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PubMed1996

Oral motor function in the neonate.

The information in this article illustrates the importance of evaluating oral motor function of the infant, not only as function of his or her own ability but also of external and maternal assistance. The proper development of maternal behavior as a contribution toward the development of sucking behavior may not be readily evident; however, awareness is growing that a close mother-infant interaction can positively affect the infant's ability to feed, as well as his or her psychosomatic development. As a consequence, it becomes essential that the integrity of the nursing dyad be protected. More often than not, caretakers have seen the latter break down when mother or infant becomes too involved. Studies focusing on maternal and neonatal non-nutritional attributes stress the importance of acquiring a better appreciation of the psychosomatic benefits that can be generated by the nursing dyad. With such understanding, interventions may be developed to enhance the expression of these factors to help safeguard mother-infant relationship during difficult times.

Bottle Feeding↗
PubMed2006

Abnormal urethral motor function is common in female stress, mixed, and urge incontinence.

AIM: To investigate the urethral motor function in incontinent women. MATERIALS AND METHODS: The intraurethral pressure was measured continuously in the high-pressure zone of the urethra at rest and during repeated short squeezes around the microtip transducer catheter in a group of 205 women with clinically manifest urinary incontinence (severe), and compared with the findings of investigations in 87 middle-aged women (53-63 years) with treatment naïve incontinence (mild-to-moderate) and healthy controls. RESULTS: Women with established incontinence significantly (P < 0.001) more often (66%) had a pressure fall during or immediately following squeeze than women with treatment naïve incontinence (35%) or asymptomatic women (25%). The acceleration of urinary flow and the maximal flow rate were significantly (P < 0.01) increased in patients with incontinence: acceleration was 13 +/- 2.2 (17.8), 20 +/- 2.8 (18.9), and 32 +/- 4.9 (24.9) degrees (mean +/- SEM; SD) for incontinence, naïve incontinence and no incontinence, respectively; maximum urinary flow rate was 23, 22, and 16 ml/sec. No statistical differences in any of these measures were seen when stress and urge incontinence were compared. CONCLUSION: Women with stress, urge, and mixed urinary incontinence seem to have a primary neuromuscular disorder in the urethra, which presents itself as an overactive opening mechanism with a urethral pressure fall instead of a pressure increase on provocation during the filling phase of the bladder, and during bladder emptying a more efficient opening of the bladder outlet than in normal women. We suggest that one and the same pathophysiological mechanism participates in female stress, urge, and mixed incontinence.

Female↗
PubMed1988

Does healing of esophagitis improve esophageal motor function?

This study investigates whether healing of erosive esophagitis leads to an improvement of esophageal motor abnormalities. Manometric studies were performed in 18 patients with erosive esophagitis before and after healing of the mucosal lesions and in 15 healthy controls. Nine patients were treated with a Nissen fundoplication and nine with H2-receptor antagonists. After healing, patients were followed for a mean duration of 3.0 +/- 0.4 years. Compared to controls, patients had significantly lower contraction amplitudes and lower esophageal sphincter pressures (P less than 0.01), while the duration and velocity of esophageal contractions was similar in both groups. Lower esophageal sphincter pressure increased after surgical treatment, while no such changes were observed in medically treated patients. In both groups amplitude, duration, and velocity of esophageal contractions were not affected by healing of esophagitis. On extended follow-up, all surgically treated patients remained asymptomatic while eight of nine medically treated patients developed a symptomatic relapse which was accompanied by erosive esophagitis in six of them. The lack of improvement in esophageal motor function after healing of esophagitis may contribute to the frequent occurrence of relapse in medically treated patients.

Esophagitis, Peptic↗
PubMed2002

Factor structure, normative data and retest-reliability of a test of fine motor functions in patients with idiopathic Parkinson's disease.

