The impact of stroke on motor functioning is analyzed at different levels. ‘Impairment’ denotes the loss of basic characteristics of voluntary movement. ‘Activity limitation’ denotes the loss of normal capacity for independent execution of daily activities. Recovery from impairment is accomplished by ‘restitution’ and recovery from activity limitation is accomplished by the combined effect of ‘restitution’ and ‘compensation.’ We aimed to unravel the long-term effects of variation in lesion topography on motor impairment of the hemiparetic (...) class='Hi'>lower limb (HLL), and gait capacity as a measure of related activity limitation. Gait was assessed by the 3 m walk test (3MWT) in 67 first-event chronic stroke patients, at their homes. Enduring impairment of the HLL was assessed by the Fugl–Meyer Lower Extremity (FMA-LE) test. The impact of variation in lesion topography on HLL impairment and on walking was analyzed separately for left and right hemispheric damage (LHD, RHD) by voxel-based lesion-symptom mapping (VLSM). In the LHD group, HLL impairment tended to be affected by damage to the posterior limb of the internal capsule (PLIC). Walking capacity tended to be affected by a larger array of structures: PLIC and corona radiata, external capsule and caudate nucleus. In the RHD group, both HLL impairment and walking capacity were sensitive to damage in a much larger number of brain voxels. HLL impairment was affected by damage to the corona radiata, superior longitudinal fasciculus and insula. Walking was affected by damage to the same areas, plus the internal and external capsules, putamen, thalamus and parts of the perisylvian cortex. In both groups, voxel clusters have been found where damage affected FMA-LE and also 3MWT, along with voxels where damage affected only one of the measures (mainly 3MWT). In stroke, enduring ‘activity limitation’ is affected by damage to a much larger array of brain structures and voxels within specific structures, compared to enduring ‘impairment.’ Differences between the effects of left and right hemisphere damage are likely to reflect variation in motor-network organization and post-stroke re-organization related to hemispheric dominance. Further studies with larger sample size are required for the validation of these results. (shrink)

Falls are a leading cause of serious injury and restricted participation among persons with stroke (PwS). Reactive balance control is essential for fall prevention, however, only a few studies have explored the effects of lesion characteristics (location and extent) on balance control in PwS. We aimed to assess the impact of lesion characteristics on reactive and anticipatory balance capacity, gait, and hemiparetic lower limb function, in PwS. Forty-six subacute PwS were exposed to forward, (...) backward, right and left unannounced horizontal surface translations in 6 increasing intensities, while standing. Fall threshold (i.e., perturbation intensity that results in a fall into the harness system) was measured. In addition, the Berg Balance Scale (BBS), 6 Minute Walk Test (6MWT) and Lower Extremity Fugl-Meyer (LEFM) were measured. Lesion effects were analyzed separately for left- and right-hemisphere damaged (LHD, RHD) patients, using voxel-based lesion-symptom mapping (VLSM). Our results show that voxel clusters where damage exerted a significant impact on balance, gait and lower-limb function were found in the corticospinal tract, in its passage in the corona radiata and in the posterior limb of the internal capsule. Additional significant impact was found to lesions affecting the putamen and the external capsule. Balance, gait, and hemiparetic lower limb function showed much overlap of the corresponding ‘significant’ voxel clusters. Test scores of RHD and LHD patients were affected largely by damage to homologous regions, with the LHD group showing a wider distribution of ‘significant’ voxels. The study corroborates and extends previous findings by demonstrating that balance control, gait, and lower limb function are all affected mainly by damage to essentially the same brain structures, namely - the corticospinal tract and adjacent structures in the capsular-putaminal region. (shrink)

The existence of shoulder abduction (SA) and finger extension (FE) movement capacity shortly after stroke onset is an important prognostic factor, indicating favorable functional outcome for the hemiparetic upper limb. Here we asked whether variation in lesion topography affects these two movements in a similar or a distinct way, and whether lesion impact is similar or distinct for left and right hemisphere damage. SA and FE movements were examined in 77 chronic post-stroke patients using (...) relevant items of the Fugl-Meyer test. Lesion effects were analyzed separately for left and right hemispheric damage (LHD, RHD) patient groups using voxel-based lesion-symptom mapping. In the LHD group, SA and FE were affected only by damage to the cortico-spinal tract in its passage through the corona radiata. In contrast, following RHD, these two movements were affected not only by cortico-spinal tract damage but also by damage to white matter association tracts, the putamen and the insular cortex. In both groups, voxel clusters have been found where damage affected SA and also FE, along with voxels where damage affected only one of the two movements. The capacity to execute SA and FE movements following stroke is affected significantly by damage to shared and distinct voxels in the cortico-spinal tract in LHD patients and by damage to shared and distinct voxels in a larger array of cortical and subcortical regions in RHD patients. (shrink)

Objective:This study aimed to investigate the effect of robot-assisted gait training therapy combined with non-invasive brain stimulation on lower limb function in patients with stroke and spinal cord injury.Data sourcesPubMed, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Web of Science were searched.Study selectionRandomized controlled trials published as of 3 March 2021. RCTs evaluating RAGT combined with NIBS, such as transcranial direct current stimulation and repetitive transcranial magnetic stimulation, for lower limb function (...) and activities in patients with stroke and SCI were included.Data extractionTwo reviewers independently screened the records, extracted the data, and assessed the risk of bias.Data synthesisA meta-analysis of five studies and risk of bias were conducted. Pooled estimates demonstrated that RAGT combined with NIBS significantly improved lower limb function [standardized mean difference = 0.52; 95% confidence interval = 0.06–0.99] but not lower limb activities. Subgroup analyses also failed to find a greater improvement in lower limb function of RAGT with tDCS compared to sham stimulation. No significant differences between participant characteristics or types of NIBS were observed.ConclusionThis meta-analysis demonstrated that RAGT therapy in combination with NIBS was effective in patients with stroke and SCI. However, a greater improvement in lower limb function and activities were not observed using RAGT with tDCS compared to sham stimulation. (shrink)

Despite its importance, abnormal interactions between the proximal and distal upper extremity muscles of stroke survivors and their impact on functional task performance has not been well described, due in part to the complexity of upper extremity tasks. In this pilot study, we elucidated proximal–distal interactions and their functional impact on stroke survivors by quantitatively delineating how hand and arm movements affect each other across different phases of functional task performance, and how these interactions are influenced (...) by stroke. Fourteen subjects, including nine chronic stroke survivors and five neurologically-intact subjects participated in an experiment involving transport and release of cylindrical objects between locations requiring distinct proximal kinematics. Distal kinematics of stroke survivors, particularly hand opening, were significantly affected by the proximal kinematics, as the hand aperture decreased and the duration of hand opening increased at the locations that requires shoulder abduction and elbow extension. Cocontraction of the extrinsic hand muscles of stroke survivors significantly increased at these locations, where an increase in the intermuscular coherence between distal and proximal muscles was observed. Proximal kinematics of stroke survivors was also affected by the finger extension, but the cocontraction of their proximal muscles did not significantly increase, suggesting the changes in the proximal kinematics were made voluntarily. Our results showed significant proximal-to-distal interactions between finger extension and elbow extension/shoulder abduction of stroke survivors exist during their functional movements. Increased cocontraction of the hand muscles due to increased neural couplings between the distal and proximal muscles appears to be the underlying mechanism. (shrink)

