohort of patients with chronic LBP who have a directional preference demonstrate improved recruitment of the transversus abdominis compared to motor control exercises when measurements were assessed from ultrasound images. A randomized blinded trial with a 12-month follow-up. The Physiotherapy department of Concord Hospital a primary health care environment. 70-adults with greater than three-month history of LBP who have a directional preference. McKenzie techniques or motor control exercises for 12-sessions over eight weeks. Transversus abdominus thickness measured from real time ultrasound images, pain, global perceived effect and capacity to self-manage. This study will be the first to investigate the possible mechanism of action that McKenzie therapy and motor control exercises have on the recruitment of the transversus abdominus in a cohort of low back pain patients sub-classified with a directional preference. Patients receiving matched exercises according to their directional preference are believed to have better outcomes than those receiving unmatched exercises. A better understanding of the mechanism of action that specific treatments such as motor control exercises or McKenzie exercises have on patients classified with a directional preference will allow therapist to make a more informed choice about treatment options. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
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
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 motor achievements were significantly higher in infants receiving 400 IU/day vitamin D. Our findings also support longer infants being slightly delayed.
Zapparoli, Laura; Porta, Mauro; Gandola, Martina; Invernizzi, Paola; Colajanni, Valeria; Servello, Domenico; Zerbi, Alberto; Banfi, Giuseppe; Paulesu, Eraldo
The current study investigated the neural correlates of voluntary motor control in 24 adult Gilles de la Tourette (GTS) patients. We examined whether imagination and the execution of the same voluntary movement - finger oppositions with either hand - were associated with specific patterns of activation. We also explored whether these patterns correlated with the severity of the syndrome, as measured by the Yale Global Tic Severity Scale (YGTSS) for motor tics. The presence of brain morphometric abnormalities was also assessed using voxel-based morphometry. Crucial to our experiment was the manipulation of the presence of an explicit motor outflow in the tasks. We anticipated a reduction in the ticking manifestation during the explicit motor task and brain activation differences between GTS patients and 24 age/gender-matched normal controls. The anticipated differences were all evident in the form of hyperactivations in the GTS patients in the premotor and prefrontal areas for both motor tasks for both hands; however, the motor imagery hyperactivations also involved rostral pre-frontal and temporo-parietal regions of the right hemisphere. The blood oxygen level-dependent responses of the premotor cortices during the motor imagery task were significantly correlated with the YGTSS scores. In contrast, no significant brain morphometric differences were found. This study provides evidence of a different neurofunctional organisation of motor control between adult patients with GTS and healthy controls that is independent from the actual execution of motor acts. The presence of an explicit motor outflow in GTS mitigates the manifestation of tics and the need for compensatory brain activity in the brain regions showing task-dependent hyperactivations. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Cai, Guobiao; Cao, Binbin; Zhu, Hao; Tian, Hui; Ma, Xuan
The objective of this effort is to study the combustion performance of a hybrid rocket motor with the help of 3D steady-state numerical simulation, which applies 90% hydrogen peroxide as the oxidizer and hydroxyl-terminated polybutadiene as the fuel. A method of secondary oxidizer injection in post-chamber is introduced to investigate the flow field characteristics and combustion efficiency. The secondary injection medium is the mixed gas coming from liquid hydrogen peroxide catalytic decomposition. The secondary injectors are uniformly set along the circumferential direction of the post-chamber. The simulation results obtained by above model are verified by experimental data. Three influencing parameters are considered: secondary injection diameter, secondary injection angle and secondary injection numbers. Simulation results reveals that this design could improve the combustion efficiency with respect to the same motor without secondary injection. Besides, the secondary injection almost has no effect on the regression rate and fuel sueface temperature distribution. It is also presented that the oxidizer is injected by 8 secondary injectors with a diameter of 7-8 mm in the direction of 120°in post-chamber is identified as the optimized secondary injection pattern, through which combustion efficiency, specific impulse efficiency as well as utilization of propellants are all improved obviously.
Dr. Hofmann's work in the summer of 2003 consisted of two separate projects. In the first part of the summer, Dr. Hofmann prepared and collected information regarding rotor losses in synchronous machines; in particular, machines with low rotor losses operating in vacuum and supported by magnetic bearings, such as the motor/generator for flywheel energy storage systems. This work culminated in a presentation at NASA Glenn Research Center on this topic. In the second part, Dr. Hofmann investigated an approach to flywheel energy storage where the phases of the flywheel motor/generator are connected in parallel with the phases of an induction machine driving a mechanical actuator. With this approach, additional power electronics for driving the flywheel unit are not required. Simulations of the connection of a flywheel energy storage system to a model of an electromechanical actuator testbed at NASA Glenn were performed that validated the proposed approach. A proof-of-concept experiment using the D1 flywheel unit at NASA Glenn and a Sundstrand induction machine connected to a dynamometer was successfully conducted.
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
Pang, M Y C; Lau, R W K; Yip, S P
Whole-body vibration (WBV) has been used in older adults to improve bone health and neuromuscular function, and may have potential applications for stroke patients. To investigate the effects of WBV on bone turnover, leg muscle strength, motor function, and spasticity among chronic stroke patients. Randomized controlled trial (RCT). Community. Eighty-two chronic stroke patients. The experimental group underwent exercise training with WBV stimulation for a maximum of 15 minutes, 3 days per week for 8 weeks. The controls received the same exercises without WBV. Participants were evaluated for isokinetic knee muscle strength, serum levels of bone formation and resorption markers, spasticity and motor function of the paretic leg at baseline, immediately after the 8-week training period, and 1-month follow-up. Intention-to-treat analysis revealed no significant changes in levels of bone turnover markers and motor function of the paretic leg over time in both groups. Muscle strength outcomes showed no significant group×time interaction, with similar significant improvements found in both groups. Spasticity of the paretic knee was significantly reduced in the experimental group (P=0.005), but not in controls (P=0.465). No serious adverse events were reported. The WBV protocol used in this study did not induce additional effects on bone turnover, knee muscle strength and paretic leg motor function among chronic stroke patients. WBV may have potential to modulate spasticity, but this requires further investigation. More study on WBV is required before it can be recommended as an adjunct treatment in rehabilitation of chronic stroke patients.
Valizadeh, Leila; Sanaeefar, Mahnaz; Hosseini, Mohammad Bager; Asgari Jafarabadi, Mohammad; Shamili, Aryan
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.
... RELEASE OF ADVERSE INFORMATION TO NEWS MEDIA § 17.4 Regulatory investigations and trial-type proceedings... 45 Public Welfare 1 2010-10-01 2010-10-01 false Regulatory investigations and trial-type... organizations or to pending agency trial-type proceedings shall be released only in limited circumstances in...
Wang, Xueqiang; Pi, Yanling; Chen, Peijie; Liu, Yu; Wang, Ru; Chan, Chetwyn
We conducted a systematic review to determine the effect of cognitive motor interference (CMI) for the prevention of falls in older adults. We searched studies through Medline, Embase, the Cochrane Library, Web of Science, CINAHL, PEDro and the China Biology Medicine disc. Only randomised controlled trials examining the effects of CMI for older people were included. The primary outcome measure was falls; the secondary outcome measures included gait, balance function and reaction time. A total of 30 studies of 1,206 participants met the inclusion criteria, and 27 studies of 1,165 participants were used as data sources for the meta-analyses. The pooling revealed that CMI was superior to control group for fall rate [standard mean difference (SMD) (95% CI)=-3.03 (-4.33, -1.73), P<0.0001], gait speed [SMD (95% CI)=0.36 (0.07, 0.66), P=0.01], step length [SMD (95% CI)=0.48 (0.16, 0.80), P=0.003], cadence [SMD (95% CI)=0.19 (0.01, 0.36), P=0.03], timed up and go test [SMD (95% CI)=-0.22 (-0.38, -0.06), P=0.007], centre of pressure displacement [SMD (95% CI)=-0.32 (-1.06, 0.43), P=0.04] and reaction time [SMD (95% CI)=-0.47 (-0.86, -0.08), P=0.02]. The systematic review demonstrates that CMI is effective for preventing falls in older adults in the short term. However, there is, as yet, little evidence to support claims regarding long-term benefits. Hence, future studies should investigate the long-term effectiveness of CMI in terms of fall prevention in older adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: email@example.com.
Celik, Halil Ibrahim; Elbasan, Bulent; Gucuyener, Kivilcim; Kayihan, Hulya; Huri, Meral
The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants. We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development. The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions. Copyright © 2018 by the American Occupational Therapy Association, Inc.
Kalkman, S; van Thiel, Ghislaine J M W; Grobbee, Diederick E.; Meinecke, Anna Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M
Background: We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. Methods: We
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.
Bouwien C M Smits-Engelsman
Full Text Available 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.
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.
Fabri, Tracy L; Wilson, Katherine E; Holland, Nicole; Hickling, Andrea; Murphy, James; Fait, Philippe; Reed, Nick
Mild traumatic brain injury (or concussion) is a prevalent yet understudied health concern in children and youth. This injury can cause dysfunction in both motor and cognitive domains; however, most literature focuses on single-task neuropsychological tests which only assess cognition. Although dual-task research on concussed children and youth is needed as many daily activities require both motor and cognitive domains, we must first investigate whether performing simultaneous motor and cognitive tasks of varied complexity impact these domains in healthy children and youth. Data collected from 106 healthy children and youth (5-18 years) created a normative dataset. Participants performed motor (postural stability) and cognitive (visual attention) tasks under single- and dual-task conditions. The cognitive task difficulty remained constant while the motor task had four conditions of increasing difficulty. The relationship between the number of correct responses (cognitive performance) and sway index (motor performance) was determined using two repeated measures ANOVAs (pchildren and youth following concussion. Copyright © 2017 Elsevier B.V. All rights reserved.
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.
Frandsen, Tommy Vestergaard; Rasmussen, Peter Omand
. Suspicion of the motor saturating before the MG reached peek torque and thus measuring the maximum torque of the motor instead, made the method questionable. The MIPMG has been modified to lock the HS side of the MG mechanically and new measurements have been conducted but with the same low slip torque...
Ross, Susan; Metcalf, Amanda; Bulger, Sean M; Housner, Lynn D
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 development and learning competencies that prospective physical educators need to learn within the physical education teacher education (PETE) curriculum and to identify learning environments and instructional methods for delivering core knowledge. The study employed a 2-round, modified Delphi procedure involving the repeated circulation of a questionnaire to a panel of motor development specialists, motor learning specialists, teacher educators, and K-12 physical education teachers. Panel members rated an initial list of theoretical and applied motor development and learning competencies derived from various curricular guidelines and textbook sources. An open-response question was incorporated into the 2nd round asking panel members to recommend specific instructional methods and settings for delivering core motor development and learning content to prospective physical educators within the PETE curriculum. Expert consensus determined that 64 out of the initial 159 motor development and learning competencies were critical in preparing preservice physical educators. Early field experiences and peer practice in a variety of settings were recommended by panelists for delivering the identified competencies. The Discussion section represents an important link between the motor development and learning body of knowledge and physical education teachers' role in promoting skillful movement, physical activity, and fitness among youth in the school setting.
Steventon, Glyn B; Waring, Rosemary H; Williams, Adrian C
The role of defective 'sulphur xenobiotic' biotransformations in the aetiology of Parkinson's and motor neurone diseases has been in the literature for over a decade. Problems in the S-oxidation of aliphatic thioethers, sulphation of phenolic compounds and the S-methylation of aliphatic sulphydryl groups have all been reported. These reports have also been consistent in observing that only a 'significant minority' of patients express these problems in sulphur biotransformation pathways. However, no investigation has yet reported on the incidence of these three defective pathways in control invididuals and in patients with Parkinson's and motor neurone disease. This investigation has found that: 1. Forty percent of patients with Parkinson's and motor neurone disease have a defect in the S-oxidation of S-carboxymethyl-L-cysteine compared to 4% of controls. 2. 35-40% of patients with Parkinson's and motor neurone disease have a defect in the sulphation of paracetamol compared to 4% of controls. 3. 60% of patients with motor neurone disease have a high capacity for the S-methylation of 2-mercaptoethanol compared to 4% of controls. 4. 38% of patients with Parkinson's disease have a low capacity for the S-methylation of 2-mercaptoethanol compared to 4% of controls. 5. There is no correlation between the S-oxidation phenotype, low paracetamol sulphation phenotype and low or high S-methylation phenotype in controls or patients with Parkinson's or motor neurone disease. 6. The number of controls that expressed one of the aberrant phenotypes was 4% compared to 38% of the patients with Parkinson's disease and 47% of the patients with motor neurone disease. 7. The number of controls that expressed two of the aberrant phenotypes was 0% compared to 18% of the patients with Parkinson's disease and 19% of those with motor neurone disease. 8. No controls or patients with Parkinson's disease or motor neurone disease expressed all three of the aberrant phenotypes. The results
Miura, Misa; Seki, Kazunori; Ito, Osamu; Handa, Yasunobu; Kohzuki, Masahiro
Abdominal muscle strength declines easily with the process of aging and/or disuse, and it is difficult to strengthen weak abdominal muscles in the inactive elderly. In the present study, we applied surface electrical stimulation (ES) to the abdomen of inactive elderly people to investigate its chronic effects. Twenty inactive elderly people (65-89 years) who spent most of the day in their bedroom participated in the study. The subjects were assigned to ES and non-ES groups in a random order. In addition to conventional physical therapy and occupational therapy, ES was applied to both sides of the flank of 10 subjects (ES group) for 8 weeks. For evaluation of the abdominal muscles, the cross-sectional area (CSA) was measured with computed tomography and the electrical muscle activity (iEMG) was measured by electromyography. Functional examinations were performed at 2, 4, and 8 weeks after the beginning of the study with the following parameters: grip strength; maximum walking speed (WS); movement time for sitting up (MSU); number of trunk flexions (NTF); flexibility of the trunk; sit-to-stand time (STS); and Barthel index (BI) score. In the ES group, the NTF and MSU were significantly improved at 4 weeks and thereafter. Furthermore, the STS and WS were also improved significantly after 8 weeks (p < 0.05). The CSA and iEMG both increased significantly (p < 0.05). However, the flexibility of the trunk and BI score did not change. In conclusion, ES to the abdomen has the potential to improve motor function in the inactive elderly.
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.
Cortes, Mar; Black-Schaffer, Randie M; Edwards, Dylan J
Rationale 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. Scope 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 over 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 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 be interpreted along with clinical evaluation in this patient population. Summary 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. PMID:22624621
Vukovic, Mile; Vukovic, Irena; Stojanovik, Vesna
Specific language impairment (SLI) is usually defined as a developmental language disorder which does not result from a hearing loss, autism, neurological and emotional difficulties, severe social deprivation, low non-verbal abilities. Children affected with SLI typically have difficulties with the acquisition of different aspects of language and by definition, their impairment is specific to language and no other skills are affected. However, there has been a growing body of literature to suggest that children with SLI also have non-linguistic deficits, including impaired motor abilities. The aim of the current study is to investigate language and motor abilities of a group of thirty children with SLI (aged between 4 and 7) in comparison to a group of 30 typically developing children matched for chronological age. The results showed that the group of children with SLI had significantly more difficulties on the language and motor assessments compared to the control group. The SLI group also showed delayed onset in the development of all motor skills under investigation in comparison to the typically developing group. More interestingly, the two groups differed with respect to which language abilities were correlated with motor abilities, however Imitation of Complex Movements was the unique skill which reliably predicted expressive vocabulary in both typically developing children and in children with SLI. Copyright © 2010 Elsevier Ltd. All rights reserved.
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.
Calabrò, Rocco Salvatore; Naro, Antonino; Russo, Margherita; Leo, Antonino; De Luca, Rosaria; Balletta, Tina; Buda, Antonio; La Rosa, Gianluca; Bramanti, Alessia; Bramanti, Placido
Many studies have demonstrated the usefulness of repetitive task practice by using robotic-assisted gait training (RAGT) devices, including Lokomat, for the treatment of lower limb paresis. Virtual reality (VR) has proved to be a valuable tool to improve neurorehabilitation training. The aim of our pilot randomized clinical trial was to understand the neurophysiological basis of motor function recovery induced by the association between RAGT (by using Lokomat device) and VR (an animated avatar in a 2D VR) by studying electroencephalographic (EEG) oscillations. Twenty-four patients suffering from a first unilateral ischemic stroke in the chronic phase were randomized into two groups. One group performed 40 sessions of Lokomat with VR (RAGT + VR), whereas the other group underwent Lokomat without VR (RAGT-VR). The outcomes (clinical, kinematic, and EEG) were measured before and after the robotic intervention. As compared to the RAGT-VR group, all the patients of the RAGT + VR group improved in the Rivermead Mobility Index and Tinetti Performance Oriented Mobility Assessment. Moreover, they showed stronger event-related spectral perturbations in the high-γ and β bands and larger fronto-central cortical activations in the affected hemisphere. The robotic-based rehabilitation combined with VR in patients with chronic hemiparesis induced an improvement in gait and balance. EEG data suggest that the use of VR may entrain several brain areas (probably encompassing the mirror neuron system) involved in motor planning and learning, thus leading to an enhanced motor performance. Retrospectively registered in Clinical Trials on 21-11-2016, n. NCT02971371 .
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.
Macedo, Luciana Gazzi; Latimer, Jane; Maher, Christopher G; Hodges, Paul W; McAuley, James H; Nicholas, Michael K; Tonkin, Lois; Stanton, Chris J; Stanton, Tasha R; Stafford, Ryan
Motor control exercises to improve control and coordination of trunk muscles and graded activity under the principles of cognitive-behavioral therapy are 2 commonly used exercise therapies, yet there is little evidence to support the use of one intervention over the other. The objective of this study was to compare the effectiveness of motor control exercises and graded activity for patients with chronic nonspecific low back pain. This study was a prospectively registered randomized controlled trial with outcome assessment and statistical analyses conducted blind to group. The study was conducted in primary care settings. The participants were 172 patients with chronic (>12 weeks) nonspecific low back pain. Patients were randomly assigned to receive either motor control exercises or graded activity. There was no attempt to subclassify patients to match them to a treatment. Patients in both groups received 14 sessions of individualized, supervised exercise therapy. Primary outcomes were average pain over the previous week (numeric rating scale) and function (Patient-Specific Functional Scale); secondary outcomes were disability (24-item Roland-Morris Disability Questionnaire), global impression of change (Global Perceived Effect Scale), and quality of life (36-Item Short-Form Health Survey questionnaire [SF-36]). Outcome measures were collected at baseline and at 2, 6, and 12 months after intervention. A linear mixed models analysis showed that there were no significant differences between treatment groups at any of the time points for any of the outcomes studied. For example, the effect for pain at 2 months was 0.0 (-0.7 to 0.8). Clinicians could not be blinded to the interventions. results of this study suggest that motor control exercises and graded activity have similar effects for patients with chronic nonspecific low back pain.
Mahasup, Namfon; Sritipsukho, Paskorn; Lekskulchai, Raweewan; Hansakunachai, Tippawan
The authors aimed to compare the motor function measured by Gross Motor Function Measure (GMFM-66) between mirror neurons stimulation based VCD program at home and conventional physical therapy in children with cerebral palsy for two months. A randomized controlled trial was performed with thirty children with spastic diplegia aged 2-10 years in Thammasat university hospital and Rajanukul institue. They were randomly assigned to receive either the mirror neurons stimulation based VCD program practice at home (experimental group) or the conventional physical therapy (control group) for two months. Both groups were measured the motor function by GMFM-66 at entry, the first month and the end of the second month. Analysis of covariance was used to compare mean changes of GMFM-66 scores between both groups at the second month after adjusted for the baseline level. A total of 30 children with cerebral palsy, aged 2.2-9.5 years (mean age 5.9 +/- 2.2 years). The mean changes of the GMFM scores in experimental group were slightly higher than those in the control group of 2.1 (95% CI: -2.3, 6.5) at the second month after adjusted for the baseline level. The mean GMFM scores were significantly improved in all dimensions except lying and rolling dimension, at the first and second month when compared to the baseline level in both groups. This pilot study demonstrated the mirror neurons stimulation based VCD program can improve motor function, at least, as much as the conventional physical therapy.
Fan, Ying; Gu, Lingling; Luo, Yong; Han, Xuedong; Cheng, Ming
This paper presents a flux-modulated direct drive (FMDD) motor. The key is to integrate the magnetic gear with the PM motor while removing the gear inner-rotor. Hence, the proposed FMDD motor can achieve the low-speed high-torque output and high-speed compact design requirements as well as high-torque density with a simple structure. The output power equation is analytically derived. By using finite element analysis (FEA), the static characteristics of the proposed motor are obtained. Based on these characteristics, the system mathematical model can be established. Hence, the evaluation of system performances is conducted by computer simulation using the Matlab/Simulink. A prototype is designed and built for experimentation. Experimental results are given to verify the theoretical analysis and simulation.
Full Text Available This paper presents a flux-modulated direct drive (FMDD motor. The key is to integrate the magnetic gear with the PM motor while removing the gear inner-rotor. Hence, the proposed FMDD motor can achieve the low-speed high-torque output and high-speed compact design requirements as well as high-torque density with a simple structure. The output power equation is analytically derived. By using finite element analysis (FEA, the static characteristics of the proposed motor are obtained. Based on these characteristics, the system mathematical model can be established. Hence, the evaluation of system performances is conducted by computer simulation using the Matlab/Simulink. A prototype is designed and built for experimentation. Experimental results are given to verify the theoretical analysis and simulation.
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.
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......-user involvement, the broad population base, and the pragmatic nature of the intervention. The cohort will provide important information about the influence of early motor skills on children's development across many domains and the potential interactions between these domains. TRIAL REGISTRATION: ISRCTN registry...... 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...
Bamidele Oyebamiji Adeyemo
Full Text Available Introduction: Repetitive Transcranial Magnetic Stimulation (rTMS and Transcranial Direct Current Stimulation are two powerful non-invasive neuromodulatory therapies that have the potential to alter and evaluate the integrity of the corticospinal tract. Moreover, recent evidence has shown that brain stimulation might be beneficial in stroke recovery. Therefore, investigating and investing in innovative therapies that may improve neurorehabilitative stroke recovery are next steps in research and development.Methods: This article presents an up-to-date systematic review of the treatment effects of rTMS and tDCS on motor function. A literary search was conducted, utilizing search terms stroke and transcranial stimulation. Items were excluded if they failed to: (1 include stroke patients, (2 study motor outcomes, or (3 include rTMS/tDCS as treatments. Other exclusions included: (1 reviews, editorials, and letters, (2 animal or pediatric populations, (3 case reports or sample sizes < or = 2 patients, and (4 primary outcomes of dysphagia, dysarthria, neglect, or swallowing.Results: Investigation of PubMed English Database prior to 01/01/2012 produced 695 applicable results. Studies were excluded based on the aforementioned criteria, resulting in 50 remaining studies. They included 1314 participants (1282 stroke patients and 32 healthy subjects evaluated by motor function pre- and post- tDCS or rTMS. Heterogeneity among studies’ motor assessments was high and could not be accounted for by individual comparison. Pooled effect sizes for the impact of post-treatment improvement revealed consistently demonstrable improvements after tDCS and rTMS therapeutic stimulation. Most studies provided limited follow-up for long-term effects.Conclusions: It is apparent from the available studies that noninvasive stimulation may enhance motor recovery and may lead to clinically-meaningful functional improvements in the stroke population.
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.
Du, J; Tian, L; Liu, W; Hu, J; Xu, G; Ma, M; Fan, X; Ye, R; Jiang, Y; Yin, Q; Zhu, W; Xiong, Y; Yang, F; Liu, X
Repetitive transcranial magnetic stimulation (rTMS) changes the excitability of the motor cortex and thereby has the potential to enhance motor recovery after stroke. This randomized, sham-controlled, double-blind study was to compare the effects of high-frequency versus low-frequency rTMS on motor recovery during the early phase of stroke and to identify the neurophysiological correlates of motor improvements. A total of 69 first-ever ischemic stroke patients with motor deficits were randomly allocated to receive five daily sessions of 3-Hz ipsilesional rTMS, 1-Hz contralesional rTMS or sham rTMS in addition to standard physical therapy. Outcome measures included motor deficits, neurological scores and cortical excitability, which were assessed at baseline, after the intervention and at 3-month follow-up. The rTMS groups manifested greater motor improvements than the control group, which were sustained for at least 3 months after the end of the treatment sessions. 1-Hz rTMS over the unaffected hemisphere produced more profound effects than 3-Hz rTMS in facilitating upper limb motor performance. There was a significant correlation between motor function improvement and motor cortex excitability change in the affected hemisphere. Repetitive transcranial magnetic stimulation is a beneficial neurorehabilitative strategy for enhancing motor recovery in the acute and subacute phase after stroke. © 2016 EAN.
