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Results for “motor function”

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PubMed2005

Medial reorganization of motor function demonstrated by functional MRI and diffusion tensor tractography.

PURPOSE: Peri-lesional reorganization is a motor recovery mechanism after brain injury. The object of this study was to demonstrate the peri-lesional reorganization, using functional MRI (fMRI) and diffusion tensor tractography (DTT). METHODS: Six control subjects and a 53 year-old woman with left primary sensori-motor cortex (SM1) and underlying deep white matter injury were evaluated. The patient presented with complete paralysis of the right hand after the resection of a meningioma on the left SM1. The motor function of the affected hand had recovered slowly the extent of her being able to overcome some resistance for 6 months. At 2 years after the operation, fMRI was performed at 1.5 T in parallel with timed finger flexion-extension movements in all subjects and DTT was performed only in the patient. RESULTS: The contralateral SM1 centered on the precentral knob was activated during hand movements of unaffected (left) side or control subjects. However, the medial area of the injured SM1 was activated during affected (right) hand movements. DTT of the affected (left) hemisphere originated from the medial area of the injured SM1 and descended along the medial side of injured deep white matter. CONCLUSIONS: It seems that the motor function of the affected hand was reorganized into the medial area of the injured SM1 and deep white matter in this patient.

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PubMed1998

Prognostic value of motor evoked potential obtained by transcranial magnetic brain stimulation in motor function recovery in patients with acute ischemic stroke.

BACKGROUND AND PURPOSE: The early prognostic application of transcranial magnetic brain stimulation (TMS) for assessing motor and functional recovery in ischemic stroke patients has yielded contradictory results. We performed a prospective study of patients with acute ischemic stroke and motor deficit to evaluate the early prognostic value of TMS in motor and functional recovery. METHODS: Fifty patients with different degrees of hemiparesis were studied in the first week after ischemic stroke and evaluated by clinical scales (Medical Research Council Scale, Canadian Neurological Scale, Barthel Index), with clinical follow-up over 6 months. TMS (Magstim 200) was performed at the same time, recording the motor evoked potential (MEP) in the thenar eminence muscles, with facilitation by voluntary contraction. RESULTS: Of the total group of 50 patients, MEP was absent in 20 and present in 30 (17 with normal and 13 with delayed central conduction time [CCT]). The patients with MEP showed better motor and functional recovery than those without. The MEP provided information on patient recovery, regardless of the initial strength and/or Barthel values. The degree of recovery was better in those patients with normal CCT than in those with delayed CCT. CONCLUSIONS: MEP obtained by TMS in patients with hemiparesis after acute ischemic stroke is useful as an early prognostic indicator of motor and functional recovery. This technique would allow the early identification of those patients who will have a good recovery, particularly among those with severe initial paresis.

Activities of Daily Living↗

PubMed1980

The response of manual motor functioning in Parkinsonians to frontal EMG biofeedback and progressive relaxation.

The purpose of the current investigation was to determine the effects of frontal EMG biofeedback and progressive relaxation training on manual motor functioning in Parkinsonians. Twenty patients were matched and randomly assigned to two groups. All subjects were administered a brief manual motor assessment. The experimental group then underwent weekly sessions of frontal EMG and relaxation training for a period of 15 weeks. At the conclusion of the training period, both experimental and control groups were again administered the manual motor tasks. The results indicated that Parkinsonian patients are capable of significantly lowering frontal EMG activity levels. The motor task results, however, yielded no statistically significant differences between the two groups as a result of the biofeedback training.

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PubMed1977

A new device for the rapid measurement of impaired motor function in mice.

Measurement of the ability of mice to balance on a rotating rod or cone is often used as a measure of impaired motor function. In most of these procedures the mice must be trained prior to the test. In the new screen test described in this paper, untrained mice are used in a 60 sec test which measures the ability of mice to either climb to the top of or cling to the bottom of a horizontal screen. The ED50 values obtained for failure to reach the top of the horizontal screen are similar to those obtained with the rotarod; the values for falling from the screen are somewhat higher. With both of the horizontal screen measures there were fewer control failures than in the rotarod procedure.

Animals↗

PubMed1992

[A model of mild spinal cord injury in rats--dynamics of changes in motor function].

