Data-driven analysis of heterogeneous gait subgroups and ground reaction forces based on integrated center of pressure–center of mass dynamics in poststroke hemiparesis

 This didn't tell me ONE DAMN THING that will get survivors recovered! You're all fired!

Maybe you could get something from these instead, I'm sure your doctor isn't up-to-date on all this.

• ground reaction forces (2 posts to January 2020)
• gait analysis (122 posts to May 2015)
• center of pressure (2 posts to January 2025)
• center of mass (1 post to June 2020)

Data-driven analysis of heterogeneous gait subgroups and ground reaction forces based on integrated center of pressure–center of mass dynamics in poststroke hemiparesis

Kimihiko Mori ,Tatsuya Teramae,Masanori Wakida,Naoto Mano,Yuta Chujo,Takayuki Kuwabara,Meguru Taguchi,Kimitaka Hase,Tomoyuki Noda

Abstract

Introduction

Hemiparetic gait is characterized by abnormal ground reaction forces (GRFs) with impaired control of the center of mass (CoM) relative to the center of pressure (CoP). Although both anteroposterior and mediolateral gait control have been examined separately, how their integrated stance-phase–derived CoP–CoM interactions and local CoP-based features relate to GRF characteristics remains unclear.

Objective

This exploratory study aimed to explore the relationships between CoP–CoM and CoP-based dynamics and GRFs and descriptively identify candidate gait subgroups of individuals with poststroke hemiparesis using a data-driven clustering approach.

Methods

Seventy-eight community-dwelling individuals with poststroke hemiparesis participated in a three-dimensional gait analysis. Stance-phase–derived CoP–CoM parameters of the transverse plane and local CoP-based loading metrics were extracted during the paretic stance phase. Relationships between these gait metrics and GRFs, particularly early braking force, propulsion, and late braking force, were examined using nonparametric correlation analyses. K-means clustering was performed to explore candidate gait subgroups, and inter-cluster differences were exploratorily examined.

Results

Across all participants, several CoP–CoM interaction metrics showed significant correlations with GRFs. In particular, insufficient forward progression of the CoM relative to the CoP during late stance showed a strong correlation with late braking force (rs = 0.79). Clustering suggested the presence of four candidate gait subgroups characterized by differing combinations of anteroposterior and mediolateral CoP–CoM dynamics and local CoP loading features. However, the results of clusters with small sample sizes warrant cautious interpretation.

Conclusions

Integrated stance-phase–derived CoP–CoM dynamics and CoP-based parameters may highlight heterogeneity in hemiparetic gait and may have meaningful associations with GRF characteristics. The candidate gait subgroups should be interpreted as hypothesis-generating and may offer a descriptive framework for understanding diverse gait disorders.

Psychometric comparisons of 2 versions of the Fugl-Meyer Motor Scale and 2 versions of the Stroke Rehabilitation Assessment of Movement

 Measurements NEVER GET ANYONE RECOVERED! I'd have you all fired for incompetency in not solving stroke!

Stroke Rehabilitation Assessment of Movement (STREAM) Nothing objective here!

Using Fugl-Meyer for anything in stroke is the height of stupidity, nothing objective in it, so nothing is repeatable.

Psychometric comparisons of 2 versions of the Fugl-Meyer Motor Scale and 2 versions of the Stroke Rehabilitation Assessment of Movement

I-Ping Hsueh, MA, Miao-Ju Hsu, PhD, […], and Jau-Hong Lin, PhD+3View all authors and affiliations

Volume 22, Issue 6

https://doi.org/10.1177/1545968308315999

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Abstract

Objective. 

 To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). 

Methods. 

For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. 

Results. 

Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. 

Conclusions. 

The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

A new hand assessment instrument for severely affected stroke patients

 I don't see how 'assessments' do one damn thing for survivor recovery! You've documented the problem but haven't solved how to recover!

