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At least 523 records · Page 29Linked to original sources
PubMed2002

Evaluation of upper extremity motor function tests in tetraplegics.

OBJECTIVE: To provide an overview of arm-hand function tests useful in tetraplegic subjects. Considerations for selection of an appropriate test are also provided. DATA SOURCES: A Medline literature search was conducted covering the period from 1967 to March 2001. Relevant references cited in the selected papers were also considered, regardless of the year of publication. STUDY SELECTION: This review was restricted to strength tests, functional and ADL tests. Only general tests and tests designed specifically to test tetraplegic persons written in English, or in Dutch were included in the review. RESULTS: Information is provided on four types of strength tests, 10 general and five specific functional tests and eight ADL tests. CONCLUSION: Many tests are available to measure upper extremity motor function in tetraplegics. Selection of a test is at first determined by the outcome value in which the investigator is interested. When the type of outcome value has been determined, the most suitable test has to be selected from the range of available tests. When two tests appear to be equally suitable, the availability of information on psychometric properties of the test when used in tetraplegic patients is a decisive factor. When information on the reliability, validity and sensitivity of a test is missing, it should be gathered before using the test.

Activities of Daily Living↗
PubMed1985

[Recovery of motor function disorders in patients of different ages with infarct foci in the cerebral hemispheres (clinico-computer-tomographic correlation)].

To determine the possible role of age in motor rehabilitation, the authors compared the degree of restoration of impaired motor functions in patients of different age groups with infarction foci in the large hemispheres of the brain. Localization and size of post-ischemic changes in the cerebral substance were assessed by computer-aided tomography. By the end of the late rehabilitative period. (12 months after the development of infarction), there were no statistically significant differences between the degree of recovery of impaired motor possibilities. Most important for recovery seems to be an intactness of functionally significant structures, especially of the posterior femur of the internal capsule.

Adult↗
PubMed2004

"Functional motor amnesia" in stroke (1904) and "learned non-use phenomenon" (1966).

The "learned non-use phenomenon" described by Taub, one of the most original recent contributions to rehabilitation medicine probably corresponds to what Henry Meige (1866-1940), who studied under J.-M. Charcot, described in hemiplegics in 1904 using the expression "functional motor amnesia". He specified in 1914 at the time of the Babinski description of anosognosia, that: "Even with educated subjects who are still relatively young we are sometimes confronted with strange incapacities that are not due to impotence, negligence, or lack of confidence in the results. [...] With the transitory halting of the motility all memory of the function appears to have disappeared". Meige describes motor disorders that are: (i) distinct from lesional paralyses; (ii) secondary to the absence of activity; (iii) linked to a learning process; (iv) linked to a phenomenon of functional memory loss; (v) reversible; and (vi) motor re-education focusing on extended and repeated practice of the lost function: the same characteristics as the "phenomenon of learned non-use" described by Taub in monkeys then in man.

France↗
PubMed2001

Spasticity versus strength in cerebral palsy: relationships among involuntary resistance, voluntary torque, and motor function.

Despite the lack of consensus of the role of spasticity in the observed motor disability in cerebral palsy (CP), alleviation of spasticity remains a primary focus in the clinical management of these patients. The purposes of this study were to: (1) quantify voluntary torque and passive resistance across speeds in the hamstrings and quadriceps muscle groups with respect to the presence of stretch responses and/or passive muscle stiffness in patients with CP compared to age-related children without disability, and (2) relate these parameters to each other and to functional performance, as measured by the Gross Motor Function Measure (GMFM), in CP. Included were 23 subjects with CP, sub-grouped by the presence or absence of stretch responses as determined by electromyography, and 9 subjects without CP. Results indicated that peak torque was considerably greater in the comparison group than for each of the CP groups and resistance was greater in the CP group with spasticity compared to the nonspastic CP group in both muscles at all speeds. Stiffness differed between the spastic CP group and the comparison group only for the quadriceps at the fastest speed. Higher passive resistance torque and stiffness were correlated with decreased voluntary torque, particularly for the antagonists, and with lower GMFM scores. In conclusion, strength and motor function are related to the magnitude of resistance torque and stiffness in CP, although the small amount of variance explained reinforces the multidimensional nature of this disorder, and the challenges inherent in managing it.