Authors proceeded by performing compressive spinal traumas of variable intensity in 21 rats at lower thoracic level over an intact dura. The deficit of hind limbs motor functions was evaluated simultaneously with the two tests as follows: a) in observing the gait of an animal along with graduation in accord with modified Tarlov's classification, b) with the method of inclined plane. The reproducibility of injuries of various intensity appeared to be imperfect. Five animals with severe injury died up to 4 weeks (Fig. 4, 5). The remainder of them showed substantial approval (mild injury--Fig. 6-13). The dynamics of motor disorder showed changes up to 6 weeks, after then the state persisted unchanged up to 2 months. Within this survival interval, rats were killed either in the state of mild paresis or even under regained normal condition. It outflowed from our study that a long term monitoring of postinjury spinal cord function is important in order not to ascribe possible approval of the functions to the therapy applied. Further on course of disorder can be predicted in accordance with duration of initial paraplegia. The post-surgery paraplegia had lasted for only several hours in the animals whose injuries resulted in a normal condition.

Animals↗

PubMed1995

Regulation of tyrosine protein kinase receptor Trk-B and motor function in rats following cardiac arrest.

Following 10 min cardiac arrest and resuscitation, male Sprague-Dawley rats developed posthypoxic myoclonus. Sixty days later, the motor function of the animals was restored. In the present study, we investigated brain levels of tyrosine protein kinase receptor Trk-B with quantitative immunoblot analysis at various time points following cardiac arrest. In the frontal cortex, a significant reduction of Trk-B was found in rats 3 days (53%) after cardiac arrest, whereas significant increases were detected in rats 14 (124%) and an average 60 days (98%) after cardiac arrest. In the striatum, significant increases were found in rats 3 (389%), 14 (483%), and 60 days (521%) after resuscitation. In contrast, significant reductions of Trk-B were detected in the cerebellum of rats 3 (46%), 14 (22%), and 60 days (18%) after cardiac arrest. The results indicate that regulation of Trk-B may vary in different brain regions and have important roles in recovery processes following hypoxic-ischemic insults to the brain.

Animals↗

PubMed1999

Effect of doses of glucagon used to treat food impaction on esophageal motor function of normal subjects.

We studied 10 normal subjects to determine the effect of doses of intravenous glucagon used to treat food impaction on esophageal motor function. With a multilumen assembly perfused by a low compliance pneumohydraulic infusion pump, esophageal manometry was performed during baseline and after randomized administration of 0. 25, 0.5, and 1 mg intravenous glucagon. Mean proximal and distal amplitudes of contraction, proximal and distal amplitude of contraction duration, lower esophageal sphincter (LES) resting pressure, percentage of LES relaxation, and glucagon-related side effects were evaluated. No effect on proximal amplitude of contraction and proximal or distal esophageal contraction duration was noted. Mean amplitude of contraction in the distal esophagus was further reduced with increased dosage of glucagon but did not achieve statistical significance. Mean LES resting pressure was significantly reduced after 0.25 mg (18.7 +/- 1.8 vs. 10.2 +/- 1.5 mmHg, p = 0.0001) and further reduced after 0.5 mg (5.9 +/- 1.2 mmHg, p = 0.0009). Mean LES relaxation was significantly reduced after 0. 25 mg (93.1 +/- 2.4% vs. 63.6 +/- 8.8%, p = 0.0031). The 1-mg dose versus the 0.5-mg did not provide further reduction in any LES function parameters. One subject experienced transient nausea after 0.5 mg, and 4 subjects experienced nausea after 1 mg glucagon. In conclusion, increased doses of glucagon further reduce mean distal esophageal amplitude of contraction. Although maximum reduction in mean LES resting pressure was achieved with 0.5 mg, it did not provide any potential therapeutic advantage over 0.25 mg glucagon. Nausea is a common, transient side effect predominantly affecting subjects treated with the 1-mg dose.

Adult↗

PubMed1998

Recovery of motor function after focal cortical injury in primates: compensatory movement patterns used during rehabilitative training.

