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Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5 mA for a period of 20 min. While, in the sham group, tDCS was only activated for 30 s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We compared the clinical and analytical performance of Alzheimer's disease (AD) plasma biomarkers measured using the single-molecule array (Simoa) and Lumipulse platforms. We quantified the plasma levels of amyloid beta 42 (Aβ42), Aβ40, phosphorylated tau (Ptau181), and total tau biomarkers in 81 patients with mild cognitive impairment (MCI), 30 with AD, and 16 with non-AD dementia. We found a strong correlation between the Simoa and Lumipulse methods. Concerning the clinical diagnosis, Simoa Ptau181/Aβ42 (AUC 0.739, 95% CI 0.592-0.887) and Lumipulse Aβ42 and Ptau181/Aβ42 (AUC 0.735, 95% CI 0.589-0.882 and AUC 0.733, 95% CI 0.567-0.900) had the highest discriminating power. However, their power was significantly lower than that of CSF Aβ42/Aβ40, as measured by Lumipulse (AUC 0.879, 95% CI 0.766-0.992). Simoa Ptau181 and Lumipulse Ptau181/Aβ42 were the markers most consistent with the CSF Aβ42/Aβ40 status (AUC 0.801, 95% CI 0.712-0.890 vs. AUC 0.870, 95% CI 0.806-0.934, respectively) at the ≥2.127 and ≥0.084 cut-offs, respectively. The performance of the Simoa and Lumipulse plasma AD assays is weaker than that of CSF AD biomarkers. At present, the analysed AD plasma biomarkers may be useful for screening to reduce the number of lumbar punctures in the clinical setting.

Objective: The purpose of this study was to investigate the effect of combining 2 exercises at different angles of the hip joint on the thickness of the transverse abdominis and internal oblique muscles., Methods: Twenty-eight healthy adults (22.7 ± 2.5 years of age; 64.93 ± 8.8 kg; body mass index: 22.2 ± 2 kg/m 2 ) performed the curl-up exercise and straight leg raise with external rotation of the hip and dorsiflexion of the ankle simultaneously. The thicknesses of transverse abdominis and internal oblique muscles were measured from right and left sides while resting, in curl up, curl up with 10º flexion of hip, curl up with 15º flexion of hip, and curl up with 10º flexion and 15º abduction of the hip. The means of muscle thicknesses were compared using repeated-measures analysis of variance and post hoc Bonferroni tests in the 5 positions., Results: The thicknesses of transverse abdominis ( P < .001) and internal oblique ( P < .001) muscles were significantly greater in curl up with 10º flexion and 15º abduction of hip compared with the other positions. There was no significant difference between abdominal muscle thicknesses in measuring from either side., Conclusion: Doing the curl-up exercise with 10º flexion and 15º abduction of the hip may be beneficial in strengthening deep abdominal muscles., (© 2023 by National University of Health Sciences.)

Objective: The use of the electroencephalography (EEG) technique in Alzheimer's disease (AD) diagnosis is scarce due to a lack of validation of its neurophysiological information with current biomarkers. Therefore, our goal was to assess correlations between brain spectral power signatures and cerebrospinal fluid markers (CSF) such as amyloid-β 42 load (Aβ-42), total tau (t-tau), and phosphorylated tau (p-tau) in a mild cognitive impairment (MCI) population. Furthermore, given the AD sex-dependent vulnerability related to CSF biomarkers, we went a little forward looking for different electrophysiological correlations for males and females independently., Methods: A data-driven approach was employed to determine bidimensional spectral power signatures (space-frequency) that correlated (Spearman) significantly with any of the three CSF markers in 27 patients with MCI in any of the two sex-dependent subsamples (i.e., 12 females and 15 males)., Results: Our main significant outcomes evidenced 1) a negative correlation of Aβ-42 load with central-posterior theta power and a negative correlation of t-tau with widespread alpha power within the male subsample, and 2) a significant negative correlation between t-tau and widespread beta power in the female subgroup., Conclusions: There is a distinctive profile of correlations between resting-state electrophysiological signatures and CSF markers in male and female individuals., Significance: The combination of these two measures would be pointing out the need of a more personalized approach to promote early AD diagnosis., (Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

