The Use of Patterned Neuromuscular Stimulation to Improve Hand Function Following Surgery for Ulnar Neuropathy

1994 ◽  
Vol 19 (4) ◽  
pp. 430-433 ◽  
Author(s):  
T. PETTERSON ◽  
G. P. SMITH ◽  
J. A. OLDHAM ◽  
T. E. HOWE ◽  
R. C. TALLIS
Keyword(s):  
Ulnar Nerve ◽  
Single Case ◽  
Hand Function ◽  
Single Case Design ◽  
Neuromuscular Stimulation ◽  
Single Motor Unit ◽  
First Dorsal Interosseous Muscle ◽  
Hand Muscle ◽  
The Right ◽  
Dorsal Interosseous Muscle

A 60-year-old man with wasting and weakness of the right hand following ulnar nerve entrapment at the elbow was referred for electrotherapy. An ulnar nerve transposition had been performed 2 years previously. This had produced some improvement in nerve conduction without significantly improving hand muscle function. The right first dorsal interosseous muscle (FDI) was stimulated for 4 hours per day over a 6-week period with a stimulus pattern replicating the discharge of a single motor unit from a healthy, fatigued FDI (patterned neuromuscular stimulation or PNMS). The response was assessed using a single case design. Significant improvements in the strength and fatigue resistance of the FDI were observed, associated with improvements in general hand function. PNMS may be useful in restoring hand function in patients with muscle atrophy following entrapment neuropathy.

scholarly journals Modulation of Corticospinal Excitability Depends on the Pattern of Mechanical Tactile Stimulation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Sho Kojima ◽  
Hideaki Onishi ◽  
Shota Miyaguchi ◽  
Shinichi Kotan ◽  
Ryoki Sasaki ◽  
...  
Keyword(s):  
Tactile Stimulation ◽  
Motor Evoked Potential ◽  
Corticospinal Excitability ◽  
First Dorsal Interosseous Muscle ◽  
Stimulus Probe ◽  
Left And Right ◽  
The Right ◽  
Single Blind ◽  
Finger Pad ◽  
Dorsal Interosseous Muscle

We investigated the effects of different patterns of mechanical tactile stimulation (MS) on corticospinal excitability by measuring the motor-evoked potential (MEP). This was a single-blind study that included nineteen healthy subjects. MS was applied for 20 min to the right index finger. MS intervention was defined as simple, lateral, rubbing, vertical, or random. Simple intervention stimulated the entire finger pad at the same time. Lateral intervention stimulated with moving between left and right on the finger pad. Rubbing intervention stimulated with moving the stimulus probe, fixed by protrusion pins. Vertical intervention stimulated with moving in the forward and backward directions on the finger pad. Random intervention stimulated to finger pad with either row protrudes. MEPs were measured in the first dorsal interosseous muscle to transcranial magnetic stimulation of the left motor cortex before, immediately after, and 5–20 min after intervention. Following simple intervention, MEP amplitudes were significantly smaller than preintervention, indicating depression of corticospinal excitability. Following lateral, rubbing, and vertical intervention, MEP amplitudes were significantly larger than preintervention, indicating facilitation of corticospinal excitability. The modulation of corticospinal excitability depends on MS patterns. These results contribute to knowledge regarding the use of MS as a neurorehabilitation tool to neurological disorder.

Radial Half of the Second Metacarpal Bone and the First Dorsal Interosseous Muscle Composite Flap for Treating the First Metacarpal Bone Defect: A Case Report

2019 ◽  
Vol 24 (03) ◽  
pp. 378-382
Author(s):  
Disorn Janesaksrisakul ◽  
Nontich Pongernnak ◽  
Navapong Anantavorasakul
Keyword(s):  
Bone Defect ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Hand Function ◽  
Metacarpal Bone ◽  
First Dorsal Interosseous ◽  
Vehicle Accident ◽  
First Dorsal Interosseous Muscle ◽  
Composite Flap ◽  
Dorsal Interosseous Muscle

Traumatic bone defect is a challenging problem for both patient and doctor. The goal of treatment is the restoration of hand function with acceptable appearance of an injured hand. Especially in the injury of the thumb, length and stability are very important to achieve good holding and pinching functions. We reported a 23-year-old patient with traumatic first metacarpal bone loss after a motor vehicle accident treated with vascularized radial half of the second metacarpal bone and the first dorsal interosseous muscle composite flap.