A new hand assessment instrument for severely affected stroke patients

Doris Broetz a,∗ , Nicholas A. Del Grosso a , Massimiliano Rea a , Ander Ramos-Murguialday a,b , Surjo R. Soekadar a,c and Niels Birbaumer a,d a Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany b Health Technologies Department, TECNALIA, San Sebastian, Spain c Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany d Ospedale San Camillo, Istituto di Ricovero e Cura a Curattere Scientifico, IRCCS, Venezia, Italy

Abstract. 

BACKGROUND: 

Standard assessment instruments cannot differentiate patients with minimal residual hand function after stroke. As a result, changes in motor recovery are difficult to document using currently-available tests. In a controlled study with chronic stroke patients without residual finger extension, a new hand function test has been developed. This instrument, called Broetz Hand Test (BzH), allows to assess small variations in hand function in severely paralyzed stoke patients. The instrument is easy to use, and was developed using principles of motor learning and behavioral assessment. 

METHODS: 

The instrument consists of seven daily life-oriented tasks, each of which asks for movement of the paralyzed hand. BzH of 20 patients after stroke was evaluated before and after a behavioral physiotherapy treatment. Sensitivity, inter-observer reliability, test-retest reliability and construct validity was calculated. 

RESULTS: 

Two-tailed paired-samples t-test before and after treatment demonstrated sufficient sensitivity. Mean agreement between the raters resulted in an excellent interrater-reliability. Test-retest reliability between the pre- and post-treatment scores was 0.9. The correlation between BzH and standard test scores was statistically significant and demonstrated sufficient validity. 

CONCLUSION: 

The BzH is a valid and reliable tool to assess changes in hand function in severely paralyzed patients after stroke. But useless for recovery!

The brain has its own microbiome. Here's what it means for your health

 Behind a paywall, so you'll have to ask your competent? doctor what needs to be done with this to get you 100% recovered.  Has your doctor told you ONE DAMN THING ABOUT 100% RECOVERY? Mine knew nothing and did nothing other than write three prescriptions for E.T. (Evaluate and Treat) which a trained chimpanzee could do.

The brain has its own microbiome. Here's what it means for your health

Neuroscientists have been surprised to discover that the human brain is teeming with microbes, and we are beginning to suspect they could play a role in neurodegenerative disorders like Alzheimer's

By David Robson

Effect of Pink Noise on EEG and Memory Performance in Memory Task

 Since 30% of survivors have sleep problems, has your doctor done ONE DAMN THING about it in the last 4 years? NO? So you don't have a functioning stroke doctor, do you?

Is your doctor suggesting either of these? Never mind, way too soon for your doctor to read, understand and implement these interventions. Maybe 50 years from now. Of course your doctor needs to get this testing done on stroke survivors if they are competent at all!

Effects of saffron on sleep quality in healthy adults with self-reported poor sleep: A randomized, double-blind, placebo-controlled trial June 2020

Pink Noise Machines Improve Sleep & Fight Dementia  June 2020

 The latest here:

Effect of Pink Noise on EEG and Memory Performance in Memory Task

Akari Hatayama; Atsushi Matsubara; Sota Nakashima; Seiji Nishifuji

All Authors

---

Abstract

Document Sections

• I.
  Introduction
• II.
  METHODS
• III.
  RESULTS AND DISCUSSION
• IV.
  CONCLUSION

Authors

Figures

References

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Abstract:

Recently, improvement of memory ability by listening noise in deep sleep has attracted extensive attention for its promising potential to prevent older adults from degrading cognitive function such as mild cognitive impairment and dementia. In particular, pink noise with 1/f-characteristics was frequently used to facilitate synchronization of neural oscillatory activities. However, the effect of pink noise on short-term memory task including memory encoding and recall during awake state has not been well investigated. We conducted a simple memory task consisting of memorization of ten fish names during which pink noise was presented and recalling them before and after mental arithmetic for seven healthy young males. Memory recall performance and amplitudes of electroencephalogram (EEG) for noise-added trials were compared with those for control trials without additive noise. The beta and gamma wave amplitudes in the noise-added trials for participants with higher memory performance in the noise-added trials than the control trials were larger than the amplitudes in the control trials by about 10 points, whereas the former amplitudes for participants with lower memory performance in the noise-added trials were smaller than the latter amplitudes. There is a possibility that pink noise could affect the memory ability through the enhancement of beta and gamma wave.

