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Results for “Muscle Spasticity”

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At least 649 records · Page 36Linked to original sources
PubMed1990

The entopeduncular nucleus regulates muscle tone in genetically spastic rats: role of substance P and gamma-aminobutyric acid.

Microinjections of the substance P (SP) antagonist (D-pro2,D-phe7,D-trp9)-SP, or the gamma-aminobutyric acid (GABA) agonist, muscimol, into the entopeduncular nucleus reduced muscle tone in genetically spastic rats in a dose- and time-dependent manner. Similar injections into the ventral thalamus, zona incerta or amygdala had no effect on muscle tone. The muscle relaxant effect of (D-pro2,D-phe7,D-trp9)-SP injected into the entopeduncular nucleus was blocked by co-injections of SP, and that of muscimol by the GABAA antagonist, bicuculline methiodide. These results suggest that SP- and GABA-dependent mechanisms in the entopeduncular nucleus mediate regulation of the muscle tone.

Animals↗
PubMed2001

Botulinum toxin treatment in cerebral palsy: evidence for a new treatment option.

Intramuscular injections of botulinum toxin type A (BTX-A) have increasingly been used to reduce spasticity in specific muscle groups in children with cerebral palsy. Targets of therapeutic efforts are improvement of gross motor function, alleviation of pain or facilitation of hygienic care. Placebo-controlled studies have shown the local and functional effectiveness of BTX-A for the treatment of dynamic pes equinus. Whether long-term treatment with BTX-A improves motor development and delays contractures is still under investigation.

Animals↗
PubMed1985

Redirection of extensor pollicis longus in the treatment of spastic thumb-in-palm deformity.

Twenty patients with the thumb-in-palm deformity associated with cerebral palsy were treated surgically by redirecting the extensor pollicis longus (EPL) tendon through the first dorsal retinacular compartment in association with releasing the spastic intrinsic thenar muscles at their origin. The redirected EPL tendon augmented extension-abduction of the thumb in all patients; 18 patients were able to grasp with the thumb outside the clenched fist and noted improvement in functional activities. Augmentation tendon transfer that uses the EPL is an ideal surgical treatment for patients with cerebral palsy who have a thumb-in-palm deformity, since the procedure relieves an adduction deforming force and augments the weak extension-abduction by means of a musculotendon transfer that is known to function during digital extension. Consequently, postoperative reeducation of the transfer is minimal.

Adolescent↗
PubMedDate not supplied

Tizanidine in the management of spasticity and musculoskeletal complaints in the palliative care population.

Spasticity and other muscle symptoms in the palliative care patient can contribute to suffering, significantly detracting from overall quality of life. Current therapy primarily includes use of centrally acting muscle relaxants, which are beneficial in treating some symptoms, but frequently have extensive side effects, such as sedation and muscle weakness. Tizanidine, a central alpha 2 adrenergic agonist, has been shown in clinical studies to be as effective as other commonly used antispastic agents, but without debilitating muscle weakness. Tizanidine can cause sedation, which is minimized by dose titration. When taken at night, patients report improvement in getting to sleep and little drowsiness or "hangover sensation" upon waking. Tizanidine is potentially helpful to many palliative care patients with chronic muscle pain and sleep disturbances.

Clonidine↗
PubMed2000

High-intensity cycling exercise after a stroke: a single case study.

Aerobic exercise training has demonstrated positive effects after brain injury. However, therapists express concern regarding the use of effortful exercise in individuals presenting with spasticity or involuntary muscle activity. This study aimed to address this concern and to evaluate whether an intervention of maximal intensity cycling exercise impaired an individual's ability to actively extend his hemiparetic elbow. Using a single case design, it was shown that active elbow extension improved during the period of this investigation, and was not impaired immediately following maximal cycling exercise.

Adult↗
PubMedDate not supplied

Clinical evaluation of Functional Electrical Therapy in acute hemiplegic subjects.

This paper describes a clinical randomized single-blinded study of the effects of Functional Electrical Therapy (FET) on the paretic arms of subjects with acute hemiplegia caused by strokes. FET is an exercise program that comprises voluntary arm movements and opening, closing, holding, and releasing of objects that are assisted by a neural prosthesis (electrical stimulation). FET consisted of a 30 min everyday exercise for 3 consecutive weeks in addition to conventional therapy. Twenty-eight acute hemiplegic subjects participated in a 6 mo study. The subjects were divided into lower functioning groups (LFGs) and higher functioning groups (HFGs) based on their capacity to voluntarily extend the wrist and fingers against the gravity, and were randomly assigned to controls or FET groups. The outcomes included the Upper Extremity Function Test, the coordination of elbow and shoulder movements, spasticity of key muscles of the paretic arm, and Reduced Upper Extremity Motor Activity Log. FET and control groups showed a recovery trend in all outcome measures. The gains in FET groups were much larger compared with the gains in control groups. The speed of recovery in FET groups was substantially faster compared with the recovery rate in control groups during the first 3 weeks (treatment). The LFG subjects showed less improvement than the HFG in both the FET and control groups.

