Search

Common Spatial Pattern (CSP) has been recognized as a standard and powerful method for the identification of Electroencephalography (EEG)-based Motor Imagery (MI) tasks when implementing brain–computer interface (BCI) systems towards the motor rehabilitation of lost movements. The combination of BCI systems with robotic systems, such as upper limb exoskeletons, has proven to be a reliable tool for neuromotor rehabilitation. Therefore, in this study, the effects of temporal and frequency segmentation combined with layer increase for spatial filtering were evaluated, using three variations of the CSP method for the identification of passive movement vs. MI+passive movement. The passive movements were generated using a left upper-limb exoskeleton to assist flexion/extension tasks at two speeds (high—85 rpm and low—30 rpm). Ten healthy subjects were evaluated in two recording sessions using Linear Discriminant Analysis (LDA) as a classifier, and accuracy (ACC) and False Positive Rate (FPR) as metrics. The results allow concluding that the use of temporal, frequency or spatial selective information does not significantly (p< 0.05) improve task identification performance. Furthermore, dynamic temporal segmentation strategies may perform better than static segmentation tasks. The findings of this study are a starting point for the exploration of complex MI tasks and their application to neurorehabilitation, as well as the study of brain effects during exoskeleton-assisted MI tasks.

Simple Summary: An essential stage in the maturation of the central nervous system and the self-organization of neural circuits occurs during the first year of life. Sensory feedback resulting from interactive and spontaneous movements is instrumental for developing sensorimotor circuits in early infancy, and shorter gestational periods may have an impact on muscle strength and functionality. We examined developmental changes in muscle responses to passive movements and muscle activities during spontaneous movements in preterm and full-term infants by analyzing polymyographic recordings in the lower and upper limb muscles. The major finding of the current study was that there were age-related changes in the manifestation of muscle responses in both preterm and full-term infants. The first six months were the major observational period for the variations in post-term development of muscle activity in preterm infants. Manifestation of muscle reactions at an early developmental stage may reflect the processes underlying the generation of appropriate muscle tone, which is also an integral part of all movements. In preterm infants, some aspects of muscular development may occur differently than in infants born at term. Here we evaluated early manifestations of muscle tone by measuring muscle responses to passive stretching (StR) and shortening (ShR) in both upper and lower limbs in preterm infants (at the corrected age from 0 weeks to 12 months), and compared them to those reported in our previous study on full-term infants. In a subgroup of participants, we also assessed spontaneous muscle activity during episodes of relatively large limb movements. The results showed very frequent StR and ShR, and also responses in muscles not being primarily stretched/shortened, in both preterm and full-term infants. A reduction of sensorimotor responses to muscle lengthening and shortening with age suggests a reduction in excitability and/or the acquisition of functionally appropriate muscle tone during the first year of life. The alterations of responses during passive and active movements in preterm infants were primarily seen in the early months, perhaps reflecting temporal changes in the excitability of the sensorimotor networks. [ABSTRACT FROM AUTHOR]

Robot-assisted body movements are a useful approach for the rehabilitation of motor dysfunction. Various robots based on end-effector or exoskeleton type have been proposed. However, the effect of these robots on brain activity during assistive lower limb movements remains unclear. In this study, we evaluated brain activity results among robot-assisted passive movements, voluntary active movements, and kinesthetic motor imagery. We measured and compared the brain activities of 21 young, healthy individuals during three experimental conditions associated with lower limb movements (active, passive, and imagery conditions) using functional near-infrared spectroscopy (fNIRS). Our results showed that although different brain areas with significant activity were observed among the conditions, the temporal patterns of the activity in each recording channel and the spatial patterns of functional connectivity showed high similarity between robot-assisted passive movements and voluntary active movements. Conversely, the robot-assisted passive movements did not show any similarity to motor imagery. Overall, these findings suggest that the robotic assistive approach is useful for activating not only afferent processes associated with sensory feedback processing but also motor control-related efferent processes. [ABSTRACT FROM AUTHOR]