The purpose of this study was to measure the stability of motor functions in patients with idiopathic Parkinson's disease (IPD). A test of fine motor skills was developed that allow objective repeated measures of momentary capability among this group of patients. The study included 114 right-handed IPD-patients (mean age: 67.0+/-9.4 years, mean duration of the disease: 6.1+/-4.9 years). Patients with dementia, pharmacogenic psychiatric side-effects, other neurological diseases and tremor-type IPD were excluded. All patients were tested with an apparative motor performance test ('Motorische Leistungsserie nach Schoppe') and 24 hr later, again with the identical test. The patients (all properly adjusted to medication) were receiving different drug combinations; there was no change in the medication between tests for patients included in the analysis. Seven factors were extracted: 'finger-tapping speed,' 'speeded manual dexterity,' 'speeded finger dexterity,' 'movement planning,' 'complex movement: right,' 'complex movement: left,' and 'steadiness.' The subtests proved to have acceptable test-retest reliability. It is thus possible to produce objective, statistically sound data which enable a confirmation of improvement via medication or of the illness' progression. The presentation of normative data permits intra- and inter-individual interpretations of a single patient's performance. In addition, the patients' performance can also be compared with that of healthy controls in similar age groups (cf. data in the literature).

Cognition↗
PubMed1987

[Dynamics of the recovery of motor functions after the stereotaxic removal of intracerebral hematomas (clinical computed tomographic study)].

The recovery of impaired motor functions in patients with intracerebral haemorrhages depends on many factors. It has been proved that surgical removal of intracerebral hematomas improves the survival rate. Yet, the results of recovery primarily depend on the type of surgery. A new method of stereotaxic removal of intracerebral hematomas has a number of advantages over the open method, primarily low traumatism. The prognosis of the recovery of motor ability is determined by not only the type of surgery but by a number of other factors as well, namely, the volume and localization of the hematoma, the degree of deformation of the brain stem and the timing of surgical intervention. The results of clinical employment of the new method in 51 patients should be considered encouraging while the operation of stereotaxic removal of intracerebral hematomas appears rather promising.

Adult↗
PubMed1978

[A developmental study of visual-motor function in cerebral palsied children (author's transl)].

The purpose of this study was to investigate whether the disorder in the visual-motor function of cerebral palsied children was affected by specific defects or by the distortion in perceptual motor system or by mere developmental lag in the function of recognition and reconstruction using the method of multiple choice and Shochi's Block Design Test (1971). The results were as follows : Cerebral palsied children's developmental lag in the function of recognition was not conspicuous but the development in the function of reconstruction was obviously inferior to that of normal children. There was the difference in reconstruction ability by children with the types of cerebral palsy and intellectual levels and design-constructive patterns. Those factors and the developmental lag cause visual-motor disorders.

Cerebral Palsy↗
PubMed2001

Assessing Wolf motor function test as outcome measure for research in patients after stroke.

BACKGROUND AND PURPOSE: The Wolf Motor Function Test (WMFT) is a new time-based method to evaluate upper extremity performance while providing insight into joint-specific and total limb movements. This study addresses selected psychometric attributes of the WMFT applied to a chronic stroke population. METHODS: Nineteen individuals after stroke and with intact cognition and sitting balance were age- and sex-matched with 19 individuals without impairment. Subjects performed the WMFT and the upper extremity portion of the Fugl-Meyer Motor Assessment (FMA) on 2 occasions (12 to 16 days apart), with scoring performed independently by 2 random raters. RESULTS: The WMFT and FMA demonstrated agreement (P<0.0001) between raters at each session. WMFT scores for the dominant and nondominant extremities of individuals without impairment were different (P</=0.05) from the more and less affected extremities of subjects after stroke. The FMA score for the more affected extremity of subjects after stroke was different (P</=0.05) from the dominant and nondominant extremities. However, the FMA score for the less affected upper extremity of individuals after stroke was not different (P>0.05) from the dominant and nondominant extremities of individuals without impairment. The WMFT and FMA scores were related (P<0.02) for the more affected extremity in individuals after stroke. CONCLUSIONS: The interrater reliability, construct validity, and criterion validity of the WMFT, as used in these subject samples, are supported.