The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, (...) cognitive and ADL functions, both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation. (shrink)

The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, (...) cognitive and ADL functions, both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation. (shrink)

At present, the motion control algorithms of lower limb exoskeleton robots have errors in tracking the desired trajectory of human hip and knee joints, which leads to poor follow-up performance of the human-machine system. Therefore, an iterative learning control algorithm is proposed to track the desired trajectory of human hip and knee joints. In this paper, the experimental platform of lower limb exoskeleton rehabilitation robot is built, and the control system software and hardware design and robot (...) prototype function test are carried out. On this basis, a series of experiments are carried out to verify the rationality of the robot structure and the feasibility of the control method. Firstly, the dynamic model of the lower limb exoskeleton robot is established based on the structure analysis of the human lower limb; secondly, the servo control model of the lower limb exoskeleton robot is established based on the iterative learning control algorithm; finally, the exponential gain closed-loop system is designed by using MATLAB software. The relationship between convergence speed and spectral radius is analyzed, and the expected trajectory of hip joint and knee joint is obtained. The simulation results show that the algorithm can effectively improve the gait tracking accuracy of the lower limb exoskeleton robot and improve the follow-up performance of the human-machine system. (shrink)

The ipsilesional arm of stroke patients often has functionally limiting deficits in motor control and dexterity that depend on the side of the brain that is lesioned and that increase with the severity of paretic arm impairment. However, remediation of the ipsilesional arm has yet to be integrated into the usual standard of care for upper limb rehabilitation in stroke, largely due to a lack of translational research examining the effects of ipsilesional-arm intervention. We now ask whether (...) ipsilesional-arm training, tailored to the hemisphere-specific nature of ipsilesional-arm motor deficits in participants with moderate to severe contralesional paresis, improves ipsilesional arm performance and generalizes to improve functional independence. We assessed the effects of this intervention on ipsilesional arm unilateral performance [Jebsen–Taylor Hand Function Test ], ipsilesional grip strength, contralesional arm impairment level [Fugl–Meyer Assessment ], and functional independence [Functional independence measure ]. Intervention occurred over a 3 week period for 1.5 h/session, three times each week. All sessions included virtual reality tasks that targeted the specific motor control deficits associated with either left or right hemisphere damage, followed by graded dexterity training in real-world tasks. We also exposed participants to 3 weeks of sham training to control for the non-specific effects of therapy visits and interactions. We conducted five test-sessions: two pre-tests and three post-tests. Our results indicate substantial improvements in the less-impaired arm performance, without detriment to the paretic arm that transferred to improved functional independence in all three posttests, indicating durability of training effects for at least 3 weeks. We provide evidence for establishing the basis of a rehabilitation approach that includes evaluation and remediation of the ipsilesional arm in moderately to severely impaired stroke survivors. This study was originally a crossover design; however, we were unable to complete the second arm of the study due to the COVID-19 pandemic. We report the results from the first arm of the planned design as a longitudinal study. (shrink)

Lower limb major amputations are both life-saving procedures and life-changing events. Individual responses to limb loss are varied and complex, some individuals experience functional, psychological and social dysfunction, many others adjust and function well. Some patients refuse amputation for religious and/or cultural reasons. One of the greatest difficulties for a person undergoing amputation surgery is overcoming the psychological stigma that society associates with the loss of a limb. Persons who have undergone amputations are often viewed (...) as incomplete individuals. The medical and physical consequences of amputation serve as the centerpiece in acute care and are commonly at the forefront of prosthetic rehabilitation. Prosthetic prescription aims to compensate for functional and/or cosmetic losses where possible. The aims of rehabilitation following amputation are to restore acceptable levels of functioning that allow individuals to achieve their goals, to facilitate personal health, and to improve participation in society and quality of life either with or without prosthesis. Our article aims at underscoring some medical, social and religious aspects that can contribute to the wellbeing of patients who suffer a life changing event such as lower limb amputation. (shrink)

This article explores how experienced regret and relief evoked in a risky gambling task influence subsequent intertemporal pro-social behavior. We apply a dictator game experiment with delayed rewards to investigate the effect on donating behavior by simultaneously the time delay when the recipient accepts the donation and the emotions experienced by the participant. We examine this effect using a choice titration procedure. The results reveal that independent of the prior experienced emotions, participants’ donations decrease as the time delay rises; the (...) hyperbolic model provides a better explanation of this finding. Significantly, experienced regret impacts the shape of the social discount function with delayed rewards, which is reflected in notably different discount rates. Participants who experienced regret exhibit a lower discount rate than those in the relief condition. Note that this distinct type of generosity differs significantly at the 14-day delay but not at the shortest and longest. It follows that regret can promote future altruism and intertemporal pro-social behavior, depending on the delay. (shrink)

Stroke and other neurological disorders have an effect on mobility which has a significant impact on independence and quality of life. The core rehabilitation requirements for patients with lower limb motor dysfunction are gait training, restand, and mobility. In this work, we introduce a newly developed multifunctional wheelchair that we call “ReChair” and evaluated its performance preliminarily. ReChair seamlessly integrates the mobility, gait training, and multiposture transformation. ReChair driving and multiposture transformation are done using the voice, (...) button, and mobile terminal control. This work describes the functional requirements, mechanical structure, and control system and the overall evaluation of ReChair including the kinematic simulation of the multiposture transformation and passive lower limb rehabilitation training to quantitatively verify the motion capability of ReChair, the voice control system evaluation that shows how the voice recognition system is suitable for home environment, the sensorless speed detection test results that indicate how the wheel speeds measured by sensorless method are appropriate for travelling control, and the passive and balance training test results that show how the lower limb rehabilitation training in daily life by ReChair is convenient. Finally, the experimental results show that ReChair meets the patients’ requirements and has practical significance. It is cost-effective, easy to use, and supports multiple control modes to adapt to different rehabilitation phases. (shrink)

Entropy-based algorithms have been suggested as robust estimators of electroencephalography (EEG) predictability or regularity. This study aimed to examine possible disturbances in EEG complexity as a means to elucidate the pathophysiological mechanisms in chronic stroke, before and after a brain computer interface (BCI)-motor observation intervention. Eleven chronic stroke subjects and nine unimpaired subjects were recruited to examine the differences in their EEG complexity. The BCI-motor observation intervention was designed to promote functional recovery of the hand in stroke (...) subjects. Fuzzy approximate entropy (fApEn), a novel entropy-based algorithm designed to evaluate complexity in physiological systems, was applied to assess the EEG signals acquired from unimpaired subjects and stroke subjects, both before and after training. The results showed that stroke subjects had significantly lower EEG fApEn than unimpaired subjects (p < 0.05) in the motor cortex area of the brain (C3, C4, FC3, FC4, CP3, CP4) in both hemispheres before training. After training, motor function of the paretic upper limb, assessed by the Fugl-Meyer Assessment-Upper Limb (FMA-UL), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT) improved significantly (p < 0.05). Furthermore, the EEG fApEn in stroke subjects increased considerably in the central area of the contralesional hemisphere after training (p < 0.05). A significant correlation was noted between clinical scales (FMA-UL, ARAT, and WMFT) and EEG fApEn in C3/C4 in the contralesional hemisphere (p < 0.05). This finding suggests that the increase in EEG fApEn could be an estimator of the variance in upper limb motor function improvement. In summary, fApEn can be used to identify abnormal EEG complexity in chronic stroke, when used with BCI-motor observation training. Moreover, these findings based on the fApEn of EEG signals also expand the existing interpretation of training-induced functional improvement in stroke subjects. Entropy-based analysis might serve as a novel approach to understanding the abnormal cortical dynamics of stroke and the neurological changes induced by rehabilitation training. (shrink)

