Search Results (208)

Background/Objectives: Huntington’s disease (HD) is a neurodegenerative disorder involving the basal ganglia and is characterized by psychiatric, cognitive, and movement dysfunction, including gait and balance impairment. Given the limited efficacy of pharmacological treatments for HD motor symptoms, nonpharmacological approaches like rhythmic auditory stimulation are being explored. This study aims to describe walking performance in people with HD during rhythmic auditory stimulation using external musical cues and internal singing cues. Methods: Individuals in the manifest stage of HD performed walking in four conditions: (1) comfortable pace, (2) cognitive dual task, (3) musical cue (music was played aloud), and (4) singing cue (participants sang aloud). Sensors measured cadence, velocity, stride length, and variability. Relationships between change in cadence and motor and cognitive measures were explored. Results: While no direct measurements of synchronization were performed, limiting our interpretation, neither the external musical cue nor the singing cue significantly improved walking performance. Both cues increased variability, similar to what was observed during the dual task. Greater subjective balance confidence and better cognitive performance were associated with positive cadence change during cueing. Conclusions: Musical cues may be too cognitively demanding for individuals with Huntington’s disease as they worsen gait variability without increasing gait speed, cadence, or stride length. Although global cognition and perceived balance confidence were related to the ability to increase cadence, very few people were able to increase their cadence during either cue. Therefore, the results do not support the use of musical cues to improve gait for individuals with Huntington’s disease. Full article

Hyperthermal environments are encountered in many situations, and significant heat stress can exacerbate the fatigue perception of individuals and potentially threaten their safety. Heat acclimation (HA) interventions have many benefits in preventing the risk of incidents. However, whether HA interventions in specific environments can cope with other different hyperthermal environments remains uncertain. In this study, forty-three young male participants were heat-acclimated over 10 days of training on a motorized treadmill in a fixed hyperthermal environment, and they were tested in different hyperthermal environments. Physiological indices (rectal temperature (T_r), heart rate (HR), skin temperature (T_sk), and total sweat loss (M_sl)) and subjective perception (rating of perceived exertion (RPE) and thermal sensation votes (TSVs)) were measured during both the heat stress test (HST) sessions and HA training sessions. The results show that HR and T_sk significantly differed between pre- and post-heat acclimation (p < 0.05 for all) following the acclimation program. However, after heat acclimation training, the reduction in T_r (ΔT_r) was more notable in lower-ET* environments, and M_sl showed distinct changes in different ET* environments. The RPE and TSV decreased after HA interventions, although the difference was not significant. The results indicate that HA can effectively reduce the peak of physiological parameters. However, when subjected to stronger heat stress, the improvement effects of heat acclimation on human responses will be affected. In addition, HA can alleviate physiological thermal strain, thereby reducing the adverse effects on mobility, but it has no effect on the supervisor’s ability to perceive the environment. This study suggests that additional HA training can reduce the risk of activities in high-temperature environments but exhibits different effects under different environmental conditions, indicating that hot acclimation suits have selective effects on the environment. This study provides recommendations for additional HA training before high-temperature activities. Full article

Background/Objectives: Multiple sclerosis (MS) is a complex neurological disease that is associated with a broad spectrum of physical and psychological symptoms. Psychosocial adjustment (PSA) refers to the ability to cope with these challenges, which influence quality of life (QoL) and depressiveness in ways not yet fully understood. This study explores the relationship of PSA and disease-specific symptoms in MS, including fatigue, a prominent MS symptom. Additionally, PSA was compared to Amyotrophic Lateral Sclerosis (ALS) to disentangle the impact of disease trajectory on PSA. Methods: We interviewed 77 MS patients using patient-reported outcome measures on QoL and depression and compared them to 30 ALS patients. Confirmatory factor analysis and regression analysis were used to identify PSA indicators and predictors in MS, while t-tests assessed PSA differences across diseases. Results: Key PSA indicators in MS included physical (PQoL), mental (MQoL), and subjective (SQoL) quality of life, as well as depressiveness, with cognitive and motor fatigue emerging as significant predictors. MS patients had higher PQoL and SQoL and lower levels of depression compared to ALS patients, while both groups were comparable with regard to MQoL. Conclusions: PSA in MS is supported by high QoL and low depression levels, with fatigue being a significant predictor. Despite different disease trajectories, patients with MS and ALS showed comparable MQoL, indicating that both diseases similarly impact mental QoL, reflecting a partial overlap in psychosocial adjustment. Overall, psychosocial adjustment was more favorable in MS, likely due to its slower disease progression compared to ALS. Full article

