The calcium channel blocker, Nimodipine, inhibits spinal reflex pathways in humans.

Voltage-sensitive calcium channels contribute to depolarization of both motor- and interneurons in animal studies, but less is known of their contribution to human motor control and whether blocking them has potential in future antispasmodic treatment in humans. Therefore, this study investigated the acute effect of Nimodipine on the transmission of human spinal reflex pathways involved in spasticity. In a double-blinded, cross-over study, we measured soleus muscle stretch- and H-reflexes, and tibialis anterior cutaneous reflexes in nineteen healthy subjects before and after Nimodipine (tab-let 60mg) or Baclofen (tablet 25mg).

Task difficulty of visually guided gait modifications involves differences in central drive to spinal motor neurons.

Walking in natural environments requires visually guided modifications, which can be more challenging when involving sideways steps rather than longer steps. This exploratory study investigated whether these two types of modifications involve different changes in the central drive to spinal motor neurons of leg muscles. Fifteen adults [age: 36 ± 6 (SD) years] walked on a treadmill (4 km/h) while observing a screen displaying the real-time position of their toes.

A scoping review on muscle cramps and spasms in upper motor neuron disorder-two sides of the same coin?

Background: Muscle cramps are typically regarded as benign muscle overactivity in healthy individuals, whereas spasms are linked to spasticity resulting from central motor lesions. However, their striking similarities made us hypothesize that cramping is an under-recognized and potentially misidentified aspect of spasticity.

Methods: A systematic search on spasms and cramps in patients with Upper Motor Neuron Disorder (spinal cord injury, cerebral palsy, traumatic brain injury, and stroke) was carried out in Embase/Medline, aiming to describe the definitions, characteristics, and measures of spasms and cramps that are used in the scientific literature.

Oral Motor Impairments Contribute to Weight Status of Adults with Severe Cerebral Palsy.

Adults with severe cerebral palsy (CP) are susceptible to malnutrition and metabolic disorders due to limited daily physical activity and challenges related to eating. We hypothesized that the condition of being underweight arises from inadequate energy intake due to difficulties in eating, rather than heightened total energy expenditure or an elevated resting metabolic rate. The present study encompassed 17 adults with severe CP (classified as GMFSC III-V).

Accurate Monitoring of 24-h Real-World Movement Behavior in People with Cerebral Palsy Is Possible Using Multiple Wearable Sensors and Deep Learning.

Monitoring and quantifying movement behavior is crucial for improving the health of individuals with cerebral palsy (CP). We have modeled and trained an image-based Convolutional Neural Network (CNN) to recognize specific movement classifiers relevant to individuals with CP. This study evaluates CNN's performance and determines the feasibility of 24-h recordings.

Value Propositions of Public Adult Hearing Rehabilitation in Denmark.

To obtain and evaluate detailed descriptions of potential value propositions as seen by adults undergoing hearing rehabilitation with hearing aids. Semi-structured interviews with patients and audiologists, a literature search, and the inclusion of domain knowledge from experts and scientists were used to derive value propositions. A two-alternative forced-choice paradigm and probabilistic choice models were used to investigate hearing aid users' preferences for the value propositions through an online platform.

Harnessing synthetic biology for mushroom farming.

Recent advances in synthetic biology have transformed mushroom farming from a focus on traditional cultivation to comprehensive applications based on cutting-edge biotechnologies. Synthetic biology has promising applications in this field, including precision breeding, mining biosynthetic gene clusters, developing mushroom chassis cells, and constructing cell factories for high value-added products.

Neuroplasticity at Home: Improving Home-Based Motor Learning Through Technological Solutions. A Review.

Effective science-based motor rehabilitation requires high volume of individualized, intense physical training, which can be difficult to achieve exclusively through physical 1-on-1 sessions with a therapist. Home-based training, enhanced by technological solutions, could be a tool to help facilitate the important factors for neuroplastic motor improvements. This review aimed to discover how the inclusion of modern information and communications technology in home-based training programs can promote key neuroplastic factors associated with motor learning in neurological disabilities and identify which challenges are still needed to overcome.

