PubMed · 13034460
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R WARTENBERG. 1953-04-04. Knee dropping test.. https://doi.org/10.1001/jama.1953.02940140038012
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Proprioceptive facilitation (PF) is a phenomenon occasionally seen during motor restoration following acute hemiplegia. At an early stage of recovery, a number of brief passive muscle stretches can facilitate voluntary contraction in the stretched muscles. Here we present a patient who during early recovery from a left hemispheric stroke causing right hemiplegia was able to develop maximum isometric arm force if, during this effort, large-amplitude passive stretches of the elbow were applied as conditioning stimuli. Based on clinical and positron emission tomography findings, possible physiological mechanisms of PF and the role of proprioception in stroke recovery are discussed.
PURPOSE: Deep vein thrombosis (DVT) is a well-known complication of stroke and frequently develops in acute stroke patients. Immobility in stroke patients increases the risk of DVT and pulmonary embolism (PE). The incidence of DVT in non-ambulatory stroke patients is more frequent than the incidence in ambulatory stroke patients. We report a case of DVT and PE in an ambulatory chronic stroke patient. METHOD: Initial physical examination showed heat and swelling of hemiplegic leg. The patient was only able to ambulate with the assist of a monocane and a plastic leaf spring orthosis due to ankle dorsiflexor weakness. The patient was treated with anticoagulation and inferior vena cava filter placement. RESULTS: After long-term anticoagulation, follow-up studies revealed satisfactory resolution of DVT and PE. CONCLUSIONS: We present a case of DVT and PE which developed during the chronic stage of stroke, 2 years from the onset of stroke, and review the cause of DVT.
INTRODUCTION: The author attempts to show the evolution of the ideas guiding the rehabilitation treatment of motricity disorders after a vascular or traumatic brain lesion. METHOD: Expert opinion based on an uncomprehensive review of the literature, from the databases Reedoc and Medline and from the Institut Lionnois library in Nancy and the Charcot library in Paris. RESULTS AND DISCUSSION: Many theories and techniques have been proposed. The modern history of this rehabilitation treatment has been marked by a period that stressed control of the abnormal motricity characterizing central motor disorders, sometimes too exclusively. The development of evidence-based medicine in the 1980s undermined certain dogmas. At the same time, the advent of cerebral imaging technology confirmed clinical observations and hypotheses concerning cerebral plasticity. Today, the rehabilitation treatment of these motor disorders uses notions of learning; the diversity and complementarity of the exercises, which must be task-oriented; relative earliness and intensity of therapy; close interactions between sensitivity and motricity; and different concepts as mental imagery, the perception of verticality, or muscle strengthening. CONCLUSION: To its well-known preventive and palliative roles, rehabilitation treatment has now added a curative role. All the concepts applied today are not new, but the spirit of their application is new. Because we are sure that neurological recovery can be improved, no idea can be rejected at the outset; its effect must be demonstrated. Among the numerous ideas presently proposed, future studies will define the best ones, for the most suitable patient, at the best time.