Funding for this research was provided by intramural funds from the Division of Infectious Diseases.

该研究得到了美国亚利桑那大学的机构审查委员会。与会者提供他们签字同意参加。 1.招募艾滋病病毒感染参与者<ol><li>招募艾滋病患者参加的横幅大学医学中心的森校园&gt; 50岁的彼得森诊所，能够在没有援助步行至少15英尺，承诺参加培训任命为30-60分钟，每周两次，连续六周。 </li><li>屏幕与流行病学研究中心抑郁量表（CES-D）27问卷抑郁症的新兵。 （这是收集队列代表更郁闷HIV人群子集的）。如果中度或重度抑郁（在CES-D的得分&gt; 16）问人参加学习。 </li></ol> 2.油炸等方法略有评估参与者的脆弱状态。28对于HIV人口29修改<ol><li>衡量（1）收缩或无意减肥科目; （2）运行缓慢或下降的步态速度; （3）弱点被握力测量; （4）卡路里低体力活动水平; （5）通过回答CES-D问卷用尽或抑郁症。27 </li><li> （FES-I:短期瀑布效能量表-国际）用问卷评估震落一起收集人口数据干预前30，和生活质量（短健康调查表，SF-12 31），秋史，疼痛评估用视觉模拟评分（每日的活动Barthel指数32生活）日常生活活动。 </li></ol> 3.开始训练干预<ol><li>行为训练3分钟-60在6周的时间内，如表1。 <ol><li>已经科目执行所有的练习和提高exe文件的难度rcises。 </li><li>附上5惯性传感器到被检者的身体，允许联合三维角度的估计实时33和四元参数一起提供三轴加速度计，陀螺仪和磁强计的数据。34,35在柄，大腿连接传感器和下背部用自我坚持带。 </li></ol></li><li>在基线，测量主体的平衡和步态。还可以测量平衡和步态的中点与上次会话。 <ol><li>测量平衡通过反馈来自生物传感器提供的质量中心（COM）的影响力。 <ol><li>让主体30秒，脚在双stance-第一睁眼然后用眼睛反复关闭;其次英尺半串联立场 - 眼睛打开，然后关闭。 </li><li>观察生物传感器的数据，并要求受试者在测量过程中，以保持视力墙上简单。 </li><li>收集使用放置在脚踝和传感器测量平衡腰。35,36平衡的主要成果包括在前后和中间-横向睁着眼睛和眼睛测量COM挥洒变化闭幕。 </li></ol></li><li>由具有执行主体10米步行评估步态。培训师可以观察生物传感器的数据，但这个问题不能。 <ol><li>收集步态测量单任务（一个正常水平高出10米步行），双重任务（10米步行在执行任务的认知（1从给定数量的倒数）和快速步行（快节奏10米步行路程）。 </li><li>通过在脚踝和大腿传感器所收集的评估步态速度和变化的主要步态结果。37,38 </li></ol></li><li>在基线和后续会议，给这个主题的上衣穿48小时有显示器39,40收集正常的身体活动数据。 注:以上的练习提高患者的周围神经病变的平衡24,41。 </li></ol></li><li>在会议1-12中，执行一个脚踝到达任务（ 图1）。 <ol><li>解释练习，然后让主体进行脚踝深远的任务，需要前进/后退/侧面/对角线斜塔和部分重量转移的主体，而在电脑屏幕前站立。 注:数据来自柄装传感器提供有关二维的脚踝轨迹的实时视觉反馈。踝关节的旋转被转换为在计算机屏幕上的直线的光标（ 图1）。有在屏幕上的两个圆，一个是起始圆，另一个是目标圈（它们是在计算机屏幕上，一个在底部和一个在顶部上隔开）。 </li><li>有主体移动光标从开始圆到目标圆的中间的中间（其表示该主题的屏幕上的一个点）。光标在屏幕上的位置由生物传感器确定，使得通过移动脚踝光标将移动Øn个屏幕。 <ol><li>有须经踝关节旋转导航从一开始圈光标到目标圈，而与植根于地方的脚站立。转发/移动光标落后，有与会者移动臀部在前后方向上产生踝关节背屈屈曲或跖屈。内侧，臀部外侧移动侧身导航光标。在相反方向A任务重复完成一个周期。 </li></ol></li><li>有从一个圆到另一个主题导航快速（&lt;1秒），并精确地（在圆的中间）。证实通过视觉线索（爆炸的目标）的正确执行和听觉线索（爆炸声）反馈。使用这些线索作为激励对象继续参与运动和感知运动过程中的改善。 </li><li>发送电机错误，由于导航到并及时在靶圆心停止向受试者的不准确通过在每次试验的执行结束的音频 - 视觉反馈。结合缺乏噪声的绿色圆圈的视觉提示表明太慢执行正确的动作。而在组合的蓝色圆圈与噪音的情况下的视觉提示指示正确的行动进行比程序预期的要快。 </li><li>对于每个会话，执行9块与脚踝达到20次。 <ol><li>在前后方向上进行块1 + 4 + 7。 </li><li>在用于对角运动的组合前 - 后和中间 - 横向方向执行块2 + 5 + 8。 </li><li>用visuomotor旋转任务42执行块3 + 6 + 9，以增加运动和认知的挑战。在这个任务中，通过20°旋转光标的轨迹。主题在演习中观察到的轨迹这种变化和调整脚踝协调，将光标导航向目标圈。 Visuomotor RO塔季翁提高适应姿势和姿势校正。37 </li><li>有与会者块之间休息，避免过度疲劳（30〜60秒）。 </li></ol></li><li>在会话9-12，实施更加困难脚踝达到锻炼，电动机 - 认知踝达到锻炼。 <ol><li>在这些练习中，目前5个圈屏幕和标签与编号或与原有的"家"圈子沿着字母上。给从圈将光标移动到圈以某种顺序的命令。例如，要求受光标从圈1移动到"家"2"家"3等或本命令，要求受记忆圈的顺序将光标移动到的一些变化。 注:此任务旨在增强中移动重任务踝，膝，髋关节和关节之间的协调24,41。 </li></ol></li></ol></li><li>在会议2-12，执行的障碍穿越increasi任务NG程度的困难。 <ol><li>在会话2-7，利用与在5％的障碍和主体的高度的10％的障碍物交叉的任务。在会话10 - 12日，在15％和主体的高度的20％的增加与障碍物的另一个障碍交叉任务。 </li><li>有主体面对电脑屏幕，其中受试者的化身是本表示臀部和下肢。有主体查看屏幕，同时执行此任务。 </li><li>解释后，让主体进行越障任务（ 图2）。在这个任务中的参与者穿过电脑屏幕上移动由右至左的虚拟障碍（巨石）。实时反馈使用表示参与者的髋关节和膝关节运动的简笔画头像给出。头像复制下肢运动，包括抬起腿指定到一个适当的高度跨越的障碍。 </li><li>对于每个会话，包括两个或四个系列障碍道口s的各10重复。要认知挑战的参与者，该计划要求他们越过障碍物或者与左或右小腿。如果腿升降的顺序是错误的，这个问题将通过视听反馈通知。在下一个障碍物仅在参加者之后发布要么越过或击中先前障碍物，并返回到双姿态至少2秒（对于安全性）。 </li><li>让参与者音频反馈于这说明他们是否成功横渡障碍与否每个障碍交叉试验结束。如果需要，他们可以留住一个坚固的办公桌支持。然而，获得信心后，鼓励他们不支持进行练习。 注:虚拟越障任务旨在增强下肢的位置感知，减少反应时间，提高单腿平衡。 </li></ol></li></ol> 4.培训师测量和记录所有Interventions <ol><li>收集与问卷调查评估震落沿线人口数据后干预（FES-I:短期瀑布效能量表-国际），30和生活质量（短健康调查表，SF-12 31），秋史，疼痛评估用视觉模拟评分，日常生活活动，并与CES-D抑郁问卷（生活日报32的活动Barthel指数）。27 </li></ol> 5.主题报酬他们的时间 6.所有主体及其测量的响应的任务进行统计分析<ol><li>使用配对样本学生的t检验和单因素方差分析测试基线比较患者的测量和后续对自己和随访组内（ 即抑郁/不郁闷，前体弱与非体弱等 。 ）， 分别。报告结果为+/- SEM。 </li><li>执行元线性回归分析探索响应于训练如用增量和基线步态速度抑郁症和虚弱状态假设的因素和结果。提供具有p &lt;0.05统计学显着性，并判定系数，R 2为模型拟合结果。 </li></ol>

