Age, height, weight
History and Physical Examination
Evaluation of dyspnoea: mMRC, Borg scale (Seated-Supine)
Amyotrophic lateral sclerosis functional rating scale (ALSFRS-R)
Sleep-Disordered Breathing in Neuromuscular Disease Questionnaire (SiNQ-5)
24h Blood Pressure monitor
Spirometry - FEV1 and FVC
Respiratory muscle strength - MIP, MEP, and SNIP
Arterial Blood Gases
Carotid-femoral pulse wave velocity
Breath CO exhale

Motor Neurone Disease

Hypoxemia and/or Hypercapnia

Assessments for those participants who are being set up onto NIV

Non Invasive Ventilation

Assessments for those participants who are not being set up onto NIV

Without Non Invasive Ventilation

Guys and St Thomas NHS Trust

Royal Brompton and Harefield NHS Trust

The Relationship Between Arterial Stiffness and Respiratory Failure in Motor Neurone Disease

The Relationship Between Arterial Stiffness and Respiratory Failure: Using Motor Neurone Disease as a Paradigm to Assess the Consequence of Sleep Disordered Breathing on Arterial Stiffness

Is there a difference in pulse wave velocity between patients with MND who have and those who do not have hypoxemia and/or hypercapnia

To clarify if there is an increased pulse wave velocity in MND patients and quantify whether patients are within predicted values or not against current evidenced literature

Does NIV change pulse wave velocity in MND patients

No individual participant data will be available

Guy's and St Thomas' NHS Foundation Trust

HTS stimulation while walking at a comfortable pace for 30 minutes.

Sensory TENS while walking at a comfortable pace for 30 minutes.

HTS stimulation while walking at a comfortable pace for 30 minutes.
Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to ~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.

Hybrid Training System (HTS)

Sensory TENS while walking at a comfortable pace for 30 minutes.
Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.

Transcutaneous Electrical Nerve Stimulation (TENS)

Total

Sex: Female, Male

Race and Ethnicity Not Collected

Digital physicians scale (Detecto 6449 Digital Physician Scale, DETECTO Scale Company, Webb City, MO).

Weight

Wall mounted stadiometer (seca 216 Stadiometer, seca Corporation, Chino, CA)

Height

BMI was calculated by dividing body mass by the square of the height.

Body Mass Index (BMI)

20-Meter Walk Time

5-Chair Stand Time

Stair Climb Time

Maximum isokinetic torque measured on the HUMAC NORM (Model 502140, Computer Sports Medicine, Inc., Stoughton, MA).

Knee Extension Torque

Knee Flexion Torque

The Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain subscale was used at baseline and follow-up to assess participant outcomes. The pain subscale is made up of 9 questions and was scored from zero to 100, with zero corresponding to extreme knee problems and 100 corresponding to no knee problems.

Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain Subscale

The Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QOL) subscale was used at baseline and follow-up to assess participant outcomes. The QOL subscale is made up of 4 questions and was scored from zero to 100, with zero corresponding to extreme knee problems and 100 corresponding to no knee problems.

Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QOL) sub scale

Knee pain will be evaluated using a visual analog scale (VAS) of 100 mm from no pain (0 mm) to the worst imaginable pain (100 mm). Participants will be asked to record their pain levels of the one week prior to their baseline visit.

Knee Pain by Visual Analog Scale

Participants will be familiarized with strength testing equipment and counseled on proper lifting technique. They will undergo testing to determine their peak isokinetic knee extensor torque, using an isokinetic dynamometer.

Change in Knee Extensor Strength Assessed by Isokinetic Dynamometer.

Participants will be familiarized with strength testing equipment and counseled on proper lifting technique. They will undergo testing to determine their peak isokinetic knee flexor torque, using an isokinetic dynamometer.

Change in Knee Flexor Strength Assessed by Isokinetic Dynamometer

Knee pain will be evaluated using a visual analog scale (VAS) of 100 mm from no pain (0 mm) to the worst imaginable pain (100 mm). Participants will be asked to record their pain levels of the past one week.

Change in Knee Pain Assessed by a Visual Analog Scale (VAS)

Change in Knee Pain Assessed by Knee Injury and Osteoarthritis Outcome Score (KOOS)

Change in Quality of Life (QOL) Assessed by Knee Injury and Osteoarthritis Outcome Score (KOOS)

Average time of two trials used for each participant.

Change in 20-meter Walk Time.

Change in 5-chair Stand Time.

Change in Stair Climb Time.

Overall Study

Neil Segal

Knee Osteoarthritis

Electrodes (15 cm x 6 cm) will be placed over the quadriceps and electrodes (11 cm x 6 cm) (Sekisui Plastics Co., Tokyo, Japan) will be placed over the hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5,000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor (EWTS9PD, Home Appliances Development Center Corporate Engineering Division, Appliances Company Panasonic Corporation 2-3-1-2 Noji-higashi,Kusatsu City, Shiga, Japan) is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to ~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.

The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.

Sensory TENS

University of Kansas Medical Center

Combined Application of Electrical Stimulated Antagonist Contraction During Walking (Walking Study)

Determining Efficacy of the Combined Application of Electrical Stimulated Antagonist Contraction During Walking With Sensory TENS for Increasing Strength and Decreasing Pain in Women With Frequent Knee Symptoms

Neil Segal, MD, MS

Professor and Faculty Physiatrist

Kurume University

subjects diagnosed with amyotrophic lateral sclerosis

subjects diagnosed with non-ALS neurodegenerative disease

Neurodegenerative Diseases

Amyotrophic Lateral Sclerosis

Multiple Sclerosis

Parkinson Disease

Carolinas Medical Center - Dept of Neurology

Establishment of a Human Tissue Bank for Studying the Microbial Etiology of Neurodegenerative Diseases

The goal of this protocol is to create a human tissue bank of fecal and blood samples for the future investigation of the microbial etiology and pathophysiology of neurodegenerative diseases including but not limited to Amyotrophic Lateral Sclerosis, Parkinson's Disease, and Multiple Sclerosis. Patient demographic information will be collected to allow future study of the role of bacterial pathogens and gut flora composition in the development of neurodegenerative diseases.

amyotrophic lateral sclerosis/gojaznost

The Relationship Between Arterial Stiffness and Respiratory Failure in Motor Neurone Disease

Combined Application of Electrical Stimulated Antagonist Contraction During Walking (Walking Study)

Establishment of a Human Tissue Bank for Studying the Microbial Etiology of Neurodegenerative Diseases

Motor-Point Stimulation for Conditioning the Diaphragm of Patients With Amyotrophic Lateral Sclerosis (ALS)

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