Posts Tagged Exercise

[OPINION ARTICLE] Enhancing Our Lives with Immersive Virtual Reality – Full Text

Summary

Virtual reality (VR) started about 50 years ago in a form we would recognize today [stereo head-mounted display (HMD), head tracking, computer graphics generated images] – although the hardware was completely different. In the 1980s and 1990s, VR emerged again based on a different generation of hardware (e.g., CRT displays rather than vector refresh, electromagnetic tracking instead of mechanical). This reached the attention of the public, and VR was hailed by many engineers, scientists, celebrities, and business people as the beginning of a new era, when VR would soon change the world for the better. Then, VR disappeared from public view and was rumored to be “dead.” In the intervening 25 years a huge amount of research has nevertheless been carried out across a vast range of applications – from medicine to business, from psychotherapy to industry, from sports to travel. Scientists, engineers, and people working in industry carried on with their research and applications using and exploring different forms of VR, not knowing that actually the topic had already passed away.

The purpose of this article is to survey a range of VR applications where there is some evidence for, or at least debate about, its utility, mainly based on publications in peer-reviewed journals. Of course not every type of application has been covered, nor every scientific paper (about 186,000 papers in Google Scholar): in particular, in this review we have not covered applications in psychological or medical rehabilitation. The objective is that the reader becomes aware of what has been accomplished in VR, where the evidence is weaker or stronger, and what can be done. We start in Section 1 with an outline of what VR is and the major conceptual framework used to understand what happens when people experience it – the concept of “presence.” In Section 2, we review some areas where VR has been used in science – mostly psychology and neuroscience, the area of scientific visualization, and some remarks about its use in education and surgical training. In Section 3, we discuss how VR has been used in sports and exercise. In Section 4, we survey applications in social psychology and related areas – how VR has been used to throw light on some social phenomena, and how it can be used to tackle experimentally areas that cannot be studied experimentally in real life. We conclude with how it has been used in the preservation of and access to cultural heritage. In Section 5, we present the domain of moral behavior, including an example of how it might be used to train professionals such as medical doctors when confronting serious dilemmas with patients. In Section 6, we consider how VR has been and might be used in various aspects of travel, collaboration, and industry. In Section 7, we consider mainly the use of VR in news presentation and also discuss different types of VR. In the concluding Section 8, we briefly consider new ideas that have recently emerged – an impossible task since during the short time we have written this page even newer ideas have emerged! And, we conclude with some general considerations and speculations.

Throughout and wherever possible we have stressed novel applications and approaches and how the real power of VR is not necessarily to produce a faithful reproduction of “reality” but rather that it offers the possibility to step outside of the normal bounds of reality and realize goals in a totally new and unexpected way. We hope that our article will provoke readers to think as paradigm changers, and advance VR to realize different worlds that might have a positive impact on the lives of millions of people worldwide, and maybe even help a little in saving the planet.

Continue —> Frontiers | Enhancing Our Lives with Immersive Virtual Reality | Virtual Environments

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[WEB SITE] Brain Derived Neurotrophic Factor (BDNF) and Exercise

Brain Derived Neurotrophic Factor (BDNF) has been referred to as a fertilizer for your brain. Find out how exercise can help you to get more of it.

Brain Derived Neurotrophic Factor (BDNF) has been referred to as a fertilizer for your brain. It is a substance that is found in your brain and helps to maintain the life of your brain cells, as well as grow new ones. You’ve probably heard all about ‘neuroplasticity’ and how we used to think our brains, once adult, were like a lump of concrete – unable to change and grow. Scientists now believe our brains are more like plastic – able to adapt, grow and change depending on what we do with them. BDNF is widely accepted as being a key player in this ‘plastic’ ability of the brain – its presence has been shown to make brain cells in petri dishes sprout new branches (necessary activity for a cell to make new connections!).

Low levels of BDNF have been associated with depression, anxiety, poor memory and brain degeneration as seen in conditions such as Alzheimer’s and dementia.

 

Why would you want more BDNF?

