Background: Central nervous system development is a rapid and highly plastic process during the first years of life. Tactile stimuli have been shown to induce cortical changes, but potential sex-related differences remain unexplored. This study aimed to investigate sex-specific differences in cortical activity and cerebral oxygenation in response to tactile stimulation via body massage. Methods: Four healthy full-term infants (two females and two males), all aged 11 weeks, were included in this prospective exploratory study. Each infant received a standardized 5 min massage protocol. Cortical activity and cerebral oxygenation were assessed using an 8-channel electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) before, during, and after the intervention, with a 5 min pre-intervention resting period used as the baseline. Results: EEG analysis focused on a single spectral band (4 Hz–30 Hz). This range was selected to capture the main cortical oscillations in infants, including theta, alpha, and beta activity, while delta activity below 4 Hz was partially excluded to reduce movement and physiological artifacts. Standard infant EEG bands were considered when defining this range. Data shows for the female subject an average PSD of −6.726 (± −4.075), and for the male subject, −12.594 (± −10.741). Although babies are of the same gestational age, they exhibited distinct basal cortical activity, which prevented comparisons from being made. Nevertheless, massage induced similar activity patterns in all subjects with increased cortical electrical activity in the left parietal region relative to baseline. fNIRS data showed that comparable HbO concentration patterns between participants were observed only during the second minute of recording. Relative to baseline, pre-intervention HbO responses displayed an opposite distribution, and the effects of the intervention differed by sex. The female participant exhibited a slight reduction in activation in the right hemisphere accompanied by a modest increase in the most ventral region of the left hemisphere. Conversely, the male participant showed an inverse response pattern, characterized by a marked increase in right hemispheric activation and a pronounced decrease in the left hemisphere during the intervention period. Conclusions: These preliminary observations suggest the presence of early variations in cortical processing that warrant further investigation in larger samples, although they cannot be considered conclusive. While baseline response patterns differed between participants, both showed increased left parietal activity during tactile stimulation. The inversion of HbO responses between the pre-intervention and intervention phases points to potential sex-related differences in hemodynamic trajectories. Nevertheless, these results remain preliminary, and larger, well-powered studies are required to determine whether these patterns reflect stable, sex-dependent developmental changes.

Background and Clinical Significance: Understanding early brain development in infants is essential as identifying an abnormal pattern could accelerate the start of early interventions. There is still limited evidence on how external stimuli (such as tactile, auditory, and visual inputs) influence cortical electrical activity, underscoring the need for integrative studies comparing these modalities in the first months of life. The objective of this paper is to determine the effects of different stimuli (tactile, auditory, and visual) in cortical electrical activity to take advantage of its use in individualized protocols and treatments. Case Presentation: An 8-channel electroencephalography cap was placed on the infant’s head to analyze 10 different conditions depending on the selected stimuli: Kangaroo Care with mother and father, rest, tactile stimuli, visual stimuli, acoustic stimuli, and sleep for 5 min. The environment was the same in all conditions to ensure comparison. All conditions have been able to modify the cortical electrical activity presenting different patterns of electrical activity. Tactile stimuli (massage) showed increased activity in the left parietal region. Acoustic stimuli showed increased activity in the frontal region. Visual stimuli presented different patterns, but with a higher occurrence of artifacts due to baby’s movement. Conclusions: Acoustic stimuli with music increased cortical electrical activity in frontal region, while tactile stimuli increased the left cerebral hemisphere activity. Future studies are needed to support these exploratory results to establish early interventions in pathological conditions.

