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Sample records for constraint-induced movement therapy

  1. Constraint-Induced Movement Therapy after Stroke

    PubMed Central

    Kwakkel, Gert; Veerbeek, Janne M.; van Wegen, Erwin E.H.; Wolf, Steven L.

    2015-01-01

    Constraint-induced movement therapy (CIMT) was developed to overcome upper limb impairments after stroke and is the most investigated intervention for treating stroke patients in the previous decades. This review describes the current evidence regarding: original CIMT and modified versions of CIMT (mCIMT). Meta-analysis showed strong evidence favoring both types of CIMT in terms of motor function, arm-hand activities and self-reported arm-hand functioning in daily life, immediately after treatment and at long-term follow-up, whereas no evidence was found for constraining alone (Forced Use (FU) therapy). No evidence was found that type of CIMT, intensity of practice or timing did affect outcome. Although the underlying mechanism that drive (m)CIMT is still poorly understood, recent kinematic conducted studies suggests that improvements introduced by original CIMT or mCIMT are mainly based on adaptation by learning to optimize the use of intact end-effectors by selecting patients with some voluntary motor control of wrist and finger extensors post stroke. PMID:25772900

  2. Constraint-Induced Movement Therapy (CIMT): Pediatric Applications

    ERIC Educational Resources Information Center

    Brady, Kathleen; Garcia, Teressa

    2009-01-01

    The purpose of this article is to describe theoretical and research bases for constraint-induced movement therapy (CIMT), to discuss key features and variations in protocols currently in use with children, and to review the results of studies of efficacy. CIMT has been found to be an effective intervention for increasing functional use of the…

  3. Constraint-induced movement therapy: characterizing the intervention protocol.

    PubMed

    Morris, D M; Taub, E; Mark, V W

    2006-09-01

    Constraint-induced movement therapy (CI therapy) is a rehabilitation treatment approach that improves more-affected extremity use following a stroke, especially in the life situation. The originators of the approach describe CI therapy as consisting of a family of therapies including a number of treatment components and subcomponents. When thinking of CI therapy, rehabilitation researchers and clinicians frequently cite a restraining mitt on the less affected arm as the main active ingredient behind improvements in motor function. However, substantial data suggest that restraint makes actually a relatively small contribution to treatment outcome. This paper provides a detailed description of the multiple treatment elements included in the CI therapy protocol as used in our research laboratory. Our aim is to improve understanding of CI therapy and the research supporting its use. PMID:17039224

  4. Methods to improve constraint-induced movement therapy.

    PubMed

    Tarkka, Ina M; Könönen, Mervi

    2009-01-01

    In global terms, cerebrovascular stroke is the leading cause of long-term disability. Despite improved acute phase management of stroke, the majority of survivors are disabled and many require effective rehabilitation. Constraint-induced movement therapy (CIMT) is one of the recently emerging therapies for subjects with stroke. The effects of two-week long CIMT on behavioural, neurophysiologic and neuroimaging measures in subjects with chronic stroke were studied. Furthermore, the effects of combined upper limb exercise and peripheral preprogrammed multichannel electrical stimulation, i.e. functional electrical therapy (FET), were evaluated. Behavioral gains were obtained in hand function and functional MRI activations, and, in addition, TMS responses appeared more laterally and/or bilaterally in the affected hemisphere in the subjects after CIMT. Neurophysiologic and functional imaging results were supportive evidence for the benefits of use-dependent plasticity in subjects with chronic stroke. PMID:19713619

  5. The Behavior-Analytic Origins of Constraint-Induced Movement Therapy: An Example of Behavioral Neurorehabilitation

    ERIC Educational Resources Information Center

    Taub, Edward

    2012-01-01

    Constraint-induced (CI) therapy is a term given to a family of efficacious neurorehabilitation treatments including to date: upper extremity CI movement therapy, lower extremity CI movement therapy, pediatric CI therapy, and CI aphasia therapy. The purpose of this article is to outline the behavior analysis origins of CI therapy and the ways in…

  6. Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia

    PubMed Central

    Wang, Wenqing; Wang, Aihui; Yu, Limin; Han, Xuesong; Jiang, Guiyun; Weng, Changshui; Zhang, Hongwei; Zhou, Zhiqiang

    2012-01-01

    Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusion. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia. PMID:25337108

  7. Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia.

    PubMed

    Wang, Wenqing; Wang, Aihui; Yu, Limin; Han, Xuesong; Jiang, Guiyun; Weng, Changshui; Zhang, Hongwei; Zhou, Zhiqiang

    2012-11-15

    Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusion. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia. PMID:25337108

  8. Modified constraint-induced movement therapy for clients with chronic stroke: interrupted time series (ITS) design

    PubMed Central

    Park, JuHyung; Lee, NaYun; Cho, YongHo; Yang, YeongAe

    2015-01-01

    [Purpose] The purpose of this study was to investigate the impact that modified constraint-induced movement therapy has on upper extremity function and the daily life of chronic stroke patients. [Subjects and Methods] Modified constraint-induced movement therapy was conduct for 2 stroke patients with hemiplegia. It was performed 5 days a week for 2 weeks, and the participants performed their daily living activities wearing mittens for 6 hours a day, including the 2 hours of the therapy program. The assessment was conducted 5 times in 3 weeks before and after intervention. The upper extremity function was measured using the box and block test and a dynamometer, and performance daily of living activities was assessed using the modified Barthel index. The results were analyzed using a scatterplot and linear regression. [Results] All the upper extremity functions of the participants all improved after the modified constraint-induced movement therapy. Performance of daily living activities by participant 1 showed no change, but the results of participant 2 had improved after the intervention. [Conclusion] Through the results of this research, it was identified that modified constraint-induced movement therapy is effective at improving the upper extremity functions and the performance of daily living activities of chronic stroke patients. PMID:25931770

  9. Outcomes of a Clinic-Based Pediatric Constraint-Induced Movement Therapy Program

    ERIC Educational Resources Information Center

    Reidy, Teressa Garcia; Naber, Erin; Viguers, Emily; Allison, Kristen; Brady, Kathleen; Carney, Joan; Salorio, Cynthia; Pidcock, Frank

    2012-01-01

    A single-group pre- and post-test design was used to evaluate functional outcomes of a constraint-induced movement therapy (CIMT) protocol implemented in an outpatient therapy center. The participants were 29 children with hemiplegia, ages 1.6-19.1 years old. The less-involved upper limb was placed in a cast that was worn 24 hr a day, 7 days a…

  10. Effect of Constraint-Induced Movement Therapy and Mirror Therapy for Patients With Subacute Stroke

    PubMed Central

    Yoon, Jin A; Koo, Bon Il; Shin, Myung Jun; Shin, Yong Beom; Ko, Hyun-Yoon

    2014-01-01

    Objective To evaluate the effectiveness of constraint-induced movement therapy (CIMT) and combined mirror therapy for inpatient rehabilitation of the patients with subacute stroke. Methods Twenty-six patients with subacute stroke were enrolled and randomly divided into three groups: CIMT combined with mirror therapy group, CIMT only group, and control group. Two weeks of CIMT for 6 hours a day with or without mirror therapy for 30 minutes a day were performed under supervision. All groups received conventional occupational therapy for 40 minutes a day for the same period. The CIMT only group and control group also received additional self-exercise to substitute for mirror therapy. The box and block test, 9-hole Pegboard test, grip strength, Brunnstrom stage, Wolf motor function test, Fugl-Meyer assessment, and the Korean version of Modified Barthel Index were performed prior to and two weeks after the treatment. Results After two weeks of treatment, the CIMT groups with and without mirror therapy showed higher improvement (p<0.05) than the control group, in most of functional assessments for hemiplegic upper extremity. The CIMT combined with mirror therapy group showed higher improvement than CIMT only group in box and block test, 9-hole Pegboard test, and grip strength, which represent fine motor functions of the upper extremity. Conclusion The short-term CIMT combined with mirror therapy group showed more improvement compared to CIMT only group and control group, in the fine motor functions of hemiplegic upper extremity for the patients with subacute stroke. PMID:25229024

  11. Constraint-induced movement therapy: a method for harnessing neuroplasticity to treat motor disorders.

    PubMed

    Uswatte, Gitendra; Taub, Edward

    2013-01-01

    Constraint-Induced Movement therapy or CI therapy is an approach to physical rehabilitation elaborated from basic neuroscience and behavioral research with primates. The application of the CI therapy protocol to humans began with the upper extremity after stroke and was then modified and extended to cerebral palsy in young children, traumatic brain injury, and multiple sclerosis. A form of CI therapy was developed for the lower extremities and has been used effectively after stroke, spinal cord injury, fractured hip, multiple sclerosis, and cerebral palsy. Adaptations of the CI therapy paradigm have also been developed for aphasia, focal hand dystonia in musicians, and phantom limb pain. Human and animal studies using a variety of methods provide evidence that CI therapy produces marked neuroplastic changes in the structure and function of the CNS. Moreover, these changes appear to be important for the intervention's therapeutic effect. PMID:24309263

  12. Examining the Use of Constraint-Induced Movement Therapy in Canadian Neurological Occupational and Physical Therapy

    PubMed Central

    Fleet, Alana; Che, Marion; MacKay-Lyons, Marilyn; MacKenzie, Diane; Page, Stephen; Eskes, Gail; McDonald, Alison; Boyce, Joy

    2014-01-01

    ABSTRACT Purpose: To investigate the use of constraint-induced movement therapy (CIMT) in Canadian neurological occupational and physical therapy. Method: An online survey was completed by occupational and physical therapists practising in Canadian adult neurological rehabilitation. We measured participants' practices, perceptions, and opinions in relation to their use of CIMT in clinical practice. Results: A total of 338 surveys were returned for a 13% response rate; 92% of respondents knew of CIMT, and 43% reported using it. The majority (88%) of respondents using CIMT employed a non-traditional protocol. Self-rating of level of CIMT knowledge was found to be a significant predictor of CIMT use (p≤0.001). Commonly identified barriers to use included “patients having cognitive challenges that prohibit use of this treatment” and “lack of knowledge regarding treatment.” Conclusions: Although the majority of respondents knew about CIMT, less than half reported using it. Barriers to CIMT use include lack of knowledge about the treatment and institutional resources to support its use. Identifying and addressing barriers to CIMT use—for example, by using continuing professional education to remediate knowledge gaps or developing new protocols that require fewer institutional resources—can help improve the feasibility of CIMT, and thus promote its clinical application. PMID:24719511

  13. The Effects of Constraint-Induced Movement Therapy on Activities Important to Independent School Participation of Children with Hemiparesis

    ERIC Educational Resources Information Center

    Carney, Joan

    2012-01-01

    This study investigated the efficacy of constraint-induced movement therapy (CI therapy) on activities important to school participation in children with hemiparesis. Four children, ages 4-0 to 7-10 participated in an intensive CI therapy program in a clinical setting. Constraining casts were worn 24 hours daily. Therapy was delivered 6 hours…

  14. The behavior-analytic origins of constraint-induced movement therapy: an example of behavioral neurorehabilitation.

    PubMed

    Taub, Edward

    2012-01-01

    Constraint-induced (CI) therapy is a term given to a family of efficacious neurorehabilitation treatments including to date: upper extremity CI movement therapy, lower extremity CI movement therapy, pediatric CI therapy, and CI aphasia therapy. The purpose of this article is to outline the behavior analysis origins of CI therapy and the ways in which its procedures incorporate behavior analysis methods and principles. The intervention is founded on the concept of learned nonuse, a mechanism now empirically demonstrated to exist, which occurs after many different types of damage to the central nervous system (CNS). It results from the dramatic alteration of the contingencies of reinforcement that results from substantial CNS damage and leads to a greater deficit than is warranted by the actual damage sustained. CI therapy produces a countervailing alteration in the contingencies of reinforcement. The intervention has been used successfully to substantially improve motor deficits after stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, with cerebral palsy in a pediatric population, and for language impairment in poststroke aphasia. The protocol of CI therapy consists primarily of standard behavior-analytic methods. It produces a marked plastic brain change that is correlated with its therapeutic effect, and therefore provides an example of the way in which behavior change can contribute to a profound remodeling of the brain. CI therapy may be viewed as an example of behavioral neurorehabilitation. PMID:23449867

  15. The Behavior-Analytic Origins of Constraint-Induced Movement Therapy: An Example of Behavioral Neurorehabilitation

    PubMed Central

    Taub, Edward

    2012-01-01

    Constraint-induced (CI) therapy is a term given to a family of efficacious neurorehabilitation treatments including to date: upper extremity CI movement therapy, lower extremity CI movement therapy, pediatric CI therapy, and CI aphasia therapy. The purpose of this article is to outline the behavior analysis origins of CI therapy and the ways in which its procedures incorporate behavior analysis methods and principles. The intervention is founded on the concept of learned nonuse, a mechanism now empirically demonstrated to exist, which occurs after many different types of damage to the central nervous system (CNS). It results from the dramatic alteration of the contingencies of reinforcement that results from substantial CNS damage and leads to a greater deficit than is warranted by the actual damage sustained. CI therapy produces a countervailing alteration in the contingencies of reinforcement. The intervention has been used successfully to substantially improve motor deficits after stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, with cerebral palsy in a pediatric population, and for language impairment in poststroke aphasia. The protocol of CI therapy consists primarily of standard behavior-analytic methods. It produces a marked plastic brain change that is correlated with its therapeutic effect, and therefore provides an example of the way in which behavior change can contribute to a profound remodeling of the brain. CI therapy may be viewed as an example of behavioral neurorehabilitation. PMID:23449867

  16. Constraint-induced movement therapy for a child with hemiparesis: a case report.

    PubMed

    Fergus, Andrea; Buckler, Jessica; Farrell, Janeen; Isley, Melinda; McFarland, Meghan; Riley, Bonnie

    2008-01-01

    This case report describes the outcomes of a method of constraint-induced movement therapy (CIMT) incorporated into a home program using a minimally restrictive constraint over an 18-month period. The movement of the uninvolved hand and wrist of a 13-month-old child with hemiparesis was constrained with a soft removable mitt. Caregivers performed CIMT in 2 intense periods and weaning periods, and a home exercise period. Two independent raters performed video analysis of the quantity and quality of upper extremity. All measures showed improvement. Reaches with the involved upper extremity increased from 8.9% to 41.0%. Use of advanced grasp patterns increased from 3.3% to 76.1%. Successful release of objects improved from 0% to 73.0%. Caregivers reported functional improvements and strong positive feedback regarding success, ease, and satisfaction with CIMT. This case demonstrates positive outcomes using a clinically feasible method of CIMT with far reaching implications on function. PMID:18703966

  17. Constraint-Induced Movement Therapy for Children with Obstetric Brachial Plexus Palsy: Two Single-Case Series

    ERIC Educational Resources Information Center

    Buesch, Francisca Eugster

    2010-01-01

    The objective of this pilot study was to investigate the feasibility of constraint-induced movement therapy (CIMT) in children with obstetric brachial plexus palsy and receive preliminary information about functional improvements. Two patients (age 12 years) with obstetric brachial plexus palsy were included for a 126-h home-based CIMT…

  18. Introduction to "The Behavior-Analytic Origins of Constraint-Induced Movement Therapy: An Example of Behavioral Neurorehabilitation"

    ERIC Educational Resources Information Center

    Schaal, David W.

    2012-01-01

    This article presents an introduction to "The Behavior-Analytic Origins of Constraint-Induced Movement Therapy: An Example of Behavioral Neurorehabilitation," by Edward Taub and his colleagues (Taub, 2012). Based on extensive experimentation with animal models of peripheral nerve injury, Taub and colleagues have created an approach to overcoming…

  19. Treatment of Congenital Hemiparesis with Pediatric Constraint-Induced Movement Therapy

    PubMed Central

    Taub, Edward; Griffin, Angi; Uswatte, Gitendra; Gammons, Kristin; Nick, Jennifer; Law, Charles R.

    2013-01-01

    To determine efficacy of pediatric constraint-induced therapy, 20 children with congenital hemiparesis (age, 2 to 6 years) were randomly assigned to receive the treatment or usual and customary care. Controls crossed over to constraint-induced therapy after 6 months. Children receiving the therapy first exhibited emergence of more new classes of motor patterns and skills (e.g., crawling, thumb-forefinger prehension; 6.4 vs. .02, P < .0001, effect size d = 1.3,), and demonstrated significant gains in spontaneous use of the more affected arm at home (2.2 vs. 0.1, P < .0001, d = 3.8) and in a laboratory motor function test. Depending on the measure, benefits were maintained (range, no loss to 68% retention over 6 months). When controls crossed over to constraint-induced therapy, they exhibited improvements as great or greater than those receiving therapy first. Thus, constraint-induced therapy appears to be efficacious for young children with hemiparesis consequent to congenital stroke. PMID:21771948

  20. Constraint-induced movement therapy as a paradigm of translational research in neurorehabilitation: Reviews and prospects.

    PubMed

    Huang, Wei-Chao; Chen, Yun-Ju; Chien, Chung-Liang; Kashima, Haruo; Lin, Keh-Chung

    2010-01-01

    There is an increasing awareness about the importance of translation from basic scientific findings into practical application for efficiently improving human health, especially in the pharmaceutical industry. In the field of neurorehabilitation, however, the bench-to-bedside process continues to be developing, and thus most of the therapeutic interventions have encountered barriers during exploration of evidence-based effectiveness. Despite this immaturity, constraint-induced movement therapy (CIT), a well-evidenced treatment evolved from research in nonhuman primates, is suggested to be an ideal paradigm of translational research in the field of neurorehabilitation. This article reviews the evolvement of CIT with regards to its behavioral efficacy and neuroimaging evidence through the translation roadmap developed by the National Institutes of Health. We also discuss prospects for the application of combined interventions, such as stem cell therapy or pharmaceutical prescription, with appropriate screening of patients beforehand, as well as an efficient delivery mode after the treatment. To achieve such goals and consolidate evidenced-based neurorehabilitation, we provide a framework for applications into the translational research of other therapeutic interventions aside from CIT. PMID:21139805

  1. Multiple Treatments of Pediatric Constraint-Induced Movement Therapy (pCIMT): A Clinical Cohort Study.

    PubMed

    DeLuca, Stephanie C; Ramey, Sharon Landesman; Trucks, Mary Rebekah; Wallace, Dorian Ainsworth

    2015-01-01

    Pediatric constraint-induced movement therapy (pCIMT) is one of the most efficacious treatments for children with cerebral palsy (CP). Distinctive components of pCIMT include constraint of the less impaired upper extremity (UE), high-intensity therapy for the more impaired UE (≥ 3 hr/day, many days per week, for multiple weeks), use of shaping techniques combined with repetitive task practice, and bimanual transfer. A critical issue is whether multiple treatments of pCIMT produce additional benefit. In a clinical cohort (mean age = 31 mo) of 28 children with asymmetrical CP whose parents sought multiple pCIMT treatments, the children gained a mean of 13.2 (standard deviation [SD] = 4.2) new functional skills after Treatment 1; Treatment 2 produced a mean of 7.3 (SD = 4.7) new skills; and Treatment 3, 6.5 (SD = 4.2). These findings support the conclusion that multiple pCIMT treatments can produce clinically important functional gains for children with hemiparetic CP. PMID:26565094

  2. Multiple Treatments of Pediatric Constraint-Induced Movement Therapy (pCIMT): A Clinical Cohort Study

    PubMed Central

    Ramey, Sharon Landesman; Trucks, Mary Rebekah; Wallace, Dorian Ainsworth

    2015-01-01

    Pediatric constraint-induced movement therapy (pCIMT) is one of the most efficacious treatments for children with cerebral palsy (CP). Distinctive components of pCIMT include constraint of the less impaired upper extremity (UE), high-intensity therapy for the more impaired UE (≥3 hr/day, many days per week, for multiple weeks), use of shaping techniques combined with repetitive task practice, and bimanual transfer. A critical issue is whether multiple treatments of pCIMT produce additional benefit. In a clinical cohort (mean age = 31 mo) of 28 children with asymmetrical CP whose parents sought multiple pCIMT treatments, the children gained a mean of 13.2 (standard deviation [SD] = 4.2) new functional skills after Treatment 1; Treatment 2 produced a mean of 7.3 (SD = 4.7) new skills; and Treatment 3, 6.5 (SD = 4.2). These findings support the conclusion that multiple pCIMT treatments can produce clinically important functional gains for children with hemiparetic CP. PMID:26565094

  3. Constraint-Induced Movement Therapy for Rehabilitation of Arm Dysfunction After Stroke in Adults

    PubMed Central

    2011-01-01

    Executive Summary Objective The purpose of this evidence-based analysis is to determine the effectiveness and cost of CIMT for persons with arm dysfunction after a stroke. Clinical Need: Condition and Target Population A stroke is a sudden loss of brain function caused by the interruption of blood flow to the brain (ischemic stroke) or the rupture of blood vessels in the brain (hemorrhagic stroke). A stroke can affect any number of areas including the ability to move, see, remember, speak, reason, and read and write. Stroke is the leading cause of adult neurological disability in Canada; 300,000 people or 1% of the population live with its effects. Up to 85% of persons experiencing a complete stroke have residual arm dysfunction which will interfere with their ability to live independently. Rehabilitation interventions are the cornerstone of care and recovery after a stroke. Constraint-Induced Movement Therapy Constraint-Induced Movement (CIMT) is a behavioural approach to neurorehabilitation based on the principle of ‘learned non-use’. The term is derived from studies in nonhuman primates in which somatosensory deafferentation of a single forelimb was performed and after which the animal then failed to use that limb. This failure to use the limb was deemed ‘learned non-use’. The major components of CIMT include: i) intense repetitive task-oriented training of the impaired limb ii) immobilization of the unimpaired arm, and iii) shaping. With regard to the first component, persons may train the affected arm for several hours a day for up to 10-15 consecutive days. With immobilization, the unaffected arm may be restrained for up to 90% of waking hours. And finally, with shaping, the difficulty of the training tasks is progressively increased as performance improves and encouraging feedback is provided immediately when small gains are achieved. Research Question What is the effectiveness and cost of CIMT compared with physiotherapy and/or occupational therapy

  4. Constraint-induced movement therapy enhanced neurogenesis and behavioral recovery after stroke in adult rats.

    PubMed

    Zhao, Chuansheng; Wang, Jun; Zhao, Shanshan; Nie, Yingxue

    2009-08-01

    Constraint-induced movement therapy (CIMT) has been extensively used for stroke rehabilitation. CIMT encourages use of the impaired limb along with restraint of the ipsilesional limb in daily life, and may promote behavioral recovery and induce structural changes in brain after stroke. The aim of this study was to investigate whether CIMT enhances neurogenesis in rat brain after stroke that was generated by middle cerebral artery occlusion. Adult rats were divided into sham group, ischemia group and ischemia treated with CIMT group. Rats of CIMT group were treated with a plaster cast to restrain the healthy forelimb for 14 days beginning 1 week after ischemia. The proliferation of neuronal cells labeled with bromodeoxyuridine (BrdU) and behavioral recovery were analyzed at day 29 after ischemia. We also measured the tissue level of stromal cell-derived factor 1 (SDF-1) by ELISA. SDF-1 might be involved in the regulation of neurogenesis following stroke. In the subventricular zone of the animals treated with CIMT, there was a significant increase in the number of BrdU-positive cells (135 +/- 18, P < 0.05), compared with ischemia group (87 +/- 12) or sham group (18 +/- 3.6). Likewise, in the dentate gyrus, animals treated with CIMT showed a significant increase in BrdU-positive cells (296 +/- 26, P < 0.05) compared with ischemia group (225 +/- 18) or sham group (162 +/- 11). CIMT treatment after stroke significantly improved behavioral performances and increased the SDF-1 protein levels in the cortex and dentate gyrus. In conclusion, CIMT treatment enhances neurogenesis and functional recovery after stroke. PMID:19638734

  5. MRI predicts efficacy of constraint-induced movement therapy in children with brain injury.

    PubMed

    Rocca, Maria A; Turconi, Anna C; Strazzer, Sandra; Absinta, Martina; Valsasina, Paola; Beretta, Elena; Copetti, Massimiliano; Cazzagon, Monica; Falini, Andrea; Filippi, Massimo

    2013-07-01

    Using resting state (RS) functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), we identified the predictors of clinical improvement following constraint-induced movement therapy (CIMT) in pediatric patients with chronic hemiplegia.From 14 children with congenital or acquired brain injury and 10 sex- and age-matched healthy controls, brain dual-echo, DTI and RS fMRI sequences were acquired before CIMT. The Quality of Upper Extremities Skills Test and the Gross Motor Function Measure (GMFM) were administered at baseline, at the end of CIMT (10 weeks), and after 6 months. Mean diffusivity and fractional anisotropy (FA) were measured in the lesion responsible for the clinical symptomatology, the affected and unaffected corticospinal tract (CST), motor transcallosal fibers, and uncinate fasciculus (as an internal control). Independent component analysis was used to identify the sensorimotor RS network. The ability of baseline MRI variables to predict clinical changes over time was assessed using multivariate linear models. At baseline, patients had increased mean diffusivity in the symptomatic lesion and decreased FA in the symptomatic lesion, affected corticospinal tract, and motor transcallosal fibers. A reduced RS functional connectivity was found in the bilateral cerebellum, left precentral gyrus, and right secondary sensorimotor cortex. At follow up, Quality of Upper Extremities Skills Test and GMFM scales improved significantly. Baseline average lesion FA predicted clinical improvement at week 10, and baseline functional connectivity of the right secondary sensorimotor cortex and cerebellum predicted GMFM improvement at month 6. DTI and RS fMRI offer promising and objective markers to predict clinical outcomes following CIMT in pediatric patients with congenital or acquired hemiplegia. PMID:23605556

  6. Muscle Recruitment and Coordination following Constraint-Induced Movement Therapy with Electrical Stimulation on Children with Hemiplegic Cerebral Palsy: A Randomized Controlled Trial

    PubMed Central

    Xu, Kaishou; He, Lu; Mai, Jianning; Yan, Xiaohua; Chen, Ying

    2015-01-01

    Objective To investigate changes of muscle recruitment and coordination following constraint-induced movement therapy, constraint-induced movement therapy plus electrical stimulation, and traditional occupational therapy in treating hand dysfunction. Methods In a randomized, single-blind, controlled trial, children with hemiplegic cerebral palsy were randomly assigned to receive constraint-induced movement therapy (n = 22), constraint-induced movement therapy plus electrical stimulation (n = 23), or traditional occupational therapy (n = 23). Three groups received a 2-week hospital-based intervention and a 6-month home-based exercise program following hospital-based intervention. Constraint-induced movement therapy involved intensive functional training of the involved hand during which the uninvolved hand was constrained. Electrical stimulation was applied on wrist extensors of the involved hand. Traditional occupational therapy involved functional unimanual and bimanual training. All children underwent clinical assessments and surface electromyography (EMG) at baseline, 2 weeks, 3 and 6 months after treatment. Surface myoelectric signals were integrated EMG, root mean square and cocontraction ratio. Clinical measures were grip strength and upper extremity functional test. Results Constraint-induced movement therapy plus electrical stimulation group showed both a greater rate of improvement in integrated EMG of the involved wrist extensors and cocontraction ratio compared to the other two groups at 3 and 6 months, as well as improving in root mean square of the involved wrist extensors than traditional occupational therapy group (p<0.05). Positive correlations were found between both upper extremity functional test scores and integrated EMG of the involved wrist as well as grip strength and integrated EMG of the involved wrist extensors (p<0.05). Conclusions Constraint-induced movement therapy plus electrical stimulation is likely to produce the best outcome in

  7. Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review.

    PubMed

    Taub, E; Uswatte, G; Pidikiti, R

    1999-07-01

    A new family of rehabilitation techniques, termed Constraint-Induced Movement Therapy or CI Therapy, has been developed that controlled experiments have shown is effective in producing large improvements in limb use in the real-world environment after cerebrovascular accident (CVA). The signature therapy involves constraining movements of the less-affected arm with a sling for 90% of waking hours for 2 weeks, while intensively training use of the more-affected arm. The common therapeutic factor in all CI Therapy techniques would appear to be inducing concentrated, repetitive practice of use of the more-affected limb. A number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CI Therapy produces a massive use-dependent cortical reorganization that increases the area of cortex involved in the innervation of movement of the more-affected limb. The CI Therapy approach has been used successfully to date for the upper limb of patients with chronic and subacute CVA and patients with chronic traumatic brain injury and for the lower limb of patients with CVA, incomplete spinal cord injury, and fractured hip. The approach has recently been extended to focal hand dystonia of musicians and possibly phantom limb pain. PMID:10659807

  8. FNIRS-based evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy

    NASA Astrophysics Data System (ADS)

    Cao, Jianwei; Khan, Bilal; Hervey, Nathan; Tian, Fenghua; Delgado, Mauricio R.; Clegg, Nancy J.; Smith, Linsley; Roberts, Heather; Tulchin-Francis, Kirsten; Shierk, Angela; Shagman, Laura; MacFarlane, Duncan; Liu, Hanli; Alexandrakis, George

    2015-03-01

    Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2 ± 2.1 years old) with hemiplegic cerebral palsy (CP) was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger tapping task were quantified before, immediately after, and six months after CIMT. Five age-matched healthy children (9.8 ± 1.3 years old) were also imaged at the same time points to provide comparative activation metrics for normal controls. In children with CP the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted six months later. In contrast to this longer term improvement in localized activation response, the laterality index that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed six months later.

  9. Pilot Study of the Efficacy of Constraint-Induced Movement Therapy for Infants and Toddlers with Cerebral Palsy

    PubMed Central

    Lowes, Linda Pax; Mayhan, Marianne; Orr, Teresa; Batterson, Nancy; Tonneman, Jill Alyce; Meyer, Angela; Alfano, Lindsay; Wang, Wei; Whalen, Cara N; Nelin, Mary Ann; Lo, Warren David; Case-Smith, Jane

    2014-01-01

    The evidence for Constraint-Induced Movement Therapy (CIMT) effectiveness for infants and toddlers with unilateral cerebral palsy is minimal. We performed a pilot study of CIMT using one-month usual care, one-month intervention, and one-month maintenance (return to usual care) phases on five infants (7- to 18-month old). For the CIMT phase, the infants received 2 hr of occupational therapy and 1 hr of parent-implemented home program for five days/week. The infants were casted for the rst 23 days, and bimanual therapy was provided for the last three days. Fine motor skills for the more affected arm and gross motor skills improved significantly during the CIMT; these gains were maintained at one-month follow-up. Individual infant data show mixed effects. This pilot study provides initial evidence that CIMT is feasible for infants with unilateral cerebral palsy, and presents preliminary data for CIMT on fine and gross motor performance. PMID:23848499

  10. Motor Learning Curve and Long-Term Effectiveness of Modified Constraint-Induced Movement Therapy in Children with Unilateral Cerebral Palsy: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Geerdink, Yvonne; Aarts, Pauline; Geurts, Alexander C.

    2013-01-01

    The goal of this study was to determine the progression of manual dexterity during 6 weeks (54 h) (modified) constraint-induced movement therapy ((m)CIMT) followed by 2 weeks (18 h) bimanual training (BiT) in children with unilateral spastic cerebral palsy (CP), to establish whether and when a maximal training effect was reached and which factors…

  11. Six Years after a Modified Constraint Induced Movement Therapy (CIMT) Program--What Happens when the Children Have Become Young Adults?

    ERIC Educational Resources Information Center

    Nordstrand, L.; Eliasson, A. C.

