motor

电机
  • 文章类型: Journal Article
    早期运动技能可能是神经发育状况的重要早期标志或其后期发作的预测因子。为了探索这个,我们对那些继续获得自闭症临床诊断的婴儿运动技能评估进行了系统回顾和荟萃分析,注意缺陷多动障碍(ADHD),精神分裂症,语言条件,抽动障碍,或发育协调障碍(DCD)。总的来说,65篇文章符合纳入标准。进行了三个三级荟萃分析。对N=21354名个体的里程碑成就的荟萃分析显示,与对照组相比,粗大运动里程碑明显延迟(g=0.53,p<0.001)。亚组分析显示,自闭症(g=0.63)和DCD(g=0.53)的延迟幅度最大。具体的延迟被揭示为保持头部(g=0.21),坐(g=0.28),站立(g=0.35),爬行(g=0.19),步行(g=0.71)。对N=1976个体的标准化运动技能测量的荟萃分析显示,在自闭症和语言条件下,与对照组相比,表现降低(g=-0.54,p<0.001)。一起,这些研究结果表明,在神经发育状况下,儿童早期的里程碑达到延迟和运动障碍.
    Early motor skills may be important early markers of neurodevelopmental conditions or predictors of their later onset. To explore this, we conducted a systematic review and meta-analysis of infant motor skill assessments in those who go on to gain a clinical diagnosis of autism, attention deficit hyperactivity disorder (ADHD), schizophrenia, language conditions, tic disorders, or developmental coordination disorder (DCD). In total, 65 articles met inclusion criteria. Three three-level meta-analyses were run. Meta-analysis of milestone achievement in N=21354 individuals revealed gross motor milestones were significantly delayed compared to controls (g= 0.53, p< 0.001). Subgroup analyses revealed autism (g= 0.63) and DCD (g= 0.53) had the highest magnitude delays. Specific delays were revealed for holding the head up (g= 0.21), sitting (g= 0.28), standing (g= 0.35), crawling (g=0.19), and walking (g= 0.71). Meta-analyses of standardised motor skill measurements in N=1976 individuals revealed reduced performance compared to controls in autism and language conditions (g= -0.54, p< 0.001). Together, these findings demonstrate delayed milestone attainment and motor impairments in early childhood in neurodevelopmental conditions.
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  • 文章类型: Meta-Analysis
    目的:本系统评价旨在评估产前和儿童期接触邻苯二甲酸盐与神经发育结果之间的关系。确定敏感性升高的时期。数据来源考虑了检查怀孕和儿童期反复接触邻苯二甲酸盐对神经发育的研究。方法:评估包括偏倚风险和研究质量标准。通过产前和产后测量的低和高邻苯二甲酸酯分子量和暴露以及在儿童期测量的结果来合成证据。提取了β系数及其标准误差,导致各种神经发育结果的荟萃分析:认知,运动技能,语言,行为,和气质。结果:11项妊娠和出生队列研究被确定为相关研究。对于每个邻苯二甲酸酯组和结果组合,有低或非常低的关联证据,除了产前和产后邻苯二甲酸盐暴露和行为发育以及产后暴露和认知。结论:估计的效应大小相对较小,无法阐明敏感性升高时期的有力证据。在结果方面,低分子量的邻苯二甲酸酯和高分子量的邻苯二甲酸酯之间没有区别。
    Objectives: This systematic review aims to assess the relationship between prenatal and childhood exposure to phthalates and neurodevelopmental outcomes, identifying periods of heightened susceptibility. Data sources considered studies examining repeated phthalate exposure during pregnancy and childhood on neurodevelopment. Methods: Evaluation included bias risk and study quality criteria. Evidence was synthesized by groups of low and high phthalate molecular weight and exposure measured prenatally and postnatally and outcome measured in childhood. Beta coefficients and their standard errors were extracted, leading to meta-analyses of various neurodevelopmental outcomes: cognition, motor skills, language, behavior, and temperament. Results: Eleven pregnancy and birth cohort studies were identified as relevant. For each phthalate group and outcome combination, there was low or very low evidence of an association, except for prenatal and postnatal phthalate exposure and behavioral development and postnatal exposure and cognition. Conclusion: The estimated effects sizes were relatively small and strong evidence for periods of heightened susceptibility could not be elucidated. No distinction between phthalates of low molecular weight and those of high molecular weight with regards to the outcomes was found.
