Trajectory of Walking Function in Late-Stage Older Individuals Managed with a Regular Exercise Program: A 5-Year Longitudinal Tracking with an IoT Gait Analysis System Using Accelerometers

Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized for preventive care over 5 years, using detailed gait function measurements with an accelerometer-based system. Methods: Seventy individuals (17 male and 53 female) of a daycare service in Tokyo participated in a weekly exercise program, meeting 1 - 2 times. The average age of the participants at the start of the program was 81.4 years. Gait function, including gait speed, stride length, root mean square (RMS) of acceleration, gait cycle time and its standard deviation, and left-right difference in stance time, was evaluated every 6 months. Results: Gait speed and stride length improved considerably within six months of starting the exercise program, confirming an initial improvement in gait function. This suggests that regular exercise programs can maintain or improve gait function even age groups that predictably have a gradual decline in gait ability due to enhanced age. In the long term, many indicators tended to approach baseline values. However, the exercise program seemingly counteracts age-related changes in gait function and maintains a certain level of function. Conclusions: While a decline in gait ability with aging is inevitable, establishing appropriate exercise habits in late-stage older individuals may contribute to long-term maintenance of gait function.

Gait improvement after treadmill training in ischemic stroke survivors A critical review of functional MRI studies

Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.

Role of a wireless surface electromyography in dystonic gait in functional movement disorders: A case report

BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.

Decreased Gait and Function in Duchenne Muscular Dystrophy

Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.

The Relationship between Gait Asymmetry and Respiratory Function in Stroke Patients: A Pilot Study

INTRODUCTION: Gait asymmetry can become very pronounced in patients who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. OBJECTIVE: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. METHODS: This study employed a cross-sec- tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were evaluated by spirometry. We examined the relation between SI or LI and the respiratory function/respiratory muscle strength in patients with stroke. RE- SULTS: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = ﹣0.386, r = ﹣0.392, r = ﹣0.446;p < 0.05). CONCLUSION: The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.

Effects of Water Weight-Loss Walking Training on Lower Limb Motor Function and Gait in Stroke Patients

Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.

Corticoreticular tract lesion in children with developmental delay presenting with gait dysfunction and trunk instability

The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.

全膝关节置换前膝关节伸屈肌肌肉力量与置换后步态功能的关系

背景:步态功能障碍是导致全膝关节置换后患者不满的重要原因之一,临床研究中发现术前股四头肌和腘绳肌的肌肉力量与术后步态功能障碍有关,但其相关性目前尚不完全清楚。目的:探讨全膝关节置换前以股四头肌为主的伸肌、以腘绳肌为主的屈肌肌肉力量与置换后步态功能等的相关性。方法:回顾性分析70例接受单侧初次全膝关节置换患者的纵向数据,术前测量伸屈肌的峰力矩、峰力矩体质量比、总功数据,术后6个月测量起立-步行计时测试结果和步态速度。使用岭回归分析确定术后步态功能的影响因素。结果与结论:①术前伸肌峰力矩、峰力矩体质量比、总功以及屈肌峰力矩、总功与术后步态速度呈非常强正相关(P<0.001),术前屈肌峰力矩体质量比与术后步态速度呈强正相关(P<0.001);术前伸肌、屈肌峰力矩、峰力矩体质量比、总功与术后起立-步行计时测试结果呈非常强负相关(P<0.001);②岭回归分析中,94.2%可能性可说明术前伸肌峰力矩、峰力矩体质量比、总功及屈肌峰力矩、总功对全膝关节置换后患者的步态速度具有正向影响(P<0.001),术前屈肌峰力矩体质量比对术后步态速度具有负向影响(P<0.001);87.7%可能性说明术前伸肌峰力矩、峰力矩体质量比、总功及屈肌峰力矩、总功对术后起立-步行计时测试具有负向影响(P<0.05),而屈肌峰力矩体质量比对术后起立-步行计时测试无影响(P>0.05);③提示全膝关节置换前股四头肌、腘绳肌肌肉力量的大小与置换后步态速度、起立-步行计时测试结果相关,可预测术后步态功能结果;加强置换前膝关节肌肉锻炼可能是减缓全膝关节置换后步态障碍发生的途径。