The authors have no competing financial interests or Conflicts of Interest in this research.

我们已经发现，身体虚弱的艾滋病患者中，由CES-D量表测量100％的郁闷; 30％是轻度抑郁和70％具有严重抑郁症。7强调的是在非体弱的HIV患者人群，抑郁是很常见的，以及用38％的被压下是很重要的。尽管所有的抑郁症患者availed咨询和抗抑郁药物本身，他们依然低迷，从而促进预体弱（具有油炸的5标准的1或2对受脆弱28或身体虚弱的状态，3个或更多的标准）。因为抑郁症是艾滋病患者中如此普遍，我们正试图改善情绪障碍和脆弱新颖的干预措施，如这里所描述。我们需要采用认知控制，涉及在那些经常在体弱前和体弱多病的状态受到影响艾滋病病毒感染者的平衡和步态，功能锻炼。此处所描述的健身游戏是在p非常低的冲击物质环境的意识，因此，对体弱患者风险不大。重要的是，所有的练习和会话顺序完成，因为它们变得越来越困难，特别是在认知输入的球体。例如，在以后的会话记忆通过移动脚踝移动光标的序列是成功完成重要。至关重要的是，每一个任务是为了完成要记录准确的数据，因此，有意义的比较可以受试者之间进行。 虚拟现实游戏，如任天堂Wii Exergames，能改善身体机能，认知和心理后果的老人。二十一43的研究中，60-95岁的人包括抑郁症筛查。这项研究并没有表现出在开始时测量老年抑郁量表分数任何显著差和研究结束。干预历时6周，每周由3天，35-45分会议3平衡的游戏。虽然44在该研究中，运动疗法是在长度上，在我们的研究中使用类似的商业游戏需要比在我们的研究中练习更有力的运动。此外，在我们的研究中的练习被校准到每个独特的个体，而，商业exergames都在一般人群中打算由任何人，因此，不具备的精度和准确度，这里报道的练习具备。 单独行使已显示防止抑郁症的发病。45运动可以改善抑郁症，但其效果不持久。46 HIV患者干预这里报告涉及校准到每个唯一患者虚拟现实练习。在选择如何改变患者的虚拟表示形式认知输入，动作，方向和大小的速度是主体的认知控制之下。虽然SImilar商业exergames方法的重要方式有所不同。例如，商业游戏是由大量的个体，而与我们的协议测量个体为每一个病人，被雇用在不同的身体部位要追求精确和准确的测量生物传感器的规范化使用。初步数据显示了这种形式，使得艾滋病毒感染者的抑郁和脆弱状态改进技术干预的承诺。初步结果是有希望在HIV人群的平衡和步态的改善和这种新的可穿戴式传感器虚拟现实基础的平衡点训练计划的有效性。步态是用于评估脆弱28和平衡的一种测量有助于步态的字符。在COM主导地位的显著减少和增加步行速度是有希望为这个持续时间的介入，显示改善脆弱的方面的潜力。 如疼痛，抑郁）的整体生活质量不断改进，以及客观的措施（ 即脆弱的状态，步速，COM挥洒， 等等 ） 。我们相信，随着平衡和步态的物理改善一起有可能是下降的相关风险较低和恐惧。此外，随着疼痛减轻和身体活动的鼓励和引进，通过这种干预措施，我们希望看到在日常体育和社会活动的改进认知挑战性的练习，而抑郁状态的减轻。该研究是初步但它表明了介入可有效解决脆弱的某些方面和由受试者良好接受。干预的持续时间很短，需要后续在稍后的日期来评估的真正价值和利益。一个主要缺点科目参加这项研究是学科的一部分，大的时间承诺。谁有兴趣参与的个体往往无法满足（每周两次为6周）来完成练习，很多付不起路费所需的时间承诺。我们正计划完善的练习，也许减少会议所需的时间。 本研究提供了在临床或家庭环境中使用这种新的可穿戴式传感器虚拟现实基于平衡训练锻炼计划，以改善姿势平衡和步态希望的初步结果。这项研究还探讨了潮流，那些谁获益最多的还是在这些客观的方式最大的改进是郁闷或预虚弱的个体。这可以通过减少跌倒和下降的风险和鼓励的恐惧和提高整体体育锻炼提高他们的整体生活质量。

人类免疫缺陷病毒（HIV）感染的有效的抗逆转录病毒治疗（ART）的执行已导致在活到年龄较大的感染者。1 HIV感染患者的平均年龄是增加2并且可以预测个体的73％被感染艾滋病毒将50岁以上的老年人，到2030年3人感染了艾滋病毒的老化可能有"加速老化"与早于老化的许多疾病，包括脆弱和下降的高风险的预期发生4-8同样，人HIV感染有合并症的发病率较高，包括认知功能减退，外周感觉损伤（ 即神经病变）和疼痛导致身体损伤和高温回落风险。9约有艾滋病病毒感染者的75％，接收至少一个处方药，除了ART包括高跌倒风险（心血管疾病和相关的一些偏方精神药物）。10 HIV感染与神经病，这是非常普遍的老年人与HIV之间相关联。11此外，艾滋病毒可能导致认知衰退，从而影响流动性和下降导致独立的损失和质量差的风险生活12 一些研究表明在HIV患者运动的好处， 例如 ，改进平衡，疼痛的感知，生活满意度感知，减少功能限制，和提高生活质量。13-18然而，传统的运动可能不适合于许多年长的成年人HIV由于跌倒的危险，失去了知觉关节，减少关节的灵活性和整体虚弱的状态。这些功能可能会限制运动性能特别是那些从神经病。19,20 HIV感染的痛苦可以用瘦体重的损失可能在行使涉及到的困难，营养不良有关，广泛疼痛，代谢紊乱和血脂异常，21这些都有助于一个无法参加常规锻炼。15此外，随着脆弱6,7许多练习20％的发病率将不适合年老体弱，年长的成年人。因此，需要几个因素制定和实施锻炼对老年人艾滋病的成年人，包括失去的共同看法补偿过程中予以考虑，以适应练习提高电机的认知能力，控制训练强度，以避免负担过重，最后，运动的个性化他们的强度和时间以考虑物理限制。健身游戏和虚拟现实技术已被评估为与好处，包括视觉和本体资料一致，凸反馈从关节运动，以及在脑马达相关领域的活化老年人22-24电动机控制的训练24-26 </p&gt; 在这项研究中，我们评估的有效性和实时的反馈以及对提高HIV感染的老年人姿势稳定性和日常生活活动的影响下肢的定制基于传感器的互动练习可接受性。运动训练专门针对踝关节和认知和运动部件运动的下肢范围。我们推测，通过与实时视觉关节运动的交互式界面锻炼期间运动训练不仅会提高姿势稳定性，但可以改善脆弱的特征，如果不是脆弱本身。

