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

Fifty hemiparetic subjects were selected from a population of 250 patients according to criteria forsuitable candidates for peroneal stimulation. The patients received from 10 to 120 hours of treatment during 2--5 weeks. The therapeutic results obtained were classified into four groups, ranging from none to excellent improvement of voluntary movement and reduction of spasticity. The clinical results were correlated to different variables where time from lesion, spasticity, and extent of treatment appeared to be the most important ones. The percentage of excellent results decreased with increasing time from lesion and spasticity, and increased with increasing treatment. Orthotic validity (i.e. the beneficial effect of the orthosis) was observed in 76% of the selected cases and in most of them it was very significant. Preliminary tests performed on 9 subjects showed that in cases with orthotic validity the peroneal brace slightly reduces the oxygen consumption of patients and improves their motivation. This work gives a more quantitative perspective of the validity of functional peroneal stimulation and a better indication of criteria for patient selection. The overall validity of an electronic peroneal brace appears to apply to 15% of the total ambulatory hemiparetic population and its therapeutic value is relevant in two-thirds of such cases if sufficient treatment is provided. Application of functional electrical stimulation to non-ambulatory subjects in the acute phase may however lead to a higher percentage of cases of therapeutic validity.
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PMID:Clinical experience of electronic peroneal stimulators in 50 hemiparetic patients. 31 98

To compare the effect of walking exercise in water with that in air in cerebral palsied children, we measured in ten subjects oxygen uptake (VO2) during walking for 3-minutes. In 7 children with spastic type of cerebral palsy, VO2 values were significantly lower in exercises in water than in air (p less than 0.05). No significant differences were found in athetotic children. In 5 children with crouched posture VO2 showed a tendency to be lower in exercises in water than in air (0.05 less than p less than 0.1). In contrast, significant differences were not found in 5 children without crouched posture. Children with spasticity or crouched posture may be able to walk in water more than in air.
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PMID:[Comparison of walking exercises in air and in water in children with cerebral palsy]. 280 98

Hoffmann's reflex or H-reflex (HR) is an electrically elicited reflex that measures excitability of motoneurons and shares some physiologic properties with the deep tendon reflex. Children with tendon hyperreflexia due to cerebral palsy usually have higher amplitude HRs. Nitrous oxide (N2O) depresses the HR in patients with normal spinal reflexes, although the effect of N2O in conditions with hyperreflexia such as cerebral palsy is not known. We propose to determine the effect of N2O on the amplitude of the HR under general anesthesia in children with hyperreflexia due to cerebral palsy. We studied eight children undergoing selective dorsal rhizotomy (SDR) for the relief of spasticity. The maximum amplitudes of the HR (HRmax) and direct motor response (MRmax) were routinely evoked under the following anesthetic conditions: 1) sufentanil and 66% N2O/33% oxygen; and 2) sufentanil and 100% oxygen. The HRmax amplitude was significantly lower when N2O was part of the inspired gas mixture. The differences between the no N2O and the 66% N2O groups were significant. The MRmax did not change significantly. Abnormal spinal reflexes seen in spastic diplegia can be abolished by inhaled N2O. This finding also suggests that N2O-induced depression of spinal reflexes should be a consideration during physiologic monitoring of the spinal cord under general anesthesia.
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PMID:Nitrous oxide depresses the H-reflex in children with cerebral palsy. 781 7

A patient with a cervical spinal cord injury receiving intrathecal baclofen for spasticity control underwent a 7 week course of hyperbaric oxygen therapy to induce healing of an ischial decubitus ulcer. After completion of this treatment and during a routine baclofen infusion pump refill, the actual pump reservoir volume exceeded computer measurements obtained with telemetry. Examination of the physiology of hyperbaric oxygen therapy in relation to infusion pump function revealed that the intraspinal pressures attained during hyperbaric oxygen therapy produced retrograde leakage of cerebrospinal fluid into the infusion pump reservoir.
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PMID:Hyperbaric oxygen therapy: implications for spinal cord injury patients with intrathecal baclofen infusion pumps. Case report. 802 38

