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Sample records for bloqueio neuromuscular produzido

  1. Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

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    Angélica de Fátima de Assunção Braga

    2013-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos farmacodinâmicos dos bloqueadores neuromusculares (BNM podem ser influenciados por diferentes drogas, entre elas os hipnóticos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo cisatracúrio. MÉTODO: Foram incluídos 60 pacientes, ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: GI (propofol e GII (etomidato. As pacientes receberam midazolam (0,1 mg.kg-1 por via muscular como medicação pré-anestésica, a indução foi com propofol (2,5 mg.kg-1 ou etomidato (0,3 mg.kg-1 precedido de fentanil (250 µg e seguido de cisatracúrio (0,1 mg.kg-1. Os pacientes foram ventilados com oxigênio a 100% até a obtenção de redução de 95% ou mais na amplitude da resposta do adutor do polegar, quando foi feita a laringoscopia e a intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Avaliaram-se o início de ação do cisatracúrio, as condições de intubação traqueal e as repercussões hemodinâmicas. RESULTADOS: Os tempos médios e os desvios padrão para o início de ação do cisatracúrio foram: GI (86,6 ± 14,3" e GII (116,9 ± 11,6", com diferença significativa (p < 0,0001. As condições de intubação traqueal foram aceitáveis em 100% dos pacientes do GI e em 53,3% no GII (p < 0,0001. CONCLUSÕES: A instalação do bloqueio neuromuscular com o cisatracúrio foi mais rápida e as condições de intubação traqueal foram melhores nos pacientes que receberam propofol em relação ao grupo que recebeu etomidato, sem repercussões hemodinâmicas.

  2. Phenobarbital influence on neuromuscular block produced by rocuronium in rats Influência do fenobarbital no bloqueio neuromuscular produzido pelo rocurônio em ratos

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    Angélica de Fátima de Assunção Braga

    2008-08-01

    Full Text Available PURPOSE: To evaluate in vitro and in vivo neuromuscular blockade produced by rocuronium in rats treated with Phenobarbital and to determine cytochrome P450 and cytochrome b5 concentrations in hepatic microsomes. METHODS: Thirty rats were included in the study and distributed into 6 groups of 5 animals each. Rats were treated for seven days with phenobarbital (20 mg/kg and the following parameters were evaluated: 1 the amplitude of muscle response in the preparation of rats exposed to phenobarbital; 2 rocuronium effect on rat preparation exposed or not to phenobarbital; 3 concentrations of cytochrome P450 and cytochrome b5 in hepatic microsomes isolated from rats exposed or not to phenobarbital. The concentration and dose of rocuronium used in vitro and in vivo experiments were 4 µg/mL and 0,6 mg/kg, respectively. RESULTS: Phenobarbital in vitro and in vivo did not alter the amplitude of muscle response. The neuromuscular blockade in vitro produced by rocuronium was significantly different (p=0.019 between exposed (20% and not exposed (60% rats; the blockade in vivo was significantly greater (p=0.0081 in treated rats (93.4%. The enzymatic concentrations were significantly greater in rats exposed to phenobarbital. CONCLUSIONS: Phenobarbital alone did not compromise neuromuscular transmission. It produced enzymatic induction, and neuromuscular blockade in vivo produced by rocuronium was potentiated by phenobarbital.OBJETIVO: Avaliar in vitro e in vivo o bloqueio neuromuscular produzido pelo rocurônio em ratos tratados com fenobarbital e determinar as concentrações de citocromo P450 e b5 em microssomos hepáticos. MÉTODOS: Trinta ratos foram incluídos no estudo e distribuídos em seis grupos de cinco animais cada. Ratos foram tratados por sete dias com fenobarbital (20 mg/kg e avaliou-se: 1 amplitude das respostas musculares em preparação de ratos expostos ao fenobarbital; 2 o efeito do rocurônio em preparações de ratos expostos ou n

  3. 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

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    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

  4. Influência do lítio no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato Influencia del litio en el bloqueo neuromuscular producido por el atracurio y por el cisatracurio: estudio en preparo nervio frénico-diafragma del ratón Influence of lithium on the neuromuscular blockade produced by atracurium and cisatracurium: study on rat phrenic nerve-diaphragm preparations

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    Samanta Cristina Antoniassi Fernandes

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O lítio, fármaco amplamente utilizado nos distúrbios bipolares, pode interagir com os bloqueadores neuromusculares. Os mecanismos para explicar os seus efeitos na transmissão neuromuscular e a interação com bloqueadores neuromusculares são controversos. O objetivo deste trabalho foi avaliar, em diafragma de rato, os efeitos do lítio sobre a resposta muscular à estimulação indireta e a possível interação com os bloqueadores neuromusculares. MÉTODO: Utilizaram-se ratos com peso entre 250g e 300g, sacrificados sob anestesia com uretana. A preparação nervo frênico-diafragma foi montada de acordo com a técnica descrita por Bulbring. O diafragma foi mantido sob tensão, ligado a um transdutor isométrico e submetido à estimulação indireta de 0,1 Hz de freqüência. As contrações do diafragma foram registradas em fisiógrafo. Da análise da amplitude das respostas musculares avaliaram-se: os efeitos dos fármacos: lítio (1,5 mg.mL-1; atracúrio (20 µg.mL-1 e cisatracúrio (3 µg.mL-1 empregados isoladamente; da associação lítio-bloqueadores neuromusculares; e do lítio no bloqueio neuromuscular produzido pelo atracúrio (35 µg.mL-1 e cisatracúrio (5 µg.mL-1. Os efeitos foram avaliados antes e 45 minutos após a adição dos fármacos. Também foram estudados os efeitos do lítio nos potenciais de membrana (PM e potenciais de placa terminal em miniatura (PPTM. RESULTADOS: O lítio isoladamente não alterou a amplitude das respostas musculares, mas diminuiu significativamente o bloqueio neuromuscular produzido pelo atracúrio e cisatracúrio. Não alterou o PM e ocasionou aumento inicial da freqüência dos PPTM. CONCLUSÕES: O lítio empregado isoladamente não comprometeu a transmissão neuromuscular e aumentou a resistência ao efeito do atracúrio e cisatracúrio. Não mostrou ação sobre a fibra muscular, sendo que as alterações nos potenciais de placa terminal em miniatura evidenciaram a

  5. Influência da nifedipina no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato Influencia de la nifedipina en el bloqueo neuromuscular producido por atracurio y cisatracurio: estudio en preparación nervio frénico diafragma de ratón Influence of nifedipine on the neuromuscular block produced by atracurium and cistracurium: study in rat phrenic-diaphragmatic nerve preparation

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    Silmara Rodrigues de Sousa

    2006-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os bloqueadores de canais de cálcio podem interagir com bloqueadores neuromusculares potencializando seus efeitos. Os estudos sobre essa interação mostram resultados controversos. Em alguns estudos essas drogas produziram bloqueio neuromuscular, ou contratura, ou nenhum efeito sobre as respostas musculares esqueléticas foi evidenciado. O estudo avaliou, em diafragma de rato, os efeitos da nifedipina sobre a resposta muscular e sua possível interação com os bloqueadores neuromusculares. MÉTODO: Foram utilizados 25 ratos, com peso entre 250 e 300 g sacrificados sob anestesia com pentobarbital (40 mg.kg -1 por via intraperitonial. A preparação foi montada de acordo com a técnica descrita por Bulbring. O diafragma foi mantido sob tensão, ligado a um transdutor isométrico e submetido à estimulação indireta de 0,1 Hz de freqüência. As contrações do diafragma foram registradas em fisiógrafo. Para avaliação dos efeitos das drogas na transmissão neuromuscular, estas foram adicionadas isoladamente ou associadas à preparação, nas seguintes concentrações: nifedipina (4 µg.mL-1; atracúrio (20 µg.mL-1; cisatracúrio (3 µg.mL-1. Nas preparações nervo frênico-diafragma avaliaram-se: 1 a amplitude das respostas do músculo diafragma à estimulação indireta, antes e 45 minutos após a adição da nifedipina e dos bloqueadores neuromusculares isoladamente e após a associação das drogas; 2 os efeitos da nifedipina nos potenciais de membrana (PM e potenciais de placa terminal em miniatura (PPTM. RESULTADOS: A nifedipina empregada isoladamente não alterou a amplitude das respostas musculares, mas aumentou significativamente a atividade bloqueadora neuromuscular do atracúrio e do cisatracúrio. Não alterou o potencial de membrana e ocasionou aumento inicial na freqüência dos PPTM, seguido de bloqueio. CONCLUSÕES: A nifedipina na concentração empregada potencializou o bloqueio neuromuscular

  6. Influência da freqüência de estímulos na instalação do bloqueio neuromuscular produzido pelo rocurônio e pancurônio: avaliação pelo método acelerográfico Influencia de la frecuencia de estímulos en la instalación del bloqueo neuromuscular producido por el rocuronio y pancuronio: evaluación por el método acelerográfico Influence of stimulation frequency on rocuronium and pancuronium-induced neuromuscular block onset: acceleromyography evaluation

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    Derli da Conceição Munhóz

    2004-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Fatores relacionados ao paciente e ao bloqueador neuromuscular (BNM, assim como outros inerentes à monitorização da função neuromuscular podem influenciar na instalação do bloqueio neuromuscular. O objetivo deste estudo foi avaliar a influência de duas diferentes freqüências de estímulos sobre o tempo de instalação do bloqueio produzido pelo pancurônio e pelo rocurônio. MÉTODO: Foram incluídos no estudo 120 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos, de acordo com a freqüência de estímulo empregada, para a monitorização do bloqueio neuromuscular: Grupo I - 0,1 Hz (n = 60 e Grupo II - 1 Hz (n = 60. Em cada grupo formaram-se dois subgrupos (n = 30 de acordo com o bloqueador neuromuscular empregado: Subgrupo P (pancurônio e Subgrupo R (rocurônio. A medicação pré-anestésica consistiu de midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da cirurgia. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 precedido de alfentanil (50 µg.kg-1 e seguido de pancurônio ou rocurônio. Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obtenção de redução de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de ação do pancurônio e do rocurônio; tempo para instalação do bloqueio total e condições de intubação traqueal. RESULTADOS: Os tempos médios (segundos para o início de ação e instalação de bloqueio neuromuscular total produzido pelo pancurônio foram: Grupo I (159,33 ± 35,22 e 222 ± 46,56 e Grupo II (77,83 ± 9,52 e 105,96 ± 15,58; para o rocurônio: Grupo I (83 ± 17,25 e 125,33 ± 20,12 e Grupo II (48,96 ± 10,16 e 59,83 ± 10,36 com diferença significativa

  7. 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

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    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

  8. 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

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    Marcos Guilherme Cunha Cruvinel

    2008-12-01

    Full Text Available 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 de lesão de manguito rotator. Após extubação foi evidenciado bloqueio neuromuscular residual por meio do exame clínico. Na sala de recuperação pós-anestésica evoluiu com sonolência, taquicardia, hipertensão arterial e acidose respiratória grave. Após a reintubação, evoluiu com parada cardíaca em atividade elétrica sem pulso, revertida com adrenalina e massagem cardíaca externa. Apresentou no pós-operatório elevação de segmento ST, aumento de troponina e acinesia de segmento médio-apical de ventrículo esquerdo com fração de ejeção estimada em 30%. A cineangiocoronariografia mostrou coronárias isentas de ateromatose significativa e grave comprometimento da função sistólica com acinesia inferior e ântero-septo-apical com hipercontratilidade compensatória de suas porções basais. Com o tratamento instituído houve recuperação funcional completa. CONCLUSÕES: O bloqueio neuromuscular residual associado à paralisia diafragmática e possível atelectasia pulmonar levando a insuficiência respiratória, hipercapnia e descarga adrenérgica foram os fatores desencadeantes da síndrome de Tako-Tsubo com sua grave repercussão clínica.JUSTIFICATIVA Y OBJETIVOS: El Síndrome de Tako-Tsubo es una complicación postoperatoria rara con una mortalidad en torno de un 5%. El objetivo de este relato es presentar el bloqueo neuromuscular residual como factor desencadenante del referido síndrome, discutir sobre él y alertar sobre el bloqueo

  9. Bloqueio neuromuscular prolongado após administração de mivacúrio: relato de caso Bloqueo neuromuscular prolongado después de administración de mivacúrio: relato de caso Prolonged neuromuscular block after mivacurium: case report

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    Karina Bernardi Pimenta

    2005-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Com a introdução de novos fármacos com ação de curta duração, houve aumento do número de procedimentos realizados em caráter ambulatorial. O mivacúrio com duração de ação entre 15 e 30 minutos e metabolismo enzimático tornou-se opção de bloqueador neuromuscular para estes procedimentos. O relato de caso tem como objetivo chamar a atenção para a ocorrência de bloqueio neuromuscular prolongado após administração do mivacúrio e as condutas que foram adotadas. RELATO DO CASO: Descreve-se um caso de paciente programado para procedimento de curta duração em regime ambulatorial e que apresentou bloqueio neuromuscular prolongado após administração do mivacúrio. O diagnóstico foi posteriormente confirmado pela demonstração de níveis reduzidos de atividade da colinestesterase plasmática. CONCLUSÕES: A investigação laboratorial pré-operatória, mesmo incluindo a dosagem da atividade da colinesterase, não previne a possibilidade do bloqueio neuromuscular prolongado devido à possibilidade de alteração qualitativa da atividade da enzima, não existindo recomendação para investigação sistemática. Ocorrendo esta complicação, deve-se sedar o paciente e manter ventilação mecânica até a completa recuperação da força muscular e realizar exames laboratoriais para o diagnóstico definitivo. É de responsabilidade do anestesiologista a coleta de amostra sangüínea para realização de testes quantitativos e qualitativos da colinesterase plasmática. Paciente e familiares devem ser orientados quanto à importância da investigação para classificação da variante atípica da colinesterase plasmática e suas implicações anestésicas.JUSTIFICATIVA Y OBJETIVOS: Con la introducción de nuevos fármacos con acción de corta duración, hubo aumento del número de procedimientos realizados en carácter ambulatorial. El mivacúrio con duración de acción entre 15 y 30 minutos y

  10. Efeitos neuromusculares in vitro e in vivo do atracúrio e do rocurônio em ratos submetidos a tratamento de sete dias com carbamazepina Efectos neuromusculares in vitro e in vivo del atracurio y del rocuronio en ratones sometidos a tratamiento de siete días con carbamazepina In vitro and in vivo neuromuscular effects of atracurium and rocuronium in rats treated with carbamazepine for seven days

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    Caroline Coutinho de Barcelos

    2008-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Trata-se de um estudo experimental que investigou in vitro e in vivo o bloqueio neuromuscular produzido pelo rocurônio e atracúrio em ratos tratados com carbamazepina e determinou as concentrações de citocromo P450 e b5 redutase em microssomos hepáticos. MÉTODO: Ratos foram tratados por sete dias com carbamazepina (CBZ - 40 mg.kg-1 pelo método de gavagem e sacrificados no oitavo dia sob anestesia com uretana. As preparações in vitro e in vivo foram montadas de acordo com as técnicas de Bulbring e de Leeuwin e Wolters, respectivamente. As concentrações e doses utilizadas dos bloqueadores nas preparações in vitro e in vivo foram, respectivamente, 20 µg.mL-1 e 0,5 mg.kg-1 para atracúrio (ATC; 4 µg.mL-1 e 0,6 mg.kg-1 para rocurônio (ROC. Cada protocolo teve um n = 5 e as respostas foram observadas por 60 minutos. Os efeitos do ATC e ROC foram avaliados nas preparações de ratos tratados (Cbz t e comparados com os observados nas de ratos não-tratados (CBZst. As concentrações de citocromo P450 e b5 redutase foram determinadas em microssomos isolados de fígados de ratos tratados (CBZt e comparadas com as obtidas em ratos não tratados (CBZst. RESULTADOS: A carbamazepina não alterou a amplitude das respostas musculares; in vitro e in vivo, não houve diferença entre o bloqueio neuromuscular produzido pelo atracúrio nas preparações CBZt versus CBZst; o bloqueio neuromuscular produzido pelo rocurônio nas preparações CBZt foi potencializado in vitro. A carbamazepina não alterou as concentrações de citocromo P450 e b5. CONCLUSÕES: O tratamento por sete dias com carbamazepina não influenciou no bloqueio produzido pelo atracúrio, e alterou in vitro os efeitos do rocurônio. O tempo de tratamento não foi suficiente para causar indução enzimática e diminuir a sensibilidade ao rocurônio.JUSTIFICATIVA Y OBJETIVOS: Se trata de un estudio experimental que investigó in vitro e in vivo el bloqueo

  11. Neuromuscular Disorders

    Science.gov (United States)

    ... lead to twitching, cramps, aches and pains, and joint and movement problems. Sometimes it also affects heart function and your ability to breathe. Examples of neuromuscular disorders include Amyotrophic lateral sclerosis Multiple sclerosis Myasthenia ...

  12. Reversão de bloqueio muscular profundo com sugammadex após falha de intubação traqueal em sequência rápida: relato de caso

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    Fabiano Timbó Barbosa

    2012-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O sugammadex é um agente reversor superseletivo do bloqueio neuromuscular utilizado para a reversão de rocurônio e vecurônio. Este relato descreve um caso clínico em que o sugammadex foi utilizado em paciente idosa imediatamente após uso de rocurônio. RELATO DO CASO: Paciente do sexo feminino, 88 anos, 34 kg, com fratura de fêmur foi submetida à anestesia geral após tentativa falha de raquianestesia. Optou-se por indução anestésica com propofol 1,5 mg.kg-1, rocurônio 1,2 mg.kg-1, fentanil 100 mcg e lidocaína 2 mg.kg-1. Não houve sucesso nas manobras para intubação traqueal nem no posicionamento da máscara laríngea. Optou-se pelo uso de sugammadex na dose de 16 mg.kg-1 com retorno da função respiratória. CONCLUSÕES: A dose recomendada pela literatura para o sugammadex em pacientes com bloqueio profundo, 16 mg.kg-1, foi utilizada nesta paciente com reversão rápida e eficaz do bloqueio neuromuscular permitindo que a paciente fosse submetida a outro procedimento para garantir a perviedade das vias aéreas sem comprometimento clínico de seu estado geral.

  13. Raquianestesia total após bloqueio do plexo lombar por via posterior: relato de caso

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    Duarte, Leonardo Teixeira Domingues; Saraiva, Renato Ângelo

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo lombar pode ser bastante útil em procedimentos cirúrgicos do quadril, da coxa e do joelho, mas exige prática do anestesiologista tendo em vista suas potenciais complicações. O presente relato tem por objetivo apresentar um caso de raquianestesia total após bloqueio do plexo lombar pela via posterior e discutir o provável mecanismo fisiopatológico. RELATO DO CASO: Paciente do sexo masculino, 34 anos, 97 kg, estado físico ASA I, programado para art...

  14. Raquianestesia total após bloqueio do plexo lombar: relato de caso

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    Zafer Dogan

    2014-04-01

    Full Text Available O bloqueio do plexo lombar (BPL é um método adequado para uso em pacientes idosos e cirurgias na extremidade inferior. Muitas complicações podem ser observadas durante o BPL, mas não tanto quanto no bloqueio central. Neste relato de caso, nosso objetivo foi relatar uma raquianestesia total, uma complicação incomum. BPL com bloqueio ciático foi planejado para um paciente do sexo masculino, 76 anos, programado para artroplastia total do joelho por causa de gonartrose. O paciente ficou inconsciente após o bloqueio do compartimento do psoas com a técnica de Chayen para BPL. A operação terminou em 145 minutos. O paciente foi internado em unidade de terapia intensiva até o segundo dia pós-operatório e recebeu alta hospitalar no quinto dia pós-cirúrgico. A principal preocupação da monitoração do paciente deve ser a presença do anestesiologista. Dessa forma, conclui-se que o contato com o paciente deve ser garantido durante esses procedimentos.

  15. Objective neuromuscular monitoring of neuromuscular blockade in Denmark

    DEFF Research Database (Denmark)

    Söderström, C M; Eskildsen, K Z; Gätke, M R

    2017-01-01

    BACKGROUND: Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investig...

  16. 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…

  17. Rocuronium and sugammadex in a 3 days old neonate for draining an ovarian cyst. Neuromuscular management and review of the literature

    Directory of Open Access Journals (Sweden)

    Ricardo Vieira Carlos

    2016-07-01

    Full Text Available A case is reported in which a 3-days old neonate with a giant ovarian cyst was scheduled for surgery. The patient received a dose of sugammadex to reverse a rocuronium-induced neuromuscular block. A fast and efficient recovery from neuromuscular block was achieved within 90 s. No adverse events or other safety concerns were observed. Furthermore, a review of the literature on the use of sugammadex in neonates was performed. Resumo: Relato do caso de uma criança recém-nascida de 3 dias de idade com um cisto ovariano gigante programada para a cirurgia. A paciente recebeu uma dose de sugamadex para reverter o bloqueio neuromuscular induzido por rocurônio. Uma recuperação rápida e eficiente do bloqueio neuromuscular foi obtida dentro de 90 segundos. Não foram observados efeitos adversos ou outros problemas de segurança. Além disso, uma revisão da literatura sobre o uso de sugamadex em recém-nascidos foi realizada. Keywords: Neonates, Ovarian cyst, Sugammadex, Rocuronium, Reversal agent, Palavras-chave: Recém-nascidos, Cisto ovariano, Sugammadex, Rocurônio, Agente de reversão

  18. Doenças neuromusculares Neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    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 mioneural 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.Objective: to discuss the most important aspects for performing a

  19. Neuromuscular complications of thyrotoxicosis.

    Science.gov (United States)

    Kung, Annie W C

    2007-11-01

    Thyroid hormones exert multiple effects on the neuromuscular system and the brain, with the most important being their role in stimulating the development and differentiation of the neuromuscular system and brain in foetal and neonatal life. In the presence of hyperthyroidism, muscular and neurological symptoms may be the presenting clinical features of the disease. The frequency and severity of neuromuscular complications vary considerably and are probably related to the degree of hyperthyroidism, although in some patients the neuromuscular dysfunction is caused by associated disorders rather than by hyperthyroidism per se. This update focuses on the most common neurological and muscular disorders that occur in patients with thyrotoxicosis. It is beyond the scope of this paper to discuss thyroid eye disease and cardiac complications, in themselves separate complications of specific myocytes.

  20. Bloqueio bilateral do nervo pudendo para hemorroidectomia em paciente acondroplásico: relato de caso

    OpenAIRE

    Morais, Bruno Salomé de; Cruvinel, Marcos Guilherme Cunha; Silva, Yerkes Pereira; Diniz, Dener Augusto; Castro, Carlos Henrique Viana de

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O nanismo acondroplásico ou acondroplasia é a forma mais comum de nanismo e ocorre na maioria dos casos por alteração genética espontânea. A anestesia desses pacientes apresenta várias particularidades. O objetivo do presente relato foi descrever um caso de paciente acondroplásico, com história prévia de intervenção cirúrgica da coluna para descompressão medular, submetido a hemorroidectomia através de bloqueio bilateral dos nervos pudendos. RELATO DO CASO: Paciente...

  1. 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.

  2. Bloqueio simpático esquerdo por videotoracoscopia no tratamento da cardiomiopatia dilatada

    Directory of Open Access Journals (Sweden)

    Paulo M. Pêgo-Fernandes

    2010-12-01

    Full Text Available FUNDAMENTO: O nível da atividade nervosa simpática é um dos mais importantes determinantes prognósticos em pacientes com insuficiência cardíaca. OBJETIVO: O propósito dessa investigação foi realizar um estudo de viabilidade do emprego do bloqueio simpático esquerdo por toracoscopia em pacientes com insuficiência cardíaca (IC para avaliar a segurança e os efeitos imediatos. MÉTODOS: Quinze pacientes com cardiomiopatia dilatada e fração de ejeção do ventrículo esquerdo (FEVE 65 bpm, a despeito do uso adequado de beta-bloqueadores ou intolerantes a eles, forma selecionados. Dez pacientes foram submetidos à clipagem do espaço inter-espinhal em nível de T3-T4 e da porção inferior dos gânglios estrelados esquerdos através de videotoracocopia, enquanto outros cinco pacientes foram randomizados para um grupo controle. RESULTADOS: Nenhum dos pacientes operados apresentou qualquer evento cardiovascular adverso relacionado ao procedimento cirúrgico no período perioperatório. Dois pacientes do grupo cirúrgico morreram devido a tromboembolismo pulmonar ou infarto do miocárdio nos 6 meses de seguimento inicial, enquanto três pacientes do grupo controle apresentaram progressão da IC e morreram ou desenvolveram choque cardiogênico no mesmo período. Nos pacientes tratados, houve melhora na qualidade de vida, nível de atividade física e FEVE (de 25 ± 9% para 32 ± 8%, p=0,024 aos 6 meses de seguimento, enquanto esses parâmetros não se alteraram nos pacientes do grupo controle. CONCLUSÃO: O bloqueio simpático esquerdo via toracoscopia é factível e parece ser seguro em pacientes com IC grave. Esse estudo inicial sugere que esse procedimento pode ser uma abordagem alternativa eficaz para o bloqueio simpático no tratamento de cardiomiopatias dilatadas.

  3. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

  4. MRI in neuromuscular disorders

    International Nuclear Information System (INIS)

    Fischmann, Arne

    2014-01-01

    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.)

  5. Bloqueio do nervo isquiático via médio lateral da coxa como opção anestésica no trauma: relato de caso

    OpenAIRE

    Geier, Karl Otto

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: Nos pacientes com trauma de membros inferiores e com estômago cheio, tantos os bloqueios de plexos nervosos como os bloqueios de nervos periféricos isolados são procedimentos incomuns, prevalecendo os bloqueios peridural e subaracnóideo como primeira indicação. Este relato de caso registrou a escolha do bloqueio do nervo isquiático, como melhor indicação para anestesia em paciente de estômago cheio e traumatismo grave de pé. RELATO DO CASO: Paciente do sexo masculin...

  6. Bloqueio do plano transverso abdominal contínuo bilateral em doente com cirurgia abdominal prévia

    Directory of Open Access Journals (Sweden)

    Isabel Flor de Lima

    2013-10-01

    Full Text Available Os autores apresentam um caso clínico em que foi realizado um bloqueio do plano do músculo transverso abdominal, com colocação de cateter bilateral, para analgesia pós-operatória de laparotomia exploradora, em doente com cirurgia abdominal prévia, insuficiência cardíaca, renal e hepática, em opção à analgesia epidural e aos opioides endovenosos em perfusão.

  7. Bases anatômicas para o bloqueio anestésico do plexo braquial por via infraclavicular

    OpenAIRE

    Gusmão,Luiz Carlos Buarque de; Lima,Jacqueline Silva Brito; Prates,José Carlos

    2002-01-01

    JUSTIFICATIVA E OBJETIVOS: Procuramos demonstrar neste estudo a presença constante da fossa infraclavicular, com a finalidade de sua utilização como via de acesso para o bloqueio anestésico do plexo braquial por via infraclavicular. Visando solucionar o ponto onde os fascículos do plexo braquial podem ser localizados no interior da fossa, propusemos medidas a partir da face anterior da clavícula e do ângulo formado pelo encontro do músculo deltóide com a clavícula (ângulo deltoclavicular). A ...

  8. 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.

  9. Neuromuscular control and ankle instability.

    Science.gov (United States)

    Gutierrez, Gregory M; Kaminski, Thomas W; Douex, Al T

    2009-04-01

    Lateral ankle sprains (LAS) are common injuries in athletics and daily activity. Although most are resolved with conservative treatment, others develop chronic ankle instability (AI)-a condition associated with persistent pain, weakness, and instability-both mechanical (such as ligamentous laxity) and functional (neuromuscular impairment with or without mechanical laxity). The predominant theory in AI is one of articular deafferentation from the injury, affecting closed-loop (feedback/reflexive) neuromuscular control, but recent research has called that theory into question. A considerable amount of attention has been directed toward understanding the underlying causes of this pathology; however, little is known concerning the neuromuscular mechanisms behind the development of AI. The purpose of this review is to summarize the available literature on neuromuscular control in uninjured individuals and individuals with AI. Based on available research and reasonable speculation, it seems that open-loop (feedforward/anticipatory) neuromuscular control may be more important for the maintenance of dynamic joint stability than closed-loop control systems that rely primarily on proprioception. Therefore, incorporating perturbation activities into patient rehabilitation schemes may be of some benefit in enhancing these open-loop control mechanisms. Despite the amount of research conducted in this area, analysis of individuals with AI during dynamic conditions is limited. Future work should aim to evaluate dynamic perturbations in individuals with AI, as well as subjects who have a history of at least one LAS and never experienced recurrent symptoms. These potential findings may help elucidate some compensatory mechanisms, or more appropriate neuromuscular control strategies after an LAS event, thus laying the groundwork for future intervention studies that can attempt to reduce the incidence and severity of acute and chronic lateral ankle injury.

  10. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  11. Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

    Directory of Open Access Journals (Sweden)

    Pablo Escovedo Helayel

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios nervosos guiados por ultra-som são baseadas na visualização direta das estruturas nervosas, da agulha de bloqueio e das estruturas anatômicas adjacentes. Desta maneira, é possível depositar a solução de anestésico local precisamente em torno dos nervos e acompanhar a sua dispersão em tempo real, obtendo-se, assim, um bloqueio mais eficaz, de menor latência, menor dependência de referências anatômicas, menor volume de solução anestésica e maior segurança. CONTEÚDO: O artigo revisa os aspectos relativos aos mecanismos físicos para formação de imagens, a anatomia ultra-sonográfica do neuroeixo e dos plexos braquial e lombossacral, os equipamentos e materiais empregados nos bloqueios, os ajustes do aparelho de ultra-som para melhorar as imagens, os planos de visualização das agulhas de bloqueio e as técnicas e o treinamento em bloqueios guiados por ultra-som. CONCLUSÕES: Os passos para se obter sucesso em anestesia regional incluem a identificação exata da posição dos nervos, a localização precisa da agulha, sem lesões nas estruturas adjacentes e, finalmente, a injeção cuidadosa de anestésico local junto aos nervos. Embora a neuroestimulação forneça grande auxílio na identificação dos nervos, esta não consegue, isoladamente, preencher todas essas exigências. Por isso, acredita-se que os bloqueios guiados por ultra-som serão a técnica de eleição para anestesia regional num futuro não muito distante.JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos nerviosos guiados por ultrasonido se basan en la visualización directa de las estructuras nerviosas, de la aguja de bloqueo y de las estructuras anatómicas adyacentes. De esa manera, se puede depositar la solución de anestésico local precisamente en torno de los nervios y acompañar su dispersión en tiempo real, obteniéndose así, un bloqueo más eficaz, de menor latencia, menor dependencia de

  12. Vocational perspectives and neuromuscular disorders

    NARCIS (Netherlands)

    Andries, F.; Wevers, C. W.; Wintzen, A. R.; Busch, H. F.; Höweler, C. J.; de Jager, A. E.; Padberg, G. W.; de Visser, M.; Wokke, J. H.

    1997-01-01

    The present study analyses the actual occupational situation, vocational handicaps and past labour career of a group of about 1000 Dutch patients suffering from a neuromuscular disorder (NMD). On the basis of the likelihood of a substantial employment history and sufficient numbers of patients, four

  13. Vocational perspectives and neuromuscular disorders

    NARCIS (Netherlands)

    Andries, F; Wevers, CWJ; Wintzen, AR; Busch, HFM; Howeler, CJ; deJager, AEJ; Padberg, GW; deVisser, M; Wokke, JHJ

    The present study analyses the actual occupational situation, vocational handicaps and past labour career of a group of about 1000 Dutch patients suffering from a neuromuscular disorder (NMD). On the basis of the likelihood of a substantial employment history and sufficient numbers of patients, four

  14. Palliative care in neuromuscular diseases

    NARCIS (Netherlands)

    de Visser, Marianne; Oliver, David J.

    2017-01-01

    Purpose of review Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. Neuromuscular disorders (NMDs) are characterized by progressive muscle weakness, leading to pronounced and incapacitating

  15. Effectiveness of Neuromuscular Training Based on the Neuromuscular Risk Profile.

    Science.gov (United States)

    Hewett, Timothy E; Ford, Kevin R; Xu, Yingying Y; Khoury, Jane; Myer, Gregory D

    2017-07-01

    The effects of targeted neuromuscular training (TNMT) on movement biomechanics associated with the risk of anterior cruciate ligament (ACL) injuries are currently unknown. Purpose/Hypotheses: To determine the effectiveness of TNMT specifically designed to increase trunk control and hip strength. The hypotheses were that (1) TNMT would decrease biomechanical and neuromuscular factors related to an increased ACL injury risk and (2) TNMT would decrease these biomechanical and neuromuscular factors to a greater extent in athletes identified as being at a high risk for future ACL injuries. Controlled laboratory study. Female athletes who participated in jumping, cutting, and pivoting sports underwent 3-dimensional biomechanical testing before the season and after completing TNMT. During testing, athletes performed 3 different types of tasks: (1) drop vertical jump, (2) single-leg drop, and (3) single-leg cross drop. Analysis of covariance was used to examine the treatment effects of TNMT designed to enhance core and hip strength on biomechanical and neuromuscular characteristics. Differences were also evaluated by risk profile. Differences were considered statistically significant at P risk before the intervention (risk profile III) had a more significant treatment effect of TNMT than low-risk groups (risk profiles I and II). TNMT significantly improved proximal biomechanics, including increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. TNMT that focuses exclusively on proximal leg and trunk risk factors is not, however, adequate to induce significant changes in frontal-plane knee loading. Biomechanical changes varied across the risk profile groups, with higher risk groups exhibiting greater improvements in their biomechanics.

  16. [Respiratory treatments in neuromuscular disease].

    Science.gov (United States)

    Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

    2014-10-01

    In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  17. Dengue-associated neuromuscular complications

    OpenAIRE

    Ravindra Kumar Garg; Hardeep Singh Malhotra; Amita Jain; Kiran Preet Malhotra

    2015-01-01

    Dengue is associated with many neurological dysfunctions. Up to 4% of dengue patients may develop neuromuscular complications. Muscle involvement can manifest with myalgias, myositis, rhabdomyolysis and hypokalemic paralysis. Diffuse myalgia is the most characteristic neurological symptom of dengue fever. Dengue-associated myositis can be of varying severity ranging from self-limiting muscle involvement to severe dengue myositis. Dengue-associated hypokalemic paralysis often has a rapidly evo...

  18. The undesirable effects of neuromuscular blocking drugs

    DEFF Research Database (Denmark)

    Claudius, C; Garvey, L H; Viby-Mogensen, J

    2009-01-01

    Neuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor...... in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect...... of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking...

  19. Identification and Simulation as Tools for Measurement of Neuromuscular Properties

    National Research Council Canada - National Science Library

    Kearney, R

    2001-01-01

    Quantitative, objective methods for the evaluation of neuromuscular properties are required for the diagnosis of neuromuscular disorders and the evaluation of the effectiveness of treatment and rehabilitation...

  20. BIOLOGY OF SOME NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    Gerta Vrbova

    2004-12-01

    Full Text Available In order to understand and possibly interfere/ treat neuromuscular disorders it is important to analyze the biological events that may be causing the disability. We illustrate such attempts on two examples of genetically determined neuromuscular diseases: 1 Duchenne muscular dystrophy (DMD, and 2 Spinal muscular atrophy (SMA.DMD is an x-linked hereditary muscle disease that leads to progressive muscle weakness. The altered gene in DMD affects dystrophin, a muscle membrane associated proteine. Attempts were made to replace the deficient or missing gene/ protein into muscles of Duchenne children. Two main strategies were explored: 1 Myoblast and stem cell transfer and 2 Gene delivery. The possible use of methods other than the introduction of the missing gene for dystrophin into muscle fibres are based on the knowledge about the adaptive potential of muscle to different functional demands and the ability of the muscle to express a new set of genes in response to such stimuli. Stretch or overload is now known to lead to changes of gene expression in normal muscle, and the success of muscle stretch in the management of Duchenne boys is most likely to be due to such adaptive changes. Electrical stimulation of muscles is also a powerful stimulus for inducing the expression of new genes and this method too has produced beneficial effects on the progress of the disease in mice and men.SMA is a heterogeneous group of hereditary neuromuscular disorders where the loss of lower motoneurones leads to progressive weakness and muscle atrophy. The disease subdivides into 3 forms according to the severity of the symptoms and age of onset. All three forms of SMA have been mapped to chromosome 5q11.2-13.2. Clinical features of all these forms of SMA include hypotonia shortly after birth, symmetrical muscle weakness and atrophy, finger tremor, areflexia or hyporeflexia and later contractures. In patients with SMA 1 and 2 the development of all parts of the motor

  1. Neuromuscular Control and Coordination during Cycling

    Science.gov (United States)

    Li, Li

    2004-01-01

    The neuromuscular control aspect of cycling has been investigated through the effects of modifying posture and cadence. These studies show that changing posture has a more profound influence on neuromuscular coordination than does changing slope. Most of the changes with standing posture occur late in the downstroke: increased ankle and knee joint…

  2. Kinship and interaction in neuromuscular pharmacology

    NARCIS (Netherlands)

    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

  3. Bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno intravenoso melhora a analgesia após histerectomia abdominal

    Directory of Open Access Journals (Sweden)

    Evren Yucel

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: O objetivo deste estudo foi avaliar os efeitos da aplicação intravenosa(IV de dexcetoprofeno trometamol em bloqueio dos nervos ilioinguinal e ílio-hipogástrico na qualidade analgésica e no consumo de morfina após histerectomia abdominal total. MÉTODO: Estudo clínico controlado e randomizado conduzido com 61 pacientes. O estudo foi feito em sala de operação, sala de recuperação pós-anestésica e ambulatório. Os 61 pacientes foram randomicamente alocados em três grupos: grupo controle (Grupo C, grupo bloqueio (Grupo B e grupo bloqueio com dexcetoprofeno (Grupo BD. Antes da incisão cirúrgica feita após a indução da anestesia, fizemos o bloqueio dos nervos ilioinguinal e ilio-hipogástrico (Grupo C recebeu solução salina e grupos B e BD receberam levobupivacaína. Em contraste com os grupos C e B, o Grupo BD recebeu dexcetoprofeno. Administramos morfina a todos os pacientes para analgesia, com o uso do método de analgesia controlada pelo paciente (ACP durante o pós-operatório de 24 horas. Registramos os escores para dor pela escala visual analógica (EVA, os índices de satisfação, o consumo de morfina e os efeitos colaterais durante o pós-operatório de 24 horas. RESULTADOS: Os escores EVA do Grupo BD foram menores do que os dos grupos C e B no pós-operatório (p < 0,05 nos intervalos de 1, 2, 6 e 12 horas. Os escores EVA do Grupo C foram maiores do que os do Grupo B nas primeiras 2 horas de pós-operatório. O tempo até a primeira demanda de ACP foi mais longo, os valores de consumo de morfina mais baixos e os índices de satisfação maiores no Grupo BD do que nos outros dois grupos (p < 0,05. CONCLUSÃO: O bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno IV aumenta a satisfação do paciente e diminui o consumo de opioides e sugere que dexcetoprofeno trometamol é um analgésico anti-inflamatório não esteroide eficaz em analgesia pós-operatória.

  4. A narrativa seriada televisiva: O seriado Mandrake produzido para a TV a cabo HBO

    Directory of Open Access Journals (Sweden)

    Lílian Fontes Moreira

    2007-10-01

    Full Text Available O presente artigo pretende abordar a investigação que se baseia na construção deum seriado produzido exclusivamente para uma TV a cabo, mais especificamente aHBO, baseado num personagem da literatura brasileira que surgiu na década de 60, opersonagem  Mandrake  criado pelo escritor Rubem Fonseca. Faremos, portanto, umtrajeto abordando a televisão como dispositivo audiovisual, seu papel na sociedadecontemporânea, as questões relativas à recepção e as características da narrativa seriadaaplicadas ao seriado em estudo.

  5. FUNCTIONS OF A NEUROMUSCULAR CENTRE

    Directory of Open Access Journals (Sweden)

    Janez Zidar

    2004-12-01

    Full Text Available Main functions of a neuromuscular (NM centre are making diagnosis, treatment and counselling. Some other functions, e. g. forming a register and epidemiological endeavours, could be added. All these activities are expected to be achieved by multidisciplinary approach with the idea that members use the same guidelines and share the same knowledge.NM diseases affect lower levels of the nervous system that is motor units (motor cells in the brainstem and spinal cord, nerve roots, cranial and peripheral nerves, neuromuscular junction, and muscles. There are many such diseases; a few are more common others are rare.Rational approach in making a diagnosis can be divided into several steps. The process begins with a person with clinical symptoms and signs which raise the suspicion of NM disease. The first step is the description of the predominant pattern of muscular wasting and weakness (e. g. limb-girdle, distal, ocular, facio-scapulo-humeral. Each of these syndromes require a differential diagnosis within the motor unit territory what is achieved by means of EMG and muscle biopsy. The latter is even more important to define the nature of the abnormality. Disease nature can also be determined biochemically and, as NM disorders are commonly genetically determined, at the molecular genetic level. Treatment modalities include drugs (causative and symptomatic and other measures such as promoting and maintaining good general health, preventing skeletal deformities, physiotherapy, orthoses, surgery, and prevention of respiratory and cardiac functions. Counselling is mainly by social workers that focus on the practical aspects of coping with illness and disability and by genetic counsellors who gave advise on family planning.

  6. Neuromuscular diseases: Diagnosis and management.

    Science.gov (United States)

    Mary, P; Servais, L; Vialle, R

    2018-02-01

    Neuromuscular diseases (NMDs) affect the peripheral nervous system, which includes the motor neurons and sensory neurons; the muscle itself; or the neuromuscular junction. Thus, the term NMDs encompasses a vast array of different syndromes. Some of these syndromes are of direct relevance to paediatric orthopaedic surgeons, either because the presenting manifestation is a functional sign (e.g., toe-walking) or deformity (e.g., pes cavus or scoliosis) suggesting a need for orthopaedic attention or because orthopaedic abnormalities requiring treatment develop during the course of a known NMD. The main NMDs relevant to the orthopaedic surgeon are infantile spinal muscular atrophy (a motor neuron disease), peripheral neuropathies (chiefly, Charcot-Marie-Tooth disease), congenital muscular dystrophies, progressive muscular dystrophies, and Steinert myotonic dystrophy (or myotonic dystrophy type 1). Muscle weakness is a symptom shared by all these conditions. The paediatric orthopaedic surgeon must be familiar, not only with the musculoskeletal system, but also with many other domains (particularly respiratory and cardiac function and nutrition) that may interfere with the treatment and require preoperative management. Good knowledge of the natural history of each NMD is essential to ensure optimal timing of the therapeutic interventions, which must be performed under the best possible conditions in these usually frail patients. Timing is particularly crucial for the treatment of spinal deformities due to paraspinal muscle hypotonia during growth: depending on the disease and natural history, the treatment may involve non-operative methods or growing rods, followed by spinal fusion. A multidisciplinary approach is always required. Finally, the survival gains achieved in recent years increasingly require attention to preparing for adult life, to orthopaedic problems requiring treatment before the patient leaves the paediatric environment, and to the transition towards the

  7. Neuromuscular complications of immune checkpoint inhibitor therapy.

    Science.gov (United States)

    Kolb, Noah A; Trevino, Christopher R; Waheed, Waqar; Sobhani, Fatemeh; Landry, Kara K; Thomas, Alissa A; Hehir, Mike

    2018-01-17

    Immune checkpoint inhibitor (ICPI) therapy unleashes the body's natural immune system to fight cancer. ICPIs improve overall cancer survival, however, the unbridling of the immune system may induce a variety of immune-related adverse events. Neuromuscular immune complications are rare but they can be severe. Myasthenia gravis and inflammatory neuropathy are the most common neuromuscular adverse events but a variety of others including inflammatory myopathy are reported. The pathophysiologic mechanism of these autoimmune disorders may differ from that of non-ICPI-related immune diseases. Accordingly, while the optimal treatment for ICPI-related neuromuscular disorders generally follows a traditional paradigm, there are important novel considerations in selecting appropriate immunosuppressive therapy. This review presents 2 new cases, a summary of neuromuscular ICPI complications, and an approach to the diagnosis and treatment of these disorders. Muscle Nerve, 2018. © 2018 Wiley Periodicals, Inc.

  8. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic cholecys...

  9. Neuromuscular control of prey capture in frogs.

    OpenAIRE

    Nishikawa, K C

    1999-01-01

    While retaining a feeding apparatus that is surprisingly conservative morphologically, frogs as a group exhibit great variability in the biomechanics of tongue protraction during prey capture, which in turn is related to differences in neuromuscular control. In this paper, I address the following three questions. (1) How do frog tongues differ biomechanically? (2) What anatomical and physiological differences are responsible? (3) How is biomechanics related to mechanisms of neuromuscular cont...

  10. Sugammadex: A Review of Neuromuscular Blockade Reversal.

    Science.gov (United States)

    Keating, Gillian M

    2016-07-01

    Sugammadex (Bridion(®)) is a modified γ-cyclodextrin that reverses the effect of the steroidal nondepolarizing neuromuscular blocking agents rocuronium and vecuronium. Intravenous sugammadex resulted in rapid, predictable recovery from moderate and deep neuromuscular blockade in patients undergoing surgery who received rocuronium or vecuronium. Recovery from moderate neuromuscular blockade was significantly faster with sugammadex 2 mg/kg than with neostigmine, and recovery from deep neuromuscular blockade was significantly faster with sugammadex 4 mg/kg than with neostigmine or spontaneous recovery. In addition, recovery from neuromuscular blockade was significantly faster when sugammadex 16 mg/kg was administered 3 min after rocuronium than when patients spontaneously recovered from succinylcholine. Sugammadex also demonstrated efficacy in various special patient populations, including patients with pulmonary disease, cardiac disease, hepatic dysfunction or myasthenia gravis and morbidly obese patients. Intravenous sugammadex was generally well tolerated. In conclusion, sugammadex is an important option for the rapid reversal of rocuronium- or vecuronium-induced neuromuscular blockade.

  11. Neuromuscular blockade in the elderly patient

    Directory of Open Access Journals (Sweden)

    Lee LA

    2016-06-01

    Full Text Available Luis A Lee, Vassilis Athanassoglou, Jaideep J Pandit Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Abstract: Neuromuscular blockade is a desirable or even essential component of general anesthesia for major surgical operations. As the population continues to age, and more operations are conducted in the elderly, due consideration must be given to neuromuscular blockade in these patients to avoid possible complications. This review considers the pharmacokinetics and pharmacodynamics of neuromuscular blockade that may be altered in the elderly. Compartment distribution, metabolism, and excretion of drugs may vary due to age-related changes in physiology, altering the duration of action with a need for reduced dosage (eg, aminosteroids. Other drugs (atracurium, cisatracurium have more reliable duration of action and should perhaps be considered for use in the elderly. The range of interpatient variability that neuromuscular blocking drugs may exhibit is then considered and drugs with a narrower range, such as cisatracurium, may produce more predictable, and inherently safer, outcomes. Ultimately, appropriate neuromuscular monitoring should be used to guide the administration of muscle relaxants so that the risk of residual neuromuscular blockade postoperatively can be minimized. The reliability of various monitoring is considered. This paper concludes with a review of the various reversal agents, namely, anticholinesterase drugs and sugammadex, and the alterations in dosing of these that should be considered for the elderly patient. Keywords: anesthesia, elderly, drugs, pharmacokinetics, pharmacodynamics 

  12. Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina

    OpenAIRE

    Imbelloni, Luiz Eduardo; Beato, Lúcia; Cordeiro, José Antônio

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A técnica transarterial com grandes doses de anestésico local resulta em alta efetividade para o bloqueio axilar do plexo braquial. A técnica utilizando múltiplos estímulos exige mais tempo e maior experiência. Este estudo prospectivo compara a latência e o índice de sucesso do bloqueio do plexo braquial usando duas técnicas de localização: transarterial ou múltipla estimulação dos nervos. MÉTODO: A lidocaína com epinefrina, 800 mg, foi usada inicialmente para o blo...

  13. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico El bloqueo selectivo de los nervios supraescapular y axilar promueve una analgesia satisfactoria y un menor grado de bloqueo motor: comparación con el bloqueo interescalénico Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block: comparison with interscalene block

    Directory of Open Access Journals (Sweden)

    Patrícia Falcão Pitombo

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Cirurgias artroscópicas do ombro cursam com intensa dor pós-operatória. Diversas técnicas analgésicas têm sido preconizadas. O objetivo deste estudo foi comparar o bloqueio dos nervos supraescapular e axilar nas cirurgias artroscópicas de ombro com a abordagem interescalênica do plexo braquial. MÉTODO: Sessenta e oito pacientes foram alocados em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI e grupo seletivo (GS, sendo ambas as abordagens realizadas com neuroestimulador. No GI, após resposta motora adequada foram injetados 30 mL de levopubivacaína em excesso enantiomérico de 50% a 0,33% com adrenalina 1:200.000. No GS, após resposta motora do nervo supraescapular e axilar, foram injetados 15 mL da mesma substância em cada nervo. Em seguida, realizada anestesia geral. Variáveis avaliadas: tempo para realização dos bloqueios, analgesia, consumo de opioide, bloqueio motor, estabilidade cardiocirculatória, satisfação e aceitabilidade pelo paciente. RESULTADOS: Tempo para execução do bloqueio interescalênico foi significativamente menor que para realização do bloqueio seletivo. Analgesia foi significativamente maior no pós-operatório imediato no GI e no pós-operatório tardio no GS. Consumo de morfina foi significativamente maior na primeira hora no GS. Bloqueio motor foi significativamente menor no GS. Estabilidade cardiocirculatória, satisfação e aceitabilidade da técnica pelo paciente não diferiram entre os grupos. Ocorreu uma falha no GI e duas no GS. CONCLUSÕES: Ambas as técnicas são seguras, eficazes com mesmo grau de satisfação e aceitabilidade. O bloqueio seletivo de ambos os nervos apresentou analgesia satisfatória, com a vantagem de proporcionar bloqueio motor restrito ao ombro.JUSTIFICATIVA Y OBJETIVOS: Las cirugías artroscópicas del hombro cursan con un intenso dolor postoperatorio. Diversas técnicas analgésicas han sido preconizadas

  14. Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block

    Directory of Open Access Journals (Sweden)

    Gustavo J. Ventura Couto

    2008-03-01

    Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

  15. Bloqueio completo do ramo esquerdo esforço-induzido: prevalência e prognóstico

    Directory of Open Access Journals (Sweden)

    Ricardo Stein

    2011-07-01

    Full Text Available FUNDAMENTO: O bloqueio completo do ramo esquerdo esforço-induzido (BCRE E-I é um achado infrequente ao teste de exercício e sua prevalência e significado prognóstico não são claros. OBJETIVO: Avaliar de forma longitudinal a prevalência e o significado prognóstico do BCRE E-I em homens americanos veteranos de guerra. MÉTODOS: Avaliamos 9.623 pacientes que realizaram ergometria em esteira (TE entre 1987 e 2007. Os desfechos foram comparados entre aqueles com TE NL, os com BCRE E-I e os que apresentaram Dep ST anormal. A mortalidade e a causa das mortes foram identificadas de forma cega para os resultados do TE. RESULTADOS: Nesta coorte prospectiva, 6922 indivíduos apresentaram TE NL (57,2 ± 11,4 anos, 1.739 apresentaram Dep ST anormal (62,7 ± 9,8 anos e 38 casos de BCRE E-I foram identificados (65,2 ± 11,9 anos. A prevalência do BCRE E-I foi 0,38%. Após 8,8 anos, ocorreram 1.699 mortes por todas as causas e 610 mortes cardiovasculares (CV. Doença arterial coronária e insuficiência cardíaca foram mais prevalentes nos pacientes com BCRE E-I. Pacientes com BCRE E-I tiveram razão de azar de 2,37 (p = 0,002 para mortalidade por todas as causas, mas a mesma não foi significativa quando ajustada para idade ou quando a mortalidade cardiovascular foi o desfecho avaliado. CONCLUSÃO: BCRE E-I é um achado raro. Indivíduos com BCRE E-I apresentam maior mortalidade por todas as causas quando comparados aqueles com TE NL. No entanto, tal fato é explicado por esses pacientes serem significativamente mais velhos e por apresentarem mais enfermidades cardiovasculares associadas.

  16. Intrauterine neuromuscular blockade in fetus.

    Science.gov (United States)

    Fan, S Z; Huang, F Y; Lin, S Y; Wang, Y P; Hsieh, F J

    1990-03-01

    Antenatal intrauterine fetal therapy has now become the target of numerous invasive diagnostic and therapeutic maneuvers. Fetal motion during intrauterine fetal therapy not only makes these procedures technically more difficult but also increases the likelihood of trauma to the umbilical vessels and the fetus. Combination of high doses of sedatives, tranquilizers, and narcotics rarely results in adequate suppression of fetal movement. Such medication puts the mother at risk of respiratory depression, regurgitation and aspiration. The use of pancuronium or atracurium to temporarily arrest fetal movement in ten fetus is reported. After an initial ultrasound assessment of fetal lie, placental location, and umbilical cord insertion site, the fetal weight was calculated by the ultrasound parameters of biparietal diameter and abdominal circumference. Under ultrasound guidance, we injected pancuronium 0.15 mg/kg or atracurium 1.0 mg/kg using a 23-gauge spinal needle into the fetal gluteal muscle. Short-term paralysis of the fetus was induced in all cases. Fetal movement stopped by sonographic observation within 5.8 +/- 2.3 min in the pancuronium group and 4.7 +/- 1.8 min in the atracurium group. Fetal movements returned both to maternal sensation or ultrasonic observation by 92 +/- 23 min in the first group and 36 +/- 11 min in the second group. No adverse effect of the relaxant has been observed in any of the mothers. There was no evidence of local soft tissue, nerve or muscle damage at the site of injection on initial examination of the neonates after delivery. The use of neuromuscular relaxant in fetus was a safe and useful method.

  17. 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.

  18. Prolongation of rapacuronium neuromuscular blockade by clindamycin and magnesium.

    Science.gov (United States)

    Sloan, Paul A; Rasul, Mazhar

    2002-01-01

    We report a prolonged neuromuscular block with the nondepolarizing muscle relaxant rapacuronium in the presence of clindamycin. Even when using "short-acting" muscle relaxants, the anesthesiologist must routinely monitor the neuromuscular function.

  19. Bloqueio peridural caudal: técnica anestésica de uso exclusivo em crianças? É possível sua realização em adultos? Qual o papel do ultrassom nesse contexto?

    Directory of Open Access Journals (Sweden)

    Ilana Esquenazi Najman

    2011-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. Com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. Entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos. CONTEÚDO: Uma revisão literária sobre a anatomia da região sacral e da técnica anestésica necessária para a realização adequada do bloqueio caudal foi promovida. Além disso, artigos recentes sobre estudos realizados com bloqueios peridurais caudais guiados por ultrassom tanto em crianças quanto em adultos também foram incluídos. CONCLUSÕES: O ultrassom, apesar de suas limitações, pode ser útil como ferramenta adjuvante no posicionamento da agulha no espaço caudal. Permite a fácil identificação da anatomia sacral, além de visualização da injeção, em tempo real. Sua natureza portátil, não invasiva e livre de exposição à radiação faz dele uma tecnologia atrativa na sala operatória, principalmente na emergência de casos difíceis. Entretanto, como seu uso em bloqueios centrais do neuroeixo ainda é muito primitivo, é necessário que mais pesquisas sejam feitas para se consagre como técnica de rotina na prática anestésica.

  20. Determinação do volume mínimo efetivo de bupivacaína 0,5% para bloqueio do plexo braquial por via axilar guiado por ultrassom

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Cunha Ferraro

    2014-01-01

    Full Text Available Justificativa e objetivo: o uso do ultrassom para acompanhar o correto posicionamento da agulha e a dispersão do anestésico local permitiu a redução do volume de anestésico local necessário para o bloqueio de nervos periféricos. Existem poucos trabalhos sobre o volume mínimo efetivo de anestésico local para o bloqueio do plexo braquial via axilar (BPVA. Este estudo foi conduzido com o objetivo de determinar o volume mínimo efetivo (VE90 de bupivacaína 0,5% comadrenalina (1:200.000 para o BPVA guiado por ultrassom. Método: o método up-and-down proposto por Massey e Dixon foi usado para o cálculo do volume mínimo efetivo. A dose inicial foi de 5 ml por nervo (radial, mediano, ulnar e musculocutâneo. No caso de falha do bloqueio, o volume era aumentado em 0,5 mL por nervo. O sucesso do bloqueio resultava na diminuição do volume em 0,5 mL por nervo para o paciente subsequente. O sucesso do bloqueio foi definido como bloqueio da função motora ≤ 2 segundo a escala de Bromage modificada, ausência de sensibilidade térmica e de resposta ao pinprick. Foi definido como critério para término do estudo a obtenção de cinco casos de falha seguidos de casos de sucesso. Resultados: foram incluídos 19 pacientes no estudo. O volume mínimo efetivo (VE90 de bupi-vacaína 0,5% com 1:200.000 de adrenalina foi de 1,56 ml (IC 95% 0,99-3,5 por nervo. Conclusão: este trabalho corrobora alguns estudos que mostram que é possível obter anestesia cirúrgica com baixos volumes de anestésico local para bloqueios de nervo periférico guiados por ultrassom.

  1. Computed tomography (CT) in neuromuscular disorders

    International Nuclear Information System (INIS)

    Novak, M.; Ambler, Z.

    1997-01-01

    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

  2. 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 Ⅱ (GSD Ⅱ, 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

  3. Sugammadex Improves Neuromuscular Function in Patients ...

    African Journals Online (AJOL)

    2018-02-23

    Feb 23, 2018 ... aminoglycosides), history of allergy to neuromuscular blocking agents, opioids or other drugs, and alcohol and drug dependence. Patients were divided into two ... titration microcalorimetry investigated the likelihood of the formation of complexes between sugammadex and other steroidal and nonsteroidal ...

  4. Neuromuscular transmission: new concepts and agents.

    NARCIS (Netherlands)

    Boer, H.D. de

    2009-01-01

    Sugammadex is the first selective relaxant binding agent which was originally designed to reverse the steroidal NMB drug rocuronium. The results of recent studies demonstrate that sugammadex is effective for reversal of rocuronium and vecuronium-induced neuromuscular block without apparent

  5. Níveis de organoclorados em queijos produzidos no Estado do Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Santos Joice Sifuentes dos

    2006-01-01

    Full Text Available Os compostos organoclorados são pesticidas que foram usados na agricultura, no controle de vetores biológicos e de ectoparasitas do gado. Atualmente seu uso está proibido no Brasil, exceto para o controle de vetores biológicos em casos de epidemia. No entanto, resíduos desses compostos ainda são encontrados no meio ambiente e nos alimentos. Por esse motivo, avaliou-se a presença de organoclorados em queijos produzidos no Estado do Rio Grande do Sul (Brasil, bem como os níveis desses compostos em queijos dos tipos "colonial" e industrializado. A gordura das amostras foi extraída pela adição de sulfato de sódio seguida por uma lavagem com éter de petróleo. Os pesticidas foram purificados a partir da gordura em uma coluna contendo florisil e eluída com hexano. O extrato obtido foi utilizado para as análises cromatográficas (cromatografia gasosa com captura de elétrons. Os compostos alfa-HCH, HCB, lindano, aldrin, o,p-DDD e p,p-DDD foram identificados em 100% das amostras; o,p-DDE em 88,9% e o,p-DDT em 94,4%. p,p-DDD foi o pesticida detectado na maior concentração (11,5ng g-1 de gordura, seguido pelo aldrin (8,7ng g-1 de gordura. Os níveis de alfa-HCH, aldrin e DDT total foram maiores que o limite máximo de resíduos em 2, 8 e 1 amostra de queijo, respectivamente. Não foram encontradas diferenças significativas nos níveis de organoclorados entre as amostras de queijo "colonial" e industrializado, ou entre amostras de queijos produzidos em três regiões do Estado.

  6. QUALIDADE MICROBIOLÓGICA DE SALAMES E QUEIJOS COLONIAIS PRODUZIDOS E COMERCIALIZADOS NA REGIÃO SUDOESTE DO PARANÁ

    Directory of Open Access Journals (Sweden)

    Kérley Braga Pereira Bento Casaril

    2017-06-01

    e uma amostra com Salmonella spp. tornando-os queijos impróprios para o consumo. Os resultados obtidos indicam que os salames e os queijos coloniais produzidos e comercializados na região sudoeste do Paraná devem merecer atenção dos órgãos de saúde pública, pois representam um risco potencial para a saúde do consumidor.

  7. ESTUDO DO EFEITO DA TERAPIA FOTODINÂMICA ANTIMICROBIANA SOBRE A VIABILIDADE DO BIOFILME PRODUZIDO POR Candida albicans

    Directory of Open Access Journals (Sweden)

    Ana Paula Pinto

    2017-03-01

    Full Text Available A C. albicans é um fungo comensal e oportunista, que em casos de imunossupressão pode causar infecções e levar o indivíduo à morte. O biofilme produzido por C. albicans apresenta resistência a vários antifúngicos, pois é formado por uma matriz extracelular que dificulta a difusão dos fármacos. A Terapia Fotodinâmica Antimicrobiana (TFA é uma terapia que combina uma fonte de luz visível, um agente fotossensível (não tóxico e oxigênio. Esta interação promove a produção de espécies reativas de oxigênio (ERO’s, que alteram a permeabilidade da membrana celular e podem levar à morte celular de microrganismos. Foi realizada a TFA em biofilmes produzidos por C. albicans em diferentes fases de desenvolvimento. A fonte de luz utilizada foi um Light Emitting Diode (LED (630nm e o agente fotossenssível utilizado foi o Azul de Toluidina (AT. Os resultados demonstraram que tanto sobre a formação quanto sobre o biofilme produzido por C. albicans a TFA foi capaz de reduzir a viabilidade celular e alterar a morfologia, diminuindo a quantidade do número de células e de filamentos. Assim, a TFA demonstra ser uma potencial terapia antifúngica.

  8. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

    Directory of Open Access Journals (Sweden)

    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.

  9. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    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...

  10. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning

    DEFF Research Database (Denmark)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel

    2017-01-01

    neuromuscular blockade in surgical patients at 6 Danish teaching hospitals. METHODS: In this interrupted time series study, we are collecting data repeatedly, in consecutive 3-week periods, before and after the intervention, and we will analyze the effect using segmented regression analysis. Anesthesia...... and an increased risk of respiratory complications. Use of an objective neuromuscular monitoring device may prevent residual block. Despite this, many anesthetists refrain from using the device. Efforts to increase the use of objective monitoring are time consuming and require the presence of expert personnel...... practice, and patient outcomes. The primary outcome is use of neuromuscular monitoring in patients according to the type of muscle relaxant received. Secondary outcomes include last recorded train-of-four value, administration of reversal agents, and time to discharge from the postanesthesia care unit...

