Rehabilitation Principles for Motor Dysfunctions According to the Kozyavkin Method
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VIEW Open Access Muscle Spindle Function in Healthy and Diseased Muscle Stephan Kröger* and Bridgette Watkins
Kröger and Watkins Skeletal Muscle (2021) 11:3 https://doi.org/10.1186/s13395-020-00258-x REVIEW Open Access Muscle spindle function in healthy and diseased muscle Stephan Kröger* and Bridgette Watkins Abstract Almost every muscle contains muscle spindles. These delicate sensory receptors inform the central nervous system (CNS) about changes in the length of individual muscles and the speed of stretching. With this information, the CNS computes the position and movement of our extremities in space, which is a requirement for motor control, for maintaining posture and for a stable gait. Many neuromuscular diseases affect muscle spindle function contributing, among others, to an unstable gait, frequent falls and ataxic behavior in the affected patients. Nevertheless, muscle spindles are usually ignored during examination and analysis of muscle function and when designing therapeutic strategies for neuromuscular diseases. This review summarizes the development and function of muscle spindles and the changes observed under pathological conditions, in particular in the various forms of muscular dystrophies. Keywords: Mechanotransduction, Sensory physiology, Proprioception, Neuromuscular diseases, Intrafusal fibers, Muscular dystrophy In its original sense, the term proprioception refers to development of head control and walking, an early im- sensory information arising in our own musculoskeletal pairment of fine motor skills, sensory ataxia with un- system itself [1–4]. Proprioceptive information informs steady gait, increased stride-to-stride variability in force us about the contractile state and movement of muscles, and step length, an inability to maintain balance with about muscle force, heaviness, stiffness, viscosity and ef- eyes closed (Romberg’s sign), a severely reduced ability fort and, thus, is required for any coordinated move- to identify the direction of joint movements, and an ab- ment, normal gait and for the maintenance of a stable sence of tendon reflexes [6–12]. -
Outcomes Following Unilateral Selective Dorsal Rhizotomy In
Outcomes and Perioperative Considerations for Unilateral Selective Dorsal Rhizotomy in Children with Spastic Hemiplegia with Pre- and Postoperative Quantitative Gait Analysis Christine Hunt, D.O.1, Nicholas Wetjen, M.D.2, Kenton Kaufman, Ph.D.3, Krista Coleman Wood, P.T., Ph.D.3, Joline Brandenburg, M.D.1, Bradford Landry, D.O.1 1Department of Physical Medicine & Rehabilitation, 2Department of Neurologic Surgery, 3Department of Orthopedic Surgery Mayo Clinic, Rochester, MN Abstract Background & Objectives Methods Results: Postoperative Gait Analysis Discussion Background: Selective dorsal rhizotomy (SDR) is a Background Preoperative Baseline Characteristics Patient 1: Right SDR December 2013 • Pre-SDR, patients undergo an in-depth review of their medical procedure used to improve function, decrease pain and • Several human trials examining outcomes in SDR in children • Patient 1: 6 year old male, spastic right hemiplegia • 62.5% of sensory dorsal rootlets sectioned ( L2 to S1) history and imaging studies, consultation with a physiatrist, reduce spasticity in children and adults with cerebral palsy or neurosurgeon, and orthopedic surgeon, and evaluation with PT with spastic diplegia have been conducted, but there is a • GMFCS Level II • Normalized velocity and stride length stroke. Positive outcomes have been reported by numerous and OT. Testing includes QGA, MRI lumbar spine and brain, paucity of data describing outcomes following SDR for • 12 series of botulinum toxin • Improved hip and knee kinematics and kinetics authors but pediatric -
Influence of Gestational Age on the Type of Brain Injury and Neuromotor Outcome in High-Risk Neonates