    2013-01-01

    The aim is to describe the development of hand function in young adults with unilateral cerebral palsy (CP), who participated in a 2-week Constraint Induced Movement Therapy (CIMT) camp 6 years earlier. Eleven participants, 16-21 years at follow-up, were assessed at three occasions during 2005 and once in 2011. At the 6-year follow-up, performance…

  12. Differential patterns of cortical reorganization following constraint-induced movement therapy during early and late period after stroke

    PubMed Central

    Sawaki, Lumy; Butler, Andrew J.; Leng, Xiaoyan; Wassenaar, Peter A.; Mohammad, Yousef; Blanton, Sarah; Sathian, K.; Nichols-Larsen, Deborah S.; Wolf, Steven L.; Good, David C.; Wittenberg, George F.

    2015-01-01

    OBJECTIVE Constraint-induced movement therapy (CIMT) leads to improvement in upper extremity movement and cortical reorganization after stroke. Direct comparison of the differential degree of cortical reorganization according to chronicity in stroke subjects receiving CIMT has not been performed and was the purpose of this study. We hypothesized that a higher degree of cortical reorganization would occur in the early (less than 9 months post-stroke) compared to the late group (more than 12 months post-stroke). METHODS 17 early and 9 late subjects were enrolled. Each subject was evaluated using transcranial magnetic stimulation (TMS) and the Wolf Motor Function Test (WMFT) and received CIMT for 2 weeks. RESULTS The early group showed greater improvement in WMFT compared with the late group. TMS motor maps showed persistent enlargement in both groups. The map shifted posteriorly in the late stroke group. CONCLUSION CIMT appears to lead to greater improvement in motor function in early phase after stroke. Greater cortical reorganization associated with shift in map position occurred in late group. SIGNIFICANCE The contrast between larger functional gains in the early group vs larger map expansion in the late group may indicate that cortical reorganization depends upon different neural substrates in the late stroke group. PMID:25227542

  13. The effects of constraint-induced movement therapy for a child less than one year of age.

    PubMed

    Coker, Patty; Lebkicher, Carisa; Harris, Lauren; Snape, Jamie

    2009-01-01

    The aim of this single case study was to determine the effectiveness of a modified version of constraint-induced movement therapy (mCIMT) on a child less than one year of age with a diagnosis of hemiplegic cerebral palsy. A single-subject ABAB design with a 6-month follow-up evaluation used repeated measures of gross and fine motor skills to determine changes at each phase of the study. Measures included the Peabody Developmental Motor Scale-2 (PDMS-2), the Gross Motor Fine Motor Measure-88 (GMFM-88) and videotape analysis of specific motor skills typically seen in children less than one year of age. The child in this study participated in a conventional occupational and physical therapy for 2 hours a week during the 2 baseline phases, A1 and A2, and mCIMT during the 2 intervention phases, B1 and B2. The mCIMT involved constraint of the non-affected limb for 1-hour a day for 30 consecutive days as the child was engaged in developmentally appropriate, task specific activities implemented by therapists and parents. Following participation in this mCIMT, the child demonstrated clinical improvements in both gross and fine motor skills as measured by standardized assessments and videotape analysis of motor behaviors. He was completing developmental motor tasks at his chronological age despite motor deficits resulting from a right-sided hemiparesis. The results of this study supports the use of mCIMT for children less than one year of age and could shift the focus of future research studies to determining the age in which to implement mCIMT before patterns of learned non-use begin to affect the normal development of skilled motor movements in children with hemiplegic CP. PMID:19458426

  14. Revisiting constraint-induced movement therapy: are we too smitten with the mitten? Is all nonuse "learned"? and other quandaries.

    PubMed

    Wolf, Steven L

    2007-09-01

    Constraint-induced movement therapy (CIMT) has gained considerable popularity as a valuable treatment for a hemiparetic upper extremity. This approach is compatible with the emerging notion that task-oriented or functionally oriented retraining of the impaired limb provides evidence to support its utility. This article first provides a historical perspective on the development of CIMT. An overview model of how learned nonuse of the hemiparetic limb occurs and can be overcome with CIMT is discussed, and then a more detailed model that incorporates critical issues requiring considerably more basic and applied scientific exploration is described. Among the issues considered are the extent to which hemiparetic limb nonuse and subsequent modes of delivery to overcome it are governed by structure-function deficits rather than being attributable primarily to behavioral phenomena; the relative importance of the intensity of training; the need to better balance unimanual and bimanual upper-extremity task practice; the role of psychosocial and cultural factors in fostering patient compliance; the optimization of modes of delivery; and the reevaluation of the constellation of components contributing to successful outcomes with this treatment. Finally, the strengths, uncertainties, and limitations associated with CIMT are examined. PMID:17609329

  15. Primed low-frequency repetitive transcranial magnetic stimulation and constraint-induced movement therapy in pediatric hemiparesis: a randomized trial

    PubMed Central

    GILLICK, BERNADETTE T; KRACH, LINDA E; FEYMA, TIM; RICH, TONYA L; MOBERG, KELLI; THOMAS, WILLIAM; CASSIDY, JESSICA M; MENK, JEREMIAH; CAREY, JAMES R

    2013-01-01

    Aim The aim of this study was to determine the feasibility and efficacy of five treatments of 6Hz primed, low-frequency, repetitive transcranial magnetic stimulation (rTMS) combined with constraint-induced movement therapy (CIMT) to promote recovery of the paretic hand in children with congenital hemiparesis. Method Nineteen children with congenital hemiparesis aged between 8 and 17 years (10 males, nine females; mean age 10y 10mo, SD 2y 10mo; Manual Ability Classification Scale levels I-III) underwent five sessions of either real rTMS (n=10) or sham rTMS (n=9) alternated daily with CIMT. CIMT consisted of 13 days of continuous long-arm casting with five skin-check sessions. Each child received a total of 10 hours of one-to-one therapy. The primary outcome measure was the Assisting Hand Assessment (AHA) and the secondary outcome variables were the Canadian Occupational Performance Measure (COPM) and stereognosis. A Wilcoxon signed-rank sum test was used to analyze differences between pre- and post-test scores within the groups. Analysis of covariance was used to compute mean differences between groups adjusting for baseline. Fisher’s exact test was used to compare individual change in AHA raw scores with the smallest detectable difference (SDD) of 4 points. Results All participants receiving treatment finished the study. Improvement in AHA differed significantly between groups (p=0.007). No significant differences in the secondary outcome measures were found. Eight out of 10 participants in the rTMS/CIMT group showed improvement greater than the SDD, but only two out of nine in the sham rTMS/CIMT group showed such improvement (p=0.023). No serious adverse events occurred. Interpretation Primed, low-frequency rTMS combined with CIMT appears to be safe, feasible, and efficacious in pediatric hemiparesis. Larger clinical trials are now indicated. PMID:23962321

  16. Effectiveness of Constraint induced movement therapy as compared to bimanual therapy in Upper motor function outcome in child with hemiplegic Cerebral palsy

    PubMed Central

    Zafer, Hira; Amjad, Imran; Malik, Arshad Nawaz; Shaukat, Enfall

    2016-01-01

    Objective: This study aims at determining the effectiveness of constraint induced movement therapy as compared to bimanual therapy for improving functional status in children with hemiplegic cerebral palsy. Methods: This study was a randomized control trial, children (n = 20) with spastic hemiplegic cerebral palsy was randomly allocated to CIMT (constraint induced movement therapy) and BMT (bimanual therapy) group. The children with spastic hemiplegia, age between 1.5 and 12 year and having 10 degrees of wrist extension and 10 degrees of finger extension were included in study. Treatment regime was two hours of daily training six days a week for two weeks. Constraint was applied to CIMT group for six hours. The outcome tool QUEST was used for baseline and post treatment assessment. Result: CIMT had superior outcome as compared to BMT in improving functional status (p=0.007). On QUEST tool grasp and dissociated movements results were significant (p=0.005) and (p=0.028) respectively. Weight bearing and protective extension resulted in no significant outcome (p=0.080) and (p=0.149) respectively. Dissociated movements and grasp are significantly improved but there is no difference for weight bearing and protective extension in CIMT treated group as compared to BMT treated group. Conclusion: CIMT approach is better in improving functional status of child with cerebral palsy as compared to BMT. Significant improvement in grasp and dissociated movement is noted in group of CIMT while there was no significant improvement in weight bearing and protective extension in CIMT group when compared to BMT. CIMT is considered the appropriate treatment approach for unilateral conditions while BMT for bilateral conditions. PMID:27022371

  17. INCITE: A randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia

    PubMed Central

    2010-01-01

    Background Congenital hemiplegia is the most common form of cerebral palsy (CP) accounting for 1 in 1300 live births. These children have limitations in capacity to use the impaired upper limb and bimanual coordination deficits which impact on daily activities and participation in home, school and community life. There are currently two diverse intensive therapy approaches. Traditional therapy has adopted a bimanual approach (BIM training) and recently, constraint induced movement therapy (CIMT) has emerged as a promising unimanual approach. Uncertainty remains about the efficacy of these interventions and characteristics of best responders. This study aims to compare the efficacy of CIMT to BIM training to improve outcomes across the ICF for school children with congenital hemiplegia. Methods/Design A matched pairs randomised comparison design will be used with children matched by age, gender, side of hemiplegia and level of upper limb function. Based on power calculations a sample size of 52 children (26 matched pairs) will be recruited. Children will be randomised within pairs to receive either CIMT or BIM training. Both interventions will use an intensive activity based day camp model, with groups receiving the same dosage of intervention delivered in the same environment (total 60 hours over 10 days). A novel circus theme will be used to enhance motivation. Groups will be compared at baseline, then at 3, 26 and 52 weeks following intervention. Severity of congenital hemiplegia will be classified according to brain structure (MRI and white matter fibre tracking), cortical excitability using Transcranial Magnetic Stimulation (TMS), functional use of the hand in everyday tasks (Manual Ability Classification System) and Gross Motor Function Classification System (GMFCS). Outcomes will address neurovascular changes (functional MRI, functional connectivity), and brain (re)organisation (TMS), body structure and function (range of motion, spasticity, strength and

  18. Therapeutic synergism in the treatment of post-stroke arm paresis utilizing botulinum toxin, robotic therapy, and constraint-induced movement therapy.

    PubMed

    Takebayashi, Takashi; Amano, Satoru; Hanada, Keisuke; Umeji, Atsushi; Takahashi, Kayoko; Koyama, Tetsuo; Domen, Kazuhisa

    2014-11-01

    Botulinum toxin type A (BtxA) injection, constraint-induced movement therapy (CIMT), and robotic therapy (RT) each represent promising approaches to enhance arm motor recovery after stroke. To provide more effective treatment for a 50-year-old man with severe left spastic hemiparesis, we attempted to facilitate CIMT with adaptive approaches to extend the wrist and fingers using RT for 10 consecutive weeks after BtxA injection. This combined treatment resulted in substantial improvements in arm function and the amount of arm use in activities of daily living, and may be effective for stroke patients with severe arm paresis. However, we were unable to sufficiently prove the efficacy of combined treatment based only on a single case. To fully elucidate the efficacy of the combined approach for patients with severe hemiparesis after stroke, future studies of a larger number of patients are needed. PMID:24880058

  19. Resting State and Diffusion Neuroimaging Predictors of Clinical Improvements Following Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy.

    PubMed

    Manning, Kathryn Y; Fehlings, Darcy; Mesterman, Ronit; Gorter, Jan Willem; Switzer, Lauren; Campbell, Craig; Menon, Ravi S

    2015-10-01

    The aim was to identify neuroimaging predictors of clinical improvements following constraint-induced movement therapy. Resting state functional magnetic resonance and diffusion tensor imaging data was acquired in 7 children with hemiplegic cerebral palsy. Clinical and magnetic resonance imaging (MRI) data were acquired at baseline and 1 month later following a 3-week constraint therapy regimen. A more negative baseline laterality index characterizing an atypical unilateral sensorimotor resting state network significantly correlated with an improvement in the Canadian Occupational Performance Measure score (r = -0.81, P = .03). A more unilateral network with decreased activity in the affected hemisphere was associated with greater improvements in clinical scores. Higher mean diffusivity in the posterior limb of the internal capsule of the affect tract correlated significantly with improvements in the Jebsen-Taylor score (r = -0.83, P = .02). Children with more compromised networks and tracts improved the most following constraint therapy. PMID:25762587

  20. Increased perfusion in motor areas after constraint-induced movement therapy in chronic stroke: a single-photon emission computerized tomography study.

    PubMed

    Könönen, Mervi; Kuikka, Jyrki T; Husso-Saastamoinen, Minna; Vanninen, Esko; Vanninen, Ritva; Soimakallio, Seppo; Mervaala, Esa; Sivenius, Juhani; Pitkänen, Kauko; Tarkka, Ina M

    2005-12-01

    Hemiparesis is the most common deficit after cerebral stroke. Constraint-induced movement therapy (CIMT) is a new neurorehabilitation method that emphasizes task-relevant repetitive training for the stroke hand. Twelve chronic stroke patients were studied with single-photon emission computerized tomography at rest before and after the two-week CIMT period. Increased perfusion was found in motor control related areas. The specific areas with an increase in perfusion in the affected hemisphere were in the precentral gyrus, premotor cortex (Brodmann's area 6 (BA6)), frontal cortex, and superior frontal gyrus (BA10). In the nonaffected hemisphere, perfusion was increased in the superior frontal gyrus (BA6) and cingulate gyrus (BA31). In the cerebellum increased perfusion was seen bilaterally. The brain areas with increased perfusion receive and integrate the information from different sensory systems and plan the movement execution. Regional cerebral perfusion decreased in the lingual gyrus (BA18) in the affected hemisphere. In the nonaffected frontal cortex, two areas with decreased perfusion were found in the middle frontal gyrus (BA8/10). Also, the fusiform gyrus (BA20) and inferior temporal gyrus (BA37) in the nonaffected hemisphere showed decreased perfusion. Intensive movement therapy appears to change local cerebral perfusion in areas known to participate in movement planning and execution. These changes might be a sign of active reorganization processes after CIMT in the chronic state of stroke. PMID:15931162

  1. To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke

    PubMed Central

    Batool, Sana; Soomro, Nabila; Amjad, Fareeha; Fauz, Rabia

    2015-01-01

    Objective: To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke. Method: A sample of 42 patients was recruited from the Physiotherapy Department of IPM&R and Neurology OPD of Civil Hospital Karachi through non probability purposive sampling technique. Twenty one patients were placed to each experimental and control groups. Experimental group was treated with Constraint Induced Movement Therapy (CIMT) and control group was treated with motor relearning programme (MRP) for three consecutive weeks. Pre and post treatment measurements were determined by upper arm section of Motor Assessment Scale (MAS) and Self Care item of Functional Independence Measure (FIM) Scale. Results: Intra group analysis showed statistically significant results (p-value<0.05) in all items of MAS in both groups. However, advanced hand activities item of MAS in MRP group showed insignificant result (p-value=0.059). Self-care items of FIM Scale also showed significant result (p-value< 0.05) in both groups except dressing upper body item (p-value=0.059) in CIMT group and grooming and dressing upper body items (p-value=0.059 & 0.063) in MRP group showed insignificant p-values. Conclusion: CIMT group showed more significant improvement in motor function and self-care performance of hemiplegic upper extremity as compared to MRP group in patients with sub-acute stroke assessed by the MAS and FIM scales. Thus CIMT is proved to be more statistically significant and clinically effective intervention in comparison to motor relearning programme among the patients aged between 35-60 years. Further studies are needed to evaluate CIMT effects in acute and chronic post stroke population. PMID:26649007

  2. Modified Constraint-Induced Movement Therapy Combined with Bimanual Training (mCIMT-BiT) in Children with Unilateral Spastic Cerebral Palsy: How Are Improvements in Arm-Hand Use Established?

    ERIC Educational Resources Information Center

    Aarts, Pauline B.; Jongerius, Peter H.; Geerdink, Yvonne A.; van Limbeek, Jacques; Geurts, Alexander C.

    2011-01-01

    A recent randomized controlled trial indicated that modified Constraint-Induced Movement Therapy followed by Bimanual Training (mCIMT-BiT) is an effective intervention to improve spontaneous use of the affected upper limb in children with unilateral spastic cerebral palsy (CP). The present study aimed to investigate how the above-mentioned…

  3. Feasibility of a Day-Camp Model of Modified Constraint-Induced Movement Therapy with and without Botulinum Toxin A Injection for Children with Hemiplegia

    ERIC Educational Resources Information Center

    Eliasson, Ann-Christin; Shaw, Karin; Ponten, Eva; Boyd, Roslyn; Krumlinde-Sundholm, Lena

    2009-01-01

    The objective of the study was to investigate the feasibility of modified constraint-induced (CI) therapy provided in a 2-week day-camp model with and without intramuscular botulinum toxin type A (BoNT-A) injections for children with congenital cerebral palsy. Sixteen children with congenital hemiplegia, Manual Ability Classification System (MACS)…

  4. Constraint-induced movement therapy promotes motor function recovery and downregulates phosphorylated extracellular regulated protein kinase expression in ischemic brain tissue of rats

    PubMed Central

    Zhang, Bei; He, Qiang; Li, Ying-ying; Li, Ce; Bai, Yu-long; Hu, Yong-shan; Zhang, Feng

    2015-01-01

    Motor function impairment is a common outcome of stroke. Constraint-induced movement therapy (CIMT) involving intensive use of the impaired limb while restraining the unaffected limb is widely used to overcome the effects of ‘learned non-use’ and improve limb function after stroke. However, the underlying mechanism of CIMT remains unclear. In the present study, rats were randomly divided into a middle cerebral artery occlusion (model) group, a CIMT + model (CIMT) group, or a sham group. Restriction of the affected limb by plaster cast was performed in the CIMT and sham groups. Compared with the model group, CIMT significantly improved the forelimb functional performance in rats. By western blot assay, the expression of phosphorylated extracellular regulated protein kinase in the bilateral cortex and hippocampi of cerebral ischemic rats in the CIMT group was significantly lower than that in the model group, and was similar to sham group levels. These data suggest that functional recovery after CIMT may be related to decreased expression of phosphorylated extracellular regulated protein kinase in the bilateral cortex and hippocampi. PMID:26889190

  5. Constraint-induced movement therapy promotes motor function recovery and downregulates phosphorylated extracellular regulated protein kinase expression in ischemic brain tissue of rats.

    PubMed

    Zhang, Bei; He, Qiang; Li, Ying-Ying; Li, Ce; Bai, Yu-Long; Hu, Yong-Shan; Zhang, Feng

    2015-12-01

    Motor function impairment is a common outcome of stroke. Constraint-induced movement therapy (CIMT) involving intensive use of the impaired limb while restraining the unaffected limb is widely used to overcome the effects of 'learned non-use' and improve limb function after stroke. However, the underlying mechanism of CIMT remains unclear. In the present study, rats were randomly divided into a middle cerebral artery occlusion (model) group, a CIMT + model (CIMT) group, or a sham group. Restriction of the affected limb by plaster cast was performed in the CIMT and sham groups. Compared with the model group, CIMT significantly improved the forelimb functional performance in rats. By western blot assay, the expression of phosphorylated extracellular regulated protein kinase in the bilateral cortex and hippocampi of cerebral ischemic rats in the CIMT group was significantly lower than that in the model group, and was similar to sham group levels. These data suggest that functional recovery after CIMT may be related to decreased expression of phosphorylated extracellular regulated protein kinase in the bilateral cortex and hippocampi. PMID:26889190

  6. Constraint-induced movement therapy as a rehabilitation intervention for upper extremity in stroke patients: systematic review and meta-analysis.

    PubMed

    Etoom, Mohammad; Hawamdeh, Mohannad; Hawamdeh, Ziad; Alwardat, Mohammad; Giordani, Laura; Bacciu, Serenella; Scarpini, Claudia; Foti, Calogero

    2016-09-01

    Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique designed to improve upper extremity motor functions after stroke. This review aimed to investigate evidence of the effect of CIMT on upper extremity in stroke patients and to identify optimal methods to apply CIMT. Four databases (MEDLINE, EMBASE, CINHAL, and PEDro) and reference lists of relevant articles and reviews were searched. Randomized clinical trials that studied the effect of CIMT on upper extremity outcomes in stroke patients compared with other rehabilitative techniques, usual care, or no intervention were included. Methodological quality was assessed using the PEDro score. The following data were extracted for each trial: patients' characteristics, sample size, eligibility criteria, protocols of CIMT and control groups, outcome measurements, and the PEDro score. A total of 38 trials were identified according to the inclusion criteria. The trials included were heterogeneous in CIMT protocols, time since stroke, and duration and frequency of treatment. The pooled meta-analysis of 36 trials found a heterogeneous significant effect of CIMT on upper extremity. There was no significant effect of CIMT at different durations of follow-up. The majority of included articles did not fulfill powered sample size and quality criteria. The effect of CIMT changed in terms of sample size and quality features of the articles included. These meta-analysis findings indicate that evidence for the superiority of CIMT in comparison with other rehabilitative interventions is weak. Information on the optimal dose of CIMT and optimal time to start CIMT is still limited. PMID:27123790

  7. Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Cao, Jianwei; Khan, Bilal; Hervey, Nathan; Tian, Fenghua; Delgado, Mauricio R.; Clegg, Nancy J.; Smith, Linsley; Roberts, Heather; Tulchin-Francis, Kirsten; Shierk, Angela; Shagman, Laura; MacFarlane, Duncan; Liu, Hanli; Alexandrakis, George

    2015-04-01

    Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2±2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8±1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity.

  8. Safety of primed repetitive transcranial magnetic stimulation and modified constraint-induced movement therapy in a randomized controlled trial in pediatric hemiparesis

    PubMed Central

    Gillick, Bernadette; Krach, Linda E; Feyma, Tim; Rich, Tonya L; Moberg, Kelli; Menk, Jeremiah; Cassidy, Jessica; Kimberley, Teresa; Carey, James R

    2014-01-01

    Objective To investigate the safety of combining 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) intervention in the contralesional hemisphere with a modified constraint-induced movement therapy (mCIMT) program in children with congenital hemiparesis. Design Phase 1 randomized, double-blinded, placebo-controlled pretest/posttest trial. Setting University academic facility and a pediatric specialty hospital. Participants Nineteen subjects aged 8 to 17 years with congenital hemiparesis due to ischemic stroke or periventricular leukomalacia. No subject withdrew due to adverse events. All subjects included completed the study. Interventions Subjects were randomized to one of two groups: either rTMSreal with mCIMT (n = 10) or rTMSsham with mCIMT (n = 9). Main Outcome Measures Adverse events, physician assessment, ipsilateral hand function, stereognosis, cognitive function, subject report of symptoms assessment and subject questionnaire. Results No major adverse events occurred. Minor adverse events were found in both groups. The most common were headaches (real: 50%, sham: 89%, p=0.14) and cast irritation (real: 30%, sham: 44%, p = 0.65). No differences between groups in secondary cognitive and unaffected hand motor measures were found. Conclusions Primed rTMS can be used safely with mCIMT in congenital hemiparesis. We provide new information on the use of rTMS in combination with mCIMT in children. These findings could be useful in research and future clinical applications in advancing function in congenital hemiparesis. PMID:25283350

  9. Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

    PubMed Central

    Cao, Jianwei; Khan, Bilal; Hervey, Nathan; Tian, Fenghua; Delgado, Mauricio R.; Clegg, Nancy J.; Smith, Linsley; Roberts, Heather; Tulchin-Francis, Kirsten; Shierk, Angela; Shagman, Laura; MacFarlane, Duncan; Liu, Hanli; Alexandrakis, George

    2015-01-01

    Abstract. Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2±2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8±1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity. PMID:25900145

  10. Influences of hand dominance on the maintenance of benefits after home-based modified constraint-induced movement therapy in individuals with stroke

    PubMed Central

    Lima, Renata C. M.; Nascimento, Lucas R.; Michaelsen, Stella M.; Polese, Janaine C.; Pereira, Natália D.; Teixeira-Salmela, Luci F.

    2014-01-01

    Objective: To investigate the influence of hand dominance on the maintenance of gains after home-based modified constraint-induced movement therapy (mCIMT). Method: Aprevious randomized controlled trial was conducted to examine the addition of trunk restraint to the mCIMT. Twenty-two chronic stroke survivors with mild to moderate motor impairments received individual home-based mCIMT with or without trunk restraints, five times per week, three hours daily over two weeks. In this study, the participants were separated into dominant group, which had their paretic upper limb as dominant before the stroke (n=8), and non-dominant group (n=14) for analyses. The ability to perform unimanual tasks was measured by the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL), whereas the capacity to perform bimanual tasks was measured using the Bilateral Activity Assessment Scale (BAAS). Results: Analysis revealed significant positive effects on the MAL amount of use and quality of the movement scales, as well as on the BAAS scores after intervention, with no differences between groups. Both groups maintained the bimanual improvements during follow-ups (BAAS-seconds 0.1, 95% CI -10.0 to 10.0), however only the dominant group maintained the unilateral improvements (MAL-amount of use: 1.5, 95% CI 0.7 to 2.3; MAL-quality: 1.3, 95% CI 0.5 to 2.1). Conclusions: Upper limb dominance did not interfere with the acquisition of upper limb skills after mCIMT. However, the participants whose paretic upper limb was dominant demonstrated better abilities to maintain the unilateral gains. The bilateral improvements were maintained, regardless of upper limb dominance. PMID:25372006

  11. Motor learning curve and long-term effectiveness of modified constraint-induced movement therapy in children with unilateral cerebral palsy: a randomized controlled trial.

    PubMed

    Geerdink, Yvonne; Aarts, Pauline; Geurts, Alexander C

    2013-03-01

    The goal of this study was to determine the progression of manual dexterity during 6 weeks (54h) (modified) constraint-induced movement therapy ((m)CIMT) followed by 2 weeks (18h) bimanual training (BiT) in children with unilateral spastic cerebral palsy (CP), to establish whether and when a maximal training effect was reached and which factors might influence the motor learning curve. In addition, long-term retention of effects was determined. In a randomized controlled trial of 52 children with CP, aged 2.5-8 years, comparing mCIMT-BiT to conventional therapy, 28 children were allocated to the mCIMT-BiT group. This group was assessed weekly with the Box and Block test. Long-term effectiveness was determined by collecting follow-up data of the primary (Assisting Hand Assessment, ABILHAND-Kids) and secondary (Melbourne, COPM) outcomes at six months and one year after intervention. Fifteen children (53.6%) reached a maximum training effect within the mCIMT period. This group differed from others with respect to age, but not gender, affected side or manual ability. Children younger than five years had a greater chance to reach a maximum score within 6 weeks mCIMT (OR=6.67, 95%CI=1.24-35.71) that stabilized already after four weeks; older children showed a longer progression and tended to decline afterwards. In both age groups, beneficial effects were retained in the long term. The findings suggest that children of 5 years and older might profit from a longer period of mCIMT than 54h to reach their maximum unimanual capacity and to retain this capacity during subsequent bimanual training. PMID:23291509

  12. Effects of modified constraint-induced movement therapy and functional bimanual training on upper extremity function and daily activities in a patient with incomplete spinal cord injury: a case study.

    PubMed

    Kim, Yeon-Ju; Kim, Jin-Kyung; Park, So-Yeon

    2015-12-01

    [Purpose] In this study, we examined effects of modified constraint-induced movement therapy (m-CIMT) and functional bimanual training, when applied to a patient with incomplete spinal cord injury, on upper extremity function and daily activities. [Subject and Methods] One patient, diagnosed with C4 incomplete spinal cord injury, underwent physical therapy with constraint-induced movement therapy for 3 hours and task-oriented bimanual training for 1 hour, per day. This combined 4-hour session was performed five times a week, for 3 weeks, totaling 15 sessions. Upper extremity function was measured using the Manual Function Test (MFT) and Box & Block Test (BBT). Additionally, Spinal Cord Independence Measure Version III (SCIM-III) and Short Form 36 Health Survey (SF-36) were used to assess functional outcomes. [Results] Mobility of the hand and overall function of upper extremities were enhanced following intervention. Moreover, the subject's quality of life and ability to carry out daily activities also improved. [Conclusion] Modified constraint-induced movement therapy and bimanual training was effective in enhancing upper extremity function and performance of daily routines in a patient with incomplete spinal cord injury. Further studies, recruiting multiple subjects, should focus on m-CIMT using diverse methods, performed during the course of daily activities. PMID:26834387

  13. Effects of modified constraint-induced movement therapy and functional bimanual training on upper extremity function and daily activities in a patient with incomplete spinal cord injury: a case study

    PubMed Central

    Kim, Yeon-Ju; Kim, Jin-Kyung; Park, So-Yeon

    2015-01-01

    [Purpose] In this study, we examined effects of modified constraint-induced movement therapy (m-CIMT) and functional bimanual training, when applied to a patient with incomplete spinal cord injury, on upper extremity function and daily activities. [Subject and Methods] One patient, diagnosed with C4 incomplete spinal cord injury, underwent physical therapy with constraint-induced movement therapy for 3 hours and task-oriented bimanual training for 1 hour, per day. This combined 4-hour session was performed five times a week, for 3 weeks, totaling 15 sessions. Upper extremity function was measured using the Manual Function Test (MFT) and Box & Block Test (BBT). Additionally, Spinal Cord Independence Measure Version III (SCIM-III) and Short Form 36 Health Survey (SF-36) were used to assess functional outcomes. [Results] Mobility of the hand and overall function of upper extremities were enhanced following intervention. Moreover, the subject’s quality of life and ability to carry out daily activities also improved. [Conclusion] Modified constraint-induced movement therapy and bimanual training was effective in enhancing upper extremity function and performance of daily routines in a patient with incomplete spinal cord injury. Further studies, recruiting multiple subjects, should focus on m-CIMT using diverse methods, performed during the course of daily activities. PMID:26834387

  14. Effect of small group treatment of the modified constraint induced movement therapy for clients with chronic stroke in a community setting.