  • Improved learning and memory
  • May trigger the production of more serotonin (hello happy feelings!)
  • Helps with new skill acquisition
  • Improved mood (exercise increases BDNF as much or even more than taking antidepressants does)
  • Lower rates of Alzheimer’s disease and dementia in older age may be related to higher levels of BDNF.

Are you getting the picture? Better mood, better mental performance, healthier brain as you age…

How do you get more BDNF?

One word: STIMULATION.  Stimulation of your brain and all its cells can come in many forms. Of course, traditional brain exercise has been thought of as activities such as cross words and Sudoku (which are definitely good!) but here’s another aspect you can add to the list: exercise. As little as 30 minutes of jogging on three days a week has been shown to improve brain functioning, but even better gains have been suggested with more complex activity, which requires you to build or acquire a skill. An example of this is exercise that challenges your balance or thinking, like rock climbing or dancing.

The ultimate brain booster? A bit of aerobic exercise (at least ten minutes) to increase levels of BDNF and other neurotransmitters, as well as all those other wonderful benefits of aerobic exercise, followed by a skill-based exercise to get the new brain cells creating new networks with each other.

TIP: Want to maximize the increased learning capacity of your brain? Don’t try to learn something while exercising (stop taking your study notes to the spin bike!) – blood flow increases to the brain post-exercise, while BDNF levels are still increased, meaning immediately after exercise is the perfect time to take in new information. Put on that French language podcast on the way home from the gym…

 

EXERCISE RIGHT’S FIVE FAVOURITE WAYS TO MOVE FOR MORE BDNF

  • 1. Indoor rock-climbing – especially if you actively commute to the rock wall!
  • 2. Trail running – something with twists, turns and great views is awesome
  • 3. Dancing – where you’re learning new moves and also working your fitness
  • 4. Functional movement – wait until the after school rush has finished then go check out (and play on) your nearest playground – think monkey bars, crawling through tunnels and balancing on beams
  • 5. Team sports – they require you to be getting great aerobic gains by running around, whilst also working your brain in terms of strategy and quick thinking

References:

Aisen, P. S. (2014). Serum brain-derived neurotrophic factor and the risk for dementia. JAMA, 311(16), 1684-1685. doi: 10.1001/jama.2014.3120

Binder, Devin K., & Scharfman, Helen E. (2004). Brain-derived Neurotrophic Factor. Growth factors (Chur, Switzerland), 22(3), 123-131. doi: 10.1080/08977190410001723308

Hagerman, Eric, & Ratey, Dr John J. (2010). Spark! How Exercise Will Improve the Performance of Your Brain (Kindle Edition ed.).

Source: Brain Derived Neurotrophic Factor (BDNF) and Exercise

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[ARTICLE] A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training – Full Text

Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions.

Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices.

A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover.

On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

Neurologic rehabilitation has been testing a motor learning theory for the past quarter century that may be wearing thin in terms of leading to more robust evidence-based practices. The theory has become a mantra for the field that goes like this. Repetitive practice of increasingly challenging task-related activities assisted by a therapist in an adequate dose will lead to gains in motor skills, mostly restricted to what was trained, via mechanisms of activity-dependent induction of molecular, cellular, synaptic, and structural plasticity within spared neural ensembles and networks.

This theory has led to a range of evidence-based therapies, as well as to caricatures of the mantra (eg, a therapist says to patient, “Do those plasticity reps!”). A mantra can become too automatic, no longer apt to be reexamined as a testable theory. A recent Cochrane review of upper extremity stroke rehabilitation found “adequately powered, high-quality randomized clinical trials (RCTs) that confirmed the benefit of constraint-induced therapy paradigms, mental practice, mirror therapy, virtual reality paradigms, and a high dose of repetitive task practice.”1 The review also found positive RCT evidence for other practice protocols. However, they concluded, no one strategy was clearly better than another to improve functional use of the arm and hand. The ICARE trial2 for the upper extremity after stroke found that both a state-of-the-art Accelerated Skill Acquisition Program (motor learning plus motivational and psychological support strategy) compared to motor learning-based occupational therapy for 30 hours over 10 weeks led to a 70% increase in speed on the Wolf Motor Function Test, but so did usual care that averaged only 11 hours of formal but uncharacterized therapy. In this well-designed RCT, the investigators found no apparent effect of either the dose or content of therapy. Did dose and content really differ enough to reveal more than equivalence, or is the motor-learning mantra in need of repair?