Analysis of Variance↗
PubMed1983

Effects of hemodialysis on the cognitive and sensory-motor functioning of the adult chronic hemodialysis patient.

Twenty chronically dialyzed adults were administered a repeatable battery of 14 cognitive and sensory-motor tests on 3 consecutive days: immediately prior to their midweek dialysis, approximately 20 hr after their midweek dialysis, and again immediately prior to their end-of-the week dialysis. Serum electrolyte and methylamine analyses were performed at each test session. When compared to established norms, these patients scored within the normal range in a wide variety of areas. Limited impairments, probably due to peripheral neuropathy, were in evidence on the Grooved Pegboard, Finger Tapping (females), and Grip Strength (females) measures. Impairments suggestive of cerebral dysfunction were also noted on the Benton Visual Retention Test and on the Trail Making Test, Parts A and B, with particularly severe impairment noted on Part B. Despite significant daily changes in serum levels of toxic substances retained in uremia, there was little or no evidence to suggest that well-dialyzed patients undergo daily fluctuations in their cognitive and sensory-motor functioning.

Adult↗
PubMed1997

Simplifying the evaluation of postprandial antral motor function in patients with suspected gastroparesis.

OBJECTIVES: Antral hypomotility is associated with symptoms of gastric stasis[fnc,1. AIMS: To quantitate antral motor function in patients with suspected gastroparesis due to idiopathic or secondary hypomotility; and to determine whether there are simpler indices to assess antral motility. METHODS: Standard eight-lumen antroduodenal manometry was performed in 67 patients for 3-h fasting and 2-h postprandial measurements. Antral motility 1 cm proximal to the pylorus was quantitated for a 2-h fed period as an index: MI = ln[(number contractions x (amplitudes) + 1]. Fifteen healthy volunteers served as controls. RESULTS: Forty-one patients had hypomotility and 26 normal antral motility, defined by a MI > or = 13.67. Patients with antral hypomotility due to a neuropathic (n = 17) or myopathic (n = 3) disorder showed a significantly lower MI (11.6 +/- 0.3 [SEM]; 95% confidence interval 11-12.1) compared with patients with idiopathic hypomotility (n = 21, MI = 12.5 +/- 0.2). There were fewer antral contractions postprandially in patients with secondary hypomotility than in idiopathic hypomotility (66 +/- 6 per 2 h vs 90 +/- 10; p < 0.05), and both were lower than in healthy controls (224 +/- 15). Mean amplitudes of antral contractions were similar for the neuropathic, idiopathic and control groups, but lower in myopathic (33 +/- 6 mm Hg) compared with neuropathic disorders (48 +/- 4 mm Hg; fifth percentile 30.6 mm Hg). CONCLUSIONS: An antral MI < 12.1 should lead to a search for an underlying neuropathic or myopathic process; an average of less than 1 contraction per minute postprandially is a simple estimate of significant hypomotility. Antral contractions with a mean amplitude < 30 mm Hg suggest a myopathic disorder.

Adult↗
PubMed2000

Spinal tonicaine: potency and differential blockade of sensory and motor functions.

