[WEB] How to Read Scientific Papers (for the layperson)

(source: http://www.pexels.com)

Because scientific data should be accessible to everyone.

By Corinne

Wouldn’t it be great if scientific papers were written so that everyone could understand them? We could refer to factual scientific data when someone makes a false claim, or we could use scientific papers to sort out fake news. Unfortunately, reading a scientific paper is not the same as reading a news article or blog post. They are confusing and hard to read, even scientists need to go through a lot of training to be able to read papers effectively, but this guide will make them easier to read.

If you just want to quickly scan a paper without diving deep into the study, I recommend you start with reading the abstract to get a brief summary of the study, then look through the figures and look at the data, and then the discussion/conclusion.

If you want to take a deeper look at the paper to understand the study, here’s a simple guide for how to read scientific papers for the non-scientist:

Start with the Abstract

Don’t just read the abstract and ignore the rest of the paper. The abstract is great because it will provide you with a summary of the whole paper, but it probably won’t give you all the information you need. Skim it to get an idea of what you’re about to read and move on.

Read the Introduction

This part is usually easier to read because it is written like a story. It gives some background information on the topic and will sometimes include other studies that are similar to the one you’re reading so you can find more info on the subject. The most important thing about the introduction is that it explains the purpose and importance of the study. After reading the introduction, you should be able to summarize why the scientist is studying this particular topic and what they are trying to find out.

Methods

The most important thing to look at here is the sample size and diversity. Would you trust a drug that was shown to work in 10 people or 10,000 people? A study done on 10,000 people will produce more accurate results than a study done on 10 people. It’s hard to be able to draw a conclusion from a limited sample, so make sure the study you’re looking at is using has a large sample size.

Results

Skip it for now and come back . This section is for laying out all the data, but personally I like reading the explanation of the data in the discussion/conclusion first because it’s written in a way that’s easier to understand. After I read the discussion/conclusion, I’ll come back to the results and look at the figures to make sure it all makes sense.

Discussion/Conclusion

In my opinion, this is the most important section. Just be careful what you read because this section typically includes the researchers opinion on the data. This isn’t necessarily a bad thing, but always go back and check to make sure the results match what the researcher is saying because sometimes people will exaggerate the results to help support their claims. This section is also important because the scientist might tell you about any errors that occurred in the study and whether or not more research is needed to confirm the results.

Back to the Results..

When looking at the figures, it’s important to take a look at error bars. A graph typically represents the average value of all the data collected. The error bars will show you how far the data points were from the average. A small error bar indicates that most of the data points were close to the average value and a large error bar means some of the data points were very different from the average value.

Look at the graph below. At first glance, it seems that participants who did not take medication experienced greater pain than those who took medication. However, if you look at the error bars (the thin black vertical lines sticking out of the middle of the bars), you’ll notice that they are pretty long and overlap with each other. The overlap between the error bars means the data values were similar between the two groups. This indicates the data may not be significant and patients could have experienced no change or little change in pain after taking medication.

The graph below shows no overlap between the error bars. This means the results are most likely significant and the medication probably helped with pain levels.

Don’t be afraid to go back and read the paper again

Science papers are REALLY hard to read so don’t be discouraged if you read through it once and still don’t understand, you might need to read through a few times to fully understand it. Go back, read it again, and identify any questions you may have and where you are getting confused. Google any technical jargon you don’t understand.

It is important that not only everyone has access to scientific data, but that they are able to understand it. Most scientific information is communicated through news articles by journalists who may not be trained in science. Being able to look into their sources and read through the scientific literature is important for sorting out fake news. Check out my article about it here:

The Dangers of Science Journalism

Let me know if this guide helped you at all, I’d love to hear your feedback!

Corinne, Biochemist. Writer. Health & Wellness.

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[BLOG POST] Mental Health Challenges After Brain Injury

David A. Grant, TBI Survivor August 1, 2021

Next month a significant milestone in my life will come to pass as I turn 60 years old. I sustained my traumatic brain injury at the age of 49, when I was run over by a newly licensed teenaged driver on Main Street in my New Hampshire town. I have lived the entire decade of my fifties as a brain injury survivor. 

As my 60th birthday approaches, the internal emotions are ramping up. When I was younger, someone 60 was really old. This is not the case any longer. I still cycle an hour or so every day without exception. I’m hovering within a few pounds of my high school weight, and my grey hairs are outnumbered by brown by over a hundred to one.

Over the years, I’ve heard the saying that health is one of those things you never fully appreciate until it’s gone. While this is definitely true, most often it’s used in reference to physical health. But what happens when your mental health is compromised?  While we have made great strides in acknowledging the mental health epidemic that surrounds us, like brain injury, there are still societal stigmas that surround mental illness.

The pandemic has acted like Miracle-Gro for many who have mental health challenges. For as much as I wish that I was exempt, I have been pushed to the brink of mental health unwellness a couple of times since our world changed so drastically.

