The core mission of National Institute of Neurological Disorders and Stroke (NINDS) is twofold. First, NINDS seeks fundamental knowledge about the brain and nervous system. Second, NINDS aims to use that knowledge to reduce the burden of neurological diseases. In support of its mission, NINDS performs and funds basic, translational, and clinical neuroscience research on more than 600 neurological diseases, including genetic diseases (e.g. Huntington’s disease; muscular dystrophy), developmental disorders (e.g. cerebral palsy), neurodegenerative diseases (e.g. Parkinson’s disease; Alzheimer’s disease; multiple sclerosis), metabolic diseases (e.g. Gaucher’s disease), cerebrovascular diseases (e.g. stroke; vascular dementia), trauma (e.g. spinal cord and head injury), convulsive disorders (e.g. epilepsy), infectious diseases (e.g. AIDS dementia) and brain tumors. Common marmosets (Callithrix jacchus) offer unique, powerful advantages to both components of the NINDS mission. In support of the first component, marmosets are particularly well suited for neuroanatomical and functional brain studies, as their brains retain the typical anatomical and functional organization of the primate brain. A major advantage is that the marmoset is a lissencephalic primate, which greatly facilitates the mapping of functional brain areas by neuroimaging techniques, such as fMRI and optical imaging, as well as by electrophysiology, with high spatial resolution. In support of the second component, marmosets are excellent models of neurological disorders. Unlike rodents, marmosets are outbred and every individual is genetically different. Further, the marmoset brain has a gray-to-white matter ratio comparable to humans, which strongly facilitates modeling diseases such as multiple sclerosis and small vessel disease. The species also exhibits the breadth of cognitive sophistication that distinguishes primates from other taxonomic groups. Finally, geneedited marmosets can be generated with an intergeneration time and establishment of transgenic lines 2-3 times faster than other primate species, which makes marmosets be the ideal primate species for the development of genetically engineered lines. For all of the above reasons, marmosets are poised to be a central player to advance the core mission of the NINDS.

National Institute of Neurological Disorders and Stroke

Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests.One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman's rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable).Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=-0.33), and FRT (r=-0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12).The reference values of physical performance tests in our study may be used as a guide for initial falls screening to categorize high and low physiological falls risk among community-dwelling older adults. A more comprehensive assessment of falls risk can be performed thereafter for more specific intervention of underlying impairments.

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Association between physiological falls risk and physical performance tests among community-dwelling older adults.

Background
Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.

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Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.

https://biblio.ugent.be/publication/8579841/file/8579842.pdf

Training-induced improvements in postural control are accompanied by alterations in cerebellar white matter in brain injured patients

Purpose: The United Nations Convention on the Rights of Persons with Disabilities recognises assistive technology such as wheelchairs (WCs) as a tool for social inclusion for this population. In less resourced settings, organisations lack information about effective models of WC service provision. The goal of this study was to investigate the lifespan of WCs and whether they provided reliable mobility, at one clinic in Mexico. Methods: Caregivers of children, who had requested replacements for their WCs from a clinic in Mexico, were interviewed in Spanish. Among others, the questions pertained to repairs/modifications, adverse events and WC usage characteristics. The owners exchanged their WCs for new ones at the clinic, and the maintenance status of each returned WC was evaluated using the WC Assessment Checklist (WAC). Results: Twenty-three donated WCs, used by children aged 3 to 14 years for an average of 19 months, were evaluated. Brakes (n=18), seat and back-sling upholstery (n=11 and 7 respectively), and armrests (n=14) were the components that failed most frequently. A total of 26 adverse events due to WC failure were reported. Adverse events were significantly associated with poor WAC scores (rs=-0.544, p=0.007). Conclusions: Poor WC reliability, associated with adverse events which could undermine social engagement, indicates the need for a stronger WC and for regular maintenance. For instance, brake failures which were most often

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Quantitative exploratory evaluation of the frequency, causes and consequences of rehabilitation wheelchair breakdowns delivered at a paediatric clinic in Mexico

This paper presents a novel, portable and cost-effective balance trainer with the necessary important features to improve the reach of rehabilitation to the masses. There are three factors that contribute to a person's ability to maintain standing balance: Proprioceptive feedback (from the joints), vision, and the vestibular system. These systems can be affected by injury, infection, or brain damage caused by stroke. One example of such injuries is ankle injury. A large focus of the physiotherapy and sports medicine community is using postural-control tasks to prevent, assess and rehabilitate patients. Unfortunately, there are presently two extreme ends of balance training devices. On one end, there is high-end equipment which only large hospitals are capable of buying. On the other end are the simple balance boards which offer limited features. To develop the new balance trainer – the Pro.Balance – therapists at the Singapore General Hospital drafted a new ‘wish list’ of requirements. The prototype was b...