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)
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.
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
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.
Fu, Qin-hui; Pei, Jian; Jia, Qi; Song, Yi; Gu, Yue-hua; You, Xiao-xin
Stroke is responsible for increasingly high rates of mortality and disability worldwide. Approximately two million people suffer from stroke for the first time in China each year. The high incidence (50%) of post-stroke disability brings a heavy burden to patients and their caregivers. Acupuncture has been widely used in the communities for post-stroke rehabilitation in China. The objective of this trial is to apply our acupuncture research achievement to treatment and evaluation of post-stroke hemiplegic patients in community. A multicenter, randomized, controlled trial will be performed in Longhua Hospital and a number of community health service centers in Shanghai. A total of 124 patients (estimated sample size) with post-stroke hemiplegia will be randomly divided into an acupuncture group and a control group. The patients undergoing randomization should be stratified according to National Institutes of Health Stroke Scale score at baseline. Within the acupuncture group, different acupuncture protocols are administered to patients with flaccid paralysis or spastic paralysis based on the Ashworth Scale. Patients in the acupuncture group will also be treated with comprehensive rehabilitation therapy. The control group will be treated with comprehensive rehabilitation therapy only. The primary outcome measures are the Simplified Fugl-Meyer Motor Scale, the Modified Barthel Index, and the Burden of Stroke Scale. Secondary outcome measures are the modified Rankin Scale, the modified Ashworth Scale and the Stroke Scale of Traditional Chinese Medicine. Outcome measures will be performed after 4 and 8 weeks of treatment. The patients will be followed up after 6 months. The results of this study are expected to demonstrate that our standardized acupuncture protocol for treating and evaluating post-stroke hemiplegic patients will improve motor function and lessen the burden of post-stroke patients within the communities. This will provide the evidence to support
Franzen, Samuel R P; Chandler, Clare; Enquselassie, Fikre; Siribaddana, Sisira; Atashili, Julius; Angus, Brian; Lang, Trudie
Clinical trials provide 'gold standard' evidence for policy, but insufficient locally relevant trials are conducted in low-income and middle-income countries. Local investigator-initiated trials could generate highly relevant data for national governments, but information is lacking on how to facilitate them. We aimed to identify barriers and enablers to investigator-initiated trials in Ethiopia to inform and direct capacity strengthening initiatives. Exploratory, qualitative study comprising of in-depth interviews (n=7) and focus group discussions (n=3). Fieldwork took place in Ethiopia during March 2011. Local health researchers with previous experiences of clinical trials or stakeholders with an interest in trials were recruited through snowball sampling (n=20). Detailed discussion notes were analysed using thematic coding analysis and key themes were identified. All participants perceived investigator-initiated trials as important for generating local evidence. System and organisational barriers included: limited funding allocation, weak regulatory and administrative systems, few learning opportunities, limited human and material capacity and poor incentives for conducting research. Operational hurdles were symptomatic of these barriers. Lack of awareness, confidence and motivation to undertake trials were important individual barriers. Training, knowledge sharing and experience exchange were key enablers to trial conduct and collaboration was unanimously regarded as important for improving capacity. Barriers to trial conduct were found at individual, operational, organisational and system levels. These findings indicate that to increase locally led trial conduct in Ethiopia, system wide changes are needed to create a more receptive and enabling research environment. Crucially, the creation of research networks between potential trial groups could provide much needed practical collaborative support through sharing of financial and project management burdens
Gerson, Richard F.; Thomas, Jerry R.
Children's serial motor skill acquisition was studied within a neo-Piagetian framework. High and low M-processors (a designation of a child's ability to produce problem solutions) performed on a curvilinear repositioning task. A primacy-recency effect was evidenced for both groups on the age-related task, while a recency effect occurred for only…
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…
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...
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.
Hielkema, Tjitske; Blauw-Hospers, Cornill H.; Dirks, Tineke; Drijver-Messelink, Marieke; Bos, Arend F.; Hadders-Algra, Mijna
AIM The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders onmotor outcome, as measured by the InfantMotor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation. METHOD At a corrected age of 3
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...... present a feature selection strategy consisting of channel selection by fisher ratio analysis in the frequency domain and time segment selection by visual inspection in time domain. The proposed strategy achieves an absolute improvement of 7.5% in the misclassification rate as compared with the baseline...
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.
Gurbuz, Nigar; Afsar, Sevgi Ikbali; Ayaş, Sehri; Cosar, Sacide Nur Saracgil
[Purpose] This study aimed to evaluate the effectiveness of mirror therapy combined with a conventional rehabilitation program on upper extremity motor and functional recovery in stroke patients. [Subjects and Methods] Thirty-one hemiplegic patients were included. The patients were randomly assigned to a mirror (n=16) or conventional group (n=15). The patients in both groups underwent conventional therapy for 4 weeks (60-120 minutes/day, 5 days/week). The mirror group received mirror therapy, consisting of periodic flexion and extension movements of the wrist and fingers on the non-paralyzed side. The patients in the conventional group performed the same exercises against the non-reflecting face of the mirror. The patients were evaluated at the beginning and end of the treatment by a blinded assessor using the Brunnstrom stage, Fugl-Meyer Assessment (FMA) upper extremity score, and the Functional Independence Measure (FIM) self-care score. [Results] There was an improvement in Brunnstrom stage and the FIM self-care score in both groups, but the post-treatment FMA score was significantly higher in the mirror therapy group than in the conventional treatment group. [Conclusion] Mirror therapy in addition to a conventional rehabilitation program was found to provide additional benefit in motor recovery of the upper extremity in stroke patients.
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.
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.
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 recess was not effective. CHAMP could help contribute to children's learning-related skills and physical development and subsequently to their academic success.
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
Full Text Available Background: To assess the use of functional magnetic resonance imaging (fMRI in motor neuron disease (MND, a systematic review and voxelwise meta-analysis of studies comparing brain activity in patients with MND and in healthy controls (HCs was conducted to identify common findings across studies.Methods: A search for related papers published in English and Chinese was performed in Ovid Medline, Pubmed and Embase database. Voxelwise meta-analysis was performed using signed differential mapping.Results: The findings from 55 fMRI studies on MND were tabulated, and some common findings were discussed in further details. Conclusions: These ﬁndings are preliminary, sometimes even contradictory, and do not allow a complete understanding of the functional alterations in MND. However, we documented reliable findings that MND is not confined to the motor system, but is a multisystem disorder involving extra-motor cortex areas, causing cognitive dysfunction and deficits in socioemotional and sensory processing pathways.
Bonhoeffer, Jan; Imoukhuede, Egeruan B.; Aldrovandi, Grace; Bachtiar, Novilia S.; Chan, Eng-Soon; Chang, Soju; Chen, Robert T.; Fernandopulle, Rohini; Goldenthal, Karen L.; Heffelfinger, James D.; Hossain, Shah; Jevaji, Indira; Khamesipour, Ali; Kochhar, Sonali; Makhene, Mamodikoe; Malkin, Elissa; Nalin, David; Prevots, Rebecca; Ramasamy, Ranjan; Sellers, Sarah; Vekemans, Johan; Walker, Kenneth B.; Wilson, Pam; Wong, Virginia; Zaman, Khalequz; Heininger, Ulrich
This document is intended as a guide to the protocol development for trials of prophylactic vaccines. The template may serve phases I–IV clinical trials protocol development to include safety relevant information as required by the regulatory authorities and as deemed useful by the investigators. This document may also be helpful for future site strengthening efforts. PMID:23499603
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.
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.
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
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.
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.
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.
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
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%.
Motor development related to duration of exclusive breastfeeding, B vitamin status and B12 supplementation in infants with a birth weight between 2000-3000 g, results from a randomized intervention trial.
Torsvik, Ingrid Kristin; Ueland, Per Magne; Markestad, Trond; Midttun, Øivind; Bjørke Monsen, Anne-Lise
Exclusive breastfeeding for 6 months is assumed to ensure adequate micronutrients for term infants. Our objective was to investigate the effects of prolonged breastfeeding on B vitamin status and neurodevelopment in 80 infants with subnormal birth weights (2000-3000 g) and examine if cobalamin supplementation may benefit motor function in infants who developed biochemical signs of impaired cobalamin function (total homocysteine (tHcy) > 6.5 μmol/L) at 6 months. Levels of cobalamin, folate, riboflavin and pyridoxal 5´-phosphate, and the metabolic markers tHcy and methylmalonic acid (MMA), were determined at 6 weeks, 4 and 6 months (n = 80/68/66). Neurodevelopment was assessed with the Alberta Infants Motor Scale (AIMS) and the parental questionnaire Ages and Stages (ASQ) at 6 months. At 6 months, 32 of 36 infants with tHcy > 6.5 μmol/L were enrolled in a double blind randomized controlled trial to receive 400 μg hydroxycobalamin intramuscularly (n = 16) or sham injection (n = 16). Biochemical status and neurodevelopment were evaluated after one month. Except for folate, infants who were exclusively breastfed for >1 month had lower B vitamin levels at all assessments and higher tHcy and MMA levels at 4 and 6 months. At 6 months, these infants had lower AIMS scores (p = 0.03) and ASQ gross motor scores (p = 0.01). Compared to the placebo group, cobalamin treatment resulted in a decrease in plasma tHcy (p motor scores (p = 0.03). The findings suggest that prolonged exclusive breastfeeding may not provide sufficient B vitamins for small infants, and that this may have a negative effect on early gross motor development. In infants with mild cobalamin deficiency at 6 months, cobalamin treatment significantly improvement cobalamin status and motor function, suggesting that the observed impairment in motor function associated with long-term exclusive breastfeeding, may be due to cobalamin deficiency. ClinicalTrials
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.
Pomeroy, Valerie M; Ward, Nick S; Johansen-Berg, Heidi; van Vliet, Paulette; Burridge, Jane; Hunter, Susan M; Lemon, Roger N; Rothwell, John; Weir, Christopher J; Wing, Alan; Walker, Andrew A; Kennedy, Niamh; Barton, Garry; Greenwood, Richard J; McConnachie, Alex
Functional strength training in addition to conventional physical therapy could enhance upper limb recovery early after stroke more than movement performance therapy plus conventional physical therapy. To determine (a) the relative clinical efficacy of conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy for upper limb recovery; (b) the neural correlates of response to conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy; (c) whether any one or combination of baseline measures predict motor improvement in response to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Randomized, controlled, observer-blind trial. The sample will consist of 288 participants with upper limb paresis resulting from a stroke that occurred within the previous 60 days. All will be allocated to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Functional strength training and movement performance therapy will be undertaken for up to 1·5 h/day, five-days/week for six-weeks. Measurements will be undertaken before randomization, six-weeks thereafter, and six-months after stroke. Primary efficacy outcome will be the Action Research Arm Test. Explanatory measurements will include voxel-wise estimates of brain activity during hand movement, brain white matter integrity (fractional anisotropy), and brain-muscle connectivity (e.g. latency of motor evoked potentials). The primary clinical efficacy analysis will compare treatment groups using a multilevel normal linear model adjusting for stratification variables and for which therapist administered the treatment. Effect of conventional physical therapy combined
桶谷, 涼太; 青柳, 学; 高野, 剛浩; 田村, 英樹
It is difficult for the ultrasonic motor to change the preload while driving. Then, an ultrasonic actuator that was able to electrically control a preload was developed by combining piezoelectric motor with clutch function in this study. In this paper, a hybrid actuator system combining an electromagnetic motor (EMM) with a piezoelectric motor was proposed and examined. The driving range can be widened by combining the both actuators with a different characteristic. As one of results, a riset...
Volodin, V.M.; Tsyplyaev, V.A.; Gorin, V.V.; Ivanov, Yu.N.
The motor activity of the gall bladder was studied using cholescintigraphy with sup(99m)Tc-HIDA in 57 patients with chronic cholecystitis and chronic heaptitis and in 9 controls. A comparative analysis of the curves activity-time based upon the elements of images of the external contour and the entire zone of the gall bladder, made it possible to reveal differences in the type of reaction of the gall bladder to the use of cholagogic stimulators (cholecystokinin i.v. and cholagogic breakfast). A method of the processing of the results made it possible to determine the number of contraction phases of the gall bladder during its emptying as well as the true latent period and the period of primary reactions of the beliferous apparatus after taking a food stimulus
Georgias, Christine; Grunow, Andrea; Olderog, Miriam; May, Alexander; Paulus, Ursula
With the amendment to the German Drug Law in 2004, the conduct of clinical trials changed by at least two main aspects: (1) The principles of Good Clinical Practice (GCP) were implemented in the national legislation, and (2) for the first time, the function of the sponsor of a clinical trial and the clinical trial itself have become legally binding definitions. By that, legal differences between industrial and academic clinical trials no longer exist. Clinical trials initiated by investigators have to fulfil the same requirements while the entire sponsor responsibility has to be carried out by the Coordinating Investigator or his institution including implementation of a quality management system according to the GCP. The Cologne Sponsor Model is an effective approach with settings, structures, basic features, action, and reporting lines, as well as funding for clinical trials initiated in an academic environment. The University of Cologne assumes the sponsor responsibility for clinical trials organised by the university researchers according to law. Sponsor's duties are delegated to a central operational unit of the sponsor - the Clinical Trials Center Cologne - which further delegates duties to the Coordinating Investigator. Clinical Trials Center Cologne was established in 2002 to support the performance of clinical trials at the university by offering comprehensive advisory and practical services covering all aspects of study planning and conduct. Furthermore, a specialised division of its quality management department acts as an independent sponsor's Quality Assurance Unit. The Clinical Trials Center Cologne has established a quality management system consisting of different components (1) to enable a reasoned decision to subsequent delegation, (2) for risk-based surveillance of trial conduct (audits, monitoring-checks, and reports), and (3) support and training of the Coordinating Investigator. Double functions of persons and departments in the university
Athanasiou, Alkinoos; Klados, Manousos A; Styliadis, Charis; Foroglou, Nicolas; Polyzoidis, Konstantinos; Bamidis, Panagiotis D
It is recognized that lower electroencephalography (EEG) frequencies correspond to distributed brain activity over larger spatial regions than higher frequencies and are associated with coordination. In motor processes it has been suggested that this is not always the case. Our objective was to explore this contradiction. In our study, seven healthy subjects performed four motor tasks (execution and imagery of right hand and foot) under EEG recording. Two cortical source models were defined, model «A» with 16 regions of interest (ROIs) and model «B» with 20 ROIs over the sensorimotor cortex. Functional connectivity was calculated by Directed Transfer Function for alpha and beta rhythm networks. Four graph properties were calculated for each network: characteristic path length (CPL), clustering coefficient (CC), density (D) and small-world-ness (SW). Different network modules and in-degrees of nodes were also calculated and depicted in connectivity maps. Analysis of variance was used to determine statistical significance of observed differences in the network properties between tasks, between rhythms and between ROI models. Consistently on both models, CPL and CC were lower and D was higher in beta rhythm networks. No statistically significant difference was observed for SW between rhythms or for any property between tasks on any model. Comparing the models we observed lower CPL for both rhythms, lower CC in alpha and higher CC in beta when the number of ROIs increased. Also, denser networks with higher SW were correlated with higher number of ROIs. We propose a non-exclusive model where alpha rhythm uses greater wiring costs to engage in local information progression while beta rhythm coordinates the neurophysiological processes in sensorimotor tasks. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.
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.
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
Bonvin, Antoine; Barral, Jérôme; Kakebeeke, Tanja H; Kriemler, Susi; Longchamp, Anouk; Schindler, Christian; Marques-Vidal, Pedro; Puder, Jardena J
To assess the effect of a governmentally-led center based child care physical activity program (Youp'là Bouge) on child motor skills. We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed. At baseline, 648 children present on the motor test day were included (age 3.3 ± 0.6, BMI 16.3 ± 1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n = 201), children in the intervention group (n = 187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (-0.8 to 0.3), p = 0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: (1) free-access to a movement space and parental information session for motor skills (2) highly motivated and trained educators for BMI (3) free-access to a movement space and purchase of mobile equipment for physical activity (all p child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs. Clinical trials.gov NCT00967460.
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.
Soleimani, Robabeh; Kousha, Maryam; Zarrabi, Homa; Tavafzadeh-Haghi, Seyede Mahnaz; Jalali, Mir Mohammad
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. 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 χ 2 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. 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. 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. IRCT201107071483N2.
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.
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.
Chrysagis, Nikolaos; Skordilis, Emmanouil K; Stavrou, Nektarios; Grammatopoulou, Eirini; Koutsouki, Dimitra
The aim of this study was to evaluate the effect of a treadmill program on gross motor function, walking speed, and spasticity of ambulatory adolescents with spastic cerebral palsy (diplegia and tetraplegia). In this randomized controlled trial, 22 adolescents (13-19 yrs old) from a special school for children with physical disabilities were randomly allocated to the experimental and control training groups. The experimental training group underwent a treadmill program without body weight support at a comfortable speed. The control group received treatment with conventional physiotherapy, which consisted of three sets of exercises with mat activities, balance, gait training, and functional gross motor activities. The program lasted 12 wks with a frequency of three times per week for both groups. Pretest and posttest measurements of self-selected walking speed, gross motor function, and spasticity were conducted. The analysis of covariance findings examining posttest differences between groups were significant with respect to self-selected walking speed (F = 8.545, P = 0.000) and gross motor function (F = 9.088, P = 0.007), whereas no significance was found for spasticity. Treadmill training may improve the walking speed and gross motor function of adolescents with spastic cerebral palsy, without adverse effects on spasticity.
-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
This study investigated the feasibility of active control of combustion instabilities in liquid fueled combustors using a liquid fuel injector actuator and adaptive control of combustion instabilities...
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.
van der Kolk, Nicolien M; Overeem, Sebastiaan; de Vries, Nienke M; Kessels, Roy P C; Donders, Rogier; Brouwer, Marc; Berg, Daniela; Post, Bart; Bloem, Bas R
Parkinson's disease (PD) is a neurodegenerative disorder with a wide range of motor and non-motor symptoms. Despite optimal medical management, PD still results in a high disability rate and secondary complications and many patients lead a sedentary lifestyle, which in turn is also associated with a higher co-morbidity and mortality. Exercise has been explored as a strategy to reduce secondary complications and results suggests that it not only provides general health benefits, but may also provide symptomatic relief. If this holds true exercise would be a very attractive addition to the therapeutic arsenal in PD. The supportive evidence remains incomplete. Here, we describe the design of the Park-in-Shape study, which primarily aims to evaluate whether aerobic exercise affords clinically relevant improvements in motor symptoms in sedentary PD patients. A specific new element is the introduction of gaming to optimize compliance to the exercise intervention. The Park-in-Shape study is a randomized controlled, assessor- and patient-blinded single center study. Two parallel groups will include a total of 130 patients, receiving either aerobic exercise on a home trainer equipped with gaming elements ("exergaming"), or a non-aerobic intervention (stretching, flexibility and relaxation exercises). Both groups are supported by a specifically designed motivational app that uses gaming elements to stimulate patients to exercise and rewards them after having completed the exercise. Both interventions are delivered at home at least 3 times a week for 30-45 minutes during 6 months. Eligible patients are community-dwelling, sedentary patients diagnosed with mild-moderate PD. The primary outcome is the MDS-UPDRS motor score (tested in the off state) after 6 months. Secondary outcomes include various motor and non-motor symptoms, quality of life, physical fitness, and adherence. This Park-in-Shape study is anticipated to answer the question whether high intensity aerobic
Mueller, Gabi; Hopman, Maria T E; Perret, Claudio
To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia. Randomized controlled trial. A total of 24 individuals with traumatic, complete tetraplegia (C5-C8, American Spinal Injury Association (ASIA) Impairment Scale; AIS A) were randomly assigned to 1 of 3 groups. They completed 32 supervised training sessions over a period of 8 weeks. Before and after the training period, the following tests were performed: body plethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using a visual analogue scale, voice measurements, thorax mobility and quality of life. Cohen's effect sizes and Kruskal-Wallis tests for differences between pre- and post-training values were calculated. Compared with placebo training, inspiratory resistance training showed high effect sizes for inspiratory muscle strength (d = 1.13), the subjective ability "to blow one's nose" (d = 0.97) and the physical component of quality of life (d = 0.82). Isocapnic hyperpnoea compared with placebo showed a high effect size for breathlessness during exercise (d = 0.81). We found a significant effect of inspiratory resistance training vs placebo (p = 0.016) and vs isocapnic hyperpnoea (p = 0.012) for inspiratory muscle strength. In individuals with motor and sensory complete tetraplegia during the first year post-injury, inspiratory resistance training is more advantageous than isocapnic hyperpnoea, performed 4 times a week for 10 min.
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
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.
Smits-Engelsman, Bouwien C M; Jelsma, Lemke Dorothee; Ferguson, Gillian D; Geuze, Reint H
OBJECTIVE: 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
Mestre, Tiago A; Espay, Alberto J; Marras, Connie; Eckman, Mark H; Pollak, Pierre; Lang, Anthony E
Subthalamic nucleus deep brain stimulation (STN-DBS) has revolutionized the management of disabling motor complications in Parkinson's disease. The EARLYSTIM trial applied this treatment to patients who had been experiencing motor complications for less than three years. STN-DBS significantly improved all primary and secondary outcome measures while best medical therapy failed to provide any improvement at the two-year follow-up time point. On face value these results strongly favor the application of STN-DBS far earlier than is currently applied, when patients are just beginning to experience problems with motor complications. Here we review the application of early DBS and the EARLYSTIM trial from the perspectives of clinical issues, health economics and study design and patient expectation of benefit. We conclude that the most relevant issue is not when to operate but on whom and that early is not always better. © 2014 International Parkinson and Movement Disorder Society. © 2014 International Parkinson and Movement Disorder Society.
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
I ~ ' A trial Was conducted to investigate the possible improvetmnt of Dominant D300 cock' '. (D3 OOCX) with Anak ... Key words: Broodiness, chicken breeds, cross breeding, egg Pmduaion, . indigcnous production ... 6, No.1, 2006 and BxD300Px were brooded together for 6'weeks using the conventional deep litter system.
Elizabeth C Loi
Full Text Available Though the cause of motor abnormalities in cerebral palsy is injury to the brain, structural changes in muscle and fascia may add to stiffness and reduced function. This study examined whether Myofascial Structural Integration therapy (MSI, a complementary treatment that manipulates muscle and fascia, would improve gross motor function and gait in children < 4 years with cerebral palsy. Participants (N=29 were enrolled in a randomized controlled trial (RCT: NCT01815814, https://goo.gl/TGxvwd or Open Label Extension. The main outcome was the Gross Motor Function Measure-66 assessed at 3-month intervals. Gait (n=8 was assessed using the GAITRite® electronic walkway. Parents completed a survey at study conclusion.Comparing Treatment (n=15 and Waitlist-Control Groups (n=9, we found a significant main effect of time but no effect of group or timeXgroup interaction. The pooled sample (n=27 showed a main effect of time, but no significantly greater change after treatment than between other assessments. Foot length on the affected side increased significantly after treatment, likely indicating improvement in the children’s ability to approach a heel strike. Parent surveys indicated satisfaction and improvements in the children's quality of movement. MSI did not increase the rate of motor skill development, but was associated with improvement in gait quality.
Stoykov, Mary Ellen; Madhavan, Sangeetha
Priming is a type of implicit learning wherein a stimulus prompts a change in behavior. Priming has been long studied in the field of psychology. More recently, rehabilitation researchers have studied motor priming as a possible way to facilitate motor learning. For example, priming of the motor cortex is associated with changes in neuroplasticity that are associated with improvements in motor performance. Of the numerous motor priming paradigms under investigation, only a few ...
