FRAILTY A KEY RISK FACTOR FOR DEMENTIA

Researchers at Dalhousie University have found that frailty, more so than amyloid plaques and tangles in the brain, is a key risk factor for developing Alzheimer’s disease and other forms of dementia.

PhD candidate Lindsay Wallace, lead author, and her supervisor Dr. Kenneth Rockwood, are optimistic their findings will be influential, as they were published this week in Lancet Neurology — one of the highest-impact journals in the field.

This study is the first to examine amyloid plaques and tangles in post-mortem brain tissues, in relation to both the subjects’ frailty index and the severity of their dementia symptoms when they were alive. The frailty index is a score of relative frailty based on the accumulation of deficits in physical health and ability to function.

Full story at Dalhousie University News

Children with cerebral palsy to benefit from ‘artificial muscles’

A team of researchers from the University of Delaware has received nearly $200,000 in start-up funding to develop a motorized ankle foot device for children with cerebral palsy (CP) that includes a novel artificial muscle.

The brace is the first lower extremity device designed to correct alignment or provide support using soft muscle-like “smart materials,” known as dielectric elastomer actuators, that contract in response to electric current.

Made from off-the-shelf elastic materials, these artificial muscles closely mimic the function of the body’s skeletal muscle and can help children with CP that struggle to complete a range of motion under their own power. The device is lightweight, compact and noiseless, too, reducing the size of the orthosis needed while increasing the wearer’s degree of freedom in movement — a vast improvement over heavier, more rigid technologies.

Full story at news-medical.net

Magic-themed Therapy May Help Hand and Arm Function in Children with Unilateral Cerebral Palsy, Study Says

A type of intensive therapy that asks children with unilateral cerebral palsy (CP) to learn and practice magic tricks may help improve their hand and arm function and enhance their ability to do everyday tasks, a study reports.

The study, “Upper Limb Function of Children with Unilateral Cerebral Palsy After a Magic-Themed HABIT: A Pre-Post-Study with 3- and 6-Month Follow-Up,” was published in the Journal of Physical & Occupational Therapy in Pediatrics.

Children with unilateral CP have movement limitations mainly on one side of the body, affecting their ability to perform daily activities that require the use and coordination of both hands.

Hand-arm bimanual intensive therapy, or HABIT, is based on the principles of motor learning theory and neuroplasticity through structured, playful, and activity-based tasks involving two hands. HABIT includes motor learning principles of task selection, a structured practice of grading tasks, feedback, and home practice. In this way, children are engaged in fun activities and supportive environments that are different from typical therapy.

Full story at Cerebral Palsy News Today

Systematic Review: LBP Studies Make the Case for Early Physical Therapy

Authors of a new systematic review of 11 studies on low back pain (LBP) have found that despite sometimes-wide variation in research design, a picture of the value of early physical therapy for the condition is emerging—and the results are encouraging.

According to the review, e-published ahead of print in the Archives of Physical Medicine and Rehabilitation, evidence supports the cost-effectiveness and better patient outcomes of early physical therapy over later physical therapy for LBP, and even points to a correlation between early physical therapy and lower rates of opioid prescription overall. As for utilization and costs associated with early physical therapy versus so-called “usual care” (UC)? Early treatment by a physical therapist (PT) adhering to APTA guidelines could make a positive difference there as well, authors say, but that’s a harder question to answer definitively until studies become more uniform in terminology and design.

Full story at APTA

Shedding light on spinal cord injuries

Thousands of people worldwide suffer severe spinal cord injuries each year, but little is known about why these injuries often continue to deteriorate long after the initial damage occurs.

Yi Ren, a professor of biomedical sciences at the Florida State University College of Medicine, is making progress in understanding why such significant harm is inflicted in the weeks and months after a spinal injury. In a study published today in the journal Nature Neuroscience, Ren explained how a natural immune system response may contribute to additional injury.

When spinal cord damage occurs, the endothelial cells that line blood vessels are activated to remove potentially harmful material, like myelin debris, from the site of the injury. However, Ren and her team discovered that this process may be responsible for causing further harm.