Background/Objectives: Spasticity in children with cerebral palsy (CP) can impair motor-related functions. The objective of this exploratory, prospective study was to examine if transcutaneous electrical nerve stimulation (TENS) in a whole-body suit leads to changes in spasticity and other related effects. Methods: Thirty-one children with CP GMFCS III–V, with a median age of 11.0 years (age range of 7–17 years), were consecutively included, and they used the suit with TENS for 24 weeks. The primary outcome was spasticity measured using the Modified Ashworth Scale (MAS). Functional motor-related tasks were evaluated by the Goal Attainment Scale (SMART GAS). The Modified Tardieu Scale (MTS), passive Range of Motion (pROM), GMFM-66, and Posture and Postural Ability Scale (PPAS) assessments were performed. Results: Seventeen subjects (17/31) completed the 24 weeks. Dropout was due to difficulty in donning the suit. The level of overall spasticity, most pronounced in the proximal arms and legs, was reduced according to the MAS, but not the MTS or pROM. Subject-relevant motor-related goals improved significantly in standing/walking and hand/arm function. Changes in the GMFM-66 and PPAS were not significant. Conclusions: Although there were statistically significant but underpowered changes in the MAS after 24 weeks, there were no clinically relevant effects. Exploratorily, we found observer-reliant motor-related functional improvements, which, however, we were unable to detect when trying to quantify them. Donning the suit led to dropout throughout the study. Caregivers need to allocate time, mental capacity and have the physical skill set for donning the suit for long-term use. Full article

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia. The accurate and continuous monitoring of these symptoms is essential for optimizing treatment strategies and improving patient outcomes. Traditionally, clinical assessments have relied on scales and methods that often lack the ability for continuous, real-time monitoring and can be subject to interpretation bias. Recent advancements in wearable technologies, such as smartphones, smartwatches, and activity trackers (ATs), present a promising alternative for more consistent and objective monitoring. This review aims to evaluate the use of smartphones and smart wrist devices, like smartwatches and activity trackers, in the management of PD, assessing their effectiveness in symptom evaluation and monitoring and physical performance improvement. Studies were identified by searching in PubMed, Scopus, Web of Science, and Cochrane Library. Only 13 studies of 1027 were included in our review. Smartphones, smartwatches, and activity trackers showed a growing potential in the assessment, monitoring, and improvement of motor symptoms in people with PD, compared to clinical scales and research-grade sensors. Their relatively low cost, accessibility, and usability support their integration into real-world clinical practice and exhibit validity to support PD management. Full article

This study aims to analyze the possibility of developing balance ability, highlighting symmetries, asymmetries, and levels of proprioception, in children aged 11–13 from practicing indoor and outdoor climbing and bouldering/escalation exercises. The research subjects were 54 children (both boys and girls) aged 11–13, divided into two groups: an experimental group of 28 students (14 boys and 14 girls) who participated in an extracurricular climbing activity twice a week during the 2023–2024 school year, and a control group of 26 students (13 boys and 13 girls) who did not engage in extracurricular motor activities. During the initial and final evaluations, 12 tests were used to assess balance ability, symmetries, and asymmetries—10 tests were conducted using the Sensbalance MiniBoard 1.0 platform in addition to the Standing Stork test for each leg. The analysis of the results showed statistically significant differences between the groups, with the experimental group recording improvements in symmetry and proprioception related to increased balance levels. This work is addressed to teachers, trainers, and physical therapists who, in the educational process, aim to develop balance and proprioception as objectives that improve children’s motor skills. In conclusion, the study results reveal the impact of a program based on climbing and escalating exercises in extracurricular activities on the development of static and dynamic balance ability. Full article