Eur J Pediatr DOI 10.1007/s00431-007-0629-2 ORIGINAL PAPER Influence of gestational age on the type of brain injury and neuromotor outcome in high-risk neonates Christine Van den Broeck & Eveline Himpens & Piet Vanhaesebrouck & Patrick Calders & Ann Oostra Received: 16 July 2007 /Accepted: 4 October 2007 # Springer-Verlag 2007 Abstract This study was an investigation of a possible periventricular leukomalacia, 24% intraventricular hemor- correlation between either the gestational age (GA) and rhage and 18% persistent flares. There was a significant type of brain injury or between the gestational age and type, correlation between the GA and type of brain injury (P< distribution and severity of cerebral palsy (CP). Four 0.001; Cramer’s V=0.76) and between the GA and type (P= hundred sixty-one children with a birthweight ≥1250 g 0.004; Cramer’s V=0.47) and distribution (P<0.001; and GA ≥30 weeks with a complicated neonatal period and/ Cramer’s V=0.55) of CP. There was no significant correla- or brain injury on serial cerebral ultrasound were selectively tion between the GA and severity of CP. The type of brain followed at the regional Center for Developmental Disor- injury detected by serial ultrasound during the neonatal ders. The children were divided into a preterm and term period, as well as the type and location of CP detected group. There were 40 children with cerebral palsy in the during later childhood, are all GA-dependent in at-risk preterm group and 38 children with cerebral palsy in the newborn infants with a birthweight of ≥1,250 g and term group. -
Tissue Engineered Myelination and the Stretch Reflex Arc Sensory Circuit: Defined Medium Ormulation,F Interface Design and Microfabrication
University of Central Florida STARS Electronic Theses and Dissertations, 2004-2019 2009 Tissue Engineered Myelination And The Stretch Reflex Arc Sensory Circuit: Defined Medium ormulation,F Interface Design And Microfabrication John Rumsey University of Central Florida Part of the Biology Commons Find similar works at: https://stars.library.ucf.edu/etd University of Central Florida Libraries http://library.ucf.edu This Doctoral Dissertation (Open Access) is brought to you for free and open access by STARS. It has been accepted for inclusion in Electronic Theses and Dissertations, 2004-2019 by an authorized administrator of STARS. For more information, please contact [email protected]. STARS Citation Rumsey, John, "Tissue Engineered Myelination And The Stretch Reflex Arc Sensory Circuit: Defined Medium Formulation, Interface Design And Microfabrication" (2009). Electronic Theses and Dissertations, 2004-2019. 3826. https://stars.library.ucf.edu/etd/3826 TISSUE ENGINEERED MYELINATION AND THE STRETCH REFLEX ARC SENSORY CIRCUIT: DEFINED MEDIUM FORMULATION, INTERFACE DESIGN AND MICROFABRICATION by JOHN WAYNE RUMSEY B.S. University of Florida, 2001 M.S. University of Central Florida, 2004 A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Burnett School of Biomedical Sciences in the College of Medicine at the University of Central Florida Orlando, Florida Fall Term 2009 Major Professor: James J. Hickman ABSTRACT The overall focus of this research project was to develop an in vitro tissue- engineered system that accurately reproduced the physiology of the sensory elements of the stretch reflex arc as well as engineer the myelination of neurons in the systems. In order to achieve this goal we hypothesized that myelinating culture systems, intrafusal muscle fibers and the sensory circuit of the stretch reflex arc could be bioengineered using serum-free medium formulations, growth substrate interface design and microfabrication technology. -
WCN19 Journal Posters Part 2 Revised V1
JNS-0000116542; No. of Pages 131 ARTICLE IN PRESS Journal of the Neurological Sciences (2019) xxx–xxx Contents lists available at ScienceDirect Journal of the Neurological Sciences journal homepage: www.elsevier.com/locate/jns WCN19 Journal Posters Part 2 revised_V1 WCN19-2260 WCN19-2269 Poster shift 01 - Channelopathies /neuroethics /neurooncology / Poster shift 01 - Channelopathies /neuroethics /neurooncology / pain - Part I /sleep disorders - Part I /stem cells and gene therapy - pain - Part I /sleep disorders - Part I /stem cells and gene therapy - Part I /stroke /training in neurology - Part I and traumatic brain Part I /stroke /training in neurology - Part I and traumatic brain injury injury Numb chin syndrome- The first finding in metastatic malignancy Results of surgical treatment in patients with moyamoya disease considering CT-perfusion imaging study N. Mustafayev, A. Bayrakoglu, F. Ilgen Uslu, M. Kolukısa Bezmialem University, Neurology, Istanbul, Turkey O. Harmatinaa, V. Morozb, I. Skorokhodab, I. Tyshb, N. Shahinb,R. Hanemb, U. Maliarb a Numb chin syndrome (NCS) is a sensory neuropathy