<table><tbody><tr><td>Handhold</td><td></td><td></td><td>Optional; for very frail patients</td></tr><tr><td>2 sensors: LegSys and Pamsys&amp;nbsp;</td><td>Biosensics, Cambridge, MA</td><td></td><td></td></tr><tr><td>Computer screen</td><td></td><td></td><td>Placed in front of the subject</td></tr><tr><td>Program of exercise protocols</td><td></td><td></td><td>These display objects and avatar on the screen</td></tr><tr><td>Large clinic examination room</td><td></td><td></td><td>Needs to accommodate the activities of subject and trainer</td></tr><tr><td>1 older HIV-infected subject</td><td></td><td></td><td></td></tr><tr><td>1 trainer</td><td></td><td></td><td></td></tr></tbody></table>

exergaming in older people living with hiv improves balance, mobility and ameliorates some aspects of frailty

大约有120万人在美国生活了艾滋病毒感染。医学的进步增加了预期寿命和这个世代老化。 HIV阳性者有脆弱（〜20％），特点是抑郁症和久坐行为的高发期。运动是健康的，但由于许多HIV阳性者的地位体弱，传统的演习太费力。这项研究的目的是在改善艾滋病毒感染者的脆弱性的某些方面来评价一个新颖的游戏为基础的培训计划（exergame）的有效性和可接受性。十大艾滋病毒感染的老年人在exergame干预的患者。患者进行平衡练习，如重量转移，达到踝关节和越障。实时视频/音频下肢关节运动反馈使用穿戴式传感器，以协助反馈，并鼓励学科准确地执行每个练习任务提供。训练有素的患者TWICEA周45分钟6周。平衡，步态，心理参数和生活质量参数的变化之初，中期和培训计划的结论进行了评估。 10名患者完成了试验及其结果进行分析。平均年龄为57.2±9.2年。参与者显示在大规模摆动的中心显著减少（78.2％，p值= 0.045）与眼睛半串联平衡姿态期间关闭和双任务马达认知评估期间显示在步态速度显著增加（9.3％， p值= 0.048）的增加超过0.1米/秒的步幅速度。在报道疼痛显著降低发生（43.5％，P = 0.041）。在改善平衡性和移动性，同时要求艾滋病病毒感染老年人更加活跃这exergame干预有希望的初步结果。该exergame可以在家里继续，并可能有长期的以及为改善与HIV感染有关的脆弱性的短期利益。