Despite the recognized importance of bodily movements in spatial audition, few studies have integrated action-based protocols with spatial hearing in the peripersonal space. Recent work shows that tactile feedback and active exploration allow participants to improve performance in auditory distance perception tasks. However, the role of the different aspects involved in the learning phase, such as voluntary control of movement, proprioceptive cues, and the possibility of self-correcting errors, is still unclear. We study the effect of guided reaching exploration on perceptual learning of auditory distance in peripersonal space. We implemented a pretest-posttest experimental design in which blindfolded participants must reach for a sound source located in this region. They were divided into three groups that were differentiated by the intermediate training phase: Guided, an experimenter guides the participant’s arm to contact the sound source; Active, the participant freely explores the space until contacting the source; and Control, without tactile feedback. The effects of exploration feedback on auditory distance perception in the peripersonal space are heterogeneous. Both the Guided and Active groups change their performance. However, participants in the Guided group tended to overestimate distances more than those in the Active group. The response error of the Guided group corresponds to a generalized calibration criterion over the entire range of reachable distances. Whereas the Active group made different adjustments for proximal and distal positions. The results suggest that guided exploration can induce changes on the boundary of the auditory reachable space. We postulate that aspects of agency such as initiation, control, and monitoring of movement, assume different degrees of involvement in both guided and active tasks, reinforcing a non-binary approach to the question of activity-passivity in perceptual learning and supporting a complex view of the phenomena involved in action-based learning.

Manifestation of muscle reactions at an early developmental stage may reflect the processes underlying the generation of appropriate muscle tone, which is also an integral part of all movements. In preterm infants, some aspects of muscular development may occur differently than in infants born at term. Here we evaluated early manifestations of muscle tone by measuring muscle responses to passive stretching (StR) and shortening (ShR) in both upper and lower limbs in preterm infants (at the corrected age from 0 weeks to 12 months), and compared them to those reported in our previous study on full-term infants. In a subgroup of participants, we also assessed spontaneous muscle activity during episodes of relatively large limb movements. The results showed very frequent StR and ShR, and also responses in muscles not being primarily stretched/shortened, in both preterm and full-term infants. A reduction of sensorimotor responses to muscle lengthening and shortening with age suggests a reduction in excitability and/or the acquisition of functionally appropriate muscle tone during the first year of life. The alterations of responses during passive and active movements in preterm infants were primarily seen in the early months, perhaps reflecting temporal changes in the excitability of the sensorimotor networks.

Normal subjects can completely eliminate resistance upon imposed head-on-trunk rotations when they are asked to relax. It is not, however, clear how neck reflexes to stretch can be voluntarily suppressed. Reflexive responses might be modified by adjusting the gain of the reflex loop through descending control. Theoretically, necessary corrections upon interfering disturbances during coordinated motor performance requiring the interplay of relaxation/activation may be missing if muscle relaxation is taking place exclusively by this mechanism. It has been alternatively proposed that sensory information from the periphery may be allowed to "neutralize" neck reflexes if it is fed back with opposite sign to the structures driving the reflexes. Six healthy subjects were asked to relax while subjected to head-on-trunk rotations generated by a head motor. After any initial resistance had completely subsided, the head was unexpectedly exposed to "ramp-and-hold" perturbations of up to 2-amplitude and 0.7 s duration. Resistance to stretch consistently reappeared thereupon, suggesting that stretch reflex gain had not been set to zero during the previously achieved complete relaxation. Resistance to perturbations under these circumstances was compared with the forces generated when the same ramp-and-hold displacements were delivered unpredictably to the head held stationary. A quantitative model of neck proprioceptive reflexes suppression has been thus constructed. Gain scheduling or "motor set" cannot sufficiently account for the voluntary reflex suppression during slow passive head rotations. Instead, we propose as underlying mechanism, the "neutralization" of the controlling servo by means of continuous feedback tracking displacement and force signals from the periphery. NEW & NOTEWORTHY Head stabilizing neck reflexes can be voluntarily suppressed or activated depending on the task at hand. By applying brief perturbations unexpectedly, both during passive head-on-trunk movements and at rest, we investigated the mechanism of voluntary suppression of resistance to stretch. A physiologically plausible, neuromechanical model of voluntary/reflexive interactions was constructed favoring feedback over reflex gain adjustments. Accordingly, muscle relaxation during imposed head movements is based on sensory feedback similarly to muscle contractions during purposeful movements. [ABSTRACT FROM AUTHOR]

The fMRI study of 7 healthy volunteers was performed to evaluatethe neuron networks of sensorimotor system during activeand passive movements of the left and right index fingers. Whileperforming all the tasks, the predominant activation of primarysensorimotor, premotor, supplementary motor areas, secondarysensory zones were shown on the contralateral side, as well asipsilateral cerebellar activation. It was demonstrated that brainactivation areas in both types of paradigm were corresponding,as well as the activation clusters size, amplitude and voxel coordinates,with the maximum values in the primary motor and sensorycortex. These results allow recommending the paradigm ofpassive index finger movements in given rate for the evaluation ofsensorimotor system in patients with movement disorders.

