Quantification of Dexterity Through a Novel Electronic Device

2011 ◽  
Author(s):  
Avery L. Cate ◽  
Dillon P. Eng ◽  
Rachel W. Jackson ◽  
Allison C. Scully ◽  
Jessica A. Scully
Keyword(s):  
Cerebral Palsy ◽  
Electronic Device ◽  
Muscle Tone ◽  
Treatment Options ◽  
Clinical Problem ◽  
The Body ◽  
Current State ◽  
Position Data ◽  
Spastic Hemiplegia ◽  
Treatment Plans

Cerebral palsy affects movement, muscle tone, and coordination as a result of an injury to, or lesion of, the immature brain. One of the most common manifestations of cerebral palsy is spastic hemiplegia, which limits arm and hand use on the involved side of the body [1]. Many treatment options are available but a major clinical problem is how to evaluate the success of these treatment plans. Currently, video analysis is the standard used for evaluating dexterity of cerebral palsy patients. This requires trained clinicians to spend hours watching video of patients performing specified tasks in order to evaluate baseline dexterity and improvements throughout treatment. VICON is the current state of the art device for motion capture. It captures motion using multiple video cameras around the room and outputs the position data of many points through time. VICON machines must be carefully calibrated and are too bulky to be used throughout a clinic. VICON can also not show the upper extremity dexterity necessary for tracking many cerebral palsy patients’ progress. As can be seen, no portable, efficient, and quantitative dexterity test for cerebral palsy patients currently exists.

Torsional Problems in Cerebral Palsy

Foot & Ankle ◽  
1984 ◽  
Vol 4 (4) ◽  
pp. 180-184 ◽  
Author(s):  
Howard A. King ◽  
Lynn T. Staheli
Keyword(s):  
Cerebral Palsy ◽  
Literature Review ◽  
Lower Limb ◽  
Muscle Tone ◽  
Therapeutic Challenge ◽  
Treatment Plans

Lower limb rotational problems in the patient with cerebral palsy represent a diagnostic and therapeutic challenge to the clinician. A literature review suggests that increased muscle tone may be the cause of these problems. This article proposes a simple diagnostic plan and discusses the various treatment plans and options.

scholarly journals Role of Baclofen in Combination with Intensive Rehabilitation in Spastic Cerebral Palsy

2015 ◽  
Vol 1 (1) ◽  
pp. 18-21
Author(s):  
Md Ruhul Amin ◽  
Sohely Rahman ◽  
Narayan Saha ◽  
Md Shahadat Hossain ◽  
Md Jahidul Islam ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Rating Scale ◽  
Muscle Tone ◽  
The Body ◽  
Spastic Cerebral Palsy ◽  
College Hospital ◽  
Medical College ◽  
Modified Ashworth Scale ◽  
Physician Rating ◽  
Intensive Rehabilitation

Background: The treatment of cerebral palsy is multifactorial.Objective: In this study we find out the combined efficacy of baclofen and intensive rehabilitation in the treatment of spastic cerebral palsy.Methodology: This observational study was conducted over 30 patients in Dhaka Medical College Hospital from January 2011 to December 2011.The patient satisfying the inclusion and exclusion criteria was randomly enrolled in this study. They received Baclofen orally two times daily according to the body weight regularly in combination with intensive rehabilitation 1 hour daily five times a week for 24 weeks. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks.Result: Combination of Baclofen and intensive rehabilitation is effective in reducing tone in spastic cerebral palsy by using Modified Ashworth scale (p<0.05). Combination of Baclofen and intensive rehabilitation is also effective in joint angle improvement in spastic cerebral palsy measured by physician rating scale crouch (p<0.05) and foot contact, (p<0.05) and also improvement in gross motor function (p <0.05).Conclusion: For reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients, combination of Baclofen and intensive rehabilitation may be used.J. Natl Inst. Neurosci Bangladesh 2015;1(1):18-21

scholarly journals Efficacy of baclofen in combination with intensive rehabilitation in spastic cerebral palsy- a randomized clinical trial

2015 ◽  
Vol 23 (1) ◽  
pp. 18-23
Author(s):  
Md Ruhul Amin ◽  
Narayan Chandra Saha ◽  
Sohely Rahman ◽  
Md Shahadat Hossain ◽  
Md Jahidul Islam ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cerebral Palsy ◽  
Randomized Clinical Trial ◽  
Rating Scale ◽  
Muscle Tone ◽  
The Body ◽  
Spastic Cerebral Palsy ◽  
Medical College ◽  
Superior Efficacy ◽  
Intensive Rehabilitation

