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Inter-person differences in isometric coactivations of triceps surae and tibialis anterior decrease in young, but not in older adults after 14 days of bed rest
Matjaž Divjak, Gašper Sedej, Nina Murks, Mitja Gerževič, Uroš Marušič, Rado Pišot, Boštjan Šimunič, Aleš Holobar, 2022, original scientific article

Abstract: We examined activation patterns of the gastrocnemius medialis (GM), gastrocnemius lateralis (GL), soleus (SO), and tibialis anterior (TA) muscles in eight older (58.4 ± 3.3 years) and seven young (23.1 ± 2.9 years) participants, before and after 14 days of horizontal bed rest. Visual feedback on the exerted muscle torque was provided to the participants. The discharge patterns of individual motor units (MUs) were studied in three repetitions of isometric plantar flexion at 30 and 60% of Maximum Voluntary Contraction (MVC), before, and 1 day after the 14-day bed rest, respectively. In the GL and GM muscles, the older participants demonstrated higher MU discharge rates than the young, regardless of the contraction level, both before and after the bed rest. In the TA and SO muscles, the differences between the older and young participants were less consistent. Detailed analysis revealed person-specific changes in the MU discharge rates after the bed rest. To quantify the coactivation patterns we calculated the correlation coefficients between the cumulative spike trains of identified MUs from each muscle, and measured the root mean square difference of the correlation coefficients between the trials of the same session (intra-session variability) and between different sessions (inter-session variability) in each participant (intra-person comparison) and across participants (inter-person comparison). In the intra-person comparison, the inter-session variability was higher than the intra-session variability, either before or after the bed rest. At 60% MVC torque, the young demonstrated higher inter-person variability of coactivation than the older participants, but this variability decreased significantly after the bed rest. In older participants, inter-person variability was consistently lower at 60% than at 30% MVC torque. In young participants, inter-person variability became lower at 60% than at 30% MVC torque only after the bed rest. Precaution is required when analyzing the MU discharge and coactivation patterns, as individual persons demonstrate individual adaptations to aging or bed rest.
Keywords: high density electromyography, muscle disuse, motor units, discharge rate, aging
Published in DiRROS: 05.09.2022; Views: 76; Downloads: 34
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A data-driven machine learning approach for brain-computer interfaces targeting lower limb neuroprosthetics
Arnau Dillen, Elke Lathouwers, Aleksandar Miladinović, Uroš Marušič, Fakhredinne Ghaffari, Olivier Romain, Romain Meeusen, Kevin De Pauw, 2022, original scientific article

Abstract: Prosthetic devices that replace a lost limb have become increasingly performant in recent years. Recent advances in both software and hardware allow for the decoding of electroencephalogram (EEG) signals to improve the control of active prostheses with brain-computer interfaces (BCI). Most BCI research is focused on the upper body. Although BCI research for the lower extremities has increased in recent years, there are still gaps in our knowledge of the neural patterns associated with lower limb movement. Therefore, the main objective of this study is to show the feasibility of decoding lower limb movements from EEG data recordings. The second aim is to investigate whether well-known neuroplastic adaptations in individuals with an amputation have an influence on decoding performance. To address this, we collected data from multiple individuals with lower limb amputation and a matched able-bodied control group. Using these data, we trained and evaluated common BCI methods that have already been proven effective for upper limb BCI. With an average test decoding accuracy of 84% for both groups, our results show that it is possible to discriminate different lower extremity movements using EEG data with good accuracy. There are no significant differences (p = 0.99) in the decoding performance of these movements between healthy subjects and subjects with lower extremity amputation. These results show the feasibility of using BCI for lower limb prosthesis control and indicate that decoding performance is not influenced by neuroplasticity-induced differences between the two groups.
Keywords: neuroprosthetics, brain-computer interface, machine learning, electroencephalography, data-driven learning, lower limb amputation
Published in DiRROS: 21.07.2022; Views: 141; Downloads: 94
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Impact of motor-cognitive interventions on selected gait and balance outcomes in older adults : ǂa ǂsystematic review and meta-analysis of randomized controlled trials
Kaja Teraž, Luka Šlosar, Armin Paravlić, Eling D. de Bruin, Uroš Marušič, 2022, review article

Abstract: Background: Efficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults. Methods: Six online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00. Results: From 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585). Conclusions: This study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.
Keywords: motor-cognitive interventions, dual-task, elderly, mobility, postural control
Published in DiRROS: 21.06.2022; Views: 129; Downloads: 106
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Brain dynamics underlying preserved cycling ability in patients with Parkinson’s disease and freezing of gait
Teja Ličen, Martin Rakuša, Nicolaas I. Bohnen, Paolo Manganotti, Uroš Marušič, 2022, review article