Design and development of a novel balancer with variable difficulty for training and evaluation

This paper presents a compact, portable and modular mechatronic device, which can be used for wrist and elbow rehabilitation in a user-friendly manner. Portability, modularity, compactness & degree of freedom are the main concerns of the device. Applied postoperatively, this device may be used on an inpatient or an outpatient basis. The designed device can be used for different exercises of wrist and elbow just by simply plugging in or out some of the links or by adjusting the position of some of the links. In addition, instead of going with the usual approach of using different actuators for different degrees of freedom, a single actuator is used in this project. By adjusting the links position, the patient can perform different exercises. The therapist or the patient will then select appropriate settings to run different exercises.

Design and implementation of a mechatronic device for wrist and elbow rehabilitation

This paper proposes a novel, portable and cost-effective balance trainer with all necessary important features to improve the reach of rehabilitation to the masses. There are three factors that contribute to a person's ability to maintain standing balance---proprioceptive feedback (from the joints), vision, and the vestibular system. These systems can be affected by injury, infection, or brain damage caused by stroke. One example of such injuries is ankle injury. A large focus of the physiotherapy and sports medicine community is using postural-control tasks to prevent, assess and rehabilitate patients.Unfortunately, there are presently two extreme ends of balance training devices. On one end there are the high-end equipments which only large hospitals are capable of buying. On the other end are the simple balance boards which offer very limited features.Thus, the authors proposed a novel, portable and cost-effective balance trainer with most of the necessary important features to improve the reach of rehabilitation to the masses. The device has a small footprint, incorporating only the most important and frequently used functions. These functions include being able to provide different levels of difficulty, setting different difficulty in different directions, storing of patients' performance, real-time visual feedback to aid the patients and different types of modes for different purposes. Springs are used to vary the moments, which will actually vary the difficulty levels. This is due to the fact that balancing is actually about keeping the equilibrium moments to be zero.

Asia has come a long way in its laborious journey towards an inclusive society --- one that allows full participation and equality for people with disability (PWD). The imminent aging population in Asia has injected a new-found urgency among the Asian legislators to get their countries prepared in anticipation of an explosive number of elderly people with geriatric disabilities. From the concluded Asian and Pacific Decade of Disabled Persons (1993-2002) to the Biwako Millennium Framework (2003-2012), the efforts led by the United Nation Economic and Social Commission for Asia and the Pacific have been predominantly focusing on using government policies to build the two pillars of an inclusive society: a barrier-free society and empowerment of the PWD. Notwithstanding that policy is the most powerful tool for solving the issues of the PWD, it cannot do it all by itself. The top-down nature of policy would better serve the cause in overcoming the barriers than in the empowerment of the PWD.In this paper, we advocate empowerment of the PWD through the use of technology. While policy provides the framework to integrate the PWD back into the mainstream society, technology can enhance their capability and give them a chance to compete in the real world. To popularize technology usage among the PWD, it is vital to develop an assistive and rehabilitative technology industry in Asia. Taking a leaf from philosopher Adam Smith's famed theory of the "Invisible Hand"; the authors believe the best way forward for the Asian assistive and rehabilitative technology industry is to grow it into a sustainable and profitable one without intervention and protection from the government. When there is money to be made, more players will enter the industry, thus providing better services and innovative products at more competitive prices and in consequence, the PWD will become the eventual winners.

Towards an inclusive society in Asia: the invisible helping hand

Current Brain computer interface (BCI) utilize electroencephalogram (EEG) rhythms associated with movement/ function to generate control signals. The amplitude of mu rhythm varies when the subject is not moving or not imagining and attenuates when the subject is moving or imagines movement. The classification of events is generally performed in frequency domain using fast Fourier transform (FFT) to compute band power. This papers aims to develop an alternative time-domain analysis by estimation of bandlimited signals through adaptive filtering. The design methodology estimates bandlimited signals through multiple fourier series there by estimating the individual components of frequency weights through LMS algorithm. The knowledge of individual frequency components in time-domain provides useful insight into the classification process of EEG. Instead of using the band-power, this paper analyzes the usage of frequency weights to determine the optimum band for a subject. Study is conducted on 3 subjects for optimum band selection and classification.

H. G. Tan

Papers

Design and development of a novel balancer with variable difficulty for training and evaluation

Design and implementation of a mechatronic device for wrist and elbow rehabilitation

Design and development of a novel balancer with variable difficulty for training and evaluation

Towards an inclusive society in Asia: the invisible helping hand

Adaptive estimation of EEG-rhythms for event classification