  11. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning

    DEFF Research Database (Denmark)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel

    2017-01-01

    BACKGROUND: Muscle relaxants facilitate endotracheal intubation under general anesthesia and improve surgical conditions. Residual neuromuscular blockade occurs when the patient is still partially paralyzed when awakened after surgery. The condition is associated with subjective discomfort and an......-learning module can increase anesthetists' use of neuromuscular monitoring. TRIAL REGISTRATION: Clinicaltrials.gov NCT02925143; https://clinicaltrials.gov/ct2/show/NCT02925143 (Archived by WebCite® at http://www.webcitation.org/6s50iTV2x)....

  12. Chemical encapsulation of rocuronium by synthetic cyclodextrin derivatives: reversal of neuromuscular block in anaesthetized Rhesus monkeys.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: At present, reversal of neuromuscular block induced by steroidal neuromuscular blocking agents (NMBAs) is achieved by administration of cholinesterase inhibitors. Chemical encapsulation of steroidal NMBAs, such as rocuronium, by a cyclodextrin is a new concept in neuromuscular block

  13. Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II Suprascapular nerve block: important procedure in clinical practice. Part II

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2012-08-01

    Full Text Available O bloqueio do nervo supraescapular é um método de tratamento reprodutível, confiável e extremamente efetivo no controle da dor no ombro. Esse método tem sido amplamente utilizado por profissionais na prática clínica, como reumatologistas, ortopedistas, neurologistas e especialistas em dor, na terapêutica de enfermidades crônicas, como lesão irreparável do manguito rotador, artrite reumatoide, sequelas de AVC e capsulite adesiva, o que justifica a presente revisão (Parte II. O objetivo deste estudo foi descrever as técnicas do procedimento e suas complicações descritas na literatura, já que a primeira parte reportou as indicações clínicas, drogas e volumes utilizados em aplicação única ou múltipla. Apresentamse, detalhadamente, os acessos para a realização do procedimento tanto direto como indireto, anterior e posterior, lateral e medial, e superior e inferior. Diversas são as opções para se realizar o bloqueio do nervo supraescapular. Apesar de raras, as complicações podem ocorrer. Quando bem indicado, este método deve ser considerado.The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifies the present review (Part II. The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the first part reported the clinical indications, drugs, and volumes used in single or multiple procedures. We present in details the accesses used in the procedure: direct and indirect, anterior and posterior, lateral and medial, upper and lower. There are several options to perform suprascapular nerve block

  14. ConsciÃncia Corporal e Ancestralidade Africana: Conceitos SociopoÃticos Produzidos por Pessoas de Santo

    OpenAIRE

    Norval Batista Cruz

    2009-01-01

    Este estudo apresenta os conceitos sociopoÃticos produzidos por uma comunidade de terreiro de candomblÃ, Ilà Axà Omo TifÃ, localizada no bairro de Jangurussu, na periferia de Fortaleza-Ce. O tema gerador da pesquisa à consciÃncia corporal e ancestralidade africana. Noto que, apesar dos terreiros de candomblÃ, em principio estarem mais conectados com a cultura de matriz africana, nem sempre se encontra uma prÃtica de consciÃncia corporal associada à ancestralidade africana e Ãs vezes, hà uma d...

  15. Modelagem da retração por secagem de concretos produzidos com agregados reciclados

    Directory of Open Access Journals (Sweden)

    A. E. B. Cabral

    Full Text Available A preocupação com a conservação dos recursos não renováveis tem levado o meio acadêmico a pesquisar sobre a utilização dos agregados reciclados na produção de concretos. A retração por secagem do concreto é um fenômeno que está intimamente ligado à perda de água da massa do concreto, a qual é quase inevitável, desde que o concreto esteja exposto a um ambiente de umidade abaixo da condição de saturação. Este artigo apresenta um estudo experimental, onde foram produzidos concretos variando-se a relação água/cimento (de 0,4 a 0,8 e o tipo e a proporção dos três principais constituintes do resíduo de construção e demolição (concreto, argamassa e cerâmica vermelha usados como agregados graúdos e miúdos reciclados, produzindo-se modelos matemáticos que correlacionam tais variáveis com a retração por secagem dos concretos aos 56 e 224 dias de idade. Os resultados apontam que, para a idade de 56 dias, o modelo apresentou uma excessiva variabilidade, manifestando somente 4 das 7 variáveis como termos significativos. Para a idade de 224 dias, o modelo proposto ainda apresentou uma elevada variabilidade, entretanto todas as variáveis foram tidas como significativas. Os resultados apontam que a substituição do agregado natural pelo reciclado propicia um acréscimo na retração por secagem, sendo este efeito mais sentido para a substituição do agregado miúdo. O efeito mais pronunciado está associado ao emprego do agregado miúdo reciclado de concreto e o menor, ao do agregado graúdo reciclado de concreto.

  16. Classification of neuromuscular blocking agents in a new neuromuscular preparation of the chick in vitro

    NARCIS (Netherlands)

    Riezen, H. van

    1968-01-01

    A neuromuscular preparation of the chick is described: 1. 1. The sciatic nerve-tibilis anterior muscle preparation of the 2–10 days old chick fulfils all criteria of an assay preparation and differentiates between curare-like and decamethonium-like agents. 2. 2. The preparation responds to

  17. Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients.

    Science.gov (United States)

    Silva, Mauro Prado DA; Matsui, Christiano; Kim, Daniel Dongiou; Vieira, Joaquim Edson; Malheiros, Carlos Alberto; Mathias, Ligia Andrade Silva Telles

    2017-01-01

    to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg. determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. trinta e um pacientes foram

  18. Neuromuscular adaptations induced by adjacent joint training.

    Science.gov (United States)

    Ema, R; Saito, I; Akagi, R

    2018-03-01

    Effects of resistance training are well known to be specific to tasks that are involved during training. However, it remains unclear whether neuromuscular adaptations are induced after adjacent joint training. This study examined the effects of hip flexion training on maximal and explosive knee extension strength and neuromuscular performance of the rectus femoris (RF, hip flexor, and knee extensor) compared with the effects of knee extension training. Thirty-seven untrained young men were randomly assigned to hip flexion training, knee extension training, or a control group. Participants in the training groups completed 4 weeks of isometric hip flexion or knee extension training. Standardized differences in the mean change between the training groups and control group were interpreted as an effect size, and the substantial effect was assumed to be ≥0.20 of the between-participant standard deviation at baseline. Both types of training resulted in substantial increases in maximal (hip flexion training group: 6.2% ± 10.1%, effect size = 0.25; knee extension training group: 20.8% ± 9.9%, effect size = 1.11) and explosive isometric knee extension torques and muscle thickness of the RF in the proximal and distal regions. Improvements in strength were accompanied by substantial enhancements in voluntary activation, which was determined using the twitch interpolation technique and RF activation. Differences in training effects on explosive torques and neural variables between the two training groups were trivial. Our findings indicate that hip flexion training results in substantial neuromuscular adaptations during knee extensions similar to those induced by knee extension training. © 2017 The Authors. Scandinavian Journal of Medicine & Science In Sports Published by John Wiley & Sons Ltd.

  19. Neuromuscular Manifestations of West Nile Virus Infection

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    A. Arturo eLeis

    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

  20. Acute neuromuscular weakness associated with dengue infection

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    Harmanjit Singh Hira

    2012-01-01

    Full Text Available Background: Dengue infections may present with neurological complications. Whether these are due to neuromuscular disease or electrolyte imbalance is unclear. Materials and Methods: Eighty-eight patients of dengue fever required hospitalization during epidemic in year 2010. Twelve of them presented with acute neuromuscular weakness. We enrolled them for study. Diagnosis of dengue infection based on clinical profile of patients, positive serum IgM ELISA, NS1 antigen, and sero-typing. Complete hemogram, kidney and liver functions, serum electrolytes, and creatine phosphokinase (CPK were tested. In addition, two patients underwent nerve conduction velocity (NCV test and electromyography. Results: Twelve patients were included in the present study. Their age was between 18 and 34 years. Fever, myalgia, and motor weakness of limbs were most common presenting symptoms. Motor weakness developed on 2 nd to 4 th day of illness in 11 of 12 patients. In one patient, it developed on 10 th day of illness. Ten of 12 showed hypokalemia. One was of Guillain-Barré syndrome and other suffered from myositis; they underwent NCV and electromyography. Serum CPK and SGOT raised in 8 out of 12 patients. CPK of patient of myositis was 5098 IU. All of 12 patients had thrombocytopenia. WBC was in normal range. Dengue virus was isolated in three patients, and it was of serotype 1. CSF was normal in all. Within 24 hours, those with hypokalemia recovered by potassium correction. Conclusions: It was concluded that the dengue virus infection led to acute neuromuscular weakness because of hypokalemia, myositis, and Guillain-Barré syndrome. It was suggested to look for presence of hypokalemia in such patients.

  1. Medical back belt with integrated neuromuscular electrical stimulation

    NARCIS (Netherlands)

    Bottenberg, E. (Eliza); Brinks, G.J. (Ger); Hesse, J. (Jenny)

    2014-01-01

    The medical back belt with integrated neuromuscular electrical stimulation is anorthopedic device, which has two main functions. The first function is to stimulate the backmuscles by using a neuromuscular electrical stimulation device that releases regular,electrical impulses. The second function of

  2. Neuromuscular function during a forward lunge in meniscectomized patients

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Damgaard, Jacob; Roos, Ewa M.

    2012-01-01

    This study aimed to investigate differences in knee joint kinematics, ground reaction force kinetics and neuromuscular activity including muscle coactivation, and medial versus lateral muscle activity during a forward lunge between the operated and contralateral legs of meniscectomized patients....... Such differences may represent early changes in neuromuscular function potentially contributing to the development of knee osteoarthritis....

  3. Recent achievements in restorative neurology: Progressive neuromuscular diseases

    International Nuclear Information System (INIS)

    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

  4. Electrophysiological study in neuromuscular junction disorders

    Directory of Open Access Journals (Sweden)

    Ajith Cherian

    2013-01-01

    Full Text Available This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS, congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS. SFEMG requires skill and patience and its availability is limited to a few centers. For RNS supramaximal stimulation is essential and so is display of the whole waveform of each muscle response at maximum amplitude. The amplitudes of the negative phase of the first and fourth responses are measured from baseline to negative peak, and the percent change of the fourth response compared with the first represents the decrement or increment. A decrement greater than 10% is accepted as abnormal and smooth progression of response amplitude train and reproducibility form the crux. In suspected LEMS the effect of fast rates of stimulation should be determined after RNS response to slow rates of stimulation. Caution is required to avoid misinterpretation of potentiation and pseudofacilitation.

  5. Motor neuron, nerve, and neuromuscular junction disease.

    Science.gov (United States)

    Finsterer, Josef; Papić, Lea; Auer-Grumbach, Michaela

    2011-10-01

    The aim is to review the most relevant findings published during the last year concerning clinical, genetic, pathogenic, and therapeutic advances in motor neuron disease, neuropathies, and neuromuscular junction disorders. Studies on animal and cell models have improved the understanding of how mutated survival motor neuron protein in spinal muscular atrophy governs the pathogenetic processes. New phenotypes of SOD1 mutations have been described. Moreover, animal models enhanced the insight into the pathogenetic background of sporadic and familial amyotrophic lateral sclerosis. Novel treatment options for motor neuron disease have been described in humans and animal models. Considerable progress has been achieved also in elucidating the genetic background of many forms of inherited neuropathies and high clinical and genetic heterogeneity has been demonstrated. Mutations in MuSK and GFTP1 have been shown to cause new types of congenital myasthenic syndromes. A third type of autoantibodies (Lrp4) has been detected to cause myasthenia gravis. Advances in the clinical and genetic characterization of motor neuron diseases, neuropathies, and neuromuscular transmission defects have important implications on the fundamental understanding, diagnosis, and management of these disorders. Identification of crucial steps of the pathogenetic process may provide the basis for the development of novel therapeutic strategies.

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

    Directory of Open Access Journals (Sweden)

    Hemmerling Thomas

    2008-01-01

    Full Text Available 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 immediate re-establishment of normal neuromuscular transmission at the end of surgery. Postoperative residual muscle paralysis is one of the major hurdles for immediate or early extubation after cardiac surgery. Nondepolarising neuromuscular blocking drugs for cardiac surgery should therefore be easy to titrate, of rapid onset and short duration of action with a pathway of elimination independent from hepatic or renal dysfunction, and should equally not affect haemodynamic stability. The difference between repetitive bolus application and continuous infusion is outlined in this review, with the pharmacodynamic and pharmacokinetic characteristics of vecuronium, pancuronium, rocuronium, and cisatracurium. Kinemyography and acceleromyography are the most important currently used neuromuscular monitoring methods. Whereas monitoring at the adductor pollicis muscle is appropriate at the end of surgery, monitoring of the corrugator supercilii muscle better reflects neuromuscular blockade at more central, profound muscles, such as the diaphragm, larynx, or thoraco-abdominal muscles. In conclusion, cisatracurium or rocuronium is recommended for neuromuscular blockade in modern cardiac surgery.

  7. Morangos produzidos no semiárido de Minas Gerais: qualidade do fruto e da polpa congelados

    Directory of Open Access Journals (Sweden)

    Ariane Castricini

    2017-08-01

    Full Text Available Resumo O congelamento de morangos inteiros ou em polpa pode fornecer matéria-prima para sua utilização em iogurtes, recheios, coberturas, sorvetes e sucos, fora da safra. Entretanto, ainda que o consumo não seja in natura, a qualidade do produto final deve ser satisfatória. Objetivou-se avaliar a qualidade de morangos produzidos no Semiárido de Minas Gerais, congelados inteiros e em polpa, durante o armazenamento. Frutos das cultivares Tudla, Oso Grande, Albion e Portola foram produzidos em Mocambinho, distrito de Jaíba-MG, após a colheita, foram lavados, embalados (inteiros ou polpa a vácuo e congelados por até 180 dias. Os tratamentos foram constituídos por cultivares (c e dias de armazenamento (d, constituindo fatorial duplo c × d, em que se utilizaram três repetições de 10 frutos por parcela ou três polpas embaladas, para as avaliações de frutos congelados inteiros e em polpa, respectivamente. A intensidade da cor vermelha dos morangos inteiros ou em polpa reduziu-se durante o armazenamento (redução de °hue; quando inteiros, ‘Tudla’, ‘Oso Grande’ e ‘Portola’ foram vermelhos mais claros que ‘Albion’, mas, em polpa, não ocorreu diferença entre ‘Tudla’ e ‘Albion’. Morangos ‘Oso Grande’ armazenados inteiros ou em polpa tiveram maior teor de sólidos solúveis em relação àqueles das demais cultivares, e ‘Portola’, o menor teor e a menor acidez titulável (quando inteiros. ‘Tudla’ apresentou frutos e polpa mais ácidos. Durante o armazenamento de morangos congelados inteiros ou em polpa, produzidos no Semiárido de Minas Gerais, ocorreram modificações nos parâmetros cor, sólidos solúveis e acidez titulável.

  8. [The hip joint in neuromuscular disorders].

    Science.gov (United States)

    Strobl, W M

    2009-07-01

    Physiologic motor and biomechanical parameters are prerequisites for normal hip development and hip function. Disorders of muscle activity and lack of weight bearing due to neuromuscular diseases may cause clinical symptoms such as an unstable hip or reduced range of motion. Disability and handicap because of pain, hip dislocation, osteoarthritis, gait disorders, or problems in seating and positioning are dependent on the severity of the disease, the time of occurrence, and the means of prevention and treatment. Preservation of pain-free and stable hip joints should be gained by balancing muscular forces and by preventing progressive dislocation. Most important is the exact indication of therapeutic options such as movement and standing therapy as well as drugs and surgery.

  9. Riscos cardiovasculares do bloqueio androgênico Riesgos cardiovasculares del bloqueo androgénico Cardiovascular risks of androgen deprivation therapy

    Directory of Open Access Journals (Sweden)

    Adriano Freitas Ribeiro

    2010-09-01

    Full Text Available O adenocarcinoma de próstata é o câncer mais comum no sexo masculino após o câncer de pele. Entre as várias formas de tratamento do câncer de próstata, a terapia de bloqueio androgênico é uma modalidade consagrada nos pacientes com doença metastática ou localmente avançada, que provavelmente resulta em aumento de sobrevida. No entanto, o bloqueio androgênico é causador de uma série de consequências adversas. Complicações como osteoporose, disfunção sexual, ginecomastia, anemia e alterações na composição corporal são bem conhecidas. Recentemente, uma série de complicações metabólicas foi descrita como aumento da circunferência abdominal, resistência à insulina, hiperglicemia, diabete, dislipidemia e síndrome metabólica com consequente aumento do risco de eventos coronarianos e mortalidade cardiovascular nessa população específica. Este artigo de atualização apresenta uma revisão bibliográfica realizada no MEDLINE de toda literatura publicada em inglês no período de 1966 até junho de 2009, com as seguintes palavras-chave: androgen deprivation therapy, androgen supression therapy, hormone treatment, prostate cancer, metabolic syndrome e cardiovascular disease, no intuito de analisar quais seriam os reais riscos cardiovasculares da terapia de deprivação androgênica, também chamada bloqueio androgênico, nos pacientes com câncer de próstata.El adenocarcinoma de próstata es el cáncer más común en el sexo masculino después del cáncer de piel. Entre las varias formas de tratamiento del cáncer de próstata, la terapia de bloqueo androgénico es una modalidad consagrada en los pacientes con enfermedad metastásica o localmente avanzada, que probablemente resulta en aumento de sobrevida. Mientras tanto, el bloqueo androgénico es causante de una serie de consecuencias adversas. Complicaciones como osteoporosis, disfunción sexual, ginecomastia, anemia y alteraciones en la composición corporal son

  10. Genetics of Pediatric-Onset Motor Neuron and Neuromuscular Diseases

    Science.gov (United States)

    2015-08-24

    Spinal Muscular Atrophy; Charcot-Marie-Tooth Disease; Muscular Dystrophy; Spinal Muscular Atrophy With Respiratory Distress 1; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Neuromuscular Disease; Peroneal Muscular Atrophy; Fragile X Syndrome

  11. The role of proprioception and neuromuscular stability in carpal instabilities.

    Science.gov (United States)

    Hagert, E; Lluch, A; Rein, S

    2016-01-01

    Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities. © The Author(s) 2015.

  12. Effects of napping on neuromuscular fatigue in myasthenia gravis.

    Science.gov (United States)

    Kassardjian, Charles D; Murray, Brian J; Kokokyi, Seint; Jewell, Dana; Barnett, Carolina; Bril, Vera; Katzberg, Hans D

    2013-11-01

    The relationship between sleep and neuromuscular fatigue is understood poorly. The goal of this study was to evaluate the effects of napping on quantitative measures of neuromuscular fatigue in patients with myasthenia gravis (MG). Eight patients with mild to moderate MG were recruited. Patients underwent maintenance of wakefulness tests (MWT) and multiple sleep latency tests (MSLT). The Quantitative Myasthenia Gravis Score (QMGS) was measured before nap and after each nap to examine the effects of napping and sleep on neuromuscular weakness. Results showed that QMGS improves only after naps where patients slept more than 5 min but not where patients did not sleep or slept less than 5 min. Daytime napping mitigates neuromuscular fatigue in patients with MG, especially if patients slept for more than 5 min. Copyright © 2013 Wiley Periodicals, Inc.

  13. Raquianestesia total após bloqueio do plexo lombar por via posterior: relato de caso Raquianestesia total después del bloqueo del plexo lumbar por vía posterior: relato de caso Total spinal block after posterior lumbar plexus blockade: case report

    OpenAIRE

    Leonardo Teixeira Domingues Duarte; Renato Ângelo Saraiva

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo lombar pode ser bastante útil em procedimentos cirúrgicos do quadril, da coxa e do joelho, mas exige prática do anestesiologista tendo em vista suas potenciais complicações. O presente relato tem por objetivo apresentar um caso de raquianestesia total após bloqueio do plexo lombar pela via posterior e discutir o provável mecanismo fisiopatológico. RELATO DO CASO: Paciente do sexo masculino, 34 anos, 97 kg, estado físico ASA I, programado para art...

  14. Neuromuscular fatigue and recovery profiles in individuals with intellectual disability

    OpenAIRE

    Borji , Rihab; Zghal , Firas; Zarrouk , Nidhal; Martin , Vincent; Sahli , Sonia; Rebai , Haithem

    2017-01-01

    International audience; Purpose: This study aimed to explore neuromuscular fatigue and recovery profiles in individuals with intellectual disability (ID) after exhausting submaximal contraction.Methods: Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief (3 s) isometric maximal voluntary contraction (IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during 33 min after an exhaus...

  15. Neuromuscular prehabilitation to prevent osteoarthritis after a traumatic joint injury.

    Science.gov (United States)

    Tenforde, Adam S; Shull, Pete B; Fredericson, Michael

    2012-05-01

    Post-traumatic osteoarthritis (PTOA) is a process resulting from direct forces applied to a joint that cause injury and degenerative changes. An estimated 12% of all symptomatic osteoarthritis (OA) of the hip, knee, and ankle can be attributed to a post-traumatic cause. Neuromuscular prehabilitation is the process of improving neuromuscular function to prevent development of PTOA after an initial traumatic joint injury. Prehabilitation strategies include restoration of normative movement patterns that have been altered as the result of traumatic injury, along with neuromuscular exercises and gait retraining to prevent the development of OA after an injury occurs. A review of the current literature shows that no studies have been performed to evaluate methods of neuromuscular prehabilitation to prevent PTOA after a joint injury. Instead, current research has focused on management strategies after knee injuries, the value of exercise in the management of OA, and neuromuscular exercises after total knee arthroplasty. Recent work in gait retraining that alters knee joint loading holds promise for preventing the development of PTOA after joint trauma. Future research should evaluate methods of neuromuscular prehabilitation strategies in relationship to the outcome of PTOA after joint injury. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. 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.

  17. Assessment of Motor Units in Neuromuscular Disease.

    Science.gov (United States)

    Henderson, Robert D; McCombe, Pamela A

    2017-01-01

    The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.

  18. Neuromuscular dentistry: Occlusal diseases and posture.

    Science.gov (United States)

    Khan, Mohd Toseef; Verma, Sanjeev Kumar; Maheshwari, Sandhya; Zahid, Syed Naved; Chaudhary, Prabhat K

    2013-01-01

    Neuromuscular dentistry has been a controversial topic in the field of dentistry and still remains debatable. The issue of good occlusion and sound health has been repeatedly discussed. Sometimes we get complains of sensitive teeth and sometimes of tired facial muscles on getting up in the morning. Owing to the intimate relation of masticatory apparatus with the cranium and cervico-scapular muscular system, the disorders in any system, draw attention from concerned clinicians involved in management, to develop an integrated treatment protocol for the suffering patients. There may be patients reporting to the dental clinics after an occlusal restoration or extraction, having pain in or around the temporomandibular joint, headache or neck pain. Although their esthetic demands must not be undermined during the course of treatment plan, whenever dental treatment of any sort is planned, occlusion/bite should be given prime importance. Very few dentist are able to diagnose the occlusal disease and of those who diagnose many people resort to aggressive treatment modalities. This paper aims to report the signs of occlusal disease, and discuss their association with TMDs and posture.

  19. Silent synapses in neuromuscular junction development.

    Science.gov (United States)

    Tomàs, Josep; Santafé, Manel M; Lanuza, Maria A; García, Neus; Besalduch, Nuria; Tomàs, Marta

    2011-01-01

    In the last few years, evidence has been found to suggest that some synaptic contacts become silent but can be functionally recruited before they completely retract during postnatal synapse elimination in muscle. The physiological mechanism of developmental synapse elimination may be better understood by studying this synapse recruitment. This Mini-Review collects previously published data and new results to propose a molecular mechanism for axonal disconnection. The mechanism is based on protein kinase C (PKC)-dependent inhibition of acetylcholine (ACh) release. PKC activity may be stimulated by a methoctramine-sensitive M2-type muscarinic receptor and by calcium inflow though P/Q- and L-type voltage-dependent calcium channels. In addition, tropomyosin-related tyrosine kinase B (trkB) receptor-mediated brain-derived neurotrophic factor (BDNF) activity may oppose the PKC-mediated ACh release depression. Thus, a balance between trkB and muscarinic pathways may contribute to the final functional suppression of some neuromuscular synapses during development. © 2010 Wiley-Liss, Inc.

  20. 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.

  1. Stem cell route to neuromuscular therapies.

    Science.gov (United States)

    Partridge, Terence A

    2003-02-01

    As applied to skeletal muscle, stem cell therapy is a reincarnation of myoblast transfer therapy that has resulted from recent advances in the cell biology of skeletal muscle. Both strategies envisage the reconstruction of damaged muscle from its precursors, but stem cell therapy employs precursors that are earlier in the developmental hierarchy. It is founded on demonstrations of apparently multipotential cells in a wide variety of tissues that can assume, among others, a myogenic phenotype. The main demonstrated advantage of such cells is that they are capable of colonizing many tissues, including skeletal and cardiac muscle via the blood vascular system, thereby providing the potential for a body-wide distribution of myogenic progenitors. From a practical viewpoint, the chief disadvantage is that such colonization has been many orders of magnitude too inefficient to be useful. Proposals for overcoming this drawback are the subject of much speculation but, so far, relatively little experimentation. This review attempts to give some perspective to the status of the stem cell as a therapeutic instrument for neuromuscular disease and to identify issues that need to be addressed for application of this technology.

  2. Bloqueio "3 em 1" por via anterior: bloqueio parcial, completo ou superdimensionado? Correlação entre anatomia, clínica e radio imagens Bloqueo "3 en 1" por vía anterior: bloqueo parcial, completo o superdimensionado? Correlación entre anatomía, clínica y radio imágenes Anterior "3-in-1" blockade: partial, total or overdimensioned block? Correlation between anatomy, clinic and radio images

    Directory of Open Access Journals (Sweden)

    Karl Otto Geier

    2004-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O clássico bloqueio "3 em 1" por via anterior tem suscitado divergências quanto ao envolvimento anestésico de seus três nervos participantes, o femoral, o cutâneo lateral da coxa e o obturador. O objetivo deste estudo é verificar o desfecho do bloqueio "3 em 1" por via anterior, através das técnicas: injeção única (G1, cateteres curtos (G2 e cateteres longos (G3. Os bloqueios "3 em 1", clinicamente identificados como completos ou superdimensionados foram, adicionalmente, investigados por meio de rádio imagem. MÉTODO: A identificação do espaço subfascial ilíaco nos bloqueios "3 em 1" com injeção única ou com cateteres foi feita pela perda de resistência ao ar. Em vários eventos dolorosos, o volume anestésico administrado variou entre 30 e 40 ml e a introdução cranial dos cateteres foi até 18 cm no espaço subfascial ilíaco. Quando a pesquisa clínica apontava envolvimento do nervo obturador ou de outro nervo adicional ao bloqueio "3 em 1", complementava-se a investigação com estudo radiográfico e tomodensiométrico com o propósito de estabelecer correspondência com a anatomia pélvica. RESULTADOS: O envolvimento dos nervos fêmoro cutâneo lateral e obturador não foram constantes, ao contrário do nervo femoral. No estudo, nenhum bloqueio "3 em 1" completo com injeção única (G1 se manifestou, e sim um bloqueio "2 em 1", com a participação eventual do ramo femoral do nervo genitofemoral (bloqueio "2,5 em 1". Contudo, quando foram utilizados cateteres curtos (G2, obteve-se bloqueio "3 em 1" em apenas um paciente, ao passo que com cateteres longos (G3 introduzidos no sentido cefálico até 18 cm no espaço subfascial ilíaco, três bloqueios "3 em 1" superdimensionados foram registrados, pelo envolvimento adicional dos nervos fibular comum em dois pacientes e o nervo tibial em um paciente. CONCLUSÕES: Apesar da pequena amostra, com injeção única (G1, sempre se obteve um bloqueio "2

  3. Lumbopelvic flexibility modulates neuromuscular responses during trunk flexion-extension.

    Science.gov (United States)

    Sánchez-Zuriaga, Daniel; Artacho-Pérez, Carla; Biviá-Roig, Gemma

    2016-06-01

    Various stimuli such as the flexibility of lumbopelvic structures influence the neuromuscular responses of the trunk musculature, leading to different load sharing strategies and reflex muscle responses from the afferents of lumbopelvic mechanoreceptors. This link between flexibility and neuromuscular response has been poorly studied. The aim of this study was to investigate the relationship between lumbopelvic flexibility and neuromuscular responses of the erector spinae, hamstring and abdominal muscles during trunk flexion-extension. Lumbopelvic movement patterns were measured in 29 healthy women, who were separated into two groups according to their flexibility during trunk flexion-extension. The electromyographic responses of erector spinae, rectus abdominis and biceps femoris were also recorded. Subjects with greater lumbar flexibility had significantly less pelvic flexibility and vice versa. Subjects with greater pelvic flexibility had a higher rate of relaxation and lower levels of hamstring activation during maximal trunk flexion. The neuromuscular response patterns of the hamstrings seem partially modulated by pelvic flexibility. Not so with the lumbar erector spinae and lumbar flexibility, despite the assertions of some previous studies. The results of this study improve our knowledge of the relationships between trunk joint flexibility and neuromuscular responses, a relationship which may play a role in low back pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Pharmacokinetic studies of neuromuscular blocking agents: Good Clinical Research Practice (GCRP)

    DEFF Research Database (Denmark)

    Viby-Mogensen, J.; Østergaard, D.; Donati, F.

    2000-01-01

    Good Clinical Research Practice (GCRP), neuromuscular blocking agents, pharmacokinetics, pharmacokinetic/pharmacodynamic modeling, population pharmacokinetics, statistics, study design......Good Clinical Research Practice (GCRP), neuromuscular blocking agents, pharmacokinetics, pharmacokinetic/pharmacodynamic modeling, population pharmacokinetics, statistics, study design...

  5. Reversal of profound rocuronium neuromuscular blockade by sugammadex in anesthetized rhesus monkeys.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: Reversal of neuromuscular blockade can be accomplished by chemical encapsulation of rocuronium by sugammadex, a synthetic gamma-cyclodextrin derivative. The current study determined the feasibility of reversal of rocuronium-induced profound neuromuscular blockade with sugammadex in the

  6. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade

    DEFF Research Database (Denmark)

    Brueckmann, B; Sasaki, N; Grobara, P

    2015-01-01

    BACKGROUND: This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS: Adult patients undergoing abdominal surgery received rocuronium, followed...... by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual...... measured at PACU entry. Zero out of 74 sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch® SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], P

  7. Total hip arthroplasty in patients with neuromuscular imbalance.

    Science.gov (United States)

    Konan, S; Duncan, C P

    2018-01-01

    Patients with neuromuscular imbalance who require total hip arthroplasty (THA) present particular technical problems due to altered anatomy, abnormal bone stock, muscular imbalance and problems of rehabilitation. In this systematic review, we studied articles dealing with THA in patients with neuromuscular imbalance, published before April 2017. We recorded the demographics of the patients and the type of neuromuscular pathology, the indication for surgery, surgical approach, concomitant soft-tissue releases, the type of implant and bearing, pain and functional outcome as well as complications and survival. Recent advances in THA technology allow for successful outcomes in these patients. Our review suggests excellent benefits for pain relief and good functional outcome might be expected with a modest risk of complication. Cite this article: Bone Joint J 2018;100-B(1 Supple A):17-21. ©2018 The British Editorial Society of Bone & Joint Surgery.

  8. Surgical Space Conditions During Low-Pressure Laparoscopic Cholecystectomy with Deep Versus Moderate Neuromuscular Blockade

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, Lars S.; Rosenberg, Jacob

    2014-01-01

    : In this assessor-blinded study, 48 patients undergoing elective laparoscopic cholecystectomy were administered rocuronium for neuromuscular blockade and randomized to either deep neuromuscular blockade (rocuronium bolus plus infusion maintaining a posttetanic count 0-1) or moderate neuromuscular blockade...... (rocuronium repeat bolus only for inadequate surgical conditions with spontaneous recovery of neuromuscular function). Patients received anesthesia with propofol, remifentanil, and rocuronium. The primary outcome was the proportion of procedures with optimal surgical space conditions (assessed by the surgeon...

  9. Anti-GM2 gangliosides IgM paraprotein induces neuromuscular block without neuromuscular damage.

    Science.gov (United States)

    Santafé, Manel M; Sabaté, M Mar; Garcia, Neus; Ortiz, Nico; Lanuza, M Angel; Tomàs, Josep

    2008-11-15

    We analyzed the effect on the mouse neuromuscular synapses of a human monoclonal IgM, which binds specifically to gangliosides with the common epitope [GalNAc beta 1-4Gal(3-2 alpha NeuAc)beta 1-]. We focused on the role of the complement. Evoked neurotransmission was partially blocked by IgM both acutely (1 h) and chronically (10 days). Transmission electron microscopy shows important nerve terminal growth and retraction remodelling though axonal injury can be ruled out. Synapses did not show mouse C5b-9 immunofluorescence and were only immunolabelled when human complement was added. Therefore, the IgM-induced synaptic changes occur without complement-mediated membrane attack.

  10. Exercise Therapy in Spinobulbar Muscular Atrophy and Other Neuromuscular Disorders

    DEFF Research Database (Denmark)

    Dahlqvist, Julia Rebecka; Vissing, John

    2016-01-01

    There is no curative treatment for most neuromuscular disorders. Exercise, as a treatment for these diseases, has therefore received growing attention. When executed properly, exercise can maintain and improve health and reduce the risk of cardiovascular disease, obesity, and diabetes. In persons...... in patients with neuromuscular diseases associated with weakness and wasting. We review studies that have investigated different types of exercise in both myopathies and motor neuron diseases, with particular emphasis on training of persons affected by spinobulbar muscular atrophy (SBMA). Finally, we provide...

  11. New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases

    Institute of Scientific and Technical Information of China (English)

    Charles H Knowles; Joanne E Martin

    2009-01-01

    Gastrointestinal neuromuscular diseases are a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular (including interstitial cell of Cajal) dysfunction. Common to most of these diseases are symptoms of impaired motor activity which manifest as slowed or obstructed transit with or without evidence of transient or persistent radiological visceral dilatation. A variety of histopathological techniques and allied investigations are being increasingly applied to tissue biopsies from such patients. This review outlines some of the more recent advances in this field, particularly in the most contentious area of small bowel disease manifesting as intestinal pseudo-obstruction.

  12. 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....

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

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L

    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).......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. CARACTERÍSTICAS FÍSICO-QUÍMICAS DE SOROS DE QUEIJO E RICOTA PRODUZIDOS NO VALE DO TAQUARI, RS

    Directory of Open Access Journals (Sweden)

    Júlio André Bald

    2014-11-01

    Full Text Available O Rio Grande do Sul é um dos maiores produtores de leite do país e o Vale do Taquari contribui com aproximadamente 7% da produção do estado. O queijo e a ricota são alguns dos principais derivados do leite produzidos na região, que geram nos seus processos de fabricação quantidades elevadas de soros de queijo e de ricota, respectivamente. Por sua elevada carga orgânica estes soros devem ser tratados antes do lançamento em corpos hídricos, no entanto estudos indicam que esses subprodutos podem ser reaproveitados. Portanto, o objetivo desse trabalho foi avaliar as características físico-químicas de soros de queijo e de ricota coletados em uma indústria de laticínios do Vale do Taquari visando o aproveitamento na elaboração de novos produtos alimentícios. As amostras foram submetidas às determinações de acidez, pH, cinzas, umidade, proteínas, gordura, demanda química de oxigênio, carbono e nitrogênio total e lactose. Os parâmetros avaliados apresentaram variações, provavelmente em função dos soros serem provenientes de processos de fabricação de diferentes tipos de queijo e de ricota. Além disso, o soro de queijo apresentou maior carga orgânica. As concentrações de proteínas e lactose dos soros indicam que estes podem ser reaproveitados no desenvolvimento de novos produtos e processos.

  15. Comportamento de blocos cerâmicos estruturais produzidos a partir da mistura de lama vermelha e argila

    Directory of Open Access Journals (Sweden)

    Alcebíades Negrão Macêdo

    Full Text Available A utilização de novas técnicas de aproveitamento de resíduos tem-se tornado cada vez mais importante na construção civil, principalmente quando se trata da utilização de resíduos de outros segmentos industriais e da redução de consumo de matérias-primas naturais. O objetivo deste estudo foi avaliar a utilização da lama vermelha, resíduo proveniente da produção de alumina metalúrgica, na produção de blocos cerâmicos vazados estruturais. A produção dos blocos foi realizada em uma indústria cerâmica, a partir de uma mistura de 60% de lama vermelha (LV e de 40% de argila. Após a produção dos blocos, realizaram-se ensaios de acordo com as normas técnicas, tais como absorção de água e compressão axial simples. A partir da análise dos resultados, observou-se que os blocos estruturais produzidos a partir da mistura de LV e argila atenderam aos parâmetros normativos quanto ao índice de absorção de água e de resistência à compressão, e que as resistências médias e características desses blocos foram superiores às dos blocos cerâmicos de referência.

  16. Staphylococcus aureus e Salmonella sp. em queijos de coalho artesanais produzidos em São Rafael, Rio Grande do Norte

    Directory of Open Access Journals (Sweden)

    Tarciara Magley da Fonseca Pereira

    2017-06-01

    Full Text Available O queijo de coalho artesanal é produto de origem animal muito consumido principalmente na região Nordeste do Brasil. É comumente fabricado com leite cru, não pasteurizado, como matéria prima, sem a utilização de boas práticas higiênicas, podendo veicular micro-organismos patogênicos ao consumidor. Assim, objetivou-se avaliar a presença de Salmonella sp. e quantificar Staphyloccocus aureus em queijos de coalho produzidos artesanalmente no município de São Rafael Rio Grande do Norte.Foram realizadas coletas em triplicata em sete queijarias artesanais do município, e, em seguida, os queijos foram transportados imediatamente em caixas isotérmicas, ao Laborátório de Biotecnologia Industrial da Universidade Federal Rural do Semi-Árido, onde foram submetidos à análise microbiológica de forma asséptica, conforme metodologia recomendada pela Instrução Normativa nº 62, de 26 de agosto de 2003, do Ministério da Agricultura, Pecuária e Abastecimento. Todas as amostras apresentaram elevadas contagens de Staphylococcus aureus, estando em desconformidade com o padrão exigido pela legislação brasileira para este grupo microbiano. Foi constatado ausência de Salmonella sp. nas amostras avaliadas. As análises microbiológicas evidenciaram péssimas condições de higiene de todos os queijos estudados, já que os mesmos apresentaram grande contaminação por Staphylococcus aureus, o que pode representar riscos à saúde pública.

  17. Arraste via fecal de nutrientes da ingestão produzido por bagaço de mandioca hidrolisado

    Directory of Open Access Journals (Sweden)

    Raupp Dorivaldo da Silva

    2002-01-01

    Full Text Available A ingestão de fibras alimentares pode resultar em arraste de outros nutrientes para as fezes. Bagaço de mandioca produzido por polvilheira foi submetido à hidrólise enzimática para obtenção de um produto mais concentrado em fibra alimentar insolúvel denominado de bagaço de mandioca hidrolisado (BMH. O BMH foi avaliado em ensaios biológicos com ratos Wistar quanto a sua habilidade de arrastar os nutrientes da ingestão para as fezes, tendo como padrão de fibra o farelo de trigo (FT. Acréscimo à dieta base, substituindo igual quantidade de amido, de dose de 5%, 15% ou 25% de BMH promoveu arraste significativo de minerais (globalidade ou proteína; dose de 15% ou 25% promoveu arraste significativo de lipídeo; e, dose de 25% promoveu arraste significativo de carboidrato digestível. Dose de 25% de FT produziu arraste significativo de minerais (globalidade, proteína ou carboidrato digestível, mas, o lipídeo não foi arrastado. BMH produziu efeito mais pronunciado que FT em arrastar minerais (globalidade ou proteína para a dose de 5% ou 15%; no entanto, para a dose alta, de 25%, as fontes produziram efeitos semelhantes em arrastar a proteína, mas o FT promoveu maior arraste de minerais (globalidade. Não houve diferença entre fontes, BMH e FT, em arrastar lipídeo ou carboidrato digestível para as fezes. Na dose alta (25% o BMH promoveu efeitos, no máximo, semelhantes ao FT, em arrastar para as fezes os nutrientes da ingestão; assim, é recomendado como fonte alternativa de fibra alimentar insolúvel para a formulação de alimentos funcionais-digestivos.

  18. Diagnostic value of CT scanning in neuromuscular diseases

    International Nuclear Information System (INIS)

    Bulcke, J.A.L.; Leuven Univ.; Herpels, V.

    1983-01-01

    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.)

  19. Volume of the effect compartment in simulations of neuromuscular block

    NARCIS (Netherlands)

    Nigrovic, Vladimir; Proost, Johannes H.; Amann, Anton; Bhatt, Shashi B.

    2005-01-01

    Background: The study examines the role of the volume of the effect compartment in simulations of neuromuscular block (NMB) produced by nondepolarizing muscle relaxants. Methods: The molar amount of the postsynaptic receptors at the motor end plates in muscle was assumed constant; the apparent

  20. Neuromuscular stimulation after stroke: from technology to clinical deployment

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; Renzenbrink, Gerbert J.; Geurts, Alexander C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  1. Elbow joint position sense after neuromuscular training with handheld vibration.

    Science.gov (United States)

    Tripp, Brady L; Faust, Donald; Jacobs, Patrick

    2009-01-01

    Clinicians use neuromuscular control exercises to enhance joint position sense (JPS); however, because standardizing such exercises is difficult, validations of their use are limited. To evaluate the acute effects of a neuromuscular training exercise with a handheld vibrating dumbbell on elbow JPS acuity. Crossover study. University athletic training research laboratory. Thirty-one healthy, college-aged volunteers (16 men, 15 women, age = 23 + or - 3 years, height = 173 + or - 8 cm, mass = 76 + or - 14 kg). We measured and trained elbow JPS using an electromagnetic tracking device that provided auditory and visual biofeedback. For JPS testing, participants held a dumbbell and actively identified the target elbow flexion angle (90 degrees ) using the software-generated biofeedback, followed by 3 repositioning trials without feedback. Each neuromuscular training protocol included 3 exercises during which participants held a 2.55-kg dumbbell vibrating at 15, 5, or 0 Hz and used software-generated biofeedback to locate and maintain the target elbow flexion angle for 15 seconds. We calculated absolute (accuracy) and variable (variability) errors using the differences between target and reproduced angles. Training protocols using 15-Hz vibration enhanced accuracy and decreased variability of elbow JPS (P or = .200). Our results suggest these neuromuscular control exercises, which included low-magnitude, low-frequency handheld vibration, may enhance elbow JPS. Future researchers should examine vibration of various durations and frequencies, should include injured participants and functional multijoint and multiplanar measures, and should examine long-term effects of training protocols on JPS and injury.

  2. Imaging of respiratory muscles in neuromuscular disease: A review.

    Science.gov (United States)

    Harlaar, L; Ciet, P; van der Ploeg, A T; Brusse, E; van der Beek, N A M E; Wielopolski, P A; de Bruijne, M; Tiddens, H A W M; van Doorn, P A

    2018-03-01

    Respiratory muscle weakness frequently occurs in patients with neuromuscular disease. Measuring respiratory function with standard pulmonary function tests provides information about the contribution of all respiratory muscles, the lungs and airways. Imaging potentially enables the study of different respiratory muscles, including the diaphragm, separately. In this review, we provide an overview of imaging techniques used to study respiratory muscles in neuromuscular disease. We identified 26 studies which included a total of 573 patients with neuromuscular disease. Imaging of respiratory muscles was divided into static and dynamic techniques. Static techniques comprise chest radiography, B-mode (brightness mode) ultrasound, CT and MRI, and are used to assess the position and thickness of the diaphragm and the other respiratory muscles. Dynamic techniques include fluoroscopy, M-mode (motion mode) ultrasound and MRI, used to assess diaphragm motion in one or more directions. We discuss how these imaging techniques relate with spirometric values and whether these can be used to study the contribution of the different respiratory muscles in patients with neuromuscular disease. Copyright © 2017. Published by Elsevier B.V.

  3. Neuromuscular blockade for improvement of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Scheppan, Susanne; Kissmeyer, Peter

    2015-01-01

    neuromuscular blockade (NMB), defined as a post-tetanic-count (PTC) of 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesised that deep NMB (PTC 0-1) would improve surgical conditions during upper laparotomy as compared to standard NMB with bolus administration. METHODS...

  4. 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

  5. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...

  6. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona

    2015-01-01

    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...

  7. Neuromuscular function during stair descent in meniscectomized patients and controls

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Roos, Ewa M; Aagaard, Per

    2011-01-01

    The aim of this study was to identify differences in knee range of motion (ROM), movement speed, ground reaction forces (GRF) profile, neuromuscular activity, and muscle coactivation during the transition between stair descent and level walking in meniscectomized patients at high risk of knee...

  8. Roles of neuro-exocytotic proteins at the neuromuscular junction

    NARCIS (Netherlands)

    Sons-Michel, Michèle S.

    2011-01-01

    The aim of the studies described in the thesis was to elucidate the roles of several neuro-exocytotic proteins at the motor nerve terminal in neuromuscular synaptic transmission, making use of genetic knockout (KO) mice, each missing one (or more) neuro-exocytotic proteins. In addition, it was

  9. Comparison of the Effect of Neuromuscular Electrical Stimulation ...

    African Journals Online (AJOL)

    Children with cerebral palsy (CP) often demonstrate poor hand function due to spasticity. Thus spasticity in the wrist and finger flexors poses a great deal of functional limitations. This study was therefore designed to compare the effectiveness of Cryotherapy and Neuromuscular Electrical Stimulation (NMES) on spasticity ...

  10. Biochemistry of Neuromuscular Diseases: A Course for Undergraduate Students

    Science.gov (United States)

    Ohlendieck, Kay

    2002-01-01

    This article outlines an undergraduate course focusing on supramolecular membrane protein complexes involved in the molecular pathogenesis of neuromuscular disorders. The emphasis of this course is to introduce students to the key elements involved in the ion regulation and membrane stabilization during muscle contraction and the role of these…

  11. Desenvolvimento e caracterização de salgadinho produzido a partir de gritz de milho nixtamalizado

    Directory of Open Access Journals (Sweden)

    L. A. M. Pinto

    2015-10-01

    Full Text Available Neste trabalho, buscou-se o enriquecimento nutricional de salgadinhos produzidos a partir da extrusão do gritz de milho, para tanto, duas diferentes formulações foram testadas. A primeira formulação consistiu em utilizar o gritz de milho aplicando-se o processo de nixtamalização; processo este conhecido pelo tratamento do gritz alcalinamente, utilizando o hidróxido de cálcio como agente de tratamento, enquanto que a segunda formulação, foi desenvolvida com gritz sem tratamento. Para a caracterização dos salgadinhos foram realizadas análises da composição centesimal e mineral, cor, textura e índice de expansão. Em relação à composição centesimal e concentração de cálcio, a amostra nixtamalizada apresentou diferença significativa para os parâmetros de cinzas, fibras e cálcio. Os valores obtidos para cinzas, foram de 0,44%±0,02 para os salgadinhos tratados e de 0,24%±0,08 para os não tratados. Para o teor de fibra os valores alcançados foram de 0,83%±0,16 e 0,40%±0,03, para os salgadinhos produzidos com tratamento e sem tratamento, respectivamente. Para o teor de cálcio, constatou-se um aumento superior a 6 vezes entre as formulações, em que 3,02±0,01 (gCa/Kgsnack foram obtidos para o salgadinho nixtamalizado e 0,49±0,003 (gCa/Kgsnack para os salgadinhos produzidos pelo gritz sem aplicação do tratamento. Os teores de umidade, proteínas e lipídeos, não apresentaram diferença significativa entre as formulações. A análise de cor mostrou que o salgadinho não sofreu influência do tratamento alcalino, porém a amostra tratada apresentou croma mais intensa. Já para a textura, a nixtamalização exerceu influência significativa para este parâmetro, em que os valores obtidos variaram de 1,95±0,49 N a 0,74±0,16 N para a amostra tratada e para a amostra sem tratamento, respectivamente. O índice de expansão (IE está diretamente relacionado com a crocância dos salgadinhos, dessa maneira, o (IE

  12. Interaction of antibiotics on pipecuronium-induced neuromuscular blockade.

    Science.gov (United States)

    de Gouw, N E; Crul, J F; Vandermeersch, E; Mulier, J P; van Egmond, J; Van Aken, H

    1993-01-01

    To measure the interaction of two antibiotics (clindamycin and colistin) on neuromuscular blockade induced by pipecuronium bromide (a new long-acting, steroidal, nondepolarizing neuromuscular blocking drug). Prospective, randomized, placebo-controlled study. Inpatient gynecologic and gastroenterologic service at a university medical center. Three groups of 20 ASA physical status I and II patients with normal kidney and liver function, taking no medication, and undergoing elective surgery under general anesthesia. Anesthesia was induced with propofol and alfentanil intravenously (IV) and maintained with a propofol infusion and 60% nitrous oxide in oxygen. Pipecuronium bromide 50 micrograms/kg was administered after reaching a stable baseline of single-twitch response. At 25% recovery of pipecuronium-induced neuromuscular blockade, patients received one of two antibiotics, clindamycin 300 mg or colistin 1 million IU, or a placebo. The recovery index (RI, defined as time from 25% to 75% recovery of neuromuscular blockade) was measured using the single-twitch response of the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve at the wrist. RI after administration of an antibiotic (given at 25% recovery) was measured and compared with RI of the control group using Student's unpaired t-test. Statistical analyses of the results showed a significant prolongation of the recovery time (from 25% to 75% recovery) of 40 minutes for colistin. When this type of antibiotic is used during anesthesia with pipercuronium as a muscle relaxant, one must be aware of a significant prolongation of an already long-acting neuromuscular blockade and (although not observed in this study) possible problems in antagonism.

  13. Neuromuscular Activity of Micrurus laticollaris (Squamata: Elapidae Venom in Vitro

    Directory of Open Access Journals (Sweden)

    Alejandro Carbajal-Saucedo

    2014-01-01

    Full Text Available In this work, we have examined the neuromuscular activity of Micrurus laticollaris (Mexican coral snake venom (MLV in vertebrate isolated nerve-muscle preparations. In chick biventer cervicis preparations, the MLV induced an irreversible concentration- and time-dependent (1–30 µg/mL neuromuscular blockade, with 50% blockade occurring between 8 and 30 min. Muscle contractures evoked by exogenous acetylcholine were completely abolished by MLV, whereas those of KCl were also significantly altered (86% ± 11%, 53% ± 11%, 89% ± 5% and 89% ± 7% for one, three, 10 and 30 µg of venom/mL, respectively; n = 4; p < 0.05. In mouse phrenic nerve-diaphragm preparations, MLV (1–10 µg/mL promoted a slight increase in the amplitude of twitch-tension (3 µg/mL, followed by neuromuscular blockade (n = 4; the highest concentration caused complete inhibition of the twitches (time for 50% blockade = 26 ± 3 min, without exhibiting a previous neuromuscular facilitation. The venom (3 µg/mL induced a biphasic modulation in the frequency of miniature end-plate potentials (MEPPs/min, causing a significant increase after 15 min, followed by a decrease after 60 min (from 17 ± 1.4 (basal to 28 ± 2.5 (t15 and 12 ± 2 (t60. The membrane resting potential of mouse diaphragm preparations pre-exposed or not to d-tubocurarine (5 µg/mL was also significantly less negative with MLV (10 µg/mL. Together, these results indicate that M. laticollaris venom induces neuromuscular blockade by a combination of pre- and post-synaptic activities.

  14. Stunted PFC activity during neuromuscular control under stress with obesity.

    Science.gov (United States)

    Mehta, Ranjana K

    2016-02-01

    Obesity is an established risk factor for impaired cognition, which is primarily regulated by the prefrontal cortex (PFC). However, very little is known about the neural pathways that underlie obesity-related declines in neuromuscular control, particularly under stress. The purpose of this study was to determine the role of the PFC on neuromuscular control during handgrip exertions under stress with obesity. Twenty non-obese and obese young adults performed submaximal handgrip exertions in the absence and presence of a concurrent stressful task. Primary dependent measures included oxygenated hemoglobin (HbO2: a measure of PFC activity) and force fluctuations (an indicator of neuromuscular control). Higher HbO2 levels in the PFC were observed in the non-obese compared to the obese group (P = 0.009). In addition, higher HbO2 levels were observed in the stress compared to the control condition in the non-obese group; however, this trend was reversed in the obese group (P = 0.043). In general, force fluctuations increased by 26% in the stress when compared to the control condition (P = 0.001) and obesity was associated with 39% greater force fluctuation (P = 0.024). Finally, while not significant, obesity-related decrements in force fluctuations were magnified under stress (P = 0.063). The current study provides the first evidence that neuromuscular decrements with obesity were associated with impaired PFC activity and this relationship was augmented in stress conditions. These findings are important because they provide new information on obesity-specific changes in brain function associated with neuromuscular control since the knowledge previously focused largely on obesity-specific changes in peripheral muscle capacity.

  15. Dosimetria e monitoração de feixes estreitos de raios-X, produzidos por acelerador linear de particulas, para aplicação em radiocirurgia

    OpenAIRE

    Jose Carlos Ferraz de Campos

    1986-01-01

    Resumo: O presente trabalho teve como objetivo principal investigar as características principais de dosimetria e monitoração de feixes finos de raios-x, e sua aplicação a um Acelerador Linear de Partículas de 4 MV, para seu emprego na Radiocirurgia. Com esta finalidade, construiu-se um sistema de colimação adicional, composto de 3 colimadores de Chumbo, que permite, a partir do campo mínimo protocolar produzido pelo acelerador, obter os feixes finos de 6, 10 e 15 mm de diâmetros. Um siste...

  16. Efeito do estradiol e da progesterona no desenvolvimento e na qualidade de embriões bovinos produzidos in vitro

    Directory of Open Access Journals (Sweden)

    A.N Reis

    2010-12-01

    Full Text Available Avaliaram-se o desenvolvimento e a qualidade de embriões bovinos, cocultivados com células epiteliais do oviduto bovino (CEOBs expostas ou não ao estradiol e à progesterona. Os ovócitos foram maturados in vitro por 24h e, então, fertilizados utilizando-se sêmen congelado, em estufa de CO2 a 5% e 38,5ºC. As CEOBs foram cultivadas em TCM-199 com ou sem estradiol (E2 (24 horas, nas mesmas condições da maturação e fertilização in vitro (MIV e FIV, e, em seguida, adicionadas aos diferentes grupos em CR2 com ou sem progesterona (P4 (G1=P4+E2; (G2=E2; (G3=P4 e (G4=controle. Após 18h da FIV, as células foram cultivadas nos diferentes sistemas. Nenhuma diferença (P>0,05 foi observada nas taxas de clivagem entre G1, G2 e G4 (53,5%; 56,3%; 51,7% e nos padrões de blastocistos (BLs (29,3%; 31,2%, 28,7%. Índices menores (P<0,05 foram obtidos no G3 para ambas as variáveis (34,5%; 16,4%. G1 e G2 apresentaram taxas de eclosão maiores (P<0,05 que os outros grupos (23,3%; 23,2%, sendo G4 (19,3% diferente de G3 (16,1%. Em G1, G2 e G3, o número de células nos BLs aumentou 125,9; 128,4 e 123,6, respectivamente (P<0,05, em relação ao G4 (112,5. Conclui-se que o tratamento das CEOBs com o E2, nas primeiras 24 horas de cultivo, pode ser usado isoladamente ou em combinação com a progesterona, a fim de melhorar a qualidade de embriões bovinos produzidos in vitro

  17. Pellets de trigo e soja produzidos por extrusão Wheat and soybean pellets produced by extrusion-cooking

    Directory of Open Access Journals (Sweden)

    Sin Huei Wang

    2008-09-01

    Full Text Available A mistura de trigo e soja representa uma importante fonte calórico-protéica com proteínas de boa qualidade. Apesar disso, a utilização da soja como ingrediente tem sido limitada pelo seu sabor de feijão cru (beany flavor, o qual é melhorado pelo processo de extrusão. Foram estudados os efeitos de umidade da mistura, Temperatura de Barril (TB e Velocidade de Rotação de Parafuso (VRP, Nº 5 do extrusor no Índice de Expansão (IE, no Índice de Solubilidade em Água (ISA e nas características sensoriais de pellets produzidos com mistura de trigo e soja (90:10, objetivando a otimização deste processo para a obtenção de pellets fritos com melhores qualidades sensoriais. A farinha mista crua foi extrusada em 2 umidades (32 e 35%, 4 TB (60 a 90 °C e 4 VRP (60 a 150 rpm, totalizando 32 tratamentos. O pellet frito, preparado com a farinha mista com 32% de umidade e extrusada em 60 rpm a 80 °C, apresentou o maior IE e as melhores qualidades sensoriais (aparência, sabor e textura, sendo preferido pela equipe de provadores não treinados, tanto com sabor de bacon como com sabor de queijo.The mixture of wheat with soybean represents an important calorie-protein source with good protein quality. In spite of this, the use of soybeans as an ingredient has been limited by their beany flavor, which is improved by the extrusion process. Effects of mixture moisture, Barrel Temperature (BT and Screw-Speed (SS, Nº 5 on Expansion Index (EI, Water Solubility Index (WSI and sensory characteristics of pellets produced with a wheat-soybean (90:10 mixture were studied, in order to optimize this process for obtaining fried pellets with better sensory qualities. Raw mixed flour was extruded at two moisture contents (32 and 35%, four BT (60 to 90 °C and four SS (60 to 150 rpm, totalizing 32 treatments. The fried pellets, prepared with the mixed flour with 32% moisture and extruded at 60 rpm and 80 °C, presented the greatest EI and the best sensory

  18. Analgesia para a sutura artroscópica do manguito rotador: estudo comparativo entre o bloqueio interescalênico do plexo braquial e o bloqueio da bursa subacromial contínuo Management of pain after the rotator cuff arthroscopic suture: comparative study among the interescalenic blockade and the continuous intrabursal infusion

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2007-10-01

    Full Text Available OBJETIVO: Comparar o nível de dor pós-operatória de pacientes submetidos à sutura artroscópica da lesão do manguito rotador (MR que receberam protocolos diferentes de analgesia pós-operatória. Demonstrar a relação entre dor e o sexo do paciente, a dimensão da lesão suturada e a utilização da capsulotomia interna. Verificar a prevalência dos efeitos colaterais. MÉTODO: Foram analisados três grupos de pacientes operados entre 1º de junho de 2004 e 31 de maio de 2007. O grupo I foi composto pelos pacientes que receberam bloqueio interescalênico com ropivacaína a 0,75%. No grupo II, o mesmo bloqueio foi acrescido de 150µg de clonidina. No grupo III foi administrado um bolus de 30ml de ropivacaína a 0,75% para infiltração dos portais artroscópicos e diretamente no espaço subacromial, seguido de infusão contínua de ropivacaína a 0,2% em bomba de infusão. Os pacientes foram submetidos à medição da escala analógica visual (EAV com 24 horas após o procedimento. As variáveis estudadas foram: EAV, sexo, tamanho da lesão, necessidade de capsulotomia interna e prevalência dos efeitos colaterais. O estudo avaliou 196 pacientes, dos quais foram excluídos 51, totalizando n = 145 pacientes. O total de pacientes no grupo I foi de 65; no grupo II, de 19; e no grupo III, de 61. RESULTADOS: O índice da EAV médio encontrado no grupo I foi de 3,88 ± 1,737 (3; no grupo II, de 3,8 ± 1,6 (3; e no grupo III, de 1,95 ± 1,6 (2. Houve diferença significativa ao comparar os grupos I e III (p OBJECTIVE: To compare the level of postoperative pain in patients submitted to arthroscopic suture of a rotator cuff lesion who had different analgesia protocols. To demonstrate the relationship between pain and the gender of the patient, the dimension of the lesion sutured, and the use of internal capsulotomy. To check the prevalence of side effects. METHODS: Three groups of patients operated on between June 01, 2004 and May 31, 2007 were

  19. The role of patient advocacy organisations in neuromuscular disease R&D - The case of the Dutch neuromuscular disease association VSN

    NARCIS (Netherlands)

    Boon, W.P.C.; Broekgaarden, R.

    2010-01-01

    This article investigates to what extent patient advocacy organisations play a role in influencing R&D and policymaking for rare neuromuscular diseases. The Dutch neuromuscular disease organisation VSN is studied in depth. A brief history of the VSN is sketched along with the international

  20. Learning disabilities in neuromuscular disorders: a springboard for adult life.

    Science.gov (United States)

    Astrea, Guja; Battini, Roberta; Lenzi, Sara; Frosini, Silvia; Bonetti, Silvia; Moretti, Elena; Perazza, Silvia; Santorelli, Filippo M; Pecini, Chiara

    2016-10-01

    Although the presence of cognitive deficits in Duchenne muscular dystrophy or myotonic dystrophy DM1 is well established in view of brain-specific expression of affected muscle proteins, in other neuromuscular disorders, such as congenital myopathies and limb-girdle muscular dystrophies, cognitive profiles are poorly defined. Also, there are limited characterization of the cognitive profile of children with congenital muscular dystrophies, notwithstanding the presence of cerebral abnormality in some forms, and in spinal muscular atrophies, with the exception of distal spinal muscular atrophy (such as the DYN1CH1- associated form). Starting from the Duchenne muscular dystrophy, which may be considered a kind of paradigm for the co-occurrence of learning disabilities in the contest of a progressive muscular involvement, the findings of neuropsychological (or cognitive) dysfunctions in several forms of neuromuscular diseases will be examined and reviewed.

  1. Neuromuscular deficits after peripheral joint injury: a neurophysiological hypothesis.

    Science.gov (United States)

    Ward, Sarah; Pearce, Alan J; Pietrosimone, Brian; Bennell, Kim; Clark, Ross; Bryant, Adam L

    2015-03-01

    In addition to biomechanical disturbances, peripheral joint injuries (PJIs) can also result in chronic neuromuscular alterations due in part to loss of mechanoreceptor-mediated afferent feedback. An emerging perspective is that PJI should be viewed as a neurophysiological dysfunction, not simply a local injury. Neurophysiological and neuroimaging studies have provided some evidence for central nervous system (CNS) reorganization at both the cortical and spinal levels after PJI. The novel hypothesis proposed is that CNS reorganization is the underlying mechanism for persisting neuromuscular deficits after injury, particularly muscle weakness. There is a lack of direct evidence to support this hypothesis, but future studies utilizing force-matching tasks with superimposed transcranial magnetic stimulation may be help clarify this notion. © 2014 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    Carla eFalugi

    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.

