Balance characteristics in patients with major depression after a two-month walking exercise program: A pilot study

3D-optical motion capturing examination of sensori- and psychomotor abnormalities in mental disorders: Progress and perspectives

Sensori-/psychomotor abnormalities refer to a wide range of disturbances in individual motor, affective and behavioral functions that are often observed in mental disorders. However, many of these studies have mainly used clinical rating scales, which can be potentially confounded by observer bias and are not able to detect subtle sensori-/psychomotor abnormalities. Yet, an innovative three-dimensional (3D) optical motion capturing technology (MoCap) can provide more objective and quantifiable data about movements and posture in psychiatric patients. To draw attention to recent rapid progress in the field, we performed a systematic review using PubMed, Medline, Embase, and Web of Science until May 01st 2024. We included 55 studies in the qualitative analysis and gait was the most examined movement. The identified studies suggested that sensori-/psychomotor abnormalities in neurodevelopmental, mood, schizophrenia spectrum and neurocognitive disorders are associated with alterations in spatiotemporal parameters (speed, step width, length and height; stance time, swing time, double limb support time, phases duration, adjusting sway, acceleration, etc.) during various movements such as walking, running, upper body, hand and head movements. Some studies highlighted the advantages of 3D optical MoCap systems over traditional rating scales and measurements such as actigraphy and ultrasound gait analyses. 3D optical MoCap systems are susceptible to detecting differences not only between patients with mental disorders and healthy persons but also among at-risk individuals exhibiting subtle sensori-/psychomotor abnormalities. Overall, 3D optical MoCap systems hold promise for objectively examining sensori-/psychomotor abnormalities, making them valuable tools for use in future clinical trials.

Effect of a smartphone-based physical intervention on depression, fitness factors and movement characteristics in adults

BACKGROUND

Physical activity has been shown to correlate with mental health and a reduction in symptoms of depression. However, the majority of research has focused only on the effects of either aerobic or nonaerobic exercise on depressive symptoms, while the use of novel technological innovations such as mobile phone-based activity programs and their effects on movement characteristics are underrepresented. This study had two objectives: (1) to investigate how effectively 4 weeks of mobile phone-based physical activity can affect depressive scores (CES-10-D and PHQ) and fitness levels and (2) to investigate the whether 4 weeks of mobile phone-based physical activity affected participants' movement characteristics.

METHODS

A total of 31 participants were included and divided into an exercise group (n = 21) and a control group (n = 10). The exercise group was instructed to use a mobile phone-based exercise program 5 times per week for 4 weeks. Pre- and post-exercise, the participants' depression score (CES-10-D, PHQ9), fitness level (YMCA, grip strength) and movement characteristics (postural sway, movement ROM, movement speeds, etc.) for three Azure Kinect physical activity games based on different fitness factors (balance game, cardiovascular game, reaction game) were measured.

RESULTS

Mixed model ANOVA revealed significant differences between pre- and post-intervention depression scores on the PHQ9 (P = .001) and CES-10-D (P < .001) in both the exercise group and the control group, but not between groups. In terms of movement characteristics, there was an increase in body sway (P = .045) and vertical head movement (P = .02) in the cardiovascular game jogging condition for the exercise group. In the reaction game, the exercise group showed a significant reduction in the number of mistakes (P = .03). There were no other significant differences for the other variables.

CONCLUSION

The results revealed no differences in the reduction in depression scores between the exercise group and the control group. However, this study showed that a mobile phone-based physical activity intervention affects in-game movement characteristics such as body sway and vertical head movement and therefore may show the potential of using activity-promoting mobile games for improving movement.

Examining the Role of Physical Function on Future Fall Likelihood in Older Adults With a Fear of Falling, With and Without Activity Restriction

ObjectivesAssess the influence of physical function on balance and future falls in older adults with fear of falling (FOF) and whether activity restriction modifies the contribution to falls. Methods: Analyses utilized data from Baltimore Longitudinal Study of Aging (n = 680) and National Health and Aging Trends Study (n = 4376) community-dwelling older adults. The role of physical function was examined by comparing balance performance and future fall odds before/after controlling for function in older adults with/without FOF. Fall likelihood analyses were repeated with FOF stratified by activity restriction. Results: When controlling for physical function, differences in balance and fall odds secondary to FOF/activity restricting FOF reduced but remained significant. Fall odds secondary to non-activity restricting FOF only slightly decreased. Discussion: Physical function contributes to balance and falls in older adults with FOF, more so in those restricting activity. Reduced balance and increased fall risk persists independent of function suggesting additional contributing factors.