Purpose: To evaluate the effect of using lavender oil as an olfactory stimulus with vestibular rehabilitation (VR) on balance, fear of falling down, and activities of daily living of people with multiple sclerosis., Methods: Forty participants were randomly assigned into experimental and control groups. The experimental group did the VR exercises while smelling the lavender oil scents. The control group did the VR exercises without it. Both groups did the exercises in ten 45-min sessions. We assessed the participants with the timed up and go (TUG) test, Berg balance scale (BBS), fall efficacy scale - international (FES-I), and the 29-item multiple sclerosis impact scale (MSIS-29). We did the tests at the baseline and after the last exercise session., Results: The experimental group performed significantly better in the BBS ( p  = 0.007), TUG ( p  = 0.045), and FES-I ( p  = 0.016) tests as well as in the MSIS-29's psychological subscale ( p  = 0.034) than did the control group., Conclusions: Using lavender oil as olfactory stimulus while doing the VR exercises can improve balance and reduce fear of falling down compared to doing the VR exercises without it in people with multiple sclerosis.Implications for rehabilitationIt seems that using lavender oil, as an olfactory stimulus, while doing vestibular rehabilitation exercises can improve balance and reduce fear of falling down in people with multiple sclerosis compared to doing the vestibular rehabilitation exercises without it.This treatment significantly alleviates the psychological effects of multiple sclerosis on daily life such as sleeping problems, feeling unwell, anxious, tense, depressed, etc.

Objective: Several strategies have been designed to improve balance after stroke. Although recent studies have suggested that the balance training in stroke should include exercises that are performed in different sensory conflict conditions, little attention has been paid to manipulation of visual input. This study aimed to compare effects of balance training on an unstable surface with balance training under visual deprivation conditions in persons with stroke., Method: Forty-five stroke patients were randomized into three groups: the visual deprivation- stable based training (VD-SBT); unstable based training (UBT); and control (C) groups. Subjects of the VD-SBT group performed balance training on a stable surface with closed eyes. The UBT group performed balance training on an unstable surface with open eyes. Patients were assessed before and after interventions for Timed Up and Go (TUG), Four Square Step (FSS) and Five Times Sit to Stand (FTSS) tests., Result: There was a significant difference in pre- post intervention time of TUG, FSS and FTSS tests in all three groups. In a comparison of three groups, the UBT and VD-SBT groups had a significant improvement in time of all tests but significant improvement in time of all tests was observed in the VD-SBT group in comparison with the UBT group. In the field of balance training, the manipulation of visual input was more effective than the manipulation of standing surface to reweighting the sensory information., Conclusion: We recommended balance rehabilitation programs after stroke performed under conditions to stimulate the use of underused sensory input., Competing Interests: There is no conflict of interest to disclose., (2021, JAPANESE PHYSICAL THERAPY ASSOCIATION.)

Manual ELISA assays are the most commonly used methods for quantification of biomarkers; however, they often show inter- and intra-laboratory variability that limits their wide use. Here, we compared the Innotest ELISA method with two fully automated platforms (Lumipulse and Elecsys) to determine whether these new methods can provide effective substitutes for ELISA assays. We included 149 patients with AD ( n = 34), MCI ( n = 94) and non-AD dementias ( n = 21). Aβ42, T-tau, and P-tau were quantified using the ELISA method (Innotest, Fujirebio Europe), CLEIA method on a Lumipulse G600II (Fujirebio Diagnostics), and ECLIA method on a Cobas e 601 (Roche Diagnostics) instrument. We found a high correlation between the three methods, although there were systematic differences between biomarker values measured by each method. Both Lumipulse and Elecsys methods were highly concordant with clinical diagnoses, and the combination of Lumipulse Aβ42 and P-tau had the highest discriminating power (AUC 0.915, 95% CI 0.822-1.000). We also assessed the agreement of AT(N) classification for each method with AD diagnosis. Although differences were not significant, the use of Aβ42/Aβ40 ratio instead of Aβ42 alone in AT(N) classification enhanced the diagnostic accuracy (AUC 0.798, 95% CI 0.649-0.947 vs. AUC 0.778, 95% CI 0.617-0.939). We determined the cut-offs for the Lumipulse and Elecsys assays based on the Aβ42/Aβ40 ratio ± status as a marker of amyloid pathology, and these cut-offs were consistent with those recommended by manufacturers, which had been determined based on visual amyloid PET imaging or diagnostic accuracy. Finally, the biomarker ratios (P-tau/Aβ42 and T-tau/Aβ42) were more consistent with the Aβ42/Aβ40 ratio for both Lumipulse and Elecsys methods, and Elecsys P-tau/Aβ42 had the highest consistency with amyloid pathology (AUC 0.994, 95% CI 0.986-1.000 and OPA 96.4%) at the ≥0.024 cut-off. The Lumipulse and Elecsys cerebrospinal fluid (CSF) AD assays showed high analytical and clinical performances. As both automated platforms were standardized for reference samples, their use is recommended for the measurement of CSF AD biomarkers compared with unstandardized manual methods, such as Innotest ELISA, that have demonstrated a high inter and intra-laboratory variability., 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 © 2021 Dakterzada, López-Ortega, Arias, Riba-Llena, Ruiz-Julián, Huerto, Tahan and Piñol-Ripoll.)

