[Histologic changes of the nutatory muscles in spastic torticollis].
Explore the source record for details and available documents.
Adolescent↗
SEARCH · PubMed Health
Results for “Muscle Spasticity”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Measurement of impaired muscle function of the gastrocnemius, soleus, and tibialis anterior muscles in spastic hemiplegia: a preliminary study.
Based on the results of several electrodiagnostic and biomechanical studies, the following classification of muscle dysfunction in spastic hemiplegia is proposed: changes in muscle activation (excess symptoms, e.g., spasticity, and deficit symptoms, e.g., paresis); changes in muscle stiffness; and changes in muscle length. The clinical significance of this classification is that different types of muscle dysfunction might require specific treatment. The authors have developed techniques to measure quantitatively each type of muscle dysfunction: free frequency repetitive movement (FFRM) and torque angle diagram (TAD). Surface EMGs of tibialis anterior, gastrocnemius, and soleus muscle are recorded during active (FFRM) and passive (TAD) ankle movements. EMG data are converted to parameters for abnormal muscle activation (excess and deficit symptoms). Parameters for muscle stiffness and muscle length are derived from the hysteresis curve of the TAD. This article describes the measurements and the results of a validation study. For the validation study, four hypotheses were formulated: 1) in nonimpaired control subjects, parameters expressing abnormal muscle activation are low; 2) in hemiplegic subjects, differences between the affected and the unaffected sides will be found for all types of parameters; 3) after local anaesthesia of the tibial nerve on the hemiplegic side, excess symptoms will decrease, while muscle stiffness remains unchanged; and 4) despite a uniform gait pattern, between-subject differences can be detected with regard to muscle activation, stiffness, and length. The first hypothesis was tested and confirmed in two controls; the remaining three were tested and confirmed in ten hemiplegic subjects (mean age 47.7 yrs, mean time since onset 10.7 yrs). However, the level of co-contraction of the gastrocnemius muscle was low, probably indicating that the clinical significance of this phenomenon might be limited. The results support the validity of the proposed classification and measurements.
Adult↗
Role of soleus muscle in spastic equinus foot.
Explore the source record for details and available documents.
Adolescent↗
[Transposition of the gastrocnemius muscle in spastic cases of cerebral palsy in children].
Explore the source record for details and available documents.
Achilles Tendon↗
Chronic transformation of muscle in spasticity: a peripheral contribution to increased tone.
Mechanical properties of relaxed lower leg muscles were assessed by torque measurements during imposed constant velocity dorsiflexion-plantarflexion cycles. At low angular velocities, they exhibited an elastic and an energy-consuming, velocity-independent (plastic) resistance. In most patients with long-standing spasticity, both of these were enhanced. The results support the hypothesis of secondary structural changes of muscles in spasticity.
Adult↗
Change of stretch reflex threshold in spasticity: effect of botulinum toxin injections.
Spasticity is a disorder of hypertonus associated with neurological diseases, characterized by a decrease in stretch reflex threshold. Stretch reflex threshold of wrist flexors has been recorded in subjects affected by forearm spasticity due to acute neurological lesions, occurred from one to sixty-one months before. In all the subjects a decreased stretch reflex threshold was recorded and a negative correlation between stretch reflex threshold and time of the disease resulted. In five subjects affected by mild spasticity the velocity stretch reflex threshold was tested one-three months after stroke and then six months later. In three cases a further decrease in stretch reflex threshold was recorded. Sixteen subjects affected by heavy forearm spasticity (quantified by Ashworth scale), were treated with Botulinum toxin injections to reduce spasticity. Fourteen of 16 subjects were responsive to the antispastic therapy: a decrease of at least 1 point in the Ashworth scale was detected after the treatment. In all the responsive cases an increase of stretch reflex threshold was recorded. The results confirm that the stretch reflex threshold is decreased in spastic muscles; it decreases progressively in time after the acute lesion. In addition, these results demonstrate that the decreased stretch reflex threshold can be reversed with Botulinum toxin injections. It is known that Botulinum toxin reduce the presynaptic release of Acetylcholine of neuromuscular synapses, but there are experimental evidences that it acts even on spindle's fibres, decreasing the sensitivity of intrafusal muscle fibres. This effect explains how Botulinum toxin increases the stretch reflex threshold in spastic muscles.
