Tracking the neurodegeneration of parkinsonian disorders – a pilot study

The purpose of the study was to explore the possibilities of using diffusion tensor imaging (DTI) and tractography (DTT) for the differential diagnosis and monitoring of disease progression in idiopathic Parkinson’s disease (IPD), compared with the atypical parkinsonian disorders multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). A 3.0-T MR scanner was used. DTI was acquired using a single-shot EPI sequence with diffusion encoding in 32 directions and a voxel size of 2 × 2 × 2 mm³. DTI data were analysed and DTT was performed using the PRIDE fibre tracking tool supplied by the manufacturer. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) within each tract were determined. DTI and DTT images in patients with moderate to advanced MSA demonstrated degeneration of the middle cerebellar peduncles and pontine crossing tracts, with decreased FA and increased ADC. This accounted for most of the pontine and cerebellar atrophy characteristic of this disease. In contrast, patients with PSP showed a selective degeneration of the superior cerebellar peduncle. Three-dimensional images of whole-brain white matter tracts demonstrated a reduction of cortical projection fibres in all patients with PSP. Visualization of the selective degeneration of individual fibre tracts, using DTI and DTT, adds qualitative data facilitating the differential diagnosis of parkinsonian disorders. Repeated measurements of FA and ADC values in a whole fibre tract might be used for monitoring disease progression and studying the effect of treatment in neuroprotective trials. The results are preliminary considering the small number of subjects in the study.     

Assessment of arm movements during gait in stroke – The Arm Posture Score

The purpose of the study was to apply the Arm Posture Score (APS) to a stroke population, since comprehensive measures to quantify arm swing in the affected and non-affected arms during gait are lacking. A further aim was to investigate how gait speed and upper limb function estimated by clinical measures are related to the APS in the stroke group. The APS is the summarized root mean square deviation (RMSD) from normal, based on kinematics. Four arm movements (sagittal and frontal planes) as well as six arm movements (incorporating transversal plane) were included in the calculation of APS, referred to as APS₄ and APS₆, respectively. The study population consisted of 25 persons with stroke and 25 age- and gender-matched controls. The APS measures were significantly different between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls (p ≤ 0.001). Spasticity significantly influenced both APS measures, while speed only had a significant effect on the APS₄. The APS measures correlated significantly to clinical measures of upper limb function. Both APS measures seem to be useful indices to quantify and discriminate between impaired and normal arm swing during gait after stroke. The variability of rotational arm movements needs to be studied further before considering the additional value of the APS₆ over the APS₄. When interpreting the APS, complementary kinematics should be taken into account, as the single value of the APS gives no information about the direction of the deviation.     

Assessment of arm movements during gait in stroke – The Arm Posture Score

The purpose of the study was to apply the Arm Posture Score (APS) to a stroke population, since comprehensive measures to quantify arm swing in the affected and non-affected arms during gait are lacking. A further aim was to investigate how gait speed and upper limb function estimated by clinical measures are related to the APS in the stroke group. The APS is the summarized root mean square deviation (RMSD) from normal, based on kinematics. Four arm movements (sagittal and frontal planes) as well as six arm movements (incorporating transversal plane) were included in the calculation of APS, referred to as APS₄ and APS₆, respectively. The study population consisted of 25 persons with stroke and 25 age- and gender-matched controls. The APS measures were significantly different between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls (p ≤ 0.001). Spasticity significantly influenced both APS measures, while speed only had a significant effect on the APS₄. The APS measures correlated significantly to clinical measures of upper limb function. Both APS measures seem to be useful indices to quantify and discriminate between impaired and normal arm swing during gait after stroke. The variability of rotational arm movements needs to be studied further before considering the additional value of the APS₆ over the APS₄. When interpreting the APS, complementary kinematics should be taken into account, as the single value of the APS gives no information about the direction of the deviation.     