    PubMed

    Leung, Daniel P K; Ng, Adelina K Y; Fong, Kenneth N K

    2009-12-01

    This study investigated the effects of the group treatment component of the modified constraint induced movement therapy (mCIMT) protocol for clients with chronic stroke in a community setting. A within-subjects longitudinal study was conducted to which eight participants with chronic stroke being treated in a community setting in Hong Kong were recruited. Ten 3-h group sessions were conducted on two occasions within a four-week period, with four participants per group. Participants' less-affected hands were restrained in a mitt, with a target of wearing it for 4h per weekday. Laboratory based tests and the Motor Activity Log (MAL) were used repeatedly to measure participants' hemiparetic upper extremity functions and the use of the limb in real-life on four measurement occasions: at baseline (four weeks before training), pre-test (one day before training), post-test (one day after training), and follow-up (four weeks after training). The Wilcoxon signed-rank test showed participants' baselines were stable four weeks before the intervention. The Friedman test found significant differences between pre-test, post-test and follow-up in the Box and Block Test (BBT), the total score, grasp and pinch subscores of the Action Research Arm Test (ARAT), and the Hong Kong Version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK), the Wolf Motor Function Test (WMFT), and the MAL. All these gains were maintained during the 1-month follow-up. The small group treatment component of the mCIMT was found to be effective, feasible, and capable of improving both motor performance and functional use of the affected upper extremity for patients with chronic stroke in a community setting. PMID:19837473

  15. Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper

    PubMed Central

    2010-01-01

    Background Use of Botulinum toxin-A (BoNT-A) for treatment of upper limb spasticity in children with cerebral palsy has become routine clinical practice in many paediatric treatment centres worldwide. There is now high-level evidence that upper limb BoNT-A injection, in combination with occupational therapy, improves outcomes in children with cerebral palsy at both the body function/structure and activity level domains of the International Classification of Functioning, Disability and Health. Investigation is now required to establish what amount and specific type of occupational therapy will further enhance functional outcomes and prolong the beneficial effects of BoNT-A. Methods/Design A randomised, controlled, evaluator blinded, prospective parallel-group trial. Eligible participants were children aged 18 months to 6 years, diagnosed with spastic hemiplegic cerebral palsy and who were able to demonstrate selective motor control of the affected upper limb. Both groups received upper limb injections of BoNT-A. Children were randomised to either the modified constraint-induced movement therapy group (experimental) or bimanual occupational therapy group (control). Outcome assessments were undertaken at pre-injection and 1, 3 and 6 months following injection of BoNT-A. The primary outcome measure was the Assisting Hand Assessment. Secondary outcomes included: the Quality of Upper Extremity Skills Test; Pediatric Evaluation of Disability Inventory; Canadian Occupational Performance Measure; Goal Attainment Scaling; Pediatric Motor Activity Log; modified Ashworth Scale and; the modified Tardieu Scale. Discussion The aim of this paper is to describe the methodology of a randomised controlled trial comparing the effects of modified constraint-induced movement therapy (a uni-manual therapy) versus bimanual occupational therapy (a bimanual therapy) on improving bimanual upper limb performance of children with hemiplegic cerebral palsy following upper limb injection of Bo

  16. Constraint Induced Movement Techniques To Facilitate Upper Extremity Use in Stroke Patients.

    PubMed

    Taub, E; Wolf, S L

    1997-01-01

    A new therapeutic approach to the rehabilitation of movement after stroke, termed constraint-induced (CI) movement therapy, has been derived from basic research with monkeys given somatosensory deafferentation. CI movement therapy consists of a family of therapies; their common element is that they induce stroke patients to greatly increase the use of an affected upper extremity for many hours a day over a period of 10 to 14 consecutive days. The signature intervention involves motor restriction of the contralateral upper extremity in a sling and training of the affected arm. The therapies result in large changes in amount of use of the affected arm in the activities of daily living outside of the clinic that have persisted for the 2 years measured to date. Patients who will benefit from Cl therapy can be identified before the beginning of treatment. PMID:27620374

  17. COMBIT: protocol of a randomised comparison trial of COMbined modified constraint induced movement therapy and bimanual intensive training with distributed model of standard upper limb rehabilitation in children with congenital hemiplegia

    PubMed Central

    2013-01-01

    Introduction Children with congenital hemiplegia often present with limitations in using their impaired upper limb which impacts on independence in activities of daily living, societal participation and quality of life. Traditional therapy has adopted a bimanual training approach (BIM) and more recently, modified constraint induced movement therapy (mCIMT) has emerged as a promising unimanual approach. Evidence of enhanced neuroplasticity following mCIMT suggests that the sequential application of mCIMT followed by bimanual training may optimise outcomes (Hybrid CIMT). It remains unclear whether more intensely delivered group based interventions (hCIMT) are superior to distributed models of individualised therapy. This study aims to determine the optimal density of upper limb training for children with congenital hemiplegia. Methods and analyses A total of 50 children (25 in each group) with congenital hemiplegia will be recruited to participate in this randomized comparison trial. Children will be matched in pairs at baseline and randomly allocated to receive an intensive block group hybrid model of combined mCIMT followed by intensive bimanual training delivered in a day camp model (COMBiT; total dose 45 hours direct, 10 hours of indirect therapy), or a distributed model of standard occupational therapy and physiotherapy care (SC) over 12 weeks (total 45 hours direct and indirect therapy). Outcomes will be assessed at 13 weeks after commencement, and retention of effects tested at 26 weeks. The primary outcomes will be bimanual coordination and unimanual upper-limb capacity. Secondary outcomes will be participation and quality of life. Advanced brain imaging will assess neurovascular changes in response to treatment. Analysis will follow standard principles for RCTs, using two-group comparisons on all participants on an intention-to-treat basis. Comparisons will be between treatment groups using generalized linear models. Trial registration ACTRN12613000181707

  18. The Pirate group intervention protocol: description and a case report of a modified constraint-induced movement therapy combined with bimanual training for young children with unilateral spastic cerebral palsy.

    PubMed

    Aarts, Pauline B; van Hartingsveldt, Margo; Anderson, Patricia G; van den Tillaar, Ingrid; van der Burg, Jan; Geurts, Alexander C

    2012-06-01

    The purpose of this article was to describe a child-friendly modified constraint-induced movement therapy protocol that is combined with goal-directed task-specific bimanual training (mCIMT-BiT). This detailed description elucidates the approach and supports various research reports. This protocol is used in a Pirate play group setting and aims to extend bimanual skills in play and self-care activities for children with cerebral palsy and unilateral spastic paresis of the upper limb. To illustrate the content and course of treatment and its effect, a case report of a two-year-old boy is presented. After the eight-week mCIMT-BiT intervention, the child improved the capacity of his affected arm and hand in both quantitative and qualitative terms and his bimanual performance in daily life as assessed by the Assisting Hand Assessment, ABILHAND-Kids, Video Observations Aarts and Aarts Module Determine Developmental Disregard, Canadian Occupational Performance Measure and Goal Attainment Scaling. It is argued that improvement of affected upper-limb capacity in a test situation may be achieved and retained relatively easily, but it may take a lot more training to stabilize the results and automate motor control of the upper limb. Future studies with groups of children should elaborate on these intensity and generalization issues. PMID:21751275

  19. Enhancing activities of daily living of chronic stroke patients in primary health care by modified constraint-induced movement therapy (HOMECIMT): study protocol for a cluster randomized controlled trial

    PubMed Central

    2013-01-01

    Background Stroke leads to constant rehabilitation needs even at the chronic stage. However, although many stroke patients receive physical or occupational therapy in primary health care, treatment prescriptions do not generally specify therapeutic goals; in particular, participation is not established as an explicit therapeutic goal in the ambulatory setting. The primary aim of this study is to evaluate the efficacy of a therapy regimen for chronic stroke patients (modified ‘constraint-induced movement therapy (CIMT) at home’) with impaired hand or arm function with regard to the prerequisites of participation in everyday activities: a sufficient arm and hand function. ‘CIMT at home’ will be compared with conventional physical and occupational therapy (‘therapy as usual’). Methods/design The study is a parallel cluster randomized controlled trial with therapy practices as clusters (n = 48). After written consent from the patients (n = 144), the therapists will be randomly assigned to treat either the intervention or the control group. Blinded external assessors will evaluate the patients using standardized outcome measures before and after the intervention, and six months later. The two coprimary endpoint assessments of arm and hand function as prerequisites for participation (defined as equal involvement in activities of daily living) are the motor activity log (quality of arm and hand use) and the Wolf motor function test (arm and hand function). These assessments are made four weeks post-treatment and relativized to baseline performance. Changes in primary outcomes will be analyzed with mixed models, which consider the hierarchical structure of the data and will be adjusted to the baseline measurements and sex. The primary analysis will be the comparison of the two randomized groups, with respect to the adjusted averages for each of the two coprimary endpoints. To keep an overall significance level of 5%, the two endpoints will be tested at the

  20. Constraint-induced sound therapy for sudden sensorineural hearing loss--behavioral and neurophysiological outcomes.

    PubMed

    Okamoto, Hidehiko; Fukushima, Munehisa; Teismann, Henning; Lagemann, Lothar; Kitahara, Tadashi; Inohara, Hidenori; Kakigi, Ryusuke; Pantev, Christo

    2014-01-01

    Sudden sensorineural hearing loss is characterized by acute, idiopathic hearing deterioration. We report here the development and evaluation of "constraint-induced sound therapy", which is based on a well-established neuro-rehabilitation approach, and which is characterized by the plugging of the intact ear ("constraint") and the simultaneous, extensive stimulation of the affected ear with music. The sudden sensorineural hearing loss patients who received the constraint-induced sound therapy in addition to the standard corticosteroid therapy showed significantly better recovery of hearing function compared to those who had only received corticosteroid treatments. Additionally, the brain activity obtained in a subgroup of patients suggested that the constraint-induced sound therapy could have prevented maladaptive auditory cortex reorganization. Constraint-induced sound therapy thus appears to be an effective, practical, and safe treatment option for sudden sensorineural hearing loss. PMID:24473277

  1. Constraint-induced sound therapy for sudden sensorineural hearing loss – behavioral and neurophysiological outcomes

    PubMed Central

    Okamoto, Hidehiko; Fukushima, Munehisa; Teismann, Henning; Lagemann, Lothar; Kitahara, Tadashi; Inohara, Hidenori; Kakigi, Ryusuke; Pantev, Christo

    2014-01-01

    Sudden sensorineural hearing loss is characterized by acute, idiopathic hearing deterioration. We report here the development and evaluation of “constraint-induced sound therapy”, which is based on a well-established neuro-rehabilitation approach, and which is characterized by the plugging of the intact ear (“constraint”) and the simultaneous, extensive stimulation of the affected ear with music. The sudden sensorineural hearing loss patients who received the constraint-induced sound therapy in addition to the standard corticosteroid therapy showed significantly better recovery of hearing function compared to those who had only received corticosteroid treatments. Additionally, the brain activity obtained in a subgroup of patients suggested that the constraint-induced sound therapy could have prevented maladaptive auditory cortex reorganization. Constraint-induced sound therapy thus appears to be an effective, practical, and safe treatment option for sudden sensorineural hearing loss. PMID:24473277

  2. Functional Improvement after Photothrombotic Stroke in Rats Is Associated with Different Patterns of Dendritic Plasticity after G-CSF Treatment and G-CSF Treatment Combined with Concomitant or Sequential Constraint-Induced Movement Therapy

    PubMed Central

    Leukel, Petra; Bauer, Henrike; Schäbitz, Wolf-Rüdiger; Sommer, Clemens J.; Minnerup, Jens

    2016-01-01

    We have previously shown that granulocyte-colony stimulating factor (G-CSF) treatment alone, or in combination with constraint movement therapy (CIMT) either sequentially or concomitantly, results in significantly improved sensorimotor recovery after photothrombotic stroke in rats in comparison to untreated control animals. CIMT alone did not result in any significant differences compared to the control group (Diederich et al., Stroke, 2012;43:185–192). Using a subset of rat brains from this former experiment the present study was designed to evaluate whether dendritic plasticity would parallel improved functional outcomes. Five treatment groups were analyzed (n = 6 each) (i) ischemic control (saline); (ii) CIMT (CIMT between post-stroke days 2 and 11); (iii) G-CSF (10 μg/kg G-CSF daily between post-stroke days 2 and 11); (iv) combined concurrent group (CIMT plus G-CSF) and (v) combined sequential group (CIMT between post-stroke days 2 and 11; 10 μg/kg G-CSF daily between post-stroke days 12 and 21, respectively). After impregnation of rat brains with a modified Golgi-Cox protocol layer V pyramidal neurons in the peri-infarct cortex as well as the corresponding contralateral cortex were analyzed. Surprisingly, animals with a similar degree of behavioral recovery exhibited quite different patterns of dendritic plasticity in both peri-lesional and contralesional areas. The cause for these patterns is not easily to explain but puts the simple assumption that increased dendritic complexity after stroke necessarily results in increased functional outcome into perspective. PMID:26752421

  3. Functional Improvement after Photothrombotic Stroke in Rats Is Associated with Different Patterns of Dendritic Plasticity after G-CSF Treatment and G-CSF Treatment Combined with Concomitant or Sequential Constraint-Induced Movement Therapy.

    PubMed

    Frauenknecht, Katrin; Diederich, Kai; Leukel, Petra; Bauer, Henrike; Schäbitz, Wolf-Rüdiger; Sommer, Clemens J; Minnerup, Jens

    2016-01-01

    We have previously shown that granulocyte-colony stimulating factor (G-CSF) treatment alone, or in combination with constraint movement therapy (CIMT) either sequentially or concomitantly, results in significantly improved sensorimotor recovery after photothrombotic stroke in rats in comparison to untreated control animals. CIMT alone did not result in any significant differences compared to the control group (Diederich et al., Stroke, 2012;43:185-192). Using a subset of rat brains from this former experiment the present study was designed to evaluate whether dendritic plasticity would parallel improved functional outcomes. Five treatment groups were analyzed (n = 6 each) (i) ischemic control (saline); (ii) CIMT (CIMT between post-stroke days 2 and 11); (iii) G-CSF (10 μg/kg G-CSF daily between post-stroke days 2 and 11); (iv) combined concurrent group (CIMT plus G-CSF) and (v) combined sequential group (CIMT between post-stroke days 2 and 11; 10 μg/kg G-CSF daily between post-stroke days 12 and 21, respectively). After impregnation of rat brains with a modified Golgi-Cox protocol layer V pyramidal neurons in the peri-infarct cortex as well as the corresponding contralateral cortex were analyzed. Surprisingly, animals with a similar degree of behavioral recovery exhibited quite different patterns of dendritic plasticity in both peri-lesional and contralesional areas. The cause for these patterns is not easily to explain but puts the simple assumption that increased dendritic complexity after stroke necessarily results in increased functional outcome into perspective. PMID:26752421

  4. [Dance/Movement Therapy.

    ERIC Educational Resources Information Center

    Fenichel, Emily, Ed.

    1994-01-01

    This newsletter theme issue focuses on dance, play, and movement therapy for infants and toddlers with disabilities. Individual articles are: "Join My Dance: The Unique Movement Style of Each Infant and Toddler Can Invite Communication, Expression and Intervention" (Suzi Tortora); "Dynamic Play Therapy: An Integrated Expressive Arts Approach to…

  5. Modified Constraint-Induced Therapy for Children with Hemiplegic Cerebral Palsy: A Randomized Trial

    ERIC Educational Resources Information Center

    Wallen, Margaret; Ziviani, Jenny; Naylor, Olivia; Evans, Ruth; Novak, Iona; Herbert, Robert D.

    2011-01-01

    Aim: Conventional constraint-based therapies are intensive and demanding to implement, particularly for children. Modified forms of constraint-based therapies that are family-centred may be more acceptable and feasible for families of children with cerebral palsy (CP)-but require rigorous evaluation using randomized trials. The aim of this study…

  6. Logistic Regression Analyses for Predicting Clinically Important Differences in Motor Capacity, Motor Performance, and Functional Independence after Constraint-Induced Therapy in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Wang, Tien-ni; Wu, Ching-yi; Chen, Chia-ling; Shieh, Jeng-yi; Lu, Lu; Lin, Keh-chung

    2013-01-01

    Given the growing evidence for the effects of constraint-induced therapy (CIT) in children with cerebral palsy (CP), there is a need for investigating the characteristics of potential participants who may benefit most from this intervention. This study aimed to establish predictive models for the effects of pediatric CIT on motor and functional…

  7. Effects of Home-Based Constraint-Induced Therapy versus Dose-Matched Control Intervention on Functional Outcomes and Caregiver Well-Being in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Lin, Keh-chung; Wang, Tien-ni; Wu, Ching-yi; Chen, Chia-ling; Chang, Kai-chieh; Lin, Yu-chan; Chen, Yi-ju

    2011-01-01

    This study compared home-based constraint-induced therapy (CIT) with a dose-matched home-based control intervention for children with cerebral palsy (CP). The differences in unilateral and bilateral motor performance, daily functions, and quality of parental well-being (i.e., the stress level of their parents) were evaluated. The study included 21…

  8. Evidence-Based Systematic Review: Effects of Intensity of Treatment and Constraint-Induced Language Therapy for Individuals with Stroke-Induced Aphasia

    ERIC Educational Resources Information Center

    Cherney, Leora R.; Patterson, Janet P.; Raymer, Anastasia; Frymark, Tobi; Schooling, Tracy

    2008-01-01

    Purpose: This systematic review summarizes evidence for intensity of treatment and constraint-induced language therapy (CILT) on measures of language impairment and communication activity/participation in individuals with stroke-induced aphasia. Method: A systematic search of the aphasia literature using 15 electronic databases (e.g., PubMed,…

  9. Similar Effects of Two Modified Constraint-Induced Therapy Protocols on Motor Impairment, Motor Function and Quality of Life in Patients with Chronic Stroke

    PubMed Central

    Souza, Wilma Costa; Conforto, Adriana B.; Orsini, Marco; Stern, Annette; André, Charles

    2015-01-01

    Modified constraint-induced movement therapy (CIMT) protocols show motor function and real-world arm use improvement. Meanwhile it usually requires constant supervision by physiotherapists and is therefore more expensive than customary care. This study compared the preliminary efficacy of two modified CIMT protocols. A two-group randomized controlled trial with pre and post treatment measures and six months follow-up was conducted. Nineteen patients with chronic stroke received 10 treatment sessions distributed three to four times a week over 22 days. CIMT3h_direct group received 3 hours of CIMT supervised by a therapist (n=10) while CIMT1.5h_direct group had 1.5 hours of supervised CIMT+1.5 hours home exercises supervised by a caregiver (n=9). Outcome measures were the Fugl-Meyer Assessment, the Motor Activity Log, and the Stroke Specific Quality of Life Scale. The modified CIMT protocols were feasible and well tolerated. Improvements in motor function, real-world arm use and quality of life did not differ significantly between treated groups receiving either 3 or 1.5 hours mCIMT supervised by a therapist. PMID:26294941

  10. Constraint-Induced Aphasia Therapy for Treatment of Chronic Post-Stroke Aphasia: A Randomized, Blinded, Controlled Pilot Trial

    PubMed Central

    Szaflarski, Jerzy P.; Ball, Angel L.; Vannest, Jennifer; Dietz, Aimee R.; Allendorfer, Jane B.; Martin, Amber N.; Hart, Kimberly; Lindsell, Christopher J.

    2015-01-01

    Background Few studies have documented the possibility of treatment-induced improvements in language functions 12 months or longer after stroke. The purpose of the current study was to provide a preliminary estimate of efficacy of constraint-induced aphasia therapy (CIAT) when compared to no-intervention in patients with chronic (>1 year) post-stroke aphasia in order to provide the data needed to design an appropriately powered trial. Material/Methods This was a randomized, controlled, single-blinded, pilot trial. We identified 32 patients with chronic post-stroke aphasia. Of these, 27 were offered participation, and 24 were randomized (CONSORT diagram): 14 to CIAT and to 10 to no-intervention. CIAT groups received up to 4 hours/day of intervention for 10 consecutive business days (40 hours of therapy). Outcomes were assessed within 1 week of intervention and at 1 and 12 weeks after intervention and included several linguistic measures and a measure of overall subjective communication abilities (mini-Communicative Abilities Log (mini-CAL)). To maintain blinding, clinicians treating patients (CIAT group) did not communicate with other team members and the testing team members were blinded to treatment group assignment. Results Overall, the results of this pilot trial support the results of previous observational studies that CIAT may lead to improvements in linguistic abilities. At 12 weeks, the treatment group reported better subjective communication abilities (mini-CAL) than the no-intervention group (p=0.019). Other measures trended towards better performance in the CIAT group. Conclusions In this randomized, controlled, and blinded pilot study, intensive language therapy (CIAT) led to an improvement in subjective language abilities. The effects demonstrated allow the design of a definitive trial of CIAT in patients with a variety of post-stroke aphasia types. In addition, our experiences have identified important considerations for designing subsequent trial

  11. Bilateral brain reorganization with memantine and constraint-induced aphasia therapy in chronic post-stroke aphasia: An ERP study.

    PubMed

    Barbancho, Miguel A; Berthier, Marcelo L; Navas-Sánchez, Patricia; Dávila, Guadalupe; Green-Heredia, Cristina; García-Alberca, José M; Ruiz-Cruces, Rafael; López-González, Manuel V; Dawid-Milner, Marc S; Pulvermüller, Friedemann; Lara, J Pablo

    2015-01-01

    Changes in ERP (P100 and N400) and root mean square (RMS) were obtained during a silent reading task in 28 patients with chronic post-stroke aphasia in a randomized, double-blind, placebo-controlled trial of both memantine and constraint-induced aphasia therapy (CIAT). Participants received memantine/placebo alone (weeks 0-16), followed by drug treatment combined with CIAT (weeks 16-18), and then memantine/placebo alone (weeks 18-20). ERP/RMS values (week 16) decreased more in the memantine group than in the placebo group. During CIAT application (weeks 16-18), improvements in aphasia severity and ERP/RMS values were amplified by memantine and changes remained stable thereafter (weeks 18-20). Changes in ERP/RMS occurred in left and right hemispheres and correlated with gains in language performance. No changes in ERP/RMS were found in a healthy group in two separated evaluations. Our results show that aphasia recovery induced by both memantine alone and in combination with CIAT is indexed by bilateral cortical potentials. PMID:25932618

  12. A Functional Threshold for Long-Term Use of Hand and Arm Function Can Be Determined: Predictions From a Computational Model and Supporting Data From the Extremity Constraint-Induced Therapy Evaluation (EXCITE) Trial

    PubMed Central

    Han, Cheol E.; Wolf, Steven L.; Arbib, Michael A.; Winstein, Carolee J.

    2009-01-01

    Background Although spontaneous use of the more-affected arm and hand after stroke is an important determinant of participation and quality of life, a number of patients exhibit decreases in use following rehabilitative therapy. A previous neurocomputational model predicted that if the dose of therapy is sufficient to bring performance above a certain threshold, training can be stopped. Objective The aim of this study was to test the hypothesis that there exists a threshold for function of the paretic arm and hand after therapy. If function is above this threshold, spontaneous use will increase in the months following therapy. In contrast, if function is below this threshold, spontaneous use will decrease. Methods New computer simulations are presented showing that changes in arm use following therapy depend on a performance threshold. This prediction was tested by reanalyzing the data from the Extremity Constraint-Induced Therapy Evaluation (EXCITE) trial, a phase III randomized controlled trial in which participants received constraint-induced movement therapy for 2 weeks and were tested both 1 week and 1 year after therapy. Results The results demonstrate that arm and hand function measured immediately after therapy predicts, on average, the long-term change of arm use. Above a functional threshold, use improves. Below this threshold, use decreases. Limitations The reanalysis of the EXCITE trial data provides a “group” threshold above which a majority of patients, but not all, improve spontaneously. A goal of future research is to provide the means to assess when patients reach their individual threshold. Conclusion Understanding of the causal and nonlinear relationship between limb function and daily use is important for the future development of cost-effective interventions and prevention of “rehabilitation in vain.” PMID:19797304

  13. Plasticity in the motor system related to therapy-induced improvement of movement after stroke.

    PubMed

    Kopp, B; Kunkel, A; Mühlnickel, W; Villringer, K; Taub, E; Flor, H

    1999-03-17

    Neuroplasticity might play a beneficial role in the recovery of function after stroke but empirical evidence for this is lacking thus far. Constraint-induced (CI) therapy was used to increase the use of a paretic upper extremity in four hemiparetic stroke patients. Dipole modeling of steady-state movement-related cortical potentials was applied before and after training and 3 months later. The source locations associated with affected hand movement were unusual at follow-up because activation of the ipsilateral hemisphere was found in the absence of mirror movements of the unaffected hand. This long-term change may be considered as an initial demonstration of large-scale neuroplasticity associated with increased use of the paretic limb after application of CI therapy. PMID:10208552

  14. Dance/Movement Therapy. A Healing Art.

    ERIC Educational Resources Information Center

    Levy, Fran J.

    This book examines the field of dance therapy from its inception in the 1940's to the present. A detailed analysis is conducted of the theory and practice of the major pioneers. The book covers biographical reports and the influence of many dance therapy leaders. Laban Movement Analysis (LMA) is discussed as well as dance therapy in specific…

  15. Creative Movement Therapy Benefits Children with Autism.

    ERIC Educational Resources Information Center

    Hartshorn, Kristin; Olds, Loren; Field, Tiffany; Delage, Jessie; Cullen, Christy; Escalona, Angelica

    2001-01-01

    Thirty-eight children with autism were given movement therapy in small groups led by a trained movement therapist. After two months of biweekly sessions, the children spent less time wandering, more time showing on-task behavior, less time showing negative responses to being touched, and less time resisting the teacher than those in the control…

  16. Movement-Based VR Gameplay Therapy For A Child With Cerebral Palsy.

    PubMed

    Stansfield, Sharon; Dennis, Carole; Larin, Hélène; Gallagher, Courtney

    2015-01-01

    This paper presents a single-subject feasibility study of a motion-based VR game designed to provide benefits similar to constraint-induced movement therapy for children with cerebral palsy, while providing a more enjoyable experience. The game was designed to encourage the child to perform the desired therapeutic movements by allowing him to interact with the game using only his more-affected arm. The study used an AB design: Performance across baseline and intervention phases was assessed to determine whether the intervention resulted in changes to repeated measures. Results of the study showed that compared with baseline measurements done prior to his game experience, the participant's post-intervention performance showed improvement in speed of reach, dissociated movement, and bilateral integration of upper extremities in functional tasks. The child's mother, as well as one of his therapists, reported better performance outside of the study environment as well. PMID:26799898

  17. An Ecological Approach of Constraint Induced Movement Therapy for 2-3-Year-Old Children: A Randomized Control Trial

    ERIC Educational Resources Information Center

    Eliasson, Ann-Christin; Shaw, Karin; Berg, Elisabeth; Krumlinde-Sundholm, Lena

    2011-01-01

    The aim was to evaluate the effect of Eco-CIMT in young children with unilateral cerebral palsy in a randomized controlled crossover design. The training was implemented within the regular pediatric services, provided by the child's parents and/or preschool teacher and supervised by the child's regular therapist. Methods: Twenty-five children…

  18. Dance/Movement Therapy: A Unique Career Opportunity.

    ERIC Educational Resources Information Center

    Armeniox, Leslie Flint

    Dance and movement therapy is a form of psychotherapy that uses the body, dance, and movement as the primary mediums for the therapeutic process. Dance is a fundamental art form that involves the body as an instrument of self-expression; movement is a universal means of learning and communicating. Dance and movement therapy is the…

  19. Movement therapy induced neural reorganization and motor recovery in stroke: a review.

    PubMed

    Arya, Kamal Narayan; Pandian, Shanta; Verma, Rajesh; Garg, R K

    2011-10-01

    This paper is a review conducted to provide an overview of accumulated evidence on contemporary rehabilitation methods for stroke survivors. Loss of functional movement is a common consequence of stroke for which a wide range of interventions has been developed. Traditional therapeutic approaches have shown limited results for motor deficits as well as lack evidence for their effectiveness. Stroke rehabilitation is now based on the evidence of neuroplasticity, which is responsible for recovery following stroke. The neuroplastic changes in the structure and function of relevant brain areas are induced primarily by specific rehabilitation methods. The therapeutic method which induces neuroplastic changes, leads to greater motor and functional recovery than traditional methods. Further, the recovery is permanent in nature. During the last decade various novel stroke rehabilitative methods for motor recovery have been developed. This review focuses on the methods that have evidence of associated cortical level reorganization, namely task-specific training, constraint-induced movement therapy, robotic training, mental imaging, and virtual training. All of these methods utilize principles of motor learning. The findings from this review demonstrated convincing evidence both at the neural and functional level in response to such therapies. The main aim of the review was to determine the evidence for these methods and their application into clinical practice. PMID:21943628

  20. Dance/Movement Therapy with Emotionally Disturbed Adolescents.

    ERIC Educational Resources Information Center

    Bannon, Veronica

    This outline profiles two programs that use dance/movement therapy to help students with low self-esteem, poor body image, poor self-control, lack of trust in others, difficulty identifying and expressing feelings, and poor interpersonal relating skills. Students referred for dance/movement therapy services are assessed for appropriateness, and…

  1. Directive and Non-Directive Movement in Child Therapy.

    ERIC Educational Resources Information Center

    Krason, Katarzyna; Szafraniec, Grazyna

    1999-01-01

    Presents a new authorship method of child therapy based on visualization through motion. Maintains that this method stimulates motor development and musical receptiveness, and promotes personality development. Suggests that improvised movement to music facilitates the projection mechanism and that directed movement starts the channeling phase.…

  2. Orthodontic tooth movement after different coxib therapies.

    PubMed

    de Carlos, Felix; Cobo, Juan; Perillan, Carmen; Garcia, Miguel A; Arguelles, Juan; Vijande, Manuel; Costales, Marina

    2007-12-01

    Anti-inflammatory substances used for treatment of pain and discomfort related to orthodontic treatment (OT) could slow down tooth movement. Selective cyclooxygenase-2 inhibitors are an alternative to conventional non-steroidal anti-inflammatory drugs. The aim of this study was to compare different coxibs on dental movement in the rat. Twenty-eight Wistar male rats (3 months old) divided into four experimental groups were studied: (1) Five rats underwent a 50 g coil spring implantation and received three injections of 0.5 mg/kg body weight (bw) of Rofecoxib in the maxillary gingiva, close to the first molar, on the day of implantation and after 3 and 5 days. Similar procedures were carried out (2) on six animals receiving 8 mg/kg bw of Celecoxib and (3) on five animals receiving 25 mg/kg bw of Parecoxib. (4) For the controls, 12 rats received the same OT but only equivolumetric 0.9 per cent saline solution injections. Tooth movement was measured on lateral cranial teleradiographs after 10 days of treatment. Non-parametric standard techniques (Wilcoxon, H, and Mann-Whitney, U) were used for statistical analysis. Mesial tooth displacement in the control animals was 0.33 +/- 0.07 mm. While no movement was found in rats treated with Rofecoxib, the Celecoxib- and Parecoxib-treated rats showed tooth movement of 0.42 +/- 0.09 mm and 0.22 +/- 0.04 mm, respectively. The differences were statistically significant (H = 13.07; P < 0.004). Celecoxib and Parecoxib, but not Rofecoxib, seem appropriate for discomfort and pain relief while avoiding interference during tooth movement. PMID:17878187

  3. Physical therapy and occupational therapy: partners in rehabilitation for persons with movement impairments.

    PubMed

    Nelson, David L; Cipriani, Daniel J; Thomas, Julie J

    2002-01-01

    SUMMARY The professions of physical therapy and occupational therapy have legitimate roles in the restoration of human movement in the rehabilitation process. This paper first presents a physical therapy perspective on changing trends in therapeutic exercise. Recent trends in physical therapy reflect a shift away from isolating patterns of movement and open kinetic chain exercises toward a new emphasis on functional patterns of movement and closed kinetic chain exercises. Rehabilitation of persons with hip fracture is used as an example of these shifting trends. Next, the paper presents an occupational therapy perspective. Occupational therapy's historical emphasis on the use of naturalistic occupations as the context for therapeutic exercise is described. Theoretical advantages of occupationally embedded movement are listed, and recent research in support of naturalistic occupations is summarized. Physical therapy and occupational therapy are distinct professions with autonomous outlooks and terminologies, but the responsibilities of physical therapists and occupational therapists potentially overlap in the restoration of movement. Suggestions are made for interdisciplinary teamwork whereby the holistically considered welfare of the patient is always the primary concern of all therapists. PMID:23952022

  4. Developmental stages of occupational therapy and the feminist movement.

    PubMed

    Gilligan, M B

    1976-10-01

    Developmental stages characterize the growth of both the feminist movement and the field of occupational therapy. The human development stages described by Erik Erikson are used to compare the growth stages of these two groups to the human sequence. It is hypothesized that both female-dominated groups began with an "infancy" period in the early 1900s characterized by the beginnings of identity and confidence in their respective groups. Both continued to develop through stages corresponding to the childhood stages characterized by Erikson and into the adolescent acting out stages as characterized by the demonstrations of the 1960s. Present and future trends are explored in relation to developmental stages, as well as to implications for the field of occupational therapy in education, theory, and practice. PMID:788519

  5. The Benefit of Movement: Dance/Movement Therapy and Down Syndrome

    ERIC Educational Resources Information Center

    Albin, Chloe M.

