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PubMed1978

A new method of measuring functional recovery after crushing the peripheral nerves in unanesthetized and unrestrained rats.

The distances between the first and fifth digits and between the second and fourth digits of the rat's hind paw were measured after crushing the sciatic nerve. The distances between the digits recovered significantly faster in weak nerve crushing than in strong crushing, and faster in distal nerve crushing than in proximal crushing. These results suggest that this method is available for evaluating the functional recovery after nerve crushing.

Animals↗

PubMed1975

Functional recovery from spinal cord trauma following normothermic irrigation in dogs.

The spinal cords of 16 normal dogs were exposed via dorsal laminectomies and damaged with a known impact force. In eight dogs the injured portions of the spinal cords were irrigated, without durotomy, for 2 h with normothermic saline. The remaining eight dogs were used as controls and were not irrigated. The results showed that normothemic irrigation of damaged spinal cords, immediately after impact trauma, had a significant beneficial effect on the functional recovery of the spinal cords.

Animals↗

PubMed1992

[Evaluation of renal function and prediction of renal functional recovery in children with unilateral hydronephrosis using renal pelvic urine].

In 29 children with unilateral hydronephrosis who underwent surgery at the age from 2 months to 15 years (27 patients with ureteropelvic junction stenosis and 2 with obstructive megaureter), beta 2-microglobulin (beta 2-MG), alpha 1-microglobulin (alpha 1-MG), N-acetyl-beta-D-glucosaminidase (NAG) and albumin were determined in renal pelvic urine from the hydronephrotic kidney to evaluate renal dysfunction accompanying urinary tract obstruction. Moreover, it was also examined whether it is possible to predict functional recovery of the hydronephrotic kidney on the basis of relation between these indices and pre- and postoperative changes in renal dimercaptosuccinic acid (DMSA) uptake rate. The values of beta 2-MG, alpha 1-MG, NAG and albumin in urine from the renal pelvis were high in 48%, 50%, 75% and 83% of the patients, respectively. Among the patients of one year and up, those with low preoperative DMSA uptake rate tended to have high values of beta 2-MG, alpha 1-MG and NAG. On the contrary, albumin level was high in 78% of patients who had good preoperative DMSA uptake rate. With respect to the relation between pre- and postoperative changes in DMSA uptake rate and each index, beta 2-MG and alpha 1-MG were high in 73% and 62% of patients who exhibited a marked increase in postoperative DMSA uptake rate. In patients without a remarkable change in DMSA uptake rate before and after surgery, on the other hand, the values of these were high only in 25% and 36%.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase↗

PubMed1979

Lack of functional recovery from spinal cord trauma following dimethylsulphoxide and epsilon amino caproic acid therapy in dogs.

The spinal cords of 20 normal dogs were exposed via dorsal laminectomies at L1 and damaged with a direct impact force of 440 g cm. One hour later treatment with dimethylsulphoxide (DMSO) was started on 10 dogs and with epsilon amino caproic acid (EACA) on the other 10 dogs. Administration of the DMSO ceased at 41 h after trauma and EACA at 49 h. The results showed that neither drug had a significant beneficial effect on the functional recovery of the spinal cords, when compared to a control group of similarly traumatised dogs.

Aminocaproates↗

PubMed1991

Effects of cholinergic-rich neural grafts on radial maze performance of rats after excitotoxic lesions of the forebrain cholinergic projection system--II. Cholinergic drugs as probes to investigate lesion-induced deficits and transplant-induced functional recovery.

The effects of two doses of muscarinic (arecoline and scopolamine) and nicotinic (nicotine and mecamylamine) cholinergic receptor agonists and antagonists on the radial maze errors of rats, performing poorly after ibotenate lesions to the nucleus basalis and medial septal brain regions, were assessed before and after transplantation of cholinergic-rich and -poor fetal grafts, using tasks which measured short- (working) and long-term (reference) spatial and associative memory. Lesioned rats showed improvement with the agonists, and impairment with the antagonists, at low doses which did not affect the performance of controls; these effects were more marked for working than reference memory, especially in the spatial task. The peripherally acting antagonists N-methylscopolamine and hexamethonium did not affect the performance of control or lesioned rats. Effects of the cholinergic probes were re-examined 16 weeks after grafting, in groups with cholinergic-rich grafts to cortex and/or hippocampus which showed functional recovery, and groups with cholinergic-rich grafts to basal forebrain, or cholinergic-poor grafts to basal forebrain, cortex, and hippocampus, which showed no improvement. All lesioned rats, regardless of site, type, or efficacy of transplant, continued to show marked impairment with the antagonists. Poorly performing grafted animals also showed improvement with the agonists. In rats with behaviourally effective cholinergic-rich grafts, arecoline had no effect, but nicotine substantially increased working and reference memory errors, particularly spatial working memory errors. Rats with grafts in both cortex and hippocampus showed the largest increases in errors after nicotine. These results show that lesioned rats were more sensitive to the bi-directional effects of cholinergic receptor ligands than controls, consistent with a role for acetylcholine in the lesion-induced deficits. The predominant effect of drugs on working memory may also be consistent with disruption of acquisition rather than of storage or retrieval processes in memory, and may be related to impairment of attention. The results further show that, despite behavioural recovery, supersensitive responses to cholinergic drugs were not normalized in rats with cholinergic-rich grafts, and that an additive interaction between graft and host may have occurred in response to nicotine.

