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Results for “HEMIPLEGIA”

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At least 955 records · Page 53Linked to original sources
PubMed1988

Bobath axillary support for adults with hemiplegia. A biomechanical analysis.

The purpose of this article is to report on a simple biomechanical analysis of the effects of an axillary support on shoulder subluxation. The underlying postulate was that an axillary support always is accompanied by an increase in shoulder abduction. The immediate effect of axillary support, as confirmed by roentgenograms, was a partial reduction of inferior subluxation and a decrease in the magnitude of the vertical component of the internal resultant force on the shoulder. After the axillary support was applied, the total force acting on the shoulder tissues increased with the abduction angle. The results of this study indicate that the axillary roll size and position and the stabilizing strap tension should be adjusted to the patient's specific problem or problems. This article provides a simple method to estimate, in a given patient, the magnitude and the direction of the forces involved in axillary support.

Adult↗
PubMed2002

Dorsal and ventral stream sensitivity in normal development and hemiplegia.

Form and motion coherence thresholds can provide comparable measures of global visual processing in the ventral and dorsal streams respectively. Normal development of thresholds was tested in 360 normally developing children aged 4-11 and in normal adults. The two tasks showed similar developmental trends, with some greater variability and a slight delay in motion coherence compared to form coherence performance, in reaching adult levels. To examine the proposal of dorsal stream vulnerability related to specific developmental disorders, we compared 24 children with hemiplegic cerebral palsy with the normally developing group. Hemiplegic children performed significantly worse than controls on the motion coherence task for their age, but not on the form coherence task; however, within this group no specific brain area was significantly associated with poor motion compared to form coherence performance. These results suggest that extrastriate mechanisms mediating these thresholds normally develop in parallel, but that the dorsal stream has a greater, general vulnerability to early neurological impairment.

Adult↗
PubMed2004

Late developmental deficits in force control in children with hemiplegia.

Differences related to development were investigated using a finger isometric force task in children with cerebral palsy and control children. The increase in force and force control observed in controls did not take place in patients. In the younger subset of patients (< 10 years) the force produced by the non-affected hand was greater than in either hand of young controls. This effect was not observed in the older subset of patients (< 10 years). Older controls also differed from younger controls in that they used higher frequency feedback loops. In contrast, older patients failed to show this increase. Moreover, the failure occurred both in the affected and non-affected hand, indicating that abnormalities involve the force control system of both sides.

Adolescent↗
PubMedDate not supplied

Comparison of two injection techniques using botulinum toxin in spastic hemiplegia.

This study sought to test the hypothesis that injections of botulinum toxin type A (BTX-A) at the mid belly of the gastrocnemius muscle in spastic hemiplegic adults produce superior clinical results to proximal injections directed toward the muscular origin. We designed a randomized, double-blind, placebo-controlled intervention study at a university tertiary care setting. Seventeen subjects with chronic spastic hemiplegic gait were enrolled from a volunteer community sample; time range from acute neurologic insult was 0.75 to 31 yr; age range was 19 to 71 yr; gender consisted of 11 men and 4 women; diagnoses were 12 patients with stroke, 2 with traumatic brain injuries, and 1 with a brain tumor. Two subjects were withdrawn from the study because of (1) acute vascular occlusion before intervention and (2) noncompliance with follow-up visits. After baseline measurements, subjects were injected with 50 units of BTX-A (volume, 0.5 cc) into the medial or lateral gastrocnemius: (1) proximally at one site near the muscular origin; (2) distally at three sites along the mid belly. We measured outcome using the Fugl-Meyer score, Ashworth scale, ankle range of motion, and a timed 50-ft fastest walk. No outcome measures showed a significant effect attributable to site of injections. Confounding variables included physical therapy and varying duration of illness in the study cohort. We conclude that the results failed to support the hypothesis that BTX-A injections at the mid belly of the gastrocnemius produced superior functional improvements to injections located near the muscular origin using localization techniques described. Additional research comparing more precise localization methods for BTX-A injections might further establish the importance of electromyographic guidance using BTX-A in management of spasticity.

Adult↗
PubMedDate not supplied

Hybrid functional electrical stimulation orthosis system for the upper limb: effects on spasticity in chronic stable hemiplegia.

A new hybrid functional electrical stimulation orthosis system for the upper limb has been designed to allow for ease of use in the home as a daily treatment modality, as well as offer the opportunity for function enhancement. In a pilot study, the system was used by ten patients with chronic stable hemiparesis secondary to cerebral vascular accident and head injuries. The patients were referred by their treating physicians or therapists after meeting the inclusion criteria of good general health, being greater than one year after head injury, or being ten months post-stroke, with no observed neurologic changes in the prior six weeks. Each of these patients had received prolonged physical therapy, either continuous from the initial inpatient rehabilitation treatment or on an intermittent basis over a period of years. The baseline status for factors related to increased muscle tone, i.e., passive range of motion at the wrist and elbow, posture at rest, posture immediately following activity, and spasticity were quantified before the treatment protocol with the functional electrical stimulation orthosis. Active range of motion and tests of functional use of the involved upper limb were also assessed. The patients were instructed in the protocol, trained in the use of the system, and then used the electrical orthosis at home for up to several hours per day. Follow-up assessments were at six months. A statistically significant improvement was noted in all muscle tone/spasticity parameters measured. A separate report will describe the effects on voluntary motion and functional capabilities.

Activities of Daily Living↗