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Kueper N, Kim SK, Kirchner EA. Avoidance of specific calibration sessions in motor intention recognition for exoskeleton-supported rehabilitation through transfer learning on EEG data. Sci Rep 2024; 14:16690. [PMID: 39030206 PMCID: PMC11271642 DOI: 10.1038/s41598-024-65910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/25/2024] [Indexed: 07/21/2024] Open
Abstract
Exoskeleton-based support for patients requires the learning of individual machine-learning models to recognize movement intentions of patients based on the electroencephalogram (EEG). A major issue in EEG-based movement intention recognition is the long calibration time required to train a model. In this paper, we propose a transfer learning approach that eliminates the need for a calibration session. This approach is validated on healthy subjects in this study. We will use the proposed approach in our future rehabilitation application, where the movement intention of the affected arm of a patient can be inferred from the EEG data recorded during bilateral arm movements enabled by the exoskeleton mirroring arm movements from the unaffected to the affected arm. For the initial evaluation, we compared two trained models for predicting unilateral and bilateral movement intentions without applying a classifier transfer. For the main evaluation, we predicted unilateral movement intentions without a calibration session by transferring the classifier trained on data from bilateral movement intentions. Our results showed that the classification performance for the transfer case was comparable to that in the non-transfer case, even with only 4 or 8 EEG channels. Our results contribute to robotic rehabilitation by eliminating the need for a calibration session, since EEG data for training is recorded during the rehabilitation session, and only a small number of EEG channels are required for model training.
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Affiliation(s)
- Niklas Kueper
- Robotics Innovation Center, German Research Center for Artificial Intelligence (DFKI), 28359, Bremen, Germany
| | - Su Kyoung Kim
- Robotics Innovation Center, German Research Center for Artificial Intelligence (DFKI), 28359, Bremen, Germany
| | - Elsa Andrea Kirchner
- Robotics Innovation Center, German Research Center for Artificial Intelligence (DFKI), 28359, Bremen, Germany.
- Institute of Medical Technology Systems, University of Duisburg-Essen, 47057, Duisburg, Germany.
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2
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Gangadharan SK, Ramakrishnan S, Paek A, Ravindran A, Prasad VA, Vidal JLC. Characterization of Event Related Desynchronization in Chronic Stroke Using Motor Imagery Based Brain Computer Interface for Upper Limb Rehabilitation. Ann Indian Acad Neurol 2024; 27:297-306. [PMID: 38835164 PMCID: PMC11232817 DOI: 10.4103/aian.aian_1056_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/02/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVE Motor imagery-based brain-computer interface (MI-BCI) is a promising novel mode of stroke rehabilitation. The current study aims to investigate the feasibility of MI-BCI in upper limb rehabilitation of chronic stroke survivors and also to study the early event-related desynchronization after MI-BCI intervention. METHODS Changes in the characteristics of sensorimotor rhythm modulations in response to a short brain-computer interface (BCI) intervention for upper limb rehabilitation of stroke-disabled hand and normal hand were examined. The participants were trained to modulate their brain rhythms through motor imagery or execution during calibration, and they played a virtual marble game during the feedback session, where the movement of the marble was controlled by their sensorimotor rhythm. RESULTS Ipsilesional and contralesional activities were observed in the brain during the upper limb rehabilitation using BCI intervention. All the participants were able to successfully control the position of the virtual marble using their sensorimotor rhythm. CONCLUSIONS The preliminary results support the feasibility of BCI in upper limb rehabilitation and unveil the capability of MI-BCI as a promising medical intervention. This study provides a strong platform for clinicians to build upon new strategies for stroke rehabilitation by integrating MI-BCI with various therapeutic options to induce neural plasticity and recovery.
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Affiliation(s)
- Sagila K Gangadharan
- Department of Electrical Engineering, Indian Institute of Technology Palakkad, Palakkad, Kerala, India
| | - Subasree Ramakrishnan
- Department of Neurology, National Institute of Mental Health and Neuroscience, Bengaluru, Karnataka, India
| | - Andrew Paek
- Department of Electrical and Computer Engineering, Noninvasive Brain Machine Interface Systems Lab, University of Houston, Houston, USA
| | - Akshay Ravindran
- Department of Electrical and Computer Engineering, Noninvasive Brain Machine Interface Systems Lab, University of Houston, Houston, USA
| | - Vinod A Prasad
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore
| | - Jose L Contreras Vidal
- Department of Electrical and Computer Engineering, Noninvasive Brain Machine Interface Systems Lab, University of Houston, Houston, USA
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3
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Gentile AE, Rinella S, Desogus E, Verrelli CM, Iosa M, Perciavalle V, Ruggieri M, Polizzi A. Motor imagery for paediatric neurorehabilitation: how much do we know? Perspectives from a systematic review. Front Hum Neurosci 2024; 18:1245707. [PMID: 38571523 PMCID: PMC10987782 DOI: 10.3389/fnhum.2024.1245707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/28/2024] [Indexed: 04/05/2024] Open
Abstract
Background Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders. Objectives Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders. Methods systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales. Results Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies. Conclusion MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.
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Affiliation(s)
- Amalia Egle Gentile
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Sergio Rinella
- Department of Educational Science, Chair of Pediatrics, University of Catania, Catania, Italy
| | - Eleonora Desogus
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | | | - Marco Iosa
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation (IRCCS), Rome, Italy
| | | | - Martino Ruggieri
- Unit of Clinical Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agata Polizzi
- Department of Educational Science, Chair of Pediatrics, University of Catania, Catania, Italy
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Sánchez Cuesta FJ, González-Zamorano Y, Moreno-Verdú M, Vourvopoulos A, Serrano IJ, Del Castillo-Sobrino MD, Figueiredo P, Romero JP. Effects of motor imagery-based neurofeedback training after bilateral repetitive transcranial magnetic stimulation on post-stroke upper limb motor function: an exploratory crossover clinical trial. J Rehabil Med 2024; 56:jrm18253. [PMID: 38450442 PMCID: PMC10938141 DOI: 10.2340/jrm.v56.18253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE To examine the clinical effects of combining motor imagery-based neurofeedback training with bilateral repetitive transcranial magnetic stimulation for upper limb motor function in subacute and chronic stroke. DESIGN Clinical trial following an AB/BA crossover design with counterbalanced assignment. SUBJECTS Twenty individuals with subacute (n = 4) or chronic stroke (n = 16). METHODS Ten consecutive sessions of bilateral repetitive transcranial magnetic stimulation alone (therapy A) were compared vs a combination of10 consecutive sessions of bilateral repetitive transcranial magnetic stimulation with 12 non-consecutive sessions of motor imagery-based neurofeedback training (therapy B). Patients received both therapies (1-month washout period), in sequence AB or BA. Participants were assessed before and after each therapy and at 15-days follow-up, using the Fugl-Meyer Assessment-upper limb, hand-grip strength, and the Nottingham Sensory Assessment as primary outcome measures. RESULTS Both therapies resulted in improved functionality and sensory function. Therapy B consistently exhibited superior effects compared with therapy A, according to Fugl-Meyer Assessment and tactile and kinaesthetic sensory function across multiple time-points, irrespective of treatment sequence. No statistically significant differences between therapies were found for hand-grip strength. CONCLUSION Following subacute and chronic stroke, integrating bilateral repetitive transcranial magnetic stimulation and motor imagery-based neurofeedback training has the potential to enhance functional performance compared with using bilateral repetitive transcranial magnetic stimulation alone in upper limb recovery.
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Affiliation(s)
- Francisco José Sánchez Cuesta
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
| | - Yeray González-Zamorano
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, King Juan Carlos University, Alcorcón, Spain; Cognitive Neuroscience, Pain, and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Marcos Moreno-Verdú
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain.
| | - Athanasios Vourvopoulos
- Institute for Systems and Robotics-Lisboa, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Ignacio J Serrano
- Neural and Cognitive Engineering group, Centre for Automation and Robotics (CAR) CSIC-UPM, Arganda del Rey, Madrid, Spain
| | | | - Patrícia Figueiredo
- Institute for Systems and Robotics-Lisboa, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Juan Pablo Romero
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain.
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Khan MA, Fares H, Ghayvat H, Brunner IC, Puthusserypady S, Razavi B, Lansberg M, Poon A, Meador KJ. A systematic review on functional electrical stimulation based rehabilitation systems for upper limb post-stroke recovery. Front Neurol 2023; 14:1272992. [PMID: 38145118 PMCID: PMC10739305 DOI: 10.3389/fneur.2023.1272992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Background Stroke is one of the most common neurological conditions that often leads to upper limb motor impairments, significantly affecting individuals' quality of life. Rehabilitation strategies are crucial in facilitating post-stroke recovery and improving functional independence. Functional Electrical Stimulation (FES) systems have emerged as promising upper limb rehabilitation tools, offering innovative neuromuscular reeducation approaches. Objective The main objective of this paper is to provide a comprehensive systematic review of the start-of-the-art functional electrical stimulation (FES) systems for upper limb neurorehabilitation in post-stroke therapy. More specifically, this paper aims to review different types of FES systems, their feasibility testing, or randomized control trials (RCT) studies. Methods The FES systems classification is based on the involvement of patient feedback within the FES control, which mainly includes "Open-Loop FES Systems" (manually controlled) and "Closed-Loop FES Systems" (brain-computer interface-BCI and electromyography-EMG controlled). Thus, valuable insights are presented into the technological advantages and effectiveness of Manual FES, EEG-FES, and EMG-FES systems. Results and discussion The review analyzed 25 studies and found that the use of FES-based rehabilitation systems resulted in favorable outcomes for the stroke recovery of upper limb functional movements, as measured by the FMA (Fugl-Meyer Assessment) (Manually controlled FES: mean difference = 5.6, 95% CI (3.77, 7.5), P < 0.001; BCI-controlled FES: mean difference = 5.37, 95% CI (4.2, 6.6), P < 0.001; EMG-controlled FES: mean difference = 14.14, 95% CI (11.72, 16.6), P < 0.001) and ARAT (Action Research Arm Test) (EMG-controlled FES: mean difference = 11.9, 95% CI (8.8, 14.9), P < 0.001) scores. Furthermore, the shortcomings, clinical considerations, comparison to non-FES systems, design improvements, and possible future implications are also discussed for improving stroke rehabilitation systems and advancing post-stroke recovery. Thus, summarizing the existing literature, this review paper can help researchers identify areas for further investigation. This can lead to formulating research questions and developing new studies aimed at improving FES systems and their outcomes in upper limb rehabilitation.
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Affiliation(s)
- Muhammad Ahmed Khan
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
- Department of Electrical Engineering, Stanford University, Palo Alto, CA, United States
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Hoda Fares
- Department of Electrical, Electronic, Telecommunication Engineering and Naval Architecture (DITEN), University of Genoa, Genoa, Italy
| | - Hemant Ghayvat
- Department of Computer Science, Linnaeus University, Växjö, Sweden
| | | | | | - Babak Razavi
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
| | - Maarten Lansberg
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
| | - Ada Poon
- Department of Electrical Engineering, Stanford University, Palo Alto, CA, United States
| | - Kimford Jay Meador
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
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Chen J, Xia Y, Zhou X, Vidal Rosas E, Thomas A, Loureiro R, Cooper RJ, Carlson T, Zhao H. fNIRS-EEG BCIs for Motor Rehabilitation: A Review. Bioengineering (Basel) 2023; 10:1393. [PMID: 38135985 PMCID: PMC10740927 DOI: 10.3390/bioengineering10121393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Motor impairment has a profound impact on a significant number of individuals, leading to a substantial demand for rehabilitation services. Through brain-computer interfaces (BCIs), people with severe motor disabilities could have improved communication with others and control appropriately designed robotic prosthetics, so as to (at least partially) restore their motor abilities. BCI plays a pivotal role in promoting smoother communication and interactions between individuals with motor impairments and others. Moreover, they enable the direct control of assistive devices through brain signals. In particular, their most significant potential lies in the realm of motor rehabilitation, where BCIs can offer real-time feedback to assist users in their training and continuously monitor the brain's state throughout the entire rehabilitation process. Hybridization of different brain-sensing modalities, especially functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), has shown great potential in the creation of BCIs for rehabilitating the motor-impaired populations. EEG, as a well-established methodology, can be combined with fNIRS to compensate for the inherent disadvantages and achieve higher temporal and spatial resolution. This paper reviews the recent works in hybrid fNIRS-EEG BCIs for motor rehabilitation, emphasizing the methodologies that utilized motor imagery. An overview of the BCI system and its key components was introduced, followed by an introduction to various devices, strengths and weaknesses of different signal processing techniques, and applications in neuroscience and clinical contexts. The review concludes by discussing the possible challenges and opportunities for future development.