Acetylcholine↗

PubMed1991

Effects of hydroxyethyl starch conjugated deferoxamine on myocardial functional recovery following coronary occlusion and reperfusion in dogs.

The effect of hydroxyethyl starch-conjugated deferoxamine (HES-DFO) on the recovery of regional myocardial function after 15 min of coronary artery occlusion followed by 3 h of reperfusion of the left anterior descending coronary artery (stunned myocardium) was investigated in anesthetized dogs. Regional myocardial blood flow was measured by radioactive microspheres and regional myocardial segment shortening (%SS) by sonomicrometry. HES-DFO (equivalent of 50 mg/kg DFO), iron saturated HES-DFO (HES-FO), deferoxamine (DFO, 50 mg/kg), or saline were administered by intravenous infusion starting 30 min before occlusion and throughout occlusion. Ischemic bed size and collateral blood flow were similar in all four groups. HES-DFO significantly improved %SS in the ischemic-reperfused region during reperfusion; however, HES-FO and DFO had no effect on %SS as compared to the saline-treated group. HES-DFO and HES-FO had no effect on hemodynamics; however, DFO produced a marked reduction in systemic blood pressure. Since HES-FO had no effect on the recovery of %SS, the beneficial effect of HES-DFO is thought to be due to its iron chelating characteristics. Plasma concentrations of HES-DFO not only reached a higher peak level but also had a longer half life (3 h) than that of regular DFO (20 min). Thus, high-molecular-weight HES-DFO is effective in enhancing the recovery of regional wall motion in stunned myocardium. The reason for the lack of efficacy of DFO compared to HES-DFO at this high dose may be related to the formation of a toxic deferoxamine free radical species.

Animals↗

PubMed1992

Walking track analysis: a long-term assessment of peripheral nerve recovery.

Functional recovery following sciatic, tibial, and peroneal nerve injury was assessed over a 1-year period using walking track analysis in the rat. Internal neurolysis did not affect nerve function. Crush injury induced a temporary, but complete, loss of function that recovered to control levels by 4 weeks. Nerve transection resulted in complete loss of function without any evidence of recovery. After nerve repair, functional recovery occurred, reaching near-optimal recovery by 12 weeks. The degree of functional recovery varied with the specific nerve involved. The sciatic nerve recovered 41 percent of function, whereas the tibial nerve recovered 54 percent of function. The peroneal nerve exhibited the highest degree of recovery, achieving functional levels similar to control values. Assessment of neural regeneration using walking track analysis appears to be a valuable addition to the traditional methods of histology and electrophysiology.

Analysis of Variance↗

PubMed1992

Nitrous oxide impairs functional recovery of stunned myocardium in barbiturate-anesthetized, acutely instrumented dogs.

The purpose of this investigation was to characterize the effects of nitrous oxide or nitrogen (70%) on systemic and regional hemodynamics and myocardial tissue perfusion after a brief coronary artery occlusion (15 min) and reperfusion (3 h). Two groups of experiments (14 experiments total) were completed with 24 open-chest, barbiturate-anesthetized dogs. Coronary collateral blood flow was diverted from the ischemic zone during coronary artery occlusion to eliminate a source of variability in degree of ischemia produced by differences in degrees of collateral blood flow among animals. Seven of 16 dogs treated with nitrous oxide and 7 of 8 dogs treated with nitrogen survived coronary occlusion and reperfusion (P less than 0.05). Coronary artery occlusion produced paradoxical systolic bulging in the ischemic zone in both groups of experiments. After reperfusion, segment shortening gradually returned toward control levels but remained depressed from the preocclusion state after 3 h in the nitrogen-treated control group. Similar results were observed after reperfusion in the nitrous oxide group; however, segment function in the ischemic region was significantly (P less than 0.05) depressed throughout the 3-h reperfusion period compared with the control group. Transmural coronary collateral blood flow during occlusion was not significantly different (P greater than 0.05) between groups, indicating that differences in recovery of contractile function observed between groups could not be attributed to differences in myocardial oxygen supply. In addition, the similarity in systemic hemodynamics between the nitrous oxide and control groups indirectly suggests that differences in recovery of function could not be attributed to differences in myocardial oxygen demand. The results indicate that 70% nitrous oxide produces greater mortality after coronary artery occlusion and reperfusion and reduces functional recovery of post-ischemic, reperfused myocardium compared with 70% nitrogen in open-chest, acutely instrumented dogs.

