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

Presynaptic inhibition plays an important role in controlling sensory processing of information in humans, as in other animals. However, because of experimental constraints the methods for measuring presynaptic inhibition are necessarily more indirect in humans. The most common method uses the modulation of the H-reflex by vibratory or electrical inputs. However, these stimuli can produce postsynaptic as well as presynaptic changes so it is important to use very short periods of stimulation and measure changes at a latency where presynaptic changes predominate. In addition, the stimuli should be superimposed upon a steady background of EMG activity, preferably in a single motor unit, to maintain the postsynaptic state at a constant level. Recent studies indicate that presynaptic inhibition is used as part of the program for voluntary movement and that it can be rapidly and dramatically adapted to the task being carried out. This task-dependent modulation is produced by pattern generators within the central nervous system as well as sensory feedback from the periphery, but the relative importance of the two remains uncertain. Clinical disorders, such as spasticity, affect the ability of humans to modulate presynaptic inhibition, and contribute to the deficits observed. Improved methods for treating the symptoms pharmacologically and electrically can improve function in these patients.
Prog Neurobiol 1995 Dec
PMID:Presynaptic inhibition in humans. 878 34

The study tested the spasmolytic effect of Botulinum toxin A in two groups of hemiparetic patients with lower limb spasticity: in the first group (n = 5) 2000 U Dysport were injected into the soleus, tibialis posterior and both heads of gastrocnemius muscles alone; the second (n = 5) received additional repetitive alternating electrical stimulation of M. tibialis anterior and plantar flexors for 30 min six times per day during the 3 days following the injection. Muscle tone, rated by the Ashworth spasticity score, and gait analysis including recording of vertical ground reaction forces, were assessed before and 4 weeks after injection. The combined treatment proved to be more effective with respect to the clinically assessed reduction of muscle tone, gait velocity, stride length, stance- and swing-symmetry (P < 0.05). The result is discussed with reference to animal experiments demonstrating enhanced toxin uptake and accelerated onset of its paralytic effect by electrical stimulation.
Neurosci Lett 1995 Dec 01
PMID:Short-term electrical stimulation enhances the effectiveness of Botulinum toxin in the treatment of lower limb spasticity in hemiparetic patients. 883 Mar 7

Prevention is of importance when the patient is already suffering from a serious disease, e.g., from arterial obstructive disease causing a stroke or an amputation, from a hip fracture or other diseases that might threaten his independence. Prevention covers a wide field of topics. Most importantly, the patient must recover from his acute disease. It is important to avoid complications which are not specific for the disease but are typical for a bedridden old person (decubital ulcer, dehydration etc.). Prevention also means to avoid recurrence of the same disease as well as complications that frequently occur during the clinical course and may influence the outcome (spasticity in stroke patients, muscular calcification following hip replacement).
Z Arztl Fortbild (Jena) 1995 Dec
PMID:[Current aspects of secondary and tertiary prevention from the viewpoint of the clinical gerontologist]. 885 Jan 12

A review of 1300 patients with spinal cord injury (SCI), over a period of 14 years, revealed 12 patients with an 'acute abdomen'. Seven events occurred during the initial admission, ranging from 10 days to 9 months from injury, and five during readmission of 'chronic' SCI patients. Four were in the acute stage 10-30 days from injury, all with peptic ulcer perforations. The remainder had either an intestinal obstruction, appendicitis or peritonitis. All of the neurological levels were above T6 except for one patient who had a low level paraplegia. The classical signs of an 'acute abdomen' may be missing in such patients thus delaying diagnosis by 1-4 days. The most important signs were autonomic dysreflexia, referred shoulder tip pain, abdominal pain, abdominal distension, increased spasticity and abdominal pain with nausea and vomiting. Less importance was given to the classical signs of abdominal tenderness, abdominal muscle rigidity, rebound, fever and of leukocytosis. Prompt diagnosis and treatment will minimise morbidity and mortality.
Paraplegia 1995 Dec
PMID:The acute abdomen in spinal cord injury individuals. 892 9

Changes in the delivery of health care have resulted in new sites for rehabilitation of patients with severe brain injury (BI). Adjustments in the training of resident physicians in physical medicine and rehabilitation are likely to ensue. We utilized Likert scales and open-ended questions to survey residents who were assigned over a 2(1/2)-year period to a subacute BI rehabilitation unit (SRU). Residents were surveyed about their desire to participate in a SRU training site, and the usefulness of such a rotation, and compared the rotation to traditional settings in which patients with similar diagnoses were treated. The results indicated that significant positive changes in residents' attitudes towards this type of training site occurred (p = 0.01). The rotation was felt to be useful (p = 0.008) despite initial misgivings. Positive educational aspects were exposure to the unique problems of patients with severe BI (e.g. spasticity and agitation) and a sense of independence and competence in leadership roles. Problematic aspects included the management of medically unstable patients without supportive resources, and a lack of nurses trained in rehabilitation principles. Training of residents in the rehabilitation management of patients with severe BI can be perceived as a valuable educational experience by trainees.
Brain Inj 1996 Dec
PMID:Subacute brain injury rehabilitation: an opportunity for medical education and training. 893 6