Background: Newborns’ plasticity allows the brain to adapt and reorganize in response to external stimuli; therefore, tactile stimuli could generate brain changes. The objective of this study was to verify the feasibility of using fNIRS to measure the degree of brain oxygenation with tactile techniques in babies. Methods: Oxygenation was recorded continuously and bilaterally before, during, and after the interventions (massage protocol and Reflex Locomotion Therapy) with functional near-infrared spectroscopy in 11-week-old babies. Results: Preliminary data suggested that the massage intervention decreased the activity bilaterally (first minute of the intervention) and then increased it bilaterally (second minute), where it continued to increase in the left hemisphere (third minute) before decreasing bilaterally (fourth minute). Finally, the activity continued to decrease in the right hemisphere but increased in the most dorsal area of the left hemisphere (fifth minute). For the Reflex Locomotion intervention, the activity substantially increased bilaterally (first minute of the intervention) and then decreased bilaterally, but more pronouncedly in the left hemisphere (second minute). Then, the activity decreased to pre-intervention values (third minute) and increased bilaterally again, but pronouncedly in the right hemisphere (fourth minute). In the fifth minute, the activity in the right hemisphere drastically decreased, but it increased in the left hemisphere. During the post-intervention resting period, in the massage intervention, the activity increased in the right hemisphere and in the most ventral part of the left hemisphere; in Reflex Locomotion Therapy, the activity decreased only in the left hemisphere. Conclusions: Both techniques achieve a potential increase in oxyhemoglobin concentration bilaterally during stimulation, but while the effects decrease with Reflex Locomotion Therapy, the effects are maintained with massage. More studies are needed to establish the neurophysiological basis of these therapies in pediatrics.

It has been shown that the gut and the brain are linked through a multimodal, bidirectional pathway called the gut-brain axis. In the gut-to-brain way, the gut microbiota has been shown to be the main regulator. In clinical practice, evidence of microbiota and brain interactions comes from the association of gut microbiota alterations with neurological and psychiatric conditions. However, until now, it remains unknown how the gut microbiota influences brain activity. In this paper, we show that different microbiota profiles from healthy older people are associated with different spontaneous activity in medial posterior cortical areas. These areas are associated with memory, language, and emotion processing abilities. Therefore, the results obtained provide evidence that non-pathological gut microbiota profiles are correlated to spontaneous cortical activity associated with cognitive functions that typically deteriorate with age. This implies that early nutritional interventions that modify microbiota composition could help delay or ameliorate natural age-related cognitive decline.

Objective: To examine the clinical effects of combining motor imagery-based neurofeedback training with bilateral repetitive transcranial magnetic stimulation for upper limb motor function in subacute and chronic stroke. Design: Clinical trial following an AB/BA crossover design with counterbalanced assignment. Subjects: Twenty individuals with subacute (n = 4) or chronic stroke (n = 16). Methods: Ten consecutive sessions of bilateral repetitive transcranial magnetic stimulation alone (therapy A) were compared vs a combination of10 consecutive sessions of bilateral repetitive transcranial magnetic stimulation with 12 non-consecutive sessions of motor imagery-based neurofeedback training (therapy B). Patients received both therapies (1-month washout period), in sequence AB or BA. Participants were assessed before and after each therapy and at 15-days follow-up, using the Fugl-Meyer Assessment-upper limb, hand-grip strength, and the Nottingham Sensory Assessment as primary outcome measures. Results: Both therapies resulted in improved functionality and sensory function. Therapy B consistently exhibited superior effects compared with therapy A, according to Fugl-Meyer Assessment and tactile and kinaesthetic sensory function across multiple time-points, irrespective of treatment sequence. No statistically significant differences between therapies were found for hand-grip strength. Conclusion: Following subacute and chronic stroke, integrating bilateral repetitive transcranial magnetic stimulation and motor imagery-based neurofeedback training has the potential to enhance functional performance compared with using bilateral repetitive transcranial magnetic stimulation alone in upper limb recovery.