  3. Theory of multichannel magnetic stimulation: toward functional neuromuscular rehabilitation.

    Science.gov (United States)

    Ruohonen, J; Ravazzani, P; Grandori, F; Ilmoniemi, R J

    1999-06-01

    Human excitable cells can be stimulated noninvasively with externally applied time-varying electromagnetic fields. The stimulation can be achieved either by directly driving current into the tissue (electrical stimulation) or by means of electro-magnetic induction (magnetic stimulation). While the electrical stimulation of the peripheral neuromuscular system has many beneficial applications, peripheral magnetic stimulation has so far only a few. This paper analyzes theoretically the use of multiple magnetic stimulation coils to better control the excitation and also to eventually mimic electrical stimulation. Multiple coils allow electronic spatial adjustment of the shape and location of the stimulus without moving the coils. The new properties may enable unforeseen uses for peripheral magnetic stimulation, e.g., in rehabilitation of patients with neuromuscular impairment.

  4. [Neuromuscular disease: respiratory clinical assessment and follow-up].

    Science.gov (United States)

    Martínez Carrasco, C; Villa Asensi, J R; Luna Paredes, M C; Osona Rodríguez de Torres, F B; Peña Zarza, J A; Larramona Carrera, H; Costa Colomer, J

    2014-10-01

    Patients with neuromuscular disease are an important group at risk of frequently suffering acute or chronic respiratory failure, which is their main cause of death. They require follow-up by a pediatric respiratory medicine specialist from birth or diagnosis in order to confirm the diagnosis and treat any respiratory complications within a multidisciplinary context. The ventilatory support and the cough assistance have improved the quality of life and long-term survival for many of these patients. In this paper, the authors review the pathophysiology, respiratory function evaluation, sleep disorders, and the most frequent respiratory complications in neuromuscular diseases. The various treatments used, from a respiratory medicine point of view, will be analyzed in a next paper. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  5. 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

  6. Report on Adaptive Force, a specific neuromuscular function

    Directory of Open Access Journals (Sweden)

    Marko Hoff

    2015-08-01

    Full Text Available In real life motions, as well as in sports, the adaptation of the neuromuscular systems to externally applied forces plays an important role. The term Adaptive Force (AF shall characterize the ability of the nerve-muscle-system to adapt to impacting external forces during isometric and eccentric muscle action. The focus in this paper is on the concept of this neuromuscular action, which is not yet described in this way. A measuring system was constructed and evaluated for this specific neuromuscular function, but only the main information of the evaluation of the measuring system and the preliminary reference values are mentioned here, while an article with detailed description will be published separately. This paper concentrates on the three following points: 1 What is the peculiarity of this neuromuscular function, introduced as AF? 2 Is the measuring system able to capture its specific characteristics and which phases of measurement occur? 3 It seems reasonable to discuss if AF can be distinguished and classified among the known force concepts. The article describes the measuring system and how it is able to capture special features of real life motions like submaximal intensities and the subjects’ option to react adequately on external varying forces. Furthermore, within one measurement the system records three different force qualities: the isometric submaximal Adaptive Force (AFiso, the maximal isometric Adaptive Force (AFisomax and the maximal eccentric Adaptive Force (AFeccmax. Each of these phases provide different and unique information on the nerve-muscle-system that are discussed in detail. Important, in terms of the Adaptive Force, seems to be the combination of conditional and coordinative abilities.

  7. Selective activation of neuromuscular compartments within the human trapezius muscle

    DEFF Research Database (Denmark)

    Holtermann, A; Roeleveld, K; Mork, P J

    2009-01-01

    of the human trapezius muscle can be independently activated by voluntary command, indicating neuromuscular compartmentalization of the trapezius muscle. The independent activation of the upper and lower subdivisions of the trapezius is in accordance with the selective innervation by the fine cranial and main...... branch of the accessory nerve to the upper and lower subdivisions. These findings provide new insight into motor control characteristics, learning possibilities, and function of the clinically relevant human trapezius muscle....

  8. Ultrastructural muscle and neuro-muscular junction alterations in polymyositis

    Directory of Open Access Journals (Sweden)

    L. L. Babakova

    2012-01-01

    Full Text Available Ultrastructural analysis of 7 biopsies from m.palmaris longus and m.deltoideus in patients with confirmed polymyositis revealed alterationand degeneration of muscle fibers and anomalies of neuro-muscular junction (NMJ. The NMJ abnormalities and following denervation ofmuscle fibers in polymyositis start with subsynaptic damages. The occurance of regeneration features in muscle fibers at any stage is characteristic for PM.

  9. Neuromuscular Control of Rapid Linear Accelerations in Fish

    Science.gov (United States)

    2016-06-22

    sunfish, Lepomis macrochirus. Animals with flexible bodies, like fishes , face a tradeoff for rapid movements. To produce high forces, they must...2014 30-Apr-2015 Approved for Public Release; Distribution Unlimited Final Report: Neuromuscular Control of Rapid Linear Accelerations in Fish The...Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 swimming, acceleration, fish , muscle, stiffness REPORT DOCUMENTATION PAGE 11. SPONSOR

  10. Computed tomography of skeletal muscles in neuromuscular disease

    International Nuclear Information System (INIS)

    Rodiek, S.O.; Kuether, G.; Muenchen Univ.

    1985-01-01

    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.) [de

  11. Computed tomography of skeletal muscles in neuromuscular disease

    Energy Technology Data Exchange (ETDEWEB)

    Rodiek, S.O.; Kuether, G.

    1985-06-01

    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.

  12. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    International Nuclear Information System (INIS)

    Hader, H.; Gadoth, N.; Heifetz, H.

    1983-01-01

    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

  13. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hader, H.; Gadoth, N.; Heifetz, H.

    1983-11-01

    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.

  14. Neuromuscular dose-response studies: determining sample size.

    Science.gov (United States)

    Kopman, A F; Lien, C A; Naguib, M

    2011-02-01

    Investigators planning dose-response studies of neuromuscular blockers have rarely used a priori power analysis to determine the minimal sample size their protocols require. Institutional Review Boards and peer-reviewed journals now generally ask for this information. This study outlines a proposed method for meeting these requirements. The slopes of the dose-response relationships of eight neuromuscular blocking agents were determined using regression analysis. These values were substituted for γ in the Hill equation. When this is done, the coefficient of variation (COV) around the mean value of the ED₅₀ for each drug is easily calculated. Using these values, we performed an a priori one-sample two-tailed t-test of the means to determine the required sample size when the allowable error in the ED₅₀ was varied from ±10-20%. The COV averaged 22% (range 15-27%). We used a COV value of 25% in determining the sample size. If the allowable error in finding the mean ED₅₀ is ±15%, a sample size of 24 is needed to achieve a power of 80%. Increasing 'accuracy' beyond this point requires increasing greater sample sizes (e.g. an 'n' of 37 for a ±12% error). On the basis of the results of this retrospective analysis, a total sample size of not less than 24 subjects should be adequate for determining a neuromuscular blocking drug's clinical potency with a reasonable degree of assurance.

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

    Science.gov (United States)

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

    2014-01-01

    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

  16. Bilateral neuromuscular and force differences during a plyometric task.

    Science.gov (United States)

    Ball, Nick B; Scurr, Joanna C

    2009-08-01

    The purpose of this article is to compare the bilateral neuromuscular and force contribution during a plyometric bounce drop jump task and to assess the affects of nonsimultaneous foot placement. Sixteen male participants performed bounce drop jumps from a height of 0.4 m. Mean peak electromyography activity of the soleus, medial, and lateral gastrocnemius of both legs was recorded from each phase of the drop jump and normalized to a reference dynamic muscle action. Resultant ground reaction force, ground contact time, and duration of the drop jumps were recorded from each leg. Multivariate analysis of variance was used to compare bilateral electromyographic activity, resultant peak ground reaction force, and contact duration. Pearson's correlations (r) ascertained relationships between normalized electromyographic activity and contact time. Significant differences were shown between left and right triceps surae normalized electromyography during precontact and contact40ms (p 0.01). Significant differences were found between normalized soleus electromyography and both gastrocnemii for both legs during precontact (p 0.01). Weak relationships were found between normalized electromyographic activity and nonsimultaneous foot contact (r < 0.2). This study showed differences between left and right triceps surae in neuromuscular strategies engaged in the early stages of a drop jump task. Differences in contact time initiation were present; however, they are not significant enough to cause neuromuscular differences in the plantar flexor muscles.

  17. Neuromuscular signs associated with acute hypophosphatemia in a dog.

    Science.gov (United States)

    Claus, Kimberly N; Day, Thomas K; Wolf, Christina

    2015-01-01

    The purpose of this report was to describe the successful recognition and management of neuromuscular dysfunction secondary to severe, acute hypophosphatemia in an adult dog with a 2 day history of vomiting, anorexia, and abdominal pain. Radiographs were suggestive of a foreign body obstruction, and surgery was recommended. Resection and anastomosis of the distal duodenum and proximal jejunum was performed. The dog recovered uneventfully, but approximately 36 hr postoperatively, he was found to have significant weakness and muscle tremors that were accompanied by hyperthermia. The only significant abnormality on a serum biochemical profile was a phosphorous level of 0.26 mmol/L. Within 6 hr of initiating phosphorous supplementation, the patient fully recovered and had no residual signs of neuromuscular dysfunction. Signs of neurologic dysfunction secondary to hypophosphatemia are commonly recognized in human patients. Reports of patients with severe muscle weakness, some of which necessitate ventilation due to weakening of muscles of respiration, are common throughout the literature. Less commonly, tremors are noted. This is the first known report of neuromuscular signs recognized and rapidly corrected in a dog. Although it is likely to be uncommon, hypophosphatemia should be recognized as a differential diagnosis in patients with tremors and/or muscle weakness.

  18. CT in neuromuscular disorders: A comparison of CT and histology

    International Nuclear Information System (INIS)

    Vliet, A.M. van der; Thijssen, H.O.M.; Merx, J.L.; Joosten, E.

    1988-01-01

    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.)

  19. Recent advances in antisense oligonucleotide therapy in genetic neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Ashok Verma

    2018-01-01

    Full Text Available Genetic neuromuscular diseases are caused by defective expression of nuclear or mitochondrial genes. Mutant genes may reduce expression of wild-type proteins, and strategies to activate expression of the wild-type proteins might provide therapeutic benefits. Also, a toxic mutant protein may cause cell death, and strategies that reduce mutant gene expression may provide therapeutic benefit. Synthetic antisense oligonucleotide (ASO can recognize cellular RNA and control gene expression. In recent years, advances in ASO chemistry, creation of designer ASO molecules to enhance their safety and target delivery, and scientific controlled clinical trials to ascertain their therapeutic safety and efficacy have led to an era of plausible application of ASO technology to treat currently incurable neuromuscular diseases. Over the past 1 year, for the first time, the United States Food and Drug Administration has approved two ASO therapies in genetic neuromuscular diseases. This overview summarizes the recent advances in ASO technology, evolution and use of synthetic ASOs as a therapeutic platform, and the mechanism of ASO action by exon-skipping in Duchenne muscular dystrophy and exon-inclusion in spinal muscular atrophy, with comments on their advantages and limitations.

  20. Magnetic resonance imaging (MRI) in the diagnosis of neuromuscular diseases

    International Nuclear Information System (INIS)

    Schalke, B.C.G.; Rohkamm, R.; Kaiser, W.

    1990-01-01

    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)

  1. Recent advances in neuromuscular block during anesthesia [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Martijn Boon

    2018-02-01

    Full Text Available Muscle relaxation is a routine part of anesthesia and has important advantages. However, the lingering effects of muscle relaxants in the postoperative period have historically been associated with postoperative adverse events. Neuromuscular reversal, together with neuromuscular monitoring, is a recognized strategy to reduce the rate of postoperative residual relaxation but has only marginally improved outcome in the past few decades. Sugammadex, a novel reversal agent with unique encapsulating properties, has changed the landscape of neuromuscular reversal and opened up new opportunities to improve patient care. By quickly and completely reversing any depth of neuromuscular block, it may reduce the rate of residual relaxation and improve respiratory recovery. In addition, sugammadex has made the use of deep neuromuscular block possible during surgery. Deep neuromuscular block may improve surgical working conditions and allow for a reduction in insufflation pressures during selected laparoscopic procedures. However, whether and how this may impact outcomes is not well established.

  2. The relative frequency of common neuromuscular diagnoses in a reference center

    OpenAIRE

    Cotta, Ana; Paim, Júlia Filardi; Carvalho, Elmano; da-Cunha-Júnior, Antonio Lopes; Navarro, Monica M.; Valicek, Jaquelin; Menezes, Miriam Melo; Nunes, Simone Vilela; Xavier-Neto, Rafael; Baptista Junior, Sidney; Lima, Luciano Romero; Takata, Reinaldo Issao; Vargas, Antonio Pedro

    2017-01-01

    ABSTRACT The diagnostic procedure in neuromuscular patients is complex. Knowledge of the relative frequency of neuromuscular diseases within the investigated population is important to allow the neurologist to perform the most appropriate diagnostic tests. Objective: To report the relative frequency of common neuromuscular diagnoses in a reference center. Methods: A 17-year chart review of patients with suspicion of myopathy. Results: Among 3,412 examinations, 1,603 (46.98%) yielded confir...

  3. Utilization of ACL Injury Biomechanical and Neuromuscular Risk Profile Analysis to Determine the Effectiveness of Neuromuscular Training.

    Science.gov (United States)

    Hewett, Timothy E; Ford, Kevin R; Xu, Yingying Y; Khoury, Jane; Myer, Gregory D

    2016-12-01

    The widespread use of anterior cruciate ligament (ACL) injury prevention interventions has not been effective in reducing the injury incidence among female athletes who participate in high-risk sports. The purpose of this study was to determine if biomechanical and neuromuscular factors that contribute to the knee abduction moment (KAM), a predictor of future ACL injuries, could be used to characterize athletes by a distinct factor. Specifically, we hypothesized that a priori selected biomechanical and neuromuscular factors would characterize participants into distinct at-risk profiles. Controlled laboratory study. A total of 624 female athletes who participated in jumping, cutting, and pivoting sports underwent testing before their competitive season. During testing, athletes performed drop-jump tasks from which biomechanical measures were captured. Using data from these tasks, latent profile analysis (LPA) was conducted to identify distinct profiles based on preintervention biomechanical and neuromuscular measures. As a validation, we examined whether the profile membership was a significant predictor of the KAM. LPA using 6 preintervention biomechanical measures selected a priori resulted in 3 distinct profiles, including a low (profile 1), moderate (profile 2), and high (profile 3) risk for ACL injuries. Athletes with profiles 2 and 3 had a significantly higher KAM compared with those with profile 1 (P risk profiles. Three distinct risk groups were identified based on differences in the peak KAM. These findings demonstrate the existence of discernable groups of athletes that may benefit from injury prevention interventions. ClinicalTrials.gov NCT identifier: NCT01034527. © 2016 The Author(s).

  4. A case series of re-establishment of neuromuscular block with rocuronium after sugammadex reversal.

    Science.gov (United States)

    Iwasaki, Hajime; Sasakawa, Tomoki; Takahoko, Kenichi; Takagi, Shunichi; Nakatsuka, Hideki; Suzuki, Takahiro; Iwasaki, Hiroshi

    2016-06-01

    We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. After inducing general anesthesia and placing the neuromuscular monitor, the protocol to re-establish neuromuscular block was as follows. An initial rocuronium dose of 0.6 mg/kg was followed by additional 0.3 mg/kg doses every 2 min until train-of-four responses were abolished. A total of 11 patients were enrolled in this study. Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block.

  5. Bloqueio do nervo frênico após realização de bloqueio do plexo braquial pela via interescalênica: relato de caso A bloqueo del nervio frénico después de la realización de bloqueo del plexo braquial por la vía interescalénica: relato de caso Phrenic nerve block after interscalene brachial plexus block: case report

    Directory of Open Access Journals (Sweden)

    Luis Henrique Cangiani

    2008-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Bloqueio do nervo frênico é um evento adverso do bloqueio do plexo braquial; entretanto, na sua maioria, sem repercussões clínicas importantes. O objetivo deste relato foi apresentar um caso em que ocorreu bloqueio do nervo frênico, com comprometimento ventilatório, em paciente com insuficiência renal crônica submetido a instalação de fístula arteriovenosa extensa, sob bloqueio do plexo braquial pela via perivascular interescalênica. RELATO DO CASO: Paciente do sexo masculino, 50 anos, tabagista, portador de insuficiência renal crônica em regime de hemodiálise, hipertensão arterial, hepatite C, diabetes mellitus, doença pulmonar obstrutiva crônica, a ser submetido à instalação de fístula arteriovenosa extensa no membro superior direito sob bloqueio de plexo braquial pela via interescalênica. O plexo braquial foi localizado com utilização do estimulador de nervo periférico. Foram injetados 35 mL de uma solução de anestésico local, constituída de uma mistura de lidocaína a 2% com epinefrina a 1:200.000 e ropivacaína a 0,75% em partes iguais. Ao final da injeção o paciente apresentava-se lúcido, porém com dispnéia e predomínio de incursão respiratória intercostal ipsilateral ao bloqueio. Não havia murmúrio vesicular na base do hemitórax direito. A SpO2 manteve-se em 95%, com cateter nasal de oxigênio. Não foi necessária instalação de métodos de auxílio ventilatório invasivo. Radiografia do tórax revelou que o hemidiafragma direito ocupava o 5° espaço intercostal. O quadro clínico foi revertido em três horas. CONCLUSÕES: O caso mostrou que houve paralisia total do nervo frênico com sintomas respiratórios. Apesar de não ter sido necessária terapêutica invasiva para o tratamento, fica o alerta para a restrição da indicação da técnica nesses casos.JUSTIFICATIVA Y OBJETIVOS: El bloqueo del nervio frénico es un evento adverso del bloqueo del plexo braquial, sin

  6. Comparação da qualidade do bloqueio oftálmico periconal com ropivacaína a 1% e 0,75% com punção os pontos infraorbitário lateral e medial da órbita

    Directory of Open Access Journals (Sweden)

    Vásquez Carlos Escobar

    2002-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: São diversos os fármacos empregados e diversas as vias de abordagem da região peribulbar. Nosso objetivo foi investigar a qualidade do bloqueio oftálmico periconal, através de dois pontos de punção, utilizando ropivacaína em diferentes concentrações, sem adição de hialuronidase. MÉTODO: Foram estudados 50 pacientes submetidos à cirurgia oftalmológica, distribuídos aleatoriamente em dois grupos: R1 (Ropivacaína a 1% e R0,75 (Ropivacaína a 0,75%. O volume de anestésico local injetado foi ajustado conforme a tolerância e distensibilidade do espaço periconal no ponto infraorbitário e, se necessário, um volume adicional de até 3 ml no compartimento periconal medial da órbita. Escores de motilidade foram atribuídos a cada músculo reto. Foi avaliado também o grau de bloqueio motor dos músculos elevador da pálpebra superior e orbicular ocular. Os dados foram avaliados nos seguintes momentos: M0 = imediatamente antes de realizar o bloqueio; M5 = 5 minutos após o bloqueio; M10 = 10 minutos após o bloqueio; e M15 = 15 minutos após o bloqueio. RESULTADOS: Dois pacientes do grupo R1 e oito pacientes no grupo R0,75 necessitaram complementação, sendo esta diferença significativa. Em 72% dos casos, em ambos os grupos, foram realizadas somente as duas punções iniciais. O volume total de anestésico e o volume empregado na primeira punção foram respectivamente, no grupo R1: 9,72 ± 2,38 ml e 6,96 ± 0,97 ml e no grupo R0,75: 12,64 ± 5,10 ml e 7,36 ± 1,07 ml, apresentando também diferença significativa. Houve diferença significativa dos escores de motricidade nos momentos M10(R1 = 1,6; R0,75 = 3,8 e M15(R1 = 1,04; R0,75 = 2,8. CONCLUSÕES: Concluímos que a ropivacaína a 1% mostrou-se mais eficiente do que a ropivacaína a 0,75% quando utilizadas sem hialuronidase para realização de bloqueios oftálmicos periconais pelas técnicas apresentadas. Houve uma tendência a um menor número de pun

  7. Comparação da qualidade do bloqueio oftálmico periconal com ropivacaína a 1% e 0,75% com punção os pontos infraorbitário lateral e medial da órbita

    Directory of Open Access Journals (Sweden)

    Carlos Escobar Vásquez

    2002-11-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: São diversos os fármacos empregados e diversas as vias de abordagem da região peribulbar. Nosso objetivo foi investigar a qualidade do bloqueio oftálmico periconal, através de dois pontos de punção, utilizando ropivacaína em diferentes concentrações, sem adição de hialuronidase. MÉTODO: Foram estudados 50 pacientes submetidos à cirurgia oftalmológica, distribuídos aleatoriamente em dois grupos: R1 (Ropivacaína a 1% e R0,75 (Ropivacaína a 0,75%. O volume de anestésico local injetado foi ajustado conforme a tolerância e distensibilidade do espaço periconal no ponto infraorbitário e, se necessário, um volume adicional de até 3 ml no compartimento periconal medial da órbita. Escores de motilidade foram atribuídos a cada músculo reto. Foi avaliado também o grau de bloqueio motor dos músculos elevador da pálpebra superior e orbicular ocular. Os dados foram avaliados nos seguintes momentos: M0 = imediatamente antes de realizar o bloqueio; M5 = 5 minutos após o bloqueio; M10 = 10 minutos após o bloqueio; e M15 = 15 minutos após o bloqueio. RESULTADOS: Dois pacientes do grupo R1 e oito pacientes no grupo R0,75 necessitaram complementação, sendo esta diferença significativa. Em 72% dos casos, em ambos os grupos, foram realizadas somente as duas punções iniciais. O volume total de anestésico e o volume empregado na primeira punção foram respectivamente, no grupo R1: 9,72 ± 2,38 ml e 6,96 ± 0,97 ml e no grupo R0,75: 12,64 ± 5,10 ml e 7,36 ± 1,07 ml, apresentando também diferença significativa. Houve diferença significativa dos escores de motricidade nos momentos M10(R1 = 1,6; R0,75 = 3,8 e M15(R1 = 1,04; R0,75 = 2,8. CONCLUSÕES: Concluímos que a ropivacaína a 1% mostrou-se mais eficiente do que a ropivacaína a 0,75% quando utilizadas sem hialuronidase para realização de bloqueios oftálmicos periconais pelas técnicas apresentadas. Houve uma tendência a um menor número de pun

  8. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study - Efficacy, safety, and pharmacokinetics

    NARCIS (Netherlands)

    Sparr, Harald J.; Vermeyen, Karel M.; Beaufort, Anton M.; Rietbergen, Henk; Proost, Johannes H.; Saldien, Vera; Velik-Salchner, Corinna; Wierda, J. Mark K. H.

    Background: Sugammadex reverses the neuromuscular blocking effects of rocuronium by chemical encapsulation. The efficacy, safety, and pharmacokinetics of sugammadex for reversal of profound rocuronium-induced neuromuscular blockade were evaluated. Methods: Ninety-eight male adult patients were

  9. Rapid synthesis of acetylcholine receptors at neuromuscular junctions.

    Science.gov (United States)

    Ramsay, D A; Drachman, D B; Pestronk, A

    1988-10-11

    The rate of acetylcholine receptor (AChR) degradation in mature, innervated mammalian neuromuscular junctions has recently been shown to be biphasic; up to 20% are rapidly turned over (RTOs; half life less than 1 day) whereas the remainder are lost more slowly ('stable' AChRs; half life 10-12 days). In order to maintain normal junctional receptor density, synthesis and insertion of AChRs should presumably be sufficiently rapid to replace both the RTOs and the stable receptors. We have tested this prediction by blocking pre-existing AChRs in the mouse sternomastoid muscle with alpha-bungarotoxin (alpha-BuTx), and monitoring the subsequent appearance of 'new' junctional AChRs at intervals of 3 h to 20 days by labeling them with 125I-alpha-BuTx. The results show that new receptors were initially inserted rapidly (16% at 24 h and 28% at 48 h). The rate of increase of 'new' 125I-alpha-BuTx binding sites gradually slowed down during the remainder of the time period studied. Control observations excluded possible artifacts of the experimental procedure including incomplete blockade of AChRs, dissociation of toxin-receptor complexes, or experimentally induced alteration of receptor synthesis. The present demonstration of rapid synthesis and incorporation of AChRs at innervated neuromuscular junctions provides support for the concept of a subpopulation of rapidly turned over AChRs. The RTOs may serve as precursors for the larger population of stable receptors and have an important role in the metabolism of the neuromuscular synapse.

  10. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Peter Obid

    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.

  11. Neuromuscular activity of Bothrops fonsecai snake venom in vertebrate preparations

    Science.gov (United States)

    Fernandes, Carla T; Giaretta, Vânia MA; Prudêncio, Luiz S; Toledo, Edvana O; da Silva, Igor RF; Collaço, Rita CO; Barbosa, Ana M; Hyslop, Stephen; Rodrigues-Simioni, Léa; Cogo, José C

    2014-01-01

    The neuromuscular activity of venom from Bothrops fonsecai, a lancehead endemic to southeastern Brazil, was investigated. Chick biventer cervicis (CBC) and mouse phrenic nerve-diaphragm (PND) preparations were used for myographic recordings and mouse diaphragm muscle was used for membrane resting potential (RP) and miniature end-plate potential (MEPP) recordings. Creatine kinase release and muscle damage were also assessed. In CBC, venom (40, 80 and 160μg/ml) produced concentration- and time-dependent neuromuscular blockade (50% blockade in 85±9 min and 73±8 min with 80 and 160μg/ml, respectively) and attenuated the contractures to 110μM ACh (78–100% inhibition) and 40mM KCl (45–90% inhibition). The venom-induced decrease in twitch-tension in curarized, directly-stimulated preparations was similar to that in indirectly stimulated preparations. Venom (100 and 200μg/ml) also caused blockade in PND preparations (50% blockade in 94±13 min and 49±8 min with 100 and 200μg/ml, respectively) but did not alter the RP or MEPP amplitude. In CBC, venom caused creatine kinase release and myonecrosis. The venom-induced decrease in twitch-tension and in the contractures to ACh and K+ were abolished by preincubating venom with commercial antivenom. These findings indicate that Bothrops fonsecai venom interferes with neuromuscular transmission essentially through postsynaptic muscle damage that affects responses to ACh and KCl. These actions are effectively prevented by commercial antivenom. PMID:25028603

  12. Running Economy: Neuromuscular and Joint Stiffness Contributions in Trained Runners.

    Science.gov (United States)

    Tam, Nicholas; Tucker, Ross; Santos-Concejero, Jordan; Prins, Danielle; Lamberts, Robert P

    2018-05-29

    It is debated whether running biomechanics make good predictors of running economy, with little known information about the neuromuscular and joint stiffness contributions to economical running gait. The aim of this study was to understand the relationship between certain neuromuscular and spatiotemporal biomechanical factors associated with running economy. Thirty trained runners performed a 6-minute constant-speed running set at 3.3 m∙s -1 , where oxygen consumption was assessed. Overground running trials were also performed at 3.3 m∙s -1 to assess kinematics, kinetics and muscle activity. Spatiotemporal gait variables, joint stiffness, pre-activation and stance phase muscle activity (gluteus medius; rectus femoris (RF); biceps femoris(BF); peroneus longus (PL); tibialis anterior (TA); gastrocnemius lateralis and medius (LG and MG) were variables of specific interest and thus determined. Additionally, pre-activation and ground contact of agonist:antagonist co-activation were calculated. More economical runners presented with short ground contact times (r=0.639, p<0.001) and greater strides frequencies (r=-0.630, p<0.001). Lower ankle and greater knee stiffness were associated with lower oxygen consumption (r=0.527, p=0.007 & r=0.384, p=0.043, respectively). Only LG:TA co-activation during stance were associated with lower oxygen cost of transport (r=0.672, p<0.0001). Greater muscle pre-activation and bi-articular muscle activity during stance were associated with more economical runners. Consequently, trained runners who exhibit greater neuromuscular activation prior to and during ground contact, in turn optimise spatiotemporal variables and joint stiffness, will be the most economical runners.

  13. Neuromuscular Responses to Simulated Brazilian Jiu-Jitsu Fights

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    Corrêa da Silva Bruno Victor

    2014-12-01

    Full Text Available The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest. Neuromuscular performance was measured by the bench press throw (BPT and vertical counter movement jump (VCMJ tests, assessed before the 1st fight (Pre and after the last one (Post. Blood lactate (LA was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p < 0.05 increase in VCMJ performance (40.8 ± 5.5 cm Pre vs. 42.0 ± 5.8 cm Post, but no significant changes in the BPT (814 ± 167 W Pre vs. 835 ± 213 W Post were observed. LA concentration increased significantly (p < 0.05 at Post, both in the 1st min and the 15th min of recovery. We concluded that successive simulated BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power was observed.

  14. Diagnostics of neuromuscular diseases with the aid of computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Visser, M de; Verbeeten, Jr, B J

    1988-06-04

    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.

  15. Diagnostics of neuromuscular diseases with the aid of computerized tomography

    International Nuclear Information System (INIS)

    Visser, M. de; Verbeeten, B.J. Jr.

    1988-01-01

    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

  16. Cardiac involvement in children with neuro-muscular disorders

    Directory of Open Access Journals (Sweden)

    E. N. Arkhipova

    2015-01-01

    Full Text Available Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-girdle muscular dystrophies and other disorders. Detection of cardiac pathology in patients with different muscular dystrophies is possible with ECG, echocardiography and cardiovascular magnetic resonance imaging, which are recommended for screening and early cardioprotective treatment.

  17. Schwann Cells in Neuromuscular Junction Formation and Maintenance.

    Science.gov (United States)

    Barik, Arnab; Li, Lei; Sathyamurthy, Anupama; Xiong, Wen-Cheng; Mei, Lin

    2016-09-21

    The neuromuscular junction (NMJ) is a tripartite synapse that is formed by motor nerve terminals, postjunctional muscle membranes, and terminal Schwann cells (TSCs) that cover the nerve-muscle contact. NMJ formation requires intimate communications among the three different components. Unlike nerve-muscle interaction, which has been well characterized, less is known about the role of SCs in NMJ formation and maintenance. We show that SCs in mice lead nerve terminals to prepatterned AChRs. Ablating SCs at E8.5 (i.e., prior nerve arrival at the clusters) had little effect on aneural AChR clusters at E13.5, suggesting that SCs may not be necessary for aneural clusters. SC ablation at E12.5, a time when phrenic nerves approach muscle fibers, resulted in smaller and fewer nerve-induced AChR clusters; however, SC ablation at E15.5 reduced AChR cluster size but had no effect on cluster density, suggesting that SCs are involved in AChR cluster maturation. Miniature endplate potential amplitude, but not frequency, was reduced when SCs were ablated at E15.5, suggesting that postsynaptic alterations may occur ahead of presynaptic deficits. Finally, ablation of SCs at P30, after NMJ maturation, led to NMJ fragmentation and neuromuscular transmission deficits. Miniature endplate potential amplitude was reduced 3 d after SC ablation, but both amplitude and frequency were reduced 6 d after. Together, these results indicate that SCs are not only required for NMJ formation, but also necessary for its maintenance; and postsynaptic function and structure appeared to be more sensitive to SC ablation. Neuromuscular junctions (NMJs) are critical for survival and daily functioning. Defects in NMJ formation during development or maintenance in adulthood result in debilitating neuromuscular disorders. The role of Schwann cells (SCs) in NMJ formation and maintenance was not well understood. We genetically ablated SCs during development and after NMJ formation to investigate the consequences

  18. Preventing Ischial Pressure Ulcers: I. Review of Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: Pressure ulcers (PUs are common and debilitating wounds that arise when immobilized patients cannot shift their weight. Treatment is expensive and recurrence rates are high. Pathophysiological mechanisms include reduced bulk and perfusion of chronically atrophic muscles as well as prolonged occlusion of blood flow to soft tissues from lack of voluntary postural shifting of body weight. This has suggested that PUs might be prevented by reanimating the paralyzed muscles using neuromuscular electrical stimulation (NMES. A review of the published literature over the past 2 decades is detailed.

  19. Resúmenes de los trabajos sobre las Enfermedades Neuromusculares

    OpenAIRE

    Congreso Nacional de Neurología

    2010-01-01

    Las enfermedades neuromusculares constituyen un conjunto de afectaciones que afectan las neuronas motoras periférica, las vías motoras eferentes o los efectores (músculos esqueléticos). Sus manifestaciones clínicas son muy variadas y dependen de la causa y de los niveles de afectación. En este acápite se pueden encontrar los resúmenes de trabajos relacionados con el síndrome de Guillain Barre, polineuropatía diabética, Atrofia Muscular Espinal, Distrofia miotónica y otros todos presentados en...

  20. 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.)

  1. Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: Binding of the steroidal molecule of rocuronium by a cyclodextrin is a new concept for reversal of neuromuscular block. The present study evaluated the ability of Sugammadex Org 25969, a synthetic gamma-cyclodextrin derivative, to reverse constant neuromuscular block of about 90% induced

  2. Reversal of rocuronium-induced profound neuromuscular block by sugammadex in Duchenne muscular dystrophy.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Booij, L.H.D.J.; Driessen, J.J.

    2009-01-01

    A case is reported in which a child with Duchenne muscular dystrophy received a dose of sugammadex to reverse a rocuronium-induced profound neuromuscular block. Sugammadex is the first selective relaxant binding agent and reverses rocuronium- and vecuronium-induced neuromuscular block. A fast and

  3. A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Driessen, J.J.; Booij, L.H.D.J.

    2010-01-01

    A neuromuscular blocking drug (NMBD) induced neuromuscular blockade (NMB) in patients with myasthenia gravis usually dissipates either spontaneously or by administration of neostigmine. We administered sugammadex to a patient with myasthenia gravis to reverse a rocuronium-induced profound NMB. NMBDs

  4. Fatigue in neuromuscular disorders: Focus on Guillain-Barré syndrome and Pompe disease

    NARCIS (Netherlands)

    J.M. de Vries (Juna); M.L.C. Hagemans (Marloes); J.B.J. Bussmann (Hans); A.T. van der Ploeg (Ans); P.A. van Doorn (Pieter)

    2010-01-01

    textabstractFatigue 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

  5. ANÁLISE SENSORIAL E MICROBIOLÓGICA DE KEFIR ARTESANAL PRODUZIDO A PARTIR DE LEITE DE CABRA E DE LEITE DE VACA

    Directory of Open Access Journals (Sweden)

    Felipe Alves de Almeida

    2011-02-01

    Full Text Available O kefir vem sendo considerado como um alimento funcional, produzido através da fermentação lática e alcoólica do leite por bactérias e leveduras, possuindo consistência semelhante à de um iogurte, mas de valor nutricional e terapêutico muito maior. É originário das montanhas dos Cáucaso e da Ásia Central tendo sido consumido por milhares de anos pela população das montanhas que relacionam seu uso diário com a longevidade e saúde. O objetivo deste trabalho foi elaborar um kefir a base de leite de vaca e outro a base de leite de cabra e avaliar suas características microbiológicas e a aceitabilidade de cada um dos produtos.

  6. The immediate effect of neuromuscular joint facilitation on the rotation of the tibia during walking.

    Science.gov (United States)

    Li, Desheng; Huang, Qiuchen; Huo, Ming; Hiiragi, Yukinobu; Maruyama, Hitoshi

    2017-01-01

    [Purpose] The aim of this study was to investigate the change in tibial rotation during walking among young adults after neuromuscular joint facilitation therapy. [Subjects and Methods] The subjects were twelve healthy young people (6 males, 6 females). A neuromuscular joint facilitation intervention and nonintervention were performed. The interventions were performed one after the other, separated by a 1-week interval. The order of the interventions was completely randomized. The rotation of the tibia during walking was evaluated before and after treatment. [Results] The neuromuscular joint facilitation group demonstrated increased lateral rotation of the tibia in the overall gait cycle and stance phase, and decreased medial rotation of the tibia in the overall gait cycle, stance phase, and swing phase after the neuromuscular joint facilitation intervention. In the control group, there were no significant differences. [Conclusion] These results suggest neuromuscular joint facilitation intervention has an immediate effect on the rotational function of the knee.

  7. Propriedades físicas de painéis aglomerados de madeira produzidos com adição de película de polipropileno biorientado

    Directory of Open Access Journals (Sweden)

    Laurenn B. de Macedo

    2015-07-01

    Full Text Available No Brasil, as últimas décadas foram marcadas pela crescente produção de paineis de madeira seguida pelo aumento do consumo nacional; isto descreve o quão promissora é a área devido à sua grande potencialidade quanto ao desenvolvimento de novos produtos e tecnologias; como exemplo disto existe a possibilidade de mistura entre materiais lignocelulósicos e os diversos resíduos produzidos pela sociedade. Entre tais resíduos o plástico é o que apresenta maior abundância nos descartes domésticos. Neste contexto, o presente trabalho objetivou determinar propriedades físicas de paineis aglomerados homogêneos confeccionados com partículas de madeira de Eucalyptus sp e Pinus sp e de embalagens de película de polipropileno biorientado tendo, como adesivo, a resina poliuretana à base de óleo de mamona. Foram avaliadas as propriedades: inchamento em espessura e absorção de água, com corpo de prova com e sem impermeabilização, e massa específica. Concluiu-se que, dos fatores investigados, apenas o uso do impermeabilizante foi significativo. De acordo com a ANSI A208.1 (ANS, 1999 os paineis produzidos são classificados como de alta massa específica (H. Relativamente ao inchamento em espessura por 2 h, os paineis atenderam ao exigido pela NBR 14810 (ABNT, 2013 para espessura de 8 a 13 mm.

  8. Motor unit recruitment during neuromuscular electrical stimulation: a critical appraisal.

    Science.gov (United States)

    Bickel, C Scott; Gregory, Chris M; Dean, Jesse C

    2011-10-01

    Neuromuscular electrical stimulation (NMES) is commonly used in clinical settings to activate skeletal muscle in an effort to mimic voluntary contractions and enhance the rehabilitation of human skeletal muscles. It is also used as a tool in research to assess muscle performance and/or neuromuscular activation levels. However, there are fundamental differences between voluntary- and artificial-activation of motor units that need to be appreciated before NMES protocol design can be most effective. The unique effects of NMES have been attributed to several mechanisms, most notably, a reversal of the voluntary recruitment pattern that is known to occur during voluntary muscle contractions. This review outlines the assertion that electrical stimulation recruits motor units in a nonselective, spatially fixed, and temporally synchronous pattern. Additionally, it synthesizes the evidence that supports the contention that this recruitment pattern contributes to increased muscle fatigue when compared with voluntary actions and provides some commentary on the parameters of electrical stimulation as well as emerging technologies being developed to facilitate NMES implementation. A greater understanding of how electrical stimulation recruits motor units, as well as the benefits and limitations of its use, is highly relevant when using this tool for testing and training in rehabilitation, exercise, and/or research.

  9. Ultrastructural findings in noncompaction prevail with neuromuscular disorders.

    Science.gov (United States)

    Finsterer, Josef; Stöllberger, Claudia

    2013-01-01

    Little is known about the ultrastructural abnormalities of left ventricular hypertrabeculation/noncompaction (LVHT). This literature review aimed to summarize and discuss ultrastructural abnormalities described in LVHT so far. The literature search was conducted via MEDLINE using the search terms 'non-compaction', 'noncompaction', 'left ventricular hypertrabeculation', 'spongy myocardium' in combination with the terms 'ultra-structural', or 'electron microscopy'. Altogether, 11 studies reporting ultrastructural investigations of LVHT were retrieved. In these 11 studies, data on 13 patients with LVHT were presented. Ultrastructural abnormalities found in these study patients were generally nonspecific and included an increase in the number of mitochondria (n = 3), abnormally shaped mitochondria (n = 2), distorted cristae (n = 3), sarcomeric derangement (n = 3), immature cardiomyocytes (n = 1), lipid-like inclusions (n = 1), enlarged interstitial spaces (n = 1), increased interstitial collagen (n = 1), or increased glycogen (n = 1). The morphological abnormalities were most prominent in patients with a neuromuscular disorder like Barth syndrome or mitochondrial myopathy. Only in few patients with LVHT, ultrastructural investigations have been performed so far. Ultrastructural abnormalities in LVHT are nonspecific and most prominent in patients with a neuromuscular disorder. There is a strong need to carry out thorough ultrastructural investigations of LVHT to contribute to the understanding of this still unexplained myocardial abnormality.

  10. Neuromuscular rate of force development deficit in Parkinson disease.

    Science.gov (United States)

    Hammond, Kelley G; Pfeiffer, Ronald F; LeDoux, Mark S; Schilling, Brian K

    2017-06-01

    Bradykinesia and reduced neuromuscular force exist in Parkinson disease. The interpolated twitch technique has been used to evaluate central versus peripheral manifestations of neuromuscular strength in healthy, aging, and athletic populations, as well as moderate to advanced Parkinson disease, but this method has not been used in mild Parkinson disease. This study aimed to evaluate quadriceps femoris rate of force development and quantify potential central and peripheral activation deficits in individuals with Parkinson disease. Nine persons with mild Parkinson Disease (Hoehn & Yahr≤2, Unified Parkinson Disease Rating Scale total score=mean 19.1 (SD 5.0)) and eight age-matched controls were recruited in a cross-sectional investigation. Quadriceps femoris voluntary and stimulated maximal force and rate of force development were evaluated using the interpolated twitch technique. Thirteen participants satisfactorily completed the protocol. Individuals with early Parkinson disease (n=7) had significantly slower voluntary rate of force development (p=0.008; d=1.97) and rate of force development ratio (p=0.004; d=2.18) than controls (n=6). No significant differences were found between groups for all other variables. Persons with mild-to-moderate Parkinson disease display disparities in rate of force development, even without deficits in maximal force. The inability to produce force at a rate comparable to controls is likely a downstream effect of central dysfunction of the motor pathway in Parkinson disease. Copyright © 2017. Published by Elsevier Ltd.

  11. Toward Balance Recovery With Leg Prostheses Using Neuromuscular Model Control

    Science.gov (United States)

    Geyer, Hartmut

    2016-01-01

    Objective Lower limb amputees are at high risk of falling as current prosthetic legs provide only limited functionality for recovering balance after unexpected disturbances. For instance, the most established control method used on powered leg prostheses tracks local joint impedance functions without taking the global function of the leg in balance recovery into account. Here we explore an alternative control policy for powered transfemoral prostheses that considers the global leg function and is based on a neuromuscular model of human locomotion. Methods We adapt this model to describe and simulate an amputee walking with a powered prosthesis using the proposed control, and evaluate the gait robustness when confronted with rough ground and swing leg disturbances. We then implement and partially evaluate the resulting controller on a leg prosthesis prototype worn by a non-amputee user. Results In simulation, the proposed prosthesis control leads to gaits that are more robust than those obtained by the impedance control method. The initial hardware experiments with the prosthesis prototype show that the proposed control reproduces normal walking patterns qualitatively and effectively responds to disturbances in early and late swing. However, the response to mid-swing disturbances neither replicates human responses nor averts falls. Conclusions The neuromuscular model control is a promising alternative to existing prosthesis controls, although further research will need to improve on the initial implementation and determine how well these results transfer to amputee gait. Significance This work provides a potential avenue for future development of control policies that help improve amputee balance recovery. PMID:26315935

  12. [Six-minute walk test in children with neuromuscular disease.

    Science.gov (United States)

    Cruz-Anleu, Israel Didier; Baños-Mejía, Benjamín Omar; Galicia-Amor, Susana

    2013-01-01

    Background: neuromuscular diseases affect the motor unit. When they evolve, respiratory complications are common; the six-minute walk test plays an important role in the assessment of functional capacity. Methods: prospective, transversal, descriptive and observational study. We studied seven children with a variety of neuromuscular diseases and spontaneous ambulation. We tested their lung function, and administered a six-minute walk test and a test of respiratory muscle strength to these children. Results: the age was 9.8 ± 2.4 years. All patients were males. Forced vital capacity decreased in three patients (42.8 %), forced expiratory volume during the first second (2.04 ± 1.4 L) and peak expiratory flow (4.33 ± 3.3 L/s) were normal. The maximum strength of respiratory muscles was less than 60 % of predicted values. The distance covered in the six-minute walk test was lower when compared with healthy controls (29.9 %). Conclusions: the six-minute walk test can be a useful tool in early stages of this disease, since it is easy to perform and well tolerated by the patients.

  13. Effect of salbutamol on neuromuscular function in endurance athletes.

    Science.gov (United States)

    Decorte, Nicolas; Bachasson, Damien; Guinot, Michel; Flore, Patrice; Levy, Patrick; Verges, Samuel; Wuyam, Bernard

    2013-10-01

    The potential ergogenic effects of therapeutic inhaled salbutamol doses in endurance athletes have been controversially discussed for decades. We hypothesized that salbutamol inhalation may increase peripheral muscle contractility, reduce fatigability, and improve force recovery after a localized exercise in endurance athletes. Eleven healthy, nonasthmatic male athletes with high aerobic capacities were recruited to be compared in a double-blinded, randomized crossover study of two dose levels of salbutamol (200 and 800 μg) and a placebo administered by inhalation before a quadriceps fatigue test. Subjects performed an incremental exercise protocol consisting in sets of 10 intermittent isometric contractions starting at 20% of maximum voluntary contraction (MVC) with 10% MVC increment until exhaustion. Femoral nerve magnetic stimulation was used during and after MVC to evaluate neuromuscular fatigue after each set, at task failure, and after 10 and 30 min of recovery. Initial MVC and evoked muscular responses were not modified with salbutamol (P > 0.05). The total number of submaximal contractions until task failure significantly differed between treatments (placebo, 72 ± 7; 200 µg, 78 ± 8; and 800 µg, 82 ± 7; P 0.05). Voluntary activation was unaffected by the fatiguing task and treatments (P > 0.05). Supratherapeutic inhaled doses of β2-agonists increased quadriceps endurance during an incremental and localized fatiguing task in healthy endurance-trained athletes without significant effect on neuromuscular fatigue. Further studies are needed to clarify the underlying mechanisms.

  14. Estimating neuromuscular stimulation within the human torso with Taser stimulus.

    Science.gov (United States)

    Sun, Hongyu; Webster, John G

    2007-11-07

    Designers of electromuscular incapacitation devices need to know efficacy. Which areas of nerve and muscle are stimulated and are these areas adequate to cause incapacitation? This paper focuses on efficacy, which used a torso-sized finite element model with a mesh of about 5 mm. To estimate the neuromuscular regions stimulated by the Taser X26, calculations of electric current density and field strength values with 1 A inserted into the torso using the Utah 3D mesh were made. Field-times-duration values for given Taser stimulation were calculated. Then the region where the motor nerve was stimulated by the Taser was estimated by using a field-times-duration threshold from Reilly (1998 'Applied Bioelectricity: From Electrical Stimulation to Electropathology ' (New York: Springer)). Neuromuscular stimulation occurred up to about 19 cm away from the darts and included the spinal cord. The current density at the heart for dart separation less than 10 cm was smaller than for larger dart separation. Users of finite element computer models will find information for torso models and their creation, meshing and operation.

  15. Neuromuscular compensation mechanisms in vocal fold paralysis and paresis.

    Science.gov (United States)

    Dewan, Karuna; Vahabzadeh-Hagh, Andrew; Soofer, Donna; Chhetri, Dinesh K

    2017-07-01

    Vocal fold paresis and paralysis are common conditions. Treatment options include augmentation laryngoplasty and voice therapy. The optimal management for this condition is unclear. The objective of this study was to assess possible neuromuscular compensation mechanisms that could potentially be used in the treatment of vocal fold paresis and paralysis. In vivo canine model. In an in vivo canine model, we examined three conditions: 1) unilateral right recurrent laryngeal nerve (RLN) paresis and paralysis, 2) unilateral superior laryngeal nerve (SLN) paralysis, and 3) unilateral vagal nerve paresis and paralysis. Phonatory acoustics and aerodynamics were measured in each of these conditions. Effective compensation was defined as improved acoustic and aerodynamic profile. The most effective compensation for all conditions was increasing RLN activation and decreasing glottal gap. Increasing RLN activation increased the percentage of possible phonatory conditions that achieved phonation onset. SLN activation generally led to decreased number of total phonation onset conditions within each category. Differential effects of SLN (cricothyroid [CT] muscle) activation were seen. Ipsilateral SLN activation could compensate for RLN paralysis; normal CT compensated well in unilateral SLN paralysis; and in vagal paresis/paralysis, contralateral SLN and RLN displayed antagonistic relationships. Methods to improve glottal closure should be the primary treatment for large glottal gaps. Neuromuscular compensation is possible for paresis. This study provides insights into possible compensatory mechanisms in vocal fold paresis and paralysis. NA Laryngoscope, 127:1633-1638, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Emerging modalities in dysphagia rehabilitation: neuromuscular electrical stimulation.

    Science.gov (United States)

    Huckabee, Maggie-Lee; Doeltgen, Sebastian

    2007-10-12

    The aim of this review article is to advise the New Zealand medical community about the application of neuromuscular electrical stimulation (NMES) as a treatment for pharyngeal swallowing impairment (dysphagia). NMES in this field of rehabilitation medicine has quickly emerged as a widely used method overseas but has been accompanied by significant controversy. Basic information is provided about the physiologic background of electrical stimulation. The literature reviewed in this manuscript was derived through a computer-assisted search using the biomedical database Medline to identify all relevant articles published until from the initiation of the databases up to January 2007. The reviewers used the following search strategy: [(deglutition disorders OR dysphagia) AND (neuromuscular electrical stimulation OR NMES)]. In addition, the technique of reference tracing was used and very recently published studies known to the authors but not yet included in the database systems were included. This review elucidates not only the substantive potential benefit of this treatment, but also potential key concerns for patient safety and long term outcome. The discussion within the clinical and research communities, especially around the commercially available VitalStim stimulator, is objectively explained.

  17. Analgesia pós-operatória para procedimentos cirúrgicos ortopédicos de quadril e fêmur: comparação entre bloqueio do compartimento do psoas e bloqueio perivascular inguinal Analgesia postoperatoria para procedimientos quirúrgicos ortopédicos de cadera y fémur: comparación entre bloqueo del compartimiento del psoas y bloqueo perivascular inguinal Postoperative analgesia for orthopedic surgeries of the hip and femur: a comparison between psoas compartment and inguinal paravascular blocks

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2006-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Este estudo avaliou a eficácia da injeção única de bupivacaína a 0,25% no compartimento do psoas ou perivascular inguinal por meio do estimulador de nervos periféricos para analgesia pós-operatória em pacientes submetidos a intervenções cirúrgicas ortopédicas. MÉTODO: Cem pacientes receberam bloqueio do plexo lombar através do compartimento do psoas e foram comparados com 100 pacientes que receberam bloqueio do plexo lombar via perivascular inguinal, identificados pelo estimulador de nervos periféricos com a injeção de 40 mL bupivacaína a 0,25% sem epinefrina. A analgesia nos nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foi avaliada 4, 8, 12, 16, 20 e 24 horas após o final da intervenção cirúrgica. A intensidade da dor foi também avaliada no mesmo período. A quantidade de opióides administrada no pós-operatório foi anotada. Em cinco pacientes de cada grupo, estudo radiográfico com contraste não-iônico foi realizado para avaliar a dispersão da solução anestésica. RESULTADOS: Os nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foram bloqueados em 92% dos pacientes no compartimento do psoas versus 62% no bloqueio perivascular inguinal. O bloqueio do plexo lombar reduziu a necessidade de opióides e 42% dos pacientes submetidos ao bloqueio do compartimento do psoas e 36% dos pacientes no bloqueio inguinal não necessitaram de analgésico adicional no pós-operatório. A duração da analgesia foi em torno de 21 horas com bloqueio do compartimento do psoas e 15 horas com bloqueio perivascular inguinal. CONCLUSÕES: O bloqueio do compartimento do psoas e perivascular inguinal é uma excelente técnica para analgesia pós-operatória em intervenções cirúrgicas ortopédicas reduzindo a necessidade de opióides. Este estudo mostrou que a injeção no compartimento do psoas foi mais fácil e mais efetiva no bloqueio

  18. Bloqueio extraconal para facectomia com implante de lente intra-ocular: influência do fentanil associado ao anestésico local na qualidade do bloqueio e na analgesia pós-operatória Bloqueo extraconal para facectomia con implantación de lente intra-ocular: influencia del fentanil asociado al anestésico local en la calidad del bloqueo y en la analgesia pos-operatoria Extraconal block for cataract extraction surgery with implantation of intraocular lens: contribution of fentanyl associated to local anesthetics for quality of block and postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Daniel Espada Lahoz

    2003-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A anestesia locorregional para cirurgias oftalmológicas oferece vantagens, como: mínimas alterações fisiológicas, anestesia completa, bloqueio dos reflexos oculares, pequena incidência de náuseas e vômitos, menor tempo de recuperação e analgesia pós-operatória. A preocupação constante com a qualidade do bloqueio, assim como da abordagem da analgesia pós-operatória deve ficar sob a responsabilidade do anestesiologista. O objetivo deste estudo foi avaliar se o fentanil contribui na qualidade do bloqueio extraconal e na analgesia pós-operatória de facectomias com implante de lente intra-ocular. MÉTODO: Estudou-se a associação do fentanil e bupivacaína a 0,75% na qualidade do bloqueio ocular e na analgesia pós-operatória em 164 pacientes submetidos a facectomia com implante de lente intra-ocular (técnica extracapsular, de ambos os sexos com homogeneidade de parâmetros antropométricos, olho operado, classificação do estado físico (ASA e índice de risco cardíaco de Goldman. Os pacientes foram distribuídos em dois grupos (82 pacientes em cada grupo por sorteio de forma aleatória, com e sem fentanil. Avaliou-se a qualidade do bloqueio por: aparecimento da dor no per-operatório, manutenção de movimentação das pálpebras ou do globo ocular, persistência do reflexo de Bell, número de bloqueios realizados para a obtenção de condições cirúrgicas e avaliação do bloqueio pelo cirurgião. A analgesia pós-operatória foi avaliada pela necessidade de complementação analgésica pelo paciente. RESULTADOS: Fentanil associado à solução anestésica no bloqueio extraconal aumentou significativamente o bloqueio do músculo reto medial (com fentanil - 17,1%, sem fentanil - 32,9% e diminuiu o consumo de analgésicos no período pós-operatório (uso de analgésicos com fentanil - 20,7%, não uso de analgésicos com fentanil - 41,5%. CONCLUSÕES: Nas condições deste estudo o fentanil

  19. Bloqueio do nervo alveolar mandibular com ropivacaína a 0,5 % em gatos Bockage of the jaw’s alveolar nerve with 0.5% ropivacaine in cats

    Directory of Open Access Journals (Sweden)

    Vanessa Martins Fayad Milken

    2006-04-01

    Full Text Available Objetivou-se, com este experimento, avaliar a ação da ropivacaína a 0,5% no bloqueio do nervo alveolar mandibular de gatos. Vinte gatos adultos, sem raça definida, machos ou fêmeas, receberam clorpromazina (1,0mg kg-1, VO e propofol (3,0mg kg-1, IV. Ropivacaína a 0,5% foi administrada com uma agulha 13x3,8 em forma de "L", inserida no ângulo da mandíbula direita, aproximadamente 1,0cm rostral ao processo angular e 0,5cm dorsal à superfície medial do ramo da mandíbula, a fim de depositá-la próximo ao nervo alveolar mandibular, no forame mandibular. As freqüências cardíaca e respiratória foram mensuradas antes da administração da clorpromazina, 20 minutos após administração desta (T0, 20 minutos após o bloqueio do nervo alveolar mandibular com ropivacaína (T20 e, em intervalos de 20 minutos, até a volta da sensibilidade na região anestesiada. Observou-se o período de latência e a duração da anestesia por meio do pinçamento da pele e gengiva da região lateral direita da mandíbula. Encontrou-se início da anestesia após 22 minutos, com duração de 164,25 minutos. Os parâmetros de freqüência cardíaca e freqüência respiratória tiveram alterações, porém sem significado clínico para a espécie. A ropivacaína a 0,5% anestesia a região dos dentes pré-molares, molares, caninos, incisivos, pele e mucosa oral e lábio inferior, sem causar efeitos colaterais.This study intended to evaluate the 0.5% ropivacaine action on the alveolar mandibular nerve block in cats. Twenty adult cats, non-defined breed, male or female, received chlorpromazine (1.0 mg kg-1 VO and propofol (3,0 mg/kg IV. Ropivacaine at 0.5% was administrated with an "L" 13x3,8 needle, inserted in the angle of the right mandible, close to 1.0cm rostral to the angular process and 0.5cm dorsal to the medial surface of the mandible branch, intending to deposit close to the alveolar mandibular nerve, at the mandibular forame. The heart and respiratory

  20. The Preparation Period in Basketball: Training Load and Neuromuscular Adaptations.

    Science.gov (United States)

    Ferioli, Davide; Bosio, Andrea; Bilsborough, Johann C; Torre, Antonio La; Tornaghi, Michele; Rampinini, Ermanno

    2018-01-18

    To investigate the 1) effect of the preparation period on the neuromuscular characteristics of 12 professional (PRO) and 16 semi-professional (SEMI-PRO) basketball players; 2) relationships between training load indices and changes in neuromuscular physical performance. Prior to and following the preparation period, players underwent a counter-movement jump (CMJ) test, followed by a repeated change of direction (COD) test consisting of 4 levels with increasing intensities. The peripheral neuromuscular functions of the knee extensors (peak torque, PT) were measured using electrical stimulations after each level (PT1, PT2, PT3 and PT4). Furthermore, PT Max (the highest value of PT) and PT Dec (PT decrement from PT Max to PT4) were calculated. Trivial-to-small (effect size, ES: -0.17 to 0.46) improvements were found in CMJ variables, regardless of the competitive levels. After the preparation period, peripheral fatigue induced by a COD test was similarly reduced in both PRO (PT Dec: from 27.8±21.3% to 11.4±13.7%, ES±90%CI= -0.71±0.30) and SEMI-PRO (PT Dec: from 26.1±21.9% to 10.2±8.2%, ES±90%CI= -0.69±0.32). Moderate-to-large relationships were found between session rating of perceived exertion training load and changes in PPO measured during the CMJs (r s ±90%CI: PPOabs, -0.46±0.26; PPOrel, -0.53±0.23) and in some PTs measured during the COD test (PT1, -0.45±0.26; PT2, -0.44±0.26; PT3, -0.40±0.27 and PT Max, -0.38±0.28). Preparation period induced minimal changes in the CMJ, while the ability to sustain repeated COD efforts was improved. Reaching high session rating of perceived exertion training loads might partially and negatively affect the ability to produce strength and power.

  1. Jornalismo em segunda tela. Webjornal produzido com dispositivos móveis em redação virtual

    Directory of Open Access Journals (Sweden)

    Zanei Ramos Barcellos

    2014-12-01

    Full Text Available Este artigo inicialmente aborda o uso de dispositivos móveis pessoais, portáteis, interativos e multimídias nas várias etapas da produção, distribuição e consumo de produtos e conteúdos jornalísticos. Discute a possibilidade de o trabalho jornalístico ser feito totalmente no ciberespaço de forma remota. Também propõe o uso dos termos “redação virtual” e “jornalismo em segunda tela” amparado pela narrativa transmidiática. Num segundo momento, o trabalho relata a experiência de produção, formatação e distribuição de conteúdos jornalísticos multimídia em segunda tela, usando dispositivos móveis e em redação virtual. O objetivo é produzir matérias direcionada a mídias que sejam mais adequadas à cada notícia, tendo um telejornal de grande audiência como primeira tela. A transmissão paralela ao Jornal Nacional, da Rede Globo de Televisão, levantou antecipadamente suas pautas e produziu matérias sobre os mesmos temas, mas com foco local. Esse jornal, o #Tela2, foi produzido por alunos do curso de Jornalismo da Pontifícia Universidade Católica do Paraná (PUCPR. O artigo expõe também o processo de criação e de planejamento, e detalha todas as etapas da produção realizada pelos alunos, acompanhadas de avaliações críticas. As turmas mesclaram-se e dividiram-se em equipes para desempenhar diferentes tarefas: conselho editorial, rádio-escuta, redes sociais, reportagem de televisão, reportagem de rádio, reportagem de jornal (texto e foto, reportagem com texto coletivo em tempo real. Também foram designadas equipes para a realização de três entradas ao vivo: câmera fixa para televisão, matéria de televisão ao vivo (câmara viva e entrevista de rádio. Os resultados apontam que a experimentação foi satisfatória ao demonstrar ser possível realizar jornalismo integralmente em redações virtuais, usando apenas dispositivos móveis comuns na atualidade em todas as etapas do fazer jornal

  2. Bloqueio bilateral do nervo pudendo para hemorroidectomia em paciente acondroplásico: relato de caso Bloqueo bilateral del nervio pudendo para hemorroidectomía en paciente acondroplásico: relato de caso Bilateral blockade of the pudend nerve to hemorrhoidectomy in achondroplasic patient: case report

    OpenAIRE

    Bruno Salomé de Morais; Marcos Guilherme Cunha Cruvinel; Yerkes Pereira Silva; Dener Augusto Diniz; Carlos Henrique Viana de Castro

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O nanismo acondroplásico ou acondroplasia é a forma mais comum de nanismo e ocorre na maioria dos casos por alteração genética espontânea. A anestesia desses pacientes apresenta várias particularidades. O objetivo do presente relato foi descrever um caso de paciente acondroplásico, com história prévia de intervenção cirúrgica da coluna para descompressão medular, submetido a hemorroidectomia através de bloqueio bilateral dos nervos pudendos. RELATO DO CASO: Paciente...

  3. Neuromuscular blockade for improvement of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Scheppan, Susanne; Kissmeyer, Peter

    2015-01-01

    INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep neuromus......INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep...... neuromuscular blockade (NMB), defined as a post-tetanic-count (PTC) of 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesised that deep NMB (PTC 0-1) would improve surgical conditions during upper laparotomy as compared to standard NMB with bolus administration. METHODS...

  4. Diverticular Disease of the Colon: Neuromuscular Function Abnormalities.

    Science.gov (United States)

    Bassotti, Gabrio; Villanacci, Vincenzo; Bernardini, Nunzia; Dore, Maria P

    2016-10-01

    Colonic diverticular disease is a frequent finding in daily clinical practice. However, its pathophysiological mechanisms are largely unknown. This condition is likely the result of several concomitant factors occurring together to cause anatomic and functional abnormalities, leading as a result to the outpouching of the colonic mucosa. A pivotal role seems to be played by an abnormal colonic neuromuscular function, as shown repeatedly in these patients, and by an altered visceral perception. There is recent evidence that these abnormalities might be related to the derangement of the enteric innervation, to an abnormal distribution of mucosal neuropeptides, and to low-grade mucosal inflammation. The latter might be responsible for the development of visceral hypersensitivity, often causing abdominal pain in a subset of these patients.

