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PubMed1990

Objective test of the quality of motor function of children with cerebral palsy: preliminary study.

An objective test of motor function would enable better evaluation of various treatment programmes for children with cerebral palsy. The use of tri-axial accelerometry was investigated in 36 children with cerebral palsy and in 53 children without disabilities. Variables discriminated well between able-bodied and disabled children, and there was a high level of retest reliability. The technique requires further development, but shows promise of providing the ability to gather objective data about the quality of motor function.

Cerebral Palsy↗

PubMed2000

Conditioning effects of repetitive mild neurotrauma on motor function in an animal model of focal brain injury.

A weight drop model of brain injury was used to determine the effects of repetitive mild brain injury on motor function, heat shock protein and glial fibrillary acidic protein expression in the anesthetized, adult male, Sprague-Dawley rat. Repetitive mild brain injury was produced when animals received a series of three mild injuries spaced three days apart. A separate group of repetitive mild injured animals also received a subsequent severe brain injury between three and five days after the last mild injury. All animals were trained on a beam-walking test prior to surgery. The mild, repetitive mild and repetitive mild plus severe brain injury groups showed no motor deficits in the beam-walking test, whereas the animals with only severe brain injury showed significant motor deficits (increase in number of footslips) in the beam-walking test that recovered within eight days after injury. Both repetitive mild plus severe injury and severe injury only animals had cortical necrotic cavities of similar size in the region of the hindlimb motor cortex. Both the repetitive mild and severe brain-injured animals had marked heat shock protein 27kDa and glial fibrillary acidic protein staining in the cerebral cortex. Fluoro-Jade, heat shock protein 27kDa and 72kDa labeling indicated that there were widespread effects on cortical, subcortical and spinal neurons and glial cells after repetitive mild brain injury. These results suggest that repetitive mild brain injury conditions the brain so that subsequent brain injury at the same site has no effect on motor function. Furthermore, repetitive mild injury-induced activation of processes distant to the primary injury site may have a role in activation of secondary sites involved in recovery of motor function.

Animals↗

PubMed1990

Issues in measuring change in motor function in children with cerebral palsy: a special communication.

Assessing clinical change in motor function in children with cerebral palsy is a complex measurement task. Whereas a variety of methods have been developed to quantify specific aspects of gross motor behavior (eg, gait analysis, electrophysiological tests, energy-consumption techniques), systematic measurement of overall gross motor function is a more difficult problem. This special communication reviews the structural and performance characteristics required of a well-developed, valid, and responsive clinically based evaluative measure. We discuss several recent approaches used to assess responsiveness and critically examine clinical measures used in randomized controlled trials of physical therapy for children with cerebral palsy. It is argued that the creation and validation of responsive evaluative measures is essential if we are to assess accurately whether our treatments do more good than harm.

Cerebral Palsy↗

PubMed2003

Effect of aminoguanidine on the recovery of rat hindlimb motor function after spinal cord injury.

OBJECTIVE: To study the effects of aminoguanidine (AG), the inhibitor of inducible nitric oxide synthase (NOS), on the recovery of rat hindlimb motor function after spinal cord injury and explore the possible mechanism. METHODS: Thirty rat models of spinal cord compression injury were established according to Nystrom's method. AG therapy was administered for 4 times at 1 h before and 8, 24, 36 h after the injury, and 24 h after the completion of the therapy, spectrophotography was performed to measure the content of NO and activity of NOS in the injured spinal cord, followed by flow cytometry for determining the apoptotic rate 48 h later. The evaluation of the hindlimb motor function recovery was conducted by electrophysiological method and by measuring the behavior scores. RESULTS: AG significantly decreased the NO content (from 2.2714+/-0.4239 micromol/g.pro to 0.8466+/-0.0477 micromol/g.pro, P <0.05) and NOS activity (from 0.3408+/-0.0228 U/mg pro to 0.2702+/-0.0148 U/mg pro, P <0.05) in the injured spinal cord. The apoptotic rats were also reduced (from 7.88% +/-0.79% to 3.10% +/-0.66%, P <0.05). Four weeks after the therapy, the behavior score of the rats improved from 7.1+/-4.5 to 17.3+/-4.7 (P <0.01), and the latency and amplitude of the motor evoked potentials improved from 0 ms to 8.89+/-0.91 ms and from 0 mv to 1.99+/-0.48 mv respectively, showing significant therapeutic effect of AG (P <0.05). CONCLUSION: AG can improve motor functions of injured spinal cord in rats, possibly resulting from decreased apoptotic cells of the neurons in the spinal cord in the early stages of the injury.