Previous evidence has shown that tool-use can reshape one’s own body schema, extending peripersonal space and modulating the representation of related body parts. Here, we investigated the role of tool action in shaping the body metric representation, by contrasting two different views. According to a first view, the shaping would rely on the mere execution of tool action, while the second view suggests that the shaping induced by tool action on body representation would primarily depend on the representation of the action goals to be accomplished. To this aim, we contrasted a condition in which participants voluntarily accomplish the movement by representing the program and goal of a tool action (i.e., active tool-use training) with a condition in which the tool-use training was produced without any prior goal representation (i.e., passive tool-use training by means of robotic assistance). If the body metric representation primarily depends on the coexistence between goal representation and bodily movements, we would expect an increase of the perceived forearm length in the post- with respect to the pre-training phase after the active training phase only. Healthy participants were asked to estimate the midpoint of their right forearm before and after 20 min of tool-use training. In the active condition, subjects performed “enfold-and-push” movements using a rake to prolong their arm. In the passive condition, subjects were asked to be completely relaxed while the movements were performed with robotic assistance. Results showed a significant increase in the perceived arm length in the post- with respect to the pre-training phase only in the active task. Interestingly, only in the post-training phase, a significant difference was found between active and passive conditions, with a higher perceived arm length in the former than in the latter. From a theoretical perspective, these findings suggest that tool-use may shape body metric representation only when action programs are motorically represented and not merely produced. From a clinical perspective, these results support the use of robots for the rehabilitation of brain-damaged hemiplegic patients, provided that robot assistance during the exercises is present only “as-needed” and that patients’ motor representation is actively involved.

Muscle tone represents one of the important concepts for characterizing changes in the state of the developing nervous system. It can be manifested in the level of activity of flexors and extensors and in muscle reactions to its passive stretching (StR) or shortening (ShR). Here we investigated such reactions in a cohort of healthy infants aged from 2 weeks to 12 months. We examined the presence and the characteristics of StR and ShR during slow passive cyclic flexion/extension movements (T~3 s) in the hip, knee, ankle, and elbow joints while awake infants were in the supine position. The results showed that most infants demonstrated prominent ShRs in response to passive joint rotations, although the StR was observed more frequently, suggesting that the ShR is an important component of adaptive motor behavior already at an early developmental stage. Interestingly, the occurrence of both StR and ShR in most muscles significantly decreased throughout the first year of life. Passive cyclic flexion/extension movements could also evoke rhythmic muscle responses in other joints or in the contralateral limb, however, such responses were predominantly observed in younger infants (

Muscle tone represents one of the important concepts for characterizing changes in the state of the developing nervous system. It can be manifested in the level of activity of flexors and extensors and in muscle reactions to its passive stretching (StR) or shortening (ShR). Here we investigated such reactions in a cohort of healthy infants aged from 2 weeks to 12 months. We examined the presence and the characteristics of StR and ShR during slow passive cyclic flexion/extension movements (T~3 s) in the hip, knee, ankle, and elbow joints while awake infants were in the supine position. The results showed that most infants demonstrated prominent ShRs in response to passive joint rotations, although the StR was observed more frequently, suggesting that the ShR is an important component of adaptive motor behavior already at an early developmental stage. Interestingly, the occurrence of both StR and ShR in most muscles significantly decreased throughout the first year of life. Passive cyclic flexion/extension movements could also evoke rhythmic muscle responses in other joints or in the contralateral limb, however, such responses were predominantly observed in younger infants (<6 months). A noticeable manifestation of muscle reactions at an early developmental stage, along with spontaneous motor activity in this period of life, may reflect the processes underlying a formation of appropriate muscle tone and the self-organization of neural circuits. A substantial reduction of ipsilateral and contralateral muscle responses to passive movements with age is consistent with the idea of a functional reorganization of the motor circuitry during early development. [ABSTRACT FROM AUTHOR]

