Search Results (314)

Spinal cord injury (SCI) is a major disability that, to this day, does not have a permanent cure. The spinal cord extends caudally through the body structure of the vertebral column and is part of the central nervous system (CNS). The spinal cord enables neural communication and motor coordination, so injuries can disrupt sensation, movement, and autonomic functions. Mechanical and traumatic damage to the spinal cord causes lesions to the nerves, resulting in the disruption of relayed messages to the extremities. Various forms of treatment for the spinal cord include functional electrical stimulation (FES), epidural electrical stimulation (EES), ‘SMART’ devices, exoskeleton and robotic systems, transcranial magnetic stimulation, and neuroprostheses using AI for the brain–computer interface. This research is going to analyse and review these current treatment methods for spinal cord injury and identify the current gaps and limitations in these, such as long-term biocompatibility, wireless adaptability, cost, regulatory barriers, and risk of surgery. Future advancements should work on implementing wireless data logging with AI algorithms to increase SCI device adaptability, as well as maintaining regulatory and health system integration. Full article

Background: Spinal muscular atrophy (SMA) is a treatable motor neuron disease. Biomarkers for skeletal muscle atrophy are extremely important for measuring the effects of treatment and monitoring the natural course of the disease. The urinary titin N fragment (UNT) has recently been proven to be related to muscle damage. Methods: The UNT was measured in 41 patients with SMA and 41 healthy controls. Clinical data, functional tests, and laboratory findings were also recorded. Results: We found significantly higher UNT levels in the patient samples than in the healthy subjects. The UNT was not related to disease type, functional test results, or serum creatine kinase levels. Conclusions: This cross-sectional study highlights the importance of the UNT as a potential noninvasive biomarker for spinal muscular atrophy. Its role can potentially be verified through longitudinal studies. Full article

Weakness, spasticity, and muscle shortening are common in children with cerebral palsy (CP), leading to deficits in gross motor, gait, and selective motor functions. While traditional assessments, such as the Gross Motor Function Measure (GMFM-66), instrumented gait analysis, and the Selective Control Assessment of the Lower Extremity (SCALE), are widely used, they are often limited by the resource-intensive nature of hospital-based evaluations. We employed cyclogram-based analysis, utilizing simple hip and knee joint kinematics to assess clinical measures, including GMFM-66, normalized gait speed, the gait deviation index (GDI), and the gait profile score (GPS). Principal component analysis was used to quantify the cyclogram shape characteristics. A total of 144 children with ambulatory spastic CP were included in the study. All the cyclogram parameters were significantly correlated with GMFM-66, gait speed, the GDI, and the sagittal plane subscore of the GPS for the hip and knee, with the swing phase area showing the strongest correlation. Regression models based on the swing phase area were used to estimate the GMFM-66 (R² = 0.301) and gait speed (R² = 0.484). The PC1/PC2 ratio showed a moderate correlation with selective motor control, as measured by the SCALE (R² = 0.320). These findings highlight the potential of hip–knee cyclogram parameters to be used as accessible digital biomarkers for evaluating motor control and gait function in children with bilateral spastic CP. Further prospective studies using wearable sensors, such as inertial measurement units, are warranted to validate and build upon these results. Full article

Urban mobility resilience plays a central role in sustainable urban planning discussions, especially considering the challenges of extreme events, climate change, and the increasing scarcity of fossil fuels. This study evaluates urban mobility resilience in Petrópolis (RJ), incorporating socio-spatial heterogeneity and energy vulnerability. This research fills methodological gaps in the literature by proposing a composite resilience index that integrates technical, socioeconomic, and fossil fuel dependency variables within a robust multicriteria framework. We selected eleven variables relevant to urban mobility and organized them into inference blocks. We normalized the variables using Gaussian functions, respecting their maximization or minimization characteristics. We applied the Analytic Hierarchy Process (AHP) to assign weights to the criteria and then aggregated and ranked the results using multicriteria analysis. The final index represents the adaptive capacity of urban territories facing the energy crisis, and we applied it spatially to the neighborhoods of Petrópolis. The analysis identified a significant concentration of neighborhoods with low resilience, particularly in quadrants, combining deficiencies in public transportation, high dependence on fossil fuels, and socioeconomic constraints. Factors such as limited pedestrian access, insufficient motorized public transport coverage, and a high proportion of elderly residents emerged as significant constraints on urban resilience. Intervention strategies that promote active mobility, improve accessibility, and diversify transportation modes proved essential for strengthening local resilience. The results emphasize the urgent need for public policies to reduce energy vulnerability, foster active mobility, and promote equity in access to transportation infrastructure. Full article