Anesthesia↗

PubMed1991

Metabolic and functional recovery of ischemic human myocardium after coronary angioplasty.

Although revascularization of hypoperfused but metabolically active human myocardium improves segmental function, the temporal relations among restoration of blood flow, normalization of tissue metabolism and recovery of segmental function have not been determined. To examine the effects of coronary angioplasty on 13 asynergic vascular territories in 12 patients, positron emission tomography and two-dimensional echocardiography were performed before and within 72 h of revascularization. Ten patients underwent late echocardiography (67 +/- 19 days) and eight underwent a late positron emission tomographic study (68 +/- 19 days). The extent and severity of abnormalities of wall motion, perfusion and glucose metabolism were expressed as wall motion scores, perfusion defect scores and perfusion-metabolism mismatch scores. Angioplasty significantly increased mean stenosis cross-sectional area (from 0.95 +/- 0.9 to 2.7 +/- 1.4 mm2) and mean cross-sectional luminal diameter (from 0.9 +/- 0.6 to 1.9 +/- 0.5 mm) (both p less than 0.001). Perfusion defect scores in dependent vascular territories improved early after angioplasty (from 116 +/- 166 to 31 +/- 51, p less than 0.002) with no further improvement on the late follow-up study. The mean perfusion-metabolism mismatch score decreased from 159 +/- 175 to 65 +/- 117 early after angioplasty (p less than 0.01) and to 26 +/- 29 at late follow-up (p less than 0.001 vs. before angioplasty; p = NS vs. early after angioplasty). However, absolute rates of glucose utilization remained elevated early after revascularization, normalizing only at late follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗

PubMed2026

Effects of different resistance exercise programs on upper limb functional recovery in postoperative breast cancer patients.

PURPOSE: To investigate the effects of grip strength exercise combined with upper limb resistance exercise on upper limb functional rehabilitation in patients after breast cancer surgery. METHODS: A total of 111 patients who underwent either modified radical mastectomy with ALND or breast-conserving surgery with ALND were randomly assigned to a control group, an upper limb resistance exercise group, and a combined grip and upper limb resistance exercise group. Grip strength was measured at baseline, 16 weeks after intervention, and at 3- and 6-month follow-ups, while shoulder function was assessed using the Constant-Murley Scale (CMS). RESULTS: There were no statistically significant differences in grip strength or CMS scores among the groups before intervention (P > 0.05). At the post-intervention, 3-month, and 6-month follow-ups, compared with the control group, both resistance training protocols significantly improved patients' joint range of motion, pain, muscle strength, total CMS score, and grip strength (P < 0.05). Compared with the upper limb resistance exercise group, the combined grip and upper limb resistance exercise group demonstrated superior grip strength at the 6-month follow-up (P < 0.05), as well as more significant improvements in joint range of motion, pain, muscle strength, and total CMS scores (P < 0.05). CONCLUSION: A 16-week resistance exercise program effectively improves upper limb function in post-surgical breast cancer patients, with the combined grip and upper limb resistance exercise program yielding superior outcomes.

Humans↗

PubMed1992

Freezing preservation of the mammalian cardiac explant. VI. Effect of thawing rate on functional recovery.

