Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation

BACKGROUND: Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than standard neurorehabilitation approaches. In this context, several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas. Music-supported therapy has been recently developed as a new motor rehabilitation intervention. METHODS AND RESULTS: In order to explore the plasticity effects of music-supported therapy, this therapeutic intervention was applied to twenty chronic stroke patients. Before and after the music-supported therapy, transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity, acceleration and smoothness in a set of diadochokinetic movement tasks. Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects' motor performance. CONCLUSION: Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients, and their link with the amelioration of motor performance. Further studies are needed to confirm our observations.

The Effects of Headcut and Knickpoint Propagation on Bridges in Iowa, TR-541, 2008

The overarching goal of the proposed research was to provide a predictive tool for knickpoint propagation within the HCA (Hungry Canyon Alliance) territory. Knickpoints threaten the stability of bridge structures in Western Iowa. The study involved detailed field investigations over two years in order to monitor the upstream migration of a knickpoint on Mud Creek in Mills County, IA and identify the key mechanisms triggering knickpoint propagation. A state-of-the-art laser level system mounted on a movable truss provided continuous measurements of the knickpoint front for different flow conditions. A pressure transducer found in proximity of the truss provided simultaneous measurements of the flow depth. The laser and pressure transducer measurements led to the identification of the conditions at which the knickpoint migration commences. It was suggested that negative pressures developed by the reverse roller flow near the toe of the knickpoint face triggered undercutting of the knickpoint at this location. The pressure differential between the negative pressure and the atmospheric pressure also draws the impinging jet closer to the knickpoint face producing scour. In addition, the pressure differential may induce suction of sediment from the face. Other contributing factors include slump failure, seepage effects, and local fluvial erosion due to the exerted fluid shear. The prevailing flow conditions and soil information along with the channel cross-sectional geometry and gradient were used as inputs to a transcritical, one dimensional, hydraulic/geomorphic numerical model, which was used to map the flow characteristics and shear stress conditions near the knickpoint. Such detailed flow calculations do not exist in the published literature. The coupling of field and modeling work resulted in the development of a blueprint methodology, which can be adopted in different parts of the country for evaluating knickpoint evolution. This information will assist local government agencies in better understanding the principal factors that cause knickpoint propagation and help estimate the needed response time to control the propagation of a knickpoint after one has been identified.

Cable fixation and early total hip arthroplasty in the treatment of acetabular fractures in elderly patients.

Eighteen patients with acetabular fractures, with a mean age of 76 years, were treated with cable fixation and acute total hip arthroplasty. Nine were T-shaped fractures, 4 associated transverse and posterior wall, 2 transverse, 2 posterior column and posterior wall, and 1 anterior and posterior hemitransverse fractures. One patient experienced 3 episodes of hip dislocation within 10 months after surgery. All the others had a good outcome at a mean follow-up time of 36 months. Radiographic assessment showed healing of the fracture and a satisfactory alignment of the cup without loosening. This option provides good primary fixation, stabilizes complex acetabular fractures in elderly patients, and permits early postoperative mobilization.

Maintenance and Design of Steel Abutment Piles in Iowa Bridges, TR-622, 2014

Soil consolidation and erosion caused by roadway runoff have exposed the upper portions of steel piles at the abutments of numerous bridges, leaving them susceptible to accelerated corrosion rates due to the abundance of moisture, oxygen, and chlorides at these locations. This problem is compounded by the relative inaccessibility of abutment piles for close-up inspection and repair. The objective of this study was to provide bridge owners with recommendations for effective methods of addressing corrosion of steel abutment piles in existing and future bridges A review of available literature on the performance and protection of steel piles exposed to a variety of environments was performed. Eight potential coating systems for use in protecting existing and/or new piles were selected and subjected to accelerated corrosion conditions in the laboratory. Two surface preparation methods were evaluated in the field and three coating systems were installed on three piles at an existing bridge where abutment piles had been exposed by erosion. In addition, a passive cathodic protection (CP) system using sacrificial zinc anodes was tested in the laboratory. Several trial flowable mortar mixes were evaluated for use in conjunction with the CP system. For existing abutment piles, application of a protective coating system is a promising method of mitigating corrosion. Based on its excellent performance in accelerated corrosion conditions in the laboratory on steel test specimens with SSPC-SP3, -SP6, and -SP10 surface preparations, glass flake polyester is recommended for use on existing piles. An alternative is epoxy over organic zinc rich primer. Surface preparation of existing piles should include abrasive blast cleaning to SSPC-SP6. Although additional field testing is needed, based on the results of the laboratory testing, a passive CP system could provide an effective means of protecting piles in existing bridges when combined with a pumped mortar used to fill voids between the abutment footing and soil. The addition of a corrosion inhibitor to the mortar appears to be beneficial. For new construction, shop application of thermally sprayed aluminum or glass flake polyester to the upper portion of the piles is recommended.

