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Sample records for neuromuscular control mechanisms

  1. NEUROMUSCULAR CONTROL IN LUMBAR DISORDERS

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    Ville Leinonen

    2004-03-01

    Full Text Available Impaired motor and sensory functions have been associated with low back pain (LBP. This includes disturbances in a wide range of sensorimotor control e.g. sensory dysfunctions, impaired postural responses and psychomotor control. However, the physiological mechanisms, clinical relevance and characteristics of these findings in different spinal pathologies require further clarification. The purposes of this study were to investigate postural control, lumbar muscle function, movement perception and associations between these findings in healthy volunteers (n=35, patients with lumbar disc herniation (n=20 and lumbar spinal stenosis (LSS, n=26. Paraspinal muscle responses for sudden upper limb loading and muscle activation during flexion-extension movement and the lumbar endurance test were measured by surface electromyography (EMG. Postural stability was measured on a force platform during two- and one-footed standing. Lumbar movement perception was assessed in a motorised trunk rotation unit in the seated position. In addition, measurements of motor-(MEP and somatosensory evoked potentials (SEP and needle EMG examination of lumbar multifidus muscles were performed in the LSS patients. Clinical and questionnaire data were also recorded. A short latency paraspinal muscle response (~50 ms for sudden upper limb loading was observed. The latency of the response was shortened by expectation (p=0.017. The response latency for unexpected loading was similar in healthy persons and disc herniation patients but the latency was not shortened by expectation in the patients (p = 0.014. Also impaired postural control (p < 0.05 and lumbar movement perception (p = 0.012 were observed in disc herniation patients. The impaired lumbar movement perception (p=0.054 and anticipatory muscle activation (p = 0.043 tended to be restored after successful surgery but postural control had still not recovered after 3 months of follow-up. The majority of LSS patients were unable to sense a rotational movement in the lumbar area and thus had clearly impaired lumbar movement perception (p = 0.006. Abnormal MEPs had only inconsistent and SEPs showed no associations with impaired movement perception and postural stability in LSS. Abnormal needle EMG findings and flexion-extension activation of paraspinal muscles were frequently observed in LSS patients. Lumbar paraspinal muscle endurance was better than in previously evaluated healthy subjects and chronic LBP patients (p < 0.001. The results demonstrated clearly impaired lumbar sensory and motor function in sciatica and LSS patients. The pure reflex activation of paraspinal muscles was not affected in sciatica but a difference was found in the premotoneuronal response control. The impaired proprioceptive functions and premotoneuronal response control seem to recover at least partially but the maintenance of postural stability is a complex activity which does not seem to recover automatically in operated sciatica patients at least in three months follow-up. Paraspinal muscle denervation and dysfunction were clearly detectable in LSS but lumbar paraspinal muscle endurance was unexpectedly good.

  2. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function

    OpenAIRE

    Hindle, Kayla B.; Whitcomb, Tyler J.; Briggs, Wyatt O.; Hong, Junggi

    2012-01-01

    Proprioceptive neuromuscular facilitation (PNF) is common practice for increasing range of motion, though little research has been done to evaluate theories behind it. The purpose of this study was to review possible mechanisms, proposed theories, and physiological changes that occur due to proprioceptive neuromuscular facilitation techniques. Four theoretical mechanisms were identified: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory. The studies s...

  3. [Molecular mechanisms underlying the formation of neuromuscular junction].

    Science.gov (United States)

    Higuchi, Osamu; Yamanashi, Yuji

    2011-07-01

    The neuromuscular junction (NMJ) is a synapse between a motor neuron and skeletal muscle. The contraction of skeletal muscle is controlled by the neurotransmitter acetylcholine (ACh), which is released from the motor nerve terminal. To achieve efficient neuromuscular transmission, acetylcholine receptors (AChRs) must be densely clustered on the muscle membrane of the NMJ. Failure of AChR clustering is associated with disorders of neuromuscular transmission such as congenital myasthenic syndromes (CMS) and myasthenia gravis (MG). Motoneuronal agrin and muscle-specific receptor tyrosine kinase (MuSK) are known to play essential roles in the formation and maintenance of NMJs in the central region of each muscle. However, it had been unclear how agrin activates MuSK. Recent studies have elucidated the roles of several key molecules, including the cytoplasmic adaptor protein Dok-7 and LDL receptor-related protein 4 (Lrp4), in agrin-induced MuSK activation. Moreover, new evidence indicates that cyclin-dependent kinase 5 (Cdk5) regulates postsynaptic differentiation. In this review, we summarize the latest developments in molecular mechanisms underlying NMJ formation in vertebrates. PMID:21747134

  4. Neuromuscular control and rehabilitation of the unstable ankle

    Science.gov (United States)

    Hung, You-jou

    2015-01-01

    Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. However, there is no consensus on whether the neuromuscular control and proprioception are compromised in unstable ankles. To reduce the prevalence of ankle sprains, the effectiveness of engaging balance training to enhance the neuromuscular control and proprioception of the ankle joint is also questionable. PMID:26085985

  5. Neuromuscular Disorders

    Science.gov (United States)

    Neuromuscular disorders affect the nerves that control your voluntary muscles. Voluntary muscles are the ones you can ... function and your ability to breathe. Examples of neuromuscular disorders include Amyotrophic lateral sclerosis Multiple sclerosis Myasthenia ...

  6. Invasive home mechanical ventilation, mainly focused on neuromuscular disorders

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    Börger, Sandra

    2010-01-01

    Full Text Available Introduction and background: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborate and technology-dependent ventilation is carried out via an artificial airway (tracheal cannula to the trachea. Exact numbers about the incidence of home mechanical ventilation are not available. Patients with neuromuscular diseases represent a large portion of it. Research questions: Specific research questions are formulated and answered concerning the dimensions of medicine/nursing, economics, social, ethical and legal aspects. Beyond the technical aspect of the invasive home, mechanical ventilation, medical questions also deal with the patient’s symptoms and clinical signs as well as the frequency of complications. Economic questions pertain to the composition of costs and the differences to other ways of homecare concerning costs and quality of care. Questions regarding social aspects consider the health-related quality of life of patients and caregivers. Additionally, the ethical aspects connected to the decision of home mechanical ventilation are viewed. Finally, legal aspects of financing invasive home mechanical ventilation are discussed. Methods: Based on a systematic literature search in 2008 in a total of 31 relevant databases current literature is viewed and selected by means of fixed criteria. Randomized controlled studies, systematic reviews and HTA reports (health technology assessment, clinical studies with patient numbers above ten, health-economic evaluations, primary studies with particular cost analyses and quality-of-life studies related to the research questions are included in the analysis. Results and discussion: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia are rare. Mobile home ventilators are available for the implementation of the ventilation. Their technical performance however, differs regrettably. Studies comparing the economic aspects of ventilation in a hospital to outpatient ventilation, describe home ventilation as a more cost-effective alternative to in-patient care in an intensive care unit, however, more expensive in comparison to a noninvasive (via mask ventilation. Higher expenses arise due to the necessary equipment and the high expenditure of time for the partial 24-hour care of the affected patients through highly qualified personnel. However, none of the studies applies to the German provisionary conditions. The calculated costs strongly depend on national medical fees and wages of caregivers, which barely allows a transmission of the results. The results of quality-of-life studies are mostly qualitative. The patient’s quality of life using mechanical ventilation is predominantly considered well. Caregivers of ventilated patients report positive as well as negative ratings. Regarding the ethical questions, it was researched which aspects of ventilation implementation will have to be considered. From a legal point of view the financing of home ventilation, especially invasive mechanical ventilation, requiring specialised technical nursing is regulated in the code of social law (Sozialgesetzbuch V. The absorption of costs is distributed to different insurance carriers, who often, due to cost pressures within the health care system, insurance carriers, who consider others and not themselves as responsible. Therefore in practice, the necessity to enforce a claim of cost absorption often arises in order to exercise the basic right of free choice of location. Conclusion: Positive effects of the invasive mechanical ventilation (overall survival and symptomatic are highly probable based on the analysed literature, although with a low level of evidence. An establishment of a home ventilation registry and health care research to ascertain valid data to improve outpatient structures is necessary. Gathering specific G

  7. Nonlinear neuromuscular electrical stimulation tracking control of a human limb.

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    Sharma, Nitin; Stegath, Keith; Gregory, Chris M; Dixon, Warren E

    2009-12-01

    A high-level objective of neuromuscular electrical stimulation (NMES) is to enable a person to achieve some functional task. Towards this goal, the objective of the current effort is to develop a NMES controller to produce a knee position trajectory that will enable a human shank to track any continuous desired trajectory (or constant setpoint). A nonlinear control method is developed to control the human quadriceps femoris muscle undergoing nonisometric contractions. The developed controller does not require a muscle model and can be proven to yield asymptotic stability for a nonlinear muscle model in the presence of bounded nonlinear disturbances (e.g., spasticity, delays, fatigue). The performance of the controller is demonstrated through a series of closed-loop experiments on human subjects. The experiments illustrate the ability of the controller to enable the leg shank to track single and multiple period trajectories with different periods and ranges of motion, and also track desired step changes with changing loads. PMID:19497828

  8. Neuromuscular Exercise Post Partial Medial Meniscectomy : Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S

    2015-01-01

    PURPOSE: To evaluate the effects of a 12-week, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy within the past 3-12 months. METHODS: An assessor-blinded, randomised controlled trial including people aged 30-50 years with no to mild pain following medial arthroscopic partial meniscectomy was conducted. Participants were randomly allocated to either a 12-week neuromuscular exercise program that targeted neutral lower limb alignment or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal pace walking and during a one-leg sit-to-stand. Secondary outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hipmuscle strength, and physical function measures. RESULTS: 60 out of 62 randomized participants (97%) completed the trial. There were no significant between-group differences in the change in the peak knee adduction moment during normal pace walking (mean difference (95% CI), 0.22 (-0.11 to 0.55) Nm/BW×HT %, p=0.19), or during one-leg sit-to-stand (-0.01 (-0.33 to 0.31) Nm/BW×HT %, p = 0.95). There were also no significant between-group differences for any of the secondary outcomes. CONCLUSIONS: In patients 3-12 months following a medial arthroscopic partial meniscectomy, a neuromuscular exercise program did not alter the peak knee adduction moment, a key predictor of osteoarthritis structural disease progression. Australia and New Zealand Clinical Trials Registry (#ACTRN12612000542897).

  9. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

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    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster gait and reduced excessive hip compensation. The VR group's improvements, however, were not the result of lower extremity neuromuscular pattern changes. Lower-extremity MEE increases corresponded to attenuated forward trunk linear and angular movement in the VR group, suggesting better control of upper body motion to minimize loss of balance. These data support a growing body of evidence that Tai Chi may be a valuable complementary treatment for vestibular disorders.

  10. Mechanisms Regulating Neuromuscular Junction Development and Function and Causes of Muscle Wasting.

    Science.gov (United States)

    Tintignac, Lionel A; Brenner, Hans-Rudolf; Rüegg, Markus A

    2015-07-01

    The neuromuscular junction is the chemical synapse between motor neurons and skeletal muscle fibers. It is designed to reliably convert the action potential from the presynaptic motor neuron into the contraction of the postsynaptic muscle fiber. Diseases that affect the neuromuscular junction may cause failure of this conversion and result in loss of ambulation and respiration. The loss of motor input also causes muscle wasting as muscle mass is constantly adapted to contractile needs by the balancing of protein synthesis and protein degradation. Finally, neuromuscular activity and muscle mass have a major impact on metabolic properties of the organisms. This review discusses the mechanisms involved in the development and maintenance of the neuromuscular junction, the consequences of and the mechanisms involved in its dysfunction, and its role in maintaining muscle mass during aging. As life expectancy is increasing, loss of muscle mass during aging, called sarcopenia, has emerged as a field of high medical need. Interestingly, aging is also accompanied by structural changes at the neuromuscular junction, suggesting that the mechanisms involved in neuromuscular junction maintenance might be disturbed during aging. In addition, there is now evidence that behavioral paradigms and signaling pathways that are involved in longevity also affect neuromuscular junction stability and sarcopenia. PMID:26109340

  11. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

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    João Fernando Lourenço de Almeida

    2000-06-01

    Full Text Available Neuromuscular blocking agents (NMBAs have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000 and active search of articles were the mechanisms used in this review.Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisar a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000 associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão.

  12. Neuromuscular blockade in children / Bloqueadores neuromusculares em crianças

    Scientific Electronic Library Online (English)

    João Fernando Lourenço de, Almeida; W. Jorge, Kalil Filho; Eduardo J., Troster.

    2000-06-01

    Full Text Available Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisa [...] r a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000) associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão. Abstract in english Neuromuscular blocking agents (NMBAs) have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to com [...] pare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000) and active search of articles were the mechanisms used in this review.

  13. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players

    DEFF Research Database (Denmark)

    Zebis, Mette K; Bencke, Jesper

    2008-01-01

    OBJECTIVE: The project aimed to implement neuromuscular training during a full soccer and handball league season and to experimentally analyze the neuromuscular adaptation mechanisms elicited by this training during a standardized sidecutting maneuver known to be associated with non-contact anterior cruciate ligament (ACL) injury. DESIGN: The players were tested before and after 1 season without implementation of the prophylactic training and subsequently before and after a full season with the implementation of prophylactic training. PARTICIPANTS: A total of 12 female elite soccer players and 8 female elite team handball players aged 26 +/- 3 years at the start of the study. INTERVENTION: The subjects participated in a specific neuromuscular training program previously shown to reduce non-contact ACL injury. METHODS: Neuromuscular activity at the knee joint, joint angles at the hip and knee, and ground reaction forces were recorded during a sidecutting maneuver. Neuromuscular activity in the prelanding phase was obtained 10 and 50 ms before foot strike on a force plate and at 10 and 50 ms after foot strike on a force plate. RESULTS: Neuromuscular training markedly increased before activity and landing activity electromyography (EMG) of the semitendinosus (P < 0.05), while quadriceps EMG activity remained unchanged. CONCLUSIONS: Neuromuscular training increased EMG activity for the medial hamstring muscles, thereby decreasing the risk of dynamic valgus. This observed neuromuscular adaptation during sidecutting could potentially reduce the risk for non-contact ACL injury.

  14. Aging and limb alter the neuromuscular control of goal-directed movements.

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    Kwon, MinHyuk; Chen, Yen-Ting; Fox, Emily J; Christou, Evangelos A

    2014-06-01

    The purpose of this study was to determine whether the neuromuscular control of goal-directed movements is different for young and older adults with the upper and lower limbs. Twenty young (25.1 ± 3.9 years) and twenty older adults (71.5 ± 4.8 years) attempted to accurately match the displacement of their limb to a spatiotemporal target during ankle dorsiflexion or elbow flexion movements. We quantified neuromuscular control by examining the movement endpoint accuracy and variability, and the antagonistic muscle activity using surface electromyography (EMG). Our results indicate that older adults exhibit impaired endpoint accuracy with both limbs due to greater time variability. In addition, older adults exhibit greater EMG burst and lower EMG burst variability as well as lower coactivation of the antagonistic muscles. The impaired accuracy of older adults during upper limb movements was related to lower coactivation of the antagonistic muscles, whereas their impaired accuracy during lower limb movements was related to the amplified EMG bursts. The upper limb exhibited greater movement control than the lower limb, and different neuromuscular parameters were related to the accuracy and consistency for each limb. Greater endpoint error during upper limb movements was related to lower coactivation of the antagonistic muscles, whereas greater endpoint error during lower limb movements was related to the amplified EMG bursts. These findings indicate that the age-associated impairments in movement control are associated with altered activation of the involved antagonistic muscles. In addition, independent of age, the neuromuscular control of goal-directed movements is different for the upper and lower limbs. PMID:24557320

  15. Doenças neuromusculares / Neuromuscular disorders

    Scientific Electronic Library Online (English)

    Umbertina C., Reed.

    2002-08-01

    Full Text Available Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mi [...] oneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de hipotonia muscular secundária ao comprometimento do sistema nervoso central ou a doenças sistêmicas não-neurológicas, são enfatizados, com base na experiência clínica vinda do atendimento a crianças com doenças neuromusculares durante os últimos 12 anos, no ambulatório de doenças neuromusculares do Hospital das Clínicas da Faculdade de Medicina, da Universidade de São Paulo. A revisão bibliográfica foi efetuada através do Medline e do periódico Neuromuscular Disorders, publicação oficial da World Muscle Society. Síntese dos dados: nas crianças, a maior parte destas afecções é geneticamente determinada, sendo as mais comuns a distrofia muscular progressiva ligada ao sexo, de Duchenne, a amiotrofia espinal infantil, a distrofia muscular congênita, a distrofia miotônica de Steinert, e as miopatias congênitas, estruturais e não estruturais. Polineuropatias hereditárias, síndrome miastênica congênita e miopatias metabólicas são menos comuns, porém mostram correlação geno-fenotípica cada vez mais precisa. Conclusões: na década passada, inúmeros avanços da genética molecular facilitaram imensamente o diagnóstico e o aconselhamento genético das doenças neuromusculares mais comuns das crianças, inclusive possibilitando diagnóstico fetal e, adicionalmente, vieram permitir melhor caracterização fenotípica e classificação mais objetiva. Abstract in english Objective: to discuss the most important aspects for performing a differential diagnosis among the main neuromuscular disorders in children, that include the diseases affecting the motor unity, i.e. spinal motor neurons, peripheral nerves, neuromuscular junction and muscular fibers. Sources: the rev [...] iew of the clinical aspects that should be considered for a prompt differential diagnosis among several neuromuscular disorders as well as between those and the main causes of secondary muscular hypotonia due to central nervous system or systemic disturbances is based on the clinical experience acquired along the last 12 years in following-up children with Neuromuscular Disorders attended at the outpatient Service of Neuromuscular Disorders at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. In addition, it is based on Medline and on the review of the most recent numbers of Neuromuscular Disorders, the official journal of the World Muscle Society. Summary of the findings: most of neuromuscular disorders are genetic conditions in children and the most common of them are X-linked Progressive Muscular Dystrophy of Duchenne, Spinal Muscular Atrophy, Congenital Muscular Dystrophy, Myotonic Dystrophy and Congenital Myopathies. Conclusions: due to the phenomenal development in human molecular genetics the pathogenesis of several neuromuscular disorders in children has been clarified over the last decade. Nowadays many new diagnostic methods, including techniques of fetal diagnosis, and a more objective genotype-phenotype correlation as well as classification are available.

  16. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty : a randomised controlled trial

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, SØren

    2014-01-01

    OBJECTIVE: To investigate the postoperative efficacy of a supervised programme of neuromuscular exercise prior to hip or knee arthroplasty. METHODS: In this assessor-blinded randomised controlled trial, we included 165 patients scheduled for hip or knee arthroplasty due to severe osteoarthritis (OA). An 8-week preoperative neuromuscular supervised exercise programme was delivered twice a week for 1 h as adjunct treatment to the standard arthroplasty procedure and compared with the standard arthroplasty procedure alone. The primary outcome was self-reported physical function measured on the activities of daily living (ADL) subscale in the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires for patients with hip and knee OA, respectively. Primary endpoint was 3 months after surgery. RESULTS: 165 patients randomised to the two groups were on average 67±8 years, 84 (51%) had hip OA and 92 (56%) were women. 153 patients (93%) underwentplanned surgery and were evaluated postoperatively. There was no statistically significant difference in effects between hip or knee patients (p=0.7370). Three months postoperatively, no difference was found between groups for ADL (4.4, 95% CI -0.8 to 9.5) or pain (4.5, 95% CI -0.8 to 9.9). However, there was a statistically significant difference indicating an effect of exercise over the entire period (baseline to 3-months postoperatively) (p=0.0029). CONCLUSIONS: Eight weeks of supervised neuromuscular exercise prior to total joint arthroplasty (TJA) of the hip or knee did not confer additional benefits 3 months postoperatively compared with TJA alone. However, the intervention group experienced a statistically significant short-term benefit in ADL and pain, suggesting an earlier onset of postoperative recovery. TRIAL REGISTRATION: ClinicalTrials NCT01003756.

  17. Effects of footwear comfort perception on the neuromuscular control of balance.

    Science.gov (United States)

    Burke, Jeanmarie R

    2012-04-01

    The purpose of this research was to determine the effects of footwear comfort perception on the gain of the gastrocnemius H-reflex response during single leg balance tasks. Subjects performed single leg balance tasks while wearing aerobic sneakers with two different pairs of shoe insoles that were subjectively rated for comfort using a reliable 150 mm visual analog scale. The primary outcome was the consistency of decreasing the gain of the gastrocnemius H-reflex with increasing balance task complexity as a function of footwear comfort perception. Among the asymptomatic subjects (n = 11), H-reflex gain significantly decreased by 19% and 10% from balancing on a stable surface to an unstable surface for the shoe-brand and replacement insoles, respectively (p perception may negatively impact the attenuation of gastrocnemius H-reflex gain that contributes to the neuromuscular control of challenging balance tasks. PMID:22117882

  18. [Neuromuscular choristoma].

    Science.gov (United States)

    Vajtai, I; Varga, Z; Hackel, J

    1999-08-01

    Neuromuscular choristomas are malformative pseudotumoral masses composed of striated muscle and peripheral nerves. This rare condition almost exclusively affects large nerve trunks of infants and young children, and may cause neurologic deficits of variable severity. We report a case of neuromuscular choristoma identified in the lumbosacral lipoma of a 4-month-old boy. The lesion was characterized by an organoid association of myogenic and neurogenic elements reminiscent of neuromuscular units. Myosin immunophenotyping revealed disordered groups of type-I and type-II extrafusal myofibers. There was no immunoreactivity for smooth muscle specific alpha actin. Most participating axons were of the large myelinated type. Pathogenetic theories of neuromuscular choristoma involve aberrant migration of developing peripheral nerves, dysgenesis of muscle spindles, as well as mesenchymal differentiation of the primitive neuroectoderm. Neuromuscular choristomas arising in connection with congenital lipomas may derive from a dysembryogenic process of stem cells of the caudal neural tube. PMID:10463034

  19. Center of mass acceleration feedback control for standing by functional neuromuscular stimulation: A simulation study

    Directory of Open Access Journals (Sweden)

    Raviraj Nataraj

    2012-04-01

    Full Text Available The potential efficacy of total body center of mass (COM acceleration for feedback control of standing balance by functional neuromuscular stimulation (FNS following spinal cord injury (SCI was investigated. COM acceleration may be a viable alternative to conventional joint kinematics because of its rapid responsiveness, focal representation of COM dynamics, and ease of measurement. A computational procedure was developed using an anatomically realistic, three-dimensional, bipedal biomechanical model to determine optimal patterns of muscle excitations to produce targeted effects upon COM acceleration from erect stance. The procedure was verified with electromyographic data collected from standing nondisabled subjects undergoing systematic perturbations. Using 16 muscle groups targeted by existing implantable neuroprostheses, we generated data to train an artificial neural network (ANN-based controller in simulation. During forward simulations, proportional feedback of COM acceleration drove the ANN to produce muscle excitation patterns countering the effects of applied perturbations. Feedback gains were optimized to minimize upper-limb (UL loading required to stabilize against disturbances. Compared with the clinical case of maximum constant excitation, the controller reduced UL loading by 43% in resisting external perturbations and by 51% during simulated one-arm reaching. Future work includes performance assessment against expected measurement errors and development of user-specific control systems.

  20. Rapid and reversible responses to IVIG in autoimmune neuromuscular diseases suggest mechanisms of action involving competition with functionally important autoantibodies.

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    Berger, Melvin; McCallus, Daniel E; Lin, Cindy Shin-Yi

    2013-12-01

    Intravenous immunoglobulin (IVIG) is widely used in autoimmune neuromuscular diseases whose pathogenesis is undefined. Many different effects of IVIG have been demonstrated in vitro, but few studies actually identify the mechanism(s) most important in vivo. Doses and treatment intervals are generally chosen empirically. Recent studies in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy show that some effects of IVIG are readily reversible and highly dependent on the serum IgG level. This suggests that in some autoantibody-mediated neuromuscular diseases, IVIG directly competes with autoantibodies that reversibly interfere with nerve conduction. Mechanisms of action of IVIG which most likely involve direct competition with autoantibodies include: neutralization of autoantibodies by anti-idiotypes, inhibition of complement deposition, and increasing catabolism of pathologic antibodies by saturating FcRn. Indirect immunomodulatory effects are not as likely to involve competition and may not have the same reversibility and dose-dependency. Pharmacodynamic analyses should be informative regarding most relevant mechanism(s) of action of IVIG as well as the role of autoantibodies in the immunopathogenesis of each disease. Better understanding of the role of autoantibodies and of the target(s) of IVIG could lead to more efficient use of this therapy and better patient outcomes. PMID:24200120

  1. Mechanisms of exercise limitation and pulmonary rehabilitation for patients with neuromuscular disease.

    Science.gov (United States)

    Aboussouan, L S

    2009-01-01

    Indications for exercise and pulmonary rehabilitation extend to neuromuscular diseases tough these conditions pose particular challenges given the associated skeletal muscle impairment and respiratory muscle dysfunction. These challenges are compounded by the variety of exercise prescriptions (aerobic, muscle strengthening, and respiratory muscle training) and the variety of neuromuscular disorders (muscular, motor neuron, motor nerve root, and neuromuscular transmission disorders). Studies support a level II evidence of effectiveness (i.e., likely to be effective) for a combination of aerobic exercise and strengthening exercises in muscular disorders, and for strengthening exercises in amyotrophic lateral sclerosis. The potential deleterious effects of work overload in the dystrophinopathies have not been confirmed in Becker muscular dystrophy. Adjunctive pharmacologic interventions (e.g., theophylline, steroids, PDE5 inhibitors, creatine), training recommendations (e.g., interval or lower intensity training) and supportive techniques (e.g., noninvasive ventilation, neuromuscular electrical stimulation, and diaphragm pacing) may result in more effective training but require more study before formal recommendations can be made. The exercise prescription should include avoidance of inspiratory muscle training in hypercapnia or low vital capacity, and should match the desired outcome (e.g., extremity training for task-specific performance, exercise training to enhance exercise performance, respiratory muscle training where respiratory muscle involvement contributes to the impairment). PMID:19858353

  2. EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients

    Science.gov (United States)

    Tan, Hock Guan; Shee, Cheng Yap; Kong, Keng He; Guan, Cuntai; Ang, Wei Tech

    2011-03-01

    This paper describes the Brain Computer Interface (BCI) system and the experiments to allow post-acute (neuromuscular electrical stimulation (NMES)-assisted extension of the wrist/fingers, which are essential pre-requisites for useful hand function. EEG was recorded while subjects performed motor imagery of their paretic limb, and then analyzed to determine the optimal frequency range within the mu-rhythm, with the greatest attenuation. Aided by visual feedback, subjects then trained to regulate their mu-rhythm EEG to operate the BCI to trigger NMES of the wrist/finger. 6 post-acute stroke patients successfully completed the training, with 4 able to learn to control and use the BCI to initiate NMES. This result is consistent with the reported BCI literacy rate of healthy subjects. Thereafter, without the loss of generality, the controller of the NMES is developed and is based on a model of the upper limb muscle (biceps/triceps) groups to determine the intensity of NMES required to flex or extend the forearm by a specific angle. The muscle model is based on a phenomenological approach, with parameters that are easily measured and conveniently implemented.

  3. Estimulação elétrica neuromuscular e o alongamento passivo manual na recuperação das propriedades mecânicas do músculo gastrocnêmio imobilizado Neuromuscular electric stimulation and manual passive stretching when recovering mechanical properties of immobilized gastrocnemius muscles

    OpenAIRE

    Leonardo César Carvalho; Antonio Carlos Shimano; Celso Hermínio Ferraz Picado

    2008-01-01

    Avaliamos a influência da imobilização, remobilização livre, remobilização com alongamento passivo manual, remobilização com estimulação elétrica neuromuscular (NMES) e remobilização por NMES e alongamento passivo manual associados sobre algumas propriedades mecânicas do músculo gastrocnêmio de ratas. Foram avaliadas 60 ratas divididas em seis grupos.Um destes grupos foi usado como controle. Todos os outros grupos tiveram o membro posterior direito imobilizado por 14 dias con...

  4. The Effects of Plyometric Type Neuromuscular Training on Postural Control Performance of Male Team Basketball Players.

    Science.gov (United States)

    Asadi, Abbas; Saez de Villarreal, Eduardo; Arazi, Hamid

    2015-07-01

    Asadi, A, Saez de Villarreal, E, and Arazi, H. The effects of plyometric type neuromuscular training on postural control performance of male team basketball players. J Strength Cond Res 29(7): 1870-1875, 2015-Anterior cruciate ligament injuries are common in basketball athletes; common preventive programs for decreasing these injures may be enhancing postural control (PC) or balance with plyometric training. This study investigated the efficiency of plyometric training program within basketball practice to improve PC performance in young basketball players. Sixteen players were recruited and assigned either to a plyometric + basketball training group (PT) or basketball training group (BT). All players trained twice per week, but the PT + BT followed a 6-week plyometric program implemented within basketball practice, whereas the BT followed regular practice. The star excursion balance test (SEBT) at 8 directions (anterior, A; anteromedial, AM; anterolateral, AL; medial, M; lateral, L; posterior, P; posteromedial, PM; and posterolateral, PL) was measured before and after the 6-week period. The PT group induced significant improvement (p ? 0.05) and small to moderate effect size in the SEBT (A = 0.95, AM = 0.62, AL = 0.61, M = 0.36, L = 0.47, P = 0.27, PM = 0.25, PL = 0.24). No significant improvements were found in the BT group. Also, there were significant differences between groups in all directions except PM and PL. An integrated plyometric program within the regular basketball practice can lead to significant improvements in SEBT and consequently PC. It can be recommended that strength and conditioning professionals use PT to enhance the athletes' joint awareness and PC to reduce possible future injuries in the lower extremity. PMID:25563677

  5. Neuromuscular choristoma.

    Science.gov (United States)

    Mitchell, A; Scheithauer, B W; Ostertag, H; Sepehrnia, A; Sav, A

    1995-04-01

    Neuromuscular choristomas are rare, with only 13 cases having been previously reported. They usually arise in association with large nerves, and most often occur in the first decade of life. A few have been congenital. Although resection is typically curative, in two instances partial resection alone appears to have been followed by spontaneous regression. The authors report an unusual example of an otherwise classic neuromuscular choristoma where the lesion appeared to grow after incomplete initial resection. Re-excision disclosed a fibromatosis unassociated with choristoma. Despite its wide excision, a recurrence of the fibromatosis required a forequarter amputation. Theories of histogenesis and the clinicopathologic features of the neuromuscular choristomas reported to date are reviewed. The term "benign Triton tumor," although incorrectly applied to this lesion, should be reserved for benign, true nerve sheath neoplasms exhibiting myogenic differentiation. PMID:7726144

  6. Efeitos da estimulação elétrica neuromuscular durante a imobilização nas propriedades mecânicas do músculo esquelético / Effects of neuromuscular electric stimulation during immobilization in the mechanical properties of the skeletal muscle / Efectos de la estimulación eléctrica neuromuscular durante la inmovilización en las propiedades mecánicas del músculo esquelético

    Scientific Electronic Library Online (English)

    João Paulo Chieregato, Matheus; Liana Barbaresco, Gomide; Juliana Goulart Prata de, Oliveira; José Batista, Volpon; Antônio Carlos, Shimano.

    2007-02-01

    Full Text Available A estimulação elétrica neuromuscular (EENM) é um importante recurso utilizado em medicina esportiva para acelerar processos de recuperação. O objetivo deste estudo foi analisar os efeitos da EENM durante a imobilização do músculo gastrocnêmio, em posições de alongamento (LP) e encurtamento (SP). Par [...] a tanto, 60 ratas fêmeas jovens Wistar foram distribuídas em seis grupos e acompanhadas durante sete dias: controle (C), eletroestimuladas (EE), imobilizadas em encurtamento (ISP), imobilizadas em alongamento (ILP), imobilizadas em encurtamento e eletroestimuladas (ISP + EE) e imobilizadas em alongamento e eletroestimuladas (ILP + EE). Para a imobilização, o membro posterior direito foi envolvido por uma malha tubular e ataduras de algodão juntamente à atadura gessada. A EENM foi utilizada com freqüência de 50Hz, 10 minutos por dia, totalizando 20 contrações em cada sessão. Após sete dias os animais foram submetidos a eutanásia e os músculos gastrocnêmios retirados para a realização do ensaio mecânico de tração em uma máquina universal de ensaios (EMIC®). A partir dos gráficos carga versus alongamento, foram calculadas as seguintes propriedades mecânicas: alongamento no limite de proporcionalidade (ALP), carga no limite de proporcionalidade (CLP) e rigidez. As imobilizações SP e LP promoveram reduções significativas (p Abstract in spanish La estimulación eléctrica neuromuscular (EENM) es un importante recurso utilizado en medicina deportiva para acelerar procesos de recuperación. El objetivo de este estudio ha sido analizar los efectos de la EENM durante la inmovilización del músculo gastrocnemio, en posiciones de alongamiento (LP) y [...] contracción (SP). Para tal fin, 60 ratones hembras jóvenes Wistar fueron distribuidas en seis grupos y monitoreadas durante 7 días: control (C), electro estimuladas (EE), inmovilizadas en contracción (ISP), inmovilizadas en alongamiento (ILP), inmovilizadas en contracción y electro estimuladas (ISP + EE) e inmovilizadas en alongamiento y electro estimuladas (ILP + EE). Para la inmovilización, el miembro posterior derecho fue envuelto por una malla tubular y vendas de algodón en conjunto con vendas de escayola. La EENM fue utilizada con una frecuencia de 50 Hz, 10 minutos por día, totalizando 20 contracciones en cada sesión. Después de 7 días los animales fueron sometidos a eutanasia y los músculos gastrocnemios fueron retirados para la realización del ensayo mecánico de tracción en una máquina universal de ensayos (EMIC®). A partir de los gráficos carga versus alongamiento se calculó las siguientes propiedades mecánicas: alongamiento en el límite de proporcionalidad (ALP), carga en el límite de proporcionalidad (CLP) y rigidez. Las inmovilizaciones SP y LP dieron reducciones significativas (p Abstract in english The neuromuscular electric stimulation (NMES) is an important tool used in sports medicine to accelerate the recovery process. The objective of this study was to analyze the effects of NMES during immobilization of the gastrocnemius muscle, in lengthened (LP) and shortened positions (SP). Sixty youn [...] g female Wistar rats were distributed into six groups and followed for 7 days: control (C); electric stimulation (ES); immobilized in shortening (ISP); immobilized in lengthening (ILP); immobilized in shortening and electric stimulation (ISP + ES) and immobilized in lengthening and electric stimulation (ILP + ES). For the immobilization, a tubular mesh and cotton rolls together with the plaster were wrapped around the rat's right posterior paw. NMES in a frequency of 50 Hz was used 10 minutes a day, totaling 20 contractions in each session. After 7 days the animals were sacrificed and their gastrocnemius muscles of the right paw were submitted to a mechanical test of traction in a universal test machine (EMIC®). From the load versus elongation curves the following mechanical properties were obtained: elongation in the yield limit (EPL), load in the yield limit (LPL) and stiffness. The SP a

  7. Efeitos da estimulação elétrica neuromuscular durante a imobilização nas propriedades mecânicas do músculo esquelético Efectos de la estimulación eléctrica neuromuscular durante la inmovilización en las propiedades mecánicas del músculo esquelético Effects of neuromuscular electric stimulation during immobilization in the mechanical properties of the skeletal muscle

    Directory of Open Access Journals (Sweden)

    João Paulo Chieregato Matheus

    2007-02-01

    Full Text Available A estimulação elétrica neuromuscular (EENM é um importante recurso utilizado em medicina esportiva para acelerar processos de recuperação. O objetivo deste estudo foi analisar os efeitos da EENM durante a imobilização do músculo gastrocnêmio, em posições de alongamento (LP e encurtamento (SP. Para tanto, 60 ratas fêmeas jovens Wistar foram distribuídas em seis grupos e acompanhadas durante sete dias: controle (C, eletroestimuladas (EE, imobilizadas em encurtamento (ISP, imobilizadas em alongamento (ILP, imobilizadas em encurtamento e eletroestimuladas (ISP + EE e imobilizadas em alongamento e eletroestimuladas (ILP + EE. Para a imobilização, o membro posterior direito foi envolvido por uma malha tubular e ataduras de algodão juntamente à atadura gessada. A EENM foi utilizada com freqüência de 50Hz, 10 minutos por dia, totalizando 20 contrações em cada sessão. Após sete dias os animais foram submetidos a eutanásia e os músculos gastrocnêmios retirados para a realização do ensaio mecânico de tração em uma máquina universal de ensaios (EMIC®. A partir dos gráficos carga versus alongamento, foram calculadas as seguintes propriedades mecânicas: alongamento no limite de proporcionalidade (ALP, carga no limite de proporcionalidade (CLP e rigidez. As imobilizações SP e LP promoveram reduções significativas (p La estimulación eléctrica neuromuscular (EENM es un importante recurso utilizado en medicina deportiva para acelerar procesos de recuperación. El objetivo de este estudio ha sido analizar los efectos de la EENM durante la inmovilización del músculo gastrocnemio, en posiciones de alongamiento (LP y contracción (SP. Para tal fin, 60 ratones hembras jóvenes Wistar fueron distribuidas en seis grupos y monitoreadas durante 7 días: control (C, electro estimuladas (EE, inmovilizadas en contracción (ISP, inmovilizadas en alongamiento (ILP, inmovilizadas en contracción y electro estimuladas (ISP + EE e inmovilizadas en alongamiento y electro estimuladas (ILP + EE. Para la inmovilización, el miembro posterior derecho fue envuelto por una malla tubular y vendas de algodón en conjunto con vendas de escayola. La EENM fue utilizada con una frecuencia de 50 Hz, 10 minutos por día, totalizando 20 contracciones en cada sesión. Después de 7 días los animales fueron sometidos a eutanasia y los músculos gastrocnemios fueron retirados para la realización del ensayo mecánico de tracción en una máquina universal de ensayos (EMIC®. A partir de los gráficos carga versus alongamiento se calculó las siguientes propiedades mecánicas: alongamiento en el límite de proporcionalidad (ALP, carga en el límite de proporcionalidad (CLP y rigidez. Las inmovilizaciones SP y LP dieron reducciones significativas (p The neuromuscular electric stimulation (NMES is an important tool used in sports medicine to accelerate the recovery process. The objective of this study was to analyze the effects of NMES during immobilization of the gastrocnemius muscle, in lengthened (LP and shortened positions (SP. Sixty young female Wistar rats were distributed into six groups and followed for 7 days: control (C; electric stimulation (ES; immobilized in shortening (ISP; immobilized in lengthening (ILP; immobilized in shortening and electric stimulation (ISP + ES and immobilized in lengthening and electric stimulation (ILP + ES. For the immobilization, a tubular mesh and cotton rolls together with the plaster were wrapped around the rat's right posterior paw. NMES in a frequency of 50 Hz was used 10 minutes a day, totaling 20 contractions in each session. After 7 days the animals were sacrificed and their gastrocnemius muscles of the right paw were submitted to a mechanical test of traction in a universal test machine (EMIC®. From the load versus elongation curves the following mechanical properties were obtained: elongation in the yield limit (EPL, load in the yield limit (LPL and stiffness. The SP and LP immobilizations promoted significant reductions (p < 0.05 in the EPL and LPL properties, b

  8. Load Dependency of Postural Control - Kinematic and Neuromuscular Changes in Response to over and under Load Conditions

    Science.gov (United States)

    Ritzmann, Ramona; Freyler, Kathrin; Weltin, Elmar; Krause, Anne; Gollhofer, Albert

    2015-01-01

    Introduction Load variation is associated with changes in joint torque and compensatory reflex activation and thus, has a considerable impact on balance control. Previous studies dealing with over (OL) and under loading (UL) used water buoyancy or additional weight with the side effects of increased friction and inertia, resulting in substantially modified test paradigms. The purpose of this study was to identify gravity-induced load dependency of postural control in comparable experimental conditions and to determine the underlying neuromuscular mechanisms. Methods Balance performance was recorded under normal loading (NL, 1g), UL (0.16g; 0.38g) and OL (1.8g) in monopedal stance. Center of pressure (COP) displacement and frequency distribution (low 0.15-0.5Hz (LF), medium 0.5-2Hz (MF), high 2-6Hz (HF)) as well as ankle, knee and hip joint kinematics were assessed. Soleus spinal excitability was determined by H/M-recruitment curves (H/M-ratios). Results Compared to NL, OL caused an increase in ankle joint excursion, COP HF domain and H/M-ratio. Concomitantly, hip joint excursion and COP LF decreased. Compared to NL, UL caused modulations in the opposite direction: UL decreased ankle joint excursions, COP HF and H/M-ratio. Collaterally, hip joint excursion and COP LF increased. COP was augmented both in UL and in OL compared to NL. Conclusion Subjects achieved postural stability in OL and UL with greater difficulty compared to NL. Reduced postural control was accompanied by modified balance strategies and compensatory reflex activation. With increasing load, a shift from hip to ankle strategy was observed. Accompanying, COP frequency distribution shifted from LF to HF and spinal excitability was enhanced. It is suggested that in OL, augmented ankle joint torques are compensated by quick reflex-induced postural reactions in distal muscles. Contrarily, UL is associated with diminished joint torques and thus, postural equilibrium may be controlled by the proximal segments to adjust the center of gravity above the base of support. PMID:26053055

  9. Ankles back in randomized controlled trial (ABrCt: braces versus neuromuscular exercises for the secondary prevention of ankle sprains. Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Verhagen Evert ALM

    2011-09-01

    Full Text Available Abstract Background Ankle sprains are the most common sports and physical activity related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. In up to 50% of all cases recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore ankle sprain recurrence prevention in athletes is essential. This RCT evaluates the effect of the combined use of braces and neuromuscular training (e.g. proprioceptive training/sensorimotor training/balance training against the individual use of either braces or neuromuscular training alone on ankle sprain recurrences, when applied to individual athletes after usual care. Methods/Design This study was designed as three way randomized controlled trial with one year follow-up. Healthy individuals between 12 and 70 years of age, who were actively participating in sports and who had sustained a lateral ankle sprain in the two months prior to inclusion, were eligible for inclusion. After subjects had finished ankle sprain treatment by means of usual care, they were randomised to any of the three study groups. Subjects in group 1 received an eight week neuromuscular training program, subjects in group 2 received a sports brace to be worn during all sports activities for the duration of one year, and group 3 received a combination of the neuromuscular training program and a sports brace to be worn during all sports activities for the duration of eight weeks. Outcomes were assessed at baseline and every month for 12 months therafter. The primary outcome measure was incidence of ankle sprain recurrences. Secondary outcome measures included the direct and indirect costs of recurrent injury, the severity of recurrent injury, and the residual complaints during and after the intervention. Discussion The ABrCt is the first randomized controlled trial to directly compare the secondary preventive effect of the combined use of braces and neuromuscular training, against the use of either braces or neuromuscular training as separate secondary preventive measures. This study expects to identify the most effective and cost-efficient secondary preventive measure for ankle sprains. The study results could lead to changes in the clinical guidelines on the prevention of ankle sprains, and they will become available in 2012. Trial registration Netherlands Trial Register (NTR: NTR2157

  10. Influência da procainamida sobre o bloqueio neuromuscular produzido pelo rocurônio e investigação sobre o mecanismo de ação da procainamida na junção neuromuscular Influencia de la procainamida sobre el bloqueo neuromuscular producido por el rocuronio e investigación sobre el mecanismo de acción de la procainamida en la junción neuromuscular Influence of procainamide on the neuromuscular blockade caused by rocuronium and investigation on the mechanism of action of procainamide on the neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Thalita Duque Martins

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A potencialização da procainamida sobre o bloqueio neuromuscular produzido pela d-tubocurarina já está comprovada, porém o mecanismo é controverso. O objetivo do estudo foi avaliar a influência da procainamida no bloqueio neuromuscular produzido pelo rocurônio e investigar os mecanismos desta interação. MÉTODO: Foram utilizados 15 ratos (250 a 300 g em preparação descrita por Bülbring. Formaram-se os seguintes grupos (n = 5 cada: procainamida - 20 µg.mL-1 (Grupo I; rocurônio - 4 µg.mL-1 (Grupo II e rocurônio - 4 µg.mL-1 e procainamida - 20 µg.mL-1 (Grupo III. Avaliaram-se: 1 a amplitude das contrações musculares sob estimulação indireta em cada grupo, antes e após a adição dos fármacos; 2 os potenciais de placa terminal em miniatura (PPTM; 3 a eficácia da 4-aminopiridina na reversão do bloqueio neuromuscular. O mecanismo da interação foi estudado em Biventer cervicis (n = 5 e diafragma de rato desnervado (n = 5, observando-se a influência da procainamida na resposta à acetilcolina antes e após a adição da procainamida. RESULTADOS: A procainamida isoladamente não alterou as respostas neuromusculares. O bloqueio produzido com o Grupo III foi de 68,6% ± 7,1%, com diferença significativa (p = 0,0067 em relação ao Grupo II (10,4% ± 4,5%, revertido pela 4-aminopiridina. A procainamida ocasionou aumento na freqüência dos PPTM, seguido de bloqueio revertido pela 4-aminopiridina. Em Biventer cervicis a procainamida aumentou a resposta à ação de contração da acetilcolina, resultado não observado com o diafragma desnervado. CONCLUSÕES: A procainamida potencializou o bloqueio produzido pelo rocurônio. As alterações observadas com PPTM e Biventer cervicis identificaram ação pré-sináptica. O antagonismo da 4-aminopiridina sobre o bloqueio dos PPTM sugeriu dessensibilização dos receptores pela procainamida.JUSTIFICATIVA Y OBJETIVOS: La potenciación de la procainamida sobre el bloqueo neuromuscular producido por la d-tubocurarina ya está comprobada, pero sin embargo el mecanismo es controvertido. El objetivo del estudio fue el de evaluar la influencia de la procainamida en el bloqueo neuromuscular producido por el rocuronio e investigar los mecanismos de esa interacción. MÉTODO: Se utilizaron 15 ratones (250 a 300 g en preparación descrita por Bülbring. Se formaron los siguientes grupos (n = 5 cada: procainamida - 20 µg.mL-1 (Grupo I; rocuronio - 4 µg.mL-1 (Grupo II y rocuronio - 4µg.mL-1 y procainamida - 20µg.mL-1 (Grupo III. Se evaluó: 1 la amplitud de las contracciones musculares bajo la estimulación indirecta en cada grupo, antes y después de la adición de los fármacos; 2 los potenciales de placa terminal en miniatura (PPTM; 3 la eficacia de la 4-aminopiridina en la reversión del bloqueo neuromuscular. El mecanismo de la interacción se estudió en Biventer cervicis (n = 5 y diafragma de ratón desnervado (n = 5, observándose la influencia de la procainamida en la respuesta a la acetilcolina antes y después de la adición de la procainamida. RESULTADOS: De forma aislada, la procainamida no alteró las respuestas neuromusculares. El bloqueo producido con el Grupo III fue de 68,6% ± 7,1%, con una diferencia significativa (p = 0,0067 con relación al Grupo II (10,4% ± 4,5%, revertido por la 4-aminopiridina. La procainamida ocasionó un aumento en la frecuencia de los PPTM, seguido de bloqueo revertido por la 4-aminopiridina. En Biventer cervicis, la procainamida aumentó la respuesta a la acción de contracción de la acetilcolina, resultado no observado con el diafragma desnervado. CONCLUSIONES: La procainamida potenció el bloqueo producido por el rocuronio. Las alteraciones observadas con PPTM y Biventer cervicis identificaron una acción presináptica. El antagonismo de la 4-aminopiridina sobre el bloqueo de los PPTMs sugirió la desensibilización de los receptores por la procainamida.BACKGROUND AND OBJECTIVES: It has already been proved that

  11. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    Scientific Electronic Library Online (English)

    Guilherme P. T., Areas; Audrey, Borghi-Silva; Arianne N., Lobato; Alessandra A., Silva; Renato C., Freire Jr; Fernando Z. S., Areas.

    2013-12-01

    Full Text Available BACKGROUND: Elastic resistance bands (ERB) combined with proprioceptive neuromuscular facilitation (PNF) are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle s [...] trength warrant further investigation. OBJECTIVES: The assessment of the effects of PNF combined with ERB on respiratory muscle strength. METHOD: Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10) or the control group (CG, n=10). Maximal expiratory pressure (MEP) and inspiratory pressure (MIP) were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. RESULTS: PNF combined with ERB showed significant increases in MIP and MEP (p

  12. Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bruce-Brand Robert A

    2012-07-01

    Full Text Available Abstract Background Quadriceps femoris muscle (QFM weakness is a feature of knee osteoarthritis (OA and exercise programs that strengthen this muscle group can improve function, disability and pain. Traditional supervised resistance exercise is however resource intensive and dependent on good adherence which can be challenging to achieve in patients with significant knee OA. Because of the limitations of traditional exercise programs, interest has been shown in the use of neuromuscular electrical stimulation (NMES to strengthen the QFM. We conducted a single-blind, prospective randomized controlled study to compare the effects of home-based resistance training (RT and NMES on patients with moderate to severe knee OA. Methods 41 patients aged 55 to 75 years were randomised to 6 week programs of RT, NMES or a control group receiving standard care. The primary outcome was functional capacity measured using a walk test, stair climb test and chair rise test. Additional outcomes were self-reported disability, quadriceps strength and cross-sectional area. Outcomes were assessed pre- and post-intervention and at 6 weeks post-intervention (weeks 1, 8 and 14 respectively. Results There were similar, significant improvements in functional capacity for the RT and NMES groups at week 8 compared to week 1 (p?0.001 and compared to the control group (p? Conclusions Home-based NMES is an acceptable alternative to exercise therapy in the management of knee OA, producing similar improvements in functional capacity. Trial registration: Current Controlled Trials ISRCTN85231954

  13. Acute fatigue-induced changes in muscle mechanical properties and neuromuscular activity in elite handball players following a handball match

    DEFF Research Database (Denmark)

    Thorlund, J B; Michalsik, L B

    2008-01-01

    The purpose of the present study was to determine the acute fatigue development in muscle mechanical properties and neuromuscular activity in response to handball match play. Male elite handball players (n = 10) were tested before and after a simulated handball match for maximal isometric strength [maximal voluntary contraction (MVC)] and rate of force development (RFD) with synchronous electromyography (EMG) recording, while maximal vertical jump parameters were assessed using force plate analysis. Quadriceps and hamstrings MVC and RFD decreased significantly post-match (approximately 10%, P < 0.05 and approximately 16-21%, P < 0.05, respectively). During quadriceps, MVC mean EMG amplitude [mean average voltage (MAV)] decreased for the vastus lateralis (VL) and rectus femoris (RF) (21-42%, P < or = 0.05), while MAV also decreased in the antagonist biceps femoris (BF) muscle (48-55%, P < 0.01). During hamstring MVC, MAV was reduced in BF (31%, P < 0.01). Maximum EMG amplitude during quadriceps MVC was reducedfor the VL (28%, P < 0.01) and the RF (5%, P < 0.05). During hamstring MVC, maximum EMG was reduced for BF (21%, P < 0.01). Post-match maximal jump height was reduced (5.2%, P < 0.01), as was also work (6.8%, P < 0.01), velocity of center of mass (2.4-4.0%, P < 0.01) and RFD (approximately 30%, P < 0.05). In conclusion, maximal (MVC) and rapid muscle force characteristics (RFD, impulse) were acutely affected concurrently with marked reductions in muscle EMG following handball match play, which may potentially lead to impaired functional performance.

  14. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

    Directory of Open Access Journals (Sweden)

    Hall Michelle

    2012-11-01

    Full Text Available Abstract Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during various tasks in people with a partial medial meniscectomy. If shown to reduce the knee adduction moment, neuromuscular exercise has the potential to prevent the onset of osteoarthritis or slow its progression in those with early disease. Trial Registration Australian New Zealand Clinical Trials Registry reference: ACTRN12612000542897

  15. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome : A case-control study

    DEFF Research Database (Denmark)

    Larsen, C M; SØgaard, Karen

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population with and without SIS (n=16, No-SIS=15). Surface electromyography was measured from Serratus anterior (SA) and Trapezius during bilateral arm elevation (no-load, 1kg, 3kg). Mean relative muscle activity was calculated for SA and the upper (UT) and lower part of trapezius (LWT), in addition to activation ratio and time to activity onset. In spite of a tendency to higher activity among SIS 0.10-0.30 between-group differences were not significant neither in ratio of muscle activation 0.80-0.98 nor time to activity onset 0.53-0.98. The hypothesized between-group differences in neuromuscular activity of Trapezius and Serratus was not confirmed. The tendency to a higher relative muscle activity in SIS could be due to a pain-related increase in co-activation or a decrease in maximal activation. The negative findings may display the variation in the specific muscle activation patterns depending on the criteria used to define the population of impingement patients, as well as the methodological procedure being used, and the shoulder movement investigated.

  16. Effects of shared medical appointments on quality of life and cost-effectiveness for patients with a chronic neuromuscular disease. Study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van der Wilt Gert-Jan

    2011-08-01

    Full Text Available Abstract Background Shared medical appointments are a series of one-to-one doctor-patient contacts, in presence of a group of 6-10 fellow patients. This group visits substitute the annual control visits of patients with the neurologist. The same items attended to in a one-to- one appointment are addressed. The possible advantages of a shared medical appointment could be an added value to the present management of neuromuscular patients. The currently problem-focused one-to-one out-patient visits often leave little time for the patient's psychosocial needs, patient education, and patient empowerment. Methods/design A randomized, prospective controlled study (RCT with a follow up of 6 months will be conducted to evaluate the clinical and cost-effectiveness of shared medical appointments compared to usual care for 300 neuromuscular patients and their partners at the Radboud University Nijmegen Medical Center. Every included patient will be randomly allocated to one of the two study arms. This study has been reviewed and approved by the medical ethics committee of the region Arnhem-Nijmegen, the Netherlands. The primary outcome measure is quality of life as measured by the EQ-5D, SF-36 and the Individualized neuromuscular Quality of Life Questionnaire. The primary analysis will be an intention-to-treat analysis on the area under the curve of the quality of life scores. A linear mixed model will be used with random factor group and fixed factors treatment, baseline score and type of neuromuscular disease. For the economic evaluation an incremental cost-effectiveness analysis will be conducted from a societal perspective, relating differences in costs to difference in health outcome. Results are expected in 2012. Discussion This study will be the first randomized controlled trial which evaluates the effect of shared medical appointments versus usual care for neuromuscular patients. This will enable to determine if there is additional value of shared medical appointments to the current therapeutical spectrum. When this study shows that group visits produce the alleged benefits, this may help to increase the acceptance of this innovative and creative way of using one of the most precious resources in health care more efficiently: time. Trial registration DutchTrial Register http://www.trialregister.nlNTR1412

  17. Contribución del soporte nutricional al tratamiento de las alteraciones neuro-musculares del paciente crítico / Contribution of nutritional support to treatment neuromuscular impairments of critically ill patients

    Scientific Electronic Library Online (English)

    J. C., Montejo González.

    2006-05-01

    Full Text Available Las alteraciones neuromusculares que tienen lugar en el paciente crítico han sido atribuidas a factores como la situación séptica, la liberación de mediadores inflamatorioso el empleo de fármacos que afectan desfavorablemente a la función neuro-muscular. El papel de factores metabólicos y nutriciona [...] les en el desarrollo de esta patología ha recibido poca atención. En la actualidad, el empleo de protocolos de control intensivo de la glucemia podría tener gran interés en la prevención de las alteraciones neuro-musculares de los pacientes críticos. Los mecanismos exactos de la implicación de la hiperglucemia en esta patología son, todavía, desconocidos, aunque la evidencia de los datos procedentes de la investigación es importante. La miopatía caquectizante (atrofia muscular) tiene lugar de manera habitual como consecuencia de los cambios obligados por la respuesta metabólica al estrés. El efecto del aporte de nutrientes sobre la ganancia de masa muscular es muy limitado, por lo que deben estudiarse otras acciones dirigidas a recuperar, de manera más rápida, la masa muscular perdida. Deben evitarse pautas agresivas de renutrición con objeto de prevenir el síndrome de realimentación y el consiguiente mayor deterioro de la función muscular. El aporte de substratos específicos, como la glutamina, podría tener un efecto beneficioso en la recuperación de las alteraciones neuro-musculares del paciente crítico. No obstante, no existen aún datos para justificar su empleo si el único objetivo es la recuperación de la función neuro-muscular. Abstract in english Neuromuscular impairments occurring in the critically ill patient have been attributed to factors such as sepsis, release of inflammatory mediators, or the use of drugs unfavorably affecting neuromuscular function. The role of metabolic and nutritional factors in the development of this condition ha [...] s received little attention. Currently, the use of protocols of intensive glycemia monitoring might be of great interest in preventing neuromuscular impairments in critically ill patients. The precise mechanisms of hyperglycemia involvement in this condition are still unknown, although evidence from research data is important. Cachectic myopathy (muscle atrophy) usually is the result of the obliged changes of metabolic response to stress. The effect of nutrients intake on muscle mass gaining is very limited, so that other actions aimed at more rapidly recovering lost muscle mass should be studied. Aggressive renutrition schedules should be avoided in order to prevent re-nutrition syndrome and further deterioration of muscle function. Intake of specific substrates, such as glutamine,might have a beneficial effect on recovering neuromuscular impairments in the critically ill patient. However, there are still no data to justify its use if the only purpose is to recover neuromuscular function.

  18. What Is a Neuromuscular Disease?

    Science.gov (United States)

    ... in Progress Search form Search What Is a Neuromuscular Disease? Neuromuscular diseases are rare acquired or inherited (genetic) conditions that affect some part of the neuromuscular system such as: the muscles the peripheral motor ...

  19. Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2011-12-01

    Full Text Available Abstract Background Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. Methods/Design 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis, pain, and self-reported physical function measured at baseline and immediately following the program. Secondary outcomes include the external knee adduction moment angular impulse, electromyographic muscle activation patterns, knee and hip muscle strength, balance, functional ability, and quality-of-life. Discussion The findings will help determine whether neuromuscular exercise is superior to traditional quadriceps strengthening regarding effects on knee load, pain and physical function in people with medial knee osteoarthritis and varus malalignment. Trial Registration Australian New Zealand Clinical Trials Registry reference: ACTRN12610000660088

  20. Características e impacto de la sedación, la analgesia y el bloqueo neuromuscular en los pacientes críticos que recibieron ventilación mecánica prolongada / Characteristics and impact of sedation, analgesia, and neuromuscular blockage in critical patients undergoing prolonged mechanical ventilation

    Scientific Electronic Library Online (English)

    E., Tobar; G., Bugedo; M., Andresen; M., Aguirre; M.T., Lira; J., Godoy; H., González; A., Hernández; V., Tomicic; J., Castro; J., Jara; H., Ugarte.

    2009-10-01

    Full Text Available Objetivo. Describir el uso de sedantes, analgésicos y bloqueantes neuromusculares (BNM) en los pacientes con ventilación mecánica (VM) prolongada y evaluar los factores asociados a su empleo y asociación con la mortalidad a los 28 días. Diseño. Estudio multicéntrico, prospectivo y observacional de c [...] ohorte. Ámbito. Trece unidades de cuidados intensivos (UCI) en Chile. Pacientes. Pacientes con VM superior a 48h. Excluimos los pacientes con enfermedad neurológica, cirrosis hepática, insuficiencia renal crónica, sospecha de adicción a drogas y limitación precoz del esfuerzo terapéutico. Intervención. Ninguna Variables de interés principales. Proporción de uso y dosis de sedantes, analgésicos y BNM. Nivel de sedación observado (SAS [sedation-agitation scale "escala de sedación-agitación"]). Variables asociadas al nivel de la SAS, y el uso de sedantes, analgésicos y BNM. Regresión logística multivariada de variables asociadas a la mortalidad a los 28 días. Resultados. Participaron 155 pacientes (60±18 años, el 57% eran varones, SOFA 7 [6-10], APACHE II 18 [15-22], el 63% con sepsis y el 47% con lesión pulmonar aguda/síndrome de distrés respiratorio agudo. Los fármacos empleados fueron midazolam (85%; 4 mg/h [1,9-6,8]) y fentanilo (81%; 76 µg/h [39-140]). Un 30% de los pacientes usó BNM al menos un día. El 55% de la SAS fue 1-2. Existe una asociación entre el uso de BNM y la mortalidad a los 28 días, pero ésta no fue consistente en todos los modelos de uso de BNM evaluados. Conclusiones. En el grupo estudiado fue frecuente el uso de sedantes y la presencia de sedación profunda, el midazolam y el fentanilo fueron los fármacos más usados. El uso de BNM podría asociarse de forma independiente a una mayor mortalidad. Abstract in english Aim. To describe use of sedatives, analgesics, and neuromuscular blockers (NMB) in patients undergoing long-term mechanical ventilation and to assess factors associated with their use and their association with mortality at 28 days. Design. Prospective observational multicenter cohort study. Setting [...] . Thirteen intensive care units (ICU) in Chile. Patients. Patients undergoing mechanical ventilation for more than 48h. We excluded patients with neurological disorders, cirrhosis of the liver, chronic renal failure, suspected drug addiction, and early no resuscitation orders. Intervention. None. Main measurements. Proportion of use and dosage of sedatives, analgesics, and NMB. Level of sedation observed (SAS). Variables associated with the Sedation Agitation Scale (SAS), use of sedatives, analgesics, and NMB. Multivariate logistic regression of variables associated to mortality at 28 days. Results. A total of 155 patients participated (60±18 years, 57% male, SOFA 7 [6-10], APACHE II 18 [15-22], 63% with sepsis, and 47% with acute lung injury/adult respiratory distress syndrome. The drugs most frequently used were midazolam (85%, 4 [1.9-6.8]mg/hr) and fentanyl (81%, 76 [39-140]µg/hr). NMB were administered at least 1 day in 30% of patients. SAS score was 1 or 2 in 55% of patients. There was an association between NMB use and mortality at 28 days, but it was not consistent in all the models of NMB evaluated. Conclusions. Sedatives were frequently employed and deep sedation was common. Midazolam and fentanyl were the most frequently administered drugs. The use of NMB might be independently associated to greater mortality.

  1. Characteristics of Neuromuscular Control of the Scapula after Stroke: A First Exploration

    OpenAIRE

    Baets, Liesbet; Jaspers, Ellen; Janssens, Luc; Deun, Sara

    2014-01-01

    This study aimed to characterize scapular muscle timing in stroke patients with and without shoulder pain. Muscle activity of upper trapezius, lower trapezius, serratus anterior, infraspinatus, and anterior deltoid (AD) was measured (Delsys Trigno surface EMG system, USA) in 14 healthy controls (dominant side) and 30 stroke patients (hemiplegic side) of whom 10 had impingement-like shoulder pain. Participants performed 45° and full range anteflexion, in two load conditions. The impact of gro...

  2. Effects of shared medical appointments on quality of life and cost-effectiveness for patients with a chronic neuromuscular disease. Study protocol of a randomized controlled trial

    OpenAIRE

    van der Wilt Gert-Jan; Drost Gea; Seesing Femke M; Gm, Engelen Baziel

    2011-01-01

    Abstract Background Shared medical appointments are a series of one-to-one doctor-patient contacts, in presence of a group of 6-10 fellow patients. This group visits substitute the annual control visits of patients with the neurologist. The same items attended to in a one-to- one appointment are addressed. The possible advantages of a shared medical appointment could be an added value to the present management of neuromuscular patients. The currently problem-focused one-to-one out-patient vis...

  3. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S

    2012-01-01

    Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy.

  4. Experimental study of magnetically controlled transport of neuromuscular blocking agents diadonium and dipyronium in animals

    International Nuclear Information System (INIS)

    The possibility of using liposomes containing ferrocolloid for the targeted transport of the muscle relaxants diadonium and dipyronium in cats was studied in this paper. The degree of incorporation of the drugs into magnetically controlled liposomes (MCL) was assessed quantitatively by spectrophotometry in the UV region. To assess the quantitative distribution of MCL in the tissues of the body, 14C-oleic acid incorporated into the MCL bilayer was used. The experiments confirmed that MCL may be used for directing the supply of drugs toward a target organ

  5. TEACHING NEUROMUSCULAR RELAXATION.

    Science.gov (United States)

    NORRIS, JEANNE E.; STEINHAUS, ARTHUR H.

    THIS STUDY ATTEMPTED TO FIND OUT WHETHER (1) THE METHODS FOR ATTAINING NEUROMUSCULAR RELAXATION THAT HAVE PROVED FRUITFUL IN THE ONE-TO-ONE RELATIONSHIP OF THE CLINIC CAN BE SUCCESSFULLY ADAPTED TO THE TEACHER-CLASS RELATIONSHIP OF THE CLASSROOM AND GYMNASIUM, AND (2) NEUROMUSCULAR RELAXATION CAN BE TAUGHT SUCCESSFULLY BY AN APPROPRIATELY TRAINED…

  6. Mechanisms in environmental control

    International Nuclear Information System (INIS)

    The theory of implementation provides methods for decentralization of decisions in societies. By using mechanisms (game forms) it is possible (in theory) to implement attractive states in different economic environments. As an example the market mechanisms can implement Pareto-efficient and individual rational allocations in an Arrow-Debreu economic environment without market failures. And even when there exists externalities the market mechanism sometime can be used if it is possible to make a market for the goods not allocated on a market already - examples are marketable emission permits, and deposit refund systems. But environmental problems can often be explained by the existence of other market failures (e.g. asymmetric information), and then the market mechanism do not work properly. And instead of using regulation or traditional economic instruments (subsidies, charges, fees, liability insurance, marketable emission permits, or deposit refund systems) to correct the problems caused by market failures, some other methods can be used to deal with these problems. This paper contains a survey of mechanisms that can be used in environmental control when the problems are caused by the existence of public goods, externalities, asymmetric information, and indivisible goods in the economy. By examples it will be demonstrated how the Clarke-Groves mechanism, the Cournot-Lindahl mechanism, and other mechanisms can be used to solve specific environmental problems. This ise specific environmental problems. This is only theory and examples, but a recent field study have used the Cournot-Lindahl mechanism to solve the problem of lake liming in Sweden. So this subject may be of some interests for environmental policy in the future. (au) 23 refs

  7. Control rod drive mechanism

    International Nuclear Information System (INIS)

    Purpose: To provide a control rod drive mechanism using water as an operating source, which prevents a phenomenon for forming two-layers of water in the neighbourhood of a return nozzle in a reactor to limit formation of excessive thermal stress to improve a safety. Constitution: In the control rod drive mechanism of the present invention, a heating device is installed in the neighbourhood of a pressure container for a reactor. This heating device is provided to heat return water in the reactor to a level equal to the temperature of reactor water thereby preventing a phenomenon for forming two-layers of water in the reactor. This limits formation of thermal stress in the return nozzle in the reactor. Accordingly, it is possible to minimize damages in the return nozzle portion and yet a possibility of failure in reactor water. (Kawakami, Y.)

  8. Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial

    OpenAIRE

    Bruce-Brand Robert A; Walls Raymond J; Ong Joshua C; Emerson Barry S; O’Byrne John M; Moyna Niall M

    2012-01-01

    Abstract Background Quadriceps femoris muscle (QFM) weakness is a feature of knee osteoarthritis (OA) and exercise programs that strengthen this muscle group can improve function, disability and pain. Traditional supervised resistance exercise is however resource intensive and dependent on good adherence which can be challenging to achieve in patients with significant knee OA. Because of the limitations of traditional exercise programs, interest has been shown in the use of neuromuscular elec...

  9. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee : A Secondary Analysis from a Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, SØren

    2014-01-01

    OBJECTIVE: Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA. METHODS: This was a randomized controlled assessor-blinded trial. Patients received an educational package (care-as-usual) only, or care-as-usual plus an 8-week neuromuscular exercise intervention (NEMEX-TJR). NEMEX-TJR was supervised by a physiotherapist, twice weekly for 1 h. The primary outcome was Activities of Daily Living (ADL) subscale from the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb muscle power. RESULTS: Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor of NEMEX-TJR compared with control. Second, there were statistically significant differences between groups in favor of NEMEX-TJR on all self-reported outcomes and most functional performance tests (walk, chair stands, and 1-leg knee bends). Stratified analyses according to joint revealed moderate effect size for ADL for hip patients (0.63, 95% CI 0.26 to 1.00). Corresponding effect size for knee patients was small (0.23 95% CI -0.14 to 0.60). CONCLUSION: Feasibility of neuromuscular exercise was confirmed in patients about to have total joint replacement. Self-reported activities of daily living and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA. ClinicalTrials.gov Identifier: NCT01003756.

  10. Immediate efficacy of neuromuscular exercise in patients with severe osteoarthritis of the hip or knee : a secondary analysis from a randomized controlled trial

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, SØren

    2014-01-01

    OBJECTIVE: Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA. METHODS: This was a randomized controlled assessor-blinded trial. Patients received an educational package (care-as-usual) only, or care-as-usual plus an 8-week neuromuscular exercise intervention (NEMEX-TJR). NEMEX-TJR was supervised by a physiotherapist, twice weekly for 1 h. The primary outcome was Activities of Daily Living (ADL) subscale from the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb muscle power. RESULTS: Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor of NEMEX-TJR compared with control. Second, there were statistically significant differences between groups in favor of NEMEX-TJR on all self-reported outcomes and most functional performance tests (walk, chair stands, and 1-leg knee bends). Stratified analyses according to joint revealed moderate effect size for ADL for hip patients (0.63, 95% CI 0.26 to 1.00). Corresponding effect size for knee patients was small (0.23 95% CI -0.14 to 0.60). CONCLUSION: Feasibility of neuromuscular exercise was confirmed in patients about to have total joint replacement. Self-reported activities of daily living and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA. ClinicalTrials.gov Identifier: NCT01003756.