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  • 文章类型: Journal Article
    Parkinson\'s disease (PD) is a chronic movement disorder characterized by a variety of motor and nonmotor comorbidities, including cognitive impairment, gastrointestinal (GI) dysfunction, and autonomic/sleep disturbances. Symptoms typically fluctuate with different settings and environmental factors and thus need to be consistently monitored. Current methods, however, rely on infrequent rating scales performed in clinic. The advent of wearable technologies presents a new avenue to track objective measures of PD comorbidities longitudinally and more frequently. This narrative review discusses and proposes emerging wearable technologies that can monitor manifestations of motor, cognitive, GI, and autonomic/sleep comorbidities throughout the daily lives of PD individuals. This can provide more wholistic insight into real-time physiological versus pathological function with the potential to better assess treatments during clinical trials and allow physicians to optimize treatment regimens. Additionally, this narrative review briefly examines novel applications of wearables as therapy for PD patients.
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  • 文章类型: Journal Article
    运动障碍是不完全脊髓损伤(SCI)最常见的后果。这些损伤会影响患者的功能水平和生活质量。联合机器人疗法和非侵入性脑刺激(NIBS)已用于改善皮质脊髓束病变患者的运动障碍。
    研究机器人联合治疗和NIBS对不完全SCI后运动功能的影响。
    PubMed,Scopus,MEDLINE,PEDro,WebofScience,REHABDATA,CINAHL,和EMBASE从成立到2023年7月进行了搜索。采用物理治疗证据数据库(PEDro)量表评估选定的研究质量。
    在557项研究中,五项随机试验(n=122),25%的参与者是女性,包括在这次审查中。PEDro的分数从8到9,中位数是9分。治疗方案和结果指标有所不同,导致异质性的发现。研究结果表明,机器人联合治疗和NIBS对不完全SCI个体运动功能的影响揭示了证据。
    机器人训练和NIBS联合训练对SCI不完全患者可能是安全的。关于其对SCI患者运动结果影响的现有证据有限。需要进一步的实验研究来了解机器人训练和NIBS联合对SCI人群运动障碍的影响。
    UNASSIGNED: Motor deficits are among the most common consequences of incomplete spinal cord injury (SCI). These impairments can affect patients\' levels of functioning and quality of life. Combined robotic therapy and non-invasive brain stimulation (NIBS) have been used to improve motor impairments in patients with corticospinal tract lesions.
    UNASSIGNED: To examine the effects of combined robotic therapy and NIBS on motor function post incomplete SCI.
    UNASSIGNED: PubMed, SCOPUS, MEDLINE, PEDro, Web of Science, REHABDATA, CINAHL, and EMBASE were searched from inception until July 2023. The Physiotherapy Evidence Database (PEDro) scale was employed to evaluate the selected studies quality.
    UNASSIGNED: Of 557 studies, five randomized trials (n = 122), with 25% of participants being females, were included in this review. The PEDro scores ranged from eight to nine, with a median score of nine. There were variations in treatment protocols and outcome measures, resulting in heterogeneous findings. The findings showed revealed evidence for the impacts of combined robotic therapy and NIBS on motor function in individuals with incomplete SCI.
    UNASSIGNED: Combined robotic training and NIBS may be safe for individuals with incomplete SCI. The existing evidence concerning its effects on motor outcomes in individuals with SCI is limited. Further experimental studies are needed to understand the effects of combined robotic training and NIBS on motor impairments in SCI populations.
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  • 文章类型: Journal Article
    啮齿动物行为检查技术用于评估各种心理,神经模型和神经毒性研究。因此,有趣的是,记录啮齿动物模型中使用的各种行为评估方法来研究运动,感官,认知功能和情绪行为。
    The rodent behavioural examination techniques are used to assess various psychological, neurological models and neurotoxicity studies. Therefore, it is of interest to document the various behavioural assessment methods used in rodent model to study the motor, sensory, cognitive functions and emotional behaviour.