This study investigated the effect of thawing rate on the preservation of frozen isolated rat hearts. The hearts were flushed with a hyperosmotic cardioplegic solution, CP-14/EtOH (1.15 Osm/kg), frozen at a rate of 0.18 degree C/hr for 6 h to -3.2 degrees C. Thereafter, the hearts were thawed at rates ranging from 0.08 to 1.1 degrees C/min for 1 to 14 min until the heart temperature reached -2.1 degrees C, the melting point (MP) of the flush solution; then they were held at -1 degree C for 11 to 24 min so that the total thaw time was 25 min. Post-thaw function was assessed by working reperfusion and expressed as percentage of unstored control function. Cardiac output (CO) and other hemodynamic performance showed biphasic responses to the thaw rate. At 0.08 degree C/min rate, CO recovered to 29.1 +/- 4.1 ml/min (40.8 +/- 5.8% of control). Thawing at 0.13 degree C/min enhanced the recovery of CO to 60.5 +/- 4.9%. Between 0.13 and 0.34 degree C/min, recovery was statistically insignificant. Faster thawing at 0.59 and 1.1 degrees C/min caused progressively less recovery. Overall, 0.13 degree C/min offered the highest recovery. In conclusion, function in slowly frozen heart is intimately affected by the thawing rate; there was an optimal intermediate thawing rate and both too slow and too fast thawing were detrimental.

Animals↗

PubMed1991

[The relationship between functional recovery one year after a stroke, and related factors].

This study examines the factors affecting functional performance of 40 hemiplegic subjects in their homes following discharge from the hospital. All subjects suffered a cerebral vascular accident at least one year prior to this research period. Barthel Index was used to assess subjects' self-reported functional level in activities of daily living (ADL). A backward elimination of stepwise regression analysis was performed to ascertain the predictive value of the variables in determining functional performance one year after the onset of a stroke. These variables are factors related to the initial onset and those affecting the patient's functional status at home. The results revealed that subjects who had a shorter length of stay in the hospital, scored a higher on the Barthel Index (p less than 0.05). It also demonstrated that subjects who were more satisfied with their current subjective health status, had a higher Barthel Index score.

Activities of Daily Living↗

PubMedDate not supplied

Functional recovery of hearts after cardioplegia and storage in University of Wisconsin and in St. Thomas' Hospital solutions.

There are conflicting reports of the beneficial effects of University of Wisconsin (UW) cardioplegic solution used in heart preservation techniques. Therefore we investigated the efficacy of myocardial protection in adult rat hearts subjected to single-dose infusion (3 minutes) of nonoxygenated cardioplegic solutions (UW or St. Thomas' Hospital solution No. 2 [STH]) and stored at 4 degrees C by immersion in the same solution or in saline solution. Isolated working-heart preparations (n = 8 per group) were used to assess the prearrest (20 minutes' normothermic perfusion) and postischemic left ventricular functions. Four groups of hearts underwent 5, 8, 10, and 20 hours of cold ischemia (4 degrees C) in UW solution. Hearts stored for 8 to 20 hours showed no postischemic recovery of cardiac pump function (aortic flow, 0%), had decreased levels of myocardial high-energy phosphates, and were highly edematous (50% to 70% increased). After 5 hours of storage there was also poor recovery of aortic flow, coronary flow, and aortic pressure (55.0% +/- 19.4%, 67.1% +/- 5.1%, and 58.1% +/- 11.7%, respectively) but good recovery of adenosine triphosphate, creatine phosphate, and guanosine triphosphate (18.54 +/- 1.42, 29.99 +/- 2.05, and 1.64 +/- 0.14 mumol/gm dry weight, respectively). In contrast, hearts arrested and stored in STH solution for 5 hours rapidly established normal left ventricular functions (aortic flow, 111.5% +/- 2.5%; cardiac output, 99.1% +/- 1.2%; coronary flow, 85.0% +/- 3.4%; heart rate, 95.8% +/- 2.7%; and aortic pressure, 94.6%). A group of hearts arrested with STH solution but stored in saline solution recovered more slowly, had only partial return of function (aortic flow, 73.6% +/- 14.8%; p less than 0.01 vs STH/STH group), and had significantly greater tissue water content (8.020 +/- 0.080 vs 6.870 +/- 0.126 ml/gm dry wt; p less than 0.01). These results demonstrate the superior preservation of explanted hearts at 4 degrees C obtained by STH cardioplegic solution compared with UW solution under conditions used for transplantation.

Adenosine↗

PubMed1976

Functional recovery with and without training following brain damage in experimental animals: a review.

Review of observations on experimental animals following brain damage shows that some functions may recover spontaneously and functional accomplishment can be increased by training even with unchanged reflex status. Training consists of a combination of two basic techniques: forced use of the impaired body part, and instrumental conditional relfexes. The possible mechanisms of recovery include restoration by an alternative pathway, compensation through complicated interactions among brain structures and, with training, activation of a parallel system essential to conditioned responses. Factors, such as motivation and emotion, may complicate the course of recovery. Results of recovery with training in experimental animals strongly indicate that such training can play an active and specific role in functional improvement following brain damage in man. Future development of rehabilitation medicine in this direction is suggested.