  11. Neuromuscular issues in systemic disease.

    Science.gov (United States)

    Grisold, Wolfgang; Grisold, Anna

    2015-07-01

    The neuromuscular system can be involved in several systemic conditions. Clinical manifestations can appear at onset or throughout the course of the disease process. New investigational methods, including imaging of peripheral nerves, new laboratory tests, and antibodies, are available. In addition to symptomatic therapies, specific treatment options, such as for familial amyloid neuropathy and Fabry's disease, are becoming increasingly available. Pathomechanisms vary depending on the underlying disease process. In addition to metabolic, hormonal, immune, and antibody-mediated mechanisms, in some generalized diseases, genetic causes need to be considered. This review focuses on different aspects of the peripheral nervous system including the nerve roots, plexuses, mononeuropathies and generalized neuropathies, neuromuscular junction disorders, muscle, and autonomic nervous system. PMID:26008813

  12. Feedback Control of arm movements using Neuro-Muscular Electrical Stimulation (NMES combined with a lockable, passive exoskeleton for gravity compensation

    Directory of Open Access Journals (Sweden)

    AlessandraPedrocchi

    2014-09-01

    Full Text Available Within the European project MUNDUS, an assistive framework was developed for the support of arm and hand functions during daily life activities in severely impaired people. Potential users of this system are patients with high-level spinal cord injury and neurodegenerative neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis. This contribution aims at designing a feedback control system for Neuro-Muscular Electrical Stimulation (NMES to enable reaching functions in people with no residual voluntary control of the arm due to upper motor neuron lesions after spinal cord injury. NMES is applied to the deltoids and the biceps muscles and integrated with a three degrees of freedom (DoFs passive exoskeleton, which partially compensates gravitational forces and allows to lock each DOF. The user is able to choose the target hand position and to trigger actions using an eyetracker system. The target position is selected by using the eyetracker and determined by a marker-based tracking system using Microsoft Kinect. A central controller, i.e. a finite state machine, issues a sequence of basic movement commands to the real-time arm controller. The NMES control algorithm sequentially controls each joint angle while locking the other DoFs. Daily activities, such as drinking, brushing hair, pushing an alarm button, etc., can be supported by the system. The robust and easily tunable control approach was evaluated with five healthy subjects during a drinking task. Subjects were asked to remain passive and to allow NMES to induce the movements. In all of them, the controller was able to perform the task, and a mean hand positioning error of less than five centimeters was achieved. The average total time duration for moving the hand from a rest position to a drinking cup, for moving the cup to the mouth and back, and for finally returning the arm to the rest position was 71 seconds.

  13. Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis : a controlled before-and-after study

    DEFF Research Database (Denmark)

    Ageberg, Eva; Nilsdotter, Anna

    2013-01-01

    The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee.

  14. Unmammed Gun Control Mechanism

    Directory of Open Access Journals (Sweden)

    LAXMI NIDHI, PRATYUSHA ROY, SRISHTY NAYAK, RAJINE SWETHA R

    2013-05-01

    Full Text Available From ages it has been a desire of humans to achieve the ultimate in security and make his loved ones and loved things secure. It is this desire that prompted him to make the boundaries and secure them too from all unseen and unknown sources. For this it has been always necessary to maintain a huge sum of people to guard and raise alarms in cases of emergencies. To accomplish this we propose a mechanism which will employ image processing in which a camera (webcam will be continuously observing the ‘area under surveillance’. This data will be then processed by a MatLab code which will be running on a PC and will be able to detect a particular colour (Say Red in front of a white back ground (depicting snow. Depending on this processed data the information about the intruder location will be sent to a micro-controller (89c51 via the Serial/Parallel port of the PC and then a motor controlled gun will be used to point in the direction of the intruder. This mechanism will be online i.e. the gun will continuously be pointing in the direction of the intruder. Further depending on range (distance from the gun (fixed range in this project the gun can be activated and a Laser pointer will be switched ON depict “shooting the target”.

  15. Neuromuscular Disease Descriptions

    Science.gov (United States)

    ... progressing form of Duchenne MD (see below). Congenital (CMD) • Age of onset: birth Characteristics : Generalized muscle weakness ... in neuromuscular diseases are found among people with CMD, although not everyone is affected. Children with structural ...

  16. The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis : study protocol for a randomized, single-blind, controlled trial (the EXERPHARMA trial)

    DEFF Research Database (Denmark)

    Clausen, Brian; Holsgaard-Larsen, Anders

    2014-01-01

    BACKGROUND: Knee osteoarthritis (OA) is a mechanically driven disease, and it is suggested that medial tibiofemoral knee-joint load increases with pharmacologic pain relief, indicating that pharmacologic pain relief may be positively associated with disease progression. Treatment modalities that can both relieve pain and reduce knee-joint load would be preferable. The knee-joint load is influenced by functional alignment of the trunk, pelvis, and lower-limb segments with respect to the knee, as well as the ground-reaction force generated during movement. Neuromuscular exercise can influence knee load and decrease knee pain. It includes exercises to improve balance, muscle activation, functional alignment, and functional knee stability. The primary objective of this randomized controlled trial (RCT) is to investigate the efficacy of a NEuroMuscular EXercise (NEMEX) therapy program, compared with optimized analgesics and antiinflammatory drug use, on the measures of knee-joint load in people with mild to moderate medial tibiofemoral knee osteoarthritis. METHOD/DESIGN: One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical practices and randomly allocated (1:1) to one of two 8-week treatments, either (a) NEMEX therapy twice a week or (b) information on the recommended use of analgesics and antiinflammatory drugs (acetaminophen and oral NSAIDs) via a pamphlet and video materials. The primary outcome is change in knee load during walking (the Knee Index, a composite score of the first external peak total reaction moment on the knee joint from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes include changes in the external peak knee-adduction moment and impulse and functional performance measures, in addition to changes in self-reported pain, function, health status, and quality of life. DISCUSSION: These findings will help determine whether 8 weeks of neuromuscular exercise is superior to optimized use of analgesics and antiinflammatory drugs regarding knee-joint load, pain and physical function in people with mild to moderate knee osteoarthritis. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012).

  17. Teacher's Guide to Neuromuscular Disease

    Science.gov (United States)

    ... for Updates. Home> Publications > A Teacher's Guide to Neuromuscular Disease Vea el folleto en español Download PDF for printing A Teacher's Guide to Neuromuscular Disease Updated 10|2005 Table of Contents Cover ...

  18. Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment : a randomized controlled trial

    DEFF Research Database (Denmark)

    Bennell, Kim L; Kyriakides, Mary

    2014-01-01

    OBJECTIVE: To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of mediolateral distribution of knee load), pain, and physical function in patients with medial knee joint osteoarthritis (OA) and varus malalignment. METHODS: One hundred patients with medial knee pain, mostly moderate-to-severe radiographic medial knee OA, and varus malalignment were randomly allocated to one of two 12-week exercise programs. Each program involved 14 individually supervised exercise sessions with a physiotherapist plus a home exercise component. Primary outcomes were peak external knee adduction moment (3-dimensional gait analysis), pain (visual analog scale), and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index). RESULTS: Eighty-two patients (38 [76%] of 50 in the NEXA group and 44 [88%] of 50 in the QS group) completed the trial. There was no significant between-group difference in the change in thepeak knee adduction moment (mean difference 0.13 Nm/[body weight × height]% [95% confidence interval (95% CI) -0.08, 0.33]), pain (mean difference 2.4 mm [95% CI -6.0, 10.8]), or physical function (mean difference -0.8 units [95% CI -4.0, 2.4]). Neither group showed a change in knee moments following exercise, whereas both groups showed similar significant reductions in pain and improvement in physical function. CONCLUSION: Although comparable improvements in clinical outcomes were observed with both neuromuscular and quadriceps strengthening exercise in patients with moderate varus malalignment and mostly moderate-to-severe medial knee OA, these forms of exercise did not affect the knee adduction moment, a key predictor of structural disease progression.

  19. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  20. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  1. Neuromuscular electrical stimulation in critically ill patients in the intensive care unit: a systematic review / Estimulação elétrica neuromuscular em pacientes graves em unidade de terapia intensiva: revisão sistemáticaNeuromuscular electrical stimulation in critically ill patients in the intensive care unit: a systematic review

    Scientific Electronic Library Online (English)

    Lucas Lima, Ferreira; Luiz Carlos Marques, Vanderlei; Vitor Engrácia, Valenti.

    2014-09-01

    Full Text Available Objetivo Analisar os desfechos propiciados pela estimulação elétrica neuromuscular em pacientes graves assistidos em unidade de terapia intensiva. Métodos Revisão sistemática da literatura, por meio de ensaios clínicos publicados entre 2002 e 2012 nas bases de dados LILACS, SciELO, MedLine e PE [...] Dro, usando os descritores “intensive care unit”, “physical therapy”, “physiotherapy”, “electric stimulation” e “randomized controlled trials”. Resultados Foram incluídos quatro ensaios clínicos. O tamanho amostral variou entre 8 a 33 sujeitos, de ambos os gêneros, com média de idade variando entre 52 e 79 anos, submetidos à ventilação mecânica invasiva. Dos artigos analisados, três indicaram benefícios significativos da estimulação elétrica neuromuscular em pacientes graves, como melhora na força muscular periférica, capacidade de exercício, funcionalidade ou espessura de perda da camada muscular. Conclusão A aplicação de estimulação elétrica neuromuscular promove uma resposta benéfica em pacientes graves em terapia intensiva. Objective To analyze the outcomes enabled by the neuromuscular electric stimulation in critically ill patients in intensive care unit assisted. Methods A systematic review of the literature by means of clinical trials published between 2002 and 2012 in the databases LILACS, SciELO, MEDLINE and PEDro using the descriptors “intensive care unit”, “physical therapy”, “physiotherapy”, “electric stimulation” and “randomized controlled trials”. Results We included four trials. The sample size varied between 8 to 33 individuals of both genders, with ages ranging between 52 and 79 years, undergoing invasive mechanical ventilation. Of the articles analyzed, three showed significant benefits of neuromuscular electrical stimulation in critically ill patients, such as improvement in peripheral muscle strength, exercise capacity, functionality, or loss of thickness of the muscle layer. Conclusion The application of neuromuscular electrical stimulation promotes a beneficial response in critically patients in intensive care. Abstract in english Objective To analyze the outcomes enabled by the neuromuscular electric stimulation in critically ill patients in intensive care unit assisted. Methods A systematic review of the literature by means of clinical trials published between 2002 and 2012 in the databases LILACS, SciELO, MEDLINE and [...] PEDro using the descriptors “intensive care unit”, “physical therapy”, “physiotherapy”, “electric stimulation” and “randomized controlled trials”. Results We included four trials. The sample size varied between 8 to 33 individuals of both genders, with ages ranging between 52 and 79 years, undergoing invasive mechanical ventilation. Of the articles analyzed, three showed significant benefits of neuromuscular electrical stimulation in critically ill patients, such as improvement in peripheral muscle strength, exercise capacity, functionality, or loss of thickness of the muscle layer. Conclusion The application of neuromuscular electrical stimulation promotes a beneficial response in critically patients in intensive care.

  2. Hereditary neuromuscular diseases

    International Nuclear Information System (INIS)

    This article presents the actual classification of neuromuscular diseases based on present expansion of our knowledge and understanding due to genetic developments. It summarizes the genetic and clinical presentations of each disorder together with CT findings, which we studied in a large group of patients with neuromuscular diseases. The muscular dystrophies as the largest and most common group of hereditary muscle diseases will be highlighted by giving detailed information about the role of CT and MRI in the differential diagnosis. The radiological features of neuromuscular diseases are atrophy, hypertrophy, pseudohypertrophy and fatty infiltration of muscles on a selective basis. Although the patterns and distribution of involvement are characteristic in some of the diseases, the definition of the type of disease based on CT scan only is not always possible

  3. Hereditary neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Oezsarlak, O. E-mail: ozkan.ozsarlak@uza.be; Schepens, E.; Parizel, P.M.; Goethem, J.W. van; Vanhoenacker, F.; Schepper, A.M. de; Martin, J.J

    2001-12-01

    This article presents the actual classification of neuromuscular diseases based on present expansion of our knowledge and understanding due to genetic developments. It summarizes the genetic and clinical presentations of each disorder together with CT findings, which we studied in a large group of patients with neuromuscular diseases. The muscular dystrophies as the largest and most common group of hereditary muscle diseases will be highlighted by giving detailed information about the role of CT and MRI in the differential diagnosis. The radiological features of neuromuscular diseases are atrophy, hypertrophy, pseudohypertrophy and fatty infiltration of muscles on a selective basis. Although the patterns and distribution of involvement are characteristic in some of the diseases, the definition of the type of disease based on CT scan only is not always possible.

  4. Modified Newton-Raphson method to tune feedback gains of control system for standing by functional neuromuscular stimulation following spinal cord injury

    Science.gov (United States)

    Nataraj, Raviraj; Audu, Musa L.; Triolo, Ronald J.

    2015-01-01

    BACKGROUND Functional neuromuscular stimulation (FNS) can restore standing capabilities following spinal cord injury. Feedback control of these systems can optimize performance by reducing the required upper extremity support. However, tuning these control systems can be intensive and clinically inconvenient. OBJECTIVE This case study investigated a clinical method to efficiently tune feedback gains for a control system utilizing feedback of total body center of mass acceleration to modulate stimulation levels to targeted paralyzed musculature of the lower extremities and trunk. METHODS Gains for this control system were tuned to minimize the stabilization loading by one arm against internal postural perturbations volitionally-generated during manipulation of an object using the other arm. An algorithm based on a modified form of the Newton-Raphson method was employed to find the optimal feedback gains with lower subject effort than that to determine the original tuning curves. RESULTS This method accurately (<6.2% error) approximated the optimal gains with 70% fewer manipulations by the subject. CONCLUSIONS These results suggest that optimal feedback gains for the specific FNS control system can be determined systematically with considerably less effort than heuristic gain tuning. This demonstrates the potential for devising simple, convenient methods for effective system re-tuning during clinical usage. PMID:25684981

  5. Control rod cooling mechanism

    International Nuclear Information System (INIS)

    Object: To facilitate the inspection and maintenance of control rods and control rod drives. Structure: A control rod inner tube is provided to penetrate a reactor core section within a calandria tank, and the upper end of the tube is provided with a control rod drives. A control rod is moved vertically within the tube by means of a wire rope. Meanwhile, part of a coolant circulation path passes through the outer portion of the calandria tank and connects portion of the control rod guide tube below the core section with portion of the control rod guide tube above the core section. With this construction, it is possible to perfectly separate the heavy water region and helium space within the tank and the interior of the control rod guide tube. Thus, there is no possibility of emission of radioactive substances through the guide tube even by removing the control rod drives. (Yoshino, Y.)

  6. Genetics of neuromuscular disorders.

    Science.gov (United States)

    Laing, Nigel G

    2012-01-01

    Neuromuscular disorders affect the peripheral nervous system and muscle. The principle effect of neuromuscular disorders is therefore on the ability to perform voluntary movements. Neuromuscular disorders cause significant incapacity, including, at the most extreme, almost complete paralysis. Neuromuscular diseases include some of the most devastating disorders that afflict mankind, for example motor neuron disease. Neuromuscular diseases have onset any time from in utero until old age. They are most often genetic. The last 25 years has been the golden age of genetics, with the disease genes responsible for many genetic neuromuscular disorders now identified. Neuromuscular disorders may be inherited as autosomal dominant, autosomal recessive, or X-linked traits. They may also result from mutations in mitochondrial DNA or from de novo mutations not present in the peripheral blood DNA of either parent. The high incidence of de novo mutation has been one of the surprises of the recent increase in information about the genetics of neuromuscular disorders. The disease burden imposed on families is enormous including decision making in relation to presymptomatic diagnosis for late onset neurodegenerative disorders and reproductive choices. Diagnostic molecular neurogenetics laboratories have been faced with an ever-increasing range of disease genes that could be tested for and usually a finite budget with which to perform the possible testing. Neurogenetics has moved from one known disease gene, the Duchenne muscular dystrophy gene in July 1987, to hundreds of disease genes in 2011. It can be anticipated that with the advent of next generation sequencing (NGS), most, if not all, causative genes will be identified in the next few years. Any type of mutation possible in human DNA has been shown to cause genetic neuromuscular disorders, including point mutations, small insertions and deletions, large deletions and duplications, repeat expansions or contraction and somatic mosaicism. The diagnostic laboratory therefore has to be capable of a large number of techniques in order to identify the different mutation types and requires highly skilled staff. Mutations causing neuromuscular disorders affect the largest human proteins for example titin and nebulin. Successful molecular diagnosis can make invasive and expensive diagnostic procedures such as muscle biopsy unnecessary. Molecular diagnosis is currently largely based on Sanger sequencing, which at most can sequence a small number of exons in one gene at a time. NGS techniques will facilitate molecular diagnostics, but not for all types of mutations. For example, NGS is not good at identifying repeat expansions or copy number variations. Currently, diagnostic molecular neurogenetics is focused on identifying the causative mutation(s) in a patient. In the future, the focus might move to prevention, by identifying carriers of recessive diseases before they have affected children. The pathobiology of many of the diseases remains obscure, as do factors affecting disease severity. The aim of this review is to describe molecular diagnosis of genetic neuromuscular disorders in the past, the present and speculate on the future. PMID:22468856

  7. Altered knee joint neuromuscular control during landing from a jump in 10-15year old children with Generalised Joint Hypermobility. A substudy of the CHAMPS-study Denmark

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, Niels

    2015-01-01

    Generalised Joint Hypermobility (GJH) is considered an intrinsic risk factor for knee injuries. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability. The aim was to identify differences in knee neuromuscular control during landing of the Single-Leg-Hop-for-Distance test (SLHD) in 25 children with GJH compared to 29 children without GJH (controls), all 10-15years. Inclusion criteria for GJH: Beighton score?5/9 and minimum one hypermobile knee. EMG was recorded from the quadriceps, the hamstring and the calf muscles, presented relative to Maximum Voluntary Electrical activity (MVE). There was no difference in jump length between groups. Before landing, GJH had 33% lower Semitendinosus, but 32% higher Gastrocnemius Medialis activity and 39% higher co contraction of the lateral knee muscles, than controls. After landing, GJH had 36% lower Semitendinosus activity than controls, all significant findings. Although the groups performed equally in SLHD, GJH had a Gastrocnemius Medialis dominated neuromuscular strategy before landing, plausibly caused by reduced Semitendinosus activity. Reduced Semitendinosus activity was seen in GJH after landing, but with no compensatory Gastrocnemius Medialis activity. Reduced pre and post-activation of the Semitendinosus may present a risk factor for traumatic knee injuries as ACL ruptures in GJH with knee hypermobility.

  8. Feedback control of arm movements using Neuro-Muscular Electrical Stimulation (NMES) combined with a lockable, passive exoskeleton for gravity compensation

    Science.gov (United States)

    Klauer, Christian; Schauer, Thomas; Reichenfelser, Werner; Karner, Jakob; Zwicker, Sven; Gandolla, Marta; Ambrosini, Emilia; Ferrante, Simona; Hack, Marco; Jedlitschka, Andreas; Duschau-Wicke, Alexander; Gföhler, Margit; Pedrocchi, Alessandra

    2014-01-01

    Within the European project MUNDUS, an assistive framework was developed for the support of arm and hand functions during daily life activities in severely impaired people. This contribution aims at designing a feedback control system for Neuro-Muscular Electrical Stimulation (NMES) to enable reaching functions in people with no residual voluntary control of the arm and shoulder due to high level spinal cord injury. NMES is applied to the deltoids and the biceps muscles and integrated with a three degrees of freedom (DoFs) passive exoskeleton, which partially compensates gravitational forces and allows to lock each DOF. The user is able to choose the target hand position and to trigger actions using an eyetracker system. The target position is selected by using the eyetracker and determined by a marker-based tracking system using Microsoft Kinect. A central controller, i.e., a finite state machine, issues a sequence of basic movement commands to the real-time arm controller. The NMES control algorithm sequentially controls each joint angle while locking the other DoFs. Daily activities, such as drinking, brushing hair, pushing an alarm button, etc., can be supported by the system. The robust and easily tunable control approach was evaluated with five healthy subjects during a drinking task. Subjects were asked to remain passive and to allow NMES to induce the movements. In all of them, the controller was able to perform the task, and a mean hand positioning error of less than five centimeters was achieved. The average total time duration for moving the hand from a rest position to a drinking cup, for moving the cup to the mouth and back, and for finally returning the arm to the rest position was 71 s. PMID:25228853

  9. Effects of Tai Chi versus Proprioception Exercise Program on Neuromuscular Function of the Ankle in Elderly People: A Randomized Controlled Trial

    OpenAIRE

    Jing Liu; Xue-Qiang Wang; Jie-Jiao Zheng; Yu-Jian Pan; Ying-Hui Hua; Shang-Min Zhao; Li-Yan Shen; Shuai Fan; Jiu-Gen Zhong

    2012-01-01

    Background. Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people. Methods. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures in...

  10. Control rod drive mechanism

    International Nuclear Information System (INIS)

    Purpose: To improve security of the reactor by holding in the reactor core the control rods without functions of emergency insertion in the control rod drives for the BWR type reactors. Constitution: When the pressure switch to detect pressure in the accumulator and the pressure vessel is installed and such pressure is decreased to pressure by which the control rods cannot be inserted on scram within a given period of time, the feed water valve of the feed pipe from the accumulator is opened and the control rods are inserted into the reactor core by accumulator-applied pressure. The feed valve and the drain valve are held in the closed condition when pressure inside the accumulator and the pressure vessel is lowered. Accordingly, the reactor can be improved in safety by previously inserting in the core those control rods for which pressure for emergency insertion cannot be obtained, or by prohibiting more drawing of the rods staying in a half-drawn position. (Kamimura, M.)

  11. Kinesio Taping(®) does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial.

    Science.gov (United States)

    Lins, Caio Alano de Almeida; Neto, Francisco Locks; Amorim, Anita Barros Carlos de; Macedo, Liane de Brito; Brasileiro, Jamilson Simões

    2013-02-01

    The aim of this study was to analyze the immediate effects of applying Kinesio Taping(®) (KT) on the neuromuscular performance of femoral quadriceps, postural balance and lower limb function in healthy subjects. This is a randomized, blind, controlled, clinical trial, where sixty female volunteers (age: 23.3 ± 2.5 years; BMI: 22.2 ± 2.1 kg/m(2)) were randomly assigned to three groups of 20 subjects each: control (10 min at rest); nonelastic adhesive tape (application over the rectus femoris, vastus lateralis and vastus medialis muscles); and KT (KT application over the same muscles). All individuals were assessed for single and triple hops, postural balance (by baropodometry), peak concentric and eccentric torque and electromyographic activity of vastus lateralis, before and after interventions. No significant differences in electromyographic activity of the VL or concentric and eccentric knee peak torque were recorded, between groups and initial and final assessment in any of the three groups. We also observed no significant alteration in single and triple-hop distance and one-footed static balance between the three groups. Application of KT to RF, VL and VM muscles did not significantly change lower limb function, postural balance, knee extensor peak torque or electromyographic activity of VL muscle in healthy women. PMID:22796389

  12. Urgencias en patología neuromuscular Emergencies in neuromuscular pathology

    Directory of Open Access Journals (Sweden)

    T. Ayuso

    2008-01-01

    Full Text Available La debilidad muscular aguda (DMA es el síntoma predominante de las urgencias neuromusculares, especialmente si afecta a la musculatura respiratoria u orofaríngea. La DMA es un síndrome plurietiológico y con distintos niveles lesionales en la unidad motora. Dentro del amplio grupo de enfermedades neuromusculares, las que con mayor frecuencia provocan DMA e insuficiencia respiratoria son el síndrome de Guillain-Barré (SGB y la miastenia gravis (MG. El SGB constituye la causa más frecuente de parálisis flácida aguda; puede ocasionar fallo respiratorio en un tercio de los casos precisando ventilación mecánica. El diagnóstico preciso de este síndrome permitirá iniciar tratamiento inmunomodulador, que ha demostrado que modifica el curso de la enfermedad. Además, la valoración clínica de los pacientes y el conocimiento de sencillos tests neurofisiológicos y de función respiratoria guiarán la decisión de ventilación mecánica evitando la intubación de urgencia. La urgencia más frecuente que ocasiona la MG es la crisis miasténica, definida por el deterioro en la función bulbar con insuficiencia respiratoria aguda y riesgo de parada respiratoria. Ocurre en un 15-20% de pacientes miasténicos y puede desencadenarse por múltiples factores. Además del diagnóstico preciso de la crisis es importante la supresión de los factores desencadenantes y medidas de soporte ventilatorio. Entre las medidas farmacológicas son la plasmaféresis y las inmunoglobulinas intravenosas los instrumentos más útiles en la actualidad; estos tratamientos no sustituyen la vigilancia intensiva y el reconocimiento de los signos inminentes de fallo respiratorio que implican soporte ventilatorio invasivo o no invasivo.Acute muscle weakness (AMW is the predominant symptom of neuromuscular emergencies, especially if it affects the respiratory or oropharyngeal musculature . AMW is a multi-etiological syndrome, with different lesion levels in the motor unit. Within the broad group of neuromuscular diseases, those that most frequently provoke AMW and respiratory failure are Guillain-Barré syndrome (GBS and myasthenia gravis (MG. GBS is the most frequent cause of acute flaccid paralysis; it can cause respiratory failure in a third of cases, making mechanical ventilation necessary. Accurate diagnosis of this syndrome enables immunomodulatory treatment to be started, which has been shown to modify the course of the disease. Besides, clinical evaluation of the patients and knowledge of the simple tests of neurophysiology and respiratory function will guide the decision on mechanical ventilation, avoiding emergency intubation. The most frequent emergency caused by MG is myasthenic crisis, defined by the deterioration in the bulbar function with acute respiratory insufficiency and risk of respiratory stoppage. This occurs in 15-20% of myasthenic patients and can be triggered by numerous factors. Besides early identification of the crisis, it is important to suppress the triggering factors and to provide measure of ventilatory support. Amongst the pharmacological measures, the most useful instruments at present are plasmapheresis and intravenous immunoglobulins; these treatments do not cancel the need for intensive vigilance and of checking for imminent signs of respiratory failure that will involve invasive or non-invasive ventilatory support.

  13. Influence of intense neuromuscular blockade on surgical conditions during laparotomy : a pig model

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller

    2015-01-01

    PURPOSE: Intense neuromuscular block may improve surgical conditions in ileus laparotomies; however, it is difficult to evaluate. The aim of this study was to investigate if neuromuscular block improved surgical conditions in pigs with artificial ileus laparotomy. METHODS: Six pigs were endotracheally intubated, mechanically ventilated, anesthetized with propofol and fentanyl, and randomized into two groups in a cross-over assessor-blinded design. Neuromuscular block was established with rocuronium. Artificial laparotomy for ileus was performed. We investigated the influence of intense neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while suctioning the lungs at intense neuromuscular block. Without neuromuscular block we detected abdominal contractions seen as hiccups and bucking. In all six pigs during intense neuromuscular block we found no visible electromyographic (EMG) activity in the abdominal muscles while suctioning the lungs. Without neuromuscular block suctioning the lungs elicited brief periods of abdominal EMG activity. No difference was found in the force needed to close the fascia when comparing no neuromuscular block with intense neuromuscular block. Furthermore, no significant differences were found in the width of the diastase, operating time and subjective ratings using a four-point rating scale when comparing no neuromuscular block with intense neuromuscular block. However, these outcomes were related to the order of the suturing round. CONCLUSION: Intense neuromuscular block prevented abdominal muscle contractions but did not influence the force needed to close the fascia.

  14. Man-Machine Interface System for Neuromuscular Training and Evaluation Based on EMG and MMG Signals

    OpenAIRE

    Patricia Fernández; Albano Carrera; Ramon Durán; Ramon de la Rosa; Alonso Alonso

    2010-01-01

    This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System), a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is c...

  15. MRI in neuromuscular disorders

    International Nuclear Information System (INIS)

    Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

  16. Optimal Control of Mechanical Systems

    Directory of Open Access Journals (Sweden)

    Vadim Azhmyakov

    2007-08-01

    Full Text Available In the present work, we consider a class of nonlinear optimal control problems, which can be called “optimal control problems in mechanics.” We deal with control systems whose dynamics can be described by a system of Euler-Lagrange or Hamilton equations. Using the variational structure of the solution of the corresponding boundary-value problems, we reduce the initial optimal control problem to an auxiliary problem of multiobjective programming. This technique makes it possible to apply some consistent numerical approximations of a multiobjective optimization problem to the initial optimal control problem. For solving the auxiliary problem, we propose an implementable numerical algorithm.

  17. Effect of preoperative neuromuscular training (NEMEX-TJR) on functional outcome after total knee replacement : an assessor-blinded randomized controlled trial

    DEFF Research Database (Denmark)

    Huber, Erika O; Roos, Ewa M.

    2015-01-01

    BACKGROUND: Improving functional status preoperatively through exercise may improve postoperative outcome. Previous knowledge on preoperative exercise in knee osteoarthritis is insufficient. The aim of the study was to compare the difference in change between groups in lower extremity function from baseline to 3 months after Total Knee Replacement (TKR) following a neuromuscular exercise programme (NEMEX-TJR) plus a knee school educational package (KS) or KS alone. METHODS: 45 patients (55-83 years, 53% male, waiting for TKR) were randomized to receive a minimum of 8 sessions of NEMEXTJR plus 3 sessions of KS or 3 sessions of KS alone. Function was assessed with the Chair Stand Test (CST, primary endpoint) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales focusing on daily living function (ADL) and pain (secondary endpoints). Assessments were performed immediately before and after the intervention, and at 6 weeks, 3 months and 12 months after surgery by a physiotherapist, blinded to groupallocation. RESULTS: After intervention before surgery we observed a small improvement for primary and secondary endpoints in both groups, which did not differ significantly between groups: comparing the exercise to the control group the treatment effect for the CST was -1.5 seconds (95% CI: -5.3, 2.2), for KOOS ADL and KOOS pain the treatment effect was 1.3 points (-10.1, 12.8) and -2.3 (-12.4, 7.9) respectively. At 3 months after surgery we observed a small improvement in the primary endpoint in the control group and a significant improvement in the secondary endpoints in both exercise and control groups, which did not differ significantly between groups: comparing the exercise group to the control group the treatment effect in the CST was 2.0 seconds (-1.8, 5.8), for KOOS ADL and KOOS pain the treatment effect was -4.9 points (-16.3, 6.5) and -3.3 points (-13.5, 6.8) respectively. CONCLUSIONS: A median (IQR) of 10 (8, 14) exercise sessions before surgery showed an additional small but non-significant improvement in all functional assessments compared to patient education alone. These benefits were not sustained after TKR. Our trial doesn't give a conclusive answer to whether additional preoperative exercise on postoperative functional outcomes is beneficial.

  18. 21 CFR 882.5810 - External functional neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ... false External functional neuromuscular stimulator. 882.5810 Section...882.5810 External functional neuromuscular stimulator. (a) Identification. An external functional neuromuscular stimulator is an...

  19. Comparison between two different neuromuscular electrical stimulation protocols for the treatment of female stress urinary incontinence: a randomized controlled trial / Comparação de diferentes procedimentos de estimulação elétrica neuromuscular utilizados no tratamento da incontinência urinária de esforço feminina: ensaio clínico randomizado

    Scientific Electronic Library Online (English)

    Priscila G. J. M., Alves; Fabiana R., Nunes; Elaine C. O., Guirro.

    2011-10-01

    Full Text Available CONTEXTUALIZAÇÃO: A estimulação elétrica neuromuscular (EENM) é amplamente utilizada no tratamento da incontinência urinária de esforço (IUE), no entanto não há consenso na literatura sobre os parâmetros de tratamento mais eficazes. OBJETIVO: Avaliar os procedimentos de EENM intravaginal no tratamen [...] to de mulheres com IUE. MÉTODOS: Participaram do estudo 20 voluntárias com idade média de 55,55±6,51 anos, com diagnóstico clínico de IUE. As voluntárias foram divididas aleatoriamente em dois grupos: grupo 1 (G1), que recebeu EENM com corrente de média frequência, e grupo 2 (G2), com corrente de baixa frequência. A avaliação funcional dos músculos do assoalho pélvico (MAP) foi realizada por meio de perineometria, e a severidade dos sinais e sintomas da IUE foi avaliada, objetivamente, pelo pad test de uma hora e, subjetivamente, pela Escala Visual Analógica (EVA), que mediu o desconforto causado pela incontinência. Para a análise de normalidade dos dados, utilizou-se o teste Shapiro-Wilk, seguido do teste de Friedman para dados não paramétricos. Para a análise dos sintomas relacionados à IUE, usaram-se os testes Exato de Fisher e Mann-Whitney. Em todas as análises, considerou-se o nível de significância de 5%. RESULTADOS: Não houve diferença significativa (p>0,05) entre os grupos em nenhuma variável avaliada. Na comparação intragrupos das avaliações iniciais e finais (após EENM), houve diferença significativa (p Abstract in english BACKGROUND: Neuromuscular electrical stimulation (NMES) is widely treatment for stress urinary incontinence (SUI) but there is no consensus in literature regarding the most effective treatment parameters. OBJECTIVE: To compare two NMESintra-vaginal protocols for the treatment of SUI in women. METHOD [...] S: The study included 20 volunteers with an average age of 55.55±6.51 years and with the clinical diagnosis of SUI. Volunteers were randomly divided into two groups: group 1 (G1) received NMES with medium-frequency current and group 2 (G2) received NMES with low-frequency current. Functional assessments of pelvic floor muscles (PFM) were performed by perineometry. The severity of signs and symptoms were objectively evaluated using the 1 hour pad test and subjectively evaluated using a visual analog scale that measured the discomfort caused by the SUI. Shapiro-Wilk test was used to analyze data normality, and the Friedman test was used to analyze nonparametric data. For analysis of symptoms related to SUI the Fisher exact test and the Mann-Whitney test were used. Significance level of 5% was set for all data analysis. RESULTS: No significant differences (p>0.05) were found between groups for any of the variable assessed. The within group analysis of initial and final evaluations (after NMES) demonstrated significant differences (p

  20. Comparison between two different neuromuscular electrical stimulation protocols for the treatment of female stress urinary incontinence: a randomized controlled trial Comparação de diferentes procedimentos de estimulação elétrica neuromuscular utilizados no tratamento da incontinência urinária de esforço feminina: ensaio clínico randomizado

    Directory of Open Access Journals (Sweden)

    Priscila G. J. M. Alves

    2011-10-01

    Full Text Available BACKGROUND: Neuromuscular electrical stimulation (NMES is widely treatment for stress urinary incontinence (SUI but there is no consensus in literature regarding the most effective treatment parameters. OBJECTIVE: To compare two NMESintra-vaginal protocols for the treatment of SUI in women. METHODS: The study included 20 volunteers with an average age of 55.55±6.51 years and with the clinical diagnosis of SUI. Volunteers were randomly divided into two groups: group 1 (G1 received NMES with medium-frequency current and group 2 (G2 received NMES with low-frequency current. Functional assessments of pelvic floor muscles (PFM were performed by perineometry. The severity of signs and symptoms were objectively evaluated using the 1 hour pad test and subjectively evaluated using a visual analog scale that measured the discomfort caused by the SUI. Shapiro-Wilk test was used to analyze data normality, and the Friedman test was used to analyze nonparametric data. For analysis of symptoms related to SUI the Fisher exact test and the Mann-Whitney test were used. Significance level of 5% was set for all data analysis. RESULTS: No significant differences (p>0.05 were found between groups for any of the variable assessed. The within group analysis of initial and final evaluations (after NMES demonstrated significant differences (pCONTEXTUALIZAÇÃO: A estimulação elétrica neuromuscular (EENM é amplamente utilizada no tratamento da incontinência urinária de esforço (IUE, no entanto não há consenso na literatura sobre os parâmetros de tratamento mais eficazes. OBJETIVO: Avaliar os procedimentos de EENM intravaginal no tratamento de mulheres com IUE. MÉTODOS: Participaram do estudo 20 voluntárias com idade média de 55,55±6,51 anos, com diagnóstico clínico de IUE. As voluntárias foram divididas aleatoriamente em dois grupos: grupo 1 (G1, que recebeu EENM com corrente de média frequência, e grupo 2 (G2, com corrente de baixa frequência. A avaliação funcional dos músculos do assoalho pélvico (MAP foi realizada por meio de perineometria, e a severidade dos sinais e sintomas da IUE foi avaliada, objetivamente, pelo pad test de uma hora e, subjetivamente, pela Escala Visual Analógica (EVA, que mediu o desconforto causado pela incontinência. Para a análise de normalidade dos dados, utilizou-se o teste Shapiro-Wilk, seguido do teste de Friedman para dados não paramétricos. Para a análise dos sintomas relacionados à IUE, usaram-se os testes Exato de Fisher e Mann-Whitney. Em todas as análises, considerou-se o nível de significância de 5%. RESULTADOS: Não houve diferença significativa (p>0,05 entre os grupos em nenhuma variável avaliada. Na comparação intragrupos das avaliações iniciais e finais (após EENM, houve diferença significativa (p<0,05 na quantidade de urina perdida, no desconforto causado pela incontinência urinária e na pressão perineal. CONCLUSÃO: Os procedimentos de EENM utilizados neste estudo foram igualmente eficazes no tratamento da IUE.

  1. Urgencias en patología neuromuscular / Emergencies in neuromuscular pathology

    Scientific Electronic Library Online (English)

    T., Ayuso; I., Jericó.

    Full Text Available La debilidad muscular aguda (DMA) es el síntoma predominante de las urgencias neuromusculares, especialmente si afecta a la musculatura respiratoria u orofaríngea. La DMA es un síndrome plurietiológico y con distintos niveles lesionales en la unidad motora. Dentro del amplio grupo de enfermedades ne [...] uromusculares, las que con mayor frecuencia provocan DMA e insuficiencia respiratoria son el síndrome de Guillain-Barré (SGB) y la miastenia gravis (MG). El SGB constituye la causa más frecuente de parálisis flácida aguda; puede ocasionar fallo respiratorio en un tercio de los casos precisando ventilación mecánica. El diagnóstico preciso de este síndrome permitirá iniciar tratamiento inmunomodulador, que ha demostrado que modifica el curso de la enfermedad. Además, la valoración clínica de los pacientes y el conocimiento de sencillos tests neurofisiológicos y de función respiratoria guiarán la decisión de ventilación mecánica evitando la intubación de urgencia. La urgencia más frecuente que ocasiona la MG es la crisis miasténica, definida por el deterioro en la función bulbar con insuficiencia respiratoria aguda y riesgo de parada respiratoria. Ocurre en un 15-20% de pacientes miasténicos y puede desencadenarse por múltiples factores. Además del diagnóstico preciso de la crisis es importante la supresión de los factores desencadenantes y medidas de soporte ventilatorio. Entre las medidas farmacológicas son la plasmaféresis y las inmunoglobulinas intravenosas los instrumentos más útiles en la actualidad; estos tratamientos no sustituyen la vigilancia intensiva y el reconocimiento de los signos inminentes de fallo respiratorio que implican soporte ventilatorio invasivo o no invasivo. Abstract in english Acute muscle weakness (AMW) is the predominant symptom of neuromuscular emergencies, especially if it affects the respiratory or oropharyngeal musculature . AMW is a multi-etiological syndrome, with different lesion levels in the motor unit. Within the broad group of neuromuscular diseases, those th [...] at most frequently provoke AMW and respiratory failure are Guillain-Barré syndrome (GBS) and myasthenia gravis (MG). GBS is the most frequent cause of acute flaccid paralysis; it can cause respiratory failure in a third of cases, making mechanical ventilation necessary. Accurate diagnosis of this syndrome enables immunomodulatory treatment to be started, which has been shown to modify the course of the disease. Besides, clinical evaluation of the patients and knowledge of the simple tests of neurophysiology and respiratory function will guide the decision on mechanical ventilation, avoiding emergency intubation. The most frequent emergency caused by MG is myasthenic crisis, defined by the deterioration in the bulbar function with acute respiratory insufficiency and risk of respiratory stoppage. This occurs in 15-20% of myasthenic patients and can be triggered by numerous factors. Besides early identification of the crisis, it is important to suppress the triggering factors and to provide measure of ventilatory support. Amongst the pharmacological measures, the most useful instruments at present are plasmapheresis and intravenous immunoglobulins; these treatments do not cancel the need for intensive vigilance and of checking for imminent signs of respiratory failure that will involve invasive or non-invasive ventilatory support.

  2. Patología neuromuscular en cuidados intensivos Neuromuscular abnormalities in critical illness

    Directory of Open Access Journals (Sweden)

    R. Amaya Villar

    2009-04-01

    Full Text Available La patología neuromuscular en los pacientes críticos ha comenzado a ser objeto de un importante número de estudios en los últimos años, si bien aún quedan muchas lagunas en el conocimiento de su etiología, patogenia, tratamiento y pronóstico. Dentro de esta patología debemos distinguir dos grandes grupos. En el primero, la debilidad muscular aparece antes del ingreso en UCI y es posible identificar una causa conocida. El síndrome de Guillain-Barré y la miastenia grave son las dos entidades que con mayor frecuencia requieren ser atendidas en nuestras unidades. En el segundo grupo, la debilidad muscular se adquiere en la UCI, en pacientes sin enfermedad neuromuscular previa, y es secundaria a la gravedad de la enfermedad que originó su ingreso en esta unidad y/o al tratamiento empleado. La polineuropatía del paciente crítico (PPC es, de todas ellas, la entidad más precisamente definida y de la que conocemos mejor sus características clínicas, diagnóstico y pronóstico; no obstante, aún quedan muchas sombras en cuanto a su etiopatogenia. Las alteraciones de la placa neuromuscular y sobre todo la miopatía, que frecuentemente coexiste con la PPC, son las otras complicaciones del sistema nervioso periférico que se desarrollan en pacientes críticos. Los avances en el conocimiento de estas afecciones podrían tener un importante impacto, sobre todo para el desarrollo de intervenciones terapéuticas y preventivas efectivas que mejoren el pronóstico de estos pacientes.The spectrum of neuromuscular disease encountered in today's intensive care units (ICU has evolved over the last few decades. However, in spite of many studies on neuromuscular disorders complicating critical illness as well as its epidemiology, etiology, treatment and prognosis, several key areas remain unclear. Two main groups are found among these neuromuscular abnormalities. The first group includes primary neuromuscular disorders present on admission to the ICU in which a possible etiology can be identified. Guillain-Barré syndrome and myasthenia gravis are two of the most common diseases admitted to ours units. In the second group, weakness is acquired in the ICU in the absence of preexisting neuromuscular disease. It is believed to reflect illnesses or treatments occurring in the ICU. Critical illness polyneuropathy (CIP is the most clearly defined neuromuscular complication in this group. However, although we have better knowledge of its clinical, diagnosis, and prognosis features, its pathophysiological substrate has not been fully elucidated. Neuromuscular junction defects and specially myopathies, that frequently coexist with CIP, are the others main causes of acquired weakness in critically ill patients. Advances in understanding of these neuromuscular disorders could have an important impact in terms of developing effective preventive and therapeutic interventions that could help to improve the poor prognosis of these patients.

  3. Patología neuromuscular en cuidados intensivos / Neuromuscular abnormalities in critical illness

    Scientific Electronic Library Online (English)

    R., Amaya Villar; J., Garnacho-Montero; M.D., Rincón Ferrari.

    2009-04-01

    Full Text Available La patología neuromuscular en los pacientes críticos ha comenzado a ser objeto de un importante número de estudios en los últimos años, si bien aún quedan muchas lagunas en el conocimiento de su etiología, patogenia, tratamiento y pronóstico. Dentro de esta patología debemos distinguir dos grandes g [...] rupos. En el primero, la debilidad muscular aparece antes del ingreso en UCI y es posible identificar una causa conocida. El síndrome de Guillain-Barré y la miastenia grave son las dos entidades que con mayor frecuencia requieren ser atendidas en nuestras unidades. En el segundo grupo, la debilidad muscular se adquiere en la UCI, en pacientes sin enfermedad neuromuscular previa, y es secundaria a la gravedad de la enfermedad que originó su ingreso en esta unidad y/o al tratamiento empleado. La polineuropatía del paciente crítico (PPC) es, de todas ellas, la entidad más precisamente definida y de la que conocemos mejor sus características clínicas, diagnóstico y pronóstico; no obstante, aún quedan muchas sombras en cuanto a su etiopatogenia. Las alteraciones de la placa neuromuscular y sobre todo la miopatía, que frecuentemente coexiste con la PPC, son las otras complicaciones del sistema nervioso periférico que se desarrollan en pacientes críticos. Los avances en el conocimiento de estas afecciones podrían tener un importante impacto, sobre todo para el desarrollo de intervenciones terapéuticas y preventivas efectivas que mejoren el pronóstico de estos pacientes. Abstract in english The spectrum of neuromuscular disease encountered in today's intensive care units (ICU) has evolved over the last few decades. However, in spite of many studies on neuromuscular disorders complicating critical illness as well as its epidemiology, etiology, treatment and prognosis, several key areas [...] remain unclear. Two main groups are found among these neuromuscular abnormalities. The first group includes primary neuromuscular disorders present on admission to the ICU in which a possible etiology can be identified. Guillain-Barré syndrome and myasthenia gravis are two of the most common diseases admitted to ours units. In the second group, weakness is acquired in the ICU in the absence of preexisting neuromuscular disease. It is believed to reflect illnesses or treatments occurring in the ICU. Critical illness polyneuropathy (CIP) is the most clearly defined neuromuscular complication in this group. However, although we have better knowledge of its clinical, diagnosis, and prognosis features, its pathophysiological substrate has not been fully elucidated. Neuromuscular junction defects and specially myopathies, that frequently coexist with CIP, are the others main causes of acquired weakness in critically ill patients. Advances in understanding of these neuromuscular disorders could have an important impact in terms of developing effective preventive and therapeutic interventions that could help to improve the poor prognosis of these patients.

  4. A surgeon’s assessment of inadequate neuromuscular antagonism in a case of prolonged neuromuscular blockade

    OpenAIRE

    Lamberg, James J; Answine, Joseph F

    2013-01-01

    Evaluation of the degree of neuromuscular blockade by the surgeon using clinical criteria alone is unreliable. We report a case of prolonged neuromuscular blockade lasting 5.5 h, where an additional intra-operative dose of neuromuscular relaxant was given at the request of the surgical team. Possible causes of prolonged neuromuscular antagonism are discussed, as is the importance of neuromuscular assessment prior to the administration of additional neuromuscular blocking agents when receiving...

  5. Cambios en el control neuromuscular de seis músculos de miembro inferior durante CMJ máximos realizados con fatiga / Changes in neuromuscular control of six lower limb muscles during maximum CMJ with fatigue / Mudanças no controle neuromuscular de seis músculos de membro inferior durante a execução de CMJ máximos com fadiga

    Scientific Electronic Library Online (English)

    Gabriel, Fábrica; Paula, González Rodríguez; Jefferson Fagundes, Loss.

    2013-06-01

    Full Text Available Há diferentes opiniões a respeito da existência de mudanças no controle muscular quando os saltos com contramovimento (CMJ) são realizados em condição de fadiga. Este artigo avalia se as atividades e a sequência temporal de ativação de seis músculos do membro inferior durante o CMJ mudam devido à fa [...] diga. O nível de atividade variou principalmente nos músculos biarticulares. Os tempos dos picos de atividade elétrica sugerem a existência de grupos de ação muscular e mudanças na sequência de ativação dentro de cada grupo. Foi possível estabelecer a existência de um padrão geral de controle muscular durante o apoio nos CMJ, com ajustes do nível e tempo de ativação que dependem do período temporal analisado e o músculo considerado. Abstract in spanish Hay diferentes opiniones respecto a si existen cambios en el control muscular cuando saltos con contramovimiento (CMJ) son realizados en condición de fatiga. Este trabajo evalúa si la actividad y la secuencia temporal de activación de seis músculos de miembro inferior durante CMJ cambian por causa d [...] e la fatiga. El nivel de actividad varió principalmente en los músculos biarticulares. Los tiempos de los picos de actividad eléctrica sugieren la existencia de grupos de acción muscular, si bien ocurren cambios en la secuencia de activación dentro de cada grupo. Fue posible establecer que existe un patrón general de control muscular durante el apoyo en los CMJ, con ajustes del nivel y tiempo de activación que dependen del periodo temporal analizado y el músculo considerado. Abstract in english Previous studies have not reached an agreement regarding changes in muscle control when countermovement jump (CMJ) tests are performed in fatigue conditions. This paper evaluates whether the activity and time activation sequence of six lower limb muscles change, due to fatigue during CMJ. We found t [...] hat the activity level varied mainly in the bi-articular muscles. Also, the temporal characteristics of the electrical activity peak suggested that muscles actioned as coordinated groups, although there were changes in the activation sequence within each group. Finally, it was possible to establish a general muscle control pattern during CMJ stance phase. However, adjustments were made on activation time and level that depended on the time period analyzed and the muscle considered.

  6. Control mechanisms for ecological-economic systems

    CERN Document Server

    Burkov, Vladimir N; Shchepkin, Alexander V

    2015-01-01

    This monograph presents and analyzes the optimization, game-theoretic and simulation models of control mechanisms for ecological-economic systems. It is devoted to integrated assessment mechanisms for total risks and losses, penalty mechanisms, risk payment mechanisms, financing and costs compensation mechanisms for risk level reduction, sales mechanisms for risk level quotas, audit mechanisms, mechanisms for expected losses reduction, economic motivation mechanisms, optimization mechanisms for regional environmental (risk level reduction) programs, and mechanisms for authorities' interests coordination. The book is aiming at undergraduate and postgraduate students, as well as at experts in mathematical modeling and control of ecological economic, socioeconomic and organizational systems.

  7. Age-related changes in trunk neuromuscular activation patterns during a controlled functional transfer task include amplitude and temporal synergies.

    Science.gov (United States)

    Quirk, D Adam; Hubley-Kozey, Cheryl L

    2014-12-01

    While healthy aging is associated with physiological changes that can impair control of trunk motion, few studies examine how spinal muscle responses change with increasing age. This study examined whether older (over 65 years) compared to younger (20-45 years) adults had higher overall amplitude and altered temporal recruitment patterns of trunk musculature when performing a functional transfer task. Surface electromyograms from twelve bilateral trunk muscle (24) sites were analyzed using principal component analysis, extracting amplitude and temporal features (PCs) from electromyographic waveforms. Two PCs explained 96% of the waveform variance. Three factor ANOVA models tested main effects (group, muscle and reach) and interactions for PC scores. Significant (precruited higher agonist and antagonistic activity, demonstrated continuous activation levels in specific muscle sites despite changing external moments, and had altered temporal synergies within abdominal and back musculature. In summary both older and younger adults recruit highly organized activation patterns in response to changing external moments. Differences in temporal trunk musculature recruitment patterns suggest that older adults experience different dynamic spinal stiffness and loading compared to younger adults during a functional lifting task. PMID:25457424

  8. Burn Control Mechanisms in Tokamaks

    Science.gov (United States)

    Hill, Maxwell; Stacey, Weston

    2013-10-01

    Burn control and passive safety in accident scenarios will be an important design consideration in future tokamaks, especially those used as a neutron source for fusion-fission hybrid reactors, such as the Subcritical Advanced Burner Reactor (SABR) concept. At Georgia Tech, we are developing a new burning plasma dynamics code to investigate passive safety mechanisms that could prevent power excursions in tokamak reactors. This code solves the coupled set of balance equations governing burning plasmas in conjunction with a two-point SOL-divertor model. Predictions have been benchmarked against data from DIII-D. We are examining several potential negative feedback mechanisms to limit power excursions: i) ion-orbit loss, ii) thermal instabilities, iii) the degradation of alpha-particle confinement resulting from ripples in the toroidal field, iv) modifications to the radial current profile, v) ``divertor choking'' and vi) Type 1 ELMs.

  9. Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy.

    Science.gov (United States)

    Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold's Tyson de Sousa; Moreira Dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra

    2015-05-01

    [Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care. PMID:26157261

  10. Cellular mechanisms that control mistranslation

    DEFF Research Database (Denmark)

    Reynolds, Noah M; Lazazzera, Beth A

    2010-01-01

    Mistranslation broadly encompasses the introduction of errors during any step of protein synthesis, leading to the incorporation of an amino acid that is different from the one encoded by the gene. Recent research has vastly enhanced our understanding of the mechanisms that control mistranslation at the molecular level and has led to the discovery that the rates of mistranslation in vivo are not fixed but instead are variable. In this Review we describe the different steps in translation quality control and their variations under different growth conditions and between species though a comparison of in vitro and in vivo findings. This provides new insights as to why mistranslation can have both positive and negative effects on growth and viability.

  11. Control of a mechanical gripper with a fuzzy controller

    International Nuclear Information System (INIS)

    A fuzzy logic system is used to control a mechanical gripper. System is based in a NLX230 fuzzy micro controller. Control rules are programmed by a 68020 microprocessor in the micro controller memory. Stress and its derived are used as feedback signals in the control. This system can adapt its effort to the mechanical resistance of the object between the fingers. (Author)

  12. Neuromuscular disease classification system

    Science.gov (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M.; Serrano, Carmen

    2013-06-01

    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns.

  13. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).

  14. Protein defects in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Vainzof M.

    2003-01-01

    Full Text Available Muscular dystrophies are a heterogeneous group of genetically determined progressive disorders of the muscle with a primary or predominant involvement of the pelvic or shoulder girdle musculature. The clinical course is highly variable, ranging from severe congenital forms with rapid progression to milder forms with later onset and a slower course. In recent years, several proteins from the sarcolemmal muscle membrane (dystrophin, sarcoglycans, dysferlin, caveolin-3, from the extracellular matrix (alpha2-laminin, collagen VI, from the sarcomere (telethonin, myotilin, titin, nebulin, from the muscle cytosol (calpain 3, TRIM32, from the nucleus (emerin, lamin A/C, survival motor neuron protein, and from the glycosylation pathway (fukutin, fukutin-related protein have been identified. Mutations in their respective genes are responsible for different forms of neuromuscular diseases. Protein analysis using Western blotting or immunohistochemistry with specific antibodies is of the utmost importance for the differential diagnosis and elucidation of the physiopathology of each genetic disorder involved. Recent molecular studies have shown clinical inter- and intra-familial variability in several genetic disorders highlighting the importance of other factors in determining phenotypic expression and the role of possible modifying genes and protein interactions. Developmental studies can help elucidate the mechanism of normal muscle formation and thus muscle regeneration. In the last fifteen years, our research has focused on muscle protein expression, localization and possible interactions in patients affected by different forms of muscular dystrophies. The main objective of this review is to summarize the most recent findings in the field and our own contribution.

  15. Neuromuscular Manifestations of West Nile Virus Infection

    Directory of Open Access Journals (Sweden)

    A. ArturoLeis

    2012-03-01

    Full Text Available The most common neuromuscular manifestation of West Nile virus (WNV infection is a poliomyelitis syndrome with asymmetric paralysis variably involving one (monoparesis to four limbs (quadriparesis, with or without brainstem involvement and respiratory failure. This syndrome of acute flaccid paralysis may occur without overt fever or meningoencephalitis. Although involvement of anterior horn cells in the spinal cord and motor neurons in the brainstem are the major sites of pathology responsible for neuromuscular signs, inflammation also may involve skeletal or cardiac muscle (myositis, myocarditis, motor axons (polyradiculitis, peripheral nerve (Guillain-Barré syndrome, brachial plexopathy. In addition, involvement of spinal sympathetic neurons and ganglia provides a plausible explanation for autonomic instability seen in some patients. Many patients also experience prolonged subjective generalized weakness and disabling fatigue. Despite recent evidence that WNV may persist long term in the central nervous system or periphery in animals, the evidence in humans is controversial. WNV persistence would be of great concern in immunosuppressed patients or in those with prolonged or recurrent symptoms. Support for the contention that WNV can lead to autoimmune disease arises from reports of patients presenting with various neuromuscular diseases that presumably involve autoimmune mechanisms (GBS, other demyelinating neu¬ropathies, myasthenia gravis, brachial plexopathies, stiff-person syndrome, and delayed or recurrent symptoms. Although there is no specific treatment or vaccine currently approved in humans, and the standard remains supportive care, drugs that can alter the cascade of immunobiochemical events leading to neuronal death may be potentially useful (high-dose corticosteroids, interferon preparations, and intravenous immune globulin containing WNV-specific antibodies. Human experience with these agents seems promising based on anecdotal reports.

  16. Neuromuscular Activity and Knee Kinematics in Adolescents with Patellofemoral Pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin

    2013-01-01

    : Purpose: To investigate neuromuscular control of the knee during stair descent among female adolescents with Patellofemoral Pain (PFP) and report its association with self-reported clinical status assessed by the Knee injury and Osteoarthritis Outcome Score (KOOS).Methods: Fifty-seven previously untreated female adolescents diagnosed with PFP aged 15 to 19 years were recruited from schools. The control group consisted of 29 age-matched healthy female adolescents. Bipolar surface electrodes were placed on VM and VL and an electronic knee goniometer was placed at the knee to collect knee flexion/extension kinematics. The participants walked down a stairway consisting of 24 steps at their normal pace. Sample Entropy was used to quantify the complexity of the time series from surface electromyography (sEMG) and kinematics during the stance phase. Self-reported clinical status was assessed by the KOOS and maximal quadriceps torque measured using strap-mounted handheld dynamometry.Results: Female adolescents withPFP were characterized by altered neuromuscular knee control during stair descent, lower maximal quadriceps torque, and poorer KOOS scores across all five domains. Furthermore, a positive association was found between the complexity of sEMG from VL and self-reported pain determined by KOOSpain indicating larger impairments in neuromuscular knee control among those with the highest pain levels.Conclusion: The current findings show that female adolescents with PFP are characterized by altered neuromuscular control of the knee during stair descent and lower maximal quadriceps torque. These results suggest that rehabilitation is needed, and should focus on restoring neuromuscular control and muscle strength.

  17. Sleep-disordered Breathing in Neuromuscular Disease.

    Science.gov (United States)

    Aboussouan, Loutfi S

    2015-05-01

    Sleep-disordered breathing in neuromuscular diseases is due to an exaggerated reduction in lung volumes during supine sleep, a compromised physiologic adaptation to sleep, and specific features of the diseases that may promote upper airway collapse or heart failure. The normal decrease in the rib cage contribution to the tidal volume during phasic REM sleep becomes a critical vulnerability, resulting in saw-tooth oxygen desaturation possibly representing the earliest manifestation of respiratory muscle weakness. Hypoventilation can occur in REM sleep and progress into non-REM sleep, with continuous desaturation and hypercarbia. Specific characteristics of neuromuscular disorders, such as pharyngeal neuropathy or weakness, macroglossia, bulbar manifestations, or low lung volumes, predispose patients to the development of obstructive events. Central sleep-disordered breathing can occur with associated cardiomyopathy (e.g., dystrophies) or from instability in the control of breathing due to diaphragm weakness. Mitigating factors such as recruitment of accessory respiratory muscles, reduction in REM sleep, and loss of normal REM atonia in some individuals may partially protect against sleep-disordered breathing. Noninvasive ventilation, a standard-of-care management option for sleep-disordered breathing, can itself trigger specific sleep-disordered breathing events including air leaks, patient-ventilator asynchrony, central sleep apnea, and glottic closure. These events increase arousals, reduce adherence, and impair sleep architecture. Polysomnography plays an important role in addressing pitfalls in the diagnosis of sleep-disordered breathing in neuromuscular diseases, identifying sleep-disordered breathing triggered by noninvasive ventilation, and optimizing noninvasive ventilation settings. PMID:25723731

  18. Recovery of neuromuscular junction morphology following 16 days of spaceflight.

    Science.gov (United States)

    Deschenes, M R; Britt, A A; Gomes, R R; Booth, F W; Gordon, S E

    2001-12-01

    It has previously been established that spaceflight elicits alterations in the morphology of the neuromuscular system that includes expansion of the neuromuscular junction (NMJ) and myofiber atrophy. The purpose of this study was to determine the capacity of the neuromuscular system to recover from spaceflight-induced modifications upon return to normal gravity. Soleus muscles were obtained from rats participating in the 16-day Neurolab space shuttle mission at 1 day and 14 days after returning to Earth: solei were also taken at the same time points from ground-based control rats. Cytofluorescent techniques, coupled with confocal microscopy, were used to assess NMJ morphology. Histochemistry, in conjunction with phase contrast microscopy, was employed to examine myofiber size and type. Results indicate that 1 day after landing both pre- and postsynaptic stained areas of the NMJ were significantly (P < or = 0.05) larger in the spaceflight group than in controls. Moreover, significant myofiber atrophy was demonstrated in animals subjected to 0 gravity. By 14 days following return to the Earth, however, NMJ stained areas and muscle fiber size were no longer different from control values at that same interval. These results suggest that the neuromuscular system possesses a robust capacity to recover from spaceflight-induced perturbations upon return to normal gravitational influences. PMID:11746714

  19. Automatic exchanger for control rod drive mechanisms

    International Nuclear Information System (INIS)

    Purpose: To surely stop a control rod drive mechanism at an aimed position within an allowable range of error. Constitution: The automatic exchanger has a function of determining a parameter representing a relationship of a moving distance of a control rod drive mechanism relative to the time period for a moving instruction output by applying pulse-like moving instructions of different time periods for several times to the drive mechanism and a forecasting calculation control function of outputting a required moving instruction by the use of a parameter determined based on a difference between the aimed position and the present position in the case of moving the drive mechanism to its aimed position. As the result of the forecasting calculation control, if the drive mechanism is deviated from the aimed position exceeding a predetermined allowable range, the forecasting calculation controls are repeated so that the drive mechanism can reach within the allowable range for the aimed position. (Horiuchi, T.)

  20. Neuromuscular disruption with ultrashort electrical pulses

    Science.gov (United States)

    Pakhomov, Andrei; Kolb, Juergen F.; Joshi, Ravindra P.; Schoenbach, Karl H.; Dayton, Thomas; Comeaux, James; Ashmore, John; Beason, Charles

    2006-05-01

    Experimental studies on single cells have shown that application of pulsed voltages, with submicrosecond pulse duration and an electric field on the order of 10 kV/cm, causes sudden alterations in the intracellular free calcium concentration, followed by immobilization of the cell. In order to examine electrical stimulation and incapacitation with such ultrashort pulses, experiments on anesthetized rats have been performed. The effect of single, 450 nanosecond monopolar pulses have been compared with that of single pulses with multi-microsecond duration (TASER pulses). Two conditions were explored: 1. the ability to elicit a muscle twitch, and, 2. the ability to suppress voluntary movement by using nanosecond pulses. The second condition is relevant for neuromuscular incapacitation. The preliminary results indicate that for stimulation microsecond pulses are advantageous over nanosecond pulses, whereas for incapacitation, the opposite seems to apply. The stimulation effects seem to scale with electrical charge, whereas the disruption effects don't follow a simple scaling law. The increase in intensity (time of incapacitation) for a given pulse duration, is increasing with electrical energy, but is more efficient for nanosecond than for microsecond pulses. This indicates different cellular mechanisms for incapacitation, most likely subcellular processes, which have been shown to become increasingly important when the pulse duration is shortened into the nanosecond range. If further studies can confirm these initial results, consequences of reduced pulse duration are a reduction in weight and volume of the pulse delivery system, and likely, because of the lower required energy for neuromuscular incapacitation, reduced safety risks.

  1. Development of a neuromuscular junction model on surfaces modified by plasma polymerization / Desarrollo de un modelo de unión neuromuscular sobre superficies modificadas por polimerización por plasma

    Scientific Electronic Library Online (English)

    E., Zuñiga-Aguilar; R., Godínez; O., Ramírez-Fernández; J., Morales; R., Olayo.

    Full Text Available El objetivo de este trabajo es implementar un modelo biológico de unión neuromuscular para el estudio de los mecanismos involucrados en los procesos intra e intercelulares empleando co-cultivos celulares. Con el fin de optimizar el crecimiento y desarrollo de las uniones neuromusculares, las células [...] se cultivaron sobre superficies de polipirrol obtenidas mediante polimerización por plasma que han mostrado ser adecuadas en otros tipos de cultivos celulares. Las líneas celulares que se emplearon fueron los modelos de motoneurona NG108-15 y muscular C2C12. Las células se evaluaron de acuerdo a su morfología y características electrofisiológicas. Para observar la expresión de proteínas clave de la sinapsis, se aplicaron técnicas inmunocitoquímicas utilizando anticuerpos específicos para la marcación de proteínas localizadas en las terminales nerviosas adquiriendo imágenes con microscopía de fluorescencia. Las imágenes de los co-cultivos celulares mostraron la formación de uniones neuromusculares. El método de preparación de uniones neuromusculares que se describe en este trabajo permitirá estudiar los mecanismos involucrados en sus funciones. Abstract in english The aim of this work is to implement a biological model of neuromuscular junctions to study the mechanisms involved in intra and inter cellular processes using cell co-cultures. To optimize growth and development of the neuromuscular junction, cells were seeded on plasma polymerized pyrrole which ha [...] s proven suitable for other types of cell cultures. The cell lines used were motor neuron NG108-15 and skeletal muscle C2C12. Cells were evaluated according to their morphology and electrophysiological characteristics. To observe the expression of specific proteins of the nerve synapse, immunocytochemical techniques were applied using dying antibodies. Proteins localized in nerve terminals were dyed and imaged by fluorescence microscopy. Images of cell co-cultures showed the formation of neuromuscular junctions. The preparation of neuromuscular junctions described in this work will allow the study of the mechanisms involved in their functions.

  2. Neuromuscular dressing effects: a literature review

    Directory of Open Access Journals (Sweden)

    Calero PA

    2012-05-01

    Full Text Available The kinesio taping is a technique that was created in 1979 by Doctor Kenzo Kase I’m looking through it that could generate a new therapeutic option to control pain, improve athletic performance and reduce the impact of musculoskeletal disorders. From the Sydney 2000 Olympic Games, this technique as a therapeutic alternative PTO and is composed of health professionals in the field of sport and physical rehabilitation.Objetive: This article aims to identify theoretical approaches on the bandage neuromuscular. Material and methods: held today, for which conducted a literature search of databases such as como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs.The paper proposes a scheme of contextualization of the current landscape of the use and effects of kinesio taping in the management of different pathologies of the musculo-skeletal system in sports. Conclusion: it is concluded that currently many health professionals, and take the neuromuscular bandage a good therapeutic option in the management of diseases affecting the human body is investigated and every day more about the subject, which makes these new therapeutic methods to acquire a scientific value and transcends knowledge.

  3. Inspiratory muscle training in the patient with neuromuscular disease.

    Science.gov (United States)

    McCool, F D; Tzelepis, G E

    1995-11-01

    Pulmonary complications due to respiratory muscle dysfunction are commonly a source of morbidity and mortality in patients with neuromuscular diseases. This review discusses the adverse effects of respiratory muscle weakness on pulmonary mechanics and examines the role that inspiratory muscle training may play in reversing pulmonary dysfunction in these individuals. In asymptomatic persons, it is well established that the inspiratory muscles can be trained to increase both force and endurance. In patients with neuromuscular diseases, the effects of training protocols on force and endurance are more controversial. This article reviews seven studies that have evaluated respiratory muscle training in a total of 75 patients with varied neuromuscular disorders. Training regimens included breathing through inspiratory resistive loads and isocapnic hyperpnea. Despite methodologic differences among studies, investigators have generally shown that the inspiratory muscles are similar to other skeletal muscle groups in that they can be trained for both force and endurance in these patients. The training-related improvements in inspiratory muscle performance are more pronounced in patients who are less severely affected by their disease. In those patients who have disease to the extent that they are already retaining carbon dioxide, there is little change in force or endurance with training. In these individuals, the inspiratory muscles may already be working at a level sufficiently severe to provide a training stimulus with each breath. No adverse effects of inspiratory muscle training were reported. Inspiratory muscle training can improve force and endurance in patients with neuromuscular weakness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7480122

  4. Degeneration of Neuromuscular Junction in Age and Dystrophy

    Directory of Open Access Journals (Sweden)

    Rüdiger Rudolf

    2014-05-01

    Full Text Available Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and postsynaptic origin. Consequently, neuromuscular junctions are good indicators of motor health on a systemic level. Indeed, upon sarcopenia and dystrophy, neuromuscular junctions morphologically deteriorate and exhibit altered characteristics of primary signaling molecules, such as nicotinic acetylcholine receptor and agrin. Since a remarkable reversibility of these changes can be observed by exercise, there is significant interest in understanding the molecular mechanisms underlying synaptic deterioration upon aging and dystrophy and how synapses are reset by the aforementioned treatments. Here, we review the literature that describes the phenomena observed at the neuromuscular junction in sarcopenic and dystrophic muscle as well as to how these alterations can be reversed and to what extent. In a second part, the current information about molecular machineries underlying these processes is reported.

  5. 21 CFR 882.5860 - Implanted neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Implanted neuromuscular stimulator. 882.5860 Section...Devices § 882.5860 Implanted neuromuscular stimulator. (a) Identification. An implanted neuromuscular stimulator is a device...

  6. Neuromuscular activation patterns during treadmill walking after space flight

    Science.gov (United States)

    Layne, C. S.; McDonald, P. V.; Bloomberg, J. J.

    1997-01-01

    Astronauts adopt a variety of neuromuscular control strategies during space flight that are appropriate for locomoting in that unique environment, but are less than optimal upon return to Earth. We report here the first systematic investigation of potential adaptations in neuromuscular activity patterns associated with postflight locomotion. Astronaut-subjects were tasked with walking on a treadmill at 6.4 km/h while fixating a visual target 30 cm away from their eyes after space flights of 8-15 days. Surface electromyography was collected from selected lower limb muscles and normalized with regard to mean amplitude and temporal relation to heel strike. In general, high correlations (more than 0.80) were found between preflight and postflight activation waveforms for each muscle and each subject: however relative activation amplitude around heel strike and toe off was changed as a result of flight. The level of muscle cocontraction and activation variability, and the relationship between the phasic characteristics of the ankle musculature in preparation for toe off also were altered by space flight. Subjects also reported oscillopsia during treadmill walking after flight. These findings indicate that, after space flight, the sensory-motor system can generate neuromuscular-activation strategies that permit treadmill walking, but subtle changes in lower-limb neuromuscular activation are present that may contribute to increased lower limb kinematic variability and oscillopsia also present during postflight walking.

  7. Splicing therapy for neuromuscular disease.

    OpenAIRE

    Douglas, AG; Wood, MJ

    2013-01-01

    Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) are two of the most common inherited neuromuscular diseases in humans. Both conditions are fatal and no clinically available treatments are able to significantly alter disease course in either case. However, by manipulation of pre-mRNA splicing using antisense oligonucleotides, defective transcripts from the DMD gene and from the SMN2 gene in SMA can be modified to once again produce protein and restore function. A large numb...

  8. DYNAMIC NEUROMUSCULAR STABILIZATION & SPORTS REHABILITATION

    OpenAIRE

    Frank, Clare; Kobesova, Alena; Kolar, Pavel

    2013-01-01

    Dynamic neuromuscular (core) stability is necessary for optimal athletic performance and is not achieved purely by adequate strength of abdominals, spinal extensors, gluteals or any other musculature; rather, core stabilization is accomplished through precise coordination of these muscles and intra?abdominal pressure regulation by the central nervous system. Understanding developmental kinesiology provides a framework to appreciate the regional interdependence and the inter?linking of the...

  9. Diseases of the neuromuscular junction.

    OpenAIRE

    MCCONVILLE, J; Vincent, A.

    2002-01-01

    The neuromuscular junction is a prototype synapse and it is also the site of well-characterised autoimmune and hereditary disorders. In the presynaptic terminal, voltage-gated potassium channels and voltage-gated calcium channels are subtly altered in genetic disorders and mutations in the enzyme that synthesises acetylcholine have been demonstrated in a particular form of hereditary myasthenia syndrome. Recent advances have revealed agrin, muscle-specific kinase (MuSK) and rapsyn as importan...