of the SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», mental nerve, which is accompanied by hypoesthesia and paresthe- Neuroradiology Department, Kyiv, Ukraine b sia of the jaw and lower lip. Although being well known in neurology SI «Romodanov Institute of Neurosurgery of NAMS of Ukraine», practice, most of the physicians who have not experienced this Emergency Department of Vascular Neurosurgery, Kyiv, Ukraine phenomenon are unaware of this phenomenon since it is rare and can be confused with somatic complaints. This case report aims to Aim point out that NCS may be the first sign and symptom of metastatic To improve the results of surgical treatment of patients with cancers in patients who are not diagnosed. -
Peripheral Obliterating Arteritis As a Cause of Triplegia Following Hemiplegia, and of Paraplegia
§60 ■ burr, Camp: PeeipherAIi obliterating arTeritis. of ice, bloodletting, not as a routine, but for distinct indications, and serum-therapy, all appear to have been attended with the same general result—a mortality between 50 and 60 per cent. PERIPHERAL OBLITERATING ARTERITIS AS A CAUSE OF TRIPLEGIA FOLLOWING HEMIPLEGIA, AND OF PARAPLEGIA. By Charles W. Burr, M.D., PROFESSOR OF MENTAL DISEASES, UNIVERSITY OF PENNSYLVANIA, AND C. D. Camp, M.D., ASSISTANT IN NEUROPATHOLOGY, UNIVERSITY OP PENNSYLVANIA. (From the Laboratory of Neuropathology of the University of Pennsylvania.) We purpose to describe a not very infrequent but much neglected form of palsy caused by obliterating arteritis in the extremities affected. When it affects the arteries of the legs in a hemiplegic the result is a triplegia which may be thought to have been caused by cerebrospinal disease if the possibility of local vascular disease and the disability resulting therefrom are not thought of. During the acute stage of a sudden hemiplegia caused by cerebral hemorrhage or thrombosis, but never in the slowly oncoming palsy from cerebral tumor, there is, on account of the bilateral control of movements in the cerebral cortex, a temporary lessening of power of the arm and leg on the same side as the lesion. It is also well known that in the chronic stage of hemiplegia the deep reflexes on the non-paralyzed side are often permanently increased and that even true ankle clonus may be present. This temporary partial palsy and permanent exaggeration of the deep reflexes arise without any disease of the brain and cord except that which caused the primary palsy. -
Be Able to Describe a Stretch Reflex
be able to describe a stretch reflex .(1) (2) Define muscle tone (3) be able to explain what is muscle tone (4) describe the structure , innervations and function of the muscle spindle . (5) explain what is meant by static and dynamic stretch reflex . (6) describe the spinal and supraspinal regulation of the stretch reflex . (7) describe the inverse stretch reflex and its function Stretch reflex: Whenever a muscle is stretched suddenly, excitation of the muscle spindle causes reflex contraction of the large muscle fiber (See the pictures). It is deep and monosynaptic reflex. Stretch response is produced by co-activation of alpha & gamma motor neurons. But it is maintained mainly by the tonic ( continuous) discharge of Gamma Efferent neurons. Muscle spindle: It is a sensory receptors which are distributed throughout the muscle and it sends information to nervous system about muscle length or rate of change in muscle length. - Each spindle is built around 3-12 intrafusal muscle fibers. - Muscle spindles are parallel to extrafusal muscle fibers and they are attached to them or to the tendon. Types of Intrafusal fibers Each intrafusal fiber consists of: (1) Central non-contractile area (receptor 2) Nuclear chain fibers: area). thinner and shorter 1) Nuclear bag fibers: than nuclear bag fibers (2) Peripheral contractile area. contain many nuclei in , and have one line of a dilated central area ( “ nuclei spread in a chain bag ” ) . Typically there along the receptor area are 2 nuclear bag fibers . There are 4 – 9 per spindle . nuclear chain -
Neuro-Developmental Treatment (NDT) and Neurological Disorders: the Latest Research and Resources for Ots and Pts