BackgroundUpper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke.AimSynthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in (...) people with stroke.MethodsPubMed, SCOPUS, and PEDro databases were systematically searched for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols.ResultsTwenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I255%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I273%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline.ConclusionThis review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions. (shrink)

Many individuals with disabling conditions have difficulty with gait and balance control that may result in a fall. Exoskeletons are becoming an increasingly popular technology to aid in walking. Despite being a significant aid in increasing mobility, little attention has been paid to exoskeleton features to mitigate falls. To develop improved exoskeleton stability, quantitative information regarding how a user reacts to postural challenges while wearing the exoskeleton is needed. Assessing the unique responses of individuals to postural perturbations while wearing an (...) exoskeleton provides critical information necessary to effectively accommodate a variety of individual response patterns. This report provides kinematic and neuromuscular data obtained from seven healthy, college-aged individuals during posterior support surface translations with and without wearing a lower limb exoskeleton. A 2-min, static baseline standing trial was also obtained. Outcome measures included a variety of 0 dimensional measures such as center of pressure RMS, peak amplitude, velocities, pathlength, and electromyographic RMS, and peak amplitudes. These measures were obtained during epochs associated with the response to the perturbations: baseline, response, and recovery. T-tests were used to explore potential statistical differences between the exoskeleton and no exoskeleton conditions. Time series waveforms of the COP and EMG data were also analyzed. Statistical parametric mapping was used to evaluate the 1D COP and EMG waveforms obtained during the epochs with and without wearing the exoskeleton. The results indicated that during quiet stance, COP velocity was increased while wearing the exoskeleton, but the magnitude of sway was unchanged. The OD COP measures revealed that wearing the exoskeleton significantly reduced the sway magnitude and velocity in response to the perturbations. There were no systematic effects of wearing the exoskeleton on EMG. SPM analysis revealed that there was a range of individual responses; both behaviorally and among neuromuscular activation patterns. Using both the OD and 1D measures provided a more comprehensive representation of how wearing the exoskeleton impacts the responses to posterior perturbations. This study supports a growing body of evidence that exoskeletons must be personalized to meet the specific capabilities and needs of each individual end-user. (shrink)

More than 200 million children under the age of 5 years are affected by malnutrition worldwide according to the World Health Organization. The Barbados Nutrition Study (BNS) is a 55-year longitudinal study on a Barbadian cohort with histories of moderate to severe protein-energy malnutrition (PEM) limited to the first year of life and a healthy comparison group. Using quantitative electroencephalography (EEG), differences in brain function duringchildhood(lower alpha1 activity and higher theta, alpha2 and beta activity) have previously been highlighted (...) between participants who suffered from early PEM and controls. In order to determine whether similar differences persisted intoadulthood, our current study used recordings obtained during a Go-No-Go task in a subsample of the original BNS cohort [population size (N) = 53] at ages 45–51 years. We found that previously malnourished adults [sample size (n) = 24] had a higher rate of omission errors on the task relative to controls (n= 29). Evoked-Related Potentials (ERP) were significantly different in participants with histories of early PEM, who presented with lower N2 amplitudes. These findings are typically associated with impaired conflict monitoring and/or attention deficits and may therefore be linked to the attentional and executive function deficits that have been previously reported in this cohort in childhood and again in middle adulthood. (shrink)

To maximize brain plasticity after stroke, several rehabilitation strategies have been explored, including the use of intensive motor training, motor imagery, and action observation. Growing evidence of the positive impact of virtual reality (VR) techniques on recovery following stroke has been shown. However, most VR tools are designed to exploit active movement, and hence patients with low level of motor control cannot fully benefit from them. Consequently, the idea of directly training the central nervous system has been (...) promoted by utilizing motor-imagery (MI) based brain-computer interfaces (BCIs). To date, detailed information on which VR strategies lead to successful functional recovery is still largely missing, and very little is known about how to optimally integrate BCI and VR paradigms for stroke rehabilitation. The purpose of this study was to examine the efficacy of a BCI-VR system using a MI paradigm for post-stroke upper limb rehabilitation on functional assessments, and related changes in MI ability and brain imaging. To achieve this, a 60 years old male chronic stroke patient was recruited. The patient underwent a 3-week intervention in a clinical environment, resulting in 10 BCI-VR training sessions. The patient was assessed before and after intervention, as well as on a one-month follow-up, in terms of clinical scales and brain imaging using functional MRI (fMRI). Consistent with prior research, we found important improvements in upper extremity scores (Fugl-Meyer) and identified increases in brain activation measured by fMRI that suggest neuroplastic changes in brain motor networks. This study expands on the current body of evidence as more data are needed on the effect of this type of interventions not only on functional improvement but also through brain imaging to study the effect of the intervention on plasticity. (shrink)

Some individuals facing dementia contemplate hastening their own death: weighing the possibility of living longer with dementia against the alternative of dying sooner but avoiding the later stages of cognitive and functional impairment. This weighing resonates with an ethical and legal consensus in the United States that individuals can voluntarily choose to forgo life‐sustaining interventions and also that medical professionals can support these choices even when they will result in an earlier death. For these reasons, whether and how a terminally (...) ill individual can choose to control the timing of their death is a topic that cannot be avoided when considering the dementia trajectory. With a focus on the U.S. context, this landscape review considers the status of provisions that would legally permit people facing dementia to hasten death with appropriate support from medical professionals. This review can be used to plan and guide clinical and legal practitioner discussion and policy development concerning evolving questions not fully covered by existing medical decision‐making provisions. (shrink)

Functional electrical stimulation (FES), a method for inducing muscle contraction, has been successfully used in gait rehabilitation for patients with deficits after neurological disorders and several clinical studies have found that it can improve gait function after stroke and spinal cord injury. However, FES gait training is not suitable for patients with walking difficulty, such as those with severe motor paralysis of the lower limbs. We have previously shown that action observation combined with motor imagery (AO + (...) MI) of walking induces walking-related cortical activity. Therefore, we combined FES, which alternately generates dorsiflexion and plantar flexion, with AO + MI as an alternative to gait training. The present study investigates the transient effects of 20-min of FES simultaneously with and without AO + MI of walking on corticospinal and spinal reflex excitability in able-bodied participants. We measured motor evoked potentials and Hoffmann-reflexes to assess corticospinal and spinal reflex excitability at rest before and after the 20-min FES with and without the AO + MI. Our results show that FES without AO + MI did not change excitability (p > 0.05), while FES with AO + MI facilitated corticospinal excitability (p < 0.05). This facilitation likely occurred due to the synchronization of sensory inputs from FES and cortical activity during AO + MI. Facilitation was observed only in the dorsiflexor but not the plantar flexor muscle (p < 0.05), suggesting muscle specificity of the facilitation. These results demonstrate the effectiveness of combining FES with AO + MI and pave the way for novel neurorehabilitation strategies for patients with neurological gait deficits. (shrink)