Previous evidence has shown that tool-use can reshape one's own body schema, extending peripersonal space and modulating the representation of related body parts. Here, we investigated the role of tool action in shaping the body metric representation, by contrasting two different views. According to a first view, the shaping would rely on the mere execution of tool action, while the second view suggests that the shaping induced by tool action on body representation would primarily depend on the representation of the action goals to be accomplished. To this aim, we contrasted a condition in which participants voluntarily accomplish the movement by representing the program and goal of a tool action (i.e., active tool-use training) with a condition in which the tool-use training was produced without any prior goal representation (i.e., passive tool-use training by means of robotic assistance). If the body metric representation primarily depends on the coexistence between goal representation and bodily movements, we would expect an increase of the perceived forearm length in the post- with respect to the pre-training phase after the active training phase only. Healthy participants were asked to estimate the midpoint of their right forearm before and after 20 min of tool-use training. In the active condition, subjects performed "enfold-and-push" movements using a rake to prolong their arm. In the passive condition, subjects were asked to be completely relaxed while the movements were performed with robotic assistance. Results showed a significant increase in the perceived arm length in the post- with respect to the pre-training phase only in the active task. Interestingly, only in the post-training phase, a significant difference was found between active and passive conditions, with a higher perceived arm length in the former than in the latter. From a theoretical perspective, these findings suggest that tool-use may shape body metric representation only when action programs are motorically represented and not merely produced. From a clinical perspective, these results support the use of robots for the rehabilitation of brain-damaged hemiplegic patients, provided that robot assistance during the exercises is present only "as-needed" and that patients' motor representation is actively involved. [ABSTRACT FROM AUTHOR]

Further development of an EEG based communication device for patients with disorders of consciousness (DoC) could benefit from addressing the following gaps in knowledge – first, an evaluation of different types of motor imagery; second, an evaluation of passive feet movement as a mean of an initial classifier setup; and third, rapid delivery of biased feedback. To that end we investigated whether complex and / or familiar mental imagery, passive, and attempted feet movement can be reliably detected in patients with DoC using EEG recordings, aiming to provide them with a means of communication. Six patients in a minimally conscious state (MCS) took part in this study. The patients were verbally instructed to perform different mental imagery tasks (sport, navigation), as well as attempted feet movements, to induce distinctive event-related (de)synchronization (ERD/S) patterns in the EEG. Offline classification accuracies above chance level were reached in all three tasks (i.e. attempted feet, sport, and navigation), with motor tasks yielding significant (p

The early stages of motor skill acquisition are often marked by uncertainty about the sensory and motor goals of the task, as is the case in learning to speak or learning the feel of a good tennis serve. Herewepresent an experimental model of this early learning process, in which targets are acquired by exploration and reinforcement rather than sensory error. We use this model to investigate the relative contribution of motor and sensory factors to human motor learning. Participants make active reaching movements or matched passive movements to an unseen target using a robot arm. We find that learning through passive movements paired with reinforcement is comparable with learning associated with active movement, both in terms of magnitude and durability, with improvements due to training still observable at a 1 week retest. Motor learning is also accompanied by changes in somatosensory perceptual acuity. No stable changes in motor performance are observed for participants that train, actively or passively, in the absence of reinforcement, or for participants who are given explicit information about target position in the absence of somatosensory experience. These findings indicate that the somatosensory system dominates learning in the early stages of motor skill acquisition. [ABSTRACT FROM AUTHOR]

When humans simultaneously perform different movements with both hands, each limb movement interferes with the contralateral limb movement (bimanual coupling). Previous studies on both healthy volunteers and patients with central or peripheral nervous lesions suggested that such motor constraints are tightly linked to intentional motor programs, rather than to movement execution. Here, we aim to investigate this phenomenon, by using a circles-lines task in which, when subjects simultaneously draw lines with the right hand and circles with the left hand, both the trajectories tend to become ovals (bimanual coupling effect). In a first group, we immobilized the subjects’ left arm with a cast and asked them to try to perform the bimanual task. In a second group, we passively moved the subjects’ left arm and asked them to perform voluntary movements with their right arm only. If the bimanual coupling arises from motor intention and planning rather than spatial movements, we would expect different results in the two groups. In the Blocked group, where motor intentionality was required but movements in space were prevented by immobilization of the arm, a significant coupling effect (i.e., a significant increase of the ovalization index for the right hand lines) was found. On the contrary, in the Passive group, where movements in space were present but motor intentionality was not required, no significant coupling effect was observed. Our results confirmed, in healthy subjects, the central role of the intentional and predictive operations, already evidenced in pathological conditions, for the occurrence of bimanual coupling. [ABSTRACT FROM AUTHOR]