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.
Chaudhry, Shazia H; Brehaut, Jamie C; Grimshaw, Jeremy M; Weijer, Charles; Boruch, Robert; Donner, Allan; Eccles, Martin P; McRae, Andrew D; Saginur, Raphael; Skea, Zoë C; Zwarenstein, Merrick; Taljaard, Monica
Cluster randomized trials (CRTs) complicate the interpretation of standard research ethics guidelines for several reasons. For one, the units of allocation, intervention, and observation often may differ within a single trial. In the absence of tailored and internationally accepted ethics guidelines for CRTs, researchers and research ethics committees have no common standard by which to judge ethically appropriate practices in CRTs. Moreover, lack of familiarity with and consideration of the unique features of the CRT design by research ethics committees may cause difficulties in the research ethics review process, and amplify problems such as variability in the requirements and decisions reached by different research ethics committees. We aimed to characterize research ethics review of CRTs, examine investigator experiences with the ethics review process, and assess the need for ethics guidelines for CRTs. An electronic search strategy implemented in MEDLINE was used to identify and randomly sample 300 CRTs published in English language journals from 2000 to 2008. A web-based survey with closed- and open-ended questions was administered to corresponding authors in a series of six contacts. The survey response rate was 64%. Among 182 of 285 eligible respondents, 91% indicated that they had sought research ethics approval for the identified CRT, although only 70% respondents reported research ethics approval in the published article. Nearly one-third (31%) indicated that they have had to meet with ethics committees to explain aspects of their trials, nearly half (46%) experienced variability in the ethics review process in multijurisdictional trials, and 38% experienced negative impacts of the ethics review process on their trials, including delays in trial initiation (28%), increased costs (10%), compromised ability to recruit participants (16%), and compromised methodological quality (9%). Most respondents (74%; 95% confidence interval (CI): 67%-80%) agreed or
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
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…
Full Text Available Studies of motor control have almost universally examined firing rates to investigate how the brain shapes behavior. In principle, however, neurons could encode information through the precise temporal patterning of their spike trains as well as (or instead of through their firing rates. Although the importance of spike timing has been demonstrated in sensory systems, it is largely unknown whether timing differences in motor areas could affect behavior. We tested the hypothesis that significant information about trial-by-trial variations in behavior is represented by spike timing in the songbird vocal motor system. We found that neurons in motor cortex convey information via spike timing far more often than via spike rate and that the amount of information conveyed at the millisecond timescale greatly exceeds the information available from spike counts. These results demonstrate that information can be represented by spike timing in motor circuits and suggest that timing variations evoke differences in behavior.
Li, Xiang; Yao, Zhiyuan; He, Yigang; Dai, Shichao
Ultrasonic motor operation relies on high-frequency vibration of a piezoelectric vibrator and interface friction between the stator and rotor/slider, which can cause temperature rise of the motor under continuous operation, and can affect motor parameters and performance in turn. In this paper, an integral model is developed to study the thermal-mechanical-electric coupling dynamics in a typical standing wave ultrasonic motor. Stick-slip motion at the contact interface and the temperature dependence of material parameters of the stator are taken into account in this model. The elastic, piezoelectric and dielectric material coefficients of the piezoelectric ceramic, as a function of temperature, are determined experimentally using a resonance method. The critical parameters in the model are identified via measured results. The resulting model can be used to evaluate the variation in output characteristics of the motor caused by the thermal-mechanical-electric coupling effects. Furthermore, the dynamic temperature rise of the motor can be accurately predicted under different input parameters using the developed model, which will contribute to improving the reliable life of a motor for long-term running.
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Background and Objectives: Among several methods for the treatment of wrist-fingers motor function impairment after stroke, splinting is a method commonly used as complementary option. But there are so many controversies surrounding its efficacy. The aim of this study was to compare the effect of mobilizing and immobilizing splints on wrist-fingers motor function after stroke. Methods: In this experimental study, 31 stroke patients were selected and divided randomly into three groups including: mobilizing splint, immobilizing splint and control group. Participants in intervention groups wore their own splints for eight weeks, five days per week and on average six hours per day. Motor function was measured at baseline and the eighth week by fugl-meyer (FM scale. The one-way ANOVA was used to compare scores of FM scale between three groups. Results: Data analysis showed significant increase in motor function only in mobilizing splint group (p=0/001 and this increase was significant compared with other groups (p=0/001. Conclusion: Based on these findings, using a mobilizing splint compared with immobilizing splint could have better functional results for treating wrist and finger motor impairment in post-stroke patients.
Rahimi Fard H
Full Text Available Background and Objectives: Among several methods for the treatment of wrist-fingers motor function impairment after stroke, splinting is a method commonly used as complementary option. But there are so many controversies surrounding its efficacy. The aim of this study was to compare the effect of mobilizing and immobilizing splints on wrist-fingers motor function after stroke.Methods: In this experimental study, 31 stroke patients were selected and divided randomly into three groups including: mobilizing splint, immobilizing splint and control group. Participants in intervention groups wore their own splints for eight weeks, five days per week and on average six hours per day. Motor function was measured at baseline and the eighth week by fugl-meyer (FM scale. The one-way ANOVA was used to compare scores of FM scale between three groups.Results: Data analysis showed significant increase in motor function only in mobilizing splint group (p=0/001 and this increase was significant compared with other groups (p=0/001.Conclusion: Based on these findings, using a mobilizing splint compared with immobilizing splint could have better functional results for treating wrist and finger motor impairment in post-stroke patients.
Holtrop, Joseph L; Loucks, Torrey M; Sosnoff, Jacob J; Sutton, Bradley P
Changes in fine motor control that eventually compromise dexterity accompany advanced age; however there is evidence that age-related decline in motor control may not be uniform across effectors. Particularly, the role of central mechanisms in effector-specific decline has not been examined but is relevant for placing age-related motor declines into the growing literature of age-related changes in brain function. We examined sub-maximal force control across three different effectors (fingers, lips, and tongue) in 18 young and 14 older adults. In parallel with the force variability measures we examined changes in white matter structural integrity in effector-specific pathways in the brain with diffusion tensor imaging (DTI). Motor pathways for each effector were identified by using an fMRI localizer task followed by tractography to identify the fiber tracts propagating to the midbrain. Increases in force control variability were found with age in all three effectors but the effectors showed different degrees of age-related variability. Motor control changes were accompanied by a decline in white matter structural integrity with age shown by measures of fractional anisotropy and radial diffusivity. The DTI metrics appear to mediate some of the age-related declines in motor control. Our findings indicate that the structural integrity of descending motor systems may play a significant role in age-related increases in motor performance variability, but that differential age-related declines in oral and manual effectors are not likely due to structural integrity of descending motor pathways in the brain. Copyright © 2014 Elsevier Inc. All rights reserved.
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.
Full Text Available Objective: To evaluate the effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke. Design: A randomized, sham-controlled, assessor blinded, pilot trial. Setting: Inpatient stroke rehabilitation unit. Subjects: First time onset of stroke with mean post-stroke duration of 6.41 days, able to respond to verbal instructions, and Brunnstrom recovery stage 2 and above were enrolled. Intervention: Mirror therapy group performed 30 minutes of functional synergy movements of non-paretic lower extremity, whereas control group underwent sham therapy with similar duration. In addition, both groups were administered with conventional stroke rehabilitation regime. Altogether 90 minutes therapy session per day, six days a week, for two weeks duration was administered to both groups. Outcome Measures: Lower extremity motor subscale of Fugl Meyer Assessment (FMA, Brunnel Balance Assessment (BBA and Functional Ambulation Categories (FAC. Results: Amongst the 22 patients included, equal number of patients participated in mirror group (N = 11 and control group (N = 11. Baseline variables were similar in both groups, except for Brunnstrom recovery stage. There was no statistical difference between groups, except for FAC. (FMA: P = 0.894; BBA: P = 0.358; FAC: P = 0.02. Significance was set at P < 0.05. Conclusion: Administration of mirror therapy early after stroke is not superior to conventional treatment in improving lower limb motor recovery and balance, except for improvement in mobility.
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.
Shamaei, Kamran; Cenciarini, Massimo; Adams, Albert A; Gregorczyk, Karen N; Schiffman, Jeffrey M; Dollar, Aaron M
In this study, we describe the mechanical design and control scheme of a quasi-passive knee exoskeleton intended to investigate the biomechanical behavior of the knee joint during interaction with externally applied impedances. As the human knee behaves much like a linear spring during the stance phase of normal walking gait, the exoskeleton implements a spring across the knee in the weight acceptance (WA) phase of the gait while allowing free motion throughout the rest of the gait cycle, accomplished via an electromechanical clutch. The stiffness of the device is able to be varied by swapping springs, and the timing of engagement/disengagement changed to accommodate different loading profiles. After describing the design and control, we validate the mechanical performance and reliability of the exoskeleton through cyclic testing on a mechanical knee simulator. We then describe a preliminary experiment on three healthy adults to evaluate the functionality of the device on both left and right legs. The kinetic and kinematic analyses of these subjects show that the exoskeleton assistance can partially/fully replace the function of the knee joint and obtain nearly invariant moment and angle profiles for the hip and ankle joints, and the overall knee joint and exoskeleton complex under the applied moments of the exoskeleton versus the control condition, implying that the subjects undergo a considerable amount of motor adaptation in their lower extremities to the exoskeletal impedances, and encouraging more in-depth future experiments with the device.
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
Full Text Available 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.
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.
Kim, Taeho; Frank, Cornelia; Schack, Thomas
Action observation training and motor imagery training have independently been studied and considered as an effective training strategy for improving motor skill learning. However, comparative studies of the two training strategies are relatively few. The purpose of this study was to investigate the effects of action observation training and motor imagery training on the development of mental representation structure and golf putting performance as well as the relation between the changes in mental representation structure and skill performance during the early learning stage. Forty novices were randomly assigned to one of four groups: action observation training, motor imagery training, physical practice and no practice. The mental representation structure and putting performance were measured before and after 3 days of training, then after a 2-day retention period. The results showed that mental representation structure and the accuracy of the putting performance were improved over time through the two types of cognitive training (i.e., action observation training and motor imagery training). In addition, we found a significant positive correlation between changes in mental representation structure and skill performance for the action observation training group only. Taken together, these results suggest that both cognitive adaptations and skill improvement occur through the training of the two simulation states of action, and that perceptual-cognitive changes are associated with the change of skill performance for action observation training.
Mackenzie, C.; Muir, M.; Allen, C.; Jensen, A.
Background: There has been little robust evaluation of the outcome of speech and language therapy (SLT) intervention for post-stroke dysarthria. Non-speech oro-motor exercises (NSOMExs) are a common component of dysarthria intervention. A feasibility study was designed and executed, with participants randomized into two groups, in one of which…
Full Text Available The cognitive and neural representation of abstract words is still an open question for theories of embodied cognition. Generally, it is proposed that abstract words are grounded in the activation of sensorimotor or at least experiential properties, exactly as concrete words. Further behavioral theories propose multiple representations evoked by abstract and concrete words. We conducted a functional magnetic resonance imaging study to investigate the neural correlates of concrete and abstract multi-word expressions in an action context. Participants were required to read simple sentences which combined each concrete noun with an adequate concrete verb and an adequate abstract verb, as well as an adequate abstract noun with either kind of verbs previously used. Thus, our experimental design included a continuum from pure concreteness to mere abstractness. As expected, comprehension of both concrete and abstract language content activated the core areas of the sensorimotor neural network namely the left lateral (precentral gyrus and medial (supplementary motor area premotor cortex. While the purely concrete multi-word expressions elicited activations within the left inferior frontal gyrus (pars triangularis and two foci within the left inferior parietal cortex, the purely abstract multi-word expressions were represented in the anterior part of left middle temporal gyrus that is part of the language processing system. Although the sensorimotor neural network is engaged in both concrete and abstract language contents, the present findings show that concrete multi-word processing relies more on the sensorimotor system, and abstract multi-word processing relies more on the linguistic system.
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.
Benjamin R Kunz
Full Text Available The relationship between biomechanical action and perception of self-motion during walking is typically consistent and well-learned but also adaptable. This perceptual-motor coupling can be recalibrated by creating a mismatch between the visual information for self-motion and walking speed. Perceptual-motor recalibration of locomotion has been demonstrated through effects on subsequent walking without vision, showing that learned perceptual-motor coupling influences a dynamic representation of one's spatial position during walking. Our present studies test whether recalibration of wheelchair locomotion, a novel form of locomotion for typically walking individuals, similarly influences subsequent wheelchair locomotion. Furthermore, we test whether adaptation to the pairing of visual information for self-motion during one form of locomotion transfers to a different locomotion modality. We find strong effects of perceptual-motor recalibration for matched locomotion modalities--walking/walking and wheeling/wheeling. Transfer across incongruent locomotion modalities showed weak recalibration effects. The results have implications both for theories of perceptual-motor calibration mechanisms and their effects on spatial orientation, as well as for practical applications in training and rehabilitation.
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 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.
Sindrup, S H; Konder, R; Lehmann, R
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...... 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...
Chen, Jia-Ching; Lin, Chun-Hsiang; Wei, Yu-Chun; Hsiao, Jung; Liang, Chung-Chao
To evaluate the effectiveness of thermal stimulation accompanied by either active or passive movement added to standard rehabilitation in facilitating motor and balance function of the paretic leg of acute stroke. Pilot, observer-blinded, randomized clinical trial. Department of rehabilitation medicine in a general hospital. Thirty-six patients were enrolled within four weeks of the onset of a stroke causing moderate to severe leg paresis (Brunnstrom stage ≤III). Patients were randomly assigned to thermal (standard rehabilitation plus approximately 30-40 minutes of thermal stimulation therapy daily for six weeks) and control (standard rehabilitation only) groups. Fugl-Meyer lower extremity score, Medical Research Council scale for lower extremity, Modified Motor Assessment Scale, Postural Assessment Scale for Stroke Patients Trunk Control, Berg Balance Scale, Functional Ambulation Classification and Modified Ashworth Scale. Patients in the thermal group experienced significantly better median scores for Fugl-Meyer lower extremity (14.0; interquartile range, 10.5-15.5), Medical Research Council scale for lower extremity (6.0; 4.0-7.0), Modified Motor Assessment Scale (16.0; 12.5-18.5), Berg Balance Scale (28.0; 20.5-33.5), and Functional Ambulation Classification (2.0; 2.0-2.0) (all P < 0.05). The thermal group also had more independent walkers (15/17; 88.2%) than the control group (9/16; 56.3%) after six weeks (P = 0.06). No adverse effect occurred. Thermal stimulation accompanied by either manual facilitation or encouragement for active participation of the paretic lower limb may be an effective promising supplementary treatment for the early-phase rehabilitation of moderate to severe stroke that warrants additional study.
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.
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…
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.
Guazzelli, Alice; Bakker, Emyr; Tian, Kun; Demonacos, Constantinos; Krstic-Demonacos, Marija; Mutti, Luciano
Malignant mesothelioma is a rare and lethal malignancy primarily affecting the pleura and peritoneum. Mesothelioma incidence is expected to increase worldwide and current treatments remain ineffective, leading to poor prognosis. Within this article potential targets to improve the quality of life of the patients and assessment of further avenues for research are discussed. Areas covered: This review highlights emerging therapies currently under investigation for malignant mesothelioma with a specific focus on phase I and phase II clinical trials. Three main areas are discussed: immunotherapy (immune checkpoint blockade and cancer vaccines, among others), multitargeted therapy (such as targeting pro-angiogenic genes) and gene therapy (such as suicide gene therapy). For each, clinical trials are described to detail the current or past investigations at phase I and II. Expert opinion: The approach of applying existing treatments from other cancers does not show significant benefit, with the most promising outcome being an increase in survival of 2.7 months following combination of chemotherapy with bevacizumab. It is our opinion that the hypoxic microenvironment, the role of the stroma, and the metabolic status of mesothelioma should all be assessed and characterised to aid in the development of new treatments to improve patient outcomes.
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, pDance was effective in improving motor function, cognitive function, and mental 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.
Moyle, Wendy; Jones, Cindy; Murfield, Jenny; Thalib, Lukman; Beattie, Elizabeth; Shum, David; O'Dwyer, Siobhan; Mervin, M Cindy; Draper, Brian
The robotic seal, PARO, has been used as an alternative to animal-assisted therapies with residents with dementia in long-term care, yet understanding of its efficacy is limited by a paucity of research. We explored the effects of PARO on motor activity and sleep patterns, as measured by a wearable triaxial accelerometer. Cluster-randomised controlled trial, involving 28 facilities in Queensland, Australia. Nine facilities were randomised to the PARO group (individual, non-facilitated, 15-min sessions three afternoons per week for 10 weeks), 10 to a plush toy (PARO with robotic features disabled) and nine to usual care. Changes in day- and nighttime motor activity and sleep after the 10-week intervention, as measured by SenseWear ® armbands, worn by participants continuously for 24 h at baseline, during two single intervention days in weeks 5 and 10 respectively, and post-intervention (week 15). Analyses followed intention-to-treat, using repeated-measures mixed-effects models. After 10 weeks, the PARO group showed a greater reduction in daytime step count than usual care (p = 0.023), and in nighttime step count (p = 0.028) and daytime physical activity (p = 0.026) compared with the plush toy group. At post-intervention, the PARO group showed a greater reduction in daytime step count than the plush toy group (p = 0.028), and at nighttime compared with both the plush toy group (p = 0.019) and the usual-care group (p = 0.046). The PARO group also had a greater reduction in nighttime physical activity than the usual-care group (p = 0.015). PARO may have some effect on motor activity of older people with dementia in long-term care, but not on sleep patterns. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). Copyright © 2018 Elsevier B.V. All rights reserved.
Mueller, G.; Hopman, M.T.E.; Perret, C.
OBJECTIVE: To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia. DESIGN: Randomized controlled trial. PATIENTS/METHODS: A total of 24
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.
van Dieen, J.H.; van Leeuwen, M.; Faber, G.S.
We investigated motor and sensory changes underlying learning of a balance task. Fourteen participants practiced balancing on one leg on a board that could freely rotate in the frontal plane. They performed six, 16-s trials standing on one leg on a stable surface (2 trials without manipulation, 2
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.
Kulagin, D. O.
The article presents the definition of the functions of self-excitation electromagnetic processes of asynchronous traction motor with regenerative braking powered by limited power source. It is shown that the power of current synchronous generator with brake mode is not very desirable, as leading to increased fuel consumption and can reduce the value of the braking power, engine traction which develops as a result of absorption of the resistor current synchronous generator. Therefore, it is a...
Fatemeh Fakar Gharamaleki; Mohammad Rahim Shahbodaghi; Ali Jahan; Shohre Jalayi
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 ...
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.
Chaddah, Maya R; Dickie, Brian G; Lyall, Drew; Marshall, Caroline J; Sykes, J Ben; Bruijn, Lucie I
The International Consortium of Stem Cell Networks' (ICSCN) Workshop Towards Clinical Trials Using Stem Cells for Amyotrophic Lateral Sclerosis (ALS)/Motor Neuron Disease (MND) was held on 24-25 January 2011. Twenty scientific talks addressed aspects of cell derivation and characterization; preclinical research and phased clinical trials involving stem cells; latest developments in induced pluripotent (iPS) cell technology; industry involvement and investment. Three moderated panel discussions focused on unregulated ALS/MND treatments, and the state of the art and barriers to future progress in using stem cells for ALS/MND. This review highlights the major insights that emanated from the workshop around the lessons learned and barriers to progress for using stem cells for understanding disease mechanism, drug discovery, and as therapy for ALS/MND. The full meeting report is only available in the online version of the journal. Please find this material with the following direct link to the article: http://www.informahealthcare.com/als/doi/10.3109/17482968.2011.590992 .
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.
McDermott Christopher J
Full Text Available Abstract Background Motor neurone disease (MND is a devastating illness which leads to muscle weakness and death, usually within 2-3 years of symptom onset. Respiratory insufficiency is a common cause of morbidity, particularly in later stages of MND and respiratory complications are the leading cause of mortality in MND patients. Non Invasive Ventilation (NIV is the current standard therapy to manage respiratory insufficiency. Some MND patients however do not tolerate NIV due to a number of issues including mask interface problems and claustrophobia. In those that do tolerate NIV, eventually respiratory muscle weakness will progress to a point at which intermittent/overnight NIV is ineffective. The NeuRx RA/4 Diaphragm Pacing System was originally developed for patients with respiratory insufficiency and diaphragm paralysis secondary to stable high spinal cord injuries. The DiPALS study will assess the effect of diaphragm pacing (DP when used to treat patients with MND and respiratory insufficiency. Method/Design 108 patients will be recruited to the study at 5 sites in the UK. Patients will be randomised to either receive NIV (current standard care or receive DP in addition to NIV. Study participants will be required to complete outcome measures at 5 follow up time points (2, 3, 6, 9 and 12 months plus an additional surgery and 1 week post operative visit for those in the DP group. 12 patients (and their carers from the DP group will also be asked to complete 2 qualitative interviews. Discussion The primary objective of this trial will be to evaluate the effect of Diaphragm Pacing (DP on survival over the study duration in patients with MND with respiratory muscle weakness. The project is funded by the National Institute for Health Research, Health Technology Assessment (HTA Programme (project number 09/55/33 and the Motor Neurone Disease Association and the Henry Smith Charity. Trial Registration: Current controlled trials ISRCTN53817913. The
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
Full Text Available and first trials of the structure characterization are presented. 2 Motor design and working principle Traditionally, ultrasonic motors (USM) exploit the propagation of a travelling wave in a resonator (stator) and the friction intermittently created...
Clohisy, John C; Kim, Young-Jo; Lurie, Jon; Glyn-Jones, Siôn; Wall, Peter; Wright, Rick; Spindler, Kurt; Lohmander, Stefan
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 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 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 of symptomatic FAI.
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.
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 ( ...
Full Text Available ... study results. Clinical Trial Protocol Each clinical trial has a master plan called a protocol (PRO-to-kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...
Tanner, Andrea; Kim, Sei-Hill; Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D
Clinical trials help advance public health and medical research on prevention, diagnosis, screening, treatment, and quality of life. Despite the need for access to quality care in medically underserved areas, clinical trial participation remains low among individuals in rural and African American communities. This study assessed clinical trial research in South Carolina's five main academic medical centers, focusing specifically on clinical trial investigators' perceived barriers to recruitment in the general population and in rural and African American communities. Online survey responses (N = 119) revealed that it was most difficult for investigators to recruit from rural areas and that rural residents were least likely to be represented in medical research, behind both the general public and African Americans. Barriers focusing on communication or awareness proved to be the biggest hurdles to finding potential participants in both the general public and rural communities. Psychological barriers to recruitment were perceived to be most prevalent in African American communities. Study findings provide important insights from the perspective of the clinical trial investigator that will aid in the development of effective communication and education strategies for reaching rural and African American residents with information about clinical trials.
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.
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.
Vasta, Roberta; Cerasa, Antonio; Gramigna, Vera; Augimeri, Antonio; Olivadese, Giuseppe; Pellegrino, Giovanni; Martino, Iolanda; Machado, Alexis; Cai, Zhengchen; Caracciolo, Manuela; Grova, Christophe; Quattrone, Aldo
Movement time analyzer (MTA) is an objective instrument to evaluate the degree of motor impairment as well as to investigate the dopaminergic drug effect in Parkinson's disease patients. The aim of this study is to validate a new ecologic neuroimaging tool for quantifying MTA-related hemodynamic response of the cortical motor system by means of functional near-infrared spectroscopy (fNIRS). 11 right-handed healthy volunteers (six male and five female, age range 27-64 years) were studied with fNIRS and functional magnetic resonance imaging (fMRI) while performing MTA task for each hand. MTA performance was better for the dominant hand and younger participants. Both fNIRS and fMRI analyses revealed MTA-related increase of haemoglobin levels in the primary motor and premotor cortices contralateral to the moving hand. This response progressively increased with aging. These findings supported the translation of fNIRS-based MTA behavioural tool in clinical practice.
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
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.