康复机器人训练脑性瘫痪患者:改善下肢运动功能效果的Meta分析

目的:系统评价康复机器人治疗脑性瘫痪患者下肢运动功能的临床效果,并比较不同机器人的疗效差异。方法:检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、中国生物医学文献数据库、维普和万方数据库,搜集从建库至2024-04-10发表的关于康复机器人治疗脑性瘫痪患者运动功能障碍的随机对照试验。主要结局指标包括肌肉力量,肌张力、平衡功能、步速、步频、步长、步行耐力、下肢运动功能、日常生活活动能力。根据《国际功能、残疾和健康分类》对上述指标进行编码,通过Meta分析评价临床疗效并比较不同机器人的疗效差异。由2名研究人员进行文献检索与筛选,使用Cochrane 5.1.0偏倚风险评估工具对纳入文献进行质量评价。采用RevMan 5.4软件和Stata 16.0软件进行Meta分析。结果:①最终纳入15篇文献,共512例患者,试验组260例、对照组252例。②Meta分析结果显示,与常规康复疗法相比,康复机器人可以提高身体结构和功能(SMD=0.41,95%CI:0.24-0.58,P<0.05)、活动(SMD=0.53,95%CI:0.41-0.65,P<0.05)和参与能力(MD=7.86,95%CI:1.54-14.18,P<0.05)。其中,康复机器人可以改善脑性瘫痪患者下肢肌力、平衡功能、步速、步行耐力、下肢粗大运动功能和日常生活活动能力,但对步频、步长和肌张力的效果不明显。③网状Meta分析结果显示,步速:Innowalkpro>Gait trainer>Lokomat>3DCalt;6MWT评分:Gait trainer>Lokomat>Lokohelp>Innowalkro;GMFM-88D区评分:Lokohelp>Lokomat>KidGo>Innowalkpro>3DCalt;GMFM-88E区评分:Lokomat>Lokohelp>KidGo>3DCalt>Innowalkpro。结论:基于《国际功能、残疾和健康分类》,康复机器人训练可以改善脑性瘫痪患者下肢运动功能和日常生活活动能力。在改善步速方面,Innowalkpro机器人效果更优;在改善6MWT评分方面,Gait trainer机器人效果更优;在改善GMFM-D区评分方面,Lokohelp机器人效果更优;在改善GMFM-E区评分方面,Lokomat机器人效果更优。

应用ByGait-G6060-5压感步态测试仪分析中老年单侧膝关节滑膜炎患者的步态特征

目的应用ByGait-G6060-5压感步态测试仪观察中老年单侧膝关节滑膜炎患者的步态特征,为后续康复评估及治疗提供依据。方法选择2018年1月至2019年12月安徽医科大学第二附属医院康复运动医学科住院的20例单侧膝关节滑膜炎中老年患者(观察组),其中男性6例,女性14例;年龄51~68岁,平均年龄59.20岁;身高151~174 cm,平均身高161.45 cm;体质量52~98 kg,平均体质量66.90 kg;平均日本骨科协会(JOA)评分45.60分;左侧8例,右侧12例。同期选择20例年龄相匹配的健康中老年人(对照组),其中男性9例,女性11例;年龄54~68岁,平均年龄61.45岁;身高155~171 cm,平均身高162.50 cm;体质量51~74 kg,平均体质量63.15 kg;平均JOA评分53.35分。采用中国科学院合肥物质研究院研发的ByGait-G6060-5压感步态测试仪进行步态分析数据采集。比较两组静态站立姿势下双足压力中心(BPC)轨迹、双侧足底压力比值(ROP),以及行走时的步长、步速、触地时长、足底各分区压力占比和负重面积占比,获得滑膜炎患者的步态特征。结果观察组BPC轨迹较对照组明显增加[(59.60±15.68)mm vs(34.10±9.94)mm],差异有显著统计学意义(t=6.152,P<0.01);而ROP低于对照组(0.88±0.07 vs 0.98±0.04),差异有显著统计学意义(t=-5.329,P<0.01)。观察组步长明显短于对照组[(0.38±0.08)m vs(0.59±0.09)m;t=-7.756,P<0.01];步速明显低于对照组[(1.10±0.17)m/s vs(1.33±0.20)m/s;t=-3.924,P<0.01];而触地时长明显多于对照组[(0.81±0.09)s vs(0.68±0.06)s;t=5.293,P<0.01]。观察组与对照组比较,足底第四跖骨、第五跖骨、足中部区域所受压力占比相对较高,踇趾受力较小(P<0.05);第四跖骨、足中部和足后跟外侧负重面积增大(P<0.05),踇趾区受力面积减小(P<0.05)。结论中老年单侧膝关节滑膜炎患者静态平衡能力降低,行走能力减退,与健康中老年人对比有明显差异。

经颅磁刺激联合康复训练对帕金森病患者冻结步态功能的影响

目的探究经颅磁刺激联合康复训练对帕金森病患者冻结步态功能的影响。方法本文观察对象为北京和睦家康复医院帕金森病患者共40例,收取时间段在2022年5月至2024年5月,采用随机数字表法分组,观察组20例予以经颅磁刺激联合康复训练,对照组20例予以康复训练。在干预结束后,将两组认知功能评分、治疗效果、运动功能、生活质量水平作比较。结果观察组干预后的蒙特利尔认知评估量表(MoCA)评分,治疗总有效率,躯体功能、心理健康、社会功能、物质生活等生活质量评分均高于对照组(均P<0.05)。观察组干预后统一帕金森氏症评定量表(UPDRS)-Ⅲ、冻结步态量表(FOGQ)得分均低于对照组(均P<0.05)。与结论经颅磁刺激联合康复训练对帕金森病患者冻结步态功能具有明显改善作用,还能提高其认知功能,促进生活质量的提升。

Effects of Tai Ji Quan training on gait kinematics in older Chinese women with knee osteoarthritis: A randomized controlled trial

Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.

