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Results for “Muscle Spasticity”

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At least 757 records · Page 42Linked to original sources
PubMed1978

Gastrocnemius muscle belly and tendon length in stroke patients and able-bodied persons.

Length changes of gastrocnemius muscle belly and tendon at different passive tensions and ranges of motion (ROM) were measured in 31 healthy persons and 15 hemiplegic patients with clinically demonstrated ankle joint plantar flexion (PF) contractures. Preliminary studies were done to obtain accurate determination of gastrocnemius muscle insertion and origin points on x-ray films, to calculate the magnification factor due to x-ray beam divergence and to measure the length changes in muscle belly by the use of a wire hook placed at the muscle-tendon junction. Our results revealed: (1) change in length at different passive tensions is in the muscle belly, not in the tendon, (2) in hemiplegic patients no statistical difference in elongational characteristics of affected gastrocnemius muscle bellies with clinically demonstrated ankle PF contractures and of the contralateral nonaffected muscle bellies, (3) spastic and flaccid gastrocnemius muscle bellies are not statistically different in respect to passive elongations, (4) gastrocnemius muscle bellies of both affected and nonaffected legs of hemiplegic patients were statistically different from the muscle bellies of healthy persons in regard to maximal ROM and maxinum muscle belly length changes, (5) there was approximately .5 mm change in the belly length for each degree of ankle ROM, (6) age is not a factor influencing passive elongation of muscle belly, (7) average muscle belly lengths were consistently shorter in hemiplegic muscles while their tendon lengths did not change. The enumerated findings suggest that the limitation of ankle ROM in spastic hemiplegic legs obtained by the standard clinical measurements technique represents a change in muscle belly rest length without a structural contracture of the muscle fibers.

Adult↗
PubMedDate not supplied

Evaluation of therapeutic riding (Sweden)/hippotherapy (United States). A single-subject experimental design study replicated in eleven patients with multiple sclerosis.

The aim of this study was to investigate whether therapeutic riding (TR, Sweden) hippotherapy (HT, United States) may affect balance, gait, spasticity, functional strength, coordination, pain, self-rated level of muscle tension (SRLMT), activities of daily living (ADL), and health-related quality of life. Eleven patients with multiple sclerosis (MS) were studied in a single-subject experimental design iSSED) study, type A-B-A. The intervention comprised ten weekly TR/HT sessions of 30 minutes each. The subjects were measured a maximum of 13 times. Physical tests were: the Berg balance scale, talking a figure of eight, the timed up and go test, 10 m walking, the modified Ashworth scale, the Index of Muscle Function, the Birgitta Lindmark motor assessment, part B, and individual measurements. Self-rated measures were. the Visual Analog Scale for pain, a scale for SRLMT, the Patient-Specific Functional Scale for ADL, and the SF-36. Data were analyzed visually, semi-statistically and considering clinical significance. Results showed improvement for ten subjects in one or more of the variables, particularly balance, and some improvements were also seen in pain, muscle tension, and ADL. Changes in SF-36 were mostly positive, with an improvement in Role-Emotional seen in eight patients. Conclusively, balance and Role-Emotional were the variables most often improved, but TR/HT appeared to benefit the subjects differently.

Activities of Daily Living↗
PubMed1986

Muscle relaxant action of phenobarbitone in genetically spastic rats: an electromyographic study.

The muscle relaxant effect of phenobarbitone was studied in genetically spastic rats which exhibit spontaneous tonic activity in the electromyogram (EMG) of the gastrocnemius muscle. Phenobarbitone, 10-30 mg/kg i.p., reduced the tonic activity in the EMG of the gastrocnemius muscle of such rats in a dose- and time-dependent manner. The GABA antagonists bicuculline, 2 mg/kg i.p., and picrotoxin, 2 and 3 mg/kg i.p., reduced the muscle relaxant effect of phenobarbitone, 20 and 30 mg/kg. The benzodiazepine receptor antagonists, Ro 15-1788, 5 mg/kg, and CGS 8216, 5 mg/kg (doses which do not affect tonic activity in the EMG), failed to alter the depressant effect of phenobarbitone 30 mg/kg, in the EMG. Beta-Carboline-3-carboxylic acid methylester (beta-CCM), 2 mg/kg i.p., while not affecting the tonic activity in the EMG, reversed the depressant effect of phenobarbitone, 30 mg/kg. Both Ro 15-1788, 5 mg/kg, and CGS 8216, 5 mg/kg, prevented the reversal of the depressant action of phenobarbitone, 30 mg/kg, produced by beta-CCM, 2 mg/kg. The results indicate that the muscle relaxant action of phenobarbitone in genetically spastic rats is mediated via GABA-related mechanisms and add further support to the hypothesis that both Ro 15-1788 and CGS 8216 are specific antagonists at benzodiazepine receptors, devoid of intrinsic activity at moderate doses. The results also suggest that reversal of the muscle relaxant action of phenobarbitone by beta-CCM is mediated via a GABA/benzodiazepine receptor/chloride ionophore complex.

Animals↗
PubMed1979

Gait electromyography in normal and spastic children, with special reference to quadriceps femoris and hamstring muscles.

Telemetered gait electromyography was used to investigate gait patterns and the phasic behavior of the quadriceps femoris and medial hamstring muscles in 26 normal children and 32 children with spastic cerebral palsy. The average child with spastic cerebral palsy was found to have a shorter stance phase than the normal, but the cadence, while more variable, was nearly the same as normal. The spastic muscles typically exhibited prolonged phasic activity or a dysphasic pattern. Most of the patients with spastic hamstrings also had spastic quadriceps, suggesting that over-weakening the hamstrings may produce an unwanted genu recurvatum or hyperextended knee gait. Care must be taken to balance hamstring spasticity with quadriceps spasticity. A final result with slight knee flexion is preferable to hyperextension.

