Analyzing the Combination Effects of Repetitive Transcranial Magnetic Stimulation and Motor Control Training on Balance Function and Gait in Patients with Stroke-Induced Hemiplegia

Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.

Training image analysis for three-dimensional reconstruction of porous media

In order to obtain a better sandstone three-dimensional （3D） reconstruction result which is more similar to the original sample, an algorithm based on stationarity for a two-dimensional （2D） training image is proposed. The second-order statistics based on texture features are analyzed to evaluate the scale stationarity of the training image. The multiple-point statistics of the training image are applied to obtain the multiple-point statistics stationarity estimation by the multi-point density function. The results show that the reconstructed 3D structures are closer to reality when the training image has better scale stationarity and multiple-point statistics stationarity by the indications of local percolation probability and two-point probability. Moreover, training images with higher multiple-point statistics stationarity and lower scale stationarity are likely to obtain closer results to the real 3D structure, and vice versa. Thus, stationarity analysis of the training image has far-reaching significance in choosing a better 2D thin section image for the 3D reconstruction of porous media. Especially, high-order statistics perform better than low-order statistics.

Retrospective study of effect of whole-body vibration training on balance and walking function in stroke patients

BACKGROUND Dysfunction in stroke patients has been a problem that we committed to solve and explore.Physical therapy has some effect to regain strength,balance,and coordination.However,it is not a complete cure,so we are trying to find more effective treatments.AIM To observe the effect of whole-body vibration training(WVT)on the recovery of balance and walking function in stroke patients,which could provide us some useful evidence for planning rehabilitation.METHODS The clinical data of 130 stroke participants who underwent conventional rehabilitation treatment in our hospital from January 2019 to August 2020 were retrospectively analyzed.The participants were divided into whole-body vibration training(WVT)group and non-WVT(NWVT)group according to whether they were given WVT.In the WVT group,routine rehabilitation therapy was combined with WVT by the Galileo Med L Plus vibration trainer at a frequency of 20 Hz and a vibration amplitude of 0+ACY-plusmn+ADs-5.2 mm,and in the NWVT group,routine rehabilitation therapy only was provided.The treatment course of the two groups was 4 wk.Before and after treatment,the Berg balance scale(BBS),3 m timed up-and-go test(TUGT),the maximum walking speed test(MWS),and upper limb functional reaching(FR)test were performed.RESULTS After 4 wk training,in both groups,the BBS score and the FR distance respectively increased to a certain amount(WVT=46.08±3.41 vs NWVT=40.22±3.75;WVT=20.48±2.23 vs NWVT=16.60±2.82),with P<0.05.Furthermore,in the WVT group,both BBS score and FR distance(BBS:18.32±2.18;FR:10.00±0.92)increased more than that in the NWVT group(BBS:13.29±1.66;FR:6.16±0.95),with P<0.05.Meanwhile,in both groups,the TUGT and the MWS were improved after training(WVT=32.64±3.81 vs NWVT=39.56±3.68;WVT=12.73±2.26 vs NWVT=15.04±2.27,respectively),with P<0.05.The change in the WVT group(TUGT:17.49±1.88;MWS:6.79±0.81)was greater than that in the NWVT group(TUGT:10.76±1.42;MWS:4.84±0.58),with P<0.05.CONCLUSION The WVT could effectively improve the balance and walking function in stroke patients,which may be good for improving their quality of life.

