N. R. was supported by a research fund from Shahid Beheshti University of Medical Sciences and Health Services. S. G. S. was supported by NIDCD R03 DC015091 grant.

The data presented here and previously published3 were obtained by studies carried out in accordance with the recommendations of the Ethics Committee of Shahid Beheshti University of Medical Sciences, Tehran, Iran and a protocol that was approved by the Institutional Review Board of the University.
1. Participant screening and preparation
<ol>
	<li>Recruit participants who have had a history of balance problems for more than one year. 
	NOTE: Vestibular compensation happens most effectively over the first month after a lesion. The one year timepoint was chosen to provide enough time for natural compensation to reach its plateau and also ensure that the patient does not have a fluctuating vestibular disorder.</li>
	<li>Use the following exclusion criteria for patients:
	<ol>
		<li>History of central nervous system problems (e.g., head trauma, stroke, brain tumor, etc.) that may affect the central vestibular pathways, which are required for proper compensation.</li>
		<li>Diagnosed with a fluctuating vestibular disorder (e.g., benign paroxysmal positional vertigo [BPPV] or Meniere&#8217;s disease).</li>
		<li>Patients using other forms of vestibular rehabilitation or types of physical activity (e.g., athletes) that may improve vestibular compensation independent of the unidirectional rotation rehabilitation should be excluded. 
		NOTE: This criterion is suggested only for research purposes and to control for extraneous variables.</li>
	</ol>
	</li>
	<li>Do not limit participants based on age or gender. 
	NOTE: Similar to other compensation, this rehabilitation method is expected to have less pronounced effects in older subjects.</li>
	<li>Instruct participants to refrain from using any medications that suppress the central nervous system, including antihistamines or any anti-vertigo drugs for at least 1 day prior to each experimental session.</li>
	<li>Instruct participants not to use any nervous system stimulants, including amphetamines and caffeine for at least 1 day prior to each experimental session.</li>
	<li>Instruct participants to refrain from drinking alcoholic beverages in quantities that impair normal functioning, as this can interfere with functioning of the vestibular system and affect the results.</li>
</ol>
2. Measurement of the vestibulo-ocular reflex (VOR)
<ol>
	<li>Use either videonystagmography (VNG) or electronystagmography (ENG) to measure the VOR response during whole-body rotation. 
	NOTE: The data presented in the results section was recorded by ENG. The current equipment shown in the movie uses VNG.</li>
	<li>Perform all recordings in the dark, with the head positioned 30&#176; nose-down. 
	NOTE: For visualization purposes, the associated video is not performed in the dark.</li>
	<li>Ask participants to sit in the rotary chair, secure them in the chair with the harness, put the infrared goggles on, and fix the head in the headrest at a ~30&#176; nose-down position.</li>
	<li>After participants acclimate to the dark, calibrate the eye signal by asking them to look at laser targets that are projected on the wall at &#177;10&#176; angles (e.g., to the right, left, above, and below midline).</li>
	<li>Begin running the protocol once the eye tracker is calibrated accurately, when the subjects are ready.</li>
	<li>Keep subjects alert and distracted during all vestibular testing by asking them questions or having them do mental arithmetic (e.g., count backwards from 100).</li>
</ol>
3. Unidirectional rotation stimulus
<ol>
	<li>With the subject seated in the rotary chair, use a unidirectional rotation that consists of an asymmetric triangular velocity profile with an acceleration of 80&#176;/s2 over 4 s to reach a maximum velocity of 320&#176;/s, then slowly decelerate at 10&#176;/s2 to stop in about 30 s. 
	NOTE: The slow deceleration is particularly important in order to have a smooth stop in order to avoid stimulating the opposite side.</li>
	<li>Perform five such rotations with 1 min intervals. The five rotations together are considered a rehabilitation session (Figure 1B).</li>
	<li>Keep the subject in the chair after the last unidirectional rotation to test the symmetry with a bidirectional sinusoidal harmonic acceleration (SHA) rotation test at 40 min and 70 min post-unidirectional rotation. 