Animals↗

PubMed2004

Elective cesarean delivery and long-term motor function or ambulation status in infants with meningomyelocele.

OBJECTIVE: To determine if elective cesarean delivery, when compared with trial of labor, is associated with better long-term motor function or ambulation status in infants with myelomeningocele. METHODS: This is a retrospective cohort study of patients with myelomeningocele followed at the Spinal Dysfunction Program at Alfred I. duPont Hospital for Children in Wilmington, Delaware. Medical records were reviewed for gestational age at delivery, birthweight, anatomical level of lesion, and initial (0-6 months) and long-term (10 years or longer) motor function. Ambulation status (independent ambulation, ambulant with assistance, or wheelchair-bound) at 2 and 10 years was compared with those delivered by elective cesarean versus those delivered after trial of labor. RESULTS: Of the 106 patients with myelomeningocele that were identified, 87 (82%) had all the data required for this review. There were 44 patients in the elective cesarean group and 43 in the trial of labor group. There was no significant difference in gestational age at delivery or birthweight between the groups. There was statistical difference between the 2 groups when anatomical, initial, and current motor levels were compared. Compared with the elective cesarean group, patients in the trial of labor group were more likely to be ambulatory at 2 years (independently ambulant 7% versus 28%, ambulant with assistance 63% versus 65%, or wheelchair-bound 30% versus 7%, P =.003) and at 10 years (independently ambulant 5% versus 21%, ambulant with assistance 30% versus 54%, or wheelchair-bound 65% versus 25%, P <.001). However, when logistic regression analysis was used to control for motor level of myelomeningocele, no significant association was observed in ambulatory status at ages 2 and 10 years between infants delivered by elective cesarean or after trial of labor. CONCLUSION: Elective cesarean delivery, when compared with delivery after trial of labor, was not associated with better motor function or ambulation status in myelomeningocele patients. LEVEL OF EVIDENCE: II-2

Adolescent↗

PubMed1999

Motor function in irritable bowel syndrome.

The evidence supporting a role of abnormal motor function in irritable bowel syndrome (IBS) is reviewed. Symptoms commonly present in IBS patients, such as vomiting, diarrhea, constipation or incomplete rectal evacuation, indicate that a motor disorder is implicit as either a primary or secondary disturbance. Physiological studies implicate a disturbance of transit through the small bowel and proximal colon, and abnormal motor responses of the rectum to distention in IBS patients. Intestinal contractions (physiological or 'abnormal') are associated with the sensation of pain, suggesting that these contractions are interactions between abnormal motor and sensory functions in IBS. Therapies aimed at correcting abnormal transit or antispasmodics are the main pharmacological approaches to the relief of IBS, and, although the latter are not always effective in the long term response to treatment, they support the role of dysmotility in IBS. Most novel therapies under trial probably modulate both sensory and motor functions, and are discussed briefly. In summary, the weight of clinical, physiological and pharmacological evidence supports a role of abnormal motility in IBS.

Cholinergic Antagonists↗

PubMed1995

Effects of ibogaine on sensory-motor function, activity, and spatial learning in rats.

Ibogaine, a naturally occurring alkaloid, has been show to reduce naloxone-precipitated withdrawal symptoms from morphine. Given the clinical possibilities, it is important to determine ibogaine's effects on sensory-motor function, activity, learning, and memory. Long-Evans rats injected with doses of 20-60 mg/kg of ibogaine displayed slower response times on sensory and sensory-motor tests and were impaired in performing specific motor reflexes at doses of 40-60 mg/kg. Furthermore, these rats showed a marked reduction in locomotor and nonlocomotor activity, as well as emotionality at doses ranging from 10-40 mg/kg. At the higher doses the rats appeared to be virtually inactive. There were also deficits in learning a spatial location task (a dry-land version of the Morris water-maze). The deficits, however, were probably due to a reduction in locomotor activity and reduction in detection of sensory information. In a final experiment, a single injection of 40 mg/kg of ibogaine had marked deleterious effects on the acquisition of the spatial location task 1 but not 7 days after the injection, even though in this case there were no effects on sensory motor function 1 or 7 days after the injection. Thus, there are severe sensory-motor activity and learning problems while the animal is under the influence of ibogaine (acute effect) as well as long-term consequences on learning without concomitant changes in sensory-motor function.