The recovery of skilled hand use after cortical injury was assessed in adult squirrel monkeys. Specific movement patterns used to perform a motor task requiring fine manual skill were analyzed before and after a small ischemic infarct (2.6-3.8 mm2) to the electrophysiologically identified hand area of the primary motor cortex (M1). After 1-3 weeks of pre-infarct training, each monkey stereotypically used one specific movement pattern to retrieve food pellets. After injury to the hand area of M1, the monkeys were required to retrieve the pellets using their impaired forelimb. Immediately after the injury, the number of finger flexions used by the monkeys to retrieve the pellets increased, indicating a deficit in skilled finger use. After approximately 1 month of rehabilitative training, skilled use of the fingers appeared to recover, indicated by a reduction in the number of finger flexions per retrieval. The monkeys again retrieved the pellets using one specific movement pattern in most trials. Despite the apparent recovery of skilled finger use after rehabilitative training, three of five monkeys retrieved the pellets using stereotypic movement patterns different from those used before the injury. Thus, this study provides evidence that compensatory movement patterns are used in the recovery of motor function following cortical injury, even after relatively small lesions that produce mild, transient deficits in motor performance. Examination of electrophysiological maps of evoked movements suggests that the mode of recovery (re-acquisition of pre-infarct movement strategies vs development of compensatory movement strategies) may be related to the relative size of the lesion and its specific location within the M1 hand representation.

Animals↗

PubMed1996

Assessment of motor function in people with multiple sclerosis.

Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system (CNS) which predominantly affects young adults. In order to provide physiotherapy appropriate to the needs of individuals with MS, it is necessary to assess and evaluate the nature and degree of motor and functional deficits. The aim of this research was to develop a physiotherapy assessment which would consistently and objectively evaluate motor function in people with MS. The Motor Club Assessment (MCA), originally developed for use in stroke patients, was identified as exhibiting several features which were consonant with the required criteria. It was therefore modified for use in MS. The Amended MCA (AMCA) was tested for inter-rater agreement, which was found to be good for the lower limb motor section (weighted kappa = 0.80), the upper limb motor section (weighted kappa = 0.90), and the functional activities section (weighted kappa = 0.92). The internal consistency was high for the lower limb section (alpha = 0.97) and the functional activities section (alpha = 0.92), but could not be determined for the upper limb section due to a clear ceiling effect. The study demonstrated that the AMCA is a valid tool for assessment use by physiotherapists in MS patients, and that it has an acceptable level of reliability when used in a clinic setting by physiotherapists suitably experienced in the treatment of neurological patients.

Activities of Daily Living↗

PubMed1996

Reliability of early motor function testing in persons following severe traumatic brain injury.

The purpose of this study was to determine the intra- and inter-rater reliability of selected variables measuring motor function in adults following severe traumatic brain injury (TBI). Twelve adults with a severe TBI participated in the study and were assessed (independently) by two physical therapists with extensive clinical experience. Standardized testing protocols and two- or three-point ordinal rating scales were used to evaluate the following categories of variables: primitive reflexes, equilibrium/protective reactions and several motor skills. Intra-rater reliability was generally high for all variables, with kappa values exceeding 0.65 except for the scoring of equilibrium reactions in sitting and standing. Overall, inter-rater reliability was slightly lower, with kappa values ranging from 0.39 to 1.0, indicating 'fair' to 'almost perfect' agreement. The highest level of agreement was consistently reported for the scoring of motor skills. These results suggest that physical therapists trained in the use of standardized testing and scoring procedures can reliably assess primitive reflexes, equilibrium and protective reactions and a range of motor skills in TBI adults during the acute stage of recovery. Moreover, the results provide important information which will assist in the interpretation of data collected as part of a concurrently conducted longitudinal study of early motor recovery.

Adolescent↗

PubMed1999

Effects of physostigmine on swallowing and oral motor functions in patients with progressive supranuclear palsy: A pilot study.