Published in: 2021 IEEE 10th Global Conference on Consumer Electronics (GCCE)

Date of Conference: 12-15 October 2021

Date Added to IEEE Xplore: 01 December 2021

ISBN Information:

Print on Demand(PoD) ISSN: 2378-8143

DOI: 10.1109/GCCE53005.2021.96220

Use It and Improve It or Lose It: Interactions between Arm Function and Use in Humans Post-stroke

 I absolutely hate this saying. To me this is a baseless assertion with no scientific evidence to back it up. Pop psychology if you will.

If your doctor uses this term ask for scientific research to back it up. I don't believe it, I think it is just a convenient item for the doctor to use to bamboozle you when they don't know a damn thing about your damage and have no clue how to get you 100% recovered. 

 

Damn it all, it is NOT learned nonuse. It is the actual inability to use it because of dead neurons. If you had dead brain rehab protocols, this fake learned nonuse idea would cease to exist! What multiverse do we need to send you back to where this research does ONE DAMN THING towards stroke recovery?

 And this has nothing to do with the subject at hand, be forewarned:

Use It Or Lose It:

The latest here:

Use It and Improve It or Lose It: Interactions between Arm Function and Use in Humans Post-stroke

Yukikazu Hidaka 1 , Cheol E. Han 1,2 , Steven L. Wolf 3 , Carolee J. Winstein 4 , Nicolas Schweighofer 4 * 1 Computer Science, University of Southern California, Los Angeles, California, United States of America, 2 Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea, 3 Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia, United States of America, 4 Biokinesiology, University of Southern California, Los Angeles, California, United States of America Abstract  

 

‘‘Use it and improve it, or lose it’’ is one of the axioms of motor therapy after stroke. There is, however, little understanding of the interactions between arm function and use in humans post-stroke. Here, we explored putative non-linear interactions between upper extremity function and use by developing a first-order dynamical model of stroke recovery with longitudinal data from participants receiving constraint induced movement therapy (CIMT) in the EXCITE clinical trial. Using a Bayesian regression framework, we systematically compared this model with competitive models that included, or not, interactions between function and use. Model comparisons showed that the model with the predicted interactions between arm function and use was the best fitting model. Furthermore, by comparing the model parameters before and after CIMT intervention in participants receiving the intervention one year after randomization, we found that therapy increased the parameter that controls the effect of arm function on arm use. Increase in this parameter, which can be thought of as the confidence to use the arm for a given level of function, lead to increase in spontaneous use after therapy compared to before therapy. Citation: Hidaka Y, Han CE, Wolf SL, Winstein CJ, Schweighofer N (2012) Use It and Improve It or Lose It: Interactions between Arm Function and Use in Humans Post-stroke. PLoS Comput Biol 8(2): e1002343. doi:10.1371/journal.pcbi.1002343 Editor: Jo ¨ rn Diedrichsen, University College London, United Kingdom Received October 4, 2010; Accepted November 21, 2011; Published February 16, 2012 Copyright: ß 2012 Hidaka et al. 

 

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work was funded in part by grant NIH RO3 HD050591-02, R01 HD065438, and R01 HD 37606 and by the National Research Foundation of Korea, Ministry of Education, Science and Technology (R32-10142). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: schweigh@usc.edu

Relationship Between Body-Specific Attention to a Paretic Limb and Real-World Arm Use in Stroke Patients: A Longitudinal Study

 

Damn it all, it is NOT learned nonuse. It is the actual inability to use it because of dead neurons. If you had dead brain rehab protocols, this fake learned nonuse idea would cease to exist! What multiverse do we need to send you back to where this research does ONE DAMN THING towards stroke recovery?

 

Quit blaming the patients for not recovering and blame the doctor and therapists for knowing nothing on how to get survivors recovered! 

Do you blithering idiots ever actually think about why stroke patients don't recover?