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  • 文章类型: Systematic Review
    重复经颅磁刺激(rTMS)已广泛应用于脑卒中后运动康复,和功能磁共振成像(fMRI)已用于研究中风治疗期间运动恢复的神经机制。然而,目前尚无基于fMRI明确的rTMS干预卒中后运动恢复的机制的综述.我们旨在揭示和总结通过fMRI测量的rTMS对中风后运动功能影响的神经机制。我们使用PubMed仔细进行了文献检索,EMBASE,WebofScience,和Cochrane图书馆数据库从各自的开始到2022年11月,以确定任何相关的随机对照试验。研究人员独立筛选了文献,提取的数据,并对纳入的研究进行了定性描述。最终纳入了11项研究,共420名卒中后患者。共有338名参与者在rTMS干预前后接受了fMRI检查。五项研究报告了rTMS对大脑区域激活的影响,四项研究报告了与脑功能连接(FC)相关的结果。此外,5项研究分析了fMRI与运动评估的相关性。rTMS改善卒中后运动功能的神经机制可能是运动相关脑区的激活和FCs,包括增强受影响半球运动相关大脑区域的激活,抑制未受影响的半球中与运动相关的大脑区域的激活,改变半球内和半球间运动网络的FC。
    Repetitive transcranial magnetic stimulation (rTMS) has been widely used in motor rehabilitation after stroke, and functional magnetic resonance imaging (fMRI) has been used to investigate the neural mechanisms of motor recovery during stroke therapy. However, there is no review on the mechanism of rTMS intervention for motor recovery after stroke based on fMRI explicitly. We aim to reveal and summarize the neural mechanism of the effects of rTMS on motor function after stroke as measured by fMRI. We carefully performed a literature search using PubMed, EMBASE, Web of Science, and Cochrane Library databases from their respective inceptions to November 2022 to identify any relevant randomized controlled trials. Researchers independently screened the literature, extracted data, and qualitatively described the included studies. Eleven studies with a total of 420 poststroke patients were finally included in this systematic review. A total of 338 of those participants received fMRI examinations before and after rTMS intervention. Five studies reported the effects of rTMS on activation of brain regions, and four studies reported results related to brain functional connectivity (FC). Additionally, five studies analyzed the correlation between fMRI and motor evaluation. The neural mechanism of rTMS in improving motor function after stroke may be the activation and FCs of motor-related brain areas, including enhancement of the activation of motor-related brain areas in the affected hemisphere, inhibition of the activation of motor-related brain areas in the unaffected hemisphere, and changing the FCs of intra-hemispheric and inter-hemispheric motor networks.
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  • 文章类型: Journal Article
    患有唐氏综合症(DS)的儿童通常有运动和语言需求。改善功能是康复治疗团队的共同目标,然而物理治疗,职业治疗,和语言病理学专业人员对待病人不同。这种护理差异可能会掩盖发育级联,从而在一个领域发生改变(例如,电机)可能会对另一个领域产生看似意想不到的影响(例如,语言)。
    这项范围审查确定了DS儿童的运动和语言数据一起报告的论文,并重新解释了发育级联透镜的发现。
    在线数据库用于识别2021年10月之前发表的413篇论文,其中保留了33篇论文,报告了运动(总体和/或精细)和语言(表达和/或接受)数据。
    报告DS儿童运动和语言数据的大多数论文(79%)没有检查它们的联系,而12%的人分析了运动语言的联系,而是使用横截面或回顾性设计。只有三篇论文(9%)使用纵向设计来检查预测链接。
    经常一起报道运动功能和语言功能,但没有一起分析,在DS儿童的研究中。少数分析运动语言联系的研究在很大程度上复制了其他发育人群的发现,在这些人群中,运动增益与语言增益呈正相关。当此类数据可用时,需要分析域之间的联系,以充分表征DS中的发育级联,并且可能具有广泛的临床意义。
    UNASSIGNED: Children with Down syndrome (DS) typically have motor and language needs. Improving function is a shared goal for the rehabilitation therapy team, however physical therapy, occupational therapy, and speech-language pathology professionals treat patients differently. This difference in care may mask developmental cascades whereby changes in one domain (e.g., motor) can have seemingly unexpected effects on another domain (e.g., language).
    UNASSIGNED: This scoping review identified papers where motor and language data have been reported together in children with DS and reinterpreted findings from a developmental cascades lens.
    UNASSIGNED: Online databases were used to identify 413 papers published before October 2021 from which 33 papers were retained that reported both motor (gross and/or fine) and language (expressive and/or receptive) data in individuals with DS with a chronological age of 0-18 years.
    UNASSIGNED: The majority of papers (79%) that reported motor and language data in children with DS did not examine their link, while 12% analyzed motor-language links, but using a cross-sectional or retrospective design. Only three papers (9%) utilized a longitudinal design to examine predictive links.
    UNASSIGNED: Motor functioning and language functioning have often been reported together, but not analyzed together, in studies of children with DS. The few studies that did analyze motor-language links largely replicated findings from other developmental populations where motor gains were positively linked to language gains. Analyzing links between domains when such data is available is needed to fully characterize developmental cascades in DS and may have broad clinical implications.
