Dosing overground robotic gait training after spinal cord injury: a randomized clinical trial protocol.

Background: Robotic exoskeletons have changed rehabilitation care available to people after spinal cord injury (SCI). Yet, the current evidence base is insufficient to identify the optimal dose and neurophysiological mechanism of robotic exoskeleton gait training (RGT) as an effective rehabilitation approach. This study will (1) examine whether the frequency of RGT after motor incomplete SCI impacts function and health outcomes, (2) analyze the neuroplastic effects of RGT dose, and (3) evaluate the safety, tolerability, and feasibility of delivering RGT.

Combined Transcranial Direct Current Stimulation and Pain Neuroscience Education for Chronic Low Back Pain: A Randomized Controlled Trial.

Objective: Priming the neural circuity likely targeted by pain neuroscience education (PNE), using transcranial direct current stimulation (tDCS) may enhance the efficacy of PNE. The aim of this study was to compare the effects of active tDCS + PNE to sham tDCS + PNE on measures of pain, pain behaviors, and cognitive function in participants with chronic low back pain (CLBP) and high pain catastrophizing.

Methods: 20 participants were recruited and randomly allocated into the active tDCS + PNE (n = 10) or sham tDCS + PNE (n = 10) groups.

Fatigue Is Associated With Perceived Effort and 2-Dimensional Reach Performance After Stroke.

Background And Purpose: Poststroke fatigue (PSF) is prevalent and often manifests as high perceived effort during activities. Little is known about how PSF influences goal-directed reaching after stroke. The purpose of this study was 2-fold (1) to evaluate how perceived effort changed when individuals with stroke performed a reaching task with various demands and (2) to determine whether PSF was associated with perceived effort during reaching and reach performance.

Effects of rTMS to primary motor cortex and cerebellum on balance control in healthy adults.

Both the primary motor cortex (M1) and the cerebellum are crucial for postural stability and deemed as potential targets for non-invasive brain stimulation (NIBS) to enhance balance performance. However, the optimal target remains unknown. The purpose of this study was to compare the role of M1 and the cerebellum in modulating balance performance in young healthy adults using facilitatory 5 Hz repetitive transcranial magnetic stimulation (rTMS).

Validating the Fatigue Scale for Motor and Cognitive Function (FSMC) in chronic stroke.

Background: Post-stroke fatigue can manifest as both physical and mental fatigue. The Fatigue Scale for Motor and Cognitive Functions (FSMC) evaluates fatigue on the motor and cognitive domains separately, however, the psychometric properties of this measure in stroke have not been reported.

Objective: To determine the internal consistency, test-retest reliability, and concurrent validity of the FSMC in chronic stroke.

Memory-Guided Reaching: Is It Effortful?

We previously showed that perceived effort during visually guided reaching was altered as task demand varied. Further, self-reported subjective fatigue correlated with perceived effort and reach performance under visually guided conditions. Memory-guided reaching often leads to performance deterioration and can provide insights about the planning and control of reach actions.

Optimal timing and neural loci: a scoping review on the effect of non-invasive brain stimulation on post-stroke gait and balance recovery.

Background: Little is known about the optimal timing and neural loci for applying noninvasive brain stimulation (NIBS) to promote gait and balance recovery after stroke.

Objective: To identify the optimal timing and neural loci of NIBS for gait and balance recovery after stroke.

Methods: We performed a PubMed search using keywords of stroke, transcranial magnetic stimulation, transcranial direct current stimulation, NIBS, balance, and gait.

Task matters: an investigation on the effect of different secondary tasks on dual-task gait in older adults.

Background: Dual-task gait performance declines as humans age, leading to increased fall risk among older adults. It is unclear whether different secondary cognitive tasks mediate age-related decline in dual-task gait. This study aimed to examine how type and difficulty level of the secondary cognitive tasks differentially affect dual-task gait in older adults.

Perceived effort for reaching is associated with self-reported fatigue.

Perceived effort for goal-directed reaching may be impacted by the level of self-reported fatigue, however, the relationship between self-reported fatigue and perceived effort has not been examined. We examined how perceived effort changed under varied reach conditions and the relationship between fatigue, perceived effort and reach performance. Twenty-three young adults performed reach actions toward 9 different targets on a digitizing tablet.

Single session of repetitive transcranial magnetic stimulation to left dorsolateral prefrontal cortex increased dual-task gait speed in chronic stroke: A pilot study.

Background: Individuals with stroke often experience difficulty in dual-task walking and are prone to falling when walking and talking. Previous studies in other populations have suggested that non-invasive brain stimulation could enhance dual-task gait performance by stimulating dorsolateral prefrontal cortex (DLPFC) or supplementary motor area (SMA). It was unclear if the benefits of brain stimulation would be observed in individuals with stroke.

Poststroke Fatigue Is Related to Motor and Cognitive Performance: A Secondary Analysis.

Background And Purpose: Poststroke fatigue (PSF) is a common debilitating and persistent symptom after stroke. The relationship between PSF and motor and cognitive function remains inconclusive partly due to lack of control for effects of depression and use of insensitive measures. We examined the relationship between PSF and motor and cognitive performance using a comprehensive set of behavioral measures and excluding individuals with depression.

Facilitation of supplementary motor area excitability improves dual-task walking in young adults.