	NOTE: Keeping the patient in the chair will decrease the variability.</li>
	<li>Perform the SHA test using a wide range of sinusoidal rotations at frequencies of 0.05 Hz, 0.2 Hz, and 0.8 Hz, with a peak velocity of 60&#176;/s. 
	NOTE: For data presented in the results, a sinusoidal rotation at 0.2 Hz (40&#176;/s) was used for all evaluations.</li>
</ol>
4. Experiment design
<ol>
	<li>Evaluate subjects with a full battery of vestibular tests during the initial session (see below) in order to test VOR asymmetry and rule out any central problems.</li>
	<li>One week later, expose the subjects to the unidirectional rotation and an SHA test (steps 3.1&#8211;3.4).</li>
	<li>Repeat this process&#160;2x per week during the first 2 weeks, then 1x per week for the next 2 weeks (for a total of six sessions).</li>
	<li>Administer an SHA test at the beginning (step 3.4) and end (steps 3.3 and 3.4) of each session and calculate the directional preponderance (DP) as a measure of asymmetry: 
	<img alt="Equation" src="/files/ftp_upload/60053/60053eq1.jpg" /> 
	Where: VHR and VLR represent peak eye velocities during rotations toward the side with higher responses (HR) and lower responses (LR), respectively. 
	NOTE: The directional preponderance provides a normalized measure of the difference in peak eye velocity for rotations in the two directions. While it is mainly used for measuring asymmetry in caloric responses, it can be (and is) used for quantifying VOR asymmetry in SHA24,25,26,27,28.</li>
	<li>As the final session, perform another SHA test (step 3.4) 1 week after the last rehabilitation session.</li>
</ol>
5. Sessions details
<ol>
	<li>Initial session
	<ol>
		<li>During the first visit, take a brief history of the patient&#8217;s imbalance problems to verify the duration of vestibular asymmetry and ensure no indication of a fluctuating disorder.</li>
		<li>Perform a complete set of vestibular tests, including saccades, smooth pursuit, optokinetic, gaze holding, positional and positioning, caloric, and rotational tests.</li>
		<li>Only recruit patients with VOR asymmetry during rotation who have clear abnormal directional preponderance (DP), typically with asymmetry values of more than 10%. This will be considered the initial (baseline) DP for each subject. 
		NOTE: Different equipment might provide different normal ranges and it is best to use the range specified for your device or to base the normal range on lab-specific normative data.</li>
		<li>Clearly explain to the subjects the procedure of unidirectional rotation (5x in one session) and the total number of sessions (six times total).</li>
		<li>Ask subjects to sign a consent form that has been approved by the local Institutional Review Board (or equivalent, for experiments performed outside of the United States), while clearly informing them that they can drop out of the study at any point and for any reason.</li>
	</ol>
	</li>
	<li>Unidirectional rotation sessions (six sessions)
	<ol>
		<li>Expose subjects to the unidirectional rotation (steps 3.1&#8211;3.4) during six sessions (steps 4.3 and 4.4).</li>
		<li>At the beginning of each rehabilitation session, perform an SHA test (step 3.4) and calculate the DP value. 
		NOTE: This will provide the pre-rehabilitation DP for that session and long-term post-rehabilitation DP for the previous session.</li>
		<li>Do not perform the unidirectional rotational rehabilitation if the pre-rehabilitation DP value falls in the normal range (&#60;10%) in any of the sessions and instruct the subject to return for the next session.</li>
		<li>If the pre-rehabilitation DP is in the abnormal range, wait 5 min after the SHA test and perform the unidirectional rotational rehabilitation.</li>
		<li>Perform a second SHA test 40 min and 70 min after the end of unidirectional rotation rehabilitation (step 3.4) and calculate the post-rehabilitation DP for this session.</li>
		<li>Instruct the subjects to return for the next session.</li>
	</ol>
	</li>
	<li>Final session (week seven)
	<ol>
		<li>Perform an SHA test only (step 3.4) and calculate the DP value. 
		NOTE: This will serve as the final asymmetry measurement.</li>
		<li>Do not use unidirectional rotation in this&#160;session.</li>
	</ol>
	</li>
</ol>