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  • 文章类型: Systematic Review
    目的:介绍有关扩展现实远程康复的有效性以及患者在家中使用不同类型的虚拟现实练习的经验的证据程度。方法:我们纳入了以英语发表的虚拟现实和增强现实远程康复的研究。在PubMed中进行了系统搜索,WebofSciences,Medline,Embase,CINAHL,还有PEDro,没有日期限制。我们仅纳入RCT和定性研究,以探索患者的经历。使用Cochrane偏差风险评估工具进行定量论文评估,并使用CASP量表进行定性研究。所有结果均以叙述方式呈现。结果:13项研究,九个定量和四个定性,包括在内,一个定性和七个定量具有很高的偏见风险。所有研究都报告说,与常规练习或其他扩展的现实练习相比,扩展的基于现实的远程康复可能是有效的。七项定量研究集中在上肢功能上。定性论文表明,患者认为VR练习是可行的。结论:文献表明,VR家庭锻炼对于上肢中风后的患者是可行的,并且可能有效。需要进一步的高质量研究来检查早期采用XR练习对不同定性和定量结果的有效性。注册号:(CRD42022384356)。
    Objective: To present the extent of evidence concerning the effectiveness of extended reality telerehabilitation and patients\' experiences of using different types of virtual reality exercises at home. Methods: We included studies on virtual reality and augmented reality telerehabilitation published in English. Systematic searches were undertaken in PubMed, Web of Sciences, Medline, Embase, CINAHL, and PEDro, with no date limitations. We included only RCTs and qualitative studies exploring patients\' experiences. Methodological quality was assessed using the Cochrane Risk of Bias assessment tool for quantitative papers and the CASP scale for qualitative studies. All results are presented narratively. Results: Thirteen studies, nine quantitative and four qualitative, were included, with one qualitative and seven quantitative having a high risk of bias. All studies reported that extended reality-based telerehabilitation may be effective compared to conventional exercises or other extended reality exercises. Seven quantitative studies focused on upper limb function. Qualitative papers suggested that VR exercises were perceived as feasible by patients. Conclusions: The literature suggests VR home exercises are feasible and potentially effective for patients after a stroke in the upper limb. Further high-quality studies are needed to examine the effectiveness of XR exercises early adoption on different qualitative and quantitative outcomes. Registration number: (CRD42022384356).
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  • 文章类型: Systematic Review
    尽管其潜在的临床影响,个人忽视(PN)与运动的联系,日常生活活动(ADL),卒中后的参与结局尚不清楚。因此,关于该主题的首次系统审查评估了该关联,考虑到PN的建议亚型,包括身体代表性的忽视,体感忽视,电机忽视,和运动前的忽视。2023年2月17日在PubMed进行了系统的文献检索,WebofScience,Scopus,PubPsych,和Psycarticles数据库。本研究遵循系统评价和荟萃分析的首选报告项目指南,其协议在PROSPERO(CRD42020187460)上注册。包括11项观察性研究,收集1,400人中风后(429显示PN)。结果表明,中风后身体表征忽视的个体运动控制和运动强度明显下降,功能流动性较低,与中风后没有身体代表忽视的人相比,ADL独立性。中风后运动忽视的个体比中风后没有运动忽视的个体表现出更差的运动功能和痉挛。非指定PN(即,用不允许进行分类的结果测量进行评估的PN)与推挤时更差的侧向撕脱有关,逗留时间更长,出院到家中以外的地方的可能性更大。没有研究评估体感和运动前忽视。这篇综述强调了该领域的有限研究,并强调了对更全面的PN评估的必要性。然而,目前可用的评估工具显示,准确诊断PN亚型的能力有限,未来的研究应优先开发综合诊断测试电池.
    Despite its potential clinical impact, the association of personal neglect (PN) with motor, activities of daily living (ADL), and participation outcomes after stroke is not well-understood. This first-ever systematic review on the topic therefore evaluates this association, taking into account suggested subtypes of PN, including body representation neglect, somatosensory neglect, motor neglect, and premotor neglect. A systematic literature search was conducted on February 17, 2023 in PubMed, Web of Science, Scopus, PubPsych, and PsycArticles databases. The study adheres to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered on PROSPERO (CRD42020187460). Eleven observational studies were included, gathering 1,400 individuals after stroke (429 showed PN). Results show that individuals with body representation neglect after stroke have significantly decreased movement control and motor strength, lower functional mobility, and ADL independency compared with those without body representation neglect after stroke. Individuals with motor neglect after stroke showed worse motor function and spasticity than to those without motor neglect after stroke. Nonspecified PN (i.e., PN evaluated with an outcome measure that does not allow subcategorization) was related to worse lateropulsion with pushing, longer length of stay and greater odds of being discharged to somewhere other than home. No study evaluated somatosensory and premotor neglect. This review highlights the limited research in this area and emphasizes the need for a more comprehensive PN assessment. However, currently available assessment tools show limited ability to accurately diagnose PN subtypes and future research should prioritize the development of comprehensive diagnostic test batteries.
