Instrumented assessment of lower and upper motor neuron signs in amyotrophic lateral sclerosis using robotic manipulation: an explorative study.

Background: Amyotrophic lateral sclerosis (ALS) is a lethal progressive neurodegenerative disease characterized by upper motor neuron (UMN) and lower motor neuron (LMN) involvement. Their varying degree of involvement results in a clinical heterogenous picture, making clinical assessments of UMN signs in patients with ALS often challenging. We therefore explored whether instrumented assessment using robotic manipulation could potentially be a valuable tool to study signs of UMN involvement.

Growth and impact of Project ECHO for workforce development in age-friendly care.

Background: Use of the Project ECHO® (Extension for Community Healthcare Outcomes) model in geriatrics has increased dramatically largely because of the Health Resources and Services Administration-funded Geriatrics Workforce Enhancement Programs (GWEP) utilizing it as a key tool for age-friendly, interprofessional workforce development. This manuscript describes the scope and impact of geriatrics ECHOs under the GWEP.

Methods: A survey of GWEPs was conducted to measure the reach, foci, evaluation methods, and other characteristics of ECHO networks.

Global citizenship online in higher education.

Discourses of global education, citizenship and competence have been characterising the higher education literature in recent years. The COVID-19 pandemic has both heightened the relevance of global citizenship education and presented new challenges as educators and students continue to grapple with the lasting impact and implications. This paper presents the findings of a research study which looked at the perceived learning outcomes of a 'virtual exchange' project which addressed issues relevant to global citizenship, involving students in European and Southern Mediterranean countries in online dialogue programmes.

Magnitude and variability of individual elbow load in repetitive baseball pitching.

In baseball pitchers the elbow is exposed to high and repetitive loads (i.e. external valgus torque), caused by pitching a high number of balls in a practice session or game.

Predictability of Fall Risk Assessments in Community-Dwelling Older Adults: A Scoping Review.

Fall risk increases with age, and one-third of adults over 65 years old experience a fall annually. Due to the aging population, the number of falls and related medical costs will progressively increase. Correct prediction of who will fall in the future is necessary to timely intervene in order to prevent falls.

A Muscle Load Feedback Application for Strength Training: A Proof-of-Concept Study.

Muscle overload injuries in strength training might be prevented by providing personalized feedback about muscle load during a workout. In the present study, a new muscle load feedback application, which monitors and visualizes the loading of specific muscle groups, was developed in collaboration with the fitness company Gymstory. The aim of the present study was to examine the effectiveness of this feedback application in managing muscle load balance, muscle load level, and muscle soreness, and to evaluate how its actual use was experienced.

Ankle-Foot-Orthosis "Hermes" Compensates Pathological Ankle Stiffness of Chronic Stroke-A Proof of Concept.

Individuals with an upper motor neuron syndrome, e.g., stroke survivors, may have a pathological increase of passive ankle stiffness due to spasticity, that impairs ankle function and activities such as walking.

Sensory weighting of position and force feedback during pinching.

Human hands are complex biomechanical systems that allow for dexterous tasks with many degrees of freedom. Coordination of the fingers is essential for many activities of daily living and involves integrating sensory signals. During this sensory integration, the central nervous system deals with the uncertainty of sensory signals.

Cost of Transport of Undulating Fin Propulsion.

Autonomous robots are used to inspect, repair and maintain underwater assets. These tasks require energy-efficient robots, including efficient movement to extend available operational time. To examine the suitability of a propulsion system based on undulating fins, we built two robots with one and two fins, respectively, and conducted a parametric study for combinations of frequency, amplitude, wavenumber and fin shapes in free-swimming experiments, measuring steady-state swimming speed, power consumption and cost of transport.

Detect Acute Porphyrias in Emergency Departments (DePorED) - a pilot study.

Background: Acute porphyrias (APs) are a group of rare metabolic diseases related to a disturbed heme biosynthesis. Symptoms may first occur as life threatening attacks, comprising abdominal pain and/or variable neuro-psychiatric symptoms, thus leading to presentation in emergency departments (ED) first. Due to the low prevalence, diagnosis of AP is often missed, even after readmission to the ED.

Minimally invasive cerclage at the tibia using a modified Goetze technique: An anatomical study.

Introduction: The use of minimally invasive cerclages at the tibia is not very common. First, clinical results of a new operative technique published recently showed no increased complication rate. The aim of this anatomical study was to determine, if it is possible to introduce a minimally invasive cerclage at different levels of the tibia without encasing relevant nerves, vessels or tendons into the cerclage using this technique.

Growing older with intellectual and developmental disabilities: Implementing and evaluating a project ECHO for dementia education.

The needs of the rapidly expanding population of adults growing older with intellectual and developmental disabilities (IDD) and their families span both the IDD and the aging service systems. The use of Project ECHO (Extension for Community Healthcare Outcomes) for professional education can bridge gaps and span boundaries between them at the macro, meso, and micro levels. A series of 10 ECHO sessions over 12 months was developed, incorporating key content on IDD and AD/ADRD for 145 providers in over 20 agencies.

Concomitant fractures in patients with proximal femoral fractures lead to a prolonged hospital stay but not to increased complication rates or in-house mortality if treated surgically: a matched pair analysis.