  5. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning: Protocol for the Multicenter Interrupted Time Series INVERT Study.

    Science.gov (United States)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel; Skovgaard, Lene Theil; Østergaard, Doris; Engbaek, Jens; Gätke, Mona Ring

    2017-10-06

    Muscle relaxants facilitate endotracheal intubation under general anesthesia and improve surgical conditions. Residual neuromuscular blockade occurs when the patient is still partially paralyzed when awakened after surgery. The condition is associated with subjective discomfort and an increased risk of respiratory complications. Use of an objective neuromuscular monitoring device may prevent residual block. Despite this, many anesthetists refrain from using the device. Efforts to increase the use of objective monitoring are time consuming and require the presence of expert personnel. A neuromuscular monitoring e-learning module might support consistent use of neuromuscular monitoring devices. The aim of the study is to assess the effect of a neuromuscular monitoring e-learning module on anesthesia staff's use of objective neuromuscular monitoring and the incidence of residual neuromuscular blockade in surgical patients at 6 Danish teaching hospitals. In this interrupted time series study, we are collecting data repeatedly, in consecutive 3-week periods, before and after the intervention, and we will analyze the effect using segmented regression analysis. Anesthesia departments in the Zealand Region of Denmark are included, and data from all patients receiving a muscle relaxant are collected from the anesthesia information management system MetaVision. We will assess the effect of the module on all levels of potential effect: staff's knowledge and skills, patient care practice, and patient outcomes. The primary outcome is use of neuromuscular monitoring in patients according to the type of muscle relaxant received. Secondary outcomes include last recorded train-of-four value, administration of reversal agents, and time to discharge from the postanesthesia care unit as well as a multiple-choice test to assess knowledge. The e-learning module was developed based on a needs assessment process, including focus group interviews, surveys, and expert opinions. The e

  6. Neuromuscular training in construction workers: a longitudinal controlled pilot study.

    Science.gov (United States)

    Faude, Oliver; Donath, Lars; Bopp, Micha; Hofmann, Sara; Erlacher, Daniel; Zahner, Lukas

    2015-08-01

    Many accidents at construction sites are due to falls. An exercise-based workplace intervention may improve intrinsic fall risk factors. In this pilot study, we aimed at evaluating the effects of neuromuscular exercise on static and functional balance performance as well as on lower limb explosive power in construction workers. Healthy middle-aged construction workers were non-randomly assigned to an intervention [N = 20, age = 40.3 (SD 8.3) years] or a control group [N = 20, age = 41.8 (9.9) years]. The intervention group performed static and dynamic balance and strength exercises (13 weeks, 15 min each day). Before and after the intervention and after an 8-week follow-up, unilateral postural sway, backward balancing (on 3- and 4.5-cm-wide beams) as well as vertical jump height were assessed. We observed a group × time interaction for postural sway (p = 0.002) with a reduction in the intervention group and no relevant change in the control group. Similarly, the number of successful steps while walking backwards on the 3-cm beam increased only in the intervention group (p = 0.047). These effects were likely to most likely practically beneficial from pretest to posttest and to follow-up test for postural sway (+12%, standardized mean difference (SMD) = 0.65 and 17%, SMD = 0.92) and backward balancing on the 3-cm beam (+58%, SMD = 0.59 and 37%, SMD = 0.40). Fifteen minutes of neuromuscular training each day can improve balance performance in construction workers and, thus, may contribute to a decreased fall risk.

  7. EFFECT OF NEUROMUSCULAR TRAINING ON BALANCE AMONG UNIVERSITY ATHLETES

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    Mohansundar Sankaravel

    2016-06-01

    Full Text Available Background: Proprioceptive deficiency followed by lateral ankle sprain leads to poor balance is not uncommon. It has been linked with increased injury risk among young athletes. Introducing neuromuscular training programs for this have been believed as one of the means of injury prevention. Hence, this study was aimed to determine the effects of six weeks progressive neuromuscular training (PNM Training on static balance gains among the young athletes with a previous history of ankle sprains. Methods: This study was an experimental study design, with pre and post test method to determine the effects of PNM Training on static balance gains. All data were collected at university’s sports rehabilitation lab before and after six weeks of intervention period. There were 20 male and female volunteer young athletes (20.9 ± 0.85 years of age with a previous history of ankle sprain involving various sports were recruited from the University community. All the subjects were participated in a six week PNM Training that included stability, strength and power training. Outcome measures were collected by calculating the errors on balance error scoring system made by the athletes on static balance before and after the six weeks of intervention period. Static balance was tested in firm and foam surfaces and recorded accordingly. Results: The researchers found a significant decrease (2.40 ± 0.82 in total errors among the samples at the post test compared with their pre test (P >0.05. Conclusions: The study demonstrates that a PNM Training can improve the static balance on both the firm and foam surfaces among the young athletes with a previous history of ankle sprains.

  8. Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome.

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    Peter C Rowe

    Full Text Available Chronic fatigue syndrome (CFS is a complex, multisystem disorder that can be disabling. CFS symptoms can be provoked by increased physical or cognitive activity, and by orthostatic stress. In preliminary work, we noted that CFS symptoms also could be provoked by application of longitudinal neural and soft tissue strain to the limbs and spine of affected individuals. In this study we measured the responses to a straight leg raise neuromuscular strain maneuver in individuals with CFS and healthy controls. We randomly assigned 60 individuals with CFS and 20 healthy controls to either a 15 minute period of passive supine straight leg raise (true neuromuscular strain or a sham straight leg raise. The primary outcome measure was the symptom intensity difference between the scores during and 24 hours after the study maneuver compared to baseline. Fatigue, body pain, lightheadedness, concentration difficulties, and headache scores were measured individually on a 0-10 scale, and summed to create a composite symptom score. Compared to individuals with CFS in the sham strain group, those with CFS in the true strain group reported significantly increased body pain (P = 0.04 and concentration difficulties (P = 0.02 as well as increased composite symptom scores (all P = 0.03 during the maneuver. After 24 hours, the symptom intensity differences were significantly greater for the CFS true strain group for the individual symptom of lightheadedness (P = 0.001 and for the composite symptom score (P = 0.005. During and 24 hours after the exposure to the true strain maneuver, those with CFS had significantly higher individual and composite symptom intensity changes compared to the healthy controls. We conclude that a longitudinal strain applied to the nerves and soft tissues of the lower limb is capable of increasing symptom intensity in individuals with CFS for up to 24 hours. These findings support our preliminary observations that increased mechanical

  9. Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina Comparación de las técnicas transarterial y de estimulación de múltiples nervios para bloqueo del plexo braquial por vía axilar usando lidocaína con epinefrina Comparison of transarterial and multiple nerve stimulation techniques for axillary block using lidocaine with epinephrine

    OpenAIRE

    Luiz Eduardo Imbelloni; Lúcia Beato; José Antônio Cordeiro

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A técnica transarterial com grandes doses de anestésico local resulta em alta efetividade para o bloqueio axilar do plexo braquial. A técnica utilizando múltiplos estímulos exige mais tempo e maior experiência. Este estudo prospectivo compara a latência e o índice de sucesso do bloqueio do plexo braquial usando duas técnicas de localização: transarterial ou múltipla estimulação dos nervos. MÉTODO: A lidocaína com epinefrina, 800 mg, foi usada inicialmente para o blo...

  10. Analgesia pós-operatória em correção cirúrgica de pé torto congênito: comparação entre bloqueio nervoso periférico e bloqueio peridural caudal Analgesia postoperatoria en corrección quirúrgica de pie jorobado congénito: comparación entre bloqueo nervioso periférico y bloqueo epidural caudal Postoperative analgesia for the surgical correction of congenital clubfoot: comparison between peripheral nerve block and caudal epidural block

    Directory of Open Access Journals (Sweden)

    Monica Rossi Rodrigues

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O procedimento de correção de pé torto congênito (PTC cursa com dor pós-operatória intensa. A técnica mais utilizada em crianças é a peridural caudal associada à anestesia geral. Tem como limitação a curta duração da analgesia pós-operatória. Os bloqueios de nervos periféricos têm sido apontados como procedimentos com baixa incidência de complicações e tempo prolongado de analgesia. O objetivo do estudo foi comparar o tempo de analgesia dos bloqueios nervosos periféricos e bloqueio caudal e o consumo de morfina nas primeiras 24 horas após a correção de PTC em crianças. MÉTODO: Estudo randômico, encoberto, em crianças submetidas à intervenção cirúrgica para liberação póstero-medial de PTC, alocadas em 4 grupos conforme a técnica anestésica: Caudal (ACa; Bloqueios isquiático e femoral (IF; Bloqueios isquiático e safeno (IS; Bloqueio isquiático e anestesia local (IL, associados à anestesia geral. Nas primeiras 24 horas os pacientes receberam dipirona e paracetamol via oral e foram avaliados por anestesiologista que desconhecia a técnica empregada. Conforme escores da escala CHIPPS (Children's and infants postoperative pain scale era administrada morfina via oral (0,19 mg.kg-1 por dia. RESULTADOS: Foram estudadas 118 crianças distribuídas nos grupos ACa (30, IF (32, IS (28 IL (28. O tempo médio entre o bloqueio e a primeira dose de morfina foi 6,16 horas no grupo ACa, 7,05 horas no IF, 7,58 horas no IS e 8,18 horas no IL. O consumo de morfina foi 0,3 mg.kg-1 por dia nos quatro grupos. Não houve diferença significativa entre os grupos. CONCLUSÕES: Os bloqueios nervosos periféricos não promoveram maior tempo de analgesia, tampouco redução no consumo de morfina nas primeiras 24 horas em crianças submetidas à correção de PTC quando comparados ao bloqueio peridural caudal.JUSTIFICATIVA Y OBJETIVOS: El procedimiento de corrección de pie jorobado congénito (PJC, debuta

  11. Caracterização físico-química e perfil lipídico de queijos produzidos com leite ovino

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo de Pellegrini

    2013-10-01

    Full Text Available Este trabalho teve por objetivo caracterizar os queijos Pecorino Toscano, Feta e Labneh produzidos com leite ovino quanto aos aspectos físico-químicos e perfil lipídico. Foram adquiridos e analisados queijos tipo Pecorino Toscano Fresco, com 90, 180 e 270 dias de maturação, Feta e Labneh elaborados com leite de ovelha, comercializados no estado do Rio Grande do Sul, Brasil. As análises realizadas foram: pH, acidez titulável, proteína, gordura, umidade, cinzas e perfil de ácidos graxos. O maior pH ocorreu nos queijos tipo Pecorino Toscano com 180 dias de maturação e Feta. Em relação à acidez titulável estes apresentaram comportamento contrário ao do pH. Os valores de proteína oscilaram entre 15,98 e 28,29% m/m, sendo os maiores valores para os queijos com maior tempo de maturação. A gordura apresentou variação idêntica à proteína, onde os queijos tipo Pecorino Toscano com 180 e 270 dias de maturação apresentaram maior valor. Os valores de umidade apresentaram-se inversos ao tempo de maturação, sendo que os queijos com 270, 180 e 90 dias de maturação apresentaram valores de 25,14, 25,95 e 30,26% m/m respectivamente. As cinzas também se demonstraram maiores para os queijos maturados. Em relação ao perfil lipídico, foram identificados 23 ácidos graxos, ocorrendo diferença significativa na maioria dos resultados, inclusive no somatório dos ácidos graxos saturados, monoinsaturados, poliinsaturados e na relação entre insaturados e saturados. Portanto, devido à escassez de informações sobre a composição de queijos produzidos com leite ovino, outras pesquisas devem ser realizadas para caracterizar de forma consistente estes produtos.

  12. Dutch pediatricians' views on the use of neuromuscular blockers for dying neonates: a qualitative study

    NARCIS (Netherlands)

    ten Cate, K.; van de Vathorst, S.

    2015-01-01

    To assess Dutch pediatricians' views on neuromuscular blockers for dying neonates. Qualitative study involving in-depth interviews with 10 Dutch pediatricians working with severely ill neonates. Data were analyzed using appropriate qualitative research techniques. Participants explained their view

  13. Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults

    Science.gov (United States)

    Background. Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activa...

  14. Effects of neuromuscular joint facilitation on bridging exercises with respect to deep muscle changes.

    Science.gov (United States)

    Zhou, Bin; Huang, QiuChen; Zheng, Tao; Huo, Ming; Maruyama, Hitoshi

    2015-05-01

    [Purpose] This study examined the effects of neuromuscular joint facilitation on bridging exercises by assessing the cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis. [Subjects] Twelve healthy men. [Methods] Four exercises were evaluated: (a) supine resting, (b) bridging resistance exercise involving posterior pelvic tilting, (c) bridging resistance exercise involving anterior pelvic tilting, and (d) bridging resistance exercise involving neuromuscular joint facilitation. The cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis were measured during each exercise. [Results] The cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis were significantly greater in the neuromuscular joint facilitation group than the others. [Conclusion] Neuromuscular joint facilitation intervention improves the function of deep muscles such as the multifidus muscle and musculus transversus abdominis. Therefore, it can be recommended for application in clinical treatments such as that for back pain.

  15. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults

    DEFF Research Database (Denmark)

    Hristovska, Ana-Marija; Duch, Patricia; Allingstrup, Mikkel

    2017-01-01

    , and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety......, reduced incidence of residual block on recovery, and more efficient use of healthcare resources. OBJECTIVES: The main objective of this review was to compare the efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade caused by non-depolarizing neuromuscular agents......-depolarizing neuromuscular blocking agents for an elective in-patient or day-case surgical procedure. We included all trials comparing sugammadex versus neostigmine that reported recovery times or adverse events. We included any dose of sugammadex and neostigmine and any time point of study drug administration. DATA...

  16. Novel vibration-exercise instrument with dedicated adaptive filtering for electromyographic investigation of neuromuscular activation

    NARCIS (Netherlands)

    Xu, L.; Rabotti, C.; Mischi, M.

    2012-01-01

    Vibration exercise (VE) has been suggested as an effective methodology to improve muscle strength and power performance. Several studies link the effects of vibration training to enhanced neuromuscular demand, typically ascribed to involuntary reflex mechanisms. However, the underlying mechanisms

  17. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

    NARCIS (Netherlands)

    Mullender, M.G.; Blom, N.; de Kleuver, M.; Fock, J.; Hitters, W.; Horemans, A.; Kalkman, C.; Pruijs, J.; Timmer, R.; Titarsolej, P.; van Haasteren, N.; Jager, M.V.; van Vught, A.; van Royen, B.J.

    2008-01-01

    Background: Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is

  18. Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency

    DEFF Research Database (Denmark)

    Thomsen, J L; Nielsen, C V; Palmqvist, D F

    2015-01-01

    , neuromuscular monitoring, and postoperative respiratory complications, defined as arterial oxygen desaturation prematurely awakened if anaesthesia had been terminated while the patient was still...... paralysed. RESULTS: We included 123 patients. Neuromuscular monitoring was applied before awakening in 48 (39%) patients. A nerve stimulator was never used or only after attempted awakening in the remaining 75 (61%) patients. Premature awakening occurred in 75 (100%) and 14 (29%) of the unmonitored...

  19. Risk of Unsuccessful Noninvasive Ventilation for Acute Respiratory Failure in Heterogeneous Neuromuscular Diseases: A Retrospective Study

    OpenAIRE

    Kataoka, Hiroshi; Nanaura, Hitoki; Kinugawa, Kaoru; Uchihara, Yuto; Ohara, Hiroya; Eura, Nobuyuki; Syobatake, Ryogo; Sawa, Nobuhiro; Takao, Kiriyama; Sugie, Kazuma; Ueno, Satoshi

    2017-01-01

    If invasive ventilation can be avoided by performing noninvasive mechanical ventilation (NIV) in patients with acute respiratory failure (ARF), the disease can be effectively managed. It is important to clarify the characteristics of patients with neuromuscular diseases in whom initial NIV is likely to be unsuccessful. We studied 27 patients in stable neuromuscular condition who initially received NIV to manage fatal ARF to identify differences in factors immediately before the onset of ARF a...

  20. Caracterização de blocos cerâmicos acústicos produzidos com incorporação de lodo de lavanderia têxtil

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    Thiago Morais de Castro

    2015-03-01

    Full Text Available Características físicas (absorção de água, mecânicas (resistência à compressão, de toxicidade e de superfície (microscopia eletrônica de varredura foram avaliadas em blocos cerâmicos acústicos, fabricados por meio do processo de solidificação/estabilização (S/E, a partir da incorporação de lodo proveniente de estação de tratamento de efluentes têxteis. Os blocos cerâmicos acústicos foram produzidos com incorporação de 5, 10, 15, 20, 25, 30 e 35% de lodo têxtil na massa de argila, bem como o bloco controle. Os resultados indicaram a porcentagem de 20% de lodo como o limite para fornecer material com características de acordo com os padrões estabelecidos pela legislação brasileira. O processo de S/E foi eficiente no aproveitamento/tratamento do lodo têxtil, uma vez que permitiu a imobilização dos poluentes na massa de argila, os quais não foram lixiviados, tampouco solubilizados.

  1. Effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Shim, Jae-Kwang; Choi, Ho-Suk; Shin, Jun-Ho

    2015-12-01

    [Purpose] This study examined the effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 16 adults who underwent arthroscopic anterior cruciate reconstruction and neuromuscular training. The Lysholm scale was used to assess functional disorders on the affected knee joint. A KT-2000 arthrometer was used to measure anterior displacement of the tibia against the femur. Surface electromyography was used to detect the muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus before and after neuromuscular training. [Results] There was significant relaxation in tibial anterior displacement of the affected and sound sides in the supine position before neuromuscular training. Furthermore, the difference in the tibial anterior displacement of the affected knee joints in the standing position was reduced after neuromuscular training. Moreover, the variation of the muscle activation evoked higher muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus. [Conclusion] Neuromuscular training may improve functional joint stability in patients with orthopedic musculoskeletal injuries in the postoperative period.

  2. Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives.

    Science.gov (United States)

    Carron, Michele; Bertoncello, Francesco; Ieppariello, Giovanna

    2018-01-01

    The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed.

  3. Sugammadex given for rocuronium-induced neuromuscular blockade in infants: a retrospectıve study.

    Science.gov (United States)

    Ozmete, Ozlem; Bali, Cagla; Cok, Oya Yalcin; Turk, Hatice Evren Eker; Ozyilkan, Nesrın Bozdogan; Civi, Soner; Aribogan, Anıs

    2016-12-01

    To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. Retrospective observational study. University teaching hospital. Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study. Anesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation. The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3mg/kg sugammadex was administered. The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded. Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed. The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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 suggest that a combination of these four mechanisms enhance range of motion. When completed prior to exercise, proprioceptive neuromuscular facilitation decreases performance in maximal effort exercises. When this stretching technique is performed consistently and post exercise, it increases athletic performance, along with range of motion. Little investigation has been done regarding the theoretical mechanisms of proprioceptive neuromuscular facilitation, though four mechanisms were identified from the literature. As stated, the main goal of proprioceptive neuromuscular facilitation is to increase range of motion and performance. Studies found both of these to be true when completed under the correct conditions. These mechanisms were found to be plausible; however, further investigation needs to be conducted. All four mechanisms behind the stretching technique explain the reasoning behind the increase in range of motion, as well as in strength and athletic performance. Proprioceptive neuromuscular facilitation shows potential benefits if performed correctly and consistently. PMID:23487249

  5. Developmental and adult-specific processes contribute to de novo neuromuscular regeneration in the lizard tail.

    Science.gov (United States)

    Tokuyama, Minami A; Xu, Cindy; Fisher, Rebecca E; Wilson-Rawls, Jeanne; Kusumi, Kenro; Newbern, Jason M

    2018-01-15

    Peripheral nerves exhibit robust regenerative capabilities in response to selective injury among amniotes, but the regeneration of entire muscle groups following volumetric muscle loss is limited in birds and mammals. In contrast, lizards possess the remarkable ability to regenerate extensive de novo muscle after tail loss. However, the mechanisms underlying reformation of the entire neuromuscular system in the regenerating lizard tail are not completely understood. We have tested whether the regeneration of the peripheral nerve and neuromuscular junctions (NMJs) recapitulate processes observed during normal neuromuscular development in the green anole, Anolis carolinensis. Our data confirm robust axonal outgrowth during early stages of tail regeneration and subsequent NMJ formation within weeks of autotomy. Interestingly, NMJs are overproduced as evidenced by a persistent increase in NMJ density 120 and 250 days post autotomy (DPA). Substantial Myelin Basic Protein (MBP) expression could also be detected along regenerating nerves indicating that the ability of Schwann cells to myelinate newly formed axons remained intact. Overall, our data suggest that the mechanism of de novo nerve and NMJ reformation parallel, in part, those observed during neuromuscular development. However, the prolonged increase in NMJ number and aberrant muscle differentiation hint at processes specific to the adult response. An examination of the coordinated exchange between peripheral nerves, Schwann cells, and newly synthesized muscle of the regenerating neuromuscular system may assist in the identification of candidate molecules that promote neuromuscular recovery in organisms incapable of a robust regenerative response. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Avaliação de potenciais fragmentados em presença de bloqueio de ramo direito sem alterações estruturais miocárdicas ventriculares. Estudo pelo eletrocardiograma de alta resolução no domínio da freqüência

    Directory of Open Access Journals (Sweden)

    Ginefra Paulo

    1998-01-01

    Full Text Available OBJETIVO: Em ausência de alterações estruturais miocárdicas (AEM, avaliar se o bloqueio de ramo direito (BRD gera potenciais fragmentados (PF e turbulência espectral (TE no eletrocardiograma de alta resolução (ECGAR. MÉTODOS: Doze crianças com comunicação inter-atrial (CIA e bloqueio incompleto do ramo direito (BIRD sem AEM (Grupo I, foram comparadas com 17 crianças com tetralogia de Fallot (TF operada, BCRD e AEM, 5 com extra sístoles ventriculares e 2 com taquicardia ventricular sustentada (Grupo II. Todas fizeram ECGAR nos domínios do tempo (DT e da freqüência (DF, com cinco variáveis analisadas. RESULTADOS: Os pacientes do grupo I tiveram as variáveis normais apesar do BIRD. No grupo II, 4 das cinco variáveis foram anormais, sugerindo a presença de PF e TE atribuíveis a AEM inerentes à malformação e ao ato cirúrgico. CONCLUSÃO: Na CIA o BIRD não complicado de AEM não gera PF e TE, não constituindo fator de risco para taquicardia ventricular sustentada.

  7. Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais Comparison between general anesthesia and superficial cervical plexus block in partial thyroidectomies

    Directory of Open Access Journals (Sweden)

    Rui Celso Martins Mamede

    2008-02-01

    Full Text Available Tireoidectomia sob efeito de bloqueio do plexo cervical superficial (BPCS tem sofrido resistência. OBJETIVO: Comparar variáveis cirúrgicas e anestésicas, custos do tratamento e grau de satisfação de pacientes submetidos à hemitireoidectomia sob efeito de anestesia geral e BPCS. CASUÍSTICA E MÉTODOS: Foram 21 pacientes submetidos à anestesia geral (AG e outro tanto ao BPCS. Após sedação, no grupo com BPCS, usou-se marcaína com vasoconstritor, e quando necessário, lidocaína a 2% com vasoconstritor. Sedação intra-operatória com diazepam endovenoso e metoprolol para controle da PA e FC eram administradas quando necessário. Usou-se anestesia geral (AG segundo padronização do serviço. RESULTADOS: Foram significantes (pThyroidectomy under the effect of superficial cervical plexus block (SCPB has met resistance. AIM: to compare variables in patients submitted to hemithyroidectomy under the effect of general anesthesia (GA and SCPB. CASE REPORT AND METHODS: GA was used in 21 patients, and SCPB was used in another 21 patients. Following sedation, marcaine 0.5% with vasoconstrictor was used in the SCPB group. Intraoperative sedation with diazepam and metoprolol to control arterial pressure and cardiac frequency was given as needed. GA followed the standard method in the unit. RESULTS: We found significant results (p<0.05, Student’s t-test for surgery time (GA - 111.4 min; SCPB - 125.5 min, anesthesia time (GA - 154.1 min; SCPB - 488.6 min, time in the surgery room (GA - 15 min; SCPB - 1 min, treatment costs (GA - R$203.2; SCPB - R$87.4, presence of bradycardia (GA - 0; SCPB - 23.8% and laryngotracheal injury (GA - 51; SCPB - 0 %. We also found the following non-significant results: hospitalization time (GA - 17.3; SCPB - 15.1 hours; bleeding volume (GA - 41,9 g; SCPB - 47.6 g, size of the operative specimen (GA - 52.1 cm3; SCPB - 93.69 cm3 and patient satisfaction level (GA - 3.8; SCPB - 3.9. CONCLUSION: Although the incidence of

  8. 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; Iaia, F Marcello

    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 k......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...... 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....

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

    Science.gov (United States)

    Nishimune, Hiroshi

    2012-12-01

    Presynaptic active zones are synaptic vesicle release sites that play essential roles in the function and pathology of mammalian neuromuscular junctions (NMJs). The molecular mechanisms of active zone organization use presynaptic voltage-dependent calcium channels (VDCCs) in NMJs as scaffolding proteins. VDCCs interact extracellularly with the muscle-derived synapse organizer, laminin β2 and interact intracellularly with active zone-specific proteins, such as Bassoon, CAST/Erc2/ELKS2alpha, ELKS, Piccolo, and RIMs. These molecular mechanisms are supported by studies in P/Q- and N-type VDCCs double-knockout mice, and they are consistent with the pathological conditions of Lambert-Eaton myasthenic syndrome and Pierson syndrome, which are caused by autoantibodies against VDCCs or by a laminin β2 mutation. During normal postnatal maturation, NMJs maintain the density of active zones, while NMJs triple their size. However, active zones become impaired during aging. Propitiously, muscle exercise ameliorates the active zone impairment in aged NMJs, which suggests the potential for therapeutic strategies. © 2012 New York Academy of Sciences.

  10. Interleaved neuromuscular electrical stimulation: Motor unit recruitment overlap.

    Science.gov (United States)

    Wiest, Matheus J; Bergquist, Austin J; Schimidt, Helen L; Jones, Kelvin E; Collins, David F

    2017-04-01

    In this study, we quantified the "overlap" between motor units recruited by single pulses of neuromuscular electrical stimulation (NMES) delivered over the tibialis anterior muscle (mNMES) and the common peroneal nerve (nNMES). We then quantified the torque produced when pulses were alternated between the mNMES and nNMES sites at 40 Hz ("interleaved" NMES; iNMES). Overlap was assessed by comparing torque produced by twitches evoked by mNMES, nNMES, and both delivered together, over a range of stimulus intensities. Trains of iNMES were delivered at the intensity that produced the lowest overlap. Overlap was lowest (5%) when twitches evoked by both mNMES and nNMES produced 10% peak twitch torque. iNMES delivered at this intensity generated 25% of maximal voluntary dorsiflexion torque (11 Nm). Low intensity iNMES leads to low overlap and produces torque that is functionally relevant to evoke dorsiflexion during walking. Muscle Nerve 55: 490-499, 2017. © 2016 Wiley Periodicals, Inc.

  11. Verifax: Biometric instruments measuring neuromuscular disorders/performance impairments

    Science.gov (United States)

    Morgenthaler, George W.; Shrairman, Ruth; Landau, Alexander

    1998-01-01

    VeriFax, founded in 1990 by Dr. Ruth Shrairman and Mr. Alex Landau, began operations with the aim of developing a biometric tool for the verification of signatures from a distance. In the course of developing this VeriFax Autograph technology, two other related applications for the technologies under development at VeriFax became apparent. The first application was in the use of biometric measurements as clinical monitoring tools for physicians investigating neuromuscular diseases (embodied in VeriFax's Neuroskill technology). The second application was to evaluate persons with critical skills (e.g., airline pilots, bus drivers) for physical and mental performance impairments caused by stress, physiological disorders, alcohol, drug abuse, etc. (represented by VeriFax's Impairoscope prototype instrument). This last application raised the possibility of using a space-qualified Impairoscope variant to evaluate astronaut performance with respect to the impacts of stress, fatigue, excessive workload, build-up of toxic chemicals within the space habitat, etc. The three applications of VeriFax's patented technology are accomplished by application-specific modifications of the customized VeriFax software. Strong commercial market potentials exist for all three VeriFax technology applications, and market progress will be presented in more detail below.

  12. Neuromuscular factors related to success in Olympic wrestling

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez-Moreno

    2011-03-01

    Full Text Available Abstract This study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling.  Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.

  13. Neuromuscular factors related to success in Olympic wrestling

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez-Moreno

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.

  14. Neuromuscular adjustments of the quadriceps muscle after repeated cycling sprints.

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    Olivier Girard

    Full Text Available PURPOSE: This study investigated the supraspinal processes of fatigue of the quadriceps muscle in response to repeated cycling sprints. METHODS: Twelve active individuals performed 10 × 6-s "all-out" sprints on a cycle ergometer (recovery = 30 s, followed 6 min later by 5 × 6-s sprints (recovery = 30 s. Transcranial magnetic and electrical femoral nerve stimulations during brief (5-s and sustained (30-s isometric contractions of the knee extensors were performed before and 3 min post-exercise. RESULTS: Maximal strength of the knee extensors decreased during brief and sustained contractions (~11% and 9%, respectively; P0.05. While cortical voluntary activation declined (P 40% reduced (P<0.001 following exercise. CONCLUSION: The capacity of the motor cortex to optimally drive the knee extensors following a repeated-sprint test was shown in sustained, but not brief, maximal isometric contractions. Additionally, peripheral factors were largely involved in the exercise-induced impairment in neuromuscular function, while corticospinal excitability was well-preserved.

  15. Alterations in neuromuscular function in girls with generalized joint hypermobility.

    Science.gov (United States)

    Jensen, Bente Rona; Sandfeld, Jesper; Melcher, Pia Sandfeld; Johansen, Katrine Lyders; Hendriksen, Peter; Juul-Kristensen, Birgit

    2016-10-03

    Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee extensor and calf muscle activation did not differ between groups. Flexion-extension and medial-lateral co-activation ratio during flexions were higher for girls with GJH than NGJH girls. Girls with GJH had higher capacity to rapidly generate force than NGJH girls which may reflect motor adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings.

  16. Long-term neuromuscular training and ankle joint position sense.

    Science.gov (United States)

    Kynsburg, A; Pánics, G; Halasi, T

    2010-06-01

    Preventive effect of proprioceptive training is proven by decreasing injury incidence, but its proprioceptive mechanism is not. Major hypothesis: the training has a positive long-term effect on ankle joint position sense in athletes of a high-risk sport (handball). Ten elite-level female handball-players represented the intervention group (training-group), 10 healthy athletes of other sports formed the control-group. Proprioceptive training was incorporated into the regular training regimen of the training-group. Ankle joint position sense function was measured with the "slope-box" test, first described by Robbins et al. Testing was performed one day before the intervention and 20 months later. Mean absolute estimate errors were processed for statistical analysis. Proprioceptive sensory function improved regarding all four directions with a high significance (pneuromuscular training has improved ankle joint position sense function in the investigated athletes. This joint position sense improvement can be one of the explanations for injury rate reduction effect of neuromuscular training.

  17. Kinematic and neuromuscular relationships between lower extremity clinical movement assessments.

    Science.gov (United States)

    Mauntel, Timothy C; Cram, Tyler R; Frank, Barnett S; Begalle, Rebecca L; Norcross, Marc F; Blackburn, J Troy; Padua, Darin A

    2018-06-01

    Lower extremity injuries have immediate and long-term consequences. Lower extremity movement assessments can assist with identifying individuals at greater injury risk and guide injury prevention interventions. Movement assessments identify similar movement characteristics and evidence suggests large magnitude kinematic relationships exist between movement patterns observed across assessments; however, the magnitude of the relationships for electromyographic (EMG) measures across movement assessments remains largely unknown. This study examined relationships between lower extremity kinematic and EMG measures during jump landings and single leg squats. Lower extremity three-dimensional kinematic and EMG data were sampled from healthy adults (males = 20, females = 20) during the movement assessments. Pearson correlations examined the relationships of the kinematic and EMG measures and paired samples t-tests compared mean kinematic and EMG measures between the assessments. Overall, significant moderate correlations were observed for lower extremity kinematic (r avg  = 0.41, r range  = 0.10-0.61) and EMG (r avg  = 0.47, r range  = 0.32-0.80) measures across assessments. Kinematic and EMG measures were greater during the jump landings. Jump landings and single leg squats place different demands on the body and necessitate different kinematic and EMG patterns, such that these measures are not highly correlated between assessments. Clinicians should, therefore, use multiple assessments to identify aberrant movement and neuromuscular control patterns so that comprehensive interventions can be implemented.

  18. Validity of the Neuromuscular Recovery Scale: a measurement model approach.

    Science.gov (United States)

    Velozo, Craig; Moorhouse, Michael; Ardolino, Elizabeth; Lorenz, Doug; Suter, Sarah; Basso, D Michele; Behrman, Andrea L

    2015-08-01

    To determine how well the Neuromuscular Recovery Scale (NRS) items fit the Rasch, 1-parameter, partial-credit measurement model. Confirmatory factor analysis (CFA) and principal components analysis (PCA) of residuals were used to determine dimensionality. The Rasch, 1-parameter, partial-credit rating scale model was used to determine rating scale structure, person/item fit, point-measure item correlations, item discrimination, and measurement precision. Seven NeuroRecovery Network clinical sites. Outpatients (N=188) with spinal cord injury. Not applicable. NRS. While the NRS met 1 of 3 CFA criteria, the PCA revealed that the Rasch measurement dimension explained 76.9% of the variance. Ten of 11 items and 91% of the patients fit the Rasch model, with 9 of 11 items showing high discrimination. Sixty-nine percent of the ratings met criteria. The items showed a logical item-difficulty order, with Stand retraining as the easiest item and Walking as the most challenging item. The NRS showed no ceiling or floor effects and separated the sample into almost 5 statistically distinct strata; individuals with an American Spinal Injury Association Impairment Scale (AIS) D classification showed the most ability, and those with an AIS A classification showed the least ability. Items not meeting the rating scale criteria appear to be related to the low frequency counts. The NRS met many of the Rasch model criteria for construct validity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. The rapid evolution of molecular genetic diagnostics in neuromuscular diseases.

    Science.gov (United States)

    Volk, Alexander E; Kubisch, Christian

    2017-10-01

    The development of massively parallel sequencing (MPS) has revolutionized molecular genetic diagnostics in monogenic disorders. The present review gives a brief overview of different MPS-based approaches used in clinical diagnostics of neuromuscular disorders (NMDs) and highlights their advantages and limitations. MPS-based approaches like gene panel sequencing, (whole) exome sequencing, (whole) genome sequencing, and RNA sequencing have been used to identify the genetic cause in NMDs. Although gene panel sequencing has evolved as a standard test for heterogeneous diseases, it is still debated, mainly because of financial issues and unsolved problems of variant interpretation, whether genome sequencing (and to a lesser extent also exome sequencing) of single patients can already be regarded as routine diagnostics. However, it has been shown that the inclusion of parents and additional family members often leads to a substantial increase in the diagnostic yield in exome-wide/genome-wide MPS approaches. In addition, MPS-based RNA sequencing just enters the research and diagnostic scene. Next-generation sequencing increasingly enables the detection of the genetic cause in highly heterogeneous diseases like NMDs in an efficient and affordable way. Gene panel sequencing and family-based exome sequencing have been proven as potent and cost-efficient diagnostic tools. Although clinical validation and interpretation of genome sequencing is still challenging, diagnostic RNA sequencing represents a promising tool to bypass some hurdles of diagnostics using genomic DNA.

  20. HEMODYNAMIC AND LACTIC ACID RESPONSES TO PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION EXERCISE

    Directory of Open Access Journals (Sweden)

    Zuhal Gültekin

    2006-09-01

    Full Text Available The hemodynamic and metabolic responses to proprioceptive neuromuscular facilitation (PNF exercise were examined in 32 male university students (aged 19-28 years. Ten repetitions of PNF exercises were applied to the subjects' dominant upper extremities in the following order: as an agonist pattern flexion, adduction and external rotation; and as an antagonist pattern extension, abduction and internal rotation. Heart rate (HR, systolic blood pressure (SBP, diastolic blood pressure (DBP, double product (DP, and blood lactate concentration (La were determined before, immediately after, and at 1st, 3rd, and 5th minutes after PNF exercise. A one-way ANOVA with repeated measures indicated significant differences in HR, SBP, DBP, DP and La immediately after PNF exercise. HR increased from 81 (±10 to 108 (±15 b·min-1 (p < 0.01, SBP increased from 117 (±10 to 125 (±11 mmHg (p < 0.01, DBP increased from 71 (±10 to 75 (±8 mmHg (p < 0.01, DP increased from 96 (±16 to 135 (±24 (p < 0.01, and La increased from 0.69 (±0.31 to 3.99 (±14.63 mmol·L-1 (p < 0.01. Thus PNF exercise resulted in increased hemodynamic responses and blood lactate concentration that indicate a high strain on the cardiovascular system and anaerobic metabolism in healthy subjects

  1. Neurologic and neuromuscular functional disorders of the pharynx and esophagus

    International Nuclear Information System (INIS)

    Wuttge-Hannig, A.; Hannig, C.

    2007-01-01

    Neurologic swallowing disorders are an increasing diagnostic problem in our overaged population. Undiagnosed chronic aspiration pneumonia is the cause of death in 20-40% of all inhabitants of nursing homes. In neurologic diseases of the pharynx, the physiologic interaction of pharyngeal contraction, closure of the pharynx, and esophageal motility are frequently disturbed. This may be due to cortical, bulbar, or cerebellar brain damage of ischemic or traumatic origin. Furthermore diseases or peripheral nerves, muscles, and synapses cause disturbances. The most life-threatening complication of these disturbances is tracheal aspiration, which requires an iso-osmolar contrast medium for imaging studies that cause no or minimal pulmonary problems. Utilizing fast dynamic documentation we can analyze the swallowing act in 35 images within the passage time of 0.7 s. This requires digital frame sequences from 15-50 images/s, which can be provided by DSI or videofluoroscopy. Neurologic and neuromuscular patterns are demonstrated with and without tracheal aspiration. The differentiation of aspiration in a so-called pre-, intra-, and postdeglutitive form is possible. We distinguish four grades of severity of aspiration, which is also of great clinical impact for the differential rehabilitation therapy. The efficiency of the rehabilitation protocol can be assessed by the dynamic swallowing studies. (orig.) [de

  2. Role of analgesics, sedatives, neuromuscular blockers, and delirium.

    Science.gov (United States)

    Hall, Jesse B; Schweickert, William; Kress, John P

    2009-10-01

    A major focus on critical care medicine concerns the institution of life-support therapies, such as mechanical ventilation, during periods of organ failure to permit a window of opportunity to diagnose and treat underlying disorders so that patients may be returned to their prior functional status upon recovery. With the growing success of these intensive care unit-based therapies and longer-term follow-up of patients, severe weakness involving the peripheral nervous system and muscles has been identified in many recovering patients, often confounding the time course or magnitude of recovery. Mechanical ventilation is often accompanied by pharmacologic treatments including analgesics, sedatives, and neuromuscular blockers. These drugs and the encephalopathies accompanying some forms of critical illness result in a high prevalence of delirium in mechanically ventilated patients. These drug effects likely contribute to an impaired ability to assess the magnitude of intensive care unit-acquired weakness, to additional time spent immobilized and mechanically ventilated, and to additional weakness from the patient's relative immobility and bedridden state. This review surveys recent literature documenting these relationships and identifying approaches to minimize pharmacologic contributions to intensive care unit-acquired weakness.

  3. Peripheral neuromuscular dysfunction and falls in an elderly cohort.

    Science.gov (United States)

    Sorock, G S; Labiner, D M

    1992-09-01

    In a prospective study of 169 tenants of senior citizen housing in New Jersey in 1986-1987, the relations between tests of peripheral sensory and motor functions in the lower extremities and the rate of first falls were evaluated. The mean age of the cohort was 79.8 years. Fifty-seven persons fell at least once during the follow-up period (mean, 5.6 months). After adjustment for history of stroke, heart failure, emphysema, and use of a walker or cane, rate ratios for first falls were elevated in subjects with reduced toe joint position sense (rate ratio (RR) = 2.2) and sharp-dull discrimination (RR = 2.0), but to a lesser extent for reduced ankle strength (RR = 1.5). Presence of one or more of these three deficits was defined as a peripheral neuromuscular dysfunction and was associated with first falls after adjustment for multiple covariates (RR = 2.4, 95% confidence interval 1.3-4.5). Having two or all three sensory or motor deficits increased the rate of falling 3.9 times (95% confidence interval 2.1-7.0) compared with persons without these deficits. These data suggest that impaired sensory and motor function of the lower extremities plays an important role in falls in the elderly.

  4. 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.

  5. Noninvasive Respiratory Management of Patients With Neuromuscular Disease.

    Science.gov (United States)

    Bach, John R

    2017-08-01

    This review article describes definitive noninvasive respiratory management of respiratory muscle dysfunction to eliminate need to resort to tracheotomy. In 2010 clinicians from 22 centers in 18 countries reported 1,623 spinal muscular atrophy type 1 (SMA1), Duchenne muscular dystrophy (DMD), and amyotrophic lateral sclerosis users of noninvasive ventilatory support (NVS) of whom 760 required it continuously (CNVS). The CNVS sustained their lives by over 3,000 patient-years without resort to indwelling tracheostomy tubes. These centers have now extubated at least 74 consecutive ventilator unweanable patients with DMD, over 95% of CNVS-dependent patients with SMA1, and hundreds of others with advanced neuromuscular disorders (NMDs) without resort to tracheotomy. Two centers reported a 99% success rate at extubating 258 ventilator unweanable patients without resort to tracheotomy. Patients with myopathic or lower motor neuron disorders can be managed noninvasively by up to CNVS, indefinitely, despite having little or no measurable vital capacity, with the use of physical medicine respiratory muscle aids. Ventilator-dependent patients can be decannulated of their tracheostomy tubes.

  6. Effect of calcium on excitatory neuromuscular transmission in the crayfish

    Science.gov (United States)

    Bracho, H.; Orkand, R. K.

    1970-01-01

    1. The effects of varying the external Ca concentration from 1·8 to 30 mM/l. (⅛-2 times normal) have been studied at the in vitro crayfish excitatory neuromuscular junction. Electrophysiological techniques were used to record transmembrane junctional potentials from muscle fibres and extracellular junctional currents from the vicinity of nerve terminals. 2. The excitatory junctional potential amplitude was proportional to [Ca]0n, where n varied between 0·68 and 0·94 (mean 0·82) when [Ca]0 was varied from 1·8 to 15 mM/l. 3. The increase in junctional potential amplitude on raising [Ca]0 resulted primarily from an increase in the average number of quanta of excitatory transmitter released from the presynaptic nerve terminal by the nerve impulse. 4. The size of the quanta, synaptic delay, presynaptic potential and electrical properties of the muscle membrane were little affected by changes in calcium concentration in the range studied. PMID:5498460

  7. Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease.

    Science.gov (United States)

    Khirani, Sonia; Ramirez, Adriana; Delord, Vincent; Leroux, Karl; Lofaso, Frédéric; Hautot, Solène; Toussaint, Michel; Orlikowski, David; Louis, Bruno; Fauroux, Brigitte

    2014-09-01

    Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P ventilator. Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation. Copyright © 2014 by Daedalus Enterprises.

  8. Supervised neuromuscular exercise prior to hip and knee replacement

    DEFF Research Database (Denmark)

    Fernandes, Linda; Roos, Ewa M; Overgaard, Søren

    2017-01-01

    was analysed to estimate the probability for the intervention being cost effective for a range of threshold values. A health care sector perspective was applied. RESULTS: HOOS/KOOS quality of life [8.25 (95% CI, 0.42 to 16.10)] and QALYs [0.04 (95% CI, 0.01 to 0.07)] were statistically significantly improved....... Effect-sizes ranged between 0.09-0.59 for HOOS/KOOS subscales. Despite including an intervention cost of €326 per patient, there was no difference in total cost between groups [€132 (95% CI -3942 to 3679)]. At a threshold of €40,000, preoperative exercise was found to be cost effective at 84% probability....... CONCLUSION: Preoperative supervised neuromuscular exercise for 8 weeks was found to be cost-effective in patients scheduled for THR and TKR surgery at conventional thresholds for willingness to pay. One-year clinical effects were small to moderate and favoured the intervention group, but only statistically...

  9. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players.

    Science.gov (United States)

    Fort-Vanmeerhaeghe, Azahara; Gual, Gabriel; Romero-Rodriguez, Daniel; Unnitha, Viswanath

    2016-04-01

    The primary objective of the present study was to evaluate the agreement between the dominant leg (DL) (determined subjectively) and the stronger leg (SL) (determined via a functional test) in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL) and the SL vs the weaker (WL) leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years) performed three single-leg vertical countermovement jumps (SLVCJ) on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI) were determined. Only 32 (40%) of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (pjump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  10. An examination of neuromuscular and metabolic fatigue thresholds

    International Nuclear Information System (INIS)

    Bergstrom, Haley C; Housh, Terry J; Cochrane, Kristen C; Jenkins, Nathaniel D M; Lewis, Robert W Jr; Traylor, Daniel A; Schmidt, Richard J; Johnson, Glen O; Cramer, Joel T; Zuniga, Jorge M

    2013-01-01

    This study examined the relationships among the physical working capacity at the fatigue threshold (PWC FT ), the power outputs associated with the gas exchange threshold (PGET) and the respiratory compensation point (PRCP), and critical power (CP) to identify possible physiological mechanisms underlying the onset of neuromuscular fatigue. Ten participants (mean ± SD age: 20 ± 1 years) performed a maximal incremental cycle ergometer test to determine the PWC FT , PGET, and PRCP. CP was determined from the 3 min all-out test. The PWC FT (197 ± 55 W), PRCP (212 ± 50 W), and CP (208 ± 63 W) were significantly greater than the PGET (168 ± 40 W), but there were no significant differences among the PWC FT , PRCP, and CP. All thresholds were significantly inter-4 (r = 0.794–0.958). The 17% greater estimates for the PWC FT than PGET were likely related to differences in the physiological mechanisms that underlie these fatigue thresholds, while the non-significant difference and high correlation between the PWC FT and the PRCP suggested that hyperkalemia may underlie both thresholds. Furthermore, it is possible that the 5% lower estimate of the PWC FT than CP could more accurately reflect the demarcation of the heavy from severe exercise intensity domains. (paper)

  11. A family of neuromuscular stimulators with optical transcutaneous control.

    Science.gov (United States)

    Jarvis, J C; Salmons, S

    1991-01-01

    A family of miniature implantable neuromuscular stimulators has been developed using surface-mounted Philips 4000-series integrated circuits. The electronic components are mounted by hand on printed circuits (platinum/gold on alumina) and the electrical connections are made by reflow soldering. The plastic integrated-circuit packages, ceramic resistors and metal interconnections are protected from the body fluids by a coating of biocompatible silicone rubber. This simple technology provides reliable function for at least 4 months under implanted conditions. The circuits have in common a single lithium cell power-supply (3.2 V) and an optical sensor which can be used to detect light flashes through the skin after the device has been implanted. This information channel may be used to switch the output of a device on or off, or to cycle through a series of pre-set programs. The devices are currently finding application in studies which provide an experimental basis for the clinical exploitation of electrically stimulated skeletal muscle in cardiac assistance, sphincter reconstruction or functional electrical stimulation of paralysed limbs.

  12. Pseudoephedrine and circadian rhythm interaction on neuromuscular performance.

    Science.gov (United States)

    Pallarés, J G; López-Samanes, Á; Fernández-Elías, V E; Aguado-Jiménez, R; Ortega, J F; Gómez, C; Ventura, R; Segura, J; Mora-Rodríguez, R

    2015-12-01

    This study analyzed the effects of pseudoephedrine (PSE) provided at different time of day on neuromuscular performance, side effects, and violation of the current doping cut-off threshold [World Anti-Doping Agency (WADA)]. Nine resistance-trained males carried out bench press and full squat exercises against four incremental loads (25%, 50%, 75%, and 90% one repetition maximum [1RM]), in a randomized, double-blind, cross-over design. Participants ingested either 180 mg of PSE (supra-therapeutic dose) or placebo in the morning (7:00 h; AM(PLAC) and AM(PSE)) and in the afternoon (17:00 h; PM(PLAC) and PM(PSE)). PSE enhanced muscle contraction velocity against 25% and 50% 1RM loads, only when it was ingested in the mornings, and only in the full squat exercise (4.4-8.7%; P performance improvements are accompanied by undesirable side effects and an 11% risk of surpassing the doping threshold. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives

    Directory of Open Access Journals (Sweden)

    Carron M

    2017-12-01

    Full Text Available Michele Carron, Francesco Bertoncello, Giovanna Ieppariello Department of Medicine, Anesthesiology, and Intensive Care, University of Padova, Padua, Italy Abstract: The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed. Keywords: sugammadex, aging, elderly, neuromuscular blockade, rocuronium, anesthesia, safety

  14. Characterization of cervical neuromuscular response to head-neck perturbation in active young adults.

    Science.gov (United States)

    Alsalaheen, Bara; Bean, Ryan; Almeida, Andrea; Eckner, James; Lorincz, Matthew

    2018-04-01

    The majority of studies examining the role of cervical muscles on head-neck kinematics focused on musculoskeletal attributes (e.g. strength). Cervical neuromuscular response to perturbation may represent a divergent construct that has not been examined under various perturbation conditions. This study examined the association between cervical musculoskeletal attributes and cervical neuromuscular response of the sternocleidomastoid (SCM) to perturbation. Furthermore, this study examined the effect of anticipation and preload on the SCM neuromuscular response. Nineteen participants completed measurement of SCM muscle size, cervical flexion maximal voluntary isometric contraction, and the neuromuscular response of the SCM to cervical perturbation. Cervical perturbation was delivered by dropping a 1.59 kg mass from a loading apparatus. The impulsive load was delivered under four conditions: (1) Anticipated perturbation with no preload (A-NP), (2) Unanticipated perturbation with no preload (U-NP), (3) Anticipated perturbation with preload (A-P), and (4) Unanticipated perturbation with preload (U-P). None of the cervical musculoskeletal attributes were correlated with the SCM cervical neuromuscular response. This study demonstrated significant effect of preloading and anticipation on baseline EMG amplitude and EMG onset latency for the SCM. Furthermore, there was a significant effect of preloading on average EMG response amplitude for the SCM. The findings of this study indicate that cervical neuromuscular response of the SCM is different from musculoskeletal attributes and is influenced by perturbation conditions. These findings provide conceptual support to examine the neuromuscular response of the SCM in mitigating head-neck kinematics. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Estudo qualiquantitativo do biogás produzido por substratos em biodigestores tipo batelada Qualiquantitatve study of biogas produced by substrates in batch biodigestors

    Directory of Open Access Journals (Sweden)

    João A. Galbiatti

    2010-04-01

    Full Text Available A presente pesquisa foi desenvolvida no Departamento de Engenharia Rural da FCAV/UNESP, SP, Brasil, com o objetivo de se estudar, qualiquantitativamente, o biogás produzido por 5 substratos que, após utilizados na digestão anaeróbia, foram caracterizados como: 1 - Esterco de aves de corte com cama de capim napier (EACN; 2 - Esterco de aves de corte com cama de capim napier triturado (EACNT; 3 - Esterco suíno (ES; 4 - Esterco bovino (EB e 5 - Esterco de bovino misturado com 50% de bagaço de cana-de-açúcar (EB50C. Dos dados levantados concluiu-se que: o substrato EACN e o ES produziram volumes maiores e menores de biogás, respectivamente, comparados com os demais; a mistura de bagaço de cana-de-açúcar no substrato EB prejudica a produção acumulada de biogás e sua qualidade; a partir dos 57 dias após o enchimento dos biodigestores todos os substratos já produziam biogás com teor de metano superior a 48%, com exceção do substrato ES; o substrato triturado (EACNT não apresentou características muito distintas do substrato não triturado (EACN; a qualidade do biogás na fase de produção máxima é semelhante para todos os substratos estudados; o biogás que mostrou maior valor de metano na sua composição foi o produzido com EB, superior em até 17,7% à produção do EACNT.Aiming to study the biogas produced by 5 substrates from both quality and quantity point of view, this research was conducted at the Rural Engineering Department of FCAV/UNESP - Brazil, State of São Paulo. The substractes that were used in the anaerobic digestion were characterized as: 1 - Slaughter fowls' manure with napier grass bed (MFNG; 2 - Slaughter fowls' manure with triturate napier grass bed (MFNGT; 3 - Suine manure (SM; 4 - Bovine manure (BM and 5 - Bovine manure mixed with 50% of sugarcane bagasse (BM50S. From the data colIected it was concluded that: the substract (MFNG and the substract containing SM produced higher and lower volumes of biogas

  16. Pilates and Proprioceptive Neuromuscular Facilitation Methods Induce Similar Strength Gains but Different Neuromuscular Adaptations in Elderly Women.

    Science.gov (United States)

    Teixeira de Carvalho, Fabiana; de Andrade Mesquita, Laiana Sepúlveda; Pereira, Rafael; Neto, Osmar Pinto; Amaro Zangaro, Renato

    2017-01-01

    Background/Study Context: The aging process is associated with a decline in muscle mass, strength, and conditioning. Two training methods that may be useful to improve muscle function are Pilates and proprioceptive neuromuscular facilitation (PNF). Thus, the present study aimed to compare the influence of training programs using Pilates and PNF methods with elderly women. Sixty healthy elderly women were randomly divided into three groups: Pilates group, PNF group, and control group. Pilates and PNF groups underwent 1-month training programs with Pilates and PNF methods, respectively. The control group received no intervention during the 1 month. The maximal isometric force levels from knee extension and flexion, as well as the electromyography (EMG) signals from quadriceps and biceps femoris, were recorded before and after the 1-month intervention period. A two-way analysis of variance revealed that the Pilates and PNF methods induced similar strength gains from knee flexors and extensors, but Pilates exhibited greater low-gamma drive (i.e., oscillations in 30-60 Hz) in the EMG power spectrum after the training period. These results support use of both Pilates and PNF methods to enhance lower limb muscle strength in older groups, which is very important for gait, postural stability, and performance of daily life activities.

  17. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

    Science.gov (United States)

    Zech, Astrid; Klahn, Philipp; Hoeft, Jon; zu Eulenburg, Christine; Steib, Simon

    2014-02-01

    Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

  18. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study.

    Science.gov (United States)

    Brueckmann, B; Sasaki, N; Grobara, P; Li, M K; Woo, T; de Bie, J; Maktabi, M; Lee, J; Kwo, J; Pino, R; Sabouri, A S; McGovern, F; Staehr-Rye, A K; Eikermann, M

    2015-11-01

    This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio sugammadex patients and 33 out of 76 (43.4%) usual care patients had TOF-Watch SX-assessed residual neuromuscular blockade at PACU admission (odds ratio 0.0, 95% CI [0-0.06], Psugammadex vs usual care (14.7 vs. 18.6 min respectively; P=0.02). After abdominal surgery, sugammadex reversal eliminated residual neuromuscular blockade in the PACU, and shortened the time from start of study medication administration to the time the patient was ready for discharge from the operating room. Clinicaltrials.gov:NCT01479764. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Neuromuscular disease and respiratory physiology in children: putting lung function into perspective.

    Science.gov (United States)

    Fauroux, Brigitte; Khirani, Sonia

    2014-08-01

    Neuromuscular diseases represent a heterogeneous group of disorders of the muscle, nerve or neuromuscular junction. The respiratory muscles are rarely spared in neuromuscular diseases even if the type of muscle involvement, severity and time course greatly varies among the different diseases. Diagnosis of respiratory muscle weakness is crucial because of the importance of respiratory morbidity and mortality. Presently, routine respiratory evaluation is based on non-invasive volitional tests, such as the measurement of lung volumes, spirometry and the maximal static pressures, which may be difficult or impossible to obtain in some young children. Other tools or parameters are thus needed to assess the respiratory muscle weakness and its consequences in young children. The measurement of oesogastric pressures can be helpful as they allow the diagnosis and quantification of paradoxical breathing, as well as the assessment of the strength of the inspiratory and expiratory muscles by means of the oesophageal pressure during a maximal sniff and of the gastric pressure during a maximal cough. Sleep assessment should also be part of the respiratory evaluation of children with neuromuscular disease with at least the recording of nocturnal gas exchange if polysomnography is not possible or unavailable. This improvement in the assessment of respiratory muscle performance may increase our understanding of the respiratory pathophysiology of the different neuromuscular diseases, improve patient care, and guide research and innovative therapies by identifying and validating respiratory parameters. © 2014 Asian Pacific Society of Respirology.

  20. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Titarsolej PJ

    2008-09-01

    Full Text Available Abstract Background Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care. Methods The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence. Results For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands. Conclusion In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.

  1. Computed tomography of the skeletal muscles in neuromuscular diseases

    International Nuclear Information System (INIS)

    Nagao, Hideo; Takahashi, Mitsugi; Habara, Shinji; Nagai, Yoshinao; Matsuda, Hiroshi

    1986-01-01

    Computed tomographic (CT) scans of the shoulder girdle, upper arm, waist, pelvic girdle, thigh, and lower leg were obtained in a total of 21 patients with neuromuscular diseases, including 10 with Duchenne muscle dystrophy (DMD), 3 with Fukushima type congenital muscular dystrophy (FCMD), 3 with Werdnig-Hoffmann's disease (WH), 3 with autosomal recessive muscular dystrophy in childhood (childhood MC), one with nemaline myopathy (NM), and one with myositis ossificans circumscripta (MOC). Age-dependent changes in CT findings were examined in the 10 DMD patients ranging in age from 3 to 15 years. Each muscle of the shoulder girdle and upper arm was seen as a low density area on CT in patients 9 years of age when the arms are difficult to elevate. Changes in the m. quadriceps femoris occurring in all the patients were visible earlist on CT, followed by those in the m. gluteus maximus, m. gastrocnemius, and m. soleus. CT scans of the thigh was thus considered most useful in diagnosing DMD. CT scans of the lower leg showed low density areas in the m. gastrocnemius and m. soleus in both WH and FCMD patients, while a low density area seen in the m. gluteus maximum on CT was restricted to FCMD patients. This suggests the potential of CT in the differentiation of WH from FCMD. In patients with childhood ARMD, there were various CT findings including normal and extremely low density areas. CT findings in NM patients were similar to those in DMD patients. High density areas were seen along the fascia of the trunk in MOC patients. (Namekawa, K.)

  2. Sensory threshold neuromuscular electrical stimulation fosters motor imagery performance.

    Science.gov (United States)

    Corbet, Tiffany; Iturrate, Iñaki; Pereira, Michael; Perdikis, Serafeim; Millán, José Del R

    2018-04-21

    Motor imagery (MI) has been largely studied as a way to enhance motor learning and to restore motor functions. Although it is agreed that users should emphasize kinesthetic imagery during MI, recordings of MI brain patterns are not sufficiently reliable for many subjects. It has been suggested that the usage of somatosensory feedback would be more suitable than standardly used visual feedback to enhance MI brain patterns. However, somatosensory feed-back should not interfere with the recorded MI brain pattern. In this study we propose a novel feedback modality to guide subjects during MI based on sensory threshold neuromuscular electrical stimulation (St-NMES). St-NMES depolarizes sensory and motor axons without eliciting any muscular contraction. We hypothesize that St-NMES does not induce detectable ERD brain patterns and fosters MI performance. Twelve novice subjects were included in a cross-over design study. We recorded their EEG, comparing St-NMES with visual feed-back during MI or resting tasks. We found that St-NMES not only induced significantly larger desynchronization over sensorimotor areas (p<0.05) but also significantly enhanced MI brain connectivity patterns. Moreover, classification accuracy and stability were significantly higher with St-NMES. Importantly, St-NMES alone did not induce detectable artifacts, but rather the changes in the detected patterns were due to an increased MI performance. Our findings indicate that St-NMES is a promising feedback in order to foster MI performance and cold be used for BMI online applications. Copyright © 2018. Published by Elsevier Inc.

  3. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players

    Directory of Open Access Journals (Sweden)

    Fort-Vanmeerhaeghe Azahara

    2016-04-01

    Full Text Available The primary objective of the present study was to evaluate the agreement between the dominant leg (DL (determined subjectively and the stronger leg (SL (determined via a functional test in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL and the SL vs the weaker (WL leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years performed three single-leg vertical countermovement jumps (SLVCJ on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI were determined. Only 32 (40% of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (p<0.05 inter-limb differences were found in the total group of players. When comparing between sexes, significant differences (p<0.05 arose in the female group only. With regard to the WL vs. the SL, significant (p<0.05 differences were noted in the whole group and when stratified into males and females. The mean ASI ranged from 9.31% (males to 12.84% (females and from 10.49% (males to 14.26% (females, when comparing the DL vs. the NDL and the SL vs. the WL, respectively. Subjective expression of leg dominance cannot be used as a predictor of limb jump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  4. High-Frequency Neuromuscular Electrical Stimulation Increases Anabolic Signaling.

    Science.gov (United States)

    Mettler, Joni A; Magee, Dillon M; Doucet, Barbara M

    2018-03-16

    Neuromuscular electrical stimulation (NMES) is commonly used in rehabilitation settings to increase muscle mass and strength. However, the effects of NMES on muscle growth are not clear and no human studies have compared anabolic signaling between low-frequency (LF-) and high-frequency (HF-) NMES. The purpose of this study was to determine the skeletal muscle anabolic signaling response to an acute bout of LF- and HF-NMES. Eleven young healthy volunteers (6 men; 5 women) received an acute bout of LF- (20 Hz) and HF- (60 Hz) NMES. Muscle biopsies were obtained from the vastus lateralis muscle prior to the first NMES treatment and 30-mins following each NMES treatment. Phosphorylation of the following key anabolic signaling proteins was measured by Western blot and proteins are expressed as a ratio of phosphorylated to total: mammalian target of rapamycin (mTOR), p70-S6 kinase 1 (S6K1), and eukaryotic initiation factor 4E binding protein 1 (4E-BP1). Compared to Pre-NMES, phosphorylation of mTOR was upregulated 40.2% for LF-NMES (P = 0.018) and 68.4% for HF-NMES (P 0.05). There were no differences between treatment conditions for 4E-BP1 phosphorylation (P > 0.05). An acute bout of LF- and HF-NMES upregulated anabolic signaling with HF-NMES producing a greater anabolic response compared to LF-NMES, suggesting that HF-stimulation may provide a stronger stimulus for processes that initiate muscle hypertrophy. Additionally, the stimulation frequency parameter should be considered by clinicians in the design of optimal NMES treatment protocols.

