Announcement

Collapse
No announcement yet.

Movement papers

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • CT Movement papers

    EEG Single-Trial Detection of Gait Speed Changes during Treadmill Walk
    http://www.aacijournal.com/content/7/S1/S1

    Abstract

    In this study, we analyse the electroencephalography (EEG) signal associated with gait speed changes (i.e. acceleration or deceleration). For data acquisition, healthy subjects were asked to perform volitional speed changes between 0, 1, and 2 Km/h, during treadmill walk. Simultaneously, the treadmill controller modified the speed of the belt according to the subject’s linear speed. A classifier is trained to distinguish between the EEG signal associated with constant speed gait and with gait speed changes, respectively. Results indicate that the classification performance is fair to good for the majority of the subjects, with accuracies always above chance level, in both batch and pseudo-online approaches. Feature visualisation and equivalent dipole localisation suggest that the information used by the classifier is associated with increased activity in parietal areas, where mu and beta rhythms are suppressed during gait speed changes. Specifically, the parietal cortex may be involved in motor planning and visuomotor transformations throughout the online gait adaptation, which is in agreement with previous research. The findings of this study may help to shed light on the cortical involvement in human gait control, and represent a step towards a BMI for applications in post-stroke gait rehabilitation.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

  • #2
    Modulation of Inhibitory Corticospinal Circuits Induced by a Nocebo Procedure in Motor Performance

    http://journals.plos.org/plosone/art...l.pone.0125223

    Abstract

    As recently demonstrated, a placebo procedure in motor performance increases force production and changes the excitability of the corticospinal system, by enhancing the amplitude of the motor evoked potentials (MEP) and reducing the duration of the cortical silent period (CSP). However, it is not clear whether these neurophysiological changes are related to the behavioural outcome (increased force) or to a general effect of expectation. To clarify this, we investigated the nocebo effect, in which the induced expectation decreases force production. Two groups of healthy volunteers (experimental and control) performed a motor task by pressing a piston with the right index finger. To induce a nocebo effect in the experimental group, low frequency transcutaneous electrical nerve stimulation (TENS) was applied over the index finger with instructions of its detrimental effects on force. To condition the subjects, the visual feedback on their force level was surreptitiously reduced after TENS. Results showed that the experimental group reduced the force, felt weaker and expected a worse performance than the control group, who was not suggested about TENS. By applying transcranial magnetic stimulation over the primary motor cortex, we found that while MEP amplitude remained stable throughout the procedure in both groups, the CSP duration was shorter in the experimental group after the nocebo procedure. The CSP reduction resembled previous findings on the placebo effect, suggesting that expectation of change in performance diminishes the inhibitory activation of the primary motor cortex, independently of the behavioural outcome.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • #3
      Neural Coding of Movement Direction in the Healthy Human Brain

      http://journals.plos.org/plosone/art...l.pone.0013330

      Abstract

      Neurophysiological studies in monkeys show that activity of neurons in primary cortex (M1), pre-motor cortex (PMC), and cerebellum varies systematically with the direction of reaching movements. These neurons exhibit preferred direction tuning, where the level of neural activity is highest when movements are made in the preferred direction (PD), and gets progressively lower as movements are made at increasing degrees of offset from the PD. Using a functional magnetic resonance imaging adaptation (fMRI-A) paradigm, we show that PD coding does exist in regions of the human motor system that are homologous to those observed in non-human primates. Consistent with predictions of the PD model, we show adaptation (i.e., a lower level) of the blood oxygen level dependent (BOLD) time-course signal in M1, PMC, SMA, and cerebellum when consecutive wrist movements were made in the same direction (0° offset) relative to movements offset by 90° or 180°. The BOLD signal in dorsolateral prefrontal cortex adapted equally in all movement offset conditions, mitigating against the possibility that the present results are the consequence of differential task complexity or attention to action in each movement offset condition.
      As such, the results of the present study can be attributed with considerable confidence to direction-encoding properties of neurons rather than their connections to specific muscle groups.
      Nowadays I tend to refer patients elsewhere for strength and conditioning. I don't have a gym and I know others who are better at it and more up to date than I. My exercise prescription is based on everyday movement and fifteen second bursts of smooth, mindful, change of position.