Neuro-Developmental Treatment (NDT) and Neurological Disorders: The Latest Research and Resources for OTs and PTs (2 CEs) Learning Objectives • Summarize foundational theories and treatment behind NDT. • Explain what NDT looks like as delivered through physical and occupational therapy practitioners. • Summarize current peer-reviewed NDT research. • Identify and describe NDT-appropriate neurological disorders outside of cerebral palsy (CP) and hemiplegia. • Identify updated resources for proper billing of NDT in specific practice settings. • Discuss current therapy resources for NDT to enhance the clinical practice. Introduction Neuro-developmental treatment (NDT) also referred to as the Bobath Concept or approach, has been around since the 1940s when it was first developed by Berta and Dr. Karel Bobath. Initially, the Bobaths introduced innovative therapeutic approaches for children with cerebral palsy and adults with hemiplegia. Today, NDT is widely used in the therapy realm for numerous neurological conditions and has revolutionized hands-on clinical work. Physical and occupational therapists working in various settings and capacities worldwide have incorporated NDT principles and practices into their patients’ treatment sessions. Like other theoretical and practical roots of physical therapy and occupational therapy, NDT’s foundations have aged; this, however, does not mean that NDT is less applicable or is out-of-date. As with other treatment theories, NDT was designed to evolve as clinicians learned more about the human function. In fact, the Bobaths insisted that NDT must be applied so that it could evolve over time in order to fully understand the recovery of function in neurological conditions (Runyan, 2006). As new treatments take the limelight, however, older treatment approaches are at risk of fading. -
Hepatic Myelopathy: Case Report And
LIVER RESEARCH ISSN 2379-4038 http://dx.doi.org/10.17140/LROJ-1-108 Open Journal Case Report Hepatic Myelopathy: Case Report and *Corresponding author Review of the Literature Hua Hong Department of Neurology First Affiliated Hospital Huanquan Liao1#, Zhichao Yan2#, Wei Peng3# and Hua Hong1* Sun Yat-Sen University No. 58 Zhongshan Road 2 #These authors contributed equally. Guangzhou 510080, P.R. China Tel. +008615920500906 1 Fax: +00862087331989 Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou E-mail: [email protected] 510080, P.R. China 2State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen Univer- Volume 1 : Issue 2 sity, Guangzhou 510060, Guangdong, P.R. China 3 Article Ref. #: 1000LROJ1108 Department of Stomatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, P.R. China Article History Received: August 5th, 2015 ABSTRACT Accepted: August 12th, 2015 Published: August 12th, 2015 Background: Hepatic Myelopathy (HM) is a rare complication of chronic liver disease usually associated with extensive portosystemic shunt of blood, which has been created surgically or has occurred spontaneously, causing progressive spastic paraparesis. Some single cases or short Citation clinical reports describing patients suffering from HM have been published worldwide, but are Liao H, Yan Z, Peng W, Hong H. He- patic myelopathy: case report and re- often scattered. view of the literature. Liver Res Open Material and method: One additional case of HM with typical symptoms was presented, and J. 2015; 1(2): 45-55. doi: 10.17140/ a retrospective survey of the literature in a manner of comprehensive review was undertaken. -
Adherence to Supervised and Unsupervised Home Exercise Program on Motor Milestones in Spastic Cerebral Palsy
Review Article J Yoga & Physio Volume 4 Issue 2 - March 2018 Copyright © All rights are reserved by Namrata Patil DOI: 10.19080/JYP.2018.04.555634 Adherence to Supervised and Unsupervised Home Exercise Program on Motor Milestones in Spastic Cerebral Palsy Namrata Patil*, G Varadhrajulu and Mandar Malawade Department of Pediatric Physiotherapy, Krishna College of Physiotherpay, India Submission: February 09, 2018; Published: March 19, 2018 *Corresponding author: Namrata Patil, Department of Pediatric Physiotherapy, Krishna College of Physiotherpay, KIMS, Karad 415110, India, Email: Abstract Background: Cerebral palsy (CP) describes a group of developmental disorders of movement and posture, causing activity restriction or disability that is attributed to disturbances occurring in the fetal or infant brain. The motor impairments may be accompanied by a seizure motordisorder abnormality and by impairment (spasticity, of athetosis, sensation, ataxia), cognition, area communication of the body