In the field of brain–computer interfaces (BCI), the decoding of motor imagery EEG signals is significantly hindered by individual differences in EEG signals, which limits the generalization ability of decoding models. To address this challenge, this study proposes a mutual information weighted filter bank regularized common spatial pattern (WFBRCSP) algorithm. The algorithm divides the signal into multiple frequency bands, adaptively assigns subject weights based on the mutual information maximization criterion, and optimizes the covariance matrix with a regularization strategy, significantly improving the robustness of feature extraction. The results on the public BCI competition datasets BCICIII IVa and BCICIV IIb exhibit that the WFBRCSP outperforms traditional CSP, RCSP, FBCSP, FBRCSP, and OFBRCSP methods in terms of classification accuracy (87.87% and 85.92%). In addition, through the mutual information-weighted and regularized spatial filtering of data from different subjects, WFBRCSP demonstrates excellent real-time performance in cross-subject scenarios, validating its practical value in brain–computer interface systems. This study provides a new approach to addressing the issues of individual differences and noise interference in EEG signals. Full article

Objectives: Water polo players ought to possess various physical capacities and well-developed cognitive functions that reflect the requirements of their specific playing position. Therefore, the objective of this study was to compare the cognitive performance, anthropometric characteristics and specific swimming capacities of youth water polo players in different playing positions. Methods: The present cross-sectional study involved 106 youth water polo players. The subjects were recruited as part of a project for talent identification and selection for the Croatian National Water Polo Team. Testing included anthropometric measurements, specific swimming capacities and cognitive performance (Stroop test). Results: Among the 106 youth water polo players, there were 15 goalkeepers (14.2%), 21 center-defenders (19.8%), 17 center-forwards (16.0%), 34 drivers (32.1%) and 19 wings (17.9%), with the mean age of 14.14 ± 0.38 years. The wings performed faster than center-forwards in both StroopOff time (wings: 57.14 ± 10.04 s vs. center-forwards: 67.03 ± 9.72 s, p = 0.016) and StroopOn time (wings: 66.18 ± 15.86 s vs. center-forwards: 80.24 ± 15.64 s, p = 0.019). Conclusions: In conclusion, this study demonstrated significant differences between different playing positions in youth water polo players, specifically between center-forwards and wings. They performed faster than center-forwards in all tested variables of the Stroop test, measures of psychomotor ability, response inhibition and motor speed, as well as in specific swimming capacities measured in the 50 m crawl and the 400 m crawl. The results of this study provide a valuable foundation for establishing developmental recommendations for different playing positions, aimed at improving player’s performance. These recommendations should take into account anthropometric characteristics, specific functional swimming capacities and cognitive functions that influence players’ game intelligence, which can be enhanced through properly designed training programs. Full article

Transfer learning is the act of using the data or knowledge in a problem to help solve different but related problems. In a brain computer interface (BCI), it is important to deal with individual differences between topics and/or tasks. A kind of capsule decision neural network (CDNN) based on transfer learning is proposed. In order to solve the problem of feature distortion caused by EEG feature extraction algorithm, a deep capsule decision network was constructed. The architecture includes multiple primary capsules to form a hidden layer, and the connection between the advanced capsule and the primary capsule is determined by the neural decision routing algorithm. Unlike the dynamic routing algorithm that iteratively calculates the similarity between primary capsules and advanced capsules, the neural decision network computes the relationship between each capsule in the deep and shallow hidden layers in a probabilistic manner. At the same time, the distribution of the EEG covariance matrix is aligned in Riemann space, and the regional adaptive method is further introduced to improve the independent decoding ability of the capsule decision neural network for the subject’s EEG signals. Experiments on two motor imagery EEG datasets show that CDNN outperforms several of the most advanced transfer learning methods. Full article

Objectives: The purpose of this study was to investigate the relationship of any error (delta; ∆) between the image of one’s own walking rhythm and the actual walking rhythm and physical activity, as a new motor imagery assessment. Methods: The subjects were classified into two groups: a high activity group (HA-Group) having high physical activity with less than four hours of sitting time per day, and a low activity group (LA-Group) having low physical activity with more than four hours of daily sitting time. Visual rhythm, auditory rhythm, mental comfortable walking rhythm, and mental maximum walking rhythm were used to assess new motor imagery. Their beats per minute were measured and any error (delta; ∆) from the actual rhythm was calculated: ∆ visual rhythm, ∆ auditory rhythm, ∆ mental normal gait rhythm, and ∆ mental maximal gait rhythm. Results: When comparing the two groups, the HA-Group had significantly higher ∆ visual rhythm, lower ∆ auditory rhythm, higher ∆ mental comfortable walking rhythm, and lower ∆ mental maximum walking rhythm ability than the LA-Group. Furthermore, in an ANCOVA with age, ∆visual rhythm, and ∆auditory rhythm as adjustment factors, the HA-Group had significantly lower ∆mental maximum walking rhythm than the LA-Group. Conclusions: These results showed that the rhythmic assessment of the imagery of maximum walking was associated with stationery time. It is possible that the more inaccurate the imagery of maximum walking, the longer the sitting or lying time. Full article

