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PubMed1980

Goals in hemiplegia care.

Physicians should assume leadership and a greater role in the post-stroke management of the hemiplegic patient, so that the recipient of care becomes an active participant in the treatment team. The patient should be fully aware of his condition, and partake in establishment of the goals together with subsequent evaluation of accomplishments and progress. Some short-term and some longer-term goals are outlined as a guide. A method for performance scoring is suggested. These performance ratings may assist in establishing priorities for discharge planning and continuation of care. They also may permit more accurate assessment and documentation of the patient's capacities and the efficacy of the various approaches to adequate care.

Achievement↗
PubMed2003

Ipsilateral hemiplegia in a lateral medullary infarct--Opalski's syndrome.

A 42-year-old man was admitted complaining of the sudden onset of headache, vomiting, vertigo, and gait disturbance. The authors found hemiparesis of his right limbs, right Homer's syndrome, and decreased pain and temperature sensation of his right face and left limbs. Diffusion-weighted imaging (DWI) showed an acute small infarct located on the right side of the lateral lower medulla. This is the first report of Opalski's syndrome with lower medullary infarction detected by DWI.

Adult↗
PubMed1989

The effect of hemiplegia on bone mass and soft tissue body composition.

The content of bone mineral (BMC), lean tissue, and fat tissue were measured by single and dual photon absorptiometry in both the paretic and the non-paretic limbs of 15 patients, hemiplegic due to cerebrovascular accident 23-38 weeks earlier. Compared with the non-paretic arm, the paretic arm had approximately 10% lower (P less than 0.01) BMC. This difference was largest at the measuring site with the highest ratio of trabecular to compact bone. The paretic leg had a 4% (P less than 0.001) lower BMC than the non-paretic leg. For both the arms and the legs, the lean content was lower (P less than 0.05) and the fat content higher (P less than 0.01) in the paretic than in the non-paretic. This was relatively more pronounced in the arms than in the legs. We conclude that partial immobilization, owing to paresis after a cerebrovascular accident, results in characteristic changes in the affected limbs, with a marked decrease in the content of bone and lean tissue and a pronounced increase in fatty tissue.

Adipose Tissue↗
PubMed1995

The energy cost of level walking in patients with hemiplegia.

The energy cost of level walking (Cw) was measured from the ratio of O2 consumption to speed (from 0.1 to 1.2 m.s-1) in hemiplegic patients (n = 20) and in a control group of healthy subjects (n = 17). Average age and body mass were 58, 54 years and 73, 78 kg, respectively. In hemiplegic patients Cw was higher than in control subjects (average value at 1.0 m.s-1 = 3.6 and 3.3 J.m-1.kg-1, respectively) and this difference increased at lower speeds (from 5.1% at 1.2 m.s-1 to 28.7% at 0.1 m.s-1).

Energy Metabolism↗
PubMed1975

Ectopic calcification around joints of paralysed limbs in hemiplegia, diffuse brain damage, and other neurological diseases.

Mechanical deformity associated, with neurological disease is commonly encountered in the form of contractures, or pre-existing arthritis. Less common is the occurrence of ectopic calcification around the joints of a paralysed limb. Two forms of this are presented in a series of twenty patients. Para-articular calcification with the appearance of myositis ossificans around large joints of the affected limbs occurred most often. The interior of the joints was not affected, nor was there evidence of bony injury. In some cases, however, the excessive outgrowth of bone around the joint eventually resulted in a functional ankylosis by a uniting bar of bone outside the joint. The second form of calcification was periosteal, which unlike the first type was resorbed and left an area of cortical bony thickening.

Aged↗
PubMed1990

Sparing effect of hemiplegia on scleroderma.

The paretic limb is spared in patients who develop rheumatic diseases after a hemiplegic stroke. This has been described previously in rheumatoid arthritis, gout, and osteoarthritis. A similar presentation in a case of scleroderma is described in this report. Scleroderma skin changes are absent in the completely paretic limb and were markedly reduced in the weak left leg. Inflammation may be modified either by neuropeptides or by an anatomical neurological lesion and this may explain the phenomenon.

Arm↗