Walking trials after stroke and spinal cord injury,38 such as robot-assisted stepping and body weight-supported treadmill training (BWSTT), were conceived as adhering to the task-oriented practice mantra. But they too have not improved outcomes more than conventional over-ground physical therapy. Indeed, the absolute gains in primary outcomes for moderate to severely impaired hemiplegic participants after BWSTT and other therapies have been in the range of only 0.12 to 0.22 m/s for fastest walking speed and 50 to 75 m for 6-minute walking distance after 12 to 36 training sessions over 4 to 12 weeks.3,9 These 15% to 25% increases are just as disappointing when comparing gains in those who start out at a speed of <0.4 m/s compared to >0.4 to 0.8 m/s.3

Has mantra-oriented training reached an unanticipated plateau due to inherent limitations? Clearly, if not enough residual sensorimotor neural substrate is available for training-induced adaptation or for behavioral compensation, more training may only fail. Perhaps, however, investigators need to reconsider the theoretical basis for the mantra, that is, whether they have been offering all of the necessary components of task-related practice, such as enough progressively difficult practice goals, the best context and environment for training, the behavioral training that motivates compliance and carryover of practice beyond the sessions of formal training, and blending in other physical activities such as strengthening and fitness exercise that also augment practice-related neural plasticity? These questions point to new directions for research….

Continue —> A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training – Mar 01, 2017

Figure 1. Components of a Rehabilitation-Internet-of-Things: wireless chargers for sensors (1), ankle accelerometers with gyroscopes (2) and Android phone (3) to monitor walking and cycling, and a force sensor (4) in line with a stretch band (5) to monitor resistance exercises.

 

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[WEB SITE] Exercise Prescription Software – Physical Therapy Web

Any tool that can help people be more active and involved in their own rehabilitation is worthwhile. An increase in patient compliance can be achieved by making exercise programs easier to adhere to. Clear descriptions of how to perform exercises correctly is also critical to the success of any exercise program. Here is a list of software applications that allow physical therapists to create specific exercise programs for their patients. The list is not complete. If you know of a product that should be included or if you’d like to have your exercise prescription software reviewed, please let us know.

exercise prescription software - diagram

By Udrekeli [Public domain], via Wikimedia Commons

 

Arena Health Systems: Creators of Phys-X software

“Phys-X Advanced includes over 900 of the most often prescribed range of motion, stabilization and strengthening exercises (categories listed below) and includes Full Color Photographs for most exercises! Each exercise includes an illustration and specific easy to follow instructions that allow on-the-fly modification. The exercises can even be printed with Spanish instructions.”

BPM Rx: Exercise prescription for health and fitness professionals

“Whether you’re a personal trainer or physical therapist, exercise prescription is your life. BPM Rx is the ultimate PT Software that allows you to craft stunning exercise handouts that will inspire like never before! Try it out-the first week is free!”

BioEx Systems Inc.: Easy to use home exercise database

“Exercise, Fitness Assessment, Nutrition and Management software for Physical Therapists, Personal Trainers, Dietitians, Nutritionists and other professionals. Windows based software.”

Exercise Prescriber: Provide home exercises and information advice

“…an essential clinical tool for health professionals who routinely provide home exercises and information advice for their clients.”

Exercise Pro Live : Personalized Video and Printed Exercise Programs for Rehabilitation and Fitness

“…designed by physical therapists and other fitness professionals to provide video exercise programs with clear exercise instructions, proper exercise form and improved compliance and communication between health professionals and their clients.”

HEP2go.com: HEP for rehab pro’s

“For rehabilitation professionals such as physical therapists, occupational therapists, athletic trainers, etc. to create home exercise programs for patients and or clients.”

i-HEP.com: iHomeExerciseProgram

“Innovative Video + Web-based Platform = Better HEP Management & Better Patient Education

Mavenlive: Intelligent exercise prescription, customizable images, and documentation (free-trial available)

“Using Mavenlive will benefit you not only from a clinical standpoint, but it will help you improve relationships with your patients and your referral sources. Mavenlive clients tell us that physicians love getting professional correspondence. “

myclinicspace: High quality image and video exercises for patient rehabilitation

“myclinicspace is an online exercise prescription package for health professionals.”