Abstract: Parkinson’s disease (PD) is generally associated with abnormally increased beta band oscillations in the cortico-basal ganglia loop during walking. PD patients with freezing of gait (FOG) exhibit a more distinct, prolonged narrow band of beta oscillations that are locked to the initiation of movement at ∼18 Hz. Upon initiation of cycling movements, this oscillation has been reported to be weaker and rather brief in duration. Due to the suppression of the overall beta band power during cycling and its continuous nature of the movement, cycling is considered to be less demanding for cortical networks compared to walking, including reduced need for sensorimotor processing, and thus unimpaired continuous cycling motion. Furthermore, cycling has been considered one of the most efficient non-pharmacological therapies with an influence on the subthalamic nucleus (STN) beta rhythms implicative of the deep brain stimulation effects. In the current review, we provide an overview of the currently available studies and discuss the underlying mechanism of preserved cycling ability in relation to the FOG in PD patients. The mechanisms are presented in detail using a graphical scheme comparing cortical oscillations during walking and cycling in PD.
Keywords: gait, freezing of gait, Parkinson's disease, cycling, cortical oscillations, beta band
Published in DiRROS: 21.06.2022; Views: 152; Downloads: 158
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Does cognitive training improve mobility, enhance cognition, and promote neural activation?
Uroš Marušič, Joe Verghese, Jeannette R. Mahoney, 2022, original scientific article

Abstract: A close inter-relationship between mobility and cognition is reported in older adults, with improvements in gait performance noticeable after cognitive remediation in frail individuals. The aim of this study was to evaluate the efficacy of computerized cognitive training (CCT) on mobility in healthy, independently living older adults, and to determine whether CCT is associated with changes in neural activation for mobility-related brain processes. Using a randomized single-blind control design, sixty-three non-demented adults age 60 y and older (mean age = 67 y; 76% female, mean Montreal Cognitive Assessment [MoCA] score = 27) were recruited from a local Senior Activity Center. Participants were randomly assigned to either a 2-month CCT program (8 weeks, 3x/week, 40 min/session) or a wait-list control group. Primary outcome was self-selected gait speed during single- and dual-task walking. Secondary outcome was executive function on Trail Making Test (TMT), Part B. Neural activity was assessed via electroencephalography/event-related potentials (EEG/ERPs) targeting lower-limb performance. Results from a linear mixed effect model, adjusted for baseline MoCA score, age, gender, and study completion revealed that compared to controls, CCT improved gait speed during the dual-task (p = 0.008) but not during the single-task walking condition (p = 0.057). CCT also improved executive function (p = 0.024). Further, shorter foot reaction time responses (p = 0.019) were found with enhanced neural activation over sensorimotor areas, with shorter ERP latencies during the P2 component (p = 0.008) and enhanced motor responses (p = 0.009) also evident in the CCT group after the intervention. Overall, the electrophysiological findings suggest possible neural adaptations that could explain improvements in mobility and executive functions associated with CCT in healthy older adults.
Keywords: visual evoked potentials, motor-related cortical potentials, executive control, cognitive-motor brain networks, healthy aging, sensorimotor integration, functional mobility
Published in DiRROS: 24.05.2022; Views: 176; Downloads: 151
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Neural bases of age-related sensorimotor slowing in the upper and lower limbs
Uroš Marušič, Manca Peskar, Kevin De Pauw, Nina Omejc, Gorazd Drevenšek, Bojan Rojc, Rado Pišot, Voyko Kavcic, 2022, original scientific article

Abstract: With advanced age, there is a loss of reaction speed that may contribute to an increased risk of tripping and falling. Avoiding falls and injuries requires awareness of the threat, followed by selection and execution of the appropriate motor response. Using event-related potentials (ERPs) and a simple visual reaction task (RT), the goal of our study was to distinguish sensory and motor processing in the upper- and lower-limbs while attempting to uncover the main cause of age-related behavioral slowing. Strength (amplitudes) as well as timing and speed (latencies) of various stages of stimulus- and motor-related processing were analyzed in 48 healthy individuals (young adults, n = 24, mean age = 34 years; older adults, n = 24, mean age = 67 years). The behavioral results showed a significant age-related slowing, where the younger compared to older adults exhibited shorter RTs for the upper- (222 vs. 255 ms; p = 0.006, respectively) and the lower limb (257 vs. 274 ms; p = 0.048, respectively) as well as lower variability in both modalities (p = 0.001). Using ERP indices, age-related slowing of visual stimulus processing was characterized by overall larger amplitudes with delayed latencies of endogenous potentials in older compared with younger adults. While no differences were found in the P1 component, the later components of recorded potentials for visual stimuli processing were most affected by age. This was characterized by increased N1 and P2 amplitudes and delayed P2 latencies in both upper and lower extremities. The analysis of motor-related cortical potentials (MR) revealed stronger MRCP amplitude for upper- and a non-significant trend for lower limbs in older adults. The MRCP amplitude was smaller and peaked closer to the actual motor response for the upper- than for the lower limb in both age groups. There were longer MRCP onset latencies for lower- compared to upper-limb in younger adults, and a non-significant trend was seen in older adults. Multiple regression analyses showed that the onset of the MRCP peak consistently predicted reaction time across both age groups and limbs tested. However, MRCP rise time and P2 latency were also significant predictors of simple reaction time, but only in older adults and only for the upper limbs. Our study suggests that motor cortical processes contribute most strongly to the slowing of simple reaction time in advanced age. However, late-stage cortical processing related to sensory stimuli also appears to play a role in upper limb responses in the elderly. This process most likely reflects less efficient recruitment of neuronal resources required for the upper and lower extremity response task in older adults.
Keywords: aging, sensoriomotor integration, event-related potential, finger and foot responses, motor-related cortical potential
Published in DiRROS: 04.05.2022; Views: 153; Downloads: 168
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A perspective on implementation of technology-driven exergames for adults as telerehabilitation services
Cécil J. W. Meulenberg, Eling D. de Bruin, Uroš Marušič, 2022, review article

