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PubMed1992

Optical imaging of epileptiform and functional activity in human cerebral cortex.

Optical imaging of animal somatosensory, olfactory and visual cortices has revealed maps of functional activity. In non-human primates, high-resolution maps of the visual cortex have been obtained using only an intrinsic reflection signal. Although the time course of the signal is slower than membrane potential changes, the maximum optical changes correspond to the maximal neuronal activity. The intrinsic optical signal may represent the flow of ionic currents, oxygen delivery, changes in blood volume, potassium accumulation or glial swelling. Here we use similar techniques to obtain maps from human cortex during stimulation-evoked epileptiform afterdischarges and cognitively evoked functional activity. Optical changes increased in magnitude as the intensity and duration of the afterdischarges increased. In areas surrounding the afterdischarge activity, optical changes were in the opposite direction and possibly represent an inhibitory surround. Large optical changes were found in the sensory cortex during tongue movement and in Broca's and Wernicke's language areas during naming exercises. The adaptation of high-resolution optical imaging for use on human cortex provides a new technique for investigation of the organization of the sensory and motor cortices, language, and other cognitive processes.

Brain Mapping↗
PubMed1961

Therapeutic exercise in general practice.

Newer techniques of exercise which rely on a static or isometric muscle contraction of six seconds' duration once daily offer great possibilities in the treatment of patients incapacitated by low cardiac reserve, joints that are painful on movement or debility too severe to permit a conventional exercise program for general conditioning. Increments of strength of up to two per cent per day can be thus achieved in normal muscles. Muscles deconditioned by immobilization respond at a faster rate. However, no significant muscle hypertrophy can be achieved by this technique. This form of exercise can also be used by persons who are "too busy to exercise" but who may be willing to give two minutes a day to an exercise program designed to increase and maintain muscle tone and strength.A considerable number of medical conditions could be treated more effectively and with less resultant disability if therapeutic exercises-passive, active and progressive-were accurately prescribed and supervised by a physician as part of the treatment program. Among the many conditions to be considered are poliomyelitis, peripheral nerve injuries, the neuritides, postural defects and cardiac diseases.

Exercise↗
PubMed2006

[Chronic obstructive pulmonary disease and sports].

From a moderate COPD onward, physical training is an essential component of treatment. In recent years, it has become increasingly evident that endurance training alone does not suffice to counter the progressive deconditioning process. Since the muscular strength of COPD patients is significantly reduced vis-a-vis healthy subjects, and this makes a considerable contribution to the limitation of performance, functional health can be improved in particular by adding strength training to endurance training. This applies all the more so since a decrease in muscle mass is associated with a worsening of the prognosis. In view of the fact that the ventilatory load is sometimes above the maximal breathing capacity, training should be oriented to the patient's daily requirements, in particular in advanced COPD. Furthermore, breathing and movement techniques that spare the patient's resources should be taught.

Activities of Daily Living↗
PubMed2003

Effect of knee position on hip and knee torques during the barbell squat.

UNLABELLED: Some recommendations suggest keeping the shank as vertical as possible during the barbell squat, thus keeping the knees from moving past the toes. This study examined joint kinetics occurring when forward displacement of the knees is restricted vs. when such movement is not restricted. Seven weight-trained men (mean +/- SD; age = 27.9 +/- 5.2 years) were videotaped while performing 2 variations of parallel barbell squats (barbell load = body weight). Either the knees were permitted to move anteriorly past the toes (unrestricted) or a wooden barrier prevented the knees from moving anteriorly past the toes (restricted). Differences resulted between static knee and hip torques for both types of squat as well as when both squat variations were compared with each other (p < 0.05). For the unrestricted squat, knee torque (N.m; mean +/- SD) = 150.1 +/- 50.8 and hip torque = 28.2 +/- 65.0. For the restricted squat, knee torque = 117.3 +/- 34.2 and hip torque = 302.7 +/- 71.2. Restricted squats also produced more anterior lean of the trunk and shank and a greater internal angle at the knees and ankles. The squat technique used can affect the distribution of forces between the knees and hips and on the kinematic properties of the exercise. PRACTICAL APPLICATIONS: Although restricting forward movement of the knees may minimize stress on the knees, it is likely that forces are inappropriately transferred to the hips and low-back region. Thus, appropriate joint loading during this exercise may require the knees to move slightly past the toes.

