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Sample records for causing spastic compressive

  1. Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Dewan Udita

    2010-01-01

    Full Text Available Extramedullary hemopoiesis (EMH is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

  2. Reviewing the genetic causes of spastic-ataxias.

    Science.gov (United States)

    de Bot, Susanne T; Willemsen, Michel A A P; Vermeer, Sascha; Kremer, Hubertus P H; van de Warrenburg, Bart P C

    2012-10-01

    Although the combined presence of ataxia and pyramidal features has a long differential, the presence of a true spastic-ataxia as the predominant clinical syndrome has a rather limited differential diagnosis. Autosomal recessive ataxia of Charlevoix-Saguenay, late-onset Friedreich ataxia, and hereditary spastic paraplegia type 7 are examples of genetic diseases with such a prominent spastic-ataxic syndrome as the clinical hallmark. We review the various causes of spastic-ataxic syndromes with a focus on the genetic disorders, and provide a clinical framework, based on age at onset, mode of inheritance, and additional clinical features and neuroimaging signs, that could serve the diagnostic workup. PMID:23033504

  3. Spasticity

    NARCIS (Netherlands)

    Pandyan, A.; Hermens, H.J.; Johnson, G.; Adelman, G.; Smith, B.H.

    2008-01-01

    Any lesion in the descending tracts of the central nervous system (CNS), at any level (i.e. cortex, internal capsule, brain stem, or spinal cord), can lead to a combination of sensorimotor symptoms, including spasticity (Table 1). Spasticity, a neurological impairment, is a common feature in a varie

  4. Reviewing the genetic causes of spastic-ataxias

    NARCIS (Netherlands)

    Bot, S.T. de; Willemsen, M.A.A.P.; Vermeer, S.; Kremer, H.P.H.; Warrenburg, B.P.C. van de

    2012-01-01

    Although the combined presence of ataxia and pyramidal features has a long differential, the presence of a true spastic-ataxia as the predominant clinical syndrome has a rather limited differential diagnosis. Autosomal recessive ataxia of Charlevoix-Saguenay, late-onset Friedreich ataxia, and heredi

  5. SPG10 is a rare cause of spastic paraplegia in European families.

    NARCIS (Netherlands)

    Schule, R.; Kremer, B.P.; Kassubek, J.; Auer-Grumbach, M.; Kostic, V.; Klopstock, T.; Klimpe, S.; Otto, S.; Boesch, S.; Warrenburg, B.P.C. van de; Schols, L.

    2008-01-01

    BACKGROUND: SPG10 is an autosomal dominant form of hereditary spastic paraplegia (HSP), which is caused by mutations in the neural kinesin heavy chain KIF5A gene, the neuronal motor of fast anterograde axonal transport. Only four mutations have been identified to date. OBJECTIVE: To determine the fr

  6. Hereditary spastic paraplegia-causing mutations in atlastin-1 interfere with BMPRII trafficking

    OpenAIRE

    Zhao, Jiali; Hedera, Peter

    2012-01-01

    Disruption of the bone morphogenic protein (BMP)-linked signaling pathway has been suggested as an important factor in the development of hereditary spastic paraplegia (HSP). HSP-causing proteins spastin, spartin and NIPA1 were reported to inhibit the BMP pathway. We have previously shown a strong interaction of NIPA1 and atlastin-1 proteins. Hence, we investigated the role of another HSP-associated protein atlastin-1 in this signaling cascade. Endogenous and expressed atlastin-1 showed a str...

  7. Hereditary spastic paraplegia caused by the PLP1 'rumpshaker mutation'

    DEFF Research Database (Denmark)

    Svenstrup, Kirsten; Giraud, Geneviève; Boespflug-Tanguy, Odile;

    2010-01-01

    'rumpshaker mutation.' PATIENTS: A family with HSP caused by the 'rumpshaker mutation.' RESULTS: The patients showed nystagmus during infancy and had early onset of HSP. They had normal cognition, and cerebral MRI showed relatively unspecific white matter abnormalities on T2 sequences without clear...

