Significant Functional Improvement in a Person with Multiple Sclerosis Utilizing Dynamic Neuromuscular Stabilization

2016 ◽  
Vol 48 ◽  
pp. 347-348
Author(s):  
F V. Harding ◽  
Kenneth Mengel
Keyword(s):  
Multiple Sclerosis ◽  
Functional Improvement ◽  
Significant Functional Improvement

scholarly journals Delayed functional improvement after near-fatal bleeding complication following endobronchial valve therapy for emphysema

2016 ◽  
Vol 81 (1-2) ◽  
Author(s):  
Sergio Baldi ◽  
Francesco Coni ◽  
Giorgio Limerutti ◽  
Massimo Baccega ◽  
Enrico Ruffini ◽  
...  
Keyword(s):  
Alternative Explanation ◽  
Volume Reduction ◽  
Functional Improvement ◽  
Randomised Study ◽  
Copd Exacerbations ◽  
Alveolar Collapse ◽  
Fatal Bleeding ◽  
Endobronchial Valve ◽  
Valve Placement ◽  
Significant Functional Improvement

<p>Endoscopic treatment of emphysema is supported by different methods, including valves, coils and sealants. The mechanism is mainly related to volume reduction of targeted area. Endobronchial valves (EBV) appear the most studied method. In a multicentre randomised study, placement of unidirectional endobronchial valves resulted in a statistically significant functional improvement in the treated cohort compared to the control. Adverse events, occurring post procedure, included COPD exacerbations, haemoptysis, pneumothorax and pneumonia. In our centre we treated 30 patients, between January 2009 and February 2012, with variable improvement of lung function and only mild postoperative complications. The case we report here appears very interesting for the unusual near-fatal complication (massive alveolar haemorrage) followed by delayed strong functional improvement (FEV1 +23%; RV -18%; 6MWD:+33%) six months after the valve placement. This improvement could be attributable to the EBV procedure, but an alternative explanation is that the lung volume reduction may have been enhanced by the complication itself, as an effect of alveolar collapse.</p>

scholarly journals Effect of age on outcomes after allogeneic disc tissue supplementation in patients with chronic discogenic low back pain in the VAST trial

2021 ◽  
Author(s):  
Corey W Hunter ◽  
Richard Guyer ◽  
Mark Froimson ◽  
Michael J DePalma
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Young Patients ◽  
Functional Improvement ◽  
Low Back ◽  
Disc Tissue ◽  
Discogenic Low Back Pain ◽  
Post Hoc ◽  
Significant Functional Improvement

Aim: To explore the effects of viable allogeneic disc tissue supplementation in younger patients with discogenic chronic low back pain (CLBP). Patients & methods: VAST was a randomized placebo-controlled trial of disc allograft supplementation in 218 patients with discogenic CLBP. We conducted a post hoc analysis of change from baseline to 12 months in Oswestry Disability Index (ODI) and visual analog scale for pain intensity scores stratified by patient age. Results: Patients aged <42 years receiving allograft experienced greater improvement in ODI (p = 0.042) and a higher ODI response rate (≥10-, ≥15- and ≥20-point reductions in ODI) than those receiving saline (p = 0.001, p = 0.002 and p = 0.021, respectively). Conclusion: Young patients with discogenic CLBP may have significant functional improvement following nonsurgical disc allograft supplementation.

scholarly journals Multiple sclerosis treatment: dry needling, new therapeutic frontiers

2020 ◽  
Author(s):  
Moreno Carlos Luque ◽  
Domínguez Anabel Granja ◽  
Rizo Alberto Marcos Heredia ◽  
Antón David Lucena ◽  
Mercant Alejandro Galán ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Pain Perception ◽  
Functional Limitations ◽  
Life Quality ◽  
Rectus Femoris ◽  
Functional Improvement ◽  
Dry Needling ◽  
Speed Increase ◽  
Before And After

Due to high prevalence of spasticity in Multiple Sclerosis (MS) and functional limitations that pain and gait alterations cause, is necessary to investigate possible benefits of Dry Needling (DN) in this pathology. A case study of a 35 years old Secondary Progressive MS woman with 6,5 points on Expanded Disability Status Scale by performing deep DN intervention on Rectus Femoris (RF) and Gastronecmius Medialis (GM) muscles of higher spasticity lower limb was carried out. Spasticity level, perceived pain, range of motion (ROM) and superficial electromyography activity of this lower limb, together with functional capacity, life quality and Spatial-Temporal Gait parameters before and after intervention were evaluated. After intervention, spasticity decrease (especially on RF) and gait speed increase was noticed. Also, less muscle activity on walking and less delay time of step execution was observed. Our results suggest a functional improvement of the patient’s gait motion, but conclusive changes were not objectified in pain perception and ROM. More research studies about the effect of DN in MS must be necessary in order to obtain better evidence.