The first time was in the fall of 2020. The daily stress of living under the cloak of the pandemic had taken its toll on me. The endless drumbeat of mainstream media announcing deaths that measured in the hundreds of thousands literally brought me to tears. There was no vaccine available, and all felt dark. As most of 2020 is a blur, I am unable to tell you whether it was in September or October of last year that I hit an emotional bottom, but I can tell you what I felt. 

“I just can’t do this anymore,” my mind screamed at me for a few weeks. If I see one more Target or Walmart delivery person at my front door, I’m going to go out of my mind. Think I am being overly dramatic? Think again.  

I wanted to get off the pandemic bus. There was no suicidal ideation, no desire to exit life’s stage. That would come later. Rather, I was just weary of it all—wearier than I had ever been in my life. Weariness exacerbated my brain injury challenges, and it became difficult just being me. I felt like I had taken a half-decade step backwards in my recovery.

But it passed. 

Round two of my own mental struggles occurred just last month. A few back-to-back nights with horrific PTSD nightmares took its toll on me. At one point—sleep deprived, brain-injured, and utterly exhausted—I had one of my toughest post-TBI days. It was a dark day of stunning magnitude. For a very brief moment, I almost bought into the lie … the lie that things would always be dark and that I was destined to a life of forever struggles. It became too much to even think about. In my mind flicked the dreadful thought that I could no longer take it, that it was all too much, and that I wanted to get off this planet. I had had enough.  

The very thought of living for a few more decades, forever tormented by a damaged brain and a life-long path of PTSD, seemed simply too much to bear. In that moment of despair, I lost all perspective. 

I find it hard to even admit this out loud. As I pen my experience, I wonder if I will even share these words. If you find yourself reading them, then you know I followed through. 

The tough nights continued, troubled sleep bleeding into exhausted days. Never one to be overly fond of unnecessary suffering, I began using my EMDR app more mornings than not, in a quiet quest for relief from my self-torment. But, alas, PTSD has very strong claws. Into my soul, its talons cling tightly. 

I have no death wish. It is my hope to endure well into my 90s. I also knew with every fiber of my being that this sense of despair would eventually pass. 

“But it’s been over a decade,” whispered the PTSD into my ear. “I have you in my grips forever.”

Slowly the bad PTSD nights became less frequent. My mind started to heal and I felt my mental footing once again strengthen. Today, I am back to my normal brain-injured self, a marked improvement to where I was just last month. Go figure … I’ve come to a point in my recovery where being brain-injured isn’t the biggest problem in my life. 

As I’ve done over the years, I share the solutions that have worked in my life. If they work for me, they might just work for you. There are ALWAYS solutions. Even in our most troubled moments, we must remember this.

First and most important, suicide is a permanent solution to a temporary problem—and it’s really not a solution at all. If you find yourself in a place where oblivion looks appealing, please speak with someone. You are worthwhile, and your life has value.   

In my case, my wife, Sarah, is my trusted human. She is not my therapist, nor is she a doctor. She is someone I love and who loves me. We’ve been through so much together. We talk about anything—even tough topics like fragile mental health. When I tell her that I’ve had some dark thoughts, she knows exactly what I’m talking about. Sometimes she gives me a hug; other times she lets me know in no uncertain terms to suck it up, that we all are going through tough stuff right now.

The other lifesaver for me is to try to alter my perspective. While my mind might lie to me, saying things are going to be tough forever, the reality is that I have had many, many more good days than bad, and that every tough day—without exception—has passed. When times are difficult, just reminding myself that “this too shall pass,” can carry me through the next hour, or day.

It’s complicated. So much of my journey over the last decade has been two steps forward and one back. But the net/net over time always equals forward progress.

I really am okay—as okay as I can be. Again, if suicide looks like an option for you, I beg of you to speak with someone—kind of like I’m speaking with you here, today. You are not alone, though it may feel like it right now. Remember, it all passes—the good, the bad… and the dreadful. 

And me? I am going to ride the wheels off this life, living my best life possible. 

If you or someone you know is thinking about suicide—whether you are in crisis or not—please call or live chat the National Suicide Prevention Lifeline at 1-800-273-8255.

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[ARTICLE] Do somatosensory deficits predict efficacy of neurorehabilitation using neuromuscular electrical stimulation for moderate to severe motor paralysis of the upper limb in chronic stroke? – Full Text

Abstract

Background:

Various neurorehabilitation programs have been developed to promote recovery from motor impairment of upper extremities. However, the response of patients with chronic-phase stroke varies greatly. Prediction of the treatment response is important to provide appropriate and efficient rehabilitation. This study aimed to clarify whether clinical assessments, such as motor impairments and somatosensory deficits, before treatment could predict the treatment response in neurorehabilitation.