The purpose of this pilot study was to investigate whether cholinergic stimulation reduces swallowing and oral motor disturbances in patients with progressive supranuclear palsy (PSP). A controlled, double-blind crossover trial of physostigmine, a centrally active cholinesterase inhibitor, and placebo was conducted. Patients were randomized to a 10-day crossover placebo-controlled double-blind trial of physostigmine at their previously determined best dose administered orally every 2 hr, six times per day. Patients were evaluated with ultrasound imaging of the oropharynx and an oral motor examination at baseline and during the third or fourth days of each study phase (placebo and drug). Under the double-blind placebo-controlled conditions, patients showed no statistically significant improvement in oral motor functions or swallow durations. Because patients with PSP have increased sensitivity to cholinergic blockade compared with control subjects, studies with newer, more potent cholinergic stimulating agents need further exploration. Suggestions for future research include the evaluation of newer direct cholinergic agonists in the treatment of the less-impaired PSP patients who may have a greater number of cholinergic neurons preserved and the evaluation of combined therapies.

Cholinesterase Inhibitors↗

PubMed2001

Effect of intraduodenal and intravenous amino acids on proximal gastric motor function in man.

The present study was performed to investigate the effect of amino acids during the intestinal and postabsorptive phase of digestion on proximal gastric motor function measured with an electronic barostat. Eight healthy volunteers participated in three experiments performed during continuous infusion of: (1) intravenous and intraduodenal saline, (2) intraduodenal amino acids, and (3) intravenous amino acids. Both intraduodenal and intravenous amino acids induced gastric relaxation and increased gastric compliance. Only during intraduodenal amino acids did plasma CCK levels increase significantly. Correlation between intragastric volume measurements (with pressure set at MDP + 2 mm Hg) and plasma CCK levels was 0.90 (P < 0.001) during the early intestinal phase. Relaxation of the proximal stomach is related to plasma CCK in the early intestinal phase, whereas in the postabsorptive phase of amino acids other mechanisms play a role in proximal gastric relaxation.

Adult↗

PubMed2006

Psychometric properties of a modified Wolf Motor Function test for people with mild and moderate upper-extremity hemiparesis.

OBJECTIVE: To test the necessity of videotaping, test-retest reliability, and item stability and validity of a modified Wolf Motor Function Test (WMFT) for people with mild and moderate chronic upper-extremity (UE) hemiparesis caused by stroke. DESIGN: Raters of videotape versus direct observation; test-retest reliability over 3 observations, item stability, and criterion validity with upper-extremity Fugl-Meyer Assessment (FMA) in the mildly and moderately impaired groups. SETTING: Academic research center. PARTICIPANTS: Sixty-six subjects with chronic UE hemiparesis who participated in a large intervention study. Subjects were classified into mild and moderate groups for additional analyses. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mean and median times of task completion, functional ability, and strength (weight to box) measures of the WMFT. FMA scores for validity assessment. RESULTS: In a subgroup of 10 subjects, the intraclass correlation coefficient (ICC) for videotape versus direct observation ranged from .96 to .99. For the whole group, test-retest reliability using ICC2,1 ranged from .97 to .99; stability of the test showed that administration 1 differed from administrations 2 and 3 but administrations 2 and 3 did not differ; item analysis showed that 4 of 17 items changed across time, and validity, using a correlation with UE FMA, ranged from .86 to .89. Separate mild- and moderate-group analyses were similar to whole-group results. CONCLUSIONS: Videotaping the modified WMFT was not necessary for accurate scoring. The modified WMFT is reliable and valid as an outcome measure for people with chronic moderate and mild UE hemiparesis and is stable, but 1 repeat testing is recommended when practical.

Adult↗

PubMed2003

Reliability and validity of the gross motor function classification system for cerebral palsy.

PURPOSE: The purposes of this study were to evaluate interrater reliability using videotapes and criterion-related and construct validity of the Gross Motor Function Classification System (GMFCS), aspects of reliability and validity not previously published. METHODS: Two experienced pediatric physical therapists rated 30 videotapes of children with cerebral palsy (CP) or Down syndrome (DS) to test interrater reliability. Criterion-related validity was evaluated by comparing GMFCS levels with tests of motor and nonmotor development. Construct validity was assessed by comparing GMFCS trends over time in children with CP and DS. RESULTS: Interrater reliability was 0.84. Correlation was higher between GMFCS level and tests of motor development than GMFCS level and tests of nonmotor development. The GMFCS level remained relatively stable in children with CP but tended to improve in children with DS. CONCLUSIONS: This study extends reliability and validity of the GMFCS, supporting its use in clinical practice and research.