The gut microbiota plays a pivotal role in gastrointestinal inflammation and immune response since changes in microbiota may result in abnormal neurotransmitter expression, inducing changes in gastrointestinal sensory–motor function and leading to symptom onset in irritable bowel syndrome (IBS) patients. The Bifidobacterium adolescentis species has a documented immunomodulatory effect through its ability to produce γ-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the mammalian central nervous system, which is reduced in IBS patients. This is a multicentric, randomized, double-blind, placebo-controlled, parallel-arm trial aimed at evaluating the effectiveness of Bifidobacterium adolescentis PRL2019 in children with IBS. IBS children diagnosed according to Rome IV criteria were enrolled and randomized into two groups to receive one stick containing 20 × 10⁹ colony-forming unit of Bifidobacterium adolescentis PRL2019 (Gabapral, Pontenure, Italy) or an equivalent placebo once a day, in a 1:1 ratio, for 12 weeks. Clinical evaluation of symptoms was performed every four weeks using validated scores. Bowel habit characteristics were assessed using the Bristol Stool Chart (BSC). Seventy-two subjects (mean age 12.2 ± 1.8 years, 30 males) were enrolled and randomized into two groups, each of thirty-six patients. No significant differences were observed between the two groups regarding demographic characteristics, distribution of IBS subtypes, or baseline measures of IBS severity and BSC. The proportion of patients achieving complete remission was significantly higher in the BA Group (19/36; 52.8%) than in the Placebo Group (7/36; 19.4%, p = 0.003, odds ratio [OR] 0.216, 95% confidence interval [CI] 0.075–0.619). Both groups obtained a reduction in Total IBS Symptom Severity Scale (IBS SSS), Pain Intensity Score (PIS), Pain Frequency Score (PFS), and Life Interference Score (LIS) from T0 to T12. However, upon intergroup comparison, only in the BA group did the IBS-SSS (p = 0.001), PIS (p = 0.001), LIS (p = 0.015), and PFS (p = 0.005) significantly improve between T0 and T12. BSC showed a greater representation of normal stools (type 3–4) at the end of treatment in the BA group compared with baseline (25% vs. 58.3%, p = 0.004), especially in patients who presented an IBS–constipation subtype at T0 (44.5% vs. 19.4%, p = 0.02). In our study, Bifidobacterium adolescentis PRL2019 reduces the severity and frequency of symptoms in children with IBS, positively affecting bowel habits in children with the IBS–constipation subtype. Full article

Chronic overexposure to manganese (Mn) can occur in occupational settings, such as welding, leading to increased Mn levels in the brain. Excess brain Mn accumulation may result in neurotoxicity, which is characterized by Parkinsonian-like symptoms including motor and cognitive dysfunctions. In this work, we demonstrate a novel methodology for personalized diagnosis and spatial characterization of abnormal Magnetic Resonance Imaging R1 (R1 = 1/T1) relaxation rates arising from excessive Mn accumulation in welders’ brains. Utilizing voxel-wise population-derived norms based on a frequency age-matched non-exposed group (n = 25), we demonstrate the ability to conduct subject-specific assessments and mapping of Mn exposure using MRI relaxometry. Our results show elevated R1 in multiple brain regions in individual welders, but also extreme between-subject variability in Mn accumulation, debasing the concept that high exposures correlate with uniformly high Mn deposition in the brain. Consequently, the presented personalized methodology serves as a counterpart to group-based comparison, which allows for understanding the level of individual exposure and the toxicokinetics of Mn accumulation. This work lays a foundation for improved occupational health assessments and preventive measures against neurotoxic metal exposure. Full article