A method for extracting human gait series from accelerometer signals based on the ensemble empirical mode decomposition

In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose the ac- celerometer signals, thus sifting out several intrinsic mode functions （IMFs） at disparate scales. Then, gait series can be extracted through peak detection from the eigen IMF that best represents gait rhythmicity. Compared with the method based on the empirical mode decomposition （EMD）, the EEMD-based method has the following advantages： it remarkably improves the detection rate of peak values hidden in the original accelerometer signal, even when the signal is severely contaminated by the intermittent noises; this method effectively prevents the phenomenon of mode mixing found in the process of EMD. And a reasonable selection of parameters for the stop-filtering criteria can improve the calculation speed of the EEMD-based method. Meanwhile, the endpoint effect can be suppressed by using the auto regressive and moving average model to extend a short-time series in dual directions. The results suggest that EEMD is a powerful tool for extraction of gait rhythmicity and it also provides valuable clues for extracting eigen rhythm of other physiological signals.

What Is the Association between an Anteriorly Tilted Pelvis and Trendelenburg Gait?

Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.

Quantifying prosthetic gait deviation using simple outcome measures

AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibial amputees were recruited.Twenty-eight able-bodied controls were recruited.All participants underwent 3DGA,the timed-up-and-go test and the six-minute walk test(6MWT).The lowerlimb amputees also completed the Prosthesis Evaluation Questionnaire.Results from 3DGA were summarised using the gait deviation index(GDI),which was subsequently regressed,using stepwise regression,against the other measures.RESULTS:Step-length(SL),self-selected walking speed(SSWS) and the distance walked during the 6MWT(6MWD) were significantly correlated with GDI.The 6MWD was the strongest,single predictor of the GDI,followed by SL and SSWS.The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility.CONCLUSION:This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA.

帕金森病患者出现冻结步态的危险因素分析

目的探讨帕金森病(PD)患者出现冻结步态(FOG)的危险因素。方法选取2019年7月至2022年7月中日友好医院收治的52例PD患者为研究对象,根据是否合并FOG将研究对象分为FOG组(合并FOG,14例)和非FOG组(未合并FOG,38例)。比较分析非FOG组与FOG组患者的临床特征与影像学特征。比较分析非FOG组与FOG组患者的基底前脑功能连接。采用多因素logistic回归方法分析PD患者出现FOG的独立影响因素。结果FOG组患者的国际运动障碍学会统一帕金森病评定量表Ⅱ(MDS-UPDRSⅡ)评分高于非FOG组,差异有统计学意义(P<0.05),且Meynert基底核(Ch4)与双侧中扣带回、中央前回及辅助运动区的功能连接低于非FOG组。多因素logistic回归分析结果显示,MDS-UPDRSⅡ评分、Ch4功能连接是PD患者出现FOG的独立影响因素(P<0.05)。结论MDS-UPDRSⅡ评分升高、Ch4功能连接减弱为PD患者出现FOG的独立影响因素。

天智颗粒对遗忘型轻度认知功能障碍患者神经营养因子及认知功能的影响

目的探讨天智颗粒联合艾地苯醌对遗忘型轻度认知功能障碍患者神经营养因子、认知功能及步态功能的影响。方法将100例遗忘型轻度认知功能障碍患者按照随机数字表法分为对照组和研究组,各50例。对照组患者给予单药艾地苯醌,1次30 mg,1天3次;研究组患者在对照组基础上联合天智颗粒,1次5 g,1天3次。持续治疗12周。比较治疗前后两组患者血清脑源性神经营养因子(BDNF)、酪氨酸激酶受体B(TrkB)水平,简易智能精神状态检查量表(MMSE)、癫痫患者生活质量量表-31(QOLIE-31)评分,步态功能(步长、步速和步频),并评估两组患者临床疗效。结果治疗后,两组患者BDNF、TrkB水平,MMSE、QOLIE-31各维度评分均较治疗前升高,且研究组高于对照组(P<0.05或0.01)。治疗后,两组患者步长、步速、步频均较治疗前改善,且研究组优于对照组(P<0.01)。研究组患者治疗总有效率高于对照组(P<0.05)。结论天智颗粒联合艾地苯醌对于改善遗忘型轻度认知功能障碍患者的神经功能、认知功能及步态功能具有显著作用。