  5. Development of a neuromuscular electrical stimulation protocol for sprint training.

    Science.gov (United States)

    Russ, David W; Clark, Brian C; Krause, Jodi; Hagerman, Fredrick C

    2012-09-01

    Sprint training is associated with several beneficial adaptations in skeletal muscle, including an enhancement of sarcoplasmic reticulum (SR) Ca(2+) release. Unfortunately, several patient populations (e.g., the elderly, those with cardiac dysfunction) that might derive great benefit from sprint exercise are unlikely to tolerate it. The purpose of this report was to describe the development of a tolerable neuromuscular electrical stimulation (NMES) protocol that induces skeletal muscle adaptations similar to those observed with sprint training. Our NMES protocol was modeled after a published sprint exercise protocol and used a novel electrode configuration and stimulation sequence to provide adequate training stimulus while maintaining subject tolerance. Nine young, healthy subjects (four men) began and completed the training protocol of the knee extensor muscles. All subjects completed the protocol, with ratings of discomfort far less than those reported in studies of traditional NMES. Training induced significant increases in SR Ca(2+) release and citrate synthase activity (~16% and 32%, respectively), but SR Ca(2+) uptake did not change. The percentage of myosin heavy chain IIx isoform was decreased significantly after training. At the whole muscle level, neither central activation nor maximum voluntary isometric contraction force were significantly altered, although isometric force did exhibit a trend toward an increase (~3%, P = 0.055). Surprisingly, the NMES training produced a significant increase in muscle cross-sectional area (~3%, P = 0.04). It seems that an appropriately designed NMES protocol can mimic many of the benefits of sprint exercise training, with a low overall time commitment and training volume. These findings suggest that NMES has the potential to bring the benefits of sprint exercise to individuals who are unable to tolerate traditional sprint training.

  6. Neuromuscular consequences of an extreme mountain ultra-marathon.

    Directory of Open Access Journals (Sweden)

    Guillaume Y Millet

    Full Text Available We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM with 9500 m of positive and negative elevation change. For this purpose, (i the fatigue induced by the MUM and (ii the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22, and 2, 5, 9 and 16 days after the MUM (n = 11 in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (-35% [95% CI: -28 to -42%] and -39% [95% CI: -32 to -46%] for KE and PF, respectively, with alteration of maximal voluntary activation, mainly for KE (-19% [95% CI: -7 to -32%]. Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144 ± 94 to 13,633 ± 12,626 UI L(-1, myoglobin (from 32 ± 22 to 1,432 ± 1,209 µg L(-1, and C-Reactive Protein (from <2.0 to 37.7 ± 26.5 mg L(-1. Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline.

  7. Reversal of rocuronium-induced (1.2 mg/kg) profound neuromuscular block by sugammadex: a multicenter, dose-finding and safety study.

    NARCIS (Netherlands)

    Boer, H.D. de; Driessen, J.J.; Marcus, M.A.; Kerkkamp, H.E.M.; Heeringa, M.; Klimek, M.

    2007-01-01

    BACKGROUND: Reversal of rocuronium-induced neuromuscular blockade can be accomplished by chemical encapsulation of rocuronium by sugammadex, a modified gamma-cyclodextrin derivative. This study investigated the efficacy and safety of sugammadex in reversing rocuronium-induced profound neuromuscular

  8. Neuromuscular blocking and cardiovascular effects of Org 9487, a new short-acting aminosteroidal blocking agent, in anaesthetized animals and in isolated muscle preparations

    NARCIS (Netherlands)

    Muir, A.W.; Sleigh, T.; Marshall, R.J.; Pow, E.; Anderson, K.; Booij, L.H.D.J.; Hill, D.R.

    1998-01-01

    This study was undertaken to investigate the neuromuscular blocking profile and cardiovascular effects of Org 9487, a new aminosteroidal, non-depolarizing, neuromuscular blocking agent structurally related to vecuronium, in anaesthetized animals and in isolated muscle preparations. In in vitro

  9. Bloqueio AV total congênito: novo modelo experimental para avaliação do marcapasso fetal Fetal heart block: a new experimental model to assess fetal pacing

    Directory of Open Access Journals (Sweden)

    Renato S Assad

    1994-09-01

    Full Text Available O implante de marcapasso epicárdíco em fetos via toracotomia é um procedimento potencialmente mais seguro e eficaz para se tratar o bloqueio AV total congênito (BAVT, quando associado à hidropsia fetal e refratário ao tratamento clínico. Este estudo foi desenvolvido com o objetivo de avaliar as características eletrofisiológicas de dois eletrodos epicárdicos através de novo modelo experimental de BAVT congênito induzido pela crioablação do nó AV. Foram aplicados, em 2 grupos de 6 fetos de ovelhas (80% da gestação, um eletrodo de rosqueamento (1,5 voltas e outro de sutura epicárdica. O BAVT foi obtido em todos os fetos, não sendo observado nenhum ritmo de escape ventricular. Os limiares de estimulação foram baixos para ambos os eletrodos, com valores inferiores para o eletrodo de rosqueamento com largura de pulso abaixo de 0,9 mseg (p 0,20 na amplitude da onda R dos 2 eletrodos. O slew rate foi significativamente maior para o grupo de fetos com eletrodo de rosqueamento (1,40 ± 0,2 versus 0,62 ± 0,2 V/seg. p=0,04. O método é simples e reprodutível para avaliação do marcapasso fetal, sendo que o eletrodo de rosqueamento representa a melhor opção, quando houver indicação de implante de marcapasso em fetos.Epicardial fetal pacing via thoracotomy has the potential for being a safer and more reliable procedure to treat congenital complete heart block (CHB associated with fetal hydrops refractory to medical therapy. To assess the acute electrophysiologic characteristics of two ventricular epicardial leads, a new experimental model of fetal heart block induced by cryosurgical ablation of the AV node without the need for fetal cardiac bypass was performed in 12 pregnant ewes at 110-115 days of gestation. A modified screw-in lead (one and a half turn was used in 6 fetal lambs and a stitch-on lead in the other 6 lambs. CHB was achieved in 100% of the fetal lambs, with no ventricular escape rate noticed in any of the lambs

  10. Neuroleptics as therapeutic compounds stabilizing neuromuscular transmission in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Patten, Shunmoogum A; Aggad, Dina; Martinez, Jose; Tremblay, Elsa; Petrillo, Janet; Armstrong, Gary Ab; La Fontaine, Alexandre; Maios, Claudia; Liao, Meijiang; Ciura, Sorana; Wen, Xiao-Yan; Rafuse, Victor; Ichida, Justin; Zinman, Lorne; Julien, Jean-Pierre; Kabashi, Edor; Robitaille, Richard; Korngut, Lawrence; Parker, J Alexander; Drapeau, Pierre

    2017-11-16

    Amyotrophic lateral sclerosis (ALS) is a rapidly progressing, fatal disorder with no effective treatment. We used simple genetic models of ALS to screen phenotypically for potential therapeutic compounds. We screened libraries of compounds in C. elegans, validated hits in zebrafish, and tested the most potent molecule in mice and in a small clinical trial. We identified a class of neuroleptics that restored motility in C. elegans and in zebrafish, and the most potent was pimozide, which blocked T-type Ca2+ channels in these simple models and stabilized neuromuscular transmission in zebrafish and enhanced it in mice. Finally, a short randomized controlled trial of sporadic ALS subjects demonstrated stabilization of motility and evidence of target engagement at the neuromuscular junction. Simple genetic models are, thus, useful in identifying promising compounds for the treatment of ALS, such as neuroleptics, which may stabilize neuromuscular transmission and prolong survival in this disease.

  11. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    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......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...

  12. A neuromuscular exercise programme versus standard care for patients with traumatic anterior shoulder instability

    DEFF Research Database (Denmark)

    Eshoj, Henrik; Rasmussen, Sten; Frich, Lars Henrik

    2017-01-01

    BACKGROUND: Anterior shoulder dislocation is a common injury and may have considerable impact on shoulder-related quality of life (QoL). If not warranted for initial stabilising surgery, patients are mostly left with little to no post-traumatic rehabilitation. This may be due to lack of evidence......-based exercise programmes. In similar, high-impact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL. Thus, the objective of this trial is to compare a nonoperative neuromuscular exercise shoulder programme...... dislocations due to at least one traumatic event will be randomised to 12 weeks of either a standardised, individualised or physiotherapist-supervised neuromuscular shoulder exercise programme or standard care (self-managed shoulder exercise programme). Patients will be stratified according to injury status...

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

    DEFF Research Database (Denmark)

    Andersen, Lars L; Zeeman, Peter; Jørgensen, Jørgen R

    2011-01-01

    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...... 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...... 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...

  14. Assessment of bone density in patients with scoliosis neuromuscular secondary to cerebral palsy

    Directory of Open Access Journals (Sweden)

    Charbel Jacob Júnior

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate bone mineral density in patients with neuromuscular scoliosis secondary to spastic quadriplegic cerebral palsy. METHODS: A prospective descriptive study in which, in addition to bone densitometry, the anthropometric data of the patients were assessed. As inclusion criterion we adopted patients with spastic quadriplegic cerebral palsy, wheelchair users, aged between 10 and 20 years and with neuromuscular scoliosis. RESULTS: We evaluated 31 patients, 20 female, whose average age was 14.2 years. The mean bone density was -3.2 standard deviation (Z-score, with mean biceps circumference of 19.4 cm, calf circumference 18.6 cm and BMI of 13.6 kg/m². CONCLUSION: There is a high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to spastic quadriplegic cerebral palsy.

  15. Autosomal-dominant non-autoimmune hyperthyroidism presenting with neuromuscular symptoms.

    Science.gov (United States)

    Elgadi, Aziz; Arvidsson, C-G; Janson, Annika; Marcus, Claude; Costagliola, Sabine; Norgren, Svante

    2005-08-01

    Neuromuscular presentations are common in thyroid disease, although the mechanism is unclear. In the present study, we investigated the pathogenesis in a boy with autosomal-dominant hyperthyroidism presenting with neuromuscular symptoms. The TSHr gene was investigated by direct sequencing. Functional properties of the mutant TSHr were investigated during transient expression in COS-7 cells. Family members were investigated by clinical and biochemical examinations. Sequence analysis revealed a previously reported heterozygous missense mutation Glycine 431 for Serine in the first transmembrane segment, leading to an increased specific constitutive activity. Three additional affected family members carried the same mutation. There was no indication of autoimmune disorder. All symptoms disappeared upon treatment with thacapzol and L-thyroxine and subsequent subtotal thyroidectomy. The data imply that neuromuscular symptoms can be caused by excessive thyroid hormone levels rather than by autoimmunity.

  16. Transmitter release in the neuromuscular synapse of the protein kinase C theta-deficient adult mouse.

    Science.gov (United States)

    Besalduch, Núria; Santafé, Manel M; Garcia, Neus; Gonzalez, Carmen; Tomás, Marta; Tomás, Josep; Lanuza, Maria A

    2011-04-01

    We studied structural and functional features of the neuromuscular junction in adult mice (P30) genetically deficient in the protein kinase C (PKC) theta isoform. Confocal and electron microscopy shows that there are no differences in the general morphology of the endplates between PKC theta-deficient and wild-type (WT) mice. Specifically, there is no difference in the density of the synaptic vesicles. However, the myelin sheath is not as thick in the intramuscular nerve fibers of the PKC theta-deficient mice. We found a significant reduction in the size of evoked endplate potentials and in the frequency of spontaneous, asynchronous, miniature endplate potentials in the PKC theta-deficient neuromuscular preparations in comparison with the WT, but the mean amplitude of the spontaneous potentials is not different. These changes indicate that PKC theta has a presynaptic role in the function of adult neuromuscular synapses. Copyright © 2010 Wiley-Liss, Inc.

  17. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study

    DEFF Research Database (Denmark)

    Sorgenfrei, Iben F; Norrild, Kathrine; Larsen, Per Bo

    2006-01-01

    Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block.......Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block....

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

    Science.gov (United States)

    Zebis, Mette K; Bencke, Jesper; Andersen, Lars L; Døssing, Simon; Alkjaer, Tine; Magnusson, S Peter; Kjaer, Michael; Aagaard, Per

    2008-07-01

    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. 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. 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. The subjects participated in a specific neuromuscular training program previously shown to reduce non-contact ACL injury. 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. Neuromuscular training markedly increased before activity and landing activity electromyography (EMG) of the semitendinosus (P 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.

  19. 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; Andersen, Lars

    2008-01-01

    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...

  20. The Role of Neuromuscular Changes in Aging and Knee Osteoarthritis on Dynamic Postural Control

    Science.gov (United States)

    Takacs, Judit; Carpenter, Mark G.; Garland, S. Jayne; Hunt, Michael A.

    2013-01-01

    Knee osteoarthritis (OA) is a chronic joint condition, with 30% of those over the age of 75 exhibiting severe radiographic disease. Nearly 50% of those with knee OA have experienced a fall in the past year. Falls are a considerable public health concern, with a high risk of serious injury and a significant socioeconomic impact. The ability to defend against a fall relies on adequate dynamic postural control, and alterations in dynamic postural control are seen with normal aging. Neuromuscular changes associated with aging may be responsible for some of these alterations in dynamic postural control. Even greater neuromuscular deficits, which may impact dynamic postural control and the ability to defend against a fall, are seen in people with knee OA. There is little evidence to date on how knee OA affects the ability to respond to and defend against falls and the neuromuscular changes that contribute to balance deficits. As a result, this review will: summarize the key characteristics of postural responses to an external perturbation, highlight the changes in dynamic postural control seen with normal aging, review the neuromuscular changes associated with aging that have known and possible effects on dynamic postural control, and summarize the neuromuscular changes and balance problems in knee OA. Future research to better understand the role of neuromuscular changes in knee OA and their effect on dynamic postural control will be suggested. Such an understanding is critical to the successful creation and implementation of fall prevention and treatment programs, in order to reduce the excessive risk of falling in knee OA. PMID:23696951

  1. 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.

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

    Science.gov (United States)

    O'Driscoll, Jeremiah; Kerin, Fearghal; Delahunt, Eamonn

    2011-06-09

    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. 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. 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. 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.

  3. Robotic assessment of neuromuscular characteristics using musculoskeletal models: A pilot study.

    Science.gov (United States)

    Jayaneththi, V R; Viloria, J; Wiedemann, L G; Jarrett, C; McDaid, A J

    2017-07-01

    Non-invasive neuromuscular characterization aims to provide greater insight into the effectiveness of existing and emerging rehabilitation therapies by quantifying neuromuscular characteristics relating to force production, muscle viscoelasticity and voluntary neural activation. In this paper, we propose a novel approach to evaluate neuromuscular characteristics, such as muscle fiber stiffness and viscosity, by combining robotic and HD-sEMG measurements with computational musculoskeletal modeling. This pilot study investigates the efficacy of this approach on a healthy population and provides new insight on potential limitations of conventional musculoskeletal models for this application. Subject-specific neuromuscular characteristics of the biceps and triceps brachii were evaluated using robot-measured kinetics, kinematics and EMG activity as inputs to a musculoskeletal model. Repeatability experiments in five participants revealed large variability within each subjects evaluated characteristics, with almost all experiencing variation greater than 50% of full scale when repeating the same task. The use of robotics and HD-sEMG, in conjunction with musculoskeletal modeling, to quantify neuromuscular characteristics has been explored. Despite the ability to predict joint kinematics with relatively high accuracy, parameter characterization was inconsistent i.e. many parameter combinations gave rise to minimal kinematic error. The proposed technique is a novel approach for in vivo neuromuscular characterization and is a step towards the realization of objective in-home robot-assisted rehabilitation. Importantly, the results have confirmed the technical (robot and HD-sEMG) feasibility while highlighting the need to develop new musculoskeletal models and optimization techniques capable of achieving consistent results across a range of dynamic tasks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. 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.

  5. Bloqueio dos nervos tibial e fibular comum em fossa poplítea com punção única utilizando o estimulador percutâneo de nervos: considerações anatômicas e descrição ultrassonográfica

    OpenAIRE

    Rangel, Viviane de Oliveira; Carvalho, Raphael de Almeida; Mandim, Beatriz Lemos da Silva; Alves, Rodrigo Rodrigues; Ruzi, Roberto Araújo; Fonseca, Neuber Martins da

    2011-01-01

    JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios de nervos periféricos têm ganhado popularidade nas últimas duas décadas, tornando-se crescente opção anestésica para a cirurgia de membros. Este estudo propõe uma técnica de abordagem dos nervos tibial e fibular comum na fossa poplítea por punção única e utilizando o estimulador percutâneo de nervos, considerando a correlação com estudo anatômico e ultrassonográfico. MÉTODO: Estudo prospectivo, observacional e aleatório realizado com 28 paci...

  6. Effect of temperature on spontaneous release of transmitter at the mammalian neuromuscular junction

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, C J; Statham, H E

    1977-01-01

    Temperature has a multifactorial effect on miniature endplate potential (MEPP) frequency at the mammalian neuromuscular junction, with a negative Q/sub 10/ at 14--28/sup 0/C. The results are explained in terms of the effect of temperature on the various factors that control (Ca/sup 2/+sub i/ at the presynaptic terminals. The temperature-sensitivity of the Ca/sup 2 +/-transport enzyme is believed to be of particular significance and accounts for the observed differences between the amphibian and mammalian neuromuscular junctions.

  7. Sugammadex to reverse neuromuscular blockade and provide optimal conditions for motor-evoked potential monitoring

    Directory of Open Access Journals (Sweden)

    Mehdi Trifa

    2017-01-01

    Full Text Available Sugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade (NMB via a mechanism that differs completely from acetylcholinesterase inhibitors. By encapsulating rocuronium, sugammadex can provide recovery of neuromuscular function even when there is a profound degree of NMB. We report anecdotal experience with the use of sugammadex to reverse NMB to facilitate intraoperative neurophysiological monitoring (motor evoked potentials in an adolescent with scoliosis during posterior spinal fusion. Its potential application in this unique clinical scenario is discussed, and potential dosing schemes are reviewed.

  8. Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trial

    DEFF Research Database (Denmark)

    Claudius, C; Viby-Mogensen, J; Skovgaard, Lene Theil

    2009-01-01

    ) for this purpose. The aim of this study was to compare AMG and MMG for establishing dose-response relationship and potency, using rocuronium as an example. METHODS: We included 40 adult patients in this randomized-controlled single-dose response study. Anaesthesia was induced and maintained with propofol...... and opioid. Neuromuscular blockade was induced with rocuronium 100, 150, 200 or 250 microg/kg. Neuromuscular monitoring was performed with AMG (TOF-Watch SX) with pre-load (Hand Adapter) at one arm and MMG (modified TOF-Watch SX) on the other, using 0.1 Hz single twitch stimulation. Dose...

  9. Clinical applications of immunoglobulin in neuromuscular diseases: focus on inflammatory myopathies

    Directory of Open Access Journals (Sweden)

    Paulo Victor Sgobbi de Souza

    2014-12-01

    Full Text Available 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.

  10. Protein kinase C isoforms at the neuromuscular junction: localization and specific roles in neurotransmission and development.

    Science.gov (United States)

    Lanuza, Maria A; Santafe, Manel M; Garcia, Neus; Besalduch, Núria; Tomàs, Marta; Obis, Teresa; Priego, Mercedes; Nelson, Phillip G; Tomàs, Josep

    2014-01-01

    The protein kinase C family (PKC) regulates a variety of neural functions including neurotransmitter release. The selective activation of a wide range of PKC isoforms in different cells and domains is likely to contribute to the functional diversity of PKC phosphorylating activity. In this review, we describe the isoform localization, phosphorylation function, regulation and signalling of the PKC family at the neuromuscular junction. Data show the involvement of the PKC family in several important functions at the neuromuscular junction and in particular in the maturation of the synapse and the modulation of neurotransmission in the adult. © 2013 Anatomical Society.

  11. Propiocepción y control neuromuscular en el fútblo infantil

    OpenAIRE

    Zarza, Cristían

    2014-01-01

    En el fútbol profesional la escasa utilización de la pierna no hábil hace que muchas situaciones de juego no se resuelvan eficazmente, además de predisponer a la aparición de lesiones. El presente estudio se concentró en determinar la influencia del entrenamiento propioceptivo y del control neuromuscular en las cualidades físicas y técnicas del miembro no hábil. Objetivo: Indagar el nivel propioceptivo y de control neuromuscular del miembro inferior no hábil en chicos que re...

  12. Feeding and Swallowing Disorders in Pediatric Neuromuscular Diseases: An Overview.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; de Groot, Imelda J M; de Swart, Bert J M; Erasmus, Corrie E

    2015-11-20

    Feeding and swallowing problems in infants and children have a great impact on health and wellbeing. The aim of this study was to provide an overview of recognized feeding and swallowing problems in different groups of children with neuromuscular diseases, based on relevant literature and expert opinion, and to propose recommendations for the assessment and treatment of these problems. Almost all pediatric neuromuscular diseases are accompanied by feeding and swallowing problems during the different phases of deglutition, problems that give rise to a wide variety of signs and symptoms, which emphasizes the importance of a comprehensive feeding and swallowing assessment by a speech and language therapist.

  13. O uso do carvão ativado produzido a partir da casca da Moringa oleifera, como adsorvente na remoção de metais pesados presentes na água.

    OpenAIRE

    Nogueira, Marcopaulo Wanderley

    2010-01-01

    A necessidade de atender os padrões de qualidade da água de acordo com a legislação ambiental tanto para o consumo humano quanto para o lançamento de efluentes levam a busca de soluções de baixo custo e eficientes para que seja viável o avanço do saneamento ambiental. O carvão ativado produzido a partir das cascas da semente da Moringa oleifera tem sido estudado e apontado como solução alternativa para remoção de poluentes em regiões tropicais onde a p...

  14. Avaliação de diferentes concentrações de adubo orgânico produzido a partir de resíduos de pescados e vegetais no desenvolvimento da cultura da cebolinha (Allium schoenoprasum)

    OpenAIRE

    Bruno, Fillipe Herbert Sales; Universidade Federal do Ceará; Sales, Ronaldo de Oliveira; Universidade Federal do Ceará; Oliveira, André Luiz Torres de; Universidade Federal do Ceará; Freitas, João Batista Santiago; Universidade Federal do Ceará

    2013-01-01

    O crescimento populacional nos centros urbanos tem agravado o problema do gerenciamento dos resíduos sólidos gerados pelos habitantes, causados principalmente, pelo volume de lixo produzido e pelo estilo de vida consumista. Neste contexto a reciclagem de resíduos, seja de origem agrícola ou industrial, oriundos das mais diversas cadeias produtivas, cujos descartes indevidos podem causar impactos negativos ao ambiente, como é o caso dos resíduos provenientes da indústria pesqueira e dos vegeta...

  15. Avaliação da composição mineral do adubo orgânico produzido a partir de resíduos de pescados e vegetais no desenvolvimento da cultura da cebolinha (Allium schoenoprasum)

    OpenAIRE

    Bruno, Fillipe Herbert Sales; Universidade Federal do Ceará; Sales, Ronaldo de Oliveira; Universidade Federal do Ceará; Oliveira, André Luiz Torres de; Universidade Federal do Ceará; Freitas, João Batista Santiago; Universidade Federal do Ceará

    2013-01-01

    O crescimento populacional nos centros urbanos tem agravado o problema do gerenciamento dos resíduos sólidos gerados pelos habitantes, causados principalmente, pelo volume de lixo produzido e pelo estilo de vida consumista. Neste contexto a reciclagem de resíduos, seja de origem agrícola ou industrial, oriundos das mais diversas cadeias produtivas, cujos descartes indevidos podem causar impactos negativos ao ambiente, como é o caso dos resíduos provenientes da indústria pesqueira e dos vegeta...

  16. Avaliação da qualidade de méis de abelha produzidos e comercializados em Vitória da Conquista, Bahia

    Directory of Open Access Journals (Sweden)

    Manoel Nelson de Castro Filho

    2017-10-01

    Full Text Available O mel é um produto elaborado pelas abelhas, a partir do néctar das flores ou de secreções procedentes de partes vivas das plantas, que as abelhas recolhem, transformam e combinam com substâncias específicas próprias. Este alimento é nutritivo e energético, sendo apreciado, entre outros fatores, por suas propriedades terapêuticas. Açúcares, água, vitaminas, ácidos orgânicos e sais minerais são os principais constituintes do mel. Nesse sentido, as análises laboratoriais são utilizadas para inspeção, com o objetivo de conhecer a composição química do mel, identificando a qualidade do produto. O objetivo deste estudo foi avaliar a qualidade dos méis produzidos e comercializados na cidade de Vitória da Conquista - BA e sua adequabilidade em relação à identidade e qualidade padronizadas pela legislação brasileira. As amostras foram obtidas da Casa do Mel da Universidade Estadual do Sudoeste da Bahia, em Vitória da Conquista, e analisadas no laboratório de Química Analítica e Ambiental da mesma instituição. Foram analisados teor de umidade, acidez livre, açúcares redutores e não redutores, hidroximetilfurfural, sólidos solúveis totais, pH e reação de Fiehe e Lund  em 18 amostras de méis. Das amostras avaliadas, 66,67% apresentaram valores de HMF superiores aos aceitáveis pela legislação, 11,11% para acidez e 27,78% para o teste Fiehe. O resultado das demais análises apresentaram-se dentro dos valores permitidos.

  17. Estimativas das propriedades de compostos LVL produzidos com paricá (Schizolobium amazonicum Huber ex Ducke por meio de stress wave

    Directory of Open Access Journals (Sweden)

    Rafael Rodolfo Melo

    2014-12-01

    Full Text Available Foram avaliadas as propriedades físicas e mecânicas de compósitos LVL produzidos com a madeira de paricá (Schizolobium amazonicum Huber ex. Ducke, por meio de Stress Wave Timer. Os compósitos foram confeccionados em laboratório, dos quais foram retiradas amostras, que foram inicialmente destinadas à realização dos ensaios não destrutivos. Todas as amostras, com dimensões de 2,2 × 2,2 × 40 cm, foram ensaiadas, não destrutivamente, com a propagação de ondas nos sentidos flatwise e edgewise. Em sequência, as mesmas amostras foram destinadas à confecção de subamostras, para realização dos ensaios destrutivos, físicos (absorção de água, inchamento em espessura e inchamento residual e mecânicos (resistência e rigidez à flexão estática flatwise; resistência e rigidez à flexão estática edgewise; resistência à compressão paralela e resistência ao cisalhamento paralelo e perpendicular. A velocidade de propagação das ondas (V0 e o módulo de elasticidade dinâmico (Emd, obtidos com o auxílio do Stress Wave, foram utilizados para elaboração de modelos de predição das propriedades avaliadas. Os resultados indicaram que o Stress Wave Timer apresenta resultados satisfatórios para predição das propriedades mecânicas de compósitos LVL. Com relação às propriedades físicas, embora tenham sido verificados modelos com ajustes significativos, constatou-se limitação dessa ferramenta para predição desses parâmetros. Contudo, considerando ambas as propriedades, físicas e mecânicas, os melhores ajustes foram observados em amostras ensaiadas com a propagação de ondas no sentido edgewise e com o uso da variável independente Emd.

  18. Modelo experimental de trauma medular agudo produzido por aparelho estereotáxico modificado Experimental model of acute spinal cord injury produced by modified steriotaxic equipment

    Directory of Open Access Journals (Sweden)

    B.B.J. Torres

    2010-02-01

    Full Text Available Foram utilizados 55 ratos machos da espécie Rattus novergicus, variedade Wistar, com o objetivo de propor um modelo experimental de trauma medular produzido por aparelho estereotáxico modificado, capaz de reproduzir clinicamente lesões medulares padronizadas. Após realização de laminectomia dorsal de T13, utilizou-se peso compressivo de 50,5g (25 animais - grupo I ou 70,5g (30 animais - grupo II, durante cinco minutos, comprimindo a medula espinhal. Os animais foram assistidos durante oito dias, por meio de testes comportamentais para avaliar a sensibilidade dolorosa, a capacidade motora, o posicionamento tátil e proprioceptivo e a capacidade de manter-se em plano inclinado. No grupo I, observaram-se déficits neurológicos moderados e transitórios, que variaram entre os animais. No grupo II, foi possível obter um trauma padronizado, caracterizado por paraplegia bilateral e simétrica dos membros posteriores, perda de propriocepção e da sensibilidade dolorosa de todos os animais. A utilização do aparelho estereotáxico desenvolvido permite reproduzir clinicamente trauma medular padronizado em ratos, de maneira simples, econômica e satisfatória, o que poderá proporcionar avanços nas investigações terapêuticas, abrangendo doenças neurodegenerativas, como é o caso do trauma medular agudo.Fifty-five male rats (Rattus novergicus, Wistar variety, were used with the purpose of suggesting an experimental model of spinal cord trauma performed by using a modified stereotaxic equipment capable to reproduce clinically (standardized pattern spinal cord injury. After dorsal laminectomy of T13, a compression was performed with 50.5g (25 animals - group I or 70.5g (30 animals - group II during five minutes on spinal cord. The animals were assisted during eight days by behavioral tests to evaluate painful sensibility, motor capacity, proprioceptive and tactil placing, and stability on inclined plan. In the group I, moderate and transitory

  19. Bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5% Bloqueo del plexo braquial por la vía posterior con el uso de neuroestimulador y ropivacaína a 0,5% Posterior brachial plexus block with nerve stimulator and 0.5% ropivacaine

    Directory of Open Access Journals (Sweden)

    Lúcia Beato

    2005-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Existem várias maneiras de abordar o plexo braquial dependendo da experiência do anestesiologista e da região a ser operada. O bloqueio do plexo braquial pela via posterior pode representar uma alternativa para cirurgias de ombro, clavícula e úmero proximal. O objetivo deste estudo foi mostrar os resultados observados em pacientes submetidos a bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5%. MÉTODO: Vinte e dois pacientes com idade entre 17 e 76 anos, estado físico ASA I e II, submetidos a cirurgias ortopédicas envolvendo o ombro, clavícula e úmero proximal foram anestesiados com bloqueio de plexo braquial pela via posterior utilizando neuroestimulador a partir de 1 mA. Obtida a contração desejada, a corrente foi diminuída para 0,5 mA e, permanecendo a resposta contrátil, foram injetados 40 mL de ropivacaína a 0,5%. Foram avaliados os seguintes parâmetros: latência, analgesia, duração da cirurgia, duração da analgesia e do bloqueio motor, complicações e efeitos colaterais. RESULTADOS: O bloqueio foi efetivo em 20 dos 22 pacientes; a latência média foi de 15,52 min; a duração média da cirurgia foi de 1,61 hora. A média de duração da analgesia foi de 15,85 horas e do bloqueio motor 11,16 horas. Não foram observados sinais e sintomas clínicos de toxicidade do anestésico local e nenhum paciente apresentou efeitos adversos do bloqueio. CONCLUSÕES: Nas condições deste estudo o bloqueio de plexo braquial pela via posterior com o uso do neuroestimulador e ropivacaína a 0,5% demonstrou ser uma técnica efetiva, confortável para o paciente e de fácil realização.JUSTIFICATIVA Y OBJETIVOS: Existen varios modos de abordar el plexo braquial dependiendo de la experiencia del anestesiologista y de la región que será operada. El bloqueo del plexo braquial por la vía posterior puede representar una alternativa para cirugías de hombro, clav

  20. Neuromuscular Consequences of an Extreme Mountain Ultra-Marathon

    Science.gov (United States)

    Millet, Guillaume Y.; Tomazin, Katja; Verges, Samuel; Vincent, Christopher; Bonnefoy, Régis; Boisson, Renée-Claude; Gergelé, Laurent; Féasson, Léonard; Martin, Vincent

    2011-01-01

    We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM) with 9500 m of positive and negative elevation change. For this purpose, (i) the fatigue induced by the MUM and (ii) the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF) and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22), and 2, 5, 9 and 16 days after the MUM (n = 11) in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (−35% [95% CI: −28 to −42%] and −39% [95% CI: −32 to −46%] for KE and PF, respectively), with alteration of maximal voluntary activation, mainly for KE (−19% [95% CI: −7 to −32%]). Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144±94 to 13,633±12,626 UI L−1), myoglobin (from 32±22 to 1,432±1,209 µg L−1), and C-Reactive Protein (from <2.0 to 37.7±26.5 mg L−1). Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration) were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline. PMID:21364944

  1. 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

  2. Neuromuscular Electrical Stimulation for Mobility Support of Elderly.

    Science.gov (United States)

    Mayr, Winfried

    2015-08-24

    The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in "compliance data storage" as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC) and maximum stimulation induced contraction (MSC) were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period. Therefore the

  3. Neuromuscular electrical stimulation for mobility support of elderly

    Directory of Open Access Journals (Sweden)

    Winfried Mayr

    2015-10-01

    Full Text Available The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in “compliance data storage” as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC and maximum stimulation induced contraction (MSC were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period

  4. Ação neuro-muscular do veneno crotálico: dados preliminares Neuromuscular action of crotalid venom: preliminar data

    Directory of Open Access Journals (Sweden)

    Maria Dorvalina Silva

    1996-03-01

    Full Text Available Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores admite que veneno crotálico determina síndrome miastênica. Nossos achados indicam que ptose palpebral, facies miastênico e fraqueza muscular observados após acidente crotálico, correspondem provavelmente a miopatia mitocondrial, muitas vezes transitória e reversível.We studied 6 patients and 2 dogs that have been bitten by South American rattlesnake Crotalus durissus terrificus and one rabbit inoculated with crotalid venom. We analized sensory and motor peripheral nerve conduction, repetitive stimulation for studying neuromuscular transmission and electromyographies. Muscle biopsies were processed by histochemistry. All patients had peripheral mononeuropathy of the closest sensitive nerve to the area of snakebite. The neuromuscular transmission alterations were minimal. Muscle histochemistry of 4 patients, 2 dogs and 1 rabbit showed findings of mitochondrial myopathy. The majority of authors admit that crotalid venom causes myastenic syndrome. Our findings suggest that palpebral ptosis, myastenic facies and muscular weakness observed after crotalid poisoning are, probably, due to transient and reversible mitochondrial myopathy. As far as we know, this is the first report on the ability of the venom of this rattlesnake to cause local sensitive mononeuropathy and the first muscle histochemistry showing mitochondrial myopathy in humans poisoned by crotalid venom.

  5. Neuromuscular adaptations to training, injury and passive interventions: implications for running economy.

    Science.gov (United States)

    Bonacci, Jason; Chapman, Andrew; Blanch, Peter; Vicenzino, Bill

    2009-01-01

    Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling

  6. Functional respiratory imaging after neostigmine- or sugammadex-enhanced recovery from neuromuscular blockade in the anesthetised rat: a randomised controlled pilot study

    Directory of Open Access Journals (Sweden)

    Tom Schepens

    2017-09-01

    , Rocuronium, Sugammadex, Palavras-chave: Diafragma, Neostigmina, Bloqueio neuromuscular, Rocurônio, Sugamadex

  7. Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment

    DEFF Research Database (Denmark)

    Bennell, Kim L; Kyriakides, Mary; Metcalf, Ben

    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. ME...

  8. Synaptic defects in the spinal and neuromuscular circuitry in a mouse model of spinal muscular atrophy.

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    Karen K Y Ling

    2010-11-01

    Full Text Available Spinal muscular atrophy (SMA is a major genetic cause of death in childhood characterized by marked muscle weakness. To investigate mechanisms underlying motor impairment in SMA, we examined the spinal and neuromuscular circuitry governing hindlimb ambulatory behavior in SMA model mice (SMNΔ7. In the neuromuscular circuitry, we found that nearly all neuromuscular junctions (NMJs in hindlimb muscles of SMNΔ7 mice remained fully innervated at the disease end stage and were capable of eliciting muscle contraction, despite a modest reduction in quantal content. In the spinal circuitry, we observed a ∼28% loss of synapses onto spinal motoneurons in the lateral column of lumbar segments 3-5, and a significant reduction in proprioceptive sensory neurons, which may contribute to the 50% reduction in vesicular glutamate transporter 1(VGLUT1-positive synapses onto SMNΔ7 motoneurons. In addition, there was an increase in the association of activated microglia with SMNΔ7 motoneurons. Together, our results present a novel concept that synaptic defects occur at multiple levels of the spinal and neuromuscular circuitry in SMNΔ7 mice, and that proprioceptive spinal synapses could be a potential target for SMA therapy.

  9. Optimizing referral of patients with neuromuscular disorders to allied health care.

    NARCIS (Netherlands)

    Pieterse, A.J.; Cup, E.H.C.; Akkermans, R.P.; Hendricks, H.T.; Engelen, B.G.M. van; Wilt, G.J. van der; Oostendorp, R.A.B.

    2009-01-01

    BACKGROUND AND PURPOSE: To report the predictive validity of the perceived limitations in activities and need questionnaire (PLAN-Q), a screening instrument to support neurologists to select patients with neuromuscular disorders (NMD) for referral for a one-off consultation by occupational therapist

  10. The extremity function index (EFI), a disability severity measure for neuromuscular diseases : psychometric evaluation

    NARCIS (Netherlands)

    Bos, Isaac; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Joannes

    2017-01-01

    OBJECTIVE: To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease

  11. Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis

    NARCIS (Netherlands)

    Bogaardt, Hans; van Dam, Danielle; Wever, Nienke M.; Bruggeman, Caroline E.; Koops, Johan; Fokkens, Wytske J.

    2009-01-01

    OBJECTIVES: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. METHODS: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated

  12. Dysarthria and dysphagia are highly prevalent among various types of neuromuscular diseases

    NARCIS (Netherlands)

    Knuijt, Simone; Kalf, Johanna G.; de Swart, Bert J. M.; Drost, Gea; Hendricks, Henk T.; Geurts, Alexander C. H.; van Engelen, Baziel G. M.

    2014-01-01

    Purpose: Patients with a neuromuscular disease (NMD) can present with dysarthria and/or dysphagia. Literature regarding prevalence rates of dysarthria and dysphagia is scarce. The purpose of this study was to determine prevalence rates, severity and co-presence of dysarthria and dysphagia in adult

  13. Dysarthria and dysphagia are highly prevalent among various types of neuromuscular diseases

    NARCIS (Netherlands)

    Knuijt, S.; Kalf, J.G.; Swart, B.J. de; Drost, G.; Hendricks, H.T.; Geurts, A.C.; Engelen, B.G.M. van

    2014-01-01

    PURPOSE: Patients with a neuromuscular disease (NMD) can present with dysarthria and/or dysphagia. Literature regarding prevalence rates of dysarthria and dysphagia is scarce. The purpose of this study was to determine prevalence rates, severity and co-presence of dysarthria and dysphagia in adult

  14. 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.

  15. A theoretical framework for understanding neuromuscular response to lower extremity joint injury.

    Science.gov (United States)

    Pietrosimone, Brian G; McLeod, Michelle M; Lepley, Adam S

    2012-01-01

    Neuromuscular alterations are common following lower extremity joint injury and often lead to decreased function and disability. These neuromuscular alterations manifest in inhibition or abnormal facilitation of the uninjured musculature surrounding an injured joint. Unfortunately, these neural alterations are poorly understood, which may affect clinical recognition and treatment of these injuries. Understanding how these neural alterations affect physical function may be important for proper clinical management of lower extremity joint injuries. Pertinent articles focusing on neuromuscular consequences and treatment of knee and ankle injuries were collected from peer-reviewed sources available on the Web of Science and Medline databases from 1975 through 2010. A theoretical model to illustrate potential relationships between neural alterations and clinical impairments was constructed from the current literature. Lower extremity joint injury affects upstream cortical and spinal reflexive excitability pathways as well as downstream muscle function and overall physical performance. Treatment targeting the central nervous system provides an alternate means of treating joint injury that may be effective for patients with neuromuscular alterations. Disability is common following joint injury. There is mounting evidence that alterations in the central nervous system may relate to clinical changes in biomechanics that may predispose patients to further injury, and novel clinical interventions that target neural alterations may improve therapeutic outcomes.

  16. Is there any relationship between orthotic usage and functional activities in children with neuromuscular disorders?

    Science.gov (United States)

    Alemdaroğlu, İpek; Gür, Gozde; Bek, Nilgün; Yilmaz, Öznur T; Yakut, Yavuz; Uygur, Fatma; Karaduman, Ayşe

    2014-02-01

    Contractures of Achilles tendons and gastrocnemius muscle deteriorate the performance in daily living activities of patients with neuromuscular diseases. Ankle-foot orthoses help to prevent the progression of deformities and to obtain optimal position of the joints to support standing and walking. To investigate the relationship between orthotic usage and functional activities in pediatric patients with different neuromuscular diseases. Retrospective study. A total of 127 subjects' physical assessment forms were analyzed. Functional level, type of orthoses, falling frequencies, ankle joint range of motion, and timed performance tests were examined in two consecutive dates with an interval of 3 months. A total of 91 patients were using orthoses while 36 patients were not within assessment dates. A total of 64 of 91 (70.3%) patients were diagnosed with Duchenne muscular dystrophy. A total of 81 (89.0%) subjects were using plastic ankle-foot orthoses for positioning at nights and 10 (11%) were using different types of the orthoses (knee-ankle-foot orthoses, dynamic ankle-foot orthoses, and so on) for gait in the study group. Night ankle-foot orthoses were not found to be effective directly on functional performance in children with neuromuscular diseases, although they protect ankle from contractures and may help to correct gait and balance. This retrospective study shows that the positive effects of using an ankle-foot orthosis at night are not reflected in the functional performance of children with neuromuscular diseases. This may be due to the progressive deteriorating nature of the disease.

  17. Joint angle affects volitional and magnetically-evoked neuromuscular performance differentially.

    Science.gov (United States)

    Minshull, C; Rees, D; Gleeson, N P

    2011-08-01

    This study examined the volitional and magnetically-evoked neuromuscular performance of the quadriceps femoris at functional knee joint angles adjacent to full extension. Indices of volitional and magnetically-evoked neuromuscular performance (N=15 healthy males, 23.5 ± 2.9 years, 71.5 ± 5.4 kg, 176.5 ± 5.5 cm) were obtained at 25°, 35° and 45° of knee flexion. Results showed that volitional and magnetically-evoked peak force (PF(V) and P(T)F(E), respectively) and electromechanical delay (EMD(V) and EMD(E), respectively) were enhanced by increased knee flexion. However, greater relative improvements in volitional compared to evoked indices of neuromuscular performance were observed with increasing flexion from 25° to 45° (e.g. EMD(V), EMD(E): 36% vs. 11% improvement, respectively; F([2,14])=6.8, pjoint positions. These findings suggest that the extent of the relative differential between volitional and evoked neuromuscular performance capabilities is joint angle-specific and not correlated with performance capabilities at adjacent angles, but tends to be smaller with increased flexion. As such, effective prediction of volitional from evoked performance capabilities at both analogous and adjacent knee joint positions would lack robustness. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Whole-body vibration does not influence knee joint neuromuscular function or proprioception.

    Science.gov (United States)

    Hannah, R; Minshull, C; Folland, J P

    2013-02-01

    This study examined the acute effects of whole-body vibration (WBV) on knee joint position sense and indices of neuromuscular function, specifically strength, electromechanical delay and the rate of force development. Electromyography and electrically evoked contractions were used to investigate neural and contractile responses to WBV. Fourteen healthy males completed two treatment conditions on separate occasions: (1) 5 × 1 min of unilateral isometric squat exercise on a synchronous vibrating platform [30 Hz, 4 mm peak-to-peak amplitude] (WBV) and (2) a control condition (CON) of the same exercise without WBV. Knee joint position sense (joint angle replication task) and quadriceps neuromuscular function were assessed pre-, immediately-post and 1 h post-exercise. During maximum voluntary knee extensions, the peak force (PF(V)), electromechanical delay (EMD(V)), rate of force development (RFD(V)) and EMG of the quadriceps were measured. Twitch contractions of the knee extensors were electrically evoked to assess EMD(E) and RFD(E). The results showed no influence of WBV on knee joint position, EMD(V), PF(V) and RFD(V) during the initial 50, 100 or 150 ms of contraction. Similarly, electrically evoked neuromuscular function and neural activation remained unchanged following the vibration exercise. A single session of unilateral WBV did not influence any indices of thigh muscle neuromuscular performance or knee joint proprioception. © 2011 John Wiley & Sons A/S.

  19. Adjustments with running speed reveal neuromuscular adaptations during landing associated with high mileage running training.

    Science.gov (United States)

    Verheul, Jasper; Clansey, Adam C; Lake, Mark J

    2017-03-01

    It remains to be determined whether running training influences the amplitude of lower limb muscle activations before and during the first half of stance and whether such changes are associated with joint stiffness regulation and usage of stored energy from tendons. Therefore, the aim of this study was to investigate neuromuscular and movement adaptations before and during landing in response to running training across a range of speeds. Two groups of high mileage (HM; >45 km/wk, n = 13) and low mileage (LM; joint stiffness might predominantly be governed by tendon stiffness rather than muscular activations before landing. Estimated elastic work about the ankle was found to be higher in the HM runners, which might play a role in reducing weight acceptance phase muscle activation levels and improve muscle activation efficiency with running training. NEW & NOTEWORTHY Although neuromuscular factors play a key role during running, the influence of high mileage training on neuromuscular function has been poorly studied, especially in relation to running speed. This study is the first to demonstrate changes in neuromuscular conditioning with high mileage training, mainly characterized by lower thigh muscle activation after touch down, higher initial knee stiffness, and greater estimates of energy return, with adaptations being increasingly evident at faster running speeds. Copyright © 2017 the American Physiological Society.

  20. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review

    Science.gov (United States)

    Schaller, Stefan Josef; Fink, Heidrun

    2013-01-01

    Sugammadex is the first clinical representative of a new class of drugs called selective relaxant binding agents. It has revolutionized the way anesthesiologists think about drug reversal. Sugammadex selectively binds rocuronium or vecuronium, thereby reversing their neuromuscular blocking action. Due to its 1:1 binding of rocuronium or vecuronium, it is able to reverse any depth of neuromuscular block. So far, it has been approved for use in adult patients and for pediatric patients over 2 years. Since its approval in Europe, Japan, and Australia, further insight on its use in special patient populations and specific diseases have become available. Due to its pharmacodynamic profile, sugammadex, in combination with rocuronium, may have the potential to displace succinylcholine as the “gold standard” muscle relaxant for rapid sequence induction. The use of rocuronium or vecuronium, with the potential of reverse of their action with sugammadex, seems to be safe in patients with impaired neuromuscular transmission, ie, neuromuscular diseases, including myasthenia gravis. Data from long-term use of sugammadex is not yet available. Evidence suggesting an economic advantage of using sugammadex and justifying its relatively high cost for an anesthesia-related drug, is missing. PMID:24098155

  1. Influence of deep neuromuscular block on the surgeonś assessment of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, M V; Scheppan, S; Mørk, E

    2017-01-01

    Background: During laparotomy, surgeons may experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. Deep neuromuscular block (NMB), defined as a post-tetanic-count (PTC) between 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesized th...

  2. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly

    2013-01-01

    Full Text Available Background: This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB in 2012. Methods: We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine "first choice" use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT, type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. Results: A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively. From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. Conclusions: We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20% and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  3. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  4. Efficacy of brain-computer interface-driven neuromuscular electrical stimulation for chronic paresis after stroke.

    Science.gov (United States)

    Mukaino, Masahiko; Ono, Takashi; Shindo, Keiichiro; Fujiwara, Toshiyuki; Ota, Tetsuo; Kimura, Akio; Liu, Meigen; Ushiba, Junichi

    2014-04-01

    Brain computer interface technology is of great interest to researchers as a potential therapeutic measure for people with severe neurological disorders. The aim of this study was to examine the efficacy of brain computer interface, by comparing conventional neuromuscular electrical stimulation and brain computer interface-driven neuromuscular electrical stimulation, using an A-B-A-B withdrawal single-subject design. A 38-year-old male with severe hemiplegia due to a putaminal haemorrhage participated in this study. The design involved 2 epochs. In epoch A, the patient attempted to open his fingers during the application of neuromuscular electrical stimulation, irrespective of his actual brain activity. In epoch B, neuromuscular electrical stimulation was applied only when a significant motor-related cortical potential was observed in the electroencephalogram. The subject initially showed diffuse functional magnetic resonance imaging activation and small electro-encephalogram responses while attempting finger movement. Epoch A was associated with few neurological or clinical signs of improvement. Epoch B, with a brain computer interface, was associated with marked lateralization of electroencephalogram (EEG) and blood oxygenation level dependent responses. Voluntary electromyogram (EMG) activity, with significant EEG-EMG coherence, was also prompted. Clinical improvement in upper-extremity function and muscle tone was observed. These results indicate that self-directed training with a brain computer interface may induce activity- dependent cortical plasticity and promote functional recovery. This preliminary clinical investigation encourages further research using a controlled design.

  5. A robust neuromuscular system protects rat and human skeletal muscle from sarcopenia.

    Science.gov (United States)

    Pannérec, Alice; Springer, Margherita; Migliavacca, Eugenia; Ireland, Alex; Piasecki, Mathew; Karaz, Sonia; Jacot, Guillaume; Métairon, Sylviane; Danenberg, Esther; Raymond, Frédéric; Descombes, Patrick; McPhee, Jamie S; Feige, Jerome N

    2016-04-01

    Declining muscle mass and function is one of the main drivers of loss of independence in the elderly. Sarcopenia is associated with numerous cellular and endocrine perturbations, and it remains challenging to identify those changes that play a causal role and could serve as targets for therapeutic intervention. In this study, we uncovered a remarkable differential susceptibility of certain muscles to age-related decline. Aging rats specifically lose muscle mass and function in the hindlimbs, but not in the forelimbs. By performing a comprehensive comparative analysis of these muscles, we demonstrate that regional susceptibility to sarcopenia is dependent on neuromuscular junction fragmentation, loss of motoneuron innervation, and reduced excitability. Remarkably, muscle loss in elderly humans also differs in vastus lateralis and tibialis anterior muscles in direct relation to neuromuscular dysfunction. By comparing gene expression in susceptible and non-susceptible muscles, we identified a specific transcriptomic signature of neuromuscular impairment. Importantly, differential molecular profiling of the associated peripheral nerves revealed fundamental changes in cholesterol biosynthetic pathways. Altogether our results provide compelling evidence that susceptibility to sarcopenia is tightly linked to neuromuscular decline in rats and humans, and identify dysregulation of sterol metabolism in the peripheral nervous system as an early event in this process.

  6. The effect of neuromuscular blockade on canine laparoscopic ovariectomy: A double-blinded, prospective clinical trial

    NARCIS (Netherlands)

    van Goethem, B.; van Nimwegen, S.A.; Akkerdaas, L.C.; Murrell, J.C.; Kirpensteijn, J.

    2012-01-01

    The Effect of Neuromuscular Blockade on Canine Laparoscopic Ovariectomy: A Double-Blinded, Prospective Clinical Trial Bart Van Goethem, Diplomate ECVS, Sebastiaan Alexander van Nimwegen, PhD, Ies Akkerdaas, DVM, Joanna Claire Murrell, BVSc., PhD, Diplomate ECVAA, and Jolle Kirpensteijn, PhD,

  7. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S

    2013-01-01

    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...

  8. Conservative management of neuromuscular scoliosis: personal experience and review of literature.

    Science.gov (United States)

    Kotwicki, Tomasz; Jozwiak, Marek

    2008-01-01

    The principles of conservative management of neuromuscular scoliosis in childhood and adolescence are presented. Analysis of personal experience and literature review. The topic is discussed separately for patients with flaccid or spastic paresis. These demonstrate that conservative management might be proposed for patients with neuromuscular scoliosis in many clinical situations. In spastic disorders, it maintains the symmetry around the hip joints. Bracing is technically difficult and often is not tolerated well by cerebral palsy children. In patients with flaccid paresis, the fitting and the use of brace is easier than in spastic patients. The flexibility of the spinal curvature is more important. Functional benefits of conservative management of neuromuscular scoliosis comprise stable sitting, easier use of upper limbs, discharge of the abdomen from the collapsing trunk, increased diaphragm excursion, and, not always, prevention of curve progression. Specific natural history and multiple medical problems associated with the disease make the treatment of children with neuromuscular scoliosis an extremely complex issue, best addressed when a team approach is applied. Continuously improving techniques of conservative management, comprising bracing and physiotherapy, together with correctly timed surgery incorporated in the process of rehabilitation, provide the optimal care for patients.

  9. A versatile neuromuscular exoskeleton controller for gait assistance : A preliminary study on spinal cord injury patients

    NARCIS (Netherlands)

    Wu, Amy R.; Dzeladini, Florin; Brug, Tycho J.H.; Tamburella, Federica; Tagliamonte, Nevio L.; van Asseldonk, Edwin; van der Kooij, Herman; IJspeert, Auke Jan; González-Vargas, José; Ibáñez, Jaime; Contreras-Vidal, Jose L.; van der Kooij, Herman; Pons, José Luis

    2017-01-01

    We investigated the capabilities of a reflex-based neuromuscular controller with a knee and hip gait trainer worn by a subject with a complete spinal cord injury. With controller assistance, this subject was able to reach a walking speed of 1.0m/s. Measured joint torques agreed reasonably well with

  10. The relative frequency of common neuromuscular diagnoses in a reference center.

    Science.gov (United States)

    Cotta, Ana; Paim, Júlia Filardi; Carvalho, Elmano; da-Cunha-Júnior, Antonio Lopes; Navarro, Monica M; Valicek, Jaquelin; Menezes, Miriam Melo; Nunes, Simone Vilela; Xavier-Neto, Rafael; Baptista, Sidney; Lima, Luciano Romero; Takata, Reinaldo Issao; Vargas, Antonio Pedro

    2017-11-01

    The diagnostic procedure in neuromuscular patients is complex. Knowledge of the relative frequency of neuromuscular diseases within the investigated population is important to allow the neurologist to perform the most appropriate diagnostic tests. To report the relative frequency of common neuromuscular diagnoses in a reference center. A 17-year chart review of patients with suspicion of myopathy. Among 3,412 examinations, 1,603 (46.98%) yielded confirmatory results: 782 (48.78%) underwent molecular studies, and 821 (51.21%) had muscle biopsies. The most frequent diagnoses were: dystrophinopathy 460 (28.70%), mitochondriopathy 330 (20.59%), spinal muscular atrophy 158 (9.86%), limb girdle muscular dystrophy 157 (9.79%), Steinert myotonic dystrophy 138 (8.61%), facioscapulohumeral muscular dystrophy 99 (6.17%), and other diagnoses 261 (16.28%). Using the presently-available diagnostic techniques in this service, a specific limb girdle muscular dystrophy subtype diagnosis was reached in 61% of the patients. A neuromuscular-appropriate diagnosis is important for genetic counseling, rehabilitation orientation, and early treatment of respiratory and cardiac complications.

  11. 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.

  12. Rocuronium-induced neuromuscular block and sugammadex in pediatric patient with duchenne muscular dystrophy

    Science.gov (United States)

    Kim, Ji Eun; Chun, Hea Rim

    2017-01-01

    Abstract Introduction: Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. Clinical features: An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward. Conclusion: A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD. PMID:28353578

  13. How Persons with a Neuromuscular Disease Perceive Employment Participation : A Qualitative Study

    NARCIS (Netherlands)

    Baziel van Engelen; Yvonne Heerkens; Josephine Engels; Astrid Kinébanian; Ton Satink; Marie-Antoinette van Minis

    2014-01-01

    Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant

  14. The Effect of Proprioceptive Neuromuscular Facilitation on Learning Fine Motor Skills: A Preliminary Study

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    Mohammad Reza Shahabi Kaseb

    2016-09-01

    Full Text Available Introduction: Preparation of neuromuscular system prior to performing motor skills affects the learning of motor skills. The present study was conducted to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF on limb coordination and accuracy in dart throwing skill. Methods: Thirty two male students were randomly selected as study sample. Based on the pretest scores, the participants were divided into three groups: experimental (proprioceptive neuromuscular facilitation, first control (without warm-up, and second control (specific warm-up. During the acquisition phase, the participants first performed the preparation training related to their own group, then all groups performed the exercise program of dart throwing consisting of 6 blocks of 9 trials in 4 training sessions. Finally, 20 days following the last exercise session, the subjects took the retention and transfer tests. Results: The results of one-way ANOVA test for coordination variable in acquisition test showed no significant difference between the groups, while there was a statistically significant difference between groups regarding coordination variable in retention and transfer tests. Furthermore, the results of one-way ANOVA for the accuracy variable in acquisition and retention tests showed no statistically significant difference between the three groups, while there was a statistically significant difference between groups for accuracy variable in transfer test. Conclusion: It seems that proprioceptive neuromuscular facilitation, as a preparation method before performance, can enhance the efficacy of training to better learn the coordination pattern of fine motor skills.

  15. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists.

    Science.gov (United States)

    Eldawlatly, Abdelazeem; El-Tahan, Mohamed R

    2013-04-01

    This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB) in 2012. We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine first choice use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT), type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively). From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20%) and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  16. Dysfunction of the neuromuscular junction in spinal muscular atrophy types 2 and 3.

    Science.gov (United States)

    Wadman, Renske I; Vrancken, Alexander F J E; van den Berg, Leonard H; van der Pol, W Ludo

    2012-11-13

    Spinal muscular atrophy (SMA) is pathologically characterized by degeneration of anterior horn cells. Recent observations in animal models of SMA and muscle tissue from patients with SMA suggest additional abnormalities in the development and maturation of the neuromuscular junction. We therefore evaluated neuromuscular junction function in SMA with repetitive nerve stimulation. In this case-control study, repetitive nerve stimulation was performed in 35 patients with SMA types 2, 3, and 4, 20 healthy controls, and 5 controls with motor neuron disease. Pathologic decremental responses (>10%) during 3-Hz repetitive nerve stimulation were observed in 17 of 35 patients (49%) with SMA types 2 and 3, but not in healthy controls or controls with motor neuron disease. None of the patients or controls had an abnormal incremental response of >60%. The presence of an abnormal decremental response was not specific for the type of SMA, nor was it associated with compound muscle action potential amplitude, clinical scores, or disease duration. Two of 4 patients with SMA type 3 who tried pyridostigmine reported increased stamina. These data suggest dysfunction of the neuromuscular junction in patients with SMA types 2 and 3. Therefore, drugs that facilitate neuromuscular transmission are candidate drugs for evaluation in carefully designed, placebo-controlled, clinical trials.

  17. The assisted 6-minute cycling test to assess endurance in children with a neuromuscular disorder

    NARCIS (Netherlands)

    Jansen, M.; Jong, M. de; Coes, H.M.; Eggermont, F.; Alfen, N. van; de Groot, I.J.

    2012-01-01

    Introduction: For late- or non-ambulant children with a neuromuscular disorder no suitable endurance tests are currently available. We developed the assisted 6-minute cycling test (A6MCT) for the legs and arms and investigated its psychometric properties in healthy boys and boys with Duchenne

  18. Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks.

    Science.gov (United States)

    Chappell, Jonathan D; Limpisvasti, Orr

    2008-06-01

    Altered motor control strategies are a proposed cause of the female athlete's increased risk for noncontact anterior cruciate ligament injury. Injury prevention programs have shown promising results in decreasing the incidence of anterior cruciate ligament injury. To evaluate the effect of the Kerlan-Jobe Orthopaedic Clinic Modified Neuromuscular Training Program on the biomechanics of select jumping tasks in the female collegiate athlete. Controlled laboratory study. Thirty female National Collegiate Athletic Association Division I soccer and basketball players performed vertical jump, hopping tests, and 2 jumping tasks (drop jump and stop jump). All subjects completed a 6-week neuromuscular training program with core strengthening and plyometric training. Three-dimensional motion analysis and force plate data were used to compare the kinetics and kinematics of jumping tasks before and after training. Dynamic knee valgus moment during the stance phase of stop jump tasks decreased after completion of the neuromuscular training program (P = .04), but differences were not observed for the drop jump. Initial knee flexion (P = .003) and maximum knee flexion (P = .006) angles increased during the stance phase of drop jumps after training, but differences were not observed for the stop jump. The athletes showed improved performance in vertical jump (P training program improved select athletic performance measures and changed movement patterns during jumping tasks in the subject population. The use of this neuromuscular training program could potentially modify the collegiate athlete's motion strategies, improve performance, and lower the athlete's risk for injury.

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

    DEFF Research Database (Denmark)

    Bencke, Jesper; Zebis, Mette K

    2011-01-01

    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...

  20. The relative frequency of common neuromuscular diagnoses in a reference center

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    Ana Cotta

    Full Text Available ABSTRACT The diagnostic procedure in neuromuscular patients is complex. Knowledge of the relative frequency of neuromuscular diseases within the investigated population is important to allow the neurologist to perform the most appropriate diagnostic tests. Objective: To report the relative frequency of common neuromuscular diagnoses in a reference center. Methods: A 17-year chart review of patients with suspicion of myopathy. Results: Among 3,412 examinations, 1,603 (46.98% yielded confirmatory results: 782 (48.78% underwent molecular studies, and 821 (51.21% had muscle biopsies. The most frequent diagnoses were: dystrophinopathy 460 (28.70%, mitochondriopathy 330 (20.59%, spinal muscular atrophy 158 (9.86%, limb girdle muscular dystrophy 157 (9.79%, Steinert myotonic dystrophy 138 (8.61%, facioscapulohumeral muscular dystrophy 99 (6.17%, and other diagnoses 261 (16.28%. Conclusion: Using the presently-available diagnostic techniques in this service, a specific limb girdle muscular dystrophy subtype diagnosis was reached in 61% of the patients. A neuromuscular-appropriate diagnosis is important for genetic counseling, rehabilitation orientation, and early treatment of respiratory and cardiac complications.

  1. The use of an online support group for neuromuscular disorders: a thematic analysis of message postings.

    Science.gov (United States)

    Meade, Oonagh; Buchanan, Heather; Coulson, Neil

    2017-06-08

    People affected by neuromuscular disorders can experience adverse psychosocial consequences and difficulties accessing information and support. Online support groups provide new opportunities for peer support. The aim of this study was to understand how contributors used the message board function of a newly available neuromuscular disorders online support group. Message postings (n = 1951) from the first five months of the message board of a newly formed online support group for neuromuscular disorders hosted by a charitable organization were analyzed using inductive thematic analysis. Members created a sense of community through disclosing personal information, connecting with people with similar illness experiences or interests, welcoming others and sharing aspirations for the development of a resourceful community. Experiences, emotional reactions and support were shared in relation to: delayed diagnosis; symptom interpretation; illness management and progression; the isolating impact of rare disorders; and the influence of social and political factors on illness experiences. This study provided a novel insight into individuals' experiences of accessing a newly available online support group for rare conditions hosted by a charitable organization. The findings highlight how the online support group provided an important peer support environment for members to connect with others, exchange information and support and engender discussion on political and social issues unique to living with often-rare neuromuscular disorders. Online support groups may therefore provide an important and easily accessible support outlet for people with neuromuscular disorders as well as a platform for empowering members to raise awareness about the impact of living with these conditions. Further research is needed to examine member motivations for using such groups and any effects of participation in greater detail. Implications for rehabilitation Online support groups may

  2. The Influence of Robotic Assistance on Reducing Neuromuscular Effort and Fatigue during Extravehicular Activity Glove Use

    Science.gov (United States)

    Madden, Kaci E.; Deshpande, Ashish D.; Peters, Benjamin J.; Rogers, Jonathan M.; Laske, Evan A.; McBryan, Emily R.