      Cerebellar–M1 Connectivity Changes Associated with Motor Learning Are Somatotopic Specific
      http://www.jneurosci.org/content/37/9/2377

      Abstract
      One of the functions of the cerebellum in motor learning is to predict and account for systematic changes to the body or environment. This form of adaptive learning is mediated by plastic changes occurring within the cerebellar cortex. The strength of cerebellar-to-cerebral pathways for a given muscle may reflect aspects of cerebellum-dependent motor adaptation. These connections with motor cortex (M1) can be estimated as cerebellar inhibition (CBI): a conditioning pulse of transcranial magnetic stimulation delivered to the cerebellum before a test pulse over motor cortex. Previously, we have demonstrated that changes in CBI for a given muscle representation correlate with learning a motor adaptation task with the involved limb. However, the specificity of these effects is unknown. Here, we investigated whether CBI changes in humans are somatotopy specific and how they relate to motor adaptation. We found that learning a visuomotor rotation task with the right hand changed CBI, not only for the involved first dorsal interosseous of the right hand, but also for an uninvolved right leg muscle, the tibialis anterior, likely related to inter-effector transfer of learning. In two follow-up experiments, we investigated whether the preparation of a simple hand or leg movement would produce a somatotopy-specific modulation of CBI. We found that CBI changes only for the effector involved in the movement. These results indicate that learning-related changes in cerebellar–M1 connectivity reflect a somatotopy-specific interaction. Modulation of this pathway is also present in the context of interlimb transfer of learning.

      SIGNIFICANCE STATEMENT Connectivity between the cerebellum and motor cortex is a critical pathway for the integrity of everyday movements and understanding the somatotopic specificity of this pathway in the context of motor learning is critical to advancing the efficacy of neurorehabilitation. We found that adaptive learning with the hand affects cerebellar–motor cortex connectivity, not only for the trained hand, but also for an untrained leg muscle, an effect likely related to intereffector transfer of learning. Furthermore, we introduce a novel method to measure cerebellar–motor cortex connectivity during movement preparation. With this technique, we show that, outside the context of learning, modulation of cerebellar–motor cortex connectivity is somatotopically specific to the effector being moved.
      Update 02/04/2017
      Last edited by Jo Bowyer; 09-05-2017, 09:35 AM. Reason: update
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • #4
        Fear of Movement Is Related to Trunk Stiffness in Low Back Pain

        http://journals.plos.org/plosone/art...l.pone.0067779

        Abstract

        Background

        Psychological features have been related to trunk muscle activation patterns in low back pain (LBP). We hypothesised higher pain-related fear would relate to changes in trunk mechanical properties, such as higher trunk stiffness.

        Objectives

        To evaluate the relationship between trunk mechanical properties and psychological features in people with recurrent LBP.

        Methods

        The relationship between pain-related fear (Tampa Scale for Kinesiophobia, TSK; Photograph Series of Daily Activities, PHODA-SeV; Fear Avoidance Beliefs Questionnaire, FABQ; Pain Catastrophizing Scale, PCS) and trunk mechanical properties (estimated from the response of the trunk to a sudden sagittal plane forwards or backwards perturbation by unpredictable release of a load) was explored in a case-controlled study of 14 LBP participants. Regression analysis (r2) tested the linear relationships between pain-related fear and trunk mechanical properties (trunk stiffness and damping). Mechanical properties were also compared with t-tests between groups based on stratification according to high/low scores based on median values for each psychological measure.

        Results

        Fear of movement (TSK) was positively associated with trunk stiffness (but not damping) in response to a forward perturbation (r2 = 0.33, P = 0.03), but not backward perturbation (r2 = 0.22, P = 0.09). Other pain-related fear constructs (PHODA-SeV, FABQ, PCS) were not associated with trunk stiffness or damping. Trunk stiffness was greater for individuals with high kinesiophobia (TSK) for forward (P = 0.03) perturbations, and greater with forward perturbation for those with high fear avoidance scores (FABQ-W, P = 0.01).

        Conclusions

        Fear of movement is positively (but weakly) associated with trunk stiffness. This provides preliminary support an interaction between biological and psychological features of LBP, suggesting this condition may be best understood if these domains are not considered in isolation.
        Introduction

        People with low back pain (LBP) have changes in muscle activation [1], [2], trunk mechanical properties [3], [4]) and fear of pain [5], [6]. Although biological and psychological domains are often discussed in isolation, they are likely interdependent. Consistent with this view, studies have shown that adaptation in muscle activation depends on attitudes about pain [7], and compromise of the expected relaxation of the lumbar muscles at trunk flexion end range in people with LBP correlates with high fear avoidance behaviour [8]. Although it is assumed changes in trunk muscle activation relates to differences in trunk mechanical properties, the association between variation in psychological presentation and trunk mechanical behaviour has not been tested.