    2016-01-01

    There are various forms of therapies for children with disabilities, including physical therapy, speech therapy, and alternative therapies such as music and dance therapy. Each form of therapy has its benefits for those with disabilities, but ultimately the success of the therapy rests on the attention paid to the individual. Especially for…

  6. Movement-Based Interaction Applied to Physical Rehabilitation Therapies

    PubMed Central

    Ruiz Penichet, Victor Manuel; Lozano Pérez, María Dolores

    2014-01-01

    Background Health care environments are continuously improving conditions, especially regarding the use of current technology. In the field of rehabilitation, the use of video games and related technology has helped to develop new rehabilitation procedures. Patients are able to work on their disabilities through new processes that are more motivating and entertaining. However, these patients are required to leave their home environment to complete their rehabilitation programs. Objective The focus of our research interests is on finding a solution to eliminate the need for patients to interrupt their daily routines to attend rehabilitation therapy. We have developed an innovative system that allows patients with a balance disorder to perform a specific rehabilitation exercise at home. Additionally, the system features an assistive tool to complement the work of physiotherapists. Medical staff are thus provided with a system that avoids the need for them to be present during the exercise in specific cases in which patients are under suitable supervision. Methods A movement-based interaction device was used to achieve a reliable system for monitoring rehabilitation exercises performed at home. The system accurately utilizes parameters previously defined by the specialist for correct performance of the exercise. Accordingly, the system gives instructions and corrects the patient’s actions. The data generated during the session are collected for assessment by the specialist to adapt the difficulty of the exercise to the patient’s progress. Results The evaluation of the system was conducted by two experts in balance disorder rehabilitation. They were required to verify the effectiveness of the system, and they also facilitated the simulation of real patient behavior. They used the system freely for a period of time and provided interesting and optimistic feedback. First, they evaluated the system as a tool for real-life rehabilitation therapy. Second, their

  7. Monitoring functional arm movement for home-based therapy after stroke.

    PubMed

    Sanchez, R; Reinkensmeyer, D; Shah, P; Liu, J; Rao, S; Smith, R; Cramer, S; Rahman, T; Bobrow, J

    2004-01-01

    The goal of this project is to develop a means for individuals with stroke to practice arm movement therapy at home with remote monitoring. We previously developed a Web-based system for repetitive movement training (Java Therapy). This paper describes a new input device for the system that measures and assists in naturalistic arm movement, as well as software enhancements. The new input device is an instrumented, adult-sized version of Wilmington robotic exoskeleton (WREX), which is a five degrees-of-freedom orthosis that counterbalances the weight of the arm using elastic bands. To test the ability of the new device (Training-WREX or "T-WREX") to measure and assist in functional arm movements, we measured five chronic stroke subjects' movement ability while wearing the orthosis without gravity balance compared to wearing the orthosis with gravity balance. T-WREX's gravity balance function improved a clinical measure of arm movement (Fugl-Meyer Score), range of motion of reaching movements, and accuracy of drawing movements. Coupled with an enhanced version of Java Therapy, T-WREX will thus provide a means to assist functional arm movement training at home, either over the Web in real-time, or stand-alone with periodic communication with a remote site. PMID:17271381

  8. The influence of the arts-and-crafts movement on the professional status of occupational therapy.

    PubMed

    Levine, R E

    1987-04-01

    This paper explores why occupational therapists use arts and crafts as therapeutic modalities. Beginning with the turn-of-the-century origins of occupational therapy, the paper traces the similarities and differences in the ideas and beliefs of the founders of occupational therapy and the proponents of the arts-and-crafts movement. PMID:3318480

  9. Dance Movement Therapy: A Healing Art. [Revised Edition.

    ERIC Educational Resources Information Center

    Levy, Fran J.

    The concern of this text is the need that many individuals have for nonverbal, primarily physical forms of expression, and how this need has fueled the development of a new psychomotor discipline. The book treats the theory and practice of dance therapy, and examines the entire field from its inception through the present. Dance therapy, the use…

  10. Movement.

    ERIC Educational Resources Information Center

    Online-Offline, 1998

    1998-01-01

    Focuses on movement: movable art, relocating families, human rights, and trains and cars. Describes educational resources for elementary and middle school students, including Web sites, CD-ROMs and software, videotapes, books, additional resources and activities (PEN)

  11. Effect of bilateral eye movements on frontal interhemispheric gamma EEG coherence: implications for EMDR therapy.

    PubMed

    Propper, Ruth E; Pierce, Jenna; Geisler, Mark W; Christman, Stephen D; Bellorado, Nathan

    2007-09-01

    The use of bilateral eye movements (EMs) is an important component of Eye Movement Desensitization and Reprocessing (EMDR) therapy for posttraumatic stress disorder. The neural mechanisms underlying EMDR remain unclear. However, prior behavioral work looking at the effects of bilateral EMs on the retrieval of episodic memories suggests that the EMs enhance interhemispheric interaction. The present study examined the effects of the EMs used in EMDR on interhemispheric electroencephalogram coherence. Relative to noneye-movement controls, engaging in bilateral EMs led to decreased interhemispheric gamma electroencephalogram coherence. Implications for future work on EMDR and episodic memory are discussed. PMID:17984782

  12. Developing Emotional Literacy through Individual Dance Movement Therapy: A Pilot Study

    ERIC Educational Resources Information Center

    Meekums, Bonnie

    2008-01-01

    This paper reports a pragmatic mixed methods pilot study of teacher perceptions regarding a school-based Dance Movement therapy (DMT) service for six children aged four to seven in a North of England primary school. No previous studies have systematically evaluated DMT in terms of the development of Emotional Literacy (EL), though theoretical…

  13. Becoming a Client, Becoming a Practitioner: Student Narratives of a Dance Movement Therapy Group

    ERIC Educational Resources Information Center

    Payne, Helen

    2004-01-01

    This paper documents one of several themes arising from a larger research study which invited trainees' views on their experience in a weekly, 2 year, dance movement therapy (DMT) personal development group. This group formed part of their post-graduate training. The study used a phenomenological, grounded theory and collaborative methodology…

  14. The Core Competency Movement in Marriage and Family Therapy: Key Considerations from Other Disciplines

    ERIC Educational Resources Information Center

    Miller, John K.; Todahl, Jeff L.; Platt, Jason J.

    2010-01-01

    There is a growing movement to define competency within the field of marriage and family therapy (MFT), particularly with respect to the training of practitioners and the evaluation of clinical practice. Efforts to define competency, however, transcend the practice of MFT and much can be learned from the experiences of other disciplines.…

  15. Fixing the Mirrors: A Feasibility Study of the Effects of Dance Movement Therapy on Young Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Koch, Sabine C.; Mehl, Laura; Sobanski, Esther; Sieber, Maik; Fuchs, Thomas

    2015-01-01

    From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and…

  16. Sonification of Arm Movements in Stroke Rehabilitation – A Novel Approach in Neurologic Music Therapy

    PubMed Central

    Scholz, Daniel S.; Rohde, Sönke; Nikmaram, Nikou; Brückner, Hans-Peter; Großbach, Michael; Rollnik, Jens D.; Altenmüller, Eckart O.

    2016-01-01

    Gross motor impairments are common after stroke, but efficient and motivating therapies for these impairments are scarce. We present an innovative musical sonification therapy, especially designed to retrain patients’ gross motor functions. Sonification should motivate patients and provide additional sensory input informing about relative limb position. Twenty-five stroke patients were included in a clinical pre–post study and took part in the sonification training. The patients’ upper extremity functions, their psychological states, and their arm movement smoothness were assessed pre and post training. Patients were randomly assigned to either of two groups. Both groups received an average of 10 days (M = 9.88; SD = 2.03; 30 min/day) of musical sonification therapy [music group (MG)] or a sham sonification movement training [control group (CG)], respectively. The only difference between the two protocols was that in the CG no sound was played back during training. In the beginning, patients explored the acoustic effects of their arm movements in space. At the end of the training, the patients played simple melodies by coordinated arm movements. The 15 patients in the MG showed significantly reduced joint pain (F = 19.96, p < 0.001) in the Fugl–Meyer assessment after training. They also reported a trend to have improved hand function in the stroke impact scale as compared to the CG. Movement smoothness at day 1, day 5, and the last day of the intervention was compared in MG patients and found to be significantly better after the therapy. Taken together, musical sonification may be a promising therapy for motor impairments after stroke, but further research is required since estimated effect sizes point to moderate treatment outcomes. PMID:27445970

  17. Sonification of Arm Movements in Stroke Rehabilitation - A Novel Approach in Neurologic Music Therapy.

    PubMed

    Scholz, Daniel S; Rohde, Sönke; Nikmaram, Nikou; Brückner, Hans-Peter; Großbach, Michael; Rollnik, Jens D; Altenmüller, Eckart O

    2016-01-01

    Gross motor impairments are common after stroke, but efficient and motivating therapies for these impairments are scarce. We present an innovative musical sonification therapy, especially designed to retrain patients' gross motor functions. Sonification should motivate patients and provide additional sensory input informing about relative limb position. Twenty-five stroke patients were included in a clinical pre-post study and took part in the sonification training. The patients' upper extremity functions, their psychological states, and their arm movement smoothness were assessed pre and post training. Patients were randomly assigned to either of two groups. Both groups received an average of 10 days (M = 9.88; SD = 2.03; 30 min/day) of musical sonification therapy [music group (MG)] or a sham sonification movement training [control group (CG)], respectively. The only difference between the two protocols was that in the CG no sound was played back during training. In the beginning, patients explored the acoustic effects of their arm movements in space. At the end of the training, the patients played simple melodies by coordinated arm movements. The 15 patients in the MG showed significantly reduced joint pain (F = 19.96, p < 0.001) in the Fugl-Meyer assessment after training. They also reported a trend to have improved hand function in the stroke impact scale as compared to the CG. Movement smoothness at day 1, day 5, and the last day of the intervention was compared in MG patients and found to be significantly better after the therapy. Taken together, musical sonification may be a promising therapy for motor impairments after stroke, but further research is required since estimated effect sizes point to moderate treatment outcomes. PMID:27445970

  18. Improvement of Vergence Movements by Vision Therapy Decreases K-ARS Scores of Symptomatic ADHD Children

    PubMed Central

    Lee, Sun Haeng; Moon, Byeong-Yeon; Cho, Hyun Gug

    2014-01-01

    [Purpose] To determine whether the improvement of vergence movements by vision therapy can decrease the K-ARS scores of symptomatic ADHD children. [Methods] Eighty-one out of 1,123 children surveyed using the K-ARS, a parents’-reported questionnaire, led to 16 of these 81 children being showed scores of ≥19, and measurement of binocular function diagnosed as having convergence insufficiency. The 16 children were divided equally into a control group and a vision therapy group. [Results] After vision therapy for 12 weeks, near point convergence (4.38±0.69 cm) significantly neared compared to the near point convergence before vision therapy (11.50±2.28 cm), and both the break point (32.38±2.53 Δ) and recovery point (19.75±2.11 Δ) of near positive fusional vergence significantly improved compared to their values before vision therapy (15.88±2.64 Δ, 6.38±6.70 Δ, respectively). Near exophoria after vision therapy (7.81±2.00 Δ BI) significantly decreased compared to its value before vision therapy (12.00±1.16 Δ BI). The K-ARS scores referring to symptomatic ADHD significantly decreased after vision therapy (17.13±2.84) compared to before vision therapy (23.25±1.49). [Conclusions] Convergence insufficiency symptoms are closely related to symptoms screened for ADHD, and vision therapy to improve vergence movements is an effective method of decreasing the K-ARS scores. PMID:24648636

  19. Technologies and combination therapies for enhancing movement training for people with a disability

    PubMed Central

    2012-01-01

    There has been a dramatic increase over the last decade in research on technologies for enhancing movement training and exercise for people with a disability. This paper reviews some of the recent developments in this area, using examples from a National Science Foundation initiated study of mobility research projects in Europe to illustrate important themes and key directions for future research. This paper also reviews several recent studies aimed at combining movement training with plasticity or regeneration therapies, again drawing in part from European research examples. Such combination therapies will likely involve complex interactions with motor training that must be understood in order to achieve the goal of eliminating severe motor impairment. PMID:22463132

  20. Multijoint arm stiffness during movements following stroke: implications for robot therapy

    PubMed Central

    Piovesan, D.; Casadio, M.; Mussa-Ivaldi, F. A.; Morasso, P.G

    2015-01-01

    Impaired arm movements in stroke appear as a set of stereotypical kinematic patterns, characterized by abnormal joint coupling, which have a direct consequence on arm mechanics and can be quantified by the net arm stiffness at the hand. The current available measures of arm stiffness during functional tasks have limited clinical use, since they require several repetitions of the same test movement in many directions. Such procedure is difficult to obtain in stroke survivors who have lower fatigue threshold and increased variability compared to unimpaired individuals. The present study proposes a novel, fast quantitative measure of arm stiffness during movements by means of a Time-Frequency technique and the use of a reassigned spectrogram, applied on a trial-by-trial basis with a single perturbation. We tested the technique feasibility during robot mediated therapy, where a robot helped stroke survivors to regain arm mobility by providing assistive forces during a hitting task to 13 targets covering the entire reachable workspace. The endpoint stiffness of the paretic arm was estimated at the end of each hitting movements by suddenly switching of the assistive forces and observing the ensuing recoil movements. In addition, we considered how assistive forces influence stiffness. This method will provide therapists with improved tools to target the treatment to the individual’s specific impairment and to verify the effects of the proposed exercises. PMID:22275576

  1. A review of "music and movement" therapies for children with autism: embodied interventions for multisystem development.

    PubMed

    Srinivasan, Sudha M; Bhat, Anjana N

    2013-01-01

    The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research. PMID:23576962

  2. Modeling and Predicting Tissue Movement and Deformation for High Intensity Focused Ultrasound Therapy

    PubMed Central

    Liao, Xiangyun; Yuan, Zhiyong; Lai, Qianfeng; Guo, Jiaxiang; Zheng, Qi; Yu, Sijiao; Tong, Qianqian; Si, Weixin; Sun, Mingui

    2015-01-01

    Purpose In ultrasound-guided High Intensity Focused Ultrasound (HIFU) therapy, the target tissue (such as a tumor) often moves and/or deforms in response to an external force. This problem creates difficulties in treating patients and can lead to the destruction of normal tissue. In order to solve this problem, we present a novel method to model and predict the movement and deformation of the target tissue during ultrasound-guided HIFU therapy. Methods Our method computationally predicts the position of the target tissue under external force. This prediction allows appropriate adjustments in the focal region during the application of HIFU so that the treatment head is kept aligned with the diseased tissue through the course of therapy. To accomplish this goal, we utilize the cow tissue as the experimental target tissue to collect spatial sequences of ultrasound images using the HIFU equipment. A Geodesic Localized Chan-Vese (GLCV) model is developed to segment the target tissue images. A 3D target tissue model is built based on the segmented results. A versatile particle framework is constructed based on Smoothed Particle Hydrodynamics (SPH) to model the movement and deformation of the target tissue. Further, an iterative parameter estimation algorithm is utilized to determine the essential parameters of the versatile particle framework. Finally, the versatile particle framework with the determined parameters is used to estimate the movement and deformation of the target tissue. Results To validate our method, we compare the predicted contours with the ground truth contours. We found that the lowest, highest and average Dice Similarity Coefficient (DSC) values between predicted and ground truth contours were, respectively, 0.9615, 0.9770 and 0.9697. Conclusion Our experimental result indicates that the proposed method can effectively predict the dynamic contours of the moving and deforming tissue during ultrasound-guided HIFU therapy. PMID:25993644

  3. Fixing the mirrors: a feasibility study of the effects of dance movement therapy on young adults with autism spectrum disorder.

    PubMed

    Koch, Sabine C; Mehl, Laura; Sobanski, Esther; Sieber, Maik; Fuchs, Thomas

    2015-04-01

    From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and Asperger's syndrome) with the aim to increase body awareness, social skills, self-other distinction, empathy, and well-being. We employed a manualized dance movement therapy intervention implemented in hourly sessions once a week for 7 weeks. The treatment group (n = 16) and the no-intervention control group (n = 15) were matched by sex, age, and symptom severity. Participants did not participate in any other therapies for the duration of the study. After the treatment, participants in the intervention group reported improved well-being, improved body awareness, improved self-other distinction, and increased social skills. The dance movement therapy-based mirroring approach seemed to address more primary developmental aspects of autism than the presently prevailing theory-of-mind approach. Results suggest that dance movement therapy can be an effective and feasible therapy approach for autism spectrum disorder, while future randomized control trials with bigger samples are needed. PMID:24566716

  4. Assistive acting movement therapy devices with pneumatic rotary-type soft actuators.

    PubMed

    Wilkening, André; Baiden, David; Ivlev, Oleg

    2012-12-01

    Inherent compliance and assistive behavior are assumed to be essential properties for safe human-robot interaction. Rehabilitation robots demand the highest standards in this respect because the machine interacts directly with weak persons who are often sensitive to pain. Using novel soft fluidic actuators with rotary elastic chambers (REC actuators), compact, lightweight, and cost-effective therapeutic devices can be developed. This article describes modular design and control strategies for new assistive acting robotic devices for upper and lower extremities. Due to the inherent compliance and natural back-drivability of pneumatic REC actuators, these movement therapy devices provide gentle treatment, whereby the interaction forces between humans and the therapy device are estimated without the use of expensive force/torque sensors. An active model-based gravity compensation based on separated models of the robot and of the individual patient's extremity provides the basis for effective assistive control. The utilization of pneumatic actuators demands a special safety concept, which is merged with control algorithms to provide a sufficient level of safeness and to catch any possible system errors and/or emergency situations. A self-explanatory user interface allows for easy, intuitive handling. Prototypes are very comfortable for use due to several control routines that work in the background. Assistive devices have been tested extensively with several healthy persons; the knee/hip movement therapy device is now under clinical trials at the Clinic for Orthopaedics and Trauma Surgery at the Klinikum Stuttgart. PMID:23241570

  5. A Meta-Synthesis of Qualitative Findings About Dance/Movement Therapy for Individuals With Trauma.

    PubMed

    Levine, Brooklyn; Land, Helen M

    2016-02-01

    The therapeutic potential of using dance/movement therapy is being increasingly recognized. Preliminary interdisciplinary research findings suggest engaging the body in trauma treatment might reduce the length of treatment by addressing the connections among thoughts, feelings, neurobiology, and somatic responses in the survivor. Unfortunately, empirical research investigating its effectiveness as a psychotherapeutic intervention has been limited due to the lack of a clear manual for mental health care practitioners. The present study aims to synthesize findings from the existing qualitative literature in a qualitative meta-synthesis. Our findings will contribute to the development of a body-oriented intervention for mental health care practitioners to use for trauma. PMID:26063604

  6. Tumour Movement in Proton Therapy: Solutions and Remaining Questions: A Review

    PubMed Central

    De Ruysscher, Dirk; Sterpin, Edmond; Haustermans, Karin; Depuydt, Tom

    2015-01-01

    Movement of tumours, mostly by respiration, has been a major problem for treating lung cancer, liver tumours and other locations in the abdomen and thorax. Organ motion is indeed one component of geometrical uncertainties that includes delineation and target definition uncertainties, microscopic disease and setup errors. At present, minimising motion seems to be the easiest to implement in clinical practice. If combined with adaptive approaches to correct for gradual anatomical variations, it may be a practical strategy. Other approaches such as repainting and tracking could increase the accuracy of proton therapy delivery, but advanced 4D solutions are needed. Moreover, there is a need to perform clinical studies to investigate which approach is the best in a given clinical situation. The good news is that existing and emerging technology and treatment planning systems as will without doubt lead in the forthcoming future to practical solutions to tackle intra-fraction motion in proton therapy. These developments may also improve motion management in photon therapy as well. PMID:26132317

  7. Developing movement therapy application with Microsoft Kinect control for supporting stroke rehabilitation.

    PubMed

    Mintal, Flavian A; Szucs, Veronika; Sik-Lanyi, Cecília

    2015-01-01

    The topic of this article and work was to create an application for movement therapy, which can help the rehabilitation of stroke patients. The application makes it possible to make unique exercises for different patients, adapting to the special personal needs. The developed real time gesture analyzing algorithm works in the background of the application, which has not yet spread on the field of medical devices. I deal with one part of this wide field in my dissertation, with the rehabilitation gesture analyzing. The data received from the Kinect sensor is processed by a location based gesture analyzing algorithm, and the results show that the software is suitable for the improvement of the rehabilitation process. It was a key aspect to create a simple interface. I achieved this with the use of the C# language and WPF technology. PMID:26294562

  8. Effectiveness of rhythmic movement therapy for disordered eating behaviors and obesity.

    PubMed

    Malkina-Pykh, Irina G

    2012-11-01

    The aims of the present study were: a) to examine associations between pre-treatment BMI, body dissatisfaction, perfectionism, alexithymia, and restraint, emotional and external eating behaviour in obese patients; b) to analyze the impact of the pre-treatment measures in psychological variables on the outcome of cognitive-behavioral therapy (CBT) program; c) to test the effectiveness of rhythmic movement therapy (RMT) in the treatment of disordered eating behaviors and obesity with the CBT non-responders. At the first stage of treatment a total of 104 patients (32 males and 72 females, mean age was 37.6 +/- 6.7 years) self-referred or referred by professionals to CBT weight management program were selected at random. At the second stage 58 obese CBT-non-responders were randomly divided among the continuing CBT individual treatment group and RMT group. Control group was included. Results revealed that: a) significant associations existed between pre-treatment BMI, external eating and two dimensions of perfectionism, as well as between emotional and external eating and all dimensions of perfectionism, alexithymia and body image dissatisfaction; b) pre-treatment means of psychological variables significantly impacted the CBT program outcome; c). the efficacy of RMT approach for weight reduction as well as for the improvement of psychological status for CBT-non-responders was confirmed. PMID:23156940

  9. Efficiency of low-level laser therapy within induced dental movement: A systematic review and meta-analysis.

    PubMed

    de Almeida, Vinicius Lima; de Andrade Gois, Vanessa Lima; Andrade, Ramon Nazareno Menezes; Cesar, Carla Patrícia Hernandez Alves Ribeiro; de Albuquerque-Junior, Ricardo Luiz Cavalcanti; de Mello Rode, Sigmar; Paranhos, Luiz Renato

    2016-05-01

    The low level laser is widely used in Dentistry, in particular, to decrease pain and increase the speed of tooth movement. This study was to perform a systematic literature search to investigate the effectiveness of low level laser and low energy density therapy of the induced tooth movement. This research was performed following the PRISMA instructions and was registered in the PROSPERO. The articles were searched in six electronic databases, with no date and language restriction. Only randomized clinical trials were selected. Articles that did not use the extraction of first premolars as orthodontic planning were excluded, as well as articles using high energy density laser therapy. The articles were assessed for risk of bias and individual quality. The results were analyzed using meta-analysis, using randomized effect. The initial sample consisted of 161 articles. Six articles remained eligible for qualitative analysis and five for quantitative analysis. According to the individual quality, most articles were classified as high quality. Three articles detected statistically significant differences in induced movement by comparing the orthodontic movement between the experimental and control groups. For the maxilla, there was a statistically significant influence of the laser in three months and, for the mandible, in one month. It may be concluded that there is no evidence that laser therapy can accelerate the induced tooth movement. PMID:27016661

  10. Dance/movement therapy approaches to fostering resilience and recovery among African adolescent torture survivors.

    PubMed

    Harris, David Alan

    2007-01-01

    Dance/movement therapy (DMT) interventions, if designed to promote cultural relevance and community ownership, may enhance healing among African adolescent survivors of war and organised violence. The author posits a theoretical rationale for body movement-based approaches to psychosocial rehabilitation, and offers DMT's holism as evidence of transcultural applicability. Two distinct DMT iniatives with this population are discussed in terms of theoretical assumptions, implementation, and outcomes. Both efforts afforded creative means for discharging aggression and restoring interpersonal connection. The first of these programes engaged a community of South Sudanese refugee youths, resettled to the U.S., in a series of gatherings for traditional dancing and drumming that reconstituted a central culture-of-origin ritual. Anectodal evidence supports this psychosocial intervention's emphasis on group cohesion as a vehicle with both preventive and reparative capacities. Also a series of DMT groups with youths in Sierra Leone. All organized several years post-conflict, these interventions involved applying the DMT modality within a framework of Western psychotherapeutic conventions described in a series of groups with youths, all organized several years post-conflict, is presented. Programe evaluation revealed a drop in average symptom expression among a group comprised of former boy combatants who reported continual reduction in symptoms of anxiety, depression, intrusive recollection, elevated arousal, and aggression. The group's teenage males joined actively in improvisatory dancing and in other structured creative exercices. Theese former child soldiers later elected to demonstrate their wartime experiences through public presentation of a role-play. A report on this event illustrates the success of the process in overcoming stigma and enabling meaningful community reintegration. Thus, whether introduced in refuge or post-conflict, DMT approaches are shown to embody

  11. Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial

    PubMed Central

    Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D’Angelo, Valerio; Urso, Viviana

    2015-01-01

    The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization. PMID:26504391

  12. Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial.

    PubMed

    Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D'Angelo, Valerio; Urso, Viviana

    2015-01-01

    The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization. PMID:26504391

  13. Therapies for children with cerebral palsy: A Web of Science-based literature analysis

    PubMed Central

    Mu, Yaping; Li, Na; Guan, Lijun; Wang, Chunnan; Shang, Shuyun; Wang, Yan

    2012-01-01

    OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES: (1) Number of publications on the three therapies; (2) annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; (3) annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; (4) annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS: This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology. Research institutes publishing on botulinum toxin treatments for this population are mostly in the

  14. Effect of low level laser therapy on dental pulp during orthodontic movement

    PubMed Central

    Domínguez, Ángela; Ballesteros, Rosa Emilia; Viáfara, Jairo Hernán; Tamayo, Oscar Mario

    2013-01-01

    AIM: To validate the protocol described here to be used in future clinical trials related to the effect of laser therapy on dental pulp. METHODS: Histologically treated samples from eight human healthy premolar teeth obtained from the middle root level were distributed in four groups: group 1 (G1) absolute control; group 2 (G2) only laser irradiation; group 3 (G3) exposed only to orthodontics; and group 4 (G4) treated with orthodontics and laser. Laser treatment was performed at 830 nm wavelength, 100 mW (energy 80 J/cm2, 2.2 J), for 22 s in the vestibular surface and 22 s in the palatal surface, 1 mm away from the dental root mucosa. Three staining methods were performed: hematoxylin-eosin (HE), Masson’s Trichrome method and Gomori’s method. RESULTS: The pulp histology parameters were evaluated and the results classified in to 3 parts: an inflammatory response, soft tissue response (dental pulp) and hard tissue response (dentin and predentin). There was no inflammation (chronic or acute) in any of the evaluated groups. The zones of pulp necrosis were found in one premolar of G3 and in one of G4; in groups G2 and G4 there was higher angiogenesis than in the other two groups. G4 group presented the highest level of vascularization. A reduced nerve density was observed in G3. A G2 specimen showed increased nerve density. A higher rate of calcification was observed in G1 compared to G2. Denticles, either real or false, were observed in G1, G2 and G3. Sclerosis of dentin and focal dentin loss was observed among all the groups. Secondary dentin was present in one sample in G1 and G2. A necrosis zone was found in one sample of G3 and G4. No differences between groups were observed in the odontoblast irregularity layer but the layer was wider in the group treated with laser only. A notable difference was detected in reduction of the cell-free layer between the groups G1 and G4. The findings in pulp tissue favor its adaptative response against dental movement induced

  15. Re-presentation of Olfactory Exposure Therapy Success Cues during Non-Rapid Eye Movement Sleep did not Increase Therapy Outcome but Increased Sleep Spindles

    PubMed Central

    Rihm, Julia S.; Sollberger, Silja B.; Soravia, Leila M.; Rasch, Björn

    2016-01-01

    Exposure therapy induces extinction learning and is an effective treatment for specific phobias. Sleep after learning promotes extinction memory and benefits therapy success. As sleep-dependent memory-enhancing effects are based on memory reactivations during sleep, here we aimed at applying the beneficial effect of sleep on therapy success by cueing memories of subjective therapy success during non-rapid eye movement sleep after in vivo exposure-based group therapy for spider phobia. In addition, oscillatory correlates of re-presentation during sleep (i.e., sleep spindles and slow oscillations) were investigated. After exposure therapy, spider-phobic patients verbalized their subjectively experienced therapy success under presence of a contextual odor. Then, patients napped for 90 min recorded by polysomnography. Half of the sleep group received the odor during sleep while the other half was presented an odorless vehicle as control. A third group served as a wake control group without odor presentation. While exposure therapy significantly reduced spider-phobic symptoms in all subjects, these symptoms could not be further reduced by re-presenting the odor associated with therapy success, probably due to a ceiling effect of the highly effective exposure therapy. However, odor re-exposure during sleep increased left-lateralized frontal slow spindle (11.0–13.0 Hz) and right-lateralized parietal fast spindle (13.0–15.0 Hz) activity, suggesting the possibility of a successful re-presentation of therapy-related memories during sleep. Future studies need to further examine the possibility to enhance therapy success by targeted memory reactivation (TMR) during sleep. PMID:27445775

  16. Re-presentation of Olfactory Exposure Therapy Success Cues during Non-Rapid Eye Movement Sleep did not Increase Therapy Outcome but Increased Sleep Spindles.