Adult↗
PubMed1987

Importance of the projection from the sensory to the motor cortex for recovery of motor function following partial thalamic lesion in the monkey.

Motor deficits produced by thalamic lesions were studied using adult cynomolgus monkeys. Lesioned areas included n. ventralis anterior (VA), ventralis lateralis (VL), n. ventralis posterolateralis pars oralis (VPLo), pars caudalis (VPLc) n. subthalamus (STN) and n. centrum medianum (CM). When the lesion included VA, VL and VPLo, there was a cerebellar syndrome, i.e., ataxia and dysmetria. When the lesion included VPLo and VPLc, the animal was paralyzed. When the lesion included VPLo and rostral part of VPLc, there was loss of orientation in hand movement and clumsiness of finger manipulation. These motor deficits gradually disappeared within 1-2 weeks and the function recovered near to normal except for when VPLo and VPLc were totally destroyed. After recovery of motor function, the somatic sensory cortex (areas 1, 2, 3b) ipsilateral to the thalamic lesion was removed. Removal of the sensory cortex resulted in abolition of the recovered function, but when the border area between VPLo and VPLc was intact, the function recovered again. On the other hand, when the thalamic lesion included this border area, succeeding cortical lesion permanently abolished the recovered function or the reappeared function was substantially worse than that before the cortical lesion. Neuronal mechanisms subserving these differences are discussed and it is concluded that when direct sensory input to the motor cortex was interrupted by lesion of the border area between VPLo and VPLc, the lost function was compensated by reorganization of the projection from the sensory cortex to the motor cortex.

Animals↗
PubMed2001

Does Helicobacter pylori gastritis affect motor function of proximal stomach in dyspeptic patients?

The role of Helicobacter pylori infection in proximal gastric motor function and its relation to symptoms in patients with functional dyspepsia is still unclear. We prospectively studied 26 patients with dyspepsia, no structural abnormalities found during endoscopy and biopsy-proven Helicobacter pylori-positive gastritis before and three months after Helicobacter pylori treatment. We used an 11-item score list to evaluate symptoms, gastric biopsies for histology, and a gastric barostat (isobaric inflation-deflation) for proximal gastric motility. Minimal distending pressure (MDP), mean gastric volume at operating pressure, AUC of inflation-deflation cycles, and hysteresis (difference in AUC during inflation and AUC during deflation) were calculated. After three months, Helicobacter pylori was eradicated in 96% of patients. MDP, mean gastric volume at operating pressure, gastric compliance, and hysteresis did not change significantly. Aggregate symptom score as well as histology scores in antrum and corpus decreased significantly. Reduction in postprandial pain correlated with a change in hysteresis (r = 0.567, P < 0.01), but other symptoms did not. Reduction of corpus inflammatory activity correlated with changes in hysteresis (r = 0.604, p < 0.005), suggesting that the stomach attains it original shape faster when inflammation is reduced. These observations suggest that inflammatory changes or release of inflammatory substances associated with Helicobacter pylori infection may influence proximal gastric motor characteristics.

Adult↗
PubMed2006

Stability of the gross motor function classification system.

The aim of this study was to assess the stability of the Gross Motor Function Classification System (GMFCS) by examining whether children with cerebral palsy (CP) remain in the same level over time. Participants were 610 children with CP (342 males, 268 females; mean age 6y 9mo [SD 2y 10mo]), range 16mo-13y). Children were assessed 2 to 7 times (mean 4.3) at 6-month (children <6y old) or 12-month(children >or=6y old) intervals. Seventy-three per cent of children remained in the same level for all ratings. The weighted kappa coefficient between the first and last ratings was 0.84 for children less than 6 years old and 0.89 for children at least 6 years old, indicating excellent chance-corrected agreement. Children initially classified in Levels I and V were least likely to be reclassified. There was a tendency for children younger than 6 years who were reclassified to be done so to a lower level of ability. The results provide evidence of stability of the GMFCS.

Child↗
PubMed1985

Motor function in the normal aging population: treatment with levodopa.

