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The role of afferent feedback and central motor drive in muscle activation has a profound impact on our understanding of movement control in health and disease. Dr. Richard B. Stein was a pioneer who made major contributions to the field. In addition to fundamental discoveries using animal models, he translated this to the clinic to benefit patients with spinal cord and other neurological injuries. Along the way, he inspired a generation of scientists around the world. Key words: neurophysiology, motor control, translational medicine Le role de la retroaction afferente et de l'activite motrice centrale sur l'activation musculaire a une incidence profonde sur notre comprehension du controle des mouvements chez les personnes en bonne sante comme chez les malades. Le docteur Richard B. Stein a ete un pionnier en ce sens, avec des contributions majeures dans le domaine. Il est parvenu a des decouvertes fondamentales a l'aide de modeles chez les animaux qu'il a su de surcroit appliquer en clinique pour le bienfait des patients atteints de lesions de la moelle epiniere et ailleurs dans le systeme nerveux. Tout au long de son parcours, il a ete une source d'inspiration pour une generation de scientifiques partout dans le monde. Mots-cles : neurophysiologie, controle moteur, medecine translationnelle, Introduction The passing of Richard B. Stein (RBS), a giant in the field of neurophysiology, was a major loss and he will be much missed (Fig. 1). Dick, as he [...]

Simple Summary: Head and neck cancer is associated with significant morbidity. Shoulder and neck dysfunction, weight loss, and declines in muscular strength and physical functioning are commonly seen following cancer therapies. This pragmatic randomized controlled trial involved sixty-one individuals with cancer in the head and neck region who had completed their cancer treatment. The primary aim was to assess the effectiveness of the addition of lower-body resistance exercise training to a physiotherapeutic shoulder and neck exercise protocol on fatigue-related quality of life. Findings support the benefit of the combined intervention for fatigue-related quality of life, six-minute walk test distance, upper- and lower-body muscular strength, and physical activity level. The continued improvement in treatment effect over the one-year follow-up period suggests promise from this interdisciplinary approach to bridge individuals with head and neck cancer from rehabilitation care to general exercise and physical activity. Background: Established barriers to general exercise and physical activity among individuals with head and neck cancer include dry mouth, difficulty eating, weight loss, fear of injury, comorbidities, and treatment-related symptoms of pain and fatigue. Methods/Design: A 12-week pragmatic randomized controlled trial was conducted followed by an optional supported exercise transition phase. Eligible participants were individuals with head and neck cancers who had undergone surgery and/or radiation therapy to lymph node regions in the neck. Participants were randomized to a comparison group involving a shoulder and neck physiotherapeutic exercise protocol, or to a combined experimental group comprising the shoulder and neck physiotherapeutic exercise protocol and lower-body resistance exercise training. The primary outcome of this study was fatigue-related quality of life. Results: Sixty-one participants enrolled, 59 (97%) completed the randomized trial phase, 55 (90%) completed the 24-week follow-up, and 52 (85%) completed the one-year follow-up. Statistically significant between-group differences were found in favor of the combined experimental group for the fatigue-related quality of life, fitness outcomes, and overall physical activity. Paired comparisons confirmed significant within-group improvements for both groups from baseline to one-year follow-up across most outcomes. Discussion: A group-based combined physiotherapeutic and lower-body resistance exercise program was feasible and effective. Findings are limited to individuals who had undergone a surgical neck dissection procedure. Given the complexity of head and neck cancer, further pragmatic interdisciplinary research is warranted. [ABSTRACT FROM AUTHOR]

Neural prostheses are electronic stimulators that activate nerves to restore sensory or motor functions. Implanted neural prostheses receive command signals and in some cases energy to recharge their batteries through the skin by telemetry. Here, we describe a new approach that eliminates the implanted stimulator. Stimulus pulse trains are passed between two surface electrodes placed on the skin. An insulated lead with conductive terminals at each end is implanted inside the body. One terminal is located under the cathodal surface electrode and the other is attached to a nerve targeted for stimulation. A fraction (10%-15%) of the current flowing between the surface electrodes is routed through the implanted lead. The nerve is stimulated when the amount of routed current is sufficient. The aims of this study were to establish some basic electrical properties of the system and test long-term stability in chronic implants. Stimulation of the nerve innervating the ankle flexors produced graded force over the full physiological range at amplitudes below threshold for evoking muscle contractions under the surface electrodes. Implants remained stable for over 8 mo. The findings provide the basis for a new family of neural prostheses. Index Terms--Functional electrical stimulation, neural prostheses, passive implant.

Peripheral nerve injury is common and can have devastating consequences. In severe cases, functional recovery is often poor despite surgery. This is primarily due to the exceedingly slow rate of nerve regeneration at only 1–3 mm/day. The local environment in the distal nerve stump supportive of nerve regrowth deteriorates over time and the target end organs become atrophic. To overcome these challenges, investigations into treatments capable of accelerating nerve regrowth are of great clinical relevance and are an active area of research. One intervention that has shown great promise is perioperative electrical stimulation. Postoperative stimulation helps to expedite the Wallerian degeneration process and reduces delays caused by staggered regeneration at the site of nerve injury. By contrast, preoperative “conditioning” stimulation increases the rate of nerve regrowth along the nerve trunk. Over the past two decades, a rich body of literature has emerged that provides molecular insights into the mechanism by which electrical stimulation impacts nerve regeneration. The end result is upregulation of regeneration‐associated genes in the neuronal body and accelerated transport to the axon front for regrowth. The efficacy of brief electrical stimulation on patients with peripheral nerve injuries was demonstrated in a number of randomized controlled trials on compressive, transection and traction injuries. As approved equipment to deliver this treatment is becoming available, it may be feasible to deploy this novel treatment in a wide range of clinical settings. [ABSTRACT FROM AUTHOR]

Background: Ulnar neuropathy at the elbow (UNE) is the second commonest entrapment neuropathy after carpal tunnel syndrome (CTS) and yet the laterality is not well delineated. Our aim was to establish the laterality of UNE in a large cohort of patients.Methods: All new patients with clinical and electrodiagnostic (EDX) confirmed UNE over a 13-year period were included. We used multivariate analysis to examine potential predictors of laterality, and unilateral vs bilateral UNE.Results: Of 880 cases, 61% were left-sided and 39% right-sided. These proportions did not change regardless of the handedness of the patient. Patients with bilateral UNE were much more likely to be older male and have a variety of comorbidities.Conclusions: UNE appears to be present on the left 50% more often than on the right, regardless of the patient's handedness. [ABSTRACT FROM AUTHOR]