scholarly journals Transcutaneous Spinal Neuromodulation Reorganizes Neural Networks in Patients with Cerebral Palsy

2021 ◽  
Author(s):  
Parag Gad ◽  
Susan Hastings ◽  
Hui Zhong ◽  
Gaurav Seth ◽  
Sachin Kandhari ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Weight Bearing ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Acute Effects ◽  
Joint Angles ◽  
Extensor Muscles ◽  
Sensory Motor ◽  
Coordination Patterns ◽  
Gmfcs Level

AbstractSpinal neuromodulation and activity-based rehabilitation triggers neural network reorganization and enhances sensory-motor performances involving the lower limbs, the trunk, and the upper limbs. This study reports the acute effects of Transcutaneous Electrical Spinal Cord Neuromodulation (SCONE™, SpineX Inc.) on 12 individuals (ages 2 to 50) diagnosed with cerebral palsy (CP) with Gross Motor Function Classification Scale (GMFCS) levels ranging from I to V. Acute spinal neuromodulation improved the postural and locomotor abilities in 11 out of the 12 patients including the ability to generate bilateral weight bearing stepping in a 2-year-old (GMFCS level IV) who was unable to step. In addition, we observed independent head-control and weight bearing standing with stimulation in a 10-year-old and a 4-year old (GMFCS level V) who were unable to hold their head up or stand without support in the absence of stimulation. All patients significantly improved in coordination of flexor and extensor motor pools and inter and intralimb joint angles while stepping on a treadmill. While it is assumed that the etiologies of the disruptive functions of CP are associated with an injury to the supraspinal networks, these data are consistent with the hypothesis that spinal neuromodulation and functionally focused activity-based therapies can form a functionally improved chronic state of reorganization of the spinal-supraspinal connectivity. We further suggest that the level of reorganization of spinal-supraspinal connectivity with neuromodulation contributed to improved locomotion by improving the coordination patterns of flexor and extensor muscles by modulating the amplitude and firing patterns of EMG burst during stepping.

Pain management in Avabahuka

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Prashanth AS ◽  
Praveenkumar H Bagali
Keyword(s):  
Pain Management ◽  
Research Group ◽  
Shoulder Joint ◽  
Weight Bearing ◽  
Upper Limbs ◽  
Joint Management ◽  
Attack And Defense

In the process of evolution from quadrupeds to bipeds, the forelimbs developed into upper limbs. In quadrupeds they serve the purpose of weight bearing and attack. In bipeds they serve fine functions, holding an object, attack and defense. It has been estimated by research group that the hand performs approximately thousand different functions in an ordinary day today’s activity. Apabahuka is one such disease which hampers most of the foresaid functions of the hand. Although any of the classics do not mention about the Shoola as a Laxana of Apabahuka, it still is a feature practically seen in Avabahuka patients. Chikitsa Sara Sangraha and Nidana Sara, clearly mentions about Svedana as a predominant Laxana of Avabahuka, along with other Laxana. It is often said that ‘the pain is often severe enough to disturb the sleep’. Amsa Marma is primarily involved in Avabahuka, it is a Snayu Marma and one of Vaikalyakara Marma, any trauma to this will produce disability or deformity of the shoulder joint. Management of pain is facilitated by Marma Chikitsa i.e. Nidana Parivarjana, Abhyanga, Swedana, Uttarabhaktika Snehapana, Vata Hara Oushadha Sevana, Marmabhighata Chikitsa, Brumhana, Nasya, Lepa, Seka, Nasya, Nasaapaana, Agnikarma, Siravyadha, etc.