Background/Objectives: Dyskinetic cerebral palsy (DCP) often implies severe motor impairment and risk of health problems. Our aim was to follow up a group of young adults with DCP that we previously examined as children, to describe health, function, and living conditions. Methods: Interviews regarding health issues, treatments, and living conditions, and quality of life (RAND-36) and fatigue questionnaires were completed. Gross and fine motor function, communication, and speech ability were classified, and weight, height, spasticity, and dystonia were assessed and compared to previous data. Joint range of motion (ROM) was compared to older adults with DCP. Results: Dystonia was present in all fifteen participants, and spasticity in all but two. A decrease was found mainly in those who received intrathecal baclofen (ITB). ROM limitations were most pronounced in shoulder flexion, abduction and inward rotation (while outward rotation was hypermobile), hip abduction, hamstrings, and knee extension. The majority had frequent contact with primary and specialist healthcare. Seven participants were underweight, eight had a gastrostomy, and seven had ITB. Upper gastrointestinal and respiratory problems were frequent. Orthopedic surgery for scoliosis was reported in five, and lower extremity in nine, while fractures were reported in six participants. RAND-36 revealed physical functioning, general health, and vitality as the greatest problem areas. Fatigue was significant in 64%. Eight participants lived with their parents. Participants at more functional levels completed tertiary education and lived independently. Conclusions: Most participants had severe impairment and many health issues, despite decreased dystonia and spasticity due to ITB. Sleep problems and pain were uncommon. Full article

The paper provides an analysis of the energy efficiency of the swing drive system of hydraulic excavators, which integrally includes a hydraulic motor and a planetary reducer. The indicator of the drive’s energy efficiency is determined based on the efficiency of the hydraulic motor and the planetary reducer. The efficiency of the hydraulic motor is defined as a function of the specific flow, pressure, and the number of revolutions of the hydraulic motor. The efficiency of the reducer is determined using structural analysis of planetary gearboxes and the moment method. As an example, the results of a comparative analysis of the energy efficiency of the swing drive of a tracked hydraulic excavator, weighing 16,000 kg and having a bucket volume of 0.6 m³, are presented. From the set of possible generated variant solutions of the drive, obtained through the synthesis process based on the required torque and platform rotation speed, two extreme drive variants were selected for the analysis. In the first configuration, a hydraulic motor characterized by a low specific flow is combined with a three-stage reduction gear featuring a higher overall transmission ratio, whereas the second configuration integrates a high-specific-flow hydraulic motor with a two-stage reduction gear of a lower transmission ratio. The obtained results of the comparative analysis of the drive’s energy efficiency are presented depending on the change in the required torque and the rotational speed of the platform. Full article

Upper-limb impairments after stroke significantly affect patients’ quality of life and require effective rehabilitation strategies. Rehabilitation devices play a vital role in enhancing motor recovery. This study evaluated the efficacy of the Arm Booster, a bilateral arm-training device, in improving upper-limb impairment in patients with chronic stroke. Eighteen participants were randomly assigned to two groups: a device group (n = 9), using the Arm Booster; and a conventional physiotherapy group (n = 9). Both groups performed six bilateral upper-limb exercises (32 repetitions each) three times per week for eight weeks. Participants were further classified into mild spasticity (n = 5) and moderate-to-severe spasticity (n = 4) subgroups. The primary outcome was motor impairment, assessed using the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE). Secondary outcomes included spasticity, measured by the Modified Ashworth Scale (MAS), and daily functional use of the arm, assessed with the Motor Activity Log (MAL). Both groups showed significant improvements in FMA-UE scores and overall arm movement. The conventional group demonstrated additional gains in hand and wrist function and coordination. Notably, in the moderate-to-severe spasticity subgroup, the device group exhibited improvements in upper-limb movement and a trend toward reduced spasticity. These findings suggest that the Arm Booster may support motor recovery, encourage the use of the affected arm, improve movement control, and provide an efficient means for patients to exercise more frequently on their own. Full article