Biomechanical compensation mechanisms during stair climbing – The effect of leg length inequalities

BackgroundStair climbing is a complex and demanding daily activity with increased physical loads. Therefore, analyzing stair climbing abilities is a frequently used diagnostic tool. Leg length inequalities (LLIs) are a common condition in the population, with individual consequences like lower back pain, scoliosis, and osteoarthritis. Despite its high prevalence, the necessary treatment, for mild LLIs, is still controversial. Previously, the focus was to analyze the effects of LLIs during static standing and walking. To create a holistic view on the dynamic effects of LLIs, and since climbing stairs produces a similar biomechanical imbalance as LLIs, the compensation mechanics during stair climbing are of special interest.Research questionWhat are the biomechanical compensation mechanisms of (simulated) LLIs during ascending and descending stairs?MethodsThirty-five healthy participants were measured with the inertial measurement system MyoMotion during stair climbing with simulated LLIs of 0–3 cm. The maximum estimated lower limb joint angles of the long and short leg were analyzed with statistically repeated measurement models.ResultsThe long leg showed significantly increased hip and knee flexion, while the short leg showed decreased hip and knee flexion, decreased dorsiflexion, and significantly increased plantarflexion. Different mechanisms were found in the case of 1 cm LLI when compared to greater LLIs. In the former, increased hip and knee flexion in the short leg accompanied by increased dorsiflexion in the long leg was observed. In the latter, the dorsiflexion of the long leg was reduced.SignificanceExcept for the reduced dorsiflexion of the long leg (LLI >1 cm), during stair climbing compared compensation mechanisms as during walking were presented, with the long leg functionally shortened and the short leg lengthened. Although the feet were already on different levels, during stair climbing with the step-over-step technique, significant compensation mechanisms were found as a consequence of LLIs.     

Effects of oxygen-enriched air on cognitive performance during SCUBA-diving – an open-water study

Backround: Nitrogen narcosis impairs cognitive function, a fact relevant during SCUBA-diving. Oxygen-enriched air (nitrox) became popular in recreational diving, while evidence of its advantages over air is limited. Aim: Compare effects of nitrox28 and air on two psychometric tests.

Methods: In this prospective, double-blind, open-water study, 108 advanced divers (38 females) were randomized to an air or a nitrox-group for a 60-min dive to 24 m salt water. Breathing gas effects on cognitive performance were assessed during the dive using a short- and long-term memory test and a number connection test.

Results: Nitrox28 divers made fewer mistakes only on the long-term memory test (p = 0.038). Female divers remembered more items than male divers (p < 0.001). There were no significant differences in the number connection test between the groups.

Conclusion: Likely owing to the comparatively low N₂ reduction and the conservative dive, beneficial nitrox28 effects to diver performance were moderate but could contribute to diving safety.     

The impact of transfemoral socket adduction on pelvic and trunk stabilization during level walking – A biomechanical study

BackgroundIt is common practice to align transfemoral prosthetic sockets in adduction, due to the physiologic, adducted femoral alignment in unimpaired legs. An adducted femoral and socket alignment helps tightening hip abductors to stabilize the pelvis and reduce pelvic and trunk related compensatory movements.Research questionHow do different socket adduction conditions (SAC) of transfemoral sockets affect pelvic and trunk stabilization during level ground walking in the frontal plane?MethodsSeven persons with transfemoral amputation with medium residual limb length participated in this study. The prosthetic alignment in the sagittal plane was performed according to established recommendations. SAC varied (0°, 3°, 6°, 9°). Kinematic and kinetic parameters were recorded in a gait laboratory with a 12-camera optoelectronic system and two piezoelectric force plates embedded in a 12-m walkway. The measurements were performed during level ground walking with self-selected comfortable gait speed.ResultsIn the frontal plane, nearly all investigated kinematic and kinetic parameters showed a strong correlation with the SAC. The pelvis was raised on the contralateral side throughout the gait cycle with increasing SAC. During the prosthetic side stance phase, the mean shoulder obliquity and mean lateral trunk lean to the prosthetic side tended to be reduced with increased SAC. Prosthetic side hip abduction moment decreased with increasing SAC.SignificanceThe results confirm that transfemoral SAC contributes to pelvic stabilization and reduced compensatory movements of the pelvis and trunk. Transfemoral SAC of 6 ± 1° for bench alignment seems adequate for amputees with medium residual limb length. However, the optimum value for the individual patient may differ slightly.     