<html>十年长成人艾滋病病毒感染者（年龄:57.2±9.2多年来，BMI:27.0±2.8）行6周（每周两次）培训和圆满完成了各项会议，其结果进行分析.. 与会者半串联平衡姿态呈现在大众（COM）荡荡（78.2％，P = 0.045）的中心显著减少闭眼，对这个群体的子集（ 图3）更困难的位置之一。参与者显示具有增加超过0.1米/秒的步幅速度即达到统计学显着性（ 图4）的双任务马达认知评估（9.3％，p值= 0.048）期间在步态速度显著增加。疼痛问卷也显示在报告疼痛显著减少（43.5％，p值= 0.041），对于生活质量评估的重要指标（ 图5）。 <html> ove_content"FO:保together.within页="1"&gt;表示谁在基线抑郁症（&gt; 16），由CES-D问卷评估那些参与者，报道较慢步速时单任务走的趋势（&lt; 1.3米/秒，R 2 = 0.2911），这组基线较慢步速显示为三角形步态速度较大的改进预与干预后，观察另一个趋势与步态的变化趋势（R 2 = 0.3906）速度到脆弱状态。非体弱患者报告在从基线随访（p值= 0.125）减少平均在其步态速度-0.08米/秒起始和稳态相位中，而病人列为预体弱由于在凹陷基线报道启动和稳态相位，分别干预后相对于基线（p值= 0.143）中的改进在其步态速度平均为0.09和0.082米/秒。 广告/ 54275 / 54275fig1.jpg"/&gt; 图1:主题表演电机认知踝到达任务与沃克的支持对象在屏幕上查看自己（头像）的虚拟表示形式。他的运动响应来自通过在脚踝，大腿和腰部看到的生物传感器提供的在他面前屏幕上的听觉和视觉反馈。个人给予书面同意被拍照。 <img alt="图2" src="/files/ftp_upload/54275/54275fig2.jpg" /> 图2:除执行障碍交叉任务沃克的支持主题看到屏幕和候补委员移动双腿，以避免击中屏幕上显示的虚拟障碍的只是他的下肢。个人给予书面同意被拍照。 <img alt="图3" src="/files/ftp_upload/54275/54275fig3.jpg" /> &gt; 图3:单姿态期间改善群众挥洒中心姿，预处理和后干预的主题演示动作， 也就是说 ，挥洒的减少，表明改善平衡。误差棒表示SEM。 <img alt="图4" src="/files/ftp_upload/54275/54275fig4.jpg" /> 图4:改善跨越速度，预处理和后干预跨越速度以米/秒为单位测量。更快的速度表明了更好的物理性能。误差棒表示SEM。 <img alt="图5" src="/files/ftp_upload/54275/54275fig5.jpg" /> 图5:改善疼痛评估，预处理和后干预这是获得 从自我报告问卷注意到每日疼痛的减少（在0-10的标度）。误差棒表示SEM。 ove_content"FO:保together.within页="1"&gt; <table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always"><tbody><tr><td> 会议 </td><td> 演出活动 </td><td colspan="2"> 时间 </td></tr><tr><td>底线</td><td>平衡和步态练习</td><td colspan="2">总时间20分钟;每次运动（6）和平衡的姿势（6）在持续时间2-3分钟</td></tr><tr><td>第一节</td><td>平衡和踝关节运动范围</td><td colspan="2">总时间25分钟;平衡姿势（4）为2-3分钟，3台的踝到达任务3，每个组是5分钟</td></tr><tr><td>会话2-7 </td><td>学科平衡，脚踝距离和障碍物穿越演习在5％和10％的高度</td><td colspan="2">总时间35分钟;越障，每个高度为5分钟</td></tr><tr><td>中线</td><td>重复基线</td><td colspan="2">总时间20分钟;每次运动（6）和平衡的姿势（6）在持续时间2-3分钟</td></tr><tr><td>会议9-12 </td><td>同2-7会话加上电机认知脚踝范围和跨越障碍时主题15％和20％的高度</td><td colspan="2">总时间为45分钟;对于每个加入的两种高度的附加的10分钟</td></tr><tr><td>跟进</td><td>重复基线</td><td colspan="2">总时间20分钟;每次运动（6）和平衡的姿势（6）在持续时间2-3分钟</td></tr></tbody></table> 表1: 培训和演习。

Watch this Scientific Journal Video about Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty at JoVE.com

Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

感染艾滋病毒的人往往身体虚弱，抑郁和生活久坐的生活方式为其传统的运动过于繁重。这里，我们目前能够改善在艾滋病病毒感染者脆弱的方面的运动方案。整合认知控制的exergame使用该测量天平，砝码移动和越障生物传感器的发展。

老年人艾滋病感染者健身游戏平衡改善，流动性和可改善虚弱的几个问题

Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is ...

exergaming-older-people-living-with-hiv-improves-balance-mobility

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

10.1K 次观看.  College of Medicine, University of Arizona. 感染艾滋病毒的人往往身体虚弱，抑郁和生活久坐的生活方式为其传统的运动过于繁重。这里，我们目前能够改善在艾滋病病毒感染者脆弱的方面的运动方案。整合认知控制的exergame使用该测量天平，砝码移动和越障生物传感器的发展。 

视频: Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

Community-based Adapted Tango Dancing for Individuals with Parkinson's Disease and Older Adults

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple step elements. Adapted tango involves movement initiation and cessation, multi-directional perturbations, varied speeds and rhythms. Focus on foot placement, whole body coordination, and attention to partner, path of movement, and aesthetics likely underlie adapted tango&#8217;s demonstrated efficacy for improving mobility and balance. In this paper, we describe the methodology to disseminate the adapted tango teaching methods to dance instructor trainees and to implement the adapted tango by the trainees in the community for older adults and individuals with Parkinson&#8217;s Disease (PD). Efficacy in improving mobility (measured with the Timed Up and Go, Tandem stance, Berg Balance Scale, Gait Speed and 30 sec chair stand), safety and fidelity of the program is maximized through targeted instructor and volunteer training and a structured detailed syllabus outlining class practices and progression.