  10. Decoding modulation of the neuromuscular transform

    OpenAIRE

    Stern, Estee; Fort, Timothy J.; Miller, Mark W.; Peskin, Charles S; Brezina, Vladimir

    2007-01-01

    When modulators of neuromuscular function alter the motor neuron spike patterns that elicit muscle contractions, it is predicted that they will also retune correspondingly the connecting processes of the neuromuscular transform. Here we confirm this prediction by analyzing data from the cardiac neuromuscular system of the blue crab. We apply a method that decodes the contraction response to the spike pattern in terms of three elementary building-block functions that completely characterize th...

  11. Fatigue syndromes: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders.

    OpenAIRE

    Wessely, S.; Powell, R.

    1989-01-01

    Patients (n = 47) presenting to a neurological centre with unexplained chronic "postviral" fatigue (CFS) were studied prospectively. Controls were patients with peripheral fatiguing neuromuscular diseases and inpatients with major depression in a psychiatric hospital. Seventy-two percent of the CFS patients were cases of psychiatric disorder, using criteria that excluded fatigue as a symptom, compared with 36% of the neuromuscular group. There was no difference in subjective complaints of phy...

  12. Reactive Neuromuscular Training: A Multi-level Approach to Rehabilitation of the Unstable Shoulder

    OpenAIRE

    Guido, John A.; Stemm, John

    2007-01-01

    In this clinical commentary, the use of reactive neuromuscular training (RNT) will be discussed as part of an overall functional rehabilitation program in the treatment of the unstable glenohumeral joint. The RNT program is designed to restore the synchrony and synergy of muscle firing patterns about the shoulder, which are required for dynamic joint stability and fine motor control. Reactive neuromuscular training allows the clinician to bridge the gap between the achievement of clinical bas...

  13. Computed tomography of muscles in neuromuscular disease

    International Nuclear Information System (INIS)

    137 patients with neuromuscular diseases were studied by CT scan. Four levels were chosen: mid-calf, mid-thigh, pelvic girdle, and spinal muscles. The scans were compared with normal control scans taken from the same sites. The patients were divided into those with myogenic diseases and those with neurogenic diseases. Of the 102 patients with myogenic changes, 17 had X-linked dystrophy, 13 had facio-scapulo-humeral dystrophy, 22 had limb girdle dystrophy, 19 had myotonic dystrophy, 14 had inflammatory muscle diseases, and 17 had miscellaneous muscular diseases. Of the 35 patients with neurogenic changes, 8 had amyotrophic lateral sclerosis (ALS), 16 had chronic spinal amyotrophies, 9 had peripheral neuropathies, and 2 had Friedreich's disease. The analysis of muscles changes (volume, outline, density) was established on the following muscles: tibialis anterior, peroneus, soleus, gastrocnemius mediale, gastrocnemius laterale, quadriceps, semitendinosus, semimembranosus, sartorius, adductor, gracilis, gluteus, spine extensors, and psoas

  14. Computed tomography of skeletal muscles in neuromuscular disease

    International Nuclear Information System (INIS)

    CT-documentation of skeletal muscular lesions caused by neuromuscular diseases implies an essential contribution to conventional techniques in the macroscopic field. Size, distribution and degree of lesions as well as compensatory mechanisms are proved thereby. We report about the different effects on muscle appearance referring to 106 patients of our own experience in amyotrophic lateral sclerosis, spinal muscular atrophy, poliomyelitis, polyradiculitis, polyneuropathy as well as peripheral traumatic nerve lesions. (orig.)

  15. Active zones of mammalian neuromuscular junctions: formation, density, and aging

    OpenAIRE

    Nishimune, Hiroshi

    2012-01-01

    Presynaptic active zones are synaptic vesicle release sites that playessential roles in the function and pathology of mammalian neuromuscular junctions (NMJs). The molecular mechanisms of active zone organization utilize presynaptic voltage-dependent calcium channels (VDCCs) in NMJs as scaffolding proteins. VDCCs interact extracellularly with the muscle-derived synapse organizer, laminin ?2, and interact intracellularly with active zone-specific proteins, such as Bassoon, CAST/Erc2/ELKS2alph...

  16. Nestin negatively regulates postsynaptic differentiation of the neuromuscular synapse

    OpenAIRE

    Yang, Jiefei; Dominguez, Bertha; de Winter, Fred; Gould, Thomas W.; Eriksson, John E.; Lee, Kuo-Fen

    2011-01-01

    Positive and negative regulation of neurotransmitter receptor aggregation on the postsynaptic membrane is a critical event during synapse formation. Acetylcholine (ACh) and agrin are two opposing signals that regulate ACh receptor (AChR) clustering during neuromuscular junction (NMJ) development. ACh induces dispersion of AChR clusters that are not stabilized by agrin via a cyclin-dependent kinase 5 (Cdk5)-mediated mechanism, but regulation of Cdk5 activation is poorly understood. Here we sho...

  17. Mechanical engineers' handbook, design, instrumentation, and controls

    CERN Document Server

    Kutz, Myer

    2015-01-01

    Full coverage of electronics, MEMS, and instrumentation andcontrol in mechanical engineering This second volume of Mechanical Engineers' Handbookcovers electronics, MEMS, and instrumentation and control, givingyou accessible and in-depth access to the topics you'll encounterin the discipline: computer-aided design, product design formanufacturing and assembly, design optimization, total qualitymanagement in mechanical system design, reliability in themechanical design process for sustainability, life-cycle design,design for remanufacturing processes, signal processing, dataacquisition and dis

  18. Neuromuscular: Acetylcholine and Acetylcholine Receptors

    Science.gov (United States)

    The Neuromuscular Disease Center at Washington University provides this comprehensive Web site for information on acetylcholine and acetylcholine receptors. Visitors will find detailed Web pages covering acetylcholine metabolism, acetylcholine receptors (including disorders, structure, venom binding, etc.), autonomic function, and myasthenic disorders. Related proteins are organized into data tables, which include links to protein-specific information from external sources such as the National Center for Biotechnology Information from the National Institutes of Health and the Expert Protein Analysis System (ExPASy) from the Swiss Institute of Bioinformatics.

  19. Effects of strength and power training on neuromuscular variables in older adults.

    Science.gov (United States)

    Wallerstein, Lilian França; Tricoli, Valmor; Barroso, Renato; Rodacki A, L F; Russo, Luciano; Aihara, André Yui; da Rocha Correa Fernandes, Artur; de Mello, Marco Tulio; Ugrinowitsch, Carlos

    2012-04-01

    The purpose of this study was to compare the neuromuscular adaptations produced by strength-training (ST) and power-training (PT) regimens in older individuals. Participants were balanced by quadriceps cross-sectional area (CSA) and leg-press 1-repetition maximum and randomly assigned to an ST group (n = 14; 63.6 ± 4.0 yr, 79.7 ± 17.2 kg, and 163.9 ± 9.8 cm), a PT group (n = 16; 64.9 ± 3.9 yr, 63.9 ± 11.9 kg, and 157.4 ± 7.7 cm), or a control group (n = 13; 63.0 ± 4.0 yr, 67.2 ± 10.8 kg, and 159.8 ± 6.8 cm). ST and PT were equally effective in increasing (a) maximum dynamic and isometric strength (p quadriceps muscle CSA (p < .05), and (c) decreasing electrical mechanical delay of the vastus lateralis muscle (p < .05). There were no significant changes in neuromuscular activation after training. The novel finding of the current study is that PT seems to be an attractive alternative to regular ST to maintain and improve muscle mass. PMID:22472578

  20. Papel da vitamina D na função neuro-muscular / Role of vitamin D in the neuro-muscular function

    Scientific Electronic Library Online (English)

    Márcia A. Carneiro, Pedrosa; Marise Lazaretti, Castro.

    2005-08-01

    Full Text Available A vitamina D, através de suas ações no intestino, rim, osso e glândulas paratiróides, é um hormônio fundamental para a homeostase do cálcio e para o desenvolvimento de um esqueleto saudável. Além disso, receptores deste hormônio podem ser encontrados em quase todos os tecidos do organismo e outras a [...] ções não relacionadas ao metabolismo mineral têm sido imputadas a ele. Na célula muscular esquelética, a vitamina D atua através do mecanismo clássico de ligação a um receptor nuclear e também através da ligação a um receptor de membrana, realizando ações que envolvem o transporte de cálcio, a síntese protéica e a velocidade de contração muscular. Clinicamente, a deficiência de vitamina D, que é bastante comum em idosos, inclusive em nosso país, tem sido relacionada a um aumento da incidência de quedas, a uma diminuição da força muscular e a uma deterioração do equilíbrio, avaliada pela oscilação do corpo na postura ereta. Por outro lado, tem sido demonstrado que a suplementação associada de cálcio e vitamina D em idosos deficientes contribui para melhoria destes aspectos da função neuro-muscular. Nesta revisão, serão discutidos os mecanismos conhecidos envolvidos na associação entre vitamina D e função neuro-muscular, e também a suplementação de vitamina D e cálcio na prevenção de fraturas osteoporóticas não-vertebrais sob a perspectiva dos efeitos neuro-musculares. Abstract in english Through its action in the kidney, intestines, bone and parathyroid glands vitamin D is a major regulator of calcium homeostasis and for the development of a healthy skeleton. Moreover, receptors for this hormone are present in almost all body tissues and other actions which are not related to the mi [...] neral metabolism have been imputed to it. In the skeletal muscle cell, vitamin D acts through the classic mechanism of binding to a nuclear receptor and also by binding to a membrane receptor, carrying out actions that involve calcium transport, protein synthesis and kinetics of muscle contraction. Clinically, vitamin D deficiency, which is very common among the elderly, including the ones in our country, has been related to an increase in the incidence of falls, as well as the reduction of muscle strength and deterioration of body sway, evaluated by the oscillation of the body in the erect position. On the other hand, it has been demonstrated that supplementation of calcium associated to vitamin D in deficient elderly contributes to the improvement of these aspects of the neuro-muscular function. In this review, the mechanisms involved in the association between vitamin D and neuro-muscular function will be discussed, as well as the supplementation of vitamin D and calcium to prevent non-vertebral osteoporotic fractures under the perspective of the neuro-muscular effects.

  1. Early appearance and possible roles of non-neuromuscular cholinesterases.

    Directory of Open Access Journals (Sweden)

    CarlaFalugi

    2012-04-01

    Full Text Available The biological function of the cholinesterase (ChE enzymes is well known and has been studied since the beginning of the XXth century; in particular, acetylcholinesterase (AChE, E.C. 3.1.1.7 is an enzyme playing a key role in the modulation of neuromuscular impulse transmission. However, in the past decades, there has been increasing interest concerning its role in regulating non-neuromuscular cell-to-cell interactions mediated by intracellular ion concentration changes, like the ones occurring during gamete interaction and embryonic development. An understanding of the mechanisms of the cholinergic regulation of these events can help us foresee the possible impact on environmental and human health, including gamete efficiency and possible teratogenic effects on different models, and help elucidate the extent to which exposure to ChE inhibitors may affect human health.

  2. Efectos del vendaje neuromuscular: una revisión bibliográfica / Neuromuscular dressing effects: a literature review / Efeitos neuromusculares de bandages: uma revisão da literatura

    Scientific Electronic Library Online (English)

    Pedro Antonio, Calero Saa; Gustavo Adolfo, Cañón Martínez.

    2012-08-01

    Full Text Available A kinesio taping é uma técnica que foi criada em 1979 por Dr. Kenzo Kase Estou procurando através dele que poderia gerar uma nova opção terapêutica para controlar a dor, melhorar o desempenho atlético e reduzir o impacto de distúrbios músculo-esqueléticos. Do Sydney 2000 Olympic Games, estatécnica c [...] omo uma alternativa terapêutica PTO e é composto de profissionais de saúde na área de reabilitação física e esporte. Alvo: Este artigo tem como objetivo identificar abordagens teóricas sobre oNeuromuscular curativo. Materiais e métodos: realizou hoje, para o qual realizou uma pesquisa bibliográficados bancos de dados, tais como como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs). O documento propõe um esquemade contextualização do cenário atual do uso e efeitos de kinesio taping na gestão dasdiferentes patologias do sistema músculo-esquelético no esporte. Conclusões: conclui-se quemuitos profissionais de saúde atualmente, e tomar as vandaje neuromuscular uma boa opção terapêutica no tratamento de doenças que afetam o corpo humano é investigada e cada dia mais sobre o assunto, o que torna esses novos métodosterapêuticos para adquirir um valor científico e transcende o conhecimento. Abstract in spanish El vendaje neuromuscular es una técnica creada en 1979 por el doctor Kenzo Kase, quien buscó proponer una nueva opción terapéutica para controlar el dolor, mejorar el rendimiento deportivo y reducir el impacto de los trastornos musculo-esqueléticos. A partir de los Juegos Olímpicos de Sydney 2000 es [...] ta técnica empleada por los profesionales de la salud en el campo del deporte y la rehabilitación física tomó fuerza como alternativa terapéutica. Objetivo: identificar las aproximaciones teóricas sobre el vendaje neuromuscular realizadas en la actualidad. Materiales y métodos: se llevó a cabo una búsqueda bibliográfica en bases de datos como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs). El esquema del artículo propone una contextualización del panorama actual del uso y los efectos del vendaje neuromuscular en el campo deportivo y en el manejo de diferentes patologías del sistema musculo-esquelético. Conclusiones: se concluye que actualmente muchos profesionales de la salud toman el vendaje neuromuscular como un buena opción terapéutica en el manejo de patologías que afectan el cuerpo humano, por lo cual cada día se investiga más acerca del tema, otorgando un valor científico a estos nuevos métodos. Abstract in english The kinesio taping is a technique that was created in 1979 by Doctor Kenzo Kase I'm looking through it that could generate a new therapeutic option to control pain, improve athletic performance and reduce the impact of musculoskeletal disorders. From the Sydney 2000 Olympic Games, this technique as [...] a therapeutic alternative PTO and is composed of health professionals in the field of sport and physical rehabilitation. Objetive: This article aims to identify theoretical approaches on the bandage neuromuscular. Material and methods: held today, for which conducted a literature search of databases such as como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs). The paper proposes a scheme of contextualization of the current landscape of the use and effects of kinesio taping in the management of different pathologies of the musculo-skeletal system in sports. Conclusion: it is concluded that currently many health professionals, and take the neuromuscular bandage a good therapeutic option in the management of diseases affecting the human body is investigated and every day more about the subject, which makes these new therapeutic methods to acquire a scie

  3. Emerging techniques in orthopedics: advances in neuromuscular electrical stimulation.

    Science.gov (United States)

    Paessler, Hans H

    2012-05-01

    Neuromuscular electrical stimulation (NMES) is defined as the application of an electric current to neuromuscular tissue to elicit a muscle contraction. It is typically applied in a clinical setting to strengthen muscle, particularly the quadriceps femoris, through repetitive contractions. Most studies to date involving NMES have been conducted using conventional lead-wired, or "single path" devices, and while effective, these devices have inherent limitations around comfort and incomplete muscle recruitment. In a prospective, randomized, controlled, single-blind trial, investigators found that using a novel "Multipath" device was effective when combined with standard rehabilitation in accelerating recovery after anterior cruciate ligament reconstruction. Additional research is warranted to explore whether this effect also occurs after other types of knee surgery. PMID:24911257

  4. Sniff nasal inspiratory pressure and sleep disordered breathing in childhood neuromuscular disorders.

    Science.gov (United States)

    Anderson, Vincent B; McKenzie, Jennifer A; Seton, Chris; Fitzgerald, Dominic A; Webster, Richard I; North, Kathryn N; Joffe, David A; Young, Helen K

    2012-06-01

    The ease of sniff nasal inspiratory pressure testing may extend application of respiratory muscle assessment to younger and cognitively-impaired children. We sought to quantify sniff nasal inspiratory pressure in childhood neuromuscular disorders, and to correlate this measure with conventional pulmonary function tests and overnight polysomnography. Thirty children (mean 9.7 ± 3.8 years, range 4.3-16.5 years) with diagnosed neuromuscular disorders (Duchenne muscular dystrophy, spinal muscular atrophy, Becker muscular dystrophy, congenital myopathy, facioscapulohumeral muscular dystrophy, myotonic dystrophy, multi-minicore disease) underwent assessment. Thirty-seven percent displayed cognitive impairment. Those with neuromuscular disorders were then compared with 32 volunteer age- and gender-matched controls (mean 10.9 ± 2.9 years, range 6.6-17.2 years) with normal respiratory function. Twenty-three children with neuromuscular disorders also underwent overnight polysomnography. Children with neuromuscular disorders demonstrated significantly impaired sniff nasal inspiratory pressure, maximal inspiratory pressure, FEV(1) and FVC (pprevalence of nocturnal hypoxia was observed, and 32% of children demonstrated sleep disordered breathing. Sniff nasal inspiratory pressure assessment was well tolerated, representing a promising surrogate measure for assessment of respiratory function in childhood neuromuscular disorders. PMID:22386707

  5. Neuromuscular interactions around the knee in children, adults and elderly.

    Science.gov (United States)

    Kellis, Eleftherios; Mademli, Lida; Patikas, Dimitrios; Kofotolis, Nikolaos

    2014-09-18

    Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly. The purpose of this study is to review recent evidence on age differences in neural activation and muscle balances around the knee when performing single joint movements. Particularly, current evidence indicates that there are some interesting similarities in the neuromuscular mechanisms by which children or the elderly differ compared with adults. Both children and elderly display a lower absolute muscle strength capacity than adults which cannot fully be explained by differences in muscle mass. Quadriceps activation failure is a common symptom of all knee injuries, irrespective of age but it is likely that its effect is more evident in children or adults. While one might expect that antagonist co-activation would differ between age categories, it appears that this is not the case. Although hamstring: quadriceps ratio levels are altered after knee injury, it is not clear whether this is an age specific response. Finally, evidence suggests that both children and the elderly display less stiffness of the quadriceps muscle-tendon unit than adults which affects their knee joint function. PMID:25232523

  6. Neuromuscular Highlights-AAN 2005.

    Science.gov (United States)

    Cheema, Zahid; Saperstein, David; Jackson, Carolyn; Newman, Daniel

    2006-06-01

    Summary of Neuromuscular Presentations at the 57 Annual AAN 2005 meeting in Miami Florida on topics of Facioscapulohumeral muscular dystrophy (FSHD), Duchenne muscular dystrophy (DMD), Diabetic Neuropathy, Charco Marie Tooth disease (CMT), Comparison of injected steroids versus Surgery for carpal tunnel syndrome, Rituximab in Anti-MAG associated polyneuropathy, Cannabis based medicine (CBM) in the treatment of neuropathic pain, utility of skin biopsy with intraepidermal nerve fiber density (IENFD) in sensory complaints, comparing sympathetic skin responses (SSRs) and skin biopsy in diagnosing small fiber sensory neuropathy, Chronic inflammatory demyelinating polyneuropathy (CIDP) clinical and electrophysiologic predictors, affect of limb warming in mild ulnar nerve conduction study (NCS) abnormalities, Tamoxifen affect in ALS, open label study of 3,4 DAP, Pyridostigmine and Ephedrine in fast channel syndrome, Mexilitine as an antimyotonia treatment in myotonic dystrophy (DM1), frontal lobe impairment evaluation in DM1 and DM2 patients and phenotype-genotype correlation in patients with dysferlinopathy. PMID:19078809

  7. Adiposity is associated with improved neuromuscular reaction time.

    Science.gov (United States)

    Grantham, James; Henneberg, Maciej

    2014-11-01

    Many studies have focused on the detrimental effects of malnourishment to the performance of the brain and peripheral nerves. Undernourished children and adults have been studied extensively to establish these consequences. Little attention has been given to the body habitus that affects optimum neurological performance and the implications for individuals on the spectral extremes of the healthy weight range. This paper examines the association between markers of adiposity and neurological performance, inclusive of all body types. The data were obtained from Cape Coloured youths (5-20 years) in South Africa from the rural district of Klein Karoo and the urban population of Cape Town. In all, the sums of skin-folds were measured for almost 4000 students. The neuromuscular reaction time was also calculated using a ruler drop test. This measure may serve as a gross marker of peripheral and central neurological performance as both are needed to execute the reflex command. There was a direct correlation between adiposity and neuromuscular reaction time. Whilst controlling for age, increasing fatness was associated with a decrease in neuromuscular reaction time amongst both sexes. This relationship remained statistically significant, even when removing the thinnest 40% of participants, eliminating the scope of influence exerted by malnourishment on the correlation. The trend appears to be more prominent amongst boys. These findings indicate that body lipid reserves are integral to the development of the nervous system even amongst children within the healthy weight ranges. Our hypothesis is that the myelination of the nerves, both centrally through oligodendrocytes and peripherally by Schwann cells, is integral to this process as they are predominantly lipid. Amongst thin but not clinically undernourished individuals, the somatic lipid reserves are modest. These fats may be minimally sequestered away for the development of myelin nerve sheath at the expense of saltatory conduction. This may account for the slowed neuromuscular reaction time demonstrated. PMID:25194500

  8. Pregnancy and Childbirth with Neuromuscular Disease

    Science.gov (United States)

    ... autoimmune neuromuscular disease, and put her on Mestinon (pyridostigmine bromide). But when her speech continued to slur and ... impairment, decreased fetal body weights and fetal death. pyridostigmine bromide (Mestinon) myasthenia gravis • No information on the safety ...

  9. La monitorización neuromuscular y su importancia en el uso de los bloqueantes neuromusculares / Neuromuscular monitoring and its importance in neuromuscular blockade

    Scientific Electronic Library Online (English)

    Joaquín, Fabregat López; César Augusto, Candia Arana; Caridad Greta, Castillo Monzón.

    2012-12-01

    Full Text Available Introducción: La necesidad por incorporar nuevas guías o estrategias en la buena práctica de uso de los bloqueantes neuromusculares no es un hecho de obligado cumplimento en la actualidad dentro de la anestesiología. Solo existen recomendaciones de actuación con el propósito de convencer que la moni [...] torización neuromuscular es una herramienta muy útil para el buen uso racional de los bloqueantes neuromusculares. Metodología: Las complicaciones surgen, y la parálisis residual es un evento destacado. Por esta razón, los autores propugnamos que la monitorización del bloqueo neuromuscular puede ser un factor determinante en la mejora del cuidado de nuestros pacientes, disminuyendo tanto la morbilidad como la mortalidad. Esta revisión y su metodología en base a la experiencia de los autores solo pretende exponer de forma sencilla conocimientos que consideramos básicos para su utilización sistemática en nuestra práctica rutinaria. Resultados y conclusiones: Esta actualización describe los principios fundamentales de los métodos que disponemos en la actualidad, priorizando las medidas cuantitativas de registro. Y también demuestra el diferente comportamiento de la musculatura al efecto de los bloqueantes neuromusculares, fundamentos relevantes que es preciso conocer. La monitorización neuromuscular es una práctica que debe utilizarse siempre que un bloqueo neuromuscular sea necesario. Somos conscientes que generar una recomendación explícita es difícil. Pero nuestro entusiasmo parte del beneficio de una experiencia personal con estos métodos que son conocidos desde antiguo. Debido a la potencial morbilidad asociada con bloqueos neuromusculares residuales, la monitorización perioperatoria de la función neuromuscular es esencial. Abstract in english Introduction: The incorporation of new guidelines or strategies as part of good practices in the use of muscle relaxants is not a requirement at present in the practice of anesthesia. There are only action recommendations designed to persuade clinicians of the fact that neuromuscular monitoring is a [...] very useful tool for the rational use of muscle relaxants. Methodology:Complications occur, and residual paralysis is a significant event. For this reason, the authors advocate that monitoring neuromuscular block may be a determining factor in improving patient care and reducing morbidity and mortality. This review and its methodology based on the experience of the authors is designed to present, in a simple format, the knowledge that considered fundamental for the systematic use of neuromuscular monitoring in every day practice. Results and conclusions: This update describes the fundamental principles of the methods available at present, emphasizing quantitative recording measurements. It then describes the different ways in which muscles respond to the effect of neuromuscular blockade, as these are critical fundamental principles that have to be known. Neuromuscular monitoring is a practice that should be implemented every time a neuromuscular block is required. We are aware of the difficulty of generating an explicit recommendation, but our enthusiasm is derived from the benefits we have personally experienced when applying these methods that have been known for a long time. Due to the potential morbidity associated with residual muscle relaxation, perioperative monitoring of neuromuscular function is essential.

  10. PICU EXTUBATION FAILURE: THE ROLE OF NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    N. Billan MD,

    2007-02-01

    Full Text Available ObjectiveNeuromuscular disorders (diseases of the motor unit, can cause respiratory problems such as impaired cough reflex, chest deformity, recurrent pneumonia and acute respiratory failure; these are the worst most common complications of these diseases and the leading cause of death in such patients (1, 2. Their management hence, very often, entails admission to the Pediatric Intensive Care Unit (PICU (3,4 and during this phase, endotracheal intubation is almost always necessary, to maintain the patency of airways and to apply Positive Pressure Ventilation (PPV. However, endotracheal intubation is always temporary, and its success or failure depends on the timely decision of its termination to restore the normal respiration or to avoid the risk of recurring respiratory failure (5, 6. We designed this study to evaluate the role of neuromuscular disorders in causing extubation failure as compared to that of other risk factors.Materials & MethodsIn an analytical cross-sectional study, the risk factors of reintubation and duration of mechanical ventilation in two groups of 30 patients each, was compared, the first successful extubation and the second with extubation failure.ResultsNeuromuscular disorders (including Spinal Muscular Atrophy, Guillain- Barre' Syndrome, Congenital Myopathies and Muscular Dystrophies were the main underlying diseases in extubation-failure group (P= 0.0002. Hypercapnia (PaCO2>50mmHg was shown to be the most common cause of both the first intubation (P=0.001 and reintubation (P=0.004 in the group of patients who failed extubation. The mean duration of intubation and mechanical ventilation was longer in patients with neuromuscular disorders who had extubation failure (P= 0.01.ConclusionThis study showed that, as underlying problems, neuromuscular disorders are the most common causes of prolonged intubation which defeat weaning from the ventilator and result in reintubation by inducing hypercapnia. Therefore the weaning process needs to be done gradually in these patients, and in conjunction with supportive measures, such as close observation for at least for 72 hours following extubation to monitor any possibility of recurrence of hypercapnic respiratory failure.

  11. Kinship and interaction in neuromuscular pharmacology

    OpenAIRE

    Schiere, Sjouke,

    2006-01-01

    The background of this thesis is presented in the introductory chapters and stafts with a brief history of neuromuscular relaxants. It is followed by a short description of the neuromuscular physiology and pharmacology in chapters 2 and 3, respectively. In chapter 4 the aim of the thesis is presented: To investigate the dose-concentration-effect relationship of some non-depolarising muscle relaxants and their interactions. Zie: summary

  12. Targeting RNA to treat neuromuscular disease.

    OpenAIRE

    Muntoni, F.; Wood, MJ

    2011-01-01

    The development of effective therapies for neuromuscular disorders such as Duchenne muscular dystrophy (DMD) is hampered by considerable challenges: skeletal muscle is the most abundant tissue in the body, and many neuromuscular disorders are multisystemic conditions. However, despite these barriers there has recently been substantial progress in the search for novel treatments. In particular, the use of antisense oligonucleotides, which are designed to target RNA and modulate pre-mRNA splici...

  13. Bone health in children with neuromuscular disorders.

    Science.gov (United States)

    Ness, Kathryn; Apkon, Susan D

    2014-01-01

    This paper provides a broad review of bone health issues in children with neuromuscular diseases (NMD). As Duchenne muscular dystrophy is the most common neuromuscular disease of childhood, there is a strong emphasis on this. This paper reviews the incidence of fractures, the degree of the reduced bone mineral density, the risk factors associated with this common problem, and the non-pharmacological and pharmacological treatment options. Recommendations for monitoring and treatment are provided. PMID:25096865

  14. Mechanical Control of Bacterial Cell Shape

    OpenAIRE

    Jiang, Hongyuan; Si, Fangwei; Margolin, William; Sun, Sean X.

    2011-01-01

    In bacteria, cytoskeletal filament bundles such as MreB control the cell morphology and determine whether the cell takes on a spherical or a rod-like shape. Here we use a theoretical model to describe the interplay of cell wall growth, mechanics, and cytoskeletal filaments in shaping the bacterial cell. We predict that growing cells without MreB exhibit an instability that favors rounded cells. MreB can mechanically reinforce the cell wall and prevent the onset of instability. We propose that...

  15. Electrochemical biofilm control: mechanism of action

    OpenAIRE

    Istanbullu, Ozlem; Babauta, Jerome; Nguyen, Hung Duc; Beyenal, Haluk

    2012-01-01

    Although it has been previously demonstrated that an electrical current can be used to control biofilm growth on metal surfaces, the literature results are conflicting and there is no accepted mechanism of action. One of the suggested mechanisms is the production of hydrogen peroxide (H2O2) on metal surfaces. However, there are literature studies in which H2O2 could not be detected in the bulk solution. This is most likely because H2O2 was produced at a low concentration near the surface and ...

  16. Helicopter Pitch-Control Mechanism Reduces Vibration

    Science.gov (United States)

    Lemont, H.

    1986-01-01

    Large forces accommodated without increasing weight of helicopter structure. New mechanism yields stiffer control and improves accuracy of pitch changes under load. As result, heavy casting not for gearbox, nor extra reinforcing members needed for fuselage bulkheads, stringers, skin, and other parts. In new mechanism, reaction forces developed in rotor hub. Long load paths to gearbox and fuselage elminated. Reaction member rigidly attached to hub and rotates with it. At lower end of reaction member, bearing forms bridge to fuselage through stationary beam and antirotation link. Beam connected to reaction plate through rods.

  17. Papel da vitamina D na função neuro-muscular Role of vitamin D in the neuro-muscular function

    Directory of Open Access Journals (Sweden)

    Márcia A. Carneiro Pedrosa

    2005-08-01

    Full Text Available A vitamina D, através de suas ações no intestino, rim, osso e glândulas paratiróides, é um hormônio fundamental para a homeostase do cálcio e para o desenvolvimento de um esqueleto saudável. Além disso, receptores deste hormônio podem ser encontrados em quase todos os tecidos do organismo e outras ações não relacionadas ao metabolismo mineral têm sido imputadas a ele. Na célula muscular esquelética, a vitamina D atua através do mecanismo clássico de ligação a um receptor nuclear e também através da ligação a um receptor de membrana, realizando ações que envolvem o transporte de cálcio, a síntese protéica e a velocidade de contração muscular. Clinicamente, a deficiência de vitamina D, que é bastante comum em idosos, inclusive em nosso país, tem sido relacionada a um aumento da incidência de quedas, a uma diminuição da força muscular e a uma deterioração do equilíbrio, avaliada pela oscilação do corpo na postura ereta. Por outro lado, tem sido demonstrado que a suplementação associada de cálcio e vitamina D em idosos deficientes contribui para melhoria destes aspectos da função neuro-muscular. Nesta revisão, serão discutidos os mecanismos conhecidos envolvidos na associação entre vitamina D e função neuro-muscular, e também a suplementação de vitamina D e cálcio na prevenção de fraturas osteoporóticas não-vertebrais sob a perspectiva dos efeitos neuro-musculares.Through its action in the kidney, intestines, bone and parathyroid glands vitamin D is a major regulator of calcium homeostasis and for the development of a healthy skeleton. Moreover, receptors for this hormone are present in almost all body tissues and other actions which are not related to the mineral metabolism have been imputed to it. In the skeletal muscle cell, vitamin D acts through the classic mechanism of binding to a nuclear receptor and also by binding to a membrane receptor, carrying out actions that involve calcium transport, protein synthesis and kinetics of muscle contraction. Clinically, vitamin D deficiency, which is very common among the elderly, including the ones in our country, has been related to an increase in the incidence of falls, as well as the reduction of muscle strength and deterioration of body sway, evaluated by the oscillation of the body in the erect position. On the other hand, it has been demonstrated that supplementation of calcium associated to vitamin D in deficient elderly contributes to the improvement of these aspects of the neuro-muscular function. In this review, the mechanisms involved in the association between vitamin D and neuro-muscular function will be discussed, as well as the supplementation of vitamin D and calcium to prevent non-vertebral osteoporotic fractures under the perspective of the neuro-muscular effects.

  18. Clinical applications of immunoglobulin in neuromuscular diseases: focus on inflammatory myopathies / Aplicações clínicas de imunoglobulina em doenças neuromusculares com foco em miopatias inflamatórias

    Scientific Electronic Library Online (English)

    Paulo Victor Sgobbi de, Souza; Wladimir Bocca Vieira de Rezende, Pinto; Acary Souza Bulle, Oliveira.

    2014-12-01

    Full Text Available Nos últimos anos, um número progressivo de doenças neuromusculares passaram a ser reconhecidas tanto por ser causadas por mecanismos autoimunes ou por envolver importantes componentes autoimunes. Os mecanismos fisiopatológicos e as manifestações clínicas envolvidos têm sido mais bem reconhecidos e m [...] uitas de tais doenças são potencialmente tratáveis por imunossupressão ou imunomodulação com imunoglobulina intravenosa (IVIg). IVIg vem sendo utilizada em uma variedade de doenças neurológicas imunomediadas, sendo alvo de amplo uso em doenças dos sistemas nervosos central e periférico. Objetivo Oferecer uma visão global sobre os principais tópicos relacionados aos mecanismos de ação e aos diferentes usos terapêuticos da IVIg na prática neurológica, principalmente em doenças neuromusculares. Abstract in english During recent years, an increasing number of neuromuscular diseases have been recognized either to be caused primarily by autoimmune mechanisms, or to have important autoimmune components. The involved pathophysiological mechanisms and clinical manifestations have been better recognized and many of [...] these disorders are potentially treatable by immunosuppression or by immunomodulation with intravenous immunoglobulin (IVIg). IVIg has been tried in a variety of immune-mediated neurological diseases, being target of widespread use in central and peripheral nervous systems diseases. Objective To give an overview of the main topics regarding the mechanism of action and different therapeutic uses of IVIg in neurological practice, mainly in neuromuscular diseases.

  19. The neuromuscular differential diagnosis of joint hypermobility.

    Science.gov (United States)

    Donkervoort, S; Bonnemann, C G; Loeys, B; Jungbluth, H; Voermans, N C

    2015-03-01

    Joint hypermobility is the defining feature of various inherited connective tissue disorders such as Marfan syndrome and various types of Ehlers-Danlos syndrome and these will generally be the first conditions to be considered by geneticists and pediatricians in the differential diagnosis of a patient presenting with such findings. However, several congenital and adult-onset inherited myopathies also present with joint hypermobility in the context of often only mild-to-moderate muscle weakness and should, therefore, be included in the differential diagnosis of joint hypermobility. In fact, on the molecular level disorders within both groups represent different ends of the same spectrum of inherited extracellular matrix (ECM) disorders. In this review we will summarize the measures of joint hypermobility, illustrate molecular mechanisms these groups of disorders have in common, and subsequently discuss the clinical features of: 1) the most common connective tissue disorders with myopathic or other neuromuscular features: Ehlers-Danlos syndrome, Marfan syndrome and Loeys-Dietz syndrome; 2) myopathy and connective tissue overlap disorders (muscle extracellular matrix (ECM) disorders), including collagen VI related dystrophies and FKBP14 related kyphoscoliotic type of Ehlers-Danlos syndrome; and 3) various (congenital) myopathies with prominent joint hypermobility including RYR1- and SEPN1-related myopathy. The aim of this review is to assist clinical geneticists and other clinicians with recognition of these disorders. © 2015 Wiley Periodicals, Inc. PMID:25821091

  20. Degradation Mechanism and Control of Silk Fibroin

    OpenAIRE

    LU Qiang; Zhang, Bing; Li, Mingzhong; Zuo, Baoqi; Kaplan, David L.; Huang, Yongli; Zhu, Hesun

    2011-01-01

    Controlling the degradation process of silk is an important and interesting subject in biomaterials field. In the present study, silk fibroin films with different secondary conformations and nanostructures were used to study the degradation behavior. Silk fibroin films with highest ?-sheet content achieved highest degradation rate, different from the previous studies. A new degradation mechanism revealed that degradation behavior of silk fibroin was related to not only crystal content, but al...

  1. Eletroestimulação neuromuscular na reabilitação da disfagia orofaríngea / Neuromuscular electrical stimulation in the rehabilitation of oropharyngeal dysphagia

    Scientific Electronic Library Online (English)

    Bruno Tavares de Lima, Guimarães; Ana Maria, Furkim; Roberta Gonçalves da, Silva.

    2010-12-01

    Full Text Available A reabilitação da disfagia orofaríngea ganhou um novo instrumento terapêutico, a eletroestimulação neuromuscular (EENM), sendo que os mais renomados pesquisadores têm estudado a indicação e os resultados desta abordagem. O objetivo deste trabalho foi apresentar revisão bibliográfica sobre a aplicabi [...] lidade da EENM na reabilitação da disfagia orofaríngea. Realizou-se amplo levantamento bibliográfico em bases de dados, englobando as duas últimas décadas de pesquisa na área. Este artigo de revisão mostrou que ainda não há consenso sobre o uso da EENM na reabilitação da disfagia. Constatou-se que a maioria dos trabalhos descreveu o uso da EENM de forma isolada, não relatou as técnicas fonoaudiológicas associadas à eletroterapia e utilizou amostras heterogêneas que agrupavam disfagias orofaríngeas mecânicas e neurogênicas. Somente recentemente programas específicos têm sido delineados e testados em populações mais homogêneas. Abstract in english The rehabilitation of oropharyngeal dysphagia has a new therapeutic tool, the neuromuscular electrical stimulation (NMES), and the most renowned researchers have been studying the applicability and the results of this approach. The aim of this study was to present a literature review regarding the a [...] pplicability of NMES in the rehabilitation of oropharyngeal dysphagia. An extensive literature review was carried out, considering the last two decades of research in the area. The review showed that there is still no consensus on the use of NMES in the rehabilitation of dysphagia. It was found that most studies described the use of NMES in isolation, did not describe the techniques associated with speech-language therapy associated to electrotherapy, and used heterogeneous samples that clustered mechanical and neurogenic oropharyngeal dysphagia. Only recently specific programs have been designed and tested in more homogeneous populations.

  2. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    Directory of Open Access Journals (Sweden)

    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  3. On the operating mechanism of population control.

    Science.gov (United States)

    Wei, J

    1992-01-01

    The progress made in population control in China is accounted for. The ingredients are a sound operating system (a mechanism), sufficient motivation, adequate and appropriate funding, information dissemination which dispels health fears and extols the health benefits, and a breakdown of social barriers to birth control. The mechanism takes into account the facts that individuals make choices about birth control and should have sufficient motivation and that the costs to society and individuals should be acceptable. Birth control will succeed when the motivation is strong and costs are reasonable. Even forced implementation will not work when costs are high and motivation weak. The current Chinese mechanism is not adequate to deal with new problems arising from reform and an opening up to the Western world. A parent's motivation is a result of supply and demand under certain conditions. The ability to produce children is related to the maximum parity under no restrictions and the probability of survival. Policy interventions must be directed to increasing the gap between supply and demand by influencing a parent's desire for more children. This desire is influenced by number, gender, and birth intervals as well as by educational and occupational goals. Son preference will increase the demand for more children. The economic value of children, resources available for raising children, and a subjective value judgement also influence the desire for children. Parental decisions may not be well-founded. The purpose of the policy is to establish minimum age requirements for employment and job-training programs and to provide old age security with greater benefits to those practicing birth control. Campaigns should be conducted to convince people to have small families. The long-term cost effectiveness of the IUD and sterilization means a wise investment. Funding has been increased to 2 yuan/person to account for the expansion of the program in breadth and depth. Misconceptions about the cost to health through side effects can be dispelled through campaigns and appropriate targets. PMID:12286125

  4. Neuromuscular Adaptations to Reduced Use

    Science.gov (United States)

    Ploutz-Snyder, Lori

    2009-01-01

    This viewgraph presentation reviews the studies done to reduce neuromuscular strength loss during unilateral lower limb suspension (ULLS). Since there are animals that undergo fairly long periods of muscular disuse without any or minimal muscular atrophy, there is an answer to that might be applicable to human in situations that require no muscular use to diminish the effects of muscular atrophy. Three sets of ULLS studies were reviewed indicated that muscle strength decreased more than the muscle mass. The study reviewed exercise countermeasures to combat the atrophy, including: ischemia maintained during Compound muscle action potential (CMAP), ischemia and low load exercise, Japanese kaatsu, and the potential for rehabilitation or situations where heavy loading is undesirable. Two forms of countermeasures to unloading have been successful, (1) high-load resistance training has maintained muscle mass and strength, and low load resistance training with blood flow restriction (LL(sub BFR)). The LL(sub BFR) has been shown to increase muscle mass and strength. There has been significant interest in Tourniquet training. An increase in Growth Hormone(GH) has been noted for LL(sub BFR) exercise. An experimental study with 16 subjects 8 of whom performed ULLS, and 8 of whom performed ULLS and LL(sub BFR) exercise three times per week during the ULLS. Charts show the results of the two groups, showing that performing LL(sub BFR) exercise during 30 days of ULLS can maintain muscle size and strength and even improve muscular endurance.

  5. Stirling engine control mechanism and method

    Science.gov (United States)

    Dineen, John J. (Durham, NH)

    1983-01-01

    A reciprocating-to-rotating motion conversion and power control device for a Stirling engine includes a hub mounted on an offset portion of the output shaft for rotation relative to the shaft and for sliding motion therealong which causes the hub to tilt relative to the axis of rotation of the shaft. This changes the angle of inclination of the hub relative to the shaft axis and changes the axial stroke of a set of arms connected to the hub and nutating therewith. A hydraulic actuating mechanism is connected to the hub for moving its axial position along the shaft. A balancing wheel is linked to the hub and changes its angle of inclination as the angle of inclination of the hub changes to maintain the mechanism in perfect balance throughout its range of motion.

  6. Study on Neuromuscular Blockade Action of Verapamil in Albino Rats

    OpenAIRE

    Nagaral, Jayashree; GH, Shashikala; K, Jagadeesh; Kumar K, Sharath; GS, Jayanth; PK, Chennaveerappa; Patil, Rajani

    2013-01-01

    Background: Calcium Channel Blockers (CCBs) are now widely employed in the treatment of cardiovascular diseases and peri operative hypertension. It has been reported that calcium channel blockers inhibit neuromuscular transmission. They have been shown to increase the neuromuscular blockade produced by neuromuscular blocking agents in in-vitro muscle nerve preparations. The present study is undertaken to demonstrate the effect of calcium channel blocker, verapamil on neuromuscular transmissio...

  7. Efeitos do aquecimento e do alongamento na resposta neuromuscular dos isquiotibiais / Effects of warm-up and stretching on the neuromuscular response of the hamstrings / Efectos del calentamiento y del alongamiento en la respuesta neuromuscular de los isquiotibiales

    Scientific Electronic Library Online (English)

    João Felipe de Souza, Nogueira; Caio Alano de Almeida, Lins; Angelica Vieira Cavalcanti, Souza; Jamilson Simões, Brasileiro.

    2014-07-01

    Full Text Available INTRODUÇÃO: A preparação para a atividade esportiva frequentemente envolve aquecimento e/ou alongamento, no intuito de prevenir lesões e/ou melhorar o desempenho. No entanto, a maneira como essas práticas podem interferir nos mecanismos neuromusculares de controle articular não é clara. OBJETIV [...] O: Analisar o efeito imediato do alongamento e do aquecimento, isolados ou associados, no tempo de latência muscular (TLM) e na amplitude de ativação dos isquiotibiais, após perturbações repentinas da articulação do joelho. MÉTODOS: Sessenta voluntários do sexo feminino (média de idade de 22,3 ± 1,7 anos e IMC 21,4 ± 1,3 kg/cm2) foram divididas aleatoriamente em quatro grupos: (1) controle, (2) aquecimento, (3) alongamento, (4) aquecimento + alongamento. A atividade elétrica dos isquiotibiais foi captada por eletromiografia de superfície durante uma perturbação súbita do joelho. Um eletrogoniômetro detectou o início da variação angular, enquanto os eletrodos captaram o início e a amplitude da atividade muscular antes e após as intervenções. Como procedimento estatístico utilizou-se ANOVA two-way e post-hoc de Tukey, considerando-se como nível de significância p Abstract in spanish INTRODUCCIÓN: La preparación para la actividad deportiva frecuentemente vincula calentamiento y/o alongamiento, con la intención de prevenir lesiones y/o mejorar el desempeño. Mientras tanto, la manera en cómo esas prácticas pueden interferir en los mecanismos neuromusculares de control articular [...] no es clara. OBJETIVO: Analizar el efecto inmediato del alongamiento y del calentamiento, aislados o asociados, en el tiempo delatencia muscular (TLM) y en la amplitud de activación de los isquiotibiales, después de perturbaciones repentinas de la articulación de la rodilla. MÉTODOS: Sesenta voluntarias del sexo femenino (promedio de edad de 22,3 ± 1,7 años e IMC 21,4 ± 1,3 kg/cm2) fueron divididas aleatoriamente en cuatro grupos: (1) control, (2) calentamiento, (3) alongamiento, (4) calentamiento + alongamiento. La actividad eléctrica de los isquiotibiales fue captada por electromiografía de superficie durante una perturbación súbita de la rodilla. Un electrogoniómetro detectó el inicio de la variación angular, mientras que los electrodos captaron el inicio y la amplitud de la actividad muscular antes y después de las intervenciones. Como procedimiento estadístico se usó ANOVA two-way y post-hoc de Tukey, considerándose como nivel de significancia p Abstract in english INTRODUCTION: The preparation for sports activities often involves warm-up and/or stretching in order to prevent injuries and/or improve performance. However, how these practices may interfere with neuromuscular mechanisms of joint control is unclear. OBJECTIVE: To analyze the immediate effect [...] of stretching and warm-up exercises, alone or combined, on muscle latency time (MLT) and hamstrings activation amplitude after sudden knee joint disturbances. METHODS: Sixty female volunteers (mean age 22.3±1.7 years, BMI 21.4±1.3kg/cm2) were randomly divided into four groups: (1) control, (2) warm-up, (3) stretching, (4) warm-up + stretching. Hamstrings electrical activity was recorded by surface electromyography during a sudden knee disturbance. An electrogoniometer detected the onset of angular variation, while electrodes recorded the onset and amplitude of muscle activity before and after interventions. Two-way ANOVA and post hoc Tukey were used in statistical analysis, considering a significance level of p

  8. Maintenance of BWR control rod drive mechanisms

    International Nuclear Information System (INIS)

    Control rod drive mechanism (CRDM) replacement and rebuilding is one of the highest dose, most physically demanding, and complicated maintenance activities routinely accomplished by BWR utilities. A recent industry workshop sponsored by the Oak Ridge National Laboratory, which dealt with the effects of CRDM aging, revealed enhancements in maintenance techniques and tooling which have reduced ALARA, improved worker comfort and productivity, and have provided revised guidelines for CRDM changeout selection. Highlights of this workshop and ongoing research on CRDM aging are presented in this paper

  9. Functional Neuromuscular Stimulation Controlled by Surface Electromyographic Signals Produced by Volitional Activation of the Same Muscle : Adaptive Removal of the Muscle Response from the Recorded EMG-Signal

    DEFF Research Database (Denmark)

    Sennels, SØren; Biering-SØrensen, Fin

    1997-01-01

    In order to use the volitional electromyography (EMG) as a control signal for the stimulation of the same muscle, it is necessary to eliminate the stimulation artifacts and the muscle responses caused by the stimulation. The stimulation artifacts, caused by the electric field in skin and tissue generated by the stimulation current, are relatively easy to eliminate by shutting down the EMG-amplifier at the onset of the stimulation pulses. The muscle response is a nonstationary signal, therefore, an adaptive linear prediction filter is proposed. The filter is implemented and for three filter lengths tested on both simulated and real data. The filter performance is compared with a conventional fixed comb filter. The simulations indicate that the adaptive filter is relatively insensitive to variations in amplitude of the muscle responses, and for all filter lengths produces a good filtering. For variations in shape of the muscle responses and for real data, an increased filter performance can be achieved by increasing the filter length. Using a filter length of up to seven stimulation periods, it is possible to reduce real muscle responses to a level comparable with the background noise. Using the shut-down circuit and the adaptive filter both the stimulation artifacts and the muscle responses can be effectively eliminated from the EMG signal from a stimulated muscle. It is therefore possible to extract the volitional EMG from a partly paralyzed muscle and use it for controlling the stimulation of the same muscle

  10. Pneumatic, PLC Controlled, Automotive Gear Shifting Mechanism

    Directory of Open Access Journals (Sweden)

    Muntaser Momani

    2010-05-01

    Full Text Available In this study, a gear shifting mechanism was designed and applied to make the shifting process faster and less destructible for the driver. The new device must be reliable, has a small dimensions, low construction and maintenance cost. This paper aims to improve gear shifting process using devices as: a manual four speed gear box, four pneumatic double acting cylinders, four pneumatic two position five ways directional control valves, Programmable Logic Controller (PLC LOGO unit, an electrical motor, an electrical clutch, a belt, two pulleys, limit switches, push buttons, bulbs, a table (holder and power supply. According to suggested gear_ shifting method the driver can select the transmission gear ratio without moving his hands from the steering wheel by putting the gear shifting push buttons on the steering wheel. Using this method leaves to the driver the excitement of choosing the shifting moment.

  11. Gain control mechanisms in spinal motoneurons

    Directory of Open Access Journals (Sweden)

    Michael David Johnson

    2014-07-01

    Full Text Available Motoneurons provide the only conduit for motor commands to reach muscles. For many years, motoneurons were in fact considered to be little more than passive “wires”. Systematic studies in the past 25 years however have clearly demonstrated that the intrinsic electrical properties of motoneurons are under strong neuromodulatory control via multiple sources. The discovery of potent neuromodulation from the brainstem and its ability to change the gain of motoneurons shows that the “passive” view of the motor output stage is no longer tenable. A mechanism for gain control at the motor output stage makes good functional sense considering our capability of generating an enormous range of forces, from very delicate (e.g. putting in a contact lens to highly forceful (emergency reactions. Just as sensory systems need gain control to deal with a wide dynamic range of inputs, so to might motor output need gain control to deal with the wide dynamic range of the normal movement repertoire. Two problems emerge from the potential use of the brainstem monoaminergic projection to motoneurons for gain control. First, the projection is highly diffuse anatomically, so that independent control of the gains of different motor pools is not feasible. In fact, the system is so diffuse that gain for all the motor pools in a limb likely increases in concert. Second, if there is a system that increases gain, probably a system to reduce gain is also needed. In this review, we summarize recent studies that show local inhibitory circuits within the spinal cord, especially reciprocal and recurrent inhibition, have the potential to solve both of these problems as well as constitute another source of gain modulation.

  12. Control mechanisms for a nonlinear model of international relations

    Energy Technology Data Exchange (ETDEWEB)

    Pentek, A.; Kadtke, J. [Univ. of California, San Diego, La Jolla, CA (United States). Inst. for Pure and Applied Physical Sciences; Lenhart, S. [Univ. of Tennessee, Knoxville, TN (United States). Mathematics Dept.; Protopopescu, V. [Oak Ridge National Lab., TN (United States). Computer Science and Mathematics Div.

    1997-07-15

    Some issues of control in complex dynamical systems are considered. The authors discuss two control mechanisms, namely: a short range, reactive control based on the chaos control idea and a long-term strategic control based on an optimal control algorithm. They apply these control ideas to simple examples in a discrete nonlinear model of a multi-nation arms race.

  13. Bloqueio neuromuscular residual após o uso de rocurônio ou cisatracúrio Bloqueo neuromuscular residual después del uso de rocuronio o cisatracúrio Residual neuromuscular block after rocuronium or cisatracurium

    Directory of Open Access Journals (Sweden)

    Bruno Salomé de Morais

    2005-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio neuromuscular residual na sala de recuperação pós-anestésica (SRPA é um fenômeno que pode aumentar a morbidade pós-operatória, com incidência variando entre 0% e 93%. O objetivo deste estudo foi avaliar a incidência do bloqueio neuromuscular residual na SRPA. MÉTODO: Foram estudados 93 pacientes submetidos à cirurgia geral com o uso de cisatracúrio ou rocurônio. Após a admissão na SRPA foi realizada a monitorização objetiva da função neuromuscular (aceleromiografia - TOF GUARD. O bloqueio neuromuscular residual foi definido como SQE JUSTIFICATIVA Y OBJETIVOS: El bloqueo neuromuscular residual en la sala de recuperación posanestésica (SRPA es un fenómeno que puede aumentar la morbidez posoperatoria, con incidencia variando entre 0% y 93%. La finalidad de este estudio fue evaluar la incidencia del bloqueo neuromuscular residual en la SRPA. MÉTODO: Fueron estudiados 93 pacientes sometidos a cirugía general con el uso de cisatracúrio o rocuronio. Después de la admisión en la SRPA fue realizada la monitorización objetiva de la función neuromuscular (aceleromiografia - TOF-GUARD. El bloqueo neuromuscular residual fue definido como TOF BACKGROUND AND OBJECTIVES: Residual neuromuscular block in the post-anesthetic recovery unit (PACU may increase postoperative morbidity from 0% to 93%. This study aimed at evaluating the incidence of residual neuromuscular block in the PACU. METHODS: Participated in this study 93 patients submitted to general anesthesia with cisatracurium or rocuronium. After PACU admission, neuromuscular function was objectively monitored (acceleromyography - TOF GUARD. Residual neuromuscular block was defined as TOF < 0.9. RESULTS: From 93 patients, 53 received cisatracurium and 40 rocuronium. Demographics, procedure length and the use of antagonists were comparable between groups. Residual neuromuscular block was 32% in subgroup C (cisatracurium and 30% in subgroup R (rocuronium. Residual neuromuscular block was unrelated to dose, age and use of antagonists, but was related to procedure length. In subgroup C, mean procedure length was 135 minutes for patients with neuromuscular block and 161 minutes for patients without (p < 0.029. In subgroup R, mean surgery length was 122 and 150 minutes, respectively (p < 0.039. CONCLUSIONS: Both groups had high incidence of residual neuromuscular block in the PACU. Residual postoperative curarization is still a problem even with new intermediary action neuromuscular blockers. It is highly important to objectively monitor all patients submitted to general anesthesia with neuromuscular blockers.

  14. Computed tomography (CT) in neuromuscular disorders

    International Nuclear Information System (INIS)

    For 24 patients with confirmed neuromuscular disorders, the clinical picture of the disease was complemented with CT examination. It is concluded, in accordance with the literature, that CT has a supplementary value as regards the extent and degree of disorder of the affected muscle groups. The basic pathological picture includes muscular atrophies, dystrophies, hypertrophies, and their combinations. The CT images are non-specific for the individual neuromuscular disorders and are of minor importance in the diagnostic process. 1 tab., 7 figs., 6 refs

  15. Research highlights of partial neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Cheng ZHANG

    2014-05-01

    Full Text Available In order to understand the latest progression on neuromuscular disorders for clinicians, this review screened and systemized the papers on neuromuscular disorders which were collected by PubMed from January 2013 to February 2014. This review also introduced the clinical diagnosis and treatment hightlights on glycogen storage disease type ? (GSD ?, Duchenne muscular dystrophy (DMD, amyotrophic lateral sclerosis (ALS and spinal muscular atrophy (SMA. The important references will be useful for clinicians. doi: 10.3969/j.issn.1672-6731.2014.05.004

  16. Transmitter release is evoked with low probability predominately by calcium flux through single channel openings at the frog neuromuscular junction.

    Science.gov (United States)

    Luo, Fujun; Dittrich, Markus; Cho, Soyoun; Stiles, Joel R; Meriney, Stephen D

    2015-04-01

    The quantitative relationship between presynaptic calcium influx and transmitter release critically depends on the spatial coupling of presynaptic calcium channels to synaptic vesicles. When there is a close association between calcium channels and synaptic vesicles, the flux through a single open calcium channel may be sufficient to trigger transmitter release. With increasing spatial distance, however, a larger number of open calcium channels might be required to contribute sufficient calcium ions to trigger vesicle fusion. Here we used a combination of pharmacological calcium channel block, high-resolution calcium imaging, postsynaptic recording, and 3D Monte Carlo reaction-diffusion simulations in the adult frog neuromuscular junction, to show that release of individual synaptic vesicles is predominately triggered by calcium ions entering the nerve terminal through the nearest open calcium channel. Furthermore, calcium ion flux through this channel has a low probability of triggering synaptic vesicle fusion (?6%), even when multiple channels open in a single active zone. These mechanisms work to control the rare triggering of vesicle fusion in the frog neuromuscular junction from each of the tens of thousands of individual release sites at this large model synapse. PMID:25652927

  17. Electromyographic and Neuromuscular Force Patterns Associated with Unexpectedly Loaded Rapid Limb Movements.

    Science.gov (United States)

    Richardson, Charles; Simmons, Roger W.

    Bi-articular, unidirectional arm movements were studied to evaluate the electromyographic (EMG) and neuromuscular force patterns that occur when a limb is unexpectedly perturbed. A series of training trials were continued with a control load spring attached to the apparatus until a pre-specified criterion for learning was attained. The limb was…

  18. Neuromuscular Adaptations to Eccentric Strength Training in Children and Adolescents with Cerebral Palsy

    Science.gov (United States)

    Reid, Siobhan; Hamer, Peter; Alderson, Jacqueline; Lloyd, David

    2010-01-01

    Aim: To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP). Method: In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11y, SD 2y range 9-15y), diagnosed with upper-limb spasticity were…

  19. O uso de bloqueadores neuromusculares no Brasil / Neuromuscular blockers in Brazil / El uso de bloqueadores neuromusculares en Brasil

    Scientific Electronic Library Online (English)

    Maria Cristina Simões de, Almeida.

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Dados estatísticos referentes ao uso de bloqueadores neuromusculares no Brasil são desconhecidos. Este trabalho se propõe a análise estatística desse tópico. MÉTODO: Foram compiladas 831 respostas de um questionário preenchido em parte por anestesiologistas presentes ao 48 [...] º Congresso Brasileiro de Anestesiologia em Recife, 2001 e em parte via Internet, por anestesiologistas cujos endereços eletrônicos constam na página da Sociedade Brasileira de Anestesiologia (www.sba.com.br). Foram analisados os seguintes dados: tempo de contato com a especialidade, região onde atuam os anestesiologistas, uso de bloqueadores neuromusculares (BNM) em ordem de preferência, indicações do uso de succinilcolina, uso do monitor da transmissão neuromuscular, critérios para se considerar o paciente descurarizado, uso de neostigmina, forma de administração dos BNM e descrição de complicações observadas. RESULTADOS: A maioria dos anestesiologistas em questão exerce a profissão há mais de 11 anos e o maior número de respostas foi proveniente da região sudeste do Brasil. O BNM mais empregado é o atracúrio, seguido de pancurônio e succinilcolina. A succinilcolina é mais empregada na indução rápida e em crianças (80% e 25% respectivamente). Monitores da transmissão neuromuscular, 53% dos anestesiologistas nunca usam, e como critério de recuperação, 92% consideram o paciente descurarizado mediante sinais clínicos. Em 45% das vezes os profissionais empregam a neostigmina de forma rotineira, e 94% administra os BNM sob forma de bolus. Cerca de 30% registra ter havido complicação decorrente do uso de BNM. As complicações mais apontadas foram o bloqueio prolongado, o broncoespasmo grave e a curarização residual. CONCLUSÕES: O atracúrio é o bloqueador neuromuscular mais empregado no Brasil, há percentual alto de uso da succinilcolina em situações não emergenciais, o uso de monitores da transmissão neuromuscular é raro, e, como um corolário, um percentual significativo de uso de critérios eminentemente clínicos para considerar o paciente descurarizado. Registrou-se que, cerca de 30% dos anestesiologistas teve algum tipo de complicação decorrente do uso desses fármacos. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: Dados estadísticos referentes al uso de bloqueadores neuromusculares en Brasil son desconocidos. Este trabajo se propone el análisis estadístico de ese tópico. MÉTODO: Fueron compiladas 831 respuestas de un cuestionario llenado en parte por anestesiologistas presentes al 4 [...] 8º Congreso Brasileño de Anestesiologia en la ciudad de Recife, 2001 y en parte vía Internet, por anestesiologistas cuyas direcciones electrónicas constan en la página de la Sociedad Brasileña de Anestesiologia (www.sba.com.br). Fueron analizados los siguientes datos: tiempo de contacto con la especialidad, región donde actúan los anestesiologistas, uso de bloqueadores neuromusculares (BNM) en orden de preferencia, indicaciones del uso de succinilcolina, uso del monitor de transmisión neuromuscular, criterios para considerar el paciente descurarizado, uso de neostigmina, forma de administración de los BNM y descripción de complicaciones observadas. RESULTADOS: La mayoría de los anestesiologistas en cuestión ejerce la profesión hace más de 11 años y el mayor número de respuestas fue proveniente de la región sudeste de Brasil. El BNM más empleado es el atracúrio, seguido de pancurónio y succinilcolina. La succinilcolina es más empleada en la inducción rápida y en niños (80% y 25% respectivamente). Monitores de la transmisión neuromuscular, 53% de los anestesiologistas nunca usan, y como criterio de recuperación, 92% consideran el paciente descurarizado mediante señales clínicas. En un 45% de las veces los profesionales emplean la neostigmina de forma rutinaria, y 94% administra los BNM bajo forma de bolus. Cerca del 30% registra que tuvieron complicación consecuente del uso de BNM. Las complicaciones más apuntadas fueron e

  20. Clinical use of creatine in neuromuscular and neurometabolic disorders.

    Science.gov (United States)

    Tarnopolsky, Mark A

    2007-01-01

    Many of the neuromuscular (e.g., muscular dystrophy) and neurometabolic (e.g., mitochondrial cytopathies) disorders share similar final common pathways of cellular dysfunction that may be favorably influenced by creatine monohydrate (CrM) supplementation. Studies using the mdx model of Duchenne muscular dystrophy have found evidence of enhanced mitochondrial function, reduced intra-cellular calcium and improved performance with CrM supplementation. Clinical trials in patients with Duchenne and Becker's muscular dystrophy have shown improved function, fat-free mass, and some evidence of improved bone health with CrM supplementation. In contrast, the improvements in function in myotonic dystrophy and inherited neuropathies (e.g., Charcot-Marie-Tooth) have not been significant. Some studies in patients with mitochondrial cytopathies have shown improved muscle endurance and body composition, yet other studies did not find significant improvements in patients with mitochondrial cytopathy. Lower-dose CrM supplementation in patients with McArdle's disease (myophosphorylase deficiency) improved exercise capacity, yet higher doses actually showed some indication of worsened function. Based upon known cellular pathologies, there are potential benefits from CrM supplementation in patients with steroid myopathy, inflammatory myopathy, myoadenylate deaminase deficiency, and fatty acid oxidation defects. Larger randomized control trials (RCT) using homogeneous patient groups and objective and clinically relevant outcome variables are needed to determine whether creatine supplementation will be of therapeutic benefit to patients with neuromuscular or neurometabolic disorders. Given the relatively low prevalence of some of the neuromuscular and neurometabolic disorders, it will be necessary to use surrogate markers of potential clinical efficacy including markers of oxidative stress, cellular energy charge, and gene expression patterns. PMID:18652078

  1. Reversión del bloqueo neuromuscular inducido por vecuronio: sugammadex o neostigmina / Reversal of vecuronium-induced neuromuscular blockade: sugammadex vs. neostigmine

    Scientific Electronic Library Online (English)

    Migdel G, Abreu Darias; Idoris, Cordero Escobar; Gisela, Pérez Martinez.

    2014-12-01

    Full Text Available Introducción: se han descrito diferencias entre la reversión de los bloqueantes neuromusculares con sugammadex y neostigmina. La mayoría concuerda que los resultados con sugammadex son superiores. Objetivos: comparar la capacidad del sugammadex y la neostigmina para revertir el bloqueo neuromuscular [...] con vecuronio. Métodos: se realizó un estudio de casos y controles, para evaluar la capacidad del recobro muscular con vecuronio, tras la reversión con sugammadex y neostigmina. Se evaluó el recobro muscular por exploración clínica. Resultados: se estudiaron un total de 405 pacientes, al Grupo S, correspondieron 135 pacientes y al Grupo N 270. El tiempo medio de duración de la intervención quirúrgica, fue para el grupo S de 32,21±1,2 min y para el Grupo N de 33,16 ±1,2 min. El promedio de tiempo de la reversión en el grupo S fue de 2.2 minutos y en el grupo N de 14.4 min. La calidad de la recuperación, en ambos grupos fue buena, no obstante las diferencias observadas en la frecuencia de los revertidos con sugammadex, resultó estadísticamente significativa (p = 0.00001). Las complicaciones fueron mas frecuentes en el grupo N. Conclusiones: se corroboró la capacidad del sugammadex para revertir el bloqueo neuromuscular con vecuronio. El tiempo de reversión del bloqueo fue 6,54 veces más prolongado con neostigmina. La calidad de la recuperación fue 1.34 veces mejor con de sugammmadex. Las reacciones adversas fueron 11,02 veces mas frecuentes con neostigmina que con sugammadex. Abstract in english Introduction: studies are available about the differences between reversal of neuromuscular blockers with sugammadex and neostigmine. Most studies agree that results are better when sugammadex is used. Objectives: compare the capacity of sugammadex and neostigmine to revert vecuronium-induced neurom [...] uscular blockade. Methods: a case-control study was conducted to evaluate neuromuscular recovery with vecuronium after reversal with sugammadex and neostigmine. Muscular recovery was evaluated by clinical examination. Results: a total 405 patients were studied. Group S was composed of 135 patients and Group N of 270. Mean surgical duration was 32.21±1.2 min for Group S and 33.16 ±1.2 min for Group N. Average reversal time was 2.2 min in Group S and 14.4 min in Group N. The quality of recovery was good in both groups. However, the frequency differences found in patients reverted with sugammadex were statistically significant (p = 0.00001). Complications were more frequent in Group N. Conclusions: the capacity of sugammadex to revert vecuronium-induced neuromuscular blockade was confirmed. Reversal time was 6.54 longer with neostigmine. The quality of recovery was 1.34 times better with sugammadex. Adverse reactions were 11.02 times more frequent with neostigmine than with sugammadex.

  2. Bloqueio neuromuscular residual após o uso de rocurônio ou cisatracúrio Bloqueo neuromuscular residual después del uso de rocuronio o cisatracúrio Residual neuromuscular block after rocuronium or cisatracurium

    OpenAIRE

    Bruno Salomé de Morais; Carlos Henrique Viana Castro; Vera Coelho Teixeira; Alexandre Silva Pinto

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio neuromuscular residual na sala de recuperação pós-anestésica (SRPA) é um fenômeno que pode aumentar a morbidade pós-operatória, com incidência variando entre 0% e 93%. O objetivo deste estudo foi avaliar a incidência do bloqueio neuromuscular residual na SRPA. MÉTODO: Foram estudados 93 pacientes submetidos à cirurgia geral com o uso de cisatracúrio ou rocurônio. Após a admissão na SRPA foi realizada a monitorização objetiva da função neuromuscular (acele...

  3. Man-Machine Interface System for Neuromuscular Training and Evaluation Based on EMG and MMG Signals

    Directory of Open Access Journals (Sweden)

    Patricia Fernández

    2010-12-01

    Full Text Available This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System, a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES and, as a novelty, the myomechanic signals (MMS. In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  4. Man-machine interface system for neuromuscular training and evaluation based on EMG and MMG signals.

    Science.gov (United States)

    de la Rosa, Ramon; Alonso, Alonso; Carrera, Albano; Durán, Ramon; Fernández, Patricia

    2010-01-01

    This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System), a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES) and, as a novelty, the myomechanic signals (MMS). In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals. PMID:22163515

  5. Neuromuscular contributions to age-related weakness

    Science.gov (United States)

    Age-related physiological change of neuromuscular function is not a linear process and is likely influenced by various biological and behavioral factors (e.g., genetics, nutrition, physical activity level, comorbidities, etc.). These factors contribute to heterogeneity among older adults, which chal...

  6. Neuromuscular Disorders: A Primer for School Psychologists

    Science.gov (United States)

    Augustyniak, Kristine; Kilanowski-Press, Lisa

    2008-01-01

    Improved medical care and legislative mandates have increased the degree to which students with neuromuscular disorders (NMD) are educated in general education environments. However, many practitioners remain largely unaware of the diverse presentations of disorders and challenges that students with NMD face. Despite the fact that school…

  7. Neuromuscular hamartoma arising in the brachial plexus.

    Science.gov (United States)

    Lai, P H; Ho, J T; Lin, S L; Hsu, S S; Chen, C; Yeh, L R; Pan, H B

    2004-03-01

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. PMID:14991257

  8. Neuromuscular hamartoma arising in the brachial plexus

    International Nuclear Information System (INIS)

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. (orig.)

  9. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Lund, Hans

    Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics Larsen CM1, Juul-Kristensen B1,2 Holtermann A3, Lund H1,2, Søgaard K1 1University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics, DK 2Institute of Occupational Therapy, Bergen University College, Bergen, Norway 3National Research Centre for the Working Environment, Copenhagen, DK E-mail: cmlarsen@health.sdu.dk AIMS: The aims were to understand potential mechanisms for impairment in the neuromuscular function of the scapular stabilisers in a general patient sample with SIS, and to assess the clinimetric properties of clinical assessment methods of scapular kinematics as important aspects for optimising effect measures of treatment in order to improve clinical guidelines in this area. METHODS: Scapular muscle activity was examined, 1) during a voluntary arm movement task and 2) selective activation tasks during sessions with and without on-line biofeedback, in a general population consisting of 16 SIS patients and 15 controls (No-SIS). Furthermore, 3) a systematic review was conducted of all available clinical scapular assessment methods and their associated clinimetric results, and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to critically assess the quality of the involved studies for each measurement property. RESULTS: 1) In spite of a general tendency for higher scapular muscle activity among SIS patients, between-group differences were not significant, either in activity level, ratio of activation between muscles or in the time of activity onset of the muscles, 2) Using the defined criteria of: (i) a selective activation above 12% of maximum activation during which other muscle parts were below 1.5% activity or (ii) an activation ratio above 95% of the total activity of all muscles, significantly fewer SIS subjects than No-SIS subjects achieved selective activation of individual scapular muscle compartments without on-line biofeedback of muscle activity from each muscle compartment of the trapezius muscle, 3) On the basis of 46 included articles, a total of 55 names of clinical assessment methods were identified. Thirty-one of the studies included in the quality assessment of the reliability and validity domains were classified as ‘fair’ (55%) to ‘poor’ (45%), with only one study being rated as ‘good’. Few of the assessment methods in the included studies with ‘fair’ or ‘good’ measurement property ratings demonstrated acceptable results for reliability and validity. Responsiveness was not investigated. CONCLUSION: 1) No between-group differences of SIS and No-SIS subjects in neuromuscular activity of scapular stabilising muscles were observed, 2) and when provided with visual EMG feedback, the SIS group performed equally well as the No-SIS group, However, when assessing the neuromuscular function with and without the use of biofeedback, the findings show that without biofeedback, the SIS group had alower scapular muscle control, 3) When addressing the possibility for measuring scapular kinematics clinically, the findings show a substantially larger number of clinical assessment methods for scapular position and function than previously reported. None of the included clinical assessment methods had been examined for all three domains: reliability, validity (diagnostic accuracy), as well as responsiveness. Based on these results, the current findings question the generalisability of current rehabilitation guidelines to the general population with SIS, however, SIS patients may benefit from biofeedback training. Lastly, these results indicate that very few clinical assessment methods have sufficient clinimetric properties that can be recommended for clinical use.