Introduction: The impact of stroke on quality of life (QoL) may be different in diverse societies because of varying availability and accessibility of health and social care services provided in various settings. The purpose of the present study was to evaluate changes in patients' QoL within three months after stroke and to address the research question; "What factors influence QoL after stroke in Iranian population?", Methods: A total number of 172 patients admitted to the Stroke Unit of Amiralmomenin Hospital in the city of Arak, Iran, were recruited in this study. The Stroke Impact Scale (SIS-16) was used at three different time-points to evaluate post-stroke QoL. Repeated measures analysis of variance (ANOVA) followed by Bonferroni method and marginal model with generalized estimating equation (GEE) were employed to analyze the data., Results: The findings revealed a significant decline in QoL within the first month after stroke compared with post-stroke state. The mean values of patients' QoL also improved within three months after stroke although they did not reach the pre-stroke level. A positive relationship was also observed between age, high National Institutes of Health Stroke Scale (NIHSS) scores, hypertension, right side lesion and previous stroke, as well as patients' poor QoL. Moreover; gender, level of education, job status, and income had no influence on QoL in stroke survivors., Conclusion: It was concluded that being older, having higher NIHSS score, suffering from hypertension, right side lesion and previous stroke could be significantly correlated with poor patients' QoL. Therefore, effective interventions focusing on older individuals especially those with more severe impairments were assumed to help in improving post-stroke QoL in patients; regardless of their gender, level of education, and social activities., (Copyright © 2019 National Medical Association. All rights reserved.)

Background: Spasticity is one of the most important causes of disability after stroke. In spite of high incidence of spasticity, little is known about the relationship between the occurrence and the development of spasticity. This study aimed to determine risk-factors of post stroke spasticity., Methods: This was an observational study of 149 persons with first ever stroke. The following parameters were assessed: Stroke severity, Spasticity, Disability and Joint contracture., Results: Prevalence of spasticity was between 17-25% during the first 3 months after stroke. The onset of spasticity was 13.79% and 4.16% at 1 and 3 months after stroke respectively. The prevalence of spasticity in the upper extremity was significantly more than lower extremity at 1 month. Spasticity was significantly more severe in the upper extremity than lower extremity. In patients with hemorrhagic stroke Odds ratios of spasticity was 2.5 times more than persons with ischemic stroke (P = 0.0210. The Odds ratios of severe spasticity at 1 and 3 months were 1.66 and 1.75 times more than the first week (P = 0.024, P = 0.042 respectively)., Conclusions: Post stroke spasticity is more common in persons with hemorrhagic stroke, severe paresis and lower functional abilities. The most incidence of spasticity happens in the first month after stroke., (Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.)

Background: Real-time ultrasound imaging is a valid method in the field of rehabilitation. The ultrasound imaging allows direct visualization for real-time study of the muscles as they contract over the time. Measuring of the size of each abdominal muscle in relation to the others provides useful information about the differences in structure, as well as data on trunk muscle activation patterns. The purpose of this study was to assess the size and symmetry of the abdominal muscles at rest in healthy adults and to provide a reference range of absolute abdominal muscle size in a relatively large population., Method: A total 156 healthy subjects with the age range of 18-44 years were randomly recruited. The thickness of internal oblique, external oblique, transverse abdominis, and rectus abdominis muscles was measured at rest on both right and left sides using ultrasound. Independent t test was used to compare the mean thickness of each abdominal muscle between males and females. Differences on side-to-side thicknesses were assessed using paired t test. The association between abdominal muscle thicknesses with gender and anthropometric variables was examined using the Pearson correlation coefficient., Results: A normal pattern of increasing order of mean abdominal muscle thickness was found in both genders at both right and left sides: transverse abdominis < external oblique < internal oblique < rectus abdominis. There was a significant difference on the size of transverse abdominis, internal oblique, and external oblique muscles between right and left sides in both genders. Males had significantly thicker abdominal muscles than females. Age was significantly correlated with the thickness of internal oblique, external oblique, and rectus abdominis muscles. Body mass index was also positively correlated with muscle thickness of rectus abdominis and external oblique., Conclusions: The results provide a normal reference range for the abdominal muscles in healthy subjects and may be used as an index to find out abnormalities and also to evaluate the effectiveness of different interventions.