• learned nonuse (11 posts to May 2018)

• nonuse (14 posts to May 2013)

Relationship Between Body-Specific Attention to a Paretic Limb and Real-World Arm Use in Stroke Patients: A Longitudinal Study

Ryoji Otaki 1,2 , Yutaka Oouchida 1,3 , Naoki Aizu 1,4 , Tamami Sudo 1,5 , Hiroshi Sasahara 2 , Yuki Saito 6 , Sunao Takemura 6 and Shin-Ichi Izumi 1,7 * 1 Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan, 2 Department of Rehabilitation, Yamagata Saisei Hospital, Yamagata, Japan, 3 Department of Education, Osaka Kyoiku University, Osaka, Japan, 4 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan, 5 Department of Computer and Information Sciences, Tokyo University of Agriculture and Technology, Tokyo, Japan, 6 Department of Neurosurgery, Yamagata Saisei Hospital, Yamagata, Japan, 7 Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan  

 

Learned nonuse is a major problem in upper limb (UL) rehabilitation after stroke. Among the various factors that contribute to learned nonuse, recent studies have focused on body representation of the paretic limb in the brain. We previously developed a method to measure body specific attention, as a marker of body representation of the paretic limb and revealed a decline in body specific attention to the paretic limb in chronic stroke patients by a cross-sectional study. However, longitudinal changes in body specific attention and paretic arm use in daily life (real-world arm use) from the onset to the chronic phase, and their relationship, remain unknown. Here, in a longitudinal, prospective, observational study, we sought to elucidate the longitudinal changes in body specific attention to the paretic limb and real-world arm use, and their relationship, by using accelerometers and psychophysical methods, respectively, in 25 patients with subacute stroke. Measurements were taken at baseline (T BL ), 2 weeks (T 2w ), 1 month (T 1M ), 2 months (T 2M ), and 6 months (T 6M ) after enrollment. UL function was measured using the Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT). Real world arm use was measured using accelerometers on both wrists. Body specific attention was measured using a visual detection task. The UL function and real-world arm use improved up to T 6M . Longitudinal changes in body specific attention were most remarkable at T 1M . Changes in body-specific attention up to T 1M correlated positively with changes in real-world arm use up to T 6M , and from T 1M to T 6M , and the latter more strongly correlated with changes in real-world arm use. Changes in real-world arm use up to T 2M correlated positively with changes in FMA up to T 2M and T 6M . No correlation was found between body specific attention and FMA scores. Thus, these results suggest that improved body specific attention to the paretic limb during the early phase contributes to increasing long-term real world arm use and that increased real-world use is associated with the recovery of UL function. Our results may contribute to the development of rehabilitation strategies to enhance adaptive changes in body representation in the brain and increase real-world arm use after stroke.

Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

 

Damn it all, it is NOT learned nonuse. It is the actual inability to use it because of dead neurons. If you had dead brain rehab protocols, this fake learned nonuse idea would cease to exist! What multiverse do we need to send you back to where this does ONE DAMN THING towards stroke recovery?

 

Quit blaming the patients for not recovering and blame the doctor and therapists for knowing nothing on how to get survivors recovered! 

Do you blithering idiots ever actually think about why stroke patients don't recover?

• learned nonuse (11 posts to May 2018)

• nonuse (14 posts to May 2013)

Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

Marian E. Michielsen, MSc†, Ruud W. Selles, PhD, Henk J. Stam, MD, PhD Gerard M. Ribbers, MD, PhD, Johannes B. Bussmann, PhD ABSTRACT. Michielsen ME, Selles RW, Stam HJ, Ribbers GM, Bussmann JB. 

  Arch Phys Med Rehabil 2012;xx:xxx.  

Objective:  

 

To quantify uni- and bimanual upper-limb use in patients with chronic stroke in daily life compared with healthy controls.  

 

Design: 

 

 Cross-sectional observational study. Setting: Outpatient rehabilitation center. Participants: Patients with chronic stroke (n=38) and healthy controls (n=18).  

 

Intervention:  

Not applicable. (This is precisely why learned nonuse research should never be done! It does nothing to get survivors recovered! I'd have you all fired!)