Decreased corticospinal excitability after subthreshold 1 Hz rTMS over lateral premotor cortex

Neurology ◽  
2001 ◽  
Vol 57 (3) ◽  
pp. 449-455 ◽  
Author(s):  
Willibald Gerschlager ◽  
Hartwig R. Siebner ◽  
John C. Rothwell
Keyword(s):  
Motor Cortex ◽  
Parietal Cortex ◽  
Motor Evoked Potentials ◽  
Premotor Cortex ◽  
Corticospinal Excitability ◽  
First Dorsal Interosseous ◽  
First Dorsal Interosseous Muscle ◽  
The Right ◽  
Hand Area ◽  
Dorsal Interosseous Muscle

Objective: To study whether trains of subthreshold 1 Hz repetitive transcranial magnetic stimulation (rTMS) over premotor, prefrontal, or parietal cortex can produce changes in excitability of motor cortex that outlast the application of the train.Background: Prolonged 1 Hz rTMS over the motor cortex can suppress the amplitude of motor-evoked potentials (MEP) for several minutes after the end of the train. Because TMS can produce effects not only at the site of stimulation but also at distant sites to which it projects, the authors asked whether prolonged stimulation of sites distant but connected to motor cortex can also lead to lasting changes in MEP.Methods: Eight subjects received 1500 magnetic stimuli given at 1 Hz over the left lateral frontal cortex, the left lateral premotor cortex, the hand area of the left motor cortex, and the left anterior parietal cortex on four separate days. Stimulus intensity was set at 90% active motor threshold. Corticospinal excitability was probed by measuring the amplitude of MEP evoked in the right first dorsal interosseous muscle by single suprathreshold stimuli over the left motor hand area before, during, and after the conditioning trains.Results: rTMS over the left premotor cortex suppressed the amplitude of MEP in the right first dorsal interosseous muscle. The effect was maximized (approximately 50% suppression) after 900 pulses and outlasted the full train of 1500 stimuli for at least 15 minutes. Conditioning rTMS over the other sites did not modify the size of MEP. A control experiment showed that left premotor cortex conditioning had no effect on MEP evoked in the left first dorsal interosseous muscle.Conclusions: Subthreshold 1 Hz rTMS of the left premotor cortex induces a short-lasting inhibition of corticospinal excitability in the hand area of the ipsilateral motor cortex. This may provide a model for studying the functional interaction between premotor and motor cortex in healthy subjects and patients with movement disorders.

Palmaris Longus Transfer for Replacement of the First Dorsal Interosseous

1986 ◽  
Vol 11 (1) ◽  
pp. 84-86
Author(s):  
T. HIRAYAMA ◽  
Y. ATSUTA ◽  
Y. TAKEMITSU
Keyword(s):  
Ulnar Nerve ◽  
Complete Recovery ◽  
Tendon Graft ◽  
First Dorsal Interosseous ◽  
Palmar Fascia ◽  
Palmaris Longus ◽  
First Dorsal Interosseous Muscle ◽  
Subcutaneous Tunnel ◽  
Dorsal Interosseous Muscle

Using palmaris longus, the first dorsal interosseous was reconstructed without free tendon graft. Palmaris longus prolonged with a strip of palmar fascia was transferred rectilinearly to the site of insertion of the first dorsal interosseous via a subcutaneous tunnel and fixed. This method was applied to seven hands of six patients and the follow-up observation continued for more than six months postoperatively. In six hands, favourable stability and abduction function of the index finger was achieved. In one hand, adhesion occurred at the site of the first dorsal interosseous muscle resulting in tenodesis. This operative method appears to be useful in the reconstruction of the first dorsal interosseous muscle from non-recovering paralysis following injury of the first dorsal interosseous muscle, or ulnar nerve. This method may also be utilized after decompression of chronic compression of the ulnar nerve giving no expectation of complete recovery by the reconstruction and augmentation of the first dorsal interosseous muscle. No unpleasant side effect was encountered.

