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J R Jenner

Publications and source records attributed to J R Jenner.

35 records · Page 2Linked to original sources

Balance evaluation in hemiparetic stroke patients using lateral forces applied to the hip.

A technique for assessing balance that involves applying predictable controlled forces to the hips is described. Impairments in hemiparetic stroke patients' balance were documented by comparing their hip movements during and after a push with those of control subjects of similar age. Stroke patients swayed further and took longer to stabilize hip position than did the control subjects. The disturbance to stroke patients' balance caused by the termination of lateral force caused them more difficulty than did the onset of the force. Differences between stroke patients' involved and noninvolved sides were more pronounced on release from a push than at its onset. The implications of the findings for the assessment and treatment of balance after stroke are discussed.

Aged↗

Low-dose, low-volume chemonucleolysis. A biochemical study.

Thirty patients with persistent sciatica due to a single disc protrusion were injected with 0.5 ml (2.0 mg) or 2.0 ml (8.0 mg) of chymopapain. Serial 24-hour urine samples were collected 1 day preinjection and for 5 days postinjection for glycosaminoglycan analysis. There was a significant increase in urinary glycosaminoglycan in both groups following chemonucleolysis, but no significant difference was found between the two groups in the total excretion of glycosaminoglycan during the 5-day period. Low-dose, low-volume chemonucleolysis may be as effective as standard doses in releasing glycosaminoglycan from intervertebral discs.

Adult↗

Recovery of elbow function in voluntary positioning of the hand following hemiplegia due to stroke.

Elbow movement during voluntary positioning of the hand (with the arm supported against gravity) is described in a longitudinal study of five patients recovering from hemiplegia due to stroke. Over a twelve month period, four of the patients improved their speed of movement, three exhibiting slightly better recovery of elbow extension, one of flexion. In some instances co-contraction of the elbow agonist and antagonist (measured just before the onset of movement) decreased with time after stroke. The effects of contrasting movements at the shoulder on elbow movement were also studied. Estimates of recovery were generally similar whether patients kept the shoulder still or made movements that were synergic or counter-synergic to those of the elbow.

Adult↗

Injuries to rowers.

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Athletic Injuries↗

Algodystrophy: a common unrecognized cause of chronic knee pain.

Thirty-three patients with undiagnosed chronic knee pain had features of autonomic disturbance. Thermography is a useful imaging technique for demonstrating this abnormality. The patients lacked the thermographic symmetry observed in 16 normal controls but this returned with resolution of the pain. Recognized radiological and scintigraphic features of algodystrophy were found. The long duration of symptoms, high proportion of young females and the severity of the associated disability were notable. It is suggested that algodystrophy is a more frequent cause of chronic knee pain than previously recognized. Autonomic abnormalities may be less intense in disease at this site, particularly in young females and may be overlooked. This characteristic of algodystrophy of the knee may contribute to chronicity and subsequent disability.

Adolescent↗

Mechanism of action of intradiscal chymopapain in the treatment of sciatica: a clinical, biochemical, and radiological study.

Seventeen patients with intractable sciatica due to prolapse of a lumbar disc, treated by intradiscal injection of chymopapain (chemonucleolysis) were studied. Analysis of serial 24 hour urine collections showed a significant increase in urinary glycosaminoglycan after chemonucleolysis. This was not detected in four patients undergoing routine discography. Enzymic analysis of urinary glycosaminoglycan after chemonucleolysis suggested that the increase in levels was largely due to an increase in the amounts of chondroitin sulphate present, probably resulting from proteoglycan breakdown in the intervertebral disc. Eight of the patients treated by chemonucleolysis underwent serial computed tomography (CT). One month after the injection the only change seen was a loss of definition of the disc prolapse, which could be interpreted as a loss of turgidity in the disc as a result of proteoglycan breakdown by chymopapain. By six months the CT of those patients whose symptoms had improved showed that the degree of disc prolapse was usually less marked and the disc margin more clearly defined, suggesting that by this stage anatomical remodelling had occurred.

Adolescent↗

Cutaneous reflex responses and their central nervous pathways studied in man.

1. Cutaneous reflex responses have been recorded in human first dorsal interosseous and extensor digitorum brevis muscles following electrical stimulation of the digital nerves of the index finger and second toe respectively.2. Recordings have been made in normal subjects and in patients with central nervous lesions.3. Cutaneous reflex responses in first dorsal interosseous were triphasic, consisting of initial short latency excitation, followed by inhibition, followed by prominent long latency excitation. Cutaneous reflex responses in extensor digitorum brevis were biphasic, consisting of short and long latency periods of excitation.4. Estimated central delay for the initial excitatory components of the cutaneous reflex in first dorsal interosseous and extensor digitorum brevis muscles ranged from 2.4 to 6.2 ms (mean 4.6 ms) and 0.6 to 4.1 ms (mean 2.3 ms) respectively.5. Differences in latency between short and long latency excitatory components of the cutaneous reflexes recorded in first dorsal interosseous and extensor digitorum brevis muscles ranged from 16 to 18 ms (mean 17.3 ms) and 27 to 32 ms (mean 29.3 ms) respectively.6. Differences in time delay between short and long latency excitation in first dorsal interosseous and extensor digitorum brevis muscles when compared in individual subjects ranged from 9 to 14 ms (mean 12 ms). These values lay within 0-7 ms (mean 4 ms) of estimates in each subject of conduction time along central pathways between T12 and C7 spinal segments.7. Differences in latency between short and long latency excitatory components of the cutaneous reflex recorded in first dorsal interosseous were 3.5-8.5 ms longer than the estimated minimum time for impulse conduction along a pathway travelling through the dorsal columns to cerebral cortex and returning by way of the corticospinal tract.8. The long latency excitatory component of the cutaneous reflex in first dorsal interosseous muscle is reduced and often delayed in patients with dorsal column lesions.9. The long latency excitatory and short latency inhibitory components of the cutaneous reflex in first dorsal interosseous muscle are absent in patients with damage to motor cortex.10. The long latency excitatory component of the cutaneous reflex in first dorsal interosseous muscle is reduced in amplitude and often delayed in patients with motoneurone disease causing damage to the corticospinal tract. The timing of short latency excitatory and inhibitory components is unchanged.11. It is concluded that the short latency excitatory and inhibitory components of the cutaneous reflex response of first dorsal interosseous muscle have a spinal pathway and that the interneurones mediating the inhibitory component are under descending extrapyramidal control from systems whose inputs are deranged by damage to motor cortex.12. It is concluded that the long latency excitatory component of the cutaneous reflex response of first dorsal interosseous muscle is of supraspinal origin requiring transmission of afferent impulses through the dorsal columns, a relay in the sensori-motor cortex and then descending transmission to the lower motoneurone pool by way of the corticospinal tract.

Adolescent↗