The effects of aerobic exercise training on oxidant-antioxidant balance, neurotrophic factor levels, and blood-brain barrier function in obese and non-obese men

Purpose: The purpose of this study was to investigate the effects of obesity and aerobic exercise training on oxidant-antioxidant balance,neurotrophic factor levels, and blood-brain barrier(BBB) function.Methods: Ten non-obese healthy men(body mass index < 25 kg/m2) and 10 obese men(body mass index ≥ 25 kg/m2) were included in the study.Both groups performed treadmill exercise for 40 min 3 times weekly for 8 weeks at 70% heart rate reserve. Blood samples were collected to examine oxidant-antioxidant balance(reactive oxygen species(ROS) and superoxide dismutase(SOD) activity levels), neurotrophic factors(brain-derived neurotrophic factor(BDNF), nerve growth factor, and glial cell line-derived neurotrophic factor levels), and BBB function(S100βand neuron-specific enolase(NSE) levels) before and after exercise training.Results: The obese group showed significantly greater changes than the non-obese group in serum ROS(-0.46 ± 0.31 mmol/L vs.-0.10 ±0.17 mmol/L,p=0.005),serum S100 p levels(-8.50 ± 5.92 ng/L vs.-0.78 ± 5.45 ng/L,p=0.007),and serum NSE levels(-0.89 ± 0.54 μg/L vs.-0.01 ± 0.74 μg/L,p= 0.007) after training. At baseline,the obese group showed significantly higher serum ROS and S100β levels and significantly lower serum SOD activity and BDNF levels than the non-obese group(p < 0.05). The obese group showed significantly lower serum ROS, S100β,and NSE levels and significantly higher serum SOD activity and BDNF levels after training compared with baseline(p < 0.05).Conclusion: These results suggest that obesity can reduce serum neurotrophic factor levels and can induce BBB dysfunction. On the other hand,aerobic exercise can improve an oxidant-antioxidant imbalance in obese subjects and limit BBB dysfunction.

Balance training in the intervention of fall risk in elderly with diabetic peripheral neuropathy: A review

Diabetic peripheral neuropathy(DPN)was the most common complications of elderly diabetic,which could contribute to an increased risk of falling.Despite the increased prevalence of elderly diabetic,high risk of falls and serious consequences of falls in elderly with DPN,It is necessary to adopt means of reducing the risk of falls in elderly with DPN.Impaired balance in the elderly with DPN was the most important risk factor of increasing falls.This review will introduce the epidemiology of falls in elderly with DPN,analysis the reasons for high risk of falls in elderly with DPN,provide a review of the development of balance training in the intervention of fall risk in elderly with DPN and offer recommendations to medical personnels on how to provide an efficient balance training for elderly with DPN.

Application of Optimal-Jerk Trajectory Planning in Gait-balance Training Robot

To accommodate the gait and balance disorder of the elderly with age progression and the occurrence of various senile diseases,this paper proposes a novel gait balance training robot(G-Balance)based on a six degree-of-freedom parallel platform.Using the platform movement and IMU wearable sensors,two training modes,i.e.,active and passive,are developed to achieve vestibular stimulation.Virtual reality technology is applied to achieve visual stimulation.In the active training mode,the elderly actively exercises to control the posture change of the platform and the switching of the virtual scene.In the passive training mode,the platform movement is combined with the virtual scene to simulate bumpy environments,such as earthquakes,to enhance the human anti-interference ability.To achieve a smooth switching of the scene,continuous speed and acceleration of the platform motion are required in some scenarios,in which a trajectory planning algorithm is applied.This paper describes the application of the trajectory planning algorithm in the balance training mode and the optimization of jerk(differential of acceleration)based on cubic spline planning,which can reduce impact on the joint and enhance stability.

An 8-week reactive balance training program in older healthy adults： A preliminary investigation

Background： This preliminary study examined the effects of an 8-week supervised reactive balance training program on reaction time （RT） and foot speed, static balance and balance confidence in healthy older adults compared to an exercise control group. Methods： Twenty-five older adults were randomly assigned to a reactive balance training group （QuickBoard; n = 12; 71.0 ± 8.6 years） or a stationary cycling group （control; n = 13; 70.2 ± 6.0 years）. Both groups were tested for foot RT foot speed, static balance, and balance confidence at baseline, 4-week, 8-week, and 4-week follow-up. Results： Results indicated significant improvements in QuickBoard foot RT and speed in both groups with greater improvements in the QuickBoard group. However, no group difference was found in static balance performance. Conclusion： Although the improvements in RT and foot speed may be beneficial for fall and trip prevention, the implications of the current findings for trio avoidance and oerformance of daily tasks are unclear.