BackgroundThe coronavirus disease 2019 pandemic has greatly affected people’s mental health resulting in severe psychological consequences. One of the leading causes of long-term disability worldwide is aphasia. The language changes experienced by a person with aphasia often have a sudden and long-lasting negative impact on social interaction, quality of life, and emotional wellbeing. The main aim of this study was to investigate the impact of COVID-19 on the different psychosocial dimensions which affect PWA.MethodsThis retrospective study included 73 PWA (...) and 81 elderly matched controls. All patients were in the chronic phase. They were all discharged from rehabilitation services, which left them with different degrees of language deficits. All participants were administered the hospital anxiety and depression scale through an online survey. PWA also took part in the stroke and aphasia quality of life scale questionnaire.ResultsAlthough the comparison between two different time points [one month before and one month after the lockdown ] led to a significant increase in depression and anxiety symptoms in both groups, lower rates of depression and anxiety were found in PWA compared to the healthy group. Significant deterioration was also present in PWA in the communication and psychosocial scales of the SAQOL-39 test, which correlated with the observed changes in the psychological domains. Interestingly, the results were not significantly influenced by the degree of aphasia severity. Similarly, in both groups, none of the demographic variables significantly affected the scores in the different subscales.ConclusionsThis evidence which, at first glance, seems to suggest that PWA have been partially spared from the impact of COVID-19, actually masks a dramatic situation that has always characterized this population. Indeed, given that PWA already live in a state of social isolation and emotional instability, these conditions might have, paradoxically, limited the effects of the coronavirus. However, as our results showed a deterioration in the emotional state and communication skills of our patients, possible solutions are discussed in order to prevent further decline of their cognitive abilities. (shrink)

The vision of an art masterpiece is associated with brain arousal by neural processes occurring quite spontaneously in the viewer. This aesthetic experience may even elicit a response in the motor areas of the observers. In the neurorehabilitation of patients with stroke, art observation has been used for reducing psychological disorders, and creative art therapy for enhancing physical functions and cognitive abilities. Here, we developed a virtual reality task which allows patients, by moving their hand on a virtual canvas, (...) to have the illusion of painting some art masterpieces, such as The Creation of Adam of Michelangelo or The birth of Venus of Botticelli. Twenty healthy subjects and four patients with stroke performed this task and a control one in which they simply colored the virtual canvas. Results from User Satisfaction Evaluation Questionnaire and the NASA Task Load Index highlighted an appropriate level of usability. Moreover, despite the motor task was the same for art and control stimuli, the art condition was performed by healthy subjects with shorter trajectories and with a lower perception of physical demand. In experiment 2, only the patients treated with artistic stimuli showed a reduction in the erroneous movements performed orthogonally to the canvas. This finding reminds the so-called Mozart effect that improves the performance of subjects when they listen to classic music. Thus, we called this improvement in the performance when interacting with an artistic stimulus as Michelangelo effect. (shrink)

In the past years motor imagery turned out to be also an innovative and effective tool for motor learning and improvement of sports performance. Whereas many studies investigating sports MI focusing on upper or lower limbs involvement, knowledge about involved neural structures during whole-body movements is still limited. In the present study we investigated brain activity of climbers during a kinesthetic motor imagery climbing task with different difficulties by means of functional near infrared spectroscopy. Twenty healthy participants were split (...) into two groups according to their climbing skill level. The aim of the current study is investigating neural correlates of a whole-body sports MI task with an additional focus on skill level dependency. Climbing experts and non-experts imagined bouldering an “easy” and “difficult” route from a first-person perspective while hemodynamic responses were recorded simultaneously. We found significant differences between the two climbing routes, easy and difficult within participants as well as between the two groups of different climbing skill levels. Overall beginners showed increased hemodynamic responses compared to experts in all defined regions of interest supporting the claim of the neural efficiency hypothesis. Even though climbing is a complex, coordinated movement of upper and lower limbs we found a stronger activation focus of the upper limbs, especially of the dominant hand-area, while the foot area seems to be deactivated or inhibited simultaneously. Summarizing, these findings provide novel insights into brain activation during the imagery of a whole-body movement and its relation to climbing expertise. (shrink)

This abstract presents a novel brain-computer interface (BCI) framework to control a prosthetic leg, for the rehabilitation of patients suffering from locomotive disorders, using functional near-infrared spectroscopy (fNIRS). fNIRS signals corresponding to walking intention and rest are used to initiate and stop the gait cycle and a nonlinear proportional derivative computed torque controller (PD-CTC) with gravity compensation is used to control torques of hip and knee joints for minimization of position error. The brain signals of walking intention and rest (...) tasks are acquired from primary motor cortex in the left hemisphere for nine subjects. After acquiring brain signals, in order to remove motion artifacts and physiological noises, the performance of six different filters i.e. Kalman, Wiener, Gaussian, hemodynamic response filter (hrf), Band-pass and finite impulse response, is evaluated. Afterwards, six different features are extracted from oxygenated hemoglobin signals and their different combinations were used for classification. The classification performance of five different classifiers i.e. artificial neural network, quadratic discriminant analysis, linear discriminant analysis (LDA), Naïve Bayes and support vector machine (SVM) is used. The classification accuracies obtained from SVM using hrf filter are significantly higher (p < 0.005) than the other combinations of classifier and filters. These accuracies are 77.5%, 72.5%, 68.3%, 74.2%, 73.3%, 80.8%, 65%, 76.7%, and 86.7% for all nine subjects. The control commands generated using classifier initiate and stop the gait cycle of the prosthetic leg whose knee and hip torques are controlled using PD-CTC to minimize position error. The proposed scheme can be effectively used for neurofeedback training and rehabilitation of lower limb amputation of paralyzed patients. (shrink)

ObjectiveThis study aimed to examine the effectiveness and safety of the Brain-computer interface in treatment of upper limb dysfunction after stroke.MethodsEnglish and Chinese electronic databases were searched up to July 2021. Randomized controlled trials were eligible. The methodological quality was assessed using Cochrane’s risk-of-bias tool. Meta-analysis was performed using RevMan 5.4.ResultsA total of 488 patients from 16 RCTs were included. The results showed that the meta-analysis of BCI-combined treatment on the improvement of the upper limb function (...) showed statistical significance [standardized mean difference : 0.53, 95% CI: 0.26–0.80, P < 0.05]; BCI treatment can improve the abilities of daily living of patients after stroke, and the analysis results are statistically significant ; and the BCI-combined therapy was not statistically significant for the analysis of the Modified Ashworth Scale.ConclusionThe meta-analysis indicates that the BCI therapy or BCI combined with other therapies such as conventional rehabilitation training and motor imagery training can improve upper limb dysfunction after stroke and enhance the quality of daily life. (shrink)