BACKGROUND: Long-acting local anesthetics are beneficial for the management of postoperative pain and chronic pain. The authors recently reported that a single injection of N-beta-phenylethyl-lidocaine (tonicaine), a quaternary lidocaine derivative, effectively blocks rat sciatic nerve function four to nine times longer than lidocaine, with a predominance of sensory versusmotor blockade. The purposes of this study were to measure directly the potency of this charged drug by internal perfusion of cultured neuronal cells, and to evaluate the differential blockade of sensory versus motor function via spinal route in rats. METHODS: The tonic and additional use-dependent blockade of Na+ currents by internal tonicaine was assayed in cultured GH3 cells during whole cell voltage-clamp conditions. In addition, tonicaine was injected into the intrathecal space of rats at intervertebral space L4-L5, and the proprioceptive, motor, and sensory functions, and tissue integrity, subsequently were evaluated. RESULTS: Internal application of tonicaine in GH3 cells revealed that it was approximately 80 times more potent in blocking Na+ currents than was externally applied lidocaine. In vivotesting in a rat neuraxial anesthesia model showed that tonicaine at 0.5 mm produced blockade that lasted much longer than that produced by bupivacaine even at approximately a 55 times higher concentration (28.8 mm). Tonicaine spinal block also produced a longer duration of sensory than motor blockade (112.5 +/- 16.3 min vs. 45.8 +/- 7.1 min). Evidence of neurotoxicity was seen at a concentration of 1.0 mm. CONCLUSION: In vitro testing shows that tonicaine displays a higher affinity for the local anesthetic binding site than does lidocaine; in vivotesting indicates that tonicaine elicits sensory blockade of a duration significantly longer than that elicited by bupivacaine. Tonicaine, however, has a narrow therapeutic index, with substantial neurotoxicity at 1 mm in rats, and may have limited clinical value.

Analysis of Variance↗
PubMed1993

Motor functions of the basal ganglia.

A study of movement disorders such as Parkinson's disease and Huntington's disease can provide an indication of the motor functions of the basal ganglia. Basal-ganglia diseases affect voluntary movement and can cause involuntary movement. Deficits are often manifested during the coordination of fine multi-joint movements (e.g., handwriting). The disturbances of motor control (e.g. akinesia, bradykinesia) caused by basal-ganglia disorders are illustrated. Data suggest that the basal ganglia play an important role in the automatic execution of serially ordered complex movements.

Basal Ganglia↗
PubMed2002

Effect of sildenafil on oesophageal motor function in healthy subjects and patients with oesophageal motor disorders.

BACKGROUND AND AIMS: Sildenafil blocks phosphodiesterase type 5 which degrades nitric oxide (NO) stimulated 3'5'-cyclic monophosphate (cGMP), thereby relaxing smooth muscle cells in various organs. We used sildenafil as a tool to investigate the role of the NO-cGMP pathway in the oesophagus of healthy volunteers and patients with hypercontractile oesophageal motility disorders. METHODS: Six healthy male volunteers participated in a randomised double blind study on two separate days before and one hour after oral intake of either sildenafil 50 mg or placebo. Oesophageal manometry was performed to determine vector volume of the lower oesophageal sphincter (LOS) and pressure amplitudes of the oesophageal body. Four of the volunteers underwent 12 hour ambulatory oesophageal manometry on two separate days, once with sildenafil 50 mg and once with placebo. An activity index for spontaneous swallowing was calculated for every hour of the study. Eleven patients with hypercontractile oesophageal motility disorders took part in an open study of the effect of 50 mg sildenafil on manometric features of their disorder and on the clinical response to sildenafil taken as required. RESULTS: In healthy subjects, sildenafil significantly reduced LOS pressure vector volume and pressure amplitudes in the distal half of the oesophageal body. In three of four subjects the inhibitory effect of sildenafil lasted at least eight hours. In nine of 11 patients, manometric improvement after sildenafil was observed but only four had an improvement in oesophageal symptoms with sildenafil taken as required. Two of these four patients however experienced side effects and did not want to continue treatment. CONCLUSIONS: Sildenafil lowers LOS pressure and propulsive forces in the body of the oesophagus of healthy subjects as well as in patients with nutcracker oesophagus, hypertensive LOS, and achalasia. The effect of sildenafil on the oesophageal body may last for up to eight hours in healthy volunteers. A subset of patients with hypertensive LOS or nutcracker oesophagus may benefit from sildenafil but side effects are a limiting factor.

Adult↗
PubMed2004

Energy cost of walking in children with cerebral palsy: relation to the Gross Motor Function Classification System.

