Although upper limb motor impairments are common, the primary tools for assessing and tracking these impairments in a clinical setting are subjective, qualitative rating scales that lack resolution and repeatability. Markerless motion capture technology has the potential to greatly improve clinical assessment by providing quick, low-cost, and accurate tools to objectively quantify motor deficits. Here we lay some of the groundwork necessary to enable markerless motion capture systems to be used in clinical settings. First, we adapted five motor tests common in clinical assessments so they can be administered via markerless motion capture. We implemented these modified tests using a particular motion capture sensor (Leap MotionTM Controller, hereafter referred to as the Leap Motion sensor) and administered the tests to 100 healthy subjects to evaluate the feasibility of administrating these tests via markerless motion capture. Second, to determine the ability of the Leap Motion sensor to accurately measure tremor, we characterized the frequency response of the Leap Motion sensor. During the administration of the five modified motor tests on 100 healthy subjects, the subjects had little trouble interfacing with the Leap Motion sensor and graphical user interface, performing the tasks with ease. The Leap Motion sensor maintained an average sampling rate above 106 Hz across all subjects during each of the five tests. The rate of adverse events caused by the Leap Motion sensor (mainly jumps in time or space) was generally below 1%. In characterizing the frequency response of the Leap Motion sensor, we found its bandwidth to vary between 1.7 and 5.5 Hz for actual tremor amplitudes above 1.5 mm, with larger bandwidth for larger amplitudes. To improve the accuracy of tremor measurements, we provide the magnitude ratios that can be used to estimate the actual amplitude of the oscillations from the measurements by the Leap Motion sensor. These results suggest that markerless motion capture systems are on the verge of becoming suitable for routine clinical use, but more work is necessary to further improve the motor tests before they can be administered via markerless motion capture with sufficient robustness for clinical settings.

A transverse study in term newborns was made to determine the occurrence of motor responses and possible asymmetries during the stimulation of the vestibular system through the head turning after release from the midline and passive rotation. From October to December of 2005, 320 neonates were admitted to the Adjacent Lodgings of the University Hospital of Santa Maria. From those, 89 were selected for assessment of the vestibular function since they have previously had fetal static control through ultrasound. Our results show that right-sided head lateralization was significantly greater than left-sided. The predominancy of the lateralization towards the right side also occurred in the male gender, cephalic presentations and left-sided back, however, not significant. On the passive rotation about the vertical axis, the great majority of the neonates presented eye deviation in the opposite direction of the body movement and about the horizontal axis, the great majority of them either remained with their eyes closed or did not present any deviation at all. Results corroborate with the existing literature and suggest an association between fetal static and vestibular function. It was shown through vestibular stimulation trials that term newborns already possess a functional asymmetry as well as motor responses to this system stimulation / Com o objetivo determinar a ocorrência de respostas motoras e possíveis assimetrias durante a estimulação do sistema vestibular pelas provas de queda da cabeça e rotação passiva, foi realizado um estudo transversal no recém-nascido de termo. No período de outubro a dezembro de 2005, 320 recém-nascidos foram admitidos no Alojamento Conjunto do Hospital Universitário de Santa Maria, e destes 89 foram selecionados para avaliação da função vestibular, por terem feito controle da estática fetal através do ultra-som. Nossos resultados mostram que a lateralização da cabeça para a direita foi significativamente maior do que para esquerda. Este predomínio da lateralização para a direita também ocorreu no gênero masculino, nas apresentações cefálicas e com o dorso para esquerda, no entanto estes não foram significativos. Nas provas de rotação passiva na vertical a grande maioria dos RN apresentou o desvio dos olhos sempre no sentido oposto ao movimento do corpo e no plano horizontal, a grande maioria dos RN permaneceu com os olhos fechados, ou não apresentou desvio algum. Nossos resultados corroboram com a literatura existente, e sugerem uma associação entre a estática fetal e a função vestibular. Através das provas de estimulação vestibular, ficou demonstrado que o RN de termo já possui respostas motoras a estimulação deste sistema, bem como uma assimetria funcional