This study addresses three major challenges in non-motorized vehicle rider helmet detection: multi-spectral interference between the helmet and hair color (HSV spatial similarity > 0.82), target occlusion in high-density traffic flows (with peak density reaching 11.7 vehicles/frame), and perception degradation under complex weather conditions (such as overcast, foggy, and strong light interference). To tackle these issues, we developed the GMAL-YOLO detection algorithm. This algorithm enhances feature representation by constructing a Feature-Enhanced Neck Network (FENN) that integrates both global and local features. It employs the Global Mamba Architecture Enhancement (GMET) to reduce parameter size while strengthening global context capturing ability. It also incorporates Multi-Scale Spatial Pyramid Pooling (MSPP) combined with multi-scale feature extraction to improve the model’s robustness. The enhanced channel attention mechanism with self-attention (ECAM) is designed to enhance local feature extraction and stabilize deep feature learning through partial convolution and residual learning, resulting in a 13.04% improvement in detection precision under occlusion scenarios. Furthermore, the model’s convergence speed and localization precision are optimized using the modified Enhanced Precision-IoU loss function(EP-IoU). Experimental results demonstrate that GMAL-YOLO outperforms existing algorithms on the self-constructed HelmetVision dataset and public datasets. Specifically, in extreme scenarios, the false detection rate is reduced by 17.3%, and detection precision in occluded scenes is improved by 13.6%, providing an effective technical solution for intelligent traffic surveillance. Full article

Aim: This study explores the effects of core stabilization exercises on balance and upper extremity functions—both unilateral and bilateral—in children with cerebral palsy (CP). Method: Thirty-six children with CP (aged 5–12) were randomly assigned to a study group (n = 18) or control group (n = 18). Both groups received four weeks of physiotherapy and occupational therapy. The study group additionally performed ~45 min of daily core stabilization exercises. Outcome measures included the Box and Block Test (BBT), Assisting Hand Assessment (AHA), Pediatric Berg Balance Scale (PBBS), and Trunk Control Measurement Scale (TCMS). (ClinicalTrials.gov ID: NCT06973213). Results: No significant baseline differences were found between the groups (p > 0.05). Post-intervention, the study group showed significant improvements in PBBS (p = 0.011), TCMS static sitting (p = 0.003), dynamic reaching (p = 0.037), and total score (p = 0.044). Between-group differences remained non-significant for BBT, AHA, and TCMS selective movement control (p > 0.05). Within-group analysis revealed significant gains in BBT (median = 7), PBBS (median = 8), TCMS total (median = 12), static sitting (median = 3.5), and selective movement (median = 6) (all p < 0.001). AHA showed a near-significant trend (median = 6, p = 0.051). Conclusions: Core stabilization exercises significantly enhance balance and unilateral upper extremity function in children with CP. However, they show limited impact on bimanual function. Integration of these exercises into rehabilitation programs may optimize motor outcomes. Full article

Objective: The objective of this study was to examine 7 years of clinical physical therapy measures in a child with spastic diplegic cerebral palsy (CP) who received multiple botulinum toxin type A (BoNT-A) injections. Methods: A boy diagnosed with spastic diplegic CP, Gross Motor Function Classification System level II, received four episodes of BoNT-A from ages 4 to 10 years. Serial clinical measures of muscle strength, spasticity, lower extremity passive range of motion, gait kinematics, and gross motor function were collected in the gait analysis lab from age 3 to 10 years. Results: After improvements from ages 3 to 7 years, gait and motor function declined from ages 8 to 10 years with no improvement in spasticity or range of motion measurements. Muscle testing and gait kinematics defined a loss of plantarflexion strength. Conclusions: A decline in gross motor skills and gait is not typical for a child with spastic diplegia at age 8 years and its association with BoNT-A injections needs to be considered. This case demonstrates the importance of evaluating treatment outcomes for youth with spastic CP utilizing a set of reliable, and clinically useful measures of strength, spasticity, contracture, gait, and motor function. Critical examination of impairment and functional level measures defines goals, guides treatment, and evaluates outcomes. With this approach, pediatric therapists can empower families to make well-informed decisions. Full article