Dynamics of Depressive and Psychomotor Symptoms During Electroconvulsive Therapy in Older Depressive Patients: A Case Series

OBJECTIVE

Electroconvulsive therapy (ECT) is an effective treatment for patients experiencing a major depressive episode, especially older ones. Identification of specific responses within early ECT sessions remains an issue of debate, however. Hence, this pilot study prospectively examined the outcome in terms of depressive signs, symptom by symptom, throughout a course of ECT, concentrating particularly on psychomotor retardation symptoms.

METHODS

Nine patients were clinically evaluated several times during the ECT course, before the first session and then weekly (over 3-6 weeks, according to their evolution), by completing the Montgomery-Åsberg Depression Rating Scale (MADRS), the Mini-Mental State Examination test, and the French Retardation Rating Scale for Depression for assessing the severity of psychomotor retardation.

RESULTS

Nonparametric Friedman tests showed significant positive changes in mood disorders during ECT in older depressive patients (mean, -27.3% of initial MADRS total score). Fast improvement in French Retardation Rating Scale for Depression score was observed at t1 (ie, after 3-4 ECT sessions), whereas a slightly delayed improvement in the MADRS scores was found at t2 (ie, after 5-6 ECT sessions). Moreover, the scores for items linked to the motor component of psychomotor retardation (eg, gait, postural control, fatigability) were the first to significantly decrease during the first 2 weeks of the ECT course compared with the cognitive component.

CONCLUSIONS

Interestingly, participants' concentration on daily functional activities, their interest and fatigability, and their reported state of sadness were the first to progress, representing possible precursor signs of positive patient outcomes after ECT.

Unlocking the Emotional World of Visual Media: An Overview of the Science, Research, and Impact of Understanding Emotion: Drawing Insights From Psychology, Engineering, and the Arts, This Article Provides a Comprehensive Overview of the Field of Emotion Analysis in Visual Media and Discusses the Latest Research, Systems, Challenges, Ethical Implications, and Potential Impact of Artificial Emotional Intelligence on Society

The emergence of artificial emotional intelligence technology is revolutionizing the fields of computers and robotics, allowing for a new level of communication and understanding of human behavior that was once thought impossible. While recent advancements in deep learning have transformed the field of computer vision, automated understanding of evoked or expressed emotions in visual media remains in its infancy. This foundering stems from the absence of a universally accepted definition of "emotion," coupled with the inherently subjective nature of emotions and their intricate nuances. In this article, we provide a comprehensive, multidisciplinary overview of the field of emotion analysis in visual media, drawing on insights from psychology, engineering, and the arts. We begin by exploring the psychological foundations of emotion and the computational principles that underpin the understanding of emotions from images and videos. We then review the latest research and systems within the field, accentuating the most promising approaches. We also discuss the current technological challenges and limitations of emotion analysis, underscoring the necessity for continued investigation and innovation. We contend that this represents a "Holy Grail" research problem in computing and delineate pivotal directions for future inquiry. Finally, we examine the ethical ramifications of emotion-understanding technologies and contemplate their potential societal impacts. Overall, this article endeavors to equip readers with a deeper understanding of the domain of emotion analysis in visual media and to inspire further research and development in this captivating and rapidly evolving field.

Motor alterations in depression and anxiety disorders: A systematic review and meta-analysis

BACKGROUND

Psychomotor retardation has long been recognized as a major feature of depression, and anxiety disorders have been linked with freeze and flight motor responses. This systematic review and meta-analysis aimed a) to synthesize available evidence of motor alterations comparing individuals with depression and anxiety disorders to healthy individuals and b) to evaluate the effect of experimental manipulations of motor displays within these clinical groups.

METHOD

The databases PubMed and PsycINFO were searched for studies either assessing motor differences between clinical and healthy control groups or manipulating the motor system within a clinical group.

RESULTS

The literature search yielded 87 relevant papers, comprising 82 studies comparing a clinical group to a healthy group and 5 studies investigating motor manipulations within a clinical sample. The results of the meta-analysis (K = 71) indicated a statistically significant combined estimate of differences between healthy and clinical groups (g = 0.38 [0.31, 0.45], adjusted for publication bias g = 0.26 [0.19, 0.33]) of a small size. This effect did not vary according to type of disorder (anxiety vs. depression, p = .468). From a narrative review of experimental studies within clinical groups, four out of five studies reported statistically significant effects of manipulating the motor system on affective outcomes.

DISCUSSION

This synthesis adds to the accumulating empirical evidence of motor alterations in depression and anxiety disorders. Future research will need to investigate how individuals suffering from depression or anxiety disorders could benefit from psychological, behavioral, and physical interventions directly aimed at the motor system.