Further development of an EEG based communication device for patients with disorders of consciousness (DoC) could benefit from addressing the following gaps in knowledge-first, an evaluation of different types of motor imagery; second, an evaluation of passive feet movement as a mean of an initial classifier setup; and third, rapid delivery of biased feedback. To that end we investigated whether complex and/or familiar mental imagery, passive, and attempted feet movement can be reliably detected in patients with DoC using EEG recordings, aiming to provide them with a means of communication. Six patients in a minimally conscious state (MCS) took part in this study. The patients were verbally instructed to perform different mental imagery tasks (sport, navigation), as well as attempted feet movements, to induce distinctive event-related (de)synchronization (ERD/S) patterns in the EEG. Offline classification accuracies above chance level were reached in all three tasks (i.e., attempted feet, sport, and navigation), with motor tasks yielding significant (p < 0.05) results more often than navigation (sport: 10 out of 18 sessions; attempted feet: 7 out of 14 sessions; navigation: 4 out of 12 sessions). The passive feet movements, evaluated in one patient, yielded mixed results: whereas time-frequency analysis revealed task-related EEG changes over neurophysiological plausible cortical areas, the classification results were not significant enough (p < 0.05) to setup an initial classifier for the detection of attempted movements. Concluding, the results presented in this study are consistent with the current state of the art in similar studies, to which we contributed by comparing different types of mental tasks, notably complex motor imagery and attempted feet movements, within patients. Furthermore, we explored new venues, such as an evaluation of passive feet movement as a mean of an initial classifier setup, and rapid delivery of biased feedback. [ABSTRACT FROM AUTHOR]

Despite the recognized importance of bodily movements in spatial audition, few studies have integrated action-based protocols with spatial hearing in the peripersonal space. Recent work shows that tactile feedback and active exploration allow participants to improve performance in auditory distance perception tasks. However, the role of the different aspects involved in the learning phase, such as voluntary control of movement, proprioceptive cues, and the possibility of self-correcting errors, is still unclear. We study the effect of guided reaching exploration on perceptual learning of auditory distance in peripersonal space. We implemented a pretest-posttest experimental design in which blindfolded participants must reach for a sound source located in this region. They were divided into three groups that were differentiated by the intermediate training phase: Guided, an experimenter guides the participant's arm to contact the sound source; Active, the participant freely explores the space until contacting the source; and Control, without tactile feedback. The effects of exploration feedback on auditory distance perception in the peripersonal space are heterogeneous. Both the Guided and Active groups change their performance. However, participants in the Guided group tended to overestimate distances more than those in the Active group. The response error of the Guided group corresponds to a generalized calibration criterion over the entire range of reachable distances. Whereas the Active group made different adjustments for proximal and distal positions. The results suggest that guided exploration can induce changes on the boundary of the auditory reachable space. We postulate that aspects of agency such as initiation, control, and monitoring of movement, assume different degrees of involvement in both guided and active tasks, reinforcing a non-binary approach to the question of activity-passivity in perceptual learning and supporting a complex view of the phenomena involved in action-based learning., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hüg, Bermejo, Tommasini and Di Paolo.)

Summary: Objectives: To identify the aims of treatment when physiotherapists use passive movements (PMs) for ventilated and sedated patients on intensive care in the UK. Method: Postal questionnaires distributed to senior physiotherapists working within all National Health Service (NHS) trusts with open level 3 ICU beds. Open questionnaire items surveyed the aims of using PMs in different clinical areas (neurology, cardiology, orthopaedics/trauma, general surgery, medicine, other). Results: The vast majority of respondents stated that the aim of using PMs was to maintain joint range of movement (ROM) in ventilated and sedated patients across all clinical areas. Respondents also identified additional uses of PMs for neurological patients. Conclusion: There appears to be a high level of consensus amongst physiotherapists that PMs influence joint range and that there will be a loss of range if PMs are not carried out. Currently this is not supported by empirical evidence. Therefore, future research should investigate the actual physiological effects of PMs and the clinical reasoning underpinning their use in critically ill patients. [Copyright &y& Elsevier]