that and is affectedbehavior. (monoplegia, The hallmark diplegia, sign of hemiplegia,group of disorders triplegia, identified tetraplegia) as CP and is locationan impairment of lesion of involuntary the brain motor (pyramidal, control. extra CP frequently pyramidal, involves mixed).Many one or studies more limbs have andbeen the conducted trunk musculature on rehab for and CP is children. classified But by no the study type soof far conducted has compared the effectiveness of supervised and non supervised home exercise program. Hence, the study was undertaken. On adherence to supervised and unsupervised home exercise program on motor milestones for spastic cerebral palsy. Methods: 30 subjects diagnosed with spastic CP (3 months) were selected months .They were divided into two groups and treated with exercises for 2 months. -
Multi-Scale Modelling of the Neuromuscular System -- Coupling
Received: 21 January 2019 Revised: 13 May 2019 Accepted: 14 May 2019 DOI: 10.1002/wsbm.1457 ADVANCED REVIEW Multiscale modeling of the neuromuscular system: Coupling neurophysiology and skeletal muscle mechanics Oliver Röhrle1,2 | Utku S¸. Yavuz1,3 | Thomas Klotz1,2 | Francesco Negro4 | Thomas Heidlauf5 1Institute for Modelling and Simulation of Biomechanical Systems, University of Abstract Stuttgart, Stuttgart, Germany Mathematical models and computer simulations have the great potential to substan- 2Stuttgart Center for Simulation Sciences tially increase our understanding of the biophysical behavior of the neuromuscular (SC SimTech), University of Stuttgart, system. This, however, requires detailed multiscale, and multiphysics models. Stuttgart, Germany Once validated, such models allow systematic in silico investigations that are not 3Biomedical Signals and Systems, Universiteit Twente, Enschede, necessarily feasible within experiments and, therefore, have the ability to provide The Netherlands valuable insights into the complex interrelations within the healthy system and for 4 Department of Clinical and Experimental pathological conditions. Most of the existing models focus on individual parts of Sciences, Universià degli Studi di Brescia, Brescia, Italy the neuromuscular system and do not consider the neuromuscular system as an 5EPS5 – Simulation and System Analysis, integrated physiological system. Hence, the aim of this advanced review is to facili- Hofer pdc GmbH, Stuttgart, Germany tate the prospective development of detailed biophysical models of the entire neu- romuscular system. For this purpose, this review is subdivided into three parts. The Correspondence Oliver Röhrle, Institute for Modelling and first part introduces the key anatomical and physiological aspects of the healthy Simulation of Biomechanical Systems, neuromuscular system necessary for modeling the neuromuscular system. -
Suit Therapy Adeli Suit
Suit Therapy Adeli Suit Alyssa Connifey Doug Eck Josh Egloff Sarah Kibiloski Maria King Sean McBride Background ● Developed in late 1960s/early 1970s by Russian space program for astronauts to maintain muscle tone in an anti- gravity environment ● Has been modified and used as an alternative treatment for patients with cerebral palsy and other neuromuscular disorders ● “Adeli” comes from the nickname of the prototype called the penguin suit, based on the Adeli Penguin Treatment ● Consists of a vest, shorts, knee pads, and shoes, connected by a series of adjustable, elastic bands ● Goal: maintain proper body alignment in order to restrict abnormal movement and ROM ● Provides immediate feedback to patient on normal movement patterns ● Suit is worn throughout intensive sessions to: ○ “retrain” the brain using correct muscle movements ○ improve body awareness ○ support weak muscles ○ improve gross motor skills and balance ○ provide normal proprioceptive input to the brain Rationale ● Research from the Pediatric Institute of the Russian Academy of Science showed that AST stimulates the restarting of the vestibular system’s development ● The vestibular system is a processing center for impulses from proprioceptors ○ The suit provides normal tactile and proprioceptive stimulation to normalize afferent vestibular-proprioceptive inputs to the vestibular system ○ Allows CNS to send out normal efferent signals ○ Muscle tone, balance, coordination, body awareness, and proprioception are influenced Treatment Sessions ● The original Russian protocol