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L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rehabilitation+outcome+in+home-based+versus+supervised+exercise+programs+for+chronically+dizzy+patients.">Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients.</a> Archives of Gerontology and Geriatrics. 51 (3), 264-267 (2010).</li><li>Topuz, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+vestibular+rehabilitation+on+chronic+unilateral+vestibular+dysfunction.">Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction.</a> Clinical Rehabilitation. 18 (1), 76-83 (2004).</li><li>Black, F. O., Pesznecker, S. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Vestibular+adaptation+and+rehabilitation.">Vestibular adaptation and rehabilitation.</a> Current Opinion in Otolaryngological Head and Neck Surgery. 11 (5), 355-360 (2003).</li></ol>

The authors have nothing to disclose.

The rehabilitation method presented here consists of repeated unidirectional rotations in the dark toward the less responsive (LR) side in patients with vestibular imbalance and VOR asymmetry. Most rehabilitation techniques enhance multisensory integration in order to improve balance16,17,18,19,20. The method presented here targets the vestibular pathway, and ...

Vestibular dysfunction is a common disorder with a prevalence of ~35% in adults above 40 years old1. Most vestibular disorders result in an asymmetry between input from both sides, resulting in an illusion of rotation called vertigo. In the absence of normal vestibular function, even simple daily activities can be challenging. Vestibular dysfunction is often quantified by the vestibulo-ocular reflex (VOR). During natural activities, such as walking or running, the VOR moves the eyes in the opposite direction&#160;and with the same velocity as head movement. This reflex has a short latency of ~5 ms, and it is mediated in the horizontal plane through a simple, three-neuron arc2. The information travels from vestibular receptors to the vestibular nuclei, then to the abducens motor neurons. These eye movements result in stabilization of horizontal gaze during daily activities. The symmetry of the VOR in response to clockwise and counterclockwise rotations is an important test of vestibular function.
Unilateral vestibular dysfunction produces central compensatory changes and centrally driven peripheral changes to overcome defective asymmetric VOR and resulting vestibular imbalance. Even after permanent vestibular lesions, such as a unilateral vestibular neurectomy, the vertigo and accompanying symptoms improve over a short period (days to weeks) of time. Due to this ability, the vestibular system has been a model for studying adaptation and compensation in neural pathways. It has been previously shown3 that changes in central vestibular pathways can be implemented by a unidirectional rotation based on a hypothesis proposed by one of the authors (N.R.) about 20 years ago. Other studies have also shown compensatory changes in different parts of the sensory pathway, including the vestibular nuclei (VN)4,5,6,7,8, commissural pathways between the VN on both sides9, cerebellar inputs10, and the vestibular periphery11. These compensatory changes result in a new balance in the activity of VN neurons on both sides.
Despite the impressive ability of the vestibular system to compensate for asymmetric inputs from the two ears, research has shown that responses to fast movements are never fully compensated12,13. It is now known that natural vestibular compensation does not use the full capacity of the system, and the compensated VOR response can be improved in animals that have participated in visual-vestibular training14,15. It has long been known that vestibular rehabilitation exercises improve the compensation in patients with chronic imbalance problems by enhancing the (non-vestibular) multisensory nature of balance control16,17,18,19,20,21. The goal of these vestibular rehabilitation exercises is to use physiological or behavioral approaches to improve symptoms as well as a patient&#39;s quality of life and independence22,23.
Described herein is a rehabilitation method that uses unidirectional rotations toward the &#34;weaker&#34; side (Figure 1A). The basic idea for this method comes from Hebbian plasticity, in which neural connections become stronger when they are stimulated. This method specifically modifies vestibular inputs rather than enhancing multisensory integration, which is the basis for other vestibular rehabilitation exercises. Previous research has shown that unidirectional rotations decreases VOR asymmetry in 1-2 sessions in patients with unilateral vestibular dysfunction3. This effect was mainly due to an increase in the activity of the side with a lower response (LR), as well as a slight decrease in the activity of the side with a higher response (HR). This change is most likely mediated by modifications in the central pathways (e.g., strengthening of afferent pathways, such as VN connections or changes in commissural inputs). In effect, this technique may be used as a supervised method for vestibular rehabilitation in those with longstanding vestibular asymmetry.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>VEST operating and analysis software</td>
			<td>NeuroKinetics</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Electronystagmograph</td>
			<td>Nicolet</td>
			<td>Spirit Model 1992</td>
			<td>Equipment used for collecting the data presented in the Results section</td>
		</tr>
		<tr>
			<td>I-Portal NOTC (Neurotologic Test Center)</td>
			<td>NeuroKinetics</td>
			<td></td>
			<td>Equipment shown for current studies and shown in the movie</td>
		</tr>
	</tbody>
</table>

using unidirectional rotations to improve vestibular system asymmetry in patients with vestibular dysfunction