Repetitive Transcranial Magnetic Stimulation (rTMS) and EEG-guided neurofeedback techniques can reduce motor symptoms in Parkinson’s disease (PD). However, the effects of their combination are unknown. Our objective was to determine the immediate and short-term effects on motor and non-motor symptoms, and neurophysiological measures, of rTMS and EEG-guided neurofeedback, alone or combined, compared to no intervention, in people with PD. A randomized, single-blinded controlled trial with 4 arms was conducted. Group A received eight bilateral, high-frequency (10 Hz) rTMS sessions over the Primary Motor Cortices; Group B received eight 30-minute EEG-guided neurofeedback sessions focused on reducing average bilateral alpha and beta bands; Group C received a combination of A and B; Group D did not receive any therapy. The primary outcome measure was the UPDRS-III at post-intervention and two weeks later. Secondary outcomes were functional mobility, limits of stability, depression, health-related quality-of-life and cortical silent periods. Treatment effects were obtained by longitudinal analysis of covariance mixed-effects models. Forty people with PD participated (27 males, age = 63 ± 8.26 years, baseline UPDRS-III = 15.63 ± 6.99 points, H Y = 1–3). Group C showed the largest effect on motor symptoms, health-related quality-of-life and cortical silent periods, followed by Group A and Group B. Negligible differences between Groups A-C and Group D for functional mobility or limits of stability were found. The combination of rTMS and EEG-guided neurofeedback diminished overall motor symptoms and increased quality-of-life, but this was not reflected by changes in functional mobility, postural stability or depression levels. NCT04017481.

Rett syndrome (RTT) is a rare multi-systemic disorder primarily linked to mutations in MECP2 gene. This study aims to describe the prevalence of orthopedic conditions in RTT patients, and examine their intricate interplay with functional capabilities, and MECP2 variant subtypes. Conducted as a cross-sectional retrospective observational study, the research encompassed 55 patients meeting clinical RTT criteria and holding MECP2 mutations. A review of clinical records was performed to gather demographic data, mutation subtypes, orthopedic conditions, management strategies, and assessments of function. Mean age of the participants was 10.22 ± 4.64 years (range, 2.9–19.41). Prevalence rates of orthopedic conditions were as follows: kyphoscoliosis 63.6

Abstract Background To study the effects of different interventions on automatic gait processing in contrast with voluntary gait processing in healthy subjects. Methods A double-blind randomised controlled trial was designed (120 able-body persons between 18 and 65 years old entered and completed the study), with pre-intervention and post-intervention assessments using the 6-Minute Walk Test (6MWT). The participants were randomly distributed into four groups. Prior to intervention, all participants performed voluntary gait on the ground (VoG) in a calibrated circuit following the 6MWT. The presence of automatic gait (AG) was explored post-intervention without a voluntary demand in the same circuit following the 6MWT. Each group received a different intervention for 30 min: Vojta stimulation, MOTOMED® at no less than 60 revolutions/minute, treadmill walking at 3 km/h, and resting in a chair (control). The main assessment, conducted by a blinded rater, was the difference in distance covered (in meters) during the 6MWT between pre- and post-intervention. Surface electromyography (sEMG) average root mean square (RMS) signals in the right tibialis anterior, right soleus, right rectus femoris, and right biceps femoris were also considered outcome measures. Results The Vojta group was the only one that initiated AG after the intervention (476.4 m ± 57.1 in VoG versus 9.0 m ± 8.9 in AG, p < 0.001) with comparable kinematics and EMG parameters during voluntary gait, except for ankle dorsal flexion. Within the Vojta group, high variability in kinematics, sEMG activity, and distance covered was observed. Conclusions AG isolation is approachable through Vojta at only one session measurable with the 6MWT without any voluntary gait demand. No automatic gait effects were observed post-intervention in the other groups. Trial registration NCT04689841 (ClinicalTrials.gov).

Purpose: First, testing an intervention of neuromodulation based on motor imagery and action observation as a promoter of motor adaptation of a complex motor task involving balance. Second, determining what prior balance factors can affect the motor adaptation task. Methods: A double-blind randomized controlled trial was performed. Forty-eight healthy subjects were recruited. The balance of all participants during gait and standing was assessed before adapting to the complex, multi-limb motor task of riding an inverse steering bicycle (ISB). Two interventions were carried out interleaved among trials of adaptation to the motor task: the experimental group (n = 24) was asked to perform neuromodulation (EN) by watching first-person ISB riding through immersive VR glasses and, simultaneously, mentally mimicking the movements. The control group (CG) was asked to watch a slideshow video of steady landscape images. Results: The results showed that the EN group did not improve the motor adaptation rate and induced higher adaptation times with respect to the CG. However, while the motor adaptation success showed a significant dependence on the prior proprioceptive participation in balance in the CG, the EN group did not present any relationship between the prior balance profile and motor adaptation outcome. Conclusions: Results point to a benefit of the visually guided neuromodulation for the motor adaptation of the subjects with low participation of proprioception in balance. Moreover, the results from the control group would allow to disclose prognostic factors about the success of the motor adaptation, and also prescription criteria for the proposed neuromodulation based on the balance profile.