        A relationship between psychological and mechanical features would support contemporary neurophysiology and psychology pain models, for example, the prediction of pain/threat of injury causes the body to protect the painful part in an effort to reduce pain [9], the fear-avoidance model [10], [11], and the diathesis-stress pain theory [12] (i.e., behaviours which provide short-term relief can have detrimental long-term effects if the behaviour remains unchanged [13]). We considered simultaneous investigation of biological and psychological systems could help to better understand this relationship between mechanical and behavioural domains.

        Investigation of how biological and psychological features interact is of relevance because they both have the potential to influence the presentation and management of LBP. Motor control (i.e., trunk stiffness, relative tissue flexibility, preferred movement strategies) and psychological factors (i.e., emotions, cognitions, behaviours) are both likely to influence motor output and alter trunk mechanical behaviour. Depending upon the robustness of ‘motor’ and ‘psychological’ systems, it is probable the relationship is bi-directional in nature. Optimal trunk mechanical performance will vary depending upon the required task, and if a person with LBP cannot efficiently alter their mechanical response, it may have negative long-term biopsychosocial consequences (i.e., increased trunk load, reduced movement variability, reinforcement of maladaptive pain behaviour).

        Several psychological features have been explored in relation to LBP, most notably dimensions related to the fear-avoidance model [14]. The three aspects of this model are fear of movement/re-injury, pain catastrophizing [15], and avoidance behaviour, all of which could relate to changes in trunk motor control. Questionnaires to assess these components have been developed [16]–[19]. There has also been a focus on distress [20], [21]. It remains unknown which psychological features, if any, are related to trunk mechanical properties. In this study we aimed to test the hypothesis that higher kinesiophobia relates to greater protection of the spine (increased trunk stiffness) by exploring the relationship between trunk mechanical properties and other aspects of the fear-avoidance model (pain catastrophizing thoughts, avoidance behaviour) as well as a component of the distress model (depression).



        Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain

        http://journals.plos.org/plosone/art...l.pone.0180788

        Abstract

        Background

        Chronic low back pain is a worldwide burden that is not being abated with our current knowledge and treatment of the condition. The fear-avoidance model is used to explain the relationship between pain and disability in patients with chronic low back pain. However there are gaps in empirical support for pathways proposed within this model, and no evidence exists as to whether physical activity moderates these pathways.

        Methods

        This was a cross-sectional study of 218 people with chronic low back pain. Multiple mediation analyses were conducted to determine the role of fear, catastrophizing, depression, and anxiety in the relationship between pain and disability. Separate analyses were performed with physical activity as the moderator. Individuals were classified as performing regular structured physical activity if they described on average once per week for > 30-minutes an activity classified at least moderate intensity (? 4–6 METs), activity prescribed by an allied health professional for their back pain, leisure time sport or recreation, or self-directed physical activity such as resistance exercise.

        Results

        Fear, catastrophizing, and depression significantly mediated the relationship between pain and disability (p<0.001). However the mediating effect of catastrophizing was conditional upon weekly physical activity. That is, the indirect effect for catastrophizing mediating the relationship between pain and disability was only significant for individuals reporting weekly physical activity (B = 1.31, 95% CI 0.44 to 2.23), compared to individuals reporting no weekly physical activity (B = 0.21, 95% CI -0.50 to 0.97). Catastrophizing also mediated the relationship between pain and fear (B = 0.37, 95% CI 0.15 to 0.62), with higher scores explaining 53% of the total effect of pain on fear.