Motor proficiency reflects the ability to perform precise and coordinated movements in different contexts. Previous research suggests that different profiles of motor proficiency may be associated with different cognitive functioning characteristics thus suggesting an interaction between cognitive and motor processes. The current study investigated this interaction in the general population of healthy adults with different profiles of motor proficiency by focusing on error-related cognitive control and behavioral adaptation mechanisms. In addition, the impact of these processes was assessed in terms (...) of trait anxiety and worries. Forty healthy adults were divided into high and low motor proficiency groups based on an assessment of their motor skills. Using electroencephalography during a flanker task, error-related negativity was measured as the neural indicator of cognitive control. Post-error slowing was measured to represent behavioral adaptation. Participants also completed an anxiety assessment questionnaire. Participants in the high motor proficiency group achieved better task accuracy and showed relatively enhanced cognitive control through increased ERN. Contrastingly, individuals in the lower motor proficiency group achieved poorer accuracy whilst showing some evidence of compensation through increased PES. Trait anxiety reflecting general worries was found to be correlated with motor functioning, but the study could not provide evidence that this was related to cognitive or behavioral control mechanisms. The interaction between cognitive and motor processes observed in this study is unique for healthy and sub-clinical populations and provides a baseline for the interpretation of similar investigations in individuals with motor disorders. (shrink)

Virtual reality (VR) through a head-mounted display (HMD) can provide new experiences. However, it remains unclear how the characteristics of HMDs affect users’ memory. To use HMDs more effectively and appropriately in several applied fields, including education, it is necessary to clarify what characteristics of HMDs affect users’ memory. A head-tracking function mounted on an HMD helps to detect the user’s head direction to enable a simulation experience akin to the real world. When we experience a simulation on an (...) HMD, we actively perceive the visual world. In this study, we assessed how active/passive viewing affects users’ memory of VR content. We conducted a psychological experiment in which participants watched a movie on an HMD. In the active viewing condition, the presented view changed depending on the participant’s head direction. In the passive viewing condition, the presented view was a recorded movie that was shown to the participants in the active viewing condition. All participants took a memory test about the content presented in the movie on the day of viewing and two weeks later. The results showed that performance on the memory test in the active viewing condition was significantly lower than that in the passive viewing condition after two weeks. This result indicated that active viewing in VR inhibited users’ memory compared to passive viewing. The current study contributes to the development of new VR techniques, such as educational learning. (shrink)

Introduction. A radical tendency in modern approaches to understanding the mechanisms of the brain is the tendency of some scientists to believe that the brain is a receptor capable of capturing thoughts; the nature of the occurrence of the thoughts themselves, however, is not to be clarified. However, speech expressing thoughts is undoubtedly the result of the work of the brain, so studies of the frequency structure of speech can be the basis for considering the material structure of the brain (...) as a kind of “antenna”. In this approach, the problem of noise protection against the background of the undeniable frequency similarity of speech and music appears to us from somewhat different positions. This study raises the question of how essential the overall height of the musical system is to the perception of music (are there musical systems that are harmful or useful, in terms of their effects on the psyche). This question is also relevant to speech perception.Methodology and sources. The main sources in which the work of the brain and the essence of consciousness are considered from the positions indicated above were for us the work of American and British neurophysiologists and psychiatrists (Sam Parnia, Peter Fenwick). These scientists are studying the phenomena that accompany clinical death, and argue that at these moments the brain functions to the greatest extent as a receiving “antenna”. Assuming that any antenna is to be tuned, we are trying to identify possible ways to “tune” the brain. To do this, we propose to study the frequency characteristics of speech (in the simplest case, when singing vowels in a calm state) for their belonging to a particular musical system, as well as the peculiarities of music perception depending on the musical system (on the height of the note “la”). Varying the frequency characteristics of speech in a particular musical system can be considered, in our opinion, the main way to “tune” the brain. The methodology of the method is based on the use of frequency analysis of sound and the basic provisions of the elementary theory of music.Results and discussion. The main conclusion made by Western psychiatrists is the brain is not an organ of thought, consciousness exists independently from outside, the work of consciousness cannot be explained by the functioning of the brain – it requires a hardware check. If the neural network is an “antenna” that captures thoughts, and its “adjustment” at the physical level can be carried out (and is carried out) through sensory systems (including the hearing organ), the study of the frequency structure of speech will answer a number of important questions, including including related and higher brain functions (insight, creativity). Our experiments (Saint Petersburg Electrotechnical University, FIBS, department of EUT) showed that the influence of the “increased” or “lowered” musical-speech system on brain activity is insignificant. The study revealed the equiprobability of the frequency structure of speech. Since our brain lacks some characteristic set of frequencies – elements of a uniformly temperamental system, it is not necessary to talk about the harmful (or any other noise) effect of the “raised” and “lowered” systems due to deviation from the “internal standard”.Conclusion. In response to the assumptions made by Western experts, we proposed a frequency interpretation of the processes occurring in the brain, which, perhaps, will explain in more detail such phenomena as inspiration, discovery, etc., which occur with minimal activity of consciousness. Despite the limited methods of hardware study of factors that influence the activity of the brain and largely determine its higher functions (for example, creativity), the results of the brain's work in relation to music (both in terms of its creation and in terms of our reaction to it) are quite analyzable, which was shown in this study. The “musicality” of speech is extremely vividly represented in its frequency structure and allows one to reveal, to one degree or another, the features of the brain. (shrink)

Complex training is a combination training method that alternates between performing high-load resistance training and plyometric training within one single session. The study aimed to examine the effects of CT on lower-limb strength and power of elite female modern pentathlon athletes under the new modern pentathlon format and competition rules. Ten female participants of the national modern pentathlon team completed 8 weeks of RT as followed by 8 weeks of CT, with 2 weeks of break. Then, the participants (...) conducted 8 weeks of CT, which included RT combined with plyometric training. All stages of training were designed by the linear strength training period theories, requiring participants to train twice for the first 4 weeks and three times for the second 4 weeks. The one-repetition maximum of squat, isometric mid-thigh pull, counter-movement jump, squat jump, pre-stretch augmentation percentage, and reaction strength index were assessed before and after both RT and CT training. One-way repeated-measure ANOVA models revealed that the 1RM of squat was significantly improved after RT as compared to pre-RT. No significant improvement in IMTP, CMJ, SJ, PSAP, and RSI was not observed. After CT, 1RM of squat, IMTP, CMJ, SJ, RSI were significant improved as compared to pre-RT, post-RT and pre-CT, while significant improvements in PSAP were observed as compared to pre-RT and pre-CT, but not to post-RT. This pilot study showed the promise of CT following RT to improve lower-limb strength and power in elite female modern pentathlon athletes. The findings are worthwhile to be confirmed in future studies with larger sample size and randomized design. (shrink)