The effect of education on rCBF changes in Alzheimer’s disease: a longitudinal SPECT study

Purpose  To determine the relationship of differing levels of education on regional cerebral blood flow (rCBF) in patients with Alzheimer’s disease (AD). Methods  Fifty-three patients with AD followed-up for an average of 36 months were divided into the high-educated group (HE, ≥12 years of schooling) and low-educated group (LE, <12 years of schooling). The cognitive and functional impairment was assessed using the Mini-Mental State Examination (MMSE) and the Functional Assessment Staging (FAST), respectively. Initial and follow-up rCBF were assessed using SPECT with N-isopropyl-p-[¹²³I]-iodoamphetamine and the SPECT data were analyzed by 3D-stereotactic surface projections. Results  At initial evaluation, the HE group had greater rCBF deficits in the parietotemporal regions than did the LE group, even though both groups had comparable MMSE and FAST scores. When compared with initial SPECT, follow-up SPECT showed a significant rCBF reduction in widespread regions, including the frontal, parietal, temporal, and limbic lobes of the HE group, while it a significant rCBF reduction in scattered and small regions of the parietotemporal, cingulate, and occipital areas of the LE group, as the HE group had faster cognitive and functional decline than the LE group. Conclusion  The HE group showed lower rCBF at initial SPECT than the LE group, suggesting more advanced AD pathology. As a result, the HE group demonstrated a more extensive and severe reduction of rCBF on follow-up SPECT in association with faster cognitive and functional decline than the LE group. Our SPECT study provides stronger support for the cognitive reserve effects of education in AD.     

The effect of ankle Kinesio™ taping on ankle joint biomechanics during unilateral balance status among collegiate athletes with chronic ankle sprain

ObjectivesTo determine the effects of ankle Kinesio-taping (KT) on postural sway, lower limb ROM, and muscle activity during a unilateral balance tasks.DesignCase control study design.SettingData were collected at the human movement analysis laboratory.Participants30 collegiate athletes with chronic ankle sprain (11 females and 19 males, 23.91 ± 2.58 years).Main outcome measureHip, knee and ankle joints ranges of motion (ROMs); postural sway area and velocities in both anteroposterior and mediolateral directions; and muscular activity amplitudes (% peak) of lateral and medial gastrocnemius, tibialis anterior and peroneus longus in a 20s single leg balance test in two non-taped (control) and KT (intervention) conditions.ResultsSignificant decrease observed in ankle lateral ROM (p = 0.048, d = 0.52), mediolateral postural sway velocity (p = 0.029, d = 1.25), and peroneus longus activity amplitudes (p = 0.042, d = 0.55) after KT application.ConclusionAcute application of KT among athletes with chronic ankle instability could provide lateral mechanical support to the ankle, potentially decreasing the velocity of frontal plane sway, and decreasing the magnitude of muscle activation. These data suggest that KT may be beneficial for improving static joint stability among individuals with chronic ankle sprain, and thus could be considered an option to allow safe return-to-activity.     

The influence of smartphone use on spinal posture – A laboratory study

BackgroundSmartphones have become increasingly more popular and complicated tasks can be performed with these devices. However, the increasing use is associated with shoulder and neck pain, as well as with psychological addiction.Research questionDo different smartphone tasks lead to changes in spinal posture and pelvic position? Is there a relationship between smartphone addiction and changes in posture?MethodsA cross-sectional study including 50 participants was performed. Test subjects completed the Smartphone Addiction Scale and the SF-36 health questionnaire. Subjects spinal posture and pelvic position during different smartphone tasks were measured through a surface topography system. The different tasks were: standing in an upright position, simulating a phone call, texting with one or two hands during standing or while walking on a treadmill. Paired T-tests and ANOVA tests were performed to evaluate differences. The Kendall rank test was used to investigate the association between clinical scores and changes in spinal posture.ResultsAll smartphone tasks lead to a significant increase in thoracic kyphosis and trunk inclination during standing and while walking. A significant increased lumbar lordosis was also found. Texting with one or two hands correlated with increased surface rotation. No associations between smartphone addiction and changes of the spinal posture were reported.SignificanceThis represents the first surface topography study that investigated the influence of different smartphone tasks on the spinal posture and pelvic position during standing and while walking. With the results of this study we demonstrated that smartphone use leads to significant changes of sagittal and frontal spine parameters. Further research should focus on the evaluation of possible detrimental effects of long-term smartphone use on the spinal posture and on the development of preventive measures.     