Methods:

The data from patients who underwent neurorehabilitation using closed-loop electromyography (EMG)-controlled neuromuscular electrical stimulation were retrospectively analyzed. A total of 66 patients with chronic-phase stroke with moderate to severe paralysis were included. The changes from baseline in the Fugl-Meyer Assessment–Upper Extremity (FMA-UE) and the Motor Activity Log-14 (MAL-14) of amount of use (AOU) and quality of movement (QOM) were used to assess treatment response, and multivariate logistic regression analysis was performed using the extracted candidate predictors, such as baseline clinical assessments, to identify predictors of FMA-UE and MAL-14 improvement.

Results:

FMA-UE and MAL-14 scores improved significantly after the intervention (FMA-UE p < 0.01, AOU p < 0.01, QOM p < 0.01). On multivariate logistic regression analysis, tactile sensory (p = 0.043) and hand function (p = 0.030) were both identified as significant predictors of FMA-UE improvement, tactile sensory (p = 0.047) was a significant predictor of AOU improvement, and hand function (p = 0.026) was a significant predictor of QOM improvement. The regression equations explained 71.2% of the variance in the improvement of FMA-UE, 69.7% of AOU, and 69.7% of QOM.

Conclusion:

Both motor and tactile sensory impairments predict improvement in motor function, tactile sensory impairment predicts improvement in the amount of paralytic hand use, and motor impairment predicts improvement in the quality of paralytic hand use following neurorehabilitation treatment in patients with moderate to severe paralysis in chronic-phase stroke. These findings may help select the appropriate treatment for patients with more severe paralysis and to maximize the treatment effect.

Introduction

Motor impairment of the upper extremities is one of the major symptoms in patients with stroke. Motor impairment occurs in approximately 70% or more of patients,^1,2 and various rehabilitation programs have been developed to promote recovery from motor impairment after stroke.³ In addition, with the recent development of neurorehabilitation, reports of interventions for residual motor paralysis in the chronic phase are increasing. However, the response to rehabilitation therapy of patients with chronic stroke varies greatly from patient to patient. Therefore, it is important to define an individualized rehabilitation treatment program according to the severity of stroke to provide appropriate and efficient rehabilitation. For this purpose, accurate prediction of the treatment response is necessary.

Somatosensory deficits, as well as motor impairments, are major symptoms in patients with stroke. Somatosensory deficits occur in more than 60% of patients⁴ and remain in about 40% of patients in the chronic phase.⁵ Along with motor impairments, somatosensory deficits affect motor functions and activities of daily living (ADLs), such as hand dexterity^6,7 and grasping and manipulating objects.^8–10 Although both motor and somatosensory functions are considered important predictors of motor function recovery in rehabilitation, many reports of patients with chronic stroke have focused only on motor function before intervention. In addition, reports using other clinical assessments, including of somatosensory deficits, are limited to mild to moderate paralysis.¹¹ Thus, whether somatosensory impairment has an impact on the recovery of motor function in neurorehabilitation of patients with chronic stroke who have more severe paralysis remains unclear.

In addition to recovery of motor function, increasing the AOU and improving the quality of movement (QOM) of the paralyzed hand are also major goals of neurorehabilitation.^12,13 It has been reported that baseline motor and somatosensory functions can both be used as predictors of the AOU and improvement in the QOM of the paralyzed hand by neurorehabilitation in subacute stroke patients.¹⁴ A report on chronic stroke patients also showed that both motor and somatosensory functions have a significant impact on prediction.¹⁵ However, similar to the recovery of motor function, reports on the AOU and QOM of the paralyzed hand are limited to mild to moderate paralysis.

This study aimed to determine the effects of clinical assessments of motor impairments and somatosensory deficits on the prediction of treatment response, such as recovery of motor impairments (increases in the amount of use and in the QOM of the paralyzed hand) in rehabilitation of patients with moderate to severe paralysis in chronic-phase stroke. We hypothesized that both pretreatment motor and somatosensory functions would be useful predictors of recovery of motor impairments (increased amount of use and improved QOM of the paralyzed hand).[…]

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[ARTICLE] Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis – Full Text

Abstract

We conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I², 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I², 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I², 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I², 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I², 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I², 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I², 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I², 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

Introduction

Stroke is a neurological disease whose sequelae are associated with physical disabilities¹. Gait limitations are noted in > 50% of patients with stroke, and these limitations may be attributable to motor or proprioceptive impairment, spasticity, and balancing problems². Impaired gait function after stroke strongly contributes to overall patient disability and increases the risk of falls³. Weakness in the ankle dorsiflexors is frequently observed after a stroke, which is one of the major factors hindering gait function⁴. Because of ankle dorsiflexor weakness, bodily instability occurs during the stance phase of gait, and the foot is dragged along the ground during the swing phase⁵. With this instability and foot dragging, walking becomes unsafe⁵. In clinical practice, ankle–foot orthoses (AFOs) are recommended for improving the gait limitations of patients. However, some clinicians have reported that AFOs can hinder the natural walking patterns of patients with stroke or hemiplegia^6,7,8.