An Estimate of the Cost to Resurface Pavements and Bridges Damaged by Studded Tires, 1972

This report contains an estimate of the cost of highway resurfacing necessitated by damage from studded tires. The total is $95,620,000 for the twenty-five years from 1971 to 1996. This total includes $51,937,000 to resurface pavements and bridges on Interstate routes and $43,683,000 for other Primary highways. The estimate for Interstate routes includes those sections now open to traffic and those planned for completion by November 1974. The estimate for other Primary routes includes rural and municipal sections open to traffic as of November 1970. The estimate was prepared by computing the cost of expected pavement and bridge resurfacing costs for the twenty-five year period assuming continued use of studded tires, then subtracting from this the expected resurfacing ) cost for the same period assuming that the use of' studded tires is prohibited. The total figure, $95,620,000, should be regarded as a conservative estimate of the cost which may be avoided by prohibiting the use of studded tires in Iowa. The conservative nature of the estimate may be demonstrated by the following examples of the guidelines used iri its preparation. 1. Only mainline pavements were included in the cost estimate for the Interstate routes. The connecting loops, exit ramps and entrance ramps at Interstate interchanges contain many additional miles of pavement subject to wear by studded tires. This pavement was omitted from the estimate because reliable ' information about the rate of pavement wear at such locations is not available. As a result, the Interstate resurfacing costs are underestimated. 2. Several other costs were also omitted from the estimate because of a lack of sufficient information. These include the cost of repairing damage caused by studded tires to city streets other than those designated as Primary routes, the damage to pavements and bridges on the more-heavily travelled Secondary roads, and the damage to pavement traffic markings on all highway systems. Experience indicates that portland cement concrete pavements in Iowa have a normal service life of twenty-five years before resurfacing becomes necessary. The service life for asphalt pavements is thirteen years. In making this cost estimate, the need for resurfacing was attributed to wear from studded tires only when the normal service life of the pavement was shortened by that wear. Consequently, this cost estimate does not account for the reduced safety and convenience to Iowa motorists during the time when pavement wear caused by studded tires is significant but less than the critical amount.

Dynamics of Highway Bridges, Iowa Highway Research Board Bulletin 17, 1960

Joint Publications from Iowa Engineering Experiment Station - Bulletin No. 188 and Iowa Highway Research Board - Bulletin No. 17. In the design of highway bridges, the 'static live load is multiplied by a factor to compensate for the dynamic effect of moving vehicles. This factor, commonly referred to as an impact factor, is intended to provide for the dynamic response of the bridge to moving loads and suddenly applied forces. Many investigators have published research which contradicts the current impact formula 1,4,17. Some investigators feel that the problem of impact deals not only with the increase in over-all static live load but that it is an integral part of a dynamic load distribution problem. The current expanded highway program with the large number of bridge structures required emphasizes the need for investigating some of the dynamic behavior problems which have been generally ignored by highway engineers. These problems generally result from the inability of a designer to predict the dynamic response of a bridge structure. Many different investigations have been made of particular portions of the overall dynamic problem. The results of these varied investigations are inevitably followed by a number of unanswered questions. Ironically, many of the unanswered questions are those which are of immediate concern in the design of highway bridges, and this emphasizes the need for additional research on the problem of impact.

Ultimate Load Behavior of Full-Scale Highway Truss Bridges: Phase I - Ultimate Load Tests of the Hubby Bridge - Boone County, Interim Report, HR-169, 1975

As a result of the construction of the Saylorville Dam and Reservoir on the Des Moines River, six highway bridges crossing the river were scheduled for removal. One of these, an old pinconnected high-truss single-lane bridge, was selected for a testing program which included ultimate load tests. The purpose of the ultimate load tests, which are summarized in this report, was to relate design and rating procedures presently used in bridge design to the field behavior of this type of truss bridge. The ultimate load tests consisted of ultimate load testing of one span of the bridge, of two I-shaped floorbeams, and of two panels of the timber deck. The theoretical capacity of each of these components is compared with the results from the field tests.

Development of Evaluation, Rehabilitation, and Strengthening Concepts for Low Volume Bridges, Phase I Progress Report, HR-323, 1990

The primary objective of this project is to develop a design manual that would aid the county or municipal engineer in making structurally sound bridge strengthening or replacement decisions. The contents of this progress report are related only to Phase I of the study and deal primarily with defining the extent of the bridge problem in Iowa. In addition, the types of bridges to which the manual should be directed have been defined.

Ultimate Load Behavior of Full-Scale Highway Truss Bridges: Phase II - Service Load and Supplementary Tests, Interim Report, HR-169, 1975

As a result of the construction of the Saylorville Dam and Reservoir on the Des Moines River, six highway bridges crossing the river were scheduled for removal. Two of these were incorporated into a comprehensive test program to study the behavior of old pin-connected high-truss single-lane bridges. The test program consisted of ultimate load tests, service load tests and a supplementary test program. The results reported in this report cover the service load tests on the two bridges as well as the supplementary tests, both static and fatigue, of eyebar members removed from the two bridges. The field test results of the service loading are compared with theoretical results of the truss analysis.