  10. Neuromuscular transmission studies in human chronic Chagas' disease Estudio de la transmisión neuromuscular en la enfermedad de Chagas crónica humana

    Directory of Open Access Journals (Sweden)

    Marcela Garcia Erro

    1989-09-01

    Full Text Available An electrophysiological investigation of the state of the neuromuscular transmission (nmt was carried out in 58 patients with the diagnosis of chronic Chagas' disease. On repetitive supramaximal nerve stimulation it was found that some patients did not show abnormalities, others had decremental muscle responses, others developed enhancement of the muscle evoked potential amplitudes, while some other patients combined both types of pathological responses. The findings suggest that some patients with chronic Chagas' disease develop impairement of nmt, though data obtained in this study do not give information about neither the type of impairement nor the localization (pre or postsynaptic, or both of the damage.Cincuenta y ocho pacientes con edades entre los 1 y 58 años, con diagnóstico de enfermedad de Chagas crónica fueron estudiados para evaluar la transmisión neuromuscular. Se estimuló en forma supramáxima el nervio cubital a nivel de muñeca, con registro de electrodos de superficie en hipotenar. Dicha estimulación se realizó a 3 Hz durante 2 segundos y 10 Hz durante 1 segundo en condiciones basales, trás 4 minutos de ejercicio mecánico, luego de 4 minutos de ejercicio mecánico mas isquemia y trás 2 minutos de liberada la isquemia. Se procedió a medir la amplitud del 3, 5, 6 y 10 potencial, que fueron expresados como variación porcentual con respecto al primero al que se le asignó un valor de 100%. Treinta pacientes no evidenciaron diferencias con respecto a la curva obtenida en 20 sujetos controles, 4 mostraron una caida del potencial evocado muscular, 6 una caida del mismo cuando el estímulo se realizó la bajas frecuencias y un incremento cuanto el estímulo fue a altas frecuencias. En los restantes 18 pacientes se observó un incremento del pem. Estos hallazgos sugieren una posible alteración de la transmisión neuromuscular en algunos pacientes que han alcanzado el estadio crónico de la enfermedad de Chagas de probable localización pré y/o post-sináptica.

  11. Neuromuscular transmission studies in human chronic Chagas' disease / Estudio de la transmisión neuromuscular en la enfermedad de Chagas crónica humana

    Scientific Electronic Library Online (English)

    Marcela Garcia, Erro; O., Genovese; J., Correale; R. E. P., Sica.

    1989-09-01

    Full Text Available Cincuenta y ocho pacientes con edades entre los 1 y 58 años, con diagnóstico de enfermedad de Chagas crónica fueron estudiados para evaluar la transmisión neuromuscular. Se estimuló en forma supramáxima el nervio cubital a nivel de muñeca, con registro de electrodos de superficie en hipotenar. Dicha [...] estimulación se realizó a 3 Hz durante 2 segundos y 10 Hz durante 1 segundo en condiciones basales, trás 4 minutos de ejercicio mecánico, luego de 4 minutos de ejercicio mecánico mas isquemia y trás 2 minutos de liberada la isquemia. Se procedió a medir la amplitud del 3, 5, 6 y 10 potencial, que fueron expresados como variación porcentual con respecto al primero al que se le asignó un valor de 100%. Treinta pacientes no evidenciaron diferencias con respecto a la curva obtenida en 20 sujetos controles, 4 mostraron una caida del potencial evocado muscular, 6 una caida del mismo cuando el estímulo se realizó la bajas frecuencias y un incremento cuanto el estímulo fue a altas frecuencias. En los restantes 18 pacientes se observó un incremento del pem. Estos hallazgos sugieren una posible alteración de la transmisión neuromuscular en algunos pacientes que han alcanzado el estadio crónico de la enfermedad de Chagas de probable localización pré y/o post-sináptica. Abstract in english An electrophysiological investigation of the state of the neuromuscular transmission (nmt) was carried out in 58 patients with the diagnosis of chronic Chagas' disease. On repetitive supramaximal nerve stimulation it was found that some patients did not show abnormalities, others had decremental mus [...] cle responses, others developed enhancement of the muscle evoked potential amplitudes, while some other patients combined both types of pathological responses. The findings suggest that some patients with chronic Chagas' disease develop impairement of nmt, though data obtained in this study do not give information about neither the type of impairement nor the localization (pre or postsynaptic, or both) of the damage.

  12. Tratamiento farmacológico de las alteraciones neuromusculares en el paciente crítico / Pharmacological treatment neuromuscular impairments in critically ill patients

    Scientific Electronic Library Online (English)

    C., Ortiz Leyba.

    2006-05-01

    Full Text Available El empleo de fármacos para tratamiento de las alteraciones neuromusculares que se presentan en el enfermo ingresado en una Unidad de Cuidados Intensivos es prácticamente inexistente. El empleo de inmunoglobulinas por vía venosa para el tratamiento de la polineuropatía del paciente crítico (PPC) no a [...] porta ninguna evidencia para su uso. Más importancia tiene el tratamiento profiláctico, como es el caso de la administración de una perfusión de insulina para prevenir la hiperglucemias que seasocian a un mayor desarrollo de la PPC. Nuevos datos inducen a pensar que el mecanismo protector de esta perfusión, normalizando los niveles de glucosa se hacen modulando una disfunción endotelial y a unos menores niveles de dimetilarginina asimétrica (ADMA). Con respecto a la miopatía del paciente crítico o a los cuadros de bloqueo neuromuscular prolongado, el tratamiento consiste en evitar el empleo de diversos fármacos que se sabe se asocian al desarrollo de estas entidades como son los corticoides, los relajantes musculares y los aminoglucósidos. Por lo que respecta a la parálisis aguda flácida -infección por el virus del oeste del nilo se han comunicado casos anecdóticos de mejoría con el empleo de corticoides o de interferón, pero su tratamiento rutinario queda aún por establecer. Abstract in english The use of drugs for treating neuromuscular impairments that present in the patient admitted to the Intensive Care Unit is virtually inexistent. The use of intravenous immunoglobulins for managing polyneuropathy of the critically ill patient (PCIP) is supported by no evidence. More important is prop [...] hylactic therapy, as is the administration of insulin perfusion to prevent hyperglycemia that is associated to increased development of PCIP. New data suggest that the protective mechanism of this perfusion, which normalizes glucose levels, is achieved through the modulation of endothelial dysfunction and lowering levels of asymmetrical di-methyl arginine (ADMA). As for myopathy of the critically ill patient or conditions with prolonged neuromuscular blockade, treatment consists in avoiding the use of several drugs known to be associated with development of these conditions, such as muscle relaxants and aminoglycosides. In relation to acute flaccid paralysis -an infection caused by the Western Nile Virus, anecdotic cases have been reported of improvement with the use steroids or interferon, although routine management remains to be established.

  13. Interacciones farmacológicas con el uso de bloqueantes neuromusculares / Drug interactions with the use of neuromuscular blockers

    Scientific Electronic Library Online (English)

    Idoris, Cordero Escobar.

    2014-12-01

    Full Text Available Introducción: la interacción medicamentosa es la capacidad que tiene un fármaco de alterar los efectos farmacológicos de otro que se administre simultáneamente. Objetivo: realizar una actualización sobre la interacción farmacológica de los bloqueantes neuromusculares, con fármacos de uso frecuente. [...] Desarrollo: los bloqueadores neuromusculares, se utilizan para relajar la musculatura estriada, garantizar la intubación traqueal, la ventilación y producir un plano quirúrgico suficiente. Muchos medicamentos interactúan con ellos y con frecuencia potencian el efecto bloqueante muscular. Esto resulta de importancia clínica en el caso de antibióticos, anestésicos inhalatorios, litio y ciclosporina. Se puede producir dificultad en la reversión del bloqueo con los bloqueadores de los canales de calcio y la polimixina. Otros como la fenitoína, carbamazepina y litio pueden provocar resistencia a estos fármacos. Existen compuestos que tienen la capacidad de producir relajación muscular por su propia acción, de forma aditiva o sinérgica. En algunas situaciones dichas interacciones pueden ser beneficiosas, como en el caso de los agentes inhalados que cursan con buena relajación muscular y disminuyen los requerimientos de las dosis de bloqueantes neuromusculares; pero en la mayoría de los casos las interacciones son peligrosas. Conclusiones: aunque el anestesiólogo moderno tiene suficientes conocimientos teóricos sobre interacciones medicamentosas, debe tener presenta las que pueden producir los bloqueantes neuromusculares, pues pueden inducir un bloqueo neuromuscular impredecible en la práctica diaria. Abstract in english Introduction: drug interaction is the capacity of a drug to alter the pharmacological effects of another one being administered simultaneously. Objective: carry out an update of the interaction of neuromuscular blockers with frequently used drugs. Results: neuromuscular blockers are used to relax th [...] e striated muscle, permit tracheal intubation and ventilation, and create sufficient surgical plane. Many drugs interact with them, and they frequently enhance the muscular blocking effect. The process is clinically important in the case of antibiotics, inhaled anesthetics, lithium and cyclosporin. Difficulty in blockade reversal may arise when calcium channel blockers and polymyxin are administered. Other drugs, such as phenytoin, carbamazepine and lithium, may cause resistance to these medications. There are compounds which may cause muscular relaxation due to their own action or in an additive or synergic manner. Some such interactions may be beneficial, as is the case with inhaled agents, which produce good muscular relaxation and lower the dose requirements of neuromuscular blockers. But in most cases interactions are dangerous. Conclusions: even though modern anesthesiologists have sufficient theoretical knowledge about drug interactions, they should bear in mind those produced by neuromuscular blockers, for they may induce unpredictable neuromuscular blockade in daily practice.

  14. Adaptation of neuromuscular activation patterns during treadmill walking after long-duration space flight

    Science.gov (United States)

    Layne, C. S.; Lange, G. W.; Pruett, C. J.; McDonald, P. V.; Merkle, L. A.; Mulavara, A. P.; Smith, S. L.; Kozlovskaya, I. B.; Bloomberg, J. J.

    The precise neuromuscular control needed for optimal locomotion, particularly around heel strike and toe off, is known to be compromised after short duration (8- to 15-day) space flight. We hypothesized here that longer exposure to weightlessness would result in maladaptive neuromuscular activation during postflight treadmill walking. We also hypothesized that space flight would affect the ability of the sensory-motor control system to generate adaptive neuromuscular activation patterns in response to changes in visual target distance during postflight treadmill walking. Seven crewmembers, who completed 3- to 6-month missions, walked on a motorized treadmill while visually fixating on a target placed 30 cm (NEAR) or 2 m (FAR) from the subject's eyes. Electronic foot switch data and surface electromyography were collected from selected muscles of the right lower limb. Results indicate that the phasic features of neuromuscular activation were moderately affected and the relative amplitude of activity in the tibialis anterior and rectus femoris around toe off changed after space flight. Changes also were evident after space flight in how these muscles adapted to the shift in visual target distance.

  15. Uso de sugamadex após reversão incompleta com neostigmine do bloqueio neuromuscular induzido por rocurônio / Use of sugammadex after neostigmine incomplete reversal of rocuronium-induced neuromuscular blockade / Uso de sugamadex después de la reversión incompleta con neostigmine del bloqueo neuromuscular inducido por rocuronio

    Scientific Electronic Library Online (English)

    Cássio Campelo de, Menezes; Lilian Akemi Moore, Peceguini; Enis Donizetti, Silva; Claudia Marquez, Simões.

    2012-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O uso de bloqueadores neuromusculares (BNM) na prática anestésica já tem mais de meio século e sempre foi um desafio para os anestesiologistas. Até bem pouco tempo a reversão dos bloqueadores neuromusculares adespolarizantes só possuia uma opção: a utilização de anticoline [...] sterásicos. No entanto em algumas situações como na presença de bloqueio neuromuscular profundo após o uso de altas doses do relaxante, o uso de anticolinesterásicos não possibilita a adequada reversão do bloqueio neuromuscular. Recentemente uma ciclodextrina gama mostrou-se altamente eficaz para a reversão do BNM de agentes esteroidais, o sugamadex. RELATO DO CASO: Paciente do sexo feminino, submetida à laparotomia exploradora de emergência após intubação em sequência rápida com uso de rocurônio 1,2 mg.kg-1. Ao final da cirurgia a paciente foi descurarizada com neostigmina, no entanto a monitoração da junção neuromuscular não apresentou a recuperação esperada, revelando curarização residual. Foi utilizado sugamadex 2 mg.kg-1 e a paciente apresenta reversão completa do BNM em apenas 2 minutos. CONCLUSÃO: A adequada recuperação do bloqueio neuromuscular residual é necessária para o pleno controle das funções da faringe e respiratória, evitando assim complicações. A adequada recuperação só pode ser obtida através da monitoração da junção neuromuscular com uma relação de TOF acima de 0,9. Muitas vezes a reversão do BNM com o uso de anticolinesterásicos pode não reverter completamente o BNM, no entanto na ausência da monitoração objetiva este diagnóstico não é possível. O caso ilustra o diagnóstico de BNM residual mesmo após a reversão com anticolinesterásicos, resolvido com a administração de sugamadex, uma alternativa segura para a reversão dos BNM adespolarizantes esteroidais. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: El uso de bloqueantes neuromusculares (BNM) en la práctica anestésica cuenta ya con más de medio y siempre fue un reto para los anestesiólogos. Hasta hace poco tiempo la reversión de los bloqueantes neuromusculares adespolarizantes solo tenía una opción: la utilización de [...] antocolinesterásicos. Sin embargo, en algunas situaciones como en presencia de bloqueo neuromuscular profundo después del uso de altas dosis del relajante, el uso de anticolinesterásicos no posibilita la adecuada reversión del bloqueo neuromuscular. Recientemente una ciclodextrina gama mostró ser altamente eficaz para la reversión del BNM de agentes esteroidales, como el sugamadex. RELATO DE CASO: Paciente del sexo femenino, sometida a la laparotomía exploradora de emergencia después de la intubación en secuencia rápida con el uso de rocuronio 1,2 mg.kg-1. Al término de la operación, la paciente fue descurarizada con neostigmina, pero la monitorización de la junción neuromuscular no presentó la recuperación esperada, revelando la curarización residual. Fue utilizado sugamadex 2 mg.kg-1 y comprobamos que la paciente presenta una reversión completa del BNM en solamente 2 minutos. CONCLUSIONES: La correcta recuperación del bloqueo neuromuscular residual es necesaria para el pleno control de las funciones de la faringe y respiratoria, evitando así complicaciones. La adecuada recuperación solo puede obtenerse por medio de la monitorización de la junción neuromuscular con una relación de TOF por encima de 0,9. En muchas ocasiones, la reversión del BNM con el uso de anticolinesterásicos puede no revertir completamente el BNM, pero sin embargo en ausencia de la monitorización objetiva, ese diagnóstico no puede ser alcanzado. El caso ilustra el diagnóstico de BNM residual incluso después de la reversión con anticolinesterásicos, resuelto con la administración de sugamadex, una alternativa segura para la reversión de los BNM adespolarizantes esteroidales. Abstract in english BACKGROUND AND OBJECTIVES: Neuromuscular blockers (NMB) have been used for more than half of a century in anesthesia and have alway

  16. Sleep abnormalities associated with neuromuscular disease: pathophysiology and evaluation.

    Science.gov (United States)

    Piper, Amanda

    2002-06-01

    The development of respiratory failure is common in patients with neuromuscular disorders that involve the respiratory muscles. However, the high incidence of sleep-related breathing problems in this population is less well known. In patients with neuromuscular disease, nocturnal breathing abnormalities frequently precede respiratory failure during wakefulness by months or even years. These nocturnal breathing problems are caused by multiple factors, including diaphragm and upper airway muscle weakness, scoliosis, obesity, and central respiratory control problems. Advances in the understanding of the links between sleep-disordered breathing and the development of daytime dysfunction and respiratory failure has revolutionized the management of these individuals. Mask positive pressure therapy is now available to improve both quality of life and longevity for these individuals. The lack of correlation between daytime testing and the severity of nocturnal breathing abnormalities makes it difficult to predict the presence of sleep-disordered breathing. Further, patients may not always be aware of symptoms associated with sleep-disordered breathing, even if specifically questioned. However, simple bedside measurements of vital capacity and inspiratory muscle strength can provide useful guides for when nocturnal respiratory monitoring is indicated. PMID:16088613

  17. Neuromuscular stimulation therapy after incomplete spinal cord injury promotes recovery of interlimb coordination during locomotion

    Science.gov (United States)

    Jung, R.; Belanger, A.; Kanchiku, T.; Fairchild, M.; Abbas, J. J.

    2009-10-01

    The mechanisms underlying the effects of neuromuscular electrical stimulation (NMES) induced repetitive limb movement therapy after incomplete spinal cord injury (iSCI) are unknown. This study establishes the capability of using therapeutic NMES in rodents with iSCI and evaluates its ability to promote recovery of interlimb control during locomotion. Ten adult female Long Evans rats received thoracic spinal contusion injuries (T9; 156 ± 9.52 Kdyne). 7 days post-recovery, 6/10 animals received NMES therapy for 15 min/day for 5 days, via electrodes implanted bilaterally into hip flexors and extensors. Six intact animals served as controls. Motor function was evaluated using the BBB locomotor scale for the first 6 days and on 14th day post-injury. 3D kinematic analysis of treadmill walking was performed on day 14 post-injury. Rodents receiving NMES therapy exhibited improved interlimb coordination in control of the hip joint, which was the specific NMES target. Symmetry indices improved significantly in the therapy group. Additionally, injured rodents receiving therapy more consistently displayed a high percentage of 1:1 coordinated steps, and more consistently achieved proper hindlimb touchdown timing. These results suggest that NMES techniques could provide an effective therapeutic tool for neuromotor treatment following iSCI.

  18. Brain mechanisms that control sleep and waking

    Science.gov (United States)

    Siegel, Jerome

    This review paper presents a brief historical survey of the technological and early research that laid the groundwork for recent advances in sleep-waking research. A major advance in this field occurred shortly after the end of World War II with the discovery of the ascending reticular activating system (ARAS) as the neural source in the brain stem of the waking state. Subsequent research showed that the brain stem activating system produced cortical arousal via two pathways: a dorsal route through the thalamus and a ventral route through the hypothalamus and basal forebrain. The nuclei, pathways, and neurotransmitters that comprise the multiple components of these arousal systems are described. Sleep is now recognized as being composed of two very different states: rapid eye movements (REMs) sleep and non-REM sleep. The major findings on the neural mechanisms that control these two sleep states are presented. This review ends with a discussion of two current views on the function of sleep: to maintain the integrity of the immune system and to enhance memory consolidation.

  19. Spectrum of Cyber threats & Available Control Mechanisms

    Directory of Open Access Journals (Sweden)

    Vikram Mangla, Dr.S.N.Panda

    2013-04-01

    Full Text Available The Internet is undoubtedly the largest public data network enabling and facilitating both personal & business communications worldwide. Wireless networking has experienced a tremendous growth becoming an integral part of homes, offices & all type of businesses. It provides many advantages, but it is also coupled with many security threats and alters the organizations overall information security risk profile. Although implementation of technological solution is the usual respond to the wireless security threats and vulnerabilities, wireless security is primarily a management issue. Cyber crime is constantly evolving and the growing increase in the number of threats that use social engineering techniques is causing concern for several businesses. All it takes is for one user to click on a malicious link and a firm’s network can be brought to a grinding halt. But the early days of cyber threats have gone now. Cyber threats have increased in large number. The volume of effect of these attacks has increased tremendously whereas the transaction time has decreased. The sources of attacks and exploitations are difficult to determine within time frames that enable victims to avoid damage, and any defensive measure is likely eventually to fail given the vulnerabilities of most cyber systems and the incapacities of users. In this paper we review different cyber threats and control mechanisms available and how these are affecting the network world.

  20. Adaptive mechanically controlled lubrication mechanism found in articular joints

    OpenAIRE

    Greene, George W.; Banquy, Xavier; Lee, Dong Woog; Lowrey, Daniel D.; Yu, Jing; Israelachvili, Jacob N.

    2011-01-01

    Articular cartilage is a highly efficacious water-based tribological system that is optimized to provide low friction and wear protection at both low and high loads (pressures) and sliding velocities that must last over a lifetime. Although many different lubrication mechanisms have been proposed, it is becoming increasingly apparent that the tribological performance of cartilage cannot be attributed to a single mechanism acting alone but on the synergistic action of multiple “modes” of l...

  1. Effects of neuromuscular blocking agents on central respiratory chemosensitivity in newborn rats

    Scientific Electronic Library Online (English)

    SHIGEKI, SAKURABA; SHUN-ICHI, KUWANA; LARS I, ERIKSSON; YASUMASA, OKADA; RYOICHI, OCHIAI; MASANORI, KASHIWAGI; EIKI, HATORI; STEN G. E., LINDAHL; JUNZO, TAKEDA.

    Full Text Available Neuromuscular blocking agents suppress central respiratory activity through their inhibitory effects on preinspiratory neurons and the synaptic drive from preinspiratory neurons to inspiratory neurons. Central CO2-chemosensitive areas, which partly consist of CO2-excited neurons, in the rostral vent [...] rolateral medulla are thought to provide tonic drive to the central respiratory network and involve cholinergic mechanisms, which led us to hypothesize that neuromuscular blocking agents can inhibit CO2-excited neurons and attenuate respiratory CO2 responsiveness. To test this hypothesis, we used isolated brainstem-spinal cord preparations from newborn rats. The increase of C4 burst frequency induced by a hypercapnic superfusate, i.e. respiratory CO2 responsiveness, was suppressed by the application of neuromuscular blocking agents, either d-tubocurarine (10, 100?M) or vecuronium (100?M). These agents (40?M) also induced hyperpolarization and decreases in firing frequency of CO2-excited neurons in the rostral ventrolateral medulla. Our results demonstrate that neuromuscular blocking agents inhibit CO2-excited tonic firing neurons and attenuate respiratory CO2 responsiveness.

  2. Coherent, mechanical control of a single electronic spin.

    Science.gov (United States)

    Hong, Sungkun; Grinolds, Michael S; Maletinsky, Patrick; Walsworth, Ronald L; Lukin, Mikhail D; Yacoby, Amir

    2012-08-01

    We demonstrate coherent quantum control of a single spin driven by the motion of a mechanical resonator. The motion of a mechanical resonator is magnetically coupled to the electronic spin of a single nitrogen-vacancy center in diamond. Synchronization of spin-addressing protocols to the motion of the driven oscillator is used to fully exploit the coherence of this hybrid mechanical-spin system. We demonstrate applications of this coherent mechanical spin-control technique to nanoscale scanning magnetometry. PMID:22800099

  3. MECHANISMS OF DRY SO2 CONTROL PROCESSES

    Science.gov (United States)

    The report discusses physical and chemical processes and reaction mechanisms for lime spray drying and dry injection of sodium compounds in dry flue gas desulfurization (FGD) processes. It includes: chemical reactions, physical changes, proposed reaction mechanisms and mathematic...

  4. Neuromuscular hamartomas of the head and neck.

    Science.gov (United States)

    Tiffee, J C; Barnes, E L

    1998-02-01

    The neuromuscular hamartoma (also referred to as the neuromuscular choristoma or benign triton tumor) is a rare developmental lesion composed of mature elements of both striated muscle and nerve. To date, less than 20 cases have been reported in the English language literature. The majority of these have involved large nerves, such as the sciatic or brachial plexus, but cutaneous lesions have also been reported. We report 2 cases that involve the head and neck and that are among the few described in this location. The majority of cases have been described in infants and young children. However, 1 of our cases (and at least 1 previously reported case) occurred in an adult. While surgical excision has been the most widely used form of therapy, a few cases have been complicated by and/or associated with a second lesion, such as a fibromatosis or lymphangioma. PMID:9485116

  5. Neuromuscular choristoma of the internal auditory meatus.

    Science.gov (United States)

    Nikolaou, Georgios; Röösli, Christof; Huber, Alex; Probst, Rudolf

    2012-01-01

    Choristomas of the internal auditory meatus are exceedingly rare tumors. In most cases, neuromuscular choristomas have initially been misdiagnosed as vestibular schwannomas (VS). No known characteristics in the clinical presentation or in imaging exist distinguishing these tumors from VS, which are the most common tumors at this location [Smith et al.: AJNR Am J Neuroradiol 1997;18:327-329]. We present a case of a neuromuscular choristoma of the 8th cranial nerve that was operated because of growth demonstrated on two MRI scans 3 months apart. We were convinced that this young patient would require treatment sometime in the future, and we believed that an operation at that time had higher chances to preserve the anatomical structures. Histomorphological examination of the tumor revealed a nodular lesion with fascicular and nodular assembled smooth muscle cells, connective tissue and nerve fibers. PMID:23076347

  6. Pulmonary Rehabilitation in Patients with Neuromuscular Disease

    OpenAIRE

    Kang, Seong-woong

    2006-01-01

    In neuromuscular disease (NMD) patients with progressive muscle weakness, respiratory muscles are also affected and hypercapnia can increase gradually as the disease progresses. The fundamental respiratory problems NMD patients experience are decreased alveolar ventilation and coughing ability. For these reasons, it is necessary to precisely evaluate pulmonary function to provide the proper inspiratory and expiratory muscle aids in order to maintain adequate respiratory function. As inspirato...

  7. Neuromuscular Fatigue During 200 M Breaststroke

    OpenAIRE

    Conceição, Ana; Silva, António J.; Barbosa, Tiago; Karsai, István; Louro, Hugo

    2014-01-01

    The aims of this study were: i) to analyze activation patterns of four upper limb muscles (duration of the active and non-active phase) in each lap of 200m breaststroke, ii) quantify neuromuscular fatigue, with kinematics and physiologic assessment. Surface electromyogram was collected for the biceps brachii, deltoid anterior, pectoralis major and triceps brachii of nine male swimmers performing a maximal 200m breaststroke trial. Swimming speed, SL, SR, SI decreased from the 1st to the 3rd la...

  8. Acute neuromuscular responses to car racing

    OpenAIRE

    Backman, Jani

    2005-01-01

    Purpose: The primary purpose of this study was to determine racing car drivers’ acute neuromuscular responses to race driving. The secondary purpose was to compare the cardiovascular loading of driving to that of maximal rowing action. Methods: The subjects of the present cross-sectional study (n = 9) were international level karting drivers. The study was performed in two parts; the laboratory tests and driving test. All subjects took part to the laboratory tests and five of the subjects per...

  9. Wnt Signaling in Neuromuscular Junction Development

    OpenAIRE

    Koles, Kate; Budnik, Vivian

    2012-01-01

    Wnt proteins are best known for their profound roles in cell patterning, because they are required for the embryonic development of all animal species studied to date. Besides regulating cell fate, Wnt proteins are gaining increasing recognition for their roles in nervous system development and function. New studies indicate that multiple positive and negative Wnt signaling pathways take place simultaneously during the formation of vertebrate and invertebrate neuromuscular junctions. Although...

  10. Neuromuscular efficiency of the rectus abdominis differs with gender and sport practice.

    OpenAIRE

    David, Pascal; Mora, Isabelle; Pe?rot, Chantal

    2008-01-01

    The purpose of this investigation was to distinguish the abilities of the rectus abdominis (RA) muscle according to gender and sport training by means of neuromuscular parameters extracted from electromyography (EMG)-torque relationships. Thirty-eight healthy students, divided into 4 groups (i.e., 8 male runners, 10 female gymnasts, 12 male controls, and 8 female controls) were asked to perform 6 seconds of isometric trunk flexions at 20%, 25%, 75%, and 100% of their maximal voluntary contrac...

  11. Neuromuscular scoliosis - surgical management and outcomes

    Scientific Electronic Library Online (English)

    A, Puddu; RN, Dunn.

    Full Text Available Neuromuscular scoliosis affects a heterogeneous group of patients with myopathic, upper and lower motor neuron diseases. Spinal surgery is often required to optimise respiratory, sitting and ambulatory function. OBJECTIVES: Review of management and outcomes of surgically treated neuromuscular scolio [...] sis. STUDY DESIGN: Retrospective review of prospectively maintained data, including demographics, intra-operative variables, pre- and post-operative imaging, complications, outcomes and a telephonic follow-up questionnaire. RESULTS: Ninety-eight patients (45 male and 53 female) were included in the study. The average operating time was 230 (100-525 ± 60.9) minutes and an average of 15.4 (8-19 ± 2.9) levels were fused. Pedicle screw only constructs corrected the primary curve by 63% initially and 56% correction at last follow-up. Hybrid constructs had an immediate correction of 69% and 47% at last follow-up. Although pedicle screw constructs lost less correction when compared to hybrid constructs, this was not a statistically significant difference. Pelvic obliquity was corrected from 14.02 (0-80 ± 15.54) to 4.06 (0-35 ± 7.69) degrees. The majority of the telephonic responses were positive. CONCLUSION: : Corrective spinal surgery in the neuromuscular patient is demanding with a high rate of complications but outcomes are good, with radiographic correction maintained in the long term and high level of patient and parent satisfaction. LEVEL OF EVIDENCE: III

  12. Estimulação elétrica neuromuscular na reversão da ossificação heterotópica Neuromuscular electric stimulation in heterotropic ossification regression

    Directory of Open Access Journals (Sweden)

    Daniel Bechara Jacob Ferreira

    2006-01-01

    Full Text Available A ossificação heterotópica é uma complicação freqüente após a lesão medular. Os avanços graduais no campo da fisiopatologia, reabilitação e novos métodos de tratamento são uma esperança para a reversão do quadro clínico do lesado medular num futuro próximo. O objetivo desse estudo é avaliar a resposta da ossificação heterotópica das articulações coxo femorais à estimulação elétrica neuromuscular em pacientes tetraplégicos após trauma raquimedular. Seis pacientes foram submetidos à estimulação elétrica neuromuscular por um período médio de 16,6 meses, sendo avaliados radiologicamente. Foi identificada a melhora radiológica em dois pacientes e a não progressão do quadro nos demais. A estimulação elétrica neuromuscular em lesados medulares pode ser um método válido no tratamento da ossificação heterotópica e prevenção de sua progressão.Heterotropic ossification is a common complication after spinal cord injury. Gradual advancements in the physiopathology and rehabilitation fields, and new treatment methods are a hope for the recovery of the clinical picture of injured individuals in the near future. The objective of this study was to evaluate the heterotropic ossification response of the thigh-femoral joints to neuromuscular electric stimulation in tetraplegic patients after rachial-medullar trauma. Six patients were submitted to neuromuscular electric stimulation for an average period of 16.6 months, being evaluated for X-ray imaging. Improvements on X-ray images were identified in two patients and the non-progression of the picture was observed in the remaining patients. Neuromuscular electric stimulation in spinal cord-injured individuals could be a useful method for treating heterotropic ossification and related progression prevention.

  13. Estimulação elétrica neuromuscular na reversão da ossificação heterotópica / Neuromuscular electric stimulation in heterotropic ossification regression

    Scientific Electronic Library Online (English)

    Daniel Bechara Jacob, Ferreira; Henrique Cambraia, Lippelt; Alberto, Cliquet Júnior.

    Full Text Available A ossificação heterotópica é uma complicação freqüente após a lesão medular. Os avanços graduais no campo da fisiopatologia, reabilitação e novos métodos de tratamento são uma esperança para a reversão do quadro clínico do lesado medular num futuro próximo. O objetivo desse estudo é avaliar a respos [...] ta da ossificação heterotópica das articulações coxo femorais à estimulação elétrica neuromuscular em pacientes tetraplégicos após trauma raquimedular. Seis pacientes foram submetidos à estimulação elétrica neuromuscular por um período médio de 16,6 meses, sendo avaliados radiologicamente. Foi identificada a melhora radiológica em dois pacientes e a não progressão do quadro nos demais. A estimulação elétrica neuromuscular em lesados medulares pode ser um método válido no tratamento da ossificação heterotópica e prevenção de sua progressão. Abstract in english Heterotropic ossification is a common complication after spinal cord injury. Gradual advancements in the physiopathology and rehabilitation fields, and new treatment methods are a hope for the recovery of the clinical picture of injured individuals in the near future. The objective of this study was [...] to evaluate the heterotropic ossification response of the thigh-femoral joints to neuromuscular electric stimulation in tetraplegic patients after rachial-medullar trauma. Six patients were submitted to neuromuscular electric stimulation for an average period of 16.6 months, being evaluated for X-ray imaging. Improvements on X-ray images were identified in two patients and the non-progression of the picture was observed in the remaining patients. Neuromuscular electric stimulation in spinal cord-injured individuals could be a useful method for treating heterotropic ossification and related progression prevention.

  14. How Are Neuromuscular Diseases Treated?

    Science.gov (United States)

    ... and arm use. Prednisone’s undesirable side effects include weight gain, loss of bone mass, thinning of the skin, raised blood pressure and blood sugar, depression, and difficulties with thinking, sleeping and controlling behavior. ...

  15. Control of a mechanical gripper with a fuzzy controller; Control de una garra robotizada mediante un controlador borroso

    Energy Technology Data Exchange (ETDEWEB)

    Alberdi, J.; Barcala, J.M.; Gamero, E.; Navarrete, J.J.

    1995-07-01

    A fuzzy logic system is used to control a mechanical gripper. System is based in a NLX230 fuzzy micro controller. Control rules are programmed by a 68020 microprocessor in the micro controller memory. Stress and its derived are used as feedback signals in the control. This system can adapt its effort to the mechanical resistance of the object between the fingers. (Author)

  16. The tested control rod drive mechanism system based on PLC

    International Nuclear Information System (INIS)

    In order to test control rod drive mechanism would be match the functions and performance of the requirements of the design specifications, and complete the factory test, design this test device for test drive mechanism. The device based on programmable logic controller realized rod lifting, rod keeping, rod inserting and integrated alarm etc. Function. It introduces the working principle and realization method of the test device of control rod drive mechanism. Through connecting debugging with driving mechanism. The result proved that the test device would be match requirements of the technical agreement, the function and performance of CRDM meet the requirements of the design specifications of the production. (authors)

  17. Biomechanical and neuromuscular characteristics of male athletes: implications for the development of anterior cruciate ligament injury prevention programs.

    Science.gov (United States)

    Sugimoto, Dai; Alentorn-Geli, Eduard; Mendiguchía, Jurdan; Samuelsson, Kristian; Karlsson, Jon; Myer, Gregory D

    2015-06-01

    Prevention of anterior cruciate ligament (ACL) injury is likely the most effective strategy to reduce undesired health consequences including reconstruction surgery, long-term rehabilitation, and pre-mature osteoarthritis occurrence. A thorough understanding of mechanisms and risk factors of ACL injury is crucial to develop effective prevention programs, especially for biomechanical and neuromuscular modifiable risk factors. Historically, the available evidence regarding ACL risk factors has mainly involved female athletes or has compared male and female athletes without an intra-group comparison for male athletes. Therefore, the principal purpose of this article was to review existing evidence regarding the investigation of biomechanical and neuromuscular characteristics that may imply aberrant knee kinematics and kinetics that would place the male athlete at risk of ACL injury. Biomechanical evidence related to knee kinematics and kinetics was reviewed by different planes (sagittal and frontal/coronal), tasks (single-leg landing and cutting), situation (anticipated and unanticipated), foot positioning, playing surface, and fatigued status. Neuromuscular evidence potentially related to ACL injury was reviewed. Recommendations for prevention programs for ACL injuries in male athletes were developed based on the synthesis of the biomechanical and neuromuscular characteristics. The recommendations suggest performing exercises with multi-plane biomechanical components including single-leg maneuvers in dynamic movements, reaction to and decision making in unexpected situations, appropriate foot positioning, and consideration of playing surface condition, as well as enhancing neuromuscular aspects such as fatigue, proprioception, muscle activation, and inter-joint coordination. PMID:25663251

  18. Partial neuromuscular blockade in humans enhances muscle blood flow during exercise independently of muscle oxygen uptake and acetylcholine receptor blockade

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Krustrup, Peter

    2009-01-01

    This study examined the role of acetylcholine for skeletal muscle blood flow during exercise by use of the competitive neuromuscular blocking agent cisatracurium in combination with the acetylcholine receptor blocker glycopyrrone. Nine healthy male subjects performed a 10-min bout of one-legged knee-extensor exercise (18W) during control conditions and with cisatracurium blockade, as well as with cisatracurium blockade with prior glycopyrrone infusion. Thigh blood flow and vascular conductance in control and with cisatracurium infusion were similar at rest and during passive movement of the leg, but higher (p<0.05) during exercise with cisatracurium than in control (3.83+/-0.42 vs. 2.78+/-0.21 L min(-1) and 26.9+/-3.4 vs. 21.8+/-2.0 ml min(-1) mmHg(-1) at the end of exercise). Thigh oxygen uptake was similar in control and with cisatracurium infusion both at rest and during exercise, being 354+/-33 and 406+/-34 ml min(-1), at the end of exercise. Combined infusion of cisatracurium and glycopyrron caused a similar increase in blood flow as cisatracurium infusion alone. The current results demonstrate that neuromuscular blockade leads to enhanced thigh blood flow and vascular conductance during exercise, events that are not associated with either acetylcholine or an increased oxygen demand. The results do not support an essential role for acetylcholine, released form the neuromuscular junction, in exercise hyperaemia or for the enhanced blood flow during neuromuscular blockade. The enhanced exercise hyperemia during partial neuromuscular blockade may be related to a greater recruitment of fast-twitch muscle fibres. Key words: blood flow, neuromuscular blockade, exercise, skeletal muscle.

  19. Controlling a mechanical oscillator with a tunable coherent feedback network

    CERN Document Server

    Kerckhoff, Joseph; Ku, H S; Kindel, William F; Cicak, Katarina; Simmonds, Raymond W; Lehnert, K W

    2012-01-01

    We demonstrate a fully cryogenic microwave feedback network composed of distinct superconducting devices interconnected by waveguides and designed to control a mechanical oscillator coupled to one of the devices. The network is partitioned into an electromechanical device to be controlled and a dynamically tunable controller that coherently receives, processes and feeds back continuous microwave signals that modify the dynamics and readout of the mechanical state. While previous electromechanical systems represent some compromise between efficient control and efficient readout of the mechanical state, as set by the electromagnetic decay rate, this flexible controller yields a closed-loop network that can be dynamically and continuously tuned between both extremes much faster than the mechanical response time. We demonstrate that the microwave decay rate may be modulated by at least a factor of 10 at a rate greater than $10^4$ times the mechanical response rate.

  20. Avaliação da ativação neuromuscular em indivíduos com escoliose através da eletromiografia de superfície / Assessment of neuromuscular activation in individuals with scoliosis using surface electromyography

    Scientific Electronic Library Online (English)

    E, Bassani; CT, Candotti; M, Pasini; M, Melo; M, La Torre.

    2008-02-01

    Full Text Available OBJETIVO: O objetivo desse estudo foi verificar o potencial da eletromiografia (EMG) de superfície para a avaliação da eficiência neuromuscular e da fadiga muscular localizada dos extensores lombares em indivíduos com escoliose. MÉTODOS: Participaram deste estudo 20 indivíduos divididos igualmente e [...] m dois grupos, (1) Grupo com Escoliose e (2) Grupo Controle, que foram submetidos a um teste de indução dos músculos extensores lombares a fadiga, o qual constituiu da realização de uma contração voluntária máxima isométrica (CVM), e realização de um teste com esforço a 80% da CVM. Foram coletados simultaneamente sinais de força e eletromiográficos (sinal EMG). O sinal EMG foi processado no domínio da freqüência, utilizando-se a transformada rápida de Fourier (FFT), por meio da mediana da freqüência (MF), e no domínio do tempo, pelo cálculo do valor root mean square (RMS). Os dados foram submetidos a uma análise de variância one-way para verificar as diferenças entre os dois grupos. Para verificar a simetria entre os lados direito e esquerdo, foi realizado o teste t pareado. O nível de significância adotado foi 0,05. RESULTADOS: os resultados demonstraram que indivíduos com escoliose apresentaram: (1) simetria de ativação neuromuscular entre os lados; (2) menor eficiência neuromuscular; (3) maior capacidade de resistir a fadiga; e (4) valores de força 42,6% menores que os indivíduos do GC. CONCLUSÕES: Os resultados sugerem que a EMG de superfície corresponde a um efetivo instrumento de avaliação funcional da escoliose, embora o protocolo estabelecido tenha limitado a participação dos indivíduos com escoliose, do ponto de vista da eficiência neuromuscular. Abstract in english OBJECTIVE: The aim of this study was to investigate the potential of surface electromyography (EMG) for assessing neuromuscular efficiency and localized muscle fatigue in the lumbar extensors, in individuals with scoliosis. METHODS: Twenty individuals participated in this study, divided equally into [...] two groups: (1) Scoliosis Group and (2) Control Group. These subjects underwent a fatigue induction test on their lumbar extensor muscles, consisting of one maximum voluntary isometric contraction (MVIC) followed by a test at 80% of the MVIC effort. Force and EMG signals were collected simultaneously. The EMG signal was processed in the frequency domain by means of fast Fourier transforms using the median frequency; and in the time domain by calculating the root mean square value. The data were analyzed by means of one-way analysis of variance to investigate the differences between the two groups. Paired t test was used to investigate the symmetry between the right and left sides. The significance level adopted was 0.05. RESULTS: The results showed that the individuals with scoliosis presented: (1) symmetrical neuromuscular activation between the sides; (2) lower neuromuscular efficiency; (3) greater capacity to resist fatigue; and (4) force values 42.6% lower than those of the individuals in the Control Group. CONCLUSIONS: The results suggest that surface EMG is an effective tool for functional assessments of scoliosis, although the protocol established limited the participation of individuals with scoliosis, from the perspective of neuromuscular efficiency.

  1. Avaliação da ativação neuromuscular em indivíduos com escoliose através da eletromiografia de superfície Assessment of neuromuscular activation in individuals with scoliosis using surface electromyography

    Directory of Open Access Journals (Sweden)

    E Bassani

    2008-02-01

    Full Text Available OBJETIVO: O objetivo desse estudo foi verificar o potencial da eletromiografia (EMG de superfície para a avaliação da eficiência neuromuscular e da fadiga muscular localizada dos extensores lombares em indivíduos com escoliose. MÉTODOS: Participaram deste estudo 20 indivíduos divididos igualmente em dois grupos, (1 Grupo com Escoliose e (2 Grupo Controle, que foram submetidos a um teste de indução dos músculos extensores lombares a fadiga, o qual constituiu da realização de uma contração voluntária máxima isométrica (CVM, e realização de um teste com esforço a 80% da CVM. Foram coletados simultaneamente sinais de força e eletromiográficos (sinal EMG. O sinal EMG foi processado no domínio da freqüência, utilizando-se a transformada rápida de Fourier (FFT, por meio da mediana da freqüência (MF, e no domínio do tempo, pelo cálculo do valor root mean square (RMS. Os dados foram submetidos a uma análise de variância one-way para verificar as diferenças entre os dois grupos. Para verificar a simetria entre os lados direito e esquerdo, foi realizado o teste t pareado. O nível de significância adotado foi 0,05. RESULTADOS: os resultados demonstraram que indivíduos com escoliose apresentaram: (1 simetria de ativação neuromuscular entre os lados; (2 menor eficiência neuromuscular; (3 maior capacidade de resistir a fadiga; e (4 valores de força 42,6% menores que os indivíduos do GC. CONCLUSÕES: Os resultados sugerem que a EMG de superfície corresponde a um efetivo instrumento de avaliação funcional da escoliose, embora o protocolo estabelecido tenha limitado a participação dos indivíduos com escoliose, do ponto de vista da eficiência neuromuscular.OBJECTIVE: The aim of this study was to investigate the potential of surface electromyography (EMG for assessing neuromuscular efficiency and localized muscle fatigue in the lumbar extensors, in individuals with scoliosis. METHODS: Twenty individuals participated in this study, divided equally into two groups: (1 Scoliosis Group and (2 Control Group. These subjects underwent a fatigue induction test on their lumbar extensor muscles, consisting of one maximum voluntary isometric contraction (MVIC followed by a test at 80% of the MVIC effort. Force and EMG signals were collected simultaneously. The EMG signal was processed in the frequency domain by means of fast Fourier transforms using the median frequency; and in the time domain by calculating the root mean square value. The data were analyzed by means of one-way analysis of variance to investigate the differences between the two groups. Paired t test was used to investigate the symmetry between the right and left sides. The significance level adopted was 0.05. RESULTS: The results showed that the individuals with scoliosis presented: (1 symmetrical neuromuscular activation between the sides; (2 lower neuromuscular efficiency; (3 greater capacity to resist fatigue; and (4 force values 42.6% lower than those of the individuals in the Control Group. CONCLUSIONS: The results suggest that surface EMG is an effective tool for functional assessments of scoliosis, although the protocol established limited the participation of individuals with scoliosis, from the perspective of neuromuscular efficiency.

  2. Analysis and control of underactuated mechanical systems

    CERN Document Server

    Choukchou-Braham, Amal; Djemaï, Mohamed; Busawon, Krishna

    2014-01-01

    This monograph provides readers with tools for the analysis, and control of systems with fewer control inputs than degrees of freedom to be controlled, i.e., underactuated systems. The text deals with the consequences of a lack of a general theory that would allow methodical treatment of such systems and the ad hoc approach to control design that often results, imposing a level of organization whenever the latter is lacking. The authors take as their starting point the construction of a graphical characterization or control flow diagram reflecting the transmission of generalized forces through the degrees of freedom. Underactuated systems are classified according to the three main structures by which this is found to happen—chain, tree, and isolated vertex—and control design procedures proposed. The procedure is applied to several well-known examples of underactuated systems: acrobot; pendubot; Tora system; ball and beam; inertia wheel; and robotic arm with elastic joint. The text is illustrated with MATL...

  3. The immediate effect of neuromuscular joint facilitation (NJF) treatment on the standing balance in younger persons.

    Science.gov (United States)

    Onoda, Ko; Huo, Ming; Maruyama, Hitoshi

    2015-05-01

    [Purpose] The aim of this study was to investigate the change in standing balance of younger persons after neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 57 healthy young people, who were divided into three groups: The NJF group, and the Proprioceptive Neuromuscular Facilitation (PNF) group and the control group. [Methods] Functional reach test and body sway were measured before and after intervention in three groups. Four hip patterns of NJF or PNF were used. Two-way ANOVA and multiple comparisons were performed. [Results] The rate of change of FRT in the NJF group increased than the PNF group. The root mean square area at NJF and PNF group increased than control group. [Conclusion] The results suggest that caput femoris rotation function can be improved by NJF treatment, and that improvement of caput femoris rotation contributes to improve dynamic balance. PMID:26157245

  4. Recent achievements in restorative neurology: Progressive neuromuscular diseases

    International Nuclear Information System (INIS)

    This book contains 27 chapters. Some of the chapter titles are: Computed Tomography of Muscles in Neuromuscular Disease; Mapping the Genes for Muscular Dystrophy; Trophic Factors and Motor Neuron Development; Size of Motor Units and Firing Rate in Muscular Dystrophy; Restorative Possibilities in Relation to the Pathology of Progressive Neuromuscular Disease; and An Approach to the Pathogenesis of some Congenital Myopathies

  5. Recent achievements in restorative neurology: Progressive neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Dimitrijevic, M.R.; Kakulas, B.A.; Vrbova, G.

    1986-01-01

    This book contains 27 chapters. Some of the chapter titles are: Computed Tomography of Muscles in Neuromuscular Disease; Mapping the Genes for Muscular Dystrophy; Trophic Factors and Motor Neuron Development; Size of Motor Units and Firing Rate in Muscular Dystrophy; Restorative Possibilities in Relation to the Pathology of Progressive Neuromuscular Disease; and An Approach to the Pathogenesis of some Congenital Myopathies.

  6. Control Mechanism and Security Region for Intentional Islanding Transition

    DEFF Research Database (Denmark)

    Chen, Yu; Xu, Zhao

    2009-01-01

    This paper investigates the control mechanism for intentional islanding transition, when a Low Voltage (LV) or Medium Voltage (MV) distribution system, which is usually under grid connection mode, is supposed to be separated from the upstream grid, due to either maintenance or a disturbance in the grid. The concept of Islanding Security Region (ISR) has been proposed as an organic composition of the developed control mechanism. The purpose of this control mechanism is to maintain the frequency stability and eventually the security of power supply to the customers, by utilizing resources from generation and demand sides. The control mechanism can be extended to consider the distributed generations like wind power and other innovative technologies such as the Demand as Frequency controlled Reserve (DFR) technique in the future.

  7. Controlling chaos based on an adaptive adjustment mechanism

    International Nuclear Information System (INIS)

    In this paper, we extend the ideas and techniques developed by Huang [Huang W. Stabilizing nonlinear dynamical systems by an adaptive adjustment mechanism. Phys Rev E 2000;61:R1012-5] for controlling discrete-time chaotic system using adaptive adjustment mechanism to continuous-time chaotic system. Two control approaches, namely adaptive adjustment mechanism (AAM) and modified adaptive adjustment mechanism (MAAM), are investigated. In both case sufficient conditions for the stabilization of chaotic systems are given analytically. The simulation results on Chen chaotic system have verified the effectiveness of the proposed techniques

  8. Effect of Neuromuscular Electrical Stimulation on Pain and Functional Parameters in Knee Osteoarthritis

    OpenAIRE

    Duygu Geler Külcü; Burcu Yan?k; Gülçin Gül?en Demirel; Derya Gökmen

    2009-01-01

    Objective: To assess the effect of neuromuscular electrical stimulation (NMES) of quadriceps muscle on pain and functional level in knee osteoarthritis. Materials and Methods: Forty patients diagnosed as knee osteoarthritis participated in the study. Patients were randomized to two groups. First group received hotpack, ultrasound, transcutaneous electrical nerve stimulation (TENS) and isometric quadriceps exercises (control group), and second group received NMES of quadriceps muscle in additi...

  9. The Effects on the Pulmonary Function of Normal Adults Proprioceptive Neuromuscular Facilitation Respiration Pattern Exercise

    OpenAIRE

    Seo, KyoChul; Cho, Misuk

    2014-01-01

    [Purpose] The purpose of this study was to determine whether proprioceptive neuromuscular facilitation (PNF) respiration exercise increases the pulmonary function of normal adults. [Subjects and Methods] Twenty-eight normal adults in their 20s were randomly assigned to an experimental group (n=14) or control group (n=14). Over the course of four weeks, the experimental group participated in PNF respiration pattern exercises for 30 minutes three times per week. Subjects were ass...

  10. Cross-training effects of a proprioceptive neuromuscular facilitation exercise programme on knee musculature

    OpenAIRE

    Kofotolis, N.D.; ?????????, ?.?.; Kellis, E.; ??????, ?.

    2010-01-01

    Objectives: To examine the cross-training effects of a proprioceptive neuromuscular facilitation training (PNF) program on peak torque and endurance. Design: Factorial design. Participants: Twenty-three males were assigned to a PNF group (n=12) or a control group (n=11). Interventions: The PNF program included training of the knee extensor and flexor muscles for a period of 8 weeks, exercising three times a week. PNF training included performance of knee movements through range of motion agai...

  11. Prolonged mental exertion does not alter neuromuscular function of the knee extensors

    OpenAIRE

    Pageaux, Benjamin; Marcora, Samuele; Lepers, Romuald

    2013-01-01

    Purpose: The aim of this study was to test the hypotheses that prolonged mental exertion i) reduces maximal muscle activation and ii) increases the extent of central fatigue induced by subsequent endurance exercise. Methods: Neuromuscular function of the knee extensor muscles was assessed in 10 male subjects in two different conditions: i) before and after prolonged mental exertion leading to mental fatigue; ii) before and after an easy cognitive task (control). Both cognitive tasks lasted 90...

  12. Neto-Mediated Intracellular Interactions Shape Postsynaptic Composition at the Drosophila Neuromuscular Junction

    Science.gov (United States)

    Ramos, Cathy I.; Igiesuorobo, Oghomwen; Wang, Qi; Serpe, Mihaela

    2015-01-01

    The molecular mechanisms controlling the subunit composition of glutamate receptors are crucial for the formation of neural circuits and for the long-term plasticity underlying learning and memory. Here we use the Drosophila neuromuscular junction (NMJ) to examine how specific receptor subtypes are recruited and stabilized at synaptic locations. In flies, clustering of ionotropic glutamate receptors (iGluRs) requires Neto (Neuropillin and Tolloid-like), a highly conserved auxiliary subunit that is essential for NMJ assembly and development. Drosophila neto encodes two isoforms, Neto-? and Neto-?, with common extracellular parts and distinct cytoplasmic domains. Mutations that specifically eliminate Neto-? or its intracellular domain were generated. When Neto-? is missing or is truncated, the larval NMJs show profound changes in the subtype composition of iGluRs due to reduced synaptic accumulation of the GluRIIA subunit. Furthermore, neto-? mutant NMJs fail to accumulate p21-activated kinase (PAK), a critical postsynaptic component implicated in the synaptic stabilization of GluRIIA. Muscle expression of either Neto-? or Neto-? rescued the synaptic transmission at neto null NMJs, indicating that Neto conserved domains mediate iGluRs clustering. However, only Neto-? restored PAK synaptic accumulation at neto null NMJs. Thus, Neto engages in intracellular interactions that regulate the iGluR subtype composition by preferentially recruiting and/or stabilizing selective receptor subtypes. PMID:25905467

  13. Mechanical systems a unified approach to vibrations and controls

    CERN Document Server

    Gans, Roger F

    2015-01-01

    This essential textbook covers analysis and control of engineering mechanisms, which include almost any apparatus with moving parts used in daily life, from musical instruments to robots. The text  presents both vibrations and controls with considerable breadth and depth using a unified notation. It strikes a nice balance between the analytical and the practical.  This text contains enough material for a two semester sequence, but it can also be used in a single semester course combining the two topics. Mechanical Systems: A Unified Approach to Vibrations and Controls presents a common notation and approach to these closely related areas. Examples from the both vibrations and controls components are integrated throughout this text. This book also: ·         Presents a unified approach to vibrations and controls, including an excellent diagram that simultaneously discusses embedding classical vibrations (mechanical systems) in a discussion of models, inverse models, and open and closed loop control ...

  14. Evaluation of skeletal muscular involvement in neuromuscular disorders with thallium-201 whole body scintigraphy

    International Nuclear Information System (INIS)

    The extent as well as severity of pathologic changes of skeletal muscles were analyzed with thallium-201 whole body scintigraphy (WBS) in 29 cases of various types of neuromuscular diseases (18 cases of myogenic and 11 cases of neurogenic muscular diseases) and 14 cases of normal controls. After intravenous injection of 2 mCi of thallium-201 chloride, WBS was performed for 15 minutes using a gamma camera with twin-opposed large rectangular detectors. Counts at brachia, forearms, thighs, and calves were assessed after reconstruction of the scintigram of the whole body by taking the geometric mean of the anterior and posterior data. WBS showed uniform tracer activities in the 4 extremities in 12 cases among 14 controls. Laterality in distribution of counts of both legs and arms was noted in the remaining 2 controls. WBS revealed decrease of perfusion in the extremities with muscular atrophy and/or weakness in neuromuscular diseases. The overall diagnostic accuracy of WBS for evaluation of skeletal muscle involvement was 75 to 80 % except for the bilateral brachia for which it decreased to 65 %. All of the three cases of muscular dystrophy with pseudohypertrophy of the calves or thighs showed unequivocal decrease of perfusion of those regions in WBS. In conclusion, thallium-201 WBS was considered to be a useful clinical means in evaluating the extent and severity of muscular involvement of various types of neuromuscular disorders. (author)

  15. Cutaneous mechanisms of isometric ankle force control

    DEFF Research Database (Denmark)

    Choi, Julia T; Jensen, Jesper Lundbye

    2013-01-01

    The sense of force is critical in the control of movement and posture. Multiple factors influence our perception of exerted force, including inputs from cutaneous afferents, muscle afferents and central commands. Here, we studied the influence of cutaneous feedback on the control of ankle force output. We used repetitive electrical stimulation of the superficial peroneal (foot dorsum) and medial plantar nerves (foot sole) to disrupt cutaneous afferent input in 8 healthy subjects. We measured the effects of repetitive nerve stimulation on (1) tactile thresholds, (2) performance in an ankle force-matching and (3) an ankle position-matching task. Additional force-matching experiments were done to compare the effects of transient versus continuous stimulation in 6 subjects and to determine the effects of foot anesthesia using lidocaine in another 6 subjects. The results showed that stimulation decreased cutaneous sensory function as evidenced by increased touch threshold. Absolute dorsiflexion force error increased without visual feedback during peroneal nerve stimulation. This was not a general effect of stimulation because force error did not increase during plantar nerve stimulation. The effects of transient stimulation on force error were greater when compared to continuous stimulation and lidocaine injection. Position-matching performance was unaffected by peroneal nerve or plantar nerve stimulation. Our results show that cutaneous feedback plays a role in the control of force output at the ankle joint. Understanding how the nervous system normally uses cutaneous feedback in motor control will help us identify which functional aspects are impaired in aging and neurological diseases.

  16. The influence of gender on neuromuscular pre-activity during side-cutting

    DEFF Research Database (Denmark)

    Bencke, Jesper; Zebis, Mette K

    2011-01-01

    It is well established that female athletes are at increased risk for sustaining ACL injuries in sports, where sudden changes of direction are a frequent movement pattern. The underlying neuromuscular mechanisms related to the elevated ACL injury rate in female athletes has yet to be fully investigated. This cross-sectional study aimed to examine gender differences in neuromuscular pre-activity during a maneuver that mimics a movement associated with the incidence of ACL injuries. Twenty-four team handball players (12 male and 12 female) with no history of ACL injury were tested for EMG pre-activity of vastus lateralis, vastus medialis, semitendinosus, and biceps femoris during a side-cutting maneuver. Mean EMG amplitude 50ms prior to toe down was normalized to maximal EMG obtained during maximal isometric contraction. The results showed that females had significantly lower hamstring EMG pre-activity 50ms prior to toe-down than males (P

  17. A Markov computer simulation model of the economics of neuromuscular blockade in patients with acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Chow John L

    2006-03-01

    Full Text Available Abstract Background Management of acute respiratory distress syndrome (ARDS in the intensive care unit (ICU is clinically challenging and costly. Neuromuscular blocking agents may facilitate mechanical ventilation and improve oxygenation, but may result in prolonged recovery of neuromuscular function and acute quadriplegic myopathy syndrome (AQMS. The goal of this study was to address a hypothetical question via computer modeling: Would a reduction in intubation time of 6 hours and/or a reduction in the incidence of AQMS from 25% to 21%, provide enough benefit to justify a drug with an additional expenditure of $267 (the difference in acquisition cost between a generic and brand name neuromuscular blocker? Methods The base case was a 55 year-old man in the ICU with ARDS who receives neuromuscular blockade for 3.5 days. A Markov model was designed with hypothetical patients in 1 of 6 mutually exclusive health states: ICU-intubated, ICU-extubated, hospital ward, long-term care, home, or death, over a period of 6 months. The net monetary benefit was computed. Results Our computer simulation modeling predicted the mean cost for ARDS patients receiving standard care for 6 months to be $62,238 (5% – 95% percentiles $42,259 – $83,766, with an overall 6-month mortality of 39%. Assuming a ceiling ratio of $35,000, even if a drug (that cost $267 more hypothetically reduced AQMS from 25% to 21% and decreased intubation time by 6 hours, the net monetary benefit would only equal $137. Conclusion ARDS patients receiving a neuromuscular blocker have a high mortality, and unpredictable outcome, which results in large variability in costs per case. If a patient dies, there is no benefit to any drug that reduces ventilation time or AQMS incidence. A prospective, randomized pharmacoeconomic study of neuromuscular blockers in the ICU to asses AQMS or intubation times is impractical because of the highly variable clinical course of patients with ARDS.

  18. Neuromuscular imaging in inherited muscle diseases

    International Nuclear Information System (INIS)

    Driven by increasing numbers of newly identified genetic defects and new insights into the field of inherited muscle diseases, neuromuscular imaging in general and magnetic resonance imaging (MRI) in particular are increasingly being used to characterise the severity and pattern of muscle involvement. Although muscle biopsy is still the gold standard for the establishment of the definitive diagnosis, muscular imaging is an important diagnostic tool for the detection and quantification of dystrophic changes during the clinical workup of patients with hereditary muscle diseases. MRI is frequently used to describe muscle involvement patterns, which aids in narrowing of the differential diagnosis and distinguishing between dystrophic and non-dystrophic diseases. Recent work has demonstrated the usefulness of muscle imaging for the detection of specific congenital myopathies, mainly for the identification of the underlying genetic defect in core and centronuclear myopathies. Muscle imaging demonstrates characteristic patterns, which can be helpful for the differentiation of individual limb girdle muscular dystrophies. The aim of this review is to give a comprehensive overview of current methods and applications as well as future perspectives in the field of neuromuscular imaging in inherited muscle diseases. We also provide diagnostic algorithms that might guide us through the differential diagnosis in hereditary myopathies. (orig.))

  19. Mechanics and model-based control of advanced engineering systems

    CERN Document Server

    Irschik, Hans; Krommer, Michael

    2014-01-01

    Mechanics and Model-Based Control of Advanced Engineering Systems collects 32 contributions presented at the International Workshop on Advanced Dynamics and Model Based Control of Structures and Machines, which took place in St. Petersburg, Russia in July 2012. The workshop continued a series of international workshops, which started with a Japan-Austria Joint Workshop on Mechanics and Model Based Control of Smart Materials and Structures and a Russia-Austria Joint Workshop on Advanced Dynamics and Model Based Control of Structures and Machines. In the present volume, 10 full-length papers based on presentations from Russia, 9 from Austria, 8 from Japan, 3 from Italy, one from Germany and one from Taiwan are included, which represent the state of the art in the field of mechanics and model based control, with particular emphasis on the application of advanced structures and machines.

  20. Insuficiência respiratória crônica nas doenças neuromusculares: diagnóstico e tratamento Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ilma Aparecida Paschoal

    2007-02-01

    Full Text Available As doenças neuromusculares prejudicam a renovação do ar alveolar e, por esta razão, produzem insuficiência respiratória crônica. A instalação da insuficiência respiratória pode acontecer de modo agudo, como nos traumas, ou ser lenta ou rapidamente progressiva, como na esclerose lateral amiotrófica, distrofias musculares, doença da placa mioneural, etc. O comprometimento da musculatura respiratória prejudica também a eficiência da tosse e, no estado atual da terapêutica disponível no Brasil para estes doentes, pode-se dizer que a morbimortalidade nestes indivíduos está mais associada ao fato de que eles tossem mal do que de que ventilam mal. Nesta revisão, uma breve compilação histórica procura mostrar a evolução das órteses e próteses respiratórias, desde o final do século XIX até agora, com o objetivo de apresentar as opções de máquinas disponíveis para o suporte e substituição da ventilação nas doenças neuromusculares. Além disso, são enfatizados os elementos fundamentais para o diagnóstico da hipoventilação alveolar e da falência do mecanismo protetor da tosse: história clínica, determinação do pico de fluxo da tosse, medida da pressão expiratória máxima e da pressão inspiratória máxima, espirometria em dois decúbitos (sentado e supino, oximetria de pulso, capnografia e polissonografia. São apresentados os valores limites disponíveis na literatura tanto para a indicação do suporte noturno da ventilação como para a extensão do suporte para o período diurno. As manobras para incremento da eficiência da tosse são aqui também discutidas, assim como o momento adequado para sua introdução.Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid, as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc. Respiratory muscle impairment also affects cough efficiency and, according to the current knowledge regarding the type of treatment available in Brazil to these patients, it can be said that the high rates of morbidity and mortality in these individuals are more often related to the fact that they cough inefficiently rather than to the fact that they ventilate poorly. In this review, with the objective of presenting the options of devices available to support and substitute for natural ventilation in patients with neuromuscular diseases, we have compiled a brief history of the evolution of orthopedic braces and prostheses used to aid respiration since the end of the 19th century. In addition, we highlight the elements that are fundamental to the diagnosis of alveolar hypoventilation and of failure of the protective cough mechanism: taking of a clinical history; determination of peak cough flow; measurement of maximal inspiratory and expiratory pressures; spirometry in two positions (sitting and supine; pulse oximetry; capnography; and polysomnography. Furthermore, the threshold values available in the literature for the use of nocturnal ventilatory support and for the extension of this support through the daytime period are presented. Moreover, the maneuvers used to increase cough efficiency, as well as the proper timing of their introduction, are discussed.

  1. Insuficiência respiratória crônica nas doenças neuromusculares: diagnóstico e tratamento / Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment

    Scientific Electronic Library Online (English)

    Ilma Aparecida, Paschoal; Wander de Oliveira, Villalba; Mônica Corso, Pereira.

    2007-02-01

    Full Text Available As doenças neuromusculares prejudicam a renovação do ar alveolar e, por esta razão, produzem insuficiência respiratória crônica. A instalação da insuficiência respiratória pode acontecer de modo agudo, como nos traumas, ou ser lenta ou rapidamente progressiva, como na esclerose lateral amiotrófica, [...] distrofias musculares, doença da placa mioneural, etc. O comprometimento da musculatura respiratória prejudica também a eficiência da tosse e, no estado atual da terapêutica disponível no Brasil para estes doentes, pode-se dizer que a morbimortalidade nestes indivíduos está mais associada ao fato de que eles tossem mal do que de que ventilam mal. Nesta revisão, uma breve compilação histórica procura mostrar a evolução das órteses e próteses respiratórias, desde o final do século XIX até agora, com o objetivo de apresentar as opções de máquinas disponíveis para o suporte e substituição da ventilação nas doenças neuromusculares. Além disso, são enfatizados os elementos fundamentais para o diagnóstico da hipoventilação alveolar e da falência do mecanismo protetor da tosse: história clínica, determinação do pico de fluxo da tosse, medida da pressão expiratória máxima e da pressão inspiratória máxima, espirometria em dois decúbitos (sentado e supino), oximetria de pulso, capnografia e polissonografia. São apresentados os valores limites disponíveis na literatura tanto para a indicação do suporte noturno da ventilação como para a extensão do suporte para o período diurno. As manobras para incremento da eficiência da tosse são aqui também discutidas, assim como o momento adequado para sua introdução. Abstract in english Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid), as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc. Respi [...] ratory muscle impairment also affects cough efficiency and, according to the current knowledge regarding the type of treatment available in Brazil to these patients, it can be said that the high rates of morbidity and mortality in these individuals are more often related to the fact that they cough inefficiently rather than to the fact that they ventilate poorly. In this review, with the objective of presenting the options of devices available to support and substitute for natural ventilation in patients with neuromuscular diseases, we have compiled a brief history of the evolution of orthopedic braces and prostheses used to aid respiration since the end of the 19th century. In addition, we highlight the elements that are fundamental to the diagnosis of alveolar hypoventilation and of failure of the protective cough mechanism: taking of a clinical history; determination of peak cough flow; measurement of maximal inspiratory and expiratory pressures; spirometry in two positions (sitting and supine); pulse oximetry; capnography; and polysomnography. Furthermore, the threshold values available in the literature for the use of nocturnal ventilatory support and for the extension of this support through the daytime period are presented. Moreover, the maneuvers used to increase cough efficiency, as well as the proper timing of their introduction, are discussed.

  2. Consecuencias clínicas de las alteraciones neuromusculares en el paciente crítico / Clinical consequences of neuromuscular impairments in critically ill patients

    Scientific Electronic Library Online (English)

    A., Mesejo; E., Pérez-Sancho; E., Moreno.