Adult↗
PubMed2005

Educating patients: self-management approaches.

PURPOSE: To review and evaluate approaches to educating patients with fibromyalgia syndrome (FMS). METHODS: A narrative literature review was undertaken to summarize the published literature on patient education for FMS patients. RESULTS: A number of studies contain specific education strategies while others are combined with exercise or movement therapies or cognitive-behavioural therapy. CONCLUSIONS: Self-efficacy provides an effective theoretical model from which to understand how patients change as a result of education strategies that focus on self-management. Programmes that combine education with cognitive-behavioural techniques and exercise are most effective in enhancing self-efficacy and decreasing symptoms of FMS.

Behavior Therapy↗
PubMed2000

New surgical technique for the correction of congenital muscular torticollis (wry neck).

Congenital muscular torticollis (wry neck) results from shortening of the sternocleidomastoid muscle and may lead to limitation of neck movement and craniofacial deformity. If conservative treatment is started early, with a regimen of passive stretching exercises and active strengthening of the contralateral muscle, about 95% of patients achieve an acceptable range of neck movement. The surgical management of patients who do not respond to physiotherapy remains controversial. Its aim is to provide a long-term, cosmetic restoration of neck mobility while minimizing the development of craniofacial deformity and upper cervical scoliosis; few previously advocated techniques achieve both these goals. We describe a technique that combines subperiosteal lengthening of the sternocleidomastoid muscle at its mastoid insertion, and division of lower fibrotic bands with minimal postoperative fibrosis. As the sternomastoid muscle is reattached lower down on the mastoid process, the lengthening of the muscle is stable, because the tendency to fibrosis and shortening is minimized. Comparison of the results with previous series shows that this technique provides immediate benefit and good long-term results.

Adolescent↗
PubMed1999

The rehabilitation of a competitive swimmer with an asymmetrical breaststroke movement pattern.

This case study describes the treatment and management of an 11-year-old competitive swimmer who was repeatedly disqualified from races because of an asymmetrical movement pattern, otherwise called stroke. The treatment was based on the impairments found during the physical examination that were considered relevant to the physical dysfunction resulting in the asymmetrical stroke. This gave rise to the hypothesis that muscle imbalances around the right shoulder and left hip, together with a relative restriction of motion in these joints, were resulting in the transmission of forces up and down the kinetic chain and that these were contributing factors to the asymmetrical breaststroke stroke. An eclectic approach was used in the analysis, and the subsequent treatment and management, of the problem. To achieve the goal of a symmetrical stroke, the muscle balance/imbalance approaches of Janda (1994), Sahrmann (1988) and Kendall et al. (1993) were used. The joint impairments were treated with techniques described by Maitland (1986) and Mulligan (1996), while the exercise programme included the core/stabilizing approach presented by Blanch (1997). The treatment period consisted of four phases of 3 weeks each. The result indicates that early identification and treatment of muscle imbalance syndromes and relative joint restrictions by the physiotherapist and coach working together may be useful in establishing good movement patterns and technique for competitive swimmers.

Child↗
PubMed1997

Establishment of behavioral parameters for the evaluation of osteopathic treatment principles in a rat model of arthritis.

Unilateral arthritis was produced in rats by use of methylated bovine serum albumin in a model of antigen-induced arthritis. The progression of arthritis was measured by computerized motion analysis, bilateral joint circumference, voluntary extension force of the hindlegs, and length of ankle extension. Animals with induced arthritis were assigned to treated and untreated groups on the basis of approximately equal deficits by the parameters measured. A third group of rats, which did not have arthritis induced and received no treatment, served to establish mean normal parameters. Modified techniques of muscle energy, passive movement of the ankle and knee, and passive myofascial stretch were applied to the animals, and the animals were exercised in a mechanized exercise wheel. Parameters associated with gait were examined by computerized motion analysis of walking. Animals treated with manipulation and exercise improved significantly relative to untreated animals with antigen-induced arthritis in vertical ankle lift, ankle-based and foot-based stride lengths, knee circumference, and normalized extension of the ankle. The results demonstrate that the parameters identified can be used to detect functional deficits and significant improvement from those deficits can be derived from a nonpharmacologic treatment paradigm that includes osteopathic manipulation and exercise in an animal model of arthritis. These parameters may be useful in the identification of the relative benefits of independent treatment variables including frequency of osteopathic manipulation and exercise and the relative benefits of each in this model. Also, they may elucidate how these treatments produce their beneficial effects clinically.

