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ஐ.எஸ்.எஸ்.என்: 2376-0281

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தொகுதி 4, பிரச்சினை 2 (2017)

வர்ணனை

Commentary on “Group-Based Exercise Combined with Dual-Task Training Improves Gait but not Vascular Health in Active Older Adults without Dementia” - Missed Opportunities for Mediation Analyses

Gregory MA

This commentary considers the implications of the findings related to the effect of a community-based, multiple modality and dual-task exercise training program in the Archives of Gerontology and Geriatrics. Findings from this study suggest that participants who performed the multiple modality and dual-task exercise intervention experienced greater improvements in global cognition, greater elevations in dual-task gait speed and dual-task step-length and greater reductions in dual-task stride time variability when compared to participants who did not perform the dual-task component of the exercise training program. The ability of exercise to impart cognitive and other physiological benefits has been long understood; however, the mechanisms that facilitate these training-induced improvements remain elusive. Mediation analyses provide a unique avenue to investigate the relationship between various physiological measures and can provide insight related to the causal sequence that drives the beneficial physiological and psychological response to an intervention. Recent works have incorporated mediation analyses within their study designs and the insight provided therein has revealed a number of intriguing intricacies with respect to cognition in aging and the effect of exercise on the body and brain. Mediation analyses are rarely utilized in neurophysiological research; however, the complex phenomenological relationships that can be revealed using this method will be crucially required for the identification of factors responsible for improvements in cognition following pharmacological or lifestyle-based interventions, and the development of effective management strategies for older adults with cognitive impairment.

வர்ணனை

Evolution of Neurology in the German-Speaking Countries

Hansruedi Isler

In this region 18th century brain research met with scientist’s prejudice against causal interaction of body and soul. Advances in neurology had to rely on rather mythological ideologies such as Phrenology and Vitalism which revived localizing research from the 17th century origins of neurology. In the early 1800s the last great Vitalist, Johannes Müller, set off an explosion of progress in biology that transformed medicine and neurology into applied biology and replaced Müller’s Vitalism by hardline Mechanism. Later in the 1800s the typical Germanic neuro-psychiatrists developed psychiatry and completed cerebral localization, finally obtaining the divorce of neurology from psychiatry.

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Influence of Motor Imagery Incorporating Material Perception on Spinal Anterior Horn Cells

Takahiro Takenaka and Yuji Nakazumi

Introduction: We consider that an image of material perception activates a real and vivid motor image in motor imagery (MI) tasks, such as visualizing grasping movements during rehabilitation. However, no studies have examined whether the excitability of spinal neural function is affected by visualizing the tactile perception of the object to grasp. In this study, we measured the excitability of spinal neural function during MI tasks by using F-waves, and examined the influence of visualizing material/tactile perception on the excitability of spinal anterior horn cells. Methods: Task 1, F-waves were recorded while the subject placed his hand lightly on a ball and visualized maximum isometric contraction grasping force in a functional position with isometric opponens pollicis activity. Task 2, F-waves were recorded while the subject placed his hand lightly on a baseball and visualized maximum isometric contraction grasping force in a functional position with isometric opponens pollicis activity, while perceiving the material, including the stitches, of the baseball during the MI. The results of Tasks 1 and 2 were analyzed with a paired t-test. Results: The results also showed that the facilitation was greater in the second task when the subject visualized both the grasping movement as well as perceiving the material, compared to the first task when only the grasping movement was visualized. Conclusion: MI involving material perception influenced the excitability of spinal anterior horn cells. In the future, we plan to examine the usefulness of MI intervention incorporating material perception in many patients with extrapyramidal diseases.

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Comment on“ Classification of Advanced Stages of Parkinson’s Disease: Translation into Stratified Treatments”

Pierre Kolber and Rejko Krüger

Parkinson’s disease (PD) is increasingly recognized as a heterogeneous disorder combining equally diverse motor and non-motor symptoms, with a complex interplay and different individual presentations, especially in the advanced stages of the disease. Current classifications and related stage-adapted therapeutic recommendations still lack of precision, as traditional concepts of advanced PD (advPD) are mainly based on milestones of motor disabilities. In this short review, we present the concepts delineated by Krüger and colleagues published in the ‘Journal of Neural Transmission’ on current classifications for advPD and novel directions for future clinical trials, a precision medicine approach by empowerment of patients and their involvement in therapeutic decisions.