Some previously published systematic reviews or meta-analyses have assessed the effect of AFO on gait function in patients with stroke. In 2013, Tyson et al. found that AFO was effective in improving gait function but only evaluated the kinematics and oxygen consumption⁹. In 2018, Daryabor et al. reported that any type of AFO could improve foot drop but did not proceed with statistical analysis¹⁰. In 2020, Darybor et al., in a systematic review, reported that AFO could improve walking energy costs in patients with stroke in the short term¹¹, and Shahabi et al. reported that AFO could improve walking speed in patients with stroke, but other gait-related factors were not analyzed¹².

In our meta-analysis for a detailed evaluation of the effectiveness of AFO, we attempted to examine various gait-related variables, including walking speed, cadence, step length, stride length, stride time, Timed up-and-go test (TUG), functional ambulation category (FAC), body sway, ankle sagittal plane angle at initial contact, knee sagittal plane angle at toe-off, and hip sagittal plane angle at toe-off.[…]

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[Editorial] Sex and gender in physiotherapy research

Evidence from preclinical and clinical research demonstrates that sex and gender can impact disease presentation, prognosis and response to treatment.¹ Sex refers to the biological attributes that define humans as male, female, or intersex, including chromosomes, gene expression, hormone levels and reproductive anatomy.² Gender refers to the socially constructed norms, behaviours and roles of girls, women, boys, men and gender-diverse people.² Gender is a continuum and not a static concept; gender can change over time. The mechanisms by which sex and gender impact health are complex and not yet fully understood, but include an interaction between epigenetic, genetic, environmental, social and behavioural factors, among others.³

Disaggregation of data by sex and/or gender helps to unpack the complex biological and psychosocial interactions that might influence disease presentation and progression. In a clinical setting, unpacking this interaction helps us to screen for disease more effectively, and choose the best evidence-based treatment course for patients. Differences between females/women and males/men have already been identified across several disciplines of physiotherapy, including neurology,⁴ musculoskeletal⁵ and cardiopulmonary.⁶

In clinical research, recruiting sex-diverse and gender-diverse populations is essential to enable disaggregation of data. Historically, health data have been collected on males and generalised to females.⁷ Such patterns are still observed in certain health fields such as pain research,⁸ exercise science⁹ and pharmaceutical trials.¹⁰ To remedy this, the governmental funding bodies of many countries have mandated equality in the collection, analysis and reporting of sex-specific and gender-specific health. It is still debateable whether or not these policies translate into research, so that the complex biological and psychosocial interactions of sex and gender with health can be unpacked.⁹ However, the first step in this process for clinical research must be the recruitment of sex-diverse and gender-diverse populations.

It is currently unknown whether physiotherapy research trials recruit sex-diverse and gender-diverse populations, or whether data are reported as sex and/or gender disaggregated. To gauge the current but pre-pandemic status of sex and gender reporting in physiotherapy trials, the reports of 250 randomised trials published in 2019 were randomly sampled from among those on the Physiotherapy Evidence Database (PEDro). Among these, four trial reports provided no information or conflicting information on sex and gender; these were not analysed further. Fifty-five trials studied females only or males only, and the remaining 191 trials included some degree of sex or gender diversity among the participants.

In the 55 trials that studied females only or males only, the minority were related to conditions that are female-specific (breast cancer n = 6, menopause n = 5, pregnancy n = 2, puberty n = 1) or male-specific (prostatitis n = 1). The other 39 trials involved participants with female sex only (n = 27), male sex only (n = 11) or female gender only (n = 1), even though the condition being investigated affects both females and males. Of these 39 trials, only 17 studies provided a rationale as to why they were investigating a single sex or gender; the remaining 22 studies failed to provide a rationale. Interestingly, the high proportion of female-only trials is in contrast to what has been seen in other health disciplines, where trials are more likely to be male-only⁹ or have a higher proportion of male participant inclusion.^11,12

Sex and gender diversity in physiotherapy research

The 191 trials with sex/gender diversity among participants included data on 19,390 participants. Nineteen trials, involving 1,049 participants, failed to specify the male/female split and so could not be included in the analysis of sex or gender ratio. For the remaining trials, the percentage of female participants was calculated. Among trials reporting the sex of participants, the mean percentage of female participants was 50% (SD 9), indicating that these trials typically had roughly equal participation of males and females. Among trials reporting the gender of participants, the mean percentage of female participants was 55% (SD 22). While this result again indicates roughly equal participation of males and females overall, the larger SD indicates that more trials would have had substantial imbalance. Also, no trials reported including any gender-diverse participants beyond binary males or females. Population-based studies estimate the prevalence of gender nonconformity to occur in up to 4.6% of the general population.¹³ That no trials included gender-nonconforming participants highlights a gap in current physiotherapy research. Previous research has identified that LGBTIQ+ individuals often have uncomfortable experiences with physiotherapists and physiotherapists lack knowledge specific to the needs of these individuals.¹⁴ These findings may reflect: poor physiotherapist training on gender diversity and inclusion; poor participation or recruitment of gender-diverse participants; and/or poor data collection and reporting regarding gender in research. It also indicates some deficiency in the evidence that physiotherapists have with which to tailor their clinical decision making to individual patients.

