Poster 66: The Adult Spasticity International Registry (ASPIRE) Study: Treatment Utilization Patterns in Patients Treated for Both Upper and Lower Limb Spasticity

Biallelic mutations in the CYP7B1 gene lead to spastic paraplegia-5 (SPG5). We report herein the case of a patient whose clinical symptoms began with progressive lower limb spasticity during childhood, and who secondly developed amyotrophic lateral sclerosis/frontotemporal dementia (ALS/FTD) at the age of 67 years. Hereditary spastic paraplegia (HSP) gene analysis identified the compound heterozygous mutations c.825T>A (pTyr275*) and c.1193C>T (pPro398Leu) in CYP7B1 gene. No other pathogenic variant in frequent ALS/FTD causative genes was found. The CYP7B1 gene seems, therefore, to be the third gene associated with the phenoconversion from HSP to ALS, after the recently described UBQLN2 and ERLIN2 genes. We therefore expand the phenotype associated with CYP7B1 biallelic mutations and make an assumption about a link between cholesterol dyshomeostasis and ALS/FTD.

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The effectiveness of additional core stability exercises in improving dynamic sitting balance, standing balance, lower-limb spasticity, falls and gait in subacute stroke patients (CORE-trial). Study protocol for a Randomized Controlled Trial

10.21203/rs.3.rs-162002/v1 ◽

2021 ◽

Author(s):

Rosa Cabanas-Valdés ◽

Lidia Boix-Sala ◽

Montserrat Grau-Pellicer ◽

Juan Antonio Guzmán-Bernal ◽

Fernanda Maria Caballero-Gómez ◽

...

Keyword(s):

Lower Limb ◽

Daily Living ◽

Controlled Trial ◽

Core Stability ◽

Standing Balance ◽

Stroke Patients ◽

Randomized Controlled ◽

Limb Spasticity ◽

Lower Limb Spasticity ◽

Dynamic Sitting

Abstract BackgroundTrunk impairment produces disorders of motor control, balance, and gait that are correlated with increased risk of falls and reduced mobility in stroke survivors. This creates disability and dependency to perform their activities of daily living. Alterations in body alignment occur, requiring treatment strategies focused on improving the postural control. bearing. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, dynamic sitting, standing balance, and gait. There is some evidence about its effectiveness but it is still necessary to run a large multicenter trial to ratify that existing evidence.MethodsThis is a single-blind multicenter randomized controlled trial. Two parallel groups are compared and both perform the same type of therapy. A control group (CG) (n=110) performs conventional physiotherapy (CP) (1 hour per session) focused on improving balance. An experimental group (EG) (n=110) performs CSE (30 minutes) in addition to CP (30 minutes) (1 hour/session in total). EG is divided in two subgroups, in which only half of patients (n=55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by Spanish-version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at 3 weeks (T1), at 5 weeks -at the end of the intervention (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a 5-week intervention, followed by a 24-week post-intervention). DiscussionThe study will provide useful information on the short and long term effects of a physiotherapy rehabilitation program based on core stability exercises performed in subacute phase.Trial registrationClinicalTrials.gov Identifier NCT03975985. Data registration June 5th, 2019. Retrospectively registered. Date of registration in primary registry: June 5, 2019. Protocol version 1

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A STUDY OF RELATION OF LOWER LIMB SPASTICITY WITH LIPID PROFILE AND FASTING PLASMA GLUCOSE LEVELS IN CHRONIC MOTOR COMPLETE SPINAL CORD INJURY PATIENTS.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.1041 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Batra Amit ◽

Prakash Om ◽

Jindal Rajeshwari ◽

Batra Shivra

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Lower Limb ◽

Density Lipoprotein ◽

Fasting Plasma ◽

Cord Injury ◽

Limb Spasticity ◽

Lower Limb Spasticity

Background: Most common cause of spinal cord injury in India is fall from height followed by road accidents which may lead to incomplete or complete disruption of neural signal transmission across and below the level of injury. Spasticity is a common but not an inevitable complication following spinal cord injury. Study Objective: The present study tried to explore the correlation between the lower limb spasticity following spinal cord injury and the metabolic markers. Study design: Hospital-based cross-sectional study. Material and Methods: Fifty patients recruited from Department of Physical Medicine and Rehabilitation, Sawai Man Singh Hospital, Jaipur (Raj.), were categorized into mild (16),moderate (11), and severe (23)spastic groups based on assessment of ankle/knee extensor muscle group spasticity using the modified Ashworth scale. The metabolic profile markers such as Total Cholesterol (TC), Low-density Lipoprotein (LDL), High-Density Lipoprotein (HDL), Triglyceride (TG) and Fasting Plasma Glucose (FPG) were estimated and compared between the three groups. Results: The triglycerides, total cholesterol, low density lipoproteins and the fasting plasma glucose level were significantly negatively correlated with the grading of spasticity in lowerlimbs (P <0.001). The high density lipoproteins level was higher in a severe spastic group as compared to the mild and moderate spastic groups; but this result was statistically non-significant (P=0.14). Conclusion: Spasticity in motor complete SCI may have beneficial effects in preserving glucose homeostasis and defending rise in adiposity, rationalizing the need for its judicious management to maintain the crucial balance between its beneficial and problematic effects. Keywords: Spasticity, Modified Ashworth score, Spinal cord injury, lipid profile, fasting plasma glucose.

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