Action Potentials↗
Non-reflex and reflex mediated ankle joint stiffness in multiple sclerosis patients with spasticity.
In this study, we have measured the passive, the intrinsic, and the reflex-mediated mechanical response to stretch of the ankle extensors and flexors in 13 spastic multiple sclerosis patients and 10 healthy control subjects. In the ankle flexors, the patients had no reflex-mediated stiffness. The passive stiffness was increased by 138% (95% confidence interval: 26-91%) and the intrinsic stiffness by 79% (41-158%) when compared with the healthy subjects. In the ankle extensors, the reflex-mediated stiffness and the intrinsic stiffness of the patients were equal to the reflex-mediated and the intrinsic stiffness in healthy subjects. The passive stiffness was increased by 152% (41-352%). We conclude that spastic muscles in multiple sclerosis patients have an increased non-reflex stiffness (passive plus intrinsic stiffness), and that the reflex-mediated stiffness in the extensors during a sustained voluntary contraction does not differ significantly from healthy subjects.
Adult↗
Intrathecal baclofen--the importance of catheter position.
In a patient receiving intrathecal baclofen injections for intractable trunk and leg spasms, positioning the subarachnoid catheter tip just caudal to the spinal segments innervating the spastic muscles enhanced the spasmolytic effect of bolus injections of intrathecal baclofen on the affected muscles. Such selective positioning of subarachnoid catheters may facilitate segmental spasmolysis with lower intrathecal doses of baclofen and provide an important alternative to relying only on ascending CSF concentration gradients of baclofen from chronic lumbar intrathecal infusion.
Adult↗
The painful hemiplegic shoulder: effects of intra-articular triamcinolone acetonide.
Effects of intra-articular triamcinolone acetonide on pain and passive range of motion (ROM) in the painful hemiplegic shoulder were studied. A Multiple baseline (or AB) design across seven subjects was used. The length of the baseline condition (or A phase) was either 2 or 3 wk, and randomized across subjects. Subsequently, a treatment condition (or B phase) of 4 wk was applied during which three intra-articular injections of triamcinolone acetonide were administered at day 1, 8, and 22. Pain and ROM were the primary outcome parameters and were measured three times each week by means of a visual analogue scale (VAS) and a fluid-filled goniometer, respectively. In addition, a number of secondary outcome parameters were assessed, i.e., spastic muscle activity (Ashworth scale), motor function (Fugl-Meyer index), upper limb function (action research arm test) and signs and symptoms of a shoulder hand syndrome (clinical scoring list). Statistical analysis of the combined time series showed significant effects on pain (P = 0.025). Analysis of the individual time series revealed that five out of seven patients had significant reduction of pain. ROM improved significantly in four out of seven patients. However, improvement of ROM did not reach significance at the group level (P = 0.13). None of the secondary parameters showed significant changes. The correlation coefficient between upper limb function (ARA) at intake and size of treatment effect approached a level of significance (P = 0.09). The results indicate that intra-articular triamcinolone may be of benefit in reducing hemiplegic shoulder pain.
Aged↗
The acute effect of the GABA-agonist, THIP, on proprioceptive and flexor reflexes in spastic patients.
THIP (Lu 2-030) is pharmacologically a specific and potent GABA-receptor-agonist which in animal studies depresses monosynaptic and, to a smaller extent, polysynaptic spinal reflexes. 5 spastic patients were investigated by means of neurophysiological tests comparing the acute effect of a single oral dose of THIP (15-25 mg) to "the test situation without drug administration" with an interval of 2 days. The neurophysiological tests included quantitative studies of proprioceptive reflexes (T-reflex, vibratory inhibition of the T-reflex, resistance to passive movement of a spastic muscle and clonus) and of the flexor reflex (threshold and latency). The voluntary power was measured by a static technique. THIP clearly reduced the monosynaptic T-reflex and reinforced vibratory inhibition of the IA monosynaptic pathway. The flexor reflex threshold was slightly increased during THIP administration, but the changes were not significant. Flexor reflex latency, resistance to passive movement, clonus and voluntary power were unchanged.