    2017-01-01

    The three-layered, pressurized space suit glove worn by Extravehicular Activity (EVA) crew members during missions commonly causes hand and forearm fatigue. The Spacesuit RoboGlove (SSRG), a Phase VI EVA space suit glove modified with robotic grasp-assist capabilities, has been developed to augment grip strength in order to improve endurance and reduce the risk of injury in astronauts. The overall goals of this study were to i) quantify the neuromuscular modulations that occur in response to wearing a conventional Phase VI space suit glove (SSG) during a fatiguing task, and ii) determine the efficacy of Spacesuit RoboGlove (SSRG) in reversing the adverse neuromuscular modulations and restoring altered muscular activity to barehanded levels. Six subjects performed a fatigue sequence consisting of repetitive dynamic-gripping interspersed with isometric grip-holds under three conditions: barehanded, wearing pressurized SSG, and wearing pressurized SSRG. Surface electromyography (sEMG) from six forearm muscles (flexor digitorum superficialis (FDS), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), extensor digitorum (ED), extensor carpi radialis longus (ECRL), and extensor carpi ulnaris (ECU)) and subjective fatigue ratings were collected during each condition. Trends in amplitude and spectral distributions of the sEMG signals were used to derive metrics quantifying neuromuscular effort and fatigue that were compared across the glove conditions. Results showed that by augmenting finger flexion, the SSRG successfully reduced the neuromuscular effort needed to close the fingers of the space suit glove in more than half of subjects during two types of tasks. However, the SSRG required more neuromuscular effort to extend the fingers compared to a conventional SSG in many subjects. Psychologically, the SSRG aided subjects in feeling less fatigued during short periods of intense work compared to the SSG. The results of this study reveal the promise of the SSRG as a

  3. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study

    Science.gov (United States)

    Duyff, R.; Van den Bosch, J.; Laman, D; van Loon, B.-J. P.; Linssen, W.

    2000-01-01

    OBJECTIVES—To evaluate neuromuscular signs and symptoms in patients with newly diagnosed hypothyroidism and hyperthyroidism.
METHODS—A prospective cohort study was performed in adult patients with newly diagnosed thyroid dysfunction. Patients were evaluated clinically with hand held dynamometry and with electrodiagnosis. The clinical features of weakness and sensory signs and the biochemical data were evaluated during treatment.
RESULTS—In hypothyroid patients 79% had neuromuscular complaints, 38% had clinical weakness (manual muscle strength testing) in one or more muscle groups, 42% had signs of sensorimotor axonal neuropathy, and 29% had carpal tunnel syndrome. Serum creatine kinase did not correlate with weakness. After 1 year of treatment 13% of the patients still had weakness. In hyperthyroid patients 67% had neuromuscular symptoms, 62% had clinical weakness in at least one muscle group that correlated with FT4 concentrations, but not with serum CK. Nineteen per cent of the patients had sensory-motor axonal neuropathy and 0% had carpal tunnel syndrome. The neuromuscular signs developed rapidly, early in the course of the disorder and were severe, but resolved rapidly and completely during treatment (average time 3.6months).
CONCLUSIONS—Neuromuscular symptoms and signs were present in most patients. About 40% of the hypothyroid patients and 20% of the hyperthyroid patients had predominantly sensory signs of a sensorimotor axonal neuropathy early in the course of thyroid disease. Weakness in hyperthyroidism evolved rapidly at an early stage of the disorder and resolved completely during treatment, suggesting a functional muscle disorder. Hand held dynamometry is sensitive for the detection of weakness and for the clinical evaluation of treatment effects. Weakness in hypothyroidism is more difficult to treat, suggesting myopathy.

 PMID:10811699

  4. Fatiguing exercise intensity influences the relationship between parameters reflecting neuromuscular function and postural control variables.

    Directory of Open Access Journals (Sweden)

    Sébastien Boyas

    Full Text Available The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R(2≤0.82 of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R(2≤0.73 for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.

  5. Neuromuscular performance in the hip joint of elderly fallers and non-fallers.

    Science.gov (United States)

    Morcelli, Mary Hellen; LaRoche, Dain Patrick; Crozara, Luciano Fernandes; Marques, Nise Ribeiro; Hallal, Camilla Zamfolini; Rossi, Denise Martineli; Gonçalves, Mauro; Navega, Marcelo Tavella

    2016-06-01

    Low strength and neuromuscular activation of the lower limbs have been associated with falls making it an important predictor of functional status in the elderly. To compare the rate of neuromuscular activation, rate of torque development, peak torque and reaction time between young and elderly fallers and non-fallers for hip flexion and extension. We evaluated 44 elderly people who were divided into two groups: elderly fallers (n = 20) and elderly non-fallers (n = 24); and 18 young people. The subjects performed three isometric hip flexion and extension contractions. Electromyography data were collected for the rectus femoris, gluteus maximus and biceps femoris muscles. The elderly had 49 % lower peak torque and 68 % lower rate of torque development for hip extension, 28 % lower rate of neuromuscular activation for gluteus maximus and 38 % lower rate of neuromuscular activation for biceps femoris than the young (p neuromuscular for rectus femoris than the young (p < 0.05). The elderly fallers showed consistent trend toward a lower rate of torque development than elderly non-fallers for hip extension at 50 ms (29 %, p = 0.298, d = 0.76) and 100 ms (26 %, p = 0.452, d = 0.68).The motor time was 30 % slower for gluteus maximus, 42 % slower for rectus femoris and 50 % slower for biceps femoris in the elderly than in the young. Impaired capacity of the elderly, especially fallers, may be explained by neural and morphological aspects of the muscles. The process of senescence affects the muscle function of the hip flexion and extension, and falls may be related to lower rate of torque development and slower motor time of biceps femoris.

  6. Dexamethasone Does Not Inhibit Sugammadex Reversal After Rocuronium-Induced Neuromuscular Block.

    Science.gov (United States)

    Buonanno, Pasquale; Laiola, Anna; Palumbo, Chiara; Spinelli, Gianmario; Servillo, Giuseppe; Di Minno, Raffaele Maria; Cafiero, Tullio; Di Iorio, Carlo

    2016-06-01

    Sugammadex is a relatively new molecule that reverses neuromuscular block induced by rocuronium. The particular structure of sugammadex traps the cyclopentanoperhydrophenanthrene ring of rocuronium in its hydrophobic cavity. Dexamethasone shares the same steroidal structure with rocuronium. Studies in vitro have demonstrated that dexamethasone interacts with sugammadex, reducing its efficacy. In this study, we investigated the clinical relevance of this interaction and its influence on neuromuscular reversal. In this retrospective case-control study, we analyzed data from 45 patients divided into 3 groups: dexamethasone after induction group (15 patients) treated with 8 mg dexamethasone as an antiemetic drug shortly after induction of anesthesia; dexamethasone before reversal group (15 patients) treated with dexamethasone just before sugammadex injection; and control group (15 patients) treated with 8 mg ondansetron. All groups received 0.6 mg/kg rocuronium at induction, 0.15 mg/kg rocuronium at train-of-four ratio (TOF) 2 for neuromuscular relaxation, and 2 mg/kg sugammadex for reversal at the end of the procedure at TOF2. Neuromuscular relaxation was monitored with a TOF-Watch® system. The control group had a recovery time of 154 ± 54 seconds (mean ± SD), the dexamethasone after induction group 134 ± 55 seconds, and the dexamethasone before reversal group 131 ± 68 seconds. The differences among groups were not statistically significant (P = 0.5141). Our results show that the use of dexamethasone as an antiemetic drug for the prevention of postoperative nausea and vomiting does not interfere with reversal of neuromuscular blockade with sugammadex in patients undergoing elective surgery with general anesthesia in contrast to in vitro studies that support this hypothesis.

  7. Ammonia modifies enteric neuromuscular transmission through glial γ-aminobutyric acid signaling.

    Science.gov (United States)

    Fried, David E; Watson, Ralph E; Robson, Simon C; Gulbransen, Brian D

    2017-12-01

    Impaired gut motility may contribute, at least in part, to the development of systemic hyperammonemia and systemic neurological disorders in inherited metabolic disorders, or in severe liver and renal disease. It is not known whether enteric neurotransmission regulates intestinal luminal and hence systemic ammonia levels by induced changes in motility. Here, we propose and test the hypothesis that ammonia acts through specific enteric circuits to influence gut motility. We tested our hypothesis by recording the effects of ammonia on neuromuscular transmission in tissue samples from mice, pigs, and humans and investigated specific mechanisms using novel mutant mice, selective drugs, cellular imaging, and enzyme-linked immunosorbent assays. Exogenous ammonia increased neurogenic contractions and decreased neurogenic relaxations in segments of mouse, pig, and human intestine. Enteric glial cells responded to ammonia with intracellular Ca 2+ responses. Inhibition of glutamine synthetase and the deletion of glial connexin-43 channels in hGFAP :: Cre ER T2+/- /connexin43 f/f mice potentiated the effects of ammonia on neuromuscular transmission. The effects of ammonia on neuromuscular transmission were blocked by GABA A receptor antagonists, and ammonia drove substantive GABA release as did the selective pharmacological activation of enteric glia in GFAP::hM3Dq transgenic mice. We propose a novel mechanism whereby local ammonia is operational through GABAergic glial signaling to influence enteric neuromuscular circuits that regulate intestinal motility. Therapeutic manipulation of these mechanisms may benefit a number of neurological, hepatic, and renal disorders manifesting hyperammonemia. NEW & NOTEWORTHY We propose that local circuits in the enteric nervous system sense and regulate intestinal ammonia. We show that ammonia modifies enteric neuromuscular transmission to increase motility in human, pig, and mouse intestine model systems. The mechanisms underlying the

  8. S-nitrosoglutathione reductase deficiency-induced S-nitrosylation results in neuromuscular dysfunction.

    Science.gov (United States)

    Montagna, Costanza; Di Giacomo, Giuseppina; Rizza, Salvatore; Cardaci, Simone; Ferraro, Elisabetta; Grumati, Paolo; De Zio, Daniela; Maiani, Emiliano; Muscoli, Carolina; Lauro, Filomena; Ilari, Sara; Bernardini, Sergio; Cannata, Stefano; Gargioli, Cesare; Ciriolo, Maria R; Cecconi, Francesco; Bonaldo, Paolo; Filomeni, Giuseppe

    2014-08-01

    Nitric oxide (NO) production is implicated in muscle contraction, growth and atrophy, and in the onset of neuropathy. However, many aspects of the mechanism of action of NO are not yet clarified, mainly regarding its role in muscle wasting. Notably, whether NO production-associated neuromuscular atrophy depends on tyrosine nitration or S-nitrosothiols (SNOs) formation is still a matter of debate. Here, we aim at assessing this issue by characterizing the neuromuscular phenotype of S-nitrosoglutathione reductase-null (GSNOR-KO) mice that maintain the capability to produce NO, but are unable to reduce SNOs. We demonstrate that, without any sign of protein nitration, young GSNOR-KO mice show neuromuscular atrophy due to loss of muscle mass, reduced fiber size, and neuropathic behavior. In particular, GSNOR-KO mice show a significant decrease in nerve axon number, with the myelin sheath appearing disorganized and reduced, leading to a dramatic development of a neuropathic phenotype. Mitochondria appear fragmented and depolarized in GSNOR-KO myofibers and myotubes, conditions that are reverted by N-acetylcysteine treatment. Nevertheless, although atrogene transcription is induced, and bulk autophagy activated, no removal of damaged mitochondria is observed. These events, alongside basal increase of apoptotic markers, contribute to persistence of a neuropathic and myopathic state. Our study provides the first evidence that GSNOR deficiency, which affects exclusively SNOs reduction without altering nitrotyrosine levels, results in a clinically relevant neuromuscular phenotype. These findings provide novel insights into the involvement of GSNOR and S-nitrosylation in neuromuscular atrophy and neuropathic pain that are associated with pathological states; for example, diabetes and cancer.

  9. AVALIAÇÃO DAS PROPRIEDADES DE PAINÉIS COMPENSADOS DE Melia azedarach L. PRODUZIDOS COM DIFERENTES GRAMATURAS E TEMPOS DE PRENSAGEM

    Directory of Open Access Journals (Sweden)

    Rosilani Trianoski

    2015-08-01

    Full Text Available RESUMOO Brasil é um grande produtor de painéis compensados, suas florestas de Pinus são as mais utilizadas nesse processo e grande parte dessa produção é destinada à indústria moveleira. Muitas espécies têm sido introduzidas no país para essa e outras finalidades, entre elas a Melia azedarach, que ainda requer diversos estudos tecnológicos para a melhor utilização de sua madeira. Nesse contexto, o objetivo desta pesquisa foi avaliar a viabilidade de utilização da Melia azedarach para a produção de painéis compensados e o efeito da gramatura de adesivo e do tempo de prensagem sobre as propriedades dos painéis. Foram utilizadas cinco árvores provenientes de um plantio experimental localizado em Corupá, SC, das quais foram obtidas amostras para determinação da densidade básica (COPANT 461/1972 e das propriedades químicas (TAPPI 204, 1997; 207, 1999; 280, 1999; 212, 2002; 252, 2002, bem como para a obtenção das lâminas. Os painéis foram produzidos com dimensões de 500 mm x 500 mm x 10 mm (cinco lâminas, segundo um delineamento em arranjo fatorial (3x2 com três gramaturas (320 g/m2,360g/m2 e 400 g/m2 e dois tempos de prensagem (8 e 10 min, adesivo ureia-formaldeído, pressão específica de 1 MPa e temperatura de 110 °C. As propriedades dos painéis foram avaliadas a partir do ensaio de flexão estática (EN:310:2002 e resistência da linha de cola ao cisalhamento (EN 3141:2004 e EN 314-2:2002. Os resultados indicaram diferença estatística significativa dos efeitos principais: a gramatura e tempo de prensagem apenas no módulo de elasticidade no sentido perpendicular e a inexistência de diferença estatística significativa entre as médias a partir da interação dessas duas variáveis de resposta. Concluiu-se que a espécie apresenta viabilidade técnica para a produção de painéis compensados, podendo maximizar a produtividade e minimizar os custos de produção, por meio da utilização da menor gramatura de

  10. Qualidade de mamão 'Formosa' produzido no RN e armazenado sob atmosfera passiva Quality of 'Formosa' papaya produced at RN and storage under passive atmosphere

    Directory of Open Access Journals (Sweden)

    Paula Lidiane de Oliveira Fernandes

    2010-12-01

    Full Text Available Este trabalho teve por objetivo avaliar o efeito da cera de carnaúba (Primax Wax e filme plástico de polietileno de baixa densidade "X-tend" sobre a vida útil pós-colheita de mamão 'Formosa' (Tainung 1 produzido em Baraúna - RN. O experimento foi conduzido no laboratório de Pós-colheita da Universidade Federal Rural do Semi-Árido (UFERSA. Utilizou-se um esquema fatorial 3 x 6 com 3 repetições de três frutos por parcela, constituindo na combinação de 3 tipos de atmosferas (cera, filme de polietileno e controle com 6 tempos de armazenamento (0; 7; 14; 21; 28; 35. Os frutos dos distintos tratamentos foram armazenados em câmaras frias a 10 ± 2 ºC e UR 90 ± 5%, analisados em intervalos de sete dias. As características avaliadas foram: aparência externa, perda de massa, firmeza da polpa, sólidos solúveis, acidez titulável e vitamina C. Constatou-se ser o filme plástico o mais eficiente em manter a qualidade externa e reduzir a perda de massa dos frutos. A cera de carnaúba, na concentração utilizada, mostrou eficiência relativa na conservação de mamão quando comparada ao filme plástico. A vida útil pós-colheita dos frutos mantidos sob atmosfera modificada foi de 35 dias e do controle apenas 28 dias.The aim of this work was to evaluate the effect of carnauba wax (Primax Wax and low-density polyethylene film "X-tend" on shelf life of 'Formosa' papaya fruits produced in Baraúna, RN. The experiment was carried out in the Postharvest Laboratory of the Universidade Federal Rural do Semi-Árido (UFERSA. A 3 x 6 factorial scheme with three replications of three fruits per plot in a completely randomized design was used. The treatments consisted of the combination of three types of atmosphere (wax, polyethylene film and control with six storage times (0; 7; 14; 21; 28 and 35. The fruits of these treatments were stored in cold chamber at 10 ± 2 ºC and RH 90 ± 5%, and analyzed in 7 days intervals. The evaluated traits were

  11. Viabilidade do inoculante turfoso produzido com bactérias associativas e molibdênio Viability of peat inoculum produced with associative bacteria and molybdenum

    Directory of Open Access Journals (Sweden)

    Salomão Lima Guimarães

    2013-03-01

    Full Text Available Dentre os veículos de inoculação de bactérias diazotróficas, o turfoso é considerado o mais utilizado no Brasil. A turfa possibilita a viabilidade de um grande número de células, protegendo-as também das adversidades do solo. O objetivo deste trabalho foi avaliar a viabilidade do inoculante turfoso desenvolvido com bactérias diazotróficas associativas e molibdênio. As bactérias BR11417 (Herbaspirillum seropedicae e BR11340 (Burkholderia sp., foram multiplicadas por um período de 24 horas e uma alíquota de 10 mL com 10(8 cel. mL-1 foi transferida para sacos de polipropileno contendo 35 g de turfa. Foram adicionadas duas doses e duas fontes de molibdênio: 1,12 e 2,25 g de molibdato de sódio e de amônio, respectivamente. Como controle, foi utilizado o inoculante sem molibdênio. A legislação brasileira, por meio da lei n° 86955, especifica que os inoculantes comerciais à base de micro-organismos fixadores de nitrogênio apresentem concentrações mínimas de 10(8 células viáveis por grama do produto no momento do uso e que a viabilidade das células seja mantida por um período mínimo de seis meses. Este estudo mostrou que sem a adição do molibdênio ao inoculante, as bactérias sobreviveram com um número de células viáveis em torno de 10(8 células g-1 de inoculante, por um período de até 110 dias. Com a adição do molibdênio, o inoculante manteve-se viável por um período de 180 dias. A aplicação do molibdênio contribui para o aumento da viabilidade do inoculante turfoso produzido com as estirpes BR11417 e BR11340.Among the vehicles in use for diazotroph inoculation, peat is considered the most-widely used in Brazil. Peat makes possible the viability of a large number of cells, at the same time protecting them from adversities found in the soil. The objective of this study was to evaluate the viability of peat inoculum developed with diazotroph bacteria and molybdenum. The bacteria BR11417 (Herbaspirillum

  12. Crescimento vegetativo de porta-enxertos de citros produzidos em substratos comerciais Vegetative growth of citrus rootstocks producing in distinct commercials substrates

    Directory of Open Access Journals (Sweden)

    Mário Luís Fochesato

    2007-08-01

    Full Text Available Este trabalho teve o objetivo de avaliar o crescimento vegetativo de porta-enxertos de citros produzidos em diferentes substratos comerciais, mantidos em recipientes de quatro litros. O experimento foi desenvolvido em casa de vegetação, na Estação Experimental Agronômica da UFRGS, em Eldorado do Sul, RS, no período de junho/2003 a março/2004, e seguiu o delineamento experimental de blocos casualizados, testando-se três substratos comerciais: Turfa preta (Comercial 1; cascas processadas e enriquecidas, vermiculita expandida, perlita expandida e turfa (Comercial 2; e casca de pínus compostada e vermiculita (Comercial 3 e três porta-enxertos: ("Trifoliata"; citrangeiro "C13" e limoeiro "Cravo". A irrigação foi feita por gotejamento. Avaliaram-se as seguintes variáveis: diâmetro do colo; altura da parte aérea; número de folhas e área foliar; matéria seca das raízes, da parte aérea e total; conteúdo de nutrientes nas folhas e percentual de porta-enxertos aptos à enxertia. A interpretação dos resultados revelou que o substrato com cascas processadas e enriquecidas, vermiculita expandida, perlita expandida e turfa possibilitou maior desenvolvimento vegetativo aos porta-enxertos utilizados, devido ao maior aporte de nutrientes. Os porta-enxertos mostraram desenvolvimento diferenciado, sendo que o citrangeiro "C13" tem potencial de uso para a diversificação de porta-enxertos na citricultura, devido ao seu desenvolvimento vegetativo.This research was aimed at evaluating the vegetative growth of citrus rootstocks produced in different commercial substrates and cultivated in four liters containers. The experiment was carried out in greenhouse conditions at the Estação Experimental Agronômica of the Universidade Federal do Rio Grande do Sul, from June 2003 to July 2004. Three commercial substrates [black peat (Commercial 1; processed and enriched husks, expanded vermiculite, expanded perlite and peat (Commercial 2; and (pinus

  13. Atividade alelopática do filtrado de cultura produzido por Fusarium solani Allelopathic activity of culture filtrate produced by Fusarium solani

    Directory of Open Access Journals (Sweden)

    A.P.S. Souza Filho

    2007-03-01

    Full Text Available As plantas daninhas se constituem no principal problema a impor limitação à exploração da agropecuária nas áreas tropicais. Entretanto, o controle químico dessas plantas tem gerado insatisfações de ordem social, quer porque contaminam as fontes de recursos naturais ou por comprometerem a qualidade dos alimentos da dieta dos animais, em geral, e dos humanos, em particular. Os objetivos deste trabalho foram identificar e caracterizar a atividade alelopática do filtrado de cultura produzido pelo fungo Fusarium solani f. sp. pipers. Foram avaliados os efeitos das toxinas, nas concentrações de 1,0 e 4,0%, sobre a germinação de sementes e o desenvolvimento da radícula e do hipocótilo das plantas daninhas malícia (Mimosa pudica e mata-pasto (Senna obtusifolia. Os resultados mostraram presença de atividade alelopática inibitória, com variações de acordo com a concentração e a planta receptora. A intensidade dos efeitos inibitórios induzidos pelo extrato esteve positivamente associada à concentração, com efeitos mais intensos verificados a 4,0%. Independentemente da concentração e do bioensaio, a espécie malícia se mostrou mais sensível aos efeitos do filtrado da cultura. O desenvolvimento da radícula foi o fator da planta mais intensamente inibido. Os resultados indicam a existência de potencial de utilização da toxina produzida pelo fungo, como fonte alternativa no controle de plantas daninhas, o que justifica estudos mais avançados.Weeds are a major problem limiting agriculture and cattle raising activities in the tropics. Current chemical control measures have raised environmental concerns due to their potential of contaminating natural resources and compromising the quality of animal feed. The objective of this paper was to identify and characterize the potential allelopathic activity of Fusarium solani f. sp. pipers culture filtrate. The effects of the toxin were analyzed at 1% and 4% concentration, on seed

  14. Aleloquímico produzido pela gramínea forrageira Brachiaria humidicola Allelochemical produced by the forage grass Brachiaria humidicola

    Directory of Open Access Journals (Sweden)

    A.P.S. Souza Filho

    2005-03-01

    Full Text Available Os métodos usuais de controle de plantas daninhas não atendem mais as atuais e futuras exigências da sociedade em relação à preservação dos recursos naturais e da qualidade de vida. Uma alternativa para essa questão seriam os metabólitos secundários produzidos pelas plantas, que apresentam pouco risco para o ambiente e para os interesses da sociedade. Os objetivos deste trabalho foram isolar, identificar e caracterizar a atividade alelopática de substâncias químicas produzidas pela gramínea forrageira Brachiaria humidicola. Analisaram-se os efeitos alelopáticos dos extratos, frações e substâncias isoladas sobre a germinação e o desenvolvimento da radícula das invasoras malícia, fedegoso e mata-pasto, em bioensaios monitorados em períodos de 10 dias, em condições de 25 ºC e fotoperíodo de 12 horas, para a germinação, e 24 horas, para o desenvolvimento da radícula. A partir do extrato hidrometanólico, foi isolado e identificado o ácido p-cumárico. Os efeitos alelopáticos estiveram positivamente relacionados à concentração do ácido, à espécie de planta daninha e à característica da espécie analisada. Comparativamente, fedegoso e malícia se mostraram mais sensíveis aos efeitos alelopáticos. A germinação e o desenvolvimento da radícula do mata-pasto não foram afetados pelo ácido p-cumárico nas concentrações de 1,0 a 8,0 mg L¹. O alongamento da radícula se mostrou mais sensível aos efeitos alelopáticos do ácido pcumárico do que a germinação das sementes.The traditional methods of weed control in cultivated pasture do not meet society's present and future needs of protecting natural resources and life quality. An alternative to this problem could be the use of secondary metabolites produced by plants. These products present few risks to the environment and meet society interests. Therefore, this research was carried out to isolate, identify and characterize the allelopathic activity of

  15. Bloqueio pleural bilateral: analgesia e funções pulmonares em pós-operatório de laparotomias medianas Bloqueo pleural bilateral: analgesia y funciones pulmonares en pós-operatorio de laparotomias medianas Bilateral pleural block: analgesia and pulmonary functions in postoperative of median laparotomies

    Directory of Open Access Journals (Sweden)

    Karl Otto Geier

    2004-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Não obstante o bloqueio pleural ter sido convertido quase numa panacéia analgésica, resultados contraditórios foram publicados. O objetivo deste estudo foi observar o desempenho analgésico e espirométrico das funções pulmonares no pós-operatório imediato de 21 pacientes com o bloqueio pleural bilateral em laparotomias medianas de urgência. MÉTODO: Bloqueio pleural bilateral foi realizado em decúbito dorsal horizontal em 21 pacientes com 20 ml de bupivacaína a 0,375% com adrenalina a 1:400.000 administrados por cateter em cada hemitórax durante o pós-operatório imediato. Soluções aleatórias de bupivacaína e de solução fisiológica foram administradas por residentes ou enfermeiras que desconheciam o conteúdo das seringas, e seus desfechos analgésicos avaliados de acordo com a escala de dor Prince Henry ao comparar os valores pré e pós-bloqueio pleural bilateral. Em função da dor pós-operatória, testes espirométricos das funções pulmonares também foram determinados mediante espirômetro portátil. RESULTADOS: Analgesia pós-operatória, com duração média de 247,75 ± 75 minutos foi constatada em todos os pacientes com a bupivacaína, embora tenha persistido dor residual de menor intensidade na região suprapúbica em cinco pacientes (8% e em dois pacientes na apófise xifóide (3,2%. Nenhum efeito analgésico foi obtido com solução fisiológica. Face à dor pós-operatória, as funções pulmonares, avaliadas antes e após os bloqueios, registraram melhora com a bupivacaína na CVF (p JUSTIFICATIVA Y OBJETIVOS: No obstante el bloqueo pleural haber sido convertido casi en una panacea analgésica, fueron publicados resultados contradictorios. El objetivo de este estudio fue observar el desempeño analgésico y espirométrico de las funciones pulmonares en el pós-operatorio inmediato de 21 pacientes con el bloqueo pleural bilateral en laparotomias medianas de urgencia. M

  16. Reversal of neuromuscular blockade by sugammadex in laparoscopic bariatric surgery: In support of dose reduction.

    Science.gov (United States)

    Badaoui, Rachid; Cabaret, Aurélie; Alami, Youssef; Zogheib, Elie; Popov, Ivan; Lorne, Emmanuel; Dupont, Hervé

    2016-02-01

    Sugammadex is the first molecule able to antagonize steroidal muscle relaxants with few adverse effects. Doses are adjusted to body weight and the level of neuromuscular blockade. Sleeve gastrectomy is becoming a very popular form of bariatric surgery. It requires deep muscle relaxation followed by complete and rapid reversal to decrease postoperative and especially post-anaesthetic morbidity. Sugammadex is therefore particularly indicated in this setting. The objective of this study was to evaluate the deep neuromuscular blockade reversal time after administration of various doses of sugammadex (based on real weight or at lower doses). Secondary endpoints were the interval between the sugammadex injection and extubation and transfer from the operating room to the recovery room. We then investigated any complications observed in the recovery room. This pilot, prospective, observational, clinical practice evaluation study was conducted in the Amiens University Hospital. Neuromuscular blockade was induced by rocuronium. At the end of the operation, deep neuromuscular blockade was reversed by sugammadex at the dose of 4mg/kg. Sixty-four patients were included: 31 patients received sugammadex at a dosage based on their real weight (RW) and 33 patients received a lower dose (based on ideal weight [IW]). For identical rocuronium doses calculated based on IBW, sugammadex doses were significantly lower in the IW group: 349 (± 65) mg versus 508 (± 75) mg (Psugammadex and extubation (P=0.07) and transfer from the operating room to the recovery room (P=0.68) were also non-significantly longer in the IW group. The mean dose of sugammadex used by anaesthetists in the IW group was 4mg/kg of ideal weight increased by 35% to 50% (n=20; 351±34mg). No sugammadex adverse effects and no residual neuromuscular blockades were observed. Postoperative nausea and vomiting (PONV) was observed in 19.4% of patients in the real weight group versus 27.3% in the ideal weight group (P

  17. Architectural properties of the neuromuscular compartments in selected forearm skeletal muscles.

    Science.gov (United States)

    Liu, An-Tang; Liu, Ben-Li; Lu, Li-Xuan; Chen, Gang; Yu, Da-Zhi; Zhu, Lie; Guo, Rong; Dang, Rui-Shan; Jiang, Hua

    2014-07-01

    The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm(2)), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm(2)). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18-0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the 'design' of their

  18. Architectural properties of the neuromuscular compartments in selected forearm skeletal muscles

    Science.gov (United States)

    Liu, An-Tang; Liu, Ben-Li; Lu, Li-Xuan; Chen, Gang; Yu, Da-Zhi; Zhu, Lie; Guo, Rong; Dang, Rui-Shan; Jiang, Hua

    2014-01-01

    The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm2), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm2). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18–0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the ‘design’ of their

  19. Maximum inspiratory pressure as a clinically meaningful trial endpoint for neuromuscular diseases: A comprehensive review of the literature

    NARCIS (Netherlands)

    B. Schoser; Fong, E. (Edward); Geberhiwot, T. (Tarekegn); Hughes, D. (Derralynn); Kissel, J.T. (John T.); Madathil, S.C. (Shyam C.); Orlikowski, D. (David); Polkey, M.I. (Michael I.); M. Roberts (Mark); H.A.W.M. Tiddens (Harm); Young, P. (Peter)

    2017-01-01

    textabstractRespiratory muscle strength is a proven predictor of long-term outcome of neuromuscular disease (NMD), including amyotrophic lateral sclerosis, Duchenne muscular dystrophy, and spinal muscular atrophy. Maximal inspiratory pressure (MIP), a sensitive measure of respiratory muscle

  20. An Integrated Approach to Change the Outcome Part II: Targeted Neuromuscular Training Techniques to Reduce Identified ACL Injury Risk Factors

    Science.gov (United States)

    Myer, Gregory D.; Ford, Kevin R.; Brent, Jensen L.; Hewett, Timothy E.

    2014-01-01

    Prior reports indicate that female athletes who demonstrate high knee abduction moments (KAMs) during landing are more responsive to neuromuscular training designed to reduce KAM. Identification of female athletes who demonstrate high KAM, which accurately identifies those at risk for noncontact anterior cruciate ligament (ACL) injury, may be ideal for targeted neuromuscular training. Specific neuromuscular training targeted to the underlying biomechanical components that increase KAM may provide the most efficient and effective training strategy to reduce noncontact ACL injury risk. The purpose of the current commentary is to provide an integrative approach to identify and target mechanistic underpinnings to increased ACL injury in female athletes. Specific neuromuscular training techniques will be presented that address individual algorithm components related to high knee load landing patterns. If these integrated techniques are employed on a widespread basis, prevention strategies for noncontact ACL injury among young female athletes may prove both more effective and efficient. PMID:22580980

  1. Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade?

    DEFF Research Database (Denmark)

    Pedersen, T; Viby-Mogensen, J; Bang, U

    1990-01-01

    pancuronium), the anesthetists assessed the degree of neuromuscular blockade during operation and during recovery from neuromuscular blockade by manual evaluation of the response to TOF nerve stimulation. In the other two groups, one of which received vecuronium and the other pancuronium, the anesthetists...... evaluated the degree of neuromuscular blockade solely by clinical criteria. The use of a nerve stimulator was found to have no effect on the dose of relaxant given during anesthesia, on the need for supplementary doses of anticholinesterase in the recovery room, on the time from end of surgery to end...... of anesthesia, or on the incidence of postoperative residual neuromuscular blockade evaluated clinically. The median (and range of) TOF ratios recorded in the recovery room were 0.75 (0.33-0.96) and 0.79 (0.10-0.97) in the vecuronium groups monitored with and without a nerve stimulator, respectively...

  2. Reversal of rocuronium-induced neuromuscular block by sugammadex is independent of renal perfusion in anesthetized cats

    NARCIS (Netherlands)

    Staals, L.M.; Boer, H.D. de; Egmond, J. van; Hope, F.; Pol, F.M. van de; Bom, A.H.; Driessen, J.J.; Booij, L.H.D.J.

    2011-01-01

    PURPOSE: Sugammadex is a selective relaxant binding agent designed to encapsulate the aminosteroidal neuromuscular blocking agent rocuronium, thereby reversing its effect. Both sugammadex and the sugammadex-rocuronium complex are eliminated by the kidneys. This study investigated the effect of

  3. The effect of neuromuscular blockade on oxygen consumption in sedated and mechanically ventilated pediatric patients after cardiac surgery.

    NARCIS (Netherlands)

    Lemson, J.; Driessen, J.J.; Hoeven, J.G. van der

    2008-01-01

    OBJECTIVE: To measure the effect of intense neuromuscular blockade (NMB) on oxygen consumption (VO(2)) in deeply sedated and mechanically ventilated children on the first day after complex congenital cardiac surgery. DESIGN: Prospective clinical interventional study. SETTING: Pediatric intensive

  4. Cortical somatosensory-evoked potentials during spine surgery in patients with neuromuscular and idiopathic scoliosis under propofol-remifentanil anaesthesia

    NARCIS (Netherlands)

    Hermanns, H.; Lipfert, P.; Meier, S.; Jetzek-Zader, M.; Krauspe, R.; Stevens, M. F.

    2007-01-01

    BACKGROUND: Intraoperative monitoring of the spinal cord via cortical somatosensory-evoked potentials (SSEP) is a routine during spinal surgery. However, especially in neuromuscular scoliosis, the reliability of cortical SSEP has been questioned. Therefore, we compared the feasibility of cortical

  5. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Análise físico-química dos méis das abelhas Apis mellifera e Melipona scutellaris produzidos em regiões distintas no Estado da Paraíba

    Directory of Open Access Journals (Sweden)

    Evangelista-Rodrigues Adriana

    2005-01-01

    Full Text Available O mel de abelhas é um produto muito apreciado, no entanto, de fácil adulteração com açúcares ou xaropes. Desta forma, é necessário que haja algumas análises para a determinação da sua qualidade para que seja comercializado. Este trabalho teve como objetivo fazer a análise físico-química dos méis de abelha Apis mellifera. e Melipona scutellaris para a comparação entre as espécies e entre as localidades do Brejo e do Cariri (regiões do Estado da Paraíba. Observou-se que o mel de abelha nativa apresenta um maior teor de água (umidade de 25,25% quando comparado com o mel de abelha africanizada (18,76%, dificultando o seu armazenamento, pois o alto teor de água do produto diminui a sua vida útil de prateleira. Para as análises de hidroximetilfurfural, o valor mais alto foi para o mel produzido na região do Cariri, quando comparado com o mel produzido na região do Brejo, o que pode ser explicado pela diferença de temperatura, sendo mais alta no Cariri. Para os valores de pH, obteve-se diferença significativa entre os méis, com o mel do Cariri apresentando valor mais baixo (3,8. Para Acidez Total, o mel de abelha africanizada do Brejo Paraibano apresentou 41,6 meq/kg de mel, enquanto o mel de abelha nativa apresentou 28,3 meq/kg de mel. Para os demais parâmetros estudados, não houve diferença significativa entre os tratamentos. Conclui-se que os méis produzidos pelas abelhas africanizadas (A. mellifera e pela abelha nativa Melipona scutellaris na Estação Experimental do Cariri e da Chã-de-Jardim pertencentes ao CCA/UFPB apresentam valores diferentes dos padrões da Regulamento Técnico de Identidade e Qualidade do Mel (Ministério da Agricultura e do Abastecimento para alguns parâmetros, o que pode dificultar o seu armazenamento por um longo período.

  7. [Impact of a quality assurance program on the use of neuromuscular monitoring and reversal of muscle relaxants].

    Science.gov (United States)

    Motamed, C; Bourgain, J-L

    2009-04-01

    As part of a quality assurance in the anaesthesia department, this study was designed to enhance the rate of neuromuscular blockade monitoring for patients receiving muscle relaxant during anaesthesia. After approval of our local ethical committee, we assessed 200 computerized anaesthesia records in which neuromuscular relaxants were used. The following data were collected: demographic characteristics, durations of anaesthesia and surgery, use of neuromuscular monitoring, reversal agents and the quality of neuromuscular monitoring. The results were discussed with all anaesthesia providers of the department and an internal guideline was elaborated with the endpoint that all patients having muscle relaxants should have quantitative neuromuscular monitoring. Six months later, another assessment of 200 consecutive records collected the same data to check the efficiency of the elaborated guideline. The monitoring rate was of 67% at the first assessment and increased to 94% (passessment and was stable at the second assessment (50%). The rate of patients not monitored and not reversed decreased from 5 to 2% (pquality assurance program systematic quantitative monitoring of neuromuscular blockade can be significantly increased.

  8. Effects of aquatic balance training and detraining on neuromuscular performance and balance in healthy middle aged male

    Directory of Open Access Journals (Sweden)

    Ali Abbasi

    2012-04-01

    Full Text Available Introduction: Since disorders in neuromuscular performance and imbalance are the main cause of fallingamong the middle aged, their aspects including rehabilitation of balance are the main concern theresearchers attend to them. The aim of this study was to determine the effects of eight weeks aquaticbalance training (ABT and detraining on neuromuscular performance and balance in healthy middle agedmale.Materials and Methods: Thirty adult male subjects were randomized into two groups of ABT and control(n=15 per group. Berg balance scale, Timed Up and Go and 5-Chair stand tests, as they are indicators ofbalance and neuromuscular performance in older subjects, were taken as pretest and post-test and after four,six, and eight weeks of detraining as well. The ABT consisted of the sessions that lasted one hour, threetimes a week, for eight weeks.Results: Results showed that neuromuscular performance and balance improved significantly in ABTgroup (P 0.05.Conclusion: ABT can affect neuromuscular performance and balance in healthy middle aged male, andreduce the probability of falling among them. Moreover, the effects of these training are persistent afterdetraining periods. Hence, ABT can be recommended as an effective neuromuscular and balance training inhealthy middle aged male

  9. Bloqueio dos nervos femoral e isquiático guiados por ultrassom em paciente anticoagulado: case reports Bloqueo de los nervios femoral e isquiático guiados por ultrasonido en paciente anticoagulado Ultrasound-guided femoral and sciatic nerve blocks in an anticoagulated patient: relato de casos

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Cunha Ferraro

    2010-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O uso de ultrassom para guiar a punção em bloqueios de nervos periféricos tem-se tornado cada vez mais frequente. Com a menor probabilidade de promover lesões vasculares, o ultrassom torna-se uma ferramenta interessante na realização de bloqueios periféricos, especialmente nos pacientes em uso de anticoagulantes ou com distúrbios da coagulação. O objetivo foi relatar dois casos em que se realizaram os bloqueios isquiático e femoral guiados por ultrassom em pacientes anticoagulados. RELATO DOS CASOS: No primeiro caso, a cirurgia realizada consistiu na amputação de antepé esquerdo devido a necrose e sinais de infecção e, no segundo caso, em limpeza cirúrgica de joelho esquerdo. Os pacientes apr esentavam distúrbios de coagulação com atividade de protrombina e tempo de tromboplastina ativado acima dos valores da normalidade. Ambos os pacientes foram submetidos a bloqueio femoral e isquiático guiados por ultrassom, evoluindo sem alteração motora ou sensitiva nos territórios desses nervos e sem hematoma no local da punção. CONCLUSÕES: A anticoagulação impõe certas restrições à aplicação das técnicas anestésicas regionais clássicas. Com o avanço dos equipamentos e métodos de ultrassom, hoje é possível identificar com alta precisão estruturas vasculares e neurais. Isso possibilita que a punção guiada por ultrassom seja mais precisa, tanto para atingir a área de interesse como para minimizar os riscos de lesão vascular acidental. Até o presente, não se recomenda a realização de bloqueio periférico em pacientes anticoagulados ou portadores de coagulopatias. Entretanto, considerando que há poucos relatos sobre bloqueios regionais com ultrassom em situações de coagulopatias, a segurança de tal técnica nessas condições ainda não foi estabelecida.JUSTIFICATIVA Y OBJETIVOS: El uso del ultrasonido para guiar la punción en bloqueos de nervios periféricos se ha convertido

  10. An 8-Week Neuromuscular Exercise Program for Patients With Mild to Moderate Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Clausen, Brian; Holsgaard-Larsen, Anders; Roos, Ewa M

    2017-01-01

    OBJECTIVE:   To describe the feasibility of a neuromuscular exercise (NEMEX) program in patients with mild to moderate knee osteoarthritis (KOA). BACKGROUND:   Neuromuscular exercise has been increasingly used in patients with osteoarthritis to achieve sensorimotor control and improved daily...... function. TREATMENT:   A study of the first 23 physically active patients (11 men, 12 women; age range = 48-70 years) who had mild to moderate KOA and were undergoing an 8-week, twice-weekly program, consisting of 11 exercises with 3 to 4 levels of difficulty, as part of an ongoing randomized controlled...... to increased (n = 2) or persisting (n = 1) knee pain. However, their pain ratings did not show worsening symptoms. UNIQUENESS:   This NEMEX-KOA program was designed for physically active middle-aged patients with mild to moderate KOA; therefore, it involved exercises and difficulty levels that were more...

  11. INTERACTION OF VERAPAMIL AND LITHIUM AT THE NEUROMUSCULAR JUNCTION ON RAT ISOLATED MUSCLE-HEMIDIAPHRAGM

    Directory of Open Access Journals (Sweden)

    H. R. Sadeghipour

    1998-08-01

    Full Text Available It has been reported that cither lithium or verapamil can potentiate the neuromuscular blocking activity of certain neuromuscular blockers. In the present investigation, possible interaction of verapamil with lithium has been described. The dose ■ response effects of verapamil and lithium on diaphragmatic contractility were assessed in vitro. Mechanical responses of the muscle to indirect (nerve and direct (muscle electrical stimulation were recorded. Verapamil depressed rat diaphragm twitch tensions induced by nerve stimulation in a dose - dependent manner with the 50 percent depression of the original twitch tensions (ICSQ by 5.6 xlO^mmol/l."nThe IC50 of verapamil for direct stimulation of the muscle was LI x W'5 mmol II. Partial replacement of sodium chloride by lithium chloride (0.5, 1.5 and 5 mmol /1 in the medium did not change the depressant effect of verapamil on muscle twitches induced by direct (muscle or indirect (nerve electrical stimulation.

  12. The immediate effect of lumbar spine patterns of neuromuscular joint facilitation in young amateur baseball players.

    Science.gov (United States)

    Huo, Ming; Maruyama, Hitoshi; Kaneko, Takasumi; Naito, Daiki; Koiso, Yuta

    2013-12-01

    [Purpose] The aim of the study was to investigate the changes in baseball pitching velocity, the functional reach test (FR) and the simple reaction times (SRT) in young amateur baseball players after lumbar spine patterns of neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 11 young amateur baseball players. An NJF intervention and a proprioceptive neuromuscular facilitation (PNF) intervention were performed. The interventions were performed one after the other with one week between them. The order of the interventions was completely randomized. [Methods] The baseball pitching velocity, the FR and the SRT were evaluated before and after treatment. [Results] In the NJF group, there were significant differences in baseball pitching velocity, FR and SRT after treatment. In the PNF group, there was a significant difference in SRT after treatment. [Conclusion] NJF intervention shortens the SRT, increases the baseball pitching velocity and FR, and may be recommended to improve performance in baseball players.

  13. 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.

  14. The Immediate Effect of Neuromuscular Joint Facilitation (NJF) Treatment on Electromechanical Reaction Times of Hip Flexion.

    Science.gov (United States)

    Huo, Ming; Wang, Hongzhao; Ge, Meng; Huang, Qiuchen; Li, Desheng; Maruyama, Hitoshi

    2013-11-01

    [Purpose] The aim of this study was to investigate the change in electromechanical reaction times (EMG-RT) of hip flexion of younger persons after neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 39 healthy young people, who were divided into two groups: a NJF group and a proprioceptive neuromuscular facilitation (PNF) group. The NJF group consisted of 16 subjects (7 males, 9 females), and the PNF group consisted of 23 subjects (10 males, 13 females). [Methods] Participants in the NJF group received NJF treatment. We measured the EMG-RT, the premotor time (PMT) and the motor time (MT) during hip flexion movement before and after the intervention in both groups. [Results] There were no significant differences among the results of the PNF group. For the NJF group, there were significant differences in PMT and EMG-RT after NJF treatment. [Conclusion] These results suggest that there is an immediate effect of NJF intervention on electromechanical reaction times of hip flexion.

  15. Neuromechanical evidence of improved neuromuscular control around knee joint in volleyball players.

    Science.gov (United States)

    Masci, Ilaria; Vannozzi, Giuseppe; Gizzi, Leonardo; Bellotti, Pasquale; Felici, Francesco

    2010-02-01

    The aim of the present work was to verify that skilled volleyball players present specific adaptations in both neuromuscular control and movement biomechanics, showing an improved neuromuscular control around the knee joint than in non-jumper athletes. Seven male volleyball players and seven male non-jumper athletes were recruited for this study. The following tests were performed in a random order: single countermovement jump (CMJ), single squat jump. At the end of the series, subjects performed a repetitive CMJ test. Electromyographic signals were recorded from vastus lateralis and biceps femoris muscles on both sides. Ground reaction forces and moments were measured with a force plate. Volleyball athletes performed better in all tests and were more resistant to fatigue than non-jumper athletes. Furthermore, volleyball athletes showed a reduced co-activation of knee flexor/extensor muscles. The present results seem to stand for a neural adaptation of the motor control scheme to training.

  16. Neuromuscular-skeletal origins of predominant patterns of coordination in rhythmic two-joint arm movement.

    Science.gov (United States)

    de Rugy, Aymar; Riek, Stephan; Carson, Richard G

    2006-01-01

    The authors tested for predominant patterns of coordination in the combination of rhythmic flexion-extension (FE) and supination- (SP) at the elbow-joint complex. Participants (N=10) spontaneously established in-phase (supination synchronized with flexion) and antiphase (pronation synchronized with flexion) patterns. In addition, the authors used a motorized robot arm to generate involuntary SP movements with different phase relations with respect to voluntary FE. The involuntarily induced in-phase pattern was accentuated and was more consistent than other patterns. The result provides evidence that the predominance of the in-phase pattern originates in the influence of neuromuscular-skeletal constraints rather than in a preference dictated by perceptual-cognitive factors implicated in voluntary control. Neuromuscular-skeletal constraints involved in the predominance of the in-phase and the antiphase patterns are discussed.

  17. Sugammadex to reverse neuromuscular blockade in a child with a past history of cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Karen Miller

    2017-01-01

    Full Text Available Sugammadex is a novel agent for the reversal of neuromuscular blockade. The speed and efficacy of reversal with sugammadex are significantly faster than acetylcholinesterase inhibitors, such as neostigmine. Sugammadex also has a limited adverse profile when compared with acetylcholinesterase inhibitors, specifically in regard to the incidence of bradycardia. This adverse effect may be particularly relevant in the setting of a heart transplant recipient with a denervated heart. The authors present a case of an 8-year-old child, status postcardiac transplantation, who required anesthetic care for laparoscopy and lysis of intra-abdominal adhesions. Sugammadex was used to reverse neuromuscular blockade and avoid the potential adverse effects of neostigmine. The unique mechanism of action of sugammadex is discussed, previous reports of its use in this unique patient population are reviewed, and its potential benefits compared to traditional acetylcholinesterase inhibitors are presented.

  18. Sugammadex to reverse neuromuscular blockade in a child with a past history of cardiac transplantation.

    Science.gov (United States)

    Miller, Karen; Hall, Brian; Tobias, Joseph D

    2017-01-01

    Sugammadex is a novel agent for the reversal of neuromuscular blockade. The speed and efficacy of reversal with sugammadex are significantly faster than acetylcholinesterase inhibitors, such as neostigmine. Sugammadex also has a limited adverse profile when compared with acetylcholinesterase inhibitors, specifically in regard to the incidence of bradycardia. This adverse effect may be particularly relevant in the setting of a heart transplant recipient with a denervated heart. The authors present a case of an 8-year-old child, status postcardiac transplantation, who required anesthetic care for laparoscopy and lysis of intra-abdominal adhesions. Sugammadex was used to reverse neuromuscular blockade and avoid the potential adverse effects of neostigmine. The unique mechanism of action of sugammadex is discussed, previous reports of its use in this unique patient population are reviewed, and its potential benefits compared to traditional acetylcholinesterase inhibitors are presented.

  19. Sugammadex, a Neuromuscular Blockade Reversal Agent, Causes Neuronal Apoptosis in Primary Cultures

    Science.gov (United States)

    Palanca, José M.; Aguirre-Rueda, Diana; Granell, Manuel V.; Aldasoro, Martin; Garcia, Alma; Iradi, Antonio; Obrador, Elena; Mauricio, Maria Dolores; Vila, Jose; Gil-Bisquert, Anna; Valles, Soraya L.

    2013-01-01

    Sugammadex, a γ-cyclodextrin that encapsulates selectively steroidal neuromuscular blocking agents, such as rocuronium or vecuronium, has changed the face of clinical neuromuscular pharmacology. Sugammadex allows a rapid reversal of muscle paralysis. Sugammadex appears to be safe and well tolerated. Its blood-brain barrier penetration is poor (Sugammadex in neurons in primary culture. Here we show that clinically relevant sugammadex concentrations cause apoptotic/necrosis neuron death in primary cultures. Studies on the underlying mechanism revealed that sugammadex-induced activation of mitochondria-dependent apoptosis associates with depletion of neuronal cholesterol levels. Furthermore SUG increase CytC, AIF, Smac/Diablo and CASP-3 protein expression in cells in culture. Potential association of SUG-induced alteration in cholesterol homeostasis with oxidative stress and apoptosis activation occurs. Furthermore, resistance/sensitivity to oxidative stress differs between neuronal cell types. PMID:23983586

  20. Sugammadex and Reversal of Neuromuscular Block in Adult Patient with Duchenne Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Ahmed Abdelgawwad Wefki Abdelgawwad Shousha

    2014-01-01

    Full Text Available Duchenne’s muscular dystrophy (DMD is the most common and severe form of myopathy. Patients with DMD are more sensitive to sedative, anesthetic, and neuromuscular blocking agents which may result in intraoperative and early postoperative cardiovascular and respiratory complications, as well as prolonged recovery from anesthesia. In this case report, we describe a 25-year-old male patient admitted for cholecystectomy under general anesthesia. We induced our anesthesia by oxygen, propofol, fentanyl, and rocuronium bromide. Maintenance was done by fentanyl, rocuronium bromide, sevoflurane, and O2. We report in this case the safety use of sugammadex to antagonize the neuromuscular block and rapid recovery in such category of patients.

  1. Neuromuscular fatigue during high-intensity intermittent exercise in individuals with intellectual disability.

    Science.gov (United States)

    Borji, Rihab; Sahli, Sonia; Zarrouk, Nidhal; Zghal, Firas; Rebai, Haithem

    2013-12-01

    This study examined neuromuscular fatigue after high-intensity intermittent exercise in 10 men with mild intellectual disability (ID) in comparison with 10 controls. Both groups performed three maximal voluntary contractions (MVC) of knee extension with 5 min in-between. The highest level achieved was selected as reference MVC. The fatiguing exercise consists of five sets with a maximal number of flexion-extension cycles at 80% of the one maximal repetition (1RM) for the right leg at 90° with 90 s rest interval between sets. The MVC was tested again after the last set. Peak force and electromyography (EMG) signals were measured during the MVC tests. Root Mean Square (RMS) and Median Frequency (MF) were calculated. Neuromuscular efficiency (NME) was calculated as the ratio of peak force to the RMS. Before exercise, individuals with ID had a lower MVC (psport train ID individuals, they should consider this nervous system weakness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Stability and migration across femoral varus derotation osteotomies in children with neuromuscular disorders

    DEFF Research Database (Denmark)

    Buxbom, Peter; Sonne-Holm, Stig; Ellitsgaard, Niels

    2017-01-01

    ), and acetabuloplasty. Relapse is observed in one-fifth of cases during adolescence. In this prospective cohort study, we performed a descriptive evaluation of translation and rotation across VDROs in children with neuromuscular disorders and syndromes by radiostereometric analysis (RSA). We assessed "RSA stability......" and migration across the VDROs. Patients and methods - Children with a neuromuscular disorder were set up for skeletal corrective surgery of the hip. RSA follow-ups were performed postoperatively, at 5 weeks, and 3, 6, and 12 months after surgery. Results - 27 femoral VDROs were included; 2 patients were...... excluded during the study period. RSA data showed stability across the VDRO in the majority of cases within the first 5 weeks. At the 1-year follow-up, the mean translations (SD) of the femoral shaft distal to the VDRO were 0.51 (1.12) mm medial, 0.69 (1.61) mm superior, and 0.21 (1.28) mm posterior...

  3. Tilted seat position for non-ambulant individuals with neurological and neuromuscular impairment: a systematic review.

    Science.gov (United States)

    Michael, S M; Porter, D; Pountney, T E

    2007-12-01

    To determine the effects of tilt-in-space seating on outcomes for people with neurological or neuromuscular impairment who cannot walk. Search through electronic databases (MEDLINE, Embase, CINAHL, AMED). Discussions with researchers who are active in field. Selection criteria included interventional studies that investigated the effects of seat tilt on outcome or observational studies that identified outcomes for those who had used tilt-in-space seating in populations with neurological or neuromuscular impairments. Two reviewers independently selected trials for inclusion, assessed quality and extracted data. Nineteen studies were identified which fulfilled the selection criteria. Seventeen of these were essentially before-after studies investigating the immediate effects of tilting the seating. All studies looked at populations with neurological impairment, and most were on children with cerebral palsy (n=8) or adults with spinal cord injury (n=8). REVIEWER'S CONCLUSION: Posterior tilt can reduce pressures at the interface under the pelvis.

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

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Larsen, Anders Holsgaard

    . 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......±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...

  5. Effects of Neuromuscular Electrical Stimulation During Hemodialysis on Peripheral Muscle Strength and Exercise Capacity: A Randomized Clinical Trial.

    Science.gov (United States)

    Brüggemann, Ana Karla; Mello, Carolina Luana; Dal Pont, Tarcila; Hizume Kunzler, Deborah; Martins, Daniel Fernandes; Bobinski, Franciane; Pereira Yamaguti, Wellington; Paulin, Elaine

    2017-05-01

    To evaluate the effects of neuromuscular electrical stimulation of high and low frequency and intensity, performed during hemodialysis, on physical function and inflammation markers in patients with chronic kidney disease (CKD). Randomized clinical trial. Hemodialysis clinic. Patients with CKD (N=51) were randomized into blocks of 4 using opaque sealed envelopes. They were divided into a group of high frequency and intensity neuromuscular electrical stimulation and a group of low frequency and intensity neuromuscular electrical stimulation. The high frequency and intensity neuromuscular electrical stimulation group was submitted to neuromuscular electrical stimulation at a frequency of 50Hz and a medium intensity of 72.90mA, and the low frequency and intensity neuromuscular electrical stimulation group used a frequency of 5Hz and a medium intensity of 13.85mA, 3 times per week for 1 hour, during 12 sessions. Peripheral muscle strength, exercise capacity, levels of muscle trophism marker (insulin growth factor 1) and levels of proinflammatory (tumor necrosis factor α) and anti-inflammatory (interleukin 10) cytokines. The high frequency and intensity neuromuscular electrical stimulation group showed a significant increase in right peripheral muscle strength (155.35±65.32Nm initial vs 161.60±68.73Nm final; P=.01) and left peripheral muscle strength (156.60±66.51Nm initial vs 164.10±69.76Nm final; P=.02) after the training, which did not occur in the low frequency and intensity neuromuscular electrical stimulation group for both right muscle strength (109.40±32.08Nm initial vs 112.65±38.44Nm final; P=.50) and left muscle strength (113.65±37.79Nm initial vs 116.15±43.01Nm final; P=.61). The 6-minute walk test distance (6MWTD) increased in both groups: high frequency and intensity neuromuscular electrical stimulation group (435.55±95.81m initial vs 457.25±90.64m final; P=.02) and low frequency and intensity neuromuscular electrical stimulation group (403.80

  6. Effects of exercise on activity-and blood flow-related neuromuscular degeneration

    OpenAIRE

    Ishihara, Akihiko; 石原 昭彦

    2006-01-01

    Effects of running exercise with increasing loads on hindlimb unloading-induced neuromuscular degeneration in male rats were investigated. Ten-week-old male rats were hindlimb suspended at horizontal position for two weeks and thereafter were rehabilitated by voluntary running exercise with increasing loads for two weeks. A decreased percentage of type 1 fibers and atrophy and decreased oxidative enzyme activity of all types of fibers in the soleus muscle were observed after hindlimb unloadin...

  7. Trunk and hip control neuromuscular training for the prevention of knee joint injury.

    Science.gov (United States)

    Myer, Gregory D; Chu, Donald A; Brent, Jensen L; Hewett, Timothy E

    2008-07-01

    This article provide evidences to outline a novel theory used to define the mechanisms related to increased risk of ACL injury in female athletes. In addition, this discussion will include theoretical constructs for the description of the mechanisms that lead to increased risk. Finally, a clinical application section will outline novel neuromuscular training techniques designed to target deficits that underlie the proposed mechanism of increased risk of knee injury in female athletes.

  8. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Surface neuromuscular electrical stimulation for quadriceps strengthening pre and post total knee replacement.

    LENUS (Irish Health Repository)

    Monaghan, Brenda

    2010-01-01

    Total knee replacement has been demonstrated to be one of the most successful procedures in the treatment of osteoarthritis. However quadriceps weakness and reductions in function are commonly reported following surgery. Recently Neuromuscular Electrical Stimulation (NMES) has been used as an adjunct to traditional strengthening programmes. This review considers the effectiveness of NMES as a means of increasing quadriceps strength in patients before and after total knee replacement.

  10. Effects of heavy metals on the neuromuscular transmission of the mouse diaphragm

    Energy Technology Data Exchange (ETDEWEB)

    Fu, W M; Shiau, S Y.L.

    1978-04-01

    Effects of heavy metals including Mn, Co, Ni, Cd, Zn, Cu, Sr, Ba, and UO/sub 2//sup +/ ions on the neuromuscular transmission of the mouse diaphragm were studied and compared. From the dose-inhibition curves, the concentrations (mM) required to inhibit 50% of the contraction (ID/sub 50/) for Cd, Mn, Co, Ni, Zn and Sr are 0.03, 0.8, 0.75, 0.82, 1.2 and >20 respectively. In addition to the potent neuromuscular blocking action, both Cd and Zn induce a contracture of the mouse diaphram. Among the cations tested, Cu is the most potent in inducing the contracture. Mn does not cause a contracture, while Co and Ni induce a contracture only after a prolonged incubation for 3 hours. The neuromuscular blocking action of most of the cations tested can be completely or partially reversed by either high Ca or cysteine except the irreversible action of Zn and Cu. These findings suggest that most divalent cations block the neuromuscular transmission by binding to the -SH group of the cell membrane and inhibiting Ca influx. On the other hand, both Ba and UO/sub 2/ at low concentration increase but at high concentration inhibit the twitch response. Sine Ba increases the twitch response of the mouse diaphragm stimulated directly in the presence of d-tubocurarine as well as that stimulated indirectly, Ba/sup + +/ acts mainly directly on the muscle. In contrast, UO/sub 2//sup +/ ions at low concentration increases the twitch response possibly by releasing acetylcholine from the nerve endings.

  11. Sugammadex in antagonism of neuromuscular block in anesthesia: a clinical and economic profile

    Directory of Open Access Journals (Sweden)

    Viola Sacchi

    2009-09-01

    Full Text Available Sugammadex is a modified cyclodextrin which acts by encapsulating and inactivating the neuromuscular blocking agents (NMBAs rocuronium and vecuronium, used to induce relaxation of skeletal muscles during surgery and to facilitate endotracheal intubation. The procedure of reversal of the block at the end of surgery can influence the time to discharge from the operating room and post-operative residual curarization (PORC incidence, which is related to an increased rate of adverse respiratory events in the post-anaesthesia care unit. Cholinesterase inhibitors are frequently used to reverse neuromuscular block, but their use is associated with potential cardiovascular and respiratory side-effects. The recommended dose-range for sugammadex is 2-16 mg/kg, depending on the level of block: the dose is approximately 2 mg/kg for reversal of moderate blockade, 4 mg/kg for deep blockade and 16 mg/kg for the immediate reversal of a neuromuscular blockade as early as 3 minutes after 1-1.2 mg/kg of rocuronium. Four pivotal, phase III trials studied sugammadex in routine reversal of moderate, deep neuromuscular block and in the immediate reversal of rocuronium-induced block. In all the cases the drug demonstrated of being significantly more efficient than other reversal strategies, providing a faster reversal than the most used anticholinesterase comparator neostigmine. Sugammadex also appeared to have an acceptable safety profile. Acquisition cost of sugammadex is greater than that of neostigmine, but cost-savings related to the reduced theatre time and to the reduced incidence of PORC episodes can offset it. A Budget Impact analysis in the perspective of the hospital has been conducted for the Italian setting resulting in a total cost-save of 7,420 € for one year of activity. In conclusion, sugammadex appears to be a valuable innovation in anesthesiology. This drug represents a safe and effective alternative to anticholinesterase agents.

  12. Negative Pressure Pulmonary Edema after Reversing Rocuronium-Induced Neuromuscular Blockade by Sugammadex

    Directory of Open Access Journals (Sweden)

    Manzo Suzuki

    2014-01-01

    Full Text Available Negative pressure pulmonary edema (NPPE is a rare complication that accompanies general anesthesia, especially after extubation. We experienced a case of negative pressure pulmonary edema after tracheal extubation following reversal of rocuronium-induced neuromuscular blockade by sugammadex. In this case, the contribution of residual muscular block on the upper airway muscle as well as large inspiratory forces created by the respiratory muscle which has a low response to muscle relaxants, is suspected as the cause.