Animals↗

PubMed1996

Correlation between the gross motor function measure scores and gait spatiotemporal measures in children with neurological impairments.

Twenty six children with a diagnosis of cerebral palsy and four with a diagnosis of head injury, aged between 1 and 8 years, participated in this study, undertaken to determine the relation between spatiotemporal measures (STM) of gait (velocity, cadence, stride length, and cycle duration) and the results of a standardized clinical test of motor function. STM were assessed by a clinical videographic gait test (VGT) whereas the Gross Motor Function Measure (GMFM) was used to assess motor function. For the total group of children, significant linear relations (r = 0.91, r = 0.93; p < 0.0001) were obtained between gait velocity and the GMFM sections D and E which include gait-related activities. These indicate that velocity is a parameter capable of reflecting functional locomotor behavior of these children. The results suggest that GMFM sections D and E may be used as locomotor predictors. The effect of walking with or without support was also investigated. The correlation between gait velocity and the GMFM(E) score was higher (r = 0.69) in the group of children walking with support than in those walking without (r = 0.35). The first group were younger and walked at velocities under 45 cm/s whereas children walking without support were older and walked at velocities ranging from 55 to 110 cm/s. These results suggest that the GMFM(E) score becomes less discriminant at gait velocities above 45 cm/s.

Cerebral Palsy↗

PubMed2006

Psychosocial, cognitive, and motor functioning in patients with suspected Sotos syndrome: a comparison between patients with and without NSD1 gene alterations.

The aim of this study was to investigate psychosocial, cognitive, and motor functioning in patients clinically suspected of Sotos syndrome and to examine differences between patients with deletions or mutations of the gene encoding nuclear SET domain-containing protein 1 (NSD1; the major cause of the syndrome) and those without such alterations. Twenty-nine participants (21 males, 8 females) clinically suspected of Sotos syndrome (mean age 11y 10mo [SD 10y 11mo], range 1y 10mo-48y 5mo) were divided into an NSD1 mutation group (n=12; 8 males, 4 females) and an NSD1 non-mutation group (n=17; 13 males, 4 females). Intelligence, behaviour problems, attention-deficit-hyperactivity disorder (ADHD) symptoms, temperament, adaptive behaviour, and motor functioning were assessed with an extensive test battery. Scores were compared with those of control groups, and scores of the two subgroups were compared with each other. The mean IQ in the 21 individuals tested was 76 (SD 16; range 47-105). High rates of behaviour problems were found and patients lagged 1y 7mo to 2y 7mo behind in aspects of adaptive behaviour. In comparison with a control group of patients with a learning disability, motor functioning was better. NSD1 mutation compared with NSD1 non-mutation patients showed easier temperament, and fewer NSD1 mutation patients scored in the clinical range for 'total behaviour problems' (3/11 vs 13/17), 'internalizing behaviour' (2/11 vs 11/17), and ADHD (0/9 vs 4/15).

Abnormalities, Multiple↗

PubMedDate not supplied

A force meter to assess lower limb motor function after epidural analgesia.

BACKGROUND AND OBJECTIVES: Current methods of assessing lower limb motor function using low-dose epidural analgesia are either too insensitive (Bromage scale) or too cumbersome for use during labor. Accordingly, we have designed a force meter that quantitatively measures isometric muscle power of the lower limbs during peak voluntary exertion. METHODS: The force meter was tested for linearity using calibrated reference weights. Measurements were made on two occasions (separated by an interval of approximately 5 years), and differences in response were assessed by regression analysis. Departure from linearity was examined by a lack of fit test. RESULTS: There was no significant nonlinearity in response over the range 0-15 kg, nor was there any significant difference in slope between the two functional modes of this device. The device overread slightly at the higher weights. CONCLUSIONS: The force meter described was found to be sufficiently accurate and suitable for the quantitative assessment of lower limb motor function after epidural analgesia during labor.

Analgesia, Epidural↗

PubMed2003

The effects of Ginkgo biloba extracts on the memory and motor functions of rats with chronic cerebral insufficiency.

The main goal of the current study was to investigate the effects of two Ginkgo leaf extracts, EGb 761 and an extract of local Ginkgo leaf (LGb), on the memory and motor functions of rats with chronic cerebral insufficiency (produced by bilateral common carotid artery ligation). After the operation, spatial memory and motor functions were tested for over 80 days. Tests included (1) radial-arm maze test for testing spatial memory and locomotor activity and (2) muscle force and hind limbs for escape. The results indicate that both EGb 761 and LGb improved spatial memory from the second week after operation, but only EGb 761 delayed deterioration of motor functions from the fifth week after operation.