The vestibular system provides information about head movement and mediates reflexes that contribute to balance control and gaze stabilization during daily activities. Vestibular sensors are located in the inner ear on both sides of the head and project to the vestibular nuclei in the brainstem. Vestibular dysfunction is often due to an asymmetry between input from the two sides. This results in asymmetrical neural inputs from the two ears, which can produce an illusion of rotation, manifested as vertigo. The vestibular system has an impressive capacity for compensation, which serves to rebalance how asymmetrical information from the sensory end organs on both sides is processed at the central level. To promote compensation, various rehabilitation programs are used in the clinic; however, they primarily use exercises that improve multisensory integration. Recently, visual-vestibular training has also been used to improve the vestibulo-ocular reflex (VOR) in animals with compensated unilateral lesions. Here, a new method is introduced for rebalancing the vestibular activity on both sides in human subjects. This method consists of five unidirectional rotations in the dark (peak velocity of 320&#176;/s) toward the weaker side. The efficacy of this method was shown in a sequential, double-blinded clinical trial in 16 patients with VOR asymmetry (measured by the directional preponderance in response to sinusoidal rotations). In most cases, VOR asymmetry decreased after a single session, reached normal values within the first two sessions in one week, and the effects lasted up to 6 weeks. The rebalancing effect is due to both an increase in VOR response from the weaker side and a decrease in response from the stronger side. The findings suggest that unidirectional rotation can be used as a supervised rehabilitation method to reduce VOR asymmetry in patients with longstanding vestibular dysfunction.

Short-term effects of the unidirectional rotation were evaluated by measuring the VOR with a 0.2 Hz (40&#176;/s) sinusoidal rotation test at 70 min after rehabilitation3. Figure 2 shows the peak eye velocities during the VOR responses to rotations in the two directions (Figure 2A) and the change in the DP (Figure 2B). Following unidirectional rotation, the response to rotation...

Watch this Scientific Journal Video about Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction at JoVE.com

Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction

A new rehabilitation method is presented for rebalancing the vestibular system in patients with asymmetric responses, which consists of unidirectional rotations toward the weaker side. By directly modifying the vestibular pathway rather than enhancing the multisensory aspects of compensation, asymmetry can be normalized within 1-2 sessions and show lasting effects.

The vestibular system provides information about head movement and mediates reflexes that contribute to balance control and gaze stabilization during ...

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Behavior

7.1K Views.  Shahid Beheshti University of Medical Sciences and Health Services. A new rehabilitation method is presented for rebalancing the vestibular system in patients with asymmetric responses, which consists of unidirectional rotations toward the weaker side. By directly modifying the vestibular pathway rather than enhancing the multisensory aspects of compensation, asymmetry can be normalized within 1-2 sessions and show lasting effects. 

Video: Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction

Behavioral Assessment of the Aging Mouse Vestibular System

Age related decline in balance performance is associated with deteriorating muscle strength, motor coordination and vestibular function. While a number of studies show changes in balance phenotype with age in rodents, very few isolate the vestibular contribution to balance under either normal conditions or during senescence. We use two standard behavioral tests to characterize the balance performance of mice at defined age points over the lifespan: the rotarod test and the inclined balance beam test. Importantly though, a custom built rotator is also used to stimulate the vestibular system of mice (without inducing overt signs of motion sickness). These two tests have been used to show that changes in vestibular mediated-balance performance are present over the murine lifespan. Preliminary results show that both the rotarod test and the modified balance beam test can be used to identify changes in balance performance during aging as an alternative to more difficult and invasive techniques such as vestibulo-ocular (VOR) measurements.

Motor control and balance performance are known to deteriorate with age. This paper presents a number of standard noninvasive behavioral tests with the addition of a simple rotary stimulus to challenge the vestibular system and show changes in balance performance in a murine model of aging.

Age related decline in balance performance is associated with deteriorating muscle strength, motor coordination and vestibular function. While a number of ...