Animals↗
PubMed2006

[What are management practices for speech therapy in amyotrophic lateral sclerosis?].

Amyotrophic lateral sclerosis involves deterioration of speech and swallowing. The objectives of rehabilitation are to maintain a comprehensible speech, using exercises on airflow-phonic coordination and breath, lingual and labial movements. Rehabilitation exercises also focus on the different times of swallowing to improve management of the food bolus in the mouth, to learn facilitating techniques and to adopt postures favoring passage of the food bolus. No studies have addressed the question of the effectiveness of rehabilitation in amyotrophic lateral sclerosis, in term of quality of life, maintenance of comprehensible speech or reduction of respiratory risks. Rehabilitation programs are established on an individual basis according to the clinical presentation and course.

Amyotrophic Lateral Sclerosis↗
PubMed2001

An investigation of the effectiveness of exercise and manual therapy in treating symptoms of TMJ osteoarthritis.

UNLABELLED: The background and purpose of this investigation was to evaluate the use of a treatment protocol which included active and passive jaw movements, manual therapy techniques, correction of body posture, and relaxation techniques for the treatment of temporomandibular joint (TMJ) osteoarthrosis (OA). Twenty consecutive patients suffering from TMJ OA participated in this study. INCLUSION CRITERIA: a. pain in the temporomandibular region; b. symptoms lasting at least three months; and c. radiologically proven OA. All patients were assigned to a waiting list, serving as a no treatment control period. Nineteen patients completed the study. No adverse effects occurred. During the control period (mean duration 35 days), the parameters did not change significantly. After treatment (mean duration 46 days) pain, impairment, and incisal edge clearance improved significantly (Wilcoxon test p < 0.001). At follow-up, pain and impairment were further reduced. The number of patients experiencing no pain at rest (80%), chi-square test p = 0.02) and stress (47%), chi-square test p = 0.03), and no impairment (37%), chi-square test p = 0.05) increased significantly. This therapeutic treatment protocol seems to be useful treatment for the symptoms of clinical dysfunction in OA of the TMJ.

Activities of Daily Living↗
PubMed2004

Effect of wheelchair stroke pattern on mechanical efficiency.

OBJECTIVE: To investigate the effect of different wheelchair stroke patterns on efficiency and propulsion technique (force application and timing). DESIGN: Inexperienced, able-bodied subjects were randomly divided into two velocity groups (1.11 m/sec [n = 13] and 1.39 m/sec [n = 11]). An external (medium) load was set at 0.23 N/kg. Subjects performed four 4-min exercise blocks on a wheelchair ergometer. The first block was performed with a freely chosen movement pattern of the hand. Thereafter, the pumping, semicircular, or single-looping over propulsion pattern were performed in a counterbalanced order. Gross mechanical efficiency and propulsion technique variables were measured with Oxycon Alpha and an instrumented wheelchair ergometer. RESULTS: A significant difference was found for mechanical efficiency, with pumping showing the highest efficiency and semicircular the lowest efficiency, regardless of velocity. Timing variables and negative power deflections before and after the push phase showed significant differences between the stroke patterns. CONCLUSIONS: Pumping is the energetically most efficient stroke pattern in contrast to the semicircular pattern in this subject group. Propulsion technique could not explain the difference in efficiency.

Adult↗
PubMed1988

Movement therapy.

Nursing's holistic approach to patient care requires that nurses use interventions that promote holism. Movement therapy is one of a number of possible holistic interventions neuroscience nurses can use. This intervention helps persons to become aware of their bodies and to use the body for expressing inner feelings. Two techniques, creative dance and afspaending, are described along with suggestions for their use with neuroscience populations.

Exercise Therapy↗
PubMed2000

Condylar process fractures of the mandible.

Treatment of condylar process fractures is a highly debated topic because available minimal scientific evidence is concerning outcomes comparing open and closed treatment. Decisions on treatment are therefore based more upon experience, training, and whim rather than upon outcome data. This article presents the author's open and closed techniques for treating condylar process fractures and briefly discusses considerations about which fractures deserve open treatment.