This study compared the energy cost of walking in children with cerebral palsy (CP) classified at different levels of the Gross Motor Function Classification System (GMFCS) with that in children with typical development. Sixteen female and 14 male children with CP (mean age 9 years 6 months, SD 2 years 4 months, range 6 years 4 months to 13 years 4 months) and 14 male and 13 female typically developing children (mean age 10 years, SD 1 year 6 months, range 7 years 1 month to 12 years 11 months) participated. Children with CP were classified at GMFCS level I, n=5; level II, n=10; level II, n=9; and level IV, n=6. Energy cost was assessed by the gas dilution method as each child walked around an oval track wearing a dilution mask. Significant differences were found across GMFCS levels (p<0.0001) and between adjacent levels (p<0.013). Children with CP displayed a higher energy cost of walking than the typically developing children (p<0.0001). A strong correlation (0.87) was found between the energy cost of walking and GMFCS level (p<0.01) when children with typical development were assigned a GMFCS level of zero to allow statistical analysis. This indicates increasing energy cost of walking with increasing severity of functional involvement. These differences in energy cost across GMFCS levels provide another distinguishing factor between GMFCS levels and further emphasize the importance of considering metabolic demand in determining treatment options.

Adolescent↗
PubMed1999

Effect of tramadol and morphine on pain and gastrointestinal motor function in patients with chronic pancreatitis.

Tramadol and morphine were compared for treatment of severe chronic pancreatitis pain and their interaction with gut motor function. Oral tramadol or morphine doses were titrated double-blinded and randomized for five days in 25 patients and pain, side effects, bowel function, orocecal and colonic transit, anal resting pressure, and rectal distension thresholds were measured. Pain intensities (mean+/-SD, 0 = none, 100 = unbearable) before treatment and on day 4 were 75+/-19 and 8+/-13 with tramadol (P < 0.001), and 65+/-21 and 5+/-6 with morphine (P < 0.001). On day 4, 67% of patients with tramadol and 20% with morphine rated their analgesia as excellent (P < 0.001) with mean respective doses of 840 mg (range: 80-1920) and 238 mg (20-1125). Orocecal transit was unchanged after five days of tramadol, but increased with morphine (P < 0.05). More patients had prolonged colonic transit times with morphine by day 5 (P < 0.05). Rectal distension threshold pressures increased only with tramadol (P < 0.01). It is concluded tramadol and morphine are potent analgesics in severe chronic pancreatitis pain when individually titrated. Tramadol interfered significantly less with gastrointestinal function and was more often rated as an excellent analgesic than morphine.

Adult↗
PubMedDate not supplied

[The effect of exogenous bradykinin on gastric motor function in an experimental model of ulcerative lesions of the antrum].

Experiments on 29 cats demonstrated a direct dependence of changes in stomach motor activity on the amount of injected bradykinin. The motor response to the agent was stronger in cats with ulcer of the stomach than in intact animals. A stimulating effect of exogenous bradykinin on motor function and increased sensitivity of kininergic structures of the stomach in experimental ulcer were revealed.

Acetates↗
PubMed2003

Cognitive and motor functioning in gene carriers for Huntington's disease: a baseline study.

The aim of this study was to investigate the first changes in cognitive and motor functioning in Huntington's disease. Forty-six gene carriers, not clinically diagnosed for HD, were compared with 88 non-gene carriers. Gene carriers performed significantly worse on the Benton Visual Retention Test. This result was due to a minority of participants who had already developed cognitive impairment. Marginal differences appeared on the motor times of single reaction time measures after correction for motor signs. The findings are discussed in the context of inconsistencies in previous studies and underscore the need for longitudinal research.

Adolescent↗
PubMed2001

Cannabinoid receptor agonist and antagonist effects on motor function in normal and 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP)-treated non-human primates.

