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Bursac N.,Duke University | Juhas M.,Duke University | Rando T.A.,Stanford University | Rando T.A.,Rehabilitation Research and Development Service
Annual Review of Biomedical Engineering | Year: 2015

Although skeletal muscle is one of the most regenerative organs in our body, various genetic defects, alterations in extrinsic signaling, or substantial tissue damage can impair muscle function and the capacity for self-repair. The diversity and complexity of muscle disorders have attracted much interest from both cell biologists and, more recently, bioengineers, leading to concentrated efforts to better understand muscle pathology and develop more efficient therapies. This review describes the biological underpinnings of muscle development, repair, and disease, and discusses recent bioengineering efforts to design and control myomimetic environments, both to study muscle biology and function and to aid in the development of new drug, cell, and gene therapies for muscle disorders. The synergy between engineering-Aided biological discovery and biology-inspired engineering solutions will be the path forward for translating laboratory results into clinical practice. © 2015 by Annual Reviews. All rights reserved. Source

Moy M.L.,Rehabilitation Research and Development Service | Moy M.L.,Brigham and Womens Hospital | Moy M.L.,Harvard University | Weston N.A.,VA Boston Healthcare System | And 4 more authors.
Respiratory Medicine | Year: 2012

Background: Higher levels of physical activity are associated with better functional status, fewer hospital admissions, and lower mortality. In this pilot study, we examined the feasibility and safety of a novel program that combines a pedometer with a website to increase walking. Methods: 27 persons with stable COPD wore the Omron HJ-720ITC pedometer and used the website for 90 days. They uploaded step-count data to the study server using their home computer and received an email each week with their individualized step-count goal. The website provided step-count feedback, education, and motivational content. Subjects participated in a monthly semi-structured interview by telephone. Subjects reported changes in medical condition by telephone or on the website. Paired T-tests assessed change in daily step counts. Results: Subjects were males, mean age 72 ± 8 years, with moderate COPD, FEV1 1.57 ± 0.48 L (55 ± 16% predicted). 87% and 65% reported no problems using the pedometer and website, respectively. At month 3, 96% reported it was true that they knew their step count goal every day, and 52% reported that they were able to reach their goal. 95% of participants said they would recommend the walking program to another person with COPD. Eight subjects experienced breathing problems unrelated to the intervention. In 24 subjects with step counts at baseline and month 3, there was a significant increase of 1263 steps per day (approximately 1.0 km), p = 0.0054. Conclusions: The use of a website and pedometer was feasible and safe, and persons increased their daily walking. Registration Site and Registration Number: ClinicalTrials.gov Identifier NCT01564043. © 2012 Elsevier Ltd. All rights reserved. Source

Bansal A.K.,Brown University | Vargas-Irwin C.E.,Brown University | Truccolo W.,Brown University | Truccolo W.,Massachusetts General Hospital | And 3 more authors.
Journal of Neurophysiology | Year: 2011

A prominent feature of motor cortex field potentials during movement is a distinctive low-frequency local field potential (lf-LFP) (4 Hz), referred to as the movement event-related potential (mEP). The lf-LFP appears to be a global signal related to regional synaptic input, but its relationship to nearby output signaled by single unit spiking activity (SUA) or to movement remains to be established. Previous studies comparing information in primary motor cortex (MI) lf-LFPs and SUA in the context of planar reaching tasks concluded that lf-LFPs have more information than spikes about movement. However, the relative performance of these signals was based on a small number of simultaneously recorded channels and units, or for data averaged across sessions, which could miss information of larger-scale spiking populations. Here, we simultaneously recorded LFPs and SUA from two 96-microelectrode arrays implanted in two major motor cortical areas, MI and ventral premotor (PMv), while monkeys freely reached for and grasped objects swinging in front of them. We compared arm end point and grip aperture kinematics= decoding accuracy for lf-LFP and SUA ensembles. The results show that lf-LFPs provide enough information to reconstruct kinematics in both areas with little difference in decoding performance between MI and PMv. Individual lf-LFP channels often provided more accurate decoding of single kinematic variables than any one single unit. However, the decoding performance of the best single unit among the large population usually exceeded that of the best single lf-LFP channel. Furthermore, ensembles of SUA outperformed the pool of lf-LFP channels, in disagree- ment with the previously reported superiority of lf-LFP decoding. Decoding results suggest that information in lf-LFPs recorded from intracortical arrays may allow the reconstruction of reach and grasp for real-time neuroprosthetic applications, thus potentially supplementing the ability to decode these same features from spiking populations. © 2011 the American Physiological Society. Source