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Affiliation(s)
- Jianan Chen
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (J.C.); (Y.X.); (X.Z.); (A.T.)
| | - Yunjia Xia
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (J.C.); (Y.X.); (X.Z.); (A.T.)
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, University College London (UCL), London WC1E 6BT, UK; (E.V.R.); (R.J.C.)
| | - Xinkai Zhou
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (J.C.); (Y.X.); (X.Z.); (A.T.)
| | - Ernesto Vidal Rosas
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, University College London (UCL), London WC1E 6BT, UK; (E.V.R.); (R.J.C.)
- Digital Health and Biomedical Engineering, School of Electronics and Computer Science, University of Southampton, Southampton SO17 1BJ, UK
| | - Alexander Thomas
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (J.C.); (Y.X.); (X.Z.); (A.T.)
- Aspire CREATe, Department of Orthopaedics & Musculoskeletal Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (R.L.); (T.C.)
| | - Rui Loureiro
- Aspire CREATe, Department of Orthopaedics & Musculoskeletal Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (R.L.); (T.C.)
| | - Robert J. Cooper
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, University College London (UCL), London WC1E 6BT, UK; (E.V.R.); (R.J.C.)
| | - Tom Carlson
- Aspire CREATe, Department of Orthopaedics & Musculoskeletal Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (R.L.); (T.C.)
| | - Hubin Zhao
- HUB of Intelligent Neuro-engineering (HUBIN), Aspire CREATe, IOMS, Division of Surgery and Interventional Science, University College London (UCL), Stanmore, London HA7 4LP, UK; (J.C.); (Y.X.); (X.Z.); (A.T.)
- DOT-HUB, Department of Medical Physics & Biomedical Engineering, University College London (UCL), London WC1E 6BT, UK; (E.V.R.); (R.J.C.)
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Lim RY, Ang KK, Chew E, Guan C. A Review on Motor Imagery with Transcranial Alternating Current Stimulation: Bridging Motor and Cognitive Welfare for Patient Rehabilitation. Brain Sci 2023; 13:1584. [PMID: 38002544 PMCID: PMC10670393 DOI: 10.3390/brainsci13111584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/26/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Research has shown the effectiveness of motor imagery in patient motor rehabilitation. Transcranial electrical stimulation has also demonstrated to improve patient motor and non-motor performance. However, mixed findings from motor imagery studies that involved transcranial electrical stimulation suggest that current experimental protocols can be further improved towards a unified design for consistent and effective results. This paper aims to review, with some clinical and neuroscientific findings from literature as support, studies of motor imagery coupled with different types of transcranial electrical stimulation and their experiments onhealthy and patient subjects. This review also includes the cognitive domains of working memory, attention, and fatigue, which are important for designing consistent and effective therapy protocols. Finally, we propose a theoretical all-inclusive framework that synergizes the three cognitive domains with motor imagery and transcranial electrical stimulation for patient rehabilitation, which holds promise of benefiting patients suffering from neuromuscular and cognitive disorders.
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Affiliation(s)
- Rosary Yuting Lim
- Institute for Infocomm Research, Agency for Science Technology and Research, A*STAR, 1 Fusionopolis Way, #21-01 Connexis, Singapore 138632, Singapore;
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science Technology and Research, A*STAR, 1 Fusionopolis Way, #21-01 Connexis, Singapore 138632, Singapore;
- School of Computer Science and Engineering, Nanyang Technological University, 50 Nanyang Ave., #32 Block N4 #02a, Singapore 639798, Singapore;
| | - Effie Chew
- Division of Rehabilitation Medicine, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore;
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore
| | - Cuntai Guan
- School of Computer Science and Engineering, Nanyang Technological University, 50 Nanyang Ave., #32 Block N4 #02a, Singapore 639798, Singapore;
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Seok H, Choi YH. The Impact of Mental Practice on Motor Function in Patients With Stroke: A Systematic Review and Meta-analysis. BRAIN & NEUROREHABILITATION 2023; 16:e31. [PMID: 38047096 PMCID: PMC10689861 DOI: 10.12786/bn.2023.16.e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Mental practice (MP), the cognitive rehearsal of physical activities without overt movements, has recently emerged as a promising rehabilitation method for patients with stroke. This paper presents a systematic review and meta-analysis critically evaluating the existing evidence to offer a comprehensive estimate of the overall effect of MP on motor function in stroke patients. A systematic search of 3 international databases (PubMed, Embase, and the Cochrane Library) was conducted for randomized controlled trials. We finally selected 31 randomized clinical trials and conducted meta-analysis to determine the effectiveness of MP on motor recovery of upper extremity, upper extremity function, activities of daily living, and gait velocity in stroke patients. The results of the systematic reviews showed that MP combined with conventional therapy has a positive impact on improving upper extremity motor function, with a moderate quality of evidence. However, the beneficial effect of MP on gait velocity was not demonstrated. It is recommended to treat with MP in addition to conventional rehabilitation therapy to improve the motor outcome of stroke depending on the patient's condition (Recommendation level: Conditional Recommend Evidence certainty: Moderate).
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Affiliation(s)
- Hyun Seok
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon-Hee Choi
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Sui YF, Cui ZH, Song ZH, Fan QQ, Lin XF, Li B, Tong LQ. Effects of trunk training using motor imagery on trunk control ability and balance function in patients with stroke. BMC Sports Sci Med Rehabil 2023; 15:142. [PMID: 37884964 PMCID: PMC10601186 DOI: 10.1186/s13102-023-00753-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE To explore the effects of trunk training using motor imagery on trunk control and balance function in patients with stroke. METHODS One hundred eligible stroke patients were randomly divided into a control group and trial group. The control group was given routine rehabilitation therapy, while the trial group was given routine rehabilitation therapy and trunk training using motor imagery. RESULTS Prior to treatment, there was no significant difference between the two groups (P > 0.05) in Sheikh's trunk control ability, Berg rating scale (BBS), Fugl-Meyer assessment (FMA), movement length, movement area, average front-rear movement speed, average left-right movement speed, and surface electromyography (sEMG) signal of the bilateral erector spinae and rectus abdominis. After treatment, Sheikh's trunk control ability, FMA, and BBS in the two groups were significantly higher than those before treatment (P < 0.05). The movement length, movement area, the average front-rear movement speed, and the average left-right movement speed in the two groups decreased significantly (P < 0.05). The differences of these indicators between the two groups were statistically significant (P < 0.05). After treatment, the rectus abdominis and erector spinae on the affected side of the two groups improved when compared with those before treatment (P < 0.05). The rectus abdominis and erector spinae on the healthy side of the trial group descended after treatment (P < 0.05), while little changes were observed on the healthy side of the control group after treatment (P > 0.05). The rectus abdominis and erector spinae on the affected side of the trial group improved when compared with those in the control group (P < 0.05). There was no significant difference between the two groups in the decline of abdominalis rectus and erector spinal muscle on the healthy side. CONCLUSION Trunk training using motor imagery can significantly improve the trunk control ability and balance function of stroke patients and is conducive to promoting the recovery of motor function.
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Affiliation(s)
- Yan-Fang Sui
- Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, 570208, China
| | - Zhen-Hua Cui
- Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, 570208, China
| | - Zhen-Hua Song
- Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, 570208, China
| | - Qian-Qian Fan
- Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, 570208, China
| | - Xia-Fei Lin
- Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, 570208, China
| | - Binbin Li
- Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, 570208, China
| | - Lang-Qian Tong
- Department of nuclear medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, No.43 of Renmin Road, Haikou District, Haikou, 570208, China.
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Almufareh MF, Kausar S, Humayun M, Tehsin S. Leveraging Motor Imagery Rehabilitation for Individuals with Disabilities: A Review. Healthcare (Basel) 2023; 11:2653. [PMID: 37830690 PMCID: PMC10572951 DOI: 10.3390/healthcare11192653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
Motor imagery, an intricate cognitive procedure encompassing the mental simulation of motor actions, has surfaced as a potent strategy within the neuro-rehabilitation domain. It presents a non-invasive, economically viable method for facilitating individuals with disabilities in enhancing their motor functionality and regaining self-sufficiency. This manuscript delivers an exhaustive analysis of the significance of motor imagery in augmenting functional rehabilitation for individuals afflicted with physical impairments. It investigates the fundamental mechanisms governing motor imagery, its applications across diverse disability conditions, and the prospective advantages it renders. Moreover, this document addresses the prevailing obstacles and prospective trajectories in this sector, accentuating the necessity for continued investigation and the invention of cutting-edge technologies that optimize the potentiality of motor imagery in aiding disabled persons.
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Affiliation(s)
- Maram Fahaad Almufareh
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakakah 72388, Saudi Arabia
| | - Sumaira Kausar
- Center of Excellence in Artificial Intelligence COE-AI, Department of CS, Bahria University, Islamabad 44000, Pakistan; (S.K.); (S.T.)
| | - Mamoona Humayun
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakakah 72388, Saudi Arabia
| | - Samabia Tehsin
- Center of Excellence in Artificial Intelligence COE-AI, Department of CS, Bahria University, Islamabad 44000, Pakistan; (S.K.); (S.T.)
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Šlosar L, Puš K, Marušič U. Validation of the Slovenian Version of the Movement Imagery Questionnaire for Children (MIQ-C): A Measurement Tool to Assess the Imagery Ability of Motor Tasks in Children. Zdr Varst 2023; 62:113-120. [PMID: 37327132 PMCID: PMC10263371 DOI: 10.2478/sjph-2023-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/17/2023] [Indexed: 06/18/2023] Open
Abstract
Purpose The ability to perform motor imagery has been shown to influence individual athletic performance and rehabilitation. Recent evidence supports its potential as a training tool to improve motor skills in children. Although there is a standardized assessment of the imagery abilities in Slovenian-speaking adults, there is currently no validated instrument for use with Slovenian children. Therefore, the aim of the present study was to conduct a linguistic validation study of the movement imagery questionnaire for children (MIQ-C). Methods A total of 100 healthy children (mean age 10.3±1.3 years; 50 female) were assessed with a Slovenian version of the MIQ-C at Day 1 and Day 8. Inter-day agreement was examined using intraclass correlation coefficients (ICC). Construct validity and internal consistency were assessed using a Cronbach's alpha coefficient and exploratory - confirmatory factor analysis, respectively. Results The test-retest ICC were very high for all three scales examined (ICCKI=0.90; ICCIVI=0.92; ICCEVI=0.90). Excellent internal consistency (up to 0.90) was found for kinaesthetic and both visual imageries. Confirmatory analysis confirmed a three-factorial structure of the MIQ-C. Conclusions The Slovenian version of the MIQ-C proved to be highly reliable and valid in assessing children's motor imagery abilities, and as such for use with Slovene-speaking children. Moreover, this standardized instrument can be a helpful tool in training and rehabilitation practice with children aged 7-12 years.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Kozlovičeva 23, 6000Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Slovenska 17, 2000Maribor, Slovenia
| | - Katarina Puš
- Science and Research Centre Koper, Institute for Kinesiology Research, Kozlovičeva 23, 6000Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Slovenska 17, 2000Maribor, Slovenia
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000Ljubljana, Slovenia
| | - Uroš Marušič
- Science and Research Centre Koper, Institute for Kinesiology Research, Kozlovičeva 23, 6000Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Slovenska 17, 2000Maribor, Slovenia
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12
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Zhang K, Wang H, Wang X, Xiong X, Tong S, Sun C, Zhu B, Xu Y, Fan M, Sun L, Guo X. Neuroimaging prognostic factors for treatment response to motor imagery training after stroke. Cereb Cortex 2023; 33:9504-9513. [PMID: 37376787 DOI: 10.1093/cercor/bhad220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
The efficacy of motor imagery training for motor recovery is well acknowledged, but with substantial inter-individual variability in stroke patients. To help optimize motor imagery training therapy plans and screen suitable patients, this study aimed to explore neuroimaging biomarkers explaining variability in treatment response. Thirty-nine stroke patients were randomized to a motor imagery training group (n = 22, received a combination of conventional rehabilitation therapy and motor imagery training) and a control group (n = 17, received conventional rehabilitation therapy and health education) for 4 weeks of interventions. Their demography and clinical information, brain lesion from structural MRI, spontaneous brain activity and connectivity from rest fMRI, and sensorimotor brain activation from passive motor task fMRI were acquired to identify prognostic factors. We found that the variability of outcomes from sole conventional rehabilitation therapy could be explained by the reserved sensorimotor neural function, whereas the variability of outcomes from motor imagery training + conventional rehabilitation therapy was related to the spontaneous activity in the ipsilesional inferior parietal lobule and the local connectivity in the contralesional supplementary motor area. The results suggest that additional motor imagery training treatment is also efficient for severe patients with damaged sensorimotor neural function, but might be more effective for patients with impaired motor planning and reserved motor imagery.