Abstract: A major concern of public health authorities is to also encourage adults to be exposed to enriched environments (sensory and cognitive-motor activity) during the pandemic lockdown, as was recently the case worldwide during the COVID-19 outbreak. Games for adults that require physical activity, known as exergames, offer opportunities here. In particular, the output of the gaming industry nowadays offers computer games with extended reality (XR) which combines real and virtual environments and refers to human-machine interactions generated by computers and wearable technologies. For example, playing the game in front of a computer screen while standing or walking on a force plate or treadmill allows the user to react to certain infrastructural changes and obstacles within the virtual environment. Recent developments, optimization, and minimizations in wearable technology have produced wireless headsets and sensors that allow for unrestricted whole-body movement. This makes the virtual experience more immersive and provides the opportunity for greater engagement than traditional exercise. Currently, XR serves as an umbrella term for current immersive technologies as well as future realities that enhance the experience with features that produce new controllable environments. Overall, these technology-enhanced exergames challenge the adult user and modify the experience by increasing sensory stimulation and creating an environment where virtual and real elements interact. As a therapy, exergames can potentially create new environments and visualizations that may be more ecologically valid and thus simulate real activities of daily living that can be trained. Furthermore, by adding telemedicine features to the exergame, progress over time can be closely monitored and feedback provided, offering future opportunities for cognitive-motor assessment. To more optimally serve and challenge adults both physically and cognitively over time in future lockdowns, there is a need to provide long-term remote training and feedback. Particularly related to activities of daily living that create opportunities for effective and lasting rehabilitation for elderly and sufferers from chronic non-communicable diseases (CNDs). The aim of the current review is to envision the remote training and monitoring of physical and cognitive aspects for adults with limited mobility (due to disability, disease, or age), through the implementation of concurrent telehealth and exergame features using XR and wireless sensor technologies.
Keywords: older adults, telemedicine, virtual reality, rehabilitation, active video games
Published in DiRROS: 17.03.2022; Views: 204; Downloads: 172
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Removal of movement-induced EEG artifacts : current state of the art and guidelines
Daša Gorjan, Klaus Gramann, Kevin De Pauw, Uroš Marušič, 2022, review article

Abstract: Electroencephalography (EEG) is a non-invasive technique used to record cortical neurons' electrical activity using electrodes placed on the scalp. It has become a promising avenue for research beyond state-of-the-art EEG research that is conducted under static conditions. EEG signals are always contaminated by artifacts and other physiological signals. Artifact contamination increases with the intensity of movement. In the last decade (since 2010), researchers have started to implement EEG measurements in dynamic setups to increase the overall ecological validity of the studies. Many different methods are used to remove non-brain activity from the EEG signal, and there are no clear guidelines on which method should be used in dynamic setups and for specific movement intensities. Currently, the most common methods for removing artifacts in movement studies are methods based on independent component analysis (ICA). However, the choice of method for artifact removal depends on the type and intensity of movement, which affects the characteristics of the artifacts and the EEG parameters of interest. When dealing with EEG under non-static conditions, special care must be taken already in the designing period of an experiment. Software and hardware solutions must be combined to achieve sufficient removal of unwanted signals from EEG measurements. We have provided recommendations for the use of each method depending on the intensity of the movement and highlighted the advantages and disadvantages of the methods. However, due to the current gap in the literature, further development and evaluation of methods for artifact removal in EEG data during locomotion is needed.
Published in DiRROS: 01.03.2022; Views: 190; Downloads: 182
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