Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple sclerosis (MS) is the most common cause of progressive neurological disability in young adults. In addition to spasticity, tremors, weakness, sensory disturbances, depression, cognitive problems, and bladder or bowel dysfunction, sexual dysfunction (SD) is also a prevalent and destructive manifestation of the disease that severely affects quality of life. Evaluation of this disorder requires insight into the primary (changes that directly affect libido, sexual response and orgasm due to direct damage to the nervous system), secondary (complaints which are related to the physical disability of MS, such as fatigue, muscle rigidity, weakness and spasms), and tertiary (emotional, social and cultural aspects of MS) components of MS-associated SD. Given the complexity and multifactorial nature of SD, a multidisciplinary approach is necessary when treating patients with MS. The aim of this Review is to provide a holistic approach to the evaluation and management of SD in patients with MS, incorporating the latest data from the fields of urology, neurology, nursing, social work, and psychology. What is currently known regarding the evaluation and management of SD in patients with MS will be presented from the perspective of these specialties.
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PMID:Sexual dysfunction in patients with multiple sclerosis: a multidisciplinary approach to evaluation and management. 1919 23

A 53-yr-old woman developed contralateral weakness and fatigue, without autonomic symptoms, 2 wks after receiving an injection with 800 units of botulinum toxin A for management of her poststroke spasticity. Although the patient reported resolution 4 wks later, clinical evaluations suggested an even longer time course. The patient then experienced the same contralateral symptoms again more than a year later, after a 500-unit injection, which took a similar length of time to resolve. We report the first known case of repeated contralateral weakness and fatigue after high-dose botulinum toxin A injection. Currently, dosage is largely titrated by the practitioner based on individual patient response. Before performing botulinum toxin A injections for therapeutic purposes, the expected risks and benefits for each patient must be carefully considered.
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PMID:Contralateral weakness and fatigue after high-dose botulinum toxin injection for management of poststroke spasticity. 1945 55

A high-level objective of neuromuscular electrical stimulation (NMES) is to enable a person to achieve some functional task. Towards this goal, the objective of the current effort is to develop a NMES controller to produce a knee position trajectory that will enable a human shank to track any continuous desired trajectory (or constant setpoint). A nonlinear control method is developed to control the human quadriceps femoris muscle undergoing nonisometric contractions. The developed controller does not require a muscle model and can be proven to yield asymptotic stability for a nonlinear muscle model in the presence of bounded nonlinear disturbances (e.g., spasticity, delays, fatigue). The performance of the controller is demonstrated through a series of closed-loop experiments on human subjects. The experiments illustrate the ability of the controller to enable the leg shank to track single and multiple period trajectories with different periods and ranges of motion, and also track desired step changes with changing loads.
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PMID:Nonlinear neuromuscular electrical stimulation tracking control of a human limb. 1949 28

Amyotrophic lateral sclerosis (ALS) is a progressive fatal neurological disease that affects approximately 20,000 Americans. Symptoms include muscle weakness, fatigue, twitching, atrophy, spasticity, pain, oropharyngeal dysfunction, pseudobulbar affect, weight loss, and respiratory impairment. Death occurs within 3-5 yr after onset of symptoms, with diagnosis taking from 11 to 17.5 months. The only FDA-approved drug for ALS is Riluzole, which only increases the life expectancy by a few months. All other treatments for ALS provide symptom management to improve the patient's quality of life. An interdisciplinary palliative care team for the ALS patient helps to reduce the stress that the illness places on families. Massage can be a useful adjunctive treatment for spasticity and pain when medication side effects are unwanted. A holistic interdisciplinary palliative care team supports both the patient and the family improving their quality of life.
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PMID:Interdisciplinary palliative care, including massage, in treatment of amyotrophic lateral sclerosis. 1976 55

The purpose of this investigation was to determine whether changes in surface electromyography (EMG) data during an isometric muscle protocol, in combination with maximal voluntary isometric force, provide information on fatigue occurrence and exercise limitation in children with cerebral palsy. Twelve children with cerebral palsy and 10 age-matched controls completed an assessment of quadriceps muscle fatigue on an isokinetic device with surface EMG measurements, during a sustained isometric contraction at 50% of the maximal voluntary isometric force. The EMG data collected in participants with cerebral palsy suggest that muscle fatigue occurred sooner in children with cerebral palsy relative to the age-matched controls. However, the results demonstrate that no difference was found in time to exhaustion between the able-bodied and participants with cerebral palsy. These contrasting results may be the result of spasticity and co-contraction during maximal testing, which may play an important role in exercise limitation in children with cerebral palsy.
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PMID:Electromyographic (EMG) analysis of quadriceps muscle fatigue in children with cerebral palsy during a sustained isometric contraction. 1979 2