    2006-05-01

    Full Text Available La patología neuromuscular en el paciente crítico se desarrolla en dos contextos: enfermedades neurológicas primarias que requieren su ingreso en Medicina Intensiva por necesitar vigilancia estricta o ventilación mecánica y manifestaciones del sistema nervioso periférico secundarias a enfermedades s [...] istémicas críticas. En el primer grupo son las más frecuentes el Síndrome de Guillain-Barré y la Miastenia Gravis y en el segundo la Polineuropatía y la Miopatía del paciente crítico. El patrón clínico común más frecuente consiste en el desarrollo de un cuadro de acusada debilidad y cuadriparesia cuya manifestación más típica es la necesidad de respiración asistida o la dificultad/imposibilidad para su retirada. Se consideran factores desencadenantes el fracaso multiorgánico y la sepsis en la polineuropatía y los esteroides y bloqueantes neuromusculares en la miopatía, actuando como coadyuvantes en ambos casos la malnutrición, particularmente la hipoalbimunemia, y la hiperglucemia. Considerando que la afectación neuropática y miopática coexisten con frecuencia, se ha acuñado el término polineuromiopatía del paciente crítico. Tanto el Síndrome de Guillain-Barré como la polineuropatía del paciente crítico se localizan a nivel del nervio periférico, por lo que debe efectuarse un diagnóstico diferencial entre ambos. La forma de presentación es diferente ya que el primero es una patología aguda que motiva su ingreso en UCI, mientras que la polineuropatía se adquiere durante la hospitalización. En el primero es frecuente la afectación del sistema nervioso autónomo y la disociación albúmino-citológica en el LCR, lo que no se da en la polineuropatía. Los estudios electrofisiológicos muestran signos de desmelinización con disminución de la velocidad de conducción y normalidad en la amplitud de potenciales motores en el Síndrome de Guillain- Barré frente a velocidad de conducción normal y amplitud reducida de potenciales motores en la polineuropatía axonal. La crisis miasténica afecta a la unión neuromuscular y su diagnóstico suele ser más fácil al tener en la mayoría de los casos un diagnóstico previo de miastenia gravis.La debilidad muscular aumenta durante la actividad repetida (fatiga muscular) y mejora con el reposo. Su confirmación diagnóstica se realiza con el test del edofronio y con la estimulación nerviosa repetitiva, que provoca una rápida disminución del 10-15% en la amplitud de las respuestas provocadas. La miopatía del paciente crítico se localiza en el músculo y provoca una debilidad generalizada con cuadriparesia, muy similar a la de la polineuropatía, que impide o retrasa la desconexión de la ventilación mecánica y que en sus grados avanzados puede provocar un aumento de CPK y mioglobina, junto con alteraciones en la exploración neurofisiológica. Esta última es difícil de discernir de la encontrada en la polineuropatía, aunque la normalidad en los potenciales de acción sensitiva y la redución en el potencial de ación motora con estimulación muscular directa, puede ayudar a diferenciarlos. El pronóstico funcional de las alteraciones musculares primarias suele ser bastante bueno, pero tanto la polineuropatía como la miopatía evolucionan lentamente a lo largo de semanas o meses, pudiendo quedar un importante déficit residual a los dos años en los casos más graves. Abstract in english Neuromuscular pathology in the critically ill patient develops within two settings: primary neurological diseases that require admission in the Intensive Care Medicine Unit for close monitoring or mechanical ventilation, and peripheral nervous system manifestations secondary to critical systemic dis [...] eases. The most frequent conditions in the first group are Guillain-Barré syndrome and Myasthenia Gravis, and in the second group, polyneuropathy and myopathy of the critically ill patient. The most commonly shared clinical pattern is the development of severe weakness and quadriplegia which most typical manifestation is the

  3. Consecuencias clínicas de las alteraciones neuromusculares en el paciente crítico Clinical consequences of neuromuscular impairments in critically ill patients

    Directory of Open Access Journals (Sweden)

    A. Mesejo

    2006-05-01

    Full Text Available La patología neuromuscular en el paciente crítico se desarrolla en dos contextos: enfermedades neurológicas primarias que requieren su ingreso en Medicina Intensiva por necesitar vigilancia estricta o ventilación mecánica y manifestaciones del sistema nervioso periférico secundarias a enfermedades sistémicas críticas. En el primer grupo son las más frecuentes el Síndrome de Guillain-Barré y la Miastenia Gravis y en el segundo la Polineuropatía y la Miopatía del paciente crítico. El patrón clínico común más frecuente consiste en el desarrollo de un cuadro de acusada debilidad y cuadriparesia cuya manifestación más típica es la necesidad de respiración asistida o la dificultad/imposibilidad para su retirada. Se consideran factores desencadenantes el fracaso multiorgánico y la sepsis en la polineuropatía y los esteroides y bloqueantes neuromusculares en la miopatía, actuando como coadyuvantes en ambos casos la malnutrición, particularmente la hipoalbimunemia, y la hiperglucemia. Considerando que la afectación neuropática y miopática coexisten con frecuencia, se ha acuñado el término polineuromiopatía del paciente crítico. Tanto el Síndrome de Guillain-Barré como la polineuropatía del paciente crítico se localizan a nivel del nervio periférico, por lo que debe efectuarse un diagnóstico diferencial entre ambos. La forma de presentación es diferente ya que el primero es una patología aguda que motiva su ingreso en UCI, mientras que la polineuropatía se adquiere durante la hospitalización. En el primero es frecuente la afectación del sistema nervioso autónomo y la disociación albúmino-citológica en el LCR, lo que no se da en la polineuropatía. Los estudios electrofisiológicos muestran signos de desmelinización con disminución de la velocidad de conducción y normalidad en la amplitud de potenciales motores en el Síndrome de Guillain- Barré frente a velocidad de conducción normal y amplitud reducida de potenciales motores en la polineuropatía axonal. La crisis miasténica afecta a la unión neuromuscular y su diagnóstico suele ser más fácil al tener en la mayoría de los casos un diagnóstico previo de miastenia gravis.La debilidad muscular aumenta durante la actividad repetida (fatiga muscular y mejora con el reposo. Su confirmación diagnóstica se realiza con el test del edofronio y con la estimulación nerviosa repetitiva, que provoca una rápida disminución del 10-15% en la amplitud de las respuestas provocadas. La miopatía del paciente crítico se localiza en el músculo y provoca una debilidad generalizada con cuadriparesia, muy similar a la de la polineuropatía, que impide o retrasa la desconexión de la ventilación mecánica y que en sus grados avanzados puede provocar un aumento de CPK y mioglobina, junto con alteraciones en la exploración neurofisiológica. Esta última es difícil de discernir de la encontrada en la polineuropatía, aunque la normalidad en los potenciales de acción sensitiva y la redución en el potencial de ación motora con estimulación muscular directa, puede ayudar a diferenciarlos. El pronóstico funcional de las alteraciones musculares primarias suele ser bastante bueno, pero tanto la polineuropatía como la miopatía evolucionan lentamente a lo largo de semanas o meses, pudiendo quedar un importante déficit residual a los dos años en los casos más graves.Neuromuscular pathology in the critically ill patient develops within two settings: primary neurological diseases that require admission in the Intensive Care Medicine Unit for close monitoring or mechanical ventilation, and peripheral nervous system manifestations secondary to critical systemic diseases. The most frequent conditions in the first group are Guillain-Barré syndrome and Myasthenia Gravis, and in the second group, polyneuropathy and myopathy of the critically ill patient. The most commonly shared clinical pattern is the development of severe weakness and quadriplegia which most typical manifestation is the need for assisted ventilation and/or

  4. Molecular motors: design, mechanism and control

    CERN Document Server

    Chowdhury, Debashish

    2007-01-01

    Biological functions in each animal cell depend on coordinated operations of a wide variety of molecular motors. Some of the these motors transport cargo to their respective destinations whereas some others are mobile workshops which synthesize macromolecules while moving on their tracks. Some other motors are designed to function as packers and movers. All these motors require input energy for performing their mechanical works and operate under conditions far from thermodynamic equilibrium. The typical size of these motors and the forces they generate are of the order of nano-meters and pico-Newtons, respectively. They are subjected to random bombardments by the molecules of the surrounding aqueous medium and, therefore, follow noisy trajectories. Because of their small inertia, their movements in the viscous intracellular space exhibits features that are characteristics of hydrodynamics at low Reynold's number. In this article we discuss how theoretical modeling and computer simulations of these machines by...

  5. Novel Mechanism Control Algorithm for Wired Network

    Directory of Open Access Journals (Sweden)

    V. B. Kirubanand

    2011-01-01

    Full Text Available Problem statement: A critical issue in wireless network where the data can hack by the person and we add a novel encryption mechanism to protect the data transfer from client to server and vice versa. Approach: We present a queuing model of a client and server that uses for bulk arrival service. The arrival of data requests is assumed to Markov Poisson Distributed Process (MPDP and the events are considered in the server for process sharing. We obtained the parameter of service rate, arrival rate, expected waiting time and expected busy period. We also derive the expression for the data value of threshold. Results: The total number of packets request processed, there was no time limit to arrivals, while compared to m/m/1 model. Our model m/m (1,b/1 was more efficient to find response and request time in between client and server. Conclusions: Our proposed simulation model validated through Java programming.

  6. The effect of routine reversal of neuromuscular blockade on adequacy of recurrent laryngeal nerve stimulation during thyroid surgery.

    Science.gov (United States)

    Marshall, S D; Boden, E; Serpell, J

    2015-07-01

    Testing of the integrity of the recurrent laryngeal nerve during thyroid surgery has become routine practice for many surgeons to aid dissection and minimise the chance of inadvertent nerve injury. We hypothesised that routine reversal of an intermediate-acting, non-depolarising neuromuscular blocking agent would improve conditions for stimulation of the recurrent laryngeal nerve. We conducted a single-centre, randomised, double-blind placebo-controlled trial of patients undergoing thyroid surgery by the same surgeon. After randomisation, the participants received either neostigmine 2.5 mg with glycopyrrolate 0.4 mg or placebo, at 30 minutes after induction of anaesthesia and administration of 0.4 mg/kg of atracurium. The primary outcome was the subjective assessment by the surgeon as to whether the neuromuscular function was adequate for stimulation of the recurrent laryngeal nerve using a neuromuscular integrity monitor (NIM). Time to NIM stimulation was 44.6 minutes in the placebo group and 41.4 minutes in the intervention group (P=0.268). Of the 21 patients who received the neuromuscular blockade reversal, 20 (95.2%) had adequate surgical conditions for NIM stimulation, compared to 9 out of 18 patients (50%) in the placebo group (P=0.002). Three of the ten patients (30%) with inadequate reversal showed no evidence of residual blockade assessed peripherally. The routine reversal of neuromuscular blockade at 30 minutes post induction appears to result in adequate surgical conditions for safe stimulation of the recurrent laryngeal nerve. Return of neuromuscular function at a peripheral site does not guarantee adequate laryngeal muscle function for use of the NIM. PMID:26099761

  7. System defense mechanisms in nuclear power generation control computers

    International Nuclear Information System (INIS)

    Dual-redundant computers are used to control and monitor the production of power from Ontario Hydro's nuclear power reactors. Each computer must have the capability of monitoring its own performance and detecting faults. Upon fault detection, each computer must initiate corrective responses to ensure the integrity of critical control functions. This paper reviews those features the authors have termed system defense mechanisms

  8. Spinal mechanisms may provide a combination of intermittent and continuous control of human posture: predictions from a biologically based neuromusculoskeletal model.

    Science.gov (United States)

    Elias, Leonardo Abdala; Watanabe, Renato Naville; Kohn, André Fabio

    2014-11-01

    Several models have been employed to study human postural control during upright quiet stance. Most have adopted an inverted pendulum approximation to the standing human and theoretical models to account for the neural feedback necessary to keep balance. The present study adds to the previous efforts in focusing more closely on modelling the physiological mechanisms of important elements associated with the control of human posture. This paper studies neuromuscular mechanisms behind upright stance control by means of a biologically based large-scale neuromusculoskeletal (NMS) model. It encompasses: i) conductance-based spinal neuron models (motor neurons and interneurons); ii) muscle proprioceptor models (spindle and Golgi tendon organ) providing sensory afferent feedback; iii) Hill-type muscle models of the leg plantar and dorsiflexors; and iv) an inverted pendulum model for the body biomechanics during upright stance. The motor neuron pools are driven by stochastic spike trains. Simulation results showed that the neuromechanical outputs generated by the NMS model resemble experimental data from subjects standing on a stable surface. Interesting findings were that: i) an intermittent pattern of muscle activation emerged from this posture control model for two of the leg muscles (Medial and Lateral Gastrocnemius); and ii) the Soleus muscle was mostly activated in a continuous manner. These results suggest that the spinal cord anatomy and neurophysiology (e.g., motor unit types, synaptic connectivities, ordered recruitment), along with the modulation of afferent activity, may account for the mixture of intermittent and continuous control that has been a subject of debate in recent studies on postural control. Another finding was the occurrence of the so-called "paradoxical" behaviour of muscle fibre lengths as a function of postural sway. The simulations confirmed previous conjectures that reciprocal inhibition is possibly contributing to this effect, but on the other hand showed that this effect may arise without any anticipatory neural control mechanism. PMID:25393548

  9. Neuromuscular contacts of expanded motor units in rat soleus muscles are rescued by leupeptin.

    Science.gov (United States)

    Connold, A L; Vrbová, G

    1994-11-01

    In the soleus muscle of the rat following section of the L5 ventral ramus (partial denervation) the remaining motor axons increase their territory by sprouting. Nerve sprouts are first seen two to three days after the operation, their number peaks at 10-14 days and subsequently remains at this level. The time course of the initial sprouting in partially denervated muscles is not altered by paralysing the muscles with alpha-bungarotoxin, and the initial extent of the sprouting is, if anything, greater in the paralysed muscles. However, unlike in controls, this level of sprouting is not maintained and neuromuscular contacts are lost when muscles recover from the paralysis. The loss of these contacts can be prevented by treatment of these partially denervated paralysed muscles with leupeptin, an inhibitor of calcium-activated neutral protease. Interestingly, more contacts are rescued when leupeptin is applied 10 days after alpha-bungarotoxin treatment, when sprouting has reached high levels, than at three days, when sprouting has just begun. The neuromuscular connections rescued by leupeptin are functional. Maximum tetanic tension produced by untreated soleus muscles two to five months after partial denervation is 66 +/- 9% of contralateral control muscles, but only 39 +/- 8% when the muscles were paralysed with alpha-bungarotoxin for 12-14 days after partial denervation. However, when partially denervated paralysed muscles were treated with leupeptin three and 10 days after alpha-bungarotoxin treatment their tension output is 74 +/- 3% and 81 +/- 8%, respectively. After partial denervation alone, motor units are twice their normal size. Short-term paralysis with alpha-bungarotoxin prevents this increase in motor unit territory. However, the application of leupeptin to the paralysed muscles rescues neuromuscular contacts, allowing motor unit size to remain expanded, at around 2-2.5-fold. Thus, following recovery from temporary paralysis with alpha-bungarotoxin, there is a sudden withdrawal of neuromuscular contacts and these can be rescued by treatment with leupeptin. PMID:7898657

  10. Soft Time-Suboptimal Controlling Structure for Mechanical Systems

    DEFF Research Database (Denmark)

    Kulczycki, Piotr; Wisniewski, Rafal

    2004-01-01

    The paper presents conception of a soft control structure based on the time-optimal approach. Its parameters are selected in accordance with the rules of the statistical decision theory and additionally it allows to eliminate rapid changes in control values. The object is a basic mechanical system, with uncertain (also non-stationary) mass treated as a stochastic process. The methodology proposed here is of a universal nature and may easily be applied with respect to other uncertainty elements of timeoptimal controlled mechanical systems.

  11. Sliding mode control on electro-mechanical systems

    OpenAIRE

    Vadim I. Utkin; Hao-Chi Chang

    2002-01-01

    The first sliding mode control application may be found in the papers back in the 1930s in Russia. With its versatile yet simple design procedure the methodology is proven to be one of the most powerful solutions for many practical control designs. For the sake of demonstration this paper is oriented towards application aspects of sliding mode control methodology. First the design approach based on the regularization is generalized for mechanical systems. It is shown that stability of zero dy...

  12. Neuromuscular hamartoma: imaging features of a rare paediatric craniofacial tumour

    International Nuclear Information System (INIS)

    Neuromuscular hamartoma (also referred to as neuromuscular choristoma or benign triton tumour) has not previously been described in the radiological literature. It is a rare benign lesion composed of mature elements of striated muscle and neural tissue. We report a case of neuromuscular hamartoma involving the skull base, nasopharynx, orbit and maxilla in a 2.5-year-old child who presented with facial swelling. The CT and MRI appearances of this unusual soft-tissue tumour are emphasized, together with a discussion of the pathological findings, differential diagnosis and review of the literature. (orig.)

  13. Neuromuscular hamartoma: imaging features of a rare paediatric craniofacial tumour.

    Science.gov (United States)

    Oeppen, Rachel S; Harden, Stephen P; Argent, Julie D

    2003-01-01

    Neuromuscular hamartoma (also referred to as neuromuscular choristoma or benign triton tumour) has not previously been described in the radiological literature. It is a rare benign lesion composed of mature elements of striated muscle and neural tissue. We report a case of neuromuscular hamartoma involving the skull base, nasopharynx, orbit and maxilla in a 2.5-year-old child who presented with facial swelling. The CT and MRI appearances of this unusual soft-tissue tumour are emphasized, together with a discussion of the pathological findings, differential diagnosis and review of the literature. PMID:12497240

  14. Sleep polygraphic parameters in neuromuscular diseases Parâmetros poligráficos do sono em doenças neuromusculares

    OpenAIRE

    Márcia Pradella

    1994-01-01

    In a polysomnography study of 32 neuromuscular patients - 22 with a form of muscular dystrophy, 3 with a form of congenital myopathy, 4 with a form of spinal muscular atrophy, 1 with a recurrent form of polymyositis and 1 with osteogenesis imperfecta syndrome - of which 21 were nonambulatory, we observed sleep related respiratory disturbances represented by: drops in oxygen saturation (SaO2), cardiac arrythmia, sleep disruption, apneas, tachypnea, tachycardia and snoring. Nine out of the coho...

  15. A systematic literature review on the use of proprioceptive neuromuscular facilitation in neuromuscular rehabilitation

    OpenAIRE

    Shrestha, Yugal

    2013-01-01

    The purpose of this thesis was to review and critically analyze the literatures from 1990 to 2013 in order to investigate the methodological quality of the studies, indications and goals of PNF treatment, and to explore the components of PNF that are being used in treatment of neurological disorders. And to overview on the effectiveness and use of PNF approach in neuromuscular rehabilitation through the findings of this study. The research method used for this thesis was systematic litera...

  16. Estimulação elétrica neuromuscular na reversão da ossificação heterotópica Neuromuscular electric stimulation in heterotropic ossification regression

    OpenAIRE

    Daniel Bechara Jacob Ferreira; Henrique Cambraia Lippelt; Alberto Cliquet Júnior

    2006-01-01

    A ossificação heterotópica é uma complicação freqüente após a lesão medular. Os avanços graduais no campo da fisiopatologia, reabilitação e novos métodos de tratamento são uma esperança para a reversão do quadro clínico do lesado medular num futuro próximo. O objetivo desse estudo é avaliar a resposta da ossificação heterotópica das articulações coxo femorais à estimulação elétrica neuromuscular em pacientes tetraplégicos após trauma raquimedular. Seis pacientes ...

  17. Anormalidades neuromuscular no desuso, senilidade e caquexia Neuromuscular abnormalities in disuse, cachexia and ageing

    OpenAIRE

    João Aris Kouyoumdjian

    1993-01-01

    É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso) deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural;...

  18. Mechanisms of using mutations in pest control

    International Nuclear Information System (INIS)

    Traditional chemically based methods for insect control have been shown to have serious limitations, and many alternative approaches have been developed and evaluated, including those based on the use of different types of mutation. The mutagenic action of ionizing radiation was well known in the field of genetics long before it was realized by entomologists that it might be used to induce dominant lethal mutations in insects, which, when released, could sterilize wild female insects. The use of radiation to induce dominant lethal mutations in the sterile insect technique is now a major component of many large and successful programs for pest suppression and eradication. Specific types of mutations can also be used to make improvements to the sterile insect technique, especially for the development of strains for the production of only male insects for sterilization and release. These strains utilize male translocations and a variety of selectable mutations, either conditional or visible, so that at some stages of development, the males can be separated from the females. (author)

  19. The Drosophila wings apart gene anchors a novel, evolutionarily conserved pathway of neuromuscular development.

    Science.gov (United States)

    Morriss, Ginny R; Jaramillo, Carmelita T; Mikolajczak, Crystal M; Duong, Sandy; Jaramillo, Maryann S; Cripps, Richard M

    2013-11-01

    wings apart (wap) is a recessive, semilethal gene located on the X chromosome in Drosophila melanogaster, which is required for normal wing-vein patterning. We show that the wap mutation also results in loss of the adult jump muscle. We use complementation mapping and gene-specific RNA interference to localize the wap locus to the proximal X chromosome. We identify the annotated gene CG14614 as the gene affected by the wap mutation, since one wap allele contains a non-sense mutation in CG14614, and a genomic fragment containing only CG14614 rescues the jump-muscle phenotypes of two wap mutant alleles. The wap gene lies centromere-proximal to touch-insensitive larva B and centromere-distal to CG14619, which is tentatively assigned as the gene affected in introverted mutants. In mutant wap animals, founder cell precursors for the jump muscle are specified early in development, but are later lost. Through tissue-specific knockdowns, we demonstrate that wap function is required in both the musculature and the nervous system for normal jump-muscle formation. wap/CG14614 is homologous to vertebrate wdr68, DDB1 and CUL4 associated factor 7, which also are expressed in neuromuscular tissues. Thus, our findings provide insight into mechanisms of neuromuscular development in higher animals and facilitate the understanding of neuromuscular diseases that may result from mis-expression of muscle-specific or neuron-specific genes. PMID:24026097

  20. Nonmuscle Myosin II helps regulate synaptic vesicle mobility at the Drosophila neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Qiu Xinping

    2010-03-01

    Full Text Available Abstract Background Although the mechanistic details of the vesicle transport process from the cell body to the nerve terminal are well described, the mechanisms underlying vesicle traffic within nerve terminal boutons is relatively unknown. The actin cytoskeleton has been implicated but exactly how actin or actin-binding proteins participate in vesicle movement is not clear. Results In the present study we have identified Nonmuscle Myosin II as a candidate molecule important for synaptic vesicle traffic within Drosophila larval neuromuscular boutons. Nonmuscle Myosin II was found to be localized at the Drosophila larval neuromuscular junction; genetics and pharmacology combined with the time-lapse imaging technique FRAP were used to reveal a contribution of Nonmuscle Myosin II to synaptic vesicle movement. FRAP analysis showed that vesicle dynamics were highly dependent on the expression level of Nonmuscle Myosin II. Conclusion Our results provide evidence that Nonmuscle Myosin II is present presynaptically, is important for synaptic vesicle mobility and suggests a role for Nonmuscle Myosin II in shuttling vesicles at the Drosophila neuromuscular junction. This work begins to reveal the process by which synaptic vesicles traverse within the bouton.

  1. PREVENÇÃO DE LESÕES EM FUTEBOLISTAS ATRAVÉS DO TREINAMENTO NEUROMUSCULAR E PROPRIOCEPTIVO EM MEMBROS INFERIORES

    Directory of Open Access Journals (Sweden)

    Léo de Paiva Montenegro

    2014-02-01

    Full Text Available Objective: To study the importance of neuromuscular and proprioceptive training in football for the prevention of sports injuries in the lower limbs. Materials and Methods: We performed a literature review using the virtual databases Bireme, Scielo and Medline. Were used articles published between 1995 and 2012. Results: The study addressed the types, location of injury in football, showed that the lower limb is more affected by injury, being physical contact or without physical contact. Intervention programs are shown effective in increasing muscular strength, muscular endurance, agility, power and increased proprioception. Discussion: Due to the different mechanisms responsible for the injuries and the considerable increase of injuries in high performance sports, the study of means to prevent injury was drafted. Many studies have shown the effectiveness of training programs and proprioceptive neuromuscular to reduce the number of injuries during the season and to reduce the distance between the matches. Low cost programs may reduce the incidence of injuries in football. Conclusion: The neuromuscular and proprioceptive training can prevent injuries in football players due to the protective action in joints and muscles, should being included in the training of athletes.

  2. Recovery of altered neuromuscular junction morphology and muscle function in mdx mice after injury.

    Science.gov (United States)

    Pratt, Stephen J P; Shah, Sameer B; Ward, Christopher W; Kerr, Jaclyn P; Stains, Joseph P; Lovering, Richard M

    2015-01-01

    Duchenne muscular dystrophy (DMD) is a devastating neuromuscular disease in which weakness, increased susceptibility to muscle injury, and inadequate repair underlie the pathology. While most attention has focused within the muscle fiber, we recently demonstrated significant alterations in the neuromuscular junction (NMJ) morphology and resulting neuromuscular transmission failure (NTF) 24 h after injury in mdx mice (murine model for DMD). Here we determine the contribution of NMJ morphology and NTF to the recovery of muscle contractile function post-injury. NMJ morphology and NTF rates were assessed day 0 (immediately after injury) and days 1, 7, 14 and 21 after quadriceps injury. Eccentric injury of the quadriceps resulted in a significant loss of maximal torque in both WT (39 ± 6 %) and mdx (76 ± 8 %) with a full recovery in WT by day 7 and in mdx by day 21. Post-injury alterations in NMJ morphology and NTF were found only in mdx, were limited to days 0 and 1, and were independent of changes in MuSK or AChR expression. Such early changes at the NMJ after injury are consistent with mechanical disruption rather than newly forming NMJs. Furthermore, we show that the dense microtubule network that underlies the NMJ is significantly reduced and disorganized in mdx compared to WT. These structural changes at the NMJ may play a role in the increased NMJ disruption and the exaggerated loss of nerve-evoked muscle force seen after injury to dystrophic muscles. PMID:24947322

  3. From Neuromuscular Activation to End-point Locomotion: An Artificial Neural Network-based Technique for Neural Prostheses

    OpenAIRE

    Chang, Chia-Lin; Jin, Zhanpeng; Chang, Hou-Cheng; Cheng, Allen C

    2009-01-01

    Neuroprostheses, implantable or non-invasive ones, are promising techniques to enable paralyzed individuals with conditions, such as spinal cord injury or spina bifida (SB), to control their limbs voluntarily. Direct cortical control of invasive neuroprosthetic devices and robotic arms have recently become feasible for primates. However, little is known about designing non-invasive, closed-loop neuromuscular control strategies for neural prostheses. Our goal was to investigate if an Artificia...

  4. ?????????????????? Brown Adipsoe Tissue Differentiation and Control Mechanism

    Directory of Open Access Journals (Sweden)

    ??

    2011-12-01

    Full Text Available ?????????????????????????(???????????????????????????????????????????????????????????????????????????????BMP7 (bone morphogenetic proteins 7???????-??????(transforming growth?TGF-?????????????????????????????????????????????????????????BMP7??????????????????BMP7??PRDM16?PGC-1??????????????UCP1????????????????????????????????????????????? BMP7?PRDM16 ?????????????????????????????????????????????????–???????????????(?X-????????(18F-FDG-PET/CT????????????????????????????????????????????????????????????????????Humans and other mammals have two main adipose tissue depots: white adipose tissue (include visceral- and subcutaneous- white adipose tissue, and brown adipose tissue, each of which possesses unique cell-autonomous properties. In contrast to visceral adipose tissue, which can induce detrimental metabolic ef-fects, subcutaneous white adipose tissue and brown adipose tissue have the potential to benefit metabolism by improving glucose homeostasis and increasing energy consumption. BMP7 (bone morphogenetic proteins7 is one of members of the transforming growth factor-? (TGF-? superfamily and control multiple key steps of embryonic development and differentiation. In recent studies, people found that BMP7-induced UCP1 ex-pression was markedly diminished in brown preadipocytes deficient in both PRDM16 and PGC (PGC-1? and PGC-1?, it ultimately induces BAT mitochondrial cells in the biological production and cell differentiation. There are two ways in development of brown adipose tissue. These researches indicate the potential to treat obesity and related diseases through activating BMP7 and PRDM16 to produce brown adipose tissue. Re-cently, using 18F-fluorodeoxyglucose (18F-FDG positron-emission tomographic and computed tomographic (PET-CT scans showed that adults retain metabolically active BAT depots that can be induced in response to cold and sympathetic nervous system activation. These findings high light BAT as a potenial relevant tar get for pharmacological and gene expression manipulation to combat human obesity. We reviewed the recent re-search progresses of BAT in human and its potential functional significance.

  5. The Role of Chest Physiotherapy in Prevention of Postextubation Atelectasis in Pediatric Patients with Neuromuscular Diseases

    Directory of Open Access Journals (Sweden)

    Nemat BILAN

    2013-02-01

    Full Text Available How to Cite This Article: Bilan N, Poorshiri B.The Role of Chest Physiotherapy in Prevention of Postextubation Atelectasis in Pediatric Patients with Neuromuscular Diseases. Iran J Child Neurol. 2013 Winter; 7 (1:21-24. ObjectiveThere are controversial findings in the literature on the effects of chest physiotherapy on postextubation lung collapse in pediatric age group. Therefore, we aimed to investigate the efficacy of chest physiotherapy in prevention of postextubation atelectasis in pediatric patients. Materials & Methods In a case-control study from March 2007 to March 2011, two groups of patients (35 patients in each group susceptible to lung collapse were enrolled in the study. The studied patients had neuromuscular diseases such as spinal muscular atrophy, Guillain-Barre syndrome, critical illness polyneuropathy/myopathy, and cerebral palsy. The patients were randomly divided into two groups (case and control; The case group underwent daily chest physiotherapy through vibrator and chest percussion and the control group was under supervision. In the latter group, the underlying disease was treated and the lung collapse was managed, if occurred. Results The frequency of atelectasis was lower in the case group who received prophylactic chest physiotherapy compared to the control group (16.6% vs. 40%. Conclusion Chest physiotherapy as well as appropriate and regular change of position can considerably reduce the rate of pulmonary collapse in pediatric patients.References Jorgensen J, Wei JL, Sykes KJ, Klem SA, Weatherly RA, Bruegger DE, Latz AD, Nicklaus PJ. Incidence of and risk factors for airway complications following endotracheal intubation for bronchiolitis. Otolaryngol Head Neck Surg 2007;137(3:394-9.Flenady VJ, Gray PH. Chest physiotherapy for preventing morbidity in babies being extubated from mechanical ventilation. Cochrane Database Syst Rev 2002;(2:CD000283.Odita JC, Kayyali M, Ammari A. Post-extubation atelectasis in ventilated newborn infants. Pediatr Radiol 1993;23(3:183-5.Balachandran A, Shivbalan S, Thangavelu S. Chest physiotherapy in pediatric practice. Indian Pediatr 2005;42(6:559-68.Finer NN, Moriartey RR, Boyd J, Phillips HJ, Stewart AR, Ulan O. Postextubation atelectasis: a retrospective review and a prospective controlled study. J Pediatr 1979;94(1:110-3.Al-Alaiyan S, Dyer D, Khan B. Chest physiotherapy and post-extubation atelectasis in infants. Pediatr Pulmonol. 1996;21(4:227-30.Bloomfield FH, Teele RL, Voss M, Knight DB, Harding JE. The role of neonatal chest physiotherapy in preventing postentubation atelectasis. J pediatr 1998;133(2:269-71.Bagley CE, Gray PH, Tudehope DI, Flenady V, Shearman AD, Lamont A. Routine neonatal postextubation chest physiotherapy: a randomized controlled trial. J Paediatr Child Health 2005;41(11:592-7.Vivian-Beresford A, King C, Macauley H. Neonatal post-extubation complications: the preventive role of physiotherapy. Physiother Can 1987;39:184-90.Bagley C, Flenady V, Tudehope D, Gray P. The role of postextubation chest physiotherapy: A randomised controlled trial. Proceedings of the Perinatal Society of Australia and New Zealand 4th Annual Congress. Brisbane: 1999.Reines HD, Sade RM, Bradford BF, Marshall J. Chest physiotherapy fails to prevent postoperative atelectasis in children after cardiac surgery. Ann Surg 1982;195(4:451-5. Cavenaghi S, Moura SC, Silva TH, Venturinelli TD, Marino LH, Lamari NM. Importance of pre- and postoperative physiotherapy in pediatric cardiac surgery. Rev Bras Cir Cardiovasc 2009;24(3:397-400.Deakins K, Chatburn RL. A comparison of intrapulmonary percussive ventilation and conventional chest physiotherapy for the treatment of atelectasis in the pediatric patient. Respir Care 2002;47(10:1162-7.

  6. Amplification of neuromuscular transmission by postjunctional folds.

    Science.gov (United States)

    Martin, A R

    1994-12-22

    Previously, suggestions have been made that postjunctional folds at the vertebrate motor end plate might, in some way, serve to enhance neuromuscular transmission. This suggestion was examined quantitatively using a model junction with geometry similar to that seen in mammalian 'fast twitch' muscles. It was found that the depolarization produced at the top of an interfold by a quantum of acetylcholine is significantly greater than that produced in the absence of folds because of the series resistance of the interfold myoplasm. As a result, voltage-sensitive sodium channels in the postsynaptic membrane are activated more readily. In the model, activation of as few as four interfolds by eight quanta is sufficient for excitation to spread to the remainder of the muscle. With no folds, 19 quanta are required. PMID:21710792

  7. Gastrointestinal neuromuscular pathology in alpers disease.

    Science.gov (United States)

    Kapur, Raj P; Fligner, Corinne; Maghsoodi, Bita; Jaffe, Ronald

    2011-05-01

    Alpers disease is a recessive mitochondrial disorder caused by mutations in POLG1 and characterized primarily by progressive neurological and hepatic degeneration. Intestinal dysmotility is a frequent symptom, but it is often overshadowed by other clinical manifestations. The onset and progression of Alpers disease vary; however, most patients die during childhood, often before a specific diagnosis has been established. The gastrointestinal neuromuscular pathology of 4 patients, obtained largely from postmortem specimens, showed distinctive eosinophilic cytoplasmic granules in a subset of enteric ganglia and patchy atrophy of small intestinal muscularis externa. The cytoplasmic inclusions corresponded to abnormal mitochondria, which have been reported previously in another mitochondrial disorder (mitochondrial neurogastrointestinal encephalomyopathy) but not in Alpers disease. Recognition of these distinctive light microscopic findings, in an appropriate clinical setting, should prompt the evaluation of an underlying primary mitochondriopathy. PMID:21451360

  8. Habitual exercise plus dietary supplementation with milk fat globule membrane improves muscle function deficits via neuromuscular development in senescence-accelerated mice.

    Science.gov (United States)

    Haramizu, Satoshi; Mori, Takuya; Yano, Michiko; Ota, Noriyasu; Hashizume, Kohjiro; Otsuka, Atsuko; Hase, Tadashi; Shimotoyodome, Akira

    2014-01-01

    We examined the effects of habitual exercise plus nutritional intervention through consumption of milk fat globule membrane (MFGM), a milk component, on aging-related deficits in muscle mass and function in senescence-accelerated P1 mice. Combining wheel-running and MFGM (MFGMEx) intake significantly attenuated age-related declines in quadriceps muscle mass (control: 318?±?6 mg; MFGMEx: 356?±?9 mg; P?Dok-7) and myogenin mRNA expression. Treatment of differentiating myoblasts with MFGM-derived phospholipid or sphingolipid fractions plus mechanical stretching also significantly increased Dok-7 mRNA expression. These findings suggest that habitual exercise plus dietary MFGM improves muscle function deficits through neuromuscular development, and that phospholipid and sphingolipid in MFGM contribute to its physiological actions. PMID:25110626

  9. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

    Science.gov (United States)

    Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

    2015-07-01

    Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. PMID:26084526

  10. Learning to Live with Neuromuscular Disease: A Message for Parents

    Science.gov (United States)

    Learning to Live with Neuromuscular Disease A Message for Parents This booklet is for parents who’ve ... Blackburn Duchenne muscular dystrophy Your first task is learning to deal with your feelings in the most ...

  11. Formation of neuromuscular junctions in rat embryo cell cultures

    International Nuclear Information System (INIS)

    The morphological evidence of the primary nerve muscle contacts are described. They consist of areas of cholinesterase activity (detected histochemically) localized on the myotube membranes and of multiple clusters of ACh receptors whose 125I-?-bungarotoxin binding sites are revealed by radioautography. After the stage of the primary nerve muscle contacts, some of which seem transient, characteristic neuromuscular junctions appear. These neuromuscular junctions which possess subneural infoldings are similar to the end-plates of the rat in vivo

  12. Degeneration of Neuromuscular Junction in Age and Dystrophy

    OpenAIRE

    Rüdiger Rudolf; Siegfried Labeit; Deschenes, Michael R.

    2014-01-01

    Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and postsynaptic origin. Consequently, neuromuscular junctions are good indicators of motor health on a systemic level. Indeed, upon sarco...

  13. Neuromuscular blockade in cardiac surgery: An update for clinicians

    OpenAIRE

    Hemmerling Thomas; Russo Gianluca; Bracco David

    2008-01-01

    There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary) sufficiently profound neuromuscular blockade during surgery and i...

  14. Neuromuscular choristoma of the sciatic nerve. Case report.

    Science.gov (United States)

    Maher, Cormac O; Spinner, Robert J; Giannini, Caterina; Scheithauer, Bernd W; Crum, Brian A

    2002-06-01

    The authors report the findings of a neuromuscular choristoma of the sciatic nerve in an otherwise healthy 18-year-old man who presented with sensorimotor symptoms and deformities of the right leg and foot. Only a few cases of this rare tumor, also known as "neuromuscular hamartoma" or "benign triton tumor," have been reported in the surgical literature. The authors discuss the clinical presentation, radiological findings, pathological diagnosis, and surgical rationale for this case and review the associated literature. PMID:12066915

  15. Molecular targets for autoimmune and genetic disorders of neuromuscular transmission.

    OpenAIRE

    Vincent, A.; Beeson, D.; Lang, B.

    2000-01-01

    The neuromuscular junction is the target of a variety of autoimmune, neurotoxic and genetic disorders, most of which result in muscle weakness. Most of the diseases, and many neurotoxins, target the ion channels that are essential for neuromuscular transmission. Myasthenia gravis is an acquired autoimmune disease caused in the majority of patients by antibodies to the acetylcholine receptor, a ligand-gated ion channel. The antibodies lead to loss of acetylcholine receptor, reduced efficiency ...

  16. Hexosamine biosynthetic pathway mutations cause neuromuscular transmission defect.

    OpenAIRE

    Senderek, J.; Müller, JS; Dusl, M; Strom, TM; Guergueltcheva, V; Diepolder, I; Laval, SH; Maxwell, S.; Cossins, J; Krause, S.; Muelas, N; Vilchez, JJ; Colomer, J.; Mallebrera, CJ; Nascimento, A.

    2011-01-01

    Neuromuscular junctions (NMJs) are synapses that transmit impulses from motor neurons to skeletal muscle fibers leading to muscle contraction. Study of hereditary disorders of neuromuscular transmission, termed congenital myasthenic syndromes (CMS), has helped elucidate fundamental processes influencing development and function of the nerve-muscle synapse. Using genetic linkage, we find 18 different biallelic mutations in the gene encoding glutamine-fructose-6-phosphate transaminase 1 (GFPT1)...

  17. Optimal piezo-electro-mechanical coupling to control plate vibrations

    OpenAIRE

    Alessandroni, Silvio; Isola, Francesco; Frezza, Fabrizio

    2010-01-01

    A new way of coupling electrical and mechanical waves, using piezoelectric effect, is presented here. Since the energy exchange between two systems supporting wave propagation is maximum when their evolution is governed by similar equations, hence, an optimal electromechanical coupling is obtained by designing an electric network which is "analog" to the mechanical structure to be controlled. In this paper, we exploit this idea to enhance the coupling, between a Kirchhoff-Lo...

  18. Study of Seed Dormancy Mechanisms; Causes and Control

    OpenAIRE

    Syeda Nasreen; Yousaf, M.; Mohmand, Akbar S.; Ashraf Mailk, M.

    2002-01-01

    Dormancy mechanisms in cereals and oilseed crops were reviewed. Objective was to determine the causes of seed dormancy. The methods of control of seed dormancy were also reviewed and the following results were obtained. During seed dormancy, a mature embryo remains inactive but viable. An understanding of seed dormancy mechanisms can be helpful in optimizing the distribution of seed germination in time or space. Seed coats, cotyledons and growth hormones play an important role in maintaining ...

  19. Governance control mechanisms in Portuguese agricultural credit cooperatives

    OpenAIRE

    Cabo, Paula; Rebelo, João

    2005-01-01

    Over the last decade Portuguese Agricultural Credit Cooperatives (ACCs) have increasingly face survival challenges related to their difficulty in gathering equity. The main source of ACCs equity is the net benefit; thus, understanding how ACCs governance can work on correcting bad economic performance is of crucial importance to overcome this constraint. The main objective of this paper is to describe the governance control mechanisms in the ACCs. Five governance mechanisms are id...

  20. Dynamics and control of mechanical systems in offshore engineering

    CERN Document Server

    He, Wei; How, Bernard Voon Ee; Choo, Yoo Sang

    2014-01-01

    Dynamics and Control of Mechanical Systems in Offshore Engineering is a comprehensive treatment of marine mechanical systems (MMS) involved in processes of great importance such as oil drilling and mineral recovery. Ranging from nonlinear dynamic modeling and stability analysis of flexible riser systems, through advanced control design for an installation system with a single rigid payload attached by thrusters, to robust adaptive control for mooring systems, it is an authoritative reference on the dynamics and control of MMS. Readers will gain not only a complete picture of MMS at the system level, but also a better understanding of the technical considerations involved and solutions to problems that commonly arise from dealing with them. The text provides:                                                                                                                                 ...

  1. Squeezing of mechanical motion via qubit-assisted control

    International Nuclear Information System (INIS)

    We propose a feedback control mechanism for the squeezing of the phononic mode of a mechanical oscillator. We show how, under appropriate working conditions, a simple adiabatic approach is able to induce mechanical squeezing. We then go beyond the limitations of such a working point and demonstrate the stationary squeezing induced by using repeated measurements and reinitialization of the state of a two-level system ancilla coupled to the oscillator. Our nonadaptive feedback loop offers interesting possibilities for quantum state engineering and steering in open-system scenarios. (paper)

  2. A Cell-Level Mechanism of Contrast Gain Control

    OpenAIRE

    Schumacher, Linus J.; Nicholls, Geoff K.

    2013-01-01

    The gain of neurons' responses in the auditory cortex is sensitive to contrast changes in the stimulus within a spectrotemporal range similar to their receptive fields, which can be interpreted to represent the tuning of the input to a neuron. This indicates a local mechanism of contrast gain control, which we explore with a minimal mechanistic model here. Gain control through noisy input has been observed in vitro and in a range of computational models. We investigate the b...

  3. Optimal Control of Underactuated Mechanical Systems: A Geometric Approach

    OpenAIRE

    L. Colombo; de Diego, D. Martin; Zuccalli, M.

    2009-01-01

    In this paper, we consider a geometric formalism for optimal control of underactuated mechanical systems. Our techniques are an adaptation of the classical Skinner and Rusk approach for the case of Lagrangian dynamics with higher-order constraints. We study a regular case where it is possible to establish a symplectic framework and, as a consequence, to obtain a unique vector field determining the dynamics of the optimal control problem. These developments will allow us to d...

  4. Control rod drive mechanism with shock absorber for nuclear reactor

    International Nuclear Information System (INIS)

    The mechanism usable in a PWR has a shaft carrying the bar vertically displaceable in the reactor internals and a dash pot with a hydraulic cylinder and a piston. The cylinder has a large diameter perforated upper section to the cylinder, a small diameter lower section, a piston traversed by the control rod sized to fit into the upper section and forced downwards when the control descends. The shock absorbing chamber is defined between the piston and the upper section

  5. Aging interferes central control mechanism for eccentric muscle contraction

    OpenAIRE

    Yao, Wan X.; Jinqi Li; Zhiguo Jiang; Jia-Hong Gao; Yufei Huang

    2014-01-01

    Previous studies report greater activation in the cortical motor network in controlling eccentric contraction (EC) than concentric contraction (CC) despite lower muscle activation level associated with EC vs. CC in healthy, young individuals. It is unknown, however, whether elderly people exhibiting increased difficulties in performing EC than CC possess this unique cortical control mechanism for EC movements. To address this question, we examined functional magnetic resonance imaging (fMRI) ...

  6. Topology of optimally controlled quantum mechanical transition probability landscapes

    International Nuclear Information System (INIS)

    An optimally controlled quantum system possesses a search landscape defined by the physical objective as a functional of the control field. This paper particularly explores the topological structure of quantum mechanical transition probability landscapes. The quantum system is assumed to be controllable and the analysis is based on the Euler-Lagrange variational equations derived from a cost function only requiring extremizing the transition probability. It is shown that the latter variational equations are automatically satisfied as a mathematical identity for control fields that either produce transition probabilities of zero or unit value. Similarly, the variational equations are shown to be inconsistent (i.e., they have no solution) for any control field that produces a transition probability different from either of these two extreme values. An upper bound is shown to exist on the norm of the functional derivative of the transition probability with respect to the control field anywhere over the landscape. The trace of the Hessian, evaluated for a control field producing a transition probability of a unit value, is shown to be bounded from below. Furthermore, the Hessian at a transition probability of unit value is shown to have an extensive null space and only a finite number of negative eigenvalues. Collectively, these findings show that (a) the transition probability landscape extrema consists of values corresponding to no control or full control, (b) approachi no control or full control, (b) approaching full control involves climbing a gentle slope with no false traps in the control space and (c) an inherent degree of robustness exists around any full control solution. Although full controllability may not exist in some applications, the analysis provides a basis to understand the evident ease of finding controls that produce excellent yields in simulations and in the laboratory

  7. Vendaje neuromuscular: Efectos neurofisiológicos y el papel de las fascias / Neuromuscular Bandage: Neurophysiological Effects and the Role of Fascias / Bandagem neuromuscular: Efeitos neurofisiológicos e o papel das fáscia

    Scientific Electronic Library Online (English)

    Ximena María, Villota Chicaíza.

    2014-08-01

    Full Text Available Durante os últimos anos a bandagem neuromuscular, um aplicativo terapêutico criado em 1979 pelo doutor KJenzo Kase tem vindo se introduzindo no maneio de muitas alterações do sistema musculoesquelético e especialmente no tratamento de transtornos neurológicos; esta ferramenta terapêutica que consist [...] e em uma bandagem elástica autoadesiva, permite a recuperação da parte lesada sem diminuir sua função corporal. De acordo com a literatura existente sobre os efeitos fisiológicos produzidos por este aplicativo terapêutico no organismo poderia se dizer que existe consenso. No entanto, neste artigo a autora quer destacar o significativo ainda pouco destacado papel que jogam as fáscias nos efeitos terapêuticos da bandagem neuromuscular, analisando desde uma perspectiva reflexiva o efeito analgésico, neuromecânico e circulatório, como efeitos fundamentais da bandagem neuromuscular e a função das fáscias, tentando aportar um entendimento global na forma como se relacionam todos os tecidos conectivos, aspectos que são de grande importância tanto para a avaliação de alterações quanto para a prescrição adequada da bandagem neuromuscular. Abstract in spanish Durante los últimos años, el vendaje neuromuscular, un aplicativo terapéutico creado en 1979 por el doctor Kenzo Kase, ha venido introduciéndose en el manejo de muchas alteraciones del sistema músculo-esquelético y más aún en el tratamiento de trastornos neurológicos; esta herramienta terapéutica qu [...] e consiste en un vendaje elástico autoadhesivo permite la recuperación de la parte lesionada sin disminuir su función corporal. De acuerdo con la literatura existente sobre los efectos fisiológicos producidos por este aplicativo terapéutico en el organismo, se podría decir que existe consenso. Sin embargo, en este artículo la autora quiere destacar el significativo aunque poco resaltado papel que juegan las fascias en los efectos terapéuticos del vendaje neuromuscular, analizando desde una perspectiva reflexiva el efecto analgésico, neuromecánico y circulatorio, como efectos fundamentales del vendaje neuromuscular y la función de las fascias en los mismos, con lo que intenta aportar un entendimiento global en la manera como se relacionan todos los tejidos conectivos, aspectos que son de gran importancia tanto para la evaluación de alteraciones como para la prescripción adecuada del vendaje neuromuscular. Abstract in english During the last years, neuromuscular bandage, a therapeutic application created in 1979 by doctor Kenzo Kase has been introduced in the management of many disorders of the musculo-skeletal system and even more so in the treatment of neurological disorders; This therapeutic tool which consists of a s [...] elf adhesive elastic bandage allows recovery of the injured party without diminish- ing its bodily function. According to the existing literature on the physiological effects of this therapeutic application in the body, you could say that there is consensus. However in this article the author wants to highlight the significant although little highlighted role played by the fascias on the therapeutic effects of neuromuscular bandage, analyzing from a reflective perspective the analgesic, neuromechanical and circulatory effects, as fundamental effects of neuromuscular bandage and fascias in the same function, trying to bring a global understanding on the way they relate to all connective tissues, aspects that are of great importance for the proper evaluation of alterations and prescription of neuromuscular bandage.

  8. Neuromuscular disease. DOK7 gene therapy benefits mouse models of diseases characterized by defects in the neuromuscular junction.

    OpenAIRE

    Arimura, S.; Okada, T.; Tezuka, T.; Chiyo, T.; Kasahara, Y.; Yoshimura, T.; Motomura, M.; Yoshida, N.; Beeson, D.; Takeda, S.; Yamanashi, Y.

    2014-01-01

    The neuromuscular junction (NMJ) is the synapse between a motor neuron and skeletal muscle. Defects in NMJ transmission cause muscle weakness, termed myasthenia. The muscle protein Dok-7 is essential for activation of the receptor kinase MuSK, which governs NMJ formation, and DOK7 mutations underlie familial limb-girdle myasthenia (DOK7 myasthenia), a neuromuscular disease characterized by small NMJs. Here, we show in a mouse model of DOK7 myasthenia that therapeutic administration of an aden...

  9. Estimulação elétrica neuromuscular em cães com atrofia muscular induzida / Neuromuscular electric stimulation in dogs with induced muscle atrophy

    Scientific Electronic Library Online (English)

    C., Pelizzari; A., Mazzanti; A.G., Raiser; S.T.A., Lopes; D.L., Graça; A.T., Ramos; F.Z., Salbego; R., Festugatto; D.V., Beckmann; L.B., Souza; M.G.M.C.M., Cunha; R.P., Santos; B., Garmatz; A.P., Silva; D.A.F., Sturza.

    2008-02-01

    Full Text Available Empregou-se a estimulação elétrica neuromuscular (EENM) de baixa freqüência no músculo quadríceps femoral de cães com atrofia induzida e avaliou-se a ocorrência de ganho de massa nessa musculatura. Foram utilizados oito cães com pesos entre 15 e 30kg, distribuídos aleatoriamente em dois grupos denom [...] inados de I ou controle e II ou tratado. A articulação femorotibiopatelar esquerda foi imobilizada por 30 dias pelo método de transfixação percutânea tipo II, com retirada de aparelho de imobilização após esse período. Decorridas 48 horas da remoção, foi realizada a EENM nos cães do grupo II, cinco vezes por semana, com intervalo de 24 horas cada sessão, pelo período de 60 dias. Foram avaliadas a circunferência da coxa, a goniometria do joelho, a análise clínica da marcha, as enzimas creatina-quinase (CK) e aspartato-amino-transferase (AST) e a morfometria das fibras musculares em cortes transversais do músculo vasto lateral colhido mediante biópsia muscular. A EENM foi empregada no músculo quadríceps femoral na freqüência de 50Hz, duração de pulso de 300 milisegundos e relação de tempo on/off de 1:2. Quanto à morfometria das fibras do músculo vasto lateral, no grupo tratado houve aumento significativo (P Abstract in english Low frequency neuromuscular electrical stimulation (NMES) was used on the femoral quadriceps of dogs with induced muscular atrophy and the occurrence of gain in mass in these muscles was evaluated. Eight dogs from 15 to 30kg were randomly distributed in two groups named I, or control; and II, or tre [...] ated. For the induction of muscular atrophy, the left femoral-tibial-patellar joint was immobilized for 30 days by percutaneous transfixation type II. After 30 days, the immobilization device was removed. The NMES treatment began 48 hours after the removal of the immobilization device of the dogs of group II, and it was carried out five times per week with an interval of 24 hours between each session, for 60 days. The following parameters were measured: thigh circumference, goniometry of the knee, clinical gait analysis, creatine kinase (CK) and aspartate aminotransferase (AST) enzymes, and morphometry of the muscular fibers in transversal cuts of the vastus lateralis muscle collected through muscular biopsy. The NMES was applied on the femoral quadriceps at a frequency of 50 Hz, with pulse duration of 300 milliseconds, and the on/off time was at a proportion of 1:2. Regarding the morphometry of the vastus lateralis fibers, a significant increase (P

  10. Efeito do priming na redução da latência do pipecurônio, novo bloqueador neuromuscular não-despolarizante / Effect of priming in shortening onset of pipecuronium, a new nondepolarizing neuromuscular blocker / Efecto del priming en la reducción de la latencia del pipecuronio, nuevo bloqueador neuromuscular no despolarizante

    Scientific Electronic Library Online (English)

    José Carlos, Canga; Carlos Neutzling, Lehn; Deoclécio, Tonelli; Paula de Camargo Neves, Sacco; Danielle, Beltrão; Marcelo, Kirsch; Fernando César, Serralheiro; Gustavo, Cimerman.

    2005-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Uma das mais importantes propriedades dos bloqueadores neuromusculares é o rápido início de ação, possibilitando intubação traqueal precoce. A administração de pequena dose de bloqueador não-despolarizante antes da dose plena é sabidamente redutora da latência da maioria d [...] os bloqueadores neuromusculares utilizados. O brometo de pipecurônio é um agente aminoesteróide de longa duração com grande estabilidade cardiovascular, porém, com início de ação tardio. O objetivo desse estudo foi avaliar o efeito do priming do pipecurônio em pacientes adultos submetidos a cirurgias eletivas sob anestesia geral. MÉTODO: Foram estudados 33 pacientes adultos de ambos os sexos, com idade entre 20 e 65 anos, estado físico ASA I ou II, submetidos a cirurgias eletivas sob anestesia geral. Foram excluídos do estudo pacientes com insuficiência renal ou hepática, neuromiopatia, uso concomitante de drogas que influenciem a sua farmacocinética ou pacientes com histórico familiar de hipertermia maligna. Foram divididos em dois grupos: Grupo 1 onde foi utilizado o priming com 0,01 mg.kg-1 e três minutos depois completada a dose de 0,08 mg.kg-1 e o Grupo 2, sem dose priming (Grupo Controle). O relaxamento neuromuscular foi controlado pela aceleromiografia (Aparelho TOF-Guard) e no momento em que T1 Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: Una de las más importantes propiedades de los bloqueadores neuromusculares es el rápido inicio de acción, posibilitando intubación orotraqueal precoz. La administración de pequeña dosis del bloqueador no despolarizante antes de la dosis completa es consabidamente reductora [...] de la latencia de la mayoría de los bloqueadores neuromusculares utilizados. El bromuro de pipecuronio es un agente aminoesteroide de larga duración con grande estabilidad cardiovascular, sin embargo, con inicio de acción tardía. El objetivo de ese estudio es evaluar el efecto del priming del pipecuronio en pacientes adultos sometidos a cirugías electivas bajo anestesia general. MÉTODO: Fueron estudiados 32 pacientes adultos de ambos sexos, con edad entre 20 y 65 años, estado físico ASA I ó II, a ser sometidos a cirugías electivas bajo anestesia general. Fueron excluidos del estudio pacientes con insuficiencia renal o hepática, neuromiopatia, uso concomitante de drogas que influencien la farmacocinética de la droga o pacientes con histórico familiar de hipertermia maligna. Fueron divididos en dos grupos: Grupo 1 donde fue utilizada el priming con 0,01 mg.kg-1 3 minutos después de completada la dosis de 0,08 mg.kg-1 y el Grupo 2, sin dosis priming (Grupo Control). El relajamiento neuromuscular fue controlado por la aceleromiografía (Aparato TOF-Guard) y en el momento en que T1 Abstract in english BACKGROUND AND OBJECTIVES: One of the most important neuromuscular blockers property is short onset, allowing early tracheal intubation. Low nondepolarizing blocker dose before the full dose is known to decrease the onset of most neuromuscular blockers. Pipecuronium bromide is a long-lasting aminost [...] eroid with major cardiovascular stability, however, with late onset. This study aimed at evaluating pipecuronium priming effect in adult patients submitted to elective surgeries under general anesthesia. METHODS: Participated in this study 33 adult patients of both genders, aged 20 to 65 years, physical status ASA I or II, to be submitted to elective surgeries under general anesthesia. Exclusion criteria were patients with kidney or liver failure, neuromuscular diseases, in concurrent use of drugs influencing pipecuronium pharmacokinetics, and patients with family history of malignant hyperthermia. Patients were divided in 2 groups: Group 1 = priming with 0.01 mg.kg-1 and 3 minutes later the remaining 0.07 mg.kg-1 (total 0.08 mg.kg-1); Group 2 = no priming dose (group control). Neuromuscular relaxation was controlled by acceleromyography (TOF-Guard device) and laryngoscopy was accomplished when T1

  11. Applications of Shape Memory Alloys for Neurology and Neuromuscular Rehabilitation

    Directory of Open Access Journals (Sweden)

    Simone Pittaccio

    2015-05-01

    Full Text Available Shape memory alloys (SMAs are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE, shape memory effect (SME and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous.

  12. Applications of shape memory alloys for neurology and neuromuscular rehabilitation.

    Science.gov (United States)

    Pittaccio, Simone; Garavaglia, Lorenzo; Ceriotti, Carlo; Passaretti, Francesca

    2015-01-01

    Shape memory alloys (SMAs) are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE), shape memory effect (SME) and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous. PMID:26023790

  13. An Artificial Neural Network Estimation of Gait Balance Control in the Elderly Using Clinical Evaluations

    OpenAIRE

    Lugade, Vipul; Lin, Victor; Farley, Arthur; Chou, Li-Shan

    2014-01-01

    The use of motion analysis to assess balance is essential for determining the underlying mechanisms of falls during dynamic activities. Clinicians evaluate patients using clinical examinations of static balance control, gait performance, cognition, and neuromuscular ability. Mapping these data to measures of dynamic balance control, and the subsequent categorization and identification of community dwelling elderly fallers at risk of falls in a quick and inexpensive manner is needed. The purpo...

  14. Performance Analysis of Concurrency Control Mechanisms for OLTP Databases

    Directory of Open Access Journals (Sweden)

    Samuel Kaspi

    2014-08-01

    Full Text Available Concurrency control (CC in distributed and multidimensional databases is becoming more important due to recent increase in high-volume data storage with increasing online transaction processing (OLTP requirements for medium and large organisations. This paper examines three concurrency control mechanisms commonly adopted and analyses their performance in distributed databases for OLTP operational systems of enterprises. The three CC mechanisms investigated are, two phase locking (2PL, wait depth limited (WDL and optimistic concurrency control. These CC mechanisms have been studied well in disk-based systems. However, with the recent advances of cost-effective main memory or in-memory storage that can support much higher transaction rates than disk-based systems, there is sufficient motivation to re-investigate the performance of such CC mechanisms in diverse processor configurations. This paper presents a comparison of their behaviour and performance in terms of throughput rates achieved with varying transaction size and contention. The outcome of this study has resulted in further research proposals for improving the performance of these CC mechanisms for OLTP databases.

  15. Context-Based E-Health System Access Control Mechanism

    Science.gov (United States)

    Al-Neyadi, Fahed; Abawajy, Jemal H.

    E-Health systems logically demand a sufficiently fine-grained authorization policy for access control. The access to medical information should not be just role-based but should also include the contextual condition of the role to access data. In this paper, we present a mechanism to extend the standard role-based access control to incorporate contextual information for making access control decisions in e-health application. We present an architecture consisting of authorisation and context infrastructure that work cooperatively to grant access rights based on context-aware authorization policies and context information.

  16. Fabrication and Utilization of Mechanically Controllable Break Junction for Bioelectronics

    OpenAIRE

    XIANG, DONG

    2012-01-01

    In dieser Arbeit wurde ein mechanisch kontrollierbarer Bruchkontaktaufbau (mechanically controllable break junction = MCBJ) entwickelt und für die Untersuchung von vier Aspekten des Elektronentransports von Molekülen benutzt. Das Hauptmerkmal der hier hergestellten MCBJ ist deren beeindruckende Stabilität. Federstahlsubstrate mit einer Länge von 44 mm und einer Breite von 12 mm wurden für die Herstellung der MCBJ Chips verwendet. Durch Elektronenstrahllitographie wurden dünne Brücke...

  17. Use of focal mechanisms to determine stress: a control study.

    Science.gov (United States)

    Michael, A.J.

    1987-01-01

    The results of this control study show that focal mechanisms can be inverted to find the best stress tensor, but the resolution is decreased unless the fault planes can be picked a priori. The resolution can also be increased by including constraints on the magnitude of the tangential traction on the fault plane.-from Author

  18. Quasivelocities and Optimal Control for Underactuated Mechanical Systems

    OpenAIRE

    L. Colombo; de Diego, D. Martin

    2010-01-01

    This paper is concerned with the application of the theory of quasivelocities for optimal control for underactuated mechanical systems. Using this theory, we convert the original problem in a variational second-order lagrangian system subjected to constraints. The equations of motion are geometrically derived using an adaptation of the classical Skinner and Rusk formalism.

  19. Fluid Mechanics of Wing Adaptation for Separation Control

    Science.gov (United States)

    Chandrasekhara, M. S.; Wilder, M. C.; Carr, L. W.; Davis, Sanford S. (Technical Monitor)

    1997-01-01

    The unsteady fluid mechanics associated with use of a dynamically deforming leading edge airfoil for achieving compressible flow separation control has been experimentally studied. Changing the leading edge curvature at rapid rates dramatically alters the flow vorticity dynamics which is responsible for the many effects observed in the flow.

  20. Quasivelocities and Optimal Control for underactuated Mechanical Systems

    International Nuclear Information System (INIS)

    This paper is concerned with the application of the theory of quasivelocities for optimal control for underactuated mechanical systems. Using this theory, we convert the original problem in a variational second-order lagrangian system subjected to constraints. The equations of motion are geometrically derived using an adaptation of the classical Skinner and Rusk formalism.

  1. Mechanisms controlling the onset of simulated convectively coupled Kelvin waves

    Directory of Open Access Journals (Sweden)

    Željka Fuchs

    2014-01-01

    Full Text Available Convectively coupled Kelvin waves (CCKW are analysed using a cloud-resolving model to gain a better understanding of the mechanisms that initiate and drive these waves. We compare the modelled precipitation and vertical structure of a convectively coupled Kelvin wave to the mechanisms that control precipitation over warm tropical oceans: convective inhibition (CIN, saturation fraction, atmospheric stability and surface moist entropy fluxes. Our results show that the primary onset mechanism for precipitation associated with CCKW is CIN associated with a decrease in the threshold moist entropy. Saturation fraction and atmospheric instability exhibit a time lag in comparison with the rainfall evolution and are, therefore, not primary controls in the onset of these waves. The modelled CCKW evolve by starting with congestus convection, develop into deep convection and decay with the stratiform convection. The results from the presented model agree with observations and linearised models.

  2. Fisiopatología de las alteraciones neuromusculares en el paciente crítico / Pathophysiology of neuromuscular impairments in the critically ill patients

    Scientific Electronic Library Online (English)

    A., García de Lorenzo; E., Vilas; J. A., Rodríguez Montes.

    2006-05-01

    Full Text Available Objetivo: Analizar las causas y manifestaciones de la debilidad muscular que desarrollan los pacientes críticos durante su estancia en la UCI y revisar la bibliografía. Desarrollo: A principios de los años 80 se describió en pacientes críticos sépticos una polineuropatía axonal mixta que clínicament [...] e se caracterizaba por una debilidad muscular de intensidad variable que en su vertiente más grave producía tetraplejia y/o dependencia del ventilador. Casi paralelamente se describió la miopatía aguda de los cuidados intensivos en pacientes asmáticos que eran ingresados en la UCI por exacerbación de su enfermedad. Con posterioridad se observó que esta miopatía se presentaba también en pacientes trasplantados, sépticos o quemados. Hay autores que consideran a la miopatía aguda de los cuidados intensivos como la primera causa de debilidad muscular en la UCI. Conclusiones: En este artículo se describen la clínica, etiopatogenia, diagnóstico y tratamiento de la polineuropatía del paciente crítico y de la miopatía aguda de los cuidados intensivos. Los dos cuadros clínicos son diferenciables en muchas ocasiones, siendo de gran ayuda los estudios neurofisiológicos y eventualmente la biopsia muscular. Aunque algunos autores prefieren englobar estas entidades bajo el nombre de polineuromiopatía, proponemos la denominación general de Síndrome Neuromuscular Agudo en el paciente crítico término más descriptivo, que no presupone un mecanismo ni una etiología única. Abstract in english Objective: to analyze the causes and manifestations of muscle weakness that critically ill patients develop during their staying at the ICU, and literature review. Development: in the early 1980s, a mixed axonal polyneuropathy was described in septic critically ill patients, which clinically manifes [...] ted by muscle weakness of variable severity, leading to quadriplegia and/or ventilator dependency in its most severe presentation. Almost at the same time, an acute intensive care myopathy was described in asthmatic patients admitted to the ICU for asthma exacerbation. Later on, this myopathy was also observed in transplanted, septic, or burnt patients. Several authors consider acute intensive care myopathy as the main cause of muscle weakness in the ICU. Conclusions: in this article, we describe the clinical presentation, etiopathogenesis, diagnosis, and treatment of polyneuropathy of the critically ill patient and of acute intensive care myopathy. Both clinical pictures may be differentiated, with neurophysiological studies and eventually muscle biopsy being of great help. Although some authors rather include these conditions under the name of polyneuromyopathy, we propose the general denomination of Acute Neuromuscular Syndrome of the Critically Ill Patient, a more descriptive term no presupposing a single mechanism or etiology.

  3. View-based access control mechanism for spatial database

    Science.gov (United States)

    Lin, Jiayuan; Fang, Yu; Chen, Bin; Wan, Lin

    2008-12-01

    The development and application of spatial database ultimately create the demand for spatial information security, and access control is our primary concern. The access control requirements for spatial database contain two special aspects: 1) fine-grained; 2) meeting certain conditions, including spatial and non-spatial. In this paper, we propose a view-based mechanism to implement access control functionalities. We firstly present the authorization model for spatial data. Then we thoroughly discuss the definition of various views and their authorization, and explain the advantages and disadvantages of this model. We also provide a reference framework for the view-based access control system, and the components and control flow are explained. Finally, we use a case study to demonstrate the feasibility and effectiveness of view-based authorization model for securing spatial database access.

  4. Sliding mode control on electro-mechanical systems

    Directory of Open Access Journals (Sweden)

    Utkin Vadim I.

    2002-01-01

    Full Text Available The first sliding mode control application may be found in the papers back in the 1930s in Russia. With its versatile yet simple design procedure the methodology is proven to be one of the most powerful solutions for many practical control designs. For the sake of demonstration this paper is oriented towards application aspects of sliding mode control methodology. First the design approach based on the regularization is generalized for mechanical systems. It is shown that stability of zero dynamics should be taken into account when the regular form consists of blocks of second-order equations. Majority of applications in the paper are related to control and estimation methods of automotive industry. New theoretical methods are developed in the context of these studies: sliding made nonlinear observers, observers with binary measurements, parameter estimation in systems with sliding mode control.

  5. Neuromuscular electrical stimulation for motor relearning in hemiparesis.

    Science.gov (United States)

    Chae, John

    2003-02-01

    Neuromuscular electrical stimulation may have an important role in improving the motor function of stroke survivors. Active, repetitive movement training mediated by transcutaneous cyclic and EMG-triggered NMES may facilitate the motor recovery of stroke survivors. Multicenter, double-blinded, randomized clinical trials should be pursued to confirm the motor-relearning effects of transcutaneous NMES and to define appropriate prescriptive specifications. Intramuscular EMG-controlled NMES may be superior to transcutaneous systems and is presently undergoing preliminary randomized clinical trials. Neuroprostheses systems may provided the highest level of goal-oriented activity and cognitive investments, which may lead to significant motor relearning. Implementation of clinically viable neuroprosthesis systems, however, will probably require additional technical developments including more reliable control paradigms and methods for blocking undesirable muscle contractions. In view of the dynamic nature of the present health care environment, the future of NMES technology is difficult to predict. By necessity, scientists and clinicians must continue to explore new ideas and to improve on the present systems. Components will be smaller, more durable, and more reliable. Control issues will remain critical for both motor relearning and neuroprosthetic applications, and the implementation of cortical control is likely to dictate the nature of future generations of NMES systems. Finally, consumers will direct future developments. In the present health care environment, where cost has become an overwhelming factor in the development and implementation of new technology, the consumer will become one of technology's greatest advocates. The usual drive toward greater complexity will be tempered by the practical issues of clinical implementation, where patient acceptance is often a function of a tenuous balance between the burden or cost associated with using a system and the system's impact on the user's life. PMID:12625640

  6. Neuromuscular efficiency of the rectus abdominis differs with gender and sport practice.

    Science.gov (United States)

    David, Pascal; Mora, Isabelle; Pérot, Chantal

    2008-11-01

    The purpose of this investigation was to distinguish the abilities of the rectus abdominis (RA) muscle according to gender and sport training by means of neuromuscular parameters extracted from electromyography (EMG)-torque relationships. Thirty-eight healthy students, divided into 4 groups (i.e., 8 male runners, 10 female gymnasts, 12 male controls, and 8 female controls) were asked to perform 6 seconds of isometric trunk flexions at 20%, 25%, 75%, and 100% of their maximal voluntary contraction. Flexion torque and surface EMG of the RA muscle were recorded simultaneously to construct a EMG-torque relationship. Under maximal and submaximal conditions, an index of neuromuscular efficiency (NME) was determined to characterize the capacity of the RA muscle to develop a torque. At each level of contraction, the area of data scattering (ADS), reflecting torque and EMG fluctuations, was computed to express the capacity to maintain a constant target torque. Flexion torque, NME, and ADS values differed significantly between genders, but when data were related to anthropometric characteristics, no difference was observed. Although runners were not distinguished from male controls, gymnasts had higher flexion torque, higher NME, and lower ADS values than female controls had. These differences should reflect neural and muscular adaptations linked to the specificity of gymnastic training. These findings revealed different functional abilities of the RA muscle, according to gender and sport practices. The indices of neuromuscular capacities used in this study could constitute complementary tools to athletic trainers and professionals in sports medicine for evaluating and following, during sport-specific training programs, the abdominal muscle performance implied in force transfers with a lower cost and lower risks of back pain. PMID:18978621

  7. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training.

    Science.gov (United States)

    Behrens, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance. PMID:26029114

  8. A influência da fadiga neuromuscular e da acidose metabólica sobre a corrida de 400 metros / Influence of neuromuscular fatigue and metabolic acidosis on the 400-meter race

    Scientific Electronic Library Online (English)

    Flávio Roberto, Pelicer; Wonder Passoni, Higino; Ricardo Yoshio, Horita; Franco Carlos, Meira; Alexandre Policher, Alves.

    2011-04-01

    Full Text Available Exercícios inabituais podem levar a danos musculares que persistem por alguns dias diminuindo a capacidade de desempenho em decorrência da fadiga. Além disso, o aumento da acidose intramuscular pode limitar o metabolismo celular no processo de gerar trabalho. Com isso, esta pesquisa teve como finali [...] dade analisar a influência da fadiga neuromuscular e da acidose metabólica sobre a corrida de 400 metros. Foram selecionados 20 indivíduos, sedentários, com idade entre 18 e 35 anos. Estes foram submetidos aos seguintes protocolos: teste incremental em esteira, para determinação do VO2max; limiares aeróbio e anaeróbio, teste de 400m (400/C), atividade pliométrica, com repouso ativo/passivo, seguida de corrida de 400m logo após (400/Pós) e 24 horas após a atividade pliométrica (400/24h). Os resultados obtidos mostram que, quando comparados os grupos ativo e passivo, não apresentaram diferenças significantes no desempenho dos 400/ Pós, mas o tempo deste foi maior, para os dois grupos quando comparado com os 400/C. No entanto, o 400/24h não foi significantemente diferente quando comparado com o 400/C para ambos os grupos. Concluise que, independente do tipo de recuperação - ativa ou passiva -, a diminuição de desempenho em uma corrida de 400 metros após atividade pliométrica parece ser ocasionada por mecanismos neuromusculares que levam à fadiga e não a limitações metabólicas. Abstract in english Unusual exercises can lead to muscle damage that persists for a few days reducing performance ability due to fatigue onset. Moreover, intramuscular acidity increase can limit the cell metabolism in the process of producing work. Therefore, the objective of this research was to analyze the influence [...] of neuromuscular fatigue and metabolic acidity in the 400 m race. The selected sample consisted of 20 sedentary individuals, aged between 18 and 35 years. They were submitted to the following protocols: treadmill incremental test for determination of VO2max; aerobic and anaerobic threshold; 400m race test (400/R); plyometric activity with active/passive rest followed by 400m race immediately after (400/Post) and 24 hours after the plyometric activity (400/24h). The obtained results show that when the active and passive groups are compared, they do not show significant difference in 400/Post performance, but this time was longer for both groups when compared with the 400/R. Nevertheless, the 400/24h was not significantly different when compared with the 400/R to both groups. It was concluded that regardless of the kind of recovery, active or passive, the performance reduction in a 400-meter race after plyometric activity seems to occur by neuromuscular mechanisms that lead to fatigue and not to metabolic limitations.