RATIONALE: Although cannabinoid effects on motor function have been extensively studied in rodents, the role of cannabinoids in regulating behavior in primates is relatively unknown. OBJECTIVES: We compared the effects of cannabinoid agonists and dopamine antagonists on unconditioned behaviors in cynomolgus monkeys (Macaca fascicularis). We further investigated the therapeutic potential of cannabinoid antagonists in a primate model of Parkinson's disease. METHODS: Drugs were administered i.m., and sessions were videotaped and rated by a "blind" observer using a rating scale. RESULTS: The dopamine antagonist haloperidol decreased locomotor activity and increased bradykinesia in three subjects. Haloperidol also produced a dose-dependent increase in freezing and catalepsy in two out of the three subjects. The cannabinoid agonist levonantradol dose-dependently decreased general and locomotor activity and increased bradykinesia. In contrast to haloperidol, levonantradol failed to produce freezing or catalepsy. At the dose range studied, tetrahydrocannabinol did not affect general or locomotor activity, but increased bradykinesia. In view of the psychomotor slowing induced by cannabinoid agonists, we investigated the therapeutic potential of the cannabinoid receptor antagonist SR141716A in an early and advanced stage of 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine-induced parkinsonism. In both models of Parkinson's disease, SR141716A failed to alleviate the motor deficits of parkinsonism. CONCLUSIONS: Cannabinoid agonists do not induce catalepsy in primates, a finding that differs from their effects in rodents. The primate may be more suitable than rodents for predicting the effects of cannabinoids and their therapeutic potential on select primate behaviors.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1992

Foregut motor function in chronic renal failure.

In children with chronic renal failure (CRF) anorexia, nausea, and vomiting are common yet poorly understood symptoms. We studied oesophageal and gastric motor function in 12 children (age 7 months-6.8 years) with severe CRF not undergoing dialysis who had persistent anorexia and vomiting. Eight of 12 patients had significant gastro-oesophageal reflux (reflux index 5.2% to 21.9%, mean 11.3%; controls < 5%), 7/10 had altered gastric half emptying times (T1/2) for 5% glucose or milk (glucose meal--controls: 8-14 min, two CRF patients: 18-25 min; milk meal--controls: 48-72 min, five CRF patients 27, 28, 82, 83, and 110 min). Gastric antral electrical control activity was abnormal in 6/11 patients, with different types of gastric dysrhythmias whereas the remainder and controls showed a regular dominant frequency of 0.05 Hz. In 7/9 patients fasting serum gastrin concentration was raised (53 to > 400, mean 168 pmol/l, controls < 40 pmol/l). All CRF patients with anorexia and vomiting had one or more disorder of foregut motility. The nature and variety of the motor disorders and the raised concentrations of circulating gastrin suggest that the normal environment generated by CRF affects the function of the smooth muscle of the foregut.

Child↗
PubMed2004

Quantitative assessment of deficits and recovery of forelimb motor function after cervical spinal cord injury in mice.

A large proportion of spinal cord injuries (SCIs) in humans are at the cervical (C) level, but there are few tests to quantitatively assess forelimb motor function after cervical spinal cord injury in rodents. Here, we describe a simple and reliable technique for assessing forelimb grip strength over time. Female C57Bl/6 mice were trained on the Grip Strength Meter (GSM, TSE-Systems), then received a lateral hemisection of the spinal cord at level C5, C6, C7, or T1. Gripping ability by each forepaw was then tested for 4 weeks postinjury. Before injury, there was no significant difference in the force exerted by either forepaw. After hemisections at C5, C6, or C7, the forepaw ipsilateral to the injury was initially completely unable to grip (day 2 postinjury), and there was a slight transient decrease in the strength of the contralateral paw compared to presurgical levels. The ipsilateral forepaw exhibited no ability to grip until about 10-14 days postlesion, at which time grip reappeared and strength then recovered over a period of a few days to a level that was about 50% of preinjury levels. Grip strength was minimally and transiently affected by hemisection at T1. The grip strength analysis provides a convenient, quantitative measure of the loss and recovery of forelimb function after cervical injury.

Animals↗