Adapted tango has demonstrated efficacy for improving mobility and balance. We describe the dissemination of adapted tango teaching methods to dance instructor trainees and the implementation of adapted tango by the trainees in the community for improving mobility and balance in older adults and individuals with Parkinson&#8217;s disease.

以社区为基础改编的探戈舞的个人与帕金森氏病和老年人

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple ...

科研

行为学

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. Game-based therapy can promote patients&#39; engagement in rehabilitation therapy as a more interesting and a motivating tool. Mobile devices such as smartphones and tablet PCs can provide personalized home-based therapy with interactive communication between patients and clinicians. In this study, a mobile VR upper extremity rehabilitation program using game applications was developed. The findings from the study show that the mobile game-based VR program effectively promotes upper extremity recovery in patients with stroke. In addition, patients completed two weeks of treatment using the program without adverse effects and were generally satisfied with the program. This mobile game-based VR upper extremity rehabilitation program can substitute for some parts of the conventional therapy that are delivered one-on-one by an occupational therapist. This time-efficient, easy to implement, and clinically effective program would be a good candidate tool for tele-rehabilitation for upper extremity recovery in patients with stroke. Patients and therapists can collaborate remotely through these e-health rehabilitation programs while reducing economic and social costs.

Here, we present a protocol to develop and apply a mobile game-based virtual reality program for the recovery of upper limb dysfunction in patients with stroke. The present study shows that the mobile program is feasible and effectively promotes upper limb recovery in stroke patients.

基于移动游戏的上肢卒中康复虚拟现实程序

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. ...

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

A simple, validated protocol consisting of a battery of tests is available to identify elderly patients with frailty syndrome. This syndrome of decreased reserve and resistance to stressors increases in incidence with increasing age. In the elderly, frailty may pursue a step-wise loss of function from non-frail to pre-frail to frail. We studied frailty in HIV-infected patients and found that ~20% are frail using the Fried phenotype using stringent criteria developed for the elderly1,2. In HIV infection the syndrome occurs at a younger age.
HIV patients were checked for 1) unintentional weight loss; 2) slowness as determined by walking speed; 3) weakness as measured by a grip dynamometer; 4) exhaustion by responses to a depression scale; and 5) low physical activity was determined by assessing kilocalories expended in a week's time. Pre-frailty was present with any two of five criteria and frailty was present if any three of the five criteria were abnormal.
The tests take approximately 10-15 min to complete and they can be performed by medical assistants during routine clinic visits. Test results are scored by referring to standard tables. Understanding which of the five components contribute to frailty in an individual patient can allow the clinician to address relevant underlying problems, many of which are not evident in routine HIV clinic visits.

Frailty syndrome is commonly seen in the aged and reflects multi-system physiological change. However, with reduced functional reserve and resilience frailty is also known to be common in the HIV infected population. This study outlined an easily administered screening test to identify HIV patients with frailty. When significant components of frailty are identified, clinicians will be able to focus on amelioration of the problem and promote reversion to the pre-frail state.

在感染艾滋病毒的个体的测量弱者。体弱患者的识别是第一步改良与弱者拨回

A simple, validated protocol consisting of a battery of tests is available to identify elderly patients with frailty syndrome. This syndrome of decreased ...

医学

Walk with Me Hybrid Virtual/In-Person Walking for Older Adults with Neurodegenerative Disease

This study presents a protocol for virtual and in-person walking groups for older adults with neurodegenerative diseases and addresses the decline in physical activity and social connectivity during the pandemic. Physical activity, specifically moderate-intensity walking, has been shown to have multiple health benefits for older adults. This methodology was created during the COVID-19 pandemic, contributing to lower physical activity levels and social isolation in older adults. Both the in-person and virtual classes utilize technology such as fitness tracking apps and video platforms. Data are presented from two groups of older adults with neurodegenerative disease: people with prodromal Alzheimer's disease and people with Parkinson's disease. Participants in the virtual classes were screened for balance impairments before the walk, and any person deemed at risk for falls was not eligible to participate virtually. As COVID vaccines became available and restrictions were lifted, in-person walking groups became feasible. Staff and caregivers were trained in balance management, roles/responsibilities, and delivering walking cues. Both walks, virtual and in-person, consisted of a warm up, a walk, and a cool down, and posture, gait, and safety cues were given throughout. Measures of the rate of perceived exertion (RPE) and heart rate (HR) were taken pre-warm up, post-warm up, and at 15 min, 30 min, and 45 min time points. Participants also used a walking application (app) on their phones to record the distance walked and the number of steps taken. The study showed a positive correlation between HR and RPE in both groups. The participants in the virtual group rated the walking group favorably in terms of improving their quality of life during a period of social isolation and contributing to physical, mental, and emotional well-being. The methodology shows a safe and feasible way to implement virtual and in-person walking groups for older adults with neurological diseases.