Journal Article↗

PubMed2006

Pain relief and motor function during continuous interscalene analgesia after open shoulder surgery: a prospective, randomized, double-blind comparison between levobupivacaine 0.25%, and ropivacaine 0.25% or 0.4%.

BACKGROUND AND OBJECTIVES: To compare pain relief and motor impairment of 0.25% levobupivacaine with either an equivalent (0.25%) or equipotent (0.4%) concentration of ropivacaine for continuous interscalene block after open shoulder surgery. METHODS: Seventy-two adult patients scheduled for elective major shoulder surgery received an interscalene injection of mepivacaine 1.5% 30 mL followed by 24 h patient-controlled interscalene analgesia (basal infusion rate: 5 mL h-1; incremental bolus: 2 mL; lockout period: 10 min; maximum boluses per hour: 4) with either 0.25% levobupivacaine (n = 24), 0.25% ropivacaine (n = 24) or 0.4% ropivacaine (n = 24). A blinded observer recorded the evolution of pain relief and recovery of motor block during the first 24 h. Motor function was assessed as the maximum pressure developed while squeezing a sphygmomanometer cuff with the blocked hand. The reduction from preoperative values was considered as an index of motor impairment. RESULTS: No differences were reported among the three groups in the quality of postoperative analgesia. The number of incremental patient-controlled interscalene analgesia doses, total volume of local anaesthetic infused during the 24-h patient-controlled interscalene analgesia, and number of rescue ketoprofen analgesia were higher in the ropivacaine 0.25% group than in the other two groups (P = 0.0005). The hand strength recovered to >or=90% of baseline values within the first 24 h of infusion in all groups, without differences among the three groups. CONCLUSION: When providing patient-controlled interscalene analgesia after open shoulder surgery 0.25% levobupivacaine and 0.4% ropivacaine performed equally in terms of pain relief, motor block and number of patient-controlled boluses required, while patients receiving 0.25% ropivacaine needed significantly more boluses and rescue analgesia to control their pain.

Adolescent↗

PubMed2005

Obesity and gastrointestinal sensory-motor function.

Obesity has become a significant public health problem in the United States and has been associated with significant morbidity and mortality. Alterations in gastrointestinal sensory-motor function are now recognized to be associated with obesity and may be the cause of functional gastrointestinal symptoms commonly seen in these patients. The gut peptides are intimately involved in this process and may provide attractive therapeutic targets in the fight against this very morbid disease.

Journal Article↗

PubMed1986

[Electromyographical study on motor function of residual intestine after massive resection of small intestine].

Canine intestine 80% was resected, and the post-operative residual intestine was observed on its motor-function in time course by the use of electro-myographic test. The results are as follows. Post-operative frequency of electric discharge was reduced, and it was reduced at the residual jejunum in time course, while it was nearly constant at the residual ileum. Residual jejunum showed no significant change in the continuous time and amplitude of spike burst after operation. While residual ileum showed the post-operative increasing tendency. When the ratio of active phase, average of spike burst occurrences in one minute was regarded as index of intestinal excitability, the excitability was increased in both jejunum and ileum at earlier stage after operation. However, the ileum showed earlier recovery tendency. Electric discharge interval after resection became irregular, and the occurrence rate of antiperistaltic propagation was elevated. Residual ileum showed a longer tendency of one series of MMC after operation. Residual jejunum showed numerous occurrences of MMC up to 3 months after operation, there after, occurring interval of MMC was extended, and MMC-series showed the shortened tendency. Conduction velocity was higher after operation at the residual ileum, and it was not recovered even after 2-3 years, while residual jejunum showed a recovery trend with the peak at the 6th week after operation.

Animals↗

PubMed1988

Evidence that amphetamine with physical therapy promotes recovery of motor function in stroke patients.

We conducted a double-blind pilot study of 8 patients with established cerebral infarction to evaluate the effect of a single dose of amphetamine on recovery of motor function using the Fugl-Meyer scale. Four patients received amphetamine; the rest were given placebo. All underwent a session of physical therapy. Patients treated with amphetamine obtained greater increments in motor scores than the controls. Along with animal studies, these findings may allow the development of a pharmacological approach to stroke rehabilitation.

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