மினி விமர்சனம்

Low-Level Laser Therapy (LLLT) Improves the Repair Process of Peripheral Nerve Injuries: A Mini Review

Marcelie Priscila de Oliveira Rosso, Daniela Vieira Buchaim, Geraldo Marco Rosa Junior, Jesus Carlos Andreo, Karina Torres Pomini and Rogerio Leone Buchaim

Purpose: The aim of this study was to perform a mini-review on the effects of low-level laser therapy on nerve regeneration.

Methods: In this study, the authors associated the new fibrin sealant derived from snake venom as a method of nerve repair end-to-side.

Results and conclusion: The use of fibrin sealant effectively provided an axonal regeneration and the association with low-level laser therapy elevated this regenerative process, as demonstrated in the morphometric and morphological analyzes.

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Functional Outcomes of Patients with Acute Spinal Cord Injury

Mohammed Al Hamawi, Wafa Al Yazedi, Amit Ramesh Dhumale, Hani Hassan Al Yahary, Ginny Varghese and Navas Nadukkandiyi

The purpose of this study was to identify relationships between age, length of stay, the American Spinal Injury Association classification (ASIA) with total functional gain during inpatient rehabilitation for patients with Spinal Cord Injury (SCI) with functional independence and rehabilitation outcomes of traumatic spinal cord patients. The data were obtained for 49 patients with traumatic spinal cord lesions admitted to the neuro physical therapy unit from 2006 to 2008. The mean age was 33 ± 10.63 years. Study design: Retrospective observational study. The patient’s characteristics and outcomes were analysed and compared according to the severity of traumatic spinal cord injuries (SCI) and its appearance according to vertebral level correlations of SCI with co-morbidities was analysed. The Functional Independent measure scores of patient at admission (FIMa) on were compared to Functional Independent Measure scores recorded at discharge (FIMd) to get the total gain for each patient. Patients were grouped according to age, level of neurological injury, length of stay to compare with the total gain. The Length of stay was also compared with the American Spinal Injury Association classification (ASIA) at discharge. The author had been observed that there is negative correlation of LOSa with FIMd and Gain (r=-0.507, p=0.00 and r=-0.402, p=0.004), respectively. FIMa is positively correlated with FIMd but negatively correlated to Gain. FIMd is positively related with Gain. The Mean LOSa and LOSr are 44.80 days and 174.37 days, respectively. The Mean FIMa and FIMd are 53.22% and 75.73%, respectively. It revealed that, a significant improvement in FIM at the time of discharge in SCI patients. The differences were found in the extent of functional improvement between subgroups of patients with different levels and extents of lesions. Regarding the outcome of Functional Independent measure better observed in incomplete cervical spinal cord injuries and complete thoracic spinal cord level injuries. Interestingly, independence in bowel management, independent mobility and locomotion were only attained by patients with incomplete lesions. This study provides insight into the functional outcomes of a group of inpatients with traumatic spinal cord injury. More research is needed to determine the specialized rehabilitation program for these patients.

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Effect of Dual Tasking on Gait and Balance in Geriatric Population: An Observational Study

Palak M Engineer and Shraddha Diwan

Background: Aging is a process of growing old which describes a wide array of physiological changes in the body system. With aging, structural changes of the brain occur, especially in the prefrontal areas, which have been associated with the Executive function and attention systems. Dual tasking demands divided attention which increases chances of fall in Geriatric people. Aim: To evaluate whether Gait or Balance which one is more sensitive for dual task activity in geriatric population and detecting changes in Gait and Balance performance. Materials and methodology: 57 Participants with the age group of 60-84 years (70.51 ± 6.33) took part in the study. Each participant performs 10 meter walk test and berg balance scale. Gait parameters and BBS Score were measured as a baseline data. Then perform 10 MWT and BBS with cognitive and motor task (Dual Task). All gait and balance parameters were documented during dual task activity. Results: The result shows statistical significant (p<0.05) effect of dual task on both Gait and Balance parameters. During dual task activity time and cadence were increased but speed, step length and stride length were reduced. BBS Score were also reduced. Conclusion: Dual tasking affects Gait and Balance both, Where Balance is more affected than Gait in Geriatric population.

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