Objective: To find out the combined efficacy of baclofen and intensive rehabilitation in the treatment of spastic cerebral palsy. Methods: This randomized clinical trial was conducted over 60 patients in Dhaka Medical College Hospital, Dhaka, between January and December 2011. The patient satisfying the inclusion and exclusion criteria was randomly enrolled into two groups; Group A (case) included 30 patients received only intensive rehabilitation and Group B (control) included 30 patients who received baclofen orally two times daily according to the body weight regularly in combination with intensive rehabilitation 1 hour daily five times a week for 24 weeks. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks. Results: Combination of baclofen and intensive rehabilitation has superior efficacy in reducing tone in spastic cerebral palsy over only rehabilitation measured by using Modified Ashworth scale (p<0.001). Combination of baclofen and intensive rehabilitation is also superior in physician rating scale crouch (p<0.0001) and foot contact, (p<0.0001) and also improvement in gross motor function (p<0.01). Conclusion: Combination of baclofen and intensive rehabilitation group has superior efficacy than only rehabilitation group for reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22688 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 18-23

Osteopathic support of sportsmen during the annual training process

2020 ◽  
pp. 37-43 ◽  
Author(s):  
R. A. Yakupov ◽  
G. I. Safiullina ◽  
A. A. Safiullina ◽  
E. R. Burganov
Keyword(s):  
Musculoskeletal Diseases ◽  
Muscle Tone ◽  
The Body ◽  
Training Process ◽  
Health Maintenance ◽  
Osteopathic Treatment ◽  
Leading Position ◽  
Myofascial Syndrome ◽  
Sports Activities ◽  
Timely Treatment

Introduction. Modern sports places high demands on the functional systems of the body at all stages of the training and competitive processes. High loads create signifi cant background for the occurrence of musculoskeletal diseases, among which the myofascial syndrome (MFS) holds the leading position. MFS negatively affects the functional readiness of the sportsman′s body and is a risk factor for injuries of the musculoskeletal system. In this regard, timely treatment of MFS is important. It creates the conditions for the improvement of sports achievements, for health maintenance and sports longevity. Treatment of patients with MFS should include methods that normalize trophism and muscle tone. Given the problem of doping, the use of non-drug methods, including osteopathy, is preferable. The goal of research — to develop a system of monitoring and osteopathic correction of myofascial disorders (MFD) and to introduce it into the practice of medical and biological support for sportsmen of different categories and levels during the annual training process.Materials and methods. 93 sportsmen (45 women and 48 men), mean age 22,1±1,1 years, representing diffe rent sports were examined. The essence of the proposed system is regular clinical and electroneurophysiological monitoring of the body condition and preventive correction of myofascial disorders in order to exclude their infl uence on the success of sports activities.Results. It was established that the proposed system of monitoring and osteopathic correction led to a signifi cant reduction in clinical and electroneurophysiological manifestations both in local and in extensive forms of myofascial disorders, which allowed to maintain the optimal functional readiness of sportsmen throughout the entire annual training cycle.Conclusion. The system of monitoring and correction of MFS with the use of osteopathic treatment can be one of the elements of medical and biological support for sportsmen during the annual training process.

Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

2020 ◽  
Author(s):  
Guanghui Xu ◽  
Yuhao Wang ◽  
Hushan Zhang ◽  
Xueke She ◽  
Jianjun Yang
Keyword(s):  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Predictive Biomarkers ◽  
The Body ◽  
Low Grade ◽  
Ablative Therapies ◽  
Cancer Types ◽  
New Treatment ◽  
Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

scholarly journals Neglected femoral neck fractures in cerebral palsy: a narrative review

2020 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Giuseppe Toro ◽  
Antimo Moretti ◽  
Marco Paoletta ◽  
Annalisa De Cicco ◽  
Adriano Braile ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Femoral Neck ◽  
Motor Function ◽  
Treatment Options ◽  
High Morbidity ◽  
Fibular Graft ◽  
Motor Impairments ◽  
High Prevalence ◽  
Neck Fracture

Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a ‘neglected femoral neck fracture’ (NFNF). Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain. Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function. Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients. After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019

scholarly journals Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Muscle Tone ◽  
Controlled Trial ◽  
Gait Pattern ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Gait Parameters ◽  
Experimental Group