Asymmetry in gait pattern following tibial shaft fractures – a prospective one-year follow-up study of 49 patients

IntroductionDespite the high number of studies evaluating the outcomes following tibial shaft fractures, the literature lacks studies including objective assessment of patients’ recovery regarding gait pattern. The purpose of the present study was to evaluate whether gait patterns at 6 and 12 months post-operatively following intramedullary nailing of a tibial shaft fracture are different compared with a healthy reference population.Patients and methodsThe study design was a prospective cohort study. The primary outcome measurement was the gait patterns at 6 and 12 months post-operatively measured with a 6-metre-long pressure-sensitive mat. The mat registers footprints and present gait speed, cadence as well as temporal and spatial parameters of the gait cycle. Gait patterns were compared to a healthy reference population.Results49 patients were included with a mean age of 43.1 years (18–79 years). Forty-three patients completed the 12-month follow-up (88%). Gait speed and cadence were significantly increased between the 6- and 12-month follow-up (P < 0.001). At 6-month follow-up, patients showed considerable asymmetry in the injured leg compared with the non-injured leg: single-support time 12.8% shorter, swing-time 12.8% longer, step-length 11.9% shorter, and rotation of the foot increased by 32.3%. At the 12-month follow-up, gait asymmetry become almost normalized compared to a healthy reference group.ConclusionIn patients treated by intramedullary nailing following a tibial shaft fracture, gait asymmetry accompanied with slower speed and cadence are common during the first 6 months and become normalized compared with a healthy reference population between 6 and 12 months post-operatively.     

The beneficial effect of α-tocopherol succinate supplementation on DNA oxidation induced by intensive exercise training

Sport Sciences for Health - Production of reactive oxygen species (ROS) induced by exercise training yields serious oxidative damage to cellular structures. Antioxidant supplements are widely used...     

The effect of the time-of-day of training during Ramadan on soccer players’ chronotype and mood states

The aim of the present study was to investigate the effect of time-of-day of training during Ramadan on soccer players’ chronotype and mood states. Thirty participants were randomly assigned to either a morning training group (MTG, trained between 0700 and 0830 hours, n = 10), an evening training group (ETG, trained between 1700 and 1830 hours, n = 10), or a control group (CG, did not train, n = 10). They completed two questionnaires before (BR) and at the end of (ER) Ramadan: the Horne and Östberg’s self-assessment questionnaire and the Profile of Mood States (POMS) questionnaire. The results showed that the MTG maintained the Horne and Östberg’s scores during ER compared with BR, with all players classified as “moderately morning type”. However, Horne and Östberg’s scores were reduced in the ETG (p < 0.05), with all players classified as “moderately evening type”, and in the CG, with six players classified as “neither type” and four as “moderately evening type”. There was not a significant effect of Ramadan on mood states. Only fatigue was increased and vigor was reduced in the ETG. Therefore, morning training did not affect the chronotype of the players during Ramadan. However, evening training reduced the Horne and Östberg’s scores. During ER, the participants of the MTG were classified as “moderately morning type” and the participants of the ETG were classified as “neither type” (n = 6) and “moderately evening type” (n = 4).     

Fast gait spatiotemporal parameters in adults and association with muscle strength – The Yishun study

BackgroundThere is limited data on fast gait speed and spatial-temporal parameters across age groups among Asian adults, and the associations between upper and lower extremity muscle strength with gait.Research questionWhat values characterise fast gait spatiotemporal parameters across the age groups of an Asian population? Are hand grip strength (HGS) and knee extension strength (KES) associated with fast gait speed and spatiotemporal parameters?MethodsHealthy community-living adults between 21–90 years (n = 487) were recruited. Fast gait was assessed using a 6 m instrumented walkway, and spatiotemporal parameters including variability for fast gait speed, stride length, stride width, stride time, stance time, swing time, single support time and double support time were analysed. Maximum HGS and KES were also assessed. Linear regression modelling was used to explore the association of HGS and KES with fast gait speed, spatiotemporal parameters and their variability.ResultsAge reduced fast gait speed and stride length, but increased stride width, stance time, stride time and double support time. Age increased all investigated gait variabilities except stride width variability. Gender differences were observed for all gait features except for fast gait speed and double support time. Both HGS and KES were positively associated with fast gait speed in both young and old adults. KES was positively associated with spatiotemporal variations in stride length, stride time, stance time and double support time. HGS was also significantly associated with two additional temporal parameters – positively with swing time and negatively with double support time variability.SignificanceThe data from this study contributes to reference values database for the use of fast gait assessments in adults.