The degree of activation of the central stepping program during passive leg movement was studied in healthy subjects under unloading conditions; the excitability of spinal motoneurons was studied during passive and voluntary stepping movements. Passive stepping movements with characteristics maximally close to those during voluntary stepping were accomplished by the experimenter. The bursts of muscular activity during voluntary and imposed stepping movements were compared. In addition, the influence on the leg movement of artificially created loading onto the foot was studied. The excitability of spinal motoneurons was estimated by the amplitude of modulation of the m. soleus H reflex. Changes in the H reflex (Hoffmann's reflex) after fixation of the knee and hip joints were also studied. In most subjects, passive movements were accompanied by bursts of electromyographic (EMG) activity in the hip muscles (sometimes in shank muscles); the timing of the EMG burst during the step cycle coincided with the burst's timing during voluntary stepping. In many cases, the bursts in EMG activity exceeded the activity of homonymous muscles during voluntary stepping. Simulation of foot loading influenced significantly the distal part of the moving extremity during both voluntary and passive movements, which was expressed in the appearance of movements in the ankle joint and an increase in the phasic EMG activity of the shank muscles. The excitability of motoneurons during passive movements was higher than during voluntary movements. Changes and modulation of the H reflex throughout the step cycle were similar without restriction of joint mobility and without hip joint mobility. Fixation of the knee joint was of great importance. It is supposed that imposed movements activate the same mechanisms of rhythm generation as supraspinal commands during voluntary movements. During passive movements, presynaptic inhibition depends mostly on the afferent influences from the moving leg rather than on the central commands. Under the conditions of 'air-stepping,' the afferent influences from the foot pressure receptors are likely to interact actively with the central program of stepping and to determine the final activity pattern irrespective of the movement type (voluntary or passive). [ABSTRACT FROM AUTHOR]

In this paper we present an original method to estimate in vivo the joint dynamics of the human limbs. The method is based on a noninvasive and painless technology making use of an optical motion capture system and an associated skeletal model to record the human motion and compute its kinematics and its dynamics. The formalism that is used for the identification is commonly used in robotics. The passive limb joints properties are modeled by enhanced springdamper systems. The inverse dynamics is sampled along a movement to give an over-determined system. The obtained system is solved by the linear least-squares method. To perform the estimation, we place emphasis on giving indicators and requirements to interpret the obtained results, and on using painless, passive constraint-free movements that are usually performed during the clinical diagnosis of neuromuscular diseases. Finally the method is experimentally applied to two healthy subjects and five patients of neuromuscular diseases in order to estimate the upper-limb viscoelastic properties. The obtained results are discussed. [ABSTRACT FROM AUTHOR]

Patients with multiple sclerosis (MS) activate a more diffuse cortical network than do healthy subjects when they perform motor tasks. This brain functional reorganisation might contribute to the limiting of disability, but it is unclear whether there is a loss of regional activation in more advanced disease. The aim of this study was to assess whether functional reorganisation diminishes in more disabled patients with primary progressive (PP) MS. The differences in the fMRI response to active and passive movements of the dominant ankle of 13 patients and 16 controls were assessed. The relationships between functional activation and disability and brain lesion load and atrophy were investigated. Patients showed greater fMRI activation than controls with passive movements in the superior temporal gyrus, rolandic operculum, and putamen. The fMRI response to active and passive movements in the ipsilateral inferior frontal gyrus was lower in patients with greater disability and greater brain T2 lesion load, respectively. Furthermore, the fMRI activation with active movements in the contralateral cerebellum was lower in patients with worse mobility. The increased activity with passive movements in regions that participate in sensori–motor integration, such as the putamen, reflects true functional reorganisation, since passive movements induce brain activation through sensory afferents only. The inverse correlation between the fMRI response in regions that are associated with motor control, and clinical or MRI measures of disease progression, suggests that there is a loss of distributed activation in more disabled patients. This may inform future treatment strategies. [ABSTRACT FROM AUTHOR]