Animals↗

PubMed2006

Salvianolic acid B improves motor function after cerebral ischemia in rats.

In a previous short-term study, salvianolic acid B was reported to have a protective effect on cerebral ischemia. Here, we investigated whether salvianolic acid B improves the recovery of motor function after cerebral ischemia in a 14-day investigation. Cerebral ischemia was induced by middle cerebral artery occlusion in rats. Motor function was evaluated with beam-walking performance. Neural cell injury in both the sensorimotor cortex and CA1 of the hippocampus ipsilateral to ischemia was studied by Nissl stain with methylene blue. The integrity of cerebral microvessels was monitored by immunoglobulin extravasations. Neurogenesis in the subgranular zone in the dentate gyrus of the hippocampus was detected with 5'-bromo-2'-deoxyuridine incorporation. Animals receiving salvianolic acid B at a dose of 10 mg/kg had a more rapid recovery of beam-walking performance than vehicle-treated ischemia animals, and the improvement became significant at 10 and 14 days after ischemia (P<0.05). Treatment with salvianolic acid B at a dose of 10 mg/kg also significantly prevented neural cell loss in CA1 of the hippocampus. Neural cells in the sensorimotor cortex were also preserved in animals that received salvianolic acid B at a high dose of 10 mg/kg. Salvianolic acid B (10 mg/kg) also improved the integrity of microvessels after ischemia. We observed a slight increase in 5'-bromo-2'-deoxyuridine-positive cells in the subgranular zone of the hippocampus in the animals treated with salvianolic acid B at a dose of 10 mg/kg. These data indicate that salvianolic acid B could improve the recovery of motor function after cerebral ischemia in rats.

Animals↗

PubMed1994

Instability in functional motor laterality of children and adolescents with endogenous psychosis and predominantly motor disturbances.

A group of eight unmediated right-handed children and adolescents with endogenous psychosis and predominantly motor disturbances and two right-handed control groups (6 healthy subjects and 10 patients with different psychiatric diseases) were investigated with the help of a tapping-test series. The most important finding was related to differences in the stability of functional motor laterality between controls and psychotics. Stability of instability in functional motor laterality was identified by referring to the standard deviation (SD) of percentile right-left tapping differences calculated for each subject for the various parts of the tapping-test series. The high SDs in psychotics, in contrast to the low SDs in both control groups, point to increased variations or instabilities in the functional superiority of the preferred hand. Instability in functional motor laterality in this test is considered characteristic of this subgroup of patients, and may be due to a partial relapse to a lower hierarchical stage of handedness.

Adolescent↗

PubMed2004

The mechanisms of morphological-motor functioning in elementary school female first- to fourth-graders.

Four morphological and 7 motor variables were assessed in a sample of 2,235 female children (subdivided into 4 groups) aged 7-11 years, elementary school first- to fourth-graders from the Primorje-Gorski Kotar County, Republic of Croatia. The study objective was to analyze the morphological-motor structures according to age. Factor analysis was done for each of the four subject groups. Results clearly showed the morphological-motor functioning of the girls to change with age. Developmental processes lead to the formation of a general morphological factor defined as ectomesomorph and two general mechanisms responsible for motor efficiency in the form of strength regulation and speed regulation. The results obtained were found to be consistent with the existing relevant models related to the morphological, motor, functional and cognitive systems. The more so, these results allow for a supramodel to design, which will integrate relevant elements of all these models to define the function of the body as a whole.

Age Factors↗

PubMed2003

Chylomicron components activate duodenal vagal afferents via a cholecystokinin A receptor-mediated pathway to inhibit gastric motor function in the rat.