Wang, Xiuling; Lan, Chao; Chen, Juwu; Wang, Wenying; Zhang, Hua; Li, Li
The aim of this study is to determine whether the creative arts program (HA) is effective in preventing the onset of Posttraumatic stress disorder (PTSD). PTSD develops in 10-20% of motor vehicle accident survivors (MVAs). MVAs in the initial months after the accident were randomly assigned to receive 8-week HA intervention (n = 26) or wait the list (WL, n = 26). The arts program consisted of writing and drawing. PTSD severity was assessed at 2, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale, CAPS) and self-report instrument (Impact of Event Scale-Revised, IES-R). Secondary outcomes were post-traumatic growth (PTG), depression and anxiety symptoms. Repeated measures analysis of variance indicated that both HA and WL group exhibited a significant effect of time (P creative arts program is effect in avoiding MVA-related PTSD symptoms. But it only seems to be a short-term, rather than a long-term effect.
Bergmann, L; Berns, B; Dalgleish, A G; von Euler, M; Hecht, T T; Lappin, G L; Reed, N; Palmeri, S; Smyth, J; Embacher-Aichorn, S; Zwierzina, H
Drug development traditionally has relied upon the complementary contributions of clinicians and scientists at academic institutions and at pharmaceutical companies. Greater regulatory burdens, increased bureaucratic requirements, restricted reimbursement, and spiralling research and development costs are exerting pressure on the drug development pipeline. The result is a de-emphasis of exploratory research, particularly independent academic research, despite its proven value in identifying new drug targets and developing innovative cancer therapies. An expert panel assembled by the Biotherapy Development Association-a nonprofit international forum for academic and industry researchers, patients, and government regulatory and postregulatory agencies-examined the growing schism between academia and industry and identified several causes of declining academic research. The authors propose solutions to sustain investigator-initiated research and provide a new model whereby expert organisations provide a forum for academia and industry to plan studies within a regulatory framework to support licensure/authorisation and reimbursement for new molecularly targeted agents and biomarkers. Investigator-initiated trials have led to the discovery and development of innovative, safe, and effective cancer treatments. To ensure that such research continues, action will be required on the parts of legislative and regulatory bodies, industry, universities, patient advocacy organisations, and preclinical and clinical academic scientists.
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
Bazán, Paulo Rodrigo; Biazoli, Claudinei Eduardo; Sato, João Ricardo; Amaro, Edson
The default-mode network (DMN) has been implicated in many conditions. One particular function relates to its role in motor preparation. However, the possibly complex relationship between DMN activity and motor preparation has not been fully explored. Dynamic interactions between default mode and motor networks may compromise the ability to evaluate intrinsic connectivity using resting period data extracted from task-based experiments. In this study, we investigated alterations in connectivity between the DMN and the motor network that are associated with motor readiness during the intervals between motor task trials. fMRI data from 20 normal subjects were acquired under three conditions: pure resting state; resting state interleaved with brief, cued right-hand movements at constant intervals (lower readiness); and resting state interleaved with the same movements at unpredictable intervals (higher readiness). The functional connectivity between regions of motor and DMNs was assessed separately for movement periods and intertask intervals. We found a negative relationship between the DMN and the left sensorimotor cortex during the task periods for both motor conditions. Furthermore, during the intertask intervals of the unpredictable condition, the DMN showed a positive relationship with right sensorimotor cortex and a negative relation with the left sensorimotor cortex. These findings indicate a specific modulation on motor processing according to the state of motor readiness. Therefore, connectivity studies using task-based fMRI to probe DMN should consider the influence of motor system modulation when interpreting the results.
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.
Scherer, Roberta W.; Sieving, Pamela C.; Ervin, Ann-Margret; Dickersin, Kay
Purpose To reduce publication bias, systematic reviewers are advised to search conference abstracts to identify randomized controlled trials (RCTs) conducted in humans and not published in full. We assessed the information provided by authors to aid identification of RCTs for reviews. Methods We handsearched the Association for Research in Vision and Ophthalmology (ARVO) meeting abstracts for 2004 to 2009 to identify reports of RCTs. We compared our classification with that of authors (requested by ARVO 2004–2006), and authors’ report of trial registration (required by ARVO 2007–2009). Results Authors identified their study as a clinical trial for 169/191 (88%; 95% CI, 84–93) RCTs we identified for 2004, 174/212 (82%; 95% CI, 77–87) for 2005 and 162/215 (75%; 95% CI, 70–81) for 2006. Authors provided registration information for 107/172 (62%; 95% CI, 55–69) RCTs for 2007, 103/153 (67%; 95% CI, 60–75) for 2008, and 126/171 (74%; 95% CI, 67–80) for 2009. Most RCT authors providing a trial register name specified ClinicalTrials.gov (276/312; 88%; 95% CI, 85–92) and provided a valid ClinicalTrials.gov registration number (261/276; 95%; 95% CI, 92–97). Based on information provided by authors, trial registration information would be accessible for 48% (83/172) (95% CI, 41–56) of all ARVO abstracts describing RCTs in 2007, 63% (96/153) (95% CI, 55–70) in 2008, and 70% in 2009 (118/171) (95% CI, 62–76). Conclusions Authors of abstracts describing RCTs frequently did not classify them as clinical trials nor comply with reporting trial registration information, as required by the conference organizers. Systematic reviewers cannot rely on authors to identify relevant unpublished trials or report trial registration, if present. PMID:22984474
Roberta W Scherer
Full Text Available PURPOSE: To reduce publication bias, systematic reviewers are advised to search conference abstracts to identify randomized controlled trials (RCTs conducted in humans and not published in full. We assessed the information provided by authors to aid identification of RCTs for reviews. METHODS: We handsearched the Association for Research in Vision and Ophthalmology (ARVO meeting abstracts for 2004 to 2009 to identify reports of RCTs. We compared our classification with that of authors (requested by ARVO 2004-2006, and authors' report of trial registration (required by ARVO 2007-2009. RESULTS: Authors identified their study as a clinical trial for 169/191 (88%; 95% CI, 84-93 RCTs we identified for 2004, 174/212 (82%; 95% CI, 77-87 for 2005 and 162/215 (75%; 95% CI, 70-81 for 2006. Authors provided registration information for 107/172 (62%; 95% CI, 55-69 RCTs for 2007, 103/153 (67%; 95% CI, 60-75 for 2008, and 126/171 (74%; 95% CI, 67-80 for 2009. Most RCT authors providing a trial register name specified ClinicalTrials.gov (276/312; 88%; 95% CI, 85-92 and provided a valid ClinicalTrials.gov registration number (261/276; 95%; 95% CI, 92-97. Based on information provided by authors, trial registration information would be accessible for 48% (83/172 (95% CI, 41-56 of all ARVO abstracts describing RCTs in 2007, 63% (96/153 (95% CI, 55-70 in 2008, and 70% in 2009 (118/171 (95% CI, 62-76. CONCLUSIONS: Authors of abstracts describing RCTs frequently did not classify them as clinical trials nor comply with reporting trial registration information, as required by the conference organizers. Systematic reviewers cannot rely on authors to identify relevant unpublished trials or report trial registration, if present.
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
de Dios, Marcel A; Anderson, Bradley J; Stanton, Cassandra; Audet, Daniel A; Stein, Michael
Light smoking is particularly prevalent among Latino smokers. Nicotine replacement (NRT) and varenicline are effective medications for smoking cessation for moderate-heavy smokers but have not been tested in light smokers, and thus, there are no treatment guidelines for use with light smokers. This pilot trial tested the efficacy of NRT and varenicline in increasing smoking abstinence among Latino light smokers. A 3-group (NRT, varenicline, and varenicline-placebo) randomized design was used, and Latino light smokers (≤10 cigarettes per day) received 12 weeks of treatment, which included a culturally informed behavioral health session and ongoing medication management visits. At follow-up, there were no abstinent participants in the placebo and NRT groups. However, 30% of participants in the varenicline group were abstinent at the 3-, 4-, and 6-month follow-up. This study represents the only investigation that specifically targets Latino light smokers using these treatments and characterizing their treatment adherence. Copyright © 2012 Elsevier Inc. All rights reserved.
Rutger M. van den Bor
Full Text Available Failure to meet subject recruitment targets in clinical trials continues to be a widespread problem with potentially serious scientific, logistical, financial and ethical consequences. On the operational level, enrollment-related issues may be mitigated by careful site selection and by allocating monitoring or training resources proportionally to the anticipated risk of poor enrollment. Such procedures require estimates of the expected recruitment performance that are sufficiently reliable to allow centers to be sensibly categorized. In this study, we investigate whether information obtained from feasibility questionnaires can potentially be used to predict which centers will and which centers will not meet their enrollment targets by means of multivariable logistic regression analysis. From a large set of 59 candidate predictors, we determined the subset that is optimal for predictive purposes using Least Absolute Shrinkage and Selection Operator (LASSO regularization. Although the extent to which the results are generalizable remains to be determined, they indicate that the prediction accuracy of the optimal model is only a marginal improvement over the intercept-only model, illustrating the difficulty of prediction in this setting.
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
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
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
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
Middleton, Kathryn R.; Perri, Michael G.
Objective: The current study was a randomized controlled trial investigating the effect of an innovative, short-term lifestyle intervention on weight gain in female freshman college students. Participants: Ninety-five freshmen were recruited from a large public university in the United States. Methods: Participants completed baseline assessments…
Clayton, Gemma L; Smith, Isabelle L; Higgins, Julian P T; Mihaylova, Borislava; Thorpe, Benjamin; Cicero, Robert; Lokuge, Kusal; Forman, Julia R; Tierney, Jayne F; White, Ian R; Sharples, Linda D; Jones, Hayley E
When designing and analysing clinical trials, using previous relevant information, perhaps in the form of evidence syntheses, can reduce research waste. We conducted the INVEST (INVestigating the use of Evidence Synthesis in the design and analysis of clinical Trials) survey to summarise the current use of evidence synthesis in trial design and analysis, to capture opinions of trialists and methodologists on such use, and to understand any barriers. Our sampling frame was all delegates attending the International Clinical Trials Methodology Conference in November 2015. Respondents were asked to indicate (1) their views on the use of evidence synthesis in trial design and analysis, (2) their own use during the past 10 years and (3) the three greatest barriers to use in practice. Of approximately 638 attendees of the conference, 106 (17%) completed the survey, half of whom were statisticians. Support was generally high for using a description of previous evidence, a systematic review or a meta-analysis in trial design. Generally, respondents did not seem to be using evidence syntheses as often as they felt they should. For example, only 50% (42/84 relevant respondents) had used a meta-analysis to inform whether a trial is needed compared with 74% (62/84) indicating that this is desirable. Only 6% (5/81 relevant respondents) had used a value of information analysis to inform sample size calculations versus 22% (18/81) indicating support for this. Surprisingly large numbers of participants indicated support for, and previous use of, evidence syntheses in trial analysis. For example, 79% (79/100) of respondents indicated that external information about the treatment effect should be used to inform aspects of the analysis. The greatest perceived barrier to using evidence synthesis methods in trial design or analysis was time constraints, followed by a belief that the new trial was the first in the area. Evidence syntheses can be resource-intensive, but their use in
Full Text Available Background: Clinical research in India experienced dramatic changes with series of stringent guidelines introduced by regulatory authorities. These guidelines posed significant challenges for the clinical trial industry. Objective: To assess the perceptions and opinion of Indian Investigators about the new regulatory guidelines. Methods: We developed a survey questionnaire on recent regulatory guidelines which was hosted on a web portal. Seventy-three investigators from India participated in the survey. Results: Central registration of Ethics Committees (ECs was agreed by 90.1% participants, 76.8% participants agreed to compensation of subjects for study related Serious Adverse Events (SAE's. The compulsion to include government sites in clinical trials was not agreed by 49.3% participants while 21.2% agreed to it. Restriction on a number of trials per investigator was agreed by 49.3% of participants while 40.9% disagreed. Participants (50.7% disagreed to the introduction of audio-video (AV recording of informed consent, 36.6% agreed and 12.7% were neutral. Discussion: Participants observed that post central registration; ECs have improved systems with adequate member composition, functional Standard Operating Procedures, and timely approvals. Participants agreed that compensation of study related SAE's would assure subject protection and safety. The introduction of AV consenting was strongly debated sighting sociocultural issues in the implementation of the same. Conclusion: Participants endorsed guidelines pertaining to the central registration of ECs, SAE related compensation. Restrictions on a number of trials per investigator and AV consenting were debated ardently. The response of the survey participants who are clinical trial investigators in India showed general acceptance, effectiveness and anticipated compliance to the new regulatory guidelines.
Full Text Available The subcortical saccade-generating system consists of the retina, superior colliculus, cerebellum and brainstem motoneuron areas. The superior colliculus is the site of sensory-motor convergence within this basic visuomotor loop preserved throughout the vertebrates. While the system has been extensively studied, there are still several outstanding questions regarding how and where the saccade eye movement profile is generated and the contribution of respective parts within this system. Here we construct a spiking neuron model of the whole intermediate layer of the superior colliculus based on the latest anatomy and physiology data. The model consists of conductance-based spiking neurons with quasi-visual, burst, buildup, local inhibitory, and deep layer inhibitory neurons. The visual input is given from the superficial superior colliculus and the burst neurons send the output to the brainstem oculomotor nuclei. Gating input from the basal ganglia and an integral feedback from the reticular formation are also included.We implement the model in the NEST simulator and show that the activity profile of bursting neurons can be reproduced by a combination of NMDA-type and cholinergic excitatory synaptic inputs and integrative inhibitory feedback. The model shows that the spreading neural activity observed in vivo can keep track of the collicular output over time and reset the system at the end of a saccade through activation of deep layer inhibitory neurons. We identify the model parameters according to neural recording data and show that the resulting model recreates the saccade size-velocity curves known as the saccadic main sequence in behavioral studies. The present model is consistent with theories that the superior colliculus takes a principal role in generating the temporal profiles of saccadic eye movements, rather than just specifying the end points of eye movements.
Burfeind, Sean M; Chimera, Nicole
Athletes participating in upper-extremity-dominant sports such as softball and volleyball are at increased risk for glenohumeral-joint pain and injury. For these athletes, an integral part of many injury-prevention and -rehabilitation programs includes improving joint proprioception. One way to measure joint proprioception is through the reproduction of joint angles, or joint-reposition sense (JRS). Kinesiology tape is purported to enhance neuromuscular feedback; therefore, it may influence JRS. However, conflicting findings and the lack of research in the upper extremity warrant further investigation. To determine the effects of kinesiology tape on shoulder-joint proprioception by actively reproducing joint angles, or measurement of JRS. Randomized controlled trial. College laboratory. 9 men and 7 women 24 ± 3 y old. SpiderTech kinesiology tape precut Shoulder Spider was applied to the shoulder of participants block randomized to the experimental group, following product-specific instructions, to measure its influence on JRS compared with a control group. JRS-error scores in shoulder flexion, extension, internal rotation, and external rotation (ER). There was a significant interaction between groups pre- to postintervention resulting in decreased JRS errors in flexion (P = .04) and ER (P = .03) in the experimental compared with the control group. The 95% confidence intervals suggest a clinically relevant difference in the variability of JRS errors between postintervention movements for the experimental group in flexion and ER, such that the control group demonstrated much more variability in JRS errors than the experimental group. After the application of kinesiology tape the JRS errors were smaller in flexion and ER. This may be of clinical significance in improving proprioception and thus improving joint stability. Additional research should determine the effectiveness of kinesiology tape in reducing joint injury.
Sadnicka, Anna; Stevenson, Anna; Bhatia, Kailash P; Rothwell, John C; Edwards, Mark J; Galea, Joseph M
For the healthy motor control system, an essential regulatory role is maintaining the equilibrium between keeping unwanted motor variability in check whilst allowing informative elements of motor variability. Kinematic studies in children with generalised dystonia (due to mixed aetiologies) show that movements are characterised by increased motor variability. In this study, the mechanisms by which high motor variability may influence movement generation in dystonia were investigated. Reaching movements in the symptomatic arm of 10 patients with DYT1 dystonia and 12 age-matched controls were captured using a robotic manipulandum and features of motor variability were extracted. Given that task-relevant variability and sensorimotor adaptation are related in health, markers of variability were then examined for any co-variance with performance indicators during an error-based learning visuomotor adaptation task. First, we confirmed that motor variability on a trial-by-trial basis was selectively increased in the homogenous and prototypical dystonic disorder DYT1 dystonia. Second, high baseline variability predicted poor performance in the subsequent visuomotor adaptation task offering insight into the rules which appear to govern dystonic motor control. The potential mechanisms behind increased motor variability and its corresponding implications for the rehabilitation of patients with DYT1 dystonia are highlighted.
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
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.
Volpert-Esmond, Hannah I; Merkle, Edgar C; Levsen, Meredith P; Ito, Tiffany A; Bartholow, Bruce D
EEG data, and specifically the ERP, provide psychologists with the power to examine quickly occurring cognitive processes at the native temporal resolution at which they occur. Despite the advantages conferred by ERPs to examine processes at different points in time, ERP researchers commonly ignore the trial-to-trial temporal dimension by collapsing across trials of similar types (i.e., the signal averaging approach) because of constraints imposed by repeated measures ANOVA. Here, we present the advantages of using multilevel modeling (MLM) to examine trial-level data to investigate change in neurocognitive processes across the course of an experiment. Two examples are presented to illustrate the usefulness of this technique. The first demonstrates decreasing differentiation in N170 amplitude to faces of different races across the course of a race categorization task. The second demonstrates attenuation of the ERN as participants commit more errors within a task designed to measure implicit racial bias. Although the examples presented here are within the realm of social psychology, the use of MLM to analyze trial-level EEG data has the potential to contribute to a number of different theoretical domains within psychology. © 2017 Society for Psychophysiological Research.
Pattison, Natalie; Arulkumaran, Nishkantha; Humphreys, Sally; Walsh, Tim
Clinical trials in critical care are often resource-intense, with many unique challenges. Barriers to effective recruitment and implementation of study intervention have not been explored in a UK context. To identify facilitating factors and barriers to enrolling patients into critical care clinical trials within the UK from clinician's perspectives. A qualitative interview study was undertaken on behalf of the National Institute of Health Research critical care specialty group, in which research active clinicians across different Clinical Research Networks were interviewed. A loosely structured interview schedule was used, based on themes generated from the literature associated with accessing critical care trials. Research teams (critical care doctors, research nurses, and trial coordinators) from hospitals from each Clinical Research Network were contacted to try to achieve representation across the UK. Interviews were carried out across nine UK Clinical Research Networks with a range of doctors and research nurses. All hospitals were teaching hospitals with varying research nurse numbers and allocated consultant research sessions. There were a range of six to nine ongoing clinical trials in critical care for each centre representative interviewed. Data were analysed using framework analysis, and six final themes were identified related to factors associated with: centre, unit, resources, study, clinician, and patient/family. The most commonly cited barrier to conducting clinical trials was related to resources, namely insufficient human and financial resources, leading to staff and study recruitment difficulties. Clinical uncertainty and equipoise regarding comparative merits of trials were challenging in terms of engaging critical care teams. A number of patient and family factors added complexities in terms of recruitment; however, refusal rates were generally reported as low. Flexibility in funding and employment by research teams enables continuity of
Worsley, Sally D; Oude Rengerink, Katrien; Irving, Elaine; Lejeune, Stephane; Mol, Koen; Collier, Sue; Groenwold, Rolf H H; Enters-Weijnen, Catherine; Egger, Matthias; Rhodes, Thomas
This second article in the series on pragmatic trials describes the challenges in selection of sites for pragmatic clinical trials and the impact on validity, precision, and generalizability of the results. The selection of sites is an important factor for the successful execution of a pragmatic trial and impacts the extent to which the results are applicable to future patients in clinical practice. The first step is to define usual care and understand the heterogeneity of sites, patient demographics, disease prevalence and country choice. Next, specific site characteristics are important to consider such as interest in the objectives of the trial, the level of research experience, availability of resources, and the expected number of eligible patients. It can be advisable to support the sites with implementing the trial-related activities and minimize the additional burden that the research imposes on routine clinical practice. Health care providers should be involved in an early phase of protocol development to generate engagement and ensure an appropriate selection of sites with patients who are representative of the future drug users. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Gonser, P; Matern, U
It has become common for hospitals to borrow medical devices from manufacturers to test and try them during the daily routine before purchasing which today is known as trial provision. This study aims at offering a precise definition of trial provisions and a description of the way of proceeding. A total of 60 medical practitioners in 5 German hospitals were surveyed (surgeons n = 40, 66.7 %, radiologists n = 12, 20 % and anesthesiologists n = 8, 13.3 %). Manufacturers and distributors of medical devices (n = 10) and hospital administration executives (n = 8) were also interviewed. Trial provisions are a promotional marketing tool for manufacturers of medical devices. By lending the device over a specific period for testing before purchasing, hospitals can gain experience in the usage and handling of devices on which a purchase decision can be made. The survey revealed that there are basically three procedural methods which can, however, differ even within one hospital. Trial provisions influence purchasing decisions in clinics. If implemented incorrectly trial provisions may compromise physical integrity, safety and health of patients and can thus lead to judicial and legal consequences for hospitals and medical staff.
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
Murphy, J R; Hall, D L
This paper describes an alternative to the continual reassessment method (CRM) for phase I trials. The logistic dose ranging strategy (LDRS) uses logistic regression and a dose allocation scheme similar to the CRM. It can easily be implemented from any logistic regression program. The LDRS can be a stand alone dose allocation scheme or it can be incorporated into standard three on a dose strategies to indicate when escalation can proceed more rapidly. Finally, the effect of covariates such as age or comorbid conditions on the toxicity expected for the dose selected for a phase II trial can be examined.
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.
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...... properties of this facility in the path from synaptic sites to the motor axon is reviewed with emphasis on voltage sensitive ion channels and regulatory metabotropic transmitter pathways. The catalog of the intrinsic response properties, their underlying mechanisms, and regulation obtained from motoneurons...... 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....
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.
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
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…
Green, David; Lindemann, Iris; Marshall, Kelly; Wilkinson, Grette
It is accepted that using electronic detection methods has benefits within an overall strategy to promote academic integrity in an institution. Little attention has been paid to obtaining student perceptions to evaluate the cost/benefit of using such methods. This study reports on the evaluation of a trial of Turnitin software. 728 students…
McDonnell, Anthony; Rex, John H; Goossens, Herman; Bonten, Marc; Fowler, Vance G; Dane, Aaron
The economics of antibiotics can be improved by infectious diseases-specific clinical trial networks. While developers would still need to implement an independent phase 1 program as well as studies focused on highly resistant pathogens, standardized procedures in a network focused on usual drug
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
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...
Visser, Kirsten; Greaves-Lord, Kirstin; Tick, Nouchka T.; Verhulst, Frank C.; Maras, Athanasios; van der Vegt, Esther J. M.
BACKGROUND: 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 avai...
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.
Gangsar, Purushottam; Tiwari, Rajiv
This paper presents an investigation of vibration and current monitoring for effective fault prediction in induction motor (IM) by using multiclass support vector machine (MSVM) algorithms. Failures of IM may occur due to propagation of a mechanical or electrical fault. Hence, for timely detection of these faults, the vibration as well as current signals was acquired after multiple experiments of varying speeds and external torques from an experimental test rig. Here, total ten different fault conditions that frequently encountered in IM (four mechanical fault, five electrical fault conditions and one no defect condition) have been considered. In the case of stator winding fault, and phase unbalance and single phasing fault, different level of severity were also considered for the prediction. In this study, the identification has been performed of the mechanical and electrical faults, individually and collectively. Fault predictions have been performed using vibration signal alone, current signal alone and vibration-current signal concurrently. The one-versus-one MSVM has been trained at various operating conditions of IM using the radial basis function (RBF) kernel and tested for same conditions, which gives the result in the form of percentage fault prediction. The prediction performance is investigated for the wide range of RBF kernel parameter, i.e. gamma, and selected the best result for one optimal value of gamma for each case. Fault predictions has been performed and investigated for the wide range of operational speeds of the IM as well as external torques on the IM.
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
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.