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Affiliation(s)
- Kexu Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hewei Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200240, China
| | - Xu Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xin Xiong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Shanbao Tong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Changhui Sun
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200240, China
| | - Bing Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200240, China
| | - Yiming Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200240, China
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai 200241, China
| | - Limin Sun
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200240, China
| | - Xiaoli Guo
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
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13
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Autonomous grasping of 3-D objects by a vision-actuated robot arm using Brain–Computer Interface. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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14
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Kurkin S, Gordleeva S, Savosenkov A, Grigorev N, Smirnov N, Grubov VV, Udoratina A, Maksimenko V, Kazantsev V, Hramov AE. Transcranial Magnetic Stimulation of the Dorsolateral Prefrontal Cortex Increases Posterior Theta Rhythm and Reduces Latency of Motor Imagery. SENSORS (BASEL, SWITZERLAND) 2023; 23:4661. [PMID: 37430576 DOI: 10.3390/s23104661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 07/12/2023]
Abstract
Experiments show activation of the left dorsolateral prefrontal cortex (DLPFC) in motor imagery (MI) tasks, but its functional role requires further investigation. Here, we address this issue by applying repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC and evaluating its effect on brain activity and the latency of MI response. This is a randomized, sham-controlled EEG study. Participants were randomly assigned to receive sham (15 subjects) or real high-frequency rTMS (15 subjects). We performed EEG sensor-level, source-level, and connectivity analyses to evaluate the rTMS effects. We revealed that excitatory stimulation of the left DLPFC increases theta-band power in the right precuneus (PrecuneusR) via the functional connectivity between them. The precuneus theta-band power negatively correlates with the latency of the MI response, so the rTMS speeds up the responses in 50% of participants. We suppose that posterior theta-band power reflects attention modulation of sensory processing; therefore, high power may indicate attentive processing and cause faster responses.
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Affiliation(s)
- Semen Kurkin
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
| | - Susanna Gordleeva
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Andrey Savosenkov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Nikita Grigorev
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Nikita Smirnov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
| | - Vadim V Grubov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
| | - Anna Udoratina
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Vladimir Maksimenko
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Victor Kazantsev
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
| | - Alexander E Hramov
- Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, 236016 Kaliningrad, Russia
- Neurodynamics and Cognitive Technology Laboratory, Lobachevsky State University of Nizhny Novgorod, 603105 Nizhniy Novgorod, Russia
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15
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Zhao LJ, Jiang LH, Zhang H, Li Y, Sun P, Liu Y, Qi R. Effects of Motor Imagery Training for Lower Limb Dysfunction in Patients With Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Phys Med Rehabil 2023; 102:409-418. [PMID: 36170751 PMCID: PMC10125126 DOI: 10.1097/phm.0000000000002107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study is to determine the effects of motor imagery training associated with conventional rehabilitation therapies on lower limb motor function recovery in poststroke patients. DESIGN Comprehensive literature searches were performed to identify studies published before June 5, 2022. RevMan 5.3 software was used for meta-analysis. The quality of the included studies was assessed using the Cochrane risk-of-bias tool and the modified Jadad scale. The certainty of the evidence was evaluated with the Grading of Recommendations, Assessment, Development and Evaluations system. RESULT Twenty-three trials and/or 1109 participants with motor imagery training ability were included in this review. Motor imagery training combined with conventional rehabilitation therapies versus conventional rehabilitation therapies demonstrated significant benefits in motor function, balance function, temporospatial gait variables (walking speed, stride length, and cadence) and activities of daily living. Subgroup analysis demonstrated that motor imagery training-conventional rehabilitation therapies had a better effect on improvement in motor function and activities of daily living in the acute phase and had a greater benefit on walking speed in the chronic phase. In addition, motor imagery training-conventional rehabilitation therapies resulted in greater improvements in stride length, cadence, walking ability, and balance function in the subacute phase. CONCLUSIONS Motor imagery training-conventional rehabilitation therapies have better effects on the recovery of lower limb motor function in poststroke patients than conventional rehabilitation therapies, which may be most beneficial for lower extremity motor function recovery in the first 7 days to 6 mos.
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16
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Fujiwara K, Shibata M, Awano Y, Iso N, Shibayama K, Higashi T. Differences in Cortical Area Activity and Motor Imagery Vivid-Ness during Evaluation of Motor Imagery Tasks in Right and Left Hemiplegics. Brain Sci 2023; 13:brainsci13050748. [PMID: 37239220 DOI: 10.3390/brainsci13050748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/18/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
The ability to develop vivid motor imagery (MI) is important for effective mental practice. Therefore, we aimed to determine differences in the MI clarity and cortical area activity between patients with right hemiplegia and left hemiplegia after stroke in an MI task. In total, 11 participants with right hemiplegia and 14 with left hemiplegia were categorized into two groups. The MI task required the flexion and extension of the finger on the paralyzed side. Considering that MI vividness changes with MI practice, we measured the MI vividness and cortical area activity during the task before and after MI practice. MI vividness was evaluated subjectively using the visual analog scale, and cerebral hemodynamics during the task were measured using near-infrared spectroscopy in cortical regions during the MI task. The MI sharpness and cortical area activity in the MI task were significantly lower in the right hemiplegia group than in the left hemiplegia group. Therefore, when practicing mental practices with right hemiplegia, it is necessary to devise ways by which to increase MI vividness.
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Affiliation(s)
- Kengo Fujiwara
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8520, Japan
| | - Masatomo Shibata
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan
| | - Yoshinaga Awano
- School Corporation Tamaki Gakuen Nagasaki College of Medical Technology, Nagasaki 850-0822, Japan
| | - Naoki Iso
- Faculty of Health Sciences, Tokyo Kasei University, Saitama 350-1398, Japan
| | - Koji Shibayama
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan
| | - Toshio Higashi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8520, Japan
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17
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Seebacher B, Reindl M, Kahraman T. Factors and strategies affecting motor imagery ability in people with multiple sclerosis: a systematic review. Physiotherapy 2023; 118:64-78. [PMID: 36184292 DOI: 10.1016/j.physio.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 07/03/2022] [Accepted: 09/13/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although growing evidence has shown beneficial effects of motor imagery (MI) training in different populations including people with multiple sclerosis (pwMS), not all patients with neurological diseases may benefit from MI. OBJECTIVES To investigate factors and strategies affecting and enhancing MI ability in pwMS. DATA SOURCES MEDLINE/PubMed, PsycINFO, Cochrane Library, Scopus, EMBASE, EBSCOhost, Web of Science and REHABDATA databases, clinical trials registries, dissertation repositories, study bibliographies and internet search engines were searched through August 2021. STUDY SELECTION Any study type but single case studies investigating factors or strategies contributing to MI ability in pwMS. STUDY APPRAISAL AND SYNTHESIS METHODS Risk of bias (RoB) was assessed using the Joanna Briggs Institute Checklist for Case-Control and Analytical Cross-Sectional Studies and Cochrane RoB-2.0 tool for randomised trials. A qualitative synthesis was performed summarising main results. RESULTS Eight databases, 4 trial registries, 9 dissertation repositories, and 1 internet search engine were searched. Fourteen studies including 366 pwMS and 236 healthy controls were included. Most frequently, cognitive impairment was reported as a negative factor influencing MI ability in pwMS. Other negative factors were cognitive fatigue and disability. Inconsistent evidence was found on the contribution of MS phenotype, anxiety, and depression. Using a theory-based MI framework and familiarisation to MI and external cueing may enhance MI ability. LIMITATIONS Eligible studies were highly heterogeneous. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS Cognitive impairment, cognitive fatigue and disability negatively influence MI ability in pwMS. Visual and/or auditory cueing of MI are strategies for facilitating MI ability. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020173081 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Barbara Seebacher
- Clinical Department of Neurology, Medical University of Innsbruck, Austria; Department of Rehabilitation Research, Rehab Centre Münster, Austria.
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Turkey
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18
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Lambert KJM, Hoar C, Houle J, Motley C, Ball N, Leung AWS. Motor imagery as an intervention to improve activities of daily living post-stroke: A systematic review of randomized controlled trials. Br J Occup Ther 2023. [DOI: 10.1177/03080226221145441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Introduction: Motor imagery (MI) may be an effective tool for improving activities of daily living (ADL) post-stroke. However, no review to date has examined ADL independence when investigating training effectiveness. This review aimed to evaluate the quality of evidence and the effectiveness of MI training for improving ADL independence post-stroke. Method: Randomized controlled trial (RCT) studies comparing MI to conventional therapies were reviewed. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Results: Thirteen articles met inclusion criteria. The overall quality was considered moderate to good, with a PEDro score ranging from 3 to 8. Most studies (9 out of 13) were considered good quality, with one rating of poor quality and three of fair quality. The primary findings suggest that MI training is a low-risk tool that may facilitate ADL independence. Audio-based MI training seems to improve ADL independence when paired with other rehabilitation methods, but the results should be interpreted with caution. Conclusion: To our knowledge, this is the first systematic review to examine RCTs investigating MI effectiveness in improving ADL post-stroke. Results support the use of MI to facilitate ADL independence. However, more research is needed to establish practice guidelines for implementing MI training post-stroke.
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Affiliation(s)
- Kathryn JM Lambert
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Cole Hoar
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jordan Houle
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Catrin Motley
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Natalie Ball
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ada WS Leung
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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19
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Martel M, Glover S. TMS over dorsolateral prefrontal cortex affects the timing of motor imagery but not overt action: Further support for the motor-cognitive model. Behav Brain Res 2023; 437:114125. [PMID: 36167217 DOI: 10.1016/j.bbr.2022.114125] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/08/2022] [Accepted: 09/23/2022] [Indexed: 11/27/2022]
Abstract
The Motor-Cognitive model suggests a functional dissociation between motor imagery and overt action, in contrast to the Functional Equivalence view of common processes between the two behaviours. According to the Motor-Cognitive model, motor imagery differs from overt action primarily through the use of executive resources to monitor and elaborate a motor image during execution, which can result in a lack of correspondence between motor imagery and its overt action counterpart. The present study examined the importance of executive resources in motor imagery by using TMS to impair the function of the dorsolateral prefrontal cortex while measuring the time to complete imagined versus overt actions. In two experiments, TMS over the dorsolateral prefrontal cortex slowed motor imagery but did not affect overt actions. TMS over the same region also interfered with performance of a mental calculation task, though it did not reliably affect less demanding cognitive tasks also thought to rely on executive functions. Taken together, these results were consistent with the Motor-Cognitive model but not with the idea of functional equivalence. The implications of these results for the theoretical understanding of motor imagery, and potential applications of the Motor-Cognitive model to the use of motor imagery in training and rehabilitation, are discussed.