Three-phase Enriched Environment Improves Post-stroke Gait Dysfunction via Facilitating Neuronal Plasticity in the Bilateral Sensorimotor Cortex:A Multimodal MRI/PET Analysis in Rats

The three-phase Enriched Environment(EE)paradigm has been shown to promote post-stroke functional improvement,but the neuronal mechanisms are still unclear.In this study,we applied a multimodal neuroimaging protocol combining magnetic resonance imaging(MRI)and positron emission tomography(PET)to examine the effects of post-ischemic EE treatment on structural and functional neuroplasticity in the bilateral sensorimotor cortex.Rats were subjected to permanent middle cerebral artery occlusion.The motor function of the rats was examined using the DigiGait test.MRI was applied to investigate the EE-induced structural modifications of the bilateral sensorimotor cortex.[^(18)F]-fluorodeoxyglucose PET was used to detect glucose metabolism.Blood oxygen level-dependent(BOLD)-functional MRI(fMRI)was used to identify the regional brain activity and functional connectivity(FC).In addition,the expression of neuroplasticity-related signaling pathways including neurotrophic factors(BDNF/CREB),axonal guidance proteins(Robo1/Slit2),and axonal growth-inhibitory proteins(NogoA/NgR)as well as downstream proteins(RhoA/ROCK)in the bilateral sensorimotor cortex were measured by Western blots.Our results showed the three-phase EE improved the walking ability.Structural T2 mapping imaging and diffusion tensor imaging demonstrated that EE benefited structure integrity in the bilateral sensorimotor cortex.PET-MRI fused images showed improved glucose metabolism in the corresponding regions after EE intervention.Specifically,the BOLD-based amplitude of low-frequency fluctuations showed that EE increased spontaneous activity in the bilateral motor cortex and ipsilateral sensory cortex.In addition,FC results showed increased sensorimotor connectivity in the ipsilateral hemisphere and increased interhemispheric motor cortical connectivity and motor cortical-thalamic connectivity following EE intervention.In addition,a strong correlation was found between increased functional connectivity and improved motor performance of limbs.Specifically,EE regulated the expression of neuroplasticity-related signaling,involving BDNF/CREB,Slit2/Robo1,as well as the axonal growth–inhibitory pathways Nogo-A/Nogo receptor and RhoA/ROCK in the bilateral sensorimotor cortex.Our results indicated that the three-phase enriched environment paradigm enhances neuronal plasticity of the bilateral sensorimotor cortex and consequently ameliorates post-stroke gait deficits.These findings might provide some new clues for the development of EE and thus facilitate the clinical translation of EE.

北京社区55~75岁高、低痴呆风险人群身体素质及其认知功能特点

目的分析预测社区中处于生命中期健康老年人痴呆风险因素。方法2021年7月至2023年4月招募北京市两个社区常住1年以上的55~75岁中老年人175例,收集心血管危险因素、衰老和痴呆(CAIDE)相关危险因素和其他一般人口资料,CAIDE风险评分≥9分为高危组,<9分为低危组。采用Stroop色词测验(SCWT)、两元素1-back任务范式、连线测验(TMT)进行评估;测量握力、30 s前臂屈曲测验和5次坐站试验;记录平地步行10 m的平均步速和步长。结果高危组CAIDE总分平均9.86分,低危组4.95分。两组年龄无显著性差异(P=0.188)。男性,受教育程度<7年、收缩压>140 mmHg、胆固醇>6.5 mmol/L、体质量指数>30 kg/m^(2)和缺乏体力活动人群CAIDE痴呆风险评分更高(χ^(2)>3.116,P<0.05)。高危组握力(t=-4.174)、步速(t=-2.414)、SCWT正确率(Z=-2.684)均差于低危组(P<0.05)。Logistic回归分析显示,步速(OR=25.483)、握力(OR=1.133),SCWT正确率(OR=37.430)是痴呆的独立危险因素(P<0.05)。结论握力弱、步速慢、抑制控制能力差可能预示痴呆风险增加。

Multi-level gait transition model for a new type of arthropod robot

To realize the continuous and variable gait transition for a new type of arthropod robot, a multi-level gait transition model is studied in this paper. The model is composed of central pattern generator （CPG） and saturation function. The CPG consists of four pairs of oscillators which can ex- hibit rhythmic activity when given stimulation signal S that lies in the range of saturation function. All oscillators receive the same S, but each pair of oscillators has different saturation functions. Multi- level gait transition can be realized when S changes regularly, as the oscillators start or stop oscilla- ting at different times. After computer simulation, the gait transition model is implemented in the ar- thropod robot. The experimental results show that ideal gait transition for the arthropod robot can be realized with the multi-level gait transition model.