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Biomedical subjects

Victoria Galea

Publications and source records attributed to Victoria Galea.

6 recordsLinked to original sources

Speculations surrounding a spinal reflex.

A method has been developed for measuring the Ia fibre input/motoneurone output relationship for the soleus H-reflex in healthy human volunteers. The shift in the relationship during weak toe extension, and in some subjects during weak plantar flexion, indicates the imposition of an inhibitory mechanism, presumably presynaptic. From these observations, and others previously made on long-loop reflexes, it is argued that the inhibitory mechanism may have evolved to suppress unwanted information from the periphery, not only during movement but in the resting state, and that this development was a necessary accompaniment of encephalisation.

Animals↗

Botulinum toxin as an adjunct to motor learning therapy and surgery for obstetrical brachial plexus injury.

Following obstetrical brachial plexus injury, infants are unable to learn specific patterns of movement due to the disruption of neural pathways. Even with successful reinnervation (spontaneously or post surgical reconstruction), function can be suboptimal due to overactivity in antagonist muscles preventing movement of reinnervated muscles. Botulinum toxin type A (BTX-A) was used to temporarily weaken antagonistic muscles early in the reinnervation process following brachial plexus injury, with the aim of facilitating functional improvement. A case series of eight children (five females, three males; mean age 12.5mo [SD 6.43]; range 5-22mo) with significant muscle imbalances but evidence of reinnervation were given BTX-A injections into the triceps, pectoralis major, and/or latissimus dorsi muscles. After a single injection, all parents reported improvement in function. Active Movement Scale total score changed significantly between pre BTX-A and 1 month (p=0.014), and 4 months (p=0.022) post BTX-A injection. It is proposed that BTX-A facilitated motor learning through improved voluntary relaxation of antagonist muscles while allowing increased activity in reinnervated muscles.

Biomechanical Phenomena↗

Reliability of the long-range power-law correlations obtained from the bilateral stride intervals in asymptomatic volunteers whilst treadmill walking.

Stride intervals measured during steady-state walking are irregular. These stride interval fluctuations are not random but exhibit long-range power-law correlation (alpha) such that a given stride interval is 'influenced' by earlier variations in the stride intervals. To estimate alpha, one requires a minute long sequence of right or left side stride interval data. However, to obtain a reliable alpha point estimate, the minimal stride sequence length is unknown. Additionally, it is unknown if the right and left side alpha are equivalent. In this study, the within-day and the right and left side reliabilities of alpha point estimates were examined in 23 volunteers performing three 8-min treadmill walks. In addition, eight volunteers were retested on three additional days to estimate between-day reliability. The standard error of measurement (S.E.M.) and the within- and between-day intraclass correlation (ICC) values, and their 95% confidence intervals, each calculated using the combined right and left leg 8-min alpha estimates were acceptable [0.047 (0.044-0.051); 0.914 (0.882-0.932) and 0.769 (0.689-0.815), respectively]. The left alpha (0.688 +/- 0.93) was greater than the right alpha (0.664 +/- 0.094), albeit this finding was underpowered (0.55). The alpha point estimates obtained from the full 8-min walks provided minimal S.E.M. and maximal within- and between-day ICCs. However, the minimal S.E.M. was statistically indistinguishable from the 6- and 7-min walk durations and all of the within-day and between-day ICCs were similar except for the 3- and 8-min between-day ICCs. This study suggests that data from four 3 min, three 6 min or two 8 min walk duration trials provide reliable alpha point estimates from a short series of short treadmill walks.

Adolescent↗

Women with fibromyalgia walk with an altered muscle synergy.

