2015 Highlights from the Motor Impairment Group at NeuRA


falling

  • Members of the Motor Impairment Research Program conducted a randomized controlled trial to assess whether step training can improve physical and neuropsychological measures associated with falls in people with multiple sclerosis (MS). 50 people with MS participated in the trial in which intervention group participants (n = 28) performed step training for 12 weeks while controls (n = 22) continued usual physical activity. 44 participants completed the study and no adverse events were reported. Compared with the control group, the intervention group performed significantly better at the end of the trial in tests of balance, coordination, attention and quick, accurate stepping. The findings indicate that step training is feasible, safe and effective in improving stepping, standing balance, coordination and functional performance in people with MS. For more details please see: Hoang P, Schoene DS, Gandevia SC and Lord SR, Multiple Sclerosis Journal, 2015.  
  • Rob Herbert and colleagues published an important trial (the EXACT trial ).  It shows that supervised rehabilitation is not needed after uncomplicated ankle fracture – that is it has no effect on outcomes.  So, supervised exercise programs after immobilization cannot be justified for patients with a simple ankle fracture. Reference: Moseley AM, Beckenkamp PR, Haas M, Herbert RD and Lin C-WC, JAMA, 2015.
  • Fatigue in combination with gait and balance impairments can severely limit daily activities in people with multiple sclerosis (MS). In association with colleagues at Flinders University, Stephen Lord conducted a randomised cross-over trial with 40 people with MS. On two separate days within two weeks, participants completed either the 6-minute walk test (6MWT) or the 6MWT while wearing a dorsiflexion ankle orthosis (DAO). There were no differences in distance walked or perceived fatigue between the 2 walking conditions. However, there was a reduced physiological cost of walking and smaller reductions in knee extensor strength and balance control after walking while wearing the DAO. This encouraging finding suggests an inexpensive orthosis may have benefits for fatigue-related motor impairments in people with MS. McLoughlin J, Barr C, Crotty M, Lord SR and Sturnieks DL, Archives of Physical Medicine and Rehabilitation, 2015.

exercise fatigue

  • David Kennedy and colleagues published a surprising result about the effect of fatigue-related firing of group III and IV muscle nociceptors. Fatigue-related sensory feedback reduces performance of an unfatigued muscle within the same limb in the leg or arm, but fatiguing a muscle in one leg does not impair performance of unfatigued muscles in the other leg. Reference: Kennedy DS, Fitzpatrick SC, Gandevia SC & Taylor JL, Journal of Applied Physiology, 2015.
  • Jessica D’Amico working with Janet Taylor received awards for her oral presentations at the Brisbane Sensorimotor Control meeting and was 4th in the hotly contested Young Investigator Award at the 20th Annual Congress of the European College of Sport Science for “Activation of 5HT1A receptors: a plausible contributor to central fatigue”.  More on this topic soon we hope.
  • What are the initial changes in the brain and spinal cord with strength training?   Jim Nuzzo and colleagues showed that after one session of repeated high-force contractions the spinal cord changes such that the same descending corticospinal input produces an increased output from the motoneurones. This spinal-level change may be the start of improved strength due to training via improvements in function of the nervous system. For more details please see: Nuzzo JL, Barry BK, Gandevia SC & Taylor JL, Medicine and Science in Sports and Exercise, 2016.
  • Transcranial magnetic stimulation is a popular method to assess the function of the motor cortex but many results using it are hard to reproduce and are likely affected by publication bias and by some questionable research practices.  This was the conclusion of Simon Gandevia, Janet Taylor and Martin Heroux who surveyed this field.  Simon also summarized on the ABC Science show some of the difficulties with the reproduction of research results in medicine more broadly, the misinformation associated with probability values, and the bias in the literature due to the publication of mostly positive ‘findings’. More on this later, but for more information please see: Heroux ME, Taylor JL and Gandevia SC, PloS One, 2015.
  • Assessment of physiological performance in many domains shows a diminution with ageing.  This review by Stephen Lord, Kim Delbaere and Simon Gandevia highlights physiological ways to track motor impairments and how obtaining a physiological profile of performance can track the impairments in a range of neurological and other diseases.  Hopefully it will help with interventions which increase the healthspan. Lord SR, Delbaere K and Gandevia SC, Journal of Physiology, 2015.
  • Finally, during the year, Stephen Lord received a Thomson Reuters Highly Cited Researcher Award (Highlycited.com) by writing the greatest numbers of reports officially designated by Essential Science Indicators as highly-cited papers. This ranks him among the top 1% most cited researchers for the broad field of social science (general) for the period 2002- 2012.

     

MotorImpairment meeting 2015

MotorImpairment meeting 2015

    

 

 

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