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

scholarly journals Effects of Dominant and Nondominant Limb Immobilization on Muscle Activation and Physical Demand during Ambulation with Axillary Crutches

2021 ◽  
Vol 6 (1) ◽  
pp. 16
Author(s):  
Kara B. Bellenfant ◽  
Gracie L. Robbins ◽  
Rebecca R. Rogers ◽  
Thomas J. Kopec ◽  
Christopher G. Ballmann
Keyword(s):  
Lower Limb ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Lower Limbs ◽  
Medial Gastrocnemius ◽  
Bipedal Walking ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Physical Demand ◽  
Limb Dominance

The purpose of this study was to investigate the effects of how limb dominance and joint immobilization alter markers of physical demand and muscle activation during ambulation with axillary crutches. In a crossover, counterbalanced study design, physically active females completed ambulation trials with three conditions: (1) bipedal walking (BW), (2) axillary crutch ambulation with their dominant limb (DOM), and (3) axillary crutch ambulation with their nondominant limb (NDOM). During the axillary crutch ambulation conditions, the non-weight-bearing knee joint was immobilized at a 30-degree flexion angle with a postoperative knee stabilizer. For each trial/condition, participants ambulated at 0.6, 0.8, and 1.0 mph for five minutes at each speed. Heart rate (HR) and rate of perceived exertion (RPE) were monitored throughout. Surface electromyography (sEMG) was used to record muscle activation of the medial gastrocnemius (MG), soleus (SOL), and tibialis anterior (TA) unilaterally on the weight-bearing limb. Biceps brachii (BB) and triceps brachii (TB) sEMG were measured bilaterally. sEMG signals for each immobilization condition were normalized to corresponding values for BW.HR (p < 0.001) and RPE (p < 0.001) were significantly higher for both the DOM and NDOM conditions compared to BW but no differences existed between the DOM and NDOM conditions (p > 0.05). No differences in lower limb muscle activation were noted for any muscles between the DOM and NDOM conditions (p > 0.05). Regardless of condition, BB activation ipsilateral to the ambulating limb was significantly lower during 0.6 mph (p = 0.005) and 0.8 mph (p = 0.016) compared to the same speeds for BB on the contralateral side. Contralateral TB activation was significantly higher during 0.6 mph compared to 0.8 mph (p = 0.009) and 1.0 mph (p = 0.029) irrespective of condition. In conclusion, limb dominance appears to not alter lower limb muscle activation and walking intensity while using axillary crutches. However, upper limb muscle activation was asymmetrical during axillary crutch use and largely dependent on speed. These results suggest that functional asymmetry may exist in upper limbs but not lower limbs during assistive device supported ambulation.

A variant of the gene HARS detected in the clinical exome: etiology of a peripheral neuropathy undiagnosed for 20 years

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Raquel Lahoz Alonso ◽  
Paula Sienes Bailo ◽  
Jose Luis Capablo Liesa ◽  
Sara Álvarez de Andrés ◽  
Jose Luis Bancalero Flores ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Neurological Disease ◽  
Motor Impairment ◽  
Lower Limbs ◽  
Case Presentation ◽  
Genetic Sequencing ◽  
Charcot Marie Tooth ◽  
Sensory Motor ◽  
Exacerbation Of Symptoms ◽  
Over Time

AbstractObjectivesDescribe a case with axonal Charcot-Marie-Tooth (CMT) type 2W, a neurological disease characterized by peripheral neuropathy typically involving the lower limbs and causing gait alterations and distal sensory-motor impairment.Case presentationWe report this case, where the application of massive genetic sequencing (NGS) with clinical exome in a molecular genetics laboratory enabled to detect the presence of candidate variants of the clinic of the patient.ConclusionsThe variant detected in HARS gene suggests that this variant could be causative of the symptoms of the patient, who went undiagnosed for 20 years and experienced an exacerbation of symptoms over time.

scholarly journals Musculoskeletal biomechanics in sit-to-stand and stand-to-sit activities with stroke subjects: a systematic review

2010 ◽  
Vol 23 (1) ◽  
pp. 35-52 ◽  
Author(s):  
Christina Danielli Coelho de Morais Faria ◽  
Viviane Amaral Saliba ◽  
Luci Fuscaldi Teixeira-Salmela
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Weight Bearing ◽  
Experimental Studies ◽  
Quality Parameters ◽  
Lower Limbs ◽  
Extensive Literature ◽  
Manual Search ◽  
Sit To Stand ◽  
Extensive Literature Search