Three-dimensional nonlinear H_2/H_∞ guidance law based upon approach of solving the state feedback Nash balance point

Based upon the theory of the nonlinear quadric two-person nonzero-sum differential game,the fact that the time-limited mixed H2/H∞ control problem can be turned into the problem of solving the state feedback Nash balance point is mentioned. Upon this,a theorem about the solution of the state feedback control is given,the Lyapunov stabilization of the nonlinear system under this control is proved,too. At the same time,this solution is used to design the nonlinear H2/H∞ guidance law of the relative motion between the missile and the target in three-dimensional(3D) space. By solving two coupled Hamilton-Jacobi partial differential inequalities(HJPDI),a control with more robust stabilities and more robust performances is obtained. With different H∞ performance indexes,the correlative weighting factors of the control are analytically designed. At last,simulations under different robust performance indexes and under different initial conditions and under the cases of intercepting different maneuvering targets are carried out. All results indicate that the designed law is valid.

Effect of respiratory muscle training on trunk control and balance ability in stroke patients

Objective: To investigate the effect of respiratory muscle training combined with conventional rehabilitation therapy on trunk control, balance ability and activities of daily living in stroke patients. Methods: Sixty stroke patients were divided into control group and experimental group by random number table, 30 each, and received conventional rehabilitation therapy. Moreover, the experimental group underwent respiratory muscle training (RMT), for four weeks. In each patient, maximal inspiratory pressure (MIP) was measured for the inspiratory muscle strength. Maximal expiratory pressure (MEP) was measured for the expiratory muscle strength. The trunk control was measured using the Trunk Impairment Scale (TIS). The Berg balance scale (BBS) was used to assess the balance function. The modified Barthel index (MBI) was used to evaluate activities of daily living. Results: There were no significant differences in MIP, MEP, TIS, BBS and MBI between the two groups before treatment. The MIP, MEP, TIS, BBS and MBI functions of the control group and the experimental group were improved after treatment, And the functional improvement of the above indicators in the experimental group after treatment was significantly higher than that of the control group. Conclusion: This study proved that RMT improved respiratory muscle strength, trunk control, balance function, and ADL in stroke patients.

Effects of balance exercise training on chronic nerve injury, GLP-1 and inflammatory mediator secretion in patients with senile dementia

Objective: To study the effects of balance exercise training on chronic nerve injury, GLP-1 and inflammatory mediator secretion in patients with senile dementia. Methods: Patients with senile dementia who were treated in the Fourth People's Hospital of Ya'an between February 2015 and January 2018 were chosen as the research subjects and randomly divided into two groups, the experimental group received balance exercise training and the control group received routine intervention. The levels of chronic nerve injury indexes, GLP-1 and inflammatory cytokines in serum as well as the expression of inflammatory signaling molecules in peripheral blood were determined before and after intervention. Results:Compared with those of same group before intervention, serum Hcy, Aβ1-42, Tau, IL-1β, IL-18, TNF-α and IFN-γ levels as well as peripheral blood NLRP3, Caspase-1 and DOCK2 expression intensity of both groups were decreasing whereas serum SOD, PON1 and GLP-1 levels as well as peripheral blood PKA and CREB expression intensity were increasing after intervention, and serum Hcy, Aβ1-42, Tau, IL-1β, IL-18, TNF-α and IFN-γ levels as well as peripheral blood NLRP3, Caspase-1 and DOCK2 expression intensity of experimental group after intervention were lower than those of control group whereas serum SOD, PON1 and GLP-1 levels as well as peripheral blood PKA and CREB expression intensity were higher than those of control group. Conclusion: Balance exercise training can reduce the chronic nerve injury and regulate the secretion of GLP-1 and inflammatory mediators in patients with senile dementia.