 

Main Outcome Measures:  

 

Upper-limb use in daily life was measured with an accelerometry based upper-limb activity monitor, an accelerometer based measurement device. Uni- manual use of the paretic and the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours. Outcomes were expressed in terms of both duration and intensity.  

 

Results:  

 

Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h), while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients used their paretic side less than controls used their nondominant side and their nonparetic side more than controls their dominant side. The intensity with which patients used their paretic side was lower than that with which controls used their nondominant side, while that of the nonparetic side was higher than that of the dominant side of controls. Finally, patients used their paretic side almost exclusively in bimanual activities. During bimanual activities, the intensity with which they used their affected side was much lower than that of the nonaffected side.  

 

Conclusion:  

 

Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during unimanual and bimanual activities in patients with chronic stroke. Patients do compensate for this with increased use of the nonparetic side.(As they should since you incompetently don't know about the research that shows using the good side helps recover the bad side!

Exercising the good side to recover the 'bad' side. December 2012)

Key Words: Ambulatory monitoring; Motor activity; Rehabilitation; Stroke; Upper extremity. © 2012 by the American Congress of Rehabilitation Medicine  

 

FIFTY TO 70% OF PATIENTS with stroke suffer from long-term motor deficits of the upper limb, 1 with a decreased use of the paretic upper extremity in daily life. 2 Be- cause this latter may have a great impact on the manner in which a patient is able to participate in daily life activities, maximizing purposeful use of the upper extremity in daily life is a key factor in motor rehabilitation following stroke. While it is clear that a decreased motor capacity of the paretic arm influences the use of both extremities, the exact changes in upper-limb use following stroke are not yet fully understood. Regarding the paretic upper extremity, many studies have shown that there is no 1-on-1 relation between motor impairment and functional use. 3,4 This may be related to the phenomenon of learned nonuse, 5 which describes how patients will have “learned” not to use the paretic side to its full capacity. 6 Brain injury causes structural damage to motor path- ways as well as depression of neural excitability near the lesion. Decreasing activity of the upper extremity leads to a further reduction in excitability and as such starts a vicious circle of decreasing excitability and decreasing activity. 7 Even less is known about the consequences of stroke on the nonparetic side. Motor performance of the nonparetic side may be impaired compared with that in healthy subjects, showing, for instance, decreased speed and consistency of performance. 8 In addition, it has been shown that patients with acute stroke have a more reduced use of the nonparetic side in daily life than do healthy subjects. 9 On the other hand, it is generally assumed that post stroke the nonparetic side will be used more to compensate for the decreased use of the paretic side. However, to our knowledge, this has not been investigated in patients with chronic stroke. Overall many questions on techniques to optimize the function of the paretic extremity after stroke still need to be answered. The optimal rehabilitation technique is still not defined, and different approaches in reducing upper-extremity paresis are distinguished. 7 Several therapies have been developed to improve the use of the nonparetic arm in daily life. For example, constraint-induced movement therapy (CIMT), 10,11 or forced use, 12 reported as a beneficial treatment option for motor recovery of the arm, 13 prevents the use of the nonparetic upper limb and aims to counterbalance the learned nonuse. CIMT is an augmentative technique, 7 a high-intensity, uni- manual training aiming to counterbalance the vicious circle of decreasing excitability and decreasing activity. Furthermore, CIMT has aspects of task specific exercising. Bilateral training programs have also been developed, for example, with rhythmic

 

More at link.

Does Limited Dorsiflexion during Swing Phase in Hemiparesis Depend on Spasticity?

So you described a problem but failed to do ONE DAMN THING to solve it? That is pure incompetence! Stroke research should get survivors recovered!

 Does Limited Dorsiflexion during Swing Phase in Hemiparesis Depend on Spasticity?