Adult↗
Unique changes found on the Qi Gong (Chi Gong) Master's and patient's body during Qi Gong treatment; their relationships to certain meridians & acupuncture points and the re-creation of therapeutic Qi Gong states by children & adults.
Changes taking place in both Qi Gong Masters and their patients during Qi Gong treatment were evaluated using the Bi-Digital O-Ring Test. During the Qi Gong state, on the Qi-Gong Master's body, as well as the body of the patient being treated, acupuncture points CV5 (Shi Men) and CV6 (Qi Hai)-- located below the umbilicus-- show changes from +4 in the pre-Qi Gong state to between -3 and -4 during the Qi Gong state. Before and after the Qi Gong, there is a normal +4 response to the Bi-Digital O-Ring Test at these acupuncture points. Similar changes were also observed on acupuncture points CV17 (Shan Zhong), CV 22 (Tian Tu), Yin Tang (at an area just between the eyebrows: the pituitary gland representation area, colloquially known as the "third eye") and GV20(Bai Hui), the entire pericardium meridian & triple burner meridian, their acupuncture points, the adrenal glands, testes, ovaries and perineum, as well as along the entire spinal vertebrae, particularly on and above the 12th thoracic vertebra, medulla oblongata, pons, and the intestinal representation areas of the brain located just above and behind the upper ear. Using these findings as criteria for evaluating the effectiveness of reaching the Qi Gong state, we were able to reproduce during the experimental trials similar changes in ourselves and the patient being treated with therapeutic effects comparable to those of the Qi Gong Master. Beneficial effects of external Qi Gong treatment given by a Qi Gong practitioner 1 to 3 times for 10-20 seconds each (although most Qi Gong masters take 3-20 minutes per treatment) often resulted in improvement of circulation and lowering of high blood pressure, as well as relaxation of spastic muscles, relief of pain, and enhanced general well-being, all of which resemble acupuncture effects. In order to reproduce the same procedure with others, we selected 4 children ranging between 8 and 11 years of age who had no knowledge of Qi Gong or Oriental medicine. One of these four children, the 8 year old, was able to consistently reach the same Qi Gong state after less than a half day and another child, 11, after less than 2 days. Within a week, the other two were sometimes able to reproduce the Qi Gong state but not always. Using the Qi Gong state thus obtained, it was found that this type of Qi Gong energy is directed to specific directions from the hand and can even penetrate wooden or metal doors.(ABSTRACT TRUNCATED AT 400 WORDS)
Acupuncture Therapy↗
Negative transfer of training following brief practice of elbow tracking movements with electromyographic feedback from spastic antagonists.
This study aimed to overcome gaps in the literature by investigating effects of EMG feedback provided specifically from spastic muscles during antagonist phases of active movement, while controlling for the effects of practicing the movement and while testing for transfer of training without confounding several transfer phenomena. In a single training session, two groups of stroke patients practiced a pursuit tracking task by following a moving target with elbow flexion and extension, simultaneously attempting to reduce the activity of elbow flexors. Both groups tracked the target more accurately following training. Transfer tests failed to demonstrate effects of feedback on accuracy of tracking or on electromyographic activity during performance of the practiced task without feedback. Moreover, the group that was trained with electromyographic feedback exhibited negative transfer on variants of the practiced task: tracking faster or less predictable targets.
Biofeedback, Psychology↗
Sativex for the management of multiple sclerosis symptoms.