  9. Effects of aminoglycoside antibiotics on the neuromuscular junction: Part I.

    Science.gov (United States)

    Yamada, S; Kuno, Y; Iwanaga, H

    1986-03-01

    The effects of aminoglycoside antibiotics (AGA) including streptomycin (SM), kanamycin (KM), gentamicin (GM), dibekacin (DKB), amikacin (AMK) and sisomycin (SISO), on the neuromuscular junction were studied by in vivo and in vitro experiments. In in vitro experiments, no effect of AGA on rat phrenic nerve diaphragm preparations was observed, but the use of the antibiotics at a high concentration exerted a slight blocking effect on the neuromuscular junction. The blocking effect of SISO and DKB on the neuromuscular junction was marked. These antibiotics were definitely found to compete with eserine in terms of the blocking effect on the neuromuscular junction, but did not compete with calcium chloride. In in vitro experiments with frog sciatic nerve and musculus sartorius preparations, DKB and SISO exerted a blocking effect on the NMJ, inducing the disappearance of action potentials and the appearance of endplate potentials (EPPs). In in vitro experiments with the preparations from Rana catesbiana frogs, SM, GM, DKB and SISO exhibited an inhibiting effect on the release of acetylcholine (ACh), a chemical neurotransmitter in neuromuscular junction, resulting in a decrease in the frequency of miniature endplate potentials (mEPPS). In in vivo experiments with rabbit sciatic tibialis anterior muscle preparations, SM, GM, DKB and SISO exerted a blocking effect on the neuromuscular junction. From the facts that the effect was augmented by the use of magnesium chloride combined with these antibiotics and that the antibiotics competed with calcium chloride and potassium chloride in terms of the blocking effect on the neuromuscular junction, the effects seemed to be due to the inhibition of ACh release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3699939

  10. Optimal piezo-electro-mechanical coupling to control plate vibrations

    CERN Document Server

    Alessandroni, S; Frezza, F

    2010-01-01

    A new way of coupling electrical and mechanical waves, using piezoelectric effect, is presented here. Since the energy exchange between two systems supporting wave propagation is maximum when their evolution is governed by similar equations, hence, an optimal electromechanical coupling is obtained by designing an electric network which is "analog" to the mechanical structure to be controlled. In this paper, we exploit this idea to enhance the coupling, between a Kirchhoff-Love plate and one possible synthesis of its circuital analog, as obtained by means of a set of piezoelectric actuators uniformly distributed upon the plate. It is shown how this approach allows for an optimal energy exchange between the mechanic and the electric forms independent of the modal evolution of the structure. Moreover, we show how an efficient electric dissipation of the mechanical energy can be obtained adding dissipative elements in the electric network.

  11. Hibernation Control Mechanism and Possible Applications to Humans

    Science.gov (United States)

    Kondo, N.

    Mammalian hibernation, characterized by the ability to survive temporarily at low body temperatures close to 0oC, has been reported to increase resistance to various lethal events such as low body temperature, severe ischemia, bacterial infection and irradiation, and to prolong the life span. The application of this physiological phenomenon to space life has been dreamed of. However, realization of this dream has been prevented by a poor understanding of the control mechanisms of hibernation. Recent findings of a novel and unique protein complex (HP) in the blood of chipmunks, a rodent hibernator, which is controlled by the endogenous circannual rhythm of hibernation, allowed new developments in understanding the molecular mechanism of hibernation and its physiological significance. From these studies, two hormones regulated by the brain were identified as promising candidate molecules controlling HP production in the liver, assuming that hibernation is controlled via the neuroendocrine system and regulated by the endogenous circannual rhythm in the brain. A circannual HP rhythm was observed in chipmunks maintaining euthermia under conditions of constant warmth, suggesting that the physiological control of hibernation progresses without a lowering of body temperature. Furthermore, the study of HP rhythm on longevity revealed that a circannual rhythm plays an essential role in the much longer life span of hibernators. The present progress in hibernation research may open a new pathway for manipulating a circannual rhythm controlling hibernation in humans. In the future, this will make it feasible to take advantage of hibernation in space life.

  12. The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review

    Directory of Open Access Journals (Sweden)

    Herman Katherine

    2012-07-01

    Full Text Available Abstract Background Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective. Methods Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy. Results Nine studies were identified including six randomized controlled trials (RCT and three controlled clinical trials (CCT. Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI 0.54 to 0.84 and overuse (RR 0.45, CI 0.28 to 0.71 lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72 injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76 and overuse (RR 0.44, CI 0.22 to 0.86 injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP strategy reduces the incidence of anterior cruciate ligament (ACL injuries (RR 0.18, CI 0.08 to 0.42. The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76 in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54 in military recruits. Conclusions Effective implementation of practical neuromuscular warm-up strategies can reduce lower extremity injury incidence in young, amateur, female athletes and male and female military recruits. This is typically a warm-up strategy that includes stretching, strengthening, balance exercises, sports-specific agility drills and landing techniques applied consistently for longer than three consecutive months. In order to optimize these strategies, the mechanisms for their effectiveness require further evaluation.

  13. Stem cell therapy for GI neuromuscular disorders.

    Science.gov (United States)

    Bitar, Khalil N; Raghavan, Shreya

    2014-12-01

    The enteric nervous system is the intrinsic innervation of the gut. Several neuromuscular disorders affect the neurons and glia of the enteric nervous system adversely, resulting in disruptions in gastrointestinal motility and function. Pharmacological interventions to remedy gastrointestinal function do not address the underlying cause of dysmotility arising from lost, absent, or damaged enteric neuroglial circuitry. Cell-based therapies have gained traction in the past decade, following the discovery of several adult stem cell niches in the human body. Adult neural stem cells can be isolated from the postnatal and adult intestine using minimally invasive biopsies. These stem cells retain the ability to differentiate into several functional classes of enteric neurons and enteric glia. Upon identification of these cells, several groups have also established that transplantation of these cells into aganglionic or dysganglionic intestine rescues gastrointestinal motility and function. This chapter highlights key studies performed in the field of stem cell transplantation therapies that are targeted towards the remedy of gastrointestinal motility and function. PMID:25381632

  14. Neuromuscular Fatigue During 200 M Breaststroke

    Directory of Open Access Journals (Sweden)

    Ana Conceição

    2014-03-01

    Full Text Available The aims of this study were: i to analyze activation patterns of four upper limb muscles (duration of the active and non-active phase in each lap of 200m breaststroke, ii quantify neuromuscular fatigue, with kinematics and physiologic assessment. Surface electromyogram was collected for the biceps brachii, deltoid anterior, pectoralis major and triceps brachii of nine male swimmers performing a maximal 200m breaststroke trial. Swimming speed, SL, SR, SI decreased from the 1st to the 3rd lap. SR increased on the 4th lap (35.91 ± 2.99 stroke·min-1. Peak blood lactate was 13.02 ± 1.72 mmol·l-1 three minutes after the maximal trial. The EMG average rectified value (ARV increased at the end of the race for all selected muscles, but the deltoid anterior and pectoralis major in the 1st lap and for biceps brachii, deltoid anterior and triceps brachii in the 4th lap. The mean frequency of the power spectral density (MNF decreased at the 4th lap for all muscles. These findings suggest the occurrence of fatigue at the beginning of the 2nd lap in the 200m breaststroke trial, characterized by changes in kinematic parameters and selective changes in upper limb muscle action. There was a trend towards a non-linear fatigue state.

  15. Versatile cable handling mechanisms for remote operator control

    International Nuclear Information System (INIS)

    This paper describes a system of cable management for keeping the umbilical cables of remote operating vehicles and manipulators tidy and contained without direct intervention by operators. Two distinct types of winding mechanism have been designed. One mechanism is a fixed reel type where the cable is wound onto the reel by a rotating bail arm. The other mechanism consists of a pair of curved belts held against each other, between which cable is passed. The complete system includes tension measuring and slack loop take-up devices. The whole system is controlled by a servo system in conjunction with a PC based visual graphic environment which allows a variety of mechanisms to be built up into a system able to handle up to four umbilical cables simultaneously. The control system provides additional tension sensors and cable odometers connected to the control system so that the operator has immediate perception of all the cable parameters, and by defining rules, can set up a variety of alarm situations. (UK)

  16. Development of moving coil type control rod drive mechanism

    International Nuclear Information System (INIS)

    Kyoto University High Flux Reactor; 30 megawatt light water moderated reserarch reactor, has coupled cores in two separate core vessels surrounded by a heavy water reflector tank. Various investigations and tests were performed and a new type of control rod drive mechanism wa s developed. A plunger train connected to a control rod by a connecting rod in a guide tube is magnetically suspended with a coil train located out side of a guide tube. The drive mechanism developed has following merits. There is no leakage of core cooling water in principle because it has no sliding seal, rotary seal or reentrant thimble which are needed when the mechanisms pass through the core vessel. Maintenance is very easy because it has no complex mechanism in the core cooling water region. Scram for emergency shut down is performed on a loss of electric power. The control rod can be positioned continuously. This method will be applicable not only in nuclear reactors, but also in other plants in need of isolation. (author)

  17. Model Predictive Vibration Control Efficient Constrained MPC Vibration Control for Lightly Damped Mechanical Structures

    CERN Document Server

    Takács, Gergely

    2012-01-01

    Real-time model predictive controller (MPC) implementation in active vibration control (AVC) is often rendered difficult by fast sampling speeds and extensive actuator-deformation asymmetry. If the control of lightly damped mechanical structures is assumed, the region of attraction containing the set of allowable initial conditions requires a large prediction horizon, making the already computationally demanding on-line process even more complex. Model Predictive Vibration Control provides insight into the predictive control of lightly damped vibrating structures by exploring computationally efficient algorithms which are capable of low frequency vibration control with guaranteed stability and constraint feasibility. In addition to a theoretical primer on active vibration damping and model predictive control, Model Predictive Vibration Control provides a guide through the necessary steps in understanding the founding ideas of predictive control applied in AVC such as: ·         the implementation of ...

  18. Eletroestimulação neuromuscular, exercícios contrarresistência, força muscular, dor e função motora em pacientes com osteoartrite primária de joelho / Neuromuscular electrical stimulation, exercises against resistance, muscle strength, pain, and motor function in patients with primary osteoarthritis of the knee

    Scientific Electronic Library Online (English)

    Thais Varanda, Dadalto; Cintia Pereira de, Souza; Elirez Bezerra da, Silva.

    2013-12-01

    Full Text Available INTRODUÇÃO: A osteoartrite (OA) do joelho é um processo degenerativo e os sintomas são dor mecânica e períodos de dor inflamatória, rigidez articular e fraqueza muscular. Ela não tem cura. O objetivo do tratamento é aliviar os sinais e sintomas e, quando possível, retardar sua evolução. O fortalecim [...] ento muscular é indicado como tratamento da OA. OBJETIVO: Comparar a eficácia da eletroestimulação neuromuscular (EENM) e de exercícios contrarresistência (ECR) no ganho de força extensora de joelho, na diminuição da dor e na recuperação da função motora em pacientes com OA primária do joelho. MATERIAIS E MÉTODOS: Participaram da pesquisa 23 pacientes com diagnóstico de OA primária do joelho, segundo os critérios clínicos e radiológicos do American College of Rheumatology. Eles foram alocados aleatoriamente para um grupo de ECR (n = 9), um grupo de EENM (n = 8) e um grupo controle (n = 6), e foram submetidos aos procedimentos característicos de seu grupo três vezes por semana até completar 24 sessões. Foram avaliadas de forma cega a força extensora de joelho, a dor e a função motora. Foi utilizado o teste MANOVA 3 x 2 com medidas repetidas para P Abstract in english INTRODUCTION: Knee osteoarthritis (OA) is a degenerative and the symptoms are mechanical pain and periods of inflammatory pain, joint stiffness and muscle weakness. OA has no cure and treatment serves to relieve the signs and symptoms and, when they can, slow its progression. Muscle strengthening is [...] indicated as the treatment. OBJECTIVE: To compare the effectiveness of NMES and resistance exercise in knee extensor strength gain, pain reduction and recovery of motor function in patients diagnosed with primary osteoarthritis of the knee. MATERIALS AND METHODS: Participated 23 patients with primary knee osteoarthritis, according to the clinical and radiological criteria of the American College of Rheumatology. Patients were randomly assigned to a group of resistance exercise (ECR n = 9), a group of neuromuscular electrical stimulation (NMES n = 8) and a control group (n = 6). They underwent characteristic procedures of their group three times per week until 24 sessions. The knee extensor strength pain and function were evaluated. Statistical analyses used was a 3 x 2 MANOVA with repeated measures, P

  19. Estudio electromiográfico de fibra aislada en enfermedades neuromusculares Single fiber electromyographic study in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Roger Álvarez Fiallo

    2005-06-01

    Full Text Available Se implementó la electromiografía de fibra aislada en la práctica asistencial. Se realizó el estudio electromiográfico de fibra aislada de 191 pacientes con enfermedades neuromusculares. Se obtuvo una positividad de los estudios en el grupo de las radiculopatías de C6 del 15,2 %, para las lesiones del plexo braquial del 33, 3 %, para la esclerosis lateral amiotrófica del 44,1 %, para las miopatías del 21,9 % y se destaca la sensibilidad del mismo en el grupo de pacientes de miastenia gravis, que llegó al 70 %. Se concluye que se ratifica la alta sensibilidad del método de electromiografía de fibra aislada en el diagnóstico de la miastenia gravis y se señala su positividad moderada o baja en el resto de las enfermedades estudiadas.The single fiber electromyography was implemented in the health care practice. The single fiber electromyographic study of 191 patients with neuromuscular diseases was carried out. It was obtained a positivity of 15,2 % in the studies conducted in the group of C6 radiculopathies; 33,3 % in the brachial plexus injuries; 44,1 % in the amyotrophic lateral sclerosis; and 21,9 % in the myopathies. Its sensitivity was stressed in the group of patients with myasthenia gravis that reached 70 %. To conclude, it was ratified the high sensitivity of the method of single fibre electromyography in the diagnosis of myasthenia gravis, and it was underlined its moderate or low positivity in the rest of the studied diseases.

  20. Estudio electromiográfico de fibra aislada en enfermedades neuromusculares / Single fiber electromyographic study in neuromuscular diseases

    Scientific Electronic Library Online (English)

    Roger, Álvarez Fiallo; Carlos, Santos Anzorandia; Esther, Medina Herrera; Rosa, Jiménez Paneque; Ángela, Gutiérrez Sánchez.

    2005-06-01

    Full Text Available Se implementó la electromiografía de fibra aislada en la práctica asistencial. Se realizó el estudio electromiográfico de fibra aislada de 191 pacientes con enfermedades neuromusculares. Se obtuvo una positividad de los estudios en el grupo de las radiculopatías de C6 del 15,2 %, para las lesiones d [...] el plexo braquial del 33, 3 %, para la esclerosis lateral amiotrófica del 44,1 %, para las miopatías del 21,9 % y se destaca la sensibilidad del mismo en el grupo de pacientes de miastenia gravis, que llegó al 70 %. Se concluye que se ratifica la alta sensibilidad del método de electromiografía de fibra aislada en el diagnóstico de la miastenia gravis y se señala su positividad moderada o baja en el resto de las enfermedades estudiadas. Abstract in english The single fiber electromyography was implemented in the health care practice. The single fiber electromyographic study of 191 patients with neuromuscular diseases was carried out. It was obtained a positivity of 15,2 % in the studies conducted in the group of C6 radiculopathies; 33,3 % in the brach [...] ial plexus injuries; 44,1 % in the amyotrophic lateral sclerosis; and 21,9 % in the myopathies. Its sensitivity was stressed in the group of patients with myasthenia gravis that reached 70 %. To conclude, it was ratified the high sensitivity of the method of single fibre electromyography in the diagnosis of myasthenia gravis, and it was underlined its moderate or low positivity in the rest of the studied diseases.

  1. Neuromuscular disorders: from diagnosis to translational research, drug development and clinical trials

    OpenAIRE

    Tasker, Robert C.; Darras, Basil T.

    2013-01-01

    Pediatric neuromuscular disorders are a heterogeneous group of conditions that form four distinct groupings: (1) motor neuron diseases, (2) neuropathies, (3) disorders of the neuromuscular junction, and (4) myopathies.

  2. Intravenous lidocaine has no impact on rocuronium-induced neuromuscular block. Randomised study

    OpenAIRE

    Czarnetzki, C; Lysakowski, Christopher; Elia, Nadia; Tramer, Martin

    2012-01-01

    Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block.

  3. Role of Neuromuscular Junction Monitoring in Management of a Postpartum Eclamptic Patient with Iatrogenic Hypermagnesemia

    OpenAIRE

    Harshel G Parikh; Upasani, Chitra B.

    2010-01-01

    Accidental hypermagnesemia is a common and often missed complication during treatment in a postpartum eclamptic patient. As symptomatic hypermagnesemia leads to neuromuscular junction blockade, neuromuscular junction monitoring serves the purpose of vigilant monitoring and prevents iatrogenic overdose of magnesium.

  4. Effects of hindlimb unloading on neuromuscular development of neonatal rats

    Science.gov (United States)

    Huckstorf, B. L.; Slocum, G. R.; Bain, J. L.; Reiser, P. M.; Sedlak, F. R.; Wong-Riley, M. T.; Riley, D. A.

    2000-01-01

    We hypothesized that hindlimb suspension unloading of 8-day-old neonatal rats would disrupt the normal development of muscle fiber types and the motor innervation of the antigravity (weightbearing) soleus muscles but not extensor digitorum longus (EDL) muscles. Five rats were suspended 4.5 h and returned 1.5 h to the dam for nursing on a 24 h cycle for 9 days. To control for isolation from the dam, the remaining five littermates were removed on the same schedule but not suspended. Another litter of 10 rats housed in the same room provided a vivarium control. Fibers were typed by myofibrillar ATPase histochemistry and immunostaining for embryonic, slow, fast IIA and fast IIB isomyosins. The percentage of multiple innervation and the complexity of singly-innervated motor terminal endings were assessed in silver/cholinesterase stained sections. Unique to the soleus, unloading accelerated production of fast IIA myosin, delayed expression of slow myosin and retarded increases in standardized muscle weight and fiber size. Loss of multiple innervation was not delayed. However, fewer than normal motor nerve endings achieved complexity. Suspended rats continued unloaded hindlimb movements. These findings suggest that motor neurons resolve multiple innervation through nerve impulse activity, whereas the postsynaptic element (muscle fiber) controls endplate size, which regulates motor terminal arborization. Unexpectedly, in the EDL of unloaded rats, transition from embryonic to fast myosin expression was retarded. Suspension-related foot drop, which stretches and chronically loads EDL, may have prevented fast fiber differentiation. These results demonstrate that neuromuscular development of both weightbearing and non-weightbearing muscles in rats is dependent upon and modulated by hindlimb loading.

  5. The Analysis on Financial Cooperative Controlling Mechanism of Enterprise Group

    Directory of Open Access Journals (Sweden)

    Ziqin Feng

    2010-12-01

    Full Text Available As the core of modern market economy, enterprise group is an advanced form of organization after productive forces reached to a certain stage. For the reason of complexity and specificity of organizational form of enterprise group, the issue of financial cooperative control has been widespread concerned by theorists. Although many researches have been done, but there are still lacking of systematic research results especially in the fields of mechanism of financial cooperative control. After exploring the relationship of value effect and financial control, this paper puts forword a system model of financial cooperative control. It also gives a system analysis including system hierarchy analysis, synergy analysis and coupling analysis. All of these can provide a decision making support for the collaborative mana- gement of enterprise group.

  6. Controlling chaos based on an adaptive nonlinear compensator mechanism

    International Nuclear Information System (INIS)

    The control problems of chaotic systems are investigated in the presence of parametric uncertainty and persistent external disturbances based on nonlinear control theory. By using a designed nonlinear compensator mechanism, the system deterministic nonlinearity, parametric uncertainty and disturbance effect can be compensated effectively. The renowned chaotic Lorenz system subjected to parametric variations and external disturbances is studied as an illustrative example. From the Lyapunov stability theory, sufficient conditions for choosing control parameters to guarantee chaos control are derived. Several experiments are carried out, including parameter change experiments, set-point change experiments and disturbance experiments. Simulation results indicate that the chaotic motion can be regulated not only to steady states but also to any desired periodic orbits with great immunity to parametric variations and external disturbances

  7. Dynamic Inversion based Control of a Docking Mechanism

    Science.gov (United States)

    Kulkarni, Nilesh V.; Ippolito, Corey; Krishnakumar, Kalmanje

    2006-01-01

    The problem of position and attitude control of the Stewart platform based docking mechanism is considered motivated by its future application in space missions requiring the autonomous docking capability. The control design is initiated based on the framework of the intelligent flight control architecture being developed at NASA Ames Research Center. In this paper, the baseline position and attitude control system is designed using dynamic inversion with proportional-integral augmentation. The inverse dynamics uses a Newton-Euler formulation that includes the platform dynamics, the dynamics of the individual legs along with viscous friction in the joints. Simulation results are presented using forward dynamics simulated by a commercial physics engine that builds the system as individual elements with appropriate joints and uses constrained numerical integration,

  8. Comparative Study on New AQM Mechanisms for Congestion Control

    Directory of Open Access Journals (Sweden)

    Ramakrishna B B

    2013-09-01

    Full Text Available As usage of network goes increasing day by day, managing network traffic becomes a very difficult task. It is important to avoid high packet loss rates in the Internet. Congestion is the one of the major issue in the present networks. Congestion Control is one of the solutions adopted to solve the congestion issue and to control it. Numbers of queue management algorithms are proposed for congestion control and to reduce high packet loss rates. Active Queue Management (AQM is one such mechanism which provides better control over congestion. In this paper a study is made on recent load based AQM techniques that are proposed and its merits and shortfall is presented.

  9. Drug-induced neuromuscular blockade and myasthenia gravis.

    Science.gov (United States)

    Barrons, R W

    1997-01-01

    Myasthenia gravis is an uncommon disorder of the neuromuscular junction resulting in weakness of all striated voluntary muscles. Therapeutic advances have increased patients' age and survival. Older patients with myasthenia gravis may have additional medication needs. Numerous drugs have experimental and clinical evidence of neuromuscular blockade. A MEDLINE search of the English literature from 1966 to the present pertinent to drug-induced myasthenia gravis was performed. Additional literature was obtained from reference citations of relevant articles. Drugs with several reports of neuromuscular blockade were assessed for causality by a recognized probability scale. Prednisone was most commonly implicated as aggravating myasthenia gravis, and D-penicillamine was most commonly associated with myasthenic syndrome. The greatest frequency of drug-induced neuromuscular blockade was seen with aminoglycoside-induced postoperative respiratory depression. However, drugs most likely to impact myasthenic patients negatively are those used in the treatment of the disease. These include overuse of anticholinesterase drugs, high-dose prednisone, and anesthesia and neuromuscular blockers for thymectomy. PMID:9399604

  10. Optimal Control of Underactuated Mechanical Systems: A Geometric Approach

    CERN Document Server

    Colombo, L; Zuccalli, M

    2009-01-01

    In this paper, we consider a geometric formalism for optimal control of underactuated mechanical systems. Our techniques are an adaptation of the classical Skinner and Rusk approach for the case of Lagrangian dynamics with higher-order constraints. We study a regular case where it is possible to establish a symplectic framework and, as a consequence, to obtain a unique vector field determining the dynamics of the optimal control problem. These developments will allow us to develop a new class of geometric integrators based on discrete variational calculus.

  11. Quality control of injection moulded micro mechanical parts

    DEFF Research Database (Denmark)

    Gasparin, Stefania; Tosello, Guido

    2009-01-01

    Quality control of micro components is an increasing challenge. Smaller mechanical parts are characterized by smaller tolerance to be verified. This paper focuses on the dimensional verification of micro injection moulded components selected from an industrial application. These parts are measured using an Optical Coordinate Measuring Machine (OCMM), which guarantees fast surface scans suitable for in line quality control. The uncertainty assessment of the measurements is calculated following the substitution method. To investigate the influence parameters in optical coordinate metrology two analyses are carried out and discussed. The estimation of the total variability of optical measurements and instrument repeatability are reported.

  12. Resistance training improves capacity to delay neuromuscular fatigue in older adults.

    Science.gov (United States)

    Emerson, Nadia S; Stout, Jeffrey R; Fukuda, David H; Robinson, Edward H; Iv; Scanlon, Tyler C; Beyer, Kyle S; Fragala, Maren S; Hoffman, Jay R

    2015-01-01

    The purpose of this study was to investigate the effects of short term resistance exercise on neuromuscular fatigue threshold (PWCFT), strength, functional performance, and body composition in older adults. Twenty-three participants (71.2±6.0yr) were randomly assigned to 6 weeks of resistance exercise (EXE) or control (CONT). A submaximal cycle ergometer test, physical working capacity at fatigue threshold, was used to determine PWCFT. Strength was assessed with predicted leg extension 1-RM and functional performance with time to complete 5 chair rises (CHAIR) and walk an 8-ft course (WALK). PWCFT, 1-RM and CHAIR significantly (pneuromuscular fatigue in older adults. PMID:25957058

  13. Antenna mechanism of length control of actin cables

    CERN Document Server

    Mohapatra, Lishibanya; Kondev, Jane

    2014-01-01

    Actin cables are linear cytoskeletal structures that serve as tracks for myosin-based intracellular transport of vesicles and organelles in both yeast and mammalian cells. In a yeast cell undergoing budding, cables are in constant dynamic turnover yet some cables grow from the bud neck toward the back of the mother cell until their length roughly equals the diameter of the mother cell. This raises the question: how is the length of these cables controlled? Here we describe a novel molecular mechanism for cable length control inspired by recent experimental observations in cells. This antenna mechanism involves three key proteins: formins, which polymerize actin, Smy1 proteins, which bind formins and inhibit actin polymerization, and myosin motors, which deliver Smy1 to formins, leading to a length-dependent actin polymerization rate. We compute the probability distribution of cable lengths as a function of several experimentally tuneable parameters such as the formin-binding affinity of Smy1 and the concentra...

  14. Mechanical impulses can control metaphase progression in a mammalian cell

    OpenAIRE

    Itabashi, Takeshi; Terada, Yasuhiko; Kuwana, Kenta; Kan, Tetsuo; Shimoyama, Isao; Ishiwata, Shin’ichi

    2012-01-01

    Chromosome segregation machinery is controlled by mechanochemical regulation. Tension in a mitotic spindle, which is balanced by molecular motors and polymerization-depolymerization dynamics of microtubules, is thought to be essential for determining the timing of chromosome segregation after the establishment of the kinetochore-microtubule attachments. It is not known, however, whether and how applied mechanical forces modulate the tension balance and chemically affect the molecular processe...

  15. Multi-finger prehension: control of a redundant mechanical system.

    Science.gov (United States)

    Latash, Mark L; Zatsiorsky, Vladimir M

    2009-01-01

    The human hand has been a fascinating object of study for researchers in both biomechanics and motor control. Studies of human prehension have contributed significantly to the progress in addressing the famous problem of motor redundancy. After a brief review of the hand mechanics, we present results of recent studies that support a general view that the apparently redundant design of the hand is not a source of computational problems but a rich apparatus that allows performing a variety of tasks in a reliable and flexible way (the principle of abundance). Multi-digit synergies have been analyzed at two levels of a hypothetical hierarchy involved in the control of prehensile actions. At the upper level, forces and moments produced by the thumb and virtual finger (an imagined finger with a mechanical action equal to the combined mechanical action of all four fingers of the hand) co-vary to stabilize the gripping action and the orientation of the hand-held object. These results support the principle of superposition suggested earlier in robotics with respect to the control of artificial grippers. At the lower level of the hierarchy, forces and moments produced by individual fingers co-vary to stabilize the magnitude and direction of the force vector and the moment of force produced by the virtual finger. Adjustments to changes in task constraints (such as, for example, friction under individual digits) may be local and synergic. The latter reflect multi-digit prehension synergies and may be analyzed with the so-called chain effects: Sequences of relatively straightforward cause-effect links directly related to mechanical constraints leading to non-trivial strong co-variation between pairs of elemental variables. Analysis of grip force adjustments during motion of hand-held objects suggests that the central nervous system adjusts to gravitational and inertial loads differently. The human hand is a gold mine for researchers interested in the control of natural human movements. PMID:19227523

  16. Aberrant Morphology and Residual Transmitter Release at the Munc13-Deficient Mouse Neuromuscular Synapse†

    OpenAIRE

    Varoqueaux, Fre?de?rique; Sons, Miche?le S.; Plomp, Jaap J.; Brose, Nils

    2005-01-01

    In cultured hippocampal neurons, synaptogenesis is largely independent of synaptic transmission, while several accounts in the literature indicate that synaptogenesis at cholinergic neuromuscular junctions in mammals appears to partially depend on synaptic activity. To systematically examine the role of synaptic activity in synaptogenesis at the neuromuscular junction, we investigated neuromuscular synaptogenesis and neurotransmitter release of mice lacking all synaptic vesicle priming protei...

  17. Mechanical design and optimal control of humanoid robot (TPinokio

    Directory of Open Access Journals (Sweden)

    Teck Chew Wee

    2014-04-01

    Full Text Available The mechanical structure and the control of the locomotion of bipedal humanoid is an important and challenging domain of research in bipedal robots. Accurate models of the kinematics and dynamics of the robot are essential to achieve bipedal locomotion. Toe-foot walking produces a more natural and faster walking speed and it is even possible to perform stretch knee walking. This study presents the mechanical design of a toe-feet bipedal, TPinokio and the implementation of some optimal walking gait generation methods. The optimality in the gait trajectory is achieved by applying augmented model predictive control method and the pole-zero cancellation method, taken into consideration of a trade-off between walking speed and stability. The mechanism of the TPinokio robot is designed in modular form, so that its kinematics can be modelled accurately into a multiple point-mass system, its dynamics is modelled using the single and double mass inverted pendulum model and zero-moment-point concept. The effectiveness of the design and control technique is validated by simulation testing with the robot walking on flat surface and climbing stairs.

  18. Confocal Microendoscopy of Neuromuscular Synapses in Living Mice.

    Science.gov (United States)

    Blanco, Gonzalo; Ribchester, Richard R

    2012-01-01

    Here we describe a step-by-step method for vital imaging of neuromuscular junctions (NMJ) and axons using fiber-optic confocal microendoscopy (CME). A commercially available system, the Cellvizio Lab, can be applied to transgenic mouse lines expressing yellow fluorescent protein in all or pseudorandom sub-subsets of motor neurons. Microscopic imaging in vivo is achieved by means of a flexible optical fiber probe that excites and collects the emitted light from fluorescently labeled structures. The hand-held probe is introduced through small skin incisions to visualize nerves and neuromuscular junctions from superficial muscles. Interpolation software then reconstructs the images in real time. The images are of sufficient quality to permit screening of axonal and neuromuscular synaptic integrity and other aspects of their phenotype in live animals. Curr. Protoc. Mouse Biol. 2:1-8 © 2012 by John Wiley & Sons, Inc. PMID:26069002

  19. Hexosamine biosynthetic pathway mutations cause neuromuscular transmission defect.

    Science.gov (United States)

    Senderek, Jan; Müller, Juliane S; Dusl, Marina; Strom, Tim M; Guergueltcheva, Velina; Diepolder, Irmgard; Laval, Steven H; Maxwell, Susan; Cossins, Judy; Krause, Sabine; Muelas, Nuria; Vilchez, Juan J; Colomer, Jaume; Mallebrera, Cecilia Jimenez; Nascimento, Andres; Nafissi, Shahriar; Kariminejad, Ariana; Nilipour, Yalda; Bozorgmehr, Bita; Najmabadi, Hossein; Rodolico, Carmelo; Sieb, Jörn P; Steinlein, Ortrud K; Schlotter, Beate; Schoser, Benedikt; Kirschner, Janbernd; Herrmann, Ralf; Voit, Thomas; Oldfors, Anders; Lindbergh, Christopher; Urtizberea, Andoni; von der Hagen, Maja; Hübner, Angela; Palace, Jacqueline; Bushby, Kate; Straub, Volker; Beeson, David; Abicht, Angela; Lochmüller, Hanns

    2011-02-11

    Neuromuscular junctions (NMJs) are synapses that transmit impulses from motor neurons to skeletal muscle fibers leading to muscle contraction. Study of hereditary disorders of neuromuscular transmission, termed congenital myasthenic syndromes (CMS), has helped elucidate fundamental processes influencing development and function of the nerve-muscle synapse. Using genetic linkage, we find 18 different biallelic mutations in the gene encoding glutamine-fructose-6-phosphate transaminase 1 (GFPT1) in 13 unrelated families with an autosomal recessive CMS. Consistent with these data, downregulation of the GFPT1 ortholog gfpt1 in zebrafish embryos altered muscle fiber morphology and impaired neuromuscular junction development. GFPT1 is the key enzyme of the hexosamine pathway yielding the amino sugar UDP-N-acetylglucosamine, an essential substrate for protein glycosylation. Our findings provide further impetus to study the glycobiology of NMJ and synapses in general. PMID:21310273

  20. Effects of intensive physical rehabilitation on neuromuscular adaptations in adults with poststroke hemiparesis

    DEFF Research Database (Denmark)

    Andersen, Lars L; Zeeman, Peter

    2011-01-01

    Hemiparesis-disability and muscle weakness of 1 side of the body-is a common consequence of stroke. High-intensity strength training may be beneficial to regain function, but strength coaches in the field of rehabilitation need evidence-based guidelines. The purpose of this study was to evaluate the effect of intensive physical rehabilitation on neuromuscular and functional adaptations in outpatients suffering from hemiparesis after stroke. A within-subject repeated-measures design with the paretic leg as the experimental leg and the nonparetic leg as the control leg was used. Eleven outpatients with hemiparesis after stroke participated in 12 weeks of intensive physical rehabilitation comprising unilateral high-intensity strength training with near-maximal loads (4-12 repetition maximum) and body weight supported treadmill training. At baseline and 12-week follow-up, the patients went through testing consisting of isokinetic muscle strength, neuromuscular activation measured with electromyography (EMG), electrically evoked muscle twitch contractile properties, and gait performance (10-m Walk Test and 6-min Walk Test). After the 12-week conditioning program, knee extensor and flexor strength increased during all contraction modes and velocities in the paretic leg. Significant increases were observed for agonist EMG amplitude at slow concentric and slow eccentric contraction. Twitch torque increased, whereas twitch time-to-peak tension remained unchanged. By contrast, no significant changes were observed in the nonparetic control leg. Gait performance increased 52-68%. In conclusion, intensive physical rehabilitation after stroke leads to clinically relevant neuromuscular improvements, leading to increased voluntary strength during a wide range of contraction modes and velocities, and improved gait velocity. Strength training coaches working in the field of rehabilitation can use this knowledge to safely and efficiently add high-intensity strength training to existing rehabilitation paradigms.

  1. Web-based neuromuscular simulator applied to the teaching of principles of neuroscience

    Scientific Electronic Library Online (English)

    Leonardo Abdala, Elias; André Fabio, Kohn.

    2013-09-01

    Full Text Available INTRODUCTION: The learning of core concepts in neuroscience can be reinforced by a hands-on approach, either experimental or computer-based. In this work, we present a web-based multi-scale neuromuscular simulator that is being used as a teaching aid in a campus-wide course on the Principles of Neur [...] oscience. METHODS: The simulator has several built-in individual models based on cat and human biophysics, which are interconnected to represent part of the neuromuscular system that controls leg muscles. Examples of such elements are i) single neurons, representing either motor neurons or interneurons mediating reciprocal, recurrent and Ib inhibition; ii) afferent fibers that can be stimulated to generate spinal reflexes; iii) muscle unit models, generating force and electromyogram; and iv) stochastic inputs, representing the descending volitional motor drive. RESULTS: Several application examples are provided in the present report, ranging from studies of individual neuron responses to the collective action of many motor units controlling muscle force generation. A subset of them was included in an optional homework assignment for Neuroscience and Biomedical Engineering graduate students enrolled in the course cited above at our University. Almost all students rated the simulator as a good or an excellent learning tool, and approximately 90% declared that they would use the simulator in future projects. CONCLUSION: The results allow us to conclude that multi-scale neuromuscular simulator is an effective teaching tool. Special features of this free teaching resource are its direct usability from any browser (http://remoto.leb.usp.br/), its user-friendly graphical user interface (GUI) and the preset demonstrations.

  2. Motor Imagery Boosts Proprioceptive Neuromuscular Facilitation in the Attainment and Retention of Range-of -Motion at the Hip Joint

    OpenAIRE

    Michael Callaghan; Jenna L. Odley; Williams, John G

    2004-01-01

    This study examined the effect of proprioceptive neuromuscular facilitation (PNF) coupled with an internal mental imagery technique (PNFI) on both the attainment and retention of increased range-of-movement (ROM) at the hip joint. Twenty-four young adult subjects were randomly allocated to PNF, PNFI, and control treatments administered in fifteen sessions over a three-week period. ROM was assessed prior to training then at the completion of sessions 1 day, 3, 7, and 14 during training, then 2...

  3. The drop height determines neuromuscular adaptations and changes in jump performance in stretch-shortening cycle training

    OpenAIRE

    Taube, Wolfgang; Leukel, Christian; Lauber, B; Gollhofer, Albert

    2012-01-01

    There is an ongoing discussion about how to improve jump performance most efficiently with plyometric training. It has been proposed that drop height influences the outcome, although longitudinal studies are missing. Based on cross-sectional drop jump studies showing height-dependent Hoffmann (H)-reflex activities, we hypothesized that the drop height should influence the neuromuscular activity and thus, the training result. Thirty-three subjects participated as a control or in one of two str...

  4. Fak56 functions downstream of integrin alphaPS3betanu and suppresses MAPK activation in neuromuscular junction growth

    Directory of Open Access Journals (Sweden)

    Van Vactor David

    2008-10-01

    Full Text Available Abstract Background Focal adhesion kinase (FAK functions in cell migration and signaling through activation of the mitogen-activated protein kinase (MAPK signaling cascade. Neuronal function of FAK has been suggested to control axonal branching; however, the underlying mechanism in this process is not clear. Results We have generated mutants for the Drosophila FAK gene, Fak56. Null Fak56 mutants display overgrowth of larval neuromuscular junctions (NMJs. Localization of phospho-FAK and rescue experiments suggest that Fak56 is required in presynapses to restrict NMJ growth. Genetic analyses imply that FAK mediates the signaling pathway of the integrin ?PS3?? heterodimer and functions redundantly with Src. At NMJs, Fak56 downregulates ERK activity, as shown by diphospho-ERK accumulation in Fak56 mutants, and suppression of Fak56 mutant NMJ phenotypes by reducing ERK activity. Conclusion We conclude that Fak56 is required to restrict NMJ growth during NMJ development. Fak56 mediates an extracellular signal through the integrin receptor. Unlike its conventional role in activating MAPK/ERK, Fak56 suppresses ERK activation in this process. These results suggest that Fak56 mediates a specific neuronal signaling pathway distinct from that in other cellular processes.

  5. Mechanical impulses can control metaphase progression in a mammalian cell.

    Science.gov (United States)

    Itabashi, Takeshi; Terada, Yasuhiko; Kuwana, Kenta; Kan, Tetsuo; Shimoyama, Isao; Ishiwata, Shin'ichi

    2012-05-01

    Chromosome segregation machinery is controlled by mechanochemical regulation. Tension in a mitotic spindle, which is balanced by molecular motors and polymerization-depolymerization dynamics of microtubules, is thought to be essential for determining the timing of chromosome segregation after the establishment of the kinetochore-microtubule attachments. It is not known, however, whether and how applied mechanical forces modulate the tension balance and chemically affect the molecular processes involved in chromosome segregation. Here we found that a mechanical impulse externally applied to mitotic HeLa cells alters the balance of forces within the mitotic spindle. We identified two distinct mitotic responses to the applied mechanical force that either facilitate or delay anaphase onset, depending on the direction of force and the extent of cell compression. An external mechanical impulse that physically increases tension within the mitotic spindle accelerates anaphase onset, and this is attributed to the facilitation of physical cleavage of sister chromatid cohesion. On the other hand, a decrease in tension activates the spindle assembly checkpoint, which impedes the degradation of mitotic proteins and delays the timing of chromosome segregation. Thus, the external mechanical force acts as a crucial regulator for metaphase progression, modulating the internal force balance and thereby triggering specific mechanochemical cellular reactions. PMID:22523237

  6. Bilingualism modulates dual mechanisms of cognitive control: Evidence from ERPs.

    Science.gov (United States)

    Morales, Julia; Yudes, Carolina; Gómez-Ariza, Carlos J; Bajo, M Teresa

    2015-01-01

    Recent behavioral findings with the AX-Continous Performance Task (AX-CPT; Morales et al., 2013) show that bilinguals only outperform monolinguals under conditions that require the highest adjustment between monitoring (proactive) and inhibitory (reactive) control, which supports the idea that bilingualism modulates the coordination of different control mechanisms. In an ERP experiment we aimed to further investigate the role that bilingualism plays in the dynamic combination of proactive and reactive control in the AX-CPT. Our results strongly indicate that bilingualism facilitates an effective adjustment between both components of cognitive control. First, we replicated previous behavioral results. Second, ERP components indicated that bilingualism influences the conflict monitoring, response inhibition and error monitoring components of control (as indexed by the N2 and P3a elicited by the probe and the error-related negativity following incorrect responses, respectively). Thus, bilinguals exerted higher reactive control than monolinguals but only when they needed to overcome the competing cue-information. These findings join others in suggesting that a better understanding of the cognitive benefits of bilingualism may require consideration of a multi-component perspective. PMID:25448864

  7. Neuromuscular exercise as treatment of degenerative knee disease

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Ewa M.

    2015-01-01

    Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise.

  8. Magnetic resonance imaging of myoedema in neuromuscular diseases

    International Nuclear Information System (INIS)

    Magnetic resonance imaging was done in 100 patients suffering from various generalized neuromuscular diseases. 30 (30%) showed higher signal intensities on T2-weighted images compared to T1-weighted images without contrast medium, indicating muscle edema. In inflammatory myopathies diffuse and severe muscle edema were found, whereas local and slight or moderate muscle edema were unspecific findings. In 10 patients also contrast enhanced T1-weighted images were done, showing no more sensitivity than T2-weighted images. In conclusion, we think that magnetic resonance imaging may contribute to differential diagnosis of neuromuscular diseases. (orig.)

  9. Dolor en niños y adolescentes con enfermedades neuromusculares / Pain in children and adolescents with neuromuscular diseases

    Scientific Electronic Library Online (English)

    M., López; J., Miró.

    2013-06-01

    Full Text Available El objetivo de este trabajo es revisar la información disponible sobre la experiencia de dolor en niños y adolescentes con una enfermedad neuromuscular (ENM). Para ello, se examinaron las bases de datos SCOPUS y MEDLINE y se localizaron los artículos publicados sobre el tema hasta marzo de 2012. Tra [...] s un análisis exhaustivo, se identificaron 33 artículos que cumplían con los criterios de inclusión. Del análisis efectuado se desprende que el dolor es una experiencia muy habitual en estos jóvenes, que se trata de molestias, por lo general, de moderadas a severas, con una alta frecuencia de aparición y de larga duración. Habitualmente se trata de cuadros crónicos. Estos problemas afectan a la calidad de vida de los jóvenes, más allá de lo que puede explicar la propia ENM. Los estudios revisados muestran que no solo la calidad de vida de los jóvenes se ve afectada por la presencia del dolor, también la de sus cuidadores. Abstract in english The aim of this paper is to review the available information on the experience of pain in children and adolescents with neuromuscular disease (NMD). In order to do this, we examined the MEDLINE and SCOPUS databases and located published articles on the subject until March 2012. After a thorough anal [...] ysis, we identified 33 articles that met the inclusion criteria. The analysis conducted shows that pain is a very common experience for these young people, usually moderate to severe, with a high frequency of occurrence and long lasting. In general, these are chronic conditions. These chronic pain problems affect the quality of life of young people, beyond what could be explained by the NMD alone. The reviewed studies show that pain not only negatively impacts the quality of life of young people, also that of their caregivers is at jeopardy.

  10. Genetic and evolutionary analysis of the Drosophila larval neuromuscular junction

    Science.gov (United States)

    Campbell, Megan

    Although evolution of brains and behaviors is of fundamental biological importance, we lack comprehensive understanding of the general principles governing these processes or the specific mechanisms and molecules through which the evolutionary changes are effected. Because synapses are the basic structural and functional units of nervous systems, one way to address these problems is to dissect the genetic and molecular pathways responsible for morphological evolution of a defined synapse. I have undertaken such an analysis by examining morphology of the larval neuromuscular junction (NMJ) in wild caught D. melanogaster as well as in over 20 other species of Drosophila. Whereas variation in NMJ morphology within a species is limited, I discovered a surprisingly extensive variation among different species. Compared with evolution of other morphological traits, NMJ morphology appears to be evolving very rapidly. Moreover, my data indicate that natural selection rather than genetic drift is primarily responsible for evolution of NMJ morphology. To dissect underlying molecular mechanisms that may govern NMJ growth and evolutionary divergence, I focused on a naturally occurring variant in D. melanogaster that causes NMJ overgrowth. I discovered that the variant mapped to Mob2, a gene encoding a kinase adapter protein originally described in yeast as a member of the Mitotic Exit Network (MEN). I have subsequently examined mutations in the Drosophila orthologs of all the core components of the yeast MEN and found that all of them function as part of a common pathway that acts presynaptically to negatively regulate NMJ growth. As in the regulation of yeast cytokinesis, these components of the MEN appear to act ultimately by regulating actin dynamics during the process of bouton growth and division. These studies have thus led to the discovery of an entirely new role for the MEN---regulation of synaptic growth---that is separate from its function in cell division. This work has identified a rich source of material for discovery of novel genes and mechanisms that regulate synaptic growth and development, and has also provided new insights into the mechanisms that underlie morphological evolution of nervous systems.

  11. Repouso da junção neuromuscular no tratamento de crises miastênicas e colinérgicas / Management of the myasthenic and cholinergic crisis by neuromuscular junction rest

    Scientific Electronic Library Online (English)

    J. Lamartine de, Assis; Paulo A. P., Saraiva.

    1968-06-01

    Full Text Available Os autores trataram 18 crises miastênicas e colinérgicas desenvolvidas em 12 pacientes com forma generalizada e severa de miastenia grave, mediante o "repouso" da junção neuromuscular. Êste foi conseguido, em um grupo de 6 enfermos, pela suspensão das drogas anticolinesterásicas, emprego da respiraç [...] ão artificial e alimentação por sonda nasogástrica — "repouso relativo". Outro grupo de 6 pacientes foi submetido ao "repouso absoluto" da junção neuromuscular, mediante o uso da respiração artificial, alimentação por sonda nasogástrica e curarização prolongada pela galamina. Em mais de 50% das crises observaram-se melhoras imediatas e acentuadas com o método de tratamento pelo "repouso" da junção neuromuscular, ao lado de redução significativa da taxa de mortalidade nas crises. A evolução mostrou que os pacientes que responderam melhor durante e logo após o tratamento da crise, tiveram, também, melhor evolução ulterior. Dos 12 enfermos somente um era portador de timoma e, mesmo nesse paciente, a evolução foi satisfatória. A sensibilidade inicial ao curare foi muito grande em todos os doentes submetidos à curarização prolongada, mas, em prazo relativamente curto (alguns dias), esta hipersensibilidade diminuiu sensivelmente. Apesar de todos os cuidados, as infecções respiratórias foram a regra, exigindo tratamento enérgico e bem orientado. Abstract in english The neuromuscular junction rest method was employed in the treatment of 18 myasthenic and cholinergic crisis occurring in 12 patients with severe forms of myasthenia gravis. Six of these patients received a "relative rest" and other six patients received an "absolute rest" treatment. In the first gr [...] oup of patients the method consisted essentially in withdrawal of anticholinesterase therapy and mechanical respiratory support with early performance of traqueostomy and use of the intermitente positive pressure breathing (I.P.P.B.) with cuffed traqueostomy tube. The patients of second group, in addition to this management, were submitted to prolonged curarization by galamine (Flaxedil by intramuscular injection); all of them presented an initial curare supersensitivity which always decreased shortly. In both methods the reinstitution of the drug therapy was progressive. The respirator weanned of progressively and the patients were kept under observation for adequate ventilation. The doses were variable but subsequent doses of antimyasthenic medications were determined by clinical findings and response to the tensilon or prostigmine tests. The doses were increased or decreased accordingly in each individual case, rapid changes of drug doses to perfect adjustment being undesirable in this transition period. Partial or temporary remission occurred in some patients. Others were able to sustain satisfactory ventilation for a long period or definitively. Most of the crisis improved and most of the patients benefited from the therapeutic method of the neuromuscular junction rest. There was a remarkable reduction in the mortality rate from the crisis. One patient had a thymoma which was malignant; in spite of this the evolution of this case has been good after the treatment. Those patients who had immediate good response to the treatment of the crisis had a favorable fellow up, even a complete remission. Respiratory infections were very common in spite of all cares. Culture of tracheal secretions and wound exsudates were made. Bactericidal and broad-spectrum antibiotics were used, depending of the laboratory report cf patient's sensitivity. Physiotherapy besides other prophylactic measures was used against bronchopneumonia. Atelectasis was a common complication in the crisis and all efforts to prevent it were made, including daily clinical examination of pulmonary conditions, Vt,, blood pressure and bed side chest films. The routine use of atropine sulfate promoved inspissation of bronchial secretions, plugging of the bronchi, and attendant atelectasis, infection and bronchopneumonia. Exceptionally, steroids

  12. Patient Machine Interface for the Control of Mechanical Ventilation Devices

    Directory of Open Access Journals (Sweden)

    Rolando Grave de Peralta

    2013-11-01

    Full Text Available The potential of Brain Computer Interfaces (BCIs to translate brain activity into commands to control external devices during mechanical ventilation (MV remains largely unexplored. This is surprising since the amount of patients that might benefit from such assistance is considerably larger than the number of patients requiring BCI for motor control. Given the transient nature of MV (i.e., used mainly over night or during acute clinical conditions, precluding the use of invasive methods, and inspired by current research on BCIs, we argue that scalp recorded EEG (electroencephalography signals can provide a non-invasive direct communication pathway between the brain and the ventilator. In this paper we propose a Patient Ventilator Interface (PVI to control a ventilator during variable conscious states (i.e., wake, sleep, etc.. After a brief introduction on the neural control of breathing and the clinical conditions requiring the use of MV we discuss the conventional techniques used during MV. The schema of the PVI is presented followed by a description of the neural signals that can be used for the on-line control. To illustrate the full approach, we present data from a healthy subject, where the inspiration and expiration periods during voluntary breathing were discriminated with a 92% accuracy (10-fold cross-validation from the scalp EEG data. The paper ends with a discussion on the advantages and obstacles that can be forecasted in this novel application of the concept of BCI.

  13. Control of mechanical systems with rolling constraints: Application to dynamic control of mobile robots

    Science.gov (United States)

    Sarkar, Nilanjan; Yun, Xiaoping; Kumar, Vijay

    1994-01-01

    There are many examples of mechanical systems that require rolling contacts between two or more rigid bodies. Rolling contacts engender nonholonomic constraints in an otherwise holonomic system. In this article, we develop a unified approach to the control of mechanical systems subject to both holonomic and nonholonomic constraints. We first present a state space realization of a constrained system. We then discuss the input-output linearization and zero dynamics of the system. This approach is applied to the dynamic control of mobile robots. Two types of control algorithms for mobile robots are investigated: trajectory tracking and path following. In each case, a smooth nonlinear feedback is obtained to achieve asymptotic input-output stability and Lagrange stability of the overall system. Simulation results are presented to demonstrate the effectiveness of the control algorithms and to compare the performane of trajectory-tracking and path-following algorithms.

  14. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control?

    OpenAIRE

    Ricardo Palmier Teles; Flavia Rocha Fonseca Teles

    2009-01-01

    The control of biofilm accumulation on teeth has been the cornerstone of periodontal disease prevention for decades. However, the widespread prevalence of gingivitis suggests the inefficiency of self-performed mechanical plaque control in preventing gingival inflammation. This is particularly relevant in light of recent evidence suggesting that long standing gingivitis increases the risk of loss of attachment and that prevention of gingival inflammation might reduce the prevalence of mild to ...

  15. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  16. Neuromuscular exercise improves functional performance in patients with severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, SØren

    Purpose. Exercise is regarded a cornerstone in the treatment of mild to moderate osteoarthritis (OA). However, little is known of the effects in patients with advanced and end-stage OA. The purpose was to evaluate the effect of neuromuscular exercise in patients with severe hip OA. Methods. Design. Randomized controlled trial (Clinicaltrials.gov identifier: NCT01003756). 84 patients, 51% female, mean age 68.6±7.8 years, BMI 28.7±4.7 scheduled for total hip replacement at Svendborg Community Hospital, Odense University Hospital, Denmark were included. Intervention. Participants were randomized to an eight-week neuromuscular exercise (NEMEX-TJR) intervention or care-as-usual (verbal and written preoperative information). Intervention was supervised and offered twice a week with each session lasting one hour. The program is considered feasible and safe in this patient group and previously described in detail. Assessments were carried out at baseline and within one week after the intervention. Outcomes. Functional performance: 20-m walk at maximal pace and 5 repeated chair stands timed. Muscle power: Unilateral multi-joint leg extension power and unilateral single-joint knee extension power evaluated with a leg extension press (Nottingham Power Rig, Nottingham University, Nottingham, UK) and a seated knee extension machine (Oemmebi, Moglia, Italy) adapted with a linear encoder (MuscleLab Power, Ergotest Technology, Langesund, Norway), respectively. Results. On average the intervention group attended 13±4 sessions (Table 1). In favor of the intervention group, the between-group difference was significant for 20-m walk (2.2 seconds, p=.009), chair stands (1.7 seconds, p=.022) and leg extension for the non operated leg (.17 W/kg, p=.049) (Table 2). Conclusion. Eight weeks neuromuscular exercise according to the NEMEX-TJR program improves functional performance and leg extension power in patients with severe OA of the hip joint.

  17. Direct and indirect measurement of neuromuscular fatigue in Canadian football players.

    Science.gov (United States)

    Clarke, Nick; Farthing, Jonathan P; Lanovaz, Joel L; Krentz, Joel R

    2015-05-01

    This study assessed the effects of a fatiguing game simulation (G-Sim) on the balance of collegiate Canadian football players. The purpose of the study was to evaluate postural control as a potential tool for monitoring neuromuscular fatigue (NMF) in collision-based team sports. Fifteen male Canadian football players were recruited (mean ± SD: age 21.8 ± 1.6 years, weight 97.6 ± 14.7 kg). Indirect NMF measures (postural sway and countermovement jump (CMJ)) were performed 24 h before (TBase), immediately before (TPre) and after (TPost), and 24 h (T24) and 48 h after (T48) a Canadian football G-Sim. Peak isometric knee extensor torque of a maximal voluntary contraction (MVC) and electrically evoked tetani at 20 Hz (P20) and 80 Hz (P80) were also recorded as direct NMF measures at TBase, TPre, TPost, and T48. At TPost, we observed significant declines in MVC, P20, and the MVC/P80 ratio (-15.3%, -15.7%, and -12.1%, respectively; n = 12) along with reductions in CMJ takeoff velocity and peak power (-6.9% and -6.5%, respectively; n = 12) and larger area of the center of pressure trajectory (95.2%; n = 10) during a 60-s postural sway task. All variables were no longer different than baseline by T48. Acute neuromuscular impairment in this cohort is likely attributable to alterations in excitation-contraction coupling due to structural damage and central activation failure. Congruency between the direct and indirect measures of NMF suggests monitoring postural sway has the potential to identify both neuromuscular and somatosensory alterations induced by acute game-induced fatigue in collision-based team sports players. PMID:25894521

  18. The effect of a Lucia jig for 30 minutes on neuromuscular re-programming, in normal subjects

    Scientific Electronic Library Online (English)

    Mariangela Salles Pereira, Nassar; Marcelo, Palinkas; Simone Cecilio Hallak, Regalo; Luiz Gustavo de, Sousa; Selma, Siéssere; Marisa, Semprini; Cristiane, Bataglion; César, Bataglion.

    2012-12-01

    Full Text Available The Lucia jig is a technique that promotes neuromuscular reprogramming of the masticatory system and allows the stabilization of the mandible without the interference of dental contacts, maintaining the mandible position in harmonic condition with the musculature in normal subjects or in patients wi [...] th temporomandibular dysfunction (TMD). This study aimed to electromyographically analyze the activity (RMS) of the masseter and temporal muscles in normal subjects (control group) during the use of an anterior programming device, the Lucia jig, in place for 0, 5, 10, 20 and 30 minutes to demonstrate its effect on the stomatognathic system. Forty-two healthy dentate individuals (aged 21 to 40 years) with normal occlusion and without parafunctional habits or temporomandibular dysfunction (RDC/TMD) were evaluated on the basis of the electromyographic activity of the masseter and temporal muscles before placement of a neuromuscular re-programming device, the Lucia jig, on the upper central incisors. There were no statistically significant differences (p

  19. Translational control mechanisms in angiogenesis and vascular biology.

    Science.gov (United States)

    Yao, Peng; Eswarappa, Sandeepa M; Fox, Paul L

    2015-05-01

    Among the multiple modes of regulation of gene expression, translational control is arguably the least investigated and understood, and its role in vascular biology and pathobiology is not an exception. Here, we review recent studies that have revealed exciting translational regulatory phenomena and mechanisms involving novel RNA binding proteins and microRNA machinery in vascular biology. From these studies, the importance of translational regulation in angiogenesis, atherosclerosis, and blood pressure maintenance is beginning to emerge. We believe that the recent development of powerful techniques such as ribosome profiling and translating ribosome affinity purification (TRAP) will motivate and facilitate additional research in these areas. PMID:25786748

  20. Bellows for control rod drive mechanisms of 'MONJU'

    International Nuclear Information System (INIS)

    The full mock-up operation test of Control Rod Drive Mechanism (CRDM) for 'MONJU' has been carried out since 1972 in OEC of PNC. Welded type bellows were adopted for CRDM as the boundary between sodium and atmosphere. In design, two different locations were considered for bellows, one in sodium and the other in argon gas with sodium vapor and some experiences on the bellows have been obtained. Besides the prototype tests of CRDM, several R and D on CRDM bellows, such as environment effect test and endurance test are conducted. (author)

  1. Bellows for control rod drive mechanism of 'MONJU'

    International Nuclear Information System (INIS)

    The full mock-up operation test of Control Rod Drive Mechanism (CRDM) for ''MONJU'' have been carried on since 1972 in OEC of PNC. Welded type bellows were adopted for CRDM as the boundary between sodium and atmosphere. In design, two different locations were considered for bellows, one in sodium and the other in argon gas with sodium vapor and some experiences on the bellows have been obtained. Besides the prototype tests of CRDM, several R and D on CRDM bellows, such as environment effect test and endurance test are conducted. (author)

  2. Active control of mechanical structures in research and education

    Directory of Open Access Journals (Sweden)

    Nestorovi? Tamara N.

    2013-01-01

    Full Text Available Several crucial phases of the overall approach to development and design of smart structures are outlined in this paper. They are focused on control of lightweight mechanical structures with respect to active vibration and noise attenuation using piezoelectric actuators and sensors. The research experience and growing interest in development of smart structures have motivated introduction of courses on smart structures at universities, which are being studied extensively and with great interest by young researchers and students. Some of the author’s experiences regarding education in this field will be addressed as well.

  3. Neuromuscular Retraining in Female Adolescent Athletes: Effect on Athletic Performance Indices and Noncontact Anterior Cruciate Ligament Injury Rates

    Directory of Open Access Journals (Sweden)

    Frank R. Noyes

    2015-05-01

    Full Text Available While many anterior cruciate ligament (ACL prevention programs have been published, few have achieved significant reductions in injury rates and improvements in athletic performance indices; both of which may increase compliance and motivation of athletes to participate. A supervised neuromuscular retraining program (18 sessions was developed, aimed at achieving both of these objectives. The changes in neuromuscular indices were measured after training in 1000 female athletes aged 13–18 years, and the noncontact ACL injury rate in 700 of these trained athletes was compared with that of 1120 control athletes. There were significant improvements in the drop-jump test, (p < 0.0001, effect size [ES] 0.97, the single-leg triple crossover hop (p < 0.0001, ES 0.47, the t-test (p < 0.0001, ES 0.64, the multi-stage fitness test (p < 0.0001, ES 0.57, hamstring strength (p < 0.0001, and quadriceps strength (p < 0.01. The trained athletes had a significant reduction in the noncontact ACL injury incidence rate compared with the controls (1 ACL injury in 36,724 athlete-exposures [0.03] and 13 ACL injuries in 61,244 exposures [0.21], respectively, p = 0.03. The neuromuscular retraining program was effective in reducing noncontact ACL injury rate and improving athletic performance indicators.

  4. Tracking control mechanisms for positioning automatic CRD exchanger

    International Nuclear Information System (INIS)

    Purpose: To enable completely automatic positioning for the automatic CRD (control rod drives) exchanger, as well as shorten the time for the exchanging operation and save the operator's labour. Constitution: Images of a target attached to the lower flange face of CRD are picked up by a fiber scope mounted to a mounting head. The images are converted through I.T.V. into electrical signals, passed through a cable and then sent to a pattern recognition mechanism. The position for the images of the target is calculated and the calculated position is sent to a drive control section, where the position for the images of the target is compared with a reference position for the images (exactly aligned position) and the moving amount of the mounting head is calculated to move the driving section and thereby complete the positioning. (Kawakami, Y.)

  5. Control and Virtual Reality Simulation of Tendon Driven Mechanisms

    International Nuclear Information System (INIS)

    In this paper the authors present a control strategy for tendon driven mechanisms. The aim of the control system is to find the correct torques which the motors have to exert to make the end effector describe a specific trajectory. In robotic assemblies this problem is often solved with closed loop algorithm, but here a simpler method, based on a open loop strategy, is developed. The difficulties in the actuation are in keeping the belt tight during all working conditions. So an innovative solution of this problem is presented here. This methodology can be easily applied in real time monitoring or very fast operations. For this reason several virtual reality simulations, developed using codes written in Virtual Reality Markup Language, are also presented. This approach is very efficient because it requires a very low cpu computation time, small size files, and the manipulator can be easily put into different simulated scenarios

  6. The sagital balance in idiopatic and neuromuscular scoliosis

    Scientific Electronic Library Online (English)

    Paulo Alvim, Borges; Guilherme Pereira, Ocampos; José Antonio, Mancuso Filho; Olavo Biraghi, Letaif; Raphael Martus, Marcon; Alexandre Fogaça, Cristante.

    2014-07-01

    Full Text Available OBJECTIVES: To describe and compare the distribution of spinopelvic parameters (SPP) in a Brazilian population with idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS), and evaluate the association between pelvic incidence (PI) and lumbar lordosis (LL). METHOD: Medical records investig [...] ation was performed. Sagital balance angles were measured in patients with neuromuscular and idiopathic scoliosis. RESULTS: IS sample means (in degrees): PI 55.55; Sacral Slope (SS) 45.35; Pelvic Tilt (PT) 10.19; Lumbar Lordosis (LL) 43.48; and Thoracic Kyphosis (TK) 32.10. In NMS: PI 53.77; SS 42.31; PT 11.46; LL 49.46; and TK 45.69. No statistically significant differences in PEP distribution were found between the two types of scoliosis (p=0,057). The association between pelvic incidence and lumbar lordosis is low among idiopathic scoliosis (R=0,074) and neuromuscular scoliosis (R=0,274). CONCLUSION: PEP measurements in a Brazilian population of idiopathic scoliosis and neuromuscular scoliosis patients are similar to those in the international literature and do not differ statistically between them. The association between LL and PI could not be assessed in this study. Level of Evidence IV, Case Series.

  7. Neuromuscular Integrity and Use of Sensory Motor Schemas.

    Science.gov (United States)

    Kopp, Claire B.

    The purpose of the present study was to determine whether infants categorized as demonstrating good or poor neuromuscular integrity (voluntary motor abilities reflecting movement coordination) would show differences in use of sensory motor schemas. Subjects were 26 full-term (10 males, 16 females) and 10 premature infants (6 males, 4 females)…

  8. Diagnostic value of CT scanning in neuromuscular diseases

    International Nuclear Information System (INIS)

    The diagnosis of myopathies has become easier since the CT technique is available. In this article the possibilities of CT for diagnostic procedures of neuromuscular diseases are pointed out. Density measurements increase differentiation of atrophy or hypertrophy of muscles as well as other pathological changes. (orig.)

  9. Tortuosity and anomalous diffusion in the neuromuscular junction

    Science.gov (United States)

    Lacks, Daniel J.

    2008-04-01

    The signal transfer from nerve to muscle occurs by diffusion across the neuromuscular junction. The continuum level analysis of diffusion processes is based on the diffusion equation, which in one dimension is ?c/?t=D(?2c/?x2) , where c is the molecular concentration and D is the diffusivity. However, in confined systems such as the neuromuscular junction, the diffusion equation may not be valid, and even if valid the value of D may be altered by the confinement. In this paper, Monte Carlo simulations are used to probe diffusion at the molecular level in a realistic model of a neuromuscular junction. The results show that diffusion is anomalous (i.e., not described by the diffusion equation) for time scales less than ˜0.01s , which is the time scale relevant for signaling processes in the synapse. At longer time scales, the diffusion is normal (i.e., described by the diffusion equation), but with a value of D that is reduced by a factor of ˜5 times compared to the value for diffusion in open space. As the width of the synaptic cleft decreases, these effects become even more pronounced. The physical basis of these results is described in terms of the structure of the neuromuscular junction.

  10. Neuromuscular Bandage: Neurophysiological Effects and the Role of Fascias

    Directory of Open Access Journals (Sweden)

    Ximena María Villota Chicaíza

    2014-05-01

    Full Text Available During the last years, neuromuscular bandage, a therapeutic application created in 1979 by doctor Kenzo Kase has been introduced in the management of many disorders of the musculo-skeletal system and even more so in the treatment of neurological disorders; This therapeutic tool which consists of a self adhesive elastic bandage allows recovery of the injured party without diminishing its bodily function. According to the existing literature on the physiological effects of this therapeutic application in the body, you could say that there is consensus. However in this article the author wants to highlight the significant although little highlighted role played by the fas¬cias on the therapeutic effects of neuromuscular bandage, analyzing from a reflective perspective the analgesic, neuromechanical and circulatory effects, as fundamental effects of neuromuscular bandage and fascias in the same function, trying to bring a global understanding on the way they relate to all connective tissues, aspects that are of great importance for the proper evaluation of alterations and prescription of neuromuscular bandage

  11. Rehabilitation of children and adults who have neuromuscular diseases.

    Science.gov (United States)

    Hornyak, Joseph E; Pangilinan, Percival H

    2007-11-01

    Neuromuscular diseases are a broad group of disorders that affect the motor unit. Recent advances in genetics and molecular biology have greatly furthered understanding of these diseases. Unfortunately, this has not greatly modified treatment strategies. This article addresses some common features of these diseases, and some less commonly addressed issues. PMID:17967367

  12. Hypercapnic impairment of neuromuscular function is related to afferent depression.

    Science.gov (United States)

    Beekley, Matthew D; Cullom, Damian L; Brechue, William F

    2004-01-01

    Acetazolamide (ACZ), a carbonic anhydrase inhibitor, results in altered neuromuscular function secondary to depressed afferent transmission in intact humans. One effect of ACZ is hypercapnia. Thus, to test if the neuromuscular depression observed following ACZ treatment is related to elevated CO(2), human subjects ( n=10) were exposed to 15 min of room air (0% CO(2)) or hypercapnia (7% inspired CO(2)), and neuromuscular function was evaluated. Isometric force (36.8 to 31.1 N) and peak-to-peak electromyographic amplitude (EMG, 1.5 to 1.0 mV) associated with an Achilles tendon tap, and soleus H(max):M(max) ratio (69.0 to 62.2%) were depressed, while EMG latency (34.8 to 39.8 ms) was increased by hypercapnia. Reflex recovery profiles (following a conditioning tap to the contralateral Achilles tendon), motor nerve conduction velocity, amplitude of the maximum M-wave, and peak twitch tension at M(max) were unaltered by hypercapnia. We conclude that elevated CO(2) impairs neuromuscular function through effects on afferent transmission or synaptic integrity between type Ia fibers of the muscle spindle and the alpha motor neuron, without affecting the muscle spindle, efferent conduction or skeletal muscle force-generating capacity. PMID:12955522

  13. Estimulação elétrica neuromuscular em cães com atrofia muscular induzida Neuromuscular electric stimulation in dogs with induced muscle atrophy

    Directory of Open Access Journals (Sweden)

    C. Pelizzari

    2008-02-01

    Full Text Available Empregou-se a estimulação elétrica neuromuscular (EENM de baixa freqüência no músculo quadríceps femoral de cães com atrofia induzida e avaliou-se a ocorrência de ganho de massa nessa musculatura. Foram utilizados oito cães com pesos entre 15 e 30kg, distribuídos aleatoriamente em dois grupos denominados de I ou controle e II ou tratado. A articulação femorotibiopatelar esquerda foi imobilizada por 30 dias pelo método de transfixação percutânea tipo II, com retirada de aparelho de imobilização após esse período. Decorridas 48 horas da remoção, foi realizada a EENM nos cães do grupo II, cinco vezes por semana, com intervalo de 24 horas cada sessão, pelo período de 60 dias. Foram avaliadas a circunferência da coxa, a goniometria do joelho, a análise clínica da marcha, as enzimas creatina-quinase (CK e aspartato-amino-transferase (AST e a morfometria das fibras musculares em cortes transversais do músculo vasto lateral colhido mediante biópsia muscular. A EENM foi empregada no músculo quadríceps femoral na freqüência de 50Hz, duração de pulso de 300 milisegundos e relação de tempo on/off de 1:2. Quanto à morfometria das fibras do músculo vasto lateral, no grupo tratado houve aumento significativo (PLow frequency neuromuscular electrical stimulation (NMES was used on the femoral quadriceps of dogs with induced muscular atrophy and the occurrence of gain in mass in these muscles was evaluated. Eight dogs from 15 to 30kg were randomly distributed in two groups named I, or control; and II, or treated. For the induction of muscular atrophy, the left femoral-tibial-patellar joint was immobilized for 30 days by percutaneous transfixation type II. After 30 days, the immobilization device was removed. The NMES treatment began 48 hours after the removal of the immobilization device of the dogs of group II, and it was carried out five times per week with an interval of 24 hours between each session, for 60 days. The following parameters were measured: thigh circumference, goniometry of the knee, clinical gait analysis, creatine kinase (CK and aspartate aminotransferase (AST enzymes, and morphometry of the muscular fibers in transversal cuts of the vastus lateralis muscle collected through muscular biopsy. The NMES was applied on the femoral quadriceps at a frequency of 50 Hz, with pulse duration of 300 milliseconds, and the on/off time was at a proportion of 1:2. Regarding the morphometry of the vastus lateralis fibers, a significant increase (P<0.05 in the transversal area of the treated group at 90 days was observed when compared with that identified at the time of immobilization. Thus, it can be concluded that low frequency NMES brings about hypertrophy of the vastus lateralis muscle in dogs after temporary rigid immobilization of the knee joint.