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Affiliation(s)
- Marie Martel
- Department of Psychology, Royal Holloway University of London, UK.
| | - Scott Glover
- Department of Psychology, Royal Holloway University of London, UK
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20
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Grevet E, Forge K, Tadiello S, Izac M, Amadieu F, Brunel L, Pillette L, Py J, Gasq D, Jeunet-Kelway C. Modeling the acceptability of BCIs for motor rehabilitation after stroke: A large scale study on the general public. FRONTIERS IN NEUROERGONOMICS 2023; 3:1082901. [PMID: 38235470 PMCID: PMC10790937 DOI: 10.3389/fnrgo.2022.1082901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/09/2022] [Indexed: 01/19/2024]
Abstract
Introduction Strokes leave around 40% of survivors dependent in their activities of daily living, notably due to severe motor disabilities. Brain-computer interfaces (BCIs) have been shown to be efficiency for improving motor recovery after stroke, but this efficiency is still far from the level required to achieve the clinical breakthrough expected by both clinicians and patients. While technical levers of improvement have been identified (e.g., sensors and signal processing), fully optimized BCIs are pointless if patients and clinicians cannot or do not want to use them. We hypothesize that improving BCI acceptability will reduce patients' anxiety levels, while increasing their motivation and engagement in the procedure, thereby favoring learning, ultimately, and motor recovery. In other terms, acceptability could be used as a lever to improve BCI efficiency. Yet, studies on BCI based on acceptability/acceptance literature are missing. Thus, our goal was to model BCI acceptability in the context of motor rehabilitation after stroke, and to identify its determinants. Methods The main outcomes of this paper are the following: i) we designed the first model of acceptability of BCIs for motor rehabilitation after stroke, ii) we created a questionnaire to assess acceptability based on that model and distributed it on a sample representative of the general public in France (N = 753, this high response rate strengthens the reliability of our results), iii) we validated the structure of this model and iv) quantified the impact of the different factors on this population. Results Results show that BCIs are associated with high levels of acceptability in the context of motor rehabilitation after stroke and that the intention to use them in that context is mainly driven by the perceived usefulness of the system. In addition, providing people with clear information regarding BCI functioning and scientific relevance had a positive influence on acceptability factors and behavioral intention. Discussion With this paper we propose a basis (model) and a methodology that could be adapted in the future in order to study and compare the results obtained with: i) different stakeholders, i.e., patients and caregivers; ii) different populations of different cultures around the world; and iii) different targets, i.e., other clinical and non-clinical BCI applications.
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Affiliation(s)
- Elise Grevet
- CNRS, EPHE, INCIA, UMR5287, Université de Bordeaux, Bordeaux, France
| | - Killyam Forge
- CLLE, Université de Toulouse, CNRS, Toulouse, France
| | | | - Margaux Izac
- CNRS, EPHE, INCIA, UMR5287, Université de Bordeaux, Bordeaux, France
| | | | - Lionel Brunel
- Université Paul Valéry Montpellier 3, EPSYLON EA 4556, Montpellier, France
| | - Léa Pillette
- CNRS, EPHE, INCIA, UMR5287, Université de Bordeaux, Bordeaux, France
| | - Jacques Py
- CLLE, Université de Toulouse, CNRS, Toulouse, France
| | - David Gasq
- ToNIC, Université de Toulouse, INSERM, Toulouse, France
- Centre Hospitalier Universitaire Toulouse, Toulouse, France
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21
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Haslam BS, Butler DS, Cocks TS, Kim AS, Carey LM. Body Schema as Assessed by Upper Limb Left/Right Judgment Tasks Is Altered in Stroke: Implications for Motor Imagery Training. J Neurol Phys Ther 2023; 47:26-34. [PMID: 36534017 DOI: 10.1097/npt.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Individuals with stroke often experience significant impairment of the upper limb. Rehabilitation interventions targeting the upper limb are typically associated with only small to moderate gains. The knowledge that body schema can be altered in other upper limb conditions has contributed to the development of tailored rehabilitation approaches. This study investigated whether individuals with stroke experienced alterations in body schema of the upper limb. If so, this knowledge may have implications for rehabilitation approaches such as motor imagery. METHODS An observational study performed online consisting of left/right judgment tasks assessed by response time and accuracy of: (i) left/right direction recognition; (ii) left/right shoulder laterality recognition; (iii) left/right hand laterality recognition; (iv) mental rotation of nonembodied objects. Comparisons were made between individuals with and without stroke. Secondary comparisons were made in the stroke population according to side of stroke and side of pain if experienced. RESULTS A total of 895 individuals (445 with stroke) participated. Individuals with stroke took longer for all tasks compared to those without stroke, and were less accurate in correctly identifying the laterality of shoulder (P < 0.001) and hand (P < 0.001) images, and the orientation of nonembodied objects (P < 0.001). Moreover, the differences observed in the hand and shoulder tasks were greater than what was observed for the control tasks of directional recognition and nonembodied mental rotation. No significant differences were found between left/right judgments of individuals with stroke according to stroke-affected side or side of pain. DISCUSSION AND CONCLUSIONS Left/right judgments of upper limb are frequently impaired after stroke, providing evidence of alterations in body schema. The knowledge that body schemas are altered in individuals with longstanding stroke may assist in the development of optimal, well-accepted motor imagery programs for the upper limb.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A394).
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Affiliation(s)
- Brendon S Haslam
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia (B.S.H., L.M.C.); Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia (B.H.S., L.M.C.); School of Health Sciences, University of South Australia, Adelaide, Australia (D.S.B.); Neuro-Orthopaedic Institute, Adelaide, Australia (D.S.B., T.S.C.); and Department of Neurology, Weill Institute of Neurosciences, University of California, San Francisco (A.S.K.)
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22
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Wang H, Xiong X, Zhang K, Wang X, Sun C, Zhu B, Xu Y, Fan M, Tong S, Guo X, Sun L. Motor network reorganization after motor imagery training in stroke patients with moderate to severe upper limb impairment. CNS Neurosci Ther 2022; 29:619-632. [PMID: 36575865 PMCID: PMC9873524 DOI: 10.1111/cns.14065] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Motor imagery training (MIT) has been widely used to improve hemiplegic upper limb function in stroke rehabilitation. The effectiveness of MIT is associated with the functional neuroplasticity of the motor network. Currently, brain activation and connectivity changes related to the motor recovery process after MIT are not well understood. AIM We aimed to investigate the neural mechanisms of MIT in stroke rehabilitation through a longitudinal intervention study design with task-based functional magnetic resonance imaging (fMRI) analysis. METHODS We recruited 39 stroke patients with moderate to severe upper limb motor impairment and randomly assigned them to either the MIT or control groups. Patients in the MIT group received 4 weeks of MIT therapy plus conventional rehabilitation, while the control group only received conventional rehabilitation. The assessment of Fugl-Meyer Upper Limb Scale (FM-UL) and Barthel Index (BI), and fMRI scanning using a passive hand movement task were conducted on all patients before and after treatment. The changes in brain activation and functional connectivity (FC) were analyzed. Pearson's correlation analysis was conducted to evaluate the association between neural functional changes and motor improvement. RESULTS The MIT group achieved higher improvements in FM-UL and BI relative to the control group after the treatment. Passive movement of the affected hand evoked an abnormal bilateral activation pattern in both groups before intervention. A significant Group × Time interaction was found in the contralesional S1 and ipsilesional M1, showing a decrease of activation after intervention specifically in the MIT group, which was negatively correlated with the FM-UL improvement. FC analysis of the ipsilesional M1 displayed the motor network reorganization within the ipsilesional hemisphere, which correlated with the motor score changes. CONCLUSIONS MIT could help decrease the compensatory activation at both hemispheres and reshape the FC within the ipsilesional hemisphere along with functional recovery in stroke patients.
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Affiliation(s)
- Hewei Wang
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Xin Xiong
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Kexu Zhang
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Xu Wang
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Changhui Sun
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Bing Zhu
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Yiming Xu
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
| | - Mingxia Fan
- Shanghai Key Laboratory of Magnetic ResonanceEast China Normal UniversityShanghaiChina
| | - Shanbao Tong
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Xiaoli Guo
- School of Biomedical EngineeringShanghai Jiaotong UniversityShanghaiChina
| | - Limin Sun
- Department of Rehabilitation MedicineHuashan Hospital Fudan UniversityShanghaiChina
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Fujiwara K, Shimoda R, Shibata M, Awano Y, Shibayama K, Higashi T. A Method for Using Video Presentation to Increase Cortical Region Activity during Motor Imagery Tasks in Stroke Patients. Brain Sci 2022; 13:brainsci13010029. [PMID: 36672012 PMCID: PMC9855988 DOI: 10.3390/brainsci13010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Previous studies have reported that stroke patients have difficulty recalling the motor imagery (MI) of a task, also known as MI vividness. Research on combining MI with action observation is gaining importance as a method to improve MI vividness. We enrolled 10 right-handed stroke patients and compared MI vividness and cortical activity under different presentation methods (no inverted image, inverted image of another individual’s hand, and an inverted image of the patient’s nonparalyzed hand) using near-infrared spectroscopy. Images of the nonparalyzed upper limb were inverted to make the paralyzed upper limb appear as if it were moving. Three tasks (non inverted image, AO + MI (other hand), AO + MI (own hand)) were randomly performed on 10 stroke patients. MI vividness was significantly higher when the inverted image of the nonparalyzed upper limb was presented compared to the other conditions (p < 0.01). The activity of the cortical regions was also significantly enhanced (p < 0.01). Our study highlights the potential application of inverted images of a stroke patient’s own nonparalyzed hand in mental practice to promote the motor recovery of stroke patients. This technique achieved higher levels of MI vividness and cortical activity when performing motor tasks.
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Affiliation(s)
- Kengo Fujiwara
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki 852-8520, Japan
- Correspondence: ; Tel.: +81-958-819-7994
| | - Rikako Shimoda
- Medical Corporation Zeshinkai Home Rehabilitation Center Ginya, Ginya, Nagasaki 850-0854, Japan
| | - Masatomo Shibata
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
| | - Yoshinaga Awano
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
| | - Koji Shibayama
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
| | - Toshio Higashi
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki 852-8520, Japan
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Kashoo FZ, Al-Baradie RS, Alzahrani M, Alanazi A, Manzar MD, Gugnani A, Sidiq M, Shaphe MA, Sirajudeen MS, Ahmad M, Althumayri B, Aljandal A, Almansour A, Alshewaier SA, Chahal A. Effect of Transcranial Direct Current Stimulation Augmented with Motor Imagery and Upper-Limb Functional Training for Upper-Limb Stroke Rehabilitation: A Prospective Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15199. [PMID: 36429924 PMCID: PMC9690138 DOI: 10.3390/ijerph192215199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/12/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Combining transcranial direct current stimulation (tDCS) with other therapies is reported to produce promising results in patients with stroke. The purpose of the study was to determine the effect of combining tDCS with motor imagery (MI) and upper-limb functional training for upper-limb rehabilitation among patients with chronic stroke. METHODS A single-center, prospective, randomized controlled trial was conducted among 64 patients with chronic stroke. The control group received sham tDCS with MI, while the experimental group received real tDCS with MI. Both groups performed five different upper-limb functional training exercises coupled with tDCS for 30 min, five times per week for two weeks. Fugl-Meyer's scale (FMA) and the Action Research Arm Test (ARAT) were used to measure the outcome measures at baseline and after the completion of the 10th session. RESULTS Analysis of covariance showed significant improvements in the post-test mean scores for FMA (F (414.4) = 35.79, p < 0.001; η2 = 0.37) and ARAT (F (440.09) = 37.46, p < 0.001; η2 = 0.38) in the experimental group compared to the control group while controlling for baseline scores. CONCLUSIONS Anodal tDCS stimulation over the affected primary motor cortex coupled with MI and upper-limb functional training reduces impairment and disability of the upper limbs among patients with chronic stroke.