Background: Impact of concomitant fractures on patients sustaining a proximal femur fracture remains unclear. Rising numbers and patient need for rehab is an important issue. The objective of our study was to investigate the impact of concomitant fractures, including all types of fractures, when treated operatively, for proximal femur fractures on the length of hospital stay, in-house mortality and complication rate.

Towards Single Camera Human 3D-Kinematics.

Markerless estimation of 3D Kinematics has the great potential to clinically diagnose and monitor movement disorders without referrals to expensive motion capture labs; however, current approaches are limited by performing multiple de-coupled steps to estimate the kinematics of a person from videos. Most current techniques work in a multi-step approach by first detecting the pose of the body and then fitting a musculoskeletal model to the data for accurate kinematic estimation. Errors in training data of the pose detection algorithms, model scaling, as well the requirement of multiple cameras limit the use of these techniques in a clinical setting.

Quantification of Error Sources with Inertial Measurement Units in Sports.

Background: Inertial measurement units (IMUs) offer the possibility to capture the lower body motions of players of outdoor team sports. However, various sources of error are present when using IMUs: the definition of the body frames, the soft tissue artefact (STA) and the orientation filter. Methods to minimize these errors are currently being used without knowing their exact influence on the various sources of errors.

Feasibility and validity of a single camera CNN driven musculoskeletal model for muscle force estimation during upper extremity strength exercises: Proof-of-concept.

Muscle force analysis can be essential for injury risk estimation and performance enhancement in sports like strength training. However, current methods to record muscle forces including electromyography or marker-based measurements combined with a musculoskeletal model are time-consuming and restrict the athlete's natural movement due to equipment attachment. Therefore, the feasibility and validity of a more applicable method, requiring only a single standard camera for the recordings, combined with a deep-learning model and musculoskeletal model is evaluated in the present study during upper-body strength exercises performed by five athletes.

Addressing the inconsistent electric fields of tDCS by using patient-tailored configurations in chronic stroke: Implications for treatment.

Transcranial direct current stimulation (tDCS) is a promising tool to improve and speed up motor rehabilitation after stroke, but inconsistent clinical effects refrain tDCS from clinical implementation. Therefore, this study aimed to assess the need for individualized tDCS configurations in stroke, considering interindividual variability in brain anatomy and motor function representation. We simulated tDCS in individualized MRI-based finite element head models of 21 chronic stroke subjects and 10 healthy age-matched controls.

Nociceptive Intra-epidermal Electric Stimulation Evokes Steady-State Responses in the Secondary Somatosensory Cortex.

Recent studies have established the presence of nociceptive steady-state evoked potentials (SSEPs), generated in response to thermal or intra-epidermal electric stimuli. This study explores cortical sources and generation mechanisms of nociceptive SSEPs in response to intra-epidermal electric stimuli. Our method was to stimulate healthy volunteers (n = 22, all men) with 100 intra-epidermal pulse sequences.

New ways of treatment of fractures of the humeral shaft: does the combination of intramedullary nail osteosynthesis and cerclage improve the healing process?

Introduction: The humeral shaft fracture is a rare fracture of the long bones with various treatment options. Dreaded complications such as lesions of the radial nerve or non-unions make the decision for what kind of therapy option more difficult. Biomechanically the upper arm is mostly exposed to rotational forces, which affect intramedullary nail osteosynthesis.

A minimally invasive cerclage of the tibia in a modified Goetze technique: operative technique and first clinical results.

Introduction: In spiral fractures of the tibia, the stability of an osteosynthesis may be significantly increased by additive cerclages and, according to biomechanical studies, be brought into a state that allows immediate full weight bearing. As early as 1933, Goetze described a minimally invasive technique for classic steel cerclages. This technique was modified, so that it can be used for modern cable cerclages in a soft part saving way.

Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching.

Baseball pitching is associated with a high prevalence of ulnar collateral ligament injuries, potentially due to the high external valgus load on the medial side of the elbow at the instant of maximal shoulder external rotation (MER). studies show that external valgus torque is resisted by the ulnar collateral ligament but could also be compensated by elbow muscles. As the potential active contribution of these muscles in counteracting external valgus load during baseball pitching is unknown, the aim of this study is to determine whether and to what extent the elbow muscles are active at and around MER during a fastball pitch in baseball.

MarkerLess Motion Capture: ML-MoCap, a low-cost modular multi-camera setup.

Motion capture systems are extensively used to track human movement to study healthy and pathological movements, allowing for objective diagnosis and effective therapy of conditions that affect our motor system. Current motion capture systems typically require marker placements which is cumbersome and can lead to contrived movements.Here, we describe and evaluate our developed markerless and modular multi-camera motion capture system to record human movements in 3D.

The Cortical Response Evoked by Robotic Wrist Perturbations Reflects Level of Proprioceptive Impairment After Stroke.

Proprioception is important for regaining motor function in the paretic upper extremity after stroke. However, clinical assessments of proprioception are subjective and require verbal responses from the patient to applied proprioceptive stimuli. Cortical responses evoked by robotic wrist perturbations and measured by electroencephalography (EEG) may be an objective method to support current clinical assessments of proprioception.