  14. Uranium dioxide sintering Kinetics and mechanisms under controlled oxygen potentials

    International Nuclear Information System (INIS)

    The initial, intermediate, and final sintering stages of uranium dioxide were investigated as a function of stoichiometry and temperature by following the kinetics of the sintering reaction. Stoichiometry was controlled by means of the oxygen potential of the sintering atmosphere, which was measured continuously by solid-state oxygen sensors. Included in the kinetic study were microspheres originated from UO2 gels and UO2 pellets produced by isostatic pressing ceramic grade powders. The microspheres sintering behavior was examined using hot-stage microscopy and a specially designed high-temperature, controlled atmosphere furnace. This same furnace was employed as part of an optical dilatometer, which was utilized in the UO2 pellet sintering investigations. For controlling the deviations from stoichiometry during heat treatment, the oxygen partial pressure in the sintering atmosphere was varied by passing the gas through a Cu-Ti-Cu oxygen trap. The trap temperature determined the oxygen partial pressure of the outflowing mixture. Dry hydrogen was also used in some of the UO sub(2+x) sintering experiments. The determination of diametrial shrinkages and sintering indices was made utilizing high-speed microcinematography and ultra-microbalance techniques. It was observed that the oxygen potential has a substantial influence on the kinetics of the three sintering stages. The control of the sintering atmosphere oxygen partial pressure led to very fast densification of UO sub(2+x). Values in the interval 95.0 to 99.5% of theoretical density were reached in less than one minute. Uranium volume diffusion is the dominant mechanism in the initial and intermediate sintering stages. For the final stage, uranium grain boundary diffusion was found to be the main sintering mechanism. (Author)

  15. A dedicated binding mechanism for the visual control of movement.

    Science.gov (United States)

    Reichenbach, Alexandra; Franklin, David W; Zatka-Haas, Peter; Diedrichsen, Jörn

    2014-03-31

    The human motor system is remarkably proficient in the online control of visually guided movements, adjusting to changes in the visual scene within 100 ms [1-3]. This is achieved through a set of highly automatic processes [4] translating visual information into representations suitable for motor control [5, 6]. For this to be accomplished, visual information pertaining to target and hand need to be identified and linked to the appropriate internal representations during the movement. Meanwhile, other visual information must be filtered out, which is especially demanding in visually cluttered natural environments. If selection of relevant sensory information for online control was achieved by visual attention, its limited capacity [7] would substantially constrain the efficiency of visuomotor feedback control. Here we demonstrate that both exogenously and endogenously cued attention facilitate the processing of visual target information [8], but not of visual hand information. Moreover, distracting visual information is more efficiently filtered out during the extraction of hand compared to target information. Our results therefore suggest the existence of a dedicated visuomotor binding mechanism that links the hand representation in visual and motor systems. PMID:24631246

  16. A Cell-Level Mechanism of Contrast Gain Control

    CERN Document Server

    Schumacher, Linus J

    2013-01-01

    The gain of neurons' responses in the auditory cortex is sensitive to contrast changes in the stimulus within a spectrotemporal range similar to their receptive fields, which can be interpreted to represent the tuning of the input to a neuron. This indicates a local mechanism of contrast gain control, which we explore with a minimal mechanistic model here. Gain control through noisy input has been observed in vitro and in a range of computational models. We investigate the behaviour of the simplest of such models to showcase gain control, a stochastic leaky integrate-and-fire (sLIF) neuron, which exhibits gain control through divisive normalisation of the input both with and without accompanying subtractive shift of the input-response curve, depending on whether input noise is proportional to or independent of its mean. To get a more direct understanding of how the input statistics change the response, we construct an analytic approximation to the firing rate of a sLIF neuron constituted of the expression for...

  17. Self-actuation type electromagnet for control rod retaining mechanism

    International Nuclear Information System (INIS)

    The present invention concerns a self-actuation type electromagnet for automatically inserting a control rod into a reactor core for the reactor scram upon occurrence of abnormality in FBR type reactors, etc. That is, a mechanism for preventing scorching is disposed to an attracting portion of a split type core thereby enabling reliable detachment of a control rod. For this purpose, less scorching material is embedded to the attracting portion between each of the core portions, with the surface being slightly protruded. In such an attracting portion, a fine gap is formed between each of the core portions by the contact of less scorching materials. Further, the scorching material is embedded into a metal ring, which is screw-coupled to one of the core portions such that the position is adjustable in the direction of the control rod. Further, the less scorching material is made of alumina. As a result, the attracting portion is neither scorched or fused even when it is used for a long period of time in liquid sodium at high temperature. Therefore, when the electromagnet loses the attracting force, the control rod drops surely. (I.S.)

  18. Central chemoreceptors and neural mechanisms of cardiorespiratory control

    Scientific Electronic Library Online (English)

    T.S., Moreira; A.C., Takakura; R.S., Damasceno; B., Falquetto; L.T., Totola; C.R., Sobrinho; D.T., Ragioto; F.P., Zolezi.

    2011-09-01

    Full Text Available The arterial partial pressure (P CO2) of carbon dioxide is virtually constant because of the close match between the metabolic production of this gas and its excretion via breathing. Blood gas homeostasis does not rely solely on changes in lung ventilation, but also to a considerable extent on circu [...] latory adjustments that regulate the transport of CO2 from its sites of production to the lungs. The neural mechanisms that coordinate circulatory and ventilatory changes to achieve blood gas homeostasis are the subject of this review. Emphasis will be placed on the control of sympathetic outflow by central chemoreceptors. High levels of CO2 exert an excitatory effect on sympathetic outflow that is mediated by specialized chemoreceptors such as the neurons located in the retrotrapezoid region. In addition, high CO2 causes an aversive awareness in conscious animals, activating wake-promoting pathways such as the noradrenergic neurons. These neuronal groups, which may also be directly activated by brain acidification, have projections that contribute to the CO2-induced rise in breathing and sympathetic outflow. However, since the level of activity of the retrotrapezoid nucleus is regulated by converging inputs from wake-promoting systems, behavior-specific inputs from higher centers and by chemical drive, the main focus of the present manuscript is to review the contribution of central chemoreceptors to the control of autonomic and respiratory mechanisms.

  19. Central chemoreceptors and neural mechanisms of cardiorespiratory control

    Directory of Open Access Journals (Sweden)

    T.S. Moreira

    2011-09-01

    Full Text Available The arterial partial pressure (P CO2 of carbon dioxide is virtually constant because of the close match between the metabolic production of this gas and its excretion via breathing. Blood gas homeostasis does not rely solely on changes in lung ventilation, but also to a considerable extent on circulatory adjustments that regulate the transport of CO2 from its sites of production to the lungs. The neural mechanisms that coordinate circulatory and ventilatory changes to achieve blood gas homeostasis are the subject of this review. Emphasis will be placed on the control of sympathetic outflow by central chemoreceptors. High levels of CO2 exert an excitatory effect on sympathetic outflow that is mediated by specialized chemoreceptors such as the neurons located in the retrotrapezoid region. In addition, high CO2 causes an aversive awareness in conscious animals, activating wake-promoting pathways such as the noradrenergic neurons. These neuronal groups, which may also be directly activated by brain acidification, have projections that contribute to the CO2-induced rise in breathing and sympathetic outflow. However, since the level of activity of the retrotrapezoid nucleus is regulated by converging inputs from wake-promoting systems, behavior-specific inputs from higher centers and by chemical drive, the main focus of the present manuscript is to review the contribution of central chemoreceptors to the control of autonomic and respiratory mechanisms.

  20. Neural mechanisms of attentional control in mindfulness meditation

    Science.gov (United States)

    Malinowski, Peter

    2013-01-01

    The scientific interest in meditation and mindfulness practice has recently seen an unprecedented surge. After an initial phase of presenting beneficial effects of mindfulness practice in various domains, research is now seeking to unravel the underlying psychological and neurophysiological mechanisms. Advances in understanding these processes are required for improving and fine-tuning mindfulness-based interventions that target specific conditions such as eating disorders or attention deficit hyperactivity disorders. This review presents a theoretical framework that emphasizes the central role of attentional control mechanisms in the development of mindfulness skills. It discusses the phenomenological level of experience during meditation, the different attentional functions that are involved, and relates these to the brain networks that subserve these functions. On the basis of currently available empirical evidence specific processes as to how attention exerts its positive influence are considered and it is concluded that meditation practice appears to positively impact attentional functions by improving resource allocation processes. As a result, attentional resources are allocated more fully during early processing phases which subsequently enhance further processing. Neural changes resulting from a pure form of mindfulness practice that is central to most mindfulness programs are considered from the perspective that they constitute a useful reference point for future research. Furthermore, possible interrelations between the improvement of attentional control and emotion regulation skills are discussed. PMID:23382709

  1. Neural mechanisms of attentional control in mindfulness meditation

    Directory of Open Access Journals (Sweden)

    PeterMalinowski

    2013-02-01

    Full Text Available The scientific interest in meditation and mindfulness practice has recently seen an unprecedented surge. After an initial phase of presenting beneficial effects of mindfulness practice in various domains, research is now seeking to unravel the underlying psychological and neurophysiological mechanisms. Advances in understanding these processes are required for improving and fine-tuning mindfulness-based interventions that target specific conditions such as eating disorders or attention deficit hyperactivity disorders. This review presents a theoretical framework that emphasizes the central role of attentional control mechanisms in the development of mindfulness skills. It discusses the phenomenological level of experience during meditation, the different attentional functions that are involved, and relates these to the brain networks that subserve these functions. On the basis of currently available empirical evidence specific processes as to how attention exerts its positive influence are considered and it is concluded that meditation practice appears to positively impact attentional functions by improving resource allocation processes. As a result, attentional resources are allocated more fully during early processing phases which subsequently enhance further processing. Neural changes resulting from a pure form of mindfulness practice that is central to most mindfulness programs are considered from the perspective that they constitute a useful reference point for future research. Furthermore, possible interrelations between the improvement of attentional control and emotion regulation skills are discussed.

  2. Mechanism of controlled release kinetics from medical devices

    Directory of Open Access Journals (Sweden)

    A. Raval

    2010-06-01

    Full Text Available Utilization of biodegradable polymers for controlled drug delivery has gained immense attention in the pharmaceutical and medical device industry to administer various drugs, proteins and other bio-molecules both systematically and locally to cure several diseases. The efficacy and toxicity of this local therapeutics depends upon drug release kinetics, which will further decide drug deposition, distribution, and retention at the target site. Drug Eluting Stent (DES presently possesses clinical importance as an alternative to Coronary Artery Bypass Grafting due to the ease of the procedure and comparable safety and efficacy. Many models have been developed to describe the drug delivery from polymeric carriers based on the different mechanisms which control the release phenomenon from DES. Advanced characterization techniques facilitate an understanding of the complexities behind design and related drug release behavior of drug eluting stents, which aids in the development of improved future drug eluting systems. This review discusses different drug release mechanisms, engineering principles, mathematical models and current trends that are proposed for drug-polymer coated medical devices such as cardiovascular stents and different analytical methods currently utilized to probe diverse characteristics of drug eluting devices.

  3. Mechanism of controlled release kinetics from medical devices

    Scientific Electronic Library Online (English)

    A., Raval; J., Parikh; C., Engineer.

    2010-06-01

    Full Text Available Utilization of biodegradable polymers for controlled drug delivery has gained immense attention in the pharmaceutical and medical device industry to administer various drugs, proteins and other bio-molecules both systematically and locally to cure several diseases. The efficacy and toxicity of this [...] local therapeutics depends upon drug release kinetics, which will further decide drug deposition, distribution, and retention at the target site. Drug Eluting Stent (DES) presently possesses clinical importance as an alternative to Coronary Artery Bypass Grafting due to the ease of the procedure and comparable safety and efficacy. Many models have been developed to describe the drug delivery from polymeric carriers based on the different mechanisms which control the release phenomenon from DES. Advanced characterization techniques facilitate an understanding of the complexities behind design and related drug release behavior of drug eluting stents, which aids in the development of improved future drug eluting systems. This review discusses different drug release mechanisms, engineering principles, mathematical models and current trends that are proposed for drug-polymer coated medical devices such as cardiovascular stents and different analytical methods currently utilized to probe diverse characteristics of drug eluting devices.

  4. Morphometric and Morphological Analysis of Neuromuscular Junction Alterations in the Denervated Rat Diaphragm / Evaluación de las Alteraciones Morfológicas y Morfométricas de las Uniones Neuromusculares del Diafragma Denervado en Ratas

    Scientific Electronic Library Online (English)

    M. M, Torrejais; J. C, Soares; S. M. M, Matheus; J. M, Mello; L. A. D, Francia-Farje; E. J. D, Vicente.

    1235-12-01

    Full Text Available En este trabajo se estudiaron las alteraciones morfológicas y estructurales de las uniones neuromusculares en el diafragma denervado de ratas. Se utilizaron 15 ratas albinas (Rattus norvegicus), machos, adultos, con peso promedio de 200g y cerca de 60 días de edad. Los diafragmas crónicamente denerv [...] ados fueron obtenidos y los animales se sacrificaron después de 4, 8 y 12 semanas de denervación. El antímero izquierdo del diafragma fue denervado por sección del nervio frénico y el antímero derecho fue utilizado como control. Cada antímero fue dividido en 3 fragmentos: uno fue utilizado para el estudio histoquímico (esterasa inespecífica) y morfométrico. Los otros dos se destinaron al estudio de microscopía electrónica de transmisión (MET) y microscopia electrónica de barrido (MEB) de las uniones neuromusculares. El estudio histoquímico de las uniones neuromusculares posterior a la denervación, muestra que la morfología de esas uniones sufre pequeñas alteraciones. Con la evolución del tiempo de denervación esas uniones muestran tamaños menores, son alargadas y con contornos menos nítidos. La ultra-estructura de las uniones neuromusculares después de 12 semanas, demostró que la superficie de la fibra muscular exhibe pliegues de unión más o menos organizados. La región del citoplasma de unión exhibe alteraciones importantes, con degeneración mitocondrial y presencia de muchos filamentos. En MEB se observa que los botones sinápticos primarios son profundos, presentan escavaciones periféricas donde estaban alojados los botones de las terminaciones nerviosas y exhiben internamente, los espacios sinápticos secundarios presentes entre los pliegues de unión del sarcolema. Este estudio mostró que algunos patrones morfológicos demostrados en otros músculos estriados esqueléticos denervados no se repiten con la misma intensidad y curso temporal en el diafragma de ratas. Abstract in english The morphological and structural alterations that occur in the neuromuscular junctions of the denervated rat diaphragm were studied. Fifteen adult male albino rats (Rattus norvegicus) aged about 60 days and with a mean weight of 200 g were used. Chronically denervated diaphragms were obtained and th [...] e animals were sacrificed after 4, 8 and 12 weeks of denervation. The left antimere of the diaphragm was denervated by section of the phrenic nerve and the right antimere was used as control. Each antimere was divided into three fragments: one was used for histochemical (nonspecific esterase) and morphometric study of neuromuscular junctions, and the other two were used for transmission and scanning electron microscopy (SEM) analysis. Histochemical analysis of the diaphragm neuromuscular junctions after denervation showed only small changes in junction morphology. However, these junctions became smaller and elongated and presented less visible contours with increasing time of denervation. Ultrastructural analysis of neuromuscular junctions after 12 weeks showed more or less organized junctional folds on the muscle fiber surface. The junctional cytoplasm exhibited important alterations such as mitochondrial degeneration and the presence of numerous filaments. SEM revealed the presence of deep primary synaptic grooves with peripheral excavations which housed the nerve terminal boutons and exhibited internally the secondary synaptic clefts present among the junctional folds of the sarcolemma. This study showed that some of the morphological changes demonstrated in other denervated striated skeletal muscles are not repeated at the same intensity or in the same temporal pattern in the rat diaphragm.

  5. Auction Mechanism to Allocate Air Traffic Control Slots

    Science.gov (United States)

    Raffarin, Marianne

    2003-01-01

    This article deals with an auction mechanism for airspace slots, as a means of solving the European airspace congestion problem. A disequilibrium, between Air Traffic Control (ATC) services supply and ATC services demand are at the origin of almost one fourth of delays in the air transport industry in Europe. In order to tackle this congestion problem, we suggest modifying both pricing and allocation of ATC services, by setting up an auction mechanism. Objects of the auction will be the right for airlines to cross a part of the airspace, and then to benefit from ATC services over a period corresponding to the necessary time for the crossing. Allocation and payment rules have to be defined according to the objectives of this auction. The auctioneer is the public authority in charge of ATC services, whose aim is to obtain an efficient allocation. Therefore, the social value will be maximized. Another objective is to internalize congestion costs. To that end, we apply the principle of Clarke-Groves mechanism auction: each winner has to pay the externalities imposed on other bidders. The complex context of ATC leads to a specific design for this auction.

  6. Neuromuscular disease. DOK7 gene therapy benefits mouse models of diseases characterized by defects in the neuromuscular junction.

    Science.gov (United States)

    Arimura, Sumimasa; Okada, Takashi; Tezuka, Tohru; Chiyo, Tomoko; Kasahara, Yuko; Yoshimura, Toshiro; Motomura, Masakatsu; Yoshida, Nobuaki; Beeson, David; Takeda, Shin'ichi; Yamanashi, Yuji

    2014-09-19

    The neuromuscular junction (NMJ) is the synapse between a motor neuron and skeletal muscle. Defects in NMJ transmission cause muscle weakness, termed myasthenia. The muscle protein Dok-7 is essential for activation of the receptor kinase MuSK, which governs NMJ formation, and DOK7 mutations underlie familial limb-girdle myasthenia (DOK7 myasthenia), a neuromuscular disease characterized by small NMJs. Here, we show in a mouse model of DOK7 myasthenia that therapeutic administration of an adeno-associated virus (AAV) vector encoding the human DOK7 gene resulted in an enlargement of NMJs and substantial increases in muscle strength and life span. When applied to model mice of another neuromuscular disorder, autosomal dominant Emery-Dreifuss muscular dystrophy, DOK7 gene therapy likewise resulted in enlargement of NMJs as well as positive effects on motor activity and life span. These results suggest that therapies aimed at enlarging the NMJ may be useful for a range of neuromuscular disorders. PMID:25237101

  7. Envelhecimento e treinamento de potência: aspectos neuromusculares e funcionais / Aging and power training: neuromuscular and functional aspects

    Scientific Electronic Library Online (English)

    Carlos Leandro, Tiggemann; Caroline Pieta, Dias; Matias, Noll; Maira Cristina Wolf, Schoenell; Luiz Fernando Martins, Kruel.

    2013-06-01

    Full Text Available A proporção de idosos na população é cada vez maior nos diferentes países, tornado fundamental o seu estudo em diferentes perspectivas. Desta forma, o objetivo da presente revisão é compreender como o envelhecimento atua no sistema neuromuscular, em especial na força muscular, e como este declínio a [...] tua nos aspectos funcionais, ou seja, nas tarefas do dia a dia. Além disso, será abordado como o treinamento de força, em específico visando à melhora da potência muscular, pode ser uma estratégia segura e efetiva no combate aos efeitos adversos do envelhecimento no sistema neuromuscular. Abstract in english The proportion of elderly in the population is growing in different countries, which makes essential to examine this part of the population in different perspectives. In this way, the objective of this review is to understand how aging affects the neuromuscular system, especially muscle strength, an [...] d how this decline works on functional aspects, i.e. on everyday tasks. In addition, it is investigated how strength training, specifically aimed at improving muscle strength, can be a safe and effective strategy in combating the adverse effects of aging on neuromuscular system.

  8. The tof-guard neuromuscular transmission monitor and its use in horses O monitor da transmissão neuromuscular "tof-guard" e seu uso em eqüinos

    Directory of Open Access Journals (Sweden)

    Juliana Noda Bechara

    1999-03-01

    Full Text Available It has been emphasized in the human medical literature, that when using a neuromuscular blocking agent, it is of vital importance the monitoring of the neuromuscular block and that these agents should never be used without it. The purpose of this study was to evaluate the use of the neuromuscular transmission monitor TOF-Guard in horses. Twelve horses were randomly assigned whether to receive pancuronium or atracurium as the neuromuscular blocking agent. All horses were pre-medicated with romifidine, anaesthesia induced with diazepam and ketamine and maintenance with halothane. Abolition of spontaneous ventilation was accomplished by the administration of atracurium or pancuronium. The time from injection of the muscle relaxant agent to the onset of maximum block (T1=0, recovery of T1 to 25% and the recovery of TOF ratio to 0.7 were recorded, as was the time for recovery of T1 from 25 to 75%. It was concluded that it is very important the neuromuscular transmission monitoring during the use of a nondepolarizing neuromuscular blocking agent, since it provides a safer anaesthetic and surgical procedure with the use of adequate dosages and due to the impossibility of a superficialization of the neuromuscular blockade during a surgical procedure. The TOF-Guard showed to be a good option for neuromuscular monitoring in horses.Quando da utilização de bloqueadores neuromusculares, já foi enfatizado na literatura médica humana, que é de vital imporância a monitoração do bloqueio neuromuscular e que estes agentes nunca devem ser utilizados sem a mesma. O objetivo deste estudo foi o de avaliar o uso do monitor da transmissão neuromuscular TOF-Guard em eqüinos. Para tanto, doze eqüinos foram separados aleatoriamente para receberem como bloqueadores neuromusculares o pancurônio ou o atracúrio. Todos os eqüinos foram pré-medicados com romifidina, induzidos com diazepam e quetamina e mantidos com halotano. Foi administrado o atracúrio ou o pancurônio, seguindo-se a apnéia e início da ventilação mecânica controlada. O tempo entre a administração do relaxante muscular e a obtenção de um bloqueio máximo (T1=0, o retorno do T1 para 25% e da razão do TOF para 0,7 e o tempo do retorno do T1 de 25 para 75% foram mensurados. Concluiu-se que é de grande importância a monitoração do bloqueio neuromuscular quando da utilização de um bloqueador neuromuscular não-despolarizante, uma vez que ela torna o ato anestésico e cirúrgico mais seguro, com a utilização de doses adequadas que inviabilizam a superficialização do bloqueio durante o procedimento cirúrgico. O monitor TOF-Guard mostrou ser uma boa opção para a monitoração do bloqueio neuromuscular em eqüinos.

  9. The tof-guard neuromuscular transmission monitor and its use in horses / O monitor da transmissão neuromuscular "tof-guard" e seu uso em eqüinos

    Scientific Electronic Library Online (English)

    Juliana Noda, Bechara; Denise Tabacchi, Fantoni; Paulo Sergio de Moraes, Barros; Elton Rodrigues, Migliati; Marcio Augusto, Ferreira; Luis Claudio Lopes Correia da, Silva.

    1999-03-01

    Full Text Available Quando da utilização de bloqueadores neuromusculares, já foi enfatizado na literatura médica humana, que é de vital imporância a monitoração do bloqueio neuromuscular e que estes agentes nunca devem ser utilizados sem a mesma. O objetivo deste estudo foi o de avaliar o uso do monitor da transmissão [...] neuromuscular TOF-Guard em eqüinos. Para tanto, doze eqüinos foram separados aleatoriamente para receberem como bloqueadores neuromusculares o pancurônio ou o atracúrio. Todos os eqüinos foram pré-medicados com romifidina, induzidos com diazepam e quetamina e mantidos com halotano. Foi administrado o atracúrio ou o pancurônio, seguindo-se a apnéia e início da ventilação mecânica controlada. O tempo entre a administração do relaxante muscular e a obtenção de um bloqueio máximo (T1=0), o retorno do T1 para 25% e da razão do TOF para 0,7 e o tempo do retorno do T1 de 25 para 75% foram mensurados. Concluiu-se que é de grande importância a monitoração do bloqueio neuromuscular quando da utilização de um bloqueador neuromuscular não-despolarizante, uma vez que ela torna o ato anestésico e cirúrgico mais seguro, com a utilização de doses adequadas que inviabilizam a superficialização do bloqueio durante o procedimento cirúrgico. O monitor TOF-Guard mostrou ser uma boa opção para a monitoração do bloqueio neuromuscular em eqüinos. Abstract in english It has been emphasized in the human medical literature, that when using a neuromuscular blocking agent, it is of vital importance the monitoring of the neuromuscular block and that these agents should never be used without it. The purpose of this study was to evaluate the use of the neuromuscular tr [...] ansmission monitor TOF-Guard in horses. Twelve horses were randomly assigned whether to receive pancuronium or atracurium as the neuromuscular blocking agent. All horses were pre-medicated with romifidine, anaesthesia induced with diazepam and ketamine and maintenance with halothane. Abolition of spontaneous ventilation was accomplished by the administration of atracurium or pancuronium. The time from injection of the muscle relaxant agent to the onset of maximum block (T1=0), recovery of T1 to 25% and the recovery of TOF ratio to 0.7 were recorded, as was the time for recovery of T1 from 25 to 75%. It was concluded that it is very important the neuromuscular transmission monitoring during the use of a nondepolarizing neuromuscular blocking agent, since it provides a safer anaesthetic and surgical procedure with the use of adequate dosages and due to the impossibility of a superficialization of the neuromuscular blockade during a surgical procedure. The TOF-Guard showed to be a good option for neuromuscular monitoring in horses.

  10. The effects of band exercise using proprioceptive neuromuscular facilitation on muscular strength in lower extremity.

    Science.gov (United States)

    Rhyu, Hyun-Seung; Kim, Su-Hyun; Park, Hye-Sang

    2015-02-01

    The purpose of this study was to examine whether a six-week elastic band exercise program using proprioceptive neuromuscular facilitation (PNF) can increase isotonic strength of abductor muscles in the lower extremity. Twenty-eight healthy students from S university were divided into an experimental group and control group. Each group was participated in pre and post-measurement in isotonic strength using an isotonic analyzer, En-treeM. Experimental group performed elastic band exercise using PNF pattern for a six-weeks, in contrast, control group did not take any exercise. In the results of this study, isotonic strength measurements of abductor muscles in lower extremity in experimental group were significantly different after exercise, but control group did not show any significant changes. Therefore, we hope that resistive exercise would be very valuable for healthy people as well as the old people with weakened muscle strength. PMID:25830142

  11. Differential neuromuscular training effects onACL injury risk factors in"high-risk" versus "low-risk" athletes

    Directory of Open Access Journals (Sweden)

    Ford Kevin R

    2007-05-01

    Full Text Available Abstract Background Neuromuscular training may reduce risk factors that contribute to ACL injury incidence in female athletes. Multi-component, ACL injury prevention training programs can be time and labor intensive, which may ultimately limit training program utilization or compliance. The purpose of this study was to determine the effect of neuromuscular training on those classified as "high-risk" compared to those classified as "low-risk." The hypothesis was that high-risk athletes would decrease knee abduction moments while low-risk and control athletes would not show measurable changes. Methods Eighteen high school female athletes participated in neuromuscular training 3×/week over a 7-week period. Knee kinematics and kinetics were measured during a drop vertical jump (DVJ test at pre/post training. External knee abduction moments were calculated using inverse dynamics. Logistic regression indicated maximal sensitivity and specificity for prediction of ACL injury risk using external knee abduction (25.25 Nm cutoff during a DVJ. Based on these data, 12 study subjects (and 4 controls were grouped into the high-risk (knee abduction moment >25.25 Nm and 6 subjects (and 7 controls were grouped into the low-risk (knee abduction Results Athletes classified as high-risk decreased their knee abduction moments by 13% following training (Dominant pre: 39.9 ± 15.8 Nm to 34.6 ± 9.6 Nm; Non-dominant pre: 37.1 ± 9.2 to 32.4 ± 10.7 Nm; p = 0.033 training X risk factor interaction. Athletes grouped into the low-risk category did not change their abduction moments following training (p > 0.05. Control subjects classified as either high or low-risk also did not significantly change from pre to post-testing. Conclusion These results indicate that "high-risk" female athletes decreased the magnitude of the previously identified risk factor to ACL injury following neuromuscular training. However, the mean values for the high-risk subjects were not reduced to levels similar to low-risk group following training. Targeting female athletes who demonstrate high-risk knee abduction loads during dynamic tasks may improve efficacy of neuromuscular training. Yet, increased training volume or more specific techniques may be necessary for high-risk athletes to substantially decrease ACL injury risk.

  12. Aging interferes central control mechanism for eccentric muscle contraction

    Directory of Open Access Journals (Sweden)

    Wan X. Yao

    2014-05-01

    Full Text Available Previous studies report greater activation in the cortical motor network in controlling eccentric contraction (EC than concentric contraction (CC despite lower muscle activation level associated with EC vs. CC in healthy, young individuals. It is unknown, however, whether elderly people exhibiting increased difficulties in performing EC than CC possess this unique cortical control mechanism for EC movements. To address this question, we examined functional MRI (fMRI data acquired during EC and CC of the first dorsal interosseous (FDI muscle in 11 young (20-32 years and 9 old (67-73 years individuals. During the fMRI experiment, all subjects performed 20 CC and 20 EC of the right FDI with the same angular distance and velocity. The major findings from the behavioral and fMRI data analysis were that (1 movement stability was poorer in EC than CC in the old but not the young group; (2 similar to previous electrophysiological and fMRI reports, the EC resulted in significantly stronger activation in the motor control network consisting of primary, secondary and association motor cortices than CC in the young and old groups; (3 the biased stronger activation towards EC was significantly greater in the old than the young group especially in the secondary and association cortices such as supplementary and premotor motor areas and anterior cingulate cortex; and (4 in the primary motor and sensory cortices, the biased activation towards EC was significantly greater in the young than the old group. Greater activation in higher-order cortical fields for controlling EC movement by elderly adults may reflect activities in these regions to compensate for aging-related impairments in the ability to control complex EC movements. Our finding is useful for potentially guiding the development of targeted therapies to counteract age-related movement deficits and to prevent injury.

  13. Efeito de um programa de treinamento de facilitação neuromuscular proprioceptiva sobre a mobilidade torácica / Effect of a training program based on proprioceptive neuromuscular facilitation onto thoracic mobility

    Scientific Electronic Library Online (English)

    Marlene Aparecida, Moreno; Ester da, Silva; Roberta Silva, Zuttin; Mauro, Gonçalves.

    2009-06-01

    Full Text Available A proposta deste estudo foi analisar o efeito de um programa de treinamento de membros superiores baseado nas técnicas de facilitação neuromuscular proprioceptiva (FNP) sobre a mobilidade torácica. Foram estudadas 24 voluntárias sedentárias, idade 22,9 ± 2,9 anos, divididas em grupo controle (GC), q [...] ue não participou do treinamento, e grupo treinado (GT). O protocolo de treinamento físico foi constituído por um programa de exercícios de FNP, realizado três vezes por semana, durante quatro semanas. Os dois grupos foram submetidos à avaliação da mobilidade torácica por meio de cirtometria, antes e após o período de treinamento. Os dados colhidos foram analisados estatisticamente, com nível de significância ? = 5%. Os valores da cirtometria axilar e xifoideana do GC antes e após o período de intervenção não apresentaram alterações significativas (p>0,05). No GT os valores das variáveis foram significantemente maiores após a intervenção (p Abstract in english The purpose of this study was to analyse the effect of an upper limb training program based on proprioceptive neuromuscular facilitation (PNF) techniques on thoracic mobility. The study was carried out with 24 sedentary female volunteers, aged 22.9±2.9 years. Participants were divided into a control [...] group (CG), who did not perform any exercise, and a trained group (TG), submitted to training. The physical training protocol consisted of a PNF exercise program, three times a week for four weeks. The two groups were assessed as to thoracic mobility by means of cirtometry before and after the training period. Data were statistically analysed and significance level set at ?=5%. In CG, initial axillary and xiphoid cirtometry values showed no significant differences when compared to data obtained on the final evaluation (p>0.05). TG measures, in turn, were significantly higher after the training program (p

  14. Sleep polygraphic parameters in neuromuscular diseases Parâmetros poligráficos do sono em doenças neuromusculares

    Directory of Open Access Journals (Sweden)

    Márcia Pradella

    1994-12-01

    Full Text Available In a polysomnography study of 32 neuromuscular patients - 22 with a form of muscular dystrophy, 3 with a form of congenital myopathy, 4 with a form of spinal muscular atrophy, 1 with a recurrent form of polymyositis and 1 with osteogenesis imperfecta syndrome - of which 21 were nonambulatory, we observed sleep related respiratory disturbances represented by: drops in oxygen saturation (SaO2, cardiac arrythmia, sleep disruption, apneas, tachypnea, tachycardia and snoring. Nine out of the cohort of 32 patients presented with significant desaturations periods. These patients presented with an associated restrictive syndrome and thoracic deformities, some with tachypnea and/or SaO2 below 90% during wakefulness. In this group, snoring was observed in those patients with a form of muscular dystrophy while tachypnea was observed in patients who presented the highest desaturations levels. Sleep quantification revealed an increase of stage 1 sleep coupled with a decrease or even total absence of REM sleep. This is, we believe, a likely consequence of episodic desaturations that may accompany sleep hypoventilation which is potentialised during REM sleep stage.Estudando 32 pacientes com doenças neuromusculares -22 com forma de distrofia muscular, 3 com forma de miopatia congênita, 4 com forma de atrofia muscular espinal, 1 com forma recorrente de polimiosite e 1 com síndrome de osteogenesis imperfecta - dos quais 21 estavam impossibilitados de deambulação, distúrbios respiratórios relacionados ao sono foram observados sob forma dessaturação da oxi-hemogloblina, arritmia cardíaca, taquipnéia, taquicardia e roncos. Nove desses 32 pacientes apresentaram períodos de dessaturação de oxi-hemoglobina maiores que 4% em relação aos níveis obtidos em vigília e repouso. Esse grupo de pacientes era caracterizado por apresentar síndrome respiratória restritiva associada a deformidade torácica (principalmente escoliose. Alguns apresentaram taquipnéia e/ou saturação da oxi-hemoglobina abaixo de 90% durante o repouso e em vigília. Neste grupo, roncos foram observados principalmente nos pacientes com forma de distrofia muscular, enquanto a taquipnéia foi observada sobretudo nos pacientes com os maiores níveis de dessaturação. A quantificação do sono mostrou aumento na porcentagem do estado 1 do sono associada a diminuição ou mesmo ausência do estado do sono paradoxal. Isso nos leva a crer em um provável mecanismo de proteção consequente à potencialização da hipoventilação observada durante o estado de sono paradoxal, em que os maiores níveis de dessaturação são observados.

  15. Sleep polygraphic parameters in neuromuscular diseases / Parâmetros poligráficos do sono em doenças neuromusculares

    Scientific Electronic Library Online (English)

    Márcia, Pradella.

    1994-12-01

    Full Text Available Estudando 32 pacientes com doenças neuromusculares -22 com forma de distrofia muscular, 3 com forma de miopatia congênita, 4 com forma de atrofia muscular espinal, 1 com forma recorrente de polimiosite e 1 com síndrome de osteogenesis imperfecta - dos quais 21 estavam impossibilitados de deambulação [...] , distúrbios respiratórios relacionados ao sono foram observados sob forma dessaturação da oxi-hemogloblina, arritmia cardíaca, taquipnéia, taquicardia e roncos. Nove desses 32 pacientes apresentaram períodos de dessaturação de oxi-hemoglobina maiores que 4% em relação aos níveis obtidos em vigília e repouso. Esse grupo de pacientes era caracterizado por apresentar síndrome respiratória restritiva associada a deformidade torácica (principalmente escoliose). Alguns apresentaram taquipnéia e/ou saturação da oxi-hemoglobina abaixo de 90% durante o repouso e em vigília. Neste grupo, roncos foram observados principalmente nos pacientes com forma de distrofia muscular, enquanto a taquipnéia foi observada sobretudo nos pacientes com os maiores níveis de dessaturação. A quantificação do sono mostrou aumento na porcentagem do estado 1 do sono associada a diminuição ou mesmo ausência do estado do sono paradoxal. Isso nos leva a crer em um provável mecanismo de proteção consequente à potencialização da hipoventilação observada durante o estado de sono paradoxal, em que os maiores níveis de dessaturação são observados. Abstract in english In a polysomnography study of 32 neuromuscular patients - 22 with a form of muscular dystrophy, 3 with a form of congenital myopathy, 4 with a form of spinal muscular atrophy, 1 with a recurrent form of polymyositis and 1 with osteogenesis imperfecta syndrome - of which 21 were nonambulatory, we obs [...] erved sleep related respiratory disturbances represented by: drops in oxygen saturation (SaO2), cardiac arrythmia, sleep disruption, apneas, tachypnea, tachycardia and snoring. Nine out of the cohort of 32 patients presented with significant desaturations periods. These patients presented with an associated restrictive syndrome and thoracic deformities, some with tachypnea and/or SaO2 below 90% during wakefulness. In this group, snoring was observed in those patients with a form of muscular dystrophy while tachypnea was observed in patients who presented the highest desaturations levels. Sleep quantification revealed an increase of stage 1 sleep coupled with a decrease or even total absence of REM sleep. This is, we believe, a likely consequence of episodic desaturations that may accompany sleep hypoventilation which is potentialised during REM sleep stage.

  16. Anormalidades neuromuscular no desuso, senilidade e caquexia Neuromuscular abnormalities in disuse, cachexia and ageing

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.Cachexia, ageing and disuse and their effects on the human and animals neuromuscular system are reviewed. Disuse induces reduction of muscle fibers (mainly II diameter with peripheral myofibrils lost; there is no core-targetoid or even reduction on myophosphorilase activity, both typical of denervation; the acetylcholine spontaneous release and trophic factors on myoneural junction are maintained; muscle fibers could change to angular shape. Ageing affects nerve and muscle by a continuous and progressive process of denervation and reinner-vation; the number of motor units diminishes in sixties without any denervation electric activity; there is also reduction on the amount of ACh release on terminal neurons and mitochondrial oxidative capacity leading to compensatory type I muscle fiber number increase. Cachexia also induces reduction on muscle fibers diameter first on legs and then on arms and trunk; there is type II atrophy with occasional angular fibers, RNA/proteic synthesis reduction and normal DNA.

  17. Anormalidades neuromuscular no desuso, senilidade e caquexia / Neuromuscular abnormalities in disuse, cachexia and ageing

    Scientific Electronic Library Online (English)

    João Aris, Kouyoumdjian.

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso) deve-se à perda de miofibrilas periféricas não oc [...] orrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal. Abstract in english Cachexia, ageing and disuse and their effects on the human and animals neuromuscular system are reviewed. Disuse induces reduction of muscle fibers (mainly II) diameter with peripheral myofibrils lost; there is no core-targetoid or even reduction on myophosphorilase activity, both typical of denerva [...] tion; the acetylcholine spontaneous release and trophic factors on myoneural junction are maintained; muscle fibers could change to angular shape. Ageing affects nerve and muscle by a continuous and progressive process of denervation and reinner-vation; the number of motor units diminishes in sixties without any denervation electric activity; there is also reduction on the amount of ACh release on terminal neurons and mitochondrial oxidative capacity leading to compensatory type I muscle fiber number increase. Cachexia also induces reduction on muscle fibers diameter first on legs and then on arms and trunk; there is type II atrophy with occasional angular fibers, RNA/proteic synthesis reduction and normal DNA.

  18. Closed-loop timing controller design for control rod drive mechanism (CRDM) control system in pressurized water reactor

    International Nuclear Information System (INIS)

    The method that the operating condition of Control Rod Drive Mechanism (CRDM) can be monitored without mounting sensors within CRDM housing was developed, and by using this developed method the closed-loop controller for the CRDM was designed which can optimize the performance and maximize the reliability of CRDM operation. Neural network is utilized as pattern recognition engine in detecting CRDM actuation. In this paper, most problems in previous open loop system are resolved. The control algorithms for closed-loop system were developed and implemented within the hardware of timing controller based on microprocessor. All functions in the timing controller were verified by means of real time CRDM simulator. The results show that the timing controller performs its intended functions properly. (author)

  19. Chemo-mechanical control of neural stem cell differentiation

    Science.gov (United States)

    Geishecker, Emily R.

    Cellular processes such as adhesion, proliferation, and differentiation are controlled in part by cell interactions with the microenvironment. Cells can sense and respond to a variety of stimuli, including soluble and insoluble factors (such as proteins and small molecules) and externally applied mechanical stresses. Mechanical properties of the environment, such as substrate stiffness, have also been suggested to play an important role in cell processes. The roles of both biochemical and mechanical signaling in fate modification of stem cells have been explored independently. However, very few studies have been performed to study well-controlled chemo-mechanotransduction. The objective of this work is to design, synthesize, and characterize a chemo-mechanical substrate to encourage neuronal differentiation of C17.2 neural stem cells. In Chapter 2, Polyacrylamide (PA) gels of varying stiffnesses are functionalized with differing amounts of whole collagen to investigate the role of protein concentration in combination with substrate stiffness. As expected, neurons on the softest substrate were more in number and neuronal morphology than those on stiffer substrates. Neurons appeared locally aligned with an expansive network of neurites. Additional experiments would allow for statistical analysis to determine if and how collagen density impacts C17.2 differentiation in combination with substrate stiffness. Due to difficulties associated with whole protein approaches, a similar platform was developed using mixed adhesive peptides, derived from fibronectin and laminin, and is presented in Chapter 3. The matrix elasticity and peptide concentration can be individually modulated to systematically probe the effects of chemo-mechanical signaling on differentiation of C17.2 cells. Polyacrylamide gel stiffness was confirmed using rheological techniques and found to support values published by Yeung et al. [1]. Cellular growth and differentiation were assessed by cell counts, immunocytochemistry (ICC), and neurite measurements. Data indicates that chemo-mechanical signaling is highly combinatorial in directing differentiation of C17.2s along a neuronal lineage in vitro. Chapter 4 discusses the design, synthesis, and characterization of a novel nanomaterial platform to investigate ligand-receptor binding. PEGylated nanoparticles were successfully synthesized and found to be relatively homogenous in size and morphology, as observed by transmission electron microscopy. However, successful binding of RGD peptide to the nanoparticle was not confirmed. Finally, a method for proteomic analysis of the C17.2 secretome is discussed in Chapter 5. Secreted proteins are of great importance as they can both influence cell behaviors as well as act as biomarkers of differentiation. Methods have been selected and optimized for protein extraction and two dimensional gel electrophoresis to be followed by mass spectrometry and protein identification. A temporal analysis of unique proteins expressed by C17.2s will result in a differentiation timeline. Deducing the dynamics of neuronal cell secretions will greatly contribute to the characterization of the C17.2 cell line and improve its relevance as a neural stem cell model. Overall, results illustrate the importance of chemical and mechanical cues in manipulating neural stem cell fate. These material platforms in combination with the further characterization of the C17.2 neural stem cells could have a great impact in the fields of neuronal biology, translational therapeutics, and pharmaceutical research.

  20. Functional Neuromuscular Stimulation Controlled by Surface Electromyographic Signals Produced by the Volitional Activation of the Same Muscle: : Acaptive Removal of the Muscle Response from the Recorded EMG-Signal

    DEFF Research Database (Denmark)

    Sennels, SØren; Fin, Biering-SØrensen

    1997-01-01

    Using the voluntary EMG as a control signal for the stimulation of the same muscle necessitates elimination of stimulus artifacts and the muscle response caused by the stimulation. The stimulus artifacts are easily eliminated by shutting down the amplifier during stimulation. The muscle response is a non-stationary signal, therefore an adaptive linear prediction filter is proposed. The filter is derived and tested for three filter lengths on both simulated and real data. The performance is compared with a conventional fixed comb filter. The simulations indicate that the adaptive filter is relatively insensitive to amplitude variations og the muscle responses. For variations in shape and for real data, an improved filter performance can be achieved by increasing the filter length. A filter length of up to 7 stimulation periods makes it possible to reduce real muscle responses to a level comparable with the background noise. It is thus possible to extract the voluntary EMG from a partly paralysed muscle and use it for controlling the stimulation of the same muscle.

  1. Moderate Aging Does Not Modulate Morphological Responsiveness of the Neuromuscular System to Chronic Overload in Fischer 344 Rats

    Science.gov (United States)

    Deschenes, Michael R.; Tenny, Kelly; Eason, Margaret K.; Gordon, Scott E.

    2007-01-01

    The purpose of this investigation was to determine the effect of aging on neuromuscular adaptations to chronic overload. Eight young adult (8 mo old) and eight aged (22 mo old) Fischer 344 rats underwent unilateral synergist ablation to overload the plantaris and soleus muscles of that hindlimb and to provide control muscles from the contralateral hindlimb. Cytofluorescent staining and confocal microscopy were used to quantify pre- and post-synaptic features of neuromuscular junctions (NMJs). Histochemical staining and light microscopy were used to assess adaptations of myofibers to chronic overload. Results demonstrate that NMJs of young adult and aged muscles did not undergo morphological remodeling as a result of four weeks of chronic overload. In contrast, myofibers of young and aged rats displayed significant (P <0.05), but similar hypertrophy (~18%) following that four week intervention. In both age groups, however, this hypertrophy was detected in the plantaris, but not the soleus. These data indicate that moderate aging (the equivalent of 65 years in human lifetime) does not modify the sensitivity of the neuromuscular system to chronic overload. PMID:17720323

  2. Acute neuromuscular manifestations in a patient associated with ingesting octopus (Octopus sp.) / Manifestações neuromusculares agudas associadas à ingestão de polvo comum Octopus sp.

    Scientific Electronic Library Online (English)

    Vidal, Haddad Junior; Regina, Moura.

    2007-02-01

    Full Text Available Os autores relatam um quadro manifestado por sintomas neurológicos e musculares em uma mulher de 45 anos, que surgiu após o consumo da carne de polvo comum (Octopus sp.). A paciente apresentou intenso mal estar, parestesias em extremidades e área perioral, fraqueza muscular intensa e hipotensão arte [...] rial, seguidos de prurido importante e uma erupção eritêmato-descamativa disseminada tardia. Não foram observadas manifestações gastrintestinais ou febre, o que reduziu a probabilidade de uma intoxicação alimentar por conservação inadequada do molusco. A presença de sintomas neuro-musculares é sugestiva de ação de neurotoxinas, comprovadamente existentes em muitos gêneros de polvos e que podem ter sido ingeridas através do consumo das glândulas salivares ou acúmulo das toxinas na carne, por algum mecanismo ainda desconhecido. As toxinas dos polvos do gênero Octopus são pouco estudadas e julgamos esta comunicação importante por alertar para a possibilidade do envenenamento nos seres humanos que consomem carne de polvos e ainda sua diferenciação das intoxicações alimentares que ocorrem por conservação inadequada do animal. Abstract in english The authors report neuromuscular manifestations in a 45-year-old woman after consuming octopus meat (Octopus sp.). The patient presented malaise, paresthesias in perioral and extremity areas, intense muscular weakness and arterial hypotension, followed by severe itch and disseminated cutaneous rash. [...] Gastrointestinal manifestations and fever were not observed, reducing the probability of alimentary poisoning. The presence of muscular and neurological symptoms suggests neurotoxin action, which could have been ingested by the victim from the octopus salivary glands or from an accumulation of toxins in the meat, or by an unknown mechanism. There is little known about toxins of the Octopus genus and this communication is important alert to the possibility of poisoning in humans that eat octopus and its differentiation from alimentary poisonings arising from incorrect conservation of seafood.

  3. Acute neuromuscular manifestations in a patient associated with ingesting octopus (Octopus sp. Manifestações neuromusculares agudas associadas à ingestão de polvo comum Octopus sp.

    Directory of Open Access Journals (Sweden)

    Vidal Haddad Junior

    2007-02-01

    Full Text Available The authors report neuromuscular manifestations in a 45-year-old woman after consuming octopus meat (Octopus sp.. The patient presented malaise, paresthesias in perioral and extremity areas, intense muscular weakness and arterial hypotension, followed by severe itch and disseminated cutaneous rash. Gastrointestinal manifestations and fever were not observed, reducing the probability of alimentary poisoning. The presence of muscular and neurological symptoms suggests neurotoxin action, which could have been ingested by the victim from the octopus salivary glands or from an accumulation of toxins in the meat, or by an unknown mechanism. There is little known about toxins of the Octopus genus and this communication is important alert to the possibility of poisoning in humans that eat octopus and its differentiation from alimentary poisonings arising from incorrect conservation of seafood.Os autores relatam um quadro manifestado por sintomas neurológicos e musculares em uma mulher de 45 anos, que surgiu após o consumo da carne de polvo comum (Octopus sp.. A paciente apresentou intenso mal estar, parestesias em extremidades e área perioral, fraqueza muscular intensa e hipotensão arterial, seguidos de prurido importante e uma erupção eritêmato-descamativa disseminada tardia. Não foram observadas manifestações gastrintestinais ou febre, o que reduziu a probabilidade de uma intoxicação alimentar por conservação inadequada do molusco. A presença de sintomas neuro-musculares é sugestiva de ação de neurotoxinas, comprovadamente existentes em muitos gêneros de polvos e que podem ter sido ingeridas através do consumo das glândulas salivares ou acúmulo das toxinas na carne, por algum mecanismo ainda desconhecido. As toxinas dos polvos do gênero Octopus são pouco estudadas e julgamos esta comunicação importante por alertar para a possibilidade do envenenamento nos seres humanos que consomem carne de polvos e ainda sua diferenciação das intoxicações alimentares que ocorrem por conservação inadequada do animal.

  4. Histochemical and immunohistological approach to comparative neuromuscular diseases.

    Directory of Open Access Journals (Sweden)

    Serenella Papparella

    2009-12-01

    Full Text Available The broad category of neuromuscular diseases covers conditions that involve the weakness or wasting of the body muscles. These problems may occur in the spinal cord, the peripheral nerves or the muscle fibers. Some may be hereditary, while others are acquired. Commonly recognized conditions fall into the categories of myopathies, which are diseases of the muscle like muscular dystrophy, disorders of the junction where the nerve impulses are transmitted to the muscle like myasthenia gravis, and neuropathies, which are diseases of the peripheral nervous system. The diagnosis of most neuromuscular diseases rest on careful clinical evaluation of the patient, electromyography, the muscle biopsy, and in some instances, molecular genetic studies. Muscle biopsy, associated to histochemical and immunohistological techniques, plays a key role in diagnosis of many neuromuscular disorders. A number of morphological abnormalities of muscle can be recognized on histological stains such as haematoxylin and eosin and Engel trichrome. Histochemical techniques are essential for the study of muscle biopsies for four main reasons. First, they demonstrate the non-uniform nature of the muscle highlighting the different biochemical properties of specific fibre type and their selective involvement in certain disease processes. Second, they may show an absences of a particular enzyme. Third, an excess of a particular substrate can be demonstrated. Fourth, they may show structural changes in the muscle which would not be apparent with routine histological stains, such as the enzyme-deficient cores in central core disease "mouth-eaten" fibers, and abnormalities in the distribution of mitochondria. In some neuromuscular disorders there could be only non-specific myopathological features. However, a number of proteins, including sarcolemmal, sarcomeric, and nuclear proteins as well as enzymes with defects responsible for neuromuscular disorders, have been identified during the past two decades, allowing a more specific and firm diagnosis of muscle diseases. Identification of protein defects relies predominantly on immunohistochemical preparations and on Western blot analysis. While immunohistochemistry is very useful in identifying abnormal expression of primary protein abnormalities in recessive conditions, it is less helpful in detecting primary defects in dominantly inherited disorders. Abnormal immunohistochemical expression patterns can be confirmed by Western blot analysis which may also be informative in dominant disorders. Besides identification of specific protein defects, immunohistochemistry is also helpful in the differentiation of inflammatory myopathies by subtyping cellular infiltrates and demonstrating up-regulation of subtle immunological parameters. This review will summarize and describe the impact that histochemistry and immunohistochemistry has had and the possibilities it has opened up in the diagnosis of neuromuscular disorders in human as well as in veterinary myology.

  5. Mechanism of anterior-posterior polarity control in planarians

    Energy Technology Data Exchange (ETDEWEB)

    Lange, C.S.; Steele, V.E.

    1978-01-01

    The substance which inhibits brain formation in the regenerating planarian Dugesia etrusca was found to be a large molecule, at least in part protein, which electrophoreses as an electronegative moiety in pH 6.8 buffer. A model is presented, based on this finding and previous studies, which proposes an electrochemical mechanism for the control of polarity and possibly for the maintenance of tissue organization in planarians. It is proposed that a bioelectric field exists and moves the electronegative brain-inhibiting substance in a posterior direction, establishing polarity. This model explains the polarity reversal experiments using external fields and many of the previously unexplained classical planarian experiments. Data are presented demonstrating the existence, magnitude, and polarity of this bioelectric field, which is not greatly altered upon decapitation, all in accord with predictions of the model.

  6. Metallurgical Mechanisms Controlling Mechanical Properties of Aluminum Alloy 2219 Produced by Electron Beam Freeform Fabrication

    Science.gov (United States)

    Domack, Marcia S.; Tainger, Karen M.

    2006-01-01

    The electron beam freeform fabrication (EBF3) layer-additive manufacturing process has been developed to directly fabricate complex geometry components. EBF3 introduces metal wire into a molten pool created on the surface of a substrate by a focused electron beam. Part geometry is achieved by translating the substrate with respect to the beam to build the part one layer at a time. Tensile properties demonstrated for electron beam deposited aluminum and titanium alloys are comparable to wrought products, although the microstructures of the deposits exhibit cast features. Understanding the metallurgical mechanisms controlling mechanical properties is essential to maximizing application of the EBF3 process. Tensile mechanical properties and microstructures were examined for aluminum alloy 2219 fabricated over a range of EBF3 process variables. Unique microstructures were observed within the deposited layers and at interlayer boundaries, which varied within the deposit height due to microstructural evolution associated with the complex thermal history experienced during subsequent layer deposition. Microstructures exhibited irregularly shaped grains with interior dendritic structures, described based on overall grain size, morphology, distribution, and dendrite spacing, and were correlated with deposition parameters. Fracture features were compared with microstructural elements to define fracture paths and aid in definition of basic processing-microstructure-property correlations.

  7. Control of forced vibrations of mechanical structures by an electromagnetic controller with a permanent magnet

    DEFF Research Database (Denmark)

    Stein, George Juraj; Darula, Radoslav

    2012-01-01

    A theoretical analysis of an electromagnetic vibration controller is presented. The analyzed device consists of a pot-type iron core with a coil and a permanent magnet as a source of constant magnetic flux. The magnetic circuit is closed by a yoke, excited by an external harmonic mechanical force. The so generated magnetic flux variation induces alternating voltage in the electric circuit, which is dissipated in a shunt resistor. The induced current driven through the coil generates magnetic force, which damps the excitation force and changes the damped natural frequency of the oscillatory system. Due to the hysteretic effects in the magnetic material the internal losses influence the overall system’s performance. A mathematical model of the force balance in the oscillatory system is derived in a simplified, linearised form. The electric as well as mechanical system is modelled using lumped-parameter approach and the actuating principle for control of forced vibration is investigated.

  8. Internal Control Rod Drive Mechanisms, Design Options for IRIS

    International Nuclear Information System (INIS)

    IRIS (International Reactor Innovative and Secure) is a medium-power (335 MWe) PWR with an integral, primary circuit configuration, where all the reactor coolant system components are contained within the reactor vessel. This integral configuration is a key reason for the success of IRIS' 'safety-by-design' approach, whereby accident initiators are eliminated or the accident consequences and/or frequency are reduced. The most obvious example of the IRIS safety by design approach is the elimination of large LOCA's, since the integral reactor coolant system has no large loop piping. Another serious accident scenario that is being addressed in IRIS is the postulated ejection of a reactor control cluster assembly (RCCA). This accident initiator can be eliminated by locating the RCCA drive mechanisms (CRDMs) inside the reactor vessel. This eliminates the mechanical drive rod penetration between the RCCA and the external CRDM, eliminating the potential for differential pressure across the pressure boundary, and thus eliminating 'by design' the possibility for rod ejection accident. Moreover, the elimination of the 'large' drive-rod penetrations and the external CRDM pressure housings decreases the likelihood of boric acid leakage and subsequent corrosion of the reactor pressure boundary (like the Davis-Besse incident). This paper will discuss the IRIS top level design requirements and objectives for internal CRDMs, and provide examples candidate designs and their specific ples candidate designs and their specific performance characteristics. (authors)

  9. Mechanically controlled molecular orbital alignment in single molecule junctions

    Science.gov (United States)

    Bruot, Christopher; Hihath, Joshua; Tao, Nongjian

    2012-01-01

    Research in molecular electronics often involves the demonstration of devices that are analogous to conventional semiconductor devices, such as transistors and diodes, but it is also possible to perform experiments that have no parallels in conventional electronics. For example, by applying a mechanical force to a molecule bridged between two electrodes, a device known as a molecular junction, it is possible to exploit the interplay between the electrical and mechanical properties of the molecule to control charge transport through the junction. 1,4'-Benzenedithiol is the most widely studied molecule in molecular electronics, and it was shown recently that the molecular orbitals can be gated by an applied electric field. Here, we report how the electromechanical properties of a 1,4'-benzenedithiol molecular junction change as the junction is stretched and compressed. Counterintuitively, the conductance increases by more than an order of magnitude during stretching, and then decreases again as the junction is compressed. Based on simultaneously recorded current-voltage and conductance-voltage characteristics, and inelastic electron tunnelling spectroscopy, we attribute this finding to a strain-induced shift of the highest occupied molecular orbital towards the Fermi level of the electrodes, leading to a resonant enhancement of the conductance. These results, which are in agreement with the predictions of theoretical models, also clarify the origins of the long-standing discrepancy between the calculated and measured conductance values of 1,4'-benzenedithiol, which often differ by orders of magnitude.

  10. Mechanisms controlling the distribution of two invasive Bromus species

    Directory of Open Access Journals (Sweden)

    Olga Bykova

    2014-03-01

    Full Text Available In order to predict future range shifts for invasive species it is important to explore their ability to acclimate to the new environment and understand physiological and reproductive constraints controlling their distribution. My dissertation studied mechanisms by which temperature may affect the distribution of two aggressive plant invaders in North America, Bromus tectorum and Bromus rubens. I first evaluated winter freezing tolerance of Bromus species and demonstrated that the mechanism explaining their distinct northern range limits is different acquisition time of freezing tolerance. While B. rubens has a slower rate of freezing acclimation that leads to intolerance of sudden, late-autumn drops in temperature below -12°C, B. tectorum rapidly hardens and so is not impacted by the sudden onset of severe late-autumn cold. In addition, the analysis of male reproductive development and seed production showed that neither species produces seed at or above 36°C, due to complete pollen sterility, which might trigger climate-mediated range contractions at B. tectorum and B. rubens southern margins. Finally, a detailed gas-exchange analysis combined with biochemical modelling demonstrated that both species acclimate to a broad range of temperatures and photosynthetic response to temperature does not explain their current range separation.

  11. Monitoring device for operation of reactor control rod driving mechanism

    International Nuclear Information System (INIS)

    The device of the present invention detects occurrence of abnormality of control rod driving mechanisms in an early stage by extracting changes of a controlling current for the CRDM of a PWR type reactor. Namely, the device of the present invention comprises an abnormality detection and processing device which performs wavelet conversion of signals of the current flowing in a lift coil, signals of the current flowing in a movable griper coil and signals of the current flowing in a stationary griper coil in the CRDM. The device compares the effective value of the wavelet conversion with a previously set reference value. The abnormality of CRDM is analyzed based on the comparative results showing that the effective value of the WAVELET conversion exceeds a predetermined relationship with the reference value. With such procedures, slight change of waveforms can be recognized accurately based on the information represented by three axes, namely, a time axis, the extent of extension/contraction of a base function and a corelationship of the base functions, without using an expensive accelerometer. (I.S.)

  12. Investigation of the profile control mechanisms of dispersed particle gel.

    Science.gov (United States)

    Zhao, Guang; Dai, Caili; Zhao, Mingwei

    2014-01-01

    Dispersed particle gel (DPG) particles of nano- to micron- to mm-size have been prepared successfully and will be used for profile control treatment in mature oilfields. The profile control and enhanced oil recovery mechanisms of DPG particles have been investigated using core flow tests and visual simulation experiments. Core flow test results show that DPG particles can easily be injected into deep formations and can effectively plug the high permeability zones. The high profile improvement rate improves reservoir heterogeneity and diverts fluid into the low permeability zone. Both water and oil permeability were reduced when DPG particles were injected, but the disproportionate permeability reduction effect was significant. Water permeability decreases more than the oil permeability to ensure that oil flows in its own pathways and can easily be driven out. Visual simulation experiments demonstrate that DPG particles can pass directly or by deformation through porous media and enter deep formations. By retention, adsorption, trapping and bridging, DPG particles can effectively reduce the permeability of porous media in high permeability zones and divert fluid into a low permeability zone, thus improving formation profiles and enhancing oil recovery. PMID:24950174

  13. Opioids in the brain: supraspinal mechanisms in pain control

    DEFF Research Database (Denmark)

    Jensen, T S

    1997-01-01

    Systemically administered opioids produce a profound inhibition of noxious-evoked activity peripherally, spinally and supraspinally in several species, including man. The role of the brain in opioid mediated-pain control has been less well characterized than that occurring at lower levels in the nervous system. Yet, classical studies indicate that in morphine-induced analgesia the individual senses noxious stimuli, but the affective, motivational and aversive character of the stimulus is no longer present. This observation indicates that morphine probably exerts a specific action on those brain systems that control complex behaviors like aversion and motivation. The failure to document such effects in experimental studies may in part be explained by less suitable methods for assessing antinociception, e.g. measurements of simple reflex behaviors. Experimental animal studies show that supraspinal opioids may influence nociception by several distinct mechanisms, which differ from those seen in the spinal cord: Change of activity in descending bulbospinal pathways. Direct inhibition of noxious throughput at brainstem level. Indirect inhibition of noxious responding brainstem neurons projecting to supraspinal centers. Influence ascending forebrain systems. Direct cortical or thalamic inhibition. In humans, the antinociceptive actions of opioids occurring in the brain has until recently been like looking into a "black box". The introduction of new imaging techniques may provide new tools for directly measuring the antinociceptive action of opioids in the brain under normal and pathological conditions. In particular, the emotional-affective aspect of pain and how this is modulated by opioids will be of interest to study.

  14. The effects of Duvernoy's gland secretion from the xenodontine colubrid Philodryas olfersii on striated muscle and the neuromuscular junction: partial characterization of a neuromuscular fraction.

    Science.gov (United States)

    Prado-Franceschi, J; Hyslop, S; Cogo, J C; Andrade, A L; Assakura, M; Cruz-Höfling, M A; Rodrigues-Simioni, L

    1996-04-01

    The effect of Philodryas olfersii Duvernoy's secretion was studied in vivo in mice and chicks as well as in the mouse phrenic nerve-diaphragm and the chick biventer cervicis preparations. The whole secretion (20-40 micrograms/ml) increased the creatine kinase (CK) levels in mice but had no effect on the mouse phrenic nerve-diaphragm preparation. In the chick, the secretion caused head drop and paresia as well as irreversible blockade of the twitch-tension evoked by indirect stimulation in the chick biventer cervicis preparation (50% paralysis in 34.5 +/- 2.7 min, n = 4). The secretion also caused muscle contracture (30% of the maximal twitch-tension generated) after a latency of nearly 9 min. Following fractionation on a Superose 12 FPLC column, the neuromuscular activity was recovered in the high mol. wt fraction (Peak I). At a concentration of 10 micrograms/ml in the chick biventer cervicis preparation, Peak I caused 50% paralysis within 18.5 +/- 3.0 min (n = 4), and evoked a strong contracture (70% of the maximal twitch-tension generated). The contractile responses of the chick preparation to ACh and KCL were partially blocked (90%) by the whole secretion and totally blocked by Peak I. CK release was increased by the whole secretion but not by Peak I. The whole secretion also produced various degrees of muscle cell lysis and extensive widening of the intercellular spaces. The latter showed a loosely arranged membranous network. In general, Peak I caused only minor morphological alterations compared with the whole secretion, although these were still significantly different from those observed in the control preparations. The changes principally involved hypercontraction of the muscle fibers. Based on the above results, we conclude that Peak I contains the factor(s) responsible for the in vitro effects on neuromuscular transmission, whereas the direct myotoxic effect is apparently caused by at least one other component of the Duvernoy's secretion. PMID:8735245

  15. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control?

    Directory of Open Access Journals (Sweden)

    Ricardo Palmier Teles

    2009-06-01

    Full Text Available The control of biofilm accumulation on teeth has been the cornerstone of periodontal disease prevention for decades. However, the widespread prevalence of gingivitis suggests the inefficiency of self-performed mechanical plaque control in preventing gingival inflammation. This is particularly relevant in light of recent evidence suggesting that long standing gingivitis increases the risk of loss of attachment and that prevention of gingival inflammation might reduce the prevalence of mild to moderate periodontitis. Several antimicrobials have been tested as adjuncts to mechanical plaque control in order to improve the results obtained with oral home care. Recent studies, including meta-analyses, have indicated that home care products containing chemical antimicrobials can provide gingivitis reduction beyond what can be accomplished with brushing and flossing. Particularly, formulations containing chlorhexidine, mouthrinses containing essential oils and triclosan/copolymer dentifrices have well documented clinical antiplaque and antigingivitis effects. In vivo microbiological tests have demonstrated the ability of these antimicrobial agents to penetrate the biofilm mass and to kill bacteria growing within biofilms. In addition, chemical antimicrobials can reach difficult-to-clean areas such as interproximal surfaces and can also impact the growth of biofilms on soft tissue. These agents have a positive track record of safety and their use does not seem to increase the levels of resistant species. Further, no study has been able to establish a correlation between mouthrinses containing alcohol and oral cancer. In summary, the adjunct use of chemical plaque control should be recommended to subjects with well documented difficulties in achieving proper biofilm control using only mechanical means.

  16. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control?

    Scientific Electronic Library Online (English)

    Ricardo Palmier, Teles; Flavia Rocha Fonseca, Teles.

    2009-06-01

    Full Text Available The control of biofilm accumulation on teeth has been the cornerstone of periodontal disease prevention for decades. However, the widespread prevalence of gingivitis suggests the inefficiency of self-performed mechanical plaque control in preventing gingival inflammation. This is particularly releva [...] nt in light of recent evidence suggesting that long standing gingivitis increases the risk of loss of attachment and that prevention of gingival inflammation might reduce the prevalence of mild to moderate periodontitis. Several antimicrobials have been tested as adjuncts to mechanical plaque control in order to improve the results obtained with oral home care. Recent studies, including meta-analyses, have indicated that home care products containing chemical antimicrobials can provide gingivitis reduction beyond what can be accomplished with brushing and flossing. Particularly, formulations containing chlorhexidine, mouthrinses containing essential oils and triclosan/copolymer dentifrices have well documented clinical antiplaque and antigingivitis effects. In vivo microbiological tests have demonstrated the ability of these antimicrobial agents to penetrate the biofilm mass and to kill bacteria growing within biofilms. In addition, chemical antimicrobials can reach difficult-to-clean areas such as interproximal surfaces and can also impact the growth of biofilms on soft tissue. These agents have a positive track record of safety and their use does not seem to increase the levels of resistant species. Further, no study has been able to establish a correlation between mouthrinses containing alcohol and oral cancer. In summary, the adjunct use of chemical plaque control should be recommended to subjects with well documented difficulties in achieving proper biofilm control using only mechanical means.

  17. Estimulação elétrica neuromuscular na disfunção patelofemoral: revisão de literatura / Neuromuscular electric stimulation in patellofemoral dysfunction: riterature review

    Scientific Electronic Library Online (English)

    Ricardo Lucas dos, Santos; Márcia Leal São Pedro, Souza; Fernanda Andrade dos, Santos.

    2013-02-01

    Full Text Available A disfunção femoropatelar é uma deficiência bastante comum entre indivíduos jovens que acomete, principalmente, o sexo feminino e pode ser caracterizada por dor, edema e creptação retropatelar. Sistematizar o conhecimento em relação ao aumento da força muscular do quadríceps e alívio de dor em pacie [...] ntes com disfunção femoropatelar, através da utilização da estimulação elétrica neuromuscular e exercícios resistidos. Trata se de um estudo de revisão narrativa da literatura no período de 2005 a 2011. Os critérios de inclusão foram artigos de intervenção, dos últimos seis anos, nos idiomas inglês, espanhol e português, que utilizaram o fortalecimento muscular e a eletroestimulação neuromuscular para reabilitação obtidos através de buscas nos bancos de dados eletrônicos Medline, Lilacs e na biblioteca Bireme. A busca bibliográfica resultou em 28 referências, destes foram excluídos nove de acordo com os objetivos e critérios de inclusão e foram selecionados 16 artigos para leitura dos resumos e posterior análise. A Estimulação Elétrica Neuromuscular (EENM) de média frequência pode ser utilizada associada a exercícios resistidos como coadjuvante no tratamento da disfunção femoropatelar (DFP), tanto para se obter um reequilíbrio muscular quanto para o alívio da dor. Abstract in english Patellofemoral dysfunction is a fairly common deficiency among young individuals that primarily affects females and may be characterized by pain, swelling and retropatellar crepitation. The purpose of this review of literature from the period between 2005 and 2011 was to systematize knowledge in rel [...] ation to the increase in quadriceps muscle strength and pain relief in patients with patellofemoral dysfunction, using neuromuscular electrical stimulation and resistance exercises. The inclusion criteria were intervention articles from the past six years, in English, Spanish and Portuguese, which used muscle strengthening and neuromuscular electrical stimulation for rehabilitation obtained through searches in the electronic databases Medline and Lilacs and in the Bireme library. The bibliographic search yielded 28 references, of which nine were excluded in accordance with the aims and inclusion criteria while 16 articles were selected for reading of the abstracts and subsequent analysis. Mediumfrequency Neuromuscular Electrical Stimulation (NMES) can be used in association with resistance exercises as an adjuvant in the treatment of patellofemoral dysfunction (PFD), both to achieve muscle rebalance and for pain relief.