Background: The influence of gait speed on lower-extremity coordination while walking in people with Parkinson’s disease (pwPD) is poorly understood. This study sought to investigate the relationship between gait speed and hip–knee coordination and coordination variability in older adults and pwPD. Methods: A total of 27 pwPD and 21 healthy older adults were recruited. Participants walked in a straight line at slow, preferred, and fast walking speeds. Gait data were collected using inertial measurement units, and the kinematics of the hip and knee were calculated. Coordination and coordination variability at the hip–knee joint pair were determined using continuous relative phase. A repeated measures two-way ANCOVA tested the impact of gait speed on coordination and coordination variability, while group differences were evaluated using statistical parametric mapping (SPM). Results: Neither the healthy older adults nor the pwPD adjusted their hip–knee coordination in response to changes in gait speed. pwPD also displayed a trend towards restricted hip and knee joint excursion compared to older adults, which may further limit their ability to adapt gait strategies. Conclusions: These findings suggest that interventions addressing both joint excursion and motor adaptability may be important for improving gait function in individuals with Parkinson’s disease. Real-world applicability can be found in the potential of wearable sensors to become a valuable tool in routine clinical practice for both diagnosis and ongoing management. Trial registration: The study is registered in the German Clinical Trials Register (DRKS00022998). Full article

Background and Objectives: Brain-computer interface (BCI) technology is revolutionizing stroke rehabilitation by offering innovative neuroengineering solutions to address neurological deficits. By bypassing peripheral nerves and muscles, BCIs enable individuals with severe motor impairments to communicate their intentions directly through control signals derived from brain activity, opening new pathways for recovery and improving the quality of life. The aim of this study was to explore the beneficial effects of BCI system-based interventions on upper limb motor function and performance of activities of daily living (ADL) in stroke patients. We hypothesized that integrating BCI into occupational therapy would result in measurable improvements in hand strength, dexterity, independence in daily activities, and cognitive function compared to baseline. Materials and Methods: An observational study was conducted on 56 patients with subacute stroke. All patients received standard medical care and rehabilitation for 54 days, as part of the comprehensive treatment protocol. Patients underwent BCI training 2–3 times a week instead of some occupational therapy sessions, with each patient completing 15 sessions of BCI-based recoveriX treatment during rehabilitation. The occupational therapy program included bilateral exercises, grip-strengthening activities, fine motor/coordination tasks, tactile discrimination exercises, proprioceptive training, and mirror therapy to enhance motor recovery through visual feedback. Participants received ADL-related training aimed at improving their functional independence in everyday activities. Routine occupational therapy was provided five times a week for 50 min per session. Upper extremity function was evaluated using the Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and dynamometry to assess gross manual dexterity, fine motor skills, and grip strength. Independence in daily living was assessed using the Functional Independence Measure (FIM). Results: Statistically significant improvements were observed across all the outcome measures (p < 0.001). The strength of the stroke-affected hand improved from 5.0 kg to 6.7 kg, and that of the unaffected hand improved from 29.7 kg to 40.0 kg. Functional independence increased notably, with the FIM scores rising from 43.0 to 83.5. Cognitive function also improved, with MMSE scores increasing from 22.0 to 26.0. The effect sizes ranged from moderate to large, indicating clinically meaningful benefits. Conclusions: This study suggests that BCI-based occupational therapy interventions effectively improve upper extremity motor function and daily functions and have a positive impact on the cognition of patients with subacute stroke. Full article

Background: Spasticity, a hallmark of quadriplegic cerebral palsy (CP), severely impacts mobility and quality of life. While exercise is known to enhance fitness and motor function in individuals with CP, its specific efficacy in reducing upper extremity spasticity remains insufficiently studied. This research investigated the effects of weight-resistance exercise (RE), hand cycle bike exercise (BE), and aquatic exercise (AE) on upper extremity spasticity in an adult with quadriplegic CP. Method: The participant was a 35-year-old individual with quadriplegic spastic CP, presenting severe spasticity in the right upper extremity and lower limbs, and milder left arm involvement. Dependent on a power wheelchair, they were cognitively intact, college-educated, and had participated in a community exercise program for five years. Over nine weeks, the participant completed 18 sessions—6 per modality of RE, BE, and AE—with each session held twice weekly for 50 min. Spasticity was assessed using the Modified Ashworth Scale (MAS) before and after sessions, with comprehensive pre- and post-intervention evaluations. Result: Total MAS scores decreased significantly from 2.76 to 2.33 (p < 0.05). AE yielded the largest reduction (2.81 to 2.10), followed by BE (2.75 to 2.36) and RE (2.72 to 2.54). ANOVA confirmed AE’s superior efficacy (F(2,15) = 27.20, p < 0.001, ηp² = 0.78), with a 0.33 reduction overall. Conclusions: AE was most effective, likely due to buoyancy, followed by BE, with RE showing the least impact. These findings highlight aquatic interventions as promising for spasticity management in CP, necessitating further longitudinal, multi-participant research. Full article