Purpose. To highlight research priorities of people with spinal cord injury (SCI), outline the current state of rehabilitation research and suggest potentially fruitful avenues for future inquiry. Method. Commentary. Results. People with SCI identify pain, depression, fatigue, pressure sores, spasticity and the management of bladder and bowel as research priorities. Research reveals multiple interconnections between these secondary problems, all of which negatively impact quality of life (QOL). However, despite a substantial volume of existing research, significant gaps in knowledge remain, duplications of research effort are apparent and few interventions have an adequate evidence base. Issues concerning community participation - another research priority - have only recently attracted researchers' attention. Conclusions. This commentary contends that research should: focus on issues and outcomes of relevance and importance to people living with SCI; address the complexities of secondary conditions and their inter-relationships; appraise environmental barriers to participation in meaningful living; be designed to identify and inform effective and relevant interventions. Innovative approaches to research partnerships, mixed methods and exploring variables usually omitted from quantitative studies might enhance the likelihood that the complexity of issues facing people living with SCI will be identified and addressed. Moreover, a governing focus on achieving lives experienced as hopeful, purposeful, satisfying and meaningful could contribute to enhancing QOL outcomes following SCI.
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PMID:Spinal cord injury rehabilitation research: patient priorities, current deficiencies and potential directions. 2013 45

While current immunomodulating drugs aim to reduce multiple sclerosis (MS) exacerbations and slow disease progression, rehabilitation aims to improve and maintain the functional abilities of patients in the face of disease progression. An increasing number of journal articles are describing the value of the many rehabilitation interventions that can be used throughout the course of the disease, from the initial symptoms to the advanced stages. An integrated team of healthcare professionals is necessary to address a myriad of problems to reduce impairments, disabilities, and handicaps. The problems may be related to fatigue, weakness, spasticity, mobility, balance, pain, cognition, mood, relationships, bowel, bladder, sexual function, swallowing, speech, transportation, employment, recreation, and activities of daily living (ADL) such as dressing, eating, bathing, and household chores. The team can help prevent complications and secondary disabilities, while increasing patient safety. Improving neurologically related function, maintaining good relationships, and feeling productive and creative adds enormously to the quality of life of people with MS and their families. Rehabilitation is more than an 'extra' service that is given after medical therapies; it is an integral part of the management of the diverse set of problems encountered throughout the course of the disease. An interdisciplinary team may have many members, including physicians, nurses, physical therapists, occupational therapists, speech and language pathologists, psychotherapists, social workers, recreational therapists, vocational rehabilitation therapists, patients, families, and other caregivers.
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PMID:Rehabilitation challenges in multiple sclerosis. 2018 78

Spinal cord injury (SCI) results in a myriad of changes in paralyzed skeletal muscle. Many of these changes stem from the disruption in nerve activation and lead to a loss of muscle mass and the transformation of muscle fiber types to a predominance of type II fast-twitch fibers. Changes to muscle contractile properties are also commonly reported, however, the results are not yet conclusive and appear to vary with the muscle examined. The presence or absence of spasticity also appears to be a significant variable, acting to preserve some muscle characteristics following paralysis. The purpose of this review is to summarize the current literature examining changes in skeletal muscle after SCI, with a particular focus on the effect on fatigue resistance. Mechanisms of fatigue in able-bodied muscle are discussed in the context of their potential to explain the decreased fatigue resistance observed after SCI.
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PMID:Muscle characteristics and fatigue properties after spinal cord injury. 2020 73

Determining whether persons with multiple sclerosis (MS) receive appropriate, comprehensive healthcare requires tools for measuring quality. The objective of this study was to develop quality indicators for the care of persons with MS. We used a modified version of the RAND/UCLA Appropriateness Method in a two-stage process to identify relevant MS care domains and to assess the validity of indicators within high-ranking care domains. Based on a literature review, interviews with persons with MS, and discussions with MS providers, 25 MS symptom domains and 14 general health domains of MS care were identified. A multidisciplinary panel of 15 stakeholders of MS care, including 4 persons with MS, rated these 39 domains in a two-round modified Delphi process. The research team performed an expanded literature review for 26 highly ranked domains to draft 86 MS care indicators. Through another two-round modified Delphi process, a second panel of 18 stakeholders rated these indicators using a nine-point response scale. Indicators with a median rating in the highest tertile were considered valid. Among the most highly rated MS care domains were appropriateness and timeliness of the diagnostic work-up, bladder dysfunction, cognition dysfunction, depression, disease-modifying agent usage, fatigue, integration of care, and spasticity. Of the 86 preliminary indicators, 76 were rated highly enough to meet predetermined thresholds for validity. Following a widely accepted methodology, we developed a comprehensive set of quality indicators for MS care that can be used to assess quality of care and guide the design of interventions to improve care among persons with MS.
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PMID:Quality indicators for multiple sclerosis. 2056 62

Multiple sclerosis (MS) causes a wide variety of neurological deficits, with ambulatory impairment the most obvious cause of disability. Within 10 to 15 years of disease onset, 80% of persons with MS experience gait problems due to muscle weakness or spasticity, fatigue, and loss of balance. To facilitate mobility, persons with MS frequently use mobility assistive technology (MAT), such as canes, crutches, walkers, wheelchairs, and scooters. We systematically reviewed the published literature on MAT use among persons with MS. We used electronic reference lists such as Ovid MEDLINE and PubMed to search the literature. We located 50 articles that met the initial criteria of providing good evidence of the types of MAT devices and their benefits for individuals with MS. A limited number of articles with higher levels of evidence was found regarding benefits of MAT use specifically for persons with MS. Evidence-based literature provides the basis for the strongest method of measurable clinical performance; therefore, having a strong research study design is vital to the justification of MAT prescription and reimbursement decisions. However, a paucity of studies with higher levels of evidence-based practice exists.
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PMID:Multiple sclerosis and mobility-related assistive technology: systematic review of literature. 2066 47


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