    PubMed

    Rihm, Julia S; Sollberger, Silja B; Soravia, Leila M; Rasch, Björn

    2016-01-01

    Exposure therapy induces extinction learning and is an effective treatment for specific phobias. Sleep after learning promotes extinction memory and benefits therapy success. As sleep-dependent memory-enhancing effects are based on memory reactivations during sleep, here we aimed at applying the beneficial effect of sleep on therapy success by cueing memories of subjective therapy success during non-rapid eye movement sleep after in vivo exposure-based group therapy for spider phobia. In addition, oscillatory correlates of re-presentation during sleep (i.e., sleep spindles and slow oscillations) were investigated. After exposure therapy, spider-phobic patients verbalized their subjectively experienced therapy success under presence of a contextual odor. Then, patients napped for 90 min recorded by polysomnography. Half of the sleep group received the odor during sleep while the other half was presented an odorless vehicle as control. A third group served as a wake control group without odor presentation. While exposure therapy significantly reduced spider-phobic symptoms in all subjects, these symptoms could not be further reduced by re-presenting the odor associated with therapy success, probably due to a ceiling effect of the highly effective exposure therapy. However, odor re-exposure during sleep increased left-lateralized frontal slow spindle (11.0-13.0 Hz) and right-lateralized parietal fast spindle (13.0-15.0 Hz) activity, suggesting the possibility of a successful re-presentation of therapy-related memories during sleep. Future studies need to further examine the possibility to enhance therapy success by targeted memory reactivation (TMR) during sleep. PMID:27445775

  17. Overcoming Disembodiment: The Effect of Movement Therapy on Negative Symptoms in Schizophrenia—A Multicenter Randomized Controlled Trial

    PubMed Central

    Martin, Lily A. L.; Koch, Sabine C.; Hirjak, Dusan; Fuchs, Thomas

    2016-01-01

    Objective: Negative symptoms of patients with Schizophrenia are resistant to medical treatment or conventional group therapy. Understanding schizophrenia as a form of disembodiment of the self, a number of scientists have argued that the approach of embodiment and associated embodied therapies, such as Dance and Movement Therapy (DMT) or Body Psychotherapy (BPT), may be more suitable to explain the psychopathology underlying the mental illness and to address its symptoms. Hence the present randomized controlled trial (DRKS00009828, http://apps.who.int/trialsearch/) aimed to examine the effectiveness of manualized movement therapy (BPT/DMT) on the negative symptoms of patients with schizophrenia. Method:A total of 68 out-patients with a diagnosis of a schizophrenia spectrum disorder were randomly allocated to either the treatment (n = 44, 20 sessions of BPT/DMT) or the control condition [n = 24, treatment as usual (TAU)]. Changes in negative symptom scores on the Scale for the Assessment of Negative Symptoms (SANS) were analyzed using Analysis of Covariance (ANCOVA) with Simpson-Angus Scale (SAS) scores as covariates in order to control for side effects of antipsychotic medication. Results:After 20 sessions of treatment (BPT/DMT or TAU), patients receiving movement therapy had significantly lower negative symptom scores (SANS total score, blunted affect, attention). Effect sizes were moderate and mean symptom reduction in the treatment group was 20.65%. Conclusion:The study demonstrates that embodied therapies, such as BPT/DMT, are highly effective in the treatment of patients with schizophrenia. Results strongly suggest that BPT/DMT should be embedded in the daily clinical routine. PMID:27064347

  18. Meditative Movement Therapies and Health-Related Quality-of-Life in Adults: A Systematic Review of Meta-Analyses.

    PubMed

    Kelley, George A; Kelley, Kristi S

    2015-01-01

    Poor health-related quality-of-life (HRQOL) is a significant public health issue while the use of meditative movement therapies has been increasing. The purpose of this investigation was to carry out a systematic review of previous meta-analyses that examined the effects of meditative movement therapies (yoga, tai chi and qigong) on HRQOL in adults. Previous meta-analyses of randomized controlled trials published up through February, 2014 were included by searching nine electronic databases and cross-referencing. Dual-selection and data abstraction occurred. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. Standardized mean differences that were pooled using random-effects models were included. In addition, 95% prediction intervals were calculated as well as the number needed-to-treat and percentile improvements. Of the 510 citations screened, 10 meta-analyses representing a median of 3 standardized mean differences in 82 to 528 participants (median = 270) with breast cancer, schizophrenia, low back pain, heart failure and diabetes, were included. Median methodological quality was 70%. Median length, frequency and duration of the meditative movement therapies were 12 weeks, 3 times per week, for 71 minutes per session. The majority of results (78.9%) favored statistically significant improvements (non-overlapping 95% confidence intervals) in HRQOL, with standardized mean differences ranging from 0.18 to 2.28. More than half of the results yielded statistically significant heterogeneity (Q ≤ 0.10) and large or very large inconsistency (I2 ≥ 50%). All 95% prediction intervals included zero. The number-needed-to-treat ranged from 2 to 10 while percentile improvements ranged from 9.9 to 48.9. The results of this study suggest that meditative movement therapies may improve HRQOL in adults with selected conditions. However, a need exists for a large, more inclusive meta-analysis (PROSPERO Registration #CRD

  19. Meditative Movement Therapies and Health-Related Quality-of-Life in Adults: A Systematic Review of Meta-Analyses

    PubMed Central

    2015-01-01

    Poor health-related quality-of-life (HRQOL) is a significant public health issue while the use of meditative movement therapies has been increasing. The purpose of this investigation was to carry out a systematic review of previous meta-analyses that examined the effects of meditative movement therapies (yoga, tai chi and qigong) on HRQOL in adults. Previous meta-analyses of randomized controlled trials published up through February, 2014 were included by searching nine electronic databases and cross-referencing. Dual-selection and data abstraction occurred. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. Standardized mean differences that were pooled using random-effects models were included. In addition, 95% prediction intervals were calculated as well as the number needed-to-treat and percentile improvements. Of the 510 citations screened, 10 meta-analyses representing a median of 3 standardized mean differences in 82 to 528 participants (median = 270) with breast cancer, schizophrenia, low back pain, heart failure and diabetes, were included. Median methodological quality was 70%. Median length, frequency and duration of the meditative movement therapies were 12 weeks, 3 times per week, for 71 minutes per session. The majority of results (78.9%) favored statistically significant improvements (non-overlapping 95% confidence intervals) in HRQOL, with standardized mean differences ranging from 0.18 to 2.28. More than half of the results yielded statistically significant heterogeneity (Q ≤ 0.10) and large or very large inconsistency (I2 ≥ 50%). All 95% prediction intervals included zero. The number-needed-to-treat ranged from 2 to 10 while percentile improvements ranged from 9.9 to 48.9. The results of this study suggest that meditative movement therapies may improve HRQOL in adults with selected conditions. However, a need exists for a large, more inclusive meta-analysis (PROSPERO Registration #CRD

  20. Cherenkoscopy based patient positioning validation and movement tracking during post-lumpectomy whole breast radiation therapy

    NASA Astrophysics Data System (ADS)

    Zhang, Rongxiao; Andreozzi, Jacqueline M.; Gladstone, David J.; Hitchcock, Whitney L.; Glaser, Adam K.; Jiang, Shudong; Pogue, Brian W.; Jarvis, Lesley A.

    2015-01-01

    To investigate Cherenkov imaging (Cherenkoscopy) based patient positioning and movement tracking during external beam radiation therapy (EBRT). In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the LINAC pulse output, during different fractions of the treatment. Patients were positioned with the aid of the AlignRT system in the beginning of each treatment session. Inter-fraction setup variation was studied by rigid image registrations between images acquired at individual treatments to the average image from all imaged treatment fractions. The amplitude of respiratory motion was calculated from the registration of each frame of Cherenkov images to the reference. A Canny edge detection algorithm was utilized to highlight the beam field edges and biological features provided by major blood vessels apparent in the images. Real-time Cherenkoscopy can monitor the treatment delivery, patient motion and alignment of the beam edge to the treatment region simultaneously. For all the imaged fractions, the patient positioning discrepancies were within our clinical tolerances (3 mm in shifts and 3 degree in pitch angle rotation), with 4.6% exceeding 3 mm but still within 4 mm in shifts. The average discrepancy of repetitive patient positioning was 1.22 mm in linear shift and 0.34 degrees in rotational pitch, consistent with the accuracy reported by the AlignRT system. The edge detection algorithm enhanced features such as field edges and blood vessels. Patient positioning discrepancies and respiratory motion retrieved from rigid image registration were consistent with the edge enhanced images. Besides positioning discrepancies caused by globally inaccurate setups, edge enhanced blood vessels indicate the existence of deformations within the treatment region, especially for large patients. Real-time Cherenkoscopy imaging during EBRT is a

  1. Cherenkoscopy based patient positioning validation and movement tracking during post-lumpectomy whole breast radiation therapy.

    PubMed

    Zhang, Rongxiao; Andreozzi, Jacqueline M; Gladstone, David J; Hitchcock, Whitney L; Glaser, Adam K; Jiang, Shudong; Pogue, Brian W; Jarvis, Lesley A

    2015-01-01

    To investigate Cherenkov imaging (Cherenkoscopy) based patient positioning and movement tracking during external beam radiation therapy (EBRT). In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the LINAC pulse output, during different fractions of the treatment. Patients were positioned with the aid of the AlignRT system in the beginning of each treatment session. Inter-fraction setup variation was studied by rigid image registrations between images acquired at individual treatments to the average image from all imaged treatment fractions. The amplitude of respiratory motion was calculated from the registration of each frame of Cherenkov images to the reference. A Canny edge detection algorithm was utilized to highlight the beam field edges and biological features provided by major blood vessels apparent in the images. Real-time Cherenkoscopy can monitor the treatment delivery, patient motion and alignment of the beam edge to the treatment region simultaneously. For all the imaged fractions, the patient positioning discrepancies were within our clinical tolerances (3 mm in shifts and 3 degree in pitch angle rotation), with 4.6% exceeding 3 mm but still within 4 mm in shifts. The average discrepancy of repetitive patient positioning was 1.22 mm in linear shift and 0.34 degrees in rotational pitch, consistent with the accuracy reported by the AlignRT system. The edge detection algorithm enhanced features such as field edges and blood vessels. Patient positioning discrepancies and respiratory motion retrieved from rigid image registration were consistent with the edge enhanced images. Besides positioning discrepancies caused by globally inaccurate setups, edge enhanced blood vessels indicate the existence of deformations within the treatment region, especially for large patients. Real-time Cherenkoscopy imaging during EBRT is a

  2. Robustness Against Interfraction Prostate Movement in Scanned Ion Beam Radiation Therapy

    SciTech Connect

    Jelen, Urszula; Ammazzalorso, Filippo; Chanrion, Marie-Anne; Graef, Sebastian; Zink, Klemens; Engenhart-Cabillic, Rita; Wittig, Andrea

    2012-10-01

    Purpose: To assess the robustness of scanned ion beam treatment plans against the interfraction internal target motion and evaluate the limits of validity of target-based isocenter realignment for prostate cancer radiation therapy. Methods and Materials: For 12 prostate patients, scanned beam carbon ion treatment plans were prepared using 2 lateral opposed beams and the raster scanning technique with different clinical target volume (CTV) to planning target volume (PTV) margins (2-10 mm). Internal target motion of 2-15 mm in anteroposterior (AP), superoinferior (SI), and left-to-right (LR) directions was simulated by displacing the CTV contours with respect to the computed tomography data. The plans were recalculated with and without target-based isocenter realignment and the CTV coverage was assessed. Results: For CTV shifts within the applied planning margin, the CI-98% is greater than 98.0%, both with and without isocenter realignment. Without realignment, because of the sharp lateral gradients, the CI-98% shows rapid fall as soon as the target shift exceeds the applied planning margin for all displacement directions. With isocenter realignment, the coverage improves notably for shifts in AP and SI directions and the CI-98% is restored to >95.0% for plans optimized with a 2-mm margin, >97% with a 3-mm margin, and >98% with larger margins. For large corrections, predominately in AP direction, cold spots in the CTV may occur. Their magnitude is dependent on the patients' individual anatomies. Conclusions: Within the physiological limits of internal prostate movement, target-based isocenter realignment results in improved CTV coverage for shifts in AP and SI directions exceeding the applied planning margin. Assuming optimal patient setup reproducibility (eg, immobilization, setup error correction, patient preparation protocols), hence negligible interfraction bone and soft-tissue variations, changes in traversed densities resulting from target-based realignment

  3. Feasibility of using a large amplitude movement therapy to improve ambulatory function in children with cerebral palsy.

    PubMed

    Hickman, Robbin; Dufek, Janet S; Lee, Szu-Ping; Blahovec, Andrea; Kuiken, Andrea; Riggins, Heather; McClellan, Jeffrey Ray

    2015-01-01

    Cerebral palsy (CP) is the most common cause of motor disability among children. Limited evidence exists regarding the efficacy of traditional rehabilitation strategies on improving ambulatory function in this population. The purpose of the study was to investigate the feasibility and short-term effects of a novel large amplitude movement therapy on ambulatory functions in children with CP. Temporal-spatial gait characteristics were examined before and after a single intervention session, replicated over five children. Five children with CP (7.0 ± 1.0 years); Gross Motor Function Classification System Levels I-II, participated. Baseline gait parameters were obtained as the participant walked across an instrumented walkway at self-selected and fast speeds. Children then participated in a 20-30 min intervention focused on making body and limb movements as large as possible with gait assessment repeated immediately. All children tolerated testing and therapy with no adverse effects. Outcomes after one intervention included: significantly greater stride velocity; reduced double support time; and greater stride length after training for three of the five participants. Results for this pilot study suggested that the large amplitude movement therapy was feasible for children with CP. There is a need for a larger scale study to determine if the protocol can be effective at an appropriate clinical dose. PMID:26154826

  4. Psychogenic Movement

    MedlinePlus

    ... also look for marked improvement in symptoms following psychotherapy, use of a placebo (a medicine with no ... multi-therapy approach to treating psychogenic movement includes psychotherapy, placebo, or suggestion; antidepressants for symptoms related to ...

  5. Early detection of hand movements from electroencephalograms for stroke therapy applications

    NASA Astrophysics Data System (ADS)

    Muralidharan, A.; Chae, J.; Taylor, D. M.

    2011-08-01

    Movement-assist devices such as neuromuscular stimulation systems can be used to generate movements in people with chronic hand paralysis due to stroke. If detectable, motor planning activity in the cortex could be used in real time to trigger a movement-assist device and restore a person's ability to perform many of the activities of daily living. Additionally, re-coupling motor planning in the cortex with assisted movement generation in the periphery may provide an even greater benefit—strengthening relevant synaptic connections over time to promote natural motor recovery. This study examined the potential for using electroencephalograms (EEGs) as a means of rapidly detecting the intent to open the hand during movement planning in individuals with moderate chronic hand paralysis following a subcortical ischemic stroke. On average, attempts to open the hand could be detected from EEGs approximately 100-500 ms prior to the first signs of movement onset. This earlier detection would minimize device activation delays and allow for tighter coupling between initial formation of the motor plan in the cortex and augmentation of that plan in the periphery by a movement-assist device. This tight temporal coupling may be important or even essential for strengthening synaptic connections and enhancing natural motor recovery.

  6. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial

    PubMed Central

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement. PMID:27134363

  7. The effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis: a randomized controlled trial.

    PubMed

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2016-03-01

    [Purpose] The purpose of this study was to investigate the effects of game-based virtual reality movement therapy plus mental practice on upper extremity function in chronic stroke patients with hemiparesis. [Subjects] The subjects were chronic stroke patients with hemiparesis. [Methods] Thirty subjects were randomly assigned to either the control group or experimental group. All subjects received 20 sessions (5 days in a week) of virtual reality movement therapy using the Nintendo Wii. In addition to Wii-based virtual reality movement therapy, experimental group subjects performed mental practice consisting of 5 minutes of relaxation, Wii games imagination, and normalization phases before the beginning of Wii games. To compare the two groups, the upper extremity subtest of the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log were performed. [Results] Both groups showed statistically significant improvement in the Fugl-Meyer Assessment, Box and Block Test, and quality of the movement subscale of Motor Activity Log after the interventions. Also, there were significant differences in the Fugl-Meyer Assessment, Box and Block Test, and quality of movement subscale of the Motor Activity Log between the two groups. [Conclusion] Game-based virtual reality movement therapy alone may be helpful to improve functional recovery of the upper extremity, but the addition of MP produces a lager improvement. PMID:27134363

  8. Effect of Low-Level Laser Therapy on Orthodontic Tooth Movement: A Clinical Investigation

    PubMed Central

    Dalaie, Kazem; Kharazifard, Mohammad Javad; Mahdian, Mina; Bayat, Mehrdad

    2015-01-01

    Objectives: One major drawback of orthodontic treatment is its long duration due to slow tooth movement and the pain at the onset of treatment following application of forces. There is controversy regarding the efficacy of laser for decreasing the treatment time and pain of orthodontic treatment. The purpose of this study was to investigate the effect of low level diode laser on the rate of orthodontic tooth movement and the associated pain. Materials and Methods: In this double blind randomized controlled clinical trial, 12 orthodontic patients referring to Shahid Beheshti School of Dentistry for first premolar extraction were randomly selected and allocated to gallium aluminum-arsenide laser (GA-AL-AS diode laser, 880 nm, 100 mW, 5 j/cm2, 8 points, 80 seconds, continuous mode) or control group. The patients initially underwent leveling and alignment using the sectional system. Force (150 gr) was applied to each canine tooth via sectional closing loops. The loops were activated every month. The rate of tooth movement and pain were monitored over the treatment period and recorded on days 1, 3, 7, 30, 33, 37, 60, 63 and 67. Two-way ANOVA was used for comparison of groups. Results: There was no significant difference in terms of tooth movement and pain scores between the irradiated and non-irradiated sides at any time point (P>0.05). Conclusion: Although laser enhanced orthodontic tooth movement in the upper jaw, we failed to provide solid evidence to support the efficacy of laser for expediting tooth movement or reducing the associated pain. PMID:26622279

  9. Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting

    PubMed Central

    Hase, Michael; Balmaceda, Ute Mirian; Hase, Adrian; Lehnung, Maria; Tumani, Visal; Huchzermeier, Christian; Hofmann, Arne

    2015-01-01

    Background Depression is a severe mental disorder that challenges mental health systems worldwide as the success rates of all established treatments are limited. Eye Movement Desensitization and Reprocessing (EMDR) therapy is a scientifically acknowledged psychotherapeutic treatment for PTSD. Given the recent research indicating that trauma and other adverse life experiences can be the basis of depression, the aim of this study was to determine the effectiveness of EMDR therapy with this disorder. Method In this study, we recruited a group of 16 patients with depressive episodes in an inpatient setting. These 16 patients were treated with EMDR therapy by reprocessing of memories related to stressful life events in addition to treatment as usual (TAU). They were compared to a group of 16 controls matched regarding diagnosis, degree of depression, sex, age and time of admission to hospital, which were receiving TAU only. Results Sixty-eight percent of the patients in the EMDR group showed full remission at end of treatment. The EMDR group showed a greater reduction in depressive symptoms as measured by the SCL-90-R depression subscale. This difference was significant even when adjusted for duration of treatment. In a follow-up period of more than 1 year the EMDR group reported less problems related to depression and less relapses than the control group. Conclusions EMDR therapy shows promise as an effective treatment for depressive disorders. Larger controlled studies are necessary to replicate our findings. PMID:26085967

  10. The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste.

    PubMed

    Schubert, Sarah J; Lee, Christopher W; de Araujo, Guilhermina; Butler, Susan R; Taylor, Graham; Drummond, Peter D

    2016-04-01

    The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy for treating trauma symptoms was examined in a postwar/conflict, developing nation, Timor Leste. Participants were 21 Timorese adults with symptoms of posttraumatic stress disorder (PTSD), assessed as those who scored ≥2 on the Harvard Trauma Questionnaire (HTQ). Participants were treated with EMDR therapy. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist. Symptom changes post-EMDR treatment were compared to a stabilization control intervention period in which participants served as their own waitlist control. Sessions were 60-90 mins. The average number of sessions was 4.15 (SD = 2.06). Despite difficulties providing treatment cross-culturally (i.e., language barriers), EMDR therapy was followed by significant and large reductions in trauma symptoms (Cohen's d = 2.48), depression (d = 2.09), and anxiety (d = 1.77). At posttreatment, 20 (95.2%) participants scored below the HTQ PTSD cutoff of 2. Reliable reductions in trauma symptoms were reported by 18 participants (85.7%) posttreatment and 16 (76.2%) at 3-month follow-up. Symptoms did not improve during the control period. Findings support the use of EMDR therapy for treatment of adults with PTSD in a cross-cultural, postwar/conflict setting, and suggest that structured trauma treatments can be applied in Timor Leste. PMID:26934487

  11. Biomechanical studies of spinal manipulative therapy (SMT): quantifying the movements of vertebral bodies during SMT

    PubMed Central

    Gál, Julianna; Herzog, Walter; Kawchuk, Gregory; Conway, Phillip; Zhang, Yuan-Ting

    1994-01-01

    The relative movements between vertebral bodies T10 and T11, and T11 and T12 were measured during clinical-type SMTs to T11 in unembalmed post-rigor human cadavers, using embedded stainless steel bone pins and high speed cinematography. Significant relative movements between target and adjacent vertebrae occurred primarily in sagittal and axial rotation during the thrust phases of the SMTs. The relative positions of the vertebral bodies were compared at similar force levels, before and after the rapid thrust phases. The sagittal angles between T11 and T12 following the SMTs, were significantly different from their pre-thrust values. Two non-invasive methods (surface markers and uni-axial accelerometers) were compared to the invasive bone pins, in order to assess their suitability to accurately measure posterior-anterior translation. The results showed that both non-invasive techniques significantly underestimated the absolute movements of all vertebral bodies during the SMTs. The relative posterior-anterior translations using the non-invasive techniques however, were not significantly different from those determined from the bone pins. ImagesFigure 2

  12. Effects of low-level laser therapy on orthodontic tooth movement and root resorption after artificial socket preservation

    PubMed Central

    Seifi, Massoud; Atri, Faezeh; Yazdani, Mohammad Masoud

    2014-01-01

    Background: Low- level laser therapy has been used to stimulate the orthodontic tooth movements (OTM) previously. Furthermore, in the orthodontic treatments accompanying tooth extractions, the adjacent teeth move towards the extraction sites and close the space in some cases. Then, the adjacent tooth movements must be prevented in the treatments requiring space. Laser stimulates and at some doses decelerates tooth movement; it also improves healing process and enhances osteogenesis. Hence, it can prevent movement by osteogenesis adjacent to the tooth. The present study investigated the effects of low-level laser therapy on the OTM and root resorption following artificial socket preservation. Materials and Methods: In this experimental animal trial, 16 male albino rabbits were selected with similar characteristics and randomly divided in two groups. Under general anesthesia, an artificial socket, 8 mm in height, was created in the mesial aspect of the first premolars of the rabbits and filled with demineralized freeze dried bone allograft (DFDBA). The first premolars were connected to the incisors using nickel titanium coil springs. In experimental group, gallium-aluminum-arsenide (GaAlAs) laser was irritated mesial to first premolar where artificial socket was created continuously (808 nm). The cycle was 10 days irritation, 14 days rest, 10 days irritation, 14 days rest (Biostimulation mode). Control group was not laser irradiated. All animals were sacrificed after 48 days and the distance between the distal aspect of the first premolars, and the mesial surface of the second premolars was measured with leaf gauge. The specimens underwent histological assessments. Integrity of root and its resorption was observed under microscope calibration. The size of resorption lacunae was calculated in mm2. Normality of data was proved according to Kolmogorov-Smirnov analysis, and Student's t-test was done. P value less than 0.05 was considered as significant. Results: The mean

  13. Physical therapy interventions for patients with movement disorders due to cerebral palsy.

    PubMed

    Barry, M J

    1996-11-01

    The purpose of this paper is to present evidence of the efficacy of physical therapy interventions for patients with cerebral palsy and identify goals for these patients. Studies suggest that neurodevelopmental treatment and Vojta techniques improve postural control. Little evidence supports the efficacy of early intervention, but researchers have not yet studied effects on the family. Strengthening, electrical stimulation, the use of orthoses, and seating show positive effects in studies of small numbers of subjects. For severely involved children, ease of care and comfort are important goals, as well as prevention of deformity, which is important for all children. To the extent possible, therapy should prepare a child for independent adult life. In early intervention through school age, therapy focuses on promoting communication, self-care, and mobility. Independence is a key issue for adolescents transitioning into adulthood. The rehabilitation and health needs of adults with cerebral palsy need to be addressed. Research needs to determine the effects of physical therapy not only on impairment but also on function and disability. PMID:8959462

  14. Perspective: assume a spherical cow: the role of free or mobile electrons in bodywork, energetic and movement therapies.

    PubMed

    Oschman, James L

    2008-01-01

    Biomedical research has led to the hypothesis that inflammation is the culprit behind almost every modern chronic illness. Hence there is interest in techniques that can resolve acute and chronic inflammation. A natural method involves connecting the human body to the earth (earthing). When done during sleep, earthing normalizes the daily cortisol rhythm, improves sleep and reduces pain and inflammation. Direct electrical connection with the earth enables diurnal (daily) electrical rhythms and electrons to flow from the earth to the body. Electrons are thought to act as natural anti-oxidants by neutralizing positively charged inflammatory free radicals. This concept requires a revision of an old idea in physiology: the human body and the cells within it are best described as volume conductors, in which charge is only conducted by dissolved electrolytes. The discussion relates to the term, "ungrounded," widely used by practitioners of bodywork, energetic and movement therapies. PMID:19083655

  15. Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder

    PubMed Central

    McGuire, Tracy M; Lee, Christopher W; Drummond, Peter D

    2014-01-01

    Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented. PMID:25302027

  16. A dance movement therapy group for depressed adult patients in a psychiatric outpatient clinic: effects of the treatment

    PubMed Central

    Pylvänäinen, Päivi M.; Muotka, Joona S.; Lappalainen, Raimo

    2015-01-01

    We were interested in investigating the effects of dance movement therapy (DMT) in a psychiatric outpatient clinic with patients diagnosed with depression. DMT aims to engage the patients in physical and verbal exploration of their experiences generated in movement based interaction. The assumption was that DMT, which includes both physical engagement as well as emotional and social exploration, would alleviate the mood and psychiatric symptoms. All adult patients (n = 33) included in the study received treatment as usual (TAU). Twenty-one patients participated in a 12-session DMT group intervention, and the remaining 12 patients chose to take TAU only. The majority of the patients suffered from moderate or severe depression, recurrent and/or chronic type. The effects of the interventions were investigated after the intervention, and at 3-month follow-up. Compared to the TAU, adding DMT seemed to improve the effect of the treatment. The effect of the DMT was observable whether the patient was taking antidepressant medication or not. At follow-up, between group effect sizes (ES) were medium in favor for the DMT group (d = 0.60–0.79). In the DMT group, the within ES at the 3 months follow-up varied from 0.62 to 0.82 as compared to TAU 0.15–0.37. The results indicated that DMT is beneficial in the treatment of depressed patients. PMID:26217292

  17. The neuronal correlates of mirror therapy: A functional magnetic resonance imaging study on mirror-induced visual illusions of ankle movements.

    PubMed

    Guo, Feng; Xu, Qun; Abo Salem, Hassan M; Yao, Yihao; Lou, Jicheng; Huang, Xiaolin

    2016-05-15

    Recovery in stroke is mediated by neural plasticity. Mirror therapy is an effective method in the rehabilitation of stroke patients, but the mechanism is still obscure. To identify the neural networks associated with the effect of lower-limbs mirror therapy, we investigated a functional magnetic resonance imaging (fMRI) study of mirror-induced visual illusion of ankle movements. Five healthy controls and five left hemiplegic stroke patients performed tasks related to mirror therapy in the fMRI study. Neural activation was compared in a no-mirror condition and a mirror condition. All subjects in the experiment performed the task of flexing and extending the right ankle. In a mirror condition, movement of the left ankle was simulated by mirror reflection of right ankle movement. Changes in neural activation in response to mirror therapy were assessed both in healthy controls and stroke patients. We found strong activation of the motor cortex bilaterally in healthy controls, as well as significant activation of the ipsilateral sensorimotor cortex, the occipital gyrus, and the anterior prefrontal gyrus in stroke patients with respect to the non-mirror condition. We concluded that mirror therapy of ankle movements may induce neural activation of the ipsilesional sensorimotor cortex, and that cortical reorganization may be useful for motor rehabilitation in stroke. PMID:26972531

  18. Effects of low-intensity laser therapy on the rate of orthodontic tooth movement: A clinical trial

    PubMed Central

    Kansal, Ankur; Kittur, Nandan; Kumbhojkar, Vinayak; Keluskar, Kanhoba Mahabaleshwar; Dahiya, Parveen

    2014-01-01

    Background: Low-intensity laser therapy (LILT) can be utilized for different treatments in the field of orthodontics and dentofacial orthopedics. The aim of the present study was to evaluate the efficacy of LILT on (1) the rate of canine movement during canine retraction phase and (2) evaluate the radiographic changes occurring during LILT around the irradiated area. Materials and Methods: A total of 10 patients of both genders were included for this study. One quadrant of the upper arch was considered control group (CG) and received mechanical activation of the canine teeth with 150 g. The opposite quadrant received the same mechanical activation and was also irradiated with a diode emitting light (gallium-arsenide laser) at 904 nm, for 10 s at 12 mW, at 4.2 J/cm2. Laser application was done on 1st day, 3rd, 7th, 14th, 21th, 28th, 35th, 42nd, 49th, 56th day respectively during the canine retraction phase. Distance was measured on 1st day, 35th day and 63rd day and appliance activation was done on 1st and 35th day. Results were analyzed using t-test with the significance level set at P < 0.01. Results: Mean value obtained from 1st to 63rd day was 3.30 ± 2.36 mm for CG and 3.53 ± 2.30 mm for laser group (LG). Conclusion: There was no statistically significant difference in the rate of tooth movement during canine retraction between the LG and the CG. There was no evidence of any pathologic changes in the radiograph following LILT. PMID:25225562

  19. The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences

    PubMed Central

    Shapiro, Francine

    2014-01-01

    Background: A substantial body of research shows that adverse life experiences contribute to both psychological and biomedical pathology. Eye movement desensitization and reprocessing (EMDR) therapy is an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice. The positive therapeutic outcomes rapidly achieved without homework or detailed description of the disturbing event offer the medical community an efficient treatment approach with a wide range of applications. Methods: All randomized studies and significant clinical reports related to EMDR therapy for treating the experiential basis of both psychological and somatic disorders are reviewed. Also reviewed are the recent studies evaluating the eye movement component of the therapy, which has been posited to contribute to the rapid improvement attributable to EMDR treatment. Results: Twenty-four randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences relevant to clinical practice. Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy. Twelve randomized studies of the eye movement component noted rapid decreases in negative emotions and/or vividness of disturbing images, with an additional 8 reporting a variety of other memory effects. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints. Conclusion: EMDR therapy provides physicians and other clinicians with an efficient approach to address psychological and physiologic symptoms stemming from adverse life experiences. Clinicians should therefore evaluate patients for experiential contributors to clinical manifestations. PMID:24626074

  20. Practical Guidance on How to Handle Levodopa/Carbidopa Intestinal Gel Therapy of Advanced PD in a Movement Disorder Clinic

    PubMed Central

    Pedersen, Stephen Wørlich; Clausen, Jesper; Gregerslund, Mie Manon

    2012-01-01

    Continuous dopaminergic delivery is recognized for the capacity to ameliorate symptoms in Parkinson’s disease (PD). In advanced PD the short comings of orally administered Levodopa/Carbidopa include fluctuations resulting in unstable effect and dyskinesia. Levodopa/Carbidopa intestinal gel, LCIG, (Duodopa®, Abbott Laboratories) is delivered continuously through a percutaneous endoscopic gastrostomy with the inner tube placed in the duodenum by means of a device (CADD legacy Duodopa pump (CE 0473)). The therapy implies continuous dopaminergic delivery directly to the duodenum and is therefore unaffected by gastric emptying and represents a major adjuvant in the treatment of advanced PD with significant improvement in motor and non-motor symptoms. The aim of this paper is to suggest the prerequisites for a LCIG clinic and propose a feasible set-up and lean organization of a movement disorder clinic. Secondly, the paper proposes practical handling of patients in LCIG treatment for advanced PD based on experience and initiation of LCIG treatment and follow-up in forty patients. PMID:22848335

  1. A randomised comparison of cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) in disaster-exposed children

    PubMed Central

    de Roos, Carlijn; Greenwald, Ricky; den Hollander-Gijsman, Margien; Noorthoorn, Eric; van Buuren, Stef; de Jongh, Ad

    2011-01-01

    Background Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Design Children (n=52, aged 4–18) were randomly allocated to either CBT (n=26) or EMDR (n=26) in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4–8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures) were conducted on the intention-to-treat sample and the completers. Results Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. Conclusion Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children. PMID:22893815

  2. Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: a hdEEG study

    PubMed Central

    Trentini, Cristina; Pagani, Marco; Fania, Piercarlo; Speranza, Anna Maria; Nicolais, Giampaolo; Sibilia, Alessandra; Inguscio, Lucio; Verardo, Anna Rita; Fernandez, Isabel; Ammaniti, Massimo

    2015-01-01

    Eye Movement Desensitization and Reprocessing (EMDR) therapy has been proven efficacious in restoring affective regulation in post-traumatic stress disorder (PTSD) patients. However, its effectiveness on emotion processing in children with complex trauma has yet to be explored. High density electroencephalography (hdEEG) was used to investigate the effects of EMDR on brain responses to adults’ emotions on children with histories of early maltreatment. Ten school-aged children were examined before (T0) and within one month after the conclusion of EMDR (T1). hdEEGs were recorded while children passively viewed angry, afraid, happy, and neutral faces. Clinical scales were administered at the same time. Correlation analyses were performed to detect brain regions whose activity was linked to children’s traumatic symptom-related and emotional-adaptive problem scores. In all four conditions, hdEEG showed similar significantly higher activity on the right medial prefrontal and fronto-temporal limbic regions at T0, shifting toward the left medial and superior temporal regions at T1. Moreover, significant correlations were found between clinical scales and the same regions whose activity significantly differed between pre- and post-treatment. These preliminary results demonstrate that, after EMDR, children suffering from complex trauma show increased activity in areas implicated in high-order cognitive processing when passively viewing pictures of emotional expressions. These changes are associated with the decrease of depressive and traumatic symptoms, and with the improvement of emotional-adaptive functioning over time. PMID:26594183

  3. Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: a hdEEG study.