“The consequences of the effort of endothelial cells to clear myelin debris is often severe, contributing to post-traumatic degeneration of the spinal cord and to the functional disabilities often associated with spinal cord injuries,” said Ren, whose team conducted the study over a period of five years.

Full story at Science Daily

UTHealth enrolls first U.S. patient in novel stem cell trial to treat stroke disability

The first U.S. patient to participate in a global study of a stem cell therapy injected directly into the brain to treat stroke disability was enrolled in the clinical trial this week at The University of Texas Health Science Center at Houston (UTHealth).

“At McGovern Medical School at UTHealth, we have been studying cellular therapies as a novel treatment for stroke over the past 10 years. We are very excited to partner with ReNeuron and enroll the first patient into the PISCES III study,” said Sean I. Savitz, MD, the study’s global principal investigator and professor and director of the Institute for Stroke and Cerebrovascular Disease at UTHealth. “This study represents an important next step in the development of novel cellular therapies for chronic stroke and, to date, is the most advanced clinical trial to determine whether neural stem cells improve recovery in patients chronically disabled by stroke.”

Full story at news-medical.net

Study: Physical Activity and Higher Motor Skills Create a ‘Cognitive Reserve’ Even When Brain Pathologies Are Present

New research combining postmortem examination of brain tissue with testing during life has revealed what researchers believe to be an as-yet unexplained connection: higher levels of physical activity (PA) and motor skills seem to create a “cognitive reserve” that buoys cognitive performance during life, even in the presence of Alzheimer’s disease (AD), Lewy body disease, and other brain pathologies associated with dementia.

For the study, published ahead of print in Neurology, researchers examined brain tissue from 454 participants involved in the Rush Memory and Aging Project (MAP). The subjects participated in a battery of annual clinical assessments and agreed to brain donation at the time of death. The clinical tests included 21 cognitive assessments, an analysis of 10 motor abilities, and an estimation of total daily PA drawn from accelerometers worn constantly for 10 days (researchers in this study used only the first 7 days’ data).

Full story at APTA

Children with disabilities reach their peak potential through rock climbing

These kids are determined, motivated and utterly excited to rock climb. They’ve learned nothing will stop them — not even a disability. 11-year-old Rachel uses crutches.

“It feels so good and perfect for me,” she said. “It’s actually really fun and helps my legs a lot.”

Eight-year-old Chanel can’t walk, yet she seems to fly up the wall.

“This program has to be the single most fulfilling thing in my entire life,” said Peak Potential founder Dr. Jenfu Cheng.

About 18 years ago, avid climber and medical doctor Cheng founded Peak Potential, an organization that provides adaptive rock climbing to children with disabilities.

Full story at njtvonline.org

Draft HHS Report Backs Nonpharmacological Pain Management, Calls for Better Payer Coverage of Physical Therapy

Much like an APTA white paper on opioids and pain management published in the summer of 2018, a draft report from the US Department of Health and Human Services (HHS) says that it’s time to address the gaps in the health care system that make it difficult to follow best practices in addressing pain—including improved access to and payment for physical therapy. APTA provided comments to the HHS task force that created the report.

The draft “Report on Pain Management Best Practices” now available for public comment aims to identify “gaps, inconsistencies, updates, and recommendations for acute and chronic pain management best practices” across 5 major interdisciplinary treatment modalities: medication, restorative therapies including physical therapy, interventional procedures, behavioral health approaches, and complementary and integrative health. The entire report is predicated on a set of “key concepts” that emphasize an individualized biopsychosocial model of care that employs a multidisciplinary approach and stresses the need for innovation and research.

Full story at APTA

Can exercise lower blood pressure as effectively as drugs?

Millions of people live with high blood pressure, which can place them at risk of developing cardiovascular diseases. For this condition, doctors typically prescribe blood-lowering drugs, but could exercise help just as well?

According to the Centers for Disease Control and Prevention (CDC), approximately 75 millionadults in the United States have to manage high blood pressure, where it exceeds the threshold of 140 millimeters of mercury (mm Hg).

The condition can increase their risk of developing heart disease or experiencing a stroke, both of which are leading causes of death in the U.S.

Full story at Medical News Today