Uncovering Beat Deafness: Detecting Rhythm Disorders with Synchronized Finger Tapping and Perceptual Timing Tasks

A set of behavioral tasks for assessing perceptual and sensorimotor timing abilities in the general population (i.e., non-musicians) is presented here with the goal of uncovering rhythm disorders, such as beat deafness. Beat deafness is characterized by poor performance in perceiving durations in auditory rhythmic patterns or poor synchronization of movement with auditory rhythms (e.g., with musical beats). These tasks include the synchronization of finger tapping to the beat of simple and complex auditory stimuli and the detection of rhythmic irregularities (anisochrony detection task) embedded in the same stimuli. These tests, which are easy to administer, include an assessment of both perceptual and sensorimotor timing abilities under different conditions (e.g., beat rates and types of auditory material) and are based on the same auditory stimuli, ranging from a simple metronome to a complex musical excerpt. The analysis of synchronized tapping data is performed with circular statistics, which provide reliable measures of synchronization accuracy (e.g., the difference between the timing of the taps and the timing of the pacing stimuli) and consistency. Circular statistics on tapping data are particularly well-suited for detecting individual differences in the general population. Synchronized tapping and anisochrony detection are sensitive measures for identifying profiles of rhythm disorders and have been used with success to uncover cases of poor synchronization with spared perceptual timing. This systematic assessment of perceptual and sensorimotor timing can be extended to populations of patients with brain damage, neurodegenerative diseases (e.g., Parkinson&#8217;s disease), and developmental disorders (e.g., Attention Deficit Hyperactivity Disorder).

Behavioral tasks that allow for the assessment of perceptual and sensorimotor timing abilities in the general population (i.e., non-musicians) are presented. Synchronization of finger tapping to the beat of an auditory stimuli and detecting rhythmic irregularities provides a means of uncovering rhythm disorders.

A set of behavioral tasks for assessing perceptual and sensorimotor timing abilities in the general population (i.e., non-musicians) is presented here ...

Assessment of Murine Exercise Endurance Without the Use of a Shock Grid: An Alternative to Forced Exercise

Using laboratory mouse models, the molecular pathways responsible for the metabolic benefits of endurance exercise are beginning to be defined. The most common method for assessing exercise endurance in mice utilizes forced running on a motorized treadmill equipped with a shock grid. Animals who quit running are pushed by the moving treadmill belt onto a grid that delivers an electric foot shock; to escape the negative stimulus, the mice return to running on the belt. However, avoidance behavior and psychological stress due to use of a shock apparatus can interfere with quantitation of running endurance, as well as confound measurements of postexercise serum hormone and cytokine levels. Here, we demonstrate and validate a refined method to measure running endurance in na&#239;ve C57BL/6 laboratory mice on a motorized treadmill without utilizing a shock grid. When mice are preacclimated to the treadmill, they run voluntarily with gait speeds specific to each mouse. Use of the shock grid is replaced by gentle encouragement by a human operator using a tongue depressor, coupled with sensitivity to the voluntary willingness to run on the part of the mouse. Clear endpoints for quantifying running time-to-exhaustion for each mouse are defined and reflected in behavioral signs of exhaustion such as splayed posture and labored breathing. This method is a humane refinement which also decreases the confounding effects of stress on experimental parameters.

A method to assess exercise endurance in laboratory mice without the use of a shock grid is demonstrated. This method is a humane refinement that can decrease the confounding effects of stress on experimental parameters.

Using laboratory mouse models, the molecular pathways responsible for the metabolic benefits of endurance exercise are beginning to be defined. The most ...

Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to progressive loss of motor and speech abilities. In addition, cognitive functions are impaired in a subset of patients. To evaluate these potential deficits in severely physically impaired ALS patients, eye-tracking is a promising means to conduct cognitive tests. The present article focuses on how eye movements, an indirect means of communication for physically disabled patients, can be utilized to allow for detailed neuropsychological assessment. The requirements, in terms of oculomotor parameters that have to be met for sufficient eye-tracking in ALS patients are presented. The properties of stimuli, including type of neuropsychological tests and style of presentation, best suited to successfully assess cognitive functioning, are also described. Furthermore, recommendations regarding procedural requirements are provided. Overall, this methodology provides a reliable, easy to administer and fast approach for assessing cognitive deficits in patients who are unable to speak or write such as patients with severe ALS. The only confounding factor might be deficits in voluntary eye movement control in a subset of ALS patients.

Cognitive deficits are common in about one third of patients with amyotrophic lateral sclerosis, a neurological condition leading to progressive impairments in speech and movement abilities. To conduct cognitive tests in patients unable to speak or write a reliable and easy to administer eye-tracking paradigm was developed.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to ...

