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At least 865 records · Page 48Linked to original sources
PubMed1996

Impaired "natural reciprocal inhibition" in patients with spasticity due to incomplete spinal cord injury.

Experiments were performed to compare the ability of normal subjects and patients with spinal spasticity to suppress antagonist H reflexes during isometric ankle contractions. Soleus H reflex suppression was examined during tonic pretibial muscle contractions in which the torque levels were constant and during dynamic pretibial muscle contractions in which the torque followed a predetermined ramp. As well, subjects were instructed to alternately contract ankle plantarflexors and dorsiflexors at various frequencies to examine patterns of EMG activity during rhythmically alternating isometric contractions in antagonist muscles. Patients with incomplete spinal cord injury demonstrated reduced ability to suppress soleus H reflexes during pretibial muscle contraction. At slow speeds of alternating contraction, spinal cord injured patients retained the ability to perform alternating isometric pretibial/soleus muscle contractions. The patients demonstrated abnormal coactivation in soleus muscle during faster alternating isometric ankle muscle contractions. Furthermore, the patients who demonstrated the greatest impairment in natural reciprocal inhibition, also displayed the largest amount of coactivation. In general, the results would suggest that impairment of natural reciprocal inhibition is correlated with an increase in the amount of antagonist muscle coactivation seen during alternating isometric muscle contractions.

Adult↗
PubMed2002

Botulinum toxin treatment of spasticity in diplegic cerebral palsy: a randomized, double-blind, placebo-controlled, dose-ranging study.

This study evaluated the efficacy and safety of three doses of botulinum toxin A (BTX-A; Dysport) in 125 patients (mean age 5.2 years, SD 2; 54% male)with dynamic equinus spasticity during walking. Participants were randomized to receive Dysport (10, 20, or 30 units/kg) or placebo to the gastrocnemius muscle of both legs. Muscle length was calculated from electrogoniometric measurements and the change in the dynamic component of gastrocnemius shortening at four weeks was prospectively identified as the primary outcome measure. All treatment groups showed statistically significant decreases in dynamic component compared with placebo at 4 weeks. Mean improvement in dynamic component was most pronounced in the 20 units/kg group, being equivalent to an increase in dorsiflexion with the knee extended at 19 degrees, and was still present at 16 weeks. The safety profile of the toxin appears satisfactory.

Botulinum Toxins, Type A↗
PubMed2006

Interrater reliability of Modified Ashworth Scale and Modified Tardieu Scale in children with spastic cerebral palsy.

Resistance to passive movement in children with spastic cerebral palsy was assessed by two raters using the Modified Ashworth Scale and the Modified Tardieu Scale. Four muscle groups in the lower limbs were tested using a standardized procedure. Interrater reliability of the scales was evaluated by the intraclass correlation coefficient. Seventeen children, with a mean age of 7 years 9 months, were included. Two children were rated twice. The intraclass correlation coefficients of both scales were low and did not reach the acceptable limit of 0.75. Caution should be used when these scales are applied.

Adolescent↗
PubMed2004

Motor impairments, neurological signs, and developmental level in individuals with Angelman syndrome.

The aim of this study was to examine the character of motor dysfunction in individuals with Angelman syndrome (AS). Thirty-three children and adolescents (median age 6 years, range 18 months to 23 years) were consecutively investigated for learning disability, epilepsy, and motor dysfunction to detect suspected AS. Twenty-three individuals (13 males, 10 females; median age 5 years 6 months, range 21 months to 23 years) fulfilled international consensus criteria for AS. Clinical diagnosis was supported by a positive DNA methylation test in eleven participants. Ten participants (seven males, three females; median age six years, range 18 months to 13 years) did not comply with consensus criteria for AS and were regarded as a comparison group. There was no significant difference between the AS and the comparison group regarding age or developmental level. Median developmental quotient level was 26 months (range 8 to 63 months); median gross motor developmental level in participants with AS was 24 months (range 8 to 60 months); median fine motor developmental level was 15 months (range 6 to 60 months). Muscle strength, spasticity, tremor, and coactivation were assessed: distal lower limb spasticity, ataxic like gait, stiff lower limbs, and the presence of coactivation during locomotion were significantly more frequent in participants with AS than in the comparison group (p<0.05). Asymmetry of muscle strength and spasticity were frequent. Neurological abnormalities were insufficient for a diagnosis of cerebral palsy and impeded function less than immaturity in both AS groups. Risk of increasing impairment needs to be anticipated to prevent negative long-term effects of muscle imbalance and motor asymmetries in individuals with AS.

Adolescent↗
PubMed1978

Excitability relationships between lower limb myotatic arcs in spasticity.

The excitability of a lower limb myotatic reflex arc is modulated by the antecedent activation of another myotatic arc in the same limb; the changes can be represented by heteronymous excitability curves. This work compares heteronymous excitability curves in spastic and normal subjects. Eighteen patients who showed clear signs of pyramidal tract lesions at a chronic stage were studied. Three myotatic arcs of the lower limb (soleus, quadriceps, and short biceps) were activated either by mechanical percussion (T Sol-T Quad-TSBi) or by electrical stimulation of the afferent nerve (H Sol-H Quad). They were used as conditioning and test responses in six different combinations, and the results compared to those obtained previously in normal volunteers. In spastic patients, heteronymous excitability curves are more obviously modified than homonymous ones. The changes are most prominent in the thigh muscles and less marked when the soleus reflex is conditioned by activation of quadriceps and biceps femoris myotatic reflex arcs.

Adult↗