Adult↗
PubMed2001

Botulinum toxin A treatment of adult upper and lower limb spasticity.

This article discusses the treatment of spasticity with botulinum toxin A as a new approach in the neurological rehabilitation of patients after stroke. Clinical studies have been reviewed to provide information about target groups, technical aspects and the advantages and disadvantages of treating spasticity with botulinum toxin A. Open and controlled studies showed that the intramuscular injection of Dysport 500 to 1,500U or Botox 100 to 300U could reversibly relieve upper limb flexor and lower limb extensor spasticity. A reduced muscle tone, pain relief, better hand hygiene and improved walking function were the main benefits. Patients tolerated the treatment well. Activity or, if not possible, electrical stimulation of the injected muscles may enhance the effectiveness of the costly toxin. Serial casting is another option. With respect to the action of botulinum toxin A, it is suggested that the effect of the toxin could be mediated by paresis of both the extrafusal and intrafusal muscle fibres, thereby altering the afferent discharge in the muscle.

Adult↗
PubMed2003

[Physiotherapy for spasticity].

The aims of physiotherapy techniques used for the treatment of spasticity are to favor sensorimotor recovery and gesture relearning and to lead to an optimal independence in daily life activities. For stroke and head injury patients, there are several techniques sometimes based on opposing principles. The concept of Bobath tries to inhibit the spastic paralysis and the associated reactions to improve the voluntary motricity of limbs with the ultimate goal of enabling exercises in a functional situation, sometimes after a very long period of therapy. On the contrary, according to the concept of Brunnstom, the goal of exercise is to strengthen the spastic paralysis and the associated reactions to enable the upright position and walking as soon as possible. This technique is especially used in very severe deficiencies where the aim is to avoid the bedridden situation. Three active principles can be identified for neurological rehabilitation. Electrical stimulation is not used routinely by rehabilitation teams. It allows to reduce the spasticity of antagonist muscles working against stimulated muscles. It participates in improving the strength of contraction of weak muscles notably in subjects with incomplete paraplegia. Finally, it can be used to improve or replace a functional command (lifting the foot during walking, for example). Nevertheless, electrical stimulation cannot replace basic rehabilitation exercises.

Central Nervous System Diseases↗
PubMed1987

Surgical management of neuromuscular deformities of the foot and ankle in children and adolescents.

Foot and ankle deformity in the face of neuromuscular involvement will challenge the podiatric surgeon's ingenuity. The basic principles of management of the various major conditions encountered in spastic and flaccid muscle paralysis-paresis has been discussed. The use of a combined approach of hard and soft tissue surgery is emphasized as well as an intimate understanding of the specific neuromuscular process itself.

Adolescent↗
PubMed1978

Autosomal recessive spastic ataxia of Charlevoix-Saguenay.

A new syndrome of autosomal recessive spastic ataxia has been isolated in the Charlevoix-Saguenay region of Quebec. This syndrome is remarkably homogeneous and includes: spasticity, dysarthria, distal muscle wasting, foot deformities, truncal ataxia, absence of sensory evoked potentials in the lower limbs, retinal striation reminiscent of early Leber's atrophy and the frequent presence (57%) of a prolapse of the mitral valve. Biochemically, many cases show impaired pyruvate oxidation, others have hyperbilirubinaemia and some have low serum beta-lipoproteins and HDL apoproteins. These features are similar to those found in typical Friedreich's ataxia.

Adolescent↗
PubMedDate not supplied

[Recessive autosomal spastic ataxia].

The authors report the case of a 12 year-old child who presented with a syndrome, isolated in Quebec, including spasticity, ataxia, distal muscle wasting, pes cavus, retinal striation, and the frequent presence of a prolapse of the mitral valve. This autosomal recessive disease is similar to Friedreich disease.

Ataxia↗
PubMed1981

Management of spasticity in spinal cord injury.

Spasticity may be a major obstacle to rehabilitation of patients with spinal cord injury. It may cause discomfort, interfere with existing functions, or result in additional complications. Many techniques-physical, chemical, and surgical- exist for modulation of spasticity. Prevention of nociception and establishment of an effective daily stretching program are the foundation on which all other managements are based. Antispasticity medications may be added: benzodiazepines, dantrolene sodium, and baclofen are effective in selected patients. Motor point blocks may partially dampen spasticity in selected muscles of some patients. Chemical and surgical neurolytic procedures are used if the first two tiers of management are inadequate. Each technique can be rationally applied by use of a pyramidal management system.

Baclofen↗
PubMed2001

Classification of gait patterns in spastic hemiplegia and spastic diplegia: a basis for a management algorithm.

Classifications of gait and postural patterns in spastic hemiplegia and spastic diplegiía are presented, based on the work of previous authors. The classifications are used as a biomechanical basis, linking spasticity, musculoskeletal pathology in the lower limbs, and the appropriate intervention strategies. The choice of target muscles for spasticity management, the muscle contractures requiring lengthening and the choice of orthotics are then linked to the underlying gait pattern.

Algorithms↗