When describing demographic data, sex was used as a descriptor in 132 trials and gender as a descriptor in 59 trials. Eleven trials conflated sex and gender, using the terms interchangeably throughout the manuscript. Twenty-seven trials did not use either term, but instead provided a number or percentage of males and/or females (n/% of males/females n = 14, n/% of males n = 7, n/% of females n = 6). No trial included a definition of either sex or gender, or stated why one variable was chosen over the other to be collected from participants.

Sex and gender disaggregation in physiotherapy research

None of the 191 trials disaggregated their data by sex or gender. Some trials used statistical methods to account for potential sex or gender differences. Twenty trials used statistical adjustments for sex differences (18% of trials reporting the sex of participants) and five trials used statistical adjustments for gender differences (9% of trials reporting the gender of participants). While statistical adjustment for demographic variables is helpful, adjusting for sex and gender is insufficient in health research. Statistical adjustments do not show where specific differences between sex and gender exist, and understanding these differences is vital for clinical decision making.

Recommendations for future research

This analysis of physiotherapy trials has highlighted strengths and weaknesses in that research. The equal recruitment of males and females by sex and gender is encouraging and is something our profession should continue to strive to do in research. However, there was a lack of inclusion of gender non-conforming participants. Future physiotherapy research should look to recruit even or representative numbers of women and men (by gender), and also include gender-nonconforming participants.

Sex and gender were often used interchangeably, and no studies provided definitions of sex or gender, or a description of why either sex or gender was chosen over the other as a demographic characteristic. Researchers are encouraged to consider sex and gender variables in the planning stage of trials, and determine which characteristic may be more important to the primary research aim. Recruitment of participants by either sex or gender, or even both, should relate to any hypotheses around whether these characteristics may influence the outcomes of the trial. Gendered Innovations in Science, Health & Medicine, Engineering, and Environment¹⁵ provides comprehensive resources for health researchers to plan for analysing sex and gender differences, and the Canadian Institutes of Health Research offer free online training courses to assist researchers in appreciating the differences between and across sexes and genders.¹⁶

While some of the included trials statistically adjusted for sex or gender variables, no trials disaggregated their data according to sex or gender. Disaggregating data in this way ensures that differences in outcomes can be observed between and across sexes and genders, which is vital information for clinicians to more effectively screen for disease and choose the best evidence-based treatment options for presenting patients. However, we recognise that analysis of subgroups by sex or gender results in a loss of statistical power, which is an important consideration in clinical trials. Therefore, we encourage researchers to run analyses to determine possible interaction effects due to sex and/or gender, preserving statistical power, and present disaggregated data where such an interaction effect exists.

If a sex or gender effect is identified, it is important to determine whether it is a consistent finding. This could be assessed in future replications of the study. It could also be assessed easily in existing similar trials if they publish the individual participant data with sex/gender data. See, for example, Table 4 in the eAddenda of the trial by Scheer et al in this issue.¹⁷

The Journal of Physiotherapy encourages researchers to consider whether sex and/or gender may moderate the effects of the intervention. Where it is plausible that sex and/or gender may be treatment effect moderators, researchers should plan, a priori, to investigate this using appropriate analyses (eg, test for an interaction effect based on sex and/or gender). If a significant interaction is found, disaggregated data should be reported. We also encourage authors to adopt this approach when submitting research to other journals.

References

1 A.J. McGregor, et al.Biol Sex Differ, 7 (2016), pp. 61-72

2 Canadian Institutes of Health ResearchWhat is gender? What is sex?https://cihr-irsc.gc.ca/e/48642.html, Accessed 28th Jul 2021Google Scholar