Abstract: We used a novel movement transition technique to look for evidence of a rapid onset drive to breathe related to the active component of exercise in humans. Ten volunteers performed the following transitions in a specially designed tandem exercise chair apparatus: rest to passive movement, passive to active movement, and rest to active movement. The transition from rest to active exercise was accompanied by an immediate increase in ventilation, as was the transition from rest to passive leg movement (Δ =6.06±1.09lmin−1, p <0.001 and Δ =3.30±0.57lmin−1, p =0.002, respectively). When subjects actively assumed the leg movements, ventilation again increased immediately and significantly (Δ =2.55±0.52lmin−1, p =0.032). Ventilation at the first point of active exercise was the same when started either from rest or from a background of passive leg movement (p =1.00). We conclude that the use of a transition from passive to active leg movements in humans recruits a ventilatory drive related to the active component of exercise, and this can be discerned as a rapid increase in breathing. [Copyright &y& Elsevier]

Recovery from hemiplegia is a complex phenomenon that depends on various adaptive processes involving both the affected and the unaffected hemisphere. Our aim in this study was to investigate changes in cerebral perfusion in hemiplegic stroke patients during passive movements and their correlation with the subsequent motor recovery. The study included 30 patients with single, subcortical ischemic cerebral lesions. Within 14 days (range 8 to 14 days) from stroke onset, all patients were examined for the effects of passive elbow movements on cerebral blood flow in the middle cerebral arteries (MCAs) by means of bilateral transcranial Doppler (TCD) ultrasonography. On the same day as TCD assessment, they were also evaluated clinically with the Canadian Neurological Scale (CNS) and with Medical Research Council (MRC) scale for motor deficit of the affected arm. A clinical evaluation using the same scales was repeated after two months of motor rehabilitation therapy. We investigated the relationship between changes of Mean Flow Velocity (MFV) during passive movements and degree of recovery after stroke. The logistic regression procedure indicated that out of all factors considered as possibly related to a good clinical motor deficit recovery of the affected arm, evaluated by means of MRC, only the MFV percentage increase played a predictive role. In particular, for each additional point of contralateral MFV percentage increase during passive movement of the affected arm, the relative probability of good clinical recovery increased 5.68 times (95% CI=1.76–18.40; p=0.004). Similar results were found when the clinical recovery was measured by means of the CNS (slope=0.40, p<0.001). Passive movements in hemiplegic stroke patients before clinical recovery elicit activation patterns that may be critical for the restoration of motor function.I n particular, early and consistent activation of the affected hemisphere, as detected with TCD, seems to predict the positive evolution of a motor deficit. [ABSTRACT FROM AUTHOR]

Non-phase-locked beta oscillatory changes during passive movements were studied in six healthy volunteers, and compared with those observed in a similar group during ballistic movements. Passive movements consisted of brisk wrist extensions done with the help of a pulley system. Changes in the beta band were determined by means of wavelet and Gabor transforms, and compared statistically with a pre-movement period. In this paradigm, a marked beta energy loss (event-related desynchronization, ERD) was present after the beginning of the movement, followed by a beta energy increase (event-related synchronization, ERS). The ERD/ERS was similar to that observed during ballistic movements, but without pre-movement components. Although both changes were maximal in the contralateral central electrode, the beta ERD showed a more bilateral topography. These findings suggest that afferent proprioceptive inputs may play a role in the final part of the beta ERD observed during voluntary movements. [Copyright &y& Elsevier]

Transcranial Doppler ultrasonography (TCD) has been widely used to obtain information about changes in cerebral perfusion during monitor activity after stroke. This type of application is greatly limited when severe motor deficits are presnet that impede the performance of an active motor task. In this study, we explored the effect of performing passive arm movements on cerebral perfusion. Twenty healthy subjects were investigated. A bilateral TCD monitoring of the middle cerebral artery (MCA) flow velocity was performed during the following experimental conditions: 1-min of active and passive flexion extension elbow movement and 1-min of active and passive dorsal extension hand movement. Each task was performed with both left and right arms. The percentage increase in flow velocity from rest to task performance was calculated. Each task produced a significantly greater increase in mean flow velocity in the contralateral MCA with respect to the ipsilateral. When comparing the effect of passive and active tasks, no significant difference in mean flow velocity changes recorded in the ipsilateral and the contralateral MCA was detected regarding either elbow or hand movements. These findings demonstrate the possibility of obtaining information about changes in hemispheric cerebral perfusion during passive movements involving elbow and hand. This type of application deserves further attention in the study of cerebral functional changes following cerebral lesions. [ABSTRACT FROM AUTHOR]