The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients: a randomized controlled trial.

BACKGROUND: Upper limb paresis remains a relevant challenge in stroke rehabilitation. AIM: To evaluate if adding mirror therapy (MT) to conventional therapy (CT) can improve motor recovery of the upper limb in subacute stroke patients. DESIGN: Prospective, single-center, single-blind, randomised, controlled trial. SETTING: Subacute stroke patients referred to a Physical and Rehabilitation Medicine Unit between October 2009 and August 2011. POPULATION: Twenty-six subacute stroke patients (time from stroke <4 weeks) with upper limb paresis (Motricity Index â0/00¤ 77). METHODS: Patients were randomly allocated to the MT (N.=13) or to the CT group (N.=13). Both followed a comprehensive rehabilitative treatment. In addition, MT Group had 30 minutes of MT while the CT group had 30 minutes of sham therapy. Action Research Arm Test (ARAT) was the primary outcome measures. Motricity Index (MI) and the Functional Independence Measure (FIM) were the secondary outcome measures. RESULTS: After one month of treatment patients of both groups showed statistically significant improvements in all the variables measured (P<0.05). Moreover patients of the MT group had greater improvements in the ARAT, MI and FIM values compared to CT group (P<0.01, Glass's Î" Effect Size: 1.18). No relevant adverse event was recorded during the study. CONCLUSION: MT is a promising and easy method to improve motor recovery of the upper limb in subacute stroke patients. CLINICAL REHABILITATION IMPACT: While MT use has been advocated for acute patients with no or negligible motor function, it can be usefully extended to patients who show partial motor recovery. The easiness of implementation, the low cost and the acceptability makes this therapy an useful tool in stroke rehabilitation.

Functional compensation of motor function in pre-symptomatic Huntington's disease.

Involuntary choreiform movements are a clinical hallmark of Huntington's disease. Studies in clinically affected patients suggest a shift of motor activations to parietal cortices in response to progressive neurodegeneration. Here, we studied pre-symptomatic gene carriers to examine the compensatory mechanisms that underlie the phenomenon of retained motor function in the presence of degenerative change. Fifteen pre-symptomatic gene carriers and 12 matched controls performed button presses paced by a metronome at either 0.5 or 2 Hz with four fingers of the right hand whilst being scanned with functional magnetic resonance imaging. Subjects pressed buttons either in the order of a previously learnt 10-item finger sequence, from left to right, or kept still. Error rates ranged from 2% to 7% in the pre-symptomatic gene carriers and from 0.5% to 4% in controls, depending on the condition. No significant difference in task performance was found between groups for any of the conditions. Activations in the supplementary motor area (SMA) and superior parietal lobe differed with gene status. Compared with healthy controls, gene carriers showed greater activations of left caudal SMA with all movement conditions. Activations correlated with increasing speed of movement were greater the closer the gene carriers were to estimated clinical diagnosis, defined by the onset of unequivocal motor signs. Activations associated with increased movement complexity (i.e. with the pre-learnt 10-item sequence) decreased in the rostral SMA with nearing diagnostic onset. The left superior parietal lobe showed reduced activation with increased movement complexity in gene carriers compared with controls, and in the right superior parietal lobe showed greater activations with all but the most demanding movements. We identified a complex pattern of motor compensation in pre-symptomatic gene carriers. The results show that preclinical compensation goes beyond a simple shift of activity from premotor to parietal regions involving multiple compensatory mechanisms in executive and cognitive motor areas. Critically, the pattern of motor compensation is flexible depending on the actual task demands on motor control.

Proposta i implementació d'un motor de recuperació d'informació especialitzat en dret d'estrangeria (Codex)

CODEX SEARCH és un motor de recuperació d'informació especialitzat en dret d'estrangeria que està basat en eines i coneixement lingüístics. Per a desenvolupar un SRI (sistema de recuperació d'informació) eficient en el domini indicat no n'hi ha prou amb emprar un model tradicional de RI (recuperació d'informació), és a dir, comparar els termes de la pregunta amb els de la resposta, bàsicament perquè no expressen implicacions. En aquest sentit, la solució lingüística proposada es basa a incorporar el coneixement dels especialistes mitjançant la integració en el sistema d'una llibreria de casos. Els casos són exemples de procediments aplicats per experts/ertes en la solució de problemes que han ocorregut en la realitat i que han acabat en èxit o fracàs. Els resultats obtinguts en aquesta primera fase són molt encoratjadors, però és necessari continuar la investigació en aquest camp per millorar el rendiment del prototip.