Park, Kyue-Nam; Kwon, Oh-Yun; Yi, Chung-Hwi; Cynn, Heon-Seock; Weon, Jong-Hyuck; Kim, Tae-Ho; Choi, Houng-Sik
The purpose of this study was to investigate the effectiveness of a 6-week motor control exercise (MCE) vs stretching exercise (SE) on reducing compensatory pelvic motion during active prone knee flexion (APKF) and intensity of low back pain. Thirty-six people in the lumbar-rotation-extension subgroup were randomly assigned equally into 2 exercise groups (18 people in each an MCE or SE group). A 3-dimensional motion-analysis system was used to measure the range and onset time of pelvic motion and knee flexion during APKF. Surface electromyography was used to measure the muscle activity and onset time of the erector spinae and the hamstrings during APKF. The level of subjective low back pain was measured using a visual analog scale. The MCE group had more significant decreases in and delay of anterior pelvic tilt, pelvic rotation, and erector spinae muscle activity during APKF, as well as reduced intensity of low back pain compared with the SE group (P < .05). For rehabilitation in patients in the lumbar-rotation-extension subgroup, MCE was more effective than SE in reducing compensatory pelvic motion and muscle activity during APKF and minimizing low back pain. Copyright © 2016. Published by Elsevier Inc.
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.
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
Stochastic transitions between two species of motor yields Bidirectional motion. • Tuning of single-motor parameters. • No need to invoke a third “coordination complex”. Page 8. PNAS, 2009. 5.5 pN. 1.1 x 5 = 5.5 pN. Page 9. Kinesin motors have a problem working together. D istance (x) or. Force = Distance * K. TRAP ...
The power factor controller (PFC) was invented by a NASA engineer. It matches voltage with a motor's actual need by sensing shifts in the relationship between voltage and current flow. With the device, power can be trimmed as much as 65%. Intellinet adopted this technology and designed "soft start" and "load-responsive" control modes to start engines gradually and recycle voltage without reducing motor speed. Other features are lower motor heat and faster fault identification.
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 caregiver-provided PTHP. Future studies should address the many important issues identified in this scoping review to improve the usefulness of the trial results. Published by
A double-blind, delayed-start trial of rasagiline in Parkinson's disease (the ADAGIO study): prespecified and post-hoc analyses of the need for additional therapies, changes in UPDRS scores, and non-motor outcomes.
Rascol, Olivier; Fitzer-Attas, Cheryl J; Hauser, Robert; Jankovic, Joseph; Lang, Anthony; Langston, J William; Melamed, Eldad; Poewe, Werner; Stocchi, Fabrizio; Tolosa, Eduardo; Eyal, Eli; Weiss, Yoni M; Olanow, C Warren
The ADAGIO study investigated whether rasagiline has disease-modifying effects in Parkinson's disease. Rasagiline 1 mg per day, but not 2 mg per day, was shown to be efficacious in the primary analysis. Here, we report additional secondary and post-hoc analyses of the ADAGIO study. ADAGIO was a placebo-controlled, double-blind, multicentre, delayed-start study, in which 1176 patients with untreated early Parkinson's disease were randomly assigned to receive rasagiline 1 mg or 2 mg per day for 72 weeks (early-start groups) or placebo for 36 weeks followed by rasagiline 1 mg or 2 mg per day for 36 weeks (delayed-start groups). We assessed the need for additional antiparkinsonian therapy and changes in non-motor experiences of daily living and fatigue scales (prespecified outcomes) and changes in unified Parkinson's disease rating scale (UPDRS) scores and subscores in placebo and active groups (post-hoc outcomes). The ADAGIO study is registered with ClinicalTrials.gov, number NCT00256204. The need for additional antiparkinsonian therapy was reduced with rasagiline 1 mg (25 of 288 [9%] patients) and 2 mg (26 of 293 [9%]) versus placebo (108 of 593 [18%]; odds ratio for 1 mg rasagiline vs placebo 0·41, 95% CI 0·25-0·65, p=0·0002; 2 mg rasagiline vs placebo 0·41, 0·26-0·64, p=0·0001). At week 36, both doses significantly improved UPDRS motor subscores compared with placebo (1 mg rasagiline mean difference -1·88 [SE 0·35]; 2 mg rasagiline -2·18 [0·35]; both prasagiline -0·86 [0·18]; 2 mg rasagiline -0·88 [0·18]; both prasagiline significantly improved UPDRS mentation subscore (-0·22 [0·08]; p=0·004). At week 72, the only significant difference between early-start and delayed-start groups was for ADL subscore with the 1 mg dose (-0·62 [0·29]; p=0·035). When assessed for the effect on non-motor symptoms at week 36, both doses showed benefits on the Parkinson fatigue scale versus placebo (1 mg rasagiline mean difference -0·14 [SE 0·05], p=0·0032; 2
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
Bae, Soo Kyung; Shon, Ji-Hong
Innovative attempts have been made to overcome nonproductivity and high expenditure in the clinical stages of new drug development. Microdosing studies using subpharmacological doses provide early insight into the body's disposition toward candidate compounds, and are innovative exploratory trials that can promote productivity in drug development. Highly sensitive analytical technology is crucial in microdosing studies that employ qualitative and quantitative assays of target materials in humans. Accelerator mass spectrometry (AMS) has facilitated the adoption of a human microdosing study in the early phase of clinical drug development. Results derived from AMS microdosing studies using labeled compounds can provide various types of information for candidate selection, including pharmacokinetic characteristics and metabolic profiles of candidate compounds. The applicability of microdosing studies is currently expanding into absolute bioavailability and mass balance studies. Although it remains uncertain whether microdosing adequately predicts the pharmacokinetics of therapeutic doses, further development of microdosing studies using AMS may benefit the field of new drug development and could pose a new challenge to researchers. The use of advanced technology in candidate selection will contribute to improved productivity and competitiveness in pharmaceutical research and development. The introduction of microdosing studies using AMS in Korea will present a newly applicable method for innovative clinical trials and contribute to development potential in global competition.
. Switch. Welte et al, 1998, Gross et al, 2002. Motion of Lipid droplets in Drosophila embryos. Page 7. • Stochastic transitions between two species of motor yields Bidirectional motion. • Tuning of single-motor parameters. • No need to invoke a ...
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...
Bertolucci, Federica; Chisari, Carmelo; Fregni, Felipe
Up to now, the mechanism of motor impairment and recovery after stroke has been thought to be based on the interhemispheric competition model. According to this model, which assumes that suppressing the excitability of contralesional hemisphere will enhance recovery by reducing transcallosal inhibition (TCI) of the stroke hemisphere, many clinical trials used non-invasive brain stimulation to improve motor function. Despite some positive findings, meta-analysis shows an important source of variability in the results, questioning whether the interhemispheric competition model would be exhaustive enough to explain the positive results or whether other mechanisms could explain the motor effects of inhibitory stimulation in the contralesional hemisphere. The goal of this study was to review the relationship between increased TCI and motor impairment after stroke.A systematic review of clinical studies investigating TCI through transcranial magnetic stimulation (TMS) in stroke patients and the relationship of this metric with motor recovery was then performed. After a literary search in PubMed eleven articles were included. The potential role of several covariates was examined and discussed.Overall, the importance of TCI as a putative mechanism for stimulation of the contralesional hemisphere seems to depend on the baseline motor function. In other words, from evidence coming mostly from chronic patients, modulation of abnormal TCI seems to be useful for patients with good motor function and less important in patients with poor motor function. TCI seems to be negatively correlated with mirror movements of the paretic hand. It can be inferred that suppressing the activity of the contralesional hemisphere could be beneficial for patients with good residual motor function and strong TCI, but not for those with poor motor function and weak TCI. Baseline motor function and measure of TCI should be taken into account for stratification of patients in clinical trials and for
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.
Jackson, V Margaret; Price, David A; Carpino, Philip A
The discovery of new antiobesity agents has attracted considerable interest over the past decade, but many of the investigational agents that have advanced into human clinical trials have shown unacceptable adverse events and/or efficacy profiles. This review summarizes the available preclinical and clinical data of antiobesity drugs currently in Phase II clinical trials. It also provides a brief summary of the mechanisms underlying the regulation of energy homeostasis. New approaches to solving the obesity epidemic are needed, exemplified in part by some of the agents currently in Phase II clinical trials. Weight loss treatments could be tailored to specific subpopulations such as morbidly obese individuals with a high risk for complications or obese patients with a specific genotype. Fixed dose combinations of drugs that target multiple complementary pathways could be developed to deliver durable, 10% or greater weight loss. A shift away from pharmacological agents that act on pathways in the CNS could lead to drugs with fewer side effects and more favorable risk/benefit ratios.
An Investigation of an Evaluation Method and Retraining Procedures for Emotionally Handicapped Children with Cognitive-Motor Deficits. Interim Report. Part I, Testing for Cognitive-Perceptual-Motor Dysfunction.
Rubin, Eli Z.; And Others
Using a 41-test battery of cognitive-perceptual-motor tests supplemented by standardized tests of intelligence, visual perception, eye hand coordination, linguistics, and non-verbal integration, a group of 200 maladjusted school age children from grades 1, 2, 3, and 5 was compared with a group of problem-free children similar in size, sex…
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.
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.
Veghte, Robert H.
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. PMID:25386609
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.
Braun, Thorsten; Gardin, Claude
Acute myelogenous leukemia (AML) is a heterogeneous group of malignancies driven by genetic mutations and deregulated epigenetic control. Relapse/refractory disease remains frequent in younger patients and even more so in older patients, including treatment with epigenetic drugs in this age group, mainly with hypomethylating agents. New treatment strategies are urgently needed. The recent discovery that epigenetic readers of the bromodomain (BRD) and extraterminal (BET) protein family, are crucial for AML maintenance by transcription of oncogenic c-MYC lead to rapid development of BET inhibitors entering clinical trials. Areas covered: We provide a critical overview using main sources for the use of BET inhibitors in AML treatment. Limits of this treatment approach including resistance mechanisms and future directions including development of new generation BET inhibitors and combination strategies with other drugs are detailed. Expert opinion: BET inhibitors were expected to overcome limits of conventional treatment in patients as impressive in vitro data emerged recently in well-characterized AML subsets, including those associated with poor risk characteristics in the clinic. Nevertheless single activity of BET inhibitors appears to be modest and resistance mechanisms were already identified. BET inhibitors with alternative mechanisms of action and/or combination strategies with epigenetic drugs should be tested.
Daliri, Seyedeh Somayeh; Forogh, Bijan; Emami Razavi, Seyedeh Zahra; Ahadi, Tannaz; Madjlesi, Faezeh; Ansari, Noureddin Nakhostin
Spasticity is a common, serious symptom after stroke. Extracorporeal shock wave therapy (ESWT) has been suggested for the treatment of muscle spasticity. To investigate the effects of ESWT on post stroke wrist flexor spasticity. Fifteen patients with poststroke wrist flexor spasticity (12 male and 3 female with a mean age of 54 years) were enrolled. Patients received 1 sham ESWT followed by 1 active ESWT 1 week later. The outcome measures were the Modified Modified Ashworth Scale (MMAS), the Hmax/Mmax ratio, and the Brunnstrom motor recovery stage. The sham ESWT had not effects on the outcome measures. After active ESW, the MMAS scores of spasticity and the Hmax/Mmax ratio improved. The improvements were maintained 5 weeks after active ESWT. No significant improvements were observed for the motor recovery after sham or active ESWT. In adult patients after stroke, a single session of active ESWT resulted in significant improvement in the wrist flexor spasticity and alpha motor neuron excitability.
Exercise, Ambulatory, Clinical Trial 21 Table of Contents...VO2max is substantially lower than predicted, and likely reflects the effects of deconditioning resulting from limited engagement in physical activity...randomized and controlled clinical trial of the effect of exercise on an established functional outcome measure will have immediate impact on
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.
Polatajko, Helene J.; And Others
A study assigned children aged 6-8 with sensory integration (SI) dysfunction to 3 groups: 35 used sensory modalities, 32 received psychomotor (PM) training, and 13 no intervention. SI and PM administered one hour per week for six months proved equally effective in improving academic and motor performance but had little effect on self-esteem. (SK)
Heleno, Lucas Rafael; da Silva, Rubens A; Shigaki, Leonardo; Araújo, Cynthia Gobbi Alves; Coelho Candido, Cristiane Regina; Okazaki, Victor Hugo Alves; Frisseli, Ariobaldo; Macedo, Christiane de S Guerino
Sensory motor training programs are used in the rehabilitation and prevention of injuries among soccer players. Inconsistencies are found in the literature regarding the duration of the protocols and the exercises and equipment used. To evaluate the benefits of a five-week sensory motor training program on the functional performance and postural control of young soccer players. The study sample comprised 22 young male soccer players who were evaluated using: the Figure-of-Eight Test (F8), Side Hop Test (SHT), Star Excursion Balance Test (SEBT), and a force platform. The players were randomly divided into a control group (N = 10), who continued their soccer practice sessions and an intervention group (N = 12), who continued their soccer practice sessions and were also enrolled in a supervised five-week sensory motor training program. After the five-week training program, the intervention group obtained significant results in the F8, SHT and SEBT, as well as in the following parameters: area of pressure of sway center (COP), mean velocity and mean frequency of COP. The five-week sensory motor training program, carried out with easily available and low cost equipment, was effective at improving functional performance and postural control in young soccer players. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
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…
Bilek, Emily L.; Ehrenreich-May, Jill
The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M = 9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were…
Larsen, Kristian Traberg; Huang, Tao; Larsen, Lisbeth Runge; Olesen, Line Grønholt; Andersen, Lars Bo; Møller, Niels Christian
Many weight-loss programs in children are performed without specific foci on training both physical fitness and motor skills. The aim of this study was to describe the effect of a one-year weight-loss program on children's motor skills and physical fitness. Participants included 115 overweight fifth-grade children (12.0 years) randomized into either a Day-Camp Intervention Arm (DCIA), with a subsequent family-based support program or a low-intense Standard Intervention Arm (SIA). Physical fitness was assessed by vertical jump, hand grip strength, and a progressive cardio-respiratory fitness test. Motor skills were assessed by the Movement Assessment Battery for Children - second edition (M-ABC-2), age band 3. Loss to follow-up after 52 weeks was 19 % and 32 % in the DCIA and SIA, respectively. Balance skills were improved post-camp, but not after 52 weeks in children from the DCIA compared to the SIA. Contrary to the expected, children from the SIA improved aiming and catching skills relative to the DCIA children. Overall z-scores of the physical fitness components and cardio-respiratory fitness improved more in children from the DCIA compared to children from the SIA. In conclusion, the day-camp intervention led to improvements in physical fitness but not in motor skills compared to the standard intervention. Including both motor skills and physical fitness could advantageously be considered in future immersive intervention programmes. Clinicaltrials NCT01574352, March 26, 2012 (retrospectively registered).
Investigacion experimental de la prestaciones de un motor monocilíndrico usando combustible diesel emulsionado; Experimental investigation of the single cylinder engine performance using emulsified diesel fuel
Eliezer Ahmed- Melo Espinosa y otros
Full Text Available En esta investigación se realiza un análisis de las prestaciones y emisiones de un motor Petter mono-cilíndrico de inyección directa al usar como combustible una emulsión de 5% de agua, 2% de surfactante y combustible diesel. Los resultados obtenidos con la emulsión muestran un ligero incremento en el torque y la potencia efectiva, así como en el consumo específico de combustible y el retardo de la ignición. Respecto a las emisiones de gases contaminantes, los hidrocarburos noquemados (HC y el monóxido de carbono (CO para la emulsió aumentaron en comparación con los resultados obtenidos para el combustible diesel. En ambos casos, los aumentos son unaconsecuencia de la disminución de las temperaturas en el interior de la cámara de combustión, los aumentos en el retardo de la ignición y al enfriamiento de la llama.In this investigation an analysis based on the performances and emission of a Petter single cylinderdirect injection diesel engine when using an emulsion of 5% of water, 2% of surfactant and diesel fuel as fuel is carried out. The result obtained with the emulsion tested shown slight increase ineffective torque and power output, but also increases in brake specific fuel consumption and ignition delay. Concerning the exhausts, increases in hydrocarbons (HC and carbon monoxide(CO emissions for emulsion were obtained. In both cases the increases are due to the effect of lower temperatures inside the combustion chamber, longer ignition delays and quenching of theflame.
Investigacion experimental de la prestaciones de un motor monocilíndrico usando combustible diesel emulsionado; Experimental investigation of the single cylinder engine performance using emulsified diesel fuel
Eliezer Ahmed Melo Espinosa
Full Text Available En esta investigación se realiza un análisis de las prestaciones y emisiones de un motor Petter mono-cilíndrico de inyección directa al usar como combustible una emulsión de 5% de agua, 2%de surfactante y combustible diesel. Los resultados obtenidos con la emulsión muestran un ligero incremento en el torque y la potencia efectiva, así como en el consumo específico de combustible y el retardo de la ignición. Respecto a las emisiones de gases contaminantes, los hidrocarburos noquemados (HC y el monóxido de carbono (CO para la emulsión aumentaron en comparación con los resultados obtenidos para el combustible diesel. En ambos casos, los aumentos son unaconsecuencia de la disminución de las temperaturas en el interior de la cámara de combustión, los aumentos en el retardo de la ignición y al enfriamiento de la llama. In this investigation an analysis based on the performances and emission of a Petter single cylinder direct injection diesel engine when using an emulsion of 5% of water, 2% of surfactant and dieselfuel as fuel is carried out. The result obtained with the emulsion tested shown slight increase in effective torque and power output, but also increases in brake specific fuel consumption and ignition delay. Concerning the exhausts, increases in hydrocarbons (HC and carbon monoxide(CO emissions for emulsion were obtained. In both cases the increases are due to the effect of lower temperatures inside the combustion chamber, longer ignition delays and quenching of the flame.
Stevely, Abigail; Dimairo, Munyaradzi; Todd, Susan; Julious, Steven A.; Nicholl, Jonathan; Hind, Daniel; Cooper, Cindy L.
Background It can be argued that adaptive designs are underused in clinical research. We have explored concerns related to inadequate reporting of such trials, which may influence their uptake. Through a careful examination of the literature, we evaluated the standards of reporting of group sequential (GS) randomised controlled trials, one form of a confirmatory adaptive design. Methods We undertook a systematic review, by searching Ovid MEDLINE from the 1st January 2001 to 23rd September 2014, supplemented with trials from an audit study. We included parallel group, confirmatory, GS trials that were prospectively designed using a Frequentist approach. Eligible trials were examined for compliance in their reporting against the CONSORT 2010 checklist. In addition, as part of our evaluation, we developed a supplementary checklist to explicitly capture group sequential specific reporting aspects, and investigated how these are currently being reported. Results Of the 284 screened trials, 68(24%) were eligible. Most trials were published in “high impact” peer-reviewed journals. Examination of trials established that 46(68%) were stopped early, predominantly either for futility or efficacy. Suboptimal reporting compliance was found in general items relating to: access to full trials protocols; methods to generate randomisation list(s); details of randomisation concealment, and its implementation. Benchmarking against the supplementary checklist, GS aspects were largely inadequately reported. Only 3(7%) trials which stopped early reported use of statistical bias correction. Moreover, 52(76%) trials failed to disclose methods used to minimise the risk of operational bias, due to the knowledge or leakage of interim results. Occurrence of changes to trial methods and outcomes could not be determined in most trials, due to inaccessible protocols and amendments. Discussion and Conclusions There are issues with the reporting of GS trials, particularly those specific to the
Full Text Available It can be argued that adaptive designs are underused in clinical research. We have explored concerns related to inadequate reporting of such trials, which may influence their uptake. Through a careful examination of the literature, we evaluated the standards of reporting of group sequential (GS randomised controlled trials, one form of a confirmatory adaptive design.We undertook a systematic review, by searching Ovid MEDLINE from the 1st January 2001 to 23rd September 2014, supplemented with trials from an audit study. We included parallel group, confirmatory, GS trials that were prospectively designed using a Frequentist approach. Eligible trials were examined for compliance in their reporting against the CONSORT 2010 checklist. In addition, as part of our evaluation, we developed a supplementary checklist to explicitly capture group sequential specific reporting aspects, and investigated how these are currently being reported.Of the 284 screened trials, 68(24% were eligible. Most trials were published in "high impact" peer-reviewed journals. Examination of trials established that 46(68% were stopped early, predominantly either for futility or efficacy. Suboptimal reporting compliance was found in general items relating to: access to full trials protocols; methods to generate randomisation list(s; details of randomisation concealment, and its implementation. Benchmarking against the supplementary checklist, GS aspects were largely inadequately reported. Only 3(7% trials which stopped early reported use of statistical bias correction. Moreover, 52(76% trials failed to disclose methods used to minimise the risk of operational bias, due to the knowledge or leakage of interim results. Occurrence of changes to trial methods and outcomes could not be determined in most trials, due to inaccessible protocols and amendments.There are issues with the reporting of GS trials, particularly those specific to the conduct of interim analyses. Suboptimal
Somers, Julian M; Patterson, Michelle L; Moniruzzaman, Akm; Currie, Lauren; Rezansoff, Stefanie N; Palepu, Anita; Fryer, Karen
dependence, suicidality, and physical illness. Randomization resulted in no meaningful detectable differences between study arms. Current Controlled Trials: ISRCTN57595077 (Vancouver at Home study: Housing First plus Assertive Community Treatment versus congregate housing plus supports versus treatment as usual) and ISRCTN66721740 (Vancouver At Home study: Housing First plus Intensive Case Management versus treatment as usual).
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
Lips Irene M
Full Text Available Abstract Background The treatment results of external beam radiotherapy for intermediate and high risk prostate cancer patients are insufficient with five-year biochemical relapse rates of approximately 35%. Several randomized trials have shown that dose escalation to the entire prostate improves biochemical disease free survival. However, further dose escalation to the whole gland is limited due to an unacceptable high risk of acute and late toxicity. Moreover, local recurrences often originate at the location of the macroscopic tumor, so boosting the radiation dose at the macroscopic tumor within the prostate might increase local control. A reduction of distant metastases and improved survival can be expected by reducing local failure. The aim of this study is to investigate the benefit of an ablative microboost to the macroscopic tumor within the prostate in patients treated with external beam radiotherapy for prostate cancer. Methods/Design The FLAME-trial (Focal Lesion Ablative Microboost in prostatE cancer is a single blind randomized controlled phase III trial. We aim to include 566 patients (283 per treatment arm with intermediate or high risk adenocarcinoma of the prostate who are scheduled for external beam radiotherapy using fiducial markers for position verification. With this number of patients, the expected increase in five-year freedom from biochemical failure rate of 10% can be detected with a power of 80%. Patients allocated to the standard arm receive a dose of 77 Gy in 35 fractions to the entire prostate and patients in the experimental arm receive 77 Gy to the entire prostate and an additional integrated microboost to the macroscopic tumor of 95 Gy in 35 fractions. The secondary outcome measures include treatment-related toxicity, quality of life and disease-specific survival. Furthermore, by localizing the recurrent tumors within the prostate during follow-up and correlating this with the delivered dose, we can obtain
Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study.
Rogić Vidaković, Maja; Jerković, Ana; Jurić, Tomislav; Vujović, Igor; Šoda, Joško; Erceg, Nikola; Bubić, Andreja; Zmajević Schönwald, Marina; Lioumis, Pantelis; Gabelica, Dragan; Đogaš, Zoran
Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.
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.
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
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
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…
Oglesby, Mary E; Allan, Nicholas P; Schmidt, Norman B
Intolerance of uncertainty (IU) is an important transdiagnostic variable within various anxiety and mood disorders. Theory suggests that individuals high in IU interpret ambiguous information in a more threatening manner. A parallel line of research has shown that interpretive biases can be modified through cognitive training and previous research aimed at modifying negative interpretations through Cognitive Bias Modification (CBM-I) has yielded promising results. Despite these findings, no research to date has examined the efficacy of an IU-focused CBM-I paradigm. The current study investigated the impact of a brief IU-focused CBM-I on reductions in IU. Participants selected for a high IU interpretation bias (IU-IB) were randomly assigned to an active (IU CBM-I) or control CBM-I condition. Results indicated that our active IU CBM-I was associated with significant changes in IU-IB from pre-to-post intervention as well as with significant reductions in IU at post-intervention and month-one follow-up. Findings also found that the IU CBM-I led to reductions in IU self-report via the hypothesized mechanism. This study is the first to provide evidence that a CBM-I focused on IU is effective in reducing IU-IB and IU across time and suggest that IU CBM-I paradigms may be a novel prevention/intervention treatment for anxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.