    PubMed

    Trentini, Cristina; Pagani, Marco; Fania, Piercarlo; Speranza, Anna Maria; Nicolais, Giampaolo; Sibilia, Alessandra; Inguscio, Lucio; Verardo, Anna Rita; Fernandez, Isabel; Ammaniti, Massimo

    2015-01-01

    Eye Movement Desensitization and Reprocessing (EMDR) therapy has been proven efficacious in restoring affective regulation in post-traumatic stress disorder (PTSD) patients. However, its effectiveness on emotion processing in children with complex trauma has yet to be explored. High density electroencephalography (hdEEG) was used to investigate the effects of EMDR on brain responses to adults' emotions on children with histories of early maltreatment. Ten school-aged children were examined before (T0) and within one month after the conclusion of EMDR (T1). hdEEGs were recorded while children passively viewed angry, afraid, happy, and neutral faces. Clinical scales were administered at the same time. Correlation analyses were performed to detect brain regions whose activity was linked to children's traumatic symptom-related and emotional-adaptive problem scores. In all four conditions, hdEEG showed similar significantly higher activity on the right medial prefrontal and fronto-temporal limbic regions at T0, shifting toward the left medial and superior temporal regions at T1. Moreover, significant correlations were found between clinical scales and the same regions whose activity significantly differed between pre- and post-treatment. These preliminary results demonstrate that, after EMDR, children suffering from complex trauma show increased activity in areas implicated in high-order cognitive processing when passively viewing pictures of emotional expressions. These changes are associated with the decrease of depressive and traumatic symptoms, and with the improvement of emotional-adaptive functioning over time. PMID:26594183

  4. Feasibility of visual instrumented movement feedback therapy in individuals with motor incomplete spinal cord injury walking on a treadmill

    PubMed Central

    Schließmann, Daniel; Schuld, Christian; Schneiders, Matthias; Derlien, Steffen; Glöckner, Maria; Gladow, Till; Weidner, Norbert; Rupp, Rüdiger

    2014-01-01

    Background: Incomplete spinal cord injury (iSCI) leads to motor and sensory deficits. Even in ambulatory persons with good motor function an impaired proprioception may result in an insecure gait. Limited internal afferent feedback (FB) can be compensated by provision of external FB by therapists or technical systems. Progress in computational power of motion analysis systems allows for implementation of instrumented real-time FB. The aim of this study was to test if individuals with iSCI can normalize their gait kinematics during FB and more importantly maintain an improvement after therapy. Methods: Individuals with chronic iSCI had to complete 6 days (1 day per week) of treadmill-based FB training with a 2 weeks pause after 3 days of training. Each day consists of an initial gait analysis followed by 2 blocks with FB/no-FB. During FB the deviation of the mean knee angle during swing from a speed matched reference (norm distance, ND) is visualized as a number. The task consists of lowering the ND, which was updated after every stride. Prior to the tests in patients the in-house developed FB implementation was tested in healthy subjects with an artificial movement task. Results: Four of five study participants benefited from FB in the short and medium term. Decrease of mean ND was highest during the first 3 sessions (from 3.93 ± 1.54 to 2.18 ± 1.04). After the pause mean ND stayed in the same range than before. In the last 3 sessions the mean ND decreased slower (2.40 ± 1.18 to 2.20 ± 0.90). Direct influences of FB ranged from 60 to 15% of reduction in mean ND compared to initial gait analysis and from 20 to 1% compared to no-FB sessions. Conclusions: Instrumented kinematic real-time FB may serve as an effective adjunct to established gait therapies in normalizing the gait pattern after incomplete spinal cord injury. Further studies with larger patient groups need to prove long term learning and the successful transfer of newly acquired skills to activities of

  5. Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: a randomized, controlled pilot-study.

    PubMed

    Novo, Patricia; Landin-Romero, Ramon; Radua, Joaquim; Vicens, Victor; Fernandez, Isabel; Garcia, Francisca; Pomarol-Clotet, Edith; McKenna, Peter J; Shapiro, Francine; Amann, Benedikt L

    2014-09-30

    Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Psychotherapeutic interventions for these events have not been studied so far. Twenty DSM-IV bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14 and 18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the treatment group showed a statistically significant improvement in depressive and hypomanic symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was only partly maintained in trauma impact at the 24 weeks follow-up visit. One patient dropped from Eye Movement Desensitization and Reprocessing group whereas four from the treatment as usual group. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients. PMID:24880581

  6. Rehabilitation, exercise therapy and music in patients with Parkinson's disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life.

    PubMed

    de Dreu, M J; van der Wilk, A S D; Poppe, E; Kwakkel, G; van Wegen, E E H

    2012-01-01

    Recent evidence suggests that music-based movement (MbM) therapy may be a promising intervention to improve gait and gait-related activities in Parkinson's disease (PD) patients, because it naturally combines cognitive movement strategies, cueing techniques, balance exercises and physical activity while focussing on the enjoyment of moving on music instead of the current mobility limitations of the patient. A meta-analysis of RCTs on the efficacy of MbM-therapy, including individual rhythmic music training and partnered dance classes, was performed. Identified studies (K = 6) were evaluated on methodological quality, and summary effect sizes (SES) were calculated. Studies were generally small (total N= 168). Significant homogeneous SESs were found for the Berg Balance Scale, Timed Up and Go test and stride length (SESs: 4.1,2.2,0.11; P-values <0.01; I(2) 0,0,7%, respectively). A sensitivity analysis on type of MbM-therapy (dance- or gait-related interventions) revealed a significant improvement in walking velocity for gait-related MbM-therapy, but not for dance-related MbM-therapy. No significant effects were found for UPDRS-motor score, Freezing of Gait and Quality of Life. Overall, MbM-therapy appears promising for the improvement of gait and gait-related activities in PD. Future studies should incorporate larger groups and focus on long-term compliance and follow-up. PMID:22166406

  7. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

    PubMed Central

    Chen, Jia-Ching; Shaw, Fu-Zen

    2014-01-01

    Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into “a training package”, based on the patient’s functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients. PMID:25133141

  8. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients.

    PubMed

    Chen, Jia-Ching; Shaw, Fu-Zen

    2014-08-16

    Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into "a training package", based on the patient's functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients. PMID:25133141

  9. The importance of foetal movement for co-ordinated cartilage and bone development in utero : clinical consequences and potential for therapy.

    PubMed

    Shea, C A; Rolfe, R A; Murphy, P

    2015-07-01

    Construction of a functional skeleton is accomplished through co-ordination of the developmental processes of chondrogenesis, osteogenesis, and synovial joint formation. Infants whose movement in utero is reduced or restricted and who subsequently suffer from joint dysplasia (including joint contractures) and thin hypo-mineralised bones, demonstrate that embryonic movement is crucial for appropriate skeletogenesis. This has been confirmed in mouse, chick, and zebrafish animal models, where reduced or eliminated movement consistently yields similar malformations and which provide the possibility of experimentation to uncover the precise disturbances and the mechanisms by which movement impacts molecular regulation. Molecular genetic studies have shown the important roles played by cell communication signalling pathways, namely Wnt, Hedgehog, and transforming growth factor-beta/bone morphogenetic protein. These pathways regulate cell behaviours such as proliferation and differentiation to control maturation of the skeletal elements, and are affected when movement is altered. Cell contacts to the extra-cellular matrix as well as the cytoskeleton offer a means of mechanotransduction which could integrate mechanical cues with genetic regulation. Indeed, expression of cytoskeletal genes has been shown to be affected by immobilisation. In addition to furthering our understanding of a fundamental aspect of cell control and differentiation during development, research in this area is applicable to the engineering of stable skeletal tissues from stem cells, which relies on an understanding of developmental mechanisms including genetic and physical criteria. A deeper understanding of how movement affects skeletogenesis therefore has broader implications for regenerative therapeutics for injury or disease, as well as for optimisation of physical therapy regimes for individuals affected by skeletal abnormalities. Cite this article: Bone Joint Res 2015;4:105-116. PMID:26142413

  10. Simulation of bilateral movement training through mirror reflection: a case report demonstrating an occupational therapy technique for hemiparesis.

    PubMed

    Stevens, Jennifer A; Stoykov, Mary Ellen Phillips

    2004-01-01

    In rehabilitation for hemiparesis, one of the goals of an occupational therapist is to practice upper extremity tasks with the recovering individual. The practice is intended to strengthen muscles and refine movements. It also provides examples for the recovering body and brain as they attempt to reestablish the now delicate cognitive and neural connections mediating voluntary behavior. However, the paresis significantly limits the movement sequence possibilities that may be physically practiced. We outline a method for using simulation of movement, which is intended to provide a means for experiencing a range of smooth and controlled movements completed by a paretic limb. The simulation provides a compelling perceptual experience of bilateral motion beyond the current capabilities of the affected limb. The benefits of this technique after a 3-week course of the simulation practice are exemplified by the presented case study that reveals improved function as demonstrated by increases in Fugl-Meyer scores and faster movement speeds as demonstrated by decreased movement times for the Jebsen test of hand function. PMID:14872400

  11. Changing beliefs for changing movement and pain: Classification-based cognitive functional therapy (CB-CFT) for chronic non-specific low back pain.

    PubMed

    Meziat Filho, N

    2016-02-01

    This case report presents the effect of classification-based cognitive functional therapy in a patient with chronic disabling low back pain. The patient was assessed using a multidimensional biopsychosocial classification system and was classified as having flexion pattern of movement impairment disorder. Management of this patient was to change her belief that bending over and sitting would cause damage to her disc, combined with active exercises for graded exposure to lumbar flexion to restore normal movement. Three months after the first appointment, the treatment resulted in reduced pain, the mitigation of fear avoidance beliefs and the remediation of functional disability. The patient returned to work and was walking for one hour a day on a treadmill. The cognitive intervention to change the patient's negative beliefs related to the biomedical model was important to make the graded exercises and the lifestyle changes possible. PMID:25920336

  12. Movement Disorders

    MedlinePlus

    ... t want them to. If you have a movement disorder, you experience these kinds of impaired movement. Dyskinesia ... movement and is a common symptom of many movement disorders. Tremors are a type of dyskinesia. Nerve diseases ...

  13. The Efficacy of Eye Movement Desensitization and Reprocessing Therapy Technique in the Treatment of Test Anxiety of College Students.

    ERIC Educational Resources Information Center

    Enright, Matthew; Baldo, Tracy D.; Wykes, Scott D.

    2000-01-01

    Explores the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of test anxiety. Thirty-five college students with test anxiety were assigned to either a treatment or delayed treatment control group. EMDR was shown to be effective in reducing overall test anxiety as well as "emotionality" and "worry" components of…

  14. Efficacy of low-level laser therapy for accelerating tooth movement during orthodontic treatment: a systematic review and meta-analysis.

    PubMed

    Ge, M K; He, W L; Chen, J; Wen, C; Yin, X; Hu, Z A; Liu, Z P; Zou, S J

    2015-07-01

    This review aimed to evaluate the efficacy of low-level laser therapy (LLLT) for accelerating tooth movement during orthodontic treatment. An extensive electronic search was conducted by two reviewers. Randomized controlled trials (RCTs) and quasi-RCTs concerning the efficacy of LLLT for accelerating tooth movement during orthodontic treatment were searched in CENTRAL, Medline, PubMed, Embase, China Biology Medicine Disc (CBM), China National Knowledge Infrastructure (CNKI), and Google Scholar. Six RCTs and three quasi-RCTs, involving 211 patients from six countries, were selected from 173 relevant studies. All nine articles were feasible for the systematic review and meta-analysis, five of which were assessed as moderate risk of bias, while the rest were assessed as high risk of bias. The mean difference and the 95 % confidence interval (95 % CI) of accumulative moved distance of teeth were observed among all the researches. The results showed that the LLLT could accelerate orthodontic tooth movement (OTM) in 7 days (mean difference 0.19, 95 % CI [0.02, 0.37], p = 0.03) and 2 months (mean difference 1.08, 95 % CI [0.16, 2.01], p = 0.02). Moreover, a relatively lower energy density (5 and 8 J/cm(2)) was seemingly more effective than 20 and 25 J/cm(2) and even higher ones. PMID:24554452

  15. Implications of CI therapy for visual deficit training.

    PubMed

    Taub, Edward; Mark, Victor W; Uswatte, Gitendra

    2014-01-01

    We address here the question of whether the techniques of Constraint Induced (CI) therapy, a family of treatments that has been employed in the rehabilitation of movement and language after brain damage might apply to the rehabilitation of such visual deficits as unilateral spatial neglect and visual field deficits. CI therapy has been used successfully for the upper and lower extremities after chronic stroke, cerebral palsy (CP), multiple sclerosis (MS), other central nervous system (CNS) degenerative conditions, resection of motor areas of the brain, focal hand dystonia, and aphasia. Treatments making use of similar methods have proven efficacious for amblyopia. The CI therapy approach consists of four major components: intensive training, training by shaping, a "transfer package" to facilitate the transfer of gains from the treatment setting to everyday activities, and strong discouragement of compensatory strategies. CI therapy is said to be effective because it overcomes learned nonuse, a learned inhibition of movement that follows injury to the CNS. In addition, CI therapy produces substantial increases in the gray matter of motor areas on both sides of the brain. We propose here that these mechanisms are examples of more general processes: learned nonuse being considered parallel to sensory nonuse following damage to sensory areas of the brain, with both having in common diminished neural connections (DNCs) in the nervous system as an underlying mechanism. CI therapy would achieve its therapeutic effect by strengthening the DNCs. Use-dependent cortical reorganization is considered to be an example of the more general neuroplastic mechanism of brain structure repurposing. If the mechanisms involved in these broader categories are involved in each of the deficits being considered, then it may be the principles underlying efficacious treatment in each case may be similar. The lessons learned during CI therapy research might then prove useful for the treatment

  16. Implications of CI therapy for visual deficit training

    PubMed Central

    Taub, Edward; Mark, Victor W.; Uswatte, Gitendra

    2014-01-01

    We address here the question of whether the techniques of Constraint Induced (CI) therapy, a family of treatments that has been employed in the rehabilitation of movement and language after brain damage might apply to the rehabilitation of such visual deficits as unilateral spatial neglect and visual field deficits. CI therapy has been used successfully for the upper and lower extremities after chronic stroke, cerebral palsy (CP), multiple sclerosis (MS), other central nervous system (CNS) degenerative conditions, resection of motor areas of the brain, focal hand dystonia, and aphasia. Treatments making use of similar methods have proven efficacious for amblyopia. The CI therapy approach consists of four major components: intensive training, training by shaping, a “transfer package” to facilitate the transfer of gains from the treatment setting to everyday activities, and strong discouragement of compensatory strategies. CI therapy is said to be effective because it overcomes learned nonuse, a learned inhibition of movement that follows injury to the CNS. In addition, CI therapy produces substantial increases in the gray matter of motor areas on both sides of the brain. We propose here that these mechanisms are examples of more general processes: learned nonuse being considered parallel to sensory nonuse following damage to sensory areas of the brain, with both having in common diminished neural connections (DNCs) in the nervous system as an underlying mechanism. CI therapy would achieve its therapeutic effect by strengthening the DNCs. Use-dependent cortical reorganization is considered to be an example of the more general neuroplastic mechanism of brain structure repurposing. If the mechanisms involved in these broader categories are involved in each of the deficits being considered, then it may be the principles underlying efficacious treatment in each case may be similar. The lessons learned during CI therapy research might then prove useful for the

  17. Interdisziplinärer Arbeitskreis Bewegungsstörungen (IAB): an interdisciplinary working group for promoting multimodal therapy of movement disorders.

    PubMed

    Adib Saberi, Fereshte; Dressler, Dirk

    2013-04-01

    Increasing complexity of therapeutic strategies for movement disorders (MD) requires multimodal therapies involving various health care professionals and physicians. Coordinating all professions involved is difficult. An interdisciplinary working group (Interdisziplinärer Arbeitskreis Bewegungsstörungen, IAB) serves to promote and improve multimodal therapies of MD. IAB was started 6 years ago in Hamburg, Germany as an interdisciplinary special interest group with about 25 physiotherapists, occupational therapists, speech therapists, nurse specialists, physicians and invited guests regularly meeting each quarter. IAB expanded and now also includes a webpage with data bases, a special interest group for Parkinson assistants, a meeting arm for organising meetings accredited by continuous medical education authorities and a publication arm for production of educational materials including a communication form and a communication calendar developed by IAB. Recently, IAB acquired a video production enterprise producing educational MD videos. In the meantime, two more IAB groups were founded in other regions of Germany. IAB's stability over more than 6 years and its expansion into more regions and other tasks documents the demand for promotion of multimodal therapies for MD. PMID:23224693

  18. The Mental Health Recovery Movement and Family Therapy, Part II: A Collaborative, Appreciative Approach for Supporting Mental Health Recovery

    ERIC Educational Resources Information Center

    Gehart, Diane R.

    2012-01-01

    A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily…

  19. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Langhorst, Jost; Klose, Petra; Dobos, Gustav J; Bernardy, Kathrin; Häuser, Winfried

    2013-01-01

    A systematic review with meta-analysis of the efficacy and safety of meditative movement therapies (Qigong, Tai Chi and Yoga) in fibromyalgia syndrome (FMS) was carried out. We screened Clinicaltrials.Gov, Cochrane Library, PsycINFO, PubMed and Scopus (through December 2010) and the reference sections of original studies for meditative movement therapies (MMT) in FMS. Randomized controlled trials (RCT) comparing MMT to controls were analysed. Outcomes of efficacy were pain, sleep, fatigue, depression and health-related quality of life (HRQOL). Effects were summarized using standardized mean differences (SMD [95% confidence interval]). Outcomes of safety were drop out because of adverse events and serious adverse events. A total of 7 out of 117 studies with 362 subjects and a median of 12 sessions (range 8-24) were included. MMT reduced sleep disturbances (-0.61 [-0.95, -0.27]; 0.0004), fatigue (-0.66 [-0.99, -0.34]; <0.0001), depression (-0.49 [-0.76, -0.22]; 0.0004) and limitations of HRQOL (-0.59 [-0.93, -0.24]; 0.0009), but not pain (-0.35 [-0.80, 0.11]; 0.14) compared to controls at final treatment. The significant effects on sleep disturbances (-0.52 [-0.97, -0.07]; 0.02) and HRQOL (-0.66 [-1.31, -0.01]; 0.05) could be maintained after a median of 4.5 (range 3-6) months. In subgroup analyses, only Yoga yielded significant effects on pain, fatigue, depression and HRQOL at final treatment. Drop out rate because of adverse events was 3.1%. No serious adverse events were reported. MMT are safe. Yoga had short-term beneficial effects on some key domains of FMS. There is a need for high-quality studies with larger sample sizes to confirm the results. PMID:22350253

  20. Psychogenic Movement Disorders

    PubMed Central

    Morgante, Francesca; Edwards, Mark J.; Espay, Alberto J.

    2013-01-01

    Purpose of Review This review describes the main clinical features of psychogenic (functional) movement disorders and reports recent advances in diagnosis, pathophysiology, and treatment. Recent Findings The terminology and definition of patients with psychogenic movement disorders remain subjects of controversy; the term “functional” has been used more frequently in the literature in recent years regarding the neurobiological substrate underpinning these disorders. Correct diagnosis of psychogenic movement disorders should rely not on the exclusion of organic disorders or the sole presence of psychological factors but on the observation or elicitation of clinical features related to the specific movement disorder (ie, a positive or inclusionary rather than exclusionary diagnosis). Sudden onset, spontaneous remissions, and variability over time or during clinical examination are useful “red flags” suggestive of a psychogenic movement disorder. Imaging studies have demonstrated impaired connectivity between limbic and motor areas involved in movement programming and hypoactivity of a brain region that compares expected data with actual sensory data occurring during voluntary movement. Treatment of psychogenic movement disorders begins with ensuring the patient’s acceptance of the diagnosis during the initial debriefing and includes nonpharmacologic (cognitive-behavioral therapy, physiotherapy) and pharmacologic options. Summary Psychogenic movement disorders represent a challenging disorder for neurologists to diagnose and treat. Recent advances have increased understanding of the neurobiological mechanism of psychogenic movement disorders. Treatment with cognitive strategies and physical rehabilitation can benefit some patients. As short duration of disease correlates with better prognosis, early diagnosis and initiation of treatment are critical. PMID:24092294

  1. Treating Post-traumatic Stress Disorder in Patients with Multiple Sclerosis: A Randomized Controlled Trial Comparing the Efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy

    PubMed Central

    Carletto, Sara; Borghi, Martina; Bertino, Gabriella; Oliva, Francesco; Cavallo, Marco; Hofmann, Arne; Zennaro, Alessandro; Malucchi, Simona; Ostacoli, Luca

    2016-01-01

    Objective: Multiple Sclerosis (MS) is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD). This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS. Methods: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20) and Relaxation Therapy (RT; n = 22). The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale 6-months after the treatment. Results: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety and depression symptoms, and to improve Quality of Life. Conclusion: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and cost-effective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition. Trial registration: NCT01743664, https://clinicaltrials.gov/ct2/show/NCT01743664 PMID:27148134

  2. Evaluating an Integrated Approach to the Management of Cerebral Palsy. Appendix C: An Analysis of the Evaluation and Follow-up Data from the Institute for Movement Therapy in Budapest, Hungary. Volume IV of IV. Final Report.

    ERIC Educational Resources Information Center

    Heal, Laird W.

    The appendix analyzed evaluation and followup data from the Institute for Movement Therapy whose procedures the Integrated Management of Cerebral Palsy project attempted to replicate. Examined were data from over a 15 year period for 866 patients treated for a broad range of motoric disabilities. Data concerned independence in eating dressing,…

  3. Bowel Movement

    MedlinePlus

    A bowel movement is the last stop in the movement of food through your digestive tract. Your stool passes out ... rectum and anus. Another name for stool is feces. It is made of what is left after ...

  4. Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis.

    PubMed

    Chen, Ling; Zhang, Guiqing; Hu, Min; Liang, Xia

    2015-06-01

    Posttraumatic stress disorder (PTSD) is a relatively common mental disorder, with an estimated lifetime prevalence of ∼5.7%. Eye movement desensitization and reprocessing (EMDR) and cognitive-behavioral therapy (CBT) are the most often studied and most effective psychotherapies for PTSD. However, evidence is inadequate to conclude which treatment is superior. Therefore, we conducted a meta-analysis to confirm the effectiveness of EMDR compared to CBT for adult PTSD. We searched Medline, PubMed, Ebsco, Proquest, and Cochrane (1989-2013) to identify relevant randomized control trials comparing EMDR and CBT for PTSD. We included 11 studies (N = 424). Although all the studies had methodological limitations, meta-analyses for total PTSD scores revealed that EMDR was slightly superior to CBT. Cumulative meta-analysis confirmed this and a meta-analysis for subscale scores of PTSD symptoms indicated that EMDR was better for decreased intrusion and arousal severity compared to CBT. Avoidance was not significantly different between groups. EMDR may be more suitable than CBT for PTSD patients with prominent intrusion or arousal symptoms. However, the limited number and poor quality of the original studies included suggest caution when drawing final conclusions. PMID:25974059

  5. Music, Movement, and Poetry.

    ERIC Educational Resources Information Center

    Carmichael, Karla D.

    This paper's premise is that music, movement, and poetry are unique and creative methods to be used by the counselor in working with both children and adults. Through these media, the counselor generates material for the counseling session that may not be available through more traditional "talk therapies." The choice of music as a counseling…

  6. [Movement disorders is psychiatric diseases].

    PubMed

    Hidasi, Zoltan; Salacz, Pal; Csibri, Eva

    2014-12-01

    Movement disorders are common in psychiatry. The movement disorder can either be the symptom of a psychiatric disorder, can share a common aetiological factor with it, or can be the consequence of psychopharmacological therapy. Most common features include tic, stereotypy, compulsion, akathisia, dyskinesias, tremor, hypokinesia and disturbances of posture and gait. We discuss characteristics and clinical importance of these features. Movement disorders are frequently present in mood disorders, anxiety disorders, schizophrenia, catatonia, Tourette-disorder and psychogenic movement disorder, leading to differential-diagnostic and therapeutical difficulties in everyday practice. Movement disorders due to psychopharmacotherapy can be classified as early-onset, late-onset and tardive. Frequent psychiatric comorbidity is found in primary movement disorders, such as Parkinson's disease, Wilson's disease, Huntington's disease, diffuse Lewy-body disorder. Complex neuropsychiatric approach is effective concerning overlapping clinical features and spectrums of disorders in terms of movement disorders and psychiatric diseases. PMID:25577484

  7. Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial.

    PubMed

    Diehle, Julia; Opmeer, Brent C; Boer, Frits; Mannarino, Anthony P; Lindauer, Ramón J L

    2015-02-01

    To prevent adverse long-term effects, children who suffer from posttraumatic stress symptoms (PTSS) need treatment. Trauma-focused cognitive behavioral therapy (TF-CBT) is an established treatment for children with PTSS. However, alternatives are important for non-responders or if TF-CBT trained therapists are unavailable. Eye movement desensitization and reprocessing (EMDR) is a promising treatment for which sound comparative evidence is lacking. The current randomized controlled trial investigates the effectiveness and efficiency of both treatments. Forty-eight children (8-18 years) were randomly assigned to eight sessions of TF-CBT or EMDR. The primary outcome was PTSS as measured with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Secondary outcomes included parental report of child PTSD diagnosis status and questionnaires on comorbid problems. The Children's Revised Impact of Event Scale was administered during the course of treatment. TF-CBT and EMDR showed large reductions from pre- to post-treatment on the CAPS-CA (-20.2; 95% CI -12.2 to -28.1 and -20.9; 95% CI -32.7 to -9.1). The difference in reduction was small and not statistically significant (mean difference of 0.69, 95% CI -13.4 to 14.8). Treatment duration was not significantly shorter for EMDR (p = 0.09). Mixed model analysis of monitored PTSS during treatment showed a significant effect for time (p < 0.001) but not for treatment (p = 0.44) or the interaction of time by treatment (p = 0.74). Parents of children treated with TF-CBT reported a significant reduction of comorbid depressive and hyperactive symptoms. TF-CBT and EMDR are effective and efficient in reducing PTSS in children. PMID:24965797

  8. The Art of Movement and Letter Learning.

    ERIC Educational Resources Information Center

    Haslett, Jacqueline G.

    Movement education techniques can be used to enhance childen's creative and expressive abilities, which can help to develop a sound self image and to transfer knowledge to reading skills. Numerous studies have explored perceptual and motor learning, movement therapy, and the needs of children with learning difficulties. Movement concepts have been…

  9. SU-E-T-603: Analysis of Optical Tracked Head Inter-Fraction Movements Within Masks to Access Intracranial Immobilization Techniques in Proton Therapy

    SciTech Connect

    Hsi, W; Zeidan, O

    2014-06-01

    Purpose: We present a quantitative methodology utilizing an optical tracking system for monitoring head inter-fraction movements within brain masks to assess the effectiveness of two intracranial immobilization techniques. Methods and Materials: A 3-point-tracking method was developed to measure the mask location for a treatment field at each fraction. Measured displacement of mask location to its location at first fraction is equivalent to the head movement within the mask. Head movements for each of treatment fields were measured over about 10 fractions at each patient for seven patients; five treated in supine and two treated in prone. The Q-fix Base-of-Skull head frame was used in supine while the CIVCO uni-frame baseplate was used in prone. Displacements of recoded couch position of each field post imaging at each fraction were extracted for those seven patients. Standard deviation (S.D.) of head movements and couch displacements was scored for statistical analysis. Results: The accuracy of 3PtTrack method was within 1.0 mm by phantom measurements. Patterns of head movement and couch displacement were similar for patients treated in either supine or prone. In superior-inferior direction, mean value of scored standard deviations over seven patients were 1.6 mm and 3.4 mm for the head movement and the couch displacement, respectively. The result indicated that the head movement combined with a loose fixation between the mask-to-head frame results large couch displacements for each patient, and also large variation between patients. However, the head movement is the main cause for the couch displacement with similar magnitude of around 1.0 mm in anterior-posterior and lateral directions. Conclusions: Optical-tracking methodology independently quantifying head movements could improve immobilization devices by correctly acting on causes for head motions within mask. A confidence in the quality of intracranial immobilization techniques could be more efficient by

  10. SU-E-J-179: Assessment of Tumor Volume Change and Movement During Stereotactic Body Radiotherapy (SBRT) for Lung Cancer: Is Adaptive Radiation Therapy (ART) Necessary?

    SciTech Connect

    Lee, C; Lee, C

    2015-06-15

    Purpose: Delineation of gross tumor volumes (GTVs) is important for stereotactic body radiotherapy (SBRT). However, tumor volume changes during treatment response. Here, we have investigated tumor volume changes and movement during SBRT for lung cancer, as a means of examining the need for adaptive radiation therapy (ART). Methods: Fifteen tumors in 15 patients with lung cancer were treated with SBRT (total dose: 60 Gy in 4 fractions). GTVs were obtained from cone-beam computed tomography scans (CBCT1–4) taken before each of the 4 fractions was administered. GTVs were delineated and measured by radiation oncologists using a treatment planning system. Variance in the tumor position was assessed between the planning CT and the CBCT images. To investigate the dosimetric effects of tumor volume changes, planning CT and CBCT4 treatment plans were compared using the conformity index (CI), homogeneity index (HI), and Paddick’s index (PCI). Results: The GTV on CBCT1 was employed as a baseline for comparisons. GTV had decreased by a mean of 20.4% (range: 0.7% to 47.2%) on CBCT4. Most patients had smaller GTVs on CBCT4 than on CBCT1. The interfractional shifts of the tumor position between the planning CT and CBCT1–4 were as follows: right-left, −0.4 to 1.3 mm; anterior-posterior, −0.8 to 0.5 mm; and superiorinferior, −0.9 to 1.1 mm. Indices for plans from the planning CT and CBCT4 were as follows: CI = 0.94±0.02 and 1.11±0.03; HI= 1.1±0.02 and 1.10±0.03; and PCI = 1.35±0.16 and 1.11±0.02, respectively. Conclusion: CI, HI, and PCI did not differ between the planning CT and CBCTs. However, daily CBCT revealed a significant decrease in the GTV during lung SBRT. Furthermore, there was an obvious interfractional shift in tumor position. Using ART could potentially lead to a reduced GTV margin and improved regional tumor control for lung cancer patients with significantly decreased GTV.

  11. Movement - uncoordinated

    MedlinePlus

    Lack of coordination; Loss of coordination; Coordination impairment; Ataxia; Clumsiness; Uncoordinated movement ... are passed through families (such as congenital cerebellar ataxia, Friedreich ataxia , ataxia - telangiectasia , or Wilson disease ) Multiple ...

  12. Dance Therapy.

    ERIC Educational Resources Information Center

    Leventhal, Marcia B.