MyPhysioRehab: A global community of therapists helping to speed your recovery (free-demo available)

“MyPhysioRehab allows you as a health professional to provide your patients with an injury profile and a rehabilitation programme to aid rapid recovery.”

PacPacs+: Online Rehabilitation Exercise and Client Management

“Manage your patient aftercare. Prescribe rehabilitation routines with multi-angle videos. Track consultation history and make notes for future sessions.”

Patient Care HEP: MedBridge

“Patient Care HEP is the fast, easy, comprehensive, and engaging home exercise program for rehabilitation professionals.”

Physiotec: Exercise and patient education database software

“Physiotec offers a health and fitness software with exercise programs for physiotherapy, rehabilitation and therapeutic exercises and distributes it across Canada, United-States (USA) and United-Kingdoms.”

PTX – PhysioTherapy eXercises: Create custom programs or choose ready made programs

“A free tool to create exercise programs for people with injuries and disabilities”

PhysioTools Software: Comprehensive and easy to use exercise software

“Exercise software for health and fitness professionals to print and email over 15,000 exercises for rehabilitation, physiotherapy, sports and education”

Physioview: Features professionally produced photographs, audio, video and text

“Physioview redefines the home exercise program from the fundamental to highly customized creation of rehabilitation exercise protocols. “

Physitrack: A mobile phone exclusively for practitioners

“Provides Physical Therapists with the ability to prescribe exercises, send messages to their patients”

The Rehab Lab: Online Exercise Prescription Software

“The Rehab Lab is an online exercise prescription software application that enables physiotherapists to create customised rehabilitation programmes for clients and patients.”

Simple Therapy: video exercise therapy that matches your needs, when and where you want it

“SimpleTherapy® offers more than 20 video-based exercise therapy programs designed by doctors.”

SimpleSet Pro: Advanced Exercise Prescription Software

“SimpleSet Pro is the ultimate online tool for professional exercise program design. With SimpleSet Pro you can create comprehensive exercise programs for your clients, and email or print them in minutes!”

SHAPES: Spatially and Human Aware Performance Evaluation System.

“SHAPES is an interactive, assistive technology (using the Microsoft Xbox Kinect) that enhances exercise routines.”

TheraVid: Connect. Discover. Recover.

“Use our expanding database of HD exercise videos and unique online interface to build better client relationships today. Free while in beta.”

WebExercises: Exercise Prescription Made Easy™

“WebExercises® will promote more frequent and proper form of all prescribed rehabilitation and corrective exercises – resulting in improved recovery and stronger happier patients and clients.”

wellpepper: gives your health a kick

“Wellpepper for iPad and iPhone enables healthcare professionals to prescribe physical therapy exercises and encourages people to complete exercises at home to help speed recovery”

Source: Exercise Prescription Software – Physical Therapy Web

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[Abstract] Caregiver-mediated exercises for improving outcomes after stroke (Cochrane review) [with consumer summary]

BACKGROUND: Stroke is a major cause of long-term disability in adults. Several systematic reviews have shown that a higher intensity of training can lead to better functional outcomes after stroke. Currently, the resources in inpatient settings are not always sufficient and innovative methods are necessary to meet these recommendations without increasing healthcare costs. A resource efficient method to augment intensity of training could be to involve caregivers in exercise training. A caregiver-mediated exercise programme has the potential to improve outcomes in terms of body function, activities, and participation in people with stroke. In addition, caregivers are more actively involved in the rehabilitation process, which may increase feelings of empowerment with reduced levels of caregiver burden and could facilitate the transition from rehabilitation facility (in hospital, rehabilitation centre, or nursing home) to home setting. As a consequence, length of stay might be reduced and early supported discharge could be enhanced.

OBJECTIVES: To determine if caregiver-mediated exercises (CME) improve functional ability and health-related quality of life in people with stroke, and to determine the effect on caregiver burden.

SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (October 2015), CENTRAL (the Cochrane Library, 2015, issue 10), Medline (1946 to October 2015), Embase (1980 to December 2015), CINAHL (1982 to December 2015), SPORTDiscus (1985 to December 2015), three additional databases (two in October 2015, one in December 2015), and six additional trial registers (October 2015). We also screened reference lists of relevant publications and contacted authors in the field.

SELECTION CRITERIA: Randomised controlled trials comparing CME to usual care, no intervention, or another intervention as long as it was not caregiver-mediated, aimed at improving motor function in people who have had a stroke.

DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials. One review author extracted data, and assessed quality and risk of bias, and a second review author cross-checked these data and assessed quality. We determined the quality of the evidence using GRADE. The small number of included studies limited the pre-planned analyses.

MAIN RESULTS: We included nine trials about CME, of which six trials with 333 patient-caregiver couples were included in the meta-analysis. The small number of studies, participants, and a variety of outcome measures rendered summarising and combining of data in meta-analysis difficult. In addition, in some studies, CME was the only intervention (CME-core), whereas in other studies, caregivers provided another, existing intervention, such as constraint-induced movement therapy. For trials in the latter category, it was difficult to separate the effects of CME from the effects of the other intervention. We found no significant effect of CME on basic ADL when pooling all trial data post intervention (4 studies; standardised mean difference (SMD) 0.21, 95% confidence interval (CI) -0.02 to 0.44; p = 0.07; moderate-quality evidence) or at follow-up (2 studies; mean difference (MD) 2.69, 95% CI -8.18 to 13.55; p = 0.63; low-quality evidence). In addition, we found no significant effects of CME on extended ADL at post intervention (two studies; SMD 0.07, 95% CI -0.21 to 0.35; p = 0.64; low-quality evidence) or at follow-up (2 studies; SMD 0.11, 95% CI -0.17 to 0.39; p = 0.45; low-quality evidence). Caregiver burden did not increase at the end of the intervention (2 studies; SMD -0.04, 95% CI -0.45 to 0.37; p = 0.86; moderate-quality evidence) or at follow-up (1 study; MD 0.60, 95% CI -0.71 to 1.91; p = 0.37; very low-quality evidence). At the end of intervention, CME significantly improved the secondary outcomes of standing balance (3 studies; SMD 0.53, 95% CI 0.19 to 0.87; p = 0.002; low-quality evidence) and quality of life (1 study; physical functioning MD 12.40, 95% CI 1.67 to 23.13; p = 0.02; mobility MD 18.20, 95% CI 7.54 to 28.86; p = 0.0008; general recovery MD 15.10, 95% CI 8.44 to 21.76; p < 0.00001; very low-quality evidence). At follow-up, we found a significant effect in favour of CME for Six-Minute Walking Test distance (1 study; MD 109.50 m, 95% CI 17.12 to 201.88; p = 0.02; very low-quality evidence). We also found a significant effect in favour of the control group at the end of intervention, regarding performance time on the Wolf Motor Function test (2 studies; MD -1.72, 95% CI -2.23 to -1.21; p < 0.00001; low-quality evidence). We found no significant effects for the other secondary outcomes (ie, patient: motor impairment, upper limb function, mood, fatigue, length of stay and adverse events; caregiver: mood and quality of life). In contrast to the primary analysis, sensitivity analysis of CME-core showed a significant effect of CME on basic ADL post intervention (2 studies; MD 9.45, 95% CI 2.11 to 16.78; p = 0.01; moderate-quality evidence). The methodological quality of the included trials and variability in interventions (eg, content, timing, and duration), affected the validity and generalisability of these observed results.

AUTHORS’ CONCLUSIONS: There is very low- to moderate-quality evidence that CME may be a valuable intervention to augment the pallet of therapeutic options for stroke rehabilitation. Included studies were small, heterogeneous, and some trials had an unclear or high risk of bias. Future high-quality research should determine whether CME interventions are (cost-)effective.

Full text (sometimes free) may be available at these link(s):      help

Source: PEDro – Search Detailed Search Results

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[Abstract] Parallels between astronauts and terrestrial patients – Taking physiotherapy rehabilitation “To infinity and beyond”

Highlights

    Neuro-musculoskeletal changes in astronauts parallel changes in patients on Earth.