Background: Synergistic co-activation of the abdominal and pelvic floor muscles (PFM) has been shown in literature. Some studies have assessed the reliability of ultrasound measures of the abdominal muscles., Objective: The aim of this study was to determine the reliability of ultrasound measurements of transverses abdominis (TrA) and obliquus internus (OI) muscles during different conditions (PFM contraction, abdominal hollowing manoeuvre (AHM) with and without PFM contraction) in participants with and without chronic low back pain (LBP)., Methods: 21 participants (9 with LBP, 12 healthy) participated in the study. The reliability of thickness measurements at rest and during each condition and thickness changes and percentage of this changes at different conditions were assessed., Results: The results showed high reliability of the thickness measurement at rest and during each condition of TrA and OI muscles, moderate to substantial reliability for the thickness change and percentage of thickness change of TrA, and fair to moderate reliability of the thickness change and percentage of thickness change of OI in both groups., Conclusions: Ultrasound imaging can be used as a reliable method for assessment of abdominal muscle activity with and without PFM contraction.

Aim: The importance of the abdominal musculature in spine stability, has promoted the development of a variety of studies. Ultrasound imaging (UI) is a valuable tool which, when applied appropriately, has the potential to provide significant insight into abdominal muscle contraction. Limited studies have been taken place regarding the relationship between ultrasound measures of muscle thickening and electromyography (EMG) measures of activation. Inconsistent results, however, have been reported. Based on previous studies association between abdominal muscle activation and thickening may be affected by contraction level. The aims of this study were to measure the relationship between abdominal muscle thickness and abdominal muscles amplitude in different levels of abdominal muscles contraction., Methods: The research was carried on with a convenience sampling at the Physical Therapy Department of University of Social Welfare and Rehabilitation Sciences. Thirty healthy participants volunteered for this study. Muscle thickness right transversus abdominis (TrA) and obliqus internus (OI) muscles in abdominal hallowing maneuvers with and without pelvic floor muscle (PFM) contraction has been measured. Additionally, surface EMG of the right TrA/IO muscles was recorded. A hardware electrical part that acts as trigger system was used to record the activities of abdominal muscles in UI and EMG synchronously. Thickness change, normalized thickness and maximum amplitude abdominal muscles were used for statistical analysis., Results: Correlations between the thickness change and amplitude measures were -0.03 -- 0.38 for TrA/IO. The Correlations between the normalized thickness and amplitude measures were -0.04--0.26 for TrA/IO., Conclusion: There is not clear relationship between increases in abdominal muscle activation and corresponding measures of thickening during abdominal muscle contraction. Changes in thickness of deep abdominal muscle cannot be used to indicate changes in the electrical activity in this muscle.

Background: Ultrasound (US) imaging has been considered as a non-invasive technique to measure thickness and estimate relative abdominal muscle activity. Although some studies have assessed the reliability of US imaging, no study has assessed the reliability of US measurement of automatic activity of abdominal muscles in positions with different levels of stability in participants with chronic low back pain (cLBP). The purpose of this study was to investigate within-day and between-days reliability of US thickness measurements of automatic activity of the abdominal muscles in asymptomatic participants and within-day reliability in those with cLBP., Methods: A total of 20 participants (10 with cLBP, 10 healthy) participated in the study. The reliability of US thickness measurements at supine lying and sitting positions (sitting on a chair, sitting on a gym ball with both feet on the ground or lifting one foot off the floor) were assessed. We evaluated within-day reliability in all participants and between-days reliability in asymptomatic participants., Results: We found high ICC scores (0.85-0.95) and also small SEM and MDC scores in both groups. The reliability of the measurements was comparable between participants with and without LBP in each position but the SEMs and MDCs was slightly higher in patient group compared with healthy group. It indicates high intra-tester reliability for the US measurement of the thickness of abdominal muscles in all positions., Conclusion: US imaging can be used as a reliable method for assessment of automatic activity of abdominal muscles in positions with low levels of stability in participants with and without LBP.

Context: Coactivation of abdominal and pelvic-floor muscles (PFM) is an issue considered by researchers recently. Electromyography (EMG) studies have shown that the abdominal-muscle activity is a normal response to PFM activity, and increase in EMG activity of the PFM concomitant with abdominal-muscle contraction was also reported., Objective: The purpose of this study was to compare the changes in EMG activity of the deep abdominal muscles during abdominal-muscle contraction (abdominal hollowing and bracing) with and without concomitant PFM contraction in healthy and low-back-pain (LBP) subjects., Design: A 2 × 2 repeated-measures design., Setting: Laboratory., Participants: 30 subjects (15 with LBP, 15 without LBP)., Main Outcome Measures: Peak rectified EMG of abdominal muscles., Results: No difference in EMG of abdominal muscles with and without concomitant PFM contraction in abdominal hollowing (P = .84) and abdominal bracing (P = .53). No difference in EMG signal of abdominal muscles with and without PFM contraction between LBP and healthy subjects in both abdominal hollowing (P = .88) and abdominal bracing (P = .98) maneuvers., Conclusion: Adding PFM contraction had no significant effect on abdominal-muscle contraction in subjects with and without LBP.