        Conclusions

        These results support previous findings about the importance of fear and depression as factors that should be targeted in low back pain patients to reduce back pain related disability. We have also extended understanding for the mediating effect of catastrophizing on back pain related disability. Back pain patients engaged with regular physical activity may require counselling with regards to negative pain perceptions.
        Update 11/07/2017
        Last edited by Jo Bowyer; 11-07-2017, 04:21 PM.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • #5
          Physical Demand but Not Dexterity Is Associated with Motor Flexibility during Rapid Reaching in Healthy Young Adults

          http://journals.plos.org/plosone/art...l.pone.0127017

          Abstract

          Healthy humans are able to place light and heavy objects in small and large target locations with remarkable accuracy. Here we examine how dexterity demand and physical demand affect flexibility in joint coordination and end-effector kinematics when healthy young adults perform an upper extremity reaching task. We manipulated dexterity demand by changing target size and physical demand by increasing external resistance to reaching. Uncontrolled manifold analysis was used to decompose variability in joint coordination patterns into variability stabilizing the end-effector and variability de-stabilizing the end-effector during reaching. Our results demonstrate a proportional increase in stabilizing and de-stabilizing variability without a change in the ratio of the two variability components as physical demands increase. We interpret this finding in the context of previous studies showing that sensorimotor noise increases with increasing physical demands. We propose that the larger de-stabilizing variability as a function of physical demand originated from larger sensorimotor noise in the neuromuscular system. The larger stabilizing variability with larger physical demands is a strategy employed by the neuromuscular system to counter the de-stabilizing variability so that performance stability is maintained. Our findings have practical implications for improving the effectiveness of movement therapy in a wide range of patient groups, maintaining upper extremity function in old adults, and for maximizing athletic performance.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • #6
            Locomotor-Like Leg Movements Evoked by Rhythmic Arm Movements in Humans

            http://journals.plos.org/plosone/art...l.pone.0090775

            Abstract

            Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e. whether arm movements can affect the lumbosacral locomotor circuitry. Here we tested the effects of voluntary rhythmic arm movements on the lower limbs. Participants lay horizontally on their side with each leg suspended in an unloading exoskeleton. They moved their arms on an overhead treadmill as if they walked on their hands. Hand-walking in the antero-posterior direction resulted in significant locomotor-like movements of the legs in 58% of the participants. We further investigated quantitatively the responses in a subset of the responsive subjects. We found that the electromyographic (EMG) activity of proximal leg muscles was modulated over each cycle with a timing similar to that of normal locomotion. The frequency of kinematic and EMG oscillations in the legs typically differed from that of arm oscillations. The effect of hand-walking was direction specific since medio-lateral arm movements did not evoke appreciably leg air-stepping. Using externally imposed trunk movements and biomechanical modelling, we ruled out that the leg movements associated with hand-walking were mainly due to the mechanical transmission of trunk oscillations. EMG activity in hamstring muscles associated with hand-walking often continued when the leg movements were transiently blocked by the experimenter or following the termination of arm movements. The present results reinforce the idea that there exists a functional neural coupling between arm and legs.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • #7
              ‘Choose to move’ is powerful, but now show me how

              http://criticalphysio.me/2015/06/24/...w-show-me-how/

              A vis rather than a paper. The debate around this challenges physiotherapists to lay their cards on the table.
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • #8
                Is this really a vision for physiotherapy?

                http://criticalphysio.me/2015/07/03/...physiotherapy/

                I prefer the Canadian version.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • #9
                  Don’t you wonder sometimes

                  http://noijam.com/2015/07/02/dont-you-wonder-sometimes/
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • #10
                    Active Prospective Control Is Required for Effective Sensorimotor Learning

                    http://journals.plos.org/plosone/art...l.pone.0077609

                    Abstract

                    Passive modeling of movements is often used in movement therapy to overcome disabilities caused by stroke or other disorders (e.g. Developmental Coordination Disorder or Cerebral Palsy). Either a therapist or, recently, a specially designed robot moves or guides the limb passively through the movement to be trained. In contrast, action theory has long suggested that effective skill acquisition requires movements to be actively generated. Is this true? In view of the former, we explicitly tested the latter. Previously, a method was developed that allows children with Developmental Coordination Disorder to produce effective movements actively, so as to improve manual performance to match that of typically developing children. In the current study, we tested practice using such active movements as compared to practice using passive movement. The passive movement employed, namely haptic tracking, provided a strong test of the comparison, one that showed that the mere inaction of the muscles is not the problem. Instead, lack of prospective control was. The result was no effective learning with passive movement while active practice with prospective control yielded significant improvements in performance.
                    Jo Bowyer
                    Chartered Physiotherapist Registered Osteopath.
                    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                    Comment