Stereotactic radiosurgery for medically refractory multiple sclerosis–related tremor

2018 ◽  
Vol 128 (4) ◽  
pp. 1214-1221 ◽  
Author(s):  
Sudesh S. Raju ◽  
Ajay Niranjan ◽  
Edward A. Monaco ◽  
John C. Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Multiple Sclerosis ◽  
Minimally Invasive ◽  
Gamma Knife ◽  
Radiation Effects ◽  
Rating Scale ◽  
Case Reports ◽  
Functional Improvement ◽  
Invasive Technique ◽  
Conventional Radiotherapy

OBJECTIVEMultiple sclerosis (MS) is a neurodegenerative disease that can lead to severe intention tremor in some patients. In several case reports, conventional radiotherapy has been reported to possibly exacerbate MS. Radiosurgery dramatically limits normal tissue irradiation to potentially avoid such a problem. Gamma Knife thalamotomy (GKT) has been established as a minimally invasive technique that is effective in treating essential tremor and Parkinson’s disease–related tremor. The goal in this study was to analyze the outcomes of GKT in patients suffering from medically refractory MS-related tremor.METHODSThe authors retrospectively studied the outcomes of 15 patients (mean age 46.5 years) who had undergone GKT over a 15-year period (1998–2012). Fourteen patients underwent GKT at a median maximum dose of 140 Gy (range 130–150 Gy) using a single 4-mm isocenter. One patient underwent GKT at a dose of 140 Gy delivered via two 4-mm isocenters (3 mm apart). The posteroinferior region of the nucleus ventralis intermedius (VIM) was the target for all GKTs. The Fahn-Tolosa-Marin clinical tremor rating scale was used to evaluate tremor, handwriting, drawing, and drinking. The median time to the last follow-up was 39 months.RESULTSAfter GKT, 13 patients experienced tremor improvement on the side contralateral to surgery. Four patients noted tremor arrest at a median of 4.5 months post-GKT. Seven patients had excellent tremor improvement and 6 had good tremor improvement. Four patients noted excellent functional improvement, 8 noted good functional improvement, and 1 noted satisfactory functional improvement. Three patients experienced diminished tremor relief at a median of 18 months after radiosurgery. Two patients experienced temporary adverse radiation effects. Another patient developed a large thalamic cyst 60 months after GKT, which was successfully managed with Ommaya reservoir placement.CONCLUSIONSGamma Knife thalamotomy was found to be a minimally invasive and beneficial procedure for medically refractory MS tremor.

scholarly journals Very Early Initiation Reduces Benefits of Poststroke Rehabilitation Despite Increased Corticospinal Projections

2019 ◽  
Vol 33 (7) ◽  
pp. 538-552 ◽  
Author(s):  
Naohiko Okabe ◽  
Naoyuki Himi ◽  
Emi Nakamura-Maruyama ◽  
Norito Hayashi ◽  
Issei Sakamoto ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Early Initiation ◽  
Functional Improvement ◽  
Initiation Time ◽  
Tracer Study ◽  
Time Dependency ◽  
Multiple Tasks ◽  
Use Dependency ◽  
Significant Functional Improvement ◽  
Training Protocol