Determination method of load balance ranges for train operation safety under strong wind

The aerodynamic performances of a passenger car and a box car with different heights of windbreak walls under strong wind were studied using the numerical simulations, and the changes of aerodynamic side force, lift force and overturning moment with different wind speeds and wall heights were calculated. According to the principle of static moment balance of vehicles, the overturning coefficients of trains with different wind speeds and wall heights were obtained. Based on the influence of wind speed and wall height on the aerodynamic performance and the overturning stability of trains, a method of determination of the load balance ranges for the train operation safety was proposed, which made the overturning coefficient have nearly closed interval. A min(|A1|+|A2|), s.t. |A1|→|A2|(A1 refers to the downwind overturning coefficient and A2 refers to the upwind overturning coefficient)was found. This minimum value helps to lower the wall height as much as possible, and meanwhile, guarantees the operation safety of various types of trains under strong wind. This method has been used for the construction and improvement of the windbreak walls along the Lanzhou–Xinjiang railway(from Lanzhou to Urumqi, China).

Athletes who train on unstable compared to stable surfaces exhibit unique postural control strategies in response to balance perturbations

Background:Athletes have been shown to exhibit better balance compared to non-athletes(NON).However,few studies have investigated how the surface on which athletes train affects the strategies adopted to maintain balance.Two distinct athlete groups who experience different types of sport-specific balance training are stable surface athletes(SSA) such as basketball players and those who train on unstable surfaces(USA) such as surfers.The purpose of this study was to investigate the effects of training surface on dynamic balance in athletes compared to NON.Methods:Eight NON,eight SSA,and eight USA performed five 20-s trials in each of five experimental conditions including a static condition and four dynamic conditions in which the support surface translated in the anteroposterior(AP) or mediolateral(ML) planes using positive or negative feedback paradigms.Approximate entropy(Ap En) and root mean square distance(RMS) of the center of pressure(Co P) were calculated for the AP and ML directions.Four 3 × 5(group × condition) repeated measures ANOVAs were used to determine significant effects of group and condition on variables of interest.Results:USA exhibited smaller Ap En values than SSA in the AP signals while no significant differences were observed in the ML Co P signals.Generally,the negative feedback conditions were associated with significantly greater RMS values than the positive feedback conditions.Conclusion:USA exhibit unique postural strategies compared to SSA.These unique strategies seemingly exhibit a direction-specific attribute and may be associated with divergent motor control strategies.

BALANCE评定与训练系统对脑卒中患者早期躯干控制能力疗效观察

目的:观察BALANCE评定与训练系统改善脑卒中患者早期躯干控制能力的临床疗效。方法:40例脑卒中患者按照随机数字表法分为治疗组和对照组,每组各20例。2组均给予营养脑神经、改善微循环药物治疗和常规Brunnstrom、Bobath的NDT、Rood、PNF、MRP及躯干肌群力量控制训练等,每周6 d,连续4周。治疗组在此基础上应用BALANCE评定与训练系统进行躯干控制能力训练。治疗前与治疗4周后2组均进行躯干控制测试(TCT)、脑卒中患者姿势评定量表(PASS)检测,应用BALANCE评定与训练系统进行坐位平衡的包络面积及动摇总轨迹长的检测。结果:2组治疗前TCT评分、PASS评分、包络面积、动摇总轨迹长比较,差异无统计学意义(P>0.05);治疗4周后,2组TCT评分、PASS评分较治疗前明显增加,包络面积、动摇总轨迹长明显减少(P<0.05或P<0.01);治疗4周后2组各指标组间比较,差异有统计学意义(P<0.05)。结论:BALANCE评定与训练系统可改善脑卒中患者早期躯干控制能力。

