10 results on '"Zörner A"'
Search Results
2. Targeted Walking in Incomplete Spinal Cord Injury: Role of Corticospinal Control
- Author
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Vinzenz von Tscharner, Armin Curt, Christopher Awai Easthope, Marc Bolliger, Christian Meyer, Tim Killeen, Stephanie A Stalder, Linard Filli, Björn Zörner, and University of Zurich
- Subjects
Adult ,Male ,030506 rehabilitation ,medicine.medical_specialty ,animal structures ,Pyramidal Tracts ,610 Medicine & health ,Electromyography ,Walking ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Humans ,Muscle, Skeletal ,Spinal cord injury ,Gait ,Spinal Cord Injuries ,Aged ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Adaptation, Physiological ,Biomechanical Phenomena ,Gait analysis ,Exercise Test ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,Female ,Neurology (clinical) ,Neuromuscular control ,0305 other medical science ,business ,030217 neurology & neurosurgery - Abstract
Locomotor recovery after incomplete spinal cord injury (iSCI) is influenced by spinal and supraspinal networks. Conventional clinical gait analysis fails to differentiate between these components. There is evidence that corticospinal control is enhanced during targeted walking, where each foot must be continuously placed on visual targets in randomized order. This study investigates the potential of targeted walking in the functional assessment of corticospinal integrity. Twenty-one controls and 16 individuals with chronic iSCI performed normal and targeted walking on a treadmill while electromyograms (EMGs) and kinematics were recorded. Precision (% of accurate foot placements) in targeted walking was significantly lower in individuals with iSCI (82.9 ± 14.7%, controls: 94.9 ± 4.0%). Although the overall kinematic pattern was comparable between walking conditions, controls showed significantly higher semitendinosus (ST) activity before heel-strike during targeted walking. This was accompanied by a shift of relative EMG intensity from 90-120 Hz to lower frequencies of 20-60 Hz, previously associated with corticospinal control of muscle activity. Targeted walking in individuals with iSCI evoked smaller EMG changes, suggesting that the switch to more corticospinal control is impaired. Accordingly, mildly impaired iSCI individuals revealed higher adaptations to the targeted walking task than more-impaired individuals. Recording of EMGs during targeted walking holds potential as a research tool to reveal further insights into the neuromuscular control of locomotion. It also complements findings of pre-clinical studies and is a promising novel surrogate marker of integrity of corticospinal control in individuals with iSCI and other neurological impairments. Future studies should investigate its potential for diagnosis or tracking recovery during rehabilitation.
- Published
- 2020
3. Targeted Walking in Incomplete Spinal Cord Injury: Role of Corticospinal Control
- Author
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Meyer, Christian, primary, Filli, Linard, additional, Stalder, Stephanie A., additional, Awai Easthope, Christopher, additional, Killeen, Tim, additional, von Tscharner, Vinzenz, additional, Curt, Armin, additional, Zörner, Björn, additional, and Bolliger, Marc, additional