Background. Although the effect of rehabilitation is influenced by aspects of the training protocol, such as initiation time and intensity of training, it is unclear whether training protocol modifications affect the corticospinal projections. Objective. The present study was designed to investigate how modification of initiation time (time-dependency) and affected forelimb use (use-dependency) influence the effects of rehabilitation on functional recovery and corticospinal projections. Methods. The time-dependency of rehabilitation was investigated in rats forced to use their impaired forelimb immediately, at 1 day, and 4 days after photothrombotic stroke. The use-dependency of rehabilitation was investigated by comparing rats with affected forelimb immobilization (forced nonuse), unaffected forelimb immobilization (forced use), and a combination of forced use and skilled forelimb training beginning at 4 days after stroke. Results. Although forced use beginning 1 day or 4 days after stroke caused significant functional improvement, immediate forced limb use caused no functional improvement. On the other hand, a combination of forced use and skilled forelimb training boosted functional recovery in multiple tasks compared to simple forced use treatment. Histological examination showed that no treatment caused brain damage. However, a retrograde tracer study revealed that immediate forced use and combination training, including forced use and skilled forelimb training, increased corticospinal projections from the contralesional and ipsilesional motor cortex, respectively. Conclusions. These results indicate that although both very early initiation time and enhanced skilled forelimb use increased corticospinal projections, premature initiation time hampers the functional improvement induced by poststroke rehabilitation.

scholarly journals Comparing Functional Outcome of Triangle Tilt Surgery Performed Before Versus After Two Years of Age

2011 ◽  
Vol 5 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Rahul K Nath ◽  
Chandra Somasundaram ◽  
Faiz Mahmooduddin
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Complete Recovery ◽  
Functional Improvement ◽  
Younger Age ◽  
Obstetric Brachial Plexus ◽  
Group 2 ◽  
Age Range ◽  
Significant Functional Improvement ◽  
Group 1

Background: Many patients each year who are born with obstetric brachial plexus injuries eventually do not achieve complete recovery. As a result of the primary nerve injuries, these patients will often develop bony deformities involving the shoulder joint as a secondary consequence. The triangle tilt surgery has been shown to be an effective procedure to correct these deformities and has been performed on patients ranging in age from less than a year old to adolescence. The purpose of this retrospective study is to compare outcomes of triangle tilt surgery performed on patients before the age of 2 years versus after 2 years of age to determine an optimal age to operate on these children. Methods: 36 patients with deformities developed secondarily from the initial obstetric brachial plexus injury in this study were divided into 2 groups. Group 1, those who had undergone triangle tilt surgery at < 2 yrs of age (16 patients). Group 2, those who were operated at > 2 yrs of age (20 patients). Group 1 age range: 9 months to 23 months, average: 18 months. Group 2 age range: 26 months to 9 years, average: 6 years. Results: Significant differences were found between the 2 groups (0-2 yrs vs > 2yrs) in regards to overall changes (pre- to post-op) in Mallet score, external rotation score, hand-to-mouth score, and supination angle. Discussion: This study demonstrates that triangle tilt surgery had better outcomes on clinical functioning if performed before the age of 2 years, however, improvement in clinical functioning can still be achieved if the triangle tilt surgery is performed after the age of 2 years as well. A possible mechanism to explain this phenomenon is the increased potential for anatomical remodeling if the triangle tilt surgery is performed at a younger age, thereby leading to significant functional improvement.

scholarly journals Psoas abscess due to mycobacterium tuberculosis: a case report

2017 ◽  
Vol 5 (7) ◽  
pp. 3251 ◽  
Author(s):  
Ranjana R. Khorgade ◽  
Pramod R. Bhise ◽  
Mukta M. Deshmukh
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Back Pain ◽  
Case Report ◽  
Rare Case ◽  
Psoas Abscess ◽  
Tuberculosis Patient ◽  
Functional Improvement ◽  
Microbiological Investigation ◽  
Significant Functional Improvement

Iliopsoas abscess (IPA), a collection of pus in the iliopsoas compartment that has traditionally been classified into primary and secondary according to its origin, is an infrequent condition worldwide. Mostly active TB is confined to the lung, but approximately 15% are extrapulmonary. The most common types of extrapulmonary TB are, in descending order of frequency, pleural, lymphatic, bone and joint, genitourinary, miliary disease, meningitis, and peritonitis. Tuberculosis (TB) remains as one of the leading opportunistic infection in patients in developing countries. Here we report a rare case of psoas abscess of tubercular origin in patient who presented with back pain and limping. Diagnosis is done based on history, physical examination, plain radiology, microbiological investigation and CT scan of abdomen which revealed a large psoas abscess caused by M. tuberculosis. Patient was diagnosed as psoas abscess due to Mycobacterium tuberculosis and treated empirically with DOTS category I and significant functional improvement was noted on follow up.

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