INTRODUCTION: Sit-to-stand and stand-to-sit are two of the most mechanically demanding activities undertaken in daily life and which are usually impaired in stroke subjects. OBJECTIVES: To determine the distinguishing characteristics in musculoskeletal biomechanical outcomes of the sit-to-stand and stand-to-sit activities with stroke subjects, with an emphasis on the clinical management of stroke disabilities, in a systematic review. MATERIAL AND METHODS: An extensive literature search was performed with the MEDLINE, CINAHL, EMBASE, PEDro, LILACS, and SciELO databases, followed by a manual search, to select studies on musculoskeletal biomechanical outcomes in both activities with stroke subjects, without language restrictions, and published until December/2007. RESULTS: Out of the 432 studies, only 11 reported biomechanical outcomes of both activities and none reached the total score on the selected quality parameters. The majority of the experimental studies which compared groups did not achieve acceptable scores on their methodological quality (PEDRo). The investigated conditions and interventions were also restricted. Only one study compared biomechanical outcomes between the activities, but only evaluated the time spent to perform them. Few musculoskeletal biomechanical outcomes have been investigated, being weight bearing on the lower limbs and duration of the activities the most investigated. CONCLUSION: There is little information regarding musculoskeletal biomechanical outcomes during these activities with stroke subjects and no definite conclusions can be drawn regarding the particularities of these outcomes on their performance with stroke survivors.

The role of rehabilitation exercises on weight, functional strength and exercise adherence in knee osteoarthritis patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Muhammad Tariq Rafiq ◽  
Mohamad Shariff Abdul Hamid ◽  
Eliza Hafiz ◽  
Khalid Rashid ◽  
Farid Ahmad Chaudhary
Keyword(s):  
Knee Osteoarthritis ◽  
Weight Bearing ◽  
Exercise Adherence ◽  
Lower Limbs ◽  
Joint Disease ◽  
Control Group ◽  
Post Test ◽  
Rehabilitation Exercises ◽  
Normally Distributed

Introduction: Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients. Materials And Method: The patients were recruited from the Urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for 12 weeks. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for the normally distributed data) and the Wilcoxon Signed Ranked Test (for the data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The analysis of variance 2 × 2 factors and the Mann-Whitney U-test were used to analyze the difference of weight and functional strength respectively between the groups. Results: The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within the group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within the group. The improvement in the scores of functional strength was greater in the patients of RG than the CG (p < 0.001. Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001). Conclusion: The REs could improve weight, functional strength and exercise adherence.

Lower-Limb Rehabilitation at Home

2021 ◽  
Vol 13 (2) ◽  
pp. 12-23
Author(s):  
Seanglidet Yean ◽  
Bu-Sung Lee ◽  
Chai Kiat Yeo
Keyword(s):  
Lower Limbs ◽  
Ageing Population ◽  
Joint Angles ◽  
Functional Activities ◽  
State Identification ◽  
Motion State ◽  
Limb Rehabilitation ◽  
Lower Limb Rehabilitation ◽  
Rehabilitation Exercise ◽  
At Home

Ageing causes loss of muscle strength, especially on the lower limbs, resulting in higher risk to injuries during functional activities. The path to recovery is through physiotherapy and adopt customized rehabilitation exercise to assist the patients. Hence, lowering the risk of incorrect exercise at home involves the use of biofeedback for physical rehabilitation patients and quantitative reports for clinical physiotherapy. This research topic has garnered much attention in recent years owing to the fast ageing population and the limited number of clinical experts. In this paper, the authors survey the existing works in exercise assessment and state identification. The evaluation results in the accuracy of 95.83% average classifying exercise motion state using the proposed raw signal. It confirmed that raw signals have more impact than using sensor-fused Euler and joint angles in the state identification prediction model.

Sign in / Sign up

Export Citation Format

Share Document