In normal elderly humans there is progressive motor dysfunction and loss of nigrostriatal neurons and brain dopamine similar to, although of a milder degree than, that seen in Parkinson's disease. Ten healthy elderly volunteers were given carbidopa/levodopa or placebo in a double-blind crossover study. We measured movement velocity, reaction time, tremor, visual evoked response (VER), and electroretinography (ERG). Significant changes were seen only in ERG. Motor functions and VER were unchanged. Although there appeared to be pharmacologic activity (ie, changes in ERG), levodopa, in adequate antiparkinson dosage, had no impact on the mild extrapyramidal impairment of normal elderly subjects.

Aged↗
PubMed1984

Alterations in cognitive performance and affect-arousal state during fluctuations in motor function in Parkinson's disease.

Sixteen patients with idiopathic Parkinson's disease were selected who were all showing severe fluctuations in motor function ("on-off" phenomenon). Measures of cognitive function and of subjective affect/arousal state were taken on two occasions, once when "on" and once when "off". Twenty-five matched normal controls were also assessed on the same measures. Results revealed, on the average, a drop in cognitive function plus an adverse swing in affect/arousal state, in the patient group in the "off" condition, compared to the levels when "on". Analysis of the data suggested that the main factor associated with cognitive function when "off" was not the severity of disability but the level of affect/arousal. The fluctuations in cognitive function found tended to be mild relative to the severe changes in motor ability, and were present in only a proportion of patients.

Adult↗
PubMed1995

The objective rating of oral-motor functions during feeding.

The Schedule for Oral Motor Assessment (SOMA) was developed to record oral-motor skills objectively in infants between ages 8 and 24 months postnatal. Its aim is to identify areas of dysfunction that could contribute to feeding difficulties. The procedure takes approximately 20 min to administer, and is intended to be rated largely from a videorecording of a structured feeding session. A series of foodstuffs of varying textures, including liquids, is presented to the child in a standardized manner. Oral-motor skills are evaluated in terms of discrete oral-motor movements. The schedule distinguishes these from skills at more aggregated levels of functioning such as jaw, lip, and tongue control. A total of 127 children have been studied with the instrument, including normal healthy infants and samples with nonorganic failure to thrive, and cerebral palsy. Interrater and test-retest reliabilities were determined on a subset of 10 infants who each took part in three trials rated by 2 therapists. Excellent levels of interrater reliability (kappa > 0.75) were obtained for the presence/absence of 69% of discrete oral-motor behaviors. Test-retest reliability was similarly excellent for 85% of ratable behaviors. For the first time an assessment of oral-motor functioning has been shown to have adequate reliability for children aged 8-24 months. The validation of the SOMA on a large sample of normally developing infants and its application to clinical groups is presented in an accompanying paper [1].

Bottle Feeding↗
PubMed2003

Upper limb motor function in hemiparesis: concurrent validity of the Arm Motor Ability test.

OBJECTIVE: To evaluate the concurrent validity of the Arm Motor Ability Test (AMAT) using the Fugl-Meyer Assessment (FMA) as the criterion measure of poststroke upper limb motor impairment. DESIGN: Upper limb motor impairment and arm ability of 30 chronic stroke survivors were assessed with the FMA and AMAT, respectively. Spearman's correlation coefficients were generated relating the components of FMA and AMAT. Scatterplots were generated to provide qualitative assessments of the relationship between FMA and AMAT. Bar graphs of FMA and AMAT normalized to their maximum scores were generated to compare the levels of motor status measured by each instrument. RESULTS: All components of AMAT correlated highly with FMA total (r = 0.92-0.94; P < 0.001). AMAT functional ability and AMAT quality of movement were linearly related with FMA total. However, AMAT time of performance exhibited significant ceiling and floor effects with respect to FMA. Normalized AMAT scores were generally lower than normalized FMA scores (P < 0.001), with the greatest difference in scores observed in subjects with more severe motor impairments. CONCLUSION: This study demonstrates a high degree of concurrent criterion validity of the AMAT. However, AMAT tends to underestimate the arm motor status of those with more severe motor impairments.