STUDY DESIGN:This is a retrospective, observational comparative study. OBJECTIVE:The aim of this study is to determine whether a relationship exists between the functional level and spinal deformity in patients with Down syndrome (DS). SUMMARY OF BACKGROUND DATA:Patients with DS have a higher incidence of scoliosis than the general population; however, it is unknown whether functional level influences the characteristics and severity of the deformity. MATERIALS AND METHODS:Of 649 patients with DS included in a pediatric referral center database, we identified 59 with a diagnosis of scoliosis (59.32% female; mean age, 14.19±1.82 y); the 46 patients who met the inclusion criteria comprised the study cohort. According to their functional gait skills and gross motor skills, they were classified into 2 levels. Different coronal and sagittal parameters were measured using full-spine standing radiographs. The need for surgical treatment and history of thoracotomy were recorded as well. Finally, a multivariate association analysis was performed between radiologic parameters and functional level. RESULTS:Twenty-two patients had a functional level consistent with level I and 24 with level II. Twelve curves were thoracic, 10 thoracolumbar, and 24 lumbar. A statistically significant relationship was found between functional level I and II and curve magnitude: 18.9 degrees (6.8) versus 36.9 degrees (20.3) ( P =0.001) with a cutoff point at 22.3 degrees (area under the curve=0.919, P <0.005, sensitivity=0.917 and specificity=0.818). The relationship between patients who required surgery and level II was also significant ( P =0.016). No relationship was found between functional level and coronal and sagittal balance, nor with other radiologic parameters or with curve location, or between the history of thoracotomy and thoracic curves. CONCLUSIONS:DS adolescents with poorer functional level were associated with larger curves and greater risk for surgery. These findings may provide valuable guidance for the follow-up of scoliosis in patients with DS based on their functional level. LEVEL OF EVIDENCE:Level III-retrospective comparative study.

Retrospective analytical study that aims to evaluate the kinematic and kinetic results obtained after percutaneous lengthening with an intramuscular needle (PLIN) of gastrocsoleus complex (GSC) zones I, II, and III, performed outside the operating room between 2018 and 2019, in pediatric patients with equinus gait resistant to non-operative treatment. Gait analysis was performed prior to treatment and 6 months post treatment in 48 ankles (30 patients), with a median patient age of 10.11 (2.85) years. Twelve patients had a diagnosis of idiopathic equinus, twelve spastic hemiplegia, and six spastic diplegia. Statistical analysis included pre–post comparison, correlation, and linear regression of critical kinematic and kinetic ankle values. Significant improvement was observed for the following parameters: ankle angle at initial contact, −4.57(10.31)/0.05(3.04)°; maximum ankle dorsiflexion in the stance phase (mADFStP), 3.70(7.56)/10.42(4.52)°; and maximum ankle dorsiflexion in the swing phase (mADFSwP), −6.54(8.41)/−0.35(6.17)°. In addition, an inversely proportional correlation with pre-intervention values was obtained for those parameters, with rho values of −0.864, −0.755, and −0.696, respectively (p < 0.0005). No significant changes in ankle kinetics were evidenced. Linear regression equations allowed for estimation of the post mADFStP, with a standard error (SE) = 1.82; R2 = 0.797 (p < 0.0005), and the post mADFSwP, with an SE = 2.376; R2 = 0.829 (p < 0.0005). To conclude, the addition of the GSC in patients with resistant equinus significantly improves ankle initial contact, mADFStP, and mADFSwP, with greater changes occurring with worse initial values. The regression formulas used to estimate post-procedure results will allow therapeutic indications to be adjusted.