La douleur éprouvée lors de trauma crânien est reliée à la sensibilisation du système nerveux central et aux maux de tête chroniques lorsque la douleur n’est pas traitée. Par contre, chez l’humain, l’utilisation d’analgésiques doit être faite avec précaution puisqu’ils sont associés à des déficits moteurs et cognitifs. La présente étude vise à évaluer l’efficacité du fentanyl pour le traitement de la douleur lors d’une hémorragie intracérébrale et les effets sur la motricité en utilisant un modèle induit d’hémorragie intracérébrale chez le rat. Pour ce faire, une hémorragie intracérébrale a été induite par injection stéréotaxique de 2 µL de collagénase (0.5 UI), injectée dans un noyau caudoputamen, chez vingt-et-un rats Sprague-Dawley mâles sous anesthésie générale. Le groupe contrôle (n=6) a reçu de la saline sous-cutanée (SC), et les groupe expérimentaux ont reçu respectivement des doses de 5 (n=6), 10 (n=6) et 20 (n=3) µg/kg de fentanyl SC, 2h suite à la chirurgie et ensuite 1 fois par jour pour les 2 jours suivants. Les animaux ont été évalués pendant les 5 jours suivants la chirurgie à l’aide d’une vidéo (grimace de la douleur), d’un examen neurologique, du test de la poutre et du rotarod. Le dernier jour, les animaux ont été euthanasiés, les cerveaux ont été prélevés et évalués pour déterminer le volume de l’hémorragie, l’astrocytose et le nombre de cellules nécrotiques. Comparé aux contrôles, le groupe ayant reçu 5 µg/kg de fentanyl a éprouvé un soulagement significatif de la douleur au jour 2 (p<0,01) tandis que le groupe 10 µg/kg a éprouvé un soulagement de façon significative au jour 1 (p<0,01), 2 (p<0,001) et 3 (p<0,01). Pour le rotarod, le groupe 10 µg/kg a démontré une diminution significative de sa performance aux jours 5 (p<0,05) et 6 (p<0,02). À l’examen neurologique, le sautillement a montré une piètre récupération pour les groupes de 5 et 10 µg/kg comparés au contrôle (p<0,01). À l’examen des cerveaux, aucune différence n’a été observée pour les 3 paramètres entre les groupes expérimentaux. En conclusion, le fentanyl à une dose de 10 µg/kg SC est efficace pour diminuer la douleur suite à une hémorragie intracérébrale; par contre il peut avoir un effet sur la motricité des animaux. / The pain associated with traumatic brain injury is linked with the central nervous system sensitization and chronic cephalalgia when pain is not treated. However, analgesics in human patient must be done with caution since they are associated with cognitive and motor deficits. The present study aims to assess the efficiency of fentanyl to treat pain and evaluate motor behaviors on a rat model of intracerebral hemorrhage (IH). Twenty-one male Sprague-Dawley rats underwent a stereotaxic surgery to produce a collagenase-induced IH with an injection of 2 µL of colagenase (0.5 UI) in the right caudoputamen nucleus. The control group (n=6) received saline subcutaneously (SC), and experimental groups received either 5 (n=6), 10 (n=6), or 20 (n=3) µg/kg of fentanyl SC, 2h following surgery and on the 2 subsequent days. The rat grimace scale, a neurological examination, balance beam test and rotarod test were performed for 5 consecutive days postoperatively to evaluate pain and motor performance. At the end of the experimentation, the animals were euthanized, the brains were collected and evaluated to determine hematoma volume, the number of reactive astrocytes and necrotic neurons. When compared to controls, the grimace scale has showed that 5 µg/kg fentanyl significantly alleviated pain on day 2 only (p<0.01) and that 10 µg/kg alleviated pain on days 1 (p<0.01), 2 (p<0.001), and 3 (p<0.01). For the rotarod test, only the 10 µg/kg group showed significant decreases in performance on days 5 (p<0.05) and 6 (p<0.02). The neurologic exam was not significantly different between groups, but only the hopping test showed a poor recuperation for the 5 and 10 µg/kg fentanyl group when compared to saline (p<0.01). During brains exams, no differences were found between groups for the results of the 3 parameters. Fentanyl, at a dose of 10 µg/kg SC, has provided a substantial analgesia following a collagenase-induced intracerebral hemorrhage in rats; however it can alter motor performance following analgesic treatments.