Moving Forward Four Words at a Time: Effects of a Supplemental Preschool Vocabulary Intervention

2020 ◽  
Vol 51 (1) ◽  
pp. 165-175 ◽  
Author(s):  
Lindsey A. Peters-Sanders ◽  
Elizabeth S. Kelley ◽  
Christa Haring Biel ◽  
Keri Madsen ◽  
Xigrid Soto ◽  
...  
Keyword(s):  
Group Intervention ◽  
Single Case ◽  
Single Case Design ◽  
Vocabulary Intervention ◽  
Iterative Development ◽  
At Risk Children ◽  
Before And After ◽  
Child Friendly ◽  
Interactive Lessons ◽  
Case Design

Purpose This study evaluated the effects of an automated, small-group intervention designed to teach preschoolers challenging vocabulary words. Previous studies have provided evidence of efficacy. In this study, we evaluated the effects of the program after doubling the number of words taught from 2 to 4 words per book. Method Seventeen preschool children listened to 1 prerecorded book per week for 9 weeks. Each storybook had embedded, interactive lessons for 4 target vocabulary words. Each lesson provided repeated exposures to words and their definitions, child-friendly contexts, and multiple opportunities for children to respond verbally to instructional prompts. Participants were asked to define the weekly targeted vocabulary before and after intervention. A repeated acquisition single-case design was used to examine the effects of the books and embedded lessons on learning of target vocabulary words. Results Treatment effects were observed for all children across many of the books. Learning of at least 2 points (i.e., 1 word) was replicated for 74.5% of 149 books tested across the 17 participants. On average, children learned to define 47% of the target vocabulary words (17 out of 36). Conclusions Results support including 4 challenging words per book, as children learned substantially more words when 4 words were taught, in comparison to previous studies. Within an iterative development process, results of the current study take us 1 step closer to creating an optimal vocabulary intervention that supports the language development of at-risk children.

Successful Implicit Vocabulary Intervention for Three Cantonese-Speaking Toddlers: A Replicated Single-Case Design

2020 ◽  
Vol 63 (12) ◽  
pp. 4148-4161
Author(s):  
Christine S.-Y. Ng ◽  
Stephanie F. Stokes ◽  
Mary Alt
Keyword(s):  
Single Case ◽  
Cross Cultural ◽  
Neighborhood Density ◽  
Expressive Vocabulary ◽  
Single Case Design ◽  
Vocabulary Intervention ◽  
Phonological Neighborhood Density ◽  
Phonological Neighborhood ◽  
And Control ◽  
Case Design

Purpose We report on a replicated single-case design study that measured the feasibility of an expressive vocabulary intervention for three Cantonese-speaking toddlers with small expressive lexicons relative to their age. The aim was to assess the cross-cultural and cross-linguistic feasibility of an intervention method developed for English-speaking children. Method A nonconcurrent multiple-baseline design was used with four baseline data points and 16 intervention sessions per participant. The intervention design incorporated implicit learning principles, high treatment dosage, and control of the phonological neighborhood density of the stimuli. The children (24–39 months) attended 7–9 weeks of twice weekly input-based treatment in which no explicit verbal production was required from the child. Each target word was provided as input a minimum of 64 times in at least two intervention sessions. Treatment feasibility was measured by comparison of how many of the target and control words the child produced across the intervention period, and parent-reported expressive vocabulary checklists were completed for comparison of pre- and postintervention child spoken vocabulary size. An omnibus effect size for the treatment effect of the number of target and control words produced across time was calculated using Kendall's Tau. Results There was a significant treatment effect for target words learned in intervention relative to baselines, and all children produced significantly more target than control words across the intervention period. The effect of phonological neighborhood density on expressive word production could not be evaluated because two of the three children learned all target words. Conclusion The results provide cross-cultural evidence of the feasibility of a model of intervention that incorporated a high-dosage, cross-situational statistical learning paradigm to teach spoken word production to children with small expressive lexicons.

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