3 Z. Wainer, et al.Med J Aust, 212 (2020), pp. 57-62 Download PDFView Record in Scopus

4 R.A. Haast, et al.J Cereb Blood Flow Metab, 32 (2012), pp. 2100-2107 Download PDFCrossRefView Record in Scopus

5 S.Z. George, et al.J Orthop Sports Phys Ther, 36 (2006), pp. 354-363 Download PDFCrossRefView Record in Scopus

6 J.A. Krishnan, et al.Arch Intern Med, 161 (2001), pp. 1660-1668 Download PDFView Record in Scopus

7 C.C. PerezInvisible women: Exposing data bias in a world designed for menRandom House (2019)Google Scholar

8 J.S. MogilNat Rev Neurosci, 21 (2020), pp. 353-365CrossRefView Record in Scopus

9 J.T. Costello, et al.Eur J Sport Sci, 14 (2014), pp. 847-851CrossRefView Record in Scopus

10 S.S. Richardson, et al.Proc Natl Acad Sci, 112 (2015), pp. 13419-13420 Download PDFCrossRefView Record in Scopus

11 V.S. Prakash, et al.J Womens Health, 27 (2018), pp. 1342-1348CrossRefView Record in Scopus

12 S. Feldman, et al.JAMA Netw Open, 2 (2019), Article e196700 Download PDFCrossRefView Record in Scopus

13 L. Kuyper, et al.Arch Sex Behav, 43 (2014), pp. 377-385CrossRefView Record in Scopus

14 M.H. Ross, et al.J Physiother, 65 (2019), pp. 99-105ArticleDownload PDFView Record in Scopus

15 Gendered Innovations http://genderedinnovations.stanford.edu/index.html, Accessed 9th Aug 2021Google Scholar

16 Canadian Institutes of HealthSex and Gender Training Moduleshttps://www.cihr-irsc-igh-isfh.ca/, Accessed 9th Aug 2021Google Scholar17A. Scheer, et al.J Physiother, 67 (2021)XXX–XXX

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[BLOG POST] Home After a Stroke: Reducing Spasticity Without Needles

Many stroke survivors suffer with painful muscle spasticity.  For example, the photo shows that spasticity can force stroke survivors to point their toes every time they straighten their knee to take a step.  Spasticity has been treated with Botox shots and repeatedly sticking needles into the painful area (needling).  

Researchers found a less painful way to treat spasticity (1). Both the experimental group (n=25) and control group (n=25) got 30 minutes of exercise followed by 30 minutes of wearing a TENS unit that provided relaxing muscle stimulation.  The experimental group then had their ankles taped in the bent position to stop them from pointing their foot.  The tape was replaced every day.  Treatment was given 5 days a week for 6 weeks.

After treatment both groups showed reduced ankle spasticity and faster gait.  However, the group that also had their ankle taped improved significantly more (p < 0.05).  Creating a less painful way to treat a painful condition would be my preference.  homeafterstroke.blogspot.com

1. Tae-Sung In, Jin-Wae Jung, Kyoung-Sim Jung, Hwi-Young Cho. Effectiveness of transcutaneous electrical nerve stimulation with taping for stroke rehabilitation.  Biomed Research International. 2021; Article ID 9912094. doi:10.1155/2021/99112094.

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[VIDEO] Gait training with Lokomat – Product Presentation – YouTube

The Lokomat is the world‘s leading robotic medical device that provides highly repetitive and the most physiological gait training – especially to severely impaired patients.

Advantages of Lokomat Therapy:

1. Effective Gait Training Robot-assisted therapy enables effective and intensive training and ensures the optimal exploitation of neuroplasticity and recovery potential.

2. Most Physiological Gait The physiological gait pattern is ensured by the individually adjustable exoskeleton combined with the patented dynamic body weight support system.

3. Optimal Patient Challenge During rehabilitation, patients need to be challenged at and beyond their individual capabilities. Speed, loading and robotic support can be adjusted to optimally shape the intensity of the therapy.

4. Increased Efficiency The Lokomat allows therapists to focus on the patient and the actual therapy. It enhances staff efficiency and safety, leading to higher training intensity, more treatments per therapist and consistent, superior patient care.

Learn more about Lokomat here: https://bit.ly/3bwZhCc.

[Abstract + References] An Upper Limb Rehabilitation Exercise Status Identification System Based on Machine Learning and IoT

Abstract

Rapid increase in stroke incidence coupled with the high cost and limited availability of healthcare professionals has made stroke rehabilitation process inaccessible to many patients in developing countries. Stroke rehabilitation exercises are of critical importance in ensuring quick and lasting recovery. A machine learning-based system that can automatically identify the completion status of upper limb rehabilitation exercises is presented in this study. Proposed system can detect completion status of twelve hand and arm rehabilitation exercises: six hand, four forearm and two shoulder exercises. Accelerometers record the movement of the upper limb part being exercised in the form of data sequences. Six curve-fitting-based machine learning model types are trained and evaluated for their effectiveness in modelling these sequences. This resulted in a total of 216 models (i.e. 12 exercises × 3 axes of motion × 6 model types) being evaluated on three performance measures: SSE, RMSE and R². Best-performing model for each exercise is plugged into the proposed exercise completion status identification algorithm. System effectiveness is validated using four performance measures: accuracy, precision, recall and F1-score. Proposed system is demonstrated to be capable of detecting the exercise completion status with up to 90% accuracy. The proposed system is connected to cloud via an IoT interface with a dashboard type visualization system that allows for the healthcare professionals to remotely monitor the progress for each patient as well as carry out offline analysis. A game interaction interface is also provided to enable interaction with video games, helping in higher patient engagement while performing exercises.