    Motor control training for low back pain patients is applicable to astronauts.

    Astronaut reconditioning principles may be relevant to intensive care patients.

    Benefits of exchanging physiotherapy practices between space and Earth are reciprocal.

Abstract

Exposure to the microgravity environment induces physiological changes in the cardiovascular, musculoskeletal and sensorimotor systems in healthy astronauts. As space agencies prepare for extended duration missions, it is difficult to predict the extent of the effects that prolonged exposure to microgravity will have on astronauts. Prolonged bed rest is a model used by space agencies to simulate the effects of spaceflight on the human body, and bed rest studies have provided some insights into the effects of immobilisation and inactivity. Whilst microgravity exposure is confined to a relatively small population, on return to Earth, the physiological changes seen in astronauts parallel many changes routinely seen by physiotherapists on Earth in people with low back pain (LBP), muscle wasting diseases, exposure to prolonged bed rest, elite athletes and critically ill patients in intensive care. The medical operations team at the European Space Agency are currently involved in preparing astronauts for spaceflight, advising on exercises whilst astronauts are on the International Space Station, and reconditioning astronauts following their return. There are a number of parallels between this role and contemporary roles performed by physiotherapists working with elite athletes and muscle wasting conditions. This clinical commentary will draw parallels between changes which occur to the neuromuscular system in the absence of gravity and conditions which occur on Earth. Implications for physiotherapy management of astronauts and terrestrial patients will be discussed.

Source: Parallels between astronauts and terrestrial patients – Taking physiotherapy rehabilitation “To infinity and beyond”

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[WEB SITE] Unmotivated to exercise? Dopamine could be to blame

 

Perhaps you have told yourself many times that, as of next week, you will start exercising more. Perhaps next month. Maybe even next year. For many of us, however, sticking to a disciplined program of physical exercise is one of the hardest New Year’s resolutions. New research offers clues as to why finding the motivation to exercise can be so difficult.

New research links a deficit in dopamine to the lack of physical activity in mice.

The benefits of physical activity are well known. The Centers for Disease Control and Prevention (CDC) report that regular physical activity can reduce the risk of severe illnesses, such as type 2 diabetes, cancer, and cardiovascular disease.

Exercise can also improve one’s overall physical and mental health, as well as increase longevity.

If you are looking to control your weight, the advantages of exercise are numerous. Not only has physical activity been shown to reduce metabolic syndrome – which means that it is good for regulating one’s metabolism – but it also burns calories, and in combination with a healthful diet, exercise can help to maintain weight over a long period of time.

While many people are aware of the benefits of physical activity in theory, many of us find it particularly hard in practice to stay physically active. New research may help to explain why this is so.

Can dopamine explain lack of physical activity?

Lead researcher Alexxai V. Kravitz – of the Diabetes, Endocrinology, and Obesity Branch at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – wondered why it is that obese animals have such a hard time doing physical activity.

The common perception is that animals, or people that are obese, are less physically active because they have to carry much more body weight. However, because Kravitz has a background in Parkinson’s disease, he noticed similarities between obese mice and Parkinsonian mice while he was studying.

This triggered his hypothesis that perhaps something else could contribute to physical inactivity.

“We know that physical activity is linked to overall good health, but not much is known about why people or animals with obesity are less active. There is a common belief that obese animals don’t move as much because carrying extra body weight is physically disabling. But our findings suggest that assumption does not explain the whole story.”

Alexxai V. Kravitz

Kravitz hypothesized that a dysfunction in rodents’ dopamine system might help to explain their lack of physical activity.

“Other studies have connected dopamine signaling defects to obesity, but most of them have looked at reward processing – how animals feel when they eat different foods. We looked at something simpler: dopamine is critical for movement, and obesity is associated with a lack of movement. Can problems with dopamine signaling alone explain the inactivity?”

Examining dopamine receptors in mice

Researchers set out to examine dopamine signaling in lean and obese mice, and the findings were published in the journal Cell Metabolism.

To do this, they fed a group of eight mice a normal diet, and they fed another group a high-fat diet for 18 weeks.