Maria Vinti * , Mathias Blandeau * , Hélène Pillet , Wafa Skalli , Philippe Decq , Andrea Merlo ,
Jean-Michel Gracies , Nicolas Bayle , Mouna Ghédira , Emilie Hutin
Posted Date: 19 February 2024
doi: 10.20944/preprints202402.0932.v1

Maria Vinti PhD 1, *, Mathias Blandeau PhD 2, *, Hélène Pillet PhD 3, Wafa Skalli PhD 3,
Philippe Decq MD 3,4, Andrea Merlo PhD 5, Jean-Michel Gracies MD PhD 6,7,
Nicolas Bayle MD 6,7, Mouna Ghédira PhD 6,7 and Emilie Hutin PhD 6,7
1 Univ. Limoges, HAVAE, UR 20217, F-87000 Limoges, France
2 Univ. Polytechnic Hauts-de-France, CNRS, UMR 8201 LAMIH, F-59313, Valenciennes, France
3 Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Sciences et Technologies, Paris,
France
4 AP-HP, Service de Neurochirurgie, Hôpital Beaujon, Clichy, 92 France
5 LAM–Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di
Reggio Emilia, San Sebastiano Hospital, Correggio (RE), Italy
6 UR 7377 BIOTN, Université Paris-Est Créteil (UPEC), F-94000 Créteil, France
7 Laboratoire Analyse et Restauration du Mouvement, AP-HP, Service de Rééducation Neurolocomotrice,
Hôpitaux Universitaires Henri Mondor, F-94000 Créteil, France
* Correspondence: mariaconcetta.vinti@unilim.fr (M.V.); mathias.blandeau@uphf.fr (M.B.)

Abstract: 

Plantar flexors (PF) spasticity is known to poorly correlate with active dorsiflexion (DF)
impairment throughout the swing phase of hemiparetic gait. Spastic Cocontraction, instead,
stemming from descending pathways, potentially misdirect antagonist PF activity opposing DF
during swing. Electromyographic (EMG) recordings, while unable to differentiate between
reflex-based and descending origins, may offer valuable insights into this distinction by exploring
PF EMG activity after tibial nerve neurotomy (which eliminates PF spasticity). Eleven subjects with
hemiparesis walking at comfortable velocity and 11 controls walking at comfortable and slow
velocity, underwent kinematic and PF/DF EMG analysis. Five of the hemiparetic subjects
underwent tibial neurotomy >1 year prior. We evaluated spasticity at rest (Tardieu scale), maximal
ankle dorsiflexion, tibialis anterior agonist recruitment and gastrocnemius medialis and soleus
cocontraction coefficients during swing. At slow velocity, controls (0.80±0.12 m/s) moved at a
similar pace as hemiparetic subjects (0.73±0.37 m/s, NS). Hemiparetic subjects showed: (i) reduced
ankle DF across swing (ii) increased PF cocontraction, including before any DF (iii) higher
cocontraction despite absent spasticity in tibial neurotomy subjects (iv) higher tibialis anterior
recruitment. Increased PF cocontraction occurs in the absence of spasticity or ankle DF despite
higher agonist recruitment. Spastic cocontraction is a major factor limiting active DF at swing,
unlike spasticity.

Rehabilitation robots: a compliment to virtual reality

In the 13 years since this came out; has your doctor done one damn thing with either virtual reality or robotics? The answer will tell you how fucking incompetent your doctor is.

• immersive virtual reality (10 posts to January 2021)

• virtual reality (185 posts to September 2011)

• virtual reality gait training (1 post to November 2022)

• virtual reality games (7 posts to June 2016)

• virtual reality training (13 posts to June 2013)

• virtual reality goggles (1 post to January 2016)

 Rehabilitation robots: a compliment to virtual reality

Schedae
2010Prépublication n° 6 | Fascicule n° 1
J.V.G. Robertson, N. Jarrassé, A. Roby-Brami« Rehabilitation robots: a compliment to virtual reality »
Schedae
, 2010, prépublication n° 6 (fascicule n° 1, p. 77 - 94).
77
 Rehabilitation robots: a compliment to virtual reality
 J.V.G. Robertson
1, 2
 , N. Jarrassé
3
 , A. Roby-Brami
1, 2, 4
 
1
Laboratoire Neurophysique et physiologie, Université Paris Descartes, CNRS UMR 8119. 45 rue des Saints Pères, Paris 75006.
2
Service MPR, Hôpital Raymond Poincaré, 92380 Garches.
3
Institut Systèmes Intelligents et Robotique, Université Pierre et Marie Curie, CNRS UMR 7222, 4 place Jussieu, 75252 ParisCedex 05
.
 