Differences in Postural Balance, Pain Sensitivity and Depression between Individuals with Acute and Chronic Back Pain

To compare differences in postural balance, pain and depression in patients with chronic and acute low back pain, twenty patients with chronic and twenty patients with acute low back pain from the Edward Francis Small Hospital (Banjul, Gambia), as well as 20 age-matched healthy controls participated in the study. A modified Romberg test was used to assess postural balance during one minute with closed eyes. Body sway in the anteroposterior and mediolateral axes was video-recorded during test performance and further analyzed with an open source software for movement analyses (CvMob). Pain sensitivity was assessed by means of pressure pain thresholds and depression by a self-report questionnaire (PHQ-9). As results, patients with chronic low back pain displayed higher body sway in the anteroposterior and mediolateral axes, as well as faster body sway than patients with acute low back pain and healthy controls. Nevertheless, group differences disappeared when depression was introduced as a covariate, indicating a major role of depression in postural balance deficits of patients with pain disorders. As conclusions, the assessment of postural balance and depression should be implemented in the clinical routine for the design of tailored interventions in pain conditions.

Instrumental assessment of balance and gait in depression: A systematic review

Psychomotor symptoms of depression are understudied despite having a severe impact on patient outcomes. This review aims to summarize the evidence on motor features of depression assessed with instrumental procedures, and examine age-related differences. We included studies investigating posture, balance and gait ascertained with instrumental measurements among individuals with depressive symptoms or disorders. Studies on subjects with specific physical illnesses were excluded. Methodological quality was assessed with the Newcastle - Ottawa Scale (NOS) and PRISMA guidelines were followed. 33 studies (13 case-control, five cross-sectional, nine longitudinal and six intervention) with overall low-medium quality were included. Different instruments were employed to assess posture (e.g. digital cameras), balance (balance, stepping platform) or gait (e.g. Six-Minute-Walking Test, instrumented walkways). Results suggest that depression in adults is associated with significant impairments of posture, balance and gait. Motor abnormalities among depressed older adults may depend on the interplay of physical diseases, cognitive impairment and mood. Very few intervention studies measured motor symptoms as outcome. Available evidence suggests, however, that antidepressant drugs and physical exercise may be beneficial for motor abnormalities. Despite the lack of high-quality studies, instrumental assessments confirm the presence and importance of motor abnormalities in depression, with potential age-related differences in their pathophysiology.

The effect of mood phases on balance control in bipolar disorder

The aim of this study was to investigate balance control during gait and sit-to-walk in individuals with bipolar disorder and healthy controls by examining the inclination angles between the whole-body center-of-mass (COM) and ankle in the sagittal plane. Twenty-one individuals with bipolar disorder in the euthymic (i.e., asymptomatic; n = 11) and depressed (n = 10) phases and 7 healthy controls (ages between 18 and 45) performed gait and sit-to-walk at self-selected comfortable speed. Mood phases for individuals with bipolar disorder were measured using the Patient Health Questionnaire and Altman Self-Rating Mania Scale. We collected motion data using a 16-camera motion capture technology. We found smaller COM-ankle inclination angles at seat-off during sit-to-walk for the bipolar-depressed group compared to the bipolar-euthymic and healthy groups, indicating poorly controlled balance for the bipolar-depressed group in sit-to-walk. However, we found larger COM-ankle inclination angles at beginning of single stance phase of gait for the bipolar-euthymic group compared to the healthy group, indicating well controlled balance for the bipolar-euthymic group in gait. Our results suggest an association between the depressed phase and balance impairment during daily movements in relatively young adults (ages ≤ 45 years). Our results also suggest that the depressed phase may be as detrimental to balance control as the effect of age-related neuromuscular weakness.

Factors associated with self-reported falls, balance or walking difficulty in older survivors of breast, colorectal, lung, or prostate cancer: Results from Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey linkage

Background

Cancer and its treatment affect body systems that are important in preventing falls and controlling balance/walking. This study examined factors associated with self-reported falls and balance/walking difficulty in the past 12 months in older survivors of four major cancers.

Methods

This was a cross-sectional study analyzing population-based data from Surveillance, Epidemiology, and End Results–Medicare Health Outcomes Survey (SEER-MHOS). Data from cohorts 9 to 14 (January 2006 to December 2013) were extracted. Inclusion criteria were: age ≥65 years at cancer diagnosis, first MHOS completed during years 1–5 post-cancer diagnosis, first primary breast (n = 2725), colorectal (n = 1646), lung (n = 752), and prostate (n = 4245) cancer, and availability of cancer staging information. Primary outcomes were self-reported falls and balance/walking difficulty in the past 12 months. Multivariable logistic regression was constructed for each cancer type to examine independent factors associated with falls and balance/walking difficulty.