Background: Gait and balance alterations in post-stroke patients are one of the most disabling symptoms that can persist in chronic stages of the disease. In this context, rehabilitation has the fundamental role of promoting functional recovery, mitigating gait and balance deficits, and preventing falling risk. Robotic end-effector devices, like the G-EO system (e.g., G-EO system, Reha Technology, Olten, Switzerland), can be a useful device to promote gait recovery in patients with chronic stroke. Materials and Methods: Twelve chronic stroke patients were enrolled and evaluated at baseline (T0) and at post-treatment (T1). These patients received forty sessions of robotic gait training (RGT) with the G-EO system (experimental group, EG), for eight weeks consecutively, in addition to standard rehabilitation therapy. The data of these subjects were compared with those coming from a sample of twelve individuals (control group, CG) matched for clinical and demographic features who underwent the same amount of conventional gait training (CGT), in addition to standard rehabilitation therapy. Results: All patients completed the trial, and none reported any side effects either during or following the training. The EG showed significant improvements in balance (p = 0.012) and gait (p = 0.004) functions measured with the Tinetti Scale (TS) after RGT. Both groups (EG and CG) showed significant improvement in functional independence (FIM, p < 0.001). The Fugl-Meyer Assessment—Lower Extremity (FMA-LE) showed significant improvements in motor function (p = 0.001, p = 0.031) and passive range of motion (p = 0.031) in EG. In EG, gait and balance improvements were influenced by session, age, gender, time since injury (TSI), cadence, and velocity (p < 0.05), while CG showed fewer significant effects, mainly for age, TSI, and session. EG showed significantly greater improvements than CG in balance (p = 0.003) and gait (p = 0.05) based on the TS. Conclusions: RGT with end-effectors, like the G-EO system, can be a valuable complementary treatment in neurorehabilitation, even for chronic stroke patients. Our findings suggest that RGT may improve gait, balance, and lower limb motor functions, enhancing motor control and coordination. Full article

The Grey Wolf Optimizer (GWO) is a well-known metaheuristic algorithm that currently has an extremely wide range of applications. However, with the increasing demand for accuracy, its shortcomings of low exploratory and population diversity are increasingly exposed. A modified Grey Wolf Optimizer (M-GWO) is proposed to tackle these weaknesses of the GWO. The M-GWO introduces mutation operators and different location-update strategies, achieving a balance between exploration and development. The experiment validated the performance of the M-GWO using the CEC2017 benchmark function and compared the results with five other advanced metaheuristic algorithms: the Improved Grey Wolf Optimizer (IGWO), GWO, Whale Optimization Algorithm (WOA), Dung Beetle Optimizer (DBO), and Harris Hawks Optimization (HHO). The performance results indicate that the M-GWO has a better performance than competitor algorithms on all 29 functions in dimensions 30 and 50, except for function 26 in dimension 30 and function 28 in dimension 50. Compared with competitor algorithms, the proposed M-GWO is the most effective algorithm, with an overall effectiveness of 96.5%. In addition, in order to show the value of the M-GWO in the practical engineering field, the M-GWO is used to optimize the PI controller parameters of the current loop of the permanent magnet synchronous motor (PMSM) system. By designing a PI controller parameter optimization scheme based on the M-GWO, the fluctuation of the q-axis current and d-axis current of the motor is reduced. The designed scheme reduces the q-axis fluctuation to around −2~1 A and the d-axis current fluctuation to around −2~2 A. By comparing the current-tracking errors of the $q$-axis and $d$-axis under different algorithms, the validity of the optimized parameters of the M-GWO is proved. Full article