4
Institut fédératif de recherche sur le Handicap (IFR25).
The aim of this paper is to discuss the use of robots for upper limb rehabilitation following strokes
in adults. We describe the main robots currently being developed and the results of clinical studies
that have been carried out. The association of virtual reality interfaces and the robotic rehabilita-tion programs providing therapy in the form of games with a view to helping therapists increasethe duration of rehabilitation exercise.

Le but de cet article est de discuter l’apport de la robotique pour la rééducation du membre supé-
rieur à la suite d’un accident vasculaire cérébral chez les adultes. Les principaux robots qui ont été développés sont décrits en relation avec les résultats des évaluations cliniques. Le couplage
entre des interfaces de réalité virtuelle et les programmes de rééducation utilisant les robots offre
des ouvertures thérapeutiques sous forme de jeux en vue d’aider les thérapeutes à accroître ladurée des exercices de rééducation.

 Introduction
Over the past fifteen years, a plethora of rehabilitation robots in many shapes and forms have
popped out from laboratories all over the world. Many have not yet got beyond the stage of feasibility tests. However, a few have begun to be evaluated in clinical trials and today
we are beginning to have an idea of the effects of robotic therapy on recovery of motor
function, even though many questions remain unanswered. Robots have been developed
to compensate for loss of motor capacity [ROB 02], for retraining gait [HES 06, MAY 07]  and for upper limb rehabilitation. Robots are highly complementary to virtual reality for
therapy as they can provide a haptic interface and/or support and assistance. The aim of
this paper is to discuss the use of robots for upper limb rehabilitation following stroke in
adults. Firstly we will describe the main robots currently being developed and the results of clinical studies which have been carried out. We will then go on to discuss the perspectives for this type of rehabilitation.

Evolution of Brain Activation with Good and Poor Motor Recovery after Stroke

I don't see one damn thing here that gets survivors recovered!

Evolution of Brain Activation with Good and Poor Motor Recovery after Stroke

 Neurorehabil Neural Repair 2006 20: 24
DOI: 10.1177/1545968305283053

 

 Leeanne M. Carey, PhD, David F. Abbott, PhD, Gary F. Egan, PhD,Graham J. O’Keefe, PhD, Graham D. Jackson, MD, Julie Bernhardt, PhD,and Geoffrey A. Donnan, MD
Objective  

To characterize the evolution of brain activation in stroke patients with variable motor recovery and quantify changes relative to healthy controls.
 Methods Serial PET activation studies, using a simple finger-tapping task, and quantitative measures of motor performance were obtained in 9 patients (2–7 weeks post stroke and 6 months later) and compared with serial healthy volunteer data. Results. Patients with moderate impairment and good recovery (n= 5) activated the primary sensorimotor cortex (SM1) contralateral to the paretic hand moved, bilateral supplementary motor area(SMA), contralateral cingulate gyrus, and ipsilateral lateral premotor cortex. Activation in the bilateral SMA was greater at the initial study but reduced over time com-pared to healthy controls and poor recoverers. Patients with severe impairment and poor recovery (n = 4) showed limited activation of contralateral SM1 and SMAat both studies and no significant change over time. A posterior shift in SM1 activation was evident in good and poor recoverers.
 Conclusions.
 Activation of typical motor regions and recruitment of additional sites occur subacutely post stroke, with evolution to normal patterns in moderately impaired patients who recover well. In comparison, severely impaired, poor-recovery patients show persistent, reduced activation. Dynamic changes in SMA, differentially observed in good recoverers over6 months, highlight its importance in recovery.

Scientists prove how many daily steps you should take to avoid early death - 7,000

 Other numbers to see if your doctor knows one damn thing about walking.