Activations of the DLPFC and SMA have been shown to correlate with dual-task walking. However, very few investigations have directly perturbed the activations of these areas to establish a cause-and-effect relationship. The objectives of this study were: 1) to investigate the role of DLPFC and SMA in dual-task walking using rTMS and 2) to determine whether the secondary task difficulty mediates the roles of these cortical areas.

Social Participation Determines Quality of Life Among Urban-Dwelling Older Adults With Stroke in a Developing Country.

Background And Purpose: Poor quality of life (QoL) is a well-recognized consequence after stroke. Quality of life is influenced by a complex interaction between personal and environmental factors. Most previous investigations of the QoL after stroke have focused on personal factors, for example, physical deficits directly resulting from stroke.

Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population.

Introduction: Hand strength is a good indicator of physical fitness and frailty among the elderly. However, there are no published hand strength references for Malaysians aged > 65 years. This study aimed to establish normative data for hand grip strength (HGS) and key pinch strength (KPS) for Malaysians aged ≥ 60 years, and explore the relationship between hand strength and physical ability.

Test-retest reliability, internal consistency and concurrent validity of Fatigue Severity Scale in measuring post-stroke fatigue.

Background: Post-stroke fatigue (PSF) is a common complaint among stroke survivors and has significant impacts on recovery and quality of life. Limited tools that measure fatigue have been validated in stroke.

Aim: The purpose of this study was to determine the psychometric properties of Fatigue Severity Scale (FSS) in patients with stroke.

Falls and Fear of Falling After Stroke: A Case-Control Study.

Background: Falls are common after stroke, with potentially serious consequences. Few investigations have included age-matched control participants to directly compare fall characteristics between older adults with and without stroke. Further, fear of falling, a significant psychological consequence of falls, has only been examined to a limited degree as a risk factor for future falls in a stroke population.

Axial Segmental Coordination During Turning: Effects of Stroke and Attentional Loadings.

Attentional loadings deteriorate straight walking performance for individuals poststroke, but its effects on turning while walking remain to be determined. Here we compared turning kinematics under three attentional loading conditions (single, dual-motor, and dual-cognitive task) between stroke survivors and healthy controls. Nine chronic stroke survivors and 10 healthy controls performed the Timed Upand- Go test while their full-body kinematics were recorded.

Test-Retest Reliability and Validity of the Malay Version Life Habits Assessment (LIFE-H 3.1) to Measure Social Participation in Adults With Physical Disabilities.

Background And Purpose: Social participation restriction is a common barrier encountered by older adults and individuals with physical disabilities. To best direct the limited resource to support social services for individuals with disability, there is a need to objectively measure social participation restriction. A number of tools to measure levels of social participation are available, but none of them has been translated into the Malay language.

Effects of Attentional Loadings on Gait Performance Before Turning in Stroke Survivors.

Background: Attentional loadings have significant impacts on turning performance in individuals with stroke. Improper gait modification before turning may contribute to falls after stroke. Therefore, examination of the changes in temporal-spatial gait parameters before turning may reveal important deficits in gait control when stroke survivors are challenged by dual-tasking.

Post-stroke fatigue: a review on prevalence, correlates, measurement, and management.

Background: Post-stroke fatigue (PSF) is a common yet debilitating symptom for the majority of patients post-stroke. However, limited information is available for the management of this disabling condition. This is partly due to our poor understanding of the condition.

Aftereffects of 2 noninvasive brain stimulation techniques on corticospinal excitability in persons with chronic stroke: a pilot study.

Background And Purpose: Noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), have gained popularity in the stroke rehabilitation literature. Little is known about the time course and duration of effects of noninvasive brain stimulation on corticospinal excitability in individuals with stroke. We examined the aftereffects of a single session of high-frequency rTMS (5 Hz) and anodal tDCS on corticospinal excitability in the same sample of participants with chronic stroke.

Evaluation of attentional demands during motor learning: validity of a dual-task probe paradigm.

The aim of this study was to examine the validity of a 2-choice audio-vocal reaction time (RT) probe task for measuring the changes in attentional demand during practice and learning of a discrete motor task. Twenty participants practiced the motor task across 3 days and were probed with the RT task during either the preparation or execution phase of the primary task. As practice progressed, participants improved in the primary task performance and shortened the RTs to the probe task.

Motor learning in children with hemiplegic cerebral palsy: feedback effects on skill acquisition.

Aim: Motor learning is enhanced with practice and feedback. This cohort control study investigated the effect of different relative feedback frequencies during skill acquisition in children with cerebral palsy (CP) and children with typical development.

Method: Nineteen children with spastic hemiplegic CP (nine males, 10 females; mean age 11 y 7 mo; range 8-16 y) and 20 children with typical development (12 males, eight females; mean age 10 y 8 mo; range 8-14 y) were assigned to 100% or reduced (62%) feedback subgroups as they practised 200 trials of a discrete arm movement with specific spatiotemporal parameters.

Neural correlates of dual-task practice benefit on motor learning: a repetitive transcranial magnetic stimulation study.

Dual-task practice has been previously shown to enhance motor learning when both primary and secondary tasks engage similar cognitive processes. In the present study, participants practiced a finger sequence task with the non-dominant hand under a single-task condition (i.e.

Dual-task practice enhances motor learning: a preliminary investigation.

Practicing a motor task under dual-task conditions can be beneficial to motor learning when the secondary task is difficult (Roche et al. in Percept Psychophys 69(4):513-522, 2007) or when it engages similar processes as the primary motor task (Hemond et al. in J Neurosci 30(2):650-654, 2010).