Activities of Daily Living↗
PubMed2006

Spiral drawing performance as an indicator of fine motor function in people with multiple sclerosis.

This study investigated spiral drawing performance as an indicator of fine motor function, as well as to gain insight into adaptive movement strategies used by people with multiple sclerosis (MS). Seven people with MS, nine younger controls (mean age of 20) and eight older controls (mean age of 40) drew spirals on a graphics tablet at a comfortable speed and size. Spirography (i.e., a subjective visual assessment of the static trace) revealed indications of reduced control of the pen for people with MS. Analysis of the movements showed that people with MS tended to draw the spirals slower and with less pen pressure than controls. All groups increased their speed and pressure along with spiral size, but this increase was much steeper for the controls. MS participants drew spirals with more variability around an ideal trajectory, highlighting fine motor control degradation. MS patients tended to use a smaller scaling ratio, resulting in smaller spirals for a given number of revolutions. The younger and older control groups drew the spirals in a similar manner, and age was not a significant factor in any of the analyses. It is argued that the relatively lower pressure used, and slower, smaller movements (particularly during the more difficult outer sections of the spiral) are in part an adaptive strategy used to reduce movement variability. These results demonstrate the utility of the analysis of spiral movements as an objective technique for assessing motor control degradation, which can compliment the subjective rating based on the static pen trace. As such, it can provide further insight into the biomechanical strategies used when performing fine movements.

Adult↗
PubMed1990

Hemicerebellectomy and motor behaviour in rats. I. Development of motor function after neonatal lesion.

This study was undertaken to determine the effect of a neonatal hemicerebellectomy (HCb) on the motor development of rats and to determine whether various aspects of motor behaviour were affected to a similar degree. Postnatal development of postural reflexes, locomotion and dynamic postural adjustments was examined during the first four months of life in normal and in neonatal HCbed rats. The results indicate that classes of motor responses are controlled by cerebellar networks to clearly different extents. Emergence of quadruped stance, placing reactions and swimming development were unaffected by neonatal cerebellar lesion. Righting reflexes, cliff avoidance and geotaxic reactions, pivoting and crawling all showed a delayed development although the subsequent recovery was almost complete. The complex postural adjustments required in crossing a narrow path or in suspending on a wire remained permanently impaired. Finally, some behaviours developed normally and only subsequently became defective. This "growing into a deficit" was displayed by the progressively reduced hindlimb grasping and the development of a vestibular drop response with a directional bias. An impressive finding was the shifting of postural asymmetries from the lesion side to the contralateral one occurring around the third postnatal week. These data providing a description of the effect of HCb on motor development are interpreted as indicating a progressive involvement of the archi- and neo-cerebellar structures in the motor function of the rat.

Animals↗
PubMed1998

Effects of pramipexole on contraversive rotation and functional motor impairments in 1-methyl-4-phenyl1,2,3, 6-tetrahydropyridine-induced chronic hemiparkinsonian monkeys.

Rotational and functional motor behavioral changes were studied in five MPTP lesioned chronic hemiparkinsonian Macaca nemestrina monkeys after i.m. pramipexole, a predominant D2 subfamily agonist. Pramipexole induced contraversive rotations in a dose-dependent manner with an optimal dose of 56 microg/kg for approximately 2 to 4 hr after injection. Three different rating scales were used to determine drug-induced functional improvement. They included a monkey parkinsonism rating scale, volitional responses to fruit presentations, and number of hand movements that appeared volitional. A dose of 56 microg/kg of pramipexole produced functional improvements on hand disability, and on a parkinsonian rating scale for monkeys in a dose-dependent manner from 32 to 100 microg/kg. These doses produced an increase in significant hand movements in the affected (contralateral) as well as in the normal (ipsilateral) hand to the side of the brain lesion compared with 5% dextrose in water vehicle control. With a dose of 100 microg/kg, the therapeutic effects of pramipexole on hand movements were less than with 56 microg/kg, due to side effects such as scratching.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