Associations between a physically active leisure, physical fitness, impairment and disability have been tested in 123 volunteers (73 with paraplegia and 50 with quadriplegia). Active physical leisure was assessed by the questionnaire of Godin and Shephard (Canadian Journal of Sports Sciences 10, 141-6 1985). Fitness measures included body mass index, peak oxygen intake on a wheelchair ergometer, and tests of muscle strength and endurance (peak isokinetic torque, average muscle power and total muscle work for shoulder flexion, shoulder adduction and elbow flexion at movement speeds of 60 degrees and 180 degrees s-1). Primary impairment was assessed by the ISMGF scale, and secondary impairment was judged from reported pressure scores, spasticity, and urinary infections over the previous 12 months. Scores for self-care and mobility were obtained using a modified Barthel Index. Physically active leisure and fitness were unrelated to secondary impairment. However, functional ability for a given primary impairment was significantly correlated with peak oxygen intake and the three indices of muscle strength, particularly in individuals with high level lesions. Associations between physical activity and functional ability were weaker, but tended in the same direction. Although longitudinal studies are needed to prove the causality of these relationships, the findings point towards a significant influence of fitness status upon functional ability. Rehabilitation teams should thus give a stronger emphasis to systematic exercise conditioning programmes when planning overall treatment following SCI.
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PMID:Relationship of impairment and functional ability to habitual activity and fitness following spinal cord injury. 817 29

The debilitating loss of function after a stroke has both primary and secondary effects on sensorimotor function. Primary effects include paresis, paralysis, spasticity, and sensory-perceptual dysfunction due to upper motor neuron damage. Secondary effects, contractures and disuse muscle atrophy, are also debilitating. This paper presents theoretical and empirical benefits of aerobic exercise after stroke, issues relevant to measuring peak capacity, exercise training protocols, and the clinical use of aerobic exercise in this patient population. A stroke, and resulting hemiparesis, produces physiological changes in muscle fibres and muscle metabolism during exercise. These changes, along with comorbid cardiovascular disease, must be considered when exercising stroke patients. While few studies have measured peak exercise capacity in hemiparetic populations, it has been consistently observed in these studies that stroke patients have a lower functional capacity than healthy populations. Hemiparetic patients have low peak exercise responses probably due to a reduced number of motor units available for recruitment during dynamic exercise, the reduced oxidative capacity of paretic muscle, and decreased overall endurance. Consequently, traditional methods to predict aerobic capacity are not appropriate for use with stroke patients. Endurance exercise training is increasingly recognised as an important component in rehabilitation. An average improvement in maximal oxygen consumption (VO2max) of 13.3% in stroke patients who participated in a 10-week aerobic exercise training programme has been reported compared with controls. This study underscored the potential benefits of aerobic exercise training in stroke patients. In this paper, advantages and disadvantages of exercise modalities are discussed in relation to stroke patients. Recommendations are presented to maximise physical performance and minimise potential cardiac risks during exercise.
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PMID:Benefits of aerobic exercise after stroke. 872 2