Starting from week 2, the mice on a high-fat diet started gaining significantly more weight than the lean ones. By week 4, obese mice spent less time moving, had fewer movements, and were slower when they did move, compared with lean mice.

Scientists examined whether changes in movement correlated with body weight gain, and they found that it did not. Interestingly, the mice on a high-fat diet moved less before they gained the majority of the weight, which suggests that the extra weight could not have been responsible for the reduced movement.

To identify the mechanisms behind physical inactivity, Kravitz and team quantified several aspects of dopamine signaling.

They found that the D-2 type receptor (D2R) binding, found in the striatum, was reduced in obese mice. This was consistent with previous research in rodents.

Then, scientists genetically removed D2Rs from the striatum of lean mice to determine if there was a causal link between D2Rs and inactivity. Researchers then placed the lean mice on a high-fat diet.

Surprisingly, they found that these mice did not gain more weight, despite their physical inactivity.

This suggests that although deficits in striatal D2R contribute to physical inactivity in obesity, such inactivity is more “a consequence than a cause of obesity,” as the authors put it.

Dopamine deficit may explain physical inactivity, reducing stigma

Although “there are probably other factors involved as well, the deficit in D2 is sufficient to explain the lack of activity,” says Danielle Friend, first author of the study and former NIDDK postdoctoral fellow.

Kravitz mentions that his future research will examine the connection between diet and dopamine signaling. Kravitz and team will investigate whether unhealthful eating affects dopamine signaling, and how quickly mice recover to normal activity levels once they start eating healthfully and losing weight.

Finally, Kravitz hopes that his research will help to relieve some of the stigma faced by people with obesity.

“In many cases, willpower is invoked as a way to modify behavior. But if we don’t understand the underlying physical basis for that behavior, it is difficult to say that willpower alone can solve it.”

Alexxai V. Kravitz

Learn how the brain thinks yo-yo dieting is a famine and how this causes weight gain.

Source: Unmotivated to exercise? Dopamine could be to blame – Medical News Today

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[Abstract] A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Abstract

Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope.

We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement.

Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

Source: A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

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[Abstract] A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Abstract

Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

Source: A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

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[WEB SITE] New wearable electronic device could revolutionise treatment for stroke patients

Stroke patients are starting a trial of a new electronic device to recover movement and control of their hand.

Neuroscientists at Newcastle University have developed the device, the size of a mobile phone, which delivers a series of small electrical shocks followed by an audible click to strengthen brain and spinal connections.

The experts believe this could revolutionise treatment for patients, providing a wearable solution to the effects of stroke.

Following successful work in primates and healthy human subjects, the Newcastle University team are now working with colleagues at the prestigious Institute of Neurosciences, Kolkata, India, to start the clinical trial. Involving 150 stroke patients, the aim of the study is to see whether it leads to improved hand and arm control.

Stuart Baker, Professor of Movement Neuroscience at Newcastle University who has led the work said: “We were astonished to find that a small electric shock and the sound of a click had the potential to change the brain’s connections. However, our previous research in primates changed our thinking about how we could activate these pathways, leading to our study in humans.”

Recovering hand control

Publishing today in the Journal of Neuroscience, the team report on the development of the miniaturised device and its success in healthy patients at strengthening connections in the reticulospinal tract, one of the signal pathways between the brain and spinal cord.

This is important for patients as when people have a stroke they often lose the major pathway found in all mammals connecting the brain to spinal cord. The team’s previous work in primates showed that after a stroke they can adapt and use a different, more primitive pathway, the reticulospinal tract, to recover.

However, their recovery tends to be imbalanced with more connections made to flexors, the muscles that close the hand, than extensors, those that open the hand. This imbalance is also seen in stroke patients as typically, even after a period of recuperation, they find that they still have weakness of the extensor muscles preventing them opening their fist which leads to the distinctive curled hand.

Partial paralysis of the arms, typically on just one side, is common after stroke, and can affect someone’s ability to wash, dress or feed themselves. Only about 15% of stroke patients spontaneously recover the use of their hand and arm, with many people left facing the rest of their lives with a severe level of disability.