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation

Failed back surgery syndrome (FBSS) refers to persistent, chronic pain following spinal surgery. Spinal cord stimulation with dorsal epidural leads can be used to treat back and leg pain in FBSS patients. This paper presents a detailed protocol for using spinal cord stimulation with surgical leads in FBSS patients. In our department, with the patient under general anesthesia, we place the lead in the epidural space by means of a small laminectomy at the 10th thoracic level. Placement of the lead is followed by a 1 month trial period with an externalized lead. If pain relief is greater than 50% at the end of this 1 month stimulation trial (required by Belgian reimbursement criteria), an internal pulse generator is then placed under the skin and connected to the lead in a second surgical procedure. We have demonstrated that using this technique in rigorously selected FBSS patients can significantly improve back pain, leg pain, patient activity, and quality of life for a sustained period of time.

This paper presents a method that uses spinal cord stimulation with a multicolumn lead to treat neuropathic low back pain in failed back surgery patients.

Failed back surgery syndrome (FBSS) refers to persistent, chronic pain following spinal surgery. Spinal cord stimulation with dorsal epidural leads can be ...

Recording Horizontal Saccade Performances Accurately in Neurological Patients Using Electro-oculogram

Electro-oculogram (EOG) has been widely used for clinical eye movement recording, especially horizontal saccades, although the video-oculography (VOG) has largely taken the place of it nowadays due to its higher spatial accuracy. However, there are situations in which EOG has clear advantages over VOG, e.g., subjects with narrow eye clefts or having cataract lenses, and patients with movement disorders. The present article shows that if properly implemented, EOG can achieve an accuracy almost as good as VOG with substantial stability for recording, while circumventing problems associated with VOG recording. The present paper describes a practical method for recording horizontal saccades using oculomotor paradigms with high accuracy and stability by EOG in neurological patients. The necessary measures are to use an Ag-AgCl electrode with a wide plastic fringe capable of reducing noise, and to wait for sufficient light adaptation to occur. This waiting period also helps to lower the impedance between the electrodes and the skin, thereby ensuring stable signal recorded as time goes by. Furthermore, re-calibration is performed as needed during the task performance. Using this method, the experimenter can avoid drifts of signals, as well as contamination of artifacts or noise from the electromyogram and electroencephalogram, and can collect sufficient data for clinical evaluation of saccades. Thus when implemented, EOG can still be a method of high practicability that can be widely applied to neurological patients, but may be effective also for studies in normal subjects.

The article describes a practical method for recording horizontal eye movements with high accuracy by electro-oculogram in neurological patients, using a cup Ag-AgCl electrode with a wide plastic fringe. Stable measurement requires proper selection and fixation of electrodes, taking sufficient time for light adaptation to occur, and re-calibration as needed.

Electro-oculogram (EOG) has been widely used for clinical eye movement recording, especially horizontal saccades, although the video-oculography (VOG) has ...

Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults

A real-time locating system (RTLS) can be used to track the walking activity of institutionalized older adults in long-term care who are at risk for wandering behaviors. The benefits of a RTLS are objective and continuous measurements of activity. Self-report methods of activity, especially wandering, by health care staff are vulnerable to floor effects and recall bias, and continuous clinical or research observation over the long-term can be time-consuming and expensive. Health care staff also fail to recognize the onset and/or duration of wandering behaviors, which are associated with a variety of adverse health outcomes in this population but amenable to intervention. RTLS technologies can measure the walking activity of institutionalized residents with cognitive impairment over time with a high degree of accuracy. This is particularly useful for the study of wandering, defined as walking for at least 60 seconds with few (if any) breaks in activity. Wandering is associated with disease progression, hospitalizations, falls and death. Previous work suggests older adults with poor balance ability and high sustained walking activity may be particularly susceptible to poor health outcomes. RTLS&#39;s are used to assess cognitive impairment and factors associated with gait and balance; however, supplemental paper and pencil gait/balance tools may be used to further refine risk profiles. This project discusses the use of a RTLS to measure walking activity and also gait quality and balance ability measures on this population.

This paper discusses the use of a continuous and objective real-time locating system to measure walking activity associated with wandering behaviors, focusing on older adults with cognitive impairment. Walking activity is measured by walking distance, sustained walking distance, and sustained gait speed. Also assessed are gait quality and balance ability.

A real-time locating system (RTLS) can be used to track the walking activity of institutionalized older adults in long-term care who are at risk for ...