Numerous organizations have faced substantial environmental performance challenges resulting from more than a half-century of worldwide industrialization. Grounded in social learning theory and recourse-based view theory, this study explores environmental performance and its impact on employees and industry outcomes. Drawing on a cross-sectional online survey of 500 full-time employees working in the chemical industry in Lahore, Pakistan. The results revealed a significant positive influence of Green HRM practices on employees’ Green innovation as well as on environmental performance. Additionally, significant (...) influences of study variables were recorded on outcomes such as green compensation and reward, green performance management and appraisal, green training and development, and green recruitment and selection. Several key policy insights related to consumer resistance to innovation in low income societies and future research directions are suggested, along with theoretical and practical implications. (shrink)

Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life.Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion, and balance confidence.Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale were divided into (...) two groups: High Spasticity Group or a Low Spasticity Group. The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured.Results: The ankle joint proprioception was significantly better in the LSG compared to the HSG. No significant differences were found between the LSG and HSG on all other outcome measures. There were no significant relationships between the spasticity severity and passive ankle dorsiflexion ROM, and balance confidence.Conclusion: The severity of ankle plantar flexor spasticity had no effects on balance of patients with stroke. However, the ankle joint proprioception was better in patients with low spasticity. Our findings suggest that the balance is affected regardless of the severity of the ankle plantar flexor spasticity in this group of participants with stroke. (shrink)

PurposeThe effect of sensorimotor stripping on neuroplasticity and motor imagery capacity is unknown, and the physiological mechanisms of post-amputation phantom limb pain (PLP) illness remain to be investigated.Materials and methodsIn this study, an electroencephalogram (EEG)-based event-related (de)synchronization (ERD/ERS) analysis was conducted using a bilateral lower limb motor imagery (MI) paradigm. The differences in the execution of motor imagery tasks between left lower limb amputations and healthy controls were explored, and a correlation analysis was calculated between (...) level of phantom limb pain and ERD/ERS.ResultsThe multiple frequency bands showed a significant ERD phenomenon when the healthy control group performed the motor imagery task, whereas amputees showed significant ERS phenomena in mu band. Phantom limb pain in amputees was negatively correlated with bilateral sensorimotor areas electrode powers.ConclusionSensorimotor abnormalities reduce neural activity in the sensorimotor cortex, while the motor imagination of the intact limb is diminished. In addition, phantom limb pain may lead to over-activation of sensorimotor areas, affecting bilateral sensorimotor area remodeling. (shrink)

BackgroundPatients with chronic conditions are less physically active than the general population despite knowledge of positive effects on physical and mental health. There is a variety of reasons preventing people with disabilities from achieving levels of physical activities resulting in health benefits. However, less is known about potential facilitators and barriers for physical activity in people with severe movement impairments. The aim of this study was to identify obstacles and facilitators of PA in individuals with severe disabilities.Materials and methodsUsing a (...) qualitative approach to explore individuals’ subjective perspectives in depth, five community-dwelling adults living with chronic mobility impairments after stroke that restrict independent PA were interviewed. A semi structured topic guide based on the theoretical domains framework was utilized. The interview data was analyzed thematically, and the theoretical domains framework constructs were mapped onto the main and sub-categories.ResultsThe six main categories of facilitators and barriers along the capability, opportunity, motivation–behavior framework were: physical capabilities, psychological capabilities, motivation reflective, motivation automatic, opportunity physical, and opportunity social. The physical capabilities to independently perform PA were variable between participants but were not necessarily perceived as a barrier. Participants were highly motivated to maintain and/or increase their abilities to master their everyday lives as independently as possible. It became clear that a lack of physical opportunities, such as having access to adequate training facilities can present a barrier. Social opportunities in the form of social support, social norms, or comparisons with others can act as both facilitators and barriers.ConclusionWhile confirming known barriers and facilitators that impact the ability of individuals with functional limitations to be active, the findings highlight the need and opportunities for comprehensive service models based on interdisciplinary collaborations. (shrink)

Human gait is a complex activity that requires high coordination between the central nervous system, the limb, and the musculoskeletal system. More research is needed to understand the latter coordination's complexity in designing better and more effective rehabilitation strategies for gait disorders. Electroencephalogram and functional near-infrared spectroscopy are among the most used technologies for monitoring brain activities due to portability, non-invasiveness, and relatively low cost compared to others. Fusing EEG and fNIRS is a well-known and established methodology proven to (...) enhance brain–computer interface performance in terms of classification accuracy, number of control commands, and response time. Although there has been significant research exploring hybrid BCI involving both EEG and fNIRS for different types of tasks and human activities, human gait remains still underinvestigated. In this article, we aim to shed light on the recent development in the analysis of human gait using a hybrid EEG-fNIRS-based BCI system. The current review has followed guidelines of preferred reporting items for systematic reviews and meta-Analyses during the data collection and selection phase. In this review, we put a particular focus on the commonly used signal processing and machine learning algorithms, as well as survey the potential applications of gait analysis. We distill some of the critical findings of this survey as follows. First, hardware specifications and experimental paradigms should be carefully considered because of their direct impact on the quality of gait assessment. Second, since both modalities, EEG and fNIRS, are sensitive to motion artifacts, instrumental, and physiological noises, there is a quest for more robust and sophisticated signal processing algorithms. Third, hybrid temporal and spatial features, obtained by virtue of fusing EEG and fNIRS and associated with cortical activation, can help better identify the correlation between brain activation and gait. In conclusion, hBCI system is not yet much explored for the lower limb due to its complexity compared to the higher limb. Existing BCI systems for gait monitoring tend to only focus on one modality. We foresee a vast potential in adopting hBCI in gait analysis. Imminent technical breakthroughs are expected using hybrid EEG-fNIRS-based BCI for gait to control assistive devices and Monitor neuro-plasticity in neuro-rehabilitation. However, although those hybrid systems perform well in a controlled experimental environment when it comes to adopting them as a certified medical device in real-life clinical applications, there is still a long way to go. (shrink)

Earthquake is a kind of natural disaster, which will have a great impact on the building structure. In the vibration control field of building structures, the timeliness of system stability is extremely important. In traditional control methods, the timeliness is not paid enough attention for systems with uncertain seismic waves. For setting this problem, fuzzy adaptive compensation control for uncertain building structural systems by sliding-mode technology is proposed. It is combined with fuzzy adaptive control and sliding-mode control to (...) ensure that the system can be stable with satisfied timeliness. Also, saturation function is used to ensure the feasible physical implementation of the control system. Compared with the traditional LQR control, the simulation results showed that the proposed method can make the system reach a stable state with rapid convergence performance and has a feasible physical implementation. (shrink)