Background/Objectives: To determine whether epidural electrical stimulation (EES) improves sensory recovery and walking function in patients with chronic spinal cord injury (SCI) with a grade on the American Spinal Cord Injury Association impairment scale (AIS) of C or D at the cervical level. Methods: Three individuals with cervical-level chronic AIS D SCI were enrolled in the study. The mean injury duration and age were 4.8 ± 4.5 (range: 1.5–10) and 56.7 ± 9 years, respectively. The participants received personalized electrical stimulation for 36 weeks and were evaluated for their SCI characteristics, the result of an AIS assessment according to the lower extremity sensorimotor scale, their muscle activity, and preoperative walking ability parameters, initially as well as at weeks 8 and 36 of the EES intervention. Results: Participants receiving EES significantly increased the muscle activity in most lower limb muscles. Regarding the AIS assessment of the lower extremities, one participant fully regained a light touch sensation, while two fully recovered their pinprick sensation (AIS sensory scores increased from 14 to 28). One participant achieved a full motor score, whereas the others’ scores increased by 19 and 7 points. Compared with preoperative gait parameters, two participants showed improvements in their walking speed and cadence. Walking symmetry, an important parameter for assessing walking function, improved by 68.7%, 88%, and 77% in the three participants, significantly improving the symmetry index (p = 0.003). Conclusions: Thus, EES may be an effective strategy for sensory impairment recovery, as well as muscular activity and strength improvement. These findings may facilitate stable walking in subjects with chronic incomplete SCI, but larger clinical trials are warranted. Clinical trial: NCT05433064. Full article

Background: Motor skills in early and middle childhood are essential for physical play, social interactions, and academic development. Children with autism spectrum disorder (ASD) often exhibit atypical sensory responses, which can impact self-care and other developmental areas. This study explores the impact of sensory and motor rehabilitation using a Motor Sensory Room to stimulate motor development in children with ASD. Methods: Twenty-five children with ASD, preschool and school-aged (2–10 years), were divided into three groups based on the DSM-5 severity levels. The PEP-3 scale was used to assess cognitive, language, motor, emotional, social, and behavioral development. Ten children underwent a 3-month Motor Sensory Room intervention, and data were collected longitudinally. A control group of ten children, matched in age, sex, and diagnosis, did not receive the intervention. A 12-month follow-up is planned for all participants. Results: Children exhibited diverse profiles. Type B subjects displayed more severe symptoms, while Type A showed milder symptoms with better language and interpersonal skills. After the 3-month intervention, improvements were noted in several PEP-3 areas. For sensory levels (hypo-reactivity), the percentage of individuals at medium levels increased from 44% to 50%. For hyper-reactivity, the percentage at medium levels rose from 30% to 40%. Motor skills improved, with the percentage of individuals with high motor abilities rising from 20% to 25%. Relational behaviors also saw gains, with an increase from 50% to 55% in medium-level behaviors. The experimental group demonstrated better outcomes compared to the control group, particularly in sensory and motor skills. Conclusions: Preliminary findings suggest that sensory and motor training in a Motor Sensory Room improves sensory integration, motor coordination, and social interaction in children with ASD. Further research is needed to confirm long-term benefits. Full article

Brain–computer interfaces (BCI) are an effective tool for recognizing motor imagery and have been widely applied in the motor control and assistive operation domains. However, traditional intention-recognition methods face several challenges, such as prolonged training times and limited cross-subject adaptability, which restrict their practical application. This paper proposes an innovative method that combines a lightweight convolutional neural network (CNN) with domain adaptation. A lightweight feature extraction module is designed to extract key features from both the source and target domains, effectively reducing the model’s parameters and improving the real-time performance and computational efficiency. To address differences in sample distributions, a domain adaptation strategy is introduced to optimize the feature alignment. Furthermore, domain adversarial training is employed to promote the learning of domain-invariant features, significantly enhancing the model’s cross-subject generalization ability. The proposed method was evaluated on an fNIRS motor imagery dataset, achieving an average accuracy of 87.76% in a three-class classification task. Additionally, lightweight experiments were conducted from two perspectives: model structure optimization and data feature selection. The results demonstrated the potential advantages of this method for practical applications in motor imagery recognition systems. Full article