Adolescent↗
PubMed2005

The efficacy of diazepam in enhancing motor function in children with spastic cerebral palsy.

Muscle spasm and hypertonia limit mobility in children with spastic cerebral palsy. This double-blind, placebo-controlled, randomized controlled clinical trial studies the clinical efficacy of a low dose of diazepam in enhancing movement in children with spastic cerebral palsy. One hundred and eighty children fulfilled the criteria and were randomly allocated to receive one of two doses of diazepam or placebo at bedtime; 173 completed the study. There was a significant reduction of hypertonia, improvement in the range of passive movement, and an increase in spontaneous movement in the children who received diazepam. There was no report of daytime drowsiness. In developing countries, where cost factors often determine choice of drug, diazepam is a cheap and effective way of relieving spasm and stiffness, optimizing physical therapy and facilitating movement in children with spasticity.

Analysis of Variance↗
PubMed2000

Anti-spasticity agents for multiple sclerosis.

BACKGROUND: Spasticity is a common problem in MS patients causing pain, spasms, loss of function and difficulties in nursing care. A variety of oral and parenteral medications are available. OBJECTIVES: To assess the absolute and comparative efficacy and tolerability of anti-spasticity agents in multiple sclerosis (MS) patients. SEARCH STRATEGY: Randomised controlled trials (RCTs) of anti-spasticity agents were identified using MEDLINE, EMBASE, bibliographies of relevant articles, personal communication, manual searches of relevant journals and information from drug companies. SELECTION CRITERIA: Double-blind, randomised controlled trials (either placebo-controlled or comparative studies) of at least seven days duration. DATA COLLECTION AND ANALYSIS: Two independent reviewers extracted data and the findings of the trials were summarised. Missing data were collected by correspondence with principal investigators. A meta-analysis was not performed due to the inadequacy of outcome measures and methodological problems with the studies reviewed. MAIN RESULTS: Twenty-three placebo-controlled studies (using baclofen, dantrolene, tizanidine, botulinum toxin, vigabatrin, prazepam and threonine) and thirteen comparative studies met the selection criteria. Only thirteen of these studies used the Ashworth scale, of which only three of the six placebo-controlled trials and none of the seven comparative studies showed a statistically significant difference between test drugs. Spasms, other symptoms and overall impressions were only assessed using unvalidated scores and results of functional assessments were inconclusive. REVIEWER'S CONCLUSIONS: The absolute and comparative efficacy and tolerability of anti-spasticity agents in multiple sclerosis is poorly documented and no recommendations can be made to guide prescribing. The rationale for treating features of the upper motor neurone syndrome must be better understood and sensitive, validated spasticity measures need to be developed.

Anti-Dyskinesia Agents↗
PubMed1990

Instrumented gait analysis after selective dorsal rhizotomy.

In an attempt to assess quantitatively the effects of selective dorsal rhizotomy on ambulatory patients with cerebral palsy, instrumental gait analysis was used to document and compare changes following surgery. Stride characteristics, dynamic surface electromyography, foot-floor contact patterns and motion of the thigh, knee and ankle were analysed. 14 patients (seven independent ambulators, seven using assistive devices) aged between 4.6 and 23.5 years were tested before surgery and again six to 14 months later. After surgery, the seven independent walkers retained the same level of function and one of the assisted walkers had progressed to independent walking, but the other six still used the same device as before surgery. Selective dorsal rhizotomy reduces spasticity and improves gait dynamics, but does not change patterns of muscle activation during walking.

Adolescent↗
PubMed1984

Orofacial fine motor control impairments in congenital spasticity: evidence against hypertonus-related performance deficits.

Motor impairments in the fine force control of lips, tongue, and jaw were measured in subjects with congenital spasticity. Because these orofacial motor systems are not uniformly endowed with muscle spindles and monosynaptic reflexes, quantification of these motor impairments addresses the question of whether stretch reflex hypertonus is a positive or negative sign. The results indicated that hyperactive muscle spindle-based monosynaptic reflexes are not a causal factor in these voluntary orofacial motor impairments. These data also indicated that motor impairments were disproportionately greater at finer levels of isometric force control. These fine control measures appear useful as a quantitative index of general voluntary motor deficit.

Adult↗
PubMed1982

Interaction between phenytoin and diazepam in mutant Han-Wistar rats with progressive spastic paresis.

The muscle relaxant (antispastic) effect of diazepam, alone or in combination with phenytoin, was studied in mutant Han-Wistar rats with progressive spastic paresis. Alone, phenytoin did not alter the spontaneous activity in the electromyogram (EMG) of the gastrocnemius soleus (GS) muscle of mutant rats, but strongly enhanced the depressant action of diazepam on the spontaneous EMG activity. Picrotoxin reduced the antispastic effect of diazepam alone and partially reversed the antispastic effect of combined treatment. Therefore, the antagonistic effect of picrotoxin on the reduction of the spontaneous activity in the EMG produced by the combination of both drugs hardly suggests an interaction of picrotoxin with phenytoin, but rather indicates an interaction with the effect of diazepam. Phenytoin enhancement of the depressant action of diazepam on the spontaneous EMG activity of mutant rats strongly suggests the potential therapeutic usefulness of the combined treatment with both drugs.

Animals↗