The motor modules during human walking are identified using non-negative matrix factorization from surface electromyography signals. The extraction of motor modules in healthy participants is affected by the change in pre-processing of EMG signals, such as low-pass filters ; however, the effect of different pre-processing methods, such as the number of necessary gait cycles in post-stroke patients with varying steps, remains unknown. We aimed to specify that the number of GCs influenced the motor modules extracted in the consideration of (...) LPFs in post-stroke patients. In total, 10 chronic post-stroke patients walked at a self-selected speed on an overground walkway, while EMG signals were recorded from the eight muscles of paretic lower limb. To verify the number of GCs, five GC conditions were set, namely, 25, 20, 15, 10, and 5 gate cycles with three LPFs. First, the number of modules, variability accounted for, and muscle weightings extracted by the NNMF algorithm were compared between the conditions. Next, a modified NNMF algorithm, in which the activation timing profiles among different GCs were unified, was performed to compare the muscle weightings more robustly between GCs. The number of motor modules was not significantly different, regardless of the GCs. The difference in VAF and muscle weightings in the different GCs decreased with the LPF of 4 Hz. Muscle weightings in 15 GCs or less were significantly different from those in 25 GCs using the modified NNMF. Therefore, we concluded that the variability extracted motor modules by different GCs was suppressed with lower LPFs; however, 20 GCs were needed for more representative extraction of motor modules during walking in post-stroke patients. (shrink)

Stroke survivors undergo a thorough cognitive diagnosis that often involves administration of multiple standardized tests. However, patient’s narrative discourse can provide clinicians with additional knowledge on patient’s subjective experience of illness, attitude toward current situation, and motivation for treatment. We evaluated the methods of analyzing thematic content and story types in relationship to cognitive impairment in stroke survivors with no aphasia. Cognitive impairment was evaluated in comparison to a group of 25 patients with orthopaedic injury not involving the (...) brain. Our findings primarily show that higher elaboration on own cognitive problems, physical ailments or coping strategies in LHD patients and cognitive problems, emotional issues and circumstances of illness onset in RHD patients is related to deficits in executive functions and retrieval of information from memory. Furthermore, RHD patients who use more chaos story type show lower executive functioning. However, these results did not survive the significance threshold of p < 0.05 after Bonferroni adjustment for multiple comparisons. In conclusion, this study provides preliminary evidence that stroke survivor’s narrative can constitute an additional source of clinically-relevant information regarding patient’s experience of illness and attitude toward recovery. This knowledge can aid clinicians and nurses in everyday interactions with the patients and support individualized strategy to treatment. Still, the current results need be confirmed with future studies in a larger cohort of stroke patients. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.4 (2003) 101-107 [Access article in PDF] Art Education in Lower Secondary Schools in Japan and the United Kingdom This essay compares the system and practice of art education in Japan and the United Kingdom at the lower secondary school level. Three surveys on how art is taught form the basis of this research. I conducted the first survey in 1992, distributed (...) to 156 art teachers in Japan on their "real" curricula and compared them with syllabus samplers of nationally authorized textbooks. From 1993 to 1994, I studied in the United Kingdom the newly introduced National Curriculum and performed a survey on its impact on classroomteaching in 49 art departments in secondary schools, mostly in England. Since 1994, I have participated in a joint study project on craft education in secondary schools in Japan and Britain, in which 717 Japanese schools are cooperating via a questionnaire survey. The issues common to these surveys are how art teachers respond to the national standards in their own teaching practice, and what these responses suggest for the future development of this subject. This essay identifies survey findings in both countries, together with overviews on the systems and cultural factors affecting the state of Art and its implementation in curricula. Japan and the United Kingdom: An Overview Let us look briefly at the historical background of the national curricula in Japan and the United Kingdom. The education system in Japan was established by the central government and has maintained its unity. After World War II, a new national Course of Study was recommended but was not compulsory. But in the legislation of 1958, this Course of Study became binding and a new subject called "Technology and Home Economics" was introduced. A new term, "design" was adopted in Art, "craft" was removed, and the time allocated to Art was drastically reduced. In the 1969 revision, five main areas of Art study were established: drawing (painting), sculpture, design, craft, and art appreciation. In 1977, a recommended time allocation for each area in Art was eliminated, and the five areas were reorganized into two fields: "expression" and "appreciation." Between 1969 and 1977, lower secondary schools in Japan allotted two compulsory hours per week for Art in grades 7 and 8, one compulsory hour and one non-compulsory hour in grade 9. However, after the revisions of 1989 and 1998, the time allotted for Art has gradually decreased. [End Page 101]In the United Kingdom, different educational systems developed concurrently, and through political and ideological conflicts, the involvement of central government gradually grew until an integrated school system was established. 1 The National Curriculum, first introduced through the Education Act of 1988, clearly indicates Art as compulsory from Years 1 to 9 in state schools. 2 The Courses of Study in Japan are separated into primary, lower, and upper secondary levels, however, the consistency of Art as a subject is not as clear. 3 In England, the content is not differentiated into the areas of art, craft, and design, but is organized as a series of processes common to these areas including investigation, creation, and evaluation, based upon knowledge and understanding.The United Kingdom has no national system for authorizing textbooks, but the examination board syllabus for the General Certificate ofSecondary Education (GCSE), for example, has influenced the school curriculum. Art departments of each secondary school function as fairly independent entities, taking responsibility for curriculum and study resources. In Japan, in most cases, lower and upper secondary schools are separated, with only about one art teacher per school, which means improving the curriculum is determined by the efforts of the individual teacher in a limited environment.We also need to consider the cultural background. The United Kingdom has made a notable effort to incorporate a multicultural perspective, based upon the urgent recognition that the country has become a multi-ethnic society. There is also a growing awareness in Western societies that individual expression should be approved in relation to the culture of a given social group. In Japan, it has... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.4 (2003) 101-107 [Access article in PDF] Art Education in Lower Secondary Schools in Japan and the United Kingdom This essay compares the system and practice of art education in Japan and the United Kingdom at the lower secondary school level. Three surveys on how art is taught form the basis of this research. I conducted the first survey in 1992, distributed (...) to 156 art teachers in Japan on their "real" curricula and compared them with syllabus samplers of nationally authorized textbooks. From 1993 to 1994, I studied in the United Kingdom the newly introduced National Curriculum and performed a survey on its impact on classroomteaching in 49 art departments in secondary schools, mostly in England. Since 1994, I have participated in a joint study project on craft education in secondary schools in Japan and Britain, in which 717 Japanese schools are cooperating via a questionnaire survey. The issues common to these surveys are how art teachers respond to the national standards in their own teaching practice, and what these responses suggest for the future development of this subject. This essay identifies survey findings in both countries, together with overviews on the systems and cultural factors affecting the state of Art and its implementation in curricula. Japan and the United Kingdom: An Overview Let us look briefly at the historical background of the national curricula in Japan and the United Kingdom. The education system in Japan was established by the central government and has maintained its unity. After World War II, a new national Course of Study was recommended but was not compulsory. But in the legislation of 1958, this Course of Study became binding and a new subject called "Technology and Home Economics" was introduced. A new term, "design" was adopted in Art, "craft" was removed, and the time allocated to Art was drastically reduced. In the 1969 revision, five main areas of Art study were established: drawing (painting), sculpture, design, craft, and art appreciation. In 1977, a recommended time allocation for each area in Art was eliminated, and the five areas were reorganized into two fields: "expression" and "appreciation." Between 1969 and 1977, lower secondary schools in Japan allotted two compulsory hours per week for Art in grades 7 and 8, one compulsory hour and one non-compulsory hour in grade 9. However, after the revisions of 1989 and 1998, the time allotted for Art has gradually decreased. [End Page 101]In the United Kingdom, different educational systems developed concurrently, and through political and ideological conflicts, the involvement of central government gradually grew until an integrated school system was established. 1 The National Curriculum, first introduced through the Education Act of 1988, clearly indicates Art as compulsory from Years 1 to 9 in state schools. 2 The Courses of Study in Japan are separated into primary, lower, and upper secondary levels, however, the consistency of Art as a subject is not as clear. 3 In England, the content is not differentiated into the areas of art, craft, and design, but is organized as a series of processes common to these areas including investigation, creation, and evaluation, based upon knowledge and understanding.The United Kingdom has no national system for authorizing textbooks, but the examination board syllabus for the General Certificate ofSecondary Education (GCSE), for example, has influenced the school curriculum. Art departments of each secondary school function as fairly independent entities, taking responsibility for curriculum and study resources. In Japan, in most cases, lower and upper secondary schools are separated, with only about one art teacher per school, which means improving the curriculum is determined by the efforts of the individual teacher in a limited environment.We also need to consider the cultural background. The United Kingdom has made a notable effort to incorporate a multicultural perspective, based upon the urgent recognition that the country has become a multi-ethnic society. There is also a growing awareness in Western societies that individual expression should be approved in relation to the culture of a given social group. In Japan, it has... (shrink)