- Published
- 2020
- Full Text
- View/download PDF
4. Modulating Arm Swing Symmetry with Cognitive Load: A Window on Rhythmic Spinal Locomotor Networks in Humans?
- Author
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Tim Killeen, Armin Curt, Marc Bolliger, Linard Filli, Christopher S. Easthope, Björn Zörner, and Michael Linnebank
- Subjects
Adult ,Male ,030506 rehabilitation ,medicine.medical_specialty ,Movement ,Walking ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Physical medicine and rehabilitation ,Rhythm ,medicine ,Humans ,Spinal cord injury ,Spinal Cord Injuries ,Aged ,Motor control ,Middle Aged ,medicine.disease ,Spinal cord ,Biomechanical Phenomena ,medicine.anatomical_structure ,Gait analysis ,Arm ,Exercise Test ,Physical therapy ,Female ,Neurology (clinical) ,Nerve Net ,0305 other medical science ,Psychology ,Locomotion ,030217 neurology & neurosurgery ,Cognitive load ,Stroop effect - Abstract
In healthy subjects, changes in arm swing symmetry while walking are observed when a cognitive dual task is added, with a tendency toward left-dominant arm swing as cognitive load increases. We applied a modified Stroop word/color naming paradigm to investigate this effect in spinal cord injured (SCI) patients. Six patients with cervical SCI (cSCI), 6 with thoracic injuries (tSCI; all 12 patients American Spinal Injury Association [ASIA] Injury Score [AIS]D), and 12 healthy, matched controls underwent three-dimensional 3D gait analysis while walking normally at a comfortable speed (NW) and when performing an additional congruent (CS) and incongruent (IS) Stroop task. An arm swing symmetry index (ASI)-in which positive values indicate proportionally more movement on the left and vice versa-was calculated. Even in the baseline NW condition, all three subject groups showed larger arm movements on the left. In controls, ASI increased (NW, 13.7 ± 6.3; CS, 16.6 ± 6.4; IS, 19.6 ± 7.8) as the task became more demanding. A larger shift in tSCI patients (NW, 15.8 ± 6.0; CS, 23.4 ± 3.8; IS, 30.7 ± 4.4) was driven by a significant reduction in right wrist trajectory (p = 0.014), whereas cSCI patients showed a small reduction in mean ASI with high variability (NW, 14.2 ± 10.7; CS, 9.3 ± 13.5; IS, 6.0 ± 12.9). The effect of the IS task on ASI compared to baseline (NW) was significantly different between tSCI (+12.5 ± 6.3) and cSCI (-8.2 ± 6.0) patients (p = 0.011). Disruption of the long propriospinal connections coordinating arm and leg movements during walking may explain the heightened sensitivity to manipulation of cognitive load in tSCI, whereas the more robust automaticity in cSCI may be attributed to impaired supraspinal inputs in the context of preserved intraspinal pathways.
- Published
- 2017
5. SHORT COMMUNICATION: Levodopa Therapy in Incomplete Spinal Cord Injury
- Author
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Björn Zörner, Oliver Maric, and Volker Dietz
- Subjects
Levodopa ,medicine.medical_specialty ,Activities of daily living ,business.industry ,Spinal cord ,medicine.disease ,Placebo ,Crossover study ,law.invention ,Physical medicine and rehabilitation ,medicine.anatomical_structure ,Randomized controlled trial ,law ,medicine ,Physical therapy ,Neurology (clinical) ,business ,Spinal cord injury ,Stroke ,medicine.drug - Abstract
We studied the influence of levodopa (L-Dopa) on training effects in subjects with spinal cord injury (SCI). A low-dose of L-Dopa per day is known to enhance the effects of physical training after stroke. This is tested here in subjects suffering a SCI. Twelve subacute, incomplete SCI (iSCI) subjects (ASIA C and D) were randomized in a trial with a double-blind, crossover design to receive 6 weeks of L-Dopa (200 mg), followed by 6 weeks of placebo, or vice versa. Outcome measures were ASIA Motor-Score (AMS) reflecting motor recovery; walking ability, assessed by the Walking Index of Spinal Cord Injury (WISCI); and Activities of Daily Living (ADL), as monitored by the Spinal Cord Independence Measure (SCIM). Both placebo and L-Dopa, in combination with physiotherapy, produced a significant motor recovery after SCI. The combination of L-Dopa and physiotherapy had no greater effect on the outcome than placebo and physiotherapy. The possible reasons for the different effect of L-Dopa in stroke and iSCI subjects are discussed.
- Published
- 2008
6. Modulating Arm Swing Symmetry with Cognitive Load: A Window on Rhythmic Spinal Locomotor Networks in Humans?
- Author
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Killeen, Tim, primary, Easthope, Christopher S., additional, Filli, Linard, additional, Linnebank, Michael, additional, Curt, Armin, additional, Bolliger, Marc, additional, and Zörner, Björn, additional
- Published
- 2017
- Full Text
- View/download PDF
7. Levodopa therapy in incomplete spinal cord injury
- Author
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Oliver, Maric, Björn, Zörner, and Volker, Dietz
- Subjects
Adult ,Male ,Movement ,Recovery of Function ,Walking ,Middle Aged ,Combined Modality Therapy ,Antiparkinson Agents ,Levodopa ,Young Adult ,Double-Blind Method ,Activities of Daily Living ,Humans ,Female ,Physical Therapy Modalities ,Spinal Cord Injuries ,Aged - Abstract
We studied the influence of levodopa (L-Dopa) on training effects in subjects with spinal cord injury (SCI). A low-dose of L-Dopa per day is known to enhance the effects of physical training after stroke. This is tested here in subjects suffering a SCI. Twelve subacute, incomplete SCI (iSCI) subjects (ASIA C and D) were randomized in a trial with a double-blind, crossover design to receive 6 weeks of L-Dopa (200 mg), followed by 6 weeks of placebo, or vice versa. Outcome measures were ASIA Motor-Score (AMS) reflecting motor recovery; walking ability, assessed by the Walking Index of Spinal Cord Injury (WISCI); and Activities of Daily Living (ADL), as monitored by the Spinal Cord Independence Measure (SCIM). Both placebo and L-Dopa, in combination with physiotherapy, produced a significant motor recovery after SCI. The combination of L-Dopa and physiotherapy had no greater effect on the outcome than placebo and physiotherapy. The possible reasons for the different effect of L-Dopa in stroke and iSCI subjects are discussed.