Corticomuscular coherence is reduced in relation to dorsiflexion fatigability to the same extent in adults with cerebral palsy as in neurologically intact adults.

Purpose: Fatigue is frequent in adults with cerebral palsy (CP) and it is unclear whether this is due to altered corticospinal drive. We aimed to compare changes in corticospinal drive following sustained muscle contractions in adults with CP and neurologically intact (NI) adults.

Methods: Fourteen adults with CP [age 37.

Contribution of sensory feedback to soleus muscle activity during voluntary contraction in humans.

Sensory feedback through spinal interneurons contributes to plantar flexor muscle activity during walking, but it is unknown whether this is also the case during nonlocomotor movements. Here, we explored the effect of temporary reduction of sensory feedback to ankle plantar flexors during voluntary contraction in sitting subjects. Thirteen healthy adults (mean age 32 yr) were seated with the right leg attached to a foot plate which could be moved in dorsi- or plantarflexion direction by a computer-controlled motor.

Dynamics of cortical and corticomuscular connectivity during planning and execution of visually guided steps in humans.

The cortical mechanisms underlying the act of taking a step-including planning, execution, and modification-are not well understood. We hypothesized that oscillatory communication in a parieto-frontal and corticomuscular network is involved in the neural control of visually guided steps. We addressed this hypothesis using source reconstruction and lagged coherence analysis of electroencephalographic and electromyographic recordings during visually guided stepping and 2 control tasks that aimed to investigate processes involved in (i) preparing and taking a step and (ii) adjusting a step based on visual information.

Muscle Contractures in Adults With Cerebral Palsy Characterized by Combined Ultrasound-Derived Echo Intensity and Handheld Dynamometry Measures.

We used ultrasound-derived echo intensity and hand-held dynamometry to characterize plantar flexor muscle contractures in adults with cerebral palsy (CP). Eleven adults with CP (aged 41 ± 12 y, Gross Motor Function Classification System I-II) and 11 neurologically intact adults (aged 35 ± 10 y) participated in the study. Echo intensity was measured from the medial gastrocnemius muscle using brightness mode ultrasound.

Quantitative MRI and Clinical Assessment of Muscle Function in Adults With Cerebral Palsy.

To relate quantitative magnetic resonance imaging (MRI) of ankle plantar flexor muscles to clinical functional tests in adults with cerebral palsy (CP) and neurologically intact (NI) adults. Eleven adults with CP (aged 41 ± 12, GMFCS level I-II) and 11 NI adults (aged 35 ± 10) participated in this case-control study. We used MRI to assess muscle volume and composition of the triceps surae muscles.

The effect of cathodal transspinal direct current stimulation on tibialis anterior stretch reflex components in humans.

Spinal DC stimulation (tsDCS) shows promise as a technique for the facilitation of functional recovery of motor function following central nervous system (CNS) lesion. However, the network mechanisms that are responsible for the effects of tsDCS are still uncertain. Here, in a series of experiments, we tested the hypothesis that tsDCS increases the excitability of the long-latency stretch reflex, leading to increased excitability of corticospinal neurons in the primary motor cortex.

Parent-Infant Interactions Among Infants With High Risk of Cerebral Palsy: A Protocol for an Observational Study of Infant and Parental Factors for Dyadic Reciprocity.

An early diagnosis of chronic disability, such as risk of Cerebral Palsy (CP), is likely to affect the quality of parent-infant interactions by affecting both infant and parental factors. Due to adverse perinatal events, infants at high risk of CP may exhibit less engagement in interactions, while parents may experience increased mental health problems and disrupted parental representations that can have a negative effect on parental sensitivity. Recent clinical guidelines on early intervention among families with infants at risk of CP recommends supporting parental sensitivity and mutual enjoyable interactions more research is needed to inform such interventions.