Modified Blood Collection from Tail Veins of Non-anesthetized Mice with a Vacuum Blood Collection System and Eyeglass Magnifier

Blood sample collection is the basis of experimental animal research. It is of importance to obtain adequate blood samples for various research purposes. The tail veins of mice are small, and it is sometimes difficult to obtain the required blood volume by conventional puncture methods. This study investigates the superiority of repeated blood sample collection from tail veins of mice through use of a vacuum blood collection system and eyeglass magnifier (experimental group) compared to conventional blood sampling methods (conventional group), performed by beginners and experts, respectively. With the help of an eyeglass magnifier, a butterfly needle tip is inserted into the tail vein of each mouse in the experimental group. When the vein is penetrated successfully, a blood sample is collected in the vacuum collection tube by insertion of the rubber end of a butterfly needle into the vacuum blood collection tube. The plunger is then used to collect blood without the help of the eyeglass magnifier in the conventional group. Success rates of blood sample collection by the beginners and experts were shown to be 70% vs. 100% (p &#60; 0.01) in the experimental group and 35% vs. 85% (p &#60; 0.01) in the conventional group. For both beginners and experts, puncture times required for obtaining required blood sample were significantly lower in the experimental group compared to the conventional group (2.40 &#177; 0.75 vs. 2.90 &#177; 0.31, p &#60; 0.05; 1.15 &#177; 0.37 vs. 1.55 &#177; 0.76, p &#60; 0.05). In conclusion, the presented blood sampling technique is feasible and easy to practice and enables frequent sampling of adequate blood volumes from non-anesthetized mice.&#160;

This study reports blood sampling from tail vein in mice using a vacuum extraction tube system with eyeglass magnifier. Our method is easy to practice and could be used for repeat blood sampling in mice.

Blood sample collection is the basis of experimental animal research. It is of importance to obtain adequate blood samples for various research purposes. ...

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

As a systemic disease, chronic obstructive pulmonary disease (COPD) affects the respiratory system, inducing restless and exercise dyspnea. It also impacts exercise capacity and forms a vicious circle in which it further aggravates the condition of patients and accelerates disease progression. As a functional holistic exercise, traditional Chinese exercises (TCE) play an important role in the rehabilitation of COPD on the basis of adjusting the breath and performing coordinated movements. This study investigates the effects of prescribed pulmonary exercises (which are modified from TCE) on exercise capacity of upper and lower limbs, endurance exercise capacity, and quality of life in stable COPD patients. The goal is to determine the accessibility of these prescribed exercises in COPD rehabilitation. Participants are randomly divided into a non-exercise control group (CG) or prescribed pulmonary exercise group (PG) at a ratio of 1: 1. The PG receives intervention for 60 min twice per day, 7 days a week, for a total of 3 months. The intensity is measured using the Borg category-ratio 10 scale and with a heart-rate monitor. Then, an exercise capacity test and quality of life questionnaire are scheduled at 1 week before and after the formal intervention. After 3 months of intervention, the 30 s arm curl test, 30 s sit-to-stand test, 6 min walking test, and quality of life show significant improvement in COPD patients (p &#60; 0.05). These findings indicate that prescribed pulmonary exercises can be applied as alternative, convenient, and effective home- and community-based exercises for stable COPD patients.

Presented here is a protocol to investigate the effects of home-based prescribed pulmonary exercise in stable chronic obstructive pulmonary disease (COPD) patients, which is modified based on traditional Chinese exercises according to dyspnea and limited exercise capacity observed in COPD patients.

As a systemic disease, chronic obstructive pulmonary disease (COPD) affects the respiratory system, inducing restless and exercise dyspnea. It also ...

Automated Rat Single-Pellet Reaching with 3-Dimensional Reconstruction of Paw and Digit Trajectories

Rodent skilled reaching is commonly used to study dexterous skills, but requires significant time and effort to implement the task and analyze the behavior. Several automated versions of skilled reaching have been developed recently. Here, we describe a version that automatically presents pellets to rats while recording high-definition video from multiple angles at high frame rates (300 fps). The paw and individual digits are tracked with DeepLabCut, a machine learning algorithm for markerless pose estimation. This system can also be synchronized with physiological recordings, or be used to trigger physiologic interventions (e.g., electrical or optical stimulation).

Rodent skilled reaching is commonly used to study dexterous skills, but requires significant time and effort to implement the task and analyze the behavior. We describe an automated version of skilled reaching with motion tracking and three-dimensional reconstruction of reach trajectories.