Background and Objective: Clinical scales used by well-trained clinicians to assess motor symptoms in patients with Parkinson's Disease (PD) allow to establish the patients' medical therapy and follow-up their response. However, these assessments are subjective and their application to patients requires experienced and qualified operators. This study analyzes the role of the kinematic patient's features, captured by a simple computer keyboard paradigm, in predicting the scores prescribed by an experienced neurologist. Methods: A total of 47 patients in their ON medication state participated in this study. Their motor capacity was assessed by an experienced neurologist with several standardized clinical scales. The patients also performed 5 consecutive trials of 10 s of a computerized finger tapping task by pressing with their index the space bar, first with their dominant hand and then with the other hand. 270 tapping-related features were extracted from the tapping task data for each participant and linear regression multivariate models for each clinical variable were built by using these features. Results: The best resulting models were for the motor capacity (Unified Parkisnon Disase Scale Revised - MDSUPDRS Part III), years from disease onset and balance scores (Limit of Stability - LoS), with root mean squared errors (RMSE) of 0.268, 0.254 and 0.150, respectively, all bellow their corresponding minimal clinically important differences. Those models included variables from both hands and from all trials, mainly regarding slow and fast tapping-related variables in different degrees. Conclusions: A simple bimanual non-alternating finger tapping task has shown to foresee motor capacity and balance scores by using statistical and machine learning methods. This easy and quick task could be performed periodically in the medical office or at home helping the clinician to know the patients' motor state and temporary alterations in that way and to make finer clinical decisions about the proper pharmacological treatment of every patient.

Introduction: Planovalgus foot (PVF) is the most common orthopaedic abnormality in children with Down syndrome (DS), and as a result these patients rarely develop an adequate plantar arch in adulthood. The present study aims to evaluate the impact of PVF on activities of daily living and participation in sports among young adults with DS and determine whether this impact is related to the degree of foot deformity based on clinical and imaging studies. Methods: Observational analytical study examining a database of 649 patients with DS from a pediatric referral center, identifying those individuals over age 20 years at the time of the study with a childhood diagnosis of PVF. Finally, 51 patients (102 feet) were evaluated based on clinical and imaging studies, and function was assessed using the The Foot and Ankle Outcome Score (FAOS) and the Visual Analogue Scale (VAS) pain scale. A correlation analysis was performed to determine the clinical and radiographic variables associated with functional outcomes. Linear regression models were obtained to quantify the impact of these variables on function. Results: Patients had a mean age of 26.14±3.88 years and body mass index of 24.51±4.57. Clinically, 63.65% presented grade 3 or 4 PVF, and most were flexible. Radiographically, midfoot flattening was mild-moderate in 92.16%, 58.82% had medial talo-navicular uncoverage, and 30.39% had an increased hallux valgus (HV) angle. Mean scores for all FAOS subscales were between 65 and 71% and the mean VAS score was 1.45±1.96. An association analysis revealed a tendency toward lower scores on all FAOS subscales and greater pain according to the VAS scale in more severe PVF and in cases of moderate HV with asymmetry between feet. Linear regression models showed that major contributors to functional scores were radiographic evidence of hindfoot valgus, midfoot abduction, and flattening, and HV. Conclusions: Young adults with DS who are diagnosed with PVF in childhood have acceptable functional scores and low pain. Alteration of radiographic parameters toward flatter, more valgus and abducted feet and greater and asymmetric HV tend to be associated with worse long-term functional scores in activities of daily living and sports participation and increased pain. Therefore, non-operative management of these patients is justified, although individualized treatment is recommended. Level of Evidence: Level IV, Case series.