基于Nintendo Wii Balance Board的平衡测量及神经反馈训练提高健康人平衡能力的初步研究（英文）

神经反馈训练在提高认知能力及治疗精神疾病方面具有积极效果,但其在健康人平衡能力方面的作用还没有研究.本文对神经反馈训练用于提高健康人平衡能力进行了初步研究.为了经济有效地检测平衡能力及神经反馈后的平衡能力变化,首先研究了作为平衡测量系统的Nintendo Wii Balance Board(WBB),实验结果表明WBB具有良好的可靠性及灵敏度.对一位年轻健康的受试者做了连续5天的神经反馈训练,并在神经反馈训练前后用WBB测量了其平衡能力.神经反馈训练以后,该受试者左脚睁眼站立的平衡能力得到了改善.

Pediatric obesity prevention:From na?ve examination of energy imbalance towards strategies that influence the competition for nutrient resources among tissues

Current pediatric obesity interventions have collectively yielded relatively unsuccessful results. In this Field of Vision, we present plausible physiologic underpinnings fostering ineffectiveness of conventional strategies grounded in requisite induction of negative energy imbalance. Moreover, such recommendations exacerbate the underlying metabolic dysfunction by further limiting metabolic fuel availability, lowering energy expenditure, and increasing hunger(recapitulating the starvation response amid apparent nutritional adequacy) which precede and promote obesity during growth and development. The qualitative aspects of musculoskeletal system(i.e., endocrine response, muscle functional capacity) are likely to improve metabolic function and increase nutrient delivery and utilization. An intricate and complex system including multiple feedback mechanisms operates to homeostatically regulate energy balance and support optimal body composition trajectories and metabolic health, during growth and development. Thus, ignoring the interdependencies of regulatory growth processes initiates a nuanced understanding of energy regulation and thus misguided attempts at preventive strategies. Importantly, these gains are not dependent upon weight-loss, rather we suggest can be achieved through resistance training. Collectively, optimizing musculoskeletal health via resistance training elicits augmentation of competitive capacity across systems. Further, substantial gains can be achieved in skeletal muscle mass, strength, and functional capacity through resistance training in a relatively short period of time.

Action for Rehabilitation from Neurological Injury (ARNI): A pragmatic study of functional training for stroke survivors

This study evaluated the effectiveness of a twelve-week community-based functional training on measures of impairment, activity and participation in a group of stroke survivors. Isometric strength of the knee musculature, Centre-Of-Pressure (COP) based measures of balance, Berg Balance Scale (BBS), 10 m walk test, and the Subjective Index of Physical and Social Out come (SIPSO), were recorded at baseline, post-intervention, and after twelve weeks (follow-up). Exercise instructors delivered training once a week in a group format at a community centre. Significant improvement was noted in the BBS (p < 0.002), and 10 m walk speed (p = 0.03) post intervention which remained unchanged at follow-up. Total SIPSO score improved significantly post-intervention (p = 0.044). No other significant differences and no adverse effects were observed. It is possible that functional training provided more opportunity for the improvement of dynamic aspects of balance control that could be captured by the BBS but not with the traditional measures of balance using COP data. Results also suggest positive effects on the level of participation, and lack of association between measures of impairment and activity. Community based functional training could be effective and used to extend access to rehabilitation services beyond the acute and sub-acute stages after stroke.

Application and Design of Virtual Reality Technology in Railway Maintenance Training

Virtual reality technology is a brand new comprehensive information technology emerging during the end of 21 st century. In recent years in particular, it gains rapid development, involving industries like education, industry, military, entertainment and medicine. Combined with the characteristics of railway maintenance training, this thesis proposes the application of virtual reality in courseware, distance education, locomotive simulation driving, locomotive overhauling oil and breakdown processing, and illustrates key technology and solution of the exploitation of virtual reality technology.

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.