- Published
- 2008
8. SHORT COMMUNICATION: Levodopa Therapy in Incomplete Spinal Cord Injury
- Author
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Maric, Oliver, primary, Zörner, Björn, additional, and Dietz, Volker, additional
- Published
- 2008
- Full Text
- View/download PDF
9. Clinical Algorithm for Improved Prediction of Ambulation and Patient Stratification after Incomplete Spinal Cord Injury.
- Author
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Björn Zörner, Wolf U. Blanckenhorn, Volker Dietz, and Armin Curt
- Subjects
- *
MEDICAL protocols , *SPINAL cord injuries , *OUTPATIENT medical care , *SOMATOSENSORY evoked potentials , *HEALTH outcome assessment , *CLINICAL trials , *LOGISTIC regression analysis , *STATISTICAL correlation - Abstract
AbstractThe extent of ambulatory recovery after motor incomplete spinal cord injury (miSCI) differs considerably amongst affected persons. This makes individual outcome prediction difficult and leads to increased within-group variation in clinical trials. The aims of this study on subjects with miSCI were: (1) to rank the strongest single predictors and predictor combinations of later walking capacity; (2) to develop a reliable algorithm for clinical prediction; and (3) to identify subgroups with only limited recovery of walking function. Correlation and logistic regression analyses were performed on a dataset of 90 subjects with tetra- or paraparesis, recruited in a prospective European multicenter study. Eleven measures obtained in the subacute injury period, including clinical examination, tibial somatosensory evoked potentials (tSSEP), and demographic factors, were related to ambulatory outcome (WISCI II, 6minWT) 6 months after injury. The lower extremity motor score (LEMS) alone and in combination was identified as most predictive for later walking capacity in miSCI. Ambulatory outcome of subjects with tetraparesis was correctly predicted for 92% (WISCI II) or 100% (6minWT) of the cases when LEMS was combined with either tSSEP or the ASIA Impairment Scale, respectively. For individuals with paraparesis, prediction was less distinct, mainly due to low prediction rates for individuals with poor walking outcome. A clinical algorithm was generated that allowed for the identification of a subgroup composed of individuals with tetraparesis and poor ambulatory recovery. These data provide evidence that a combination of predictors enables a reliable prediction of walking function and early patient stratification for clinical trials in miSCI. [ABSTRACT FROM AUTHOR]
- Published
- 2010
10. SHORT COMMUNICATION: Levodopa Therapy in Incomplete Spinal Cord Injury.
- Author
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Oliver Maric, Björn Zörner, and Volker Dietz
- Subjects
- *
SPINAL cord injuries , *THERAPEUTICS , *DOPA , *PHYSICAL therapy , *PLACEBOS , *MOTOR ability , *HEALTH outcome assessment - Abstract
AbstractWe studied the influence of levodopa (L-Dopa) on training effects in subjects with spinal cord injury (SCI). A low-dose of L-Dopa per day is known to enhance the effects of physical training after stroke. This is tested here in subjects suffering a SCI. Twelve subacute, incomplete SCI (iSCI) subjects (ASIA C and D) were randomized in a trial with a double-blind, crossover design to receive 6 weeks of L-Dopa (200 mg), followed by 6 weeks of placebo, or vice versa. Outcome measures were ASIA Motor-Score (AMS) reflecting motor recovery; walking ability, assessed by the Walking Index of Spinal Cord Injury (WISCI); and Activities of Daily Living (ADL), as monitored by the Spinal Cord Independence Measure (SCIM). Both placebo and L-Dopa, in combination with physiotherapy, produced a significant motor recovery after SCI. The combination of L-Dopa and physiotherapy had no greater effect on the outcome than placebo and physiotherapy. The possible reasons for the different effect of L-Dopa in stroke and iSCI subjects are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
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