Other walking prevention items:

My numbers for steps.

10,000 Steps A Day? How Many You Really Need To Boost Longevity - 4,400

This one suggests 8900 steps a day:

Can Exercise Protect Against Alzheimer's?

 

Exactly How Many Steps You Need to Take a Day to Not Gain Weight - 15,000

Every 2,000 steps a day could help keep premature death at bay

The latest here:

Scientists prove how many daily steps you should take to avoid early death

In a significant shift from the common belief that individuals should aim for 10,000 steps daily for optimal health, a new international study spearheaded by the University of Granada has established a different standard.

The research not only highlights the ideal number of daily steps people should target but also emphasizes the health advantages of the walking pace.

Dissecting the myth of 10,000 daily steps

The notion advocating for 10,000 daily steps, originating in Japan around the 1960s, was widely accepted but lacked substantial scientific backing.

This recent study demystifies that number, pointing out that the key to reducing the risk of premature death significantly lies in accomplishing approximately 7,000 daily steps.

This translates to about 6.4 kilometers (4 miles) per day, given the average human stride. The research also delineates that the pace of walking fortifies the health benefits gained.

Optimal daily step count

The study is the product of collaboration among specialists from various international institutions. These include the Radboud University Medical Center in the Netherlands, the Universities of Granada and Castilla-La Mancha in Spain, and Iowa State University in the United States.

 How just 22 minutes of your day can reduce risk of dying earlier (The Independent)What they found is that if you are physically active,

Ortega emphasized that reaching between 7,000 and 9,000 daily steps emerges as a practical health objective for the majority. The revelation comes after a comprehensive literature review and meta-analysis encompassing data from twelve international studies, which collectively involved more than 110,000 participants.

From 10,000 to 7,000: Establishing clear targets

Esmée Bakker, a Marie Curie Postdoctoral Research Fellow at the University of Granada and a principal author of the study, shared insights distinguishing this research from others.

"What sets our study apart is the establishment of clear step goals. We indicate that health improvements are observable with minor increases in daily steps, especially for individuals presently less active," she stated.

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According to the findings, even incremental objectives like an additional 500 daily steps could offer health improvements. This recommendation is particularly encouraging for those who find the prospect of nearly 9,000 steps daunting.

Fast walking enhances benefits

The study doesn't stop at just quantifying steps. It further uncovers that the speed at which a person walks plays a crucial role. Faster walking correlates with a lower mortality risk, irrespective of the total daily steps. The researchers also found these results consistent across genders.

Moreover, the study's insights extend to practicality. It underscores that the means of counting steps, whether through a smartwatch, a wrist-based tracker, or a smartphone, doesn't influence the outcomes.

Health benefits at every age

One might wonder if ceasing to walk beyond approximately 9,000 steps is advisable. "Absolutely not," asserts Francisco B. Ortega. The research indicates no upper limit to harmful steps.

Ortega notes that walking as many as 16,000 steps daily still showcases health advantages, albeit with diminishing risk reductions beyond the 7,000-9,000 step bracket.

Importantly, the study advocates for age-appropriate step targets. Younger individuals might have higher step goals compared to their older counterparts.

Notably, the research scope was confined to analyzing the effects on all-cause mortality and cardiovascular diseases. A broad spectrum of scientific literature suggests that moderate to vigorous physical activities correlate with numerous other health benefits.

Daily steps simplify public health goals

The significance of this study is not just in its scientific findings but also in its practical implications. National physical activity guidelines recommending 150-300 minutes of moderate-intensity exercise weekly often leave individuals at a crossroads. Most people are unsure about exercise intensity, or whether their activities meet these standards.

Counting steps simplifies this. It offers a tangible, measurable goal that most people can track thanks to prevalent technology like smartphones and wearable devices.

In summary, the study serves as a beacon, guiding individuals towards achievable health goals through walking. By establishing a more accessible target and recognizing the role of walking pace, the research paves the way for enhanced public health strategies. It encourages communities to step up -- quite literally -- for their health.

The full study was published in Journal of the American College of Cardiology.

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