Most individuals can use different movement and muscle recruitment patterns to perform a stated task but often only one pattern is selected which optimizes an unknown global objective given the individual's neuromusculoskeletal characteristics. Patients with fibromyalgia syndrome (FS), characterized by their chronic pain, reduced physical work capacity and muscular fatigue, could exhibit a different control signature compared to asymptomatic control volunteers (CV). To test this proposal, 22 women with FS, and 11 CV, were assessed in a gait analysis laboratory. Each subject walked repeatedly at self-selected slow, comfortable, and fast walking speeds. The gait analysis provided, for each walk, each subject's stride time, length, and velocity, and ground reaction force, and lower extremity joint kinematics, moments and powers. The data were then anthropometrically scaled and velocity normalized to reduce the influence of subject mass, leg length, and walking speed on the measured gait outcomes. Similarities and differences in the two groups' scaled and normalized gait patterns were then determined. Results show that FS and CV walk with externally similar stride lengths, times, and velocities, and joint angles and ground reaction forces but they use internally different muscle recruitment patterns. Specifically, FS preferentially power gait using their hip flexors instead of their ankle plantarflexors. Interestingly, CV use a similar muscle fatiguing recruitment pattern to walk fast which parallels the common complaint of fatigue reported by FS walking at comfortable speed.

Adult↗

Measurement of balance in survivors of acute lymphoblastic leukemia in childhood.

Survivors of acute lymphoblastic leukemia (ALL) in childhood have been identified with balance problems. The goals of this study were to objectively quantify these observations by measuring the displacement and velocity of the body centre of pressure, a measure of 'sway'. The subjects included 79 ALL survivors who were at least 1 year post-treatment for ALL and 83 age-matched controls. Testing was carried out using various static balance tests designed to challenge central nervous system maintenance of balance and postural control. Patients were different from controls, across all age groups, in the more difficult task in which they were required to balance over a narrow base of support. However this did not reach statistical significance. When they were asked to perform this task with their eyes closed 32% of the patients tested, as opposed to 2% of controls, were unable to complete the task (significant at P<0.01, chi(2)). The youngest group of patients (children aged 5-7 years) presented consistently with lower (or similar) displacement and lower velocity measures. This phenomenon has been observed in healthy children, however, in patients, these trends were magnified and beyond the normal age range in healthy children. The velocity values were significantly different from the other patient groups (normalized values for velocity; P<0.01). These observations then manifested as higher sway values when patients were challenged with a difficult task with their eyes closed. We propose that survivors of childhood ALL have delayed motor development compared to age-matched controls giving rise to impairment in balance and postural control. It is possible that these impairments are a consequence of intensive multi-agent chemotherapy and cranial irradiation.

Adolescent↗

Repeated treadmill walks affect physiologic responses in children with cerebral palsy.

PURPOSE: To determine whether physiologic responses during treadmill walking in children with cerebral palsy (CP) are affected by repeated walking bouts on different days, and whether effects are different at different speeds. METHODS: Three girls and five boys (9.2-15.7 yr, 23.3-64.4 kg) with mild CP received 12-15 min of treadmill walking practice and had their fastest walking speed (FWS) determined during an introductory visit. During each of three subsequent visits (day 1, day 2, day 3), subjects walked for 3 min at 60, 75, and 90% FWS. Resting physiologic measures were taken on day 1. RESULTS: From day 1 to day 3, net ventilation ([OV0312]E), and net heart rate (HR) at 90% FWS decreased by 3.6 L.min-1 and 8 beats.min-1, respectively. There were no differences between day 1 and day 2 or day 1 and day 3 for any other physiologic variable at any speed. Day 3 was less than day 2 for net HR (60% FWS) and, independent of speed, net [OV0312]O2 (per kilogram of body mass and per stride) and net energy expenditure (kJ.min-1). Between-day reliability (R) of physiologic responses was > or = 0.95, except respiratory rate (R = 0.75). Intrasubject, between-day variability for the [OV0312]O2 measures was 7.6-12.9%. CONCLUSION: Because there were no day 1 to day 3 reductions in metabolic variables, day 1 to day 3 reductions at 90% FWS in net HR may reflect decreased emotional stress over time and reductions in net [OV0312]E, an uncoupling of [OV0312]O2 and [OV0312]E. Despite between-day differences, reliable net physiologic and stable net metabolic variables may be collected in subjects with mild CP after one treadmill walking practice session.

Adolescent↗