Choi K.-H.,Rehabilitation Research and Development Service | Choi K.-H.,Yale University | Choi K.-H.,Korea University | Fiszdon J.M.,Rehabilitation Research and Development Service | And 3 more authors.
Journal of Nervous and Mental Disease | Year: 2013

Studies that have specifically examined the effects of motivation on work have been limited to evaluations of baseline motivation and have not accounted for cognition. These have also not examined whether motivation changes over time. In the current analyses, we examined how baseline motivation and longitudinal changes in motivation, along with the effects of baseline cognition, related to work function in a sample of 123 individuals with schizophrenia or schizoaffective disorder participating in a 26-week vocational rehabilitation program. Our results indicate that cognition at baseline was a significant predictor of work outcomes over time. Baseline motivation and changes in motivation were significantly linked to work outcomes. The impact of motivation remained significant even after accounting for baseline cognition. These findings provide evidence that motivation is malleable during vocational rehabilitation and has an important impact on vocational function above and beyond the impact of cognition. Copyright © 2013 by Lippincott Williams & Wilkins. Source

Moy M.L.,Rehabilitation Research and Development Service | Moy M.L.,Brigham and Womens Hospital | Moy M.L.,Harvard University | Teylan M.,Pulmonary and Critical Care Medicine Section | And 5 more authors.
PLoS ONE | Year: 2013

Background:COPD is characterized by variability in exercise capacity and physical activity (PA), and acute exacerbations (AEs). Little is known about the relationship between daily step count, a direct measure of PA, and the risk of AEs, including hospitalizations.Methods:In an observational cohort study of 169 persons with COPD, we directly assessed PA with the StepWatch Activity Monitor, an ankle-worn accelerometer that measures daily step count. We also assessed exercise capacity with the 6-minute walk test (6MWT) and patient-reported PA with the St. George's Respiratory Questionnaire Activity Score (SGRQ-AS). AEs and COPD-related hospitalizations were assessed and validated prospectively over a median of 16 months.Results:Mean daily step count was 5804±3141 steps. Over 209 person-years of observation, there were 263 AEs (incidence rate 1.3±1.6 per person-year) and 116 COPD-related hospitalizations (incidence rate 0.56±1.09 per person-year). Adjusting for FEV1 % predicted and prednisone use for AE in previous year, for each 1000 fewer steps per day walked at baseline, there was an increased rate of AEs (rate ratio 1.07; 95%CI = 1.003-1.15) and COPD-related hospitalizations (rate ratio 1.24; 95%CI = 1.08-1.42). There was a significant linear trend of decreasing daily step count by quartiles and increasing rate ratios for AEs (P = 0.008) and COPD-related hospitalizations (P = 0.003). Each 30-meter decrease in 6MWT distance was associated with an increased rate ratio of 1.07 (95%CI = 1.01-1.14) for AEs and 1.18 (95%CI = 1.07-1.30) for COPD-related hospitalizations. Worsening of SGRQ-AS by 4 points was associated with an increased rate ratio of 1.05 (95%CI = 1.01-1.09) for AEs and 1.10 (95%CI = 1.02-1.17) for COPD-related hospitalizations.Conclusions:Lower daily step count, lower 6MWT distance, and worse SGRQ-AS predict future AEs and COPD-related hospitalizations, independent of pulmonary function and previous AE history. These results support the importance of assessing PA in patients with COPD, and provide the rationale to promote PA as part of exacerbation-prevention strategies. Source

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