                    • #11
                      The Effect of Antagonist Muscle Sensory Input on Force Regulation

                      http://journals.plos.org/plosone/art...l.pone.0133561

                      Abstract

                      The purpose of this study was to understand how stretch-related sensory feedback from an antagonist muscle affects agonist muscle output at different contraction levels in healthy adults. Ten young (25.3 ± 2.4 years), healthy subjects performed constant isometric knee flexion contractions (agonist) at 6 torque levels: 5%, 10%, 15%, 20%, 30%, and 40% of their maximal voluntary contraction. For half of the trials, subjects received patellar tendon taps (antagonist sensory feedback) during the contraction. We compared error in targeted knee flexion torque and hamstring muscle activity, with and without patellar tendon tapping, across the 6 torque levels. At lower torque levels (5%, 10%, and 15%), subjects produced greater knee torque error following tendon tapping compared with the same torque levels without tendon tapping. In contrast, we did not find any difference in torque output at higher target levels (20%, 30%, and 40%) between trials with and without tendon tapping. We also observed a load-dependent increase in the magnitude of agonist muscle activity after tendon taps, with no associated load-dependent increase in agonist and antagonist co-activation, or reflex inhibition from the antagonist tapping. The findings suggest that at relatively low muscle activity there is a deficiency in the ability to correct motor output after sensory disturbances, and cortical centers (versus sub-cortical) are likely involved.
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • #12
                        Voluntary Exercise Training: Analysis of Mice in Uninjured, Inflammatory, and Nerve-Injured Pain States

                        http://journals.plos.org/plosone/art...l.pone.0133191

                        Abstract

                        Both clinical and animal studies suggest that exercise may be an effective way to manage inflammatory and neuropathic pain conditions. However, existing animal studies commonly use forced exercise paradigms that incorporate varying degrees of stress, which itself can elicit analgesia, and thus may complicate the interpretation of the effects of exercise on pain. We investigated the analgesic potential of voluntary wheel running in the formalin model of acute inflammatory pain and the spared nerve injury model of neuropathic pain in mice. In uninjured, adult C57BL/6J mice, 1 to 4 weeks of exercise training did not alter nociceptive thresholds, lumbar dorsal root ganglia neuronal excitability, or hindpaw intraepidermal innervation. Further, exercise training failed to attenuate formalin-induced spontaneous pain. Lastly, 2 weeks of exercise training was ineffective in reversing spared nerve injury-induced mechanical hypersensitivity or in improving muscle wasting or hindpaw denervation. These findings indicate that in contrast to rodent forced exercise paradigms, short durations of voluntary wheel running do not improve pain-like symptoms in mouse models of acute inflammation and peripheral nerve injury.
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • #13
                          The reliability and minimal detectable change of Timed Up and Go test in individuals with grade 1 – 3 knee osteoarthritis

                          http://www.biomedcentral.com/1471-2474/16/174

                          Abstract
                          Background
                          The Timed Up and Go (TUG) test is quick and easy tests to assess patients’ functional mobility. However, its reliability in individuals with knee osteoarthritis (OA) has not been well established. The aims of this study were to determine the reliability and minimal detectable change of the TUG test in individuals with doubtful to moderate (Grade 1–3) knee OA.

                          Methods
                          Sixty-five subjects (25 male, 40 female), aged 45–70 years, with knee OA participated. Inter-rater reliability was assessed using two observers at different times of the same day in an alternating order. Intra-rater reliability was assessed on two consecutive visits with a 2-day interval. The standard error of measurement (SEM) and the minimum detectable change (MDC) were calculated to determine statistically meaningful changes.

                          Results
                          Intra-rater and inter-rater reliability were 0.97 (95 % confidence interval [CI], 0.95 – 0.98) and 0.96 (95 % confidence interval [CI], 0.94 – 0.97), respectively. The MDC, based on measurements by a single rater and between raters, was 1.10 and 1.14 seconds, respectively.

                          Conclusions
                          The TUG is a reliable test with adequate MDC for clinical use in individuals with doubtful to moderate knee OA.
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • #14
                            The effect of changing movement and posture using motion-sensor biofeedback, versus guidelines-based care, on the clinical outcomes of people with sub-acute or chronic low back pain.......