The present protocol aims to inform rehabilitation specialists and fitness instructors in safe, feasible, and evidence-based methods of delivering virtual and in-person walking classes to older adults with neurodegenerative diseases.

与我同行:为患有神经退行性疾病的老年人提供混合虚拟/面对面步行

This study presents a protocol for virtual and in-person walking groups for older adults with neurodegenerative diseases and addresses the decline in ...

A Human-machine-interface Integrating Low-cost Sensors with a Neuromuscular Electrical Stimulation System for Post-stroke Balance Rehabilitation

A stroke is caused when an artery carrying blood from heart to an area in the brain bursts or a clot obstructs the blood flow to brain thereby preventing delivery of oxygen and nutrients. About half of the stroke survivors are left with some degree of disability. Innovative methodologies for restorative neurorehabilitation are urgently required to reduce long-term disability. The ability of the nervous system to reorganize its structure, function and connections as a response to intrinsic or extrinsic stimuli is called neuroplasticity. Neuroplasticity is involved in post-stroke functional disturbances, but also in rehabilitation. Beneficial neuroplastic changes may be facilitated with non-invasive electrotherapy, such as neuromuscular electrical stimulation (NMES) and sensory electrical stimulation (SES). NMES involves coordinated electrical stimulation of motor nerves and muscles to activate them with continuous short pulses of electrical current while SES involves stimulation of sensory nerves with electrical current resulting in sensations that vary from barely perceivable to highly unpleasant. Here, active cortical participation in rehabilitation procedures may be facilitated by driving the non-invasive electrotherapy with biosignals (electromyogram (EMG), electroencephalogram (EEG), electrooculogram (EOG)) that represent simultaneous active perception and volitional effort. To achieve this in a resource-poor setting, e.g., in low- and middle-income countries, we present a low-cost human-machine-interface (HMI) by leveraging recent advances in off-the-shelf video game sensor technology. In this paper, we discuss the open-source software interface that integrates low-cost off-the-shelf sensors for visual-auditory biofeedback with non-invasive electrotherapy to assist postural control during balance rehabilitation. We demonstrate the proof-of-concept on healthy volunteers.

A novel low-cost human-machine interface for interactive post-stroke balance rehabilitation system is presented in this article. The system integrates off-the-shelf low-cost sensors towards volitionally driven electrotherapy paradigm. The proof-of-concept software interface is demonstrated on healthy volunteers.

人机界面集成的低成本传感器，具有神经肌肉电刺激系统中风后康复平衡

A stroke is caused when an artery carrying blood from heart to an area in the brain bursts or a clot obstructs the blood flow to brain thereby preventing ...

神经科学

Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis (MS). It is known that resistance strength training (RST) can improve strength in individuals with MS, however; it remains unclear the duration of RST that is needed to make strength gains and how to adapt hip strengthening exercises for individuals of varying strength using only resistance bands. This paper describes the methodology to set up and implement an adapted resistance strength training program, using resistance bands, for individuals with MS. Directions for pre- and post-strength tests to evaluate efficacy of the strength-training program are included. Safety features and detailed instructions outline the weekly program content and progression. Current evidence is presented showing that significant strength gains can be made within 8 weeks of starting a RST program. Evidence is also presented showing that resistance strength training can be successfully adapted for individuals with MS of varying strength with little equipment.

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis. Isolated muscle strengthening is a useful method to target specific weaknesses. This protocol describes a progressive resistance-training program using exercise bands to increase hip muscle strength.

改编阻力训练提高力量在八周内的个人与多发性硬化症

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis (MS). It is known that resistance strength training (RST) can ...

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in elderly people performing short-term resistance training (RET). Supervised progressive resistance training for 1 h three times a week over 8 weeks was performed by RET participants (71&#177;1 years, range 65-80). Compared to a control group without training, the RET showed improvements on the measures used to indicate strength, power, glucose tolerance, and several parameters of muscle aerobic capacity. Strength training was performed in a gym with only robust fitness equipment. An isokinetic dynamometer for knee extensor strength permitted the measurement of concentric, eccentric, and static strength, which increased for the RET group (8-12% post- versus pre-test). The power (rate of force development, RFD) at the initial 0-30 ms also showed an increase for the RET group (52%). A glucose tolerance test with frequent blood glucose measurements showed improvements only for the RET group in terms of blood glucose values after 2 h (14%) and the area under the curve (21%). The blood lipid profile also improved (8%). From muscle biopsy samples prepared using histochemistry, the amount of fiber type IIa increased, and a trend towards a decrease in IIx in the RET group reflected a change to a more oxidative profile in terms of fiber composition. Western blot (to determine the protein content related to the signaling for muscle protein synthesis) showed a rise of 69% in both Akt and mTOR in the RET group; this also showed an increase in mitochondrial proteins for OXPHOS complex II and citrate synthase (both ~30%) and for complex IV (90%), in only the RET group. We demonstrate that this type of progressive resistance training offers various improvements (e.g., strength, power, aerobic capacity, glucose tolerance, and plasma lipid profile).