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

scholarly journals Electro-Quasistatic Animal Body Communication for Untethered Rodent Biopotential Recording

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shreeya Sriram ◽  
Shitij Avlani ◽  
Matthew P. Ward ◽  
Shreyas Sen
Keyword(s):  
Lower Energy ◽  
Sensor Node ◽  
State Of The Art ◽  
The Body ◽  
Animal Body ◽  
Current State ◽  
Communication Modalities ◽  
First Time ◽  
Biopotential Recording

AbstractContinuous multi-channel monitoring of biopotential signals is vital in understanding the body as a whole, facilitating accurate models and predictions in neural research. The current state of the art in wireless technologies for untethered biopotential recordings rely on radiative electromagnetic (EM) fields. In such transmissions, only a small fraction of this energy is received since the EM fields are widely radiated resulting in lossy inefficient systems. Using the body as a communication medium (similar to a ’wire’) allows for the containment of the energy within the body, yielding order(s) of magnitude lower energy than radiative EM communication. In this work, we introduce Animal Body Communication (ABC), which utilizes the concept of using the body as a medium into the domain of untethered animal biopotential recording. This work, for the first time, develops the theory and models for animal body communication circuitry and channel loss. Using this theoretical model, a sub-inch$$^3$$ 3 [1″ × 1″ × 0.4″], custom-designed sensor node is built using off the shelf components which is capable of sensing and transmitting biopotential signals, through the body of the rat at significantly lower powers compared to traditional wireless transmissions. In-vivo experimental analysis proves that ABC successfully transmits acquired electrocardiogram (EKG) signals through the body with correlation $$>99\%$$ > 99 % when compared to traditional wireless communication modalities, with a 50$$\times$$ × reduction in power consumption.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals The Evolution and Role of the Bursal Acromial Reconstruction

2021 ◽  
Vol 1 (2) ◽  
pp. 263502542110013
Author(s):  
Daniel M. Curtis ◽  
W. Michael Pullen ◽  
Kevin Helenius ◽  
Michael T. Freehill
Keyword(s):  
Glenohumeral Joint ◽  
Total Shoulder Arthroplasty ◽  
Treatment Options ◽  
Clinical Problem ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Subacromial Space ◽  
Promising Alternative ◽  
Diagnostic Arthroscopy ◽  
Superior Capsular Reconstruction

Background: Massive, irreparable rotator cuff tears (RCTs) remain a challenging clinical problem with numerous described treatment options. Bursal acromial reconstruction (BAR) represents a promising and evolving technique for a subset of patients with irreparable RCTs. Indications: BAR is indicated for patients with massive, irreparable RCTs with a primary complaint of pain, well-compensated shoulder function, and minimal radiographic degenerative changes of the glenohumeral joint as an alternative to reverse total shoulder arthroplasty or superior capsular reconstruction. Technique Description: Positioning per surgeon preference and diagnostic arthroscopy is performed. Subacromial decompression with a minimal and gentle acromioplasty is performed, followed by assessment of RCT repairability. If the tear is deemed irreparable, acromial measurements in the medial-lateral and anterior-posterior dimensions are obtained. Two pieces of acellular dermal allograft are cut to the acromial dimensions and affixed together using fibrin glue. The reactive side (facing the acromion), medial, and anterior sides of the graft are labeled. Two suture tapes are passed through the corners of the graft and self-locked and run diagonally in a cruciate configuration using an antegrade suture passer. Medial and lateral #2 fiberwire sutures are placed in a luggage-tag configuration. Neviaser (posterior), middle, and anterior acromioclavicular joint portals are created for medial sided suture passage. Medial graft sutures are shuttled through the respective medial portals and the graft is pulled into the subacromial space. The lateral sutures are then removed from percutaneous posterolateral, middle lateral, and anterolateral portals along the acromial edge. Medial sutures are retrieved using a suture grasper subcutaneously on top of the acromion through the percutaneous lateral portals. The sutures are tied through the lateral portals, starting with the medial-lateral sutures, and the knots are buried. Postoperatively, patients are progressed through passive, active-assisted, and active range of motion between weeks 2 and 6 and strengthening is progressed at 6 weeks. Results: Clinical results are lacking in the literature, but anecdotal results in our institution have demonstrated promising early outcomes. Discussion/Conclusion: BAR represents a promising alternative in the array of surgical options for treatment of irreparable RCTs.

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