Background
High‐intensity occupational therapy can improve arm function after stroke, but many people lack access to such therapy. Home‐based therapies could address this need, but they don’t typically address abnormal muscle co‐activation, an important aspect of arm impairment. An earlier study using lab‐based, myoelectric computer interface game training enabled chronic stroke survivors to reduce abnormal co‐activation and improve arm function. Here, we assess feasibility of doing this training at home using a novel, wearable, myoelectric interface for neurorehabilitation training (MINT) paradigm.
Objective
Assess tolerability and feasibility of home‐based, high‐dose MINT therapy in severely impaired chronic stroke survivors.
Methods
Twenty‐three participants were instructed to train with the MINT and game for 90 min/day, 36 days over 6 weeks. We assessed feasibility using amount of time trained and game performance. We assessed tolerability (enjoyment and effort) using a customized version of the Intrinsic Motivation Inventory at the conclusion of training.
Results
Participants displayed high adherence to near‐daily therapy at home (mean of 82 min/day of training; 96% trained at least 60 min/day) and enjoyed the therapy. Training performance improved and co‐activation decreased with training. Although a substantial number of participants stopped training, most dropouts were due to reasons unrelated to the training paradigm itself.
Interpretation
Home‐based therapy with MINT is feasible and tolerable in severely impaired stroke survivors. This affordable, enjoyable, and mobile health paradigm has potential to improve recovery from stroke in a variety of settings.
Clinicaltrials.gov: NCT03401762.
The development of the first intermolecular
Rh2(II)-catalyzed
aziridination of olefins using anilines as nonactivated N atom precursors
and an iodine(III) reagent as the stoichiometric oxidant is reported.
This reaction requires the transfer of an N-aryl
nitrene fragment from the iminoiodinane intermediate to a Rh2(II) carboxylate catalyst; in the absence of a catalyst only diaryldiazene
formation was observed. This N-aryl aziridination
is general and can be successfully realized by using as little as
1 equiv of the olefin. Di-, tri-, and tetrasubstituted cyclic or acylic
olefins can be employed as substrates, and a range of aniline and
heteroarylamine N atom precursors are tolerated. The Rh2(II)-catalyzed N atom transfer to the olefin is stereospecific as
well as chemo- and diastereoselective to produce the N-aryl aziridine as the only amination product. Because the chemistry
of nonactivated N-aryl aziridines is underexplored,
the reactivity of N-aryl aziridines was explored
toward a range of nucleophiles to stereoselectively access privileged
1,2-stereodiads unavailable from epoxides, and removal of the N-2,4-dinitrophenyl group was demonstrated to show that
functionalized primary amines can be constructed.
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