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  • 文章类型: Systematic Review
    背景:在运动相关脑震荡后重返赛场后,发生脑震荡和肌肉骨骼损伤的风险增加。虽然有许多评估可供临床医生诊断和在脑震荡后重返比赛期间使用,许多人可能缺乏检测这些亚临床功能变化的能力.目前,关于可靠性没有共识或整理来源,这些评估的有效性和可行性,这使得临床医生和从业人员很难选择最适合他们需求的评估。
    目的:本系统综述旨在(1)巩固脑震荡管理过程中运动功能评估的信度和效度,(2)总结其对临床医生和其他最终用户的可行性。
    方法:对5个数据库进行系统检索。符合条件的研究是:(1)原始研究;(2)全文英语;(3)具有III级或更高证据的同行评审;(4)评估用于诊断或确定患有脑震荡的运动员或军事人员的下肢运动评估的有效性;(5)评估健康运动员中用于脑震荡管理的下肢运动评估的重测可靠性。可接受的下肢运动评估分为仪器和非仪器,然后分为静态(在固定点附近稳定)。动态(围绕固定点移动),步态,和其他类别。使用COSMIN检查表对每项研究进行评估,以建立方法学和测量质量。
    结果:总共确定了1270条记录,删除了637个重复项。分析了633条记录的标题和摘要,其中158项被保留用于全文审查。本次审查共包括67条记录;37条记录评估了可靠性,35条记录评估了下肢运动评估的有效性。审查中包括42项不同的评估,43%的人没有仪器,主观评价。一致的证据支持使用仪器化评估而非仪器化评估,与静态或动态评估相比,基于步态的评估显示出足够的可靠性和有效性。
    结论:这些研究结果表明,基于步态的评估应优先于静态或动态平衡评估。实验室设备的使用(即3D运动捕捉,压敏走道)平均表现出足够的信度和效度,但证明可行性差。需要进一步的高质量研究来评估更容易获得的设备(即惯性测量单元)的可靠性和有效性,以填补当前脑震荡管理协议的空白。从业人员可以使用此资源来了解他们所拥有的评估的准确性和准确性,以便就脑震荡的管理做出明智的决定。
    背景:本系统综述已在PROSPERO上注册(注册编号:CRD42021256298).
    BACKGROUND: There is an increased risk of subsequent concussion and musculoskeletal injury upon return to play following a sports-related concussion. Whilst there are numerous assessments available for clinicians for diagnosis and during return to play following concussion, many may lack the ability to detect these subclinical changes in function. Currently, there is no consensus or collated sources on the reliability, validity and feasibility of these assessments, which makes it difficult for clinicians and practitioners to select the most appropriate assessment for their needs.
    OBJECTIVE: This systematic review aims to (1) consolidate the reliability and validity of motor function assessments across the time course of concussion management and (2) summarise their feasibility for clinicians and other end-users.
    METHODS: A systematic search of five databases was conducted. Eligible studies were: (1) original research; (2) full-text English language; (3) peer-reviewed with level III evidence or higher; (4) assessed the validity of lower-limb motor assessments used to diagnose or determine readiness for athletes or military personnel who had sustained a concussion or; (5) assessed the test-retest reliability of lower-limb motor assessments used for concussion management amongst healthy athletes. Acceptable lower-limb motor assessments were dichotomised into instrumented and non-instrumented and then classified into static (stable around a fixed point), dynamic (movement around a fixed point), gait, and other categories. Each study was assessed using the COSMIN checklist to establish methodological and measurement quality.
    RESULTS: A total of 1270 records were identified, with 637 duplicates removed. Titles and abstracts of 633 records were analysed, with 158 being retained for full-text review. A total of 67 records were included in this review; 37 records assessed reliability, and 35 records assessed the validity of lower-limb motor assessments. There were 42 different assessments included in the review, with 43% being non-instrumented, subjective assessments. Consistent evidence supported the use of instrumented assessments over non-instrumented, with gait-based assessments demonstrating sufficient reliability and validity compared to static or dynamic assessments.
    CONCLUSIONS: These findings suggest that instrumented, gait-based assessments should be prioritised over static or dynamic balance assessments. The use of laboratory equipment (i.e. 3D motion capture, pressure sensitive walkways) on average exhibited sufficient reliability and validity, yet demonstrate poor feasibility. Further high-quality studies evaluating the reliability and validity of more readily available devices (i.e. inertial measurement units) are needed to fill the gap in current concussion management protocols. Practitioners can use this resource to understand the accuracy and precision of the assessments they have at their disposal to make informed decisions regarding the management of concussion.
    BACKGROUND: This systematic review was registered on PROSPERO (reg no. CRD42021256298).
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