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
Two recent conferences on the science of sport have focused on the topic of sports for older people. Investigations have been made on the special demand in motor learning, in table-tennis, family-tennis, gymnastics, and dancing. This paper summarizes some experiences and conclusions drawn from these studies, including special notes on isolated…
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
Trilok-Kumar, Geeta; Kaur, Manpreet; Rehman, Andrea M; Arora, Harsh; Rajput, Mohammad Muntafa; Chugh, Reema; Kurpad, Anura; Sachdev, Harshpal Singh; Filteau, Suzanne
The long-term effects of infant vitamin D supplementation and status are unclear since there have been few controlled intervention trials and these have been small and contradictory. The Delhi Infant Vitamin D Supplementation (DIVIDS) trial found that supplementation of low-birthweight term infants with one recommended dietary allowance of vitamin D from 1 week to 6 months of age resulted in increased length and weight at 6 months. In the DIVIDS-2 study we followed up the DIVIDS children, now aged 3-6 years, to determine longer-term effects. DIVIDS children, 446 from the vitamin D arm and 466 from the placebo arm, attended the follow-up visit. Data collection included anthropometry, blood pressure, bone structure and strength by quantitative ultrasound (QUS), gross motor tests, deuterium dilution test of body composition on a subset (n = 229) and blood samples for measurement of vitamin D status. Body mass index Z scores (BMIZ) were lower (adjusted P = 0.003)in the vitamin D Group [-1.18 (SD 0.92)] when compared with the placebo [-1.02 (SD 0.91)] group as a result of slightly lower weight and slightly greater height. The vitamin D group also had lower thigh circumference and arm muscle area and borderline lower mid-upper arm circumference. There were no group differences in body fat percentage, bone QUS or blood pressure and few differences in motor development measures. Vitamin D supplementation of low-birthweight infants in infancy resulted in children being thinner at age 3-6 years but in no differences in functional outcomes. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
Kostić Miloje M.
Full Text Available Motor energy management includes adequate sizing, control and improvement of electric energy quality, i.e. voltage quality (reducing voltage unbalance and harmonics distortion, and the proper maintenance. The specific motor price per kW is approximately constant for motors rated from 5 kW to 20 kW. By adequate sizing, or by proper replacement of the old motor with the new one, with rated output power reduced by 20% to 50% the smaller motor will be also cheaper by 20% to 50%. When the 22 kW motor is replaced with the new 15 kW that costs 64% of the price of a new 22 kW motor, the efficiency is increased by 3.6% (Example in paper. On the basis of our investigation results, it is confirmed that there are significant possibilities for energy savings by setting voltage values within the ±5% voltage band (Un±5%, since more than 80% induction motors are under loaded (£70%, especially small and medium rated power (1-30 kW motors.
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
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.
Gammelgaard Nielsen, Anders
MOTOR is the first assignment that students at Unit 1a of the School of Architecture are introduced to. The purpose of the assignment is to shake up the students and their preconceptions of what architec- ture is. This is done by introducing them to a working method that al- lows them to develop ...
Gammelgaard Nielsen, Anders
MOTOR is the first assignment that students at Unit 1a of the School of Architecture are introduced to. The purpose of the assignment is to shake up the students and their preconceptions of what architec- ture is. This is done by introducing them to a working method that al- lows them to develop...
Wolpert, Daniel M; Flanagan, J Randall
Although learning a motor skill, such as a tennis stroke, feels like a unitary experience, researchers who study motor control and learning break the processes involved into a number of interacting components. These components can be organized into four main groups. First, skilled performance requires the effective and efficient gathering of sensory information, such as deciding where and when to direct one's gaze around the court, and thus an important component of skill acquisition involves learning how best to extract task-relevant information. Second, the performer must learn key features of the task such as the geometry and mechanics of the tennis racket and ball, the properties of the court surface, and how the wind affects the ball's flight. Third, the player needs to set up different classes of control that include predictive and reactive control mechanisms that generate appropriate motor commands to achieve the task goals, as well as compliance control that specifies, for example, the stiffness with which the arm holds the racket. Finally, the successful performer can learn higher-level skills such as anticipating and countering the opponent's strategy and making effective decisions about shot selection. In this Primer we shall consider these components of motor learning using as an example how we learn to play tennis. 2010 Elsevier Ltd. All rights reserved.
Leocani, Letizia; Comi, Eleonora; Annovazzi, Pietro; Rovaris, Marco; Rossi, Paolo; Cursi, Marco; Comola, Mauro; Martinelli, Vittorio; Comi, Giancarlo
Virtual reality (VR) has been proposed as a potentially useful tool for motor assessment and rehabilitation. The objective of this study was to investigate the usefulness of VR in the assessment of short-term motor learning in multiple sclerosis (MS). Twelve right-handed MS patients and 12 control individuals performed a motor-tracking task with their right upper limb, following the trajectory of an object projected on a screen along with online visual feedback on hand position from a sensor on the index finger. A pretraining test (3 trials), a training phase (12 trials), and a posttraining test (3 trials) were administered. Distances between performed and required trajectory were computed. Both groups performed worse in depth planes compared to the frontal (x,z) plane (P plane at both evaluations (P planes only (P = .03). The authors' VR system detected impaired motor learning in MS patients, especially for task features requiring a complex integration of sensory information (movement in the depth planes). These findings stress the need for careful customization of rehabilitation strategies, which must take into account the patients' motor, sensory, and cognitive limitations.
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
Coker, Elizabeth; McIsaac, Tara L; Nilsen, Dawn
Elite dancers often engage in mental practice during training, but little is known about the effects of discrete, repetitive motor imagery on dance movement performance. This study compared the effects of two motor imagery modalities, third-person visual imagery and kinesthetic imagery, on hip and pelvis kinematics during two technical dance movements, plié and sauté. Twenty-four female dancers (mean age: 26.04; mean years of training: 19.63) were randomly assigned to a type of imagery practice: visual imagery (VI), kinesthetic imagery (KI), or a mental arithmetic task control condition (MAT). No statistically significant effects of imagery group or task type were found for external hip rotation, sagittal pelvic excursion, or a ratio relating hip to pelvic movement, suggesting that imagery practice did not affect either temporal or kinematic characteristics of the plié or sauté.
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.
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.
J Gordon Millichap
Full Text Available Of 33 children and adolescents (median age 6 years investigated for learning disability, epilepsy, and motor dysfunction to detect suspected Angelman syndrome (AS, in a study at Goteborg University, Sweden, 23 fulfilled criteria for AS.
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
Hillier, Susan; McIntyre, Auburn; Plummer, Leanne
Aquatic therapy is an intervention for children with Developmental Coordination Disorder (DCD) that has not been investigated formally. This was a pilot randomized controlled trial to investigate the feasibility and preliminary effectiveness of an aquatic therapy program to improve motor skills of children with DCD. Thirteen children (mean age 7…
Investigating methotrexate toxicity within a randomized double-blinded, placebo-controlled trial: rationale and design of the Cardiovascular Inflammation Reduction Trial-Adverse Events (CIRT-AE) Study
Background: The role of low dose methotrexate (LDM) in potential serious toxicities remains unclear despite its common use. Prior observational studies investigating LDM toxicity compared LDM to other active drugs. Prior placebo-controlled clinical trials of LDM in inflammatory conditions were not l...
E.J. Topol (Eric); N.S. Kleiman (Neal); K.L. Lee (Kerry); D. Morris; M.L. Simoons (Maarten); H.D. White (Harvey); R.M. Califf (Robert); F.J.J. van de Werf (Frans); P.W. Armstrong (Paul); G.I. Barbash
textabstractThe Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial is a large scale international trial of new myocardial reperfusion strategies. The primary hypothesis is that early and sustained coronary artery recanalization will be
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.
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
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
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.
Charlotte M. W. Gaasterland
Full Text Available Abstract Background One of the main challenges for drug evaluation in rare diseases is the often heterogeneous course of these diseases. Traditional outcome measures may not be applicable for all patients, when they are in different stages of their disease. For instance, in Duchenne Muscular Dystrophy, the Six Minute Walk Test is often used to evaluate potential new treatments, whereas this outcome is irrelevant for patients who are already in a wheelchair. A measurement instrument such as Goal Attainment Scaling (GAS can evaluate the effect of an intervention on an individual basis, and may be able to include patients even when they are in different stages of their disease. It allows patients to set individual goals, together with their treating professional. However, the validity of GAS as a measurement instrument in drug studies has never been systematically reviewed. Therefore, we have performed a systematic review to answer two questions: 1. Has GAS been used as a measurement instrument in drug studies? 2: What is known of the validity, responsiveness and inter- and intra-rater reliability of GAS, particularly in drug trials? Methods We set up a sensitive search that yielded 3818 abstracts. After careful screening, data-extraction was executed for 58 selected articles. Results Of the 58 selected articles, 38 articles described drug studies where GAS was used as an outcome measure, and 20 articles described measurement properties of GAS in other settings. The results show that validity, responsiveness and reliability of GAS in drug studies have hardly been investigated. The quality of the reporting of validity in studies in which GAS was used to evaluate a non-drug intervention also leaves much room for improvement. Conclusions We conclude that there is insufficient information to assess the validity of GAS, due to the poor quality of the validity studies. Therefore, we think that GAS needs further validation in drug studies, especially
Reus, Linda; Pillen, Sigrid; Pelzer, Ben J; van Alfen-van der Velden, Janielle A A E M; Hokken-Koelega, Anita C S; Zwarts, Machiel; Otten, Barto J; Nijhuis-van der Sanden, Maria W G
To investigate the effect of physical training combined with growth hormone (GH) on muscle thickness and its relationship with muscle strength and motor development in infants with Prader-Willi syndrome (PWS). In a randomized controlled trial, 22 infants with PWS (12.9 ± 7.1 months) were followed over 2 years to compare a treatment group (n = 10) with a waiting-list control group (n = 12). Muscle thickness of 4 muscle groups was measured by using ultrasound. Muscle strength was evaluated by using the Infant Muscle Strength meter. Motor performance was measured with the Gross Motor Function Measurement. Analyses of variance were used to evaluate between-group effects of GH on muscle thickness at 6 months and to compare pre- and posttreatment (after 12 months of GH) values. Multilevel analyses were used to evaluate effects of GH on muscle thickness over time, and multilevel bivariate analyses were used to test relationships between muscle thickness, muscle strength, and motor performance. A significant positive effect of GH on muscle thickness (P motor performance (r = 0.81, P motor performance (r = 0.76, P motor development in infants with PWS. Catch-up growth was faster in muscles that are most frequently used in early development. Because this effect was independent of GH, it suggests a training effect. Copyright © 2014 by the American Academy of Pediatrics.
Lee Kerry L
Full Text Available Abstract Background Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs reported by site investigators in the international Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin (Eptifibatide Therapy (PURSUIT trial and those adjudicated by a central clinical events committee (CEC to determine the reasons for differences in event rates. Methods The PURSUIT trial randomised 10,948 patients with acute coronary syndromes to receive eptifibatide or placebo. The primary end-point was death or post-enrolment MI at 30 days as assessed by the CEC; this end-point was also constructed using site-reported events. The CEC identified suspected MIs by systematic review of clinical, cardiac enzyme, and electrocardiographic data. Results The CEC identified 5005 (46% suspected events, of which 1415 (28% were adjudicated as MI. The site investigator and CEC assessments of whether a MI had occurred disagreed in 983 (20% of the 5005 patients with suspected MI, mostly reflecting site misclassification of post-enrolment MIs (as enrolment MIs or underreported periprocedural MIs. Patients for whom the CEC and site investigator agreed that no end-point MI had occurred had the lowest mortality at 30 days and between 30 days and 6 months, and those with agreement that a MI had occurred had the highest mortality. Conclusion CEC adjudication provides a standard, systematic, independent, and unbiased assessment of end-points, particularly for trials that span geographic regions and clinical practice settings. Understanding the review process and reasons for disagreement between CEC and site investigator assessments of MI is important to design future trials and interpret event rates between trials.
K.W. Mahaffey (Kenneth); R.A. Harrington (Robert Alex); N.S. Kleiman (Neal); L.G. Berdan (Lisa); B.S. Crenshaw (Brian); B.E. Tardiff (Barbara); C.B. Granger (Christopher); I. DeJong (Ingrid); M. Bhapkar (Manju); P. Widimsky (Petr); R. Corbalon (Ramón); K.L. Lee (Kerry); J.W. Deckers (Jaap); M.L. Simoons (Maarten); E.J. Topol (Eric); R.M. Califf (Robert); K.M. Akkerhuis (Martijn)
textabstractAbstract: Background Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs) reported by site investigators in the international Platelet Glycoprotein IIb/IIIa in
K.W. Mahaffey (Kenneth); R.A. Harrington (Robert Alex); K.M. Akkerhuis (Martijn); N.S. Kleiman (Neal); L.G. Berdan (Lisa); B.S. Crenshaw (Brian); B.E. Tardiff (Barbara); C.B. Granger (Christopher); I. DeJong (Ingrid); M. Bhapkar (Manju); P. Widimsky (Petr); R. Corbalon (Ramón); K.L. Lee (Kerry); J.W. Deckers (Jaap); M.L. Simoons (Maarten); E.J. Topol (Eric); R.M. Califf (Robert)
textabstractBackground. Limited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions (MIs) reported by site investigators in the international Platelet Glycoprotein IIb/IIIa in Unstable
Poortmans, Philip; Kouloulias, Vassilis; van Tienhoven, Geertjan; Collette, Laurence; Struikmans, Henk; Venselaar, Jack L. M.; van den Bogaert, Walter; Davis, J. Bernard; Lambin, Philippe
A quality assurance (QA) program in conjunction with the EORTC trial investigating the role of adjuvant internal mammary and medial supraclavicular irradiation in stage I-III breast cancer is presented. The results of a dummy run procedure and of an individual case review are compared to each other.
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 (Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) 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
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.
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
Cojan, Yann; Waber, Lakshmi; Carruzzo, Alain; Vuilleumier, Patrik
Brain mechanisms underlying hysterical conversion symptoms are still poorly known. Recent hypotheses suggested that activation of motor pathways might be suppressed by inhibitory signals based on particular emotional situations. To assess motor and inhibitory brain circuits during conversion paralysis, we designed a go-nogo task while a patient underwent functional magnetic resonance imaging (fMRI). Preparatory activation arose in right motor cortex despite left paralysis, indicating preserved motor intentions, but with concomitant increases in vmPFC regions that normally mediate motivational and affective processing. Failure to execute movement on go trials with the affected left hand was associated with activations in precuneus and ventrolateral frontal gyrus. However, right frontal areas normally subserving inhibition were activated by nogo trials for the right (normal) hand, but not during go trials for the left hand (affected by conversion paralysis). By contrast, a group of healthy controls who were asked to feign paralysis showed similar activation on nogo trials and left-go trials with simulated weakness, suggesting that distinct inhibitory mechanisms are implicated in simulation and conversion paralysis. In the patient, right motor cortex also showed enhanced functional connectivity with the posterior cingulate cortex, precuneus, and vmPFC. These results suggest that conversion symptoms do not act through cognitive inhibitory circuits, but involve selective activations in midline brain regions associated with self-related representations and emotion regulation.
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.
Full Text Available Objective. To investigate the relationship between changes of cortical hand motor representation and motor recovery of the affected hand in subacute stroke. Methods. 17 patients with motor impairment of the affected hand were enrolled in an in-patient neurological rehabilitation program. Hand motor function tests (Wolf Motor Function Test, Action Research Arm Test and neurophysiological evaluations (resting motor threshold, motor evoked potentials, motor map area size, motor map area volume, and motor map area location were obtained from both hands and hemispheres at baseline and two, four, and six weeks of in-patient rehabilitation. Results. There was a wide spectrum of hand motor impairment at baseline and hand motor recovery over time. Hand motor function and recovery correlated significantly with (i reduction of cortical excitability, (ii reduction in size and volume of cortical hand motor representation, and (iii a medial and anterior shift of the center of gravity of cortical hand motor representation within the contralesional hemisphere. Conclusion. Recovery of motor function of the affected hand after stroke is accompanied by definite changes in excitability, size, volume, and location of hand motor representation over the contralesional primary motor cortex. These measures may serve as surrogate markers for the outcome of hand motor rehabilitation after stroke.
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....
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
Lashkari, Negin; Poshtan, Javad; Azgomi, Hamid Fekri
The three-phase shift between line current and phase voltage of induction motors can be used as an efficient fault indicator to detect and locate inter-turn stator short-circuit (ITSC) fault. However, unbalanced supply voltage is one of the contributing factors that inevitably affect stator currents and therefore the three-phase shift. Thus, it is necessary to propose a method that is able to identify whether the unbalance of three currents is caused by ITSC or supply voltage fault. This paper presents a feedforward multilayer-perceptron Neural Network (NN) trained by back propagation, based on monitoring negative sequence voltage and the three-phase shift. The data which are required for training and test NN are generated using simulated model of stator. The experimental results are presented to verify the superior accuracy of the proposed method. Copyright © 2015. Published by Elsevier Ltd.
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
Gimbert, Anne; Colin, Anne‐Laurène; Salvo, Francesco; Becker, Madlyne; Marty, Valérie; Montastruc, Jean‐Louis; Petitpain, Nadine
Aims Sponsors of clinical trials have to analyze serious adverse events (SAEs). Both sponsors and investigators determine the relationship between the investigational medicinal product, the investigational device or procedure and SAEs. SAEs related to another cause, such as a non‐investigational medicinal product (NIMP), do not have clear pharmacovigilance reporting requirements. The aim of this study was to evaluate the amount and the nature of NIMP‐related SAEs recorded by three French academic sponsors and to propose pharmacovigilance requirements for these cases. Methods This was a retrospective descriptive study including all cases of NIMP‐related SAEs occurring in clinical trials and reported to three academic sponsors between January 2009 and October 2014. Results Among 5870 cases of SAEs, 300 (5%) were related to a NIMP in 50 clinical trials. Involved NIMPs were mainly antithrombotics, cytostatics and immunosuppressants. Some of these drugs were currently followed by a risk management plan (e.g. rivoxaban). The most frequent NIMP‐related SAEs were neurological, gastrointestinal and infectious disorders. Seven NIMP‐related SAEs were known as ‘rare’ or ‘very rare’ and two were ‘unlabelled’. Conclusions As far as we know, this is the first study to focus about NIMP‐related SAEs occurring in clinical trials. This work highlights the potential high quality source of safety data via NIMP‐related SAE collection. Globally, we propose that NIMP‐related SAEs occurring in clinical trials should systematically be notified to the pharmacovigilance system of the concerned country. Clearer procedures of interactions between safety units of academic sponsors and pharmacovigilance systems are needed to allow an effective recording of NIMP‐related SAEs. PMID:27276241
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
Stecklow, Marcus Vinicius; Infantosi, Antonio Fernando Catelli; Cagy, Maurício
The evoked cerebral electric response when sequences of complex motor imagery (MI) task are executed several times is still unclear. This work aims at investigating the existence of habituation in the cortical response, more specifically in the alpha band peak of parietal and occipital areas (10-20 international system electroencephalogram, EEG, protocol). The EEG signals were acquired during sequences of MI of volleyball spike movement in kinesthetic and visual modalities and also at control condition. Thirty right-handed male subjects (18 to 40 years) were assigned to either an 'athlete' or a 'non-athlete' group, both containing 15 volunteers. Paired Wilcoxon tests (with alpha=0.05) indicates that sequential MI of complex tasks promotes cortical changes, mainly in the power vicinity of the alpha peak. This finding is more pronounced along the initial trials and also for the athletes during the modality of kinesthetic motor imagery.
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
Gross motor control is the ability to make large, general movements (such as waving an arm or lifting a ... Gross motor control is a milestone in the development of an infant. Infants develop gross motor control before they ...
Full Text Available Abstract Background Conservative treatment of uncomplicated or mild diverticulitis usually includes antibiotic therapy. It is, however, uncertain whether patients with acute diverticulitis indeed benefit from antibiotics. In most guidelines issued by professional organizations antibiotics are considered mandatory in the treatment of mild diverticulitis. This advice lacks evidence and is merely based on experts' opinion. Adverse effects of the use of antibiotics are well known, including allergic reactions, development of bacterial resistance to antibiotics and other side-effects. Methods A randomized multicenter pragmatic clinical trial comparing two treatment strategies for uncomplicated acute diverticulitis. I A conservative strategy with antibiotics: hospital admission, supportive measures and at least 48 hours of intravenous antibiotics which subsequently are switched to oral, if tolerated (for a total duration of antibiotic treatment of 10 days. II A liberal strategy without antibiotics: admission only if needed on clinical grounds, supportive measures only. Patients are eligible for inclusion if they have a diagnosis of acute uncomplicated diverticulitis as demonstrated by radiological imaging. Only patients with stages 1a and 1b according to Hinchey's classification or "mild" diverticulitis according to the Ambrosetti criteria are included. The primary endpoint is time-to-full recovery within a 6-month follow-up period. Full recovery is defined as being discharged from the hospital, with a return to pre-illness activities, and VAS score below 4 without the use of daily pain medication. Secondary endpoints are proportion of patients who develop complicated diverticulitis requiring surgery or non-surgical intervention, morbidity, costs, health-related quality of life, readmission rate and acute diverticulitis recurrence rate. In a non-inferiority design 264 patients are needed in each study arm to detect a difference in time
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.
Young, J J; Kereiakes, D J; Grines, C L
Early coronary intervention in patients with non-ST segment elevation acute coronary syndromes (ACS) may be facilitated by adjunctive pharmacotherapies. Concomitant therapies such as low-molecular-weight heparins and platelet glycoprotein (GP) IIb/IIIa receptor blockade offer advantages in safety and efficacy during coronary intervention. Data from randomized clinical trials support the administration of both enoxaparin and platelet GP IIb/IIIa blockade to patients who present with non-ST segment elevation ACS. Enoxaparin, with its proven efficacy, predictability of action, and ease of administration, has been shown to be superior to unfractionated heparin in preventing major coronary events. Abciximab administration during percutaneous coronary intervention (PCI) reduces the incidence of ischemic adverse outcomes and appears to improve survival in long-term follow-up. The preliminary experience with combining these two therapies during PCI in the NICE 4 trial demonstrates a low incidence of minor/major bleeding and transfusion, and infrequent major cardiac events to 30 days follow-up. Algorithms for the use of these newer adjunctive pharmacotherapies in the care of patients presenting to the cardiac catheterization laboratory are presented.
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.
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.
Zhang, Rebecca; Butler, Andrew J.; Wolf, Steven L.; Alberts, Jay L.
Background 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. Objective This preliminary study explored change in patient-reported, health-related quality of life associated with robotic-assisted therapy combined with reduced therapist-supervised training. Design and Setting A single-blind, multi-site, randomized clinical trial was conducted. Participants Seventeen individuals who were 3 to 9 months poststroke participated. Intervention Sixty hours of therapist-supervised repetitive task practice (RTP) was compared with 30 hours of RTP combined with 30 hours of robotic-assisted therapy. Measurements 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. Results 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. Conclusion Robotic-assisted therapy may be an effective alternative or adjunct to the delivery of intensive task practice interventions to enhance
Büchler Markus W
Full Text Available Abstract Background 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. Methods/Design 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. Discussion 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. Trial registration ClinicalTrials.gov: NCT
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
BACKGROUND 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 a...
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.