                            http://www.biomedcentral.com/1471-2474/16/131

                            Abstract
                            Background
                            The aims of this pilot trial were to (i) test the hypothesis that modifying patterns of painful lumbo-pelvic movement using motion-sensor biofeedback in people with low back pain would lead to reduced pain and activity limitation compared with guidelines-based care, and (ii) facilitate sample size calculations for a fully powered trial.

                            Methods
                            A multicentre (8 clinics), cluster-randomised, placebo-controlled pilot trial compared two groups of patients seeking medical or physiotherapy primary care for sub-acute and chronic back pain. It was powered for longitudinal analysis, but not for adjusted single-time point comparisons. The intervention group (n = 58) received modification of movement patterns augmented by motion-sensor movement biofeedback (ViMove, dorsaVi.com) plus guidelines-based medical or physiotherapy care. The control group (n = 54) received a placebo (wearing the motion-sensors without biofeedback) plus guidelines-based medical or physiotherapy care.

                            Primary outcomes were self-reported pain intensity (VAS) and activity limitation (Roland Morris Disability Questionnaire (RMDQ), Patient Specific Functional Scale (PSFS)), all on 0–100 scales. Both groups received 6–8 treatment sessions. Outcomes were measured seven times during 10-weeks of treatment and at 12, 26 and 52 week follow-up, with 17.0 % dropout. Patients were not informed of group allocation or the study hypothesis.

                            Results
                            Across one-year, there were significant between-group differences favouring the intervention group [generalized linear model coefficient (95 % CI): group effect RMDQ −7.1 (95 % CI–12.6;–1.6), PSFS −10.3 (−16.6; −3.9), QVAS −7.7 (−13.0; −2.4); and group by time effect differences (per 100 days) RMDQ −3.5 (−5.2; −2.2), PSFS −4.7 (−7.0; −2.5), QVAS −4.8 (−6.1; −3.5)], all p < 0.001. Risk ratios between groups of probability of improving by >30 % at 12-months = RMDQ 2.4 (95 % CI 1.5; 4.1), PSFS 2.5 (1.5; 4.0), QVAS 3.3 (1.8; 5.9).

                            The only device-related side-effects involved transient skin irritation from tape used to mount motion sensors.

                            Conclusions
                            Individualised movement retraining using motion-sensor biofeedback resulted in significant and sustained improvements in pain and activity limitation that persisted after treatment finished. This pilot trial also refined the procedures and sample size requirements for a fully powered RCT.

                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • #15
                              Quality of life and acquired organ damage are intimately related to activity limitations in patients with systemic lupus erythematosus

                              http://www.biomedcentral.com/1471-2474/16/188

                              Abstract
                              Background
                              Systemic lupus erythematosus (SLE) is an autoimmune multi-organ disease, characterized by episodes of disease flares and remissions over time, which may restrain affected patients’ ability to perform daily activities. The purpose of the present study was to characterize variation in activity limitations among well-defined SLE patients, and to describe disease phenotypes, acquired organ damage and their relations to activity limitation and self-reported health, respectively.

                              Methods
                              The disease phenotypes were organized into 4 different clinical groups and logistic regression analyses were used to identify how an elevated health assessment questionnaire (HAQ) score was related to disease variables such as phenotypes, disease activity and damage accrual. Correlation and multiple linear regression analyses were used to examine the association between each group of variables – background variables, disease variables and self-reported measurements – and the degree of elevated HAQ.

                              Results
                              We found a higher proportion of activity limitation in patients with skin and joint involvement compared to others. The presence of activity limitation, as detected by the HAQ instrument, was significantly associated with quality of life (EuroQol–5D) and accrual of organ damage using the Systemic Lupus International Collaborative Clinics/ACR damage index.

                              Conclusions
                              The findings highlight the differing requirements of the multi-professional rehabilitation interventions for the various SLE phenotypes in order to optimize the clinical care of the patients.

                              Keywords: Systemic lupus erythematosus; Disease burden; Organ damage; Disability; Quality of life; Activity limitation; Disease phenotype
                              Not a movement paper as such, but further evidence that lack of functional movement can be correlated with reduced quality of life and organ damage. Patients I see with SLE do move. As a private practitioner I will not allow someone to throw good money after bad, there are plenty of others out there who are prepared to confine their practice to passive treatment modalities if that is what the patient wants.
                              Jo Bowyer
                              Chartered Physiotherapist Registered Osteopath.
                              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                              Comment

                              Working...
                              X