Background: The prevalence of hip dysplasia among patients with Down syndrome (DS) is higher than in the general population. We hypothesize that a relationship may exist between functional level and hip dysplasia in DS, but this has not been studied to date. The aim of this study is to evaluate whether there is a relationship between functional level and radiographic parameters of hip dysplasia or other measures. Methods: Retrospective cross-sectional comparative study of 652 patients with DS from a pediatric referral center database. Patients over 8 years of age with an anteroposterior pelvis radiograph and with no exclusion criteria were selected, totaling 132 patients (264 hips; 54.55% females; mean age 12.96 ± 2.87 y). Several radiographic parameters of the acetabulum [Sharp angle (SA), Tönnis angle (TA), Wiberg center-edge angle (W-CEA), extrusion index (EI), and acetabular retroversion signs], the proximal femur [neck shaft angle (NSA)], and joint congruence [Shenton line (SL)] were assessed. Patients were classified into 2 levels based on functional skills. A multivariate association analysis was performed between radiographic parameters and functional level. Results: Sixty-one patients were compatible with a functional level I and 71 with a level II. Forty-six hips were dysplastic and 60 were borderline according to the W-CEA. A statistically significant relationship was found between the categorical distribution of certain radiographic measurements of hip dysplasia (EI, SA, TA, W-CEA, SL, and classification by functional level (P < 0.0005). A significant receiver operating characteristic curve was obtained for W-CEA with a cutt-off point at 26.4 degrees for level I (area under the curve = 0.763; P < 0.005; sensitivity = 0.800 and specificity = 0.644). There was a fairly high correlation between EI and TA (0.749; P < 0.0005), EI and W-CEA (−0.817; P < 0.0005), and TA and W-CEA (−0.748; P < 0.0005). Numerous hips showed signs of acetabular retroversion, with no significant differences found between functional levels or association with hip dysplasia measures. Conclusions: The present study reveals a relationship between an increased risk of hip dysplasia and reduced functional levels in DS children older than 8 years. These findings may guide individualized clinical follow-up of hip development in DS children considering their functional level. Level of Evidence: Level III, retrospective comparative study.

Study Design: This is a retrospective, observational comparative study. Objective: The aim of this study is to determine whether a relationship exists between the functional level and spinal deformity in patients with Down syndrome (DS). Summary of Background Data: Patients with DS have a higher incidence of scoliosis than the general population; however, it is unknown whether functional level influences the characteristics and severity of the deformity. Materials and Methods: Of 649 patients with DS included in a pediatric referral center database, we identified 59 with a diagnosis of scoliosis (59.32% female; mean age, 14.19±1.82 y); the 46 patients who met the inclusion criteria comprised the study cohort. According to their functional gait skills and gross motor skills, they were classified into 2 levels. Different coronal and sagittal parameters were measured using full-spine standing radiographs. The need for surgical treatment and history of thoracotomy were recorded as well. Finally, a multivariate association analysis was performed between radiologic parameters and functional level. Results: Twenty-two patients had a functional level consistent with level I and 24 with level II. Twelve curves were thoracic, 10 thoracolumbar, and 24 lumbar. A statistically significant relationship was found between functional level I and II and curve magnitude: 18.9 degrees (6.8) versus 36.9 degrees (20.3) ( P =0.001) with a cutoff point at 22.3 degrees (area under the curve=0.919, P <0.005, sensitivity=0.917 and specificity=0.818). The relationship between patients who required surgery and level II was also significant ( P =0.016). No relationship was found between functional level and coronal and sagittal balance, nor with other radiologic parameters or with curve location, or between the history of thoracotomy and thoracic curves. Conclusions: DS adolescents with poorer functional level were associated with larger curves and greater risk for surgery. These findings may provide valuable guidance for the follow-up of scoliosis in patients with DS based on their functional level. Level of Evidence: Level III—retrospective comparative study.

Background: Conventional scores from the Iowa Gambling Task (IGT) have been used to assess decision making in a variety of disorders, including substance use. This study extends that work by examining a novel computational cognitive model of the IGT that was hypothesized to capture fine-grained differences in decision-making styles in persons with recent methamphetamine use disorders. Methods: A total of 64 participants were evaluated in this study, which included individuals with lifetime methamphetamine dependence diagnoses, individuals with diagnoses of both methamphetamine and other substance dependence, and control participants with no histories of substance use disorders. Participants were individually modeled performing the IGT by adjusting the parameters of the computational model MAIDEN-IGT with an evolutionary strategy. Results: The resultant models explained more than 80% of the participants' behavior. The common IGT net score alone was not able to detect any inter-group differences. However, the modeling process yielded differentiated inter-group patterns of behavior extracted from the computational models. Relative to control participants, methamphetamine users exhibited a lower estimation of the possible losses as well as the risk associated to the losses. In addition, multi-substance users showed a behavior pattern that affects the evaluation of losses and the risk associated with gains. Conclusions: MAIDEN-IGT computational models were more sensitive than traditional metrics to the risky decision making of persons with methamphetamine use disorders. These novel models raise plausible hypotheses about the nature of motivated behaviors in the context of substance use disorders.