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Affiliation(s)
- Faizan Zaffar Kashoo
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Raid Saleem Al-Baradie
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Msaad Alzahrani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Ahmad Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Anchit Gugnani
- NIMS College of Physiotherapy and Occupational Therapy, NIMS University Jaipur, Jaipur 303121, Rajasthan, India
| | - Mohammad Sidiq
- NIMS College of Physiotherapy and Occupational Therapy, NIMS University Jaipur, Jaipur 303121, Rajasthan, India
| | - Mohammad Abu Shaphe
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 82511, Saudi Arabia
| | - Mohamed Sherif Sirajudeen
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Mehrunnisha Ahmad
- Department of Nursing, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Bader Althumayri
- Department of Physical Therapy, Security Forces Hospital, Riyadh 11564, Saudi Arabia
| | - Abdullah Aljandal
- Department of Physical Therapy and Rehabilitation, Al Fayha Club, Al Majmmah 11952, Saudi Arabia
| | - Ahmed Almansour
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Shady Abdullah Alshewaier
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Al Majmaah 11952, Saudi Arabia
| | - Aksh Chahal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar, Mullana 133207, Haryana, India
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Park M, Song R, Ju K, Seo J, Fan X, Ryu A, Li Y, Jang T. Effects of Tai Chi and Qigong on the mobility of stroke survivors: A systematic review and meta-analysis of randomized trials. PLoS One 2022; 17:e0277541. [PMID: 36395145 PMCID: PMC9671349 DOI: 10.1371/journal.pone.0277541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/28/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stroke survivors often experience impaired mobility and physical functions. Tai Chi and Qigong have been shown to have physical and psychological benefits for stroke patients. PURPOSE To summarize the evidence on Tai Chi and Qigong for improving mobility in stroke survivors, specifically the ability to walk, dynamic balance, and activities of daily living (ADL). METHODS Independent searches of 16 electronic databases in English, Korean, and Chinese from their inception until December 2021 were conducted by two research teams. Methodological quality was assessed using Cochrane's risk of bias tool 2.0. Comprehensive Meta-Analysis 3.0 software was used to calculate effect sizes with subgroup analysis and to assess heterogeneity and publication bias. RESULTS The meta-analysis included 27 randomized trials (18 with Tai Chi and 9 with Qigong) on stroke survivors (N = 1,919). None of the studies were considered at high risk of bias, about 70% had some concerns, and 30% were considered low risk. Meta-analysis of 27 randomized controlled trials with random-effects models indicated that Tai Chi and Qigong effectively improved mobility, specifically on the ability to walk (Hedges'g = 0.81), dynamic balance (Hedges'g = 1.04), and ADL (Hedges'g = 0.43). The effects of Tai Chi and Qigong were significant for short-term and long-term programs (Hedges'g 0.91 vs. 0.75), and when compared with active controls and no treatment group (Hedges'g 0.81 vs. 0.73). CONCLUSION Tai Chi and Qigong performed for 12 weeks or less were effective in improving the mobility of stroke survivors. Further studies are warranted to assess whether Tai Chi and Qigong work best as an adjunct to rehabilitation, an effective alternative to rehabilitation or as a maintenance strategy, and whether the results could be further optimized by assessing different schools of Tai Chi and Qigong, different types of stroke patients, and different points in the post-stroke recovery process. PROSPERO REGISTRATION NUMBER This study has been registered on the UK National Institute for Health Research (http://www.crd.york.ac.uk/PROSPERO) PROSPERO registration number: CRD42020220277.
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Affiliation(s)
- Moonkyoung Park
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Rhayun Song
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
- * E-mail:
| | - Kyoungok Ju
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Jisu Seo
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Xing Fan
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Ahyun Ryu
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - YueLin Li
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Taejeong Jang
- Department of Nursing, Woosuk University, Wanju, Republic of Korea
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McCormick SA, Ireland C, Yohannes AM, Holmes PS. Technology-Dependent Rehabilitation Involving Action Observation and Movement Imagery for Adults with Stroke: Can It Work? Feasibility of Self-Led Therapy for Upper Limb Rehabilitation after Stroke. Stroke Res Treat 2022; 2022:8185893. [PMID: 36345552 PMCID: PMC9637031 DOI: 10.1155/2022/8185893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/07/2022] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Motor (re)learning via technology-dependent therapy has the potential to complement traditional therapies available to older adults living with stroke after hospital discharge and increase therapy dose. To date, little is known about the feasibility of technology-dependent therapy in a home setting for this population. OBJECTIVE To develop a technology-dependent therapy that provides mental and physical training for older adults with stroke and assess feasibility. Specifically we ask, "Can it work"? DESIGN Single group repeated measures. METHODS 13 participants, aged 18 years and over, were recruited over a six-month period. All participants had mild upper limb impairment following a stoke and were no longer receiving intensive rehabilitation. All participants received 18 days of technology-dependent therapy in their own home. Information was gathered on recruitment and retention, usability, and suitability of outcome measures. RESULTS 11 participants completed the study. The recruitment rate (number recruited/number canvassed; 10.7%) suggests 1907 participants would need to be canvassed to recruit the necessary sample size (n = 204) for a definitive trial designed to provide 90% power at 5% level of significance to detect a clinically meaningful difference of 5.7 points on the Action Research Arm Test. The usability of the application was rated as exceptional on the System Usability Scale. Effectiveness cannot be determined from this study; however, there was a trend for improvement in measures of upper limb function and emotional well-being. Limitations. The study was limited by a relatively small sample size and lack of control group. CONCLUSIONS This study demonstrated proof of concept of a technology-dependent therapy for upper limb rehabilitation following stroke. The data suggest a definitive trial is feasible, additional strategies to improve recruitment should be considered. Outcome measures aligned with the residual motor function of participants are required.
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Affiliation(s)
- Sheree A. McCormick
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | | | - Abebaw M. Yohannes
- Department of Physical Therapy, Azusa Pacific University, California, USA
| | - Paul S. Holmes
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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Yao L, Jiang N, Mrachacz-Kersting N, Zhu X, Farina D, Wang Y. Performance Variation of a Somatosensory BCI Based on Imagined Sensation: A Large Population Study. IEEE Trans Neural Syst Rehabil Eng 2022; 30:2486-2493. [PMID: 35969546 DOI: 10.1109/tnsre.2022.3198970] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A proportion of users cannot achieve adequate brain-computer interface (BCI) control. The diversity of BCI modalities provides a way to solve this emerging issue. Here, we investigate the accuracy of a somatosensory BCI based on sensory imagery (SI). During the SI tasks, subjects were instructed to imagine a tactile sensation and to maintain the attention on the corresponding hand, as if there was tactile stimulus on the skin of the wrist. The performance across 106 healthy subjects in left- and right-hand SI discrimination was 78.9±13.2%. In 70.7% of the subjects the performance was above 70%. The SI task induced a contralateral cortical activation, and high-density EEG source localization showed that the real tactile stimulation and imagined tactile stimulation shared similar cortical activations within the somatosensory cortex. The somatosensory BCI based on SI provides a new signal modality for independent BCI development. Moreover, a combination of SI and other BCI modalities, such as motor imagery, may provide new avenues for further improving BCI usage and applicability, especially in those subjects unable to attain adequate BCI control with conventional BCI modalities.
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Lu Z, Zhang X, Li H, Zhang T, Gu L, Tao Q. An asynchronous artifact-enhanced electroencephalogram based control paradigm assisted by slight facial expression. Front Neurosci 2022; 16:892794. [PMID: 36051646 PMCID: PMC9424911 DOI: 10.3389/fnins.2022.892794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/25/2022] [Indexed: 11/25/2022] Open
Abstract
In this study, an asynchronous artifact-enhanced electroencephalogram (EEG)-based control paradigm assisted by slight-facial expressions (sFE-paradigm) was developed. The brain connectivity analysis was conducted to reveal the dynamic directional interactions among brain regions under sFE-paradigm. The component analysis was applied to estimate the dominant components of sFE-EEG and guide the signal processing. Enhanced by the artifact within the detected electroencephalogram (EEG), the sFE-paradigm focused on the mainstream defect as the insufficiency of real-time capability, asynchronous logic, and robustness. The core algorithm contained four steps, including “obvious non-sFE-EEGs exclusion,” “interface ‘ON’ detection,” “sFE-EEGs real-time decoding,” and “validity judgment.” It provided the asynchronous function, decoded eight instructions from the latest 100 ms signal, and greatly reduced the frequent misoperation. In the offline assessment, the sFE-paradigm achieved 96.46% ± 1.07 accuracy for interface “ON” detection and 92.68% ± 1.21 for sFE-EEGs real-time decoding, with the theoretical output timespan less than 200 ms. This sFE-paradigm was applied to two online manipulations for evaluating stability and agility. In “object-moving with a robotic arm,” the averaged intersection-over-union was 60.03 ± 11.53%. In “water-pouring with a prosthetic hand,” the average water volume was 202.5 ± 7.0 ml. During online, the sFE-paradigm performed no significant difference (P = 0.6521 and P = 0.7931) with commercial control methods (i.e., FlexPendant and Joystick), indicating a similar level of controllability and agility. This study demonstrated the capability of sFE-paradigm, enabling a novel solution to the non-invasive EEG-based control in real-world challenges.
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Affiliation(s)
- Zhufeng Lu
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Key Laboratory of Intelligent Robot, Xi’an Jiaotong University, Xi’an, China
| | - Xiaodong Zhang
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Key Laboratory of Intelligent Robot, Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Xiaodong Zhang,
| | - Hanzhe Li
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Key Laboratory of Intelligent Robot, Xi’an Jiaotong University, Xi’an, China
| | - Teng Zhang
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Key Laboratory of Intelligent Robot, Xi’an Jiaotong University, Xi’an, China
| | - Linxia Gu
- Department of Biomedical and Chemical Engineering and Sciences, College of Engineering and Science, Florida Institute of Technology, Melbourne, FL, United States
| | - Qing Tao
- School of Mechanical Engineering, Xinjiang University, Wulumuqi, China
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Yao L, Jiang N, Mrachacz-Kersting N, Zhu X, Farina D, Wang Y. Reducing the Calibration Time in Somatosensory BCI by Using Tactile ERD. IEEE Trans Neural Syst Rehabil Eng 2022; 30:1870-1876. [PMID: 35767500 DOI: 10.1109/tnsre.2022.3184402] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We propose a tactile-induced-oscillation approach to reduce the calibration time in somatosensory brain-computer interfaces (BCI). METHODS Based on the similarity between tactile induced event-related desynchronization (ERD) and imagined sensation induced ERD activation, we extensively evaluated BCI performance when using a conventional and a novel calibration strategy. In the conventional calibration, the tactile imagined data was used, while in the sensory calibration model sensory stimulation data was used. Subjects were required to sense the tactile stimulus when real tactile was applied to the left or right wrist and were required to perform imagined sensation tasks in the somatosensory BCI paradigm. RESULTS The sensory calibration led to a significantly better performance than the conventional calibration when tested on the same imagined sensation dataset ( [Formula: see text]=10.89, P=0.0038), with an average 5.1% improvement in accuracy. Moreover, the sensory calibration was 39.3% faster in reaching a performance level of above 70% accuracy. CONCLUSION The proposed approach of using tactile ERD from the sensory cortex provides an effective way of reducing the calibration time in a somatosensory BCI system. SIGNIFICANCE The tactile stimulation would be specifically useful before BCI usage, avoiding excessive fatigue when the mental task is difficult to perform. The tactile ERD approach may find BCI applications for patients or users with preserved afferent pathways.
