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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fractures in children heal more quickly than in adults. Stiffness of joints hardly ever occurs in children, even after prolonged immobilization. Pseudoarthrosis and Sudeck's atrophy are extremely rare. Axial, lateral and longitudinal malpositioning can be largely compensated by increased growth. Only rotation malpositions remain permanent in children. By and large, the treatment of fractures in childhood is therefore still conservative. Operative treatment is recommended for some types of fractures near joints, for fractures of the neck of the femur, and for some types of the fractures around the elbow. In all other types of fractures surgery should only be undertaken when the conservative methods fail. An exception may be in adolescents over 12 to 14 years of age and children with multiple trauma, especially cerebral trauma with consecutive spasticity. In these patients, conservative treatment with extension may be difficult and an osteosynthesis may facilitate general care.
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PMID:Indications for operative treatment of fractures in childhood. 70 97

Passive elastic stiffness of muscle acting at the elbow was assessed in 19 normal subjects by measuring displacements produced by a torque motor acting at the joint. Stiffness ranged from 0.40 to 1.8 Nm/radian and was strongly correlated (r = 0.85) with upper arm volume, allowing us to define a "normal" range for stiffness when corrected for arm volume. In addition, the angle of the elbow with the arm fully relaxed and no external torque applied ("neutral" angle) was found to be 107 degrees +/- 10 degrees. Thus, we have quantified resting stiffness or "tone" in the arm and provided normal data for comparison with patients with pathophysiological conditions such as rigidity or spasticity.
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PMID:Elastic properties of muscles measured at the elbow in man: I. Normal controls. 378 78

Spasticity is a disorder of the sensorimotor system characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. It is one component of the upper motoneuron syndrome, along with released flexor reflexes, weakness, and loss of dexterity. Spasticity is an important "positive" diagnostic sign of the upper motoneuron syndrome, and when it restricts motion, disability may result. The "negative" signs--weakness and loss of dexterity--invariably alter patient function when they occur. In an upper motoneuron syndrome, the alpha motoneuron pool becomes hyperexcitable at the segmental level. This hyperexcitability is hypothesized to occur through a variety of mechanisms, not all of which have yet been demonstrated in humans. Spasticity caused by spinal cord lesions is often marked by a slow increase in excitation and over-activity of both flexors and extensors with reactions possibly occurring many segments away from the stimulus. Cerebral lesions often cause rapid build-up of excitation with a bias toward involvement of antigravity muscles. Chronic spasticity can lead to changes in the rheologic properties of the involved and neighboring muscles. Stiffness, contracture, atrophy, and fibrosis may interact with pathologic regulatory mechanisms to prevent normal control of limb position and movement. In the clinical exam, it is important to distinguish between the resistance due to spasticity and that due to rheologic changes, because the distinction has therapeutic implications. Diagnostic nerve or motor point blocks and dynamic or multichannel EMG are useful to distinguish the contributions of spasticity and stiffness to the clinical problem.
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PMID:Clinicophysiologic concepts of spasticity and motor dysfunction in adults with an upper motoneuron lesion. 982 79

Despite the lack of consensus of the role of spasticity in the observed motor disability in cerebral palsy (CP), alleviation of spasticity remains a primary focus in the clinical management of these patients. The purposes of this study were to: (1) quantify voluntary torque and passive resistance across speeds in the hamstrings and quadriceps muscle groups with respect to the presence of stretch responses and/or passive muscle stiffness in patients with CP compared to age-related children without disability, and (2) relate these parameters to each other and to functional performance, as measured by the Gross Motor Function Measure (GMFM), in CP. Included were 23 subjects with CP, sub-grouped by the presence or absence of stretch responses as determined by electromyography, and 9 subjects without CP. Results indicated that peak torque was considerably greater in the comparison group than for each of the CP groups and resistance was greater in the CP group with spasticity compared to the nonspastic CP group in both muscles at all speeds. Stiffness differed between the spastic CP group and the comparison group only for the quadriceps at the fastest speed. Higher passive resistance torque and stiffness were correlated with decreased voluntary torque, particularly for the antagonists, and with lower GMFM scores. In conclusion, strength and motor function are related to the magnitude of resistance torque and stiffness in CP, although the small amount of variance explained reinforces the multidimensional nature of this disorder, and the challenges inherent in managing it.
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PMID:Spasticity versus strength in cerebral palsy: relationships among involuntary resistance, voluntary torque, and motor function. 1185 33

Stiffness and spasticity are common neurologic symptoms that affect limb movements. We describe a patient who presented with ill-defined stiffness and an exaggerated startle response, who on serial examinations had variable degrees of stiffness and marked hyperreflexia but with plantar flexor signs. Stiff-person syndrome (SPS) was considered when axial stiffness became evident and was confirmed with highly elevated anti-GAD antibody titers. A favorable response to a short course of intravenous immunoglobulin treatment was sustained for more than 10 months, an unusual feature to the disease. We review the clinical features, pathologic mechanism, and treatment of this disorder.
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PMID:Stiffness, spasticity, or both: a case report of stiff-person syndrome. 1907 72