References

1. 1.Pandian, J.D.; Sudhan, P.: Stroke epidemiology and stroke care services in India. J. Stroke 15, 128–134 (2013)Article Google Scholar 
2. 2.Feigin, V.L.; Lawes, C.M.; Bennett, D.A.; Barker-Collo, S.L.; Parag, V.: Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 8, 355–369 (2009). https://doi.org/10.1016/S1474-4422(09)70025-0Article Google Scholar 
3. 3.Giroud, M.; Jacquin, A.; Béjot, Y.: The worldwide landscape of stroke in the 21st century. Lancet 383, 195–197 (2014). https://doi.org/10.1016/S0140-6736(13)62077-2Article Google Scholar 
4. 4.Banerjee, T.K.; Das, S.K.: Fifty years of stroke researches in India. Ann. Indian Acad. Neurol. 19, 1–8 (2016). https://doi.org/10.4103/0972-2327.168631Article Google Scholar 
5. 5.Ferri, C.P.; Schoenborn, C.; Kalra, L.; Acosta, D.; Guerra, M.; Huang, Y.; Jacob, K.S.; Rodriguez, J.J.L.; Salas, A.; Sosa, A.L.; Williams, J.D.: Prevalence of stroke and related burden among older people living in Latin America, India and China. J. Neurol. Neurosurg. Psychiatry 82, 1074–1082 (2011)Article Google Scholar 
6. 6.Kamalakannan, S.; Venkata, M.G.; Prost, A.; Pant, S.N.H.; Chitalurri, N.; Goenka, S.; Kuper, H.: Rehabilitation needs of stroke survivors after discharge from hospital in India. Arch. Phys. Med. Rehabil. 96, 1526–1532 (2016)Article Google Scholar 
7. 7.Khan, F.R.; Vijesh, P.V.; Rahool, S.; Radha, A.A.; Kurupath, S.S.R.: Physiotherapy practice in stroke rehabilitation: a cross-sectional survey of physiotherapists in the state of Kerala, India. Top. Stroke Rehabil. 19, 405–410 (2012)Article Google Scholar 
8. 8.Huang, V.S.; Krakauer, J.W.: Robotic neurorehabilitation: a computational motor learning perspective. J. Neuroeng. Rehabil. 6, 5 (2009)Article Google Scholar 
9. 9.Megalingam, R.K.; Apuroop, K.G.S.; Boddupalli, S.: Single DoF hand orthosis for rehabilitation of stroke and SCI patients. In: International Conference on Materials, Alloys and Experimental Mechanics (ICMAEM-2017). pp. 1–6 (2017)
10. 10.Megalingam, R.K.; Baburaj, A.M.; Mattathil, A.; Hari, A.; Sreekanthan, K.; Koppaka, G.S.A.: Low cost hand orthotic device to improve hand function of stroke patients. Technol. Disabil. 30, 185–197 (2019). https://doi.org/10.3233/TAD-180197Article Google Scholar 

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[WEB] How Listening To Music Benefits Your Brain

It’s long been said that music is mind medicine. Advances in neuroscience and brain imaging are revealing what’s happening in the brain to prove this true.

Research shows that listening to music can reduce anxiety, depression, blood pressure, and pain as well as improve sleep quality, mood, memory, increase some cognitive functions, enhance learning and concentration, and ward off the effects of brain aging. Music is so good for your brain because it is one of the few activities that stimulates your whole brain. Because music is structural, mathematical, and architectural based on relationships between one note and the next, it’s a total brain workout.

When you listen to music, much more is happening in your body than simple auditory processing. A recent imaging study found that music activated auditory, motor, and limbic brain regions no matter whether people were listening to Vivaldi or the Beatles. Research determined that the motor areas process rhythm, the auditory areas process sound, while the limbic regions are associated with emotions.

Music Reduces Stress and Depression

A meta-analysis of 400 studies validated the many health benefits of listening to music including lowering of the stress hormone, cortisol. In one study reviewed, patients about to undergo surgery who listened to music had less anxiety and lower cortisol levels than people who had taken drugs. The analysis determined that music had documented positive effects on brain chemistry and associated mental and physical health benefits in four areas:

• Lift mood.
• Stress reduction.
• Boosting immunity.
• Aids social bonding.

Listening to music triggers the brain’s nucleus accumbens, responsible for releasing the feel-good neurochemical dopamine, which is an integral part of the pleasure-reward and motivational systems and plays a critical role in learning. Higher dopamine levels improve concentration, boost mood, and enhance memory. Dopamine is the chemical responsible for the yummy feelings you get from eating chocolate, having an orgasm, or achieving a runner’s high.