  13. Effects of neuromuscular training on the reaction time and electromechanical delay of the peroneus longus muscle.

    Science.gov (United States)

    Linford, Christena W; Hopkins, J Ty; Schulthies, Shane S; Freland, Brent; Draper, David O; Hunter, Iain

    2006-03-01

    To examine the influence of a 6-week neuromuscular training program on the electromechanical delay and reaction time of the peroneus longus muscle. A 2 x 2 pre-post factorial design. Human performance research center biomechanics laboratory. Thirty-six healthy, physically active, college-age subjects were recruited for this study and 26 completed it. There were 5 men and 8 women in the treatment group (mean age +/- standard deviation, 21.9+/-2.1 y; height, 173.7+/-11.1cm; weight, 67.4+/-17.8 kg) and 6 men and 7 women in the control group (age, 21.8+/-2.3 y; height, 173.7+/-11.9 cm; weight, 70.8+/-19.4 kg). Subjects were not currently experiencing any lower-extremity pathology and had no history of injuries requiring treatment to either lower extremity. Subjects in the treatment group completed a 6-week neuromuscular training program involving various therapeutic exercises. Subjects in the control group were asked to continue their normal physical activity during the 6-week period. The electromechanical delay of the peroneus longus was determined by the onset of force contribution after artificial activation, as measured by electromyographic and forceplate data. Reaction time was measured after a perturbation during walking. Data were analyzed using two 2 x 2 analyses of covariance (covariate pretest score). Group (treatment, control) and sex (male, female) were between-subject factors. Neuromuscular training caused a decrease in reaction time to perturbation during walking compared with controls (F=4.030, P=.029), while there was a trend toward an increase in electromechanical delay (F=4.227, P=.052). There was no significant difference between sexes or the interaction of sex and treatment in either reaction time or electromechanical delay. The 6-week training program significantly reduced reaction time of the peroneus longus muscle in healthy subjects. Neuromuscular training may have a beneficial effect on improving dynamic restraint during activity.

  14. Long Term Follow-up of Ventilated Patients with Thoracic Restriction and Neuromuscular Disease

    Directory of Open Access Journals (Sweden)

    Dina Brooks

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate the long term effects of home mechanical ventilation (HMV on pulmonary function, nighttime gas exchange, daytime arterial blood gases, sleep architecture and functional exercise capacity (6 min walk. Patients with respiratory failure attributable to thoracic restrictive disease (TRD (kyphoscoliosis or neuromuscular disease (NMD were assessed, ventilated, trained and followed in a dedicated unit for the care of patients requiring long term ventilation.

  15. Associations between neuromuscular function and levels of physical activity differ for boys and girls during puberty.

    Science.gov (United States)

    Rudroff, Thorsten; Kelsey, Megan M; Melanson, Edward L; McQueen, Matthew B; Enoka, Roger M

    2013-08-01

    To compare the associations between neuromuscular performance and anthropometric characteristics with habitual levels of physical activity in boys and girls during the initial stages of puberty. In a cross-sectional study of 72 healthy children (39 boys and 33 girls) ranging in age from 8 to 14 years, sex differences in anthropometric and motor performance characteristics were compared at 3 Tanner stages (T1-T3). Outcome variables included dual-energy x-ray absorptiometry measurements of body composition, assessments of neuromuscular function, and levels of physical activity (steps/day) measured by accelerometry. Physical activity was lower in girls than boys at T2 and T3, but there was no sex difference at T1. Physical activity increased with Tanner stage for boys but did not differ between Tanner stages in girls. Physical activity at each Tanner stage was strongly associated (R(2) > 0.85) with neuromuscular characteristics for both boys and girls, but percentage of body fat also was associated with physical activity for T3 girls. The attenuated gains in neuromuscular function experienced by girls in early stages of puberty were strongly associated with lower levels of physical activity, whereas the increase in physical activity exhibited by boys was mostly related to increases in the strength and endurance of leg muscles. Because sedentary activity is a known contributor to the development of obesity and type 2 diabetes in youth, this study helps to identify possible contributors to decreases in physical activity in young girls and provides potential targets for early intervention. Copyright © 2013 Mosby, Inc. All rights reserved.

  16. Preferences of Mexican anesthesiologists for vecuronium, rocuronium, or other neuromuscular blocking agents: a survey

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    Garduño-Espinosa J

    2002-05-01

    Full Text Available Abstract Background Several neuromuscular blocking (NMB agents are available for clinical use in anesthesia. The present study was performed in order to identify preferences and behaviors of anesthesiologists for using vecuronium, rocuronium or other NMB agents in their clinical practice. Material and methods The cross-sectional survey was applied at the Updated Course of the Colegio Mexicano de Anestesiología performed last year. Of 989, 282 (28.5% surveys were returned. Results Most anesthesiologists were working at both public and private hospitals, performed anesthetic procedures for hospitalized and ambulatory patients, and anesthetized children as well as adults. Respondents did not consider mechanomyography as the gold standard method for neuromuscular monitoring. The T25 was not recognized as a pharmacodynamic parameter that represents the clinical duration of the neuromuscular block. Most answered that vecuronium induces less histamine release than rocuronium, had never used any neuromuscular monitor, did not know the cost of vecuronium and rocuronium, and preferred rocuronium in multiple-sampling vials and vecuronium in either a vial for single or multiple sampling. Rocuronium was preferred for emergency surgery in patients with full stomach only. Almost all of anesthesiologists that conserve the unused drug did it without refrigeration and more than 30% conserve the unused drug in one syringe for further use. Conclusion Vecuronium was preferred for most clinical situations, and the decision for this choice was not based on costs. Storage of unused drugs without refrigeration in a single syringe for purpose of future use in several patients represented a dangerous common practice.

  17. Effects of Short- and Long-Duration Space Flight on Neuromuscular Function

    Science.gov (United States)

    Buxton, Roxanne E.; Spiering, Barry A.; Ryder, Jeffrey W.; Ploutz-Snyder, Lori L.; Bloomberg, Jacob J.

    2010-01-01

    The Functional Task Tests (FTT) is an interdisciplinary study designed to correlate the changes in functional tasks (such as emergency egress, ladder climbing, and hatch opening) with changes in neuromuscular, cardiovascular, and sensorimotor function. One aspect of the FTT, the neuromuscular function test, is used to investigate the neuromuscular component underlying changes in the ability of astronauts to perform functional tasks (representative of critical mission tasks) safely and quickly after flight. PURPOSE: To describe neuromuscular function after short- and long-duration space flight. METHODS: To date, 5 crewmembers on short-duration (10- to 15-day) missions and 3 on long-duration missions have participated. Crewmembers were assessed 30 days before flight, on landing day (short-duration subjects only) and 1, 6, and 30 days after landing. The interpolated twitch technique, which utilizes a combination of maximal voluntary contractions and electrically evoked contractions, was used to assess the maximal voluntary isometric force (MIF) and central activation capacity of the knee extensors. Leg-press and bench-press devices were used to assess MIF and maximal dynamic power of the lower and upper body respectively. Specifically, power was measured during concentric-only ballistic throws of the leg-press sled and bench-press bar loaded to 40% and 30% of MIF respectively. RESULTS: Data are currently being collected from both Shuttle and ISS crewmembers. Emerging data indicate that measures of knee extensor muscle function are decreased with long-duration flight. DISCUSSION: The relationships between flight duration, neural drive, and muscle performance are of particular interest. Ongoing research will add to the current sample size and will focus on defining changes in muscle performance measures after long-duration space flight.

  18. Design of low-cost general purpose microcontroller based neuromuscular stimulator.

    Science.gov (United States)

    Koçer, S; Rahmi Canal, M; Güler, I

    2000-04-01

    In this study, a general purpose, low-cost, programmable, portable and high performance stimulator is designed and implemented. For this purpose, a microcontroller is used in the design of the stimulator. The duty cycle and amplitude of the designed system can be controlled using a keyboard. The performance test of the system has shown that the results are reliable. The overall system can be used as the neuromuscular stimulator under safe conditions.

  19. Armazenamento sob condições ambiente e aceitabilidade do melão 'F1 Jangada' produzido em sistema hidropônico Storage under atmosphere conditions and acceptability of the melon 'F1 Jangada' croped in hydroponic system

    Directory of Open Access Journals (Sweden)

    Maria M. Rinaldi

    2006-12-01

    Full Text Available O objetivo deste trabalho foi determinar o período de armazenamento pós-colheita e a aceitabilidade pelo consumidor de melão híbrido 'F1 Jangada' (Cucumis melo L., produzido em sistema hidropônico, mantido em condições ambiente (22 ± 2 ºC e umidade relativa de 40 ± 5%. O experimento compreendeu o período de 21-6-2005 a 2-8-2005. Foi utilizado o esquema fatorial 5 x 2, em delineamento experimental inteiramente casualizado, com cinco períodos de armazenamento (0; 7; 21; 28 e 42 dias e dois tipos de substrato (areia e fibra de coco, com três repetições, em que cada repetição consistiu em cinco frutos de meloeiro. Foram avaliados o pH, a acidez titulável, os sólidos solúveis, a perda de massa fresca, a análise sensorial e a decisão de compra dos melões. Foram verificados efeitos do tipo de substrato e tempo de armazenamento sobre os valores de pH dos melões. A acidez titulável dos melões diminuiu significativamente nos primeiros sete dias de armazenamento, em ambos os substratos. Não foram verificados efeitos do tipo de substrato e tempo de armazenamento nos sólidos solúveis dos melões durante o armazenamento. Não houve diferença de perda de massa fresca dos frutos produzidos nos dois substratos, sendo de 7,1 ± 0,2%, durante os 42 dias de armazenamento. O tipo de substrato não interferiu na aparência geral, cor, textura e sabor dos melões. Aos 42 dias de armazenamento, os melões produzidos nos dois tipos de substrato apresentaram-se aceitáveis pelo consumidor. No entanto, os produzidos no substrato com areia apresentaram melhor aceitabilidade e decisão de compra ao longo do armazenamento.The objective of this work was to evaluate the storage period postharvest and acceptability by consumer of hybrid melon 'F1 Jangada' (Cucumis melo L., produced in hydroponic system, stored in atmosphere conditions (22 ± 2 ºC and 40 ± 5% relative humidity. The research was carried from June 21st to August 2nd, 2005. It was

  20. Quality of raw milk produced in agreste region of Pernambuco, Brazil / Qualidade do leite cru produzido na região do agreste de Pernambuco, Brasil

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    Márcia de Aguiar Ferreira Barros

    2010-04-01

    negativamente na produção e rendimento de derivados. No Estado de Pernambuco, não é diferente. Sendo o segundo maior produtor do Nordeste, Pernambuco tem sua maior produção de leite localizada na Região Agreste do estado, que fica entre a Zona da Mata e o Sertão. A produção de leite no Agreste, cresceu 23% nos últimos dois anos, chegando a 980 mil litros/dia. Com o objetivo de avaliar a qualidade microbiológica e físico-química do leite cru produzido nesta região, foram coletadas amostras em 53 propriedades rurais, nos municípios de Saloa, Águas Belas, São Bento do Una e Bom Conselho. Enumeraram-se aeróbios mesófilos, coliformes totais, Escherichia coli e estafilococos em placas de Petrifilm™ especificas (3M do Brasil Ltda.. A detecção de Listeria monocytogenes e Salmonella ssp foi realizada utilizando o sistema VIDAS (BioMeriex®. Organofosforados e carbamatos foram pesquisados pela técnica de Cromatografia em Camada Delgada. O teor de gordura, sólidos totais, sólidos não gordurosos, densidade, proteína e lactose foram obtidos por espectroscopia de em analisador ultra-sônico (US. Realizou-se ainda crioscopia, California Mastite Teste (CMT, peroxidase, acidez Dornic e Ring-test para monitoramento da presença de Brucelose nas propriedades. Nas análises microbiológicas, as amostras apresentaram altas contagens de microrganismos aeróbios mesófilos, coliformes totais, Escherichia coli, psicrotróficos e estafilococos coagulase positiva. A média de aeróbios mesófilos foi de 1,68% X 107, sendo 83% acima de 106. Listeria monocytogenes e Salmonella sp não foram detectadas, 47% das amostras foram positivas para carbamatos, organofosforados ou ambos. No CMT 67,9% das amostras foram positivas, e no Ring test 26,4% das propriedades foram positivas. Assim, apenas 2 (3,77% das amostras estariam dentro dos padrões estabelecidos pela IN 51.

  1. Qualidade dos frutos de tipos de melão,produzidos em ambiente protegido Quality of melon fruit type produced under protected system

    Directory of Open Access Journals (Sweden)

    Micheline Tavares Paduan

    2007-01-01

    Full Text Available O interesse pela cultura do melão no Brasil tem aumentado muito nos últimos anos, pelas crescentes exportações e pelo incremento no consumo do mercado interno. O objetivo deste trabalho foi avaliar as características físicas e químicas, assim como a atividade da pectinametilesterase dos frutos de tipos de melão (Cucumis melo L., produzidos em ambiente protegido, no município de Centenário do Sul-PR. Os tipos estudados foram: Valenciano ('Amarelo-Ouro', Caipira ('Gaúcho Caipira', Net Melon ('Net Galia', Orange ('Orange Melon' e Pele-de-Sapo ('Filipo', com cinco repetições, utilizando seis frutos por repetição em delineamento inteiramente casualizado. Os frutos do Valenciano e Pele-de-Sapo destacaram-se quanto à massa, com valores 2,02 e 2,07 kg, respectivamente, e formatos alongados, enquanto os demais tipos apresentaram formatos arredondados e massa em torno de 1,4 kg. Os melões Pele-de-Sapo apresentaram espessura da polpa de 43,36 mm, estatisticamente superior à dos frutos Valenciano, com 38,98 mm. A menor espessura de polpa, 24,78 cm, e a maior espessura de casca, 9,74 mm, foram encontradas nos frutos do tipo Caipira que diferiu estatisticamente dos outros tipos. Os valores de pH não se apresentaram estatisticamente diferentes e variaram de 6,24 a 6,48. O Net Melon apresentou polpa com 12,3ºBrix e diferiu estatisticamente do Orange, Valenciano e Pele-de-Sapo, com 11;12; 10,34 e 9,94 ºBrix, respectivamente. O Caipira atingiu 5,06ºBrix, e também o menor conteúdo de acidez, 0,10 g de ac. cítrico.100-1 g de suco, o que inviabiliza sua comercialização. A atividade da pectinametilesterase na polpa dos frutos foi muito baixa, inferior a 0,005 PEu x 10(4 mL-1, nos cinco tipos avaliados. Na região norte do Paraná (Vale do Paranapanema, sob condições de cultivo protegido, os melões Pele-de-Sapo, Net Melon, Orange e Valenciano apresentaram boas características físicas e químicas dos frutos, destacando-se o Net Melon

  2. Neuromuscular Junction Impairment in Amyotrophic Lateral Sclerosis: Reassessing the Role of Acetylcholinesterase.

    Science.gov (United States)

    Campanari, Maria-Letizia; García-Ayllón, María-Salud; Ciura, Sorana; Sáez-Valero, Javier; Kabashi, Edor

    2016-01-01

    Amyotrophic Lateral Sclerosis (ALS) is a highly debilitating disease caused by progressive degeneration of motorneurons (MNs). Due to the wide variety of genes and mutations identified in ALS, a highly varied etiology could ultimately converge to produce similar clinical symptoms. A major hypothesis in ALS research is the "distal axonopathy" with pathological changes occurring at the neuromuscular junction (NMJ), at very early stages of the disease, prior to MNs degeneration and onset of clinical symptoms. The NMJ is a highly specialized cholinergic synapse, allowing signaling between muscle and nerve necessary for skeletal muscle function. This nerve-muscle contact is characterized by the clustering of the collagen-tailed form of acetylcholinesterase (ColQ-AChE), together with other components of the extracellular matrix (ECM) and specific key molecules in the NMJ formation. Interestingly, in addition to their cholinergic role AChE is thought to play several "non-classical" roles that do not require catalytic function, most prominent among these is the facilitation of neurite growth, NMJ formation and survival. In all this context, abnormalities of AChE content have been found in plasma of ALS patients, in which AChE changes may reflect the neuromuscular disruption. We review these findings and particularly the evidences of changes of AChE at neuromuscular synapse in the pre-symptomatic stages of ALS.

  3. Acute neuromuscular responses to short and long roundhouse kick striking paces in professional Muay Thai fighters.

    Science.gov (United States)

    Cimadoro, Giuseppe; Mahaffey, Ryan; Babault, Nicolas

    2018-04-04

    Muay Thai fighters strongly rely on the use of the roundhouse kick due to its effectiveness (i.e. power) and implications on the final score. Therefore, different striking tempos at full power are used during training as a method to enhance kicking power. However, the neuromuscular responses are unknown. Thus, the goal of this study was to investigate neuromuscular responses to a single bout of shorter (every second = H1) and longer (every 3s = H3) kick striking time intervals, measured with the countermovement jump (CMJ). Nine professional Muay Thai fighters participated in this randomized, cross-over trial. CMJs were measured on force plates before and after (post 0min, post 5min, post 10min, post 20min and post 30min) two striking (1set x 20reps) conditions (H1; H3). Although no difference was observed between H1 and H3 values, neuromuscular fatigue parameters displayed different patterns over time. CMJ height decreased immediately after H3 striking (PMuay Thai and conditioning coaches should focus on hard striking with both long and slow pacing during specific heavy bag or pad work.

  4. Comparing targeted exome and whole exome approaches for genetic diagnosis of neuromuscular disorders

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    Svetlana Gorokhova

    2015-12-01

    Full Text Available Massively parallel sequencing is rapidly becoming a widely used method in genetic diagnostics. However, there is still no clear consensus as to which approach can most efficiently identify the pathogenic mutations carried by a given patient, while avoiding false negative and false positive results. We developed a targeted exome approach (MyoPanel2 in order to optimize genetic diagnosis of neuromuscular disorders. Using this approach, we were able to analyse 306 genes known to be mutated in myopathies as well as in related disorders, obtaining 98.8% target sequence coverage at 20×. Moreover, MyoPanel2 was able to detect 99.7% of 11,467 known mutations responsible for neuromuscular disorders. We have then used several quality control parameters to compare performance of the targeted exome approach with that of whole exome sequencing. The results of this pilot study of 140 DNA samples suggest that targeted exome sequencing approach is an efficient genetic diagnostic test for most neuromuscular diseases.

  5. The pharmacological effect of Bothrops neuwiedii pauloensis (jararaca-pintada snake venom on avian neuromuscular transmission

    Directory of Open Access Journals (Sweden)

    C.R. Borja-Oliveira

    2003-05-01

    Full Text Available The neuromuscular effects of Bothrops neuwiedii pauloensis (jararaca-pintada venom were studied on isolated chick biventer cervicis nerve-muscle preparations. Venom concentrations of 5-50 µg/ml produced an initial inhibition and a secondary increase of indirectly evoked twitches followed by a progressive concentration-dependent and irreversible neuromuscular blockade. At venom concentrations of 1-20 µg/ml, the responses to 13.4 mM KCl were inhibited whereas those to 110 µM acetylcholine alone and cumulative concentrations of 1 µM to 10 mM were unaffected. At venom concentrations higher than 50 µg/ml, there was pronounced muscle contracture with inhibition of the responses to acetylcholine, KCl and direct stimulation. At 20-24ºC, the venom (50 µg/ml produced only partial neuromuscular blockade (30.7 ± 8.0%, N = 3 after 120 min and the initial inhibition and the secondary increase of the twitch responses caused by the venom were prolonged and pronounced and the response to KCl was unchanged. These results indicate that B.n. pauloensis venom is neurotoxic, acting primarily at presynaptic sites, and that enzyme activity may be involved in this pharmacological action.

  6. Possible applications of Neuromuscular Taping in pain reduction in Multiple Sclerosis subject: a preliminary report

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    Carmine Berlingieri

    2016-12-01

    Full Text Available Pain is a common disabling symptom in patients with Multiple Sclerosis (MS. It has been indicated that pain prevalence in MS patients is between 29–86 %. It is evident that most MS patients requiring treatment will be also searching pain related treatments to assist in day to day activities. Neuropathic pain is a difficult symptom and is generally inadequately relieved even though different rehabilitative approaches may be used. Neuromuscular Taping inducing micro-movements by stimulating receptors in the skin has been described in literature as a possible intervention in neurological and orthopedic rehabilitation improving mobility and in pain reduction. The aim of this preliminary report was to analyze the effect and to evaluate the possible applications of Neuromuscular Taping (NMT in patients with MS in order to reduce pain in comparison to the Transcutaneous Electrical Nerve Stimulation (TENS and to physical rehabilitation treatment alone. We observed that NMT together with standard physical rehabilitation was able to reduce neuropathic pain to greater lengths, with statistically significant differences between pre and post treatment, compared to the other treatments evaluated. This study showed increased efficacy in pain reduction when NMT was applied to standard physical treatment in long standing pain conditions. Neuromuscular Taping may constitute a low cost treatment strategy for neuropathic pain conditions in MS.

  7. Muscle synergies and complexity of neuromuscular control during gait in cerebral palsy.

    Science.gov (United States)

    Steele, Katherine M; Rozumalski, Adam; Schwartz, Michael H

    2015-12-01

    Individuals with cerebral palsy (CP) have impaired movement due to a brain injury near birth. Understanding how neuromuscular control is altered in CP can provide insight into pathological movement. We sought to determine if individuals with CP demonstrate reduced complexity of neuromuscular control during gait compared with unimpaired individuals and if changes in control are related to functional ability. Muscle synergies during gait were retrospectively analyzed for 633 individuals (age range 3.9-70y): 549 with CP (hemiplegia, n=122; diplegia, n=266; triplegia, n=73; quadriplegia, n=88) and 84 unimpaired individuals. Synergies were calculated using non-negative matrix factorization from surface electromyography collected during previous clinical gait analyses. Synergy complexity during gait was compared with diagnosis subtype, functional ability, and clinical examination measures. Fewer synergies were required to describe muscle activity during gait in individuals with CP compared with unimpaired individuals. Changes in synergies were related to functional impairment and clinical examination measures including selective motor control, strength, and spasticity. Individuals with CP use a simplified control strategy during gait compared with unimpaired individuals. These results were similar to synergies during walking among adult stroke survivors, suggesting similar neuromuscular control strategies between these clinical populations. © 2015 Mac Keith Press.

  8. The effect of additional joint mobilization on neuromuscular performance in individuals with functional ankle instability.

    Science.gov (United States)

    Shih, Yi-Fen; Yu, Hsiang-Ting; Chen, Wen-Yin; Liao, Kwong-Kum; Lin, Hsiu-Chen; Yang, Yea-Ru

    2018-03-01

    To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI). A cross-sectional study. Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr). Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG. Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

    LENUS (Irish Health Repository)

    Weekes, G

    2010-07-01

    A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg\\/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg\\/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.

  10. Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

    LENUS (Irish Health Repository)

    Weekes, G

    2012-02-01

    A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg\\/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg\\/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.

  11. Gradual nerve elongation affects nerve cell bodies and neuro-muscular junctions.

    Science.gov (United States)

    Kazuo Ikeda, K I; Masaki Matsuda, M M; Daisuke Yamauchi, D Y; Katsuro Tomita, K T; Shigenori Tanaka, S T

    2005-07-01

    The purpose of this study is to clarify the reactions of the neuro-muscular junction and nerve cell body to gradual nerve elongation. The sciatic nerves of Japanese white rabbits were lengthened by 30 mm in increments of 0.8 mm/day, 2.0 mm/day and 4.0 mm/day. A scanning electron microscopic examination showed no degenerative change at the neuro-muscular junction, even eight weeks after elongation in the 4-mm group. Hence, neuro-muscular junction is not critical for predicting damage from gradual nerve elongation. There were no axon reaction cells in the 0.8-mm group, a small amount in the 2-mm group, and a large amount in the 4-mm group. The rate of growth associated protein-43 positive nerve cells was significant in the 4-mm group. Hence, the safe speed for nerve cells appeared to be 0.8-mm/day, critical speed to be 2.0-mm/day, and dangerous speed to be 4.0-mm/day in this elongation model.

  12. Sugammadex reversal of rocuronium-induced neuromuscular block in a patient with ataxia-telangiectasia

    International Nuclear Information System (INIS)

    Kang, E.; Jung, J.W.

    2015-01-01

    A 17-year-old adolescent with ataxia-telangiectasia was scheduled to have laparoscopic colectomy for a resection of colon cancer. He had symptoms and signs of dyspnea, generalized dystonia, dysmetria, ataxia, and telangiectasia on the orbit. General anesthesia was performed, and rocuronium 30 mg was administered for muscle relaxation. Deep neuromuscular block (post-tetanic count: 0-8) was maintained for 95 minutes without additional rocuronium. On completion of surgery, sugammadex 80 mg was injected and train-of-four ratio was 0.93 at 210 seconds after administration. The tracheal tube was removed 5 min after the end of surgery. He recovered full spontaneous respiration and voluntary movements within 1 minute after extubation. After the surgery, he transferred to the intensive care unit and discharged 14 days after the surgery without any concrete problem. The reversal of rocuronium induced neuromuscular block by sugammadex was fast, complete, and recovered to the initial preoperative level of neuromuscular function in this patient. (author)

  13. Risk of Unsuccessful Noninvasive Ventilation for Acute Respiratory Failure in Heterogeneous Neuromuscular Diseases: A Retrospective Study.

    Science.gov (United States)

    Kataoka, Hiroshi; Nanaura, Hitoki; Kinugawa, Kaoru; Uchihara, Yuto; Ohara, Hiroya; Eura, Nobuyuki; Syobatake, Ryogo; Sawa, Nobuhiro; Takao, Kiriyama; Sugie, Kazuma; Ueno, Satoshi

    2017-02-20

    If invasive ventilation can be avoided by performing noninvasive mechanical ventilation (NIV) in patients with acute respiratory failure (ARF), the disease can be effectively managed. It is important to clarify the characteristics of patients with neuromuscular diseases in whom initial NIV is likely to be unsuccessful. We studied 27 patients in stable neuromuscular condition who initially received NIV to manage fatal ARF to identify differences in factors immediately before the onset of ARF among patients who receive continuous NIV support, patients who are switched from NIV to invasive ventilation, and patients in whom NIV is discontinued. Endpoints were evaluated 24 and 72 hours after the initiation of NIV. After 24 hours, all but 1 patient with amyotrophic lateral sclerosis (ALS) received continuous NIV support. 72 hours later, 5 patients were switched from NIV to invasive ventilation, and 5 patients continued to receive NIV support. 72 hours after the initiation of NIV, the proportion of patients with a diagnosis of ALS differed significantly among the three groups (P=0.039). NIV may be attempted to manage acute fatal respiratory failure associated with neuromuscular diseases, but clinicians should carefully manage the clinical course in patients with ALS.

  14. Risk of unsuccessful noninvasive ventilation for acute respiratory failure in heterogeneous neuromuscular diseases: a retrospective study

    Directory of Open Access Journals (Sweden)

    Hiroshi Kataoka

    2017-03-01

    Full Text Available If invasive ventilation can be avoided by performing noninvasive mechanical ventilation (NIV in patients with acute respiratory failure (ARF, the disease can be effectively managed. It is important to clarify the characteristics of patients with neuromuscular diseases in whom initial NIV is likely to be unsuccessful. We studied 27 patients in stable neuromuscular condition who initially received NIV to manage fatal ARF to identify differences in factors immediately before the onset of ARF among patients who receive continuous NIV support, patients who are switched from NIV to invasive ventilation, and patients in whom NIV is discontinued. Endpoints were evaluated 24 and 72 hours after the initiation of NIV. After 24 hours, all but 1 patient with amyotrophic lateral sclerosis (ALS received continuous NIV support. 72 hours later, 5 patients were switched from NIV to invasive ventilation, and 5 patients continued to receive NIV support. 72 hours after the initiation of NIV, the proportion of patients with a diagnosis of ALS differed significantly among the three groups (P=0.039. NIV may be attempted to manage acute fatal respiratory failure associated with neuromuscular diseases, but clinicians should carefully manage the clinical course in patients with ALS.

  15. C-terminal agrin fragment is inversely related to neuromuscular fatigue in older men.

    Science.gov (United States)

    Stout, Jeffrey R; Fragala, Maren S; Hoffman, Jay R; Robinson, Edward H; Mccormack, William P; Townsend, Jeremy R; Jatjner, Adam R; Emerson, Nadia S; Oliveira, Leonardo P; Fukuda, David H

    2015-01-01

    The aim of this study was to examine the relationship between serum C-terminal agrin fragment (CAF) concentrations and neuromuscular fatigue in older adults. Twenty-two healthy older men and women volunteered for this study. Resting fasted blood samples were collected and prepared for measurement of serum CAF concentration by a commercially available ELISA kit. The onset of neuromuscular fatigue was measured by monitoring electromyographic fatigue curves from the vastus lateralis muscle using the physical working capacity at fatigue threshold (PWCFT ) test. A significant inverse correlation for men was observed between CAF and PWCFT (r = -0.602; P = 0.05), but not for women (r = 0.208; P = 0.54). After controlling for age and body mass index, significant correlations (r = -0.69; P = 0.042) remained for men, but not for women (r = 0.12; P = 0.76). These data suggest that serum CAF concentrations were significantly related to the onset of neuromuscular fatigue independent of age and BMI in men only. © 2014 Wiley Periodicals, Inc.

  16. Alterações da junção neuromuscular em miopatias experimentais no camundongo

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    Luiz Fernando Bleggi Torres

    1989-06-01

    Full Text Available As alterações morfológicas observadas em junção neuromuscular de dois modelos de miopatia em camundongos são estudadas por métodos histoquímicos para demonstrar atividade da enzima acetilcolinesterase e por microscopia eletrônica. Em ambas as situações os resultados obtidos são similares, indicando que a junção neuromuscular permanece intacta mesmo quando a fibra que inerva está sofrendo necrose. Em fibras musculares regeneradas há acentuada simplificação das pregas pós-sinápticas, com redução de até 50% dos valores normais, comprovado por estudos morfométricos. A ausência de repercussões fisiológicas ou clínicas detectáveis nesses modelos, apesar da significativa hipotrofia da membrana pós-sináptica, sugere que a exuberante quantidade de pregas pós-sinápticas normalmente encontradas nas junções mioneürais pode representar mecanismo anatômico de segurança na transmissão química neuromuscular.

  17. The novel protein kinase C epsilon isoform modulates acetylcholine release in the rat neuromuscular junction.

    Science.gov (United States)

    Obis, Teresa; Hurtado, Erica; Nadal, Laura; Tomàs, Marta; Priego, Mercedes; Simon, Anna; Garcia, Neus; Santafe, Manel M; Lanuza, Maria A; Tomàs, Josep

    2015-12-01

    Various protein kinase C (PKC) isoforms contribute to the phosphorylating activity that modulates neurotransmitter release. In previous studies we showed that nPKCε is confined in the presynaptic site of the neuromuscular junction and its presynaptic function is activity-dependent. Furthermore, nPKCε regulates phorbol ester-induced acetylcholine release potentiation, which further indicates that nPKCε is involved in neurotransmission. The present study is designed to examine the nPKCε involvement in transmitter release at the neuromuscular junction. We use the specific nPKCε translocation inhibitor peptide εV1-2 and electrophysiological experiments to investigate the involvement of this isoform in acetylcholine release. We observed that nPKCε membrane translocation is key to the synaptic potentiation of NMJ, being involved in several conditions that upregulate PKC isoforms coupling to acetylcholine (ACh) release (incubation with high Ca(2+), stimulation with phorbol esters and protein kinase A, stimulation with adenosine 3',5'-cyclic monophosphorothioate, 8-Bromo-, Rp-isomer, sodium salt -Sp-8-BrcAMP-). In all these conditions, preincubation with the nPKCε translocation inhibitor peptide (εV1-2) impairs PKC coupling to acetylcholine release potentiation. In addition, the inhibition of nPKCε translocation and therefore its activity impedes that presynaptic muscarinic autoreceptors and adenosine autoreceptors modulate transmitter secretion. Together, these results point to the importance of nPKCε isoform in the control of acetylcholine release in the neuromuscular junction.

  18. Adenosine A2B and A3 receptor location at the mouse neuromuscular junction.

    Science.gov (United States)

    Garcia, Neus; Priego, Mercedes; Hurtado, Erica; Obis, Teresa; Santafe, Manel M; Tomàs, Marta; Lanuza, Maria Angel; Tomàs, Josep

    2014-07-01

    To date, four subtypes of adenosine receptors have been cloned (A(1)R, A(2A)R, A(2B)R, and A(3)R). In a previous study we used confocal immunocytochemistry to identify A(1)R and A(2A)R receptors at mouse neuromuscular junctions (NMJs). The data shows that these receptors are localized differently in the three cells (muscle, nerve and glia) that configure the NMJs. A(1)R localizes in the terminal teloglial Schwann cell and nerve terminal, whereas A(2A)R localizes in the postsynaptic muscle and in the axon and nerve terminal. Here, we use Western blotting to investigate the presence of A(2B)R and A(3)R receptors in striated muscle and immunohistochemistry to localize them in the three cells of the adult neuromuscular synapse. The data show that A(2B)R and A(3)R receptors are present in the nerve terminal and muscle cells at the NMJs. Neither A(2B)R nor A(3)R receptors are localized in the Schwann cells. Thus, the four subtypes of adenosine receptors are present in the motor endings. The presence of these receptors in the neuromuscular synapse allows the receptors to be involved in the modulation of transmitter release. © 2014 Anatomical Society.

  19. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

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    Vishal Sarwahi

    2015-01-01

    Full Text Available Minimally invasive surgery (MIS has been described in the treatment of adolescent idiopathic scoliosis (AIS and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

  20. Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer's disease patients with dysphagia.

    Science.gov (United States)

    Tang, Yi; Lin, Xiang; Lin, Xiao-Juan; Zheng, Wei; Zheng, Zhi-Kai; Lin, Zhao-Min; Chen, Jian-Hao

    2017-09-01

    To study the therapeutic effect of neuromuscular electrical stimulation and electromyographic biofeedback (EMG-biofeedback) therapy in improving swallowing function of Alzheimer's disease patients with dysphagia.A series of 103 Alzheimer's disease patients with dysphagia were divided into 2 groups, among which the control group (n = 50) received swallowing function training and the treatment group (n = 53) received neuromuscular electrical stimulation plus EMG-biofeedback therapy. The mini-mental state scale score was performed in all patients along the treatment period. Twelve weeks after the treatment, the swallowing function was assessed by the water swallow test. The nutritional status was evaluated by Mini Nutritional Assessment (MNA) as well as the levels of hemoglobin and serum albumin. The frequency and course of aspiration pneumonia were also recorded.No significant difference on mini-mental state scale score was noted between 2 groups. More improvement of swallowing function, better nutritional status, and less frequency and shorter course of aspiration pneumonia were presented in treatment group when compared with the control group.Neuromuscular electrical stimulation and EMG-biofeedback treatment can improve swallowing function in patients with Alzheimer's disease and significantly reduce the incidence of adverse outcomes. Thus, they should be promoted in clinical practice.

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

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Sotobata, Iwao; Indo, Toshikatsu; Matsuoka, Yukihiko; Matsushima, Hideo; Suzuki, Akio; Abe, Tetsutaro; Sakuma, Sadayuki

    1986-01-01

    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)

  2. Training the Antifragile Athlete: A Preliminary Analysis of Neuromuscular Training Effects on Muscle Activation Dynamics.

    Science.gov (United States)

    Kiefer, Adam W; Myer, Gregory D

    2015-10-01

    Athletic injuries typically occur when the stable, emergent coordination between behavioral processes breaks down due to external noise, or variability. A physiological system that operates at an optimal point on a spectrum of rigidity and flexibility may be better prepared to handle extreme external variability, and the purpose of the current experiment was to examine whether targeted neuromuscular training resulted in changes to the rigidity and flexibility of the gluteal muscle tonus signal as measured with electromyography prior to the landing phase of a drop vertical jump task. 10 adolescent female athletes who participated in a targeted 10-week neuromuscular training program and 6 controls participated, and their tonus dynamics were examined with recurrence quantification analysis prior to training and after the 10-week program. The dependent measures, percent laminarity (%LAM) and percent determinism (%DET) were hypothesized to decrease following training, and were submitted to a one tailed mixed-model ANOVA. The training group exhibited a decrease in %LAM and %DET after training compared to pre-training and controls. The present findings indicate increased metaflexibility (i.e., greater intermittency and an increase in internal randomness) in tonus dynamics following neuromuscular training, and have important implications for the prevention of musculoskeletal injury in sport, specifically within the context of external noise and antifragility.

  3. 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.

  4. Treatment of postoperative infection after posterior spinal fusion and instrumentation in a patient with neuromuscular scoliosis.

    Science.gov (United States)

    Ghattas, Paul J; Mehlman, Charles T; Eichten, David

    2014-02-01

    According to the literature, patients with neuromuscular scoliosis have a higher rate of infection after spinal fusion. No randomized controlled trials have been completed to assess the optimal treatment and related outcomes for patients with infections after posterior spinal fusion. In this article, we examine the data and report a case in which a vacuum-assisted closure (VAC) device was used as definitive treatment for a deep wound infection after posterior spinal fusion and instrumentation in a patient with neuromuscular scoliosis. Our patient, a 17-year-old adolescent girl with progressive neuromuscular scoliosis, underwent posterior spinal fusion with instrumentation and bone graft from T2 to sacrum without complication. One month after surgery, she presented with a draining wound. She underwent repeat surgical irrigation and debridement with subsequent use of a wound VAC. The wound VAC was used for more than 2 months, until skin closure was complete. The deep polymicrobial wound infection was treated successfully and definitively with a wound VAC. This case report suggests that good long-term outcomes can be achieved with use of a wound VAC for definitive closure, with possible avoidance of other secondary surgeries requiring skin grafts or flaps for wound closure.

  5. Avaliação da resistência a fadiga dos Engineered Cementitious Composites (ecc, reforçados com fibra de polipropileno e produzidos com adição de cinza de casca de arroz

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    Alceu Lopes de Freitas Júnior

    2017-07-01

    Full Text Available O Engineered Cementitious Composites - ECC – é um tipo especial de compósito cimentício de alto desempenho reforçado com fibra, cuja principal característica é a alta ductilidade. O traço de ECC é composto por cimento, material pozolânico, agregado miúdo e fibras. Este estudo avaliou a resistência à fadiga de traços de Engineered Cementitious Composites reforçados com fibras de polipropileno - PPECC – e cuja composição da matriz cimentícia tenha a incorporação de cinza de casca de arroz como material suplementar. Para isto, foram produzidos corpos de prova com substrato de concreto para pavimento e overlay com o traço de PPECC desenvolvido. Os corpos de prova foram submetidos aos ensaios de flexão a quatro pontos (estático e cíclico. Compararam-se os resultados obtidos no ensaio estático dos traços de PPECC com os resultados obtidos neste mesmo ensaio com corpos de prova produzidos somente por concreto para pavimento. Foram analisados os resultados dos ensaios cíclicos em diferentes intervalos de tensões. Com os resultados variação da tensão x números de ciclos, obtidos no ensaio cíclico, foi avaliado o comportamento à fadiga do compósito.

  6. 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

  7. Caffeine ingestion reverses the circadian rhythm effects on neuromuscular performance in highly resistance-trained men.

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    Ricardo Mora-Rodríguez

    Full Text Available PURPOSE: To investigate whether caffeine ingestion counteracts the morning reduction in neuromuscular performance associated with the circadian rhythm pattern. METHODS: Twelve highly resistance-trained men underwent a battery of neuromuscular tests under three different conditions; i morning (10:00 a.m. with caffeine ingestion (i.e., 3 mg kg(-1; AM(CAFF trial; ii morning (10:00 a.m. with placebo ingestion (AM(PLAC trial; and iii afternoon (18:00 p.m. with placebo ingestion (PM(PLAC trial. A randomized, double-blind, crossover, placebo controlled experimental design was used, with all subjects serving as their own controls. The neuromuscular test battery consisted in the measurement of bar displacement velocity during free-weight full-squat (SQ and bench press (BP exercises against loads that elicit maximum strength (75% 1RM load and muscle power adaptations (1 m s(-1 load. Isometric maximum voluntary contraction (MVC(LEG and isometric electrically evoked strength of the right knee (EVOK(LEG were measured to identify caffeine's action mechanisms. Steroid hormone levels (serum testosterone, cortisol and growth hormone were evaluated at the beginning of each trial (PRE. In addition, plasma norepinephrine (NE and epinephrine were measured PRE and at the end of each trial following a standardized intense (85% 1RM 6 repetitions bout of SQ (POST. RESULTS: In the PM(PLAC trial, dynamic muscle strength and power output were significantly enhanced compared with AM(PLAC treatment (3.0%-7.5%; p≤0.05. During AM(CAFF trial, muscle strength and power output increased above AM(PLAC levels (4.6%-5.7%; p≤0.05 except for BP velocity with 1 m s(-1 load (p = 0.06. During AM(CAFF, EVOK(LEG and NE (a surrogate of maximal muscle sympathetic nerve activation were increased above AM(PLAC trial (14.6% and 96.8% respectively; p≤0.05. CONCLUSIONS: These results indicate that caffeine ingestion reverses the morning neuromuscular declines in highly resistance

  8. Neuromuscular adaptations predict functional disability independently of clinical pain and psychological factors in patients with chronic non-specific low back pain.

    Science.gov (United States)

    Dubois, Jean-Daniel; Abboud, Jacques; St-Pierre, Charles; Piché, Mathieu; Descarreaux, Martin

    2014-08-01

    Patients with chronic low back pain exhibit characteristics such as clinical pain, psychological symptoms and neuromuscular adaptations. The purpose of this study was to determine the independent contribution of clinical pain, psychological factors and neuromuscular adaptations to disability in patients with chronic low back pain. Clinical pain intensity, pain catastrophizing, fear-avoidance beliefs, anxiety, neuromuscular adaptations to chronic pain and neuromuscular responses to experimental pain were assessed in 52 patients with chronic low back pain. Lumbar muscle electromyographic activity was assessed during a flexion-extension task (flexion relaxation phenomenon) to assess both chronic neuromuscular adaptations and neuromuscular responses to experimental pain during the task. Multiple regressions showed that independent predictors of disability included neuromuscular adaptations to chronic pain (β=0.25, p=0.006, sr(2)=0.06), neuromuscular responses to experimental pain (β=-0.24, p=0.011, sr(2)=0.05), clinical pain intensity (β=0.28, p=0.002, sr(2)=0.08) and psychological factors (β=0.58, ppain intensity and psychological factors, and contribute to inter-individual differences in patients' disability. This suggests that disability, in chronic low back pain patients, is determined by a combination of factors, including clinical pain, psychological factors and neuromuscular adaptations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Survey of how different groups of veterinarians manage the use of neuromuscular blocking agents in anesthetized dogs.

    Science.gov (United States)

    Martin-Flores, Manuel; Sakai, Daniel M; Campoy, Luis; Gleed, Robin D

    2018-03-23

    To analyze practice habits associated with the use, reversal and monitoring of nondepolarizing neuromuscular blocking agents (NMBAs) in dogs by different groups of veterinarians. Online anonymous survey to veterinarians. Data from 390 answered surveys. A questionnaire was sent to e-mail list servers of the American College of Veterinary Anesthesia and Analgesia (ACVAA-list), Sociedad Española de Anestesia y Analgesia Veterinaria (SEEAV-list), Colégio Brasileiro de Anestesiologia Veterinária (Brazilian College of Veterinary Anesthesiology; CBAV-list) and American College of Veterinary Ophthalmologists (ACVO-list) to elicit information regarding use of NMBAs and reversal agents, monitoring techniques, criteria for redosing, reversing and assessing adequacy of recovery of neuromuscular function. Binomial logistic regression was used to test for association between responses and group of veterinarians in selected questions. Veterinarians of the ACVO-list use NMBAs on a higher fraction of their caseload than other groups (all p < 0.0001). Subjective assessment (observation) of spontaneous movement, including spontaneous breathing, is the most common method for assessing neuromuscular function (43% of pooled responses); 18% of participants always reverse NMBAs, whereas 16% never reverse them. Restoration of neuromuscular function is assessed subjectively by 35% of respondents. Residual neuromuscular block is the most common concern regarding the use of NMBAs for all groups of veterinarians. Side effects of reversal agents (anticholinesterases) were of least concern for all groups. While most veterinarians are concerned about residual neuromuscular block, relatively few steps are implemented to reduce the risks of this complication, such as routine use of quantitative neuromuscular monitoring or routine reversal of NMBAs. These results suggest a limitation in transferring information among groups of veterinarians, or in implementing techniques suggested by scientific

  10. Bloqueio do plexo braquial, por via infraclavicular vertical, em paciente com doença pulmonar obstrutiva crônica: relato de caso Bloqueo del plexo braquial, por vía infraclavicular vertical, en paciente con enfermedad pulmonar obstructiva crónica: relato de caso Infraclavicular vertical brachial plexus blockade in patients with chronic obstructive pulmonary disease: case report

    Directory of Open Access Journals (Sweden)

    Diogo Brüggemann da Conceição

    2006-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os pacientes com doença pulmonar obstrutiva crônica (DPOC têm risco aumentado de complicações pós-operatórias, sobretudo quando submetidos à anestesia geral. O bloqueio do plexo braquial representa uma alternativa para estes pacientes em intervenções cirúrgicas de membros superiores. O objetivo deste relato foi apresentar um caso de bloqueio do plexo braquial, por via infraclavicular vertical em paciente com DPOC com fratura de cotovelo. RELATO DO CASO: Paciente do sexo feminino, 67 anos, 52 kg, estado físico ASA III, com indicação de osteossíntese de cotovelo, portadora de bronquiectasias desde nove anos de idade após uma pneumonia. Apresentava tosse produtiva habitualmente, e fora submetida à avaliação de seu pneumologista que a liberou para o procedimento. Após instalação de monitorização com pressão arterial não-invasiva, ECG e oxímetro de pulso, foi realizado bloqueio do plexo braquial por via infraclavicular vertical com 30 mL de ropivacaína a 0,5%. A intervenção cirúrgica foi realizada sem intercorrências. A paciente recebeu alta hospitalar no dia seguinte ao procedimento cirúrgico. CONCLUSÕES: O bloqueio do plexo braquial por via infraclavicular vertical é uma técnica alternativa para portadores de DPOC e fratura de cotovelo, por sua menor morbidade quando comparado com a anestesia geral e com a via supraclavicular.JUSTIFICATIVA Y OBJETIVOS: Los pacientes con enfermedad pulmonar obstructiva crónica (DPOC presentan riesgo mayor de complicaciones postoperatorias especialmente cuando se les someten a la anestesia general. El bloqueo del plexo braquial representa una alternativa para esos pacientes en intervenciones quirúrgicas de miembros superiores. El objetivo de este relato fue el de presentar un caso de bloqueo del plexo braquial, por vía infraclavicular vertical en paciente con DPOC con fractura de codo. RELATO DEL CASO: Paciente del sexo femenino, 67 años, 52 kg

  11. Bloqueio bilateral do nervo pudendo para hemorroidectomia em paciente acondroplásico: relato de caso Bloqueo bilateral del nervio pudendo para hemorroidectomía en paciente acondroplásico: relato de caso Bilateral blockade of the pudend nerve to hemorrhoidectomy in achondroplasic patient: case report

    Directory of Open Access Journals (Sweden)

    Bruno Salomé de Morais

    2006-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O nanismo acondroplásico ou acondroplasia é a forma mais comum de nanismo e ocorre na maioria dos casos por alteração genética espontânea. A anestesia desses pacientes apresenta várias particularidades. O objetivo do presente relato foi descrever um caso de paciente acondroplásico, com história prévia de intervenção cirúrgica da coluna para descompressão medular, submetido a hemorroidectomia através de bloqueio bilateral dos nervos pudendos. RELATO DO CASO: Paciente do sexo masculino, 47 anos, acondroplásico, internado para realização de hemorroidectomia.Ao exame físico apresentava pescoço encurtado com extensão limitada da cabeça, Mallampati classe IV, distância tireomentoniana de 6 cm e abertura da boca de 3,5 cm. A coluna vertebral apresentava cifose torácica e lordose lombar acentuada, além de cicatriz cirúrgica na região lombar. Foi realizado bloqueio bilateral dos nervos pudendos com ropivacaína a 1%, por via transperineal, com agulha isolada 0,8 mm x 100 mm 21G (Stimuplex A100 BBraun, Melsungen, Germany conectada ao estimulador de nervos periféricos (Stimuplex-DIG, BBraun.O paciente foi posicionado em decúbito ventral e a cirurgia iniciada após 15 minutos da administração do anestésico. Durante todo o procedimento o paciente permaneceu consciente e não relatou dor ou desconforto. Até o momento da alta hospitalar (22h após a realização do bloqueio o paciente não referiu dor, desconforto, náusea, vômito, bloqueio motor, retenção ou incontinência urinária. Após a alta, evoluiu bem, apresentando evacuação após 31 horas da cirurgia. CONCLUSÕES: O caso ilustrou o uso do bloqueio bilateral dos nervos pudendos, com auxílio do neuroestimulador como técnica anestésica isolada para hemorroidectomia.JUSTIFICATIVA Y OBJETIVOS: El enanismo acondroplásico o acondroplasia es la forma más común de enanismo y ocurre en la mayoría de los casos por alteración gen

  12. Manejo de longo prazo em crianças com transtornos neuromusculares Long-term management of children with neuromuscular disorders

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    Eugen-Matthias Strehle

    2009-10-01

    Full Text Available OBJETIVO: A distrofia muscular de Duchenne é o tipo mais comum de miopatia genética. Contudo, existe um grande número de doenças neuromusculares hereditárias que são individualmente muito raras e sobre as quais não há muita informação clínica disponível. Este artigo de revisão baseia-se na experiência do autor em uma clínica pediátrica para tratamento de doenças musculares e apresenta orientação prática e planos terapêuticos para os problemas frequentemente encontrados. FONTES DE DADOS: O banco de dados da MEDLINE foi pesquisado com o objetivo de localizar artigos recentes e relevantes para o manejo de crianças com miopatias e neuropatias hereditárias. Uma coorte de 200 pacientes foi avaliada através de análise estatística descritiva. SÍNTESE DOS DADOS: A distrofia muscular de Duchenne representou quase metade dos diagnósticos, seguida da atrofia muscular espinhal (12%, da distrofia muscular de Becker e da distrofia miotônica (7% cada. Dezesseis pacientes (9% apresentaram miopatia de origem desconhecida. CONCLUSÕES: Assim como ocorre com outras doenças crônicas, esses pacientes devem passar por acompanhamento periódico realizado por profissionais de saúde desde cedo para aumentar sua expectativa de vida e melhorar sua qualidade de vida. É útil para os médicos adotarem uma abordagem estruturada ao atender crianças com transtornos neuromusculares e monitorar todos os sistemas de órgãos afetados.OBJECTIVE: Duchenne muscular dystrophy is the commonest genetic myopathy but there exist a large number of inherited neuromuscular diseases which individually are very rare and where clinical information is not widely available. This review is based on the author's experience in a pediatric muscle clinic and provides practical guidance and treatment plans for frequently encountered problems. SOURCES: A MEDLINE search was conducted to retrieve recent articles relevant to the management of children with

  13. The impact of neuromuscular electrical stimulation on recovery after intensive, muscle damaging, maximal speed training in professional team sports players.

    Science.gov (United States)

    Taylor, Tom; West, Daniel J; Howatson, Glyn; Jones, Chris; Bracken, Richard M; Love, Thomas D; Cook, Christian J; Swift, Eamon; Baker, Julien S; Kilduff, Liam P

    2015-05-01

    During congested fixture periods in team sports, limited recovery time and increased travel hinder the implementation of many recovery strategies; thus alternative methods are required. We examined the impact of a neuromuscular electrical stimulation device on 24-h recovery from an intensive training session in professional players. Twenty-eight professional rugby and football academy players completed this randomised and counter-balanced study, on 2 occasions, separated by 7 days. After baseline perceived soreness, blood (lactate and creatine kinase) and saliva (testosterone and cortisol) samples were collected, players completed a standardised warm-up and baseline countermovement jumps (jump height). Players then completed 60 m × 50 m maximal sprints, with 5 min recovery between efforts. After completing the sprint session, players wore a neuromuscular electrical stimulation device or remained in normal attire (CON) for 8 h. All measures were repeated immediately, 2 and 24-h post-sprint. Player jump height was reduced from baseline at all time points under both conditions; however, at 24-h neuromuscular electrical stimulation was significantly more recovered (mean±SD; neuromuscular electrical stimulation -3.2±3.2 vs. CON -7.2±3.7%; P0.05). Neuromuscular electrical stimulation improves recovery from intensive training in professional team sports players. This strategy offers an easily applied recovery strategy which may have particular application during sleep and travel. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. 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.

  15. Report by the Spanish Foundation for the Brain on the social impact of amyotrophic lateral sclerosis and other neuromuscular disorders.

    Science.gov (United States)

    Camacho, A; Esteban, J; Paradas, C

    A thorough knowledge of the socioeconomic scope of neuromuscular disease is essential for managing resources and raising social awareness. Our group reviewed current data on the epidemiology, mortality and dependence rates, and socioeconomic impact of amyotrophic lateral sclerosis and neuromuscular diseases in Spain. We also recorded how neurological care for these patients is organised. Neuromuscular disorders are a very heterogeneous group of diseases, and some are very rare. These disorders account for between 2.8% and 18% of the total motives for a neurological consultation. In Spain, prevalence and incidence figures for amyotrophic lateral sclerosis are similar to those in other countries; however, figures for patients with other neuromuscular diseases are not known. Since the diseases are chronic, progressive, and debilitating, they cause considerable disability and dependence, which in turn directly affects healthcare and social costs associated with the disease. The costs generated by one patient with amyotrophic lateral sclerosis or Duchenne disease have been calculated at about 50 000 euros per year. Neuromuscular disease shows aetiological, diagnostic, and prognostic complexity, and it requires multidisciplinary management. Follow-up for these patients should be entrusted to specialised units. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. The punctum fixum-punctum mobile model: a neuromuscular principle for efficient movement generation?

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    von Laßberg, Christoph; Rapp, Walter

    2015-01-01

    According to the "punctum fixum-punctum mobile model" that was introduced in prior studies, for generation of the most effective intentional acceleration of a body part the intersegmental neuromuscular onset succession has to spread successively from the rotation axis (punctum fixum) toward the body part that shall be accelerated (punctum mobile). The aim of the present study was to investigate whether this principle is, indeed, fundamental for any kind of efficient rotational accelerations in general, independent of the kind of movements, type of rotational axis, the current body position, or movement direction. Neuromuscular onset succession was captured by surface electromyography of relevant muscles of the anterior and posterior muscle chain in 16 high-level gymnasts during intentional accelerating movement phases while performing 18 different gymnastics elements (in various body positions to forward and backward, performed on high bar, parallel bars, rings and trampoline), as well as during non-sport specific pivot movements around the longitudinal axis. The succession patterns to generate the acceleration phases during these movements were described and statistically evaluated based on the onset time difference between the muscles of the corresponding muscle chain. In all the analyzed movement phases, the results clearly support the hypothesized succession pattern from punctum fixum to punctum mobile. This principle was further underlined by the finding that the succession patterns do change their direction running through the body when the rotational axis (punctum fixum) has been changed (e.g., high bar or rings [hands] vs. floor or trampoline [feet]). The findings improve our understanding of intersegmental neuromuscular coordination patterns to generate intentional movements most efficiently. This could help to develop more specific methods to facilitate such patterns in particular contexts, thus allowing for shorter motor learning procedures of context

  17. Mitochondrial DNA triplication and punctual mutations in patients with mitochondrial neuromuscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Mkaouar-Rebai, Emna, E-mail: emna.mkaouar@gmail.com [Département des Sciences de la Vie, Faculté des Sciences de Sfax, Université de Sfax (Tunisia); Felhi, Rahma; Tabebi, Mouna [Laboratoire de Génétique Moléculaire Humaine, Faculté de Médecine de Sfax, Université de Sfax (Tunisia); Alila-Fersi, Olfa; Chamkha, Imen [Département des Sciences de la Vie, Faculté des Sciences de Sfax, Université de Sfax (Tunisia); Maalej, Marwa; Ammar, Marwa [Laboratoire de Génétique Moléculaire Humaine, Faculté de Médecine de Sfax, Université de Sfax (Tunisia); Kammoun, Fatma [Service de pédiatrie, C.H.U. Hedi Chaker de Sfax (Tunisia); Keskes, Leila [Laboratoire de Génétique Moléculaire Humaine, Faculté de Médecine de Sfax, Université de Sfax (Tunisia); Hachicha, Mongia [Service de pédiatrie, C.H.U. Hedi Chaker de Sfax (Tunisia); Fakhfakh, Faiza, E-mail: faiza.fakhfakh02@gmail.com [Département des Sciences de la Vie, Faculté des Sciences de Sfax, Université de Sfax (Tunisia)

    2016-04-29

    Mitochondrial diseases are a heterogeneous group of disorders caused by the impairment of the mitochondrial oxidative phosphorylation system which have been associated with various mutations of the mitochondrial DNA (mtDNA) and nuclear gene mutations. The clinical phenotypes are very diverse and the spectrum is still expanding. As brain and muscle are highly dependent on OXPHOS, consequently, neurological disorders and myopathy are common features of mtDNA mutations. Mutations in mtDNA can be classified into three categories: large-scale rearrangements, point mutations in tRNA or rRNA genes and point mutations in protein coding genes. In the present report, we screened mitochondrial genes of complex I, III, IV and V in 2 patients with mitochondrial neuromuscular disorders. The results showed the presence the pathogenic heteroplasmic m.9157G>A variation (A211T) in the MT-ATP6 gene in the first patient. We also reported the first case of triplication of 9 bp in the mitochondrial NC7 region in Africa and Tunisia, in association with the novel m.14924T>C in the MT-CYB gene in the second patient with mitochondrial neuromuscular disorder. - Highlights: • We reported 2 patients with mitochondrial neuromuscular disorders. • The heteroplasmic MT-ATP6 9157G>A variation was reported. • A triplication of 9 bp in the mitochondrial NC7 region was detected. • The m.14924T>C transition (S60P) in the MT-CYB gene was found.

  18. What occupant kinematics and neuromuscular responses tell us about whiplash injury.

    Science.gov (United States)

    Siegmund, Gunter P

    2011-12-01

    Literature-based review. To review the published data on occupant kinematic and neuromuscular responses during low-speed impacts and analyze how these data inform our understanding of whiplash injury. A stereotypical kinematic and neuromuscular response has been observed in human subjects exposed to rear-end impacts. Combined with various models of injury, these response data have been used to develop anti-whiplash seats that prevent whiplash injury in many, but not all, individuals exposed to a rear-end crash. Synthesis of the literature. Understanding of the occupant kinematics and neuromuscular responses, combined with data from various seat-related interventions, have shown that differential motion between the superior and inferior ends of the cervical spine is responsible for many whiplash injuries. The number of whiplash injuries not prevented by current anti-whiplash seats suggests than further work remains, possibly related to designing seats that respond dynamically to the occupant and collision properties. Neck muscles alter the head and neck kinematics during the interval in which injury likely occurs, even in initially relaxed occupants. It remains unclear whether muscle activation mitigates or exacerbates whiplash injury. If muscle activation mitigates injury, then advance warning could be used to help occupant tense their muscles before impact. Alternatively, if muscle activation exacerbates whiplash injury, then a loud preimpact sound that uncouples the startle and postural components of the muscle response could reduce peak muscle activation during a whiplash exposure. Our improved understanding of whiplash injury has led to anti-whiplash seats that have prevented many whiplash injuries. Further work remains to optimize these and possibly other systems to further reduce the number of whiplash injuries.

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

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    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the 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 eight 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 isometric maximum voluntary contraction 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 the 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

  20. Evaluation of the neuromuscular compartments in the peroneus longus muscle through electrical stimulation and accelerometry

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    Guillermo A. Mendez

    2013-10-01

    Full Text Available BACKGROUND: Muscles are innervated exclusively by a nerve branch and possess definite actions. However, mammalian skeletal muscles, such as the trapezius, the medial gastrocnemius, and the peroneus longus, are compartmentalized. In the peroneus longus muscle, multiple motor points, which innervate individual neuromuscular compartments (NMC, the superior (S-NMC, anteroinferior (AI-NMC, and posteroinferior (PI-NMC, have been described. The contribution of each neuromuscular compartment to the final action of the muscle is fundamental for the rehabilitation of patients afflicted by neurological and muscle dysfunctions. Interventions are often based on electrical principles that take advantage of the physiological characteristics of muscles and nerves to generate therapeutic effects. OBJECTIVE: To compare the effects of stimulating the different neuromuscular compartments (NMCs of the peroneus longus muscle on the motor threshold (MT and acceleration of the foot. METHOD: This is a cross-sectional study comprising 37 subjects. The three NMCs of the peroneus longus muscle were stimulated, and the acceleration of the foot and the motor threshold of each NMC were evaluated. A repeated measures analysis of variance with Bonferroni corrections of two intra-subjects factors was performed. RESULTS: The stimulation of the different NMCs did not result in any differences in MT (F=2.635, P=0.079. There were significant differences between the axes of acceleration caused by the stimulation of the different NMCs (F=56,233; P=0.000. The stimulation of the posteroinferior compartment resulted in the greatest acceleration in the X-axis (mean 0.614; standard deviation 0.253. CONCLUSIONS: The posteroinferior compartment primarily contributes to the eversion movement of the foot. NMCs have specific functional roles that contribute to the actions of the muscles to which they belong.