Sativex (R) is a cannabis-based pharmaceutical product containing delta 9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in a 1:1 ratio, delivered in an oromucosal (mouth) spray. It has been approved as adjunctive treatment for neuropathic pain in patients with multiple sclerosis (MS). It is being investigated for the management of other MS symptoms, such as spasticity. THC:CBD spray is regulated as a narcotic. Five randomized controlled trials (RCTs) compared the benefits and harms of THC:CBD spray with placebo. A total of 368 patients with various neurological conditions (including MS) were recruited. In some trials, THC:CBD spray significantly reduced neuropathic pain, spasticity, muscle spasms and sleep disturbances. The most common adverse events (AEs) reported in trials were dizziness, sleepiness, fatigue, feeling of intoxication and a bad taste. Long-term safety and the potential for dependence, abuse, misuse and diversion are unknown.
Administration, Oral↗
[Surgical possibilities in spastic paralysis of arm and hand].
OBJECTIVE: To determine the results of surgical correction of spastic paralysis of the hand due to cerebral palsy. DESIGN: Descriptive. SETTING: Academic Medical Centre, Amsterdam, the Netherlands, and rehabilitation centre De Trappenberg. METHOD: From 1-1-1990 until 1-6-1994 twenty patients with spastic upper limb in cerebral palsy were operated in our hospital. They were all seen preoperatively by our multidisciplinary team, and selected according to the Zancolli classification. Seventeen operations were aimed at improving hand function, the other three were performed for contractures or for cosmetic/hygienic reasons. Surgery was aimed at correcting the muscular imbalance, by weakening spastic muscles via tenotomy or lengthening and by reinforcing paralysed muscles via tendon transfer or rerouting. Often stabilisation of joints by tenodesis, capsulodesis or arthrodesis was necessary as well. RESULTS: Eighteen of the twenty patients were (very) happy with the results. In two patients there was no functional gain. Only once was a postoperative complication seen: pseudarthrosis of the first carpometacarpal joint. This was corrected successfully by rearthrodesis. We found we were able to predict the functional outcome fairly accurately. CONCLUSION: With accurate patient selection, surgical intervention in patients with cerebral palsy may restore hand function adequately and predictably.
Activities of Daily Living↗
Relationships among measures of knee musculoskeletal impairments, gross motor function, and walking efficiency in children with cerebral palsy.
PURPOSE: The study was designed to determine whether relationships exist among knee muscle spasticity, isometric knee muscle strength, knee muscle balance, gross motor function, and walking efficiency in children with spastic cerebral palsy and to evaluate the relative contributions of impairment measures to functional outcome measures. METHODS: Twenty-seven children with spastic diplegic cerebral palsy participated. Knee muscle strength and spasticity were measured by a hand-held dynamometer and the Ashworth Scale, respectively. Functional abilities were assessed by the Gross Motor Function Measure and by calculating the energy expenditure index from data collected during two three-minute walk tests (comfortable and fast speeds). RESULTS: Significant relationships were found between impairments and functional abilities (r = 0.42-0.85, p < 0.05). Isometric hamstring strength and quadriceps spasticity explained 81.5% of total Gross Motor Function Measure score variance. Quadriceps spasticity explained 56.7% of energy expenditure index variance during comfortable walking. CONCLUSION: Hamstring strength and quadriceps spasticity explain much of the variance in gross motor function and comfortable walking efficiency.
Cerebral Palsy↗
Storing of qi gong energy in various materials and drugs (qi gongnization): its clinical application for treatment of pain, circulatory disturbance, bacterial or viral infections, heavy metal deposits, and related intractable medical problems by selectively enhancing circulation and drug uptake.