We describe a male and his sister's son with microcephaly, microphthalmia, microcornea, congenital cataract, hypogenitalism, severe mental deficiency, progressive spasticity and growth retardation. Both affected males have brachycephaly, upslanting palpebral fissures, epicanthal folds, highly arched palate, small mouth, and retrognathia. Two maternal cousins of the propositus's mother may also have been affected. Chromosomal and metabolic findings in the propositus were normal. To our knowledge, this disorder has not been reported before as an X-linked syndrome.
Am J Med Genet 1996 Dec 11
PMID:X-linked microcephaly, microphthalmia, microcornea, congenital cataract, hypogenitalism, mental deficiency, growth retardation, spasticity: possible new syndrome. 895 26

The use of a functional neuromuscular stimulation (FNS) device can have therapeutic effects that persist when the device is not in use. Clinicians have reported changes in both voluntary and electrically assisted neuromuscular function and improvements in the condition of soft tissue. Motor recovery has been observed in people with incomplete spinal cord injury, stroke, or traumatic brain injury after the use of motor prostheses. Improvement in voluntary dorsiflexion and overall gait pattern has been reported both in the short term (several hours) and permanently. Electrical stimulation of skin over flexor muscles in the upper limb produced substantial reductions for up to 1 h in the severity of spasticity in brain-injured subjects, as measured by the change in torque generation during ramp-and-hold muscle stretch. There was typically an aggravation of the severity of spasticity when surface stimulation reached intensities sufficient to also excite muscle. Animals were trained to alter the size of the H-reflex to obtain a reward. The plasticity that underlies this operantly conditioned H-reflex change includes changes in the spinal cord itself. Comparable changes appear to occur with acquisition of certain motor skills. Current studies are exploring such changes in humans and animals with spinal cord injuries with the goal of using conditioning methods to assess function after injury and to promote and guide recovery of function. A better understanding of the mechanisms of neural plasticity, achieved through human and animal studies, may help us to design and implement FNS systems that have the potential to produce beneficial changes in the subject's central nervous systems.
IEEE Trans Rehabil Eng 1996 Dec
PMID:Therapeutic neural effects of electrical stimulation. 897 48

We studied the effects of electrical stimulation of the skin on upper extremity spasticity in nine hemiparetic stroke subjects. The effects were quantified by comparing reflex torque responses elicited during ramp and hold angular perturbations of the elbow recorded before and after low-intensity skin stimulation. Electrical stimulation was applied to skin over the biceps muscle for a period of ten minutes at a 20 Hz frequency, pulse duration 0.1 ms, with an intensity level below motor threshold but above sensory threshold. In seven of the nine subjects, stimulation of skin over spastic muscle reduced peak torque responses in both flexors and extensors for at least 30 min. In these seven subjects there were significant increases in mean threshold angle for the onset of reflex torque so that a greater angular rotation was required to initiate the stretch reflex response. This shift occurred without change in reflex impedance. The origins of these long-term changes in reflex torque are unclear, but may reflect synaptic plasticity of spinal circuitry outside the stretch reflex loop.
IEEE Trans Rehabil Eng 1996 Dec
PMID:Long-lasting reductions of spasticity induced by skin electrical stimulation. 897 49

The Lesch-Nyhan syndrome results from a complete or virtually complete deficiency of the purine salvage enzyme, hypoxanthine guanine phosphoribosyl transferase (HPRT). The disease is characterized by hyperuricemia, choreoathetosis, spasticity, compulsive self-mutilation, and mental retardation. Patients with a partial deficiency of HPRT are spared most of the neurological disorder of Lesch-Nyhan syndrome. The specific relationship between HPRT deficiency and the neurological dysfunction in the Lesch-Nyhan syndrome is not known, at present. The genetic lesion which result in HPRT deficiency are heterogeneous. About 90 different mutations were found in over 110 families. The DNA-based mutation detection technique can be used for the diagnosis of affected males and for the determination of carrier status of asymptomatic females. This technique is also applicable for the prenatal diagnosis for Lesch-Nyhan syndrome. Transgenic mice, deficient in HPRT activity, have been obtained but they do not show any neurological dysfunction. After administration of 9-ethyladenine, however, they showed the self-injury behavior.
Nihon Rinsho 1996 Dec
PMID:[Complete and partial deficiency of HPRT]. 897 12

F-wave amplitudes have been used to demonstrate changes of motor neuron excitability in spasticity and pharmacological antispastic therapy. In this study it is shown that F-wave amplitudes can also be used to document changes of motor neuron excitability as an effect of physiotherapy. Ten F-waves were recorded immediately before and after physiotherapy in 42 legs of 21 patients with spastic paraparesis due to multiple sclerosis. Mean F-wave amplitude, maximum F-wave amplitude, mean F-wave/M-response ratio and maximum F-wave/M-response ratio were significantly lower after physiotherapy than before. Therefore the antispastic effect of physiotherapy is documented by a decrease of F-wave-amplitude parameters.
Electromyogr Clin Neurophysiol 1996 Dec
PMID:Effects of physiotherapy on F-wave-amplitudes in spasticity. 898 80


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