  1. Population pharmacokinetic–pharmacodynamic analysis for sugammadex-mediated reversal of rocuronium-induced neuromuscular blockade

    Science.gov (United States)

    Kleijn, Huub J; Zollinger, Daniel P; van den Heuvel, Michiel W; Kerbusch, Thomas

    2011-01-01

    AIMS An integrated population pharmacokinetic–pharmacodynamic model was developed with the following aims: to simultaneously describe pharmacokinetic behaviour of sugammadex and rocuronium; to establish the pharmacokinetic–pharmacodynamic model for rocuronium-induced neuromuscular blockade and reversal by sugammadex; to evaluate covariate effects; and to explore, by simulation, typical covariate effects on reversal time. METHODS Data (n = 446) from eight sugammadex clinical studies covering men, women, non-Asians, Asians, paediatrics, adults and the elderly, with various degrees of renal impairment, were used. Modelling and simulation techniques based on physiological principles were applied to capture rocuronium and sugammadex pharmacokinetics and pharmacodynamics and to identify and quantify covariate effects. RESULTS Sugammadex pharmacokinetics were affected by renal function, bodyweight and race, and rocuronium pharmacokinetics were affected by age, renal function and race. Sevoflurane potentiated rocuronium-induced neuromuscular blockade. Posterior predictive checks and bootstrapping illustrated the accuracy and robustness of the model. External validation showed concordance between observed and predicted reversal times, but interindividual variability in reversal time was pronounced. Simulated reversal times in typical adults were 0.8, 1.5 and 1.4 min upon reversal with sugammadex 16 mg kg−1 3 min after rocuronium, sugammadex 4 mg kg−1 during deep neuromuscular blockade and sugammadex 2 mg kg−1 during moderate blockade, respectively. Simulations indicated that reversal times were faster in paediatric patients and slightly slower in elderly patients compared with adults. Renal function did not affect reversal time. CONCLUSIONS Simulations of the therapeutic dosing regimens demonstrated limited impact of age, renal function and sevoflurane use, as predicted reversal time in typical subjects was always <2 min. PMID:21535448

  2. Reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmine.

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    Lemmens Hendrikus JM

    2010-09-01

    Full Text Available Abstract Background Acetylcholinesterase inhibitors cannot rapidly reverse profound neuromuscular block. Sugammadex, a selective relaxant binding agent, reverses the effects of rocuronium and vecuronium by encapsulation. This study assessed the efficacy of sugammadex compared with neostigmine in reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia. Methods Patients aged ≥18 years, American Society of Anesthesiologists class 1-4, scheduled to undergo surgery under general anesthesia were enrolled in this phase III, multicenter, randomized, safety-assessor blinded study. Sevoflurane anesthetized patients received vecuronium 0.1 mg/kg for intubation, with maintenance doses of 0.015 mg/kg as required. Patients were randomized to receive sugammadex 4 mg/kg or neostigmine 70 μg/kg with glycopyrrolate 14 μg/kg at 1-2 post-tetanic counts. The primary efficacy variable was time from start of study drug administration to recovery of the train-of-four ratio to 0.9. Safety assessments included physical examination, laboratory data, vital signs, and adverse events. Results Eighty three patients were included in the intent-to-treat population (sugammadex, n = 47; neostigmine, n = 36. Geometric mean time to recovery of the train-of-four ratio to 0.9 was 15-fold faster with sugammadex (4.5 minutes compared with neostigmine (66.2 minutes; p Conclusions Recovery from profound vecuronium-induced block is significantly faster with sugammadex, compared with neostigmine. Neostigmine did not rapidly reverse profound neuromuscular block (Trial registration number: NCT00473694.

  3. A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis

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    Paulo Alvim Borges

    Full Text Available OBJECTIVES: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

  4. Redox homeostasis and age‐related deficits in neuromuscular integrity and function

    Science.gov (United States)

    Lightfoot, Adam P.; Earl, Kate E.; Stofanko, Martin; McDonagh, Brian

    2017-01-01

    Abstract Skeletal muscle is a major site of metabolic activity and is the most abundant tissue in the human body. Age‐related muscle atrophy (sarcopenia) and weakness, characterized by progressive loss of lean muscle mass and function, is a major contributor to morbidity and has a profound effect on the quality of life of older people. With a continuously growing older population (estimated 2 billion of people aged >60 by 2050), demand for medical and social care due to functional deficits, associated with neuromuscular ageing, will inevitably increase. Despite the importance of this ‘epidemic’ problem, the primary biochemical and molecular mechanisms underlying age‐related deficits in neuromuscular integrity and function have not been fully determined. Skeletal muscle generates reactive oxygen and nitrogen species (RONS) from a variety of subcellular sources, and age‐associated oxidative damage has been suggested to be a major factor contributing to the initiation and progression of muscle atrophy inherent with ageing. RONS can modulate a variety of intracellular signal transduction processes, and disruption of these events over time due to altered redox control has been proposed as an underlying mechanism of ageing. The role of oxidants in ageing has been extensively examined in different model organisms that have undergone genetic manipulations with inconsistent findings. Transgenic and knockout rodent studies have provided insight into the function of RONS regulatory systems in neuromuscular ageing. This review summarizes almost 30 years of research in the field of redox homeostasis and muscle ageing, providing a detailed discussion of the experimental approaches that have been undertaken in murine models to examine the role of redox regulation in age‐related muscle atrophy and weakness. PMID:28744984

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

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    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

  6. Neuromuscular Control Deficits and the Risk of Subsequent Injury after a Concussion: A Scoping Review.

    Science.gov (United States)

    Howell, David R; Lynall, Robert C; Buckley, Thomas A; Herman, Daniel C

    2018-05-01

    An emerging area of research has identified that an increased risk of musculoskeletal injury may exist upon returning to sports after a sport-related concussion. The mechanisms underlying this recently discovered phenomenon, however, remain unknown. One theorized reason for this increased injury risk includes residual neuromuscular control deficits that remain impaired despite clinical recovery. Thus, the objectives of this review were: (1) to summarize the literature examining the relationship between concussion and risk of subsequent injury and (2) to summarize the literature for one mechanism with a theorized association with this increased injury risk, i.e., neuromuscular control deficits observed during gait after concussion under dual-task conditions. Two separate reviews were conducted consistent with both specified objectives. Studies published before 9 December, 2016 were identified using PubMed, Web of Science, and Academic Search Premier (EBSCOhost). Inclusion for the objective 1 search included dependent variables of quantitative measurements of musculoskeletal injury after concussion. Inclusion criteria for the objective 2 search included dependent variables pertaining to gait, dynamic balance control, and dual-task function. A total of 32 studies were included in the two reviews (objective 1 n = 10, objective 2 n = 22). According to a variety of study designs, athletes appear to have an increased risk of sustaining a musculoskeletal injury following a concussion. Furthermore, dual-task neuromuscular control deficits may continue to exist after patients report resolution of concussion symptoms, or perform normally on other clinical concussion tests. Therefore, musculoskeletal injury risk appears to increase following a concussion and persistent motor system and attentional deficits also seem to exist after a concussion. While not yet experimentally tested, these motor system and attentional deficits may contribute to the risk of sustaining a

  7. Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA.

    Science.gov (United States)

    Levine, Michael; McElroy, Karen; Stakich, Valerie; Cicco, Jodie

    2013-03-01

    Rehabilitation following total knee arthroplasty (TKA) is a costly, cumbersome, and often painful process. Physical therapy contributes to the successful outcome of TKA but can be expensive. Alternative methods of obtaining good functional results that help minimize costs are desirable. Neuromuscular electrical stimulation (NMES) is a potential option. Neuromuscular electrical stimulation has been shown to increase quadriceps muscle strength and activation following TKA. Functional scores also improve following TKA when NMES is added to conventional therapy protocols vs therapy alone. The authors hypothesized that rehabilitation managed by a physical therapist would not result in a functional advantage for patients undergoing TKA when compared with NMES and an unsupervised at-home range of motion exercise program and that patient satisfaction would not differ between the 2 groups. Seventy patients were randomized into a postoperative protocol of conventional physical therapy with a licensed therapist, including range of motion exercises and strengthening exercises, or into a program of NMES and range of motion exercises performed at home without therapist supervision. Noninferiority of the NMES program was obtained 6 weeks postoperatively (Knee Society pain/function scores, Western Ontario and McMaster Universities Osteoarthritis Index, flexion). Noninferiority was shown 6 months postoperatively for all parameters. The results suggest that rehabilitation managed by a physical therapist results in no functional advantage or difference in patient satisfaction when compared with NMES and an unsupervised at-home range of motion program. Neuromuscular electrical stimulation and unsupervised at-home range of motion exercises may provide an option for reducing the cost of the postoperative TKA recovery process without compromising quadriceps strength or patient satisfaction. Copyright 2013, SLACK Incorporated.

  8. Neuromuscular Effects of Rocuronium Bromide in Patients in Statin Therapy for at least Three Months.

    Science.gov (United States)

    Ren, Hongwei; Lv, Huangwei

    2016-12-01

    Statins cause skeletal muscle myopathy. However, the neuromuscular effects of non-depolarizing neuromuscular-blocking agent in patients in long-term statin therapy remain unclear. Hence, we investigated the neuromuscular effects of rocuronium and muscle injury in patients in long-term statin therapy. Eighteen statin users using statins for at least 3 months were included in the statin group and 18 non-statin users were included in the non-statin group. General anaesthesia was induced with intravenous midazolam, etomidate, sufentanil and rocuronium 0.9 mg/kg (3ED 95 ) for intubation. Anaesthesia was maintained with 1% propofol and remifentanil. The onset time and duration 10% T 1 and 25% T 1 of rocuronium were recorded. Blood samples were obtained before induction and 5 min., 1 hr, 2 hr, 4 hr, 12 hr and 24 hr after rocuronium administration to measure creatine kinase (CK), myoglobin and potassium. Myalgia was determined at 2 and 24 hr after surgery. There were no significant differences in the basic clinical characteristics between the two groups. The onset time of the statin group was significantly shorter than that of the non-statin group (p = 0.02), while the duration 10% T 1 and duration 25% T 1 of the statin group were significantly longer than those of the non-statin group (p = 0.006; p = 0.045). The myoglobin and CK concentrations increased after rocuronium administration as compared to baseline in both groups. CK concentration in the statin group was significantly higher than in the non-statin group just at 24 hr (p = 0.000003). However, myoglobin showed no significant difference between the two groups. The onset time of rocuronium decreases and its duration time increases in patients in long-term statin therapy. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  9. Neuromuscular Responses of Elite Skaters During Different Roller Figure Skating Jumps

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    Pantoja Patrícia Dias

    2014-07-01

    Full Text Available This study aimed to describe the neuromuscular activity of elite athletes who performed various roller figure skating jumps, to determine whether the muscle activation is greater during jumps with more rotations and in which phase the muscles are more active. This study also aimed to analyze if there is any difference in the muscle activity pattern between female and male skaters. Four elite skaters were evaluated, and each participated in two experimental sessions. During the first session, anthropometric data were collected, and the consent forms were signed. For the second session, neuromuscular data were collected during jumps, which were performed with skates at a rink. The following four roller figure skating jumps were evaluated: single Axel, double Axel, double Mapes and triple Mapes. The neuromuscular activity of the following seven muscles was obtained with an electromyograph which was fixed to the waist of each skater with a strap: biceps femoris, lateral gastrocnemius, tibialis anterior, rectus femoris, vastus lateralis, vastus medialis and gluteus maximus. The signal was transmitted wirelessly to a laptop. During the roller figure skating jumps, the lateral gastrocnemius, rectus femoris, vastus lateralis, biceps femoris and gluteus maximus, showed more activation during the jumps with more rotations, and the activation mainly occurred during the propulsion and flight phases. Female skaters demonstrated higher muscle activities in tibialis anterior, vastus lateralis, vastus medialis and gluteus maximus during the landing phase of the triple Mapes, when compared to their male counterparts. The results obtained in this study should be considered when planning training programs with specific exercises that closely resemble the roller figure skating jumps. This may be important for the success of elite skaters in competitions.

  10. Neuromuscular Responses of Elite Skaters During Different Roller Figure Skating Jumps

    Science.gov (United States)

    Pantoja, Patrícia Dias; Mello, André; Liedtke, Giane Veiga; Kanitz, Ana Carolina; Cadore, Eduardo Lusa; Pinto, Stephanie Santana; Alberton, Cristine Lima; Kruel, Luiz Fernando Martins

    2014-01-01

    This study aimed to describe the neuromuscular activity of elite athletes who performed various roller figure skating jumps, to determine whether the muscle activation is greater during jumps with more rotations and in which phase the muscles are more active. This study also aimed to analyze if there is any difference in the muscle activity pattern between female and male skaters. Four elite skaters were evaluated, and each participated in two experimental sessions. During the first session, anthropometric data were collected, and the consent forms were signed. For the second session, neuromuscular data were collected during jumps, which were performed with skates at a rink. The following four roller figure skating jumps were evaluated: single Axel, double Axel, double Mapes and triple Mapes. The neuromuscular activity of the following seven muscles was obtained with an electromyograph which was fixed to the waist of each skater with a strap: biceps femoris, lateral gastrocnemius, tibialis anterior, rectus femoris, vastus lateralis, vastus medialis and gluteus maximus. The signal was transmitted wirelessly to a laptop. During the roller figure skating jumps, the lateral gastrocnemius, rectus femoris, vastus lateralis, biceps femoris and gluteus maximus, showed more activation during the jumps with more rotations, and the activation mainly occurred during the propulsion and flight phases. Female skaters demonstrated higher muscle activities in tibialis anterior, vastus lateralis, vastus medialis and gluteus maximus during the landing phase of the triple Mapes, when compared to their male counterparts. The results obtained in this study should be considered when planning training programs with specific exercises that closely resemble the roller figure skating jumps. This may be important for the success of elite skaters in competitions. PMID:25114728

  11. Impacts of obesity and stress on neuromuscular fatigue development and associated heart rate variability.

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    Mehta, R K

    2015-02-01

    Obesity and stress are independently associated with decrements in neuromuscular functions. The present study examined the interplay of obesity and stress on neuromuscular fatigue and associated heart rate variability (HRV). Forty-eight non-obese (18.5obese (30⩽BMI) adults performed repetitive handgrip exertions at 30% of their maximum strength until exhaustion in the absence and presence of a mental arithmetic stressor. Dependent measures included gold standard fatigue indicators (endurance time and rate of strength loss), perceived effort and mental demand, heart rate and temporal (RMSSD: root mean square of successive differences between N-N intervals) and spectral (LF/HF: ratio of low to high frequency) indices of HRV. Stress negatively affected endurance time (Pobesity × stress interactions were found on endurance time (P=0.0073), rate of strength loss (P=0.027) and perceived effort (P=0.026), indicating that stress increased fatigability, particularly in the obese group. Both obesity (P=0.001) and stress (P=0.033) independently lowered RMSSD. Finally, stress increased LF/HF ratio (P=0.028) and the interaction of stress and obesity (P=0.008) indicated that this was augmented in the obese group. The present study provides the first evidence that stress-related neuromuscular fatigue development is accelerated in obese individuals. In addition, the stress condition resulted in poorer HRV indices, which is indicative of autonomic dysfunction, particularly in the obese group. These findings indicate that workers are more susceptible to fatigue in high-stress work environments, particularly those with higher BMI, which can increase the risk of musculoskeletal injuries as well as cardiovascular diseases in this population.

  12. Spinal Muscular Atrophy: From Defective Chaperoning of snRNP Assembly to Neuromuscular Dysfunction

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    Maia Lanfranco

    2017-06-01

    Full Text Available Spinal Muscular Atrophy (SMA is a neuromuscular disorder that results from decreased levels of the survival motor neuron (SMN protein. SMN is part of a multiprotein complex that also includes Gemins 2–8 and Unrip. The SMN-Gemins complex cooperates with the protein arginine methyltransferase 5 (PRMT5 complex, whose constituents include WD45, PRMT5 and pICln. Both complexes function as molecular chaperones, interacting with and assisting in the assembly of an Sm protein core onto small nuclear RNAs (snRNAs to generate small nuclear ribonucleoproteins (snRNPs, which are the operating components of the spliceosome. Molecular and structural studies have refined our knowledge of the key events taking place within the crowded environment of cells and the numerous precautions undertaken to ensure the faithful assembly of snRNPs. Nonetheless, it remains unclear whether a loss of chaperoning in snRNP assembly, considered as a “housekeeping” activity, is responsible for the selective neuromuscular phenotype in SMA. This review thus shines light on in vivo studies that point toward disturbances in snRNP assembly and the consequential transcriptome abnormalities as the primary drivers of the progressive neuromuscular degeneration underpinning the disease. Disruption of U1 snRNP or snRNP assembly factors other than SMN induces phenotypes that mirror aspects of SMN deficiency, and splicing defects, described in numerous SMA models, can lead to a DNA damage and stress response that compromises the survival of the motor system. Restoring the correct chaperoning of snRNP assembly is therefore predicted to enhance the benefit of SMA therapeutic modalities based on augmenting SMN expression.

  13. Balance improvements in female high school basketball players after a 6-week neuromuscular-training program.

    Science.gov (United States)

    McLeod, Tamara C Valovich; Armstrong, Travis; Miller, Mathew; Sauers, Jamie L

    2009-11-01

    Poor balance has been associated with increased injury risk among athletes. Neuromuscular-training programs have been advocated as a means of injury prevention, but little is known about the benefits of these programs on balance in high school athletes. To determine whether there are balance gains after participation in a neuromuscular-training program in high school athletes. Nonrandomized controlled trial. All data were collected at each participating high school before and after a 6-wk intervention or control period. 62 female high school basketball players recruited from the local high school community and assigned to a training (n = 37) or control (n = 25) group. Training-group subjects participated in a 6-wk neuromuscular-training program that included plyometric, functional-strengthening, balance, and stability-ball exercises. Data were collected for the Balance Error Scoring System (BESS) and Star Excursion Balance Test (SEBT) before and after the 6-wk intervention or control period. The authors found a significant decrease in total BESS errors in the trained group at the posttest compared with their pretest and the control group (P = .003). Trained subjects also scored significantly fewer BESS errors on the single-foam and tandem-foam conditions at the posttest than the control group and demonstrated improvements on the single-foam compared with their pretest (P = .033). The authors found improvements in reach in the lateral, anteromedial, medial, and posterior directions in the trained group at the posttest compared with the control group (P training program can increase the balance and proprioceptive capabilities of female high school basketball players and that clinical balance measures are sensitive to detect these differences.

  14. Differences in neuromuscular strategies between landing and cutting tasks in female basketball and soccer athletes.

    Science.gov (United States)

    Cowley, Hanni R; Ford, Kevin R; Myer, Gregory D; Kernozek, Thomas W; Hewett, Timothy E

    2006-01-01

    High school female athletes are most likely to sustain a serious knee injury during soccer or basketball, 2 sports that often involve a rapid deceleration before a change of direction or while landing from a jump. To determine if female high school basketball and soccer players show neuromuscular differences during landing and cutting tasks and to examine neuromuscular differences between tasks and between dominant and nondominant sides. A 3-way mixed factorial design investigating the effects of sport (basketball, soccer), task (jumping, cutting), and side (dominant, nondominant). Laboratory. Thirty high school female athletes who listed either basketball or soccer as their only sport of participation (basketball: n = 15, age = 15.1 +/- 1.7 years, experience = 6.9 +/- 2.2 years, height = 165.3 +/- 7.9 cm, mass = 61.8 +/- 9.3 kg; soccer: n = 15, age = 14.8 +/- 0.8 years, experience = 8.8 +/- 2.5 years, height = 161.8 +/- 4.1 cm, mass = 54.6 +/- 7.6 kg). Ground reaction forces, stance time, valgus angles, and valgus moments were assessed during (1) a drop vertical jump with an immediate maximal vertical jump and (2) an immediate side-step cut at a 45 degrees angle. Basketball athletes had greater ground reaction forces (P vertical jump, whereas soccer players had greater ground reaction forces (P vertical jump. Greater valgus moments (P = .006) were noted on the dominant side during cutting. Our subjects demonstrated differences in ground reaction forces and stance times during 2 movements associated with noncontact anterior cruciate ligament injuries. Knee valgus moment and angle were significantly influenced by the type of movement performed. Sport-specific neuromuscular training may be warranted, with basketball players focusing on jumping and landing and soccer players focusing on unanticipated cutting maneuvers.

  15. The punctum fixum-punctum mobile model: a neuromuscular principle for efficient movement generation?

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    Christoph von Laßberg

    Full Text Available According to the "punctum fixum-punctum mobile model" that was introduced in prior studies, for generation of the most effective intentional acceleration of a body part the intersegmental neuromuscular onset succession has to spread successively from the rotation axis (punctum fixum toward the body part that shall be accelerated (punctum mobile. The aim of the present study was to investigate whether this principle is, indeed, fundamental for any kind of efficient rotational accelerations in general, independent of the kind of movements, type of rotational axis, the current body position, or movement direction. Neuromuscular onset succession was captured by surface electromyography of relevant muscles of the anterior and posterior muscle chain in 16 high-level gymnasts during intentional accelerating movement phases while performing 18 different gymnastics elements (in various body positions to forward and backward, performed on high bar, parallel bars, rings and trampoline, as well as during non-sport specific pivot movements around the longitudinal axis. The succession patterns to generate the acceleration phases during these movements were described and statistically evaluated based on the onset time difference between the muscles of the corresponding muscle chain. In all the analyzed movement phases, the results clearly support the hypothesized succession pattern from punctum fixum to punctum mobile. This principle was further underlined by the finding that the succession patterns do change their direction running through the body when the rotational axis (punctum fixum has been changed (e.g., high bar or rings [hands] vs. floor or trampoline [feet]. The findings improve our understanding of intersegmental neuromuscular coordination patterns to generate intentional movements most efficiently. This could help to develop more specific methods to facilitate such patterns in particular contexts, thus allowing for shorter motor learning

  16. The Punctum Fixum-Punctum Mobile Model: A Neuromuscular Principle for Efficient Movement Generation?

    Science.gov (United States)

    von Laßberg, Christoph; Rapp, Walter

    2015-01-01

    According to the “punctum fixum–punctum mobile model” that was introduced in prior studies, for generation of the most effective intentional acceleration of a body part the intersegmental neuromuscular onset succession has to spread successively from the rotation axis (punctum fixum) toward the body part that shall be accelerated (punctum mobile). The aim of the present study was to investigate whether this principle is, indeed, fundamental for any kind of efficient rotational accelerations in general, independent of the kind of movements, type of rotational axis, the current body position, or movement direction. Neuromuscular onset succession was captured by surface electromyography of relevant muscles of the anterior and posterior muscle chain in 16 high-level gymnasts during intentional accelerating movement phases while performing 18 different gymnastics elements (in various body positions to forward and backward, performed on high bar, parallel bars, rings and trampoline), as well as during non-sport specific pivot movements around the longitudinal axis. The succession patterns to generate the acceleration phases during these movements were described and statistically evaluated based on the onset time difference between the muscles of the corresponding muscle chain. In all the analyzed movement phases, the results clearly support the hypothesized succession pattern from punctum fixum to punctum mobile. This principle was further underlined by the finding that the succession patterns do change their direction running through the body when the rotational axis (punctum fixum) has been changed (e.g., high bar or rings [hands] vs. floor or trampoline [feet]). The findings improve our understanding of intersegmental neuromuscular coordination patterns to generate intentional movements most efficiently. This could help to develop more specific methods to facilitate such patterns in particular contexts, thus allowing for shorter motor learning procedures of

  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.

  18. Professional Soccer Player Neuromuscular Responses and Perceptions to Acute Whole Body Vibration Differ from Amateur Counterparts

    Directory of Open Access Journals (Sweden)

    Ross Cloak, Andrew Lane, Matthew Wyon

    2016-03-01

    Full Text Available Acute whole body vibration (WBV is an increasingly popular training technique amongst athletes immediately prior to performance and during scheduled breaks in play. Despite its growing popularity, evidence to demonstrate its effectiveness on acute neuromuscular responses is unclear, and suggestions that athlete ability impacts effectiveness warrant further investigation. The purpose of this study was to compare the neuromuscular effects of acute WBV and perceptions of whether WBV is an effective intervention between amateur and professional soccer players. Participants were 44 male soccer players (22 professional and 22 amateur; age: 23.1 ± 3.7 years, body mass: 75.6 ± 8.8 kg and height: 1.77 ± 0.05 m. Participants in each group were randomly assigned to either an intervention of 3 x 60 s of WBV at 40 Hz (8mm peak-to-peak displacement or control group. Peak knee isometric force, muscle activation and post activation potentiation (PAP of the knee extensors along with self-report questionnaire of the perceived benefits of using the intervention were collected. A three-way ANOVA with repeated measures revealed professional players demonstrated a significant 10.6% increase (p < 0.01, Partial Eta2 = 0.22 in peak knee isometric force following acute WBV with no significant differences among amateur players. A significant difference (p < 0.01, Partial Eta2 = 0.16 in PAP amongst professional players following acute WBVT was also reported. No significant differences amongst amateur players were reported across measurements. Results also indicated professional players reported significantly stronger positive beliefs in the effectiveness of the WBV intervention (p < 0.01, Partial Eta2 = 0.27 compared to amateur players. Acute WBV elicited a positive neuromuscular response amongst professional players identified by PAP and improvements in knee isometric peak force as well as perceived benefits of the intervention, benefits not found among amateur players.

  19. Impact of neuromuscular electrical stimulation on functional capacity of patients with chronic kidney disease on hemodialysis.

    Science.gov (United States)

    Roxo, Renata Spósito; Xavier, Vivian Bertoni; Miorin, Luiz Antônio; Magalhães, Andrea Olivares; Sens, Yvoty Alves Dos Santos; Alves, Vera Lúcia Dos Santos

    2016-01-01

    Literature shows that patients undergoing hemodialysis present poor physical conditioning and low tolerance to exercise. They may also suffer from respiratory dysfunctions. The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation on pulmonary function and functional capacity of patients with chronic kidney disease on hemodialysis. Forty adult patients with chronic kidney disease on hemodialysis were prospectively studied and randomized into two groups (control n = 20 and treatment n = 20). The treatment group underwent bilateral femoral quadriceps muscles electrical stimulation for 30 minutes during hemodialysis, three times per week, for two months. The patients were evaluated by pulmonary function test, maximum respiratory pressures, maximum one-repetition test, and six-minute walk test (6MWT), before and after the treatment protocol. The treatment group presented increased maximum inspiratory (MIP) (p = 0.02) and expiratory pressures (MEP) (p grupos (controle n = 20 e tratamento n = 20). O grupo tratamento realizou protocolo com estimulação elétrica neuromuscular em quadríceps femoral por 30 minutos durante a hemodiálise, três vezes por semana, durante dois meses. Todos pacientes realizaram espirometria, pressões respiratórias máximas, teste de uma repetição máxima e teste da caminhada dos seis minutos (TC6), antes e após o período de acompanhamento. O grupo tratamento apresentou aumento da pressão inspiratória máxima com p = 0,02 na comparação entre grupos e p grupo de tratamento com p grupo controle. A estimulação elétrica neuromuscular teve impacto positivo sobre a função pulmonar e a capacidade funcional levando ao melhor desempenho físico em pacientes em hemodiálise.

  20. Developing maximal neuromuscular power: Part 1--biological basis of maximal power production.

    Science.gov (United States)

    Cormie, Prue; McGuigan, Michael R; Newton, Robert U

    2011-01-01

    This series of reviews focuses on the most important neuromuscular function in many sport performances, the ability to generate maximal muscular power. Part 1 focuses on the factors that affect maximal power production, while part 2, which will follow in a forthcoming edition of Sports Medicine, explores the practical application of these findings by reviewing the scientific literature relevant to the development of training programmes that most effectively enhance maximal power production. The ability of the neuromuscular system to generate maximal power is affected by a range of interrelated factors. Maximal muscular power is defined and limited by the force-velocity relationship and affected by the length-tension relationship. The ability to generate maximal power is influenced by the type of muscle action involved and, in particular, the time available to develop force, storage and utilization of elastic energy, interactions of contractile and elastic elements, potentiation of contractile and elastic filaments as well as stretch reflexes. Furthermore, maximal power production is influenced by morphological factors including fibre type contribution to whole muscle area, muscle architectural features and tendon properties as well as neural factors including motor unit recruitment, firing frequency, synchronization and inter-muscular coordination. In addition, acute changes in the muscle environment (i.e. alterations resulting from fatigue, changes in hormone milieu and muscle temperature) impact the ability to generate maximal power. Resistance training has been shown to impact each of these neuromuscular factors in quite specific ways. Therefore, an understanding of the biological basis of maximal power production is essential for developing training programmes that effectively enhance maximal power production in the human.

  1. Efeito da estrutura ovárica e da idade de bovinos da raça Holstein Friesian na quantidade e qualidade de ovócitos e de embriões produzidos in vitro

    Directory of Open Access Journals (Sweden)

    A. Reis

    2006-10-01

    Full Text Available O objetivo do presente trabalho, foi o estudo dos efeitos da idade e da fase do ciclo estral dos bovinos na quantidade e qualidade de ovócitos e de embriões produzidos in vitro. Para isso, foram utilizados ovócitos de 63 vacas da raça Holstein-Friesian abatidas em matadouro, com idades compreendidas entre 1 e 15 anos, as quais foram divididas em 5 lotes de acordo com a idade. Cada lote foi subdividido de acordo com a fase do ciclo estral em que o animal se encontrava no dia do abate, pela presença ou não de corpo lúteo funcional na superfície do ovário. Os lotes referentes à idade foram: ;8 anos. Após punção dos folículos, os ovócitos foram divididos nas classes A, B, C e D, tendo em conta o seu aspecto morfológico, em que apenas os de classe A e B foram usados para a FIV. Observou-se que o número de ovócitos produzidos foi diretamente proporcional à idade das vacas (R=0,99 - P<0,001. Quanto à fase do ciclo estral, as vacas em fase luteínica, produziram maior número de ovócitos que as vacas em fase folicular (P<0,001, respetivamente 7,05 ± 0,11 e 10,87 ± 1,01. Relativamente à qualidade dos ovócitos em função da idade das vacas, observou-se uma correlação positiva (R = 0,94 p<0,01 até aos [7, 8] anos, começando a baixar a partir desta idade. As vacas em fase luteínica produziram ovócitos de melhor qualidade relativamente às vacas em fase folicular (6,77 ± 0,64 e 3,84± 0,64; respetivamente. Quanto à quantidade de zigotos que clivaram, esta foi superior para os lotes de vacas em fase luteínica em comparação com os de vacas em fase folicular (59,03% e 45,52%; respetivamente, observando-se ainda que as vacas em fase luteínica produziram igualmente, em geral, maior número de embriões aos 7 dias após FIV que as vacas em fase folicular(44,23% e 31,48%; respetivamente. Os resultados do presente trabalho permitem concluir que existe uma estreita relação entre a idade e a fase do ciclo estral das vacas e a

  2. Dose-response effect of photobiomodulation therapy on neuromuscular economy during submaximal running.

    Science.gov (United States)

    Dellagrana, Rodolfo André; Rossato, Mateus; Sakugawa, Raphael Luiz; Lazzari, Caetano Decian; Baroni, Bruno Manfredini; Diefenthaeler, Fernando

    2018-02-01

    The purpose of this study was to verify the photobiomodulation therapy (PBMT) effects with different doses on neuromuscular economy during submaximal running tests. Eighteen male recreational runners participate in a randomized, double-blind, and placebo-controlled trial, which each participant was submitted to the same testing protocol in five conditions: control, placebo, and PBMT with doses of 15, 30, and 60 J per site (14 sites in each lower limb). The submaximal running was performed at 8 and 9 km h -1 during 5 min for each velocity. Muscle activation of the vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF), biceps femoris (BF), and gastrocnemius lateralis (GL) was collected during the last minute of each running test. The root mean square (RMS) was normalized by maximal isometric voluntary contraction (MIVC) performed a priori in an isokinetic dynamometer. The RMS sum of all muscles (RMS LEG ) was considered as main neuromuscular economy parameter. PBMT with doses of 15, 30, and 60 J per site [33 diodes = 5 lasers (850 nm), 12 LEDs (670 nm), 8 LEDs (880 nm), and 8 LEDs (950 nm)] or placebo applications occurred before running tests. For the statistical analysis, the effect size was calculated. Moreover, a qualitative inference was used to determine the magnitude of differences between groups. Peak torque and RMS during MIVCs showed small effect sizes. According to magnitude-based inference, PBMT with dose of 15 J per site showed possibly and likely beneficial effects on neuromuscular economy during running at 8 and 9 km h -1 , respectively. On other hand, PBMT with doses of 30 and 60 J per site showed possible beneficial effects only during running at 9 km h -1 . We concluded that PBMT improve neuromuscular economy and the best PBMT dose was 15 J per site (total dose of 420 J).

  3. Role of non-invasive ventilation in difficult-to-wean children with acute neuromuscular disease.

    Science.gov (United States)

    Reddy, V G; Nair, M P; Bataclan, F

    2004-05-01

    Weaning from mechanical ventilation in children could be time-consuming and on many occasions, leads to reintubation with its associate complications. We report two children with acute neuromuscular disease, in whom bi-level positive airway pressure (BiPAP) as a mode of non-invasive ventilation was successfully used to wean the child from ventilators and prevented the need for tracheostomy. Despite the limited number of studies published in the literature suggesting BiPAP as a mode of weaning from mechanical ventilation, the technique when applied correctly seems to be safe and effective in weaning and avoiding tracheostomy.

  4. Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings.

    Directory of Open Access Journals (Sweden)

    Bart Malfait

    Full Text Available The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ.Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM,vastus lateralis(VL}, {vastus medialis(VM,hamstring medialis(HM}, {hamstring medialis(HM,hamstring lateralis(HL} and the {vastus lateralis(VL,hamstring lateralis(HL}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping.The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05. Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001. The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05. Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001. Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001.This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior

  5. Influence of patterned electrical neuromuscular stimulation on quadriceps activation in individuals with knee joint injury.

    Science.gov (United States)

    Glaviano, Neal R; Langston, William T; Hart, Joseph M; Saliba, Susan

    2014-12-01

    Neuromuscular Electrical Stimulation is a common intervention to address muscle weakness, however presents with many limitations such as fatigue, muscle damage, and patient discomfort that may influence its effectiveness. One novel form of electrical stimulation purported to improve neuromuscular re-education is Patterned Electrical Neuromuscular Stimulation (PENS), which is proposed to mimic muscle-firing patterns of healthy individuals. PENS provides patterned stimulating to the agonist muscle, antagonist muscle and then agonist muscle again in an effort to replicate firing patterns. The purpose of this study was to determine the effect of a single PENS treatment on knee extension torque and quadriceps activation in individuals with quadriceps inhibition. 18 subjects (10 males and 8 females: 24.2±3.4 years, 175.3±11.8cm, 81.8±12.4kg) with a history of knee injury/pain participated in this double-blinded randomized controlled laboratory trial. Participants demonstrated quadriceps inhibition with a central activation ratio of ≤90%. Maximal voluntary isometric contraction of the quadriceps and central activation ratio were measured before and after treatment. The treatment intervention was a 15-minute patterned electrical stimulation applied to the quadriceps and hamstring muscles with a strong motor contraction or a sham group, who received an identical set up as the PENS group, but received a 1mA subsensory stimulation. A 2×2 (group × time) ANCOVA was used to determine differences in maximal voluntary isometric contraction and central activation ratio between groups. The maximal voluntary isometric contraction was selected as a covariate due to baseline differences. There were no differences in change scores between pre- and post-intervention for maximal voluntary isometric contraction: (PENS: 0.09±0.32Nm/kg and Sham 0.15±0.18Nm/kg, p=0.713), or central activation ratio:(PENS: -1.22±6.06 and Sham: 1.48±3.7, p=0.270). A single Patterned Electrical

  6. Muscarinic, adenosine and tropomyosin-related kinase B receptors modulate the neuromuscular developmental synapse elimination process

    OpenAIRE

    Nadal Magriñà, Laura

    2017-01-01

    El desarrollo del sistema nervioso periférico implica una inicial exuberante producción de neuronas y, una posterior reducción dependiente de actividad del número de sinapsis en las uniones neuromusculares (NMJ). Este proceso se denomina eliminación sináptica. Al final de la segunda semana postnatal, cada fibra muscular esta inervadas por una solo motoneurona. Los receptores muscarínicos de acetilcolina (mAChR), los receptores de adenosina (AR) y el receptor quinasa de tropomiosina B (TrkB) p...

  7. Effect of preoperative neuromuscular training (NEMEX-TJR) on functional outcome after total knee replacement

    DEFF Research Database (Denmark)

    Huber, Erika O; Roos, Ewa M.; Meichtry, André

    2015-01-01

    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...... and after the intervention, and at 6 weeks, 3 months and 12 months after surgery by a physiotherapist, blinded to group allocation. 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...

  8. Comparison of pancuronium and vecuronium for fetal neuromuscular blockade during invasive procedures.

    Science.gov (United States)

    Watson, W J; Atchison, S R; Harlass, F E

    1996-01-01

    Neuromuscular blocking agents, used to arrest fetal motion for invasive intrauterine procedures, may cause temporary fetal heart rate changes. After 21 invasive procedures using either pancuronium bromide or vecuronium bromide, post-procedure fetal heart rate tracings were retrospectively compared. Pancuronium was associated with an increased fetal heart rate and decreased beat-to-beat variability for 2.5 hours after its use, whereas vecuronium caused no fetal heart rate changes. Vecuronium bromide offers advantages over pancuronium, because the decreased effect on the fetal heart allows better assessment of fetal well-being immediately following invasive intrauterine procedures.

  9. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.

    2016-01-01

    . A random subsample of 57 female adolescents was included and tested at baseline and after 3months. Neuromuscular control of the knee was quantified as the complexity of surface electromyography of the vastus lateralis and vastus medialis during stair descent. Secondary outcomes were complexity of knee...... during stair descent than those receiving patient education alone. This suggest that exercise therapy has an effect not only on self-reported outcome measures but also on objective measures of thigh muscle function in female adolescents with patellofemoral pain....

  10. EFEITO DO TREINO NEUROMUSCULAR NA ROTAÇÃO DO JOELHO DURANTE A ATERRISSAGEM EM MULHERES

    Directory of Open Access Journals (Sweden)

    Narayana Vianna Spanó

    2016-04-01

    Full Text Available Introdução: O grande índice de lesões do ligamento cruzado anterior sem envolver contato em mulheres é motivo de curiosidade entre os cientistas, pois avaliações de aterrissagem podem sugerir a predisposição ao risco dessa lesão. Neste sentido, vários protocolos de treinamento foram utilizados como intervenção e obtiveram resultados diversificados na alteração desse fator de risco. Objetivo: O objetivo deste projeto foi avaliar as possíveis alterações de rotação do joelho na aterrissagem unipodal após a intervenção de um programa de treinamento neuromuscular. Métodos: Participaram do estudo 18 mulheres com idade entre 18 e 51 anos, que foram distribuídas em dois grupos: grupo de treinamento neuromuscular de oito semanas (GTN (n = 11 e grupo controle (GC (n = 7. Além disso, não apresentavam lesão musculoesquelética ou dores nos membros inferiores. Cada participante realizou cinco aterrissagens unipodais válidas de uma plataforma de 40 cm de altura. O processo de captura de movimento foi realizado com 12 câmeras infravermelho do sistema OptiTrack(tm para obter as coordenadas tridimensionais de marcadores fixados nos pontos anatômicos de interesse. Os sistemas de coordenadas locais da coxa e da perna foram definidos por meio dos respectivos marcadores fixados nos pontos anatômicos. Dessa forma, foram calculados os ângulos de rotação do joelho nos planos sagital, frontal e transverso através das sequências dos ângulos de Euler e as velocidades angulares através das formulações dos quatérnions. Resultados: Os resultados mostraram que houve um aumento na velocidade de rotação do joelho após o treinamento neuromuscular. Conclusão: Conclui-se que o treinamento neuromuscular resultou em maior velocidade de rotação no joelho nos 40 milissegundos que sucedem a aterrissagem unipodal.

  11. Preventing Ischial Pressure Ulcers: III. Clinical Pilot Study of Chronic Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: BIONs™ (BIOnic Neurons are injectable, wireless microstimulators that make chronic BION Active Seating (BAS possible for pressure ulcer prevention (PUP. Neuromuscular electrical stimulation (NMES produces skeletal motion and activates trophic factors, counteracting three major etiological mechanisms leading to pressure ulcers (PUs: immobility, soft-tissue atrophy, and ischemia. Companion papers I and II reviewed prior experience with NMES for PUP, and analyzed the biomechanical considerations, respectively. This paper presents a treatment strategy derived from this analysis, and the clinical results of the first three cases.

  12. Neuromuscular Structure, Evolution and Development in Meiofaunal Annelids with Special Focus on Dinophilus gyrociliatus (Dinophilidae)

    DEFF Research Database (Denmark)

    Kerbl, Alexandra

    less complex sensory structures. Yet, very little is still known on how these small brains are organized to fulfil basic functions. This study addresses the structure, evolution and development of neuromuscular systems within two exclusively meiofaunal lineages Lobatocerebridae and Dinophilidae....... RESULTS: Both families were shown to be nested within annelids in phylogenomic analyses based on transcriptomic data, which also suggest the Spiralian ancestor to be meiofaunal (Manuscript 4). The annelid affinity of the enigmatic Lobatocerebridae was further tested by detailed morphological examinations...... warranting further studies to uncover how the genetic domains influence the configuration of the brain...

  13. Effects of regular Tai Chi practice and jogging on neuromuscular reaction during lateral postural control in older people.

    Science.gov (United States)

    Wang, Shao-Jun; Xu, Dong-Qing; Li, Jing-Xian

    2017-01-01

    This study examined the effects of regular Tai Chi practice and jogging on the neuromuscular activity of the trunk, hip, and ankle joint muscles of older people during lateral postural perturbation. A total of 42 older people participated in the study and formed the Tai Chi, jogging, and sedentary control groups. Electromyography signals were collected from the peroneus longus, anterior tibialis, gluteus medius, and erector spinae during unpredictable mediolateral perturbation. The Tai Chi group exhibited significantly faster latencies of the tibialis anterior and erector spinae than the control group. The jogging group showed a significantly shorter neuromuscular reaction time of the erector spinae than the control group. No significant difference was observed between the Tai Chi and jogging groups. Long-term regular Tai Chi practice enhanced the neuromuscular reaction of the erector spinae and tibialis anterior to lateral perturbation and will help timely posture correction when lateral postural distributions occur.

  14. Pain trajectory and exercise-induced pain flares during 8 weeks of neuromuscular exercise in individuals with knee and hip pain

    DEFF Research Database (Denmark)

    Sandal, L F; Roos, E M; Bøgesvang, S J

    2016-01-01

    OBJECTIVE: Patients considering or engaged in exercise as treatment may expect or experience transient increases in joint pain, causing fear of exercise and influencing compliance. This study investigated the pain trajectory during an 8-week neuromuscular exercise (NEMEX) program together with ac...... to educate and balance patient expectation when starting supervised neuromuscular exercise....

  15. A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia

    DEFF Research Database (Denmark)

    Duvaldestin, Philippe; Kuizenga, Karel; Saldien, Vera

    2010-01-01

    Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular...

  16. Reversal of rocuronium-induced (1.2 mg kg-1) profound neuromuscular block by accidental high dose of sugammadex (40 mg kg-1).

    NARCIS (Netherlands)

    Molina, A.L.; Boer, H.D. de; Klimek, M.; Heeringa, M.; Klein, J.

    2007-01-01

    Sugammadex is the first selective relaxant binding agent and reverses rocuronium-induced neuromuscular block. A case is reported in which a patient accidentally received a high dose of sugammadex (40 mg kg-1) to reverse a rocuronium-induced (1.2 mg kg-1) profound neuromuscular block. A fast and

  17. Increased pain sensitivity but normal function of exercise induced analgesia in hip and knee osteoarthritis - treatment effects of neuromuscular exercise and total joint replacement

    DEFF Research Database (Denmark)

    Kosek, E; Roos, Ewa M.; Ageberg, E

    2013-01-01

    To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters.......To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters....

  18. O espaço para crianças produzido pelo Programa Minha Casa, Minha Vida: estudo de caso na região metropolitana de Belém, PA

    Directory of Open Access Journals (Sweden)

    Shirley Coelho Müller

    Full Text Available Resumo A atual política de habitação de interesse social no Brasil determina que o lazer infantil seja atendido por espaços construídos especificamente para esse fim. Este artigo traz os resultados de pesquisa de espaços projetados para o lazer infantil em dois conjuntos habitacionais de interesse social produzidos pelo Programa Minha Casa, Minha Vida, Jardim Campo Grande e Jardim dos Pardais, ambos na Região Metropolitana de Belém, no Pará. Indaga-se que espaços de fato têm sido produzidos, partindo-se do princípio de que o corpo em movimento no espaço e as interações sociais possibilitadas pelo lazer são fundamentais para que o desenvolvimento sócio-cognitivo e psicomotor das crianças aconteça de forma satisfatória. Investiga-se também a efetiva utilização desses espaços pelas crianças. O método de estudo de caso combina técnicas de análise do projeto arquitetônico e do espaço físico com a observação comportamental das crianças em seu lazer. Observou-se que os espaços de lazer infantil dos conjuntos estudados carecem de elementos que atendam de forma adequada à necessidade de lazer das crianças, que seu uso independe da quantidade de área destinada a esse fim, e que fatores como sensação de segurança ou insegurança e tipologia habitacional podem limitar ou estimular o uso desses espaços e a apropriação dos espaços comuns.

  19. Antifungal compound produced by the cassava endophyte Bacillus pumilus MAIIIM4a Composto antifúngico produzido pelo endófito de mandioca Bacillus pumilus MAIIIM4a

    Directory of Open Access Journals (Sweden)

    Flávia Mandolesi Pereira de Melo

    2009-10-01

    Full Text Available In the search for new organisms and new secondary metabolites, a study was conducted to evaluate the diversity of endophytic bacteria from ethnovarieties of cassava cultivated by Brazilian Amazon Indian tribes and also to study the secondary metabolites produced by a Bacillus pumilus strain. Sixty seven cassava endophytic bacteria were subjected to 16S rRNA sequencing and FAME analysis. The bacterial profile revealed that 25% of all endophytic isolates belonged to the genus Bacillus. The isolate B. pumilus MAIIIM4a showed a strong inhibitory activity against the fungi Rhizoctonia solani, Pythium aphanidermatum and Sclerotium rolfsii. Secondary metabolites of this strain were extracted using hexane, dichloromethane and ethyl acetate. Extracts were subjected to bioautography and LC/MS analysis, which allowed the identification of pumilacidin, an antifungal compound produced by B. pumilus MAIIIM4a. The bacterial endophytic localization was confirmed by cassava cell tissue examination using scanning electron microscopy.Na busca de novos organismos e novos metabólitos secundários, um estudo foi conduzido visando avaliar a diversidade de bactérias endofíticas de etnovariedades de mandioca cultivadas por tribos indígenas da Amazônia brasileira e também para estudar metabólitos secundários produzidos por Bacillus pumilus. Sessenta e sete bactérias endofíticas de mandioca foram identificadas através do seqüenciamento do gene 16S rRNA e por meio da análise de ácidos graxos (FAME. Essas análises revelaram que 25% de todos os endofíticos pertenciam ao gênero Bacillus. O isolado Bacillus pumilus MAIIIM4a apresentou forte ação inibitória contra os fitopatógenos Rhizoctonia solani, Pythium aphanidermatum e Sclerotium rolfsii. Os metabólitos secundários deste isolado foram extraídos do sobrenadante usando-se hexano, diclorometano e acetato de etila. Esses extratos foram utilizados nas análises de bioautografia e LC-MS, as quais

  20. Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

    Directory of Open Access Journals (Sweden)

    Lara Maris Nápolis

    2011-01-01

    Full Text Available BACKGROUND: High-frequency neuromuscular electrical stimulation increases exercise tolerance in patients with advanced chronic obstructive pulmonary disease (COPD patients. However, it is conceivable that its benefits are more prominent in patients with better-preserved peripheral muscle function and structure. OBJECTIVE: To investigate the effects of high-frequency neuromuscular electrical stimulation in COPD patients with better-preserved peripheral muscle function. Design: Prospective and cross-over study. METHODS: Thirty COPD patients were randomly assigned to either home-based, high-frequency neuromuscular electrical stimulation or sham stimulation for six weeks. The training intensity was adjusted according to each subject's tolerance. Fat-free mass, isometric strength, six-minute walking distance and time to exercise intolerance (Tlim were assessed. RESULTS: Thirteen (46.4% patients responded to high-frequency neuromuscular electrical stimulation; that is, they had a post/pre Δ Tlim >10% after stimulation (unimproved after sham stimulation. Responders had a higher baseline fat-free mass and six-minute walking distance than their seventeen (53.6% non-responding counterparts. Responders trained at higher stimulation intensities; their mean amplitude of stimulation during training was significantly related to their fat-free mass (r = 0.65; p<0.01. Logistic regression revealed that fat-free mass was the single independent predictor of Tlim improvement (odds ratio [95% CI] = 1.15 [1.04-1.26]; p<0.05. CONCLUSIONS: We conclude that high-frequency neuromuscular electrical stimulation improved the exercise capacity of COPD patients with better-preserved fat-free mass because they tolerated higher training stimulus levels. These data suggest that early training with high-frequency neuromuscular electrical stimulation before tissue wasting begins might enhance exercise tolerance in patients with less advanced COPD.

  1. A systematic review and meta-analysis of lower limb neuromuscular alterations associated with knee osteoarthritis during level walking.

    Science.gov (United States)

    Mills, Kathryn; Hunt, Michael A; Leigh, Ryan; Ferber, Reed

    2013-08-01

    Neuromuscular alterations are increasingly reported in individuals with knee osteoarthritis (KOA) during level walking. We aimed to determine which neuromuscular alterations are consistent in KOA individuals and how these may be influenced by osteoarthritis severity, varus alignment and/or joint laxity. Electronic databases were searched up to July 2012. Cross-sectional observational studies comparing lower-limb neuromuscular activity in individuals with KOA, healthy controls or with different KOA cohorts were included. Two reviewers assessed methodological quality. Effect sizes were used to quantify the magnitude of observed differences. Where studies were homogenous, effect sizes were pooled using a fixed-effects model. Fourteen studies examining neuromuscular alterations in indices of co-contraction, muscle amplitude and muscle activity duration were included. Data pooling revealed that moderate KOA individuals exhibit increased co-contraction of lateral knee muscles (ES 0.64 [0.3 to 0.97]) and moderately increased rectus femoris (ES 0.73 [0.23 to 1.22]), vastus lateralis (ES 0.77 [0.27 to 1.27]) and biceps femoris (ES 1.18 [0.67 to 1.7]) mean amplitude. Non-pooled data indicated prolonged activity of these muscles. Increased medial knee neuromuscular activity was prevalent for those exhibiting varus alignment and medial knee joint laxity. Interpretation Individuals with KOA exhibited increased co-contraction, amplitude and duration of lateral knee muscles regardless of disease severity, limb alignment or medial joint laxity. Individuals with severe disease, varus alignment and medial joint laxity demonstrate up-regulation of medial knee muscles. Future research investigating the efficacy of neuromuscular rehabilitation programs should consider the effect of simultaneous up-regulation of medial and lateral knee muscles on disease progression. © 2013.

  2. 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.

  3. Residual neuromuscular block as a risk factor for critical respiratory events in the post anesthesia care unit.

    Science.gov (United States)

    Norton, M; Xará, D; Parente, D; Barbosa, M; Abelha, F J

    2013-04-01

    Residual neuromuscular block is an important postoperative complication associated to the use of neuromuscular blocking drugs. The purpose of this study was to access the incidence of residual neuromuscular block in a post-anesthesia care unit and to evaluate its association with critical respiratory events. Prospective cohort study was conducted in a Post Anesthetic Care Unit (PACU) for a period of 3 weeks. Two hundred two adult patients who submitted to scheduled non-cardiac and non-intracranial surgery were eligible to the study. The primary outcome variable was residual neuromuscular block after arrival to PACU that was defined as train-of-four ratio <0.9 and objectively quantified using acceleromyography. Demographic data, perioperative variables, lengths of hospital and recovery room stay and critical respiratory events were recorded. Inadequate emergence was classified in its different forms according to the Richmond agitation and sedation scale 10 min after admission to the recovery room. Residual neuromuscular block incidence in the post-anesthesia care unit was 29.7% (95% confidence interval: 23.4, 36.1). Patients with residual neuromuscular block had more frequently overall critical respiratory events (51% versus 16%, P<0.001), airway obstruction (10% versus 2%, P=0.029), mild-moderate hypoxemia (23% versus 4%, P<0.001), severe hypoxemia (7% versus 1%, P=0.033), respiratory failure (8% versus 1%, P=0.031), inability to breathe deeply (38% versus 12%, P<0.001) and muscular weakness (16% versus 1%, P<0.001). Residual neuromuscular block was more common after high-risk surgery (53% versus 33%, P=0.011) and was more often associated with post-operative hypoactive emergence as defined by the Richmond Agitation and Sedation Scale (21% versus 6%, P=0.001). This study suggests that residual neuromuscular block is common in the PACU and is associated with more frequent critical respiratory events. Copyright © 2012 Sociedad Española de Anestesiología, Reanimaci

  4. Neuromuscular coordination deficit persists 12 months after ACL reconstruction but can be modulated by 6 weeks of kettlebell training

    DEFF Research Database (Denmark)

    Zebis, Mette K.; Andersen, Christoffer H.; Bencke, Jesper

    2017-01-01

    The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL...... for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high...

  5. Estimating neuromuscular stimulation within the human torso with Taser (registered) stimulus

    International Nuclear Information System (INIS)

    Sun Hongyu; Webster, John G

    2007-01-01

    Designers of electromuscular incapacitation devices need to know efficacy. Which areas of nerve and muscle are stimulated and are these areas adequate to cause incapacitation? This paper focuses on efficacy, which used a torso-sized finite element model with a mesh of about 5 mm. To estimate the neuromuscular regions stimulated by the Taser (registered) X26, calculations of electric current density and field strength values with 1 A inserted into the torso using the Utah 3D mesh were made. Field-times-duration values for given Taser stimulation were calculated. Then the region where the motor nerve was stimulated by the Taser was estimated by using a field-times-duration threshold from Reilly (1998 Applied Bioelectricity: From Electrical Stimulation to Electropathology (New York: Springer)). Neuromuscular stimulation occurred up to about 19 cm away from the darts and included the spinal cord. The current density at the heart for dart separation less than 10 cm was smaller than for larger dart separation. Users of finite element computer models will find information for torso models and their creation, meshing and operation

  6. The influence of cold on the recovery of three neuromuscular blocking agents in man.

    Science.gov (United States)

    England, A J; Wu, X; Richards, K M; Redai, I; Feldman, S A

    1996-03-01

    The Arrhenius hypothesis suggests that change in temperature has a less marked effect on the rate of physical processes than on biological reactions. We have investigated the process underlying recovery from neuromuscular block in man by studying the effect of cooling on the rate of recovery from depolarising and non-depolarising block. Vecuronium, rocuronium and decamethonium (C10) neuromuscular block were investigated using the isolated forearm technique on awake human volunteers. In these experiments, one arm was cooled whilst the other was used as control. Moderate hypothermia decreased the rate of recovery from all three agents, but this was significantly less marked with the depolarising drug. The mean Q10 (the anticipated change in rate of a reaction across of 10 degrees C temperature gradient) of the rate of recovery for vecuronium was 3.21, rocuronium 2.86 and decamethonium 1.29. This suggests a different process in the recovery of these two types of drug. According to the Arrhenius hypothesis this would suggest that the recovery from non-depolarising drugs is likely to involve a biochemical mechanism and that recovery from decamethonium is controlled by a physical process.

  7. Distinct neural and neuromuscular strategies underlie independent evolution of simplified advertisement calls.

    Science.gov (United States)

    Leininger, Elizabeth C; Kelley, Darcy B

    2013-04-07

    Independent or convergent evolution can underlie phenotypic similarity of derived behavioural characters. Determining the underlying neural and neuromuscular mechanisms sheds light on how these characters arose. One example of evolutionarily derived characters is a temporally simple advertisement call of male African clawed frogs (Xenopus) that arose at least twice independently from a more complex ancestral pattern. How did simplification occur in the vocal circuit? To distinguish shared from divergent mechanisms, we examined activity from the calling brain and vocal organ (larynx) in two species that independently evolved simplified calls. We find that each species uses distinct neural and neuromuscular strategies to produce the simplified calls. Isolated Xenopus borealis brains produce fictive vocal patterns that match temporal patterns of actual male calls; the larynx converts nerve activity faithfully into muscle contractions and single clicks. In contrast, fictive patterns from isolated Xenopus boumbaensis brains are short bursts of nerve activity; the isolated larynx requires stimulus bursts to produce a single click of sound. Thus, unlike X. borealis, the output of the X. boumbaensis hindbrain vocal pattern generator is an ancestral burst-type pattern, transformed by the larynx into single clicks. Temporally simple advertisement calls in genetically distant species of Xenopus have thus arisen independently via reconfigurations of central and peripheral vocal neuroeffectors.

  8. Antagonism by hemoglobin of effects induced by L-arginine in neuromuscular preparations from rats

    Directory of Open Access Journals (Sweden)

    C.R. Ambiel

    2001-04-01

    Full Text Available Nitric oxide (NO-synthase is present in diaphragm, phrenic nerve and vascular smooth muscle. It has been shown that the NO precursor L-arginine (L-Arg at the presynaptic level increases the amplitude of muscular contraction (AMC and induces tetanic fade when the muscle is indirectly stimulated at low and high frequencies, respectively. However, the precursor in muscle reduces AMC and maximal tetanic fade when the preparations are stimulated directly. In the present study the importance of NO synthesized in different tissues for the L-Arg-induced neuromuscular effects was investigated. Hemoglobin (50 nM did not produce any neuromuscular effect, but antagonized the increase in AMC and tetanic fade induced by L-Arg (9.4 mM in rat phrenic nerve-diaphragm preparations. D-Arg (9.4 mM did not produce any effect when preparations were stimulated indirectly at low or high frequency. Hemoglobin did not inhibit the decrease of AMC or the reduction in maximal tetanic tension induced by L-Arg in preparations previously paralyzed with d-tubocurarine and directly stimulated. Since only the presynaptic effects induced by L-Arg were antagonized by hemoglobin, the present results suggest that NO synthesized in muscle acts on nerve and skeletal muscle. Nevertheless, NO produced in nerve and vascular smooth muscle does not seem to act on skeletal muscle.

  9. Neuromuscular control and running economy is preserved in elite international triathletes after cycling.

    Science.gov (United States)

    Bonacci, Jason; Saunders, Philo U; Alexander, Mark; Blanch, Peter; Vicenzino, Bill

    2011-03-01

    Running is the most important discipline for Olympic triathlon success. However, cycling impairs running muscle recruitment and performance in some highly trained triathletes; though it is not known if this occurs in elite international triathletes. The purpose of this study was to investigate the effect of cycling in two different protocols on running economy and neuromuscular control in elite international triathletes. Muscle recruitment and sagittal plane joint angles of the left lower extremity and running economy were compared between control (no preceding cycle) and transition (preceded by cycling) runs for two different cycle protocols (20-minute low-intensity and 50-minute high-intensity cycles) in seven elite international triathletes. Muscle recruitment and joint angles were not different between control and transition runs for either cycle protocols. Running economy was also not different between control and transition runs for the low-intensity (62.4 +/- 4.5 vs. 62.1 +/- 4.0 ml/min/kg, p > 0.05) and high-intensity (63.4 +/- 3.5 vs. 63.3 +/- 4.3 ml/min/kg, p > 0.05) cycle protocols. The results of this study demonstrate that both low- and high-intensity cycles do not adversely influence neuromuscular control and running economy in elite international triathletes.

  10. Bayesian analysis of the kinetics of quantal transmitter secretion at the neuromuscular junction.

    Science.gov (United States)

    Saveliev, Anatoly; Khuzakhmetova, Venera; Samigullin, Dmitry; Skorinkin, Andrey; Kovyazina, Irina; Nikolsky, Eugeny; Bukharaeva, Ellya

    2015-10-01

    The timing of transmitter release from nerve endings is considered nowadays as one of the factors determining the plasticity and efficacy of synaptic transmission. In the neuromuscular junction, the moments of release of individual acetylcholine quanta are related to the synaptic delays of uniquantal endplate currents recorded under conditions of lowered extracellular calcium. Using Bayesian modelling, we performed a statistical analysis of synaptic delays in mouse neuromuscular junction with different patterns of rhythmic nerve stimulation and when the entry of calcium ions into the nerve terminal was modified. We have obtained a statistical model of the release timing which is represented as the summation of two independent statistical distributions. The first of these is the exponentially modified Gaussian distribution. The mixture of normal and exponential components in this distribution can be interpreted as a two-stage mechanism of early and late periods of phasic synchronous secretion. The parameters of this distribution depend on both the stimulation frequency of the motor nerve and the calcium ions' entry conditions. The second distribution was modelled as quasi-uniform, with parameters independent of nerve stimulation frequency and calcium entry. Two different probability density functions for the distribution of synaptic delays suggest at least two independent processes controlling the time course of secretion, one of them potentially involving two stages. The relative contribution of these processes to the total number of mediator quanta released depends differently on the motor nerve stimulation pattern and on calcium ion entry into nerve endings.

  11. Different Muscle Action Training Protocols on Quadriceps-Hamstrings Neuromuscular Adaptations.

    Science.gov (United States)

    Ruas, Cassio V; Brown, Lee E; Lima, Camila D; Gregory Haff, G; Pinto, Ronei S

    2018-05-01

    The aim of this study was to compare three specific concentric and eccentric muscle action training protocols on quadriceps-hamstrings neuromuscular adaptations. Forty male volunteers performed 6 weeks of training (two sessions/week) of their dominant and non-dominant legs on an isokinetic dynamometer. They were randomly assigned to one of four groups; concentric quadriceps and concentric hamstrings (CON/CON, n=10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n=10), concentric quadriceps and eccentric hamstrings (CON/ECC, n=10), or no training (CTRL, n=10). Intensity of training was increased every week by decreasing the angular velocity for concentric and increasing it for eccentric groups in 30°/s increments. Volume of training was increased by adding one set every week. Dominant leg quadriceps and hamstrings muscle thickness, muscle quality, muscle activation, muscle coactivation, and electromechanical delay were tested before and after training. Results revealed that all training groups similarly increased MT of quadriceps and hamstrings compared to control (p0.05). These findings suggest that different short-term muscle action isokinetic training protocols elicit similar muscle size increases in hamstrings and quadriceps, but not for other neuromuscular variables. Nevertheless, effect sizes indicate that CON/ECC and ECC/ECC may elicit the greatest magnitude of change in muscle hypertrophy. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings.

    Science.gov (United States)

    Malfait, Bart; Dingenen, Bart; Smeets, Annemie; Staes, Filip; Pataky, Todd; Robinson, Mark A; Vanrenterghem, Jos; Verschueren, Sabine

    2016-01-01

    The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ). Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping. The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (phamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase.

  13. Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Sébastien Pesenti

    2016-01-01

    Full Text Available The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP and muscular dystrophy (DMD. Patient’s preoperative general health, weight, and nutrition were collected. Different radiographic and clinical parameters were evaluated. There were 66 CP patients (59 nonwalking and 30 DMD patients (24 nonwalking. Mean age at surgery was 16.5 years and 13.9 years, respectively. All radiographic measurements improved significantly. Wound infection rate was 16.7% (11% of reoperation rate in CP; 10% in DMD; 3 hardware removal cases. No pelvic fracture due to rod irritation was observed. Unit Rod technique provides good radiographic and clinical outcomes even if this surgery is associated with a high complication rate. It is a quick, simple, and reliable technique. Perioperati