Science shows that music can help alleviate depression and help a person feel more hopeful and in control of their life. There is even evidence that listening to music can aid in rewiring trauma in the brain. Playing music with others or enjoying live music gets the brain hormone oxytocin flowing increasing feelings of connectedness, trust, and social bonding.

One study found that listening to music reduced chronic pain by up to 21 percent and depression by up to 25 percent, and other research showed that music therapy significantly improved depressive symptoms.

How Music Enhances Cognition

Music has the power to improve specific higher brain functions and really can make you smarter.  In particular, science has shown that listening to music enhances reading and literacy skills, reasoning, and mathematical abilities.

In studies with people who listen to and play a lot of music – professional musicians’, brain scans reveal noticeably more symmetry, larger areas of the brain responsible for motor control, auditory processing, and spatial coordination, and more developed callosum. The corpus callosum is the band of nerve fibers that connects the two sides of the brain to each other, allowing communication.

Learning to play a musical instrument is one of the best things you can do for your brain, at any age. One study showed that just four years of music lessons in youth improved certain brain functions in tests 40 years later!

However, if you’re not a musician, just listening to music for enjoyment has positive effects too. Seniors who listened to specific types of music showed increased processing speed and improved episodic memory. Other tests revealed that listening to background music can increase productivity and enhance cognitive performance and creativity on some tasks.

Be careful, though. The type of music and task matter here. Certain music, like popular tunes with words, asks your brain to multi-task and can interfere with reading comprehension and information processing and is best used during breaks.

Music Boosts Memory

Your brain is hard-wired to connect music with long-term memory. Specific brain regions linked to autobiographical and episodic memories and emotions are activated by hearing familiar music. Listening to music has been shown to significantly improve working memory in older adults.

Even for persons with Alzheimer’s or severe dementia, music can tap deep into emotional recall. Personal music favorites can often calm chaotic brain activity and enable the listener to focus on the present moment and regain a connection to others. Research showed that scores on memory tests of Alzheimer’s patients improved after they listened to classical music.

Science has also confirmed that it’s possible to use music to help a young brain retain information and enhance learning.

Giving Your Brain A Musical Boost

Research is showing  that music therapy can improve health outcomes in a wide variety of populations, from premature infants and children with autism, ADHD or developmental and learning disabilities, to people with emotional trauma, substance abuse problems, brain injuries, physical disabilities, acute and chronic pain, depression, Parkinson’s disease, and more.

Science has recorded measurable changes in the brain following music therapy. Music therapy can involve working with a trained professional or completing a self-paced online program. You can also achieve benefits on your own by introducing children to music.

About a decade ago, I included music therapy from Advanced Brain Technologies as an integral part of the rehabilitation tools I used to heal from a serious brain injury. I still enjoy listening to their music today to relax and facilitate my meditation practice. Companies like Advanced Brain Technologies allow anybody to use music easily to improve their brain and life.

Advanced Brain Technology’s The Listening Program is a sound based program using the science of music to better your brain. The Listening Program trains your brain to improve how you perceive, process and respond to all of the sensory information your brain is bombarded with every day.

For more than a decade, The Listening Program has helped hundreds of thousands of children and adults with cognitive, behavioral, and emotional difficulties. People have used The Listening Program to think, speak, read and write better, prepare for college entrance exams and athletic events, improve productivity, learn new languages and musical instruments, and just to relax and sleep better. Learn more here.

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[Abstract] Music in epilepsy: Predicting the effects of the unpredictable

Abstract

Epilepsy is the most common serious neurological disorder in the world. Despite medical and surgical treatment, many individuals continue to have seizures, suggesting adjunctive management strategies are required. Promising effects of daily listening to Mozart K.448 on reducing seizure frequency in individuals with epilepsy have been demonstrated. In our recent randomized control study, we reported the positive effect of daily listening to Mozart K.448 on reducing seizures compared to daily listening to a control piece with an identical power spectrum to the Mozart piece yet devoid of rhythmic structure. Despite the promising effect of listening to Mozart K.448 on reducing seizure in individuals with epilepsy, the mechanism(s) underlying such an effect is largely unknown. In this paper, we specifically review how auditory stimulation alters brain dynamics, in addition to computational approaches to define the structural features of classical music, to then propose a plausible mechanism for the underlying anti-convulsant effects of listening to Mozart K.448. We review the evidence demonstrating that some Mozart pieces in addition to compositions from other composers such as Joplin contain less predictable rhythmic structure in comparison with other composers such as Beethoven. We propose through both entrainment and 1/f resonance mechanisms that listening to musical pieces containing the least predictable rhythmic structure, might reduce the self similarity of brain activity which in turn modulates low frequency power, situating the brain in a more “noise like” state and away from brain dynamics that can lead to seizures.

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