Balanced Nutrition Practiced with Limitations during the COVID-19 Pandemic: The Experience of Teachers in Subang District, West Java, Indonesia

The purpose of the study is to assess the knowledge on Balanced Nutrition and its practices among pre-school teachers in Subang district, West Java, Indonesia before and during the COVID-19 pandemic (before March 2020 vs. October 2021) and to seek differences in the knowledge and practices of teachers who attended nutrition training and those who did not attend any nutrition training. We evaluated the knowledge and practice of 142 teachers based on 10 messages of the 2014 Indonesian Balanced Nutrition Guidelines, using google online survey platform. The top three messages mostly selected by the teachers were consuming a variety of staple foods (87%), drinking adequate and safe water (87%), and eating plenty of vegetables and fruits (86%), while the least selected were enjoying a variety of foods (41%) and reading food labels (28%). A slight increase was found in teachers who consumed fruits daily, while the practice of washing hands before and during the pandemic was statistically and significantly increased (58% to 72%;p < 0.05). A slight decrease was found in teachers who consumed vegetables and animal protein, as well as performed physical exercise daily. Majority of teachers (80%) participated in some kinds of nutrition training in the last four years. The top three gaps of knowledge between trained and non-trained teachers were on physical activity and maintaining ideal body weight (64% vs. 33%;statistically significant at p < 0.05);limit intake of sweet, salty, and fatty food;and consuming high protein food, with the range between 20 to 35 percentage points. We concluded that teachers acquired knowledge on nutrition to some degree, but its application faced limitations during the pandemic. Dissemination of Balanced Nutrition should continue.

平衡生物反馈训练对脑卒中足内翻患者足底压力和平衡功能的影响

目的探讨平衡生物反馈训练对脑卒中足内翻患者的足底压力和平衡功能的作用。方法选择60例脑卒中足内翻患者,其中男性35例,女性25例;年龄50~58岁,平均年龄54.79岁;病程79~92 d,平均病程87.76 d;偏瘫左侧33例,右侧27例;脑梗死31例,脑出血29例。随机选择30例作为对照组,另外30例为试验组。对照组和试验组都进行综合训练,试验组在此基础上进行平衡生物反馈训练。两组连续训练8周,每周5 d,每天2次,每次共60 min。选用美国Tekscan公司的Footscan三维动态足底压力步态分析系统。在治疗前和治疗后8周,对患者的足底压力和平衡运动学参数进行对比。结果在足底压力方面,治疗前,两组患者内外侧压力和接触面积差异无统计学意义(P>0.05);治疗后,两组患者内侧压力增大(P<0.05),外侧压力减小(P<0.05)[试验组治疗前后内侧压力(150.18±96.30)N vs(175.70±99.95)N,外侧压力(184.14±85.72)N vs(166.46±112.01)N;对照组治疗前后内侧压力(147.11±74.22)N vs(165.97±71.93)N,外侧压力(230.13±93.73)N vs(223.57±114.75)N]。两组患者内侧接触面积增大(P<0.05),外侧接触面积减小(P<0.05)[试验组治疗前后内侧接触面积(26.75±12.07)cm^(2)vs(34.97±9.17)cm^(2),外侧接触面积(45.79±21.57)cm^(2)vs(37.86±21.99)cm^(2);对照组治疗前后内侧接触面积(39.28±22.25)cm^(2)vs(42.44±14.76)cm^(2),外侧接触面积(45.74±22.66)cm^(2)vs(41.73±20.54)cm^(2)],且与对照组相比,试验组内外侧压力和接触面积变化更为显著(P<0.05)。在平衡运动学参数方面,治疗前两组患者运动学参数差异无统计学意义(P>0.05);治疗后两组患者的X、Y轴上的轨迹长度、均方差、最大动摇径、总轨迹、偏移长度和包络面积均显著降低(P<0.05),速度、单位面积轨迹长度均显著升高(P<0.05),试验组平衡运动学参数改善更为显著(P<0.05)。结论平衡生物反馈训练可显著提高脑卒中足内翻患者的足底压力和平衡功能。