Transcranial Alternating Current Stimulation of the Primary Motor Cortex after Skill Acquisition Improves Motor Memory Retention in Humans: A Double-Blinded Sham-Controlled Study.

Consolidation leading to retention of motor memory following motor practice involves activity-dependent plastic processes in the corticospinal system. To investigate whether beta-band transcranial alternating current stimulation (tACS) applied immediately following skill acquisition can enhance ongoing consolidation processes and thereby motor skill retention 20 adults participated in a randomized, double-blinded, sham-controlled study. Participants received tACS at peak beta-band corticomuscular coherence (CMC) frequency or sham tACS for 10 min following practice of a visuomotor ankle dorsiflexion task.

COpenhagen Neuroplastic TRaining Against Contractures in Toddlers (CONTRACT): protocol of an open-label randomised clinical trial with blinded assessment for prevention of contractures in infants with high risk of cerebral palsy.

Introduction: Contractures are frequent causes of reduced mobility in children with cerebral palsy (CP) already at the age of 2-3 years. Reduced muscle use and muscle growth have been suggested as key factors in the development of contractures, suggesting that effective early prevention may have to involve stimuli that can facilitate muscle growth before the age of 1 year. The present study protocol was developed to assess the effectiveness of an early multicomponent intervention, CONTRACT, involving family-oriented and supervised home-based training, diet and electrical muscle stimulation directed at facilitating muscle growth and thus reduce the risk of contractures in children at high risk of CP compared with standard care.

Increased Ankle Plantar Flexor Stiffness Is Associated With Reduced Mechanical Response to Stretch in Adults With CP.

Hyperexcitable stretch reflexes are often not present despite of other signs of spasticity in people with brain lesion. Here we looked for evidence that increased resistance to length change of the plantar flexor muscle-fascicles may contribute to a reduction in the stretch reflex response in adults with cerebral palsy (CP). A total of 17 neurologically intact (NI) adults (mean age 36.

Nonsurgical Treatment Options for Muscle Contractures in Individuals With Neurologic Disorders: A Systematic Review With Meta-Analysis.

Objective: To investigate whether nonsurgical treatment can reduce muscle contractures in individuals with neurologic disorders. The primary outcome measure was muscle contractures measured as joint mobility or passive stiffness.

Data Sources: Embase, MEDLINE, Cumulative Index to Nursing and Allied Health, and Physiotherapy Evidence Database in June-July 2019 and again in July 2020.

Motor-learning based activities may improve functional ability in adults with severe cerebral palsy: A controlled pilot study.

Background: Cerebral palsy (CP) is a neurodevelopmental disturbance characterized by impaired control of movement. Function often decreases and 15% of adults are classified as severely affected (Gross Motor Function Classification Scale III-V). Little is known about interventions that aim to improve functional abilities in this population.

Gene expressions in cerebral palsy subjects reveal structural and functional changes in the gastrocnemius muscle that are closely associated with passive muscle stiffness.

Cerebral palsy (CP) is a non-progressive motor disorder that affects posture and gait due to contracture development. The purpose of this study is to analyze a possible relation between muscle stiffness and gene expression levels in muscle tissue of children with CP. Next-generation sequencing (NGS) of gene transcripts was carried out in muscle biopsies from gastrocnemius muscle (n = 13 children with CP and n = 13 typical developed (TD) children).

A simple, clinically applicable motor learning protocol to increase push-off during gait: A proof-of-concept.

Objective: Task-specific training is often used in functional rehabilitation for its potential to improve performance at locomotor tasks in neurological populations. As push-off impairment are often seen with these patients, this functional approach shows potential to retrain gait overground to normalize the gait pattern and retrain the ability to improve gait speed. The main objective of this project was to validate, in healthy participants, a simple, low-cost push-off retraining protocol based on task-specific training that could be implemented during overground walking in the clinic.