Results

In all cancer types, advancing age at cancer diagnosis and dependence in activities of daily living were significant independent factors associated with increased odds of reporting falls and balance/walking difficulty in the past 12 months. Additionally, depression was independently associated with falls and sensory impairment in feet was independently linked to balance/walking difficulty in all cancer types. Other independent factors of falls and balance/walking difficulty varied across cancer types. In breast cancer only, localized or regional cancer stage was significantly associated with increased odds of reporting falls and balance/walking difficulty, whereas treatment with radiation decreased the odds of falling. No association between falls and balance/walking difficulty with time since cancer diagnosis, cancer stage, or cancer treatment was found in colorectal, lung, and prostate cancer.

Conclusion

There exists some heterogeneity in factors associated with self-reported falls and balance/walking difficulty between different cancer types. Future research is necessary to ascertain factors predictive of falls and balance/walking difficulty in older cancer survivors, particularly factors related to cancer diagnosis and treatment.

Posture-Motor and Posture-Ideomotor Dual-Tasking: A Putative Marker of Psychomotor Retardation and Depressive Rumination in Patients With Major Depressive Disorder

Background: Recent studies have demonstrated that the assessment of postural performance may be a potentially reliable and objective marker of the psychomotor retardation (PMR) in the major depressive disorder (MDD). One of the important facets of MDD-related PMR is reflected in disrupted central mechanisms of psychomotor control, heavily influenced by compelling maladaptive depressive rumination. In view of this we designed a research paradigm that included sequential execution of simple single-posture task followed by more challenging divided attention posture tasks, involving concurring motor and ideomotor workloads. Another difficulty dimension assumed executing of all the tasks with eyes open (EO) (easy) and closed (EC) (difficult) conditions. We aimed at investigating the interplay between the severity of MDD, depressive rumination, and efficiency of postural performance.

Methods: Compared with 24 age- and body mass index-matched healthy controls (HCs), 26 patients with MDD sequentially executed three experimental tasks: (1) single-posture task of maintaining a quiet stance (ST), (2) actual posture-motor dual task (AMT); and (3) mental/imaginary posture-motor dual task (MMT). All the tasks were performed in the EO and the EC conditions. The primary dependent variable was the amount of kinetic energy (E) expended for the center of pressure deviations (CoPDs), whereas the absolute divided attention cost index showed energy cost to the dual-tasking vs. the single-posture task according to the formula: ΔE = (E_Dual-task - E_Single-task).

Results: The signs of PMR in the MDD group were objectively indexed by deficient posture control in the EC condition along with overall slowness of fine motor and ideomotor activity. Another important and probably more challenging feature of the findings was that the posture deficit manifested in the ST condition was substantially and significantly attenuated in the MMT and AMT performance dual-tasking activity. A multiple linear regression analysis evidenced further that the dual-tasking energy cost (i.e., ΔE) significantly predicted clinical scores of severity of MDD and depressive rumination.

Conclusion: The findings allow to suggest that execution of concurrent actual or imaginary fine motor task with closed visual input deallocates attentional resources from compelling maladaptive depressive rumination thereby attenuating severity of absolute dual-tasking energy costs for balance maintenance in patients with MDD.

Significance: Quantitative assessment of PMR through measures of the postural performance in dual-tasking may be useful to capture the negative impact of past depressive episodes, optimize the personalized treatment selection, and improve the understanding of the pathophysiological mechanisms underlying MDD.

Posture-cognitive dual-tasking: A relevant marker of depression-related psychomotor retardation. An illustration of the positive impact of repetitive transcranial magnetic stimulation in patients with major depressive disorder

This study examined whether postural control variables, particularly the center-of-pressure (COP) velocity-based parameters, could be a relevant hallmark of depression-related psychomotor retardation (PMR). We first aimed at investigating the interplay between the PMR scores and the COP performance in patients with major depressive disorder (MDD), as compared to age-matched healthy controls; secondly, we focused on the impact of a repetitive transcranial magnetic stimulation (rTMS) treatment on depression, PMR scores and postural performance. 16 MDD patients, and a control group of 16 healthy adults, were asked to maintain quiet standing balance during two trials with or without vision, and while backward counting (dual task). All the position and velocity-based COP variables were computed. Before and after the rTMS session (n eligible MDD = 10), we assessed the depression level with the Montgomery-Asberg Depression Rating Scale (MADRS), the PMR scores with the French Retardation Rating Scale for Depression (ERD), and postural performance. Before the treatment, significant positive partial correlations were found between the pre-ERD scores and the velocity-based COP variables, especially in the dual-task conditions (p < 0.05). In contrast, there was no significant correlation between the post-ERD scores and any postural parameter after the treatment. The MADRS and ERD scores showed a significant decrease between before and after the rTMS intervention. For the first time, the findings clearly validated the view that the assessment of postural performance - easy to envisage in clinical settings-constitutes a reliable and objective marker of PMR in MDD patients.