    1980-01-01

    Dance therapy deals with personal growth via body-mind interaction. A change in movement expression is believed to result in a personality or behavior change. The therapist is trained to become sensitive to movement expression as it relates to the psychological, motor, and cognitive development of the child. (JN)

  13. Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: a randomised clinical trial protocol

    PubMed Central

    Chorna, Olena; Heathcock, Jill; Key, Alexandra; Noritz, Garey; Carey, Helen; Hamm, Ellyn; Nelin, Mary Ann; Murray, Micah; Needham, Amy; Slaughter, James C; Maitre, Nathalie L

    2015-01-01

    Introduction Cerebral palsy (CP) is the most common physical disability in childhood. It is a disorder resulting from sensory and motor impairments due to perinatal brain injury, with lifetime consequences that range from poor adaptive and social function to communication and emotional disturbances. Infants with CP have a fundamental disadvantage in recovering motor function: they do not receive accurate sensory feedback from their movements, leading to developmental disregard. Constraint-induced movement therapy (CIMT) is one of the few effective neurorehabilitative strategies shown to improve upper extremity motor function in adults and older children with CP, potentially overcoming developmental disregard. Methods and analysis This study is a randomised controlled trial of children 12–24 months corrected age studying the effectiveness of CIMT combined with motor and sensory-motor interventions. The study population will comprise 72 children with CP and 144 typically developing children for a total of N=216 children. All children with CP, regardless of group allocation will continue with their standard of care occupational and physical therapy throughout the study. The research material collected will be in the form of data from high-density array event-related potential scan, standardised assessment scores and motion analysis scores. Ethics and dissemination The study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. Trial registration number NCT02567630. PMID:26644127

  14. Movement - uncontrollable

    MedlinePlus

    ... Nervous system diseases that are getting worse Genetic disorder Medicines Stroke or brain injury Tumors ... Physical therapy that includes swimming, stretching, walking, and ... feelings. Self-help groups are available in many communities.

  15. Cranial functional (psychogenic) movement disorders.

    PubMed

    Kaski, Diego; Bronstein, Adolfo M; Edwards, Mark J; Stone, Jon

    2015-12-01

    Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or palate--are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient. Identification of the positive features of cranial functional movement disorders such as convergence and unilateral platysmal spasm might lend diagnostic weight to a suspected functional neurological disorder. Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management. Increased understanding of these disorders is also crucial to drive clinical trials and studies of individually tailored therapies. PMID:26581970

  16. Movement - uncontrolled or slow

    MedlinePlus

    ... leg movements - uncontrollable; Slow involuntary movements of large muscle groups; Athetoid movements ... The slow twisting movements of muscles (athetosis) or jerky muscle ... including: Cerebral palsy Drug side effects Encephalitis ...

  17. Comparison of Efficacy of Eye Movement, Desensitization and Reprocessing and Cognitive Behavioral Therapy Therapeutic Methods for Reducing Anxiety and Depression of Iranian Combatant Afflicted by Post Traumatic Stress Disorder

    NASA Astrophysics Data System (ADS)

    Narimani, M.; Sadeghieh Ahari, S.; Rajabi, S.

    This research aims to determine efficacy of two therapeutic methods and compare them; Eye Movement, Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT) for reduction of anxiety and depression of Iranian combatant afflicted with Post traumatic Stress Disorder (PTSD) after imposed war. Statistical population of current study includes combatants afflicted with PTSD that were hospitalized in Isar Hospital of Ardabil province or were inhabited in Ardabil. These persons were selected through simple random sampling and were randomly located in three groups. The method was extended test method and study design was multi-group test-retest. Used tools include hospital anxiety and depression scale. This survey showed that exercise of EMDR and CBT has caused significant reduction of anxiety and depression.

  18. Movement disorders.

    PubMed

    Stoessl, A Jon; Mckeown, Martin J

    2016-01-01

    Movement disorders can be hypokinetic (e.g., parkinsonism), hyperkinetic, or dystonic in nature and commonly arise from altered function in nuclei of the basal ganglia or their connections. As obvious structural changes are often limited, standard imaging plays less of a role than in other neurologic disorders. However, structural imaging is indicated where clinical presentation is atypical, particularly if the disorder is abrupt in onset or remains strictly unilateral. More recent advances in magnetic resonance imaging (MRI) may allow for differentiation between Parkinson's disease and atypical forms of parkinsonism. Functional imaging can assess regional cerebral blood flow (functional MRI (fMRI), positron emission tomography (PET), or single-photon emission computed tomography (SPECT)), cerebral glucose metabolism (PET), neurochemical and neuroreceptor status (PET and SPECT), and pathologic processes such as inflammation or abnormal protein deposition (PET) (Table 49.1). Cerebral blood flow can be assessed at rest, during the performance of motor or cognitive tasks, or in response to a variety of stimuli. In appropriate situations, the correct imaging modality and/or combination of modalities can be used to detect early disease or even preclinical disease, and to monitor disease progression and the effects of disease-modifying interventions. Various approaches are reviewed here. PMID:27430452

  19. The functional significance of cortical reorganization and the parallel development of CI therapy.

    PubMed

    Taub, Edward; Uswatte, Gitendra; Mark, Victor W

    2014-01-01

    For the nineteenth and the better part of the twentieth centuries two correlative beliefs were strongly held by almost all neuroscientists and practitioners in the field of neurorehabilitation. The first was that after maturity the adult CNS was hardwired and fixed, and second that in the chronic phase after CNS injury no substantial recovery of function could take place no matter what intervention was employed. However, in the last part of the twentieth century evidence began to accumulate that neither belief was correct. First, in the 1960s and 1970s, in research with primates given a surgical abolition of somatic sensation from a single forelimb, which rendered the extremity useless, it was found that behavioral techniques could convert the limb into an extremity that could be used extensively. Beginning in the late 1980s, the techniques employed with deafferented monkeys were translated into a rehabilitation treatment, termed Constraint Induced Movement therapy or CI therapy, for substantially improving the motor deficit in humans of the upper and lower extremities in the chronic phase after stroke. CI therapy has been applied successfully to other types of damage to the CNS such as traumatic brain injury, cerebral palsy, multiple sclerosis, and spinal cord injury, and it has also been used to improve function in focal hand dystonia and for aphasia after stroke. As this work was proceeding, it was being shown during the 1980s and 1990s that sustained modulation of afferent input could alter the structure of the CNS and that this topographic reorganization could have relevance to the function of the individual. The alteration in these once fundamental beliefs has given rise to important recent developments in neuroscience and neurorehabilitation and holds promise for further increasing our understanding of CNS function and extending the boundaries of what is possible in neurorehabilitation. PMID:25018720

  20. The functional significance of cortical reorganization and the parallel development of CI therapy

    PubMed Central

    Taub, Edward; Uswatte, Gitendra; Mark, Victor W.

    2014-01-01

    For the nineteenth and the better part of the twentieth centuries two correlative beliefs were strongly held by almost all neuroscientists and practitioners in the field of neurorehabilitation. The first was that after maturity the adult CNS was hardwired and fixed, and second that in the chronic phase after CNS injury no substantial recovery of function could take place no matter what intervention was employed. However, in the last part of the twentieth century evidence began to accumulate that neither belief was correct. First, in the 1960s and 1970s, in research with primates given a surgical abolition of somatic sensation from a single forelimb, which rendered the extremity useless, it was found that behavioral techniques could convert the limb into an extremity that could be used extensively. Beginning in the late 1980s, the techniques employed with deafferented monkeys were translated into a rehabilitation treatment, termed Constraint Induced Movement therapy or CI therapy, for substantially improving the motor deficit in humans of the upper and lower extremities in the chronic phase after stroke. CI therapy has been applied successfully to other types of damage to the CNS such as traumatic brain injury, cerebral palsy, multiple sclerosis, and spinal cord injury, and it has also been used to improve function in focal hand dystonia and for aphasia after stroke. As this work was proceeding, it was being shown during the 1980s and 1990s that sustained modulation of afferent input could alter the structure of the CNS and that this topographic reorganization could have relevance to the function of the individual. The alteration in these once fundamental beliefs has given rise to important recent developments in neuroscience and neurorehabilitation and holds promise for further increasing our understanding of CNS function and extending the boundaries of what is possible in neurorehabilitation. PMID:25018720

  1. Constrained versus Unconstrained Intensive Language Therapy in Two Individuals with Chronic, Moderate-to-Severe Aphasia and Apraxia of Speech: Behavioral and fMRI Outcomes

    ERIC Educational Resources Information Center

    Kurland, Jacquie; Pulvermuller, Friedemann; Silva, Nicole; Burke, Katherine; Andrianopoulos, Mary

    2012-01-01

    Purpose: This Phase I study investigated behavioral and functional MRI (fMRI) outcomes of 2 intensive treatment programs to improve naming in 2 participants with chronic moderate-to-severe aphasia with comorbid apraxia of speech (AOS). Constraint-induced aphasia therapy (CIAT; Pulvermuller et al., 2001) has demonstrated positive outcomes in some…

  2. Movement recognition technology as a method of assessing spontaneous general movements in high risk infants.

    PubMed

    Marcroft, Claire; Khan, Aftab; Embleton, Nicholas D; Trenell, Michael; Plötz, Thomas

    2014-01-01

    Preterm birth is associated with increased risks of neurological and motor impairments such as cerebral palsy. The risks are highest in those born at the lowest gestations. Early identification of those most at risk is challenging meaning that a critical window of opportunity to improve outcomes through therapy-based interventions may be missed. Clinically, the assessment of spontaneous general movements is an important tool, which can be used for the prediction of movement impairments in high risk infants. Movement recognition aims to capture and analyze relevant limb movements through computerized approaches focusing on continuous, objective, and quantitative assessment. Different methods of recording and analyzing infant movements have recently been explored in high risk infants. These range from camera-based solutions to body-worn miniaturized movement sensors used to record continuous time-series data that represent the dynamics of limb movements. Various machine learning methods have been developed and applied to the analysis of the recorded movement data. This analysis has focused on the detection and classification of atypical spontaneous general movements. This article aims to identify recent translational studies using movement recognition technology as a method of assessing movement in high risk infants. The application of this technology within pediatric practice represents a growing area of inter-disciplinary collaboration, which may lead to a greater understanding of the development of the nervous system in infants at high risk of motor impairment. PMID:25620954

  3. Movement Recognition Technology as a Method of Assessing Spontaneous General Movements in High Risk Infants

    PubMed Central

    Marcroft, Claire; Khan, Aftab; Embleton, Nicholas D.; Trenell, Michael; Plötz, Thomas

    2015-01-01

    Preterm birth is associated with increased risks of neurological and motor impairments such as cerebral palsy. The risks are highest in those born at the lowest gestations. Early identification of those most at risk is challenging meaning that a critical window of opportunity to improve outcomes through therapy-based interventions may be missed. Clinically, the assessment of spontaneous general movements is an important tool, which can be used for the prediction of movement impairments in high risk infants. Movement recognition aims to capture and analyze relevant limb movements through computerized approaches focusing on continuous, objective, and quantitative assessment. Different methods of recording and analyzing infant movements have recently been explored in high risk infants. These range from camera-based solutions to body-worn miniaturized movement sensors used to record continuous time-series data that represent the dynamics of limb movements. Various machine learning methods have been developed and applied to the analysis of the recorded movement data. This analysis has focused on the detection and classification of atypical spontaneous general movements. This article aims to identify recent translational studies using movement recognition technology as a method of assessing movement in high risk infants. The application of this technology within pediatric practice represents a growing area of inter-disciplinary collaboration, which may lead to a greater understanding of the development of the nervous system in infants at high risk of motor impairment. PMID:25620954

  4. Functional (psychogenic) movement disorders

    PubMed Central

    Czarnecki, Kathrin; Hallett, Mark

    2016-01-01

    Purpose of review This review provides an overview of recent developments in diagnosis, pathophysiology, neuroimaging and management of functional (psychogenic) movement disorders (FMD) and highlights the current controversy on classification of somatoform disorders in the new DSM-5. Recent findings There has been increasing interest in recent years to study the underlying pathophysiology of FMDs, which has resulted in a broadened disease model, taking neurobiologic and psychosocial factors equally into account. In this context, the term “psychogenic” has been replaced by “functional” movement disorders by many authors in the field to express the changing focus towards a multifactorial disease model. The need for establishing a positive diagnosis of FMD as opposed to providing a diagnosis of exclusion is increasingly recognized and reflected by the introduction of “laboratory-supported” diagnostic criteria of FMD. Important advances have been made through behavioral, electrophysiological and neuroimaging studies although the fundamental etiology of FMD remains poorly understood. Of particular interest have been several reports on abnormal sensorimotor features and cortical inhibition in both organic and functional dystonia, highlighting possible shared traits of both conditions. In terms of treatment, recent studies have reported benefit from both psychiatric and physical therapy based interventions. Summary Increasing efforts have been made towards better understanding and treatment of FMD, and the disease model has been broadened to include neurobiologic and psychosocial factors. Laboratory-based diagnostic criteria have been established for many FMDs to support the clinical diagnosis. To determine the most effective management strategies for FMD, a closer collaboration between neurologists and psychiatrists and intensified research efforts with prospective treatment trials are needed. PMID:22610460

  5. The combination of lithium and l-Dopa/Carbidopa reduces MPTP-induced abnormal involuntary movements (AIMs) via calpain-1 inhibition in a mouse model: Relevance for Parkinson׳s disease therapy.

    PubMed

    Lazzara, Carol A; Riley, Rebeccah R; Rane, Anand; Andersen, Julie K; Kim, Yong-Hwan

    2015-10-01

    Lithium has recently been suggested to have neuroprotective effects in several models of neurodegenerative disease including Parkinson׳s disease (PD). Levodopa (l-Dopa) replacement therapy remains the most common and effective treatment for PD, although it induces the complication of l-Dopa induced dyskinesia after years of use. Here we examined the potential use of lithium in combination with l-Dopa/Carbidopa for both reducing MPTP-induced abnormal involuntary movements (AIMs) as well as protecting against cell death in MPTP-lesioned mice. Chronic lithium administration (0.127% LiCl in the feed) in the presence of daily l-Dopa/Carbidopa injection for a period of 2 months was sufficient to effectively reduce MPTP-induced AIMs in mice. Mechanistically, lithium was found to suppress MPTP-induced calpain activities in vivo coinciding with down-regulation of calpain-1 but not calpain-2 expression in both the striatum (ST) and the brain stem (BS). Calpain inhibition has previously been associated with increased levels of the rate-limiting enzyme in dopamine synthesis, tyrosine hydroxylase (TH), which is probably mediated by the up-regulation of the transcription factors MEF-2A and 2D. Lithium was found to induce up-regulation of TH expression in the ST and the BS, as well as in N27 rat dopaminergic cells. Further, histone acetyltransferase (HAT) expression was substantially up-regulated by lithium treatment in vitro. These results suggest the potential use of lithium in combination with l-Dopa/Carbidopa not only as a neuroprotectant, but also for reducing AIMs and possibly alleviating potential side-effects associated with the current treatment for PD. PMID:26119916

  6. Paraneoplastic disorders of eye movements

    PubMed Central

    Wray, Shirley H.; Dalmau, Josep; Chen, Athena; King, Susan; Leigh, R. John

    2011-01-01

    Paraneoplastic syndromes affecting the brainstem and cerebellum are reported to cause a variety of abnormalities of eye movements. Recent studies have begun to account for the mechanisms underlying several syndromes, characterized by opsoclonus, slow, or dysmetric saccades, as well as downbeat nystagmus. We provide evidence that upbeat nystagmus in a patient with pancreatic cancer reflected a cerebellar-induced imbalance of otolithic pathways: she showed marked retropulsion, and her nystagmus was dependent on head position, being absent when supine, and suppressed with convergence. In addition to anti-Hu antibodies, we demonstrated antibodies to a novel neuronal cell surface antigen. Taken with other recent studies, our findings suggest that paraneoplastic syndromes arise due to antibodies against surface neuronal antigens, including receptors and channels. Abnormal eye movements in paraneoplastic syndromes offer insights into the pathogenesis of these disorders and the opportunity to test potential therapies, such as new drugs with effects on neuronal channels. PMID:21951005

  7. Eye Movement Disorders

    MedlinePlus

    ... t work properly. There are many kinds of eye movement disorders. Two common ones are Strabismus - a disorder ... of the eyes, sometimes called "dancing eyes" Some eye movement disorders are present at birth. Others develop over ...

  8. Movement - unpredictable or jerky

    MedlinePlus

    ... Pregnancy (chorea gravidarum) Stroke Systemic lupus erythematosus Tardive dyskinesia (a condition that can be caused by medicines ... uncontrolled); Hyperkinetic movements References Jankovic J, Lang AE. Movement disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta ...

  9. Tectonic Plate Movement.

    ERIC Educational Resources Information Center

    Landalf, Helen

    1998-01-01

    Presents an activity that employs movement to enable students to understand concepts related to plate tectonics. Argues that movement brings topics to life in a concrete way and helps children retain knowledge. (DDR)

  10. Two different reorganization patterns after rehabilitative therapy: an exploratory study with fMRI and TMS.

    PubMed

    Hamzei, Farsin; Liepert, Joachim; Dettmers, Christian; Weiller, Cornelius; Rijntjes, Michel

    2006-06-01

    We used two complementary methods to investigate cortical reorganization in chronic stroke patients during treatment with a defined motor rehabilitation program. BOLD ("blood oxygenation level dependent") sensitive functional magnetic resonance imaging (fMRI) and intracortical inhibition (ICI) and facilitation (ICF) measured with transcranial magnetic stimulation (TMS) via paired pulse stimulation were used to investigate cortical reorganization before and after "constraint-induced movement therapy" (CI). The motor hand function improved in all subjects after CI. BOLD signal intensity changes within affected primary sensorimotor cortex (SMC) before and after CI showed a close correlation with ICI (r = 0.93) and ICF (r = 0.76) difference before and after therapy. Difference in number of voxels and ICI difference before and after CI also showed a close correlation (r = 0.92) in the affected SMC over the time period of training. A single subject analysis revealed that patients with intact hand area of M1 ("the hand knob") and its descending motor fibers (these patients revealed normal motor evoked potentials [MEP] from the affected hand) showed decreasing ipsilesional SMC activation which was paralleled by an increase in intracortical excitability. This pattern putatively reflects increasing synaptic efficiency. When M1 or its descending pyramidal tract was lesioned (MEP from the affected hand was pathologic) ipsilesional SMC activation increased, accompanied by decreased intracortical excitability. We suggest that an increase in synaptic efficiency is not possible here, which leads to reorganization with extension, shift and recruitment of additional cortical areas of the sensorimotor network. The inverse dynamic process between both complementary methods (activation in fMRI and intracortical excitability determined by TMS) over the time period of CI illustrates the value of combining methods for understanding brain reorganization. PMID:16516499

  11. Linking Literacy and Movement

    ERIC Educational Resources Information Center

    Pica, Rae

    2010-01-01

    There are many links between literacy and movement. Movement and language are both forms of communication and self-expression. Rhythm is an essential component of both language and movement. While people may think of rhythm primarily in musical terms, there is a rhythm to words and sentences as well. Individuals develop an internal rhythm when…

  12. Paradoxic vocal fold movement disorder.

    PubMed

    Matrka, Laura

    2014-02-01

    Paradoxical Vocal Fold Movement Disorder (PVFMD) is a cause of dyspnea that can mimic or occur alongside asthma or other pulmonary disease. Treatment with Laryngeal Control Therapy is very effective once the entity is properly diagnosed and contributing comorbidities are managed appropriately. In understanding the etiology of PVFMD, focus has broadened beyond psychiatric factors alone to include the spectrum of laryngeal irritants (laryngopharyngeal reflux, allergic and sinus disease, sicca, and possibly obstructive sleep apnea). The following is a discussion of the history, terminology, epidemiology, diagnosis, comorbid conditions, and treatment of this entity. PMID:24286687

  13. The Power of Rhetoric: Two Healing Movements

    PubMed Central

    Justman, Stewart

    2011-01-01

    Though we might suppose that our sensations are unaffected by the talk around us, the rhetoric surrounding a treatment can in fact color the experience of those having the treatment. So it is with both Eye Movement Desensitization and Reprocessing (EMDR) and the 18th-century therapy that has been cited as its predecessor: mesmerism. In both cases, rhetoric itself is conscripted into the service of therapeutic ends. Reports of cures are advertised and celebrated in a way that builds the expectation and feeds the experience of more of the same. Precisely because they are rooted in and speak to their time and place, however, the efficacy of these therapies may be limited. An investigation of the kinship between the two healing movements — and the driving force of a movement is nothing other than rhetoric — throws light on possibly social sources of therapeutic efficacy. PMID:21451780

  14. Therapy in Motion.

    ERIC Educational Resources Information Center

    Costonis, Maureen Needham, Ed.

    This book contains a collection of articles on the subject of movement therapy. It can be used as a set of supplementary readings for an academic course in dance therapy or a psychiatric residency program. It includes an exhaustive bibliography on this field for students and practioners in this field. Four principal themes have been selected as a…

  15. Tips for Daily Living

    MedlinePlus

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  16. Healthy Living after Stroke

    MedlinePlus

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  17. Cervical demyelinating lesion presenting with choreoathetoid movements and dystonia.

    PubMed

    de Pasqua, Silvia; Cevoli, Sabina; Calbucci, Fabio; Liguori, Rocco

    2016-09-15

    Pseudoathetosis and dystonia are rare manifestations of spinal cord disease that have been already reported in lesions involving the posterior columns at the cervical level. We report two patients with a cervical demyelinating lesion at C3-C4 level presenting with hand dystonia and pseudoathetoid movements. The movement disorder disappeared after steroid treatment. The cases we described highlight the importance of identifying secondary causes of movement disorders that can be reversible with appropriate therapy. PMID:27538633

  18. Congenital mirror movements.

    PubMed Central

    Schott, G D; Wyke, M A

    1981-01-01

    In this report are described seven patients assessed clinically and neuropsychologically in whom mirror movements affecting predominantly the hands occurred as a congenital disorder. These mirror movements, representing a specific type of abnormal synkinesia, may arise as a hereditary condition, in the presence of a recognisable underlying neurological abnormality, and sporadically, and the seven patients provide more or less satisfactory examples of each of these three groups. Despite the apparent uniformity of the disorder, the heterogeneity and variability may be marked, examples in some of our patients including the pronounced increase in tone that developed with arm movement, and the capacity for modulation of the associated movement by alteration of neck position and bio-feedback. Various possible mechanisms are considered; these include impaired cerebral inhibition of unwanted movements, and functioning of abnormal motor pathways. Emphasis has been placed on the putative role of the direct, crossed corticomotoneurone pathways and on the unilateral and bilateral cerebral events that precede movement. PMID:7288446

  19. [Sleep related movement disorders].

    PubMed

    Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Hirata, Koichi

    2015-06-01

    Sleep related movement disorders (SRMD) are characterized by simple, stereotyped movements occur during sleep, with the exception of restless legs syndrome (RLS). RLS has the following essential features; an urge to move the legs usually accompanied by uncomfortable sensation in the legs, improvement of symptoms after movement (non-stereotypical movements, such as walking and stretching, to reduce symptoms), and symptoms occur or worsen during periods of rest and in the evening and night. However, RLS is closely associated with periodic limb movement, which shows typical stererotyped limb movements. In the International Classification of Sleep Disorders, 3rd edition, sleep disturbances or daytime symptoms are prerequiste for a diagnosis of SRMD. We here review diagnosis and treatment of SRMD. PMID:26065126

  20. The mathematics of movement

    USGS Publications Warehouse

    Johnson, D.H.

    1999-01-01

    Review of: Quantitative Analysis of Movement: Measuring and Modeling Population Redistribution in Animals and Plants. Peter Turchin. 1998. Sinauer Associates, Sunderland, MA. 306 pages. $38.95 (paper).

  1. 85 Engaging Movement Activities.

    ERIC Educational Resources Information Center

    Weikart, Phyllis S.; Carlton, Elizabeth B.

    This book presents activities to keep K-6 students moving in a variety of ways as they learn. The movement experiences are planned around key curriculum concepts in movement and music as well as in academic curriculum areas. The experiences develop students' basic timing, language abilities, vocabulary, concentration, planning skills, and…

  2. Research for a Movement

    ERIC Educational Resources Information Center

    Litchfield, Randy G.

    2006-01-01

    This article discusses the new era of the Religious Education Association (REA) and how it may be seen to function as a "movement" with purposes, scope, and connectivity that bring together diverse groups. The author contends that religious education as a movement needs: (1) Research that describes patterns and uniquenesses in the religious…

  3. The Human Potential Movement.

    ERIC Educational Resources Information Center

    Tamashiro, Roy T.

    The advent of the human potential movement has generated the expectation that educators unleash the intellectual, emotional, physical, and spiritual talents of students. This movement is characterized by its focus on (1) the person as a total being, (2) the needs and concerns of students, (3) phenomenology, (4) personal values and goals, and (5)…

  4. National CARES Mentoring Movement

    ERIC Educational Resources Information Center

    Mitchell, Martin L.

    2013-01-01

    Harsh and cruel experiences have led many of our young to believe that they are alone in the world and that no one cares. In this article, Martin L Mitchell introduces us to the "National CARES Mentoring Movement" founded by Susan L.Taylor. This movement provides young people with role models who help shape their positive development.…

  5. Effects of object size on unimanual and bimanual movements in patients with schizophrenia.

    PubMed

    Wang, Shu-Mei; Kuo, Li-Chieh; Ouyang, Wen-Chen; Hsu, Hsiao-Man; Lin, Keh-Chung; Ma, Hui-Ing

    2014-01-01

    Schizophrenia affects not only mental function but also movement. We compared the movement of patients with mild schizophrenia and healthy control participants during a bimanual assembly task and examined whether changes in object size affected unimanual and bimanual movements. Fifteen patients with schizophrenia and 15 age- and gender-matched control participants were instructed to bimanually reach for and assemble objects. We manipulated the object size for the left hand (large vs. small) and measured movement time, peak velocity, and bimanual synchronization to represent movement speed, forcefulness, and bimanual coordination. Patients with schizophrenia showed slower and less forceful unimanual movements and less coordinated bimanual movements than control participants. Increasing the object size elicited faster and more forceful unimanual movements and more coordinated bimanual movements in patients. The results suggest the need for movement rehabilitation in patients with schizophrenia and the possibility of manipulating object size to optimize patients' movements. These results benefit the practice of evidence-based therapy. PMID:24581410

  6. Pediatric CI therapy for stroke-induced hemiparesis in young children.

    PubMed

    Taub, Edward; Griffin, Angi; Nick, Jennifer; Gammons, Kristin; Uswatte, Gitendra; Law, Charles R

    2007-01-01

    In this laboratory we have developed a set of techniques that randomized controlled studies and a multisite randomized controlled trial have shown can substantially reduce the motor deficit of adult patients with mild to severe chronic strokes. Equivalent results have been obtained with adult patients after traumatic brain injury and brain resection. The basic technique, termed Constraint-Induced Movement therapy or CI therapy was derived directly from basic research with monkeys with mature motor systems and with monkeys given surgical intervention either on their day of birth or prenatally by intrauterine surgical procedures. We report here the results of two randomized controlled trials of CI therapy with young children with asymmetric upper extremity motor deficits of varied etiologies from 8 months to 8 years of age in one study and with children with hemiparesis consequent to prenatal, perinatal, or early antenatal stroke from 2 to 6 years old in a second study. The procedures used with children are very similar to those used with adults and diverge simply to make the basic techniques age-appropriate. All forms of CI therapy for the upper extremity to date involve 3 main elements: (1) intensive training of the more affected extremity, (2) prolonged restraint of the less affected extremity, (3) a 'transfer package' of techniques to induce transfer of therapeutic gains achieved in the laboratory to the life situation. The results in children with cerebral palsy are considerably better than those obtained in adults. Marked changes were observed in the quality of movement in the laboratory scored by masked observers from videotape; actual amount of use of the more affected arm in the life situation; active range of motion; and emergence of new classes of behaviour never performed before, such as in individual cases, fine thumb-forefinger grasp, supination, and use of the more affected extremity in crawling with palmar placement and rhythmic alteration. In the

  7. Auxin and chloroplast movements.

    PubMed

    Eckstein, Aleksandra; Krzeszowiec, Weronika; Waligórski, Piotr; Gabryś, Halina

    2016-03-01

    Auxin is involved in a wide spectrum of physiological processes in plants, including responses controlled by the blue light photoreceptors phototropins: phototropic bending and stomatal movement. However, the role of auxin in phototropin-mediated chloroplast movements has never been studied. To address this question we searched for potential interactions between auxin and the chloroplast movement signaling pathway using different experimental approaches and two model plants, Arabidopsis thaliana and Nicotiana tabacum. We observed that the disturbance of auxin homeostasis by shoot decapitation caused a decrease in chloroplast movement parameters, which could be rescued by exogenous auxin application. In several cases, the impairment of polar auxin transport, by chemical inhibitors or in auxin carrier mutants, had a similar negative effect on chloroplast movements. This inhibition was not correlated with changes in auxin levels. Chloroplast relocations were also affected by the antiauxin p-chlorophenoxyisobutyric acid and mutations in genes encoding some of the elements of the SCF(TIR1)-Aux/IAA auxin receptor complex. The observed changes in chloroplast movement parameters are not prominent, which points to a modulatory role of auxin in this process. Taken together, the obtained results suggest that auxin acts indirectly to regulate chloroplast movements, presumably by regulating gene expression via the SCF(TIR1)-Aux/IAA-ARF pathway. Auxin does not seem to be involved in controlling the expression of phototropins. PMID:26467664

  8. The Development of Coordinated Movement.

    ERIC Educational Resources Information Center

    Montanaro, Silvana Quattrocchi

    2002-01-01

    Discusses stages of movement in the first 3 years of life with a philosophical dimension regarding evolutionary aspects of movement as first manifestation of "will." Describes how the early childhood environment is prepared to allow for movement and the connection between movement and brain development. Discusses the contribution of movement to…

  9. Activity Therapy: An Alternative Therapy for Adolescents.

    ERIC Educational Resources Information Center

    Kottman, Terry T.; And Others

    1987-01-01

    Discusses the benefits of activity therapy for preteens and adolescents, where the client is engaged in nonverbal modes of relationship--games, free play, movement, drama, music, art or other activities, as the chief therapeutic media in which conflicts are resolved and intellectual and emotional energies freed. Reviews the literature, describes…

  10. Movement Coordination during Conversation

    PubMed Central

    Latif, Nida; Barbosa, Adriano V.; Vatiokiotis-Bateson, Eric; Castelhano, Monica S.; Munhall, K. G.