The effect of short-term resistance training on elderly people was investigated through the simultaneous use of several methods. Compared to a control group, many improvements were seen, including on muscle aerobic capacity, glucose tolerance, strength, power, and muscle quality (i.e., protein involved in cell signaling and muscle fiber type composition).

通过长期进步力量训练提高力量，力量，肌肉有氧能力和葡萄糖耐量

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in ...

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. The purpose of this study is to report the physical fitness benefits of a training program for independent community-dwelling older adults using an agility ladder. Each training session lasted approximately 30 minutes, and the benefits were achieved with two sessions per week for 14 weeks. Training was timed and involved four different drills and varying levels of difficulty through time. The exercises were performed at the School of Physical Education of the University of Campinas, S&#227;o Paulo state, Brazil. The study participants (n = 16; mean age of 66.9 &#177; 5.0 years) were instructed to perform the exercises as quickly as possible without making mistakes and were assisted by a physical trainer when they made mistakes. Assessments were performed both before and after training using five functional tests (i.e., Illinois agility, five times sit-to-stand, timed up-and-go, walking usual speed, and one-leg stand). Although the study sample was not compared with a control group, the results indicate that training protocols using an agility ladder are easy and practical and improve physical function performance in older adults.

The aim of this study is to present an agility training program for older people. The feasibility of this program is described, and the training protocol demonstrated by video imaging.

一个用于社区居住老年人敏捷阶梯的培训计划

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. ...

为类风湿性关节炎患者制定锻炼计划

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) is a debilitating disease that can result in complications such as rheumatoid cachexia. While physical exercise has shown benefits for RA patients, its impact on hydration and body cell mass remains uncertain. The presence of pain, inflammation, and joint changes often restrict activity and make traditional body composition assessments unreliable due to altered hydration levels. Bioelectrical impedance is a commonly used method for estimating body composition, but it has limitations since it was primarily developed for the general population and does not consider changes in body composition. On the other hand, bioelectrical impedance vectorial analysis (BIVA) offers a more comprehensive approach. BIVA involves graphically interpreting resistance (R) and reactance (Xc), adjusted for height, to provide valuable information about hydration status and the integrity of the cell mass.
Twelve women with RA were included in this study. At the beginning of the study, hydration and body cell mass measurements were obtained using the BIVA method. Subsequently, the patients participated in a six-month dynamic exercise program encompassing cardiovascular capacity, strength, and coordination training. To evaluate changes in hydration and body cell mass, the differences in the R and Xc parameters, adjusted for height, were compared using BIVA confidence software. The results showed notable changes: resistance decreased after the exercise program, while reactance increased. BIVA, as a classification method, can effectively categorize patients into dehydration, overhydration, normal, athlete, thin, cachectic, and obese categories. This makes it a valuable tool for assessing RA patients, as it provides information independent of body weight or prediction equations. Overall, the implementation of BIVA in this study shed light on the effects of the exercise program on hydration and body cell mass in RA patients. Its advantages lie in its ability to provide comprehensive information and overcome the limitations of traditional body composition assessment methods.

作者聚焦:实施 BIVA 分析低体细胞质量患者的疾病风险因素 

This protocol assesses alterations in hydration and body cell mass status using bioelectrical impedance vectorial analysis following a dynamic exercise program designed for patients with rheumatoid arthritis. The dynamic exercise program itself is detailed, highlighting its components focused on cardiovascular capacity, strength, and coordination. The protocol details steps, instruments, and limitations.

类风湿性关节炎患者运动计划后通过生物电阻抗分析评估水合作用和体细胞质量的变化

Rheumatoid arthritis (RA) is a debilitating disease that can result in complications such as rheumatoid cachexia. While physical exercise has shown ...

老年人艾滋病感染者健身游戏平衡改善，流动性和可改善虚弱的几个问题

摘要

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基于移动游戏的上肢卒中康复虚拟现实程序

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人机界面集成的低成本传感器，具有神经肌肉电刺激系统中风后康复平衡

改编阻力训练提高力量在八周内的个人与多发性硬化症

通过长期进步力量训练提高力量，力量，肌肉有氧能力和葡萄糖耐量

一个用于社区居住老年人敏捷阶梯的培训计划

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类风湿性关节炎患者运动计划后通过生物电阻抗分析评估水合作用和体细胞质量的变化