Heath, Matthew; Weiler, Jeffrey; Gregory, Michael A; Gill, Dawn P; Petrella, Robert J
Persons with an objective cognitive impairment (OCI) are at increased risk for progression to Alzheimer's disease and related dementias. The present pilot project sought to examine whether participation in a long-term exercise program involving cognitive-motor (CM) dual-task gait training and aerobic exercise training improves executive function in persons with an OCI. To accomplish our objective, individuals with an OCI (n = 12) as determined by a Montreal Cognitive Assessment (MoCA) score of less than 26 and older adults (n = 11) deemed to be cognitively healthy (i.e., control group: MoCA score ≥26) completed a six-month moderate-to-high intensity (65-85% maximum heart rate) treadmill-based CM and aerobic exercise training program wherein pre- and post-intervention executive control was examined via the antisaccade task. Notably, antisaccades require a goal-directed eye-movement mirror-symmetrical to a target and represent an ideal tool for the study of executive deficits because of its hands- and language-free nature. As well, the cortical networks mediating antisaccades represent regions associated with neuropathology in cognitive decline and dementia (e.g., dorsolateral prefrontal cortex). Results showed that antisaccade reaction times for the OCI group reliably decreased by 30 ms from pre- to post-intervention, whereas the control group did not produce a reliable pre- to post-intervention change in reaction time (i.e., 6 ms). Thus, we propose that in persons with OCI long-term CM and aerobic training improves the efficiency and effectiveness of the executive mechanisms mediating high-level oculomotor control.
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.
Torsvik, Ingrid; Ueland, Per Magne; Markestad, Trond; Bjørke-Monsen, Anne-Lise
During infancy, minor developmental delays and gastrointestinal complaints are common, as is a biochemical profile indicative of impaired cobalamin status. We investigated whether cobalamin supplementation can improve development or symptoms in infants with biochemical signs of impaired cobalamin function and developmental delay or feeding difficulties. Infants Motor function [Alberta Infants Motor Scale (AIMS)] and clinical symptoms (parental questionnaire) were recorded at entry and after 1 mo. During follow-up, cobalamin supplementation changed all markers of impaired cobalamin status (ie, plasma tHcy decreased by 54%, and MMA decreased by 84%), whereas no significant changes were seen in the placebo group (P motor function and regurgitations, which suggest that an adequate cobalamin status is important for a rapidly developing nervous system. This trial was registered at clinicaltrials.gov as NCT00710359 and NCT00710138.
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.
Solomon, James A; Tyring, Stephen; Staedtler, Gerald; Sand, Meike; Nkulikiyinka, Richard; Shakery, Kaweh
Papulopustular rosacea (PPR) is characterized by centrofacial papules and pustules commonly associated with erythema. To compare investigator-reported efficacy outcomes for azelaic acid (AzA) foam 15% versus vehicle foam in PPR, a randomized, vehicle-controlled, double-blind phase 3 clinical trial was conducted at 48 US sites. Participants received AzA foam or vehicle foam for 12 weeks. Secondary efficacy outcomes included change in inflammatory lesion count (ILC), therapeutic response rate according to investigator global assessment (IGA), and change in erythema rating. This study was comprised of 961 participants with PPR. The results support the therapeutic superiority of AzA foam over vehicle foam.
Miskovic, D; Rosenthal, R; Zingg, U; Oertli, D; Metzger, U; Jancke, L
Findings have shown that music affects cognitive performance, but little is known about its influence on surgical performance. The hypothesis of this randomized controlled trial was that arousing (activating) music has a beneficial effect on the surgical performance of novice surgeons in the setting of a laparoscopic virtual reality task. For this study, 45 junior surgeons with no previous laparoscopic experience were randomly assigned to three equal groups. Group 1 listened to activating music; group 2 listened to deactivating music; and group 3 had no music (control) while each participant solved a surgical task five times on a virtual laparoscopic simulator. The assessed global task score, the total task time, the instrument travel distances, and the surgeons' heart rate were assessed. All surgical performance parameters improved significantly with experience (task repetition). The global score showed a trend for a between-groups difference, suggesting that the group listening to activating music had the worst performance. This observation was supported by a significant between-groups difference for the first trial but not subsequent trials (activating music, 35 points; deactivating music, 66 points; no music, 91 points; p = 0.002). The global score (p = 0.056) and total task time (p = 0.065) showed a trend toward improvement when participants considered the music pleasant rather than unpleasant. Music in the operating theater may have a distracting effect on novice surgeons performing new tasks. Surgical trainers should consider categorically switching off music during teaching procedures.
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
Emck, C.; Bosscher, R.J.; van Wieringen, P.C.W.; Doreleijers, T.A.H.; Beek, P.J.
dren with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial
Lam, K.J.Y.; Bastiaansen, M.C.M.; Dijkstra, A.F.J.; Rueschemeyer, S.A.
The current electroencephalography study investigated the relationship between the motor and (language) comprehension systems by simultaneously measuring mu and N400 effects. Specifically, we examined whether the pattern of motor activation elicited by verbs depends on the larger sentential context.
Bauer, Robert; Fels, Meike; Vukelić, Mathias; Ziemann, Ulf; Gharabaghi, Alireza
According to electrophysiological studies motor imagery and motor execution are associated with perturbations of brain oscillations over spatially similar cortical areas. By contrast, neuroimaging and lesion studies suggest that at least partially distinct cortical networks are involved in motor imagery and execution. We sought to further disentangle this relationship by studying the role of brain-robot interfaces in the context of motor imagery and motor execution networks. Twenty right-handed subjects performed several behavioral tasks as indicators for imagery and execution of movements of the left hand, i.e. kinesthetic imagery, visual imagery, visuomotor integration and tonic contraction. In addition, subjects performed motor imagery supported by haptic/proprioceptive feedback from a brain-robot-interface. Principal component analysis was applied to assess the relationship of these indicators. The respective cortical resting state networks in the α-range were investigated by electroencephalography using the phase slope index. We detected two distinct abilities and cortical networks underlying motor control: a motor imagery network connecting the left parietal and motor areas with the right prefrontal cortex and a motor execution network characterized by transmission from the left to right motor areas. We found that a brain-robot-interface might offer a way to bridge the gap between these networks, opening thereby a backdoor to the motor execution system. This knowledge might promote patient screening and may lead to novel treatment strategies, e.g. for the rehabilitation of hemiparesis after stroke. Copyright © 2014 Elsevier Inc. All rights reserved.
The seismic method is an important indirect method to investigate the subsurface of the earth. By analyzing how the earth affects the propagation of mechanical waves, the structure of the earth and its seismic properties can be inferred. The seismic vibrator is the most commonly used land source in
Rogers, E Sally; Maru, Mihoko; Kash-MacDonald, Megan; Archer-Williams, Mariah; Hashemi, Lobat; Boardman, Judith
We conducted a randomized trial to examine a model for integrating primary care into a community mental health setting. Two hundred individuals were recruited and randomly assigned to receive primary care delivered by a nurse practitioner (n = 94) or services-as-usual (n = 106), assessed on health and mental health outcomes, and followed for 12 months. Intent-to-Treat and exposure analyses were conducted and suggest that participants who engaged with the nurse practitioner experienced gains in perceptions of primary care quality. Health benefits accrued for individuals having receiving nurse practitioner services in a mental health setting to address primary care needs.
Scholtens, Rikie M.; van Munster, Barbara C.; Adamis, Dimitrios; de Jonghe, Annemarieke; Meagher, David J.; de Rooij, Sophia E. J. A.
OBJECTIVES: To examine changes in motor subtype profile in individuals with delirium. DESIGN: Observational, longitudinal study; substudy of a multicenter, randomized controlled trial. SETTING: Departments of surgery and orthopedics, Academic Medical Center and Tergooi Hospital, the Netherlands.
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.
Wong, J.D.; Kistemaker, D.A.; Chin, A; Gribble, P.L.
Recent work has investigated the link between motor learning and sensory function in arm movement control. A number of findings are consistent with the idea that motor learning is associated with systematic changes to proprioception (Haith A, Jackson C, Mial R, Vijayakumar S. Adv Neural Inf Process
Paulus, Markus; Hunnius, Sabine; Vissers, Marlies; Bekkering, Harold
The present study investigates the contribution of 2 mechanisms to imitation in infancy. The principle of rational action suggests that infants normatively evaluate the efficiency of observed actions. In contrast, it has been proposed that motor resonance (i.e., the mapping of others' actions onto one's own motor repertoire) plays a central role…
Planinsec, Jurij; Pisot, Rado
This study investigated the relationship between motor coordination and intelligence level in adolescents. The sample was comprised of 550 adolescents from Slovenia, aged 13.1 years (SD = 0.87), who attended elementary schools. For assessment of motor coordination a battery of eight tests were used. Assessment of intelligence was carried out with…
Spedden, Meaghan Elizabeth; Malling, Anne Sofie B; Andersen, Ken Kjøller
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....
Rationale and design of the participant, investigator, observer, and data-analyst-blinded randomized AGENDA trial on associations between gene-polymorphisms, endophenotypes for depression and antidepressive intervention: the effect of escitalopram versus placebo on the combined dexamethasone
Knorr, Ulla; Vinberg, Maj; Klose, Marianne
from baseline to the end of intervention. METHODS: The AGENDA trial is designed as a participant, investigator, observer, and data-analyst-blinded randomized trial. Participants are 80 healthy first-degree relatives of patients with depression. Participants are randomized to escitalopram 10 mg per day...
Poortmans, Philip; Kouloulias, Vassilis; van Tienhoven, Geertjan; Collette, Laurence; Struikmans, Henk; Venselaar, Jack L M; Van den Bogaert, Walter; Davis, J Bernard; Lambin, Philippe
A quality assurance (QA) program in conjunction with the EORTC trial investigating the role of adjuvant internal mammary and medial supraclavicular irradiation in stage I-III breast cancer is presented. The results of a dummy run procedure and of an individual case review are compared to each other. The effects of recommendations based on QA procedures on the protocol compliance are evaluated. Prior to protocol activation all participating institutes were asked to produce treatment plans according to the guidelines of the protocol based on manual outlines of an average patient. Thereafter, they were asked to provide data on each of their first six randomized patients. The dummy run provided a lot of information on specific treatment techniques. In the individual case review, additional patient- and tumor-related data were collected, showing the use of anatomic information for treatment planning. A comparison between both procedures revealed that the individual case reports concurred more accurately with protocol guidelines than the dummy run. It was observed that the number of systematic protocol deviations was substantially decreased in trial patients compared to the dummy run case. Therefore, it is concluded that this extensive QA program had a positive effect on the consistency of all institutes participating in the trial.
Casamento-Moran, Agostina; Chen, Yen-Ting; Lodha, Neha; Yacoubi, Basma; Christou, Evangelos A
Older adults exhibit altered activation of the agonist and antagonist muscles during goal-directed movements compared with young adults. However, it remains unclear whether the differential activation of the antagonistic muscles in older adults results from an impaired motor plan or an altered ability of the muscle to contract. The purpose of this study, therefore, was to determine whether the motor plan differs for young and older adults. Ten young (26.1 ± 4.3 yr, 4 women) and 16 older adults (71.9 ± 6.9 yr, 9 women) participated in the study. Participants performed 100 trials of fast goal directed movements with ankle dorsiflexion while we recorded the electromyographic activity of the primary agonist (tibialis anterior; TA) and antagonist (soleus; SOL) muscles. From those 100 trials we selected 5 trials in each of 3 movement end-point categories (fast, accurate, and slow). We investigated age-associated differences in the motor plan by quantifying the individual activity and coordination of the agonist and antagonist muscles. During similar movement end points, older adults exhibited similar activation of the agonist (TA) and antagonist (SOL) muscles compared with young adults. In addition, the coordination of the agonist and antagonist muscles (TA and SOL) was different between the two age groups. Specifically, older adults exhibited lower TA-SOL overlap ( F 1,23 = 41.2, P adults compared with young adults during fast goal-directed movements is related to an altered motor plan. For matched movements, there were differences in the coordination of antagonistic muscles but no differences in the individual activation of muscles. We provide novel evidence that the differential activation of muscles in older adults is related to an altered motor plan. Copyright © 2017 the American Physiological Society.
Wilson, Andrew (Inventor); Punnoose, Andrew (Inventor); Strausser, Katherine (Inventor); Parikh, Neil (Inventor)
A directed flux motor described utilizes the directed magnetic flux of at least one magnet through ferrous material to drive different planetary gear sets to achieve capabilities in six actuated shafts that are grouped three to a side of the motor. The flux motor also utilizes an interwoven magnet configuration which reduces the overall size of the motor. The motor allows for simple changes to modify the torque to speed ratio of the gearing contained within the motor as well as simple configurations for any number of output shafts up to six. The changes allow for improved manufacturability and reliability within the design.
Jensen, Jesper Lundbye
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...
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
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
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.
Meissner, Sarah Nadine; Keitel, Ariane; Südmeyer, Martin; Pollok, Bettina
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 (SRTT). 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.
Suzanne Meldrum; Janet A. Dunstan; Jonathan K. Foster; Karen Simmer; Susan L. Prescott
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 controlle...
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.
Noordstar, Johannes J; van der Net, Janjaap; Voerman, Lia; Helders, Paul J M; Jongmans, Marian J
Children with DCD have lower self-perceptions and are less physically active than typically developing children. The aim of this quasi-experimental study was to investigate whether an integrated perceived competence and motor intervention affects DCD children's motor performance, self-perceptions, and physical activity compared with a motor intervention only. The intervention group consisted of 20 children and the care-as-usual group consisted of 11 children, all aged 7-10 years. The perceived competence component of the intervention focused primarily on providing positive, specific, and progress feedback to enhance self-perceptions. We assessed children at baseline, after 12 treatment sessions (trial end-point), and at 3-month follow-up. Mixed linear models revealed no differences between the intervention and the care-as-usual group on any of the outcome measures. Children improved their motor performance and increased their perceived athletic competence, global self-esteem, and perceived motor competence after 12 treatment sessions. This improvement was maintained at 3-month follow-up. Motor task values and physical activity remained unchanged for all children. A perceived competence and motor intervention is as effective as care-as-usual in children with DCD. Future research should focus on improving physical activity in children with DCD. This is the first study that has investigated the effect of an integrated perceived competence and motor intervention (intervention group) on motor performance, self-perceptions, and physical activity compared with a motor intervention (care-as-usual group) in children with DCD. We made the perceived competence component explicit by providing positive, specific, and progress feedback to enhance children's self-perceptions. Also, this is one of the first studies that has investigated the effect after both 12 treatment sessions (trial end-point) and after 3 months of no intervention (3-month follow-up). We found no differences
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 at ...
Mallik, Roop; Rai, Arpan K; Barak, Pradeep; Rai, Ashim; Kunwar, Ambarish
Diverse cellular processes are driven by the collective force from multiple motor proteins. Disease-causing mutations cause aberrant function of motors, but the impact is observed at a cellular level and beyond, therefore necessitating an understanding of cell mechanics at the level of motor molecules. One way to do this is by measuring the force generated by ensembles of motors in vivo at single-motor resolution. This has been possible for microtubule motor teams that transport intracellular organelles, revealing unexpected differences between collective and single-molecule function. Here we review how the biophysical properties of single motors, and differences therein, may translate into collective motor function during organelle transport and perhaps in other processes outside transport. Copyright © 2013 Elsevier Ltd. All rights reserved.
Wen, Xu; Xiang, Ping
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. PMID:29387718
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.
Ramos-Murguialday, Ander; Birbaumer, Niels
Noninvasive brain-computer-interfaces (BCI) coupled with prosthetic devices were recently introduced in the rehabilitation of chronic stroke and other disorders of the motor system. These BCI systems and motor rehabilitation in general involve several motor tasks for training. This study investigates the neurophysiological bases of an EEG-oscillation-driven BCI combined with a neuroprosthetic device to define the specific oscillatory signature of the BCI task. Controlling movements of a hand robotic orthosis with motor imagery of the same movement generates sensorimotor rhythm oscillation changes and involves three elements of tasks also used in stroke motor rehabilitation: passive and active movement, motor imagery, and motor intention. We recorded EEG while nine healthy participants performed five different motor tasks consisting of closing and opening of the hand as follows: 1) motor imagery without any external feedback and without overt hand movement, 2) motor imagery that moves the orthosis proportional to the produced brain oscillation change with online proprioceptive and visual feedback of the hand moving through a neuroprosthetic device (BCI condition), 3) passive and 4) active movement of the hand with feedback (seeing and feeling the hand moving), and 5) rest. During the BCI condition, participants received contingent online feedback of the decrease of power of the sensorimotor rhythm, which induced orthosis movement and therefore proprioceptive and visual information from the moving hand. We analyzed brain activity during the five conditions using time-frequency domain bootstrap-based statistical comparisons and Morlet transforms. Activity during rest was used as a reference. Significant contralateral and ipsilateral event-related desynchronization of sensorimotor rhythm was present during all motor tasks, largest in contralateral-postcentral, medio-central, and ipsilateral-precentral areas identifying the ipsilateral precentral cortex as an integral
Noninvasive brain-computer-interfaces (BCI) coupled with prosthetic devices were recently introduced in the rehabilitation of chronic stroke and other disorders of the motor system. These BCI systems and motor rehabilitation in general involve several motor tasks for training. This study investigates the neurophysiological bases of an EEG-oscillation-driven BCI combined with a neuroprosthetic device to define the specific oscillatory signature of the BCI task. Controlling movements of a hand robotic orthosis with motor imagery of the same movement generates sensorimotor rhythm oscillation changes and involves three elements of tasks also used in stroke motor rehabilitation: passive and active movement, motor imagery, and motor intention. We recorded EEG while nine healthy participants performed five different motor tasks consisting of closing and opening of the hand as follows: 1) motor imagery without any external feedback and without overt hand movement, 2) motor imagery that moves the orthosis proportional to the produced brain oscillation change with online proprioceptive and visual feedback of the hand moving through a neuroprosthetic device (BCI condition), 3) passive and 4) active movement of the hand with feedback (seeing and feeling the hand moving), and 5) rest. During the BCI condition, participants received contingent online feedback of the decrease of power of the sensorimotor rhythm, which induced orthosis movement and therefore proprioceptive and visual information from the moving hand. We analyzed brain activity during the five conditions using time-frequency domain bootstrap-based statistical comparisons and Morlet transforms. Activity during rest was used as a reference. Significant contralateral and ipsilateral event-related desynchronization of sensorimotor rhythm was present during all motor tasks, largest in contralateral-postcentral, medio-central, and ipsilateral-precentral areas identifying the ipsilateral precentral cortex as an integral
Lerner-Geva, Liat; Bar-Zvi, Elinor; Levitan, Gila; Boyko, Valentina; Reichman, Brian; Pinhas-Hamiel, Orit
To assess the effectiveness of an intervention programme to improve kindergarten children's eating and leisure habits in Israel. A cluster-randomised controlled trial. Six full-day kindergartens in Israel were randomly divided into three groups. Group A received the full intervention programme, which included lessons on good eating habits and daily physical exercise. Group B received a partial intervention of lessons only. Group C, the reference group, did not receive any intervention. Children aged 4-6 years (n 204) were recruited for the study. Objective data for weight and height were collected to calculate BMI Z-scores. Activity, sedentary time, sleeping hours and daily energy intake were assessed via a parental questionnaire. Nutritional knowledge was assessed by a single dietitian using a questionnaire addressed to the children. Assessments were done at baseline and at the end of the intervention. After adjustment for baseline levels we observed a significant reduction in daily energy intake for the full intervention group A (P = 0.03). A positive intervention effect was demonstrated on nutritional knowledge in the partial intervention group B (P = 0.03), although no significant change was demonstrated for BMI Z-score. The study supports the incorporation of education on healthy lifestyle habits and physical activity into the curricula of kindergartens.
Daniel A. Braun
Full Text Available 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.
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
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
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.
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.
Parrondo, J. M. R.; Blanco, J. M.; Cao, F. J.; Brito, R.
The efficiency of different types of Brownian motors is calculated analytically and numerically. We find that motors based on flashing ratchets present a,low efficiency and an unavoidable entropy production. On the other hand, a certain class of motors based on adiabatically changing potentials, named reversible ratchets, exhibit a higher efficiency and the entropy production can be arbitrarily reduced.
Randomised controlled trial of two sequential artemisinin-based combination therapy regimens to treat uncomplicated falciparum malaria in African children: a protocol to investigate safety, efficacy and adherence
Schallig, Henk D. F. H.; Tinto, Halidou; Sawa, Patrick
Background Management of uncomplicated Plasmodium falciparum malaria relies on artemisinin-based combination therapies (ACTs). These highly effective regimens have contributed to reductions in malaria morbidity and mortality. However, artemisinin resistance in Asia and changing parasite...... susceptibility to ACT in Africa have now been well documented. Strategies that retain current ACT as efficacious treatments are urgently needed. Methods We present an open-label, randomised three-arm clinical trial protocol in three African settings representative of varying malaria epidemiology to investigate...... whether prolonged ACT-based regimens using currently available formulations can eliminate potentially resistant parasites. The protocol investigates whether a sequential course of two licensed ACT in 1080 children aged 6–120 months exhibits superior efficacy against acute P. falciparum malaria and non...
Ritzmann, M; Gerbermann, H; Gyra, H; Eichinger, H M; Heinritzi, K
In a field trial, the development of antibodies of a combined vaccine against the porcine parvovirus (PPV) as well as against swine erysipelas was compared with corresponding mono vaccines. Furthermore, these vaccines were used in different vaccination schedules. The tests were carried out on 109 gilts in three closed farms. In all gilts, a basic immunization repeated twice was carried out at the age of six months and at intervals of three weeks. The revaccination was carried out four months after the basic immunization with half of the animals, and six months after the basic immunization with the remaining gilts. Between the combined vaccine and the mono vaccine no significant differences in the development of antibodies against PPV could be found according to different vaccination schedules. The gilts having been vaccinated with the mono vaccine and boostered six months later showed significantly higher antibody titers against Erysipelothrix rhusiopathiae. Between the remaining vaccination groups no significant difference in the development of the antibodies against swine erysipelas could be found. On only one farm, a continuous decrease of antibody titers against PPV in case of altogether 238 non-vaccinated piglets until the sixth month of life could be observed. On the two other farms, an increase of antibody titers against PPV could be found at different points of time, which indicates an infection of the piglets. Between the individual vaccination groups no significant antibody titers against PPV could be measured in milk tests. With regard to the number of piglets born alive per litter, the number of piglets born dead per litter and the number of mummies, a significant difference could neither be found between the vaccination groups 1-4.
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.
Busiello, Marianna; Costantini, Marcello; Galati, Gaspare; Committeri, Giorgia
Several studies on humans have shown a recruitment of the sensory-motor system in the perception of action-related visual and verbal material, suggesting that actions are represented through sensory-motor processes. To date, these studies have not disentangled whether such a recruitment is epiphenomenal or necessary to action representation. Here we took advantage of repetition priming as a tool to investigate the cognitive representation of actions, and systematically looked whether a concurrent motor or verbal task had a detrimental effect on this representation. In a first experiment participants discriminated images depicting meaningless and meaningful actions, while performing either a concurrent sensory-motor or an articulatory suppression task. Images were classified as depicting a repeated or a new action, relative to the previous image in the trial series. We found a facilitation by repetition priming, that was unaffected by the articulatory task but was completely abolished by the sensory-motor task. In a second experiment, we investigated whether the sensory-motor system is also causally involved in processing action-related verbs. In this experiment actions were presented as written infinitive verbs rather than as images. The facilitation by repetition priming was again unaffected by the concurrent articulatory task, while the sensory-motor concurrent task, although reducing the facilitation, did not abolish it. Our data provide evidence that the sensory-motor system is differentially involved during visual processing of actions and during processing of action-related verbs. Results are discussed within the theoretical frame of embodied cognition. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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.
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.
van Hedel, Hubertus J A; Dokladal, Petra; Hotz-Boendermaker, Sabina
This study investigated the course and relationship between investigator-determined and patient-reported level of independence within the first year after spinal cord injury (SCI). The authors examined variables that contributed to these scores. In this observational cohort study, 73 patients with traumatic SCI were evaluated at 1, 3, and 6 months (and 40 subjects at 1 to 12 months). The investigator-determined independence was quantified using the Spinal Cord Independence Measure (SCIM). The subjective, patient-reported independence was determined by asking how their general restrictions influenced everyday life activities. Several variables were used to explain these 2 scores. The SCIM score was higher than the patient-reported independence and improved significantly more over time (up to about 70/100 at 12 months), whereas the perceived independence remained below 50/100. The correlations between the 2 measures were at most moderate (r(s) ≤ 0.51), but in general somewhat higher for subjects with tetraplegia. Age and muscle strength predicted the SCIM score well. No variable predicted the patient-reported level of independence. Investigator-determined and patient-reported outcomes can differ considerably and evolve differently. A patient-reported outcome measure may not detect actual functional improvement. It is likely that changes in patient-reported outcomes are influenced by many factors in addition to those associated with functional recovery, including psychological factors.