In the process of evaluating the effects of external Qi Gong on inanimate substances by the Bi-Digital O-Ring Test, Qi Gong energy was shown to have a polarity which the author designated for convenience sake (+) or (-), where (+) increases the strength of muscles and (-) weakens them. Depending upon how external Qi Gong is applied and from which part of the body it emanates, the polarity changes. In general, it was found that, when (+) polarity is applied to the painful area or spastic muscles or arteries in vaso-constriction it often reduced or eliminated the pain, spastic muscles or circulatory disturbances. The author succeeded in storing part of the Qi Gong energy in inanimate materials, such as papers, metals (such as a sheet of aluminum foil), glass, stone, band-aids, clothes, drugs, etc. in bi-polar (one end of the same material becomes (+) polarity and the other end of the same material becomes (-) polarity) form in one material or uni-polar, i.e., the entire material either has pure (+) polarity or (-) polarity. Water, EPA, vitamins, antibiotics and other drugs were also converted to (+) polarity. When the material has a bi-polar state, it becomes possible to eliminate one of the polarities by applying certain changing electrical fields. The effect of placing (+) polarity Qi Gong energy stored material was compared with direct application of the Qi Gong on pain, spastic muscle and spastic vertebral arteries. The therapeutic effects of these 2 methods were quite similar for the identical time duration but a more predictable effect was often obtained in the former. As our previous study indicates that acupuncture, electrical stimulation (1-3 pulses/sec.), as well as Qi Gong not only improved the microcirculatory disturbance and relaxed spastic muscles and vaso-constrictive arteries but also reduced or eliminated the pain and also selectively enhanced drug uptake to the area where drugs could not be delivered due to existing circulatory disturbances, by placing (+) Qi Gong stored material, such as a sheet of paper or aluminum foil, band-aid or clothes. Bi- Digital O-Ring Test evaluation indicated that not only did it produce all the beneficial effects of Qi Gong but also enhanced the drug uptake selectively in the area where it is necessary for the drug to be delivered for effective treatment, and reduced lead deposits in tissue.(ABSTRACT TRUNCATED AT 400 WORDS)
Acupuncture Therapy↗
Transcutaneous electrical nerve stimulation for treatment of spinal spasticity.
Thirty-two patients with spinally originated muscle spasticity were treated with a transcutaneous electrical nerve stimulator, the Han's acupoint nerve stimulator (HANS) via skin electrodes placed over the acupoints on the hand and leg. High frequency (100 Hz), but not the low frequency (2 Hz), stimulation was effective in ameliorating muscle spasticity. While the therapeutic effect lasted for only 10 minutes in the first treatment, it became consolidated after consecutive daily treatment for 3 months. The anti-spastic effect induced by high frequency electrical stimulation can be partially reversed by a high dose of naloxone. The results suggest that the anti-spastic effect elicited by peripheral electrical stimulation is mediated, at least in part, by the endogenous opioid ligand interacting with the kappa opiate receptors, most probably dynorphin, in the central nervous system.
Acupuncture Points↗
Stretch-induced electromyographic activity and torque in spastic elbow muscles. Differential modulation of reflex activity in passive and active motor tasks.
Stretch-evoked electromyographic (EMG) activity and torque signals have been studied in elbow joint muscles of both sides of patients with spastic hemiparesis and healthy subjects. In order to reveal differences in the generation of muscle tone between clinical assessment and functional movement, stretches of different velocities and amplitudes were applied during passive and quasi-functional active motor tasks. In spastic patients the strength and duration of the EMG responses following stretching of flexor and extensor muscles during both passive and active tasks were dependent on the stretch velocity and duration, respectively. This effect was seen on both the spastic and unaffected side. Under passive conditions EMG activity after stretching was negligible in the limb muscles of healthy subjects, of small amplitude in unaffected limbs of the patients, but was strong in affected muscles. Under active conditions, the amplitude of the early (M1) component of the EMG signal was larger, while the later components (M2 and M3) were smaller. These differences were due more to a change in reflex gain than to a change in reflex threshold when the stretch velocity signal was the basis for calculation. It is suggested that in spastic paresis, modulation of stretch-induced EMG activity in the spastic limb becomes restricted to a smaller range with a poor ability to switch off under passive conditions. Furthermore, the reflex EMG activity suffers a reduced facilitation under active conditions. In comparison with unaffected limbs the stretch-evoked torque on the affected side was increased under passive conditions (due to the extra EMG activity) and decreased under active conditions (due to a reduced EMG activity). An increased torque to EMG ratio was found in spastic flexor and extensor muscles during active tasks. This is thought to be due to changes in mechanical muscle fibre properties suffered as a consequence of defective muscle activation following cerebral lesions. The consequences for clinical assessment of muscle tone and therapy of spastic movement disorder are discussed.
Adult↗