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1.
Rev Bras Ortop (Sao Paulo) ; 59(4): e526-e531, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39239572

RESUMEN

Objective To analyze the muscle trophism and expression of interleukin-6 in the biceps brachii muscle of rats with incomplete cervical spinal cord injury treated with neuromuscular electrical stimulation (NMES). Methods Adult rats underwent C5-C7 spinal cord hemisection and a 5-week NMES protocol. Trophism of the biceps brachii was assessed using muscle weight/body weight ratio and histological analysis. Interleukin-6 expression from biceps brachii was measured using the enzyme-linked immunosorbent assay technique. Results Preservation of the biceps brachii muscle trophism was found in the NMES treated group, along with prevention of the reduction of interleukin-6 levels. Conclusion Spinal cord injury causes muscle atrophy and decreases interleukin-6 levels. These alterations are partially prevented by NMES. The results suggest a possible NMES action mechanism and underscore the clinical use of this therapeutic tool.

2.
Artículo en Inglés | MEDLINE | ID: mdl-38739520

RESUMEN

Robotic systems, such as Lokomat® have shown promising results in people with severe motor impairments, who suffered a stroke or other neurological damage. Robotic devices have also been used by people with more challenging damages, such as Spinal Cord Injury (SCI), using feedback strategies that provide information about the brain activity in real-time. This study proposes a novel Motor Imagery (MI)-based Electroencephalogram (EEG) Visual Neurofeedback (VNFB) system for Lokomat® to teach individuals how to modulate their own µ (8-12 Hz) and ß (15-20 Hz) rhythms during passive walking. Two individuals with complete SCI tested our VNFB system completing a total of 12 sessions, each on different days. For evaluation, clinical outcomes before and after the intervention and brain connectivity were analyzed. As findings, the sensitivity related to light touch and painful discrimination increased for both individuals. Furthermore, an improvement in neurogenic bladder and bowel functions was observed according to the American Spinal Injury Association Impairment Scale, Neurogenic Bladder Symptom Score, and Gastrointestinal Symptom Rating Scale. Moreover, brain connectivity between different EEG locations significantly ( [Formula: see text]) increased, mainly in the motor cortex. As other highlight, both SCI individuals enhanced their µ rhythm, suggesting motor learning. These results indicate that our gait training approach may have substantial clinical benefits in complete SCI individuals.


Asunto(s)
Electroencefalografía , Marcha , Neurorretroalimentación , Traumatismos de la Médula Espinal , Humanos , Traumatismos de la Médula Espinal/rehabilitación , Traumatismos de la Médula Espinal/fisiopatología , Neurorretroalimentación/métodos , Electroencefalografía/métodos , Masculino , Adulto , Marcha/fisiología , Robótica , Imaginación/fisiología , Femenino , Trastornos Neurológicos de la Marcha/rehabilitación , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/fisiopatología , Resultado del Tratamiento , Persona de Mediana Edad , Dispositivo Exoesqueleto , Caminata/fisiología , Ritmo beta , Imágenes en Psicoterapia/métodos
3.
Life Sci ; 232: 116627, 2019 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-31276690

RESUMEN

AIM: Evidence suggests that task-specific gait training improves locomotor impairments in people with incomplete spinal cord injury (SCI); however, plastic changes in brain areas remain poorly understood. The aim of this study was to examine the possible effects of a task-specific overground gait training on locomotor recovery and neuroplasticity markers in the cortex, cerebellum, and lumbar spinal cord in an experimental model of incomplete-SCI. MAIN METHODS: Using a blind, basic experimental design, 24 adult Wistar rats underwent a surgical procedure and were allocated into sham, non-trained SCI (SCI), and trained SCI (Tr-SCI) groups. On postoperative day 14, trained animals started a 4-week overground gait training program. All groups were subjected to weekly assessment of locomotor recovery of the hind limbs. On postoperative day 40, brain and lumbar spinal cord structures were dissected and processed for biochemical analysis of the synaptophysin, microtubule-associated protein 2 (MAP-2), and brain-derived neurotrophic factor (BDNF). KEY FINDINGS: Tr-SCI group showed greater locomotor function recovery compared with non-trained SCI from the postoperative day 21 (p < 0.05). The training was able to improve the neuroplasticity markers synaptophysin, MAP-2, and BDNF expressions in motor cortex (p < 0.05), but not in the cerebellum and in the spinal cord for trained SCI group compared to non-trained. SIGNIFICANCE: Task-specific overground gait training improves locomotor recovery in a rat model of incomplete thoracic-SCI. Furthermore, training promotes motor cortex plasticity, evidenced for increasing expression of the neuroplasticity markers that may support the functional recovery.


Asunto(s)
Terapia por Ejercicio/métodos , Locomoción/fisiología , Animales , Factor Neurotrófico Derivado del Encéfalo/metabolismo , Modelos Animales de Enfermedad , Femenino , Marcha/fisiología , Masculino , Proteínas Asociadas a Microtúbulos/metabolismo , Actividad Motora , Plasticidad Neuronal/fisiología , Ratas , Ratas Wistar , Recuperación de la Función , Médula Espinal/metabolismo , Traumatismos de la Médula Espinal/metabolismo , Traumatismos de la Médula Espinal/terapia
4.
Geriatr Gerontol Int ; 15(1): 89-95, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24456087

RESUMEN

AIM: Following the substantial growth of the elderly population in Brazil, there has been an increase in cases of Parkinson's disease (PD), which raises the need for reliable and culturally adapted scales specific to the disease. The Parkinson Activity Scale (PAS) was developed in order to assess the activity level of people with PD through tasks related to mobility. The aims of the present study were to translate the cross-cultural adaptation of the PAS into Brazilian Portuguese and analyze its reliability during the "on" phase of PD. METHODS: A total of 25 patients with PD participated in the study. The intrarater reliability was evaluated using a test-retest design with a 1-week interval. RESULTS: The interrater reliability was tested twice on the same day by two different raters. The intraclass correlation coefficient (ICC), and the Bland and Altman plots were calculated to examine the test-retest and interrater reliabilities for total score of the PAS, whereas the weighted Kappa (Wk) was used to assess interrater agreement. The interrater ICC was 0.89 and Wk was 0.65 for the total score. For intrarater reliability, the total score ICC was 0.88. CONCLUSIONS: The present study suggests that the Brazilian version of the PAS is a reliable instrument for the assessment of mobility in elderly patients with PD.


Asunto(s)
Adaptación Psicológica , Evaluación Geriátrica/métodos , Limitación de la Movilidad , Enfermedad de Parkinson/diagnóstico , Psicometría/métodos , Traducción , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Comparación Transcultural , Características Culturales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/epidemiología , Enfermedad de Parkinson/psicología , Prevalencia , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
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