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Results for “Muscle Stretching Exercises”

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PubMed1983

The chronic spinalized cat: a model for neuromuscular plasticity.

The ability of the hindlimbs to produce weight-supported locomotion on a motorized treadmill was assessed in cats spinalized (T12) at 2 or 12 weeks of age. The animals were assigned at random to nonexercised (NE) or exercised (E) groups, the latter being trained to walk on the treadmill for 30 minutes, five-times weekly. During the four-month recovery period, spontaneous clonus at 8 to 12 Hz and hyperactive cutaneous reflexes developed in all animals. Age of spinalization had an effect on the recovery of locomotion, as kittens in both the 2E and 2NE groups rated significantly higher than the 12E and 12NE cats. Treadmill training was not critical to the recovery process in the 2-week transected kittens, since both 2E and 2NE cats exhibited stepping with adequate weight support of the hindquarters. However, none of the 12NE cats developed weight-supported stepping, while some of the 12E cats did. Electromyographic recordings of ankle muscles from cats demonstrating the best locomotion revealed that progressive recruitment of the soleus and gastrocnemius muscles was normal despite significant changes in the fiber composition of these extensors. Kinematic analyses of these same animals revealed that gait abnormalities, such as the absence of a yield phase during stance and uncoupling of knee and ankle actions, were more common in the 2NE and 12E animals as compared to the 2E animals. It was concluded that although the spinal cord contains the basic pattern-generating circuitry essential for ambulatory locomotion, the development or recovery of this behavior was influenced by the animal's age at the time of cord transection, and to a less obvious extent by subsequent training.

Animals↗

PubMed2002

Upper extremity functional assessment after anterior spinal fusion via thoracotomy for adolescent idiopathic scoliosis: prospective study of twenty-five patients.

STUDY DESIGN: A prospective review of upper extremity function in 25 patients after anterior thoracotomy for instrumentation and fusion of thoracic adolescent idiopathic scoliosis was conducted. OBJECTIVE: To assess the effects of anterior spinal fusion with open thoracotomy on upper extremity function. SUMMARY OF BACKGROUND DATA: The treatment of idiopathic scoliosis through anterior thoracotomy and spinal fusion using instrumentation is a new method for correcting and stabilizing patients with major thoracic and thoracolumbar curves. No studies have assessed the functional outcome for the upper extremities after anterior open thoracotomy that involves splitting through the latissimus dorsi and serratus anterior muscles. METHODS: For this study, 25 adolescent patients with idiopathic scoliosis treated surgically were examined over a 3-year period. The average patient age was 15 years and 3 months, with a range of 11 years and 11 months to 20 years and 9 months. Preoperative activities of daily living, active range of motion, and strength were recorded by an independent occupational therapist (L.P.) for both upper extremities. Postoperative measurements were assessed at 1, 3, 6, 12, and 24 months. All the patients underwent a right thoracotomy with ribs used for autograft. The left upper extremity served as the control limb. No patients had associated anomalies or previous upper extremity surgery. All the patients underwent an upper extremity postoperative stretching and strengthening protocol. RESULTS: At 1 month, 35% of the patients had some difficulty with activities of daily living, primarily in tying their shoes and cutting meat with a knife during meals (P = 0.03). However, by 3 months, all the patients could equivocally and independently perform activities of daily living: dressing, bathing, grooming, attending to hygiene, and feeding (P = 1). Full active range of motion in their upper extremities and shoulder was achieved in all the patients by 1 month (P = 1). All 25 patients had regained normal, bilaterally symmetric strength by 3 months (P = 0.25). No postoperative complications occurred. CONCLUSIONS: Patients undergoing anterior spinal fusion with instrumentation after open thoracotomy can expect to regain full function of the ipsilateral upper extremity in terms of strength, active range of motion, and activities of daily living within 3 months. Compliance with a structured postoperative flexibility and strengthening protocol is recommended to optimize functional outcomes. A novel rehabilitation protocol for the upper extremities is presented.

Activities of Daily Living↗

PubMed1993

A highly successful and novel model for treatment of chronic painful diabetic peripheral neuropathy.

OBJECTIVE: To investigate why, in spite of a vast variety of treatment agents, the alleviation of pain in patients with diabetic neuropathy is difficult. Previous studies have not used a treatment algorithm based on anatomic site and neuropathophysiological source of the neuropathic pain. RESEARCH DESIGN AND METHODS: A model that categorizes the types of pain into three groups (superficial, deep, and muscular) was applied in 75 diabetic patients with chronic (> 12 mo) painful distal symmetrical polyneuropathy in a controlled case series. Twenty-two patients were untreated and 53 patients were treated with imipramine +/- mexiletine for deep pain, capsaicin for superficial pain, and stretching exercises and metaxalone +/- piroxican for muscular pain. Each type of pain was scored separately on a scale of 0 (none) to 19 (worst), and the total of all three types was used as an index of overall pain. Ability to sleep through the night was scored by a scale of 1 (never) to 5 (always). RESULTS: No significant differences were observed in initial pain scores, sleep scores, demographics, biochemistries, or physical findings between the two groups. After 3 mo a significant improvement in scores was noted in the treated but not the untreated patients. In addition, a significant difference was found in the change of scores between the treated and untreated patients: total pain (-18 +/- 2 vs. 0 +/- 2), deep pain (-7 +/- 1 vs. 0 +/- 1), superficial pain (-5 +/- 1 vs. 0 +/- 1), muscular pain (-6 +/- 1 vs. 0 +/- 1), and sleep (1.2 +/- 0.2 vs. 0.2 +/- 0.2), all P < 0.0001. In treated patients 21% became pain-free (total pain < 2), 66% had improvement (decrease in total pain > 5, but not total elimination of painful symptoms), and 13% were considered treatment failures (a decrease in total pain of < or = 5). This compares with 0 (P < 0.02), 10 (P < 0.0001), and 90% (P < 0.0001), respectively, in the untreated patients. CONCLUSIONS: This study presents a new rationale and hypothesis for the successful treatment of chronic painful diabetic peripheral neuropathy. It uniquely bases the treatment algorithm on the types and sources of the pain.

Analgesics↗