La Parálisis Cerebral (PC) está relacionada con un trastorno de la postura y el movimiento debido a una lesión ocasionada en el cerebro cuando éste no se ha desarrollado completamente. Al ser una de las discapacidades más prevalentes a edades tempranas, la investigación y el desarrollo de dispositivos robóticos para la rehabilitación de la marcha en estos pacientes ha incrementado en los últimos tiempos. Sin embargo, los dispositivos actuales están enfocados sólo en controlar trayectorias de movimiento, olvidando el control postural del usuario y la adaptación de la terapia a las necesidades específicas de cada paciente. Este documento presenta los resultados preliminares de la aplicación de una nueva plataforma robótica (CPWalker) en la rehabilitación de la marcha de niños con diplejía espástica, durante una validación de cinco semanas. CPWalker está formado por un andador inteligente con sistema de control de peso y locomoción autónoma y un exoesqueleto robótico que realiza el movimiento guiado de las articulaciones. Además, el dispositivo incluye la posibilidad de mejorar el control postural del paciente durante la marcha, adaptando la terapia a las necesidades demandadas por el usuario.

INTRODUCTION:Smartphone use in biomedical research is becoming more prevalent in different clinical settings. We performed a pilot study to obtain information on smartphone use by patients with essential tremor (ET) and healthy controls, with a view to determining whether performance of touchscreen tasks is different between these groups and describing touchscreen interaction factors.METHOD:A total of 31 patients with ET and 40 sex- and age-matched healthy controls completed a descriptive questionnaire about the use of smartphones. Participants subsequently interacted with an under-development Android application, and performed 4 tests evaluating typical touchscreen interaction gestures; each test was performed 5 times.RESULT:The type of smartphone use and touchscreen interaction were not significantly different between patients and controls. Age and frequency of smartphone use are key factors in touchscreen interaction.CONCLUSION:Our results support the use of smartphone touchscreens for research into ET, although further studies are required.

Motor imagery (MI) has been increasingly studied for neurorehabilitation purposes. However, issues such as large intra- and inter-subject variability still limit its practical, and more clinical, applications. Seeking appropriate features for MI-neuromodulation training is thus a crucial step. This work presents a protocol that selects features related to the MI mental patterns maximizing consistency (i.e., minimizing variability) across two recordings in different days. We apply our methodology to 3 healthy adults and 3 children with cerebral palsy, illustrating its feasibility for MI training protocols.

Motor imagery (MI) has been suggested to provide additional benefits when included in traditional approaches of physical therapy for children with cerebral palsy (CP). Regardless, little is understood about the underlying neurological substrates that might justify its supposed benefits. In this work, we studied resting-state (RS) electroencephalography (EEG) recordings of five children with CP that underwent a MI virtual-reality (VR) intervention. Our aim was to explore functional connectivity (FC) patterns alterations following this intervention through the formalism of graph theory, performing both group and subject-specific analyses. We found that FC patterns were more consistent across subjects prior to the MI-VR intervention, shifting along the anterior-posterior axis, post-intervention, for the β and γ bands. Additionally, group FC patterns were not found for the α range. Furthermore, intra-subject analyses reinforced the existence of large inter-subject variability and the need for a careful exploration of individual pattern alterations. Such patterns also hinted at a dependency between short-term functional plasticity mechanisms and the EEG frequency bands. Although our sample size is small, we provide a longitudinal analysis framework that can be replicated in future studies, especially at the group level, and whose foundation can be easily extended to verify the validity of our hypotheses.