Load Testing and Load Rating Eight State Highway Bridges in Iowa, 1999

This main report provides a general discussion of the load testing, structural evaluation, and load rating procedures. Specific details for each bridge are provided in individual report sections. Additional supporting information on load testing, analyses, and load rating are also provided in the attached appendices.

Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation

BACKGROUND: Several recently developed therapies targeting motor disabilities in stroke sufferers have shown to be more effective than standard neurorehabilitation approaches. In this context, several basic studies demonstrated that music training produces rapid neuroplastic changes in motor-related brain areas. Music-supported therapy has been recently developed as a new motor rehabilitation intervention. METHODS AND RESULTS: In order to explore the plasticity effects of music-supported therapy, this therapeutic intervention was applied to twenty chronic stroke patients. Before and after the music-supported therapy, transcranial magnetic stimulation was applied for the assessment of excitability changes in the motor cortex and a 3D movement analyzer was used for the assessment of motor performance parameters such as velocity, acceleration and smoothness in a set of diadochokinetic movement tasks. Our results suggest that the music-supported therapy produces changes in cortical plasticity leading the improvement of the subjects' motor performance. CONCLUSION: Our findings represent the first evidence of the neurophysiological changes induced by this therapy in chronic stroke patients, and their link with the amelioration of motor performance. Further studies are needed to confirm our observations.

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study.

Playing a musical instrument demands the engagement of different neural systems. Recent studies about the musician"s brain and musical training highlight that this activity requires the close interaction between motor and somatosensory systems. Moreover, neuroplastic changes have been reported in motor-related areas after short and long-term musical training. Because of its capacity to promote neuroplastic changes, music has been used in the context of stroke neurorehabilitation. The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Thus, there is an increasing demand for effective restorative interventions for neurological deficits. Music-supported Therapy (MST) has been recently developed to restore motor deficits. We report data of a selected sample of stroke patients who have been enrolled in a MST program (1 month intense music learning). Prior to and after the therapy, patients were evaluated with different behavioral motor tests. Transcranial Magnetic Stimulation (TMS) was applied to evaluate changes in the sensorimotor representations underlying the motor gains observed. Several parameters of excitability of the motor cortex were assessed as well as the cortical somatotopic representation of a muscle in the affected hand. Our results revealed that participants obtained significant motor improvements in the paretic hand and those changes were accompanied by changes in the excitability of the motor cortex. Thus, MST leads to neuroplastic changes in the motor cortex of stroke patients which may explain its efficacy.

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study.

Playing a musical instrument demands the engagement of different neural systems. Recent studies about the musician"s brain and musical training highlight that this activity requires the close interaction between motor and somatosensory systems. Moreover, neuroplastic changes have been reported in motor-related areas after short and long-term musical training. Because of its capacity to promote neuroplastic changes, music has been used in the context of stroke neurorehabilitation. The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Thus, there is an increasing demand for effective restorative interventions for neurological deficits. Music-supported Therapy (MST) has been recently developed to restore motor deficits. We report data of a selected sample of stroke patients who have been enrolled in a MST program (1 month intense music learning). Prior to and after the therapy, patients were evaluated with different behavioral motor tests. Transcranial Magnetic Stimulation (TMS) was applied to evaluate changes in the sensorimotor representations underlying the motor gains observed. Several parameters of excitability of the motor cortex were assessed as well as the cortical somatotopic representation of a muscle in the affected hand. Our results revealed that participants obtained significant motor improvements in the paretic hand and those changes were accompanied by changes in the excitability of the motor cortex. Thus, MST leads to neuroplastic changes in the motor cortex of stroke patients which may explain its efficacy.

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study.

Playing a musical instrument demands the engagement of different neural systems. Recent studies about the musician"s brain and musical training highlight that this activity requires the close interaction between motor and somatosensory systems. Moreover, neuroplastic changes have been reported in motor-related areas after short and long-term musical training. Because of its capacity to promote neuroplastic changes, music has been used in the context of stroke neurorehabilitation. The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Thus, there is an increasing demand for effective restorative interventions for neurological deficits. Music-supported Therapy (MST) has been recently developed to restore motor deficits. We report data of a selected sample of stroke patients who have been enrolled in a MST program (1 month intense music learning). Prior to and after the therapy, patients were evaluated with different behavioral motor tests. Transcranial Magnetic Stimulation (TMS) was applied to evaluate changes in the sensorimotor representations underlying the motor gains observed. Several parameters of excitability of the motor cortex were assessed as well as the cortical somatotopic representation of a muscle in the affected hand. Our results revealed that participants obtained significant motor improvements in the paretic hand and those changes were accompanied by changes in the excitability of the motor cortex. Thus, MST leads to neuroplastic changes in the motor cortex of stroke patients which may explain its efficacy.