    2014-01-01

    Behavioral coordination and synchrony contribute to a common biological mechanism that maintains communication, cooperation and bonding within many social species, such as primates and birds. Similarly, human language and social systems may also be attuned to coordination to facilitate communication and the formation of relationships. Gross similarities in movement patterns and convergence in the acoustic properties of speech have already been demonstrated between interacting individuals. In the present studies, we investigated how coordinated movements contribute to observers’ perception of affiliation (friends vs. strangers) between two conversing individuals. We used novel computational methods to quantify motor coordination and demonstrated that individuals familiar with each other coordinated their movements more frequently. Observers used coordination to judge affiliation between conversing pairs but only when the perceptual stimuli were restricted to head and face regions. These results suggest that observed movement coordination in humans might contribute to perceptual decisions based on availability of information to perceivers. PMID:25119189

  11. Stomatal development and movement

    PubMed Central

    Liu, Yu-Kun; Liu, Yu-Bo; Zhang, Mao-Ying

    2010-01-01

    Stomata are epidermal pores on plant surface used for gas exchange with the atmosphere. Stomatal development and movement are regulated by environmental and internal signals. Mitogen-activated protein kinase (MAPK) cascades are universal transducers of extracellular signals among all eukaryotes. In plant, MAPK cascades regulate diverse cellular processes occurring during the whole ontogenetic plant life and ranging from normal cell proliferation to stress-inducing plant-to-environment interactions. Recent reports reveal that MAPK signaling is involved in both stomatal development and movement. This mini-review summarizes the roles of MAPK signaling in stomatal development and movement. How MAPK specificity is maintained in stomatal development and movement is also discussed. PMID:20855958

  12. An Analysis of the Women's Movement as a Social Movement.

    ERIC Educational Resources Information Center

    Budenstein, Mary Jane

    The paper analyzes the development of the women's movement, indicating how this particular movement empirically documents the theoretical suppositions of a sociologically defined social movement. A social movement is defined as "a group venture extended beyond a local community or a single event and involving a systematic effort to inaugurate…

  13. Psychostimulants and Movement Disorders

    PubMed Central

    Asser, Andres; Taba, Pille

    2015-01-01

    Psychostimulants are a diverse group of substances with their main psychomotor effects resembling those of amphetamine, methamphetamine, cocaine, or cathinone. Due to their potential as drugs of abuse, recreational use of most of these substances is illegal since 1971 Convention on Psychotropic Substances. In recent years, new psychoactive substances have emerged mainly as synthetic cathinones with new molecules frequently complementing the list. Psychostimulant related movement disorders are a known entity often seen in emergency rooms around the world. These admissions are becoming more frequent as are fatalities associated with drug abuse. Still the legal constraints of the novel synthetic molecules are bypassed. At the same time, chronic and permanent movement disorders are much less frequently encountered. These disorders frequently manifest as a combination of movement disorders. The more common symptoms include agitation, tremor, hyperkinetic and stereotypical movements, cognitive impairment, and also hyperthermia and cardiovascular dysfunction. The pathophysiological mechanisms behind the clinical manifestations have been researched for decades. The common denominator is the monoaminergic signaling. Dopamine has received the most attention but further research has demonstrated involvement of other pathways. Common mechanisms linking psychostimulant use and several movement disorders exist. PMID:25941511

  14. Pursuit Eye Movements

    NASA Technical Reports Server (NTRS)

    Krauzlis, Rich; Stone, Leland; Null, Cynthia H. (Technical Monitor)

    1998-01-01

    When viewing objects, primates use a combination of saccadic and pursuit eye movements to stabilize the retinal image of the object of regard within the high-acuity region near the fovea. Although these movements involve widespread regions of the nervous system, they mix seamlessly in normal behavior. Saccades are discrete movements that quickly direct the eyes toward a visual target, thereby translating the image of the target from an eccentric retinal location to the fovea. In contrast, pursuit is a continuous movement that slowly rotates the eyes to compensate for the motion of the visual target, minimizing the blur that can compromise visual acuity. While other mammalian species can generate smooth optokinetic eye movements - which track the motion of the entire visual surround - only primates can smoothly pursue a single small element within a complex visual scene, regardless of the motion elsewhere on the retina. This ability likely reflects the greater ability of primates to segment the visual scene, to identify individual visual objects, and to select a target of interest.

  15. Correcting Slightly Less Simple Movements

    ERIC Educational Resources Information Center

    Aivar, M. P.; Brenner, E.; Smeets, J. B. J.

    2005-01-01

    Many studies have analysed how goal directed movements are corrected in response to changes in the properties of the target. However, only simple movements to single targets have been used in those studies, so little is known about movement corrections under more complex situations. Evidence from studies that ask for movements to several targets…

  16. Movement as utopia.

    PubMed

    Couton, Philippe; López, José Julián

    2009-10-01

    Opposition to utopianism on ontological and political grounds has seemingly relegated it to a potentially dangerous form of antiquated idealism. This conclusion is based on a restrictive view of utopia as excessively ordered panoptic discursive constructions. This overlooks the fact that, from its inception, movement has been central to the utopian tradition. The power of utopianism indeed resides in its ability to instantiate the tension between movement and place that has marked social transformations in the modern era. This tension continues in contemporary discussions of movement-based social processes, particularly international migration and related identity formations, such as open borders transnationalism and cosmopolitanism. Understood as such, utopia remains an ongoing and powerful, albeit problematic instrument of social and political imagination. PMID:20027697

  17. Combining modules for movement.

    PubMed

    Bizzi, E; Cheung, V C K; d'Avella, A; Saltiel, P; Tresch, M

    2008-01-01

    We review experiments supporting the hypothesis that the vertebrate motor system produces movements by combining a small number of units of motor output. Using a variety of approaches such as microstimulation of the spinal cord, NMDA iontophoresis, and an examination of natural behaviors in intact and deafferented animals we have provided evidence for a modular organization of the spinal cord. A module is a functional unit in the spinal cord that generates a specific motor output by imposing a specific pattern of muscle activation. Such an organization might help to simplify the production of movements by reducing the degrees of freedom that need to be specified. PMID:18029291

  18. Paroxysmal movement disorders.

    PubMed

    Waln, Olga; Jankovic, Joseph

    2015-02-01

    Paroxysmal dyskinesias represent a group of episodic abnormal involuntary movements manifested by recurrent attacks of dystonia, chorea, athetosis, or a combination of these disorders. Paroxysmal kinesigenic dyskinesia, paroxysmal nonkinesigenic dyskinesia, paroxysmal exertion-induced dyskinesia, and paroxysmal hypnogenic dyskinesia are distinguished clinically by precipitating factors, duration and frequency of attacks, and response to medication. Primary paroxysmal dyskinesias are usually autosomal dominant genetic conditions. Secondary paroxysmal dyskinesias can be the symptoms of different neurologic and medical disorders. This review summarizes the updates on etiology, pathophysiology, genetics, clinical presentation, differential diagnosis, and treatment of paroxysmal dyskinesias and other episodic movement disorders. PMID:25432727

  19. A movement ecology paradigm for unifying organismal movement research.

    PubMed

    Nathan, Ran; Getz, Wayne M; Revilla, Eloy; Holyoak, Marcel; Kadmon, Ronen; Saltz, David; Smouse, Peter E

    2008-12-01

    Movement of individual organisms is fundamental to life, quilting our planet in a rich tapestry of phenomena with diverse implications for ecosystems and humans. Movement research is both plentiful and insightful, and recent methodological advances facilitate obtaining a detailed view of individual movement. Yet, we lack a general unifying paradigm, derived from first principles, which can place movement studies within a common context and advance the development of a mature scientific discipline. This introductory article to the Movement Ecology Special Feature proposes a paradigm that integrates conceptual, theoretical, methodological, and empirical frameworks for studying movement of all organisms, from microbes to trees to elephants. We introduce a conceptual framework depicting the interplay among four basic mechanistic components of organismal movement: the internal state (why move?), motion (how to move?), and navigation (when and where to move?) capacities of the individual and the external factors affecting movement. We demonstrate how the proposed framework aids the study of various taxa and movement types; promotes the formulation of hypotheses about movement; and complements existing biomechanical, cognitive, random, and optimality paradigms of movement. The proposed framework integrates eclectic research on movement into a structured paradigm and aims at providing a basis for hypothesis generation and a vehicle facilitating the understanding of the causes, mechanisms, and spatiotemporal patterns of movement and their role in various ecological and evolutionary processes. "Now we must consider in general the common reason for moving with any movement whatever." (Aristotle, De Motu Animalium, 4th century B.C.). PMID:19060196

  20. A movement ecology paradigm for unifying organismal movement research

    PubMed Central

    Nathan, Ran; Getz, Wayne M.; Revilla, Eloy; Holyoak, Marcel; Kadmon, Ronen; Saltz, David; Smouse, Peter E.

    2008-01-01

    Movement of individual organisms is fundamental to life, quilting our planet in a rich tapestry of phenomena with diverse implications for ecosystems and humans. Movement research is both plentiful and insightful, and recent methodological advances facilitate obtaining a detailed view of individual movement. Yet, we lack a general unifying paradigm, derived from first principles, which can place movement studies within a common context and advance the development of a mature scientific discipline. This introductory article to the Movement Ecology Special Feature proposes a paradigm that integrates conceptual, theoretical, methodological, and empirical frameworks for studying movement of all organisms, from microbes to trees to elephants. We introduce a conceptual framework depicting the interplay among four basic mechanistic components of organismal movement: the internal state (why move?), motion (how to move?), and navigation (when and where to move?) capacities of the individual and the external factors affecting movement. We demonstrate how the proposed framework aids the study of various taxa and movement types; promotes the formulation of hypotheses about movement; and complements existing biomechanical, cognitive, random, and optimality paradigms of movement. The proposed framework integrates eclectic research on movement into a structured paradigm and aims at providing a basis for hypothesis generation and a vehicle facilitating the understanding of the causes, mechanisms, and spatiotemporal patterns of movement and their role in various ecological and evolutionary processes. ”Now we must consider in general the common reason for moving with any movement whatever.“ (Aristotle, De Motu Animalium, 4th century B.C.) PMID:19060196

  1. Multimodal Movement Prediction - Towards an Individual Assistance of Patients

    PubMed Central

    Kirchner, Elsa Andrea; Tabie, Marc; Seeland, Anett

    2014-01-01

    Assistive devices, like exoskeletons or orthoses, often make use of physiological data that allow the detection or prediction of movement onset. Movement onset can be detected at the executing site, the skeletal muscles, as by means of electromyography. Movement intention can be detected by the analysis of brain activity, recorded by, e.g., electroencephalography, or in the behavior of the subject by, e.g., eye movement analysis. These different approaches can be used depending on the kind of neuromuscular disorder, state of therapy or assistive device. In this work we conducted experiments with healthy subjects while performing self-initiated and self-paced arm movements. While other studies showed that multimodal signal analysis can improve the performance of predictions, we show that a sensible combination of electroencephalographic and electromyographic data can potentially improve the adaptability of assistive technical devices with respect to the individual demands of, e.g., early and late stages in rehabilitation therapy. In earlier stages for patients with weak muscle or motor related brain activity it is important to achieve high positive detection rates to support self-initiated movements. To detect most movement intentions from electroencephalographic or electromyographic data motivates a patient and can enhance her/his progress in rehabilitation. In a later stage for patients with stronger muscle or brain activity, reliable movement prediction is more important to encourage patients to behave more accurately and to invest more effort in the task. Further, the false detection rate needs to be reduced. We propose that both types of physiological data can be used in an and combination, where both signals must be detected to drive a movement. By this approach the behavior of the patient during later therapy can be controlled better and false positive detections, which can be very annoying for patients who are further advanced in rehabilitation, can be

  2. Movement - unpredictable or jerky

    MedlinePlus

    The doctor will perform a physical exam. This may include a detailed examination of the nervous and muscle systems. The doctor will ask about your medical history and symptoms, including: What kind of movement occurs? What part of the body is ...

  3. Managing Movement as Partnership

    ERIC Educational Resources Information Center

    Kimbrell, Sinead

    2011-01-01

    The associate director of education at Hubbard Street Dance Chicago recounts her learning and teaching through managing the Movement as Partnership program. Included are detailed descriptions of encounters with teachers and students as they create choreography reflective of their inquiry into integrating dance and literacy arts curriculum in the…

  4. Fluid Movement and Creativity

    ERIC Educational Resources Information Center

    Slepian, Michael L.; Ambady, Nalini

    2012-01-01

    Cognitive scientists describe creativity as fluid thought. Drawing from findings on gesture and embodied cognition, we hypothesized that the physical experience of fluidity, relative to nonfluidity, would lead to more fluid, creative thought. Across 3 experiments, fluid arm movement led to enhanced creativity in 3 domains: creative generation,…

  5. Autoimmune movement disorders.

    PubMed

    Mckeon, Andrew; Vincent, Angela

    2016-01-01

    Autoimmune movement disorders encapsulate a large and diverse group of neurologic disorders occurring either in isolation or accompanying more diffuse autoimmune encephalitic illnesses. The full range of movement phenomena has been described and, as they often occur in adults, many of the presentations can mimic neurodegenerative disorders, such as Huntington disease. Disorders may be ataxic, hypokinetic (parkinsonism), or hyperkinetic (myoclonus, chorea, tics, and other dyskinetic disorders). The autoantibody targets are diverse and include neuronal surface proteins such as leucine-rich, glioma-inactivated 1 (LGI1) and glycine receptors, as well as antibodies (such as intracellular antigens) that are markers of a central nervous system process mediated by CD8+ cytotoxic T cells. However, there are two conditions, stiff-person syndrome (also known as stiff-man syndrome) and progressive encephalomyelitis with rigidity and myoclonus (PERM), that are always autoimmune movement disorders. In some instances (such as Purkinje cell cytoplasmic antibody-1 (PCA-1) autoimmunity), antibodies detected in serum and cerebrospinal fluid can be indicative of a paraneoplastic cause, and may direct the cancer search. In other instances (such as 65kDa isoform of glutamic acid decarboxylase (GAD65) autoimmunity), a paraneoplastic cause is very unlikely, and early treatment with immunotherapy may promote improvement or recovery. Here we describe the different types of movement disorder and the clinical features and antibodies associated with them, and discuss treatment. PMID:27112684

  6. Teaching the Movement

    ERIC Educational Resources Information Center

    Watson, Jamal Eric

    2012-01-01

    Every January, Charles Cobb Jr. makes the 1,100-mile trek from sunny Jacksonville, Florida, to chilly Providence, Rhode Island. For the past eight years, Cobb--a veteran of the civil rights movement who in the 1960s served as a field secretary for the Student Nonviolent Coordinating Committee (SNCC) in Mississippi--becomes a visiting professor of…

  7. Posture and Movement

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Session TP3 includes short reports on: (1) Modification of Goal-Directed Arm Movements During Inflight Adaptation to Microgravity; (2) Quantitative Analysis of Motion control in Long Term Microgravity; (3) Does the Centre of Gravity Remain the Stabilised Reference during Complex Human Postural Equilibrium Tasks in Weightlessness?; and (4) Arm End-Point Trajectories Under Normal and Microgravity Environments.

  8. Measuring Facial Movement

    ERIC Educational Resources Information Center

    Ekman, Paul; Friesen, Wallace V.

    1976-01-01

    The Facial Action Code (FAC) was derived from an analysis of the anatomical basis of facial movement. The development of the method is explained, contrasting it to other methods of measuring facial behavior. An example of how facial behavior is measured is provided, and ideas about research applications are discussed. (Author)

  9. Harnessing Brain Plasticity through Behavioral Techniques to Produce New Treatments in Neurorehabilitation

    ERIC Educational Resources Information Center

    Taub, Edward

    2004-01-01

    Basic behavioral neuroscience research with monkeys has given rise to an efficacious new approach to the rehabilitation of movement after stroke, cerebral palsy, traumatic brain injury, and other types of neurological injury in humans termed Constraint-Induced Movement therapy or CI therapy. For the upper extremity, the treatment involves…

  10. Aphasia therapy on a neuroscience basis

    PubMed Central

    Pulvermüller, Friedemann; Berthier, Marcelo L.

    2008-01-01

    Background Brain research has documented that the cortical mechanisms for language and action are tightly interwoven and, concurrently, new approaches to language therapy in neurological patients are being developed that implement language training in the context of relevant linguistic and non-linguistic actions, therefore taking advantage of the mutual connections of language and action systems in the brain. A further well-known neuroscience principle is that learning at the neuronal level is driven by correlation; consequently, new approaches to language therapy emphasise massed practice in a short time, thus maximising therapy quantity and frequency and, therefore, correlation at the behavioural and neuronal levels. Learned non-use of unsuccessful actions plays a major role in the chronification of neurological deficits, and behavioural approaches to therapy have therefore employed shaping and other learning techniques to counteract such non-use. Aims Advances in theoretical and experimental neuroscience have important implications for clinical practice. We exemplify this in the domain of aphasia rehabilitation. Main Contribution Whereas classical wisdom had been that aphasia cannot be significantly improved at a chronic stage, we here review evidence that one type of intensive language-action therapy (ILAT)—constraint-induced aphasia therapy—led to significant improvement of language performance in patients with chronic aphasia. We discuss perspectives for further improving speech-language therapy, including drug treatment that may be particularly fruitful when applied in conjunction with behavioural treatment. In a final section we highlight intensive and rapid therapy studies in chronic aphasia as a unique tool for exploring the cortical reorganisation of language. Conclusions We conclude that intensive language action therapy is an efficient tool for improving language functions even at chronic stages of aphasia. Therapy studies using this technique can

  11. On quantifying insect movements

    SciTech Connect

    Wiens, J.A.; Crist, T.O. ); Milne, B.T. )

    1993-08-01

    We elaborate on methods described by Turchin, Odendaal Rausher for quantifying insect movement pathways. We note the need to scale measurement resolution to the study insects and the questions being asked, and we discuss the use of surveying instrumentation for recording sequential positions of individuals on pathways. We itemize several measures that may be used to characterize movement pathways and illustrate these by comparisons among several Eleodes beetles occurring in shortgrass steppe. The fractal dimension of pathways may provide insights not available from absolute measures of pathway configuration. Finally, we describe a renormalization procedure that may be used to remove sequential interdependence among locations of moving individuals while preserving the basic attributes of the pathway.

  12. Eye movement abnormalities.

    PubMed

    Moncayo, Jorge; Bogousslavsky, Julien

    2012-01-01

    Generation and control of eye movements requires the participation of the cortex, basal ganglia, cerebellum and brainstem. The signals of this complex neural network finally converge on the ocular motoneurons of the brainstem. Infarct or hemorrhage at any level of the oculomotor system (though more frequent in the brain-stem) may give rise to a broad spectrum of eye movement abnormalities (EMAs). Consequently, neurologists and particularly stroke neurologists are routinely confronted with EMAs, some of which may be overlooked in the acute stroke setting and others that, when recognized, may have a high localizing value. The most complex EMAs are due to midbrain stroke. Horizontal gaze disorders, some of them manifesting unusual patterns, may occur in pontine stroke. Distinct varieties of nystagmus occur in cerebellar and medullary stroke. This review summarizes the most representative EMAs from the supratentorial level to the brainstem. PMID:22377853

  13. Movement Education: The Place of Movement in Physical Education.

    ERIC Educational Resources Information Center

    Briggs, Megan M.

    This document is directed to physical education teachers who teach movement education in elementary and secondary schools. Its purpose is to define movement, discuss its place in the education program and the educational life of the school, and provide guidance in the presentation, subsequent development, and progression of movement education for…

  14. Islamist Movements in Iraq

    ERIC Educational Resources Information Center

    Social Education, 2004

    2004-01-01

    When the United States invaded Iraq in March 2003, one of its stated intentions was to inaugurate an era of Iraqi politics in which new kinds of democratic parties would emerge. However, one of the most dramatic effects of the U.S. invasion has been the boost it has given to the Islamist parties and movements that were banned under Saddam Hussein.…

  15. Integrating Research Competencies in Massage Therapy Education.

    ERIC Educational Resources Information Center

    Hymel, Glenn M.

    The massage therapy profession is currently engaged in a competency-based education movement that includes an emphasis on promoting massage therapy research competencies (MTRCs). A systems-based model for integrating MTRCs into massage therapy education was therefore proposed. The model and an accompanying checklist describe an approach to…

  16. A Computational Framework for Quantitative Evaluation of Movement during Rehabilitation

    NASA Astrophysics Data System (ADS)

    Chen, Yinpeng; Duff, Margaret; Lehrer, Nicole; Sundaram, Hari; He, Jiping; Wolf, Steven L.; Rikakis, Thanassis

    2011-06-01

    This paper presents a novel generalized computational framework for quantitative kinematic evaluation of movement in a rehabilitation clinic setting. The framework integrates clinical knowledge and computational data-driven analysis together in a systematic manner. The framework provides three key benefits to rehabilitation: (a) the resulting continuous normalized measure allows the clinician to monitor movement quality on a fine scale and easily compare impairments across participants, (b) the framework reveals the effect of individual movement components on the composite movement performance helping the clinician decide the training foci, and (c) the evaluation runs in real-time, which allows the clinician to constantly track a patient's progress and make appropriate adaptations to the therapy protocol. The creation of such an evaluation is difficult because of the sparse amount of recorded clinical observations, the high dimensionality of movement and high variations in subject's performance. We address these issues by modeling the evaluation function as linear combination of multiple normalized kinematic attributes y = Σwiφi(xi) and estimating the attribute normalization function φi(ṡ) by integrating distributions of idealized movement and deviated movement. The weights wi are derived from a therapist's pair-wise comparison using a modified RankSVM algorithm. We have applied this framework to evaluate upper limb movement for stroke survivors with excellent results—the evaluation results are highly correlated to the therapist's observations.

  17. Educators Assess "Open Content" Movement

    ERIC Educational Resources Information Center

    Trotter, Andrew

    2009-01-01

    This article discusses the open-content movement in education. A small but growing movement of K-12 educators is latching on to educational resources that are "open," or free for others to use, change, and republish on web sites that promote sharing. The open-content movement is fueled partly by digital creation tools that make it easy to create…

  18. Yahak Movement in South Korea

    ERIC Educational Resources Information Center

    Son, Sik

    2004-01-01

    "Yahak" means "night school" in Korean and its history can be traced back to the 1920s when Korea was under Japanese colonial rule. This paper will focus on the yahak movement during the years from 1960 to the 1990s. Yahak played an important role in raising workers' consciousness during this democratic movement. Yahak started as a movement trying…

  19. Recognizing People from Their Movement

    ERIC Educational Resources Information Center

    Loula, Fani; Prasad, Sapna; Harber, Kent; Shiffrar, Maggie

    2005-01-01

    Human observers demonstrate impressive visual sensitivity to human movement. What defines this sensitivity? If motor experience influences the visual analysis of action, then observers should be most sensitive to their own movements. If view-dependent visual experience determines visual sensitivity to human movement, then observers should be most…

  20. Orofacial Movement Disorders.

    PubMed

    Clark, Glenn T; Ram, Saravanan

    2016-08-01

    Orofacial movement disorders (OMDs) include dystonia, dyskinesia, drug-induced extrapyramidal reactions, and bruxism. The definition, epidemiology, pathophysiology, clinical features, and management are detailed. OMDs are often disabling and affect patients' overall quality of life with pain, difficulty chewing food, speech difficulty, drooling, and social embarrassment. Management involves medications, botulinum toxin injections, and peripheral or central surgery. Botulinum toxin injections are the most effective management, often used in conjunction with medications. Surgery is the last resort for patients who fail to respond to medications or develop resistance to botulinum toxin type A. PMID:27475514

  1. Molecular imaging of movement disorders

    PubMed Central

    Lizarraga, Karlo J; Gorgulho, Alessandra; Chen, Wei; De Salles, Antonio A

    2016-01-01

    caudal-to-rostral direction. Uptake declines prior to symptom presentation and progresses from contralateral to the most symptomatic side to bilateral, correlating with symptom severity. In progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), striatal activity is symmetrically and diffusely decreased. The caudal-to-rostral pattern is lost in PSP, but could be present in MSA. In corticobasal degeneration (CBD), there is asymmetric, diffuse reduction of striatal activity, contralateral to the most symptomatic side. Additionally, there is hypometabolism in contralateral parieto-occipital and frontal cortices in PD; bilateral putamen and cerebellum in MSA; caudate, thalamus, midbrain, mesial frontal and prefrontal cortices in PSP; and contralateral cortices in CBD. Finally, cardiac sympathetic SPECT signal is decreased in PD. The capacity of molecular imaging to provide in vivo time courses of gene expression, protein synthesis, receptor and transporter binding, could facilitate the development and evaluation of novel medical, surgical and genetic therapies in movement disorders. PMID:27029029

  2. Molecular imaging of movement disorders.

    PubMed

    Lizarraga, Karlo J; Gorgulho, Alessandra; Chen, Wei; De Salles, Antonio A

    2016-03-28

    -to-rostral direction. Uptake declines prior to symptom presentation and progresses from contralateral to the most symptomatic side to bilateral, correlating with symptom severity. In progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), striatal activity is symmetrically and diffusely decreased. The caudal-to-rostral pattern is lost in PSP, but could be present in MSA. In corticobasal degeneration (CBD), there is asymmetric, diffuse reduction of striatal activity, contralateral to the most symptomatic side. Additionally, there is hypometabolism in contralateral parieto-occipital and frontal cortices in PD; bilateral putamen and cerebellum in MSA; caudate, thalamus, midbrain, mesial frontal and prefrontal cortices in PSP; and contralateral cortices in CBD. Finally, cardiac sympathetic SPECT signal is decreased in PD. The capacity of molecular imaging to provide in vivo time courses of gene expression, protein synthesis, receptor and transporter binding, could facilitate the development and evaluation of novel medical, surgical and genetic therapies in movement disorders. PMID:27029029

  3. Recognizing Uncommon Presentations of Psychogenic (Functional) Movement Disorders

    PubMed Central

    Baizabal-Carvallo, José Fidel; Fekete, Robert

    2015-01-01

    Background Psychogenic or functional movement disorders (PMDs) pose a challenge in clinical diagnosis. There are several clues, including sudden onset, incongruous symptoms, distractibility, suggestibility, entrainment of symptoms, and lack of response to otherwise effective pharmacological therapies, that help identify the most common psychogenic movements such as tremor, dystonia, and myoclonus. Methods In this manuscript, we review the frequency, distinct clinical features, functional imaging, and neurophysiological tests that can help in the diagnosis of uncommon presentations of PMDs, such as psychogenic parkinsonism, tics, and chorea; facial, palatal, and ocular movements are also reviewed. In addition, we discuss PMDs at the extremes of age and mass psychogenic illness. Results Psychogenic parkinsonism (PP) is observed in less than 10% of the case series about PMDs, with a female–male ratio of roughly 1:1. Lack of amplitude decrement in repetitive movements and of cogwheel rigidity help to differentiate PP from true parkinsonism. Dopamine transporter imaging with photon emission tomography can also help in the diagnostic process. Psychogenic movements resembling tics are reported in about 5% of PMD patients. Lack of transient suppressibility of abnormal movements helps to differentiate them from organic tics. Psychogenic facial movements can present with hemifacial spasm, blepharospasm, and other movements. Some patients with essential palatal tremor have been shown to be psychogenic. Convergence ocular spasm has demonstrated a high specificity for psychogenic movements. PMDs can also present in the context of mass psychogenic illness or at the extremes of age. Discussion Clinical features and ancillary studies are helpful in the diagnosis of patients with uncommon presentations of psychogenic movement disorders. PMID:25667816

  4. Use of Movement Imagery in Neurorehabilitation: Researching Effects of a Complex Intervention

    ERIC Educational Resources Information Center

    Braun, Susy M.; Wade, Derick T.; Beurskens, Anna J. H. M.

    2011-01-01

    Since the beginning of the new millennium, the use of mental practice and movement imagery within several medical professions in rehabilitation and therapy has received an increased attention. Before this introduction in healthcare, the use of movement imagery was mainly researched in sports science. Mental practice is a complex intervention. When…

  5. The Evolution of Modern Dance Therapy.

    ERIC Educational Resources Information Center

    Levy, Fran

    1988-01-01

    The article traces the impact of the modern dance movement from the early 1900s and its emphasis on creativity and self-expression on the professional and institutional development of dance therapy. (CB)

  6. miRNA and Vascular Cell Movement

    PubMed Central

    Yue, Junming

    2011-01-01

    miRNAs are a new class of endogenous small RNAs that negatively regulate gene expression at the posttranscriptional level. Accumulating experimental evidence shows that miRNAs regulate cellular apoptosis, proliferation, differentiation, and migration. Dysregulation of miRNA expression leads to various human diseases including cancer and cardiovascular disease. miRNA maturation is regulated at multiple steps by different mechanisms, including miRNA editing, hairpin loop binding, self-regulation, and cross-talk with other signaling pathways. Vascular cell movement plays a pivotal role in the development of various cancers and cardiovascular diseases. miRNAs have been found to regulate vascular cell movement. Presently the chemically synthesized antagomir, miRNA mimics have been widely used in investigating the biological functions of miRNA genes. The viral vectors, including adenoviral, lentiviral, and adeno-associated viral vectors, have been used to efficiently overexpress or knockdown miRNAs in vitro and in vivo. Therefore, targeting vascular cell movement using miRNA-based drug or gene therapy would provide a novel therapeutic approach in the treatment of cancers and vascular diseases. PMID:21241758

  7. Observation of sonified movements engages a basal ganglia frontocortical network

    PubMed Central

    2013-01-01

    Background Producing sounds by a musical instrument can lead to audiomotor coupling, i.e. the joint activation of the auditory and motor system, even when only one modality is probed. The sonification of otherwise mute movements by sounds based on kinematic parameters of the movement has been shown to improve motor performance and perception of movements. Results Here we demonstrate in a group of healthy young non-athletes that congruently (sounds match visual movement kinematics) vs. incongruently (no match) sonified breaststroke movements of a human avatar lead to better perceptual judgement of small differences in movement velocity. Moreover, functional magnetic resonance imaging revealed enhanced activity in superior and medial posterior temporal regions including the superior temporal sulcus, known as an important multisensory integration site, as well as the insula bilaterally and the precentral gyrus on the right side. Functional connectivity analysis revealed pronounced connectivity of the STS with the basal ganglia and thalamus as well as frontal motor regions for the congruent stimuli. This was not seen to the same extent for the incongruent stimuli. Conclusions We conclude that sonification of movements amplifies the activity of the human action observation system including subcortical structures of the motor loop. Sonification may thus be an important method to enhance training and therapy effects in sports science and neurological rehabilitation. PMID:23496827

  8. Behaviorism and Cognitivism in Behavior Therapy.

    ERIC Educational Resources Information Center

    Levis, Donald J.

    The movement within behavior therapy to introduce cognitive terms, constructs, and techniques reflects and involves an extension of the pervasive cognitive movement within the experimental field and the long-standing cognitive approach of many clinicians. Modern day attacks on behaviorism by cognitivists have been almost exclusively geared to the…

  9. Arousal facilitates involuntary eye movements.

    PubMed

    DiGirolamo, Gregory J; Patel, Neha; Blaukopf, Clare L

    2016-07-01

    Attention plays a critical role in action selection. However, the role of attention in eye movements is complicated as these movements can be either voluntary or involuntary, with, in some circumstances (antisaccades), these two actions competing with each other for execution. But attending to the location of an impending eye movement is only one facet of attention that may play a role in eye movement selection. In two experiments, we investigated the effect of arousal on voluntary eye movements (antisaccades) and involuntary eye movements (prosaccadic errors) in an antisaccade task. Arousal, as caused by brief loud sounds and indexed by changes in pupil diameter, had a facilitation effect on involuntary eye movements. Involuntary eye movements were both significantly more likely to be executed and significantly faster under arousal conditions (Experiments 1 and 2), and the influence of arousal had a specific time course (Experiment 2). Arousal, one form of attention, can produce significant costs for human movement selection as potent but unplanned actions are benefited more than planned ones. PMID:26928432

  10. Social-movement analysis of the American antinuclear movement

    SciTech Connect

    Ladd, A.E.

    1981-01-01

    Utilizing data from a survey of participants at the May 6, 1979 antinuclear rally in Washington, DC (N = 420), this dissertation explored some of the major structural and ideological characteristics of the American Antinuclear Movement. By organizing the data around three of the key analytical concepts in the study of social movements - mobilization, recruitment, and ideology - the author was able to derive from the demonstration sample a descriptive and illustrative analysis of those individuals, organizations, and processes involved in the national antinuclear crusade. Given that few researchers have actively studied the antinuclear movement beyond the scope of local or regional protests, this work constitutes the only empirical study to date examining a cross section of the movement's participants from a sociological perspective. It is also one of the few attempts to use a national demonstration as a social laboratory for the study of a social movement in general. In terms of the mobilization variables examined in the study, it was found that organizational networks, past movement activism, and individual resources were important factors in the May 6 mobilization effort. While less than one-half of the demonstrators were part of the antinuclear organizational network per se, most of them had been active in the major protest movements of the 1960's and 1970's. The demonstrators were relatively high in socio-economic resources and had occupational or educational schedules conducive to creating the necessary discretionary time for movement participation.