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Boccuni L, Marinelli L, Trompetto C, Pascual-Leone A, Tormos Muñoz JM. Time to reconcile research findings and clinical practice on upper limb neurorehabilitation. Front Neurol 2022; 13:939748. [PMID: 35928130 PMCID: PMC9343948 DOI: 10.3389/fneur.2022.939748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
The problemIn the field of upper limb neurorehabilitation, the translation from research findings to clinical practice remains troublesome. Patients are not receiving treatments based on the best available evidence. There are certainly multiple reasons to account for this issue, including the power of habit over innovation, subjective beliefs over objective results. We need to take a step forward, by looking at most important results from randomized controlled trials, and then identify key active ingredients that determined the success of interventions. On the other hand, we need to recognize those specific categories of patients having the greatest benefit from each intervention, and why. The aim is to reach the ability to design a neurorehabilitation program based on motor learning principles with established clinical efficacy and tailored for specific patient's needs.Proposed solutionsThe objective of the present manuscript is to facilitate the translation of research findings to clinical practice. Starting from a literature review of selected neurorehabilitation approaches, for each intervention the following elements were highlighted: definition of active ingredients; identification of underlying motor learning principles and neural mechanisms of recovery; inferences from research findings; and recommendations for clinical practice. Furthermore, we included a dedicated chapter on the importance of a comprehensive assessment (objective impairments and patient's perspective) to design personalized and effective neurorehabilitation interventions.ConclusionsIt's time to reconcile research findings with clinical practice. Evidence from literature is consistently showing that neurological patients improve upper limb function, when core strategies based on motor learning principles are applied. To this end, practical take-home messages in the concluding section are provided, focusing on the importance of graded task practice, high number of repetitions, interventions tailored to patient's goals and expectations, solutions to increase and distribute therapy beyond the formal patient-therapist session, and how to integrate different interventions to maximize upper limb motor outcomes. We hope that this manuscript will serve as starting point to fill the gap between theory and practice in upper limb neurorehabilitation, and as a practical tool to leverage the positive impact of clinicians on patients' recovery.
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Affiliation(s)
- Leonardo Boccuni
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- *Correspondence: Leonardo Boccuni
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Clinical Neurophysiology, Genova, Italy
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Department of Neuroscience, Division of Neurorehabilitation, Genova, Italy
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology and Harvard Medical School, Boston, MA, United States
| | - José María Tormos Muñoz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
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Lee TH, Liu CH, Chen PC, Liou TH, Escorpizo R, Chen HC. Effectiveness of mental simulation practices after total knee arthroplasty in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2022; 17:e0269296. [PMID: 35657803 PMCID: PMC9165806 DOI: 10.1371/journal.pone.0269296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/18/2022] [Indexed: 02/07/2023] Open
Abstract
Mental simulation practices, such as motor imagery, action observation, and guided imagery, have been an intervention of interest in neurological and musculoskeletal rehabilitation. Application of such practices to postoperative patients in orthopedics, particularly after total knee arthroplasty, has resulted in favorable physical function outcomes. In this systematic review and meta-analysis, we wish to determine the effectiveness of mental simulation practices with standard physical therapy compared to standard physical therapy alone in patients who underwent total knee arthroplasty in terms of postoperative pain, physical functions, and patient-reported outcome measures. We identified randomized controlled trials from inception to August 28, 2021, by using the PubMed, Cochrane Library, EMBASE, and Scopus databases. Data collection was completed on August 28, 2021. Finally, eight articles (249 patients) published between 2014 and 2020 were included. The meta-analysis revealed that mental simulation practices caused more favorable results in pain [standardized mean difference = -0.42, 95% confidence interval (CI) (-0.80 to -0.04), P = 0.03], range of motion [0.55, 95% CI (0.06-1.04), P = 0.03], maximal strength of quadriceps [1.21, 95% CI (0.31-2.12), P = 0.009], and 36-Item Short-Form Survey [0.53, 95% CI (0.14-0.92), P = 0.007]. Our data suggest that mental simulation practices may be considered adjunctive to standard physiotherapy after total knee arthroplasty in patients with knee osteoarthritis.
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Affiliation(s)
- Ting-Hsuan Lee
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chia-Hung Liu
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Pei-Chi Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, University of Vermont, College of Nursing and Health Sciences, Burlington, VT, United States of America
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- * E-mail:
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Ma ZZ, Wu JJ, Hua XY, Zheng MX, Xing XX, Ma J, Li SS, Shan CL, Xu JG. Brain Function and Upper Limb Deficit in Stroke With Motor Execution and Imagery: A Cross-Sectional Functional Magnetic Resonance Imaging Study. Front Neurosci 2022; 16:806406. [PMID: 35663563 PMCID: PMC9160973 DOI: 10.3389/fnins.2022.806406] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMotor imagery training might be helpful in stroke rehabilitation. This study explored if a specific modulation of movement-related regions is related to motor imagery (MI) ability.MethodsTwenty-three patients with subcortical stroke and 21 age-matched controls were recruited. They were subjectively screened using the Kinesthetic and Visual Imagery Questionnaire (KVIQ). They then underwent functional magnetic resonance imaging (fMRI) while performing three repetitions of different motor tasks (motor execution and MI). Two separate runs were acquired [motor execution tasks (ME and rest) and motor imagery (MI and rest)] in a block design. For the different tasks, analyses of cerebral activation and the correlation of motor/imagery task-related activity and KVIQ scores were performed.ResultsDuring unaffected hand (UH) active grasp movement, we observed decreased activations in the contralateral precentral gyrus (PreCG), contralateral postcentral gyrus (PoCG) [p < 0.05, family wise error (FWE) corrected] and a positive correlation with the ability of FMA-UE (PreCG: r = 0.46, p = 0.028; PoCG: r = 0.44, p = 0.040). During active grasp of the affected hand (AH), decreased activation in the contralateral PoCG was observed (p < 0.05, FWE corrected). MI of the UH induced significant activations of the contralateral superior frontal gyrus, opercular region of the inferior frontal gyrus, and ipsilateral ACC and deactivation in the ipsilateral supplementary motor area (p < 0.05, AlphaSim correction). Ipsilateral anterior cingulate cortex (ACC) activity negatively correlated with MI ability (r = =–0.49, p = 0.022). Moreover, we found significant activation of the contralesional middle frontal gyrus (MFG) during MI of the AH.ConclusionOur results proved the dominant effects of MI dysfunction that exist in stroke during the processing of motor execution. In the motor execution task, the enhancement of the contralateral PreCG and PoCG contributed to reversing the motor dysfunction, while in the MI task, inhibition of the contralateral ACC can increase the impaired KVIQ ability. The bimodal balance recovery model can explain our results well. Recognizing neural mechanisms is critical to helping us formulate precise strategies when intervening with electrical or magnetic stimulation.
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Affiliation(s)
- Zhen-Zhen Ma
- Department of Rehabilitation Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Trauma and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Trauma and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Xin Xing
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jie Ma
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si-Si Li
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun-Lei Shan
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Chun-Lei Shan,
| | - Jian-Guang Xu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Jian-Guang Xu,
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Loria T, Teich JE, Pranjić M, Tan M, Huang A, Thaut MH. The Impact of Limb Velocity Variability on Mallet Accuracy in Marimba Performance. J Mot Behav 2022; 54:694-705. [PMID: 35473577 DOI: 10.1080/00222895.2022.2069080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present study examined spatial accuracy of mallet endpoints in a marimba performance context. Trained percussionists performed two- (i.e., Experiment 1) and four-mallet (i.e., Experiment 2) excerpts in three tempo conditions including slow, intermediate, and fast. Motion capture was utilized to gather data of upper-limb and mallet movements, as well as to compute velocities of the upper-limb joints. Mallet spatial accuracy was assessed by comparing mallet endpoints to a visual target positioned on the marimba. It was hypothesized that mallet spatial accuracy would be reduced as tempo condition increased, with effects on joint kinematics potentially revealing sensorimotor mechanisms underlying optimal sound production in marimba. Across both experiments, mallet accuracy was reduced as tempo condition increased. Interestingly, velocity variability in the elbows, wrists, and hands increased as mallet accuracy decreased. Such a pattern of effects suggested that sound production in marimba is suboptimal at fast relative to slow tempi. In addition, the velocity variability effects highlight the impact of motor planning mechanisms on sound production. Overall, the results shed new light on sensorimotor control in percussion which can be leveraged to enhance the training of percussionists.
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Affiliation(s)
- Tristan Loria
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, Canada
| | - Jessica Elizabeth Teich
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, Canada
| | - Marija Pranjić
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, Canada
| | - Melissa Tan
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, Canada
| | - Aiyun Huang
- Percussion Department, Faculty of Music, University of Toronto, Toronto, Canada
| | - Michael H Thaut
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, Canada
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Longitudinal [18]UCB-H/[18F]FDG imaging depicts complex patterns of structural and functional neuroplasticity following bilateral vestibular loss in the rat. Sci Rep 2022; 12:6049. [PMID: 35411002 PMCID: PMC9001652 DOI: 10.1038/s41598-022-09936-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
Neuronal lesions trigger mechanisms of structural and functional neuroplasticity, which can support recovery. However, the temporal and spatial appearance of structure–function changes and their interrelation remain unclear. The current study aimed to directly compare serial whole-brain in vivo measurements of functional plasticity (by [18F]FDG-PET) and structural synaptic plasticity (by [18F]UCB-H-PET) before and after bilateral labyrinthectomy in rats and investigate the effect of locomotor training. Complex structure–function changes were found after bilateral labyrinthectomy: in brainstem-cerebellar circuits, regional cerebral glucose metabolism (rCGM) decreased early, followed by reduced synaptic density. In the thalamus, increased [18F]UCB-H binding preceded a higher rCGM uptake. In frontal-basal ganglia loops, an increase in synaptic density was paralleled by a decrease in rCGM. In the group with locomotor training, thalamic rCGM and [18F]UCB-H binding increased following bilateral labyrinthectomy compared to the no training group. Rats with training had considerably fewer body rotations. In conclusion, combined [18F]FDG/[18F]UCB-H dual tracer imaging reveals that adaptive neuroplasticity after bilateral vestibular loss is not a uniform process but is composed of complex spatial and temporal patterns of structure–function coupling in networks for vestibular, multisensory, and motor control, which can be modulated by early physical training.
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From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy. Symmetry (Basel) 2022. [DOI: 10.3390/sym14020345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.
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Automatic Selection of Control Features for Electroencephalography-Based Brain–Computer Interface Assisted Motor Rehabilitation: The GUIDER Algorithm. Brain Topogr 2022; 35:182-190. [DOI: 10.1007/s10548-021-00883-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/25/2021] [Indexed: 12/25/2022]
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EEG as a marker of brain plasticity in clinical applications. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:91-104. [PMID: 35034760 DOI: 10.1016/b978-0-12-819410-2.00029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neural networks are dynamic, and the brain has the capacity to reorganize itself. This capacity is named neuroplasticity and is fundamental for many processes ranging from learning and adaptation to new environments to the response to brain injuries. Measures of brain plasticity involve several techniques, including neuroimaging and neurophysiology. Electroencephalography, often used together with other techniques, is a common tool for prognostic and diagnostic purposes, and cortical reorganization is reflected by EEG measurements. Changes of power bands in different cortical areas occur with fatigue and in response to training stimuli leading to learning processes. Sleep has a fundamental role in brain plasticity, restoring EEG bands alterations and promoting consolidation of learning. Exercise and physical inactivity have been extensively studied as both strongly impact brain plasticity. Indeed, EEG studies showed the importance of the physical activity to promote learning and the effects of inactivity or microgravity on cortical reorganization to cope with absent or altered sensorimotor stimuli. Finally, this chapter will describe some of the EEG changes as markers of neural plasticity in neurologic conditions, focusing on cerebrovascular and neurodegenerative diseases. In conclusion, neuroplasticity is the fundamental mechanism necessary to ensure adaptation to new stimuli and situations, as part of the dynamicity of life.