Previous studies have shown that the motion intention recognition for lower limb prosthesis mainly focused on the identification of performed gait. However, the bionic prosthesis needs to know the next movement at the beginning of a new gait, especially in complex operation environments. In this paper, an upcoming locomotion prediction scheme via multilevel classifier fusion was proposed for the complex operation. At first, two motion states, including steady state and transient state, were defined. Steady-state recognition was backtracking of (...) a completed gait, which would be used as prior knowledge of motion prediction. In steady-state recognition, surface electromyographic and inertial sensors were fused to improve recognition accuracy; five typical locomotion modes were recognized by random forest classifier with over 97.8% accuracy. The transient state was defined as an observation period at the initial stage of upcoming movement, in which only the sEMG signal was recorded due to the limitation of sliding window length. LightGBM classifier was validated to outperform other methods in the accuracy and prediction time of transient-state recognition. Finally, a simplified HMM model based on prior knowledge and observation result was constructed to predict upcoming locomotion. The results indicated that the locomotion prediction was over 91% accuracy. The proposed scheme implements the locomotion prediction at the initial stage of each gait and provides critical information for the gait control of lower limb prosthesis. (shrink)

Posterior parietal cortex has traditionally been considered to be a sensory association area in which higher-order processing and intermodal integration of incoming sensory information occurs. In this paper, evidence from clinical reports and from lesion and behavioral-electrophysiological experiments using monkeys is reviewed and discussed in relation to the overall functional organization of posterior parietal association cortex, and particularly with respect to a proposed posterior parietal mechanism concerned with the initiation and control of certain classes of eye and limb (...) movements. Preliminary data from studies of the effects of posterior parietal lesions on oculomotor control in monkeys are reported.The behavioral effects of lesions of posterior parietal cortex in monkeys have been found to be similar to those which follow analogous damage of the minor hemisphere in humans, while behavioral-electrophysiological experiments have disclosed classes of neurons in this area which have functional properties closely related to the behavioral acts that are disrupted by lesions of the area. On the basis of current data from these areas of study, it is proposed that the sensory association model of posterior parietal function is inadequate to account for the complexities of the present evidence. Instead, it now appears that many diverse neural mechanisms are locatedin partin parietal cortex, that some of these mechanisms are involved in sensory processing and perceptual functions, but that others participate in motor control, and that still others are involved in attentional, motivational, or emotional processes. It is further proposed that the elementary units of these various neural mechanisms are distributed within posterior parietal cortex according to the columnar hypothesis of Mountcastle. (shrink)

Stroke is a severe health issue, and motor recovery after stroke remains an important challenge in the rehabilitation field. Neurofeedback, as part of a brain–computer interface, is a technique for modulating brain activity using on-line feedback that has proved to be useful in motor rehabilitation for the chronic stroke population in addition to traditional therapies. Nevertheless, its use and applications in the field still leave unresolved questions. The brain pathophysiological mechanisms after stroke remain partly unknown, and (...) the possibilities for intervention on these mechanisms to promote cerebral plasticity are limited in clinical practice. In NFB motor rehabilitation, the aim is to adapt the therapy to the patient’s clinical context using brain imaging, considering the time after stroke, the localization of brain lesions, and their clinical impact, while taking into account currently used biomarkers and technical limitations. These modern techniques also allow a better understanding of the physiopathology and neuroplasticity of the brain after stroke. We conducted a narrative literature review of studies using NFB for post-stroke motor rehabilitation. The main goal was to decompose all the elements that can be modified in NFB therapies, which can lead to their adaptation according to the patient’s context and according to the current technological limits. Adaptation and individualization of care could derive from this analysis to better meet the patients’ needs. We focused on and highlighted the various clinical and technological components considering the most recent experiments. The second goal was to propose general recommendations and enhance the limits and perspectives to improve our general knowledge in the field and allow clinical applications. We highlighted the multidisciplinary approach of this work by combining engineering abilities and medical experience. Engineering development is essential for the available technological tools and aims to increase neuroscience knowledge in the NFB topic. This technological development was born out of the real clinical need to provide complementary therapeutic solutions to a public health problem, considering the actual clinical context of the post-stroke patient and the practical limits resulting from it. (shrink)

Executive functions represent higher order top-down mechanisms regulating information processing. While suboptimal EF have been studied in various patient groups, their impact on successful behavior is still not well described. Previously, it has been suggested that design fluency —a test including several simultaneous EF components mainly related to fluency, cognitive flexibility, and creativity—predicts successful behavior in a quickly changing environment where fast and dynamic adaptions are required, such as ball sports. We hypothesized that similar behaviors are of importance in (...) the selection process of elite police force applicants. To test this hypothesis, we compared elite police force applicants with a control group of police officer trainees. Although both groups were better than the norm, the elite police force applicants had a significantly better performance in DF total correct when adjusting for sex and age [F = 18.98, p < 0.001]. To understand how this capacity was altered by stress and tiredness, we re-tested the elite police force applicants several days during an extreme field assessment lasting 10 days. The results suggested that there was a lower than expected improvement in DF total correct and a decline in the DF3-subtest that includes a larger component of cognitive flexibility than the other subtests. Although there was a positive correlation between the baseline session and the re-test in DF3 [r = 0.49, p = 0.001], the applicants having the highest scores in the baseline test also displayed the largest percentage decline in the re-test [r = −0.46, p = 0.003]. In conclusion, our result suggests that higher order EF that include cognitive flexibility and creativity are of importance in the application for becoming an elite police officer but relatively compromised in a stressful situation. Moreover, as the decline is different between the individuals, the results suggest that applicants should be tested during baseline conditions and during stressful conditions to describe their cognitive capacity fully. (shrink)

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and (...) implicit pathways to ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)