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 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.
Full Text Available Objectives. The current study aimed to compare the efficacy and safety of a classical anti-inflammatory beclomethasone nasal spray in comparison to a physic-chemical stabilizing ectoine containing nasal spray in the treatment of allergic rhinitis. Design and Methods. This was a noninterventional, open-label, observational trial investigating the effects of beclomethasone or ectoine nasal spray on nasal symptoms and quality of life. Over a period of 14 days, patients were asked to daily document their symptoms. Efficacy and tolerability were assessed by both physicians and patients. Results. Both treatments resulted in a significant decrease of TNSS values. An equivalence test could not confirm the noninferiority of ectoine treatment in comparison with beclomethasone treatment. Although clear symptom reduction was achieved with the ectoine products, the efficacy judgment showed possible advantages for the beclomethasone group. Importantly, tolerability results were comparably good in both groups, and a very low number of adverse events supported this observation. Both treatments resulted in a clear improvement in the quality of life as assessed by a questionnaire answered at the beginning and at the end of the trial. Conclusion. Taken together, it was shown that allergic rhinitis can be safely and successfully treated with beclomethasone and also efficacy and safety were shown for ectoine nasal spray.
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
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
Özdenizci, Ozan; Yalçın, Mustafa; Erdoğan, Ahmetcan; Patoğlu, Volkan; Grosse-Wentrup, Moritz; Çetin, Müjdat
Objective. Recent brain-computer interface (BCI) assisted stroke rehabilitation protocols tend to focus on sensorimotor activity of the brain. Relying on evidence claiming that a variety of brain rhythms beyond sensorimotor areas are related to the extent of motor deficits, we propose to identify neural correlates of motor learning beyond sensorimotor areas spatially and spectrally for further use in novel BCI-assisted neurorehabilitation settings. Approach. Electroencephalographic (EEG) data were recorded from healthy subjects participating in a physical force-field adaptation task involving reaching movements through a robotic handle. EEG activity recorded during rest prior to the experiment and during pre-trial movement preparation was used as features to predict motor adaptation learning performance across subjects. Main results. Subjects learned to perform straight movements under the force-field at different adaptation rates. Both resting-state and pre-trial EEG features were predictive of individual adaptation rates with relevance of a broad network of beta activity. Beyond sensorimotor regions, a parieto-occipital cortical component observed across subjects was involved strongly in predictions and a fronto-parietal cortical component showed significant decrease in pre-trial beta-powers for users with higher adaptation rates and increase in pre-trial beta-powers for users with lower adaptation rates. Significance. Including sensorimotor areas, a large-scale network of beta activity is presented as predictive of motor learning. Strength of resting-state parieto-occipital beta activity or pre-trial fronto-parietal beta activity can be considered in BCI-assisted stroke rehabilitation protocols with neurofeedback training or volitional control of neural activity for brain-robot interfaces to induce plasticity.
de Vries, Sjoerd; Tepper, Marga; Feenstra, Wya; Oosterveld, Hanneke; Boonstra, Anne M.; Otten, Bert
There is little consensus on how motor imagery ability should be measured in stroke patients. In particular it is unclear how two methods tapping different aspects of the motor imagery process relate to each other. The aim of this study was to investigate the relationship between implicit and
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.
van Dieën, Jaap H; van Leeuwen, Marloes; Faber, Gert S
We investigated motor and sensory changes underlying learning of a balance task. Fourteen participants practiced balancing on one leg on a board that could freely rotate in the frontal plane. They performed six, 16-s trials standing on one leg on a stable surface (2 trials without manipulation, 2 with vestibular, and 2 with visual stimulation) and six trials on the balance board before and after a 30-min training. Center of mass (COM) movement, segment, and total angular momenta and board angles were determined. Trials on stable surface were compared with trials after training to assess effects of surface conditions. Trials pretraining and posttraining were compared to assess rapid (between trials pretraining) and slower (before and after training) learning, and sensory manipulation trials were compared with unperturbed trials to assess sensory weighting. COM excursions were larger on the unstable surface but decreased with practice, with the largest improvement over the pretraining trials. Changes in angular momentum contributed more to COM acceleration on the balance board, but with practice this decreased. Visual stimulation increased sway similarly in both surface conditions, while vestibular stimulation increased sway less on the balance board. With practice, the effects of visual and vestibular stimulation increased rapidly. Initially, oscillations of the balance board occurred at 3.5 Hz, which decreased with practice. The initial decrease in sway with practice was associated with upweighting of visual information, while later changes were associated with suppression of oscillations that we suggest are due to too high proprioceptive feedback gains. Copyright © 2015 the American Physiological Society.
Rogerson, Shane; Meir, Rudi; Crowley-McHattan, Zac; McEwen, Kathryn; Pastoors, Rachel
The aim of this study was to investigate the effectiveness of a short-term resilience intervention as measured by the Resilience at Work (RAW) scale. A 5-week resilience program was implemented with 28 volunteers and assessed by the 20-item RAW scale. The scale was administered electronically and participants were match paired into either a treatment or control group. Statistical analysis was conducted using a 2 × 2 group (Treatment, control) × time (pre, post) analysis of variance with repeated measures. Postintervention time point RAW total score was significantly greater in the treatment group (P < 0.01) and statistical significance was also achieved for four of the seven subscales. Employee resilience can be improved via specific educational and skills training requiring a total time commitment of just 5 hours, making this intervention feasible for most working environments.
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...... adherence. By combining biomedical, technological and humanistic approaches, we aim to understand the health benefits of physical activity in different domains of everyday life, as well as how to improve adherence to 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...
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.
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
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.
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.
Lundbye-Jensen, Jesper; Skriver, Kasper Christen; Nielsen, Jens Bo
Objective: The ability to acquire new motor skills is essential both during childhood and later in life. Recent studies have demonstrated that an acute bout of exercise can improve motor memory consolidation in adults. The objective of the present study was to investigate whether acute exercise...... protocols following motor skill practice in a school setting can also improve long-term retention of motor memory in preadolescent children. Methods: Seventy-seven pre-adolescent children (age 10.5 ± 0.75 (SD)) participated in the study. Prior to the main experiment age, BMI, fitness status and general...... for exercise groups. Delayed retention of motor memory was assessed 1 h, 24 h and 7 days after motor skill acquisition. Results: During skill acquisition, motor performance improved significantly to the immediate retention test with no differences between groups. One hour following skill acquisition, motor...
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
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
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.
Cavero, Icilio; Holzgrefe, Henry; Clements, Mike
Early clinical Phase I ECG investigations designed to replace the currently applied thorough QT (TQT) study are reviewed to examine how they could complement and verify the conclusions of nonclinical investigations and, in particular, the Comprehensive in vitro Proarrhythmia Assay (CiPA). The IQ-CSRC trial is a prospective ascending multiple-dose first in human (FIH) type investigation performed as a possible replacement for the thorough QT study (TQT). Designed in accordance with the results of a simulation study by the FDA QT Interdisciplinary Review Team (IRT), it succeeded in correctly categorizing 5/5 established QTc-prolonging agents free of notable heart rate effects (dofetilide, dolasetron, moxifloxacin, ondansetron, and quinine) and the QTc-negative drug, levocetirizine. The positive results obtained with the IQ-CSRC study require additional confirmation with threshold QTc-positive and negative drugs and established QTc prolongers producing both increases and decreases in heart rate. In the future, similar studies should also adopt and validate innovative proarrhythmic metrics, in addition to, or instead of, the traditional proarrhythmic surrogate of QTc, to assess the proarrhythmic safety of candidate drugs. Copyright © 2016 Elsevier Inc. All rights reserved.
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.
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.
Hexsel, D; Hexsel, C; Porto, M D; Siega, C
Post-inflammatory hyperpigmentation is a frequent concern when treating solar lentigines. To assess the safety and efficacy of a triple combination cream with fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05% as adjuvant to cryotherapy in the treatment of solar lentigines in hands dorsum, and in the prevention of post-inflammatory hyperpigmentation after cryotherapy. This prospective, randomized, controlled, investigator-blinded, single-centre study enrolled 50 patients. Twenty-five patients received a 2-week daily triple combination cream plus sunscreen pre-treatment and 25 received sunscreen alone. After that, cryotherapy was performed in all patients followed by a 3-week recovery period. After this period, patients received the same initial treatment and were followed up for 8 weeks. Melanin and erythema levels of a target and a control lentigo were objectively measured using a narrowband reflectance spectrophotometer. Lentigines count, colour homogeneity and global improvement were also assessed. The number of solar lentigines reduced in the first 2 weeks only in patients who used the triple combination 25 ± 7 vs. 22 ± 8 (P cryotherapy were the reported adverse reactions. Triple combination cream can be used to enhance the resolution of solar lentigines, and to significantly reduce melanin levels and lentigines count, improving treatment results. It was well-tolerated and did not increase the occurrence of neither erythema nor other side-effects after the cryotherapy. © 2014 European Academy of Dermatology and Venereology.
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
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
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
Appleman, Erica R; Albouy, Genevieve; Doyon, Julien; Cronin-Golomb, Alice; King, Bradley R
While the influence of sleep on motor memory consolidation has been extensively investigated, its relation to initial skill acquisition is less well understood. The purpose of the present study was to investigate the influence of sleep quality and quantity on subsequent motor skill acquisition in young adults without sleep disorders. Fifty-five healthy adults (mean age = 23.8 years; 34 women) wore actigraph wristbands for 4 nights, which provided data on sleep patterns before the experiment, and then returned to the laboratory to engage in a motor sequence learning task (explicit 5-item finger sequence tapping task). Indicators of sleep quality and quantity were then regressed on a measure of motor skill acquisition (Gains Within Training, GWT). Wake After Sleep Onset (WASO; i.e., the total amount of time the participants spent awake after falling asleep) was significantly and negatively related to GWT. This effect was not because of general arousal level, which was measured immediately before the motor task. Conversely, there was no relationship between GWT and sleep duration or self-reported sleep quality. These results indicate that sleep quality, as assessed by WASO and objectively measured with actigraphy before the motor task, significantly impacts motor skill acquisition in young healthy adults without sleep disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
A large number of new descending motor pathways to caudal brainstem and spinal cord have been recognized recently. Nevertheless all the new pathways seem to belong to one of three motor systems in the central nervous system (CNS). This survey gives an overview of the pathways belonging to the so-called emotional motor system or the third motor system as defined by Holstege. The similarities and differences with the core, median and lateral paracore areas of the CNS as defined by Nieuwenhuys are discussed.
Solchaga Pérez de Lazárraga, Gonzalo
El proyecto consiste en la creación de un circuito capaz de controlar la velocidad de un motor brushless sensorless. Este tipo de motores eléctricos tienen como característica que no tienen escobillas para cambiar la polaridad del bobinado de su interior y tampoco precisan de un sensor que indique que ha realizado una vuelta. Los motores brushless que son controlados por este tipo de circuitos son específicos para aeronaves no tripuladas y requieren un diseño diferente a un motor brushless pe...
Lucente, Giuseppe; Lam, Steven; Schneider, Heike; Picht, Thomas
Non-invasive pre-surgical mapping of eloquent brain areas with navigated transcranial magnetic stimulation (nTMS) is a useful technique linked to the improvement of surgical planning and patient outcomes. The stimulator output intensity and subsequent resting motor threshold determination (rMT) are based on the motor-evoked potential (MEP) elicited in the target muscle with an amplitude above a predetermined threshold of 50 μV. However, a subset of patients is unable to achieve complete relaxation in the target muscles, resulting in false positives that jeopardize mapping validity with conventional MEP determination protocols. Our aim is to explore the feasibility and reproducibility of a novel mapping approach that investigates how an increase of the MEP amplitude threshold to 300 and 500 μV affects subsequent motor maps. Seven healthy subjects underwent motor mapping with nTMS. RMT was calculated with the conventional methodology in conjunction with experimental 300- and 500-μV MEP amplitude thresholds. Motor mapping was performed with 105% of rMT stimulator intensity using the FDI as the target muscle. Motor mapping was possible in all patients with both the conventional and experimental setups. Motor area maps with a conventional 50-μV threshold showed poor correlation with 300-μV (α = 0.446, p motor area maps (α = 0.974, p motor area mapping with nTMS without losing precision.
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
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...... of a motor skill. The positive effects of acute exercise on motor memory are maximized when exercise is performed immediately after practice, during the early stages of memory consolidation. Thus, the timing of exercise in relation to practice is possibly an important factor regulating the effects of acute...... exercise on long-term motor memory....
Full Text Available Abstract Background 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. Methods 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. Results 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
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 .
Shi, Wenyin; Scannell Bryan, Molly; Gilbert, Mark R; Mehta, Minesh P; Blumenthal, Deborah T; Brown, Paul D; Valeinis, Egils; Hopkins, Kirsten; Souhami, Luis; Andrews, David W; Tzuk-Shina, Tzahala; Howard, Steve P; Youssef, Emad F; Lessard, Nathalie; Dignam, James J; Werner-Wasik, Maria
To determine the impact on overall survival with different salvage therapies, including no treatment, reirradiation, systemic therapy, or radiation and systemic therapy, in participants of a phase 3 clinical trial evaluating dose-dense versus standard-dose temozolomide for patients with newly diagnosed glioblastoma. This analysis of patients from Trial RTOG 0525 investigated the effect of reirradiation or systemic treatment after tumor progression. Survival from first progression was compared between patients receiving no therapy, systemic therapy alone, radiation alone, and both modalities. The Cox proportional hazards model was used to compare the mortality hazard, controlling for potential confounders. The analysis included 637 patients who progressed and had information on their management, excluding those who died less than half a month after progression. A total of 267 patients (42%) received neither reirradiation nor systemic treatment at progression, 24 (4%) received radiation alone, 282 (44%) received systemic treatment only, and 64 (10%) received both radiation and systemic therapy. Patients who received no treatment had a median survival of 4.8 months, lower than with radiation treatment alone (8.2 months), systemic therapy alone (10.6 months), and both radiation and systemic therapy (12.2 months). In survival models controlling for potential confounders, those who received radiation alone had modestly better survival (hazard ratio HR 0.74, 95% confidence interval [CI] 0.43-1.28), whereas those who underwent systemic therapy either without (HR 0.42, 95% CI 0.34-0.53) or with radiation therapy (HR 0.44, 95% CI 0.30-0.63) had better survival. There was no significant survival difference between patients who received radiation only and those who received systemic therapy (either with radiation or alone). Patients who received no salvage treatment had poorer survival than those who received radiation, chemotherapy, or the combination. However, patient
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.
Tavakol, Shima; Saber, Reza; Hoveizi, Elham; Aligholi, Hadi; Ai, Jafar; Rezayat, Seyed Mahdi
To date, spinal cord injury (SCI) has remained an incurable disaster. The use of self-assembling peptide nanofiber containing bioactive motifs such as bone marrow homing peptide (BMHP1) as an injectable scaffold in spinal cord regeneration has been suggested. Human endometrial-derived stromal cells (hEnSCs) have been approved by the FDA for clinical application. In this regard, we were interested in investigating the role of BMHP1 in hEnSCs' neural differentiation in vitro and evaluating the supportive effects of this scaffold in rat model of chronic SCI. 1,1-Diphenyl-2-picryl-hydrazyl (DPPH), lactate dehydrogenase (LDH) release, 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) assay, real-time PCR, and immunocyotochemistry (ICC) were performed as a biocompatibility and neural differentiation evaluations on neuron-like hEnSC-derived cells encapsulated into nanofiber. Nanofiber was implanted into rats and followed by behavioral test, Nissl, luxol fast blue (LFB) staining and immunohistostaining (IHC). Results indicated that cell membrane of neuroblastoma cells were more sensitive than hEnSCs to concentration of proton and cell proliferation decreased with increase of concentration. This effect might be related to oxygen tension and elastic modules of scaffold. -BMHP1 nanofiber induced neural differentiation in hEnSC and decreased GFAP gene and protein as a marker of reactive astrocytes in vitro and in vivo. A reason for this finding might be related to the role of spacer number in induction of mechano-transduction signals. The presented study revealed the chimeric BMHP1 nanofiber induced higher axon regeneration and myelniation around the cavity and motor neuron function was encouraged to improve with less inflammatory response following SCI in rats. These effects were possibly due to nanostructured topography and mechano-transduction signals derived from hydrogel at low concentration.
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.
Arjmand, Shokouh; Vaziri, Zohreh; Behzadi, Mina; Abbassian, Hassan; Stephens, Gary J; Shabani, Mohammad
Tremor arises from an involuntary, rhythmic muscle contraction/relaxation cycle and is a common disabling symptom of many motor-related diseases such as Parkinson disease, multiple sclerosis, Huntington disease, and forms of ataxia. In the wake of anecdotal, largely uncontrolled, observations claiming the amelioration of some symptoms among cannabis smokers, and the high density of cannabinoid receptors in the areas responsible for motor function, including basal ganglia and cerebellum, many researchers have pursued the question of whether cannabinoid-based compounds could be used therapeutically to alleviate tremor associated with central nervous system diseases. In this review, we focus on possible effects of cannabinoid-based medicines, in particular on Parkinsonian and multiple sclerosis-related tremors and the common probable molecular mechanisms. While, at present, inconclusive results have been obtained, future investigations should extend preclinical studies with different cannabinoids to controlled clinical trials to determine potential benefits in tremor.
Reissman, Megan E; Dhaher, Yasin Y
The ability to execute appropriate medio-lateral foot placements during gait is thought to require active frontal plane control and to be critical in maintaining upright posture during gait. The aggregate frontal plane metrics of step width and step width variability have been assessed for post-stroke populations, but only under normal walking conditions. However, in the case of stroke, limb specific differences in sensory-motor control are likely. Thus, an investigation of limb specific motor control characteristics under tracking task conditions is needed to appropriately characterize frontal plane sensory-motor control post-stroke. Chronic stroke subjects (n=15) and age matched control subjects (n=10) tracked static, bilateral foot placement targets at self-selected walking speeds and completed a free walking trial. Variability and error of tracking performance were analyzed for step width and foot placement. Stroke subjects demonstrated reduced ability to control step width variability and foot placement variability, compared to control subjects. Step width variability and affected limb foot placement variability were sensitive to task complexity, increasing significantly in response to a decrease in step width target size. These results show that stroke mediated changes in the sensory-motor integration processes are manifested as inter-limb differences in frontal plane motor variability during a gait tracking task, with an additional sensitivity to task complexity. Additionally, the proposed step width tracking paradigm presents a clinically reproducible motor control metric that can be used for diagnostic assessment or as a potential outcome for a gait training regimen. Copyright © 2015 Elsevier Ltd. All rights reserved.
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.
A large number of new descending motor pathways to caudal brainstem and spinal cord have been recognized recently. Nevertheless all the new pathways seem to belong to one of three motor systems in the central nervous system (CNS). This survey gives an overvieuw of the pathways belonging to the
A large number of new descending motor pathways to caudal brainstem and spinal cord have been recognized recently. Nevertheless all the new pathways seem to belong to one of three motor systems in the central nervous system (CNS). This survey gives an overvieuw of the pathways belonging to the
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...
Bourret, Steven C.; Swansen, James E.
A stepping motor is microprocessingly controlled by digital circuitry which monitors the output of a shaft encoder adjustably secured to the stepping motor and generates a subsequent stepping pulse only after the preceding step has occurred and a fixed delay has expired. The fixed delay is variable on a real-time basis to provide for smooth and controlled deceleration.
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.
Naish, Katherine R; Obhi, Sukhvinder S
The human motor system is active not only when actions are performed but also when they are observed. Experimenters often manipulate aspects of the action or context to examine factors that influence this "mirror" response. However, little is known about the role of the observer's own top-down intentions and motivation. In this exploratory study, we investigated whether observers are able to exert conscious control over their mirror response, when they are explicitly instructed to either increase or decrease mirroring. Transcranial magnetic stimulation (TMS) was used to elicit motor-evoked potentials (MEPs) in a thumb abductor muscle as participants (n = 13) watched a video of a hand squeezing a rubber ball. The size of these MEPs, relative to the size of MEPs elicited during fixation cross observation, was taken as an index of mirroring. In an initial block of trials, participants were instructed to merely observe the actions presented. After the first block, the concept of mirroring was explained to the participants, and in the second and third blocks participants were instructed to either increase or decrease their mirror response. We did not instruct them about how to achieve this increase or decrease. Our results showed no difference in either facilitation or absolute motor excitability (i.e., nonnormalized MEP size) between the three blocks, indicating that individuals do not seem to be able to exert control over motor excitability during action observation, at least in the absence of a specific and maintained strategy. Copyright © 2015 the American Physiological Society.
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
Hansen, Irving G.
Electromechanical actuators developed to date have commonly ultilized permanent magnet (PM) synchronous motors. More recently switched reluctance (SR) motors have been advocated due to their robust characteristics. Implications of work which utilized induction motors and advanced control techniques are discussed. When induction motors are operated from an energy source capable of controlling voltages and frequencies independently, drive characteristics are obtained which are superior to either PM or SR motors. By synthesizing the machine frequency from a high-frequency carrier (nominally 20 kHz), high efficiencies, low distortion, and rapid torque response are available. At this time multiple horsepower machine drives were demonstrated, and work is on-going to develop a 20 hp average, 40 hp peak class of aerospace actuators. This effort is based upon high-frequency power distribution and management techniques developed by NASA for Space Station Freedom.
Hansen, Irving G.
Electromechanical actuators developed to date have commonly utilized permanent magnet (PM) synchronous motors. More recently switched reluctance (SR) motors have been advocated due to their robust characteristics. Implications of work which utilizes induction motors and advanced control techniques are discussed. When induction motors are operated from an energy source capable of controlling voltages and frequencies independently, drive characteristics are obtained which are superior to either PM or SR motors. By synthesizing the machine frequency from a high frequency carrier (nominally 20 kHz), high efficiencies, low distortion, and rapid torque response are available. At this time multiple horsepower machine drives were demonstrated, and work is on-going to develop a 20 hp average, 40 hp peak class of aerospace actuators. This effort is based upon high frequency power distribution and management techniques developed by NASA for Space Station Freedom.
The Strengthening Exercises in Shoulder Impingement trial (The SExSI-trial) investigating the effectiveness of a simple add-on shoulder strengthening exercise programme in patients with long-lasting subacromial impingement syndrome: Study protocol for a pragmatic, assessor blinded, parallel-group, randomised, controlled trial.
Clausen, Mikkel Bek; Bandholm, Thomas; Rathleff, Michael Skovdal; Christensen, Karl Bang; Zebis, Mette Kreutzfeldt; Graven-Nielsen, Thomas; Hölmich, Per; Thorborg, Kristian
Subacromial impingement syndrome (SIS) is a painful, and often long lasting, shoulder condition affecting patient function and quality of life. In a recent study, we observed major strength impairments in shoulder external rotation and abduction (~30%) in a population of patients with pronounced and long-lasting SIS. However, the current rehabilitation of such strength impairments may be inadequate, with novel rehabilitation programmes including exercise therapy only improving external rotation strength by 4-13%. As these previous studies are the basis of current practice, this suggests that the strengthening component could be inadequate in the rehabilitation of these patients, and it seems likely that more emphasis should be placed on intensifying this part of the rehabilitation. The purpose of this study is to investigate the effectiveness of a programme consisting of progressive home-based resistance training using an elastic band, aimed at improving shoulder external rotation and abduction strength, added to usual care and initiated shortly after diagnosis has been established. A pragmatic randomised controlled superiority trial will be conducted, including 200 patients with pronounced and long-lasting SIS, diagnosed using predefined criteria. Participants will be randomised to receive either an add-on intervention of progressive home-based resistance training using an elastic band in addition to usual care or usual care alone in a 1:1 allocation ratio. The randomisation sequence is computer generated, with permuted blocks of random sizes. The primary outcome will be change in Shoulder Pain And Disability Index (SPADI) score from baseline to 16 weeks follow-up. Outcome assessors are blinded to group allocation. Intervention receivers will be kept blind to treatment allocation through minimal information about the content of the add-on intervention and control condit