Animals↗

PubMed1992

Experimental evidence of ischemic thresholds and functional recovery.

BACKGROUND: Impaired blood flow below certain critical levels and an insufficient supply of energy-rich substrates cause failure of neuronal function, triggering biochemical disturbances that eventually lead to ischemic cell damage. SUMMARY OF REVIEW: This article reviews experimental studies that attempted to define those ischemic thresholds using functional and histological markers and, more recently, chemical markers of ischemic damage. CONCLUSIONS: The duration of ischemia causing irreversible cell damage still is ill defined. Reestablishment of sufficient perfusion must be induced very early after an ischemic attack to ameliorate the potentially harmful biochemical sequelae of transient ischemia.

Biomarkers↗

PubMed1992

Functional recovery in young stroke patients.

Thirty young stroke patients were retrospectively assessed for levels of activities of daily living and of basic functional movements. Scores upon admission, discharge, and follow-up were compared in order to evaluate course of rehabilitation and functional outcome. Mean length of stay in the rehabilitation ward was 87 +/- 17 days, and duration of follow-up was 31 +/- 8 months. Multivariate analysis of covariance confirmed significant improvements during hospitalization, in transfer, standing, sitting and walking abilities (F = 3.5, p less than 0.02), as well as in activities of daily living (F = 4.7, p less than 0.01). Further improvement during the follow-up period was observed for standing and walking abilities (F = 10.2, p less than 0.001) only. No fatalities occurred among the patients during the study period. Eighty-one percent of the patients resumed their previous or other jobs six months after discharge. We conclude that for young stroke patients admitted to a rehabilitation ward shortly after the event, prognosis in terms of survival and functional outcome is favorable, and independent of precipitating factor, age, sex, or side of weakness.

Activities of Daily Living↗

PubMed1991

Assessment of functional recovery after spinal cord injury in rats by reticulospinal-mediated motor evoked responses.

Auditory startle reflexes (ASR) and cortico-myoelectric evoked potentials (CMyEP) were investigated as possible tests of descending motor function in a rat spinal cord injury model. ASR, which consist of stereotyped myoelectric responses recorded in limb and axial muscles to brief loud tones, were found to provide a simple, objective, and reliable measure of motor recovery after spinal cord injury (SCI). While ASR are easily recorded in awake rats, they are blocked by anesthetics, and thus cannot be recorded during the acute injury period. ASR were compared with CMyEP, which can be recorded while the animal is anesthetized. CMyEP were found to produce large myoelectric responses in the vastus lateralis and tibialis anterior hindlimb muscles of the rat similar to ASR except that latencies were approximately 3 msec earlier. Both ASR and CMyEP tended to be bilaterally symmetric regardless of the stimulus configuration, and threshold for responses were the same for both muscles in both hindlimbs. The results suggest that CMyEP may be related to ASR and thus mediated partly by reticulospinal pathways. Evidence supporting this hypothesis is reviewed.

Animals↗

PubMed1992

Lipid peroxidation results in compromised functional recovery of isolated rabbit hearts after low-pressure, hypothermic, perfused preservation for 24 hours.

Low-pressure, hypothermic perfusion of isolated rabbit hearts for 24 hours compromises contractile function. This occurs despite continuous recirculation of an oxygenated solution. This investigation tested the hypothesis that such functional impairment results from irreversible tissue damage consequent to ischemia-induced lipid peroxidation. Decreases in coronary flow were measured during preservation and related to concentrations of thiobarbituric acid reactive species (TBA+, primarily malondialdehyde, a by-product of lipid peroxidation) in the tissue after preservation. The concentration of TBA+ species and the percent decrease in coronary flow rates at 30 minutes and 24 hours were positively correlated (r = 0.591 and r = 0.646, respectively). India ink was used as a marker of microvascular perfusion. Hearts showing the greatest magnitude of ischemia (evidenced by decreased percentages of perfused microvessels) had the highest levels of TBA+ species (r = 0.924). Moreover, hearts that had the highest levels of TBA+ species in the tissue exhibited the lowest levels of left ventricular function (as measured on a modified Langendorff apparatus; r = 0.767). We conclude that impaired coronary flow rates during perfused preservation portend compromised myocardial contractility. Furthermore, these changes occur largely within the first 30 minutes of perfusion. It is likely that early decrements in microvascular perfusion and consequent tissue injury owing to lipid peroxidation underlie impaired myocardial function after preservation.

Animals↗