Senior author of the paper, Professor Baker added: “We have developed a miniaturised device which delivers an audible click followed by a weak electric shock to the arm muscle to strengthen the brain’s connections. This means the stroke patients in the trial are wearing an earpiece and a pad on the arm, each linked by wires to the device so that the click and shock can be continually delivered to them.

“We think that if they wear this for 4 hours a day we will be able to see a permanent improvement in their extensor muscle connections which will help them gain control on their hand.”

Improving connections

The techniques to strengthen brain connections using paired stimuli are well documented, but until now this has needed bulky equipment, with a mains electric supply.

The research published today is a proof of concept in human subjects and comes directly out of the team’s work on primates. In the paper they report how they pair a click in a headphone with an electric shock to a muscle to induce the changes in connections either strengthening or weakening reflexes depending on the sequence selected. They demonstrated that wearing the portable electronic device for seven hours strengthened the signal pathway in more than half of the subjects (15 out of 25).

Professor Stuart Baker added: “We would never have thought of using audible clicks unless we had the recordings from primates to show us that this might work. Furthermore, it is our earlier work in primates which shows that the connections we are changing are definitely involved in stroke recovery.”

The work has been funded through a Milstein Award from the Medical Research Council and the Wellcome Trust.

The clinical trial is just starting at the Institute of Neurosciences, Kolkata, India. The country has a higher rate of stroke than Western countries which can affect people at a younger age meaning there is a large number of patients. The Institute has strong collaborative links with Newcastle University enabling a carefully controlled clinical trial with results expected at the end of this year.

A patient’s perspective

Chris Blower, 30, is a third year Biomedical Sciences student at Newcastle University and he had a stroke when he was a child after open heart surgery. He describes his thoughts on the research:

I had a stroke at the age of seven. The immediate effect was paralysis of the right-hand side of my body, which caused slurred speech, loss of bowel control and an inability to move unaided. Though I have recovered from these immediate effects, I am now feeling the longer term effects of stroke; slow, limited and difficult movement of my right arm and leg.

My situation is not unique and many stroke survivors have similar long-term effects to mine. Professor Baker’s work may be able to help people in my position regain some, if not all, motor control of their arm and hand. His research shows that, in stroke, the brains motor pathway to the spinal cord is damaged and that an evolutionarily older signal pathway could be ‘piggybacked’ and used instead. With electrical stimulation, exercise and an audible cue the brain can be taught to use this older pathway instead.

This gives me a lot of hope for stroke survivors. My wrist and fingers pull in, closing my hand into a fist, but with the device Professor Baker is proposing my brain could be re-taught to use my muscles and pull back, opening my hand out. The options presented to me so far, by doctors, have been Botox injections and surgery; Botox in my arm would weaken the muscles closing my hand and allow my fingers to spread, surgery would do the same thing by moving the tendons in my arm. Professor Baker’s electrical stimulations is certainly a more appealing option, to me, as it seems to be a permanent solution that would not require an operation on my arm.

I was invited to look around the animal house and observe a macaque monkey undergoing a test and this has made me think about my own stroke and the effect it has had on my life.

I have never seen anything like this before and I didn’t know what to expect. The macaque monkey that I observed was calmly carrying out finger manipulation tests while electrodes monitored the cells of her spinal cord.

Although this procedure requires electrodes to be placed into the brain and spine of the animal, Professor Baker explained how the monkey had been practicing and learning this test for two years before the monitoring equipment was attached. In this way the testing has become routine before it had even started and the animal was in no pain or distress, even at the sight of a stranger (me).

The animals’ calm, placid temperaments carry over to their living spaces; with lots of windows, natural light and high up spaces the macaques are able to see all around them and along the corridors. This means that they aren’t feeling threatened when people approach and are comfortable enough that even a stranger (me, again) can approach and say ‘hello’.

From my tour of the animal house at the Institute of Neuroscience I saw animals in calm, healthy conditions, to which the tests were just a part of their daily routine. Animal testing is controversial but I think that the work of Professor Baker and his team is important in helping people who have suffered stroke and other life-changing trauma to regain their independence and, often, their lives.

Source: Newcastle University

Source: New wearable electronic device could revolutionise treatment for stroke patients

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