Training of Reaching in Stroke Survivors With Severe and Chronic Upper Limb Paresis Using a Novel Nonrobotic Device: A Randomized Clinical Trial

Background and Purpose—Severe upper limb paresis is a major contributor to disability after stroke. This study investigated the efficacy of a new nonrobotic training device, the Sensorimotor Active Rehabilitation Training (SMART) Arm, that was used with or without electromyography-triggered electrical stimulation of triceps brachii to augment elbow extension, permitting stroke survivors with severe paresis to practice a constrained reaching task.

Methods—A single-blind, randomized clinical trial was conducted with 42 stroke survivors with severe and chronic paresis. Thirty-three participants completed the study, of whom 10 received training using the SMART Arm with electromyography-triggered electrical stimulation, 13 received training using the SMART Arm alone, and 10 received no intervention (control). Training consisted of 12 1-hour sessions over 4 weeks. The primary outcome measure was “upper arm function,” item 6 of the Motor Assessment Scale. Secondary outcome measures included impairment measures; triceps muscle strength, reaching force, modified Ashworth scale; and activity measures: reaching distance and Motor Assessment Scale. Assessments were administered before (0 weeks) and after training (4 weeks) and at 2 months follow-up (12 weeks).

Results—Both SMART Arm groups demonstrated significant improvements in all impairment and activity measures after training and at follow-up. There was no significant difference between these 2 groups. There was no change in the control group.

Conclusions—Our findings indicate that training of reaching using the SMART Arm can reduce impairment and improve activity in stroke survivors with severe and chronic upper limb paresis, highlighting the benefits of intensive task-oriented practice, even in the context of severe paresis.

Phasic modulation of corticomotor excitability during passive movement of the upper limb: effects of movement frequency and muscle specificity

Modulations in the excitability of spinal reflex pathways during passive rhythmic movements of the lower limb have been demonstrated by a number of previous studies [4]. Less emphasis has been placed on the role of supraspinal pathways during passive movement, and on tasks involving the upper limb. In the present study, transcranial magnetic stimulation (TMS) was delivered to subjects while undergoing passive flexion-extension movements of the contralateral wrist. Motor evoked potentials (MEPs) of flexor carpi radialis (FCR) and abductor pollicus brevis (APB) muscles were recorded. Stimuli were delivered in eight phases of the movement cycle during three different frequencies of movement. Evidence of marked modulations in pathway excitability was found in the MEP amplitudes of the FCR muscle, with responses inhibited and facilitated from static values in the extension and flexion phases, respectively. The results indicated that at higher frequencies of movement there was greater modulation in pathway excitability. Paired-pulse TMS (sub-threshold conditioning) at short interstimulus intervals revealed modulations in the extent of inhibition in MEP amplitude at high movement frequencies. In the APE muscle, there was some evidence of phasic modulations of response amplitude, although the effects were less marked than those observed in FCR. It is speculated that these modulatory effects are mediated via Ia afferent pathways and arise as a consequence of the induced forearm muscle shortening and lengthening. Although the level at which this input influences the corticomotoneuronal pathway is difficult to discern, a contribution from cortical regions is suggested. (C) 2001 Published by Elsevier Science B.V.

The Dissociative Recombination of Protonated Acrylonitrile, CH2CHCNH+, with Implications for Nitrile Chemistry in Dark Molecular Clouds and the Upper Atmosphere of Titan

Measurements on the dissociative recombination (DR) of protonated acrylonitrile, CH2CHCNH+, have been performed at the heavy ion storage ring CRYRING located in the Manne Siegbahn Laboratory in Stockholm, Sweden. It has been found that at~2meV relative kinetic energy about 50% of the DR events involve only ruptures of X–H bonds (where X=C or N)while the rest leads to the production of a pair of fragments each containing two heavy atoms (alongside H and/or H2). The absolute DR cross section has been investigated for relative kinetic energies ranging from ~1 meV to 1 eV. The thermal rate coefficient has been determined to follow the expression k(T) = 1.78 × 10-6 (T/300)-0.80 cm3 s-1 for electron temperatures ranging from ~10 to 1000 K. Gas-phase models of the nitrile chemistry in the dark molecular cloud TMC-1 have been run and results are compared with observations. Also, implications of the present results for the nitrile chemistry of Titan’s upper atmosphere are discussed.

Upper and lower bounds of 180 degrees unit element of a ridge waveguide: Calculations and measurements

The upper and lower bounds on the actual solution of any microwave structure is of general interest. The purpose of this letter is to compare some calculations using the mode-matching and finite-element methods, with some measurements on a 180 degrees ridge waveguide insert between standard WR62 rectangular waveguides. The work suggests that the MMM produces an upper bound, while the FEM places a lower bound on the measurement. (C) 2001 John Wiley & Sons, Inc.

Palaeoclimate change recorded in Upper Cretaceous (Albian-Cenomanian) Kazhdumi Formation Borehole spectral Gamma-Ray Logs, South Pars Gas field, Persian Gulf

Th/U and Th/K data from spectral gamma-ray logs obtained from outcrop successions have been used as a rapid and inexpensive proxy for determining possible episodes of humid-arid palaeoclimate change. Such outcrop-based measurements have never been tested using spectral gamma-ray data obtained from wireline logs in subsurface boreholes. Th/K and Th/U ratios have traditionally been used to decipher sequence stratigraphic patterns, at outcrop and in borehole. The possible influence of palaeoclimate on such ratio changes has yet to be proven, especially from borehole data. In this work, we compare borehole-derived Th/K (and to a lesser extent Th/U) to palaeoenvironmental changes inferred from palynology and deduce that both sea level and changing hinterland weathering regimes caused discrete fluctuations observed in the spectral gamma-ray logs. This is the first time such subsurface information has been used in this way. Interpretation of wireline logs in terms of palaeoclimate as well as sea level may now be considered, and the use of such logs in palaeoclimate reconstruction is strengthened.