In 10 patients (five females) suffering from multiple sclerosis with mild degree of disability, (EDSS ranging from 0 to 2) and in 10 age and sex matched control subjects we investigated lung function, respiratory muscles strength and cardiorespiratory response to incremental exercise in order to assess the metabolic cost of exercise. In the absence of any impairment of lung volumes and flows and in- and expiratory maximal mouth pressures, at peak of exercise oxygen consumption (VO2max = 1886 +/- 145 ml/min) and workload (Wmax = 137 +/- 9.8 watts) were slightly diminished in patients, as compared with controls (VO2max = 2246 +/- 196 ml/min and Wmax = 164 +/- 14.7 watts). These findings were associated with an increased heart rate (HR) and reduced oxygen pulse (VO2/HR) at the same workloads. During the whole exercise, however, the slope of the linear relationship between VO2 and work exhibited by the patients, amounting to 9.9 +/- 0.6 ml/min/watt, was similar to that of the controls (10.9 +/- 0.42 ml/min/watt). Incidentally, both at rest and during exercise, the patients showed a significantly greater minute ventilation (VE) due to a faster respiratory rate, associated with an augmented dead space (P < 0.05). We conclude that an increase of metabolic cost of exercise does not occur in multiple sclerosis patients with mild disability, suggesting a lack or a low degree of spasticity and/or ataxia elicited by the effort. Thus, their exertional capacity appears to be limited mainly by a poor training. The tachypnea observed in these patients at rest and during exercise was unexpected and the reason for adopting such a pattern of breathing is unclear.
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PMID:Energy cost of exercise in multiple sclerosis patients with low degree of disability. 934 81

Walkers with the frame positioned behind the child have been advocated recently, mainly because they may allow a more upright and therefore more normal ambulation and perhaps encourage favourable neuromuscular development. The purpose of this study was to estimate and compare speed, energy cost, and perceived exertion during walking with an anterior walker and a posterior walker. Ten children with spastic diplegia, average age 11 years, who were familiar with both types of walker participated in the study. Spasticity was measured according to the modified Ashworth scale. Oxygen cost was determined by the argon-diluted method using a mixing box mounted on a backpack, and the perceived exertion was graded. The results of the study showed that there are no differences in the measured variables in walking between the anterior and the posterior walker in children familiar with both walkers and also that most of the children preferred the posterior walker.
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PMID:Oxygen cost, walking speed, and perceived exertion in children with cerebral palsy when walking with anterior and posterior walkers. 935 28

In this study the energy cost of level walking was measured in 23 patients with stationary spastic paresis before and after a two-week treatment (45 min daily) of hydro-kinesi therapy, the latter consisting of passive and active movements in warm (32 degrees C) sea water, free swimming and water immersion walking. Among the subjects (80.2 +/- 13.2 kg body mass; 56.0 +/- 14.6 years of age; 10.7 +/- 6.6 years of duration of spasticity), 12 were affected by hemiparesis, 4 by multiple sclerosis and 7 by spinal cord injury. The energy cost of level walking (Cw) was measured before and after therapy from the ratio of the overall steady-state oxygen consumption to the effective speed of progression. The differences in Cw due to the treatment, at matched speeds, were found to be negligible at speeds higher than 0.75 m.s-1 (less than 5%) but to increase, with decreasing speed, up to about 17% at 0.1 m.s-1. The treatment was therefore effective in improving the gait characteristics of the subjects, through a decrease of their Cw, mainly at low speeds of progression.
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PMID:The energy cost of level walking before and after hydro-kinesi therapy in patients with spastic paresis. 976 44

Hyperbaric oxygen (HBO2) therapy for children with cerebral palsy (CP) is not new. Research documenting the effects in this population has been anecdotal. We evaluated the effects of HBO2 therapy for 25 children (X = 5.6 +/- 1.6 yr) with a functional diagnosis of spastic diplegic CP. Pre- and post-HBO2 evaluations consisted of the following measures: gross motor function measure (GMFM), fine motor function (Jebsen test for hand function), spasticity (modified Ashworth scale), video analysis, and parental questionnaire. The protocol for HBO2 therapy was 20 treatments of 95% oxygen at 1.75 atm abs for 60 min. The Wilcoxon matched-pairs signed-rank test for non-parametric measures was used to compare pre- and post-treatment data. Results showed improved gross motor function in three of the five items in the GMFM test, improved fine motor function in three of the six hand tests, reduced spasticity in three of four muscle groups when assessed by a physician specializing in CP, and improvements for four of nine questions posed to parents.
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PMID:Effects of hyperbaric oxygen therapy on children with spastic diplegic cerebral palsy: a pilot project. 1064 70


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