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Abstract
AbstractIn motor imagery-based brain-computer interfaces (BCIs), the spatial covariance features of electroencephalography (EEG) signals that lie on Riemannian manifolds are used to enhance the classification performance of motor imagery BCIs. However, the problem of subject-specific bandpass frequency selection frequently arises in Riemannian manifold-based methods. In this study, we propose a multiple Riemannian graph fusion (MRGF) model to optimize the subject-specific frequency band for a Riemannian manifold. After constructing multiple Riemannian graphs corresponding to multiple bandpass frequency bands, graph embedding based on bilinear mapping and graph fusion based on mutual information were applied to simultaneously extract the spatial and spectral features of the EEG signals from Riemannian graphs. Furthermore, with a support vector machine (SVM) classifier performed on learned features, we obtained an efficient algorithm, which achieves higher classification performance on various datasets, such as BCI competition IIa and in-house BCI datasets. The proposed methods can also be used in other classification problems with sample data in the form of covariance matrices.
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Stefano Filho CA, Attux RRDF, Castellano G. Motor imagery practice and feedback effects on functional connectivity. J Neural Eng 2021; 18:066048. [PMID: 34933292 DOI: 10.1088/1741-2552/ac456d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
- Objective: the use of motor imagery (MI) in motor rehabilitation protocols has been increasingly investigated as a potential technique for enhancing traditional treatments, yielding better clinical outcomes. However, since MI performance can be challenging, practice is usually required. This demands appropriate training, actively engaging the MI-related brain areas, consequently enabling the user to properly benefit from it. The role of feedback is central for MI practice. Yet, assessing which underlying neural changes are feedback-specific or purely due to MI practice is still a challenging effort, mainly due to the difficulty in isolating their contributions. In this work, we aimed to assess functional connectivity (FC) changes following MI practice that are either extrinsic or specific to feedback. APPROACH to achieve this, we investigated FC, using graph theory, in electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) data, during MI performance and at resting-state (rs), respectively. Thirty healthy subjects were divided into three groups, receiving no feedback (control), "false" feedback (sham) or actual neurofeedback (active). Participants underwent 12 to 13 hands-MI EEG sessions and pre- and post-MI training fMRI exams. MAIN RESULTS following MI practice, control participants presented significant increases in degree and in eigenvector centrality for occipital nodes at rs-fMRI scans, whereas sham-feedback produced similar effects, but to a lesser extent. Therefore, MI practice, by itself, seems to stimulate visual information processing mechanisms that become apparent during basal brain activity. Additionally, only the active group displayed decreases in inter-subject FC patterns, both during MI performance and at rs-fMRI. SIGNIFICANCE hence, actual neurofeedback impacted FC by disrupting common inter-subject patterns, suggesting that subject-specific neural plasticity mechanisms become important. Future studies should consider this when designing experimental NFBT protocols and analyses.
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Affiliation(s)
| | - Romis Ribeiro de Faisol Attux
- Laboratory of Signal Processing for Communications, School of Electrical and Computer Engineering, University of Campinas, Laboratório de Processamento de Sinais para Comunicações, Campinas, São Paulo, 13083-852, BRAZIL
| | - Gabriela Castellano
- Department of Cosmic Rays and Chronology, University of Campinas - UNICAMP, Institute of Physics Gleb Wataghin, R. Sérgio Buarque de Holanda, nº 777, Cidade Universitária, Campinas, SP, 13083-859, BRAZIL
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Yoxon E, Brillinger M, Welsh TN. Behavioural indexes of movement imagery ability are associated with the magnitude of corticospinal adaptation following movement imagery training. Brain Res 2021; 1777:147764. [PMID: 34951972 DOI: 10.1016/j.brainres.2021.147764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022]
Abstract
Movement imagery (MI) is a cognitive process wherein an individual simulates themselves performing a movement in the absence of physical movement. The current paper reports an examination of the relationship between behavioural indexes of MI ability and the magnitude of corticospinal adaptation following MI training. Behavioural indexes of MI ability included data from a questionnaire (MIQ-3), a mental chronometry task, and a hand laterality judgment task. For the measure of corticospinal adaptation, single-pulse transcranial magnetic stimulation (TMS) was administered to elicit thumb movements to determine the representation of thumb movements before and after MI training. MI training involved participants imagining themselves moving their thumb in the opposite direction to the dominant direction of the TMS-evoked movements prior to training. Pre/post-training changes in the direction and velocity of TMS-evoked thumb movements indicated the magnitude of adaptation following MI training. The two main findings were: 1) a positive relationship was found between the MIQ-3 and the pre/post-training changes in the direction of TMS-evoked thumb movements; and 2) a negative relationship between the mental chronometry measure and both measures of corticospinal adaptation following MI training. These results indicate that both ease of imagery and timing of imagery could predict the magnitude of neuroplastic adaptation following MI training. Thus, both these measures may be considered when assessing imagery ability and determining who might benefit from MI interventions.
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Affiliation(s)
- Emma Yoxon
- Centre for Motor Control, Faculty of Kinesiology & Physical Education, University of Toronto, Canada
| | - Molly Brillinger
- Centre for Motor Control, Faculty of Kinesiology & Physical Education, University of Toronto, Canada
| | - Timothy N Welsh
- Centre for Motor Control, Faculty of Kinesiology & Physical Education, University of Toronto, Canada.
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Fujiwara K, Shibata M, Awano Y, Shibayama K, Iso N, Matsuo M, Nakashima A, Moriuchi T, Mitsunaga W, Higashi T. A method for using video presentation to increase the vividness and activity of cortical regions during motor imagery tasks. Neural Regen Res 2021; 16:2431-2437. [PMID: 33907031 PMCID: PMC8374587 DOI: 10.4103/1673-5374.313058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/29/2020] [Accepted: 10/15/2020] [Indexed: 11/07/2022] Open
Abstract
In recent years, mental practice (MP) using laterally inverted video of a subject's non-paralyzed upper limb to improve the vividness of presented motor imagery (MI) has been shown to be effective for improving the function of a paralyzed upper limb. However, no studies have yet assessed the activity of cortical regions engaged during MI task performance using inverse video presentations and neurophysiological indicators. This study sought to investigate changes in MI vividness and hemodynamic changes in the cerebral cortex during MI performance under the following three conditions in near-infrared spectroscopy: MI-only without inverse video presentation (MI-only), MI with action observation (AO) of an inverse video presentation of another person's hand (AO + MI (other hand)), and MI with AO of an inverse video presentation of a participant's own hand (AO + MI (own hand)). Participants included 66 healthy right-handed adults (41 men and 25 women; mean age: 26.3 ± 4.3 years). There were 23 patients in the MI-only group (mean age: 26.4 ± 4.1 years), 20 in the AO + MI (other hand) group (mean age: 25.9 ± 5.0 years), and 23 in the AO + MI (own hand) group (mean age: 26.9 ± 4.1 years). The MI task involved transferring 1 cm × 1 cm blocks from one plate to another, once per second, using chopsticks held in the non-dominant hand. Based on a visual analog scale (VAS), MI vividness was significantly higher in the AO + MI (own hand) group than in the MI-only group and the AO + MI (other hand) group. A main effect of condition was revealed in terms of MI vividness, as well as regions of interest (ROIs) in certain brain areas associated with motor processing. The data suggest that inverse video presentation of a person's own hand enhances the MI vividness and increases the activity of motor-related cortical areas during MI. This study was approved by the Institutional Ethics Committee of Nagasaki University Graduate School of Biomedical and Health Sciences (approval No. 18121303) on January 18, 2019.
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Affiliation(s)
- Kengo Fujiwara
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Masatomo Shibata
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Yoshinaga Awano
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Koji Shibayama
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Naoki Iso
- Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University, Tokyo, Japan
| | - Moemi Matsuo
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akira Nakashima
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takefumi Moriuchi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Wataru Mitsunaga
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Toshio Higashi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Xie J, Jiang L, Li Y, Chen B, Li F, Jiang Y, Gao D, Deng L, Lv X, Ma X, Yin G, Yao D, Xu P. Rehabilitation of motor function in children with cerebral palsy based on motor imagery. Cogn Neurodyn 2021; 15:939-948. [PMID: 34790263 DOI: 10.1007/s11571-021-09672-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/29/2020] [Accepted: 03/02/2021] [Indexed: 11/25/2022] Open
Abstract
To promote the rehabilitation of motor function in children with cerebral palsy (CP), we developed motor imagery (MI) based training system to assist their motor rehabilitation. Eighteen CP children, ten in short- and eight in long-term rehabilitation, participated in our study. In short-term rehabilitation, every 2 days, the MI datasets were collected; whereas the duration of two adjacency MI experiments was ten days in the long-term protocol. Meanwhile, within two adjacency experiments, CP children were requested to daily rehabilitate the motor function based on our system for 30 min. In both strategies, the promoted motor information processing was observed. In terms of the relative signal power spectra, a main effect of time was revealed, as the promoted power spectra were found for the last time of MI recording, compared to that of the first one, which first validated the effectiveness of our intervention. Moreover, as for network efficiency related to the motor information processing, compared to the first MI, the increased network properties were found for the last MI, especially in long-term rehabilitation in which CP children experienced a more obvious efficiency promotion. These findings did validate that our MI-based rehabilitation system has the potential for CP children to assist their motor rehabilitation.
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Affiliation(s)
- Jiaxin Xie
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - Lin Jiang
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - Yanan Li
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - Baodan Chen
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - Fali Li
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - Yuanling Jiang
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - Dongrui Gao
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
- School of Computer Science, Chengdu University of Information Technology, Chengdu, 611731 China
| | - Lili Deng
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - XuLin Lv
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
| | - XianKun Ma
- Sichuan Rehabilitation Hospital, Chengdu, China
| | - Gang Yin
- School of Medicine, Sichuan Cancer Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China
- No. 2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 611731 Sichuan China
| | - Dezhong Yao
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731 China
- No. 2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 611731 Sichuan China
| | - Peng Xu
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731 China
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731 China
- No. 2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 611731 Sichuan China
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Poveda-García A, Moret-Tatay C, Gómez-Martínez M. The Association between Mental Motor Imagery and Real Movement in Stroke. Healthcare (Basel) 2021; 9:healthcare9111568. [PMID: 34828614 PMCID: PMC8620455 DOI: 10.3390/healthcare9111568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Stroke is the main cause of disability in adults; the most common and long-term sequela is upper-limb hemiparesis. Many studies support the idea that mental motor imagery, which is related to the visualization of movement patterns, activates the same areas of the cortex as if the movement occurred. Objectives: This study aims to examine the capacity to elaborate mental motor images, as well as its relationship to loss of movement in the upper limbs after a stroke. Method: An observational study, in a sample of 39 adults who suffered a stroke, was carried out. The upper limb movement and functionality, cognitive disorders, the ability to visualize mental images, and activities of daily living were examined. Results: The results depicted a statistically significant correlation between the ability to visualize upper limb mental motor images with movement, functionality, and strength. In addition, a correlation between visual–spatial skills and mental visualization of motor ability and upper limb movement was found. Conclusions: These results suggest that the rehabilitation approach focused on the improvement of mental motor imagery could be of interest for the upper limb rehabilitation of movement and functionality.
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Affiliation(s)
- Ana Poveda-García
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, San Agustín 3, Esc. A, Entresuelo 1, 46002 València, Spain
- Correspondence:
| | - Carmen Moret-Tatay
- Facultad de Psicología, Universidad Católica de Valencia San Vicente Mártir, Avenida de la Ilustración, Burjassot, 46100 Valencia, Spain;
- Dipartimento di Neuroscienze Salute Mentale e Organi di Senso, La Sapienza Università di Roma, 00185 Rome, Italy
| | - Miguel Gómez-Martínez
- Departamento de Terapia Ocupacional, Centro Superior de Estudios Universitarios La Salle, 28023 Madrid, Spain;
- Occupational Thinks Research Group, Centro Superior de Estudios Universitarios La Salle, 28023 Madrid, Spain
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Khan MA, Saibene M, Das R, Brunner IC, Puthusserypady S. Emergence of flexible technology in developing advanced systems for post-stroke rehabilitation: a comprehensive review. J Neural Eng 2021; 18. [PMID: 34736239 DOI: 10.1088/1741-2552/ac36aa] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/04/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Stroke is one of the most common neural disorders, which causes physical disabilities and motor impairments among its survivors. Several technologies have been developed for providing stroke rehabilitation and to assist the survivors in performing their daily life activities. Currently, the use of flexible technology (FT) for stroke rehabilitation systems is on a rise that allows the development of more compact and lightweight wearable systems, which stroke survivors can easily use for long-term activities. APPROACH For stroke applications, FT mainly includes the "flexible/stretchable electronics", "e-textile (electronic textile)" and "soft robotics". Thus, a thorough literature review has been performed to report the practical implementation of FT for post-stroke application. MAIN RESULTS In this review, the highlights of the advancement of FT in stroke rehabilitation systems are dealt with. Such systems mainly involve the "biosignal acquisition unit", "rehabilitation devices" and "assistive systems". In terms of biosignals acquisition, electroencephalography (EEG) and electromyography (EMG) are comprehensively described. For rehabilitation/assistive systems, the application of functional electrical stimulation (FES) and robotics units (exoskeleton, orthosis, etc.) have been explained. SIGNIFICANCE This is the first review article that compiles the different studies regarding flexible technology based post-stroke systems. Furthermore, the technological advantages, limitations, and possible future implications are also discussed to help improve and advance the flexible systems for the betterment of the stroke community.