Adult↗
PubMed1983

Electromyographic biofeedback applications to stroke patients. A critical review.

This article critically reviews publications on EMG biofeedback applications to stroke patients. The state of the art on specificity of treatment effects, consistency across training procedures, measurement techniques, outcome assessments, transfer of treatment effect, and mechanism of action is discussed. Although EMG biofeedback may augment movement capabilities, at least as well as exercise regimens, data relating neuromuscular changes to function are limited. The deficiencies in our current knowledge about this application to stroke patients are identified, and suggestions for items requiring future clarification are delineated.

Age Factors↗
PubMedDate not supplied

[The experience of early rehabilitation].

Functional laryngectomies permit a more or less ideal preservation of laryngeal functions whose recovery, especially in les conservative operations, occurs very slowly and depends on several conditions: post operative course, sensitivity and motility of the hypopharynx, patient's ability to restore swallowing mechanisms. The Authors relate their experience concerning use of a rehabilitative program partially based on the experiences of some French logopedic schools and partially original. They illustrate the steps and goals of this program which starts on the fifth post-operative day with respiration exercises immediately followed by eight days of exercises to re-establish arytenoid mobilization and swallowing movements. If deglutition is not completely recovered and important inhalation problems persist, the logopedic approach is integrated with surgical rehabilitation consisting of one or more injection of gax-collagen. It is possible to use the same surgical technique later, after hospital discharge, if a slight dysphagia is still present in spite of continuous logopedic rehabilitation. Voice restoration exercises are introduced in the last days of the hospital stay when the patient is tube-free and continues at the office or outpatient clinic for two or three times every week. Concerning removal priority (tracheotomy tube followed by nasogastric tube or vice versa), we propose a diversified strategy for each patient, depending on the anatomicofunctional postoperative situation. Up to now 25 patients have taken part in this rehabilitation program (14 cricohyoidopexy, 6 Cricohyoidoepiglottopexy, 5 supraglottic laryngectomies). The results with regard to the amount of time that nasogastric feeding as well as tracheal tube are kept and the length of the hospital stay, were compared to those ones of a similar number of consecutive cases operated at our institution (ENT Department of Modena University) before February 1990 but not rehabilitated. In the early rehabilitated group, we observe a quicker functional recovery with a shorter hospital stay (about a week).

Breathing Exercises↗
PubMed1995

A consensus view on the technique of ambulatory blood pressure monitoring. The Fourth International Consensus Conference on 24-Hour Ambulatory Blood Pressure Monitoring.

This review, based on the Fourth International Consensus Conference on Ambulatory Blood Pressure Monitoring (Leuven, Belgium, 1994), deals with the technical aspects of ambulatory blood pressure monitoring. Ambulatory blood pressure monitoring by noninvasive intermittent techniques is widely used despite artifacts due to cuff size, movement, body position, short-term blood pressure variability, and interference with sleep. The performance of the currently available monitors under truly ambulatory conditions and during exercise remains a matter of debate, as are the procedures required to validate portable monitors under these circumstances. There is general agreement that whenever a monitor is to be used in special populations, such as older subjects or pregnant women, or in special conditions, such as exercise, a specific demonstration of its accuracy in these defined subgroups or conditions is warranted. Whether the auscultatory or oscillometric method is preferred remains controversial because each technique has specific advantages and disadvantages and because both can provide accurate results. Most experts in the field strongly believe that manufacturers should disclose the algorithms of their devices and that they should specify all changes made to the hardware and software of a previously validated monitor. Finally, the development of the volume-clamp method, which makes continuous noninvasive registration of blood pressure at the finger possible in both stationary and ambulatory conditions, opens new perspectives in research, in particular in relation to short-term blood pressure variability.

Adult↗
PubMed1989

Daily life therapy: a Japanese model for educating children with autism.

The controversial practice of Daily Life Therapy, as demonstrated at the Boston Higashi School in Massachusetts, is reviewed. Five fundamental principles of Daily Life Therapy are examined: instruction that is group-oriented; routine activities that are highly structured; instructional techniques that center on learning through imitation; a method for reducing children's levels of unproductive activity through rigorous physical exercise; and a curriculum that focuses on movement, music, and art. These central features of Daily Life Therapy are discussed in light of current theory, research, and educational practices in autism. Empirical questions raised by this unique treatment mode are outlined.

Art↗