  18. Estimulação elétrica neuromuscular na disfunção patelofemoral: revisão de literatura Neuromuscular electric stimulation in patellofemoral dysfunction: riterature review

    Directory of Open Access Journals (Sweden)

    Ricardo Lucas dos Santos

    2013-02-01

    Full Text Available A disfunção femoropatelar é uma deficiência bastante comum entre indivíduos jovens que acomete, principalmente, o sexo feminino e pode ser caracterizada por dor, edema e creptação retropatelar. Sistematizar o conhecimento em relação ao aumento da força muscular do quadríceps e alívio de dor em pacientes com disfunção femoropatelar, através da utilização da estimulação elétrica neuromuscular e exercícios resistidos. Trata se de um estudo de revisão narrativa da literatura no período de 2005 a 2011. Os critérios de inclusão foram artigos de intervenção, dos últimos seis anos, nos idiomas inglês, espanhol e português, que utilizaram o fortalecimento muscular e a eletroestimulação neuromuscular para reabilitação obtidos através de buscas nos bancos de dados eletrônicos Medline, Lilacs e na biblioteca Bireme. A busca bibliográfica resultou em 28 referências, destes foram excluídos nove de acordo com os objetivos e critérios de inclusão e foram selecionados 16 artigos para leitura dos resumos e posterior análise. A Estimulação Elétrica Neuromuscular (EENM de média frequência pode ser utilizada associada a exercícios resistidos como coadjuvante no tratamento da disfunção femoropatelar (DFP, tanto para se obter um reequilíbrio muscular quanto para o alívio da dor.Patellofemoral dysfunction is a fairly common deficiency among young individuals that primarily affects females and may be characterized by pain, swelling and retropatellar crepitation. The purpose of this review of literature from the period between 2005 and 2011 was to systematize knowledge in relation to the increase in quadriceps muscle strength and pain relief in patients with patellofemoral dysfunction, using neuromuscular electrical stimulation and resistance exercises. The inclusion criteria were intervention articles from the past six years, in English, Spanish and Portuguese, which used muscle strengthening and neuromuscular electrical stimulation for rehabilitation obtained through searches in the electronic databases Medline and Lilacs and in the Bireme library. The bibliographic search yielded 28 references, of which nine were excluded in accordance with the aims and inclusion criteria while 16 articles were selected for reading of the abstracts and subsequent analysis. Mediumfrequency Neuromuscular Electrical Stimulation (NMES can be used in association with resistance exercises as an adjuvant in the treatment of patellofemoral dysfunction (PFD, both to achieve muscle rebalance and for pain relief.

  19. Muscle edema in MR imaging of neuromuscular diseases

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the frequency of muscle edema and the diagnostic usefulness of Gd-DTPA in neuromuscular diseases. 144 consecutive patients with various generalized neuromuscular diseases were examined by MR imaging. Areas of high signal intensity, relative to normal muscle, were seen in 36% of T2-weighted images, whereas the corresponding T1-weighted images showed normal or lower signal intensities. These edema-like abnormalities -enlargement of the extracellular fluid space-were found more often in inflammatory and metabolic myopathies, but were also seen in degenerative myopathies. Contrast-enhanced T1-weighted images in 25 patients were not more sensitive than plain T2-weighted images. (orig.)

  20. Neuromuscular choristoma. A clinicopathologic study of two cases.

    Science.gov (United States)

    Bonneau, R; Brochu, P

    1983-09-01

    Neuromuscular choristoma, also known as benign "triton" tumor, is an uncommon peripheral nerve tumor usually occurring in early childhood. We report two cases, a 6-year-old girl with a solitary tumor of the supraclavicular fossa, and a 14-year-old girl with multiple small neuromuscular choristomas surrounding a recurrent massive musculoaponeurotic fibromatosis of the right axilla. These choristomas were bound firmly to the involved nerves, and consisted histologically of bundles of mature striated muscle fibers intermingled with myelinated nerve fibers. Our review of the literature indicates that these tumors are benign, regress with time, do not recur, and are usually not accompanied by functional impairment of the affected nerves before biopsy, so that wide or complete excision should not be attempted. Histogenetically, the striated muscle fibers in the nerves probably derive from nondifferentiated ectomesenchymal cells. PMID:6625049

  1. Neutralization of the neuromuscular activity of bothropstoxin-i, a myotoxin from Bothrops jararacussu snake venom, by a hydroalcoholic extract of Casearia sylvestris Sw. (guaçatonga)

    Scientific Electronic Library Online (English)

    Y., Oshima-Franco; C. M. V., Alves; N., Andréo Filho; M., Gerenutti; A. C. O., Cintra; G. B., Leite; L., Rodrigues-Simioni; M. G., Silva.

    2005-12-01

    Full Text Available Numerous plants are used as snakebite antidotes in Brazilian folk medicine, including Casearia sylvestris Swartz, popularly known as guaçatonga. In this study, we examined the action of a hydroalcoholic extract from C. sylvestris on the neuromuscular blockade caused by bothropstoxin-I (BthTX-I), a m [...] yotoxin from Bothrops jararacussu venom, in mouse isolated phrenic nerve-diaphragm (PND) preparations. Aqueous (8 and 12 mg/ml, n=4 and 5, respectively) and hydroalcoholic (12 mg/ml, n=12) extracts of the leaves of C. sylvestris caused facilitation in PND preparations followed by partial neuromuscular blockade. BthTX-I (20 µg/ml, n=4) caused 50% paralysis after 65±15 min (mean ± S.E.M). Preincubation (30 min at 37° C) of BthTX-I (20 µg/ml, n=4) with a concentration of the hydroalcoholic extract (4 mg/ml) that had no neuromuscular activity, such as the control (n=5), prevented the neuromuscular blockade caused by the toxin. This protection may be mediated by compounds such as flavonoids and phenols identified by thin-layer chromatography and colorimetric assays.

  2. Dynamic Simulation of Hybrid-driven Planar Five-bar Parallel Mechanism Based on SimMechanics and Tracking Control

    Directory of Open Access Journals (Sweden)

    Bin Zi

    2011-09-01

    Full Text Available This paper investigates dynamic simulation and trajectory tracking control of hybrid?driven planar five?bar parallel mechanism (HPPM. To begin with, a simulation model of dynamics based on MATLAB/SimMechanics is established. Then, traditional PD control and closed loop PD?type iterative learning control of the HPPM are designed. At the end, the simulation based on SimMechanics is carried out, which acquires angular, angular velocity, angular acceleration of two driving links and constraint reaction of kinematic pairs at any time. In addition, the performance of the closed loop PD?type iterative learning control is compared with that of the traditional PD controller through simulations of the HPPM in the presence of the model external disturbances. The simulation results indicate that a perfect trajectory tracking of end?effector of the HPPM is achieved by the closed loop PD?type iterative learning controller.

  3. Clinical features of the DOK7 neuromuscular junction synaptopathy.

    OpenAIRE

    Palace, J.; Lashley, D.; Newsom-davis, J.; Cossins, J.; Maxwell, S.; Kennett, R.; Jayawant, S.; Yamanashi, Y.; Beeson, D.

    2007-01-01

    Mutations in DOK7 have recently been shown to underlie a recessive congenital myasthenic syndrome (CMS) associated with small simplified neuromuscular junctions ('synaptopathy') but normal acetylcholine receptor and acetylcholinesterase function. We identified DOK7 mutations in 27 patients from 24 kinships. Mutation 1124_1127dupTGCC was common, present in 20 out of 24 kinships. All patients were found to have at least one allele with a frameshift mutation in DOK7 exon 7, suggesting that loss ...

  4. Degeneration of Neuromuscular Junction in Age and Dystrophy

    OpenAIRE

    R. Rudolf; M. M. Khan; Labeit, S.; Deschenes, M.R.

    2014-01-01

    Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions (NMJs) serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and post-synaptic origin. Consequently, NMJs are good indicators of motor health on a systemic level. Indeed, upon sarcopenia and d...

  5. Cardio-respiratory and neuromuscular responses to motocross race

    OpenAIRE

    Konttinen, Tomi

    2005-01-01

    Tomi Konttinen. 2005. Cardio-respiratory and neuromuscular responses to motocrossrace. Department of Biology of Physical Activity. University of Jyväskylä. 37p.Objectives - The primary aim of the present study was to examine physiological andneuromuscular responses during motocross racing. Furthermore, maximal isometricforce levels of the upper and lower body were studied.Methods - Seven Finnish A-level (group A) and five hobby-class (group H)motocross-riders performed a 30 minute riding te...

  6. Apparatus and simple method of monitoring neuromuscular function.

    Science.gov (United States)

    Chuang, Tsung-Yuan; Toung, Thomas Juey-Kong

    2011-09-01

    The use of muscle relaxant is an integral part of anesthetic management in present-day practice. Clinically, the neuromuscular blockade is evaluated by determining the thumb twitching to train-of-four (TOF) ulnar nerve stimulation at elbow.(1-3) There are many ways for the assessment of twitch response, such as the use of electromyography(4,5); force displacement transducer techniques(2,6-9); and most recently, the acceleration transducer-based system of neuromuscular monitoring.(10-15) These equipments are, however, bulky, cumbersome, expensive, or time consuming for operation. Because of these limitations, the routine use of such monitors is impractical. The evaluation of neuromuscular blockade, at the present time, relies on either visual or manual (tactile) thumb twitch responses to the TOF nerve stimulation. Visual or tactile evaluation of neuromuscular blockade is subjective and involves uncertainty, especially in the recovery phase. Furthermore, in certain surgical procedures, such as those on the head and neck, both hands are tucked in the sides of the table and become inaccessible, rendering visual or tactile evaluation of the thumb twitch impossible. In such situation, muscle relaxant is often given in the light of guessing rather than on objective basis. Clearly, there is a need for a simple and practical way of measuring the twitch responses to TOF stimulation during anesthesia. Based on the current method of stimulation of the ulnar nerve over the ulnar groove at the elbow, which elicits a string thumb adduction (because of stimulation of the flexor carpi ulnaris muscle), a simple method that can objectively monitor and record the thumb twitch is developed. The unique features of the method or device are its simplicity and its ability to adapt to any pressure transducer to display the twitch response to TOF simultaneously with electrocardiogram, arterial, or central venous pressure. PMID:21982173

  7. Neuromuscular abnormality and autonomic dysfunction in patients with cerebrotendinous xanthomatosis

    OpenAIRE

    Huang Chi-Ren; Lu Cheng-Hsien; Chang Chung-Chih; Tsai Nai-Wen; Chen Shu-Fang; Chuang Yao-Chung; Chang Wen-Neng

    2011-01-01

    Abstract Background Cerebrotendinous xanthomatosis (CTX) is a rare lipid-storage disease. Neuromuscular abnormality and autonomic system (ANS) dysfuction in CTX are rarely examined in large-scale studies in the literature. We studied the peripheral nervous system, myopathology, and autonomic system of four CTX patients and performed a literature review of the reported CTX patients with peripheral neuropathy. Methods Four biochemically and genetically confirmed CTX patients, belonging to two f...

  8. Neuromuscular electric stimulation in patellofemoral dysfunction: literature review

    OpenAIRE

    Dos Santos, Ricardo Lucas; Souza, Ma?rcia Leal Sa?o Pedro; Dos Santos, Fernanda Andrade

    2013-01-01

    Patellofemoral dysfunction is a fairly common deficiency among young individuals that primarily affects females and may be characterized by pain, swelling and retropatellar crepitation. The purpose of this review of literature from the period between 2005 and 2011 was to systematize knowledge in relation to the increase in quadriceps muscle strength and pain relief in patients with patellofemoral dysfunction, using neuromuscular electrical stimulation and resistance exercises. The inclusion c...

  9. Histochemical and immunohistological approach to comparative neuromuscular diseases.

    OpenAIRE

    Serenella Papparella; Orlando Paciello

    2009-01-01

    The broad category of neuromuscular diseases covers conditions that involve the weakness or wasting of the body muscles. These problems may occur in the spinal cord, the peripheral nerves or the muscle fibers. Some may be hereditary, while others are acquired. Commonly recognized conditions fall into the categories of myopathies, which are diseases of the muscle like muscular dystrophy, disorders of the junction where the nerve impulses are transmitted to the muscle like myasthenia gravis, an...

  10. Effects of whole-body vibration on thigh neuromuscular activity

    OpenAIRE

    Raimundo, Armando; Malta, Joa?o; Batalha, Nuno; Fernandes, Orlando; Tomas-carus, Pablo

    2011-01-01

    Introduction The use of whole-body vibration (WBV) appears to influence in a positive way the performance of athletes in certain characteristics such as muscular strength, power and body balance. The aim of this study was to compare the acute neuromuscular activity caused by different vibration frequencies (15Hz and 25Hz), and different knee flexion angles (120° and 150°). Methods A total of 19 male university students underwent 4 sessions of WBV. The subjects were exposed randomly...

  11. Role of amino acid infusion in delayed recovery from neuromuscular blockers

    OpenAIRE

    Gupta Anju; Gupta Nishkarsh

    2011-01-01

    This case report highlights the anaesthetic management of a patient who had residual muscle paralysis following neuromuscular blockade, which was attributed to hypothermia and corrected by administration of amino acid solution. The various causes of residual neuromuscular blockade should be considered when treating such a patient. Amino acid infusion has been found to hasten the recovery from neuromuscular block due to vecuronium bromide aggravated by hypothermia.

  12. Upregulation of PKD1L2 provokes a complex neuromuscular disease in the mouse

    OpenAIRE

    Mackenzie, Francesca E.; Romero, Rosario; Williams, Debbie; Gillingwater, Thomas; Hilton, Helen; Dick, Jim; Riddoch-contreras, Joanna; Wong, Frances; Ireson, Lisa; Powles-glover, Nicola; Riley, Genna; Underhill, Peter; Hough, Tertius; Arkell, Ruth; Greensmith, Linda

    2009-01-01

    Following a screen for neuromuscular mouse mutants, we identified ostes, a novel N-ethyl N-nitrosourea-induced mouse mutant with muscle atrophy. Genetic and biochemical evidence shows that upregulation of the novel, uncharacterized transient receptor potential polycystic (TRPP) channel PKD1L2 (polycystic kidney disease gene 1-like 2) underlies this disease. Ostes mice suffer from chronic neuromuscular impairments including neuromuscular junction degeneration, polyneuronal innervation and myop...

  13. Fatigue in neuromuscular disorders: Focus on Guillain-Barré syndrome and Pompe disease

    OpenAIRE

    Vries, J. M.; Hagemans, M. L. C.; Bussmann, J. B. J.; Ploeg, A. T.; Doorn, P. A.

    2010-01-01

    Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain–Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, ...

  14. Recovery of altered neuromuscular junction morphology and muscle function in mdx mice after injury

    OpenAIRE

    Stephen J. P. Pratt; Shah, Sameer B; Ward, Christopher W; Kerr, Jaclyn P.; Stains, Joseph P; Lovering, Richard M.

    2014-01-01

    Duchenne muscular dystrophy (DMD) is a devastating neuromuscular disease in which weakness, increased susceptibility to muscle injury, and inadequate repair underlie the pathology. While most attention has focused within the muscle fiber, we recently demonstrated significant alterations in the neuromuscular junction (NMJ) morphology and resulting neuromuscular transmission failure (NTF) 24 h after injury in mdx mice (murine model for DMD). Here we determine the contribution of NMJ morphology ...

  15. CT in neuromuscular disorders: A comparison of CT and histology

    International Nuclear Information System (INIS)

    The value of CT-examination of the muscles compared to histology was studied in a retrospective analysis of 30 patients with clinical suspicion of neuromuscular disorder. In the evaluation of the CT-results descriptive criteria were used. The histologic diagnosis came from needle-biopsies taken from the quadriceps muscle. Considering the whole group of neuromuscular disorders, CT has an overall accuracy of 84.8%, a positive predictive value of 95.5% and a negative predictive value of 63.6%. This makes the use of CT as a diagnostic tool in neuromuscular disorders a reliable examination technique. In patients with a polymyositis there is even a 100% correlation between CT findings and biopsy results. Discrepancy between the biopsy results is remarkable of the quadriceps muscle and the CT findings: The number of abnormal histological findings is twice the number of abnormal CT findings. Using the more proximal gluteal region as a biopsy site would have decreased this discrepancy and would therefore have given a better correlation between CT and histology. The choice of protocol in determining the levels to be scanned is of great importance in achieving good reproducability in follow-up CT examinations. (orig.)

  16. Magnetic resonance imaging (MRI) in the diagnosis of neuromuscular diseases

    International Nuclear Information System (INIS)

    In the last few years imaging procedures became also important in the diagnosis of neuromuscular diseases. We examined more than 150 patients with different neuromuscular diseases with MRI. Conventional diagnostic procedures like EMG, muscle biopsy can not be replaced by imaging procedures. MRI gives the chance to get additional diagnostic informations. It is possible to determine exact distribution and intensity of pathological changes in the muscle. Inflammatory muscle diseases can be differrentiated by T1/T2 values from atrophic/dystrophic diseases. The resolving power is very high and allows the exact detection of affected areas even in a single muscle. This can help to reduce false negative muscle biopsies. This is very useful in children and young adults. MRI can be used for the early detection of genetic myopathies and neuropathies. MRI allows to examine all muscles, including the heart, bone artefacts are absent. Heart muscle involvement in neuromuscular diseases can directly be shown by this method without any risk for the patient. In addition P-spectroscopy can be done for better understanding of pathogenesis, especially if the exact distribution of pathological changes is known. (author)

  17. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    International Nuclear Information System (INIS)

    The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen

  18. Anestesia peribulbar com ropivacaína como alternativa ao bloqueio neuromuscular para facectomia em cães / Peribulbar anesthesia with ropivacaine as an alternative to neuromuscular blocking agents for cataract surgery in dogs

    Scientific Electronic Library Online (English)

    V.N.L.S., Oliva; A.L., Andrade; L., Bevilacqua; L.M., Matsubara; S.H.V., Perri.

    2010-06-01

    Full Text Available Desenvolveu-se uma técnica de bloqueio peribulbar comparando-a à técnica de anestesia oftálmica com bloqueio neuromuscular parcial em cães submetidos à facectomia extracapsular. Doze cães, de diferentes raças, foram alocados em dois grupos (G1 e G2) e anestesiados com acepromazina (0,05mg/kg, IV) e [...] propofol (5mg/kg, IV) e mantidos com isofluorano sob ventilação espontânea. Os cães do G1 receberam o bloqueio peribulbar com ropivacaína 0,75%, e os do G2 o bloqueio neuromuscular parcial com brometo de pancurônio (0,01mg/kg, IV). Utilizaram-se, como parâmetros comparativos, escores de posicionamento do globo ocular, controle do reflexo oculocardíaco e pressão intraocular (mmHg). Foi possível propor uma técnica eficaz para cães baseando-se na técnica de bloqueio peribulbar posterior realizada no homem. Em ambos os grupos, o globo ocular permaneceu centralizado. Não ocorreram alterações eletrocardiográficas atribuídas ao reflexo oculocardíaco. Houve redução significativa da pressão intraocular em G1 após o bloqueio (10,7±0,6 e 14,7±0,6). Conclui-se que o bloqueio peribulbar proporcionou condições cirúrgicas apropriadas para a realização da facectomia, com a vantagem de promover bloqueio sensitivo do olho. Abstract in english A peribulbar block technique was developed and its clinical efficacy was compared with neuromuscular blockade in dogs undergoing cataract surgery. Twelve dogs of different breeds were randomly and equally allocated in two groups. After given acepromazine (0.05mg/kg, IV), anesthesia was induced with [...] propofol (5mg/kg, IV) and maintained with isoflurane in oxygen during spontaneous breathing. A peribulbar block with 0.75% ropivacaine was performed in G1 dogs while partial neuromuscular blockade with pancuronium (0.01mg/kg IV) was provided in G2 dogs. Globe position scores, oculocardiac reflex, and intra-ocular pressure (mmHg) were evaluated at pre-defined intervals during surgery. Peribulbar blocks were successful performed according to posterior peribulbar block described in humans. In both groups, the globe was centralized and globe position scores did not differ between groups. The intra-ocular pressure was significantly lower in G1 after the block (10.7±0.6 vs 14.7±0.6). There were no electrocardiographycal changes attributed to the oculocardiac reflex. In conclusion, satisfactory surgical conditions were provided by the peribulbar block. This technique can be used as an alternative to the use of neuromuscular blocking agents in dogs undergoing cataract surgery, with the advantage of providing analgesia of the eye.

  19. Use of neuromuscular monitoring to detect prolonged effect of succinylcholine or mivacurium : three case reports

    DEFF Research Database (Denmark)

    Cassel, J; Staehr-Rye, A K

    2014-01-01

    Mutations in the butyrylcholinesterase gene can lead to a prolonged effect of the neuromuscular blocking agents, succinylcholine and mivacurium. If the anaesthesiologist is not aware of this condition, it may result in insufficient respiration after tracheal extubation. However, this can be avoided with the use of objective neuromuscular monitoring if used adequately. Three case reports of prolonged effect of succinylcholine or mivacurium were presented to illustrate the importance of neuromuscular monitoring during anaesthesia. In the first case, continuous intraoperative neuromuscular monitoring allowed a prolonged neuromuscular blockade to be discovered prior to tracheal extubation of the patient. The patient was extubated after successful reversal of the neuromuscular blockade. On the contrary, neuromuscular monitoring was not used during anaesthesia in the second patient; hence, the prolonged effect of the neuromuscular blocking agent was not discovered until after extubation. In the third patient, the lack of response to nerve stimulation was interpreted as a technical failure and the prolonged effect of succinylcholine was discovered when general anaesthesia was terminated. Both patients had insufficient respiration. They were therefore re-sedated, transferred to the intensive care unit and the tracheas were extubated after full recovery from neuromuscular blockade. We recommend the use of monitoring every time these agents are used, even with short-acting drugs like succinylcholine and mivacurium.

  20. Catalytic Synthesis of Oxygenates: Mechanisms, Catalysts and Controlling Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Kamil Klier; Richard G. Herman

    2005-11-30

    This research focused on catalytic synthesis of unsymmetrical ethers as a part of a larger program involving oxygenated products in general, including alcohols, ethers, esters, carboxylic acids and their derivatives that link together environmentally compliant fuels, monomers, and high-value chemicals. The catalysts studied here were solid acids possessing strong Br�������¸nsted acid functionalities. The design of these catalysts involved anchoring the acid groups onto inorganic oxides, e.g. surface-grafted acid groups on zirconia, and a new class of mesoporous solid acids, i.e. propylsulfonic acid-derivatized SBA-15. The former catalysts consisted of a high surface concentration of sulfate groups on stable zirconia catalysts. The latter catalyst consists of high surface area, large pore propylsulfonic acid-derivatized silicas, specifically SBA-15. In both cases, the catalyst design and synthesis yielded high concentrations of acid sites in close proximity to one another. These materials have been well-characterization in terms of physical and chemical properties, as well as in regard to surface and bulk characteristics. Both types of catalysts were shown to exhibit high catalytic performance with respect to both activity and selectivity for the bifunctional coupling of alcohols to form ethers, which proceeds via an efficient SN2 reaction mechanism on the proximal acid sites. This commonality of the dual-site SN2 reaction mechanism over acid catalysts provides for maximum reaction rates and control of selectivity by reaction conditions, i.e. pressure, temperature, and reactant concentrations. This research provides the scientific groundwork for synthesis of ethers for energy applications. The synthesized environmentally acceptable ethers, in part derived from natural gas via alcohol intermediates, exhibit high cetane properties, e.g. methylisobutylether with cetane No. of 53 and dimethylether with cetane No. of 55-60, or high octane properties, e.g. diisopropylether with blending octane No. of 105, and can replace aromatics in liquid fuels.

  1. Changes in neurotransmitter release at a neuromuscular junction of the lobster caused by cannabinoids.

    Science.gov (United States)

    Turkanis, S A; Karler, R

    1988-07-01

    In vitro intracellular recording techniques were used on an excitatory neuromuscular junction of a walking-limb stretcher muscle of the lobster in order to define the synaptic pharmacology of delta-9-tetrahydrocannabinol (THC), 11-hydroxy-THC and cannabidiol. Delta-9-tetrahydrocannabinol and 11-hydroxy-THC, in relatively small concentrations, increased the amplitude of the excitatory junctional potential and the mean quantum content of a muscle fiber, whereas larger concentrations produced depression. In contrast, cannabidiol reduced the excitatory junctional potential and the mean quantum content. All three cannabinoids, however, depressed the amplitude of the spontaneous miniature junctional potential. The changes in mean quantum content point to a presynaptic site of action for the drug, while the reduction of the amplitude of the miniature junctional potential presumes a postsynaptic site. Such findings suggest synaptic mechanisms and sites of action for the central excitatory and depressant properties of the cannabinoids. PMID:2901683

  2. Laboratory Investigations into Micromechanical Mechanisms Controlling Earthquake Nucleation

    Science.gov (United States)

    Selvadurai, P. A.; Glaser, S. D.; Kiwan, R. H.

    2013-12-01

    Improving our understanding of factors controlling spontaneous shear rupture nucleation on a frictional fault would help better define the important physical processes contributing to earthquake rupture and faulting. Our current laboratory investigations quantify the local stress states on a laboratory fault, which control the transition of sliding from stable (quasi-static) to unstable (dynamic), commonly referred to as earthquake nucleation. A fault is experimentally modeled using two Poly(methyl methacrylate) samples in a direct shear configuration. During nucleation, we observed sudden, elastodynamic stress changes using an array of 16 acoustic emission (AE) sensors. Measurements of absolute displacement from these sensors allowed us to characterize general source mechanics using moment tensor inversion. This technique is widely used in seismology and we observe double-couple (DC) focal mechanisms; a source commonly used to characterize in situ earthquakes. During nucleation, we sometimes observe swarms of smaller, ';foreshock' earthquakes (Mw ~ -7), localized in time and space, prior to the incipient mainshock (Mw ~ -3.25). In general, the local perturbations in the stress field induced by the stress drop (??) from a single foreshock was insufficient to cause the subsequent foreshock at the spatial distances recorded experimentally. This implied that the underlying process driving the foreshock sequence (and eventual mainshock) was aseismic slip over the nucleation zone recorded using non-contact sensors. Spatio-temporal distributions of the foreshocks and the near-fault aseismic motions were shown to be directly related to: i) the rate at which the average bulk stress accumulates across the fault (d?f /dt) and ii) the heterogeneity of normal stress caused by the irregular distribution of asperities, respectively. (A) Locations of the foreshocks (FS1-FS9) determined using p-wave travel times from multiple AE sensors. The locations were superimposed on interfacial pressure measurements obtained using pressure sensitive film (high normal stresses appear as red). (B) Enhanced view of the location of FS6 on the pressure sensitive film. (C) Results of moment tensor inversion (red) fitting the experimental data (black) measured by five AE sensors (PZ7-PZ12) for FS6. The double-couple source was representative of a Mw = -7.0 earthquake.

  3. Immortalized pathological human myoblasts: towards a universal tool for the study of neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Mamchaoui Kamel

    2011-11-01

    Full Text Available Abstract Background Investigations into both the pathophysiology and therapeutic targets in muscle dystrophies have been hampered by the limited proliferative capacity of human myoblasts. Isolation of reliable and stable immortalized cell lines from patient biopsies is a powerful tool for investigating pathological mechanisms, including those associated with muscle aging, and for developing innovative gene-based, cell-based or pharmacological biotherapies. Methods Using transduction with both telomerase-expressing and cyclin-dependent kinase 4-expressing vectors, we were able to generate a battery of immortalized human muscle stem-cell lines from patients with various neuromuscular disorders. Results The immortalized human cell lines from patients with Duchenne muscular dystrophy, facioscapulohumeral muscular dystrophy, oculopharyngeal muscular dystrophy, congenital muscular dystrophy, and limb-girdle muscular dystrophy type 2B had greatly increased proliferative capacity, and maintained their potential to differentiate both in vitro and in vivo after transplantation into regenerating muscle of immunodeficient mice. Conclusions Dystrophic cellular models are required as a supplement to animal models to assess cellular mechanisms, such as signaling defects, or to perform high-throughput screening for therapeutic molecules. These investigations have been conducted for many years on cells derived from animals, and would greatly benefit from having human cell models with prolonged proliferative capacity. Furthermore, the possibility to assess in vivo the regenerative capacity of these cells extends their potential use. The innovative cellular tools derived from several different neuromuscular diseases as described in this report will allow investigation of the pathophysiology of these disorders and assessment of new therapeutic strategies.

  4. The effect of a carbohydrate mouth-rinse on neuromuscular fatigue following cycling exercise.

    Science.gov (United States)

    Jeffers, Robert; Shave, Robert; Ross, Emma; Stevenson, Emma J; Goodall, Stuart

    2015-06-01

    Carbohydrate (CHO) mouth-rinsing, rather than ingestion, is known to improve performance of high-intensity (>75% maximal oxygen uptake) short-duration (?1 h) cycling exercise. Mechanisms responsible for this improvement, however, are unclear. The present study aimed to investigate the effect of a CHO mouth-rinse on cycling time-trial (TT) performance and mechanisms of fatigue. On 2 separate occasions, 9 male cyclists (mean ± SD; maximal oxygen uptake, 61 ± 5 mL·kg(-1)·min(-1)) completed 45 min at 70% maximum power output (preload) followed by a 15-min TT. At 7.5-min intervals during the preload and TT, participants were given either a tasteless 6.4% maltodextrin mouth-rinse (CHO) or water (placebo (PLA)) in a double-blind, counterbalanced fashion. Isometric knee-extension force and electromyographic responses to percutaneous electrical stimulation and transcranial magnetic stimulation were measured before, after the preload, and after the TT. There were greater decreases in maximal voluntary contraction after the TT in PLA (20% ± 10%) compared with the CHO (12% ± 8%; P = 0.019). Voluntary activation was reduced following exercise in both trials, but did not differ between conditions (PLA -10% ± 8% vs. CHO -5% ± 4%; P = 0.150). The attenuation in the manifestation of global fatigue did not translate into a TT improvement (248 ± 23 vs. 248 ± 39 W for CHO and PLA, respectively). Furthermore, no differences in heart rate or ratings of perceived exertion were found between the 2 conditions. These data suggest that CHO mouth-rinsing attenuates neuromuscular fatigue following endurance cycling. Although these changes did not translate into a performance improvement, further investigation is required into the role of CHO mouth-rinse in alleviating neuromuscular fatigue. PMID:25923580

  5. Weathering controls on mechanisms of carbon storage in grassland soils

    Energy Technology Data Exchange (ETDEWEB)

    Masiello, C.A.; Chadwick, O.A.; Southon, J.; Torn, M.S.; Harden, J.W.

    2004-09-01

    On a sequence of soils developed under similar vegetation, temperature, and precipitation conditions, but with variations in mineralogical properties, we use organic carbon and 14C inventories to examine mineral protection of soil organic carbon. In these soils, 14C data indicate that the creation of slow-cycling carbon can be modeled as occurring through reaction of organic ligands with Al3+ and Fe3+ cations in the upper horizons, followed by sorption to amorphous inorganic Al compounds at depth. Only one of these processes, the chelation of Al3+ and Fe3+ by organic ligands, is linked to large carbon stocks. Organic ligands stabilized by this process traverse the soil column as dissolved organic carbon (both from surface horizons and root exudates). At our moist grassland site, this chelation and transport process is very strongly correlated with the storage and long-term stabilization of soil organic carbon. Our 14C results show that the mechanisms of organic carbon transport and storage at this site follow a classic model previously believed to only be significant in a single soil order (Spodosols), and closely related to the presence of forests. The presence of this process in the grassland Alfisol, Inceptisol, and Mollisol soils of this chronosequence suggests that this process is a more significant control on organic carbon storage than previously thought.

  6. Predictive mechanisms in the control of contour following

    Science.gov (United States)

    Tramper, Julian J.; Flanders, Martha

    2013-01-01

    In haptic exploration, when running a fingertip along a surface, the control system may attempt to anticipate upcoming changes in curvature in order to maintain a consistent level of contact force. Such predictive mechanisms are well known in the visual system, but have yet to be studied in the somatosensory system. Thus the present experiment was designed to reveal human capabilities for different types of haptic prediction. A robot arm with a large 3D workspace was attached to the index fingertip and was programmed to produce virtual surfaces with curvatures that varied within and across trials. With eyes closed, subjects moved the fingertip around elliptical hoops with flattened regions or Limaçon shapes, where the curvature varied continuously. Subjects anticipated the corner of the flattened region rather poorly, but for the Limaçon shapes they varied finger speed with upcoming curvature according to the two-thirds power law. Furthermore, although the Limaçon shapes were randomly presented in various 3D orientations, modulation of contact force also indicated good anticipation of upcoming changes in curvature. The results demonstrate that it is difficult to haptically anticipate the spatial location of an abrupt change in curvature, but smooth changes in curvature may be facilitated by anticipatory predictions. PMID:23649968

  7. Autonomic control mechanism of maximal lower body negative pressure application.

    Science.gov (United States)

    Selvaraj, Nandakumar; Shelley, Kirk H; Silverman, David G; Stachenfeld, Nina; Chon, Ki H

    2012-01-01

    Autonomic control mechanisms during progressive hemorrhage in humans remain complex and unclear. The present study investigates the autonomic reflexes during maximal application of lower body negative pressure (LBNP) that mimics severe hemorrhage in conscious human subjects (n=10) using analyses of heart rate variability (HRV) and systolic blood pressure variability (BPV) and baroreflex sensitivity. Spectral analysis of HRV included linear power spectral density (PSD), and nonlinear principal dynamic modes (PDM) methods. The maximal LBNP application decreased (Ppressures (PP), root mean square successive differences, normalized high frequency (HF) power of HRV, and transfer function gains at low frequency (LF) and HF bands. Meanwhile, increases (Pblood pressure (DBP), LFHRV, LF/HFHRV, and sympathetic activity of HRV using PDM were observed during maximal LBNP tolerance. After the termination of LBNP, no significant changes (P>0.05) were found in all the parameters except DBP and PP between recovery and baseline conditions. Rapid application of maximal LBNP that simulated severe hemorrhage was found to be associated with unloading of baroreflex mediated increased sympathetic reflex. PMID:23366586

  8. Numerical Study for Separation Control Mechanism of Impulse Actuation

    Science.gov (United States)

    Jee, Solkeun; Lopez Mejia, Omar; Moser, Robert

    2011-11-01

    A flow control mechanism by which impulse actuation delays flow separation is investigated numerically. The actuation produces a short-duration high-velocity jet, which exploits the sensitivity of separated flow to momentary actuation. Previous experimental and numerical studies have shown that this actuation disrupt the separated region on a stalled airfoil, reattaching the boundary layer. This actuation, which is spatially as well as temporally localized, globally alters the baseline flow over long time (100 times the actuation time). The computations reported here provide detailed flow structure associated with the actuation and the separated flow. The flow modification includes four major stages following an impulse actuation: disruption of the separated region, vorticity extraction from the boundary layer, the reattachment and return to stall. It was hypothesized that the disruption of the separating layer is resulted from interactions with the vortices produced by the actuation. This was tested by artificially introducing similar vortices up- and down-stream of the nominal separation. Results are consistent with the hypothesis and show that a complete disruption of the separated shear layer is required for the desired flow modifications. Supported by AFOSR and ORAU.

  9. Similar increases in strength after short-term resistance training due to different neuromuscular adaptations in young and older men.

    Science.gov (United States)

    Walker, Simon; Häkkinen, Keijo

    2014-11-01

    This study investigated whether differences in neuromuscular performance and muscle hypertrophy occur between young and older men. Twenty-three young (29 ± 9 years) and 26 older men (64 ± 8 years) completed 10 weeks of high-volume, medium load "hypertrophic" resistance training with low frequency (twice per week) with 10 young (34 ± 11 years) and 11 older men (65 ± 3 years) acting as nontraining control subjects. Training consisted of 2-5 sets of 8-14 repetitions (1- to 2-minute rest). Lower-limb dynamic (leg press) and isometric maximum leg extension force, as well as lower-limb lean mass and vastus lateralis cross-sectional area were assessed before and after the training period. Training led to significant increases in 1 repetition maximum (1RM) leg press performance in both training groups (young: 13 ± 7%, p < 0.001; older: 14 ± 9%, p < 0.001). Performance improvements were accompanied by increased muscle activation, assessed by voluntary activation level (29 ± 51%, p ? 0.05) and electromyography amplitude (35 ± 51%, p < 0.01) in older men only. Conversely, only young men showed significantly increased lower-limb lean mass (2.4 ± 2.5%, p < 0.01). Furthermore, increases in 1RM performance and lower-limb lean mass were significantly related in young men only (r = 0.524, p = 0.01, n = 23). In conclusion, although high-volume, medium load "hypertrophic" resistance training may induce similar improvements in strength between young and older men, it appears that different mechanisms underpin these improvements. PMID:25051001

  10. Genetic modifiers of ambulation in the cooperative international Neuromuscular research group Duchenne natural history study

    Science.gov (United States)

    Bello, Luca; Kesari, Akanchha; Gordish-Dressman, Heather; Cnaan, Avital; Morgenroth, Lauren P; Punetha, Jaya; Duong, Tina; Henricson, Erik K; Pegoraro, Elena; McDonald, Craig M; Hoffman, Eric P

    2015-01-01

    Objective We studied the effects of LTBP4 and SPP1 polymorphisms on age at loss of ambulation (LoA) in a multiethnic Duchenne muscular dystrophy (DMD) cohort. Methods We genotyped SPP1 rs28357094 and LTBP4 haplotype in 283 of 340 participants in the Cooperative International Neuromuscular Research Group Duchenne Natural History Study (CINRG-DNHS). Median ages at LoA were compared by Kaplan–Meier analysis and log-rank test. We controlled polymorphism analyses for concurrent effects of glucocorticoid corticosteroid (GC) treatment (time-varying Cox regression) and for population stratification (multidimensional scaling of genome-wide markers). Results Hispanic and South Asian participants (n?=?18, 41) lost ambulation 2.7 and 2 years earlier than Caucasian subjects (p?=?0.003, treatment and population stratification appears crucial in assessing genetic modifiers in DMD. PMID:25641372

  11. Síndrome de Tako-Tsubo em decorrência de bloqueio neuromuscular residual: relato de caso Síndrome de Tako-Tsubo como consecuencia de bloqueo neuromuscular residual: relato de caso Tako-Tsubo syndrome secondary to residual neuromuscular blockade: case report

    OpenAIRE

    Marcos Guilherme Cunha Cruvinel; Fabiano Soares Carneiro; Roberto Cardoso Bessa Junior; Silva, Yerkes Pereira E.; Mirna Bastos Marques

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: A síndrome de Tako-Tsubo é uma complicação pós-operatória rara, com mortalidade em torno de 5%. O objetivo deste relato é apresentar o bloqueio neuromuscular residual como fator desencadeante da referida síndrome, discutir sobre a mesma e alertar sobre o bloqueio neuromuscular residual. RELATO DO CASO: Paciente do sexo feminino, 61 anos, estado físico ASA I, submetida à anestesia geral associada a bloqueio paravertebral cervical para reparo artroscópico d...

  12. Bloqueantes neuromusculares: en pro del uso adecuado / Neuromuscular Blocking Agents: an Argument for Their Adequate Use

    Scientific Electronic Library Online (English)

    Roberto Carlo, Rivera Díaz; Johan Sebastián, Rivera Díaz.

    2011-10-01

    Full Text Available Introducción. En el uso de bloqueantes musculares hay controversia: a favor está la necesidad de garantizar una adecuada intubación de manera rápida en los casos de urgencia y facilitar el campo quirúrgico al cirujano, además de otros beneficios reportados; en contra están los efectos adversos y los [...] riesgos publicados. Objetivo. Promover la buena práctica médica en el uso de los bloqueantes musculares. Materiales y métodos. Revisión de la literatura científica disponible sobre el tema enfocada a indicaciones, riesgos, beneficios y monitoreo. Resultados. La indicación absoluta de bloqueante muscular es la intubación de secuencia rápida. Existen otros usos recomendados: intubación en cirugía electiva y ciertos tipos de cirugía y situaciones especiales (SDRA, TECAR, hipertensión intraabdominal, hipertensión intracraneana). Por otra parte, los bloqueantes pueden ser evitados en muchas anestesias generales. Lo más importante es conocer sus indicaciones y riesgos, y usarlos de manera adecuada. Conclusión. Hay situaciones en las que se puede evitar el uso de los bloqueantes, pero hay otras en las que son indispensables o están recomendados. Si van a ser usados, debe elegirse el bloqueante ideal para cada paciente, en el momento oportuno, con la dosis ajustada y siempre con el monitoreo apropiado. Abstract in english Introduction. The debate regarding the use of muscle relaxants is still ongoing, with arguments against such as their adverse effects and published risks, and arguments in favor such as the need to ensure rapid and adequate intubation in emergency cases, the benefit of an easy surgical field for the [...] surgeon, and other reported benefits. Objective. To review aspects associated with the adequate use of neuromuscular blocking agents in anesthesia. Materials and methods. Narrative review of the scientific literature available on the subject that focused on indications, risks, benefits and monitoring. Results. The absolute indication of muscle relaxants is rapid-sequence intubation, but there are other situations where they are recommended: Intubation in elective surgery, certain types of special surgical procedures and situations (ARDS, electroconvulsive therapy, intra-abdominal hypertension, intracranial hypertension), and they may be avoided in many general anesthesia cases. Most important is to be aware of their indications, risks and adequate use. Conclusion. In conclusion, there are situations where the use of muscle relaxants may be avoided, but there are also instances were they are a requirement and it is in those cases where they are recommended. Therefore, if they are to be used, they must be the ideal choice for the individual patient at the right time and the right dose, and always under appropriate monitoring.

  13. The imperative for controlled mechanical stresses in unraveling cellular mechanisms of mechanotransduction

    Directory of Open Access Journals (Sweden)

    Sorkin Adam M

    2006-05-01

    Full Text Available Abstract Background In vitro mechanotransduction studies are designed to elucidate cell behavior in response to a well-defined mechanical signal that is imparted to cultured cells, e.g. through fluid flow. Typically, flow rates are calculated based on a parallel plate flow assumption, to achieve a targeted cellular shear stress. This study evaluates the performance of specific flow/perfusion chambers in imparting the targeted stress at the cellular level. Methods To evaluate how well actual flow chambers meet their target stresses (set for 1 and 10 dyn/cm2 for this study at a cellular level, computational models were developed to calculate flow velocity components and imparted shear stresses for a given pressure gradient. Computational predictions were validated with micro-particle image velocimetry (?PIV experiments. Results Based on these computational and experimental studies, as few as 66% of cells seeded along the midplane of commonly implemented flow/perfusion chambers are subjected to stresses within ±10% of the target stress. In addition, flow velocities and shear stresses imparted through fluid drag vary as a function of location within each chamber. Hence, not only a limited number of cells are exposed to target stress levels within each chamber, but also neighboring cells may experience different flow regimes. Finally, flow regimes are highly dependent on flow chamber geometry, resulting in significant variation in magnitudes and spatial distributions of stress between chambers. Conclusion The results of this study challenge the basic premise of in vitro mechanotransduction studies, i.e. that a controlled flow regime is applied to impart a defined mechanical stimulus to cells. These results also underscore the fact that data from studies in which different chambers are utilized can not be compared, even if the target stress regimes are comparable.

  14. Effect of Low Frequency Neuromuscular Electrical Stimulation on Glucose Profile of Persons with Type 2 Diabetes: A Pilot Study

    OpenAIRE

    Jabbour, Georges; Belliveau, Lise; Probizanski, David; Newhouse, Ian; McAuliffe, Jim; Jakobi, Jennifer; Johnson, Michel

    2015-01-01

    The purpose of this study was to examine the effect of low-frequency neuromuscular electrical stimulation (NMES) on glucose profile in persons with type 2 diabetes mellitus (T2DM). Eight persons with T2DM (41 to 65 years) completed a glucose tolerance test with and without NMES delivered to the knee extensors for a 1-hour period at 8 Hz. Three blood samples were collected: at rest, and then 60 and 120 minutes after consumption of a glucose load on the NMES and control days. In NMES groups glu...

  15. Synthesis of ultra-short-acting neuromuscular blocker GW 0430: a remarkably stereo- and regioselective synthesis of mixed tetrahydroisoquinolinium chlorofumarates.

    Science.gov (United States)

    Samano, V; Ray, J A; Thompson, J B; Mook, R A; Jung, D K; Koble, C S; Martin, M T; Bigham, E C; Regitz, C S; Feldman, P L; Boros, E E

    1999-12-16

    [formula: see text] The stereo- and regioselective synthesis of ultra-short-acting nondepolarizing neuromuscular blocker GW 0430 (5a) is described. Key steps involved the enantioselective transfer hydrogenation of imine 8 employing Noyori's catalyst, the stereoselective crystallization and methanolysis of trans-bataines 11 and 12, and the stereo- and regioselective trans elimination of hydrogen chloride from 14. The latter transformation allowed complete control of the position of the chloro substituent and stereochemistry at the double bond of the linker in 15. PMID:10836056

  16. Neuromuscular determinants of maximum walking speed in well-functioning older adults

    Science.gov (United States)

    Maximum walking speed may offer an advantage over usual walking speed for clinical assessment of age-related declines in mobility function that are due to neuromuscular impairment. The objective of this study was to determine the extent to which maximum walking speed is affected by neuromuscular fun...

  17. Limitations of sniff nasal pressure in patients with severe neuromuscular weakness

    OpenAIRE

    Hart, N.; M. Polkey; Sharshar, T; Falaize, L; Fauroux, B.; Raphael, J.; Lofaso, F

    2003-01-01

    Background: Inspiratory muscle strength in patients with neuromuscular disorders can be assessed using sniff inspiratory nasal pressure (Pnsn) and maximum inspiratory mouth pressure (PImax). However, the relative merits of Pnsn against PImax are not known in patients with severe neuromuscular disease.

  18. Does neuromuscular activation capability explain mobility function among older men and women?

    Science.gov (United States)

    Age-related impairment of neuromuscular activation has been shown to contribute to weakness in older adults. However, it is unclear to what extent impaired neuromuscular activation independently accounts for decline of mobility function. The hypothesis of this study is that capability to produce rap...

  19. Does quadriceps neuromuscular activation capability explain mobility function among older men and women?

    Science.gov (United States)

    Age-related impairment of neuromuscular activation has been shown to contribute to weakness in older adults. However, it is unclear to what extent impaired neuromuscular activation independently accounts for decline of mobility function. The hypothesis of this study is that capability to produce rap...

  20. Effect of Dex medetomidine on Neuromuscular Blockade in Patients Undergoing Complex Major Abdominal or Pelvic Surgery

    International Nuclear Information System (INIS)

    Dex medetomidine is a highly selective ?2 agonist with anesthetic, analgesic and sympatholytic properties. Its neuromuscular effects in humans are unknown. This study evaluates the effect of dex medetomidine on neuromuscular block and hemodynamics during thiopental/ isoflurane anesthesia for patients with complex abdominal or pelvic surgery. Patients and methods: During thiopental/isoflurane anesthesia, the rocuronium infusion rate was adjusted in 20 complex surgery patients to maintain a stable first response (T1) in the train of four sequence of 50% ± 3 of the pre-rocuronium value. Dex medetomidine was then administered by infusion pump, targeting a plasma dex medetomidine concentration of 0.6 ng/dL for 45 min. The evoked mechanical responses of the adductor pollicis responses (T1 response and T4/T1 ratio), systolic blood pressure, diastolic blood pressure and heart rate (HR) were measured during the dex medetomidine infusion using repeated measures analysis of variance. Plasma levels ranged from 0.73 to 1.38 ng/mL. Results: T1 values decreased during the infusion from 55(?2 to 38±9 ((?< 0.05). T4/Tl values did not change during the infusion. Dex medetomidine increased SBP (?< 0.001) and decreased HR ((?< 0.05) (10 min median values) during the infusion compared with values before the infusion. This study demonstrated that dex medetomidine decreased T1, increased SBP and decreased HR during thiopental/isoflurane anesthesia. Conclusion: We conclude that dex meConclusion: We conclude that dex medetomidine induced direct vasoconstriction may alter pharmacokinetics of rocuronium, therefore increasing plasma rocuronium concentration. Although these effects were statistically significant, further studies should be held for understanding and characterizing the peripheral vasoconstrictive effects of a2 agonists that allow better management and determination of drug dosing regimens

  1. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Thomas Niemeyer

    2013-02-01

    Full Text Available Surgery in patients with neuromuscular scoliosis is associated with a higher rate of complications. It is still controversially discussed whether the patients truly benefit from deformity correction. The purpose of this study is to investigate if the quality of life has been improved and if the patients and their caregivers are satisfied with the results of surgery. This is a retrospective clinical outcome study of 46 patients with neuromuscular scoliosis which were treated with primary stable posterior pedicle screw instrumentation and correction. To achieve fusion only autologous bone was used. Follow up was minimum 2 years and maximum 5 years with an average of 36 months. The patients and/or their caregivers received a questionnaire based on the PEDI (pediatric disability inventory and the GMFS (gross motor function score. The patients (and their caregivers were also asked if the quality of life has improved after surgery. Only 32 of 46 patients answered the questionnaire. The answers showed a high approval-rate regarding the patients satisfaction with the surgery and the improvement of quality of life. The questionnaire could be answered from 1 (I do not agree to 4 (I completely agree. The average agreement to the following statements was: i the quality of life has improved: 3.35; ii I am satisfied with surgery: 3.95; iii the operation has fulfilled my expectations: 3.76. The average age at surgery was 12.7 years. The mean pre-operative cobb-angle of the main curve was 83.1° with a correction post-operatively to a mean of 36.9° and 42.6° at final follow-up. That is an average correction of 56.9%. Although spinal fusion in neuromuscular scoliosis is associated with a higher rate of complications our results show that the patients and their caregivers are satisfied with the operation and the quality of life has improved after surgery.

  2. Zero-cross detecting technology in control element drive mechanism control system of PWR

    International Nuclear Information System (INIS)

    Control Element Drive Mechanism Control System (CEDMCS) plays a decisive role in regulating the reactor power and shutting down the reactor in the trip condition. But, due to the failure of CEDMCS, the operating plants have had many experiences such as unexpected reactor trip or interruption during normal plant operation. To prevent those kinds of problems, it is required to improve control logic. Zero cross detection cards in CEDMCS could be made trouble which cause unexpected reactor trip resulted from fluctuating frequency of input signal coming from from M/G set. Some of the problems have been solved by modifying zero cross detection card circuit, but the other problems, such as output voltage variation resulted from input frequency change. Because current zero-cross detector was designed by analog technology, it was difficult to resolve output voltage variation problem. In this report the zero cross detector was improved to resolve voltage fluctuating problem by using new devices such as digital noise filtering circuit is better than old one. If suggested detector is applied to plant, it is possible to use it under House Load Operation because stable output voltage can be generated by new zero-cross detector. (author). 3 tabs., 21 figs., 10 refs

  3. Zero-cross detecting technology in control element drive mechanism control system of PWR

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Byeong Moon; Lee, Byeong Joo; Chang, Ik Ho; Jung, Ho Chang; Lee, Joong Sup

    1996-06-01

    Control Element Drive Mechanism Control System (CEDMCS) plays a decisive role in regulating the reactor power and shutting down the reactor in the trip condition. But, due to the failure of CEDMCS, the operating plants have had many experiences such as unexpected reactor trip or interruption during normal plant operation. To prevent those kinds of problems, it is required to improve control logic. Zero cross detection cards in CEDMCS could be made trouble which cause unexpected reactor trip resulted from fluctuating frequency of input signal coming from from M/G set. Some of the problems have been solved by modifying zero cross detection card circuit, but the other problems, such as output voltage variation resulted from input frequency change. Because current zero-cross detector was designed by analog technology, it was difficult to resolve output voltage variation problem. In this report the zero cross detector was improved to resolve voltage fluctuating problem by using new devices such as digital noise filtering circuit is better than old one. If suggested detector is applied to plant, it is possible to use it under House Load Operation because stable output voltage can be generated by new zero-cross detector. (author). 3 tabs., 21 figs., 10 refs.

  4. High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players:A cluster randomised trial

    OpenAIRE

    Steffen, Kathrin; Emery, Carolyn; Romiti, Maria; KANG, JIAN; Bizzini, Mario; Dvorak, Jiri; Finch, Caroline; Meeuwisse, Willem

    2013-01-01

    A protective effect on injury risk in youth sports through neuromuscular warm-up training routines has consistently been demonstrated. However, there is a paucity of information regarding the quantity and quality of coach-led injury prevention programmes and its impact on the physical performance of players. The aim of this cluster-randomised controlled trial was to assess whether different delivery methods of an injury prevention programme (FIFA 11+) to coaches could improve player performan...

  5. Feasibility of neuromuscular training in patients with severe hip or knee OA: The individualized goal-based NEMEX-TJR training program

    OpenAIRE

    Link Anne; Ageberg Eva; Roos Ewa M

    2010-01-01

    Abstract Background Although improvements are achieved by general exercise, training to improve sensorimotor control may be needed for people with osteoarthritis (OA). The aim was to apply the principles of neuromuscular training, which have been successfully used in younger and middle-aged patients with knee injuries, to older patients with severe hip or knee OA. We hypothesized that the training program was feasible, determined as: 1) at most acceptable self-reported pain following training...

  6. The Effect of NeuroMuscular Electrical Stimulation on Quadriceps Strength and Knee Function in Professional Soccer Players: Return to Sport after ACL Reconstruction

    OpenAIRE

    Taradaj, J.; T. Halski; Kucharzewski, M.; Walewicz, K.; Smykla, A.; M. Ozon; L. Slupska; R. Dymarek; Ptaszkowski, K.; J. Rajfur; M. Pasternok

    2013-01-01

    The aim of this study was to assess the clinical efficacy and safety of NMES program applied in male soccer players (after ACL reconstruction) on the quadriceps muscle. The 80 participants (NMES = 40, control = 40) received an exercise program, including three sessions weekly. The individuals in NMES group additionally received neuromuscular electrical stimulation procedures on both right and left quadriceps (biphasic symmetric rectangular pulses, frequency of impulses: 2500?Hz, and train of ...

  7. Management Control Systems and Job Stressors : Identifying the mechanisms by which budget and KPI controls influence job stressors

    OpenAIRE

    Vilhelmsson, Lars-erik; Fridlund, Eric

    2012-01-01

    This exploratory study explores how management control systems influence job stressors. More specifically, this study seeks to unravel the mechanisms by which budget and KPI controls influence job stressors. In our study we use the well-established Job Demand - Job Control - Job Support Model to compare previous research on job stressors with our case study. We interview Controllers and Managers at a manufacturing company within the industrial industry. Data was collected through semi-structu...

  8. Dinámica de transmisión del Dengue clásico con control mecánico y profilaxis / Classical dengue transmission dynamics involving mechanical control and prophylaxis

    Scientific Electronic Library Online (English)

    Hernán D, Toro-Zapata; Leonardo D, Restrepo; Juan G, Vergaño-Salazar; Aníbal, Muñoz-Loaiza.

    1020-10-01

    Full Text Available Se modela la dinámica de transmisión del dengue clásico en una región endémica considerando el uso de medidas preventivas y de control mecánico en la reducción de la transmisión de la enfermedad. Se plantea un sistema de ecuaciones diferenciales ordinarias que describe la dinámica y mediante simulac [...] ión numérica se determina su evolución en el tiempo. Se comparan diferentes estrategias de control mecánico y profilaxis con la situación sin control. Se determina el número básico de reproducción R0, mostrando que si R0 > 1 hay un alto riesgo de epidemia y que en caso contrario la enfermedad se mantiene en niveles de bajo impacto; estos resultados se contratan con los obtenidos numéricamente. Se concluye que si bien la profilaxis y el control mecánico por si solos brindan resultados efectivos en el control de la enfermedad, cuando se combinan ambos controles los niveles de infección se ven reducidos significativamente. Niveles de control mecánico y profilaxis cercanos al 60 % son los que brindan resultados adecuados en el control del brote de dengue. Abstract in english Dengue fever transmission dynamics were studied in an endemic region considering the use of preventative measures and mechanical control in reducing transmission of the disease. A system of ordinary differential equations was proposed, describing the dynamics and their evolution as determined by num [...] erical simulation. Different mechanical control and prophylaxis strategies were compared to the situation without control. The basic reproduction number R0 was determined R0 to show that if R0 > 1 there would be a risk of an epidemic and otherwise the disease would have low impact levels. The basic reproduction number helps determine the dynamics' future pattern and contrast the results so obtained with those obtained numerically. It was concluded that although prophylaxis and mechanical control alone provide effective results in controlling the disease, if both controls are combined then infection levels become significantly reduced. Around 60 % mechanical control and prevention levels are needed to provide suitable results in controlling dengue outbreaks.

  9. Dinámica de transmisión del Dengue clásico con control mecánico y profilaxis Classical dengue transmission dynamics involving mechanical control and prophylaxis

    Directory of Open Access Journals (Sweden)

    Hernán D Toro-Zapata

    2010-12-01

    Full Text Available Se modela la dinámica de transmisión del dengue clásico en una región endémica considerando el uso de medidas preventivas y de control mecánico en la reducción de la transmisión de la enfermedad. Se plantea un sistema de ecuaciones diferenciales ordinarias que describe la dinámica y mediante simulación numérica se determina su evolución en el tiempo. Se comparan diferentes estrategias de control mecánico y profilaxis con la situación sin control. Se determina el número básico de reproducción R0, mostrando que si R0 > 1 hay un alto riesgo de epidemia y que en caso contrario la enfermedad se mantiene en niveles de bajo impacto; estos resultados se contratan con los obtenidos numéricamente. Se concluye que si bien la profilaxis y el control mecánico por si solos brindan resultados efectivos en el control de la enfermedad, cuando se combinan ambos controles los niveles de infección se ven reducidos significativamente. Niveles de control mecánico y profilaxis cercanos al 60 % son los que brindan resultados adecuados en el control del brote de dengue.Dengue fever transmission dynamics were studied in an endemic region considering the use of preventative measures and mechanical control in reducing transmission of the disease. A system of ordinary differential equations was proposed, describing the dynamics and their evolution as determined by numerical simulation. Different mechanical control and prophylaxis strategies were compared to the situation without control. The basic reproduction number R0 was determined R0 to show that if R0 > 1 there would be a risk of an epidemic and otherwise the disease would have low impact levels. The basic reproduction number helps determine the dynamics' future pattern and contrast the results so obtained with those obtained numerically. It was concluded that although prophylaxis and mechanical control alone provide effective results in controlling the disease, if both controls are combined then infection levels become significantly reduced. Around 60 % mechanical control and prevention levels are needed to provide suitable results in controlling dengue outbreaks.

  10. MRI in neuromuscular disorders; MRT bei neuromuskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Fischmann, Arne [Klinik St. Anna, Luzern (Switzerland). Inst. fuer Radiologie und Nuklearmedizin; Fischer, Dirk [Kantonsspital Bruderholz (Switzerland)

    2014-03-15

    Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

  11. Nonextensivity and self-affinity in the mammalian neuromuscular junction

    Science.gov (United States)

    da Silva, A. J.; Lima, R. F.; Moret, M. A.

    2011-10-01

    We study time series and the spontaneous miniature end-plate potentials (MEPPs) of mammals recorded at neuromuscular junctions using two different approaches: generalized thermostatistics and detrended fluctuation analysis (DFA). Classical concepts establish that the magnitude of these potentials is characterized by Gaussian statistics and that their intervals are randomly displayed. First we show that MEPP distributions adequately satisfy the q-Gaussian distributions that maximize the Tsallis entropy, indicating their nonextensive and nonequilibrium behavior. We then examine the intervals between the miniature potentials via DFA, where the profile of the intervals between events configures a deviation from the expected random behavior. Some possible physiological substrates for these findings are discussed.

  12. Diagnostics of neuromuscular diseases with the aid of computerized tomography

    International Nuclear Information System (INIS)

    In this article the diagnosis of neuromuscular diseases with the aid of computerized tomography is treated. Computerized tomography of skeletal muscles give no information which is pathognomonic for particular diseases. But the technique can be used in the following aspects: to choose a muscle for a biopsy; when it is not possible to examine the function of a muscle, a CT scan can visualize morphological deviations; in the differentiation of muscle hypertrophy and pseudo-hypertrophy. For some cases as Becker-type muscular dystrophy, facioscapulohumeral dystrophy and Kugelberg-Welander type spinal muscular atrophy computerized tomography gives characteristic images. 10 refs.; 6 figs

  13. Bone health and associated metabolic complications in neuromuscular diseases.

    Science.gov (United States)

    Joyce, Nanette C; Hache, Lauren P; Clemens, Paula R

    2012-11-01

    This article reviews the recent literature regarding bone health as it relates to the patient living with neuromuscular disease (NMD). Studies defining the scope of bone-related disease in NMD are scant. The available evidence is discussed, focusing on abnormal calcium metabolism, increased fracture risk, and the prevalence of both scoliosis and hypovitaminosis D in Duchenne muscular dystrophy, amyotrophic lateral sclerosis, and spinal muscular atrophy. Future directions are discussed, including the urgent need for studies both to determine the nature and extent of poor bone health, and to evaluate the therapeutic effect of available osteoporosis treatments in patients with NMD. PMID:23137737

  14. Nerve excitability testing and its clinical application to neuromuscular diseases.

    Science.gov (United States)

    Nodera, Hiroyuki; Kaji, Ryuji

    2006-09-01

    Non-invasive nerve excitability testing measures the membrane polarization, ion channel function and paranodal/internodal condition of peripheral nerves. This technique has been recently used for various neuromuscular disorders, such as pure motor conduction block in multifocal motor neuropathy, conduction block in carpal tunnel syndrome and Na(+) channel function disorders in diabetic neuropathy, to shed light on their pathophysiology. Here, we review the basics of ion channel functions and membrane properties that influence nerve excitability, the basic principles of nerve excitability testing and the reported findings in various disorders. PMID:16631406

  15. Efeito de um programa de treinamento de facilitação neuromuscular proprioceptiva sobre a mobilidade torácica Effect of a training program based on proprioceptive neuromuscular facilitation onto thoracic mobility

    Directory of Open Access Journals (Sweden)

    Marlene Aparecida Moreno

    2009-06-01

    Full Text Available A proposta deste estudo foi analisar o efeito de um programa de treinamento de membros superiores baseado nas técnicas de facilitação neuromuscular proprioceptiva (FNP sobre a mobilidade torácica. Foram estudadas 24 voluntárias sedentárias, idade 22,9 ± 2,9 anos, divididas em grupo controle (GC, que não participou do treinamento, e grupo treinado (GT. O protocolo de treinamento físico foi constituído por um programa de exercícios de FNP, realizado três vezes por semana, durante quatro semanas. Os dois grupos foram submetidos à avaliação da mobilidade torácica por meio de cirtometria, antes e após o período de treinamento. Os dados colhidos foram analisados estatisticamente, com nível de significância ? = 5%. Os valores da cirtometria axilar e xifoideana do GC antes e após o período de intervenção não apresentaram alterações significativas (p>0,05. No GT os valores das variáveis foram significantemente maiores após a intervenção (pThe purpose of this study was to analyse the effect of an upper limb training program based on proprioceptive neuromuscular facilitation (PNF techniques on thoracic mobility. The study was carried out with 24 sedentary female volunteers, aged 22.9±2.9 years. Participants were divided into a control group (CG, who did not perform any exercise, and a trained group (TG, submitted to training. The physical training protocol consisted of a PNF exercise program, three times a week for four weeks. The two groups were assessed as to thoracic mobility by means of cirtometry before and after the training period. Data were statistically analysed and significance level set at ?=5%. In CG, initial axillary and xiphoid cirtometry values showed no significant differences when compared to data obtained on the final evaluation (p>0.05. TG measures, in turn, were significantly higher after the training program (p<0.05. The PNF protocol here proposed seems hence to be an efficient exercise program to promote increase in cirtometry values within a short period of time, suggesting that the it may be used as a physical therapy resource for the development of thoracic mobility.

  16. Estimulação elétrica neuromuscular de média freqüência (russa) em cães com atrofia muscular induzida / Medium frequency neuromuscular electrical stimulation (russian) in dogs with induced muscle atrophy

    Scientific Electronic Library Online (English)

    Charles, Pelizzari; Alexandre, Mazzanti; Alceu Gaspar, Raiser; Sonia Terezinha dos Anjos, Lopes; Dominguita Lühers, Graça; Fabiano Zaninni, Salbego; Adriano Tony, Ramos; Rafael, Festugatto; Diego Vilibaldo, Beckmann; Marina Mori da, Cunha; Rosmarini Passos dos, Santos; Juliana Filipeto, Cargnelutti; Desydere Trindade, Pereira; Tessie Beck, Martins.

    2008-06-01

    Full Text Available A estimulação elétrica neuromuscular (EENM) de média freqüência (Russa) ou de Kotz pode ser empregada para a recuperação de massa muscular em animais apresentando atrofia muscular por desuso. Assim, o objetivo deste trabalho foi empregar a EENM de média freqüência no quadríceps femoral de cães com a [...] trofia muscular induzida, avaliando-se a ocorrência de ganho de massa. Foram utilizados oito cães em dois grupos denominados de GI ou controle e de GII ou tratado. Para a indução da atrofia muscular, a articulação fêmoro-tíbio-patelar esquerda foi imobilizada por 30 dias. Após 48 horas da remoção, foi realizada a EENM nos cães do grupo II, três vezes por semana, com intervalo de 48 horas cada sessão, pelo período de 60 dias. Foram avaliadas a mensuração da perimetria da coxa, da goniometria do joelho, as enzimas creatina-quinase (CK) e morfometria das fibras musculares em cortes transversais do músculo vasto lateral, colhido mediante a biópsia muscular. A EENM foi empregada no músculo quadríceps femoral numa freqüência de 2.500Hz, largura de pulso de 50% e relação de tempo on/off de 1:2. Não houve diferença significativa quanto aos valores de perimetria da coxa e a atividade da enzima CK entre os grupos I e II. Na goniometria, houve diminuição significativa (P Abstract in english The medium frequency neuromuscular electrical stimulation (NMES) (Russa) or Kotz is designed for recuperation of muscle mass in dogs with muscular atrophy in disuse. This study aims to utilize medium frequency NMES on the femoral quadriceps of dogs with induced muscular atrophy and evaluate the occu [...] rrence of gain in mass. Eight dogs in two groups denominated GI, or control, and GII, or treated were used. For the induction of muscular atrophy, the left femoral-tibial-patellar joint was immobilized for 30 days. NMES treatment began 48 hours after the removal of the immobilization device on dogs from group II and was carried out three times per week, with an interval of 48 hours between each session, during 60 days. The following parameters were measured: thigh perimeter, goniometry of the knee, creatine kinase (CK) enzymes and morphometry of the muscular fibers in transversal cuts of the vastus lateralis muscle, collected through a muscular biopsy. EENM was utilized on the femoral quadriceps at a frequency of 2500 Hz, with pulse duration of 50%, and the time on/off was at a proportion of 1:2. There was no significant difference between the thigh perimeter and the activity of enzyme CK between groups I and II. As for the goniometry a significant increase (P

  17. Coupling device of the control rod and of the drive mechanism

    International Nuclear Information System (INIS)

    The invention proposes a coupling device removable in which the connection between the upper head of the control rod and the drive mechanism is a real rigid fixing, in the mechanical sense of the term, suppressing longitudinal play and allowing to restrict the momenta occurring when locating the control rods

  18. Differential Evolution for the Control Gain's Optimal Tuning of a Four-bar Mechanism

    Scientific Electronic Library Online (English)

    María Bárbara, Calva-Yáñez; Paola Andrea, Niño-Suárez; Miguel Gabriel, Villarreal-Cervantes; Gabriel, Sepúlveda-Cervantes; Edgar Alfredo, Portilla-Flores.

    2013-07-01

    Full Text Available In this paper the variation of the velocity error of a four-bar mechanism with spring and damping forces is reduced by solving a dynamic optimization problem using a differential evolution algorithm with a constraint handling mechanism. The optimal design of the velocity control for the mechanism is [...] formulated as a dynamic optimization problem. Moreover, in order to compare the results of the differential evolution algorithm, a simulation experiment of the proposed control strategy was carried out. The simulation results and discussion are presented in order to evaluate the performance of both approaches in the control of the mechanism.

  19. Neuromuscular efficiency of the vastus lateralis and biceps femoris muscles in individuals with anterior cruciate ligament injuries / Eficiência neuromuscular dos músculos vasto lateral e bíceps femoral em indivíduos com lesão de ligamento cruzado anterior

    Scientific Electronic Library Online (English)

    Fernando Amâncio, Aragão; Gabriel Santo, Schäfer; Carlos Eduardo de, Albuquerque; Rogério Fonseca, Vituri; Fábio Mícolis de, Azevedo; Gladson Ricardo Flor, Bertolini.

    2015-04-01

    Full Text Available OBJETIVO: Analisar a força e a integral da eletromiografia (IEMG) para obter a eficiência neuromuscular (ENM) dos músculos vasto lateral (VL) e bíceps femoral (BF) em pacientes com lesão de ligamento cruzado anterior (LCA) nas fases pré-operatória e pós-operatória, comparar o membro lesionado nos d [...] ois momentos e usar o membro não cirúrgico como controle. MÉTODOS: Foi feita a coleta de dados da EMG e da força de BF e VL durante três contrações isométricas máximas nos movimentos de flexão e extensão do joelho. O protocolo de avaliação foi aplicado nos momentos pré e pós-operatório (dois meses após a cirurgia) e obteve-se a ENM dos músculos VL e BF. RESULTADOS: Não foi encontrada diferença na ENM do músculo VL entre os momentos pré e pós-cirúrgico. Por outro lado, houve aumento da ENM do BF no membro não cirúrgico dois meses após a cirurgia. CONCLUSÕES: A ENM fornece boa estimativa da função muscular por estar diretamente relacionada à força e à capacidade de ativação dos músculos. Entretanto, os resultados apontam que dois meses após o procedimento de reconstrução do LCA, quando normalmente são iniciadas cargas em cadeia cinética aberta nos protocolos de reabilitação, a eficiência neuromuscular do VL e BF ainda não está restabelecida. Abstract in english OBJECTIVE: To analyze strength and integrated electromyography (IEMG) data in order to determine the neuromuscular efficiency (NME) of the vastus lateralis (VL) and biceps femoris (BF) muscles in patients with anterior cruciate ligament (ACL) injuries, during the preoperative and postoperative peri [...] ods; and to compare the injured limb at these two times, using the non-operated limb as a control. METHODS: EMG data and BF and VL strength data were collected during three maximum isometric contractions in knee flexion and extension movements. The assessment protocol was applied before the operation and two months after the operation, and the NME of the BF and VL muscles was obtained. RESULTS: There was no difference in the NME of the VL muscle from before to after the operation. On the other hand, the NME of the BF in the non-operated limb was found to have increased, two months after the surgery. CONCLUSIONS: The NME provides a good estimate of muscle function because it is directly related to muscle strength and capacity for activation. However, the results indicated that two months after the ACL reconstruction procedure, at the time when loading in the open kinetic chain within rehabilitation protocols is usually started, the neuromuscular efficiency of the VL and BF had still not been reestablished.