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Affiliation(s)
- Muhammad Ahmed Khan
- Technical University of Denmark, Ørsteds Plads Building 345C, Room 215, Lyngby, 2800, DENMARK
| | - Matteo Saibene
- Technical University of Denmark, Ørsteds Plads, Building 345C, Lyngby, 2800, DENMARK
| | - Rig Das
- Technical University of Denmark, Ørsteds Plads Building 345C, Room 214, Lyngby, 2800, DENMARK
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Heena N, Zia NU, Sehgal S, Anwer S, Alghadir A, Li H. Effects of task complexity or rate of motor imagery on motor learning in healthy young adults. Brain Behav 2021; 11:e02122. [PMID: 34612612 PMCID: PMC8613406 DOI: 10.1002/brb3.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/26/2021] [Accepted: 03/06/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A growing body of evidence suggests the benefit of motor imagery in motor learning. While some studies tried to look at the effect of isolated mental practice, others evaluated the combined effect of motor imagery and physical practice in clinical rehabilitation. This study aimed to investigate the effects of task complexity or rates of motor imagery on motor learning in health young adults. METHODS Eighty-eight healthy individuals participated in this study. Participants were randomly allocated to either Group A (50% complex, N = 22), Group B (75% complex, N = 22), Group C (50% simple, N = 22), or Group D (75% simple, N = 22). Participants in the complex groups performed their task with nondominant hand and those in simple groups with a dominant hand. All participants performed a task that involved reach, grasp, and release tasks. The performance of the four groups was examined in the acquisition and retention phase. The main outcome measure was the movement time. RESULTS There were significant differences between immediate (i.e., acquisition) and late (i.e., retention) movement times at all three stages of task (i.e., MT1 [reaching time], MT2 [target transport time], and TMT [reaching time plus object transport time]) when individuals performed complex task with 75% imagery rate (p < .05). Similarly, there were significant differences between immediate and late movement times at all stages of task except the MT2 when individuals performed simple task with 75% imagery rate (p < .05). There were significant effects of task complexity (simple vs. complex tasks) on immediate movement time at the first stage of task (i.e., MT1 ) and late movement times of all three stages of task (p < .05). There were significant effects of the rate of imagery (50% vs. 75%) on late movement times at all three stages of tasks (p > .05). Additionally, there were no interaction effects of either task complexity or rate of imagery on both immediate and late movement times at all three stages of tasks (p > .05). CONCLUSION This study supports the use of higher rates (75%) of motor imagery to improve motor learning. Additionally, the practice of a complex task demonstrated better motor learning in healthy young adults. Future longitudinal studies should validate these results in different patient's population such as stroke, spinal cord injury, and Parkinson's disease.
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Affiliation(s)
- Nargis Heena
- Max Smart Super Specialty HospitalNew DelhiIndia
| | - Nayeem U. Zia
- Directorate of Health Services KashmirJammu and KashmirIndia
| | - Stuti Sehgal
- Institution of Rehabilitation Sciences, ISIC Vasant KunjNew DelhiIndia
| | - Shahnawaz Anwer
- Rehabilitation Research ChairCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
- Department of Building and Real EstateHong Kong Polytechnic UniversityKowloonHong Kong Special Administrative Region
| | - Ahmad Alghadir
- Rehabilitation Research ChairCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
| | - Heng Li
- Department of Building and Real EstateHong Kong Polytechnic UniversityKowloonHong Kong Special Administrative Region
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Nogueira NGDHM, Parma JO, Leão SESDA, Sales IDS, Macedo LC, Galvão ACDR, de Oliveira DC, Murça TM, Fernandes LA, Junqueira C, Lage GM, Ferreira BDP. Mirror therapy in upper limb motor recovery and activities of daily living, and its neural correlates in stroke individuals: A systematic review and meta-analysis. Brain Res Bull 2021; 177:217-238. [PMID: 34626693 DOI: 10.1016/j.brainresbull.2021.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
Available literature indicates that 30-66% of stroke survivors present persistent upper limb impairment. Considering the importance of upper limb function for activities of daily living, it is necessary to investigate neurorehabilitation therapies that could improve the upper limb function. Among stroke complementary therapies, mirror therapy has shown promising results. Thus, the aim of this systematic review and meta-analyses was to review and synthesize clinical evidence on the use of mirror therapy on motor recovery of the upper limb and activities of daily living, and its neural correlates in stroke patients. The literature search was carried out in PubMed, ISI Web of Science, and Scopus databases. Twenty-nine studies met all the inclusion criteria. Two meta-analyses were conducted to compare mirror therapy with sham therapy on two general measures, upper limb assessment and activities of daily living. Results suggest that mirror therapy was better than sham therapy, mainly in the subacute phase, but the meta-analyses were nonsignificant. In addition, mirror therapy and cortical reorganization showed potential neural correlates, such as the primary motor cortex, precuneus, and posterior cingulate cortex.
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Affiliation(s)
| | | | | | - Izabella de Souza Sales
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lilian Carla Macedo
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Dalva Cadeu de Oliveira
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; School of Kinesiology, Auburn University, Auburn, USA; Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Physical Education, Universidade Federal de Juiz de Fora, Governador Valadares, MG, Brazil
| | - Tatiane Moisés Murça
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Cristiani Junqueira
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Guilherme Menezes Lage
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bárbara de Paula Ferreira
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189467. [PMID: 34574389 PMCID: PMC8465066 DOI: 10.3390/ijerph18189467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 12/21/2022]
Abstract
Background: There is an urgent need to systematically analyze the growing body of literature on the effect of motor imagery (MI) training in children and adolescents. Methods: Seven databases and clinicaltrials.gov were searched. Two reviewers independently screened references and full texts, and extracted data (studies’ methodology, MI elements, temporal parameters). Two studies were meta-analyzed providing the standard mean difference (SDM). Selected studies were evaluated with the risk of bias (RoB) and GRADE tools. Results: A total of 7238 references were retrieved. The sample size of the 22 included studies, published between 1995 and 2021, ranged from 18 to 136 participants, totaling 934 (nine to 18 years). Studies included healthy pupils, mentally retarded adolescents, children with motor coordination difficulties or with mild mental disabilities. The motor learning tasks focused on upper, lower and whole body movements. SMDs for the primary outcome of pooled studies varied between 0.83 to 1.87 (95% CI, I2, T2 varied 0.33–3.10; p = 0.001; 0–74%; 0–0.59). RoB varied between some concerns and high risk. GRADE rating was low. Conclusions: MI combined with physical practice (PP) might have a high potential for healthy and impaired children and adolescents. However, important reporting recommendations (PETTLEP, TIDieR, CONSORT) should be followed. The systematic review was registered with PROSPERO: CRD42021237361.
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Portillo-Lara R, Tahirbegi B, Chapman CAR, Goding JA, Green RA. Mind the gap: State-of-the-art technologies and applications for EEG-based brain-computer interfaces. APL Bioeng 2021; 5:031507. [PMID: 34327294 PMCID: PMC8294859 DOI: 10.1063/5.0047237] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/19/2021] [Indexed: 11/14/2022] Open
Abstract
Brain-computer interfaces (BCIs) provide bidirectional communication between the brain and output devices that translate user intent into function. Among the different brain imaging techniques used to operate BCIs, electroencephalography (EEG) constitutes the preferred method of choice, owing to its relative low cost, ease of use, high temporal resolution, and noninvasiveness. In recent years, significant progress in wearable technologies and computational intelligence has greatly enhanced the performance and capabilities of EEG-based BCIs (eBCIs) and propelled their migration out of the laboratory and into real-world environments. This rapid translation constitutes a paradigm shift in human-machine interaction that will deeply transform different industries in the near future, including healthcare and wellbeing, entertainment, security, education, and marketing. In this contribution, the state-of-the-art in wearable biosensing is reviewed, focusing on the development of novel electrode interfaces for long term and noninvasive EEG monitoring. Commercially available EEG platforms are surveyed, and a comparative analysis is presented based on the benefits and limitations they provide for eBCI development. Emerging applications in neuroscientific research and future trends related to the widespread implementation of eBCIs for medical and nonmedical uses are discussed. Finally, a commentary on the ethical, social, and legal concerns associated with this increasingly ubiquitous technology is provided, as well as general recommendations to address key issues related to mainstream consumer adoption.
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Affiliation(s)
- Roberto Portillo-Lara
- Department of Bioengineering, Imperial College London, Royal School of Mines, London SW7 2AZ, United Kingdom
| | - Bogachan Tahirbegi
- Department of Bioengineering, Imperial College London, Royal School of Mines, London SW7 2AZ, United Kingdom
| | - Christopher A. R. Chapman
- Department of Bioengineering, Imperial College London, Royal School of Mines, London SW7 2AZ, United Kingdom
| | - Josef A. Goding
- Department of Bioengineering, Imperial College London, Royal School of Mines, London SW7 2AZ, United Kingdom
| | - Rylie A. Green
- Department of Bioengineering, Imperial College London, Royal School of Mines, London SW7 2AZ, United Kingdom
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Feasibility of motor imagery and effects of activating and relaxing practice on autonomic functions in healthy young adults: A randomised, controlled, assessor-blinded, pilot trial. PLoS One 2021; 16:e0254666. [PMID: 34255812 PMCID: PMC8277051 DOI: 10.1371/journal.pone.0254666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/13/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Motor imagery (MI) is the mental rehearsal of a motor task. Between real and imagined movements, a functional equivalence has been described regarding timing and brain activation. The primary study aim was to investigate the feasibility of MI training focusing on the autonomic function in healthy young people. Further aims were to evaluate participants’ MI abilities and compare preliminary effects of activating and relaxing MI on autonomic function and against controls. Methods A single-blinded randomised controlled pilot trial was performed. Participants were randomised to the activating MI (1), relaxing MI (2), or control (3) group. Following a MI familiarisation, they practiced home-based kinaesthetic MI for 17 minutes, 5 times/week for 2 weeks. Participants were called once for support. The primary outcome was the feasibility of a full-scale randomised controlled trial using predefined criteria. Secondary outcomes were participants’ MI ability using the Movement Imagery Questionnaire-Revised, mental chronometry tests, hand laterality judgement and semi-structured interviews, autonomic function. Results A total of 35 participants completed the study. The feasibility of a larger study was confirmed, despite 35% attrition related to the COVID-19 pandemic. Excellent MI capabilities were seen in participants, and significant correlations between MI ability measures. Interview results showed that participants accepted or liked both interventions. Seven major themes and insider recommendations for MI interventions emerged. No significant differences and negligible to medium effects were observed in MI ability or autonomic function between baseline and post-intervention measures or between groups. Conclusions Results showed that neither activating nor relaxing MI seems to change autonomic function in healthy individuals. Further adequately powered studies are required to answer open questions remaining from this study. Future studies should investigate effects of different MI types over a longer period, to rule out habituation and assess autonomic function at several time points and simultaneously with MI.
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