Models teòrics explicatius de l'aprenentatge motor

En este artículo se repasan los principales modelos teóricos explicativos del aprendizaje motor. En un primer apartado se comentan las aportaciones propias de la psicología cognitiva y más concretamente del corriente del procesamiento de la información: la Teoría del bucle cerrado de Jack Adams y la Teoría del esquema de Richard Schmidt. Posteriormente, se exponen las críticas que han recibido estos modelos y, para hacerlo, se introducen las principales aportaciones que el científico ruso Nikolai Bernstein hizo al estudio del aprendizaje y el control motor. A partir de estas aportaciones, se introducen las formulaciones teóricas que, surgidas desde la perspectiva dinámica-ecológica, pretenden superar las limitaciones de los modelos cognitivos. Finalmente, se comparan las dos perspectivas y se sugieren algunas posibles vías de desarrollo futuro del campo que nos ocupa.

Winter Driving A Guide for Your Safety, January 17, 2012

The leading cause of death during winter storms is transportation accidents. Preparing your vehicle for the winter season and knowing how to react if stranded or lost on the road are the keys to safe winter driving.

Special investigation of the Sac County Treasurer’s Office Motor Vehicle Department for the period January 1, 2010 through February 27, 2014

Special investigation of the Sac County Treasurer’s Office Motor Vehicle Department for the period January 1, 2010 through February 27, 2014

Chronic low-frequency rTMS of primary motor cortex diminishes exercise training-induced gains in maximal voluntary force in humans.

Although there is consensus that the central nervous system mediates the increases in maximal voluntary force (maximal voluntary contraction, MVC) produced by resistance exercise, the involvement of the primary motor cortex (M1) in these processes remains controversial. We hypothesized that 1-Hz repetitive transcranial magnetic stimulation (rTMS) of M1 during resistance training would diminish strength gains. Forty subjects were divided equally into five groups. Subjects voluntarily (Vol) abducted the first dorsal interosseus (FDI) (5 bouts x 10 repetitions, 10 sessions, 4 wk) at 70-80% MVC. Another group also exercised but in the 1-min-long interbout rest intervals they received rTMS [Vol+rTMS, 1 Hz, FDI motor area, 300 pulses/session, 120% of the resting motor threshold (rMT)]. The third group also exercised and received sham rTMS (Vol+Sham). The fourth group received only rTMS (rTMS_only). The 37.5% and 33.3% gains in MVC in Vol and Vol+Sham groups, respectively, were greater (P = 0.001) than the 18.9% gain in Vol+rTMS, 1.9% in rTMS_only, and 2.6% in unexercised control subjects who received no stimulation. Acutely, within sessions 5 and 10, single-pulse TMS revealed that motor-evoked potential size and recruitment curve slopes were reduced in Vol+rTMS and rTMS_only groups and accumulated to chronic reductions by session 10. There were no changes in rMT, maximum compound action potential amplitude (M(max)), and peripherally evoked twitch forces in the trained FDI and the untrained abductor digiti minimi. Although contributions from spinal sources cannot be excluded, the data suggest that M1 may play a role in mediating neural adaptations to strength training.

Iowa Motor Fuel Tax Monthly Reports, January 2014

The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.

Iowa Motor Fuel Tax Monthly Reports, January 2012

The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.

Iowa Motor Fuel Tax Monthly Reports, January 2013

The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.

Iowa Motor Fuel Tax Monthly Reports, February 2012

The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.

Diabète et conduite: réflexions et atelier pratique [Diabetes and driving: thoughts and educational perspectives].

In Switzerland over 200'000 people with diagnosed diabetes drive a car. Their physicians endorse many roles: usual medical care as well as informing properly about driving recommandations and handling the legal issues behing the licensing procedure. Ability to drive can be impaired in three ways: hypogylcemia, diabetes complications and hyperglycemia. Hypoglycemia is the main risk factor of vehicle accident for diabetic drivers and frequent while driving. However few accidents are reported due to hypoglycemia. Swiss medical guidelines about diabetes and driving mention the requested conditions, but practically how should we do? We sought to answear by creating a specific educationnal program focused on hypoglycemia management. Building patient knowledges through experiences is the main goal of the course diabetes and driving.

Iowa Motor Fuel Tax Monthly Reports, February 2013

The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.