Nutrients in the intestine initiate changes in secretory and motor function of the gastrointestinal (GI) tract. The nature of the 'sensors' in the intestinal wall is not well characterized. Intestinal lipid stimulates the release of cholecystokinin (CCK) from mucosal entero-endocrine cells, and it is proposed that CCK activates CCK A receptors on vagal afferent nerve terminals. There is evidence that chylomicron components are involved in this lipid transduction pathway. The aim of the present study was to determine (1) the pathway mediating reflex inhibition of gastric motility and (2) activation of duodenal vagal afferents in response to chylomicrons. Mesenteric lymph was obtained from awake rats fitted with lymph fistulas during intestinal perfusion of lipid (Intralipid, 170 micromol h(-1), chylous lymph) or a dextrose and/or electrolyte solution (control lymph). Inhibition of gastric motility was measured manometrically in urethane-anaesthetized recipient rats in response to intra-arterial injection of lymph close to the upper GI tract. Chylous lymph was significantly more potent than control lymph in inhibiting gastric motility. Functional vagal deafferentation by perineural capsaicin or CCK A receptor antagonist (devazepide, 1 mg kg(-1), i.v.) significantly reduced chylous lymph-induced inhibition of gastric motility. The discharge of duodenal vagal afferent fibres was recorded from the dorsal abdominal vagus nerve in an in vitro preparation of the duodenum. Duodenal vagal afferent nerve fibre discharge was significantly increased by close-arterial injection of CCK (1-100 pmol) in 43 of 83 units tested. The discharge of 88% of CCK-responsive fibres was increased by close-arterial injection of chylous lymph; devazepide (100 microg, i.a.) abolished the afferent response to chylous lymph in 83% of these units. These data suggest that in the intestinal mucosa, chylomicrons or their products release endogenous CCK which activates CCK A receptors on vagal afferent nerve fibre terminals, which in turn initiate a vago-vagal reflex inhibition of gastric motor function.

Animals↗

PubMed1989

Lower esophageal sphincter pressure, esophageal body motor functioning, and esophageal acid sensitivity.

Esophageal acid sensitivity is believed to develop as a result of esophageal acid exposure, contributing factors being gastroesophageal reflux and delayed esophageal acid clearance. The relationship among lower esophageal sphincter pressure, motor functioning of the body of the esophagus, and esophageal acid sensitivity was examined by comparing the results from 912 patients and normal subjects studied with both esophageal manometric and Bernstein acid infusion tests. Positive acid infusions were statistically more closely associated with hypotensive lower esophageal sphincter pressures than with any motor abnormality in the body of the esophagus. Of the several esophageal body motor abnormalities considered, only feeble peristalsis had significantly more positive Bernstein tests than did normal esophageal body motor functioning. The findings from this study demonstrate that hypotensive lower esophageal sphincter pressure is more closely associated with an acid-sensitive esophagus than is impaired esophageal body motor functioning.

Esophagitis↗

PubMed2005

The effect of depression on motor function and disease severity of Parkinson's disease.

OBJECTIVES: Approximately 40% of patients with Parkinson's disease (PD) experience symptoms of depression. Our aim was to evaluate the effect of depression on disease severity, motor function and other phenotypic characteristics of PD. PATIENTS AND METHODS: We studied 32 PD patients with major depression (PD-D) according to the DSM-IV criteria and 32 PD patients with no depression (PD-C) matched for gender, age of onset and duration. RESULTS: Major depression in PD patients was associated with increased disease severity, poorer motor function and worse performance in the activities of daily living as measured by UPDRS scores. Furthermore, there was an association of depression with the severity of bradykinesia and axial rigidity. CONCLUSIONS: Depression in PD can have a profound negative impact on a patient's sense of wellbeing and motor functioning. Therefore, PD patients should be routinely and carefully screened for the presence of depression and appropriate management should be considered. Larger studies on the subject are warranted.

Cross-Sectional Studies↗

PubMed2006

A modified Hammersmith functional motor scale for use in multi-center research on spinal muscular atrophy.

The Hammersmith functional motor scale for children with spinal muscular atrophy was modified to establish a standard measure of functional ability in children with non-ambulant spinal muscular atrophy types 2 and 3 in a longitudinal multi-center clinical trial. This study assessed the intra- and interrater reliability and the test-retest stability of a modified version of the scale. Both intra- and interrater reliability were established. Results indicate that the scale is reliable and stable over a 6 month period. Reliability was maintained when patient sample criteria were expanded to include children younger than 30 months and children with popliteal angles greater than 20 degrees . These data establish the modified Hammersmith functional motor scale for children with spinal muscular atrophy as a reliable instrument for use in multi-center treatment trials in non-ambulant spinal muscular atrophy children. Our data provides additional support for the use of original scale items in terms of ease of administration, usefulness and reliability, while incorporating modifications to optimize its use in a multi-center clinical research setting.

Child, Preschool↗