  8. Congenital irreducible atlantoaxial dislocation associated with cervical intramedullary astrocytoma causing progressive spastic quadriparesis

    Directory of Open Access Journals (Sweden)

    Chatley Anooj

    2008-01-01

    Full Text Available Simultaneous presence of congenital irreducible atlantoaxial dislocation (AAD and cervical intramedullary astrocytoma has not been previously described and may cause disabling myelopathy. This 55-year-old lady presented with suboccipital pain, spastic quadriparesis, Lhermitte′s phenomenon and sphincteric disturbances. Lateral radiographs and magnetic resonance imaging showed irreducible AAD, occipitalized atlas, C2-3 fusion, and,an intramedullary tumor from C2-5 level iso-to-hypointense, non-enhancing, except in a small segment in the dorsal C2 level. A suboccipital craniectomy with C2-5 laminectomy revealed a greyish-white tenacious tumor. The tumor was decompressed using a C2-5 midline myelotomy and duroplasty. An occipitocervical lateral mass fixation was performed. Histopathology revealed a low-grade astrocytoma. At three-month follow-up, her spasticity had decreased and quadriparesis and sphincteric disturbances were persisting. Postoperative lateral radiographs and intrathecal contrast CT scan showed a stable occipitocervical construct. Thus, the suboccipital craniectomy and laminectomy with midline myelotomy and duroplasty facilitated space for progressively expanding intramedullary astrocytoma with irreducible AAD; the lateral mass fixation provided stability at the craniovertebral junction.

  9. Extramedullary haematopoeisis causing spinal cord compression

    Directory of Open Access Journals (Sweden)

    F Ismail

    2010-08-01

    Full Text Available Extramedullary haematopoeisis (EMH is a rare cause of spinal cord compression. However, in a patient with a haematological disorder and in particular thalassaemia, EMH with paraspinal masses should be considered and imaging planned appropriately.

  10. The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

    OpenAIRE

    Ashkan Irani; Azadeh Imani; Seyyed Ali Hosseini

    2012-01-01

    Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divi...

  11. Mutations in DARS Cause Hypomyelination with Brain Stem and Spinal Cord Involvement and Leg Spasticity

    Science.gov (United States)

    Taft, Ryan J.; Vanderver, Adeline; Leventer, Richard J.; Damiani, Stephen A.; Simons, Cas; Grimmond, Sean M.; Miller, David; Schmidt, Johanna; Lockhart, Paul J.; Pope, Kate; Ru, Kelin; Crawford, Joanna; Rosser, Tena; de Coo, Irenaeus F.M.; Juneja, Monica; Verma, Ishwar C.; Prabhakar, Prab; Blaser, Susan; Raiman, Julian; Pouwels, Petra J.W.; Bevova, Marianna R.; Abbink, Truus E.M.; van der Knaap, Marjo S.; Wolf, Nicole I.

    2013-01-01

    Inherited white-matter disorders are a broad class of diseases for which treatment and classification are both challenging. Indeed, nearly half of the children presenting with a leukoencephalopathy remain without a specific diagnosis. Here, we report on the application of high-throughput genome and exome sequencing to a cohort of ten individuals with a leukoencephalopathy of unknown etiology and clinically characterized by hypomyelination with brain stem and spinal cord involvement and leg spasticity (HBSL), as well as the identification of compound-heterozygous and homozygous mutations in cytoplasmic aspartyl-tRNA synthetase (DARS). These mutations cause nonsynonymous changes to seven highly conserved amino acids, five of which are unchanged between yeast and man, in the DARS C-terminal lobe adjacent to, or within, the active-site pocket. Intriguingly, HBSL bears a striking resemblance to leukoencephalopathy with brain stem and spinal cord involvement and elevated lactate (LBSL), which is caused by mutations in the mitochondria-specific DARS2, suggesting that these two diseases might share a common underlying molecular pathology. These findings add to the growing body of evidence that mutations in tRNA synthetases can cause a broad range of neurologic disorders. PMID:23643384

  12. A MELAS-associated ND1 mutation causing leber hereditary optic neuropathy and spastic dystonia.

    NARCIS (Netherlands)

    Spruijt, L.; Smeets, H.J.M.; Hendrickx, A.; Bettink-Remeijer, M.W.; Maat-Kievit, A.; Schoonderwoerd, K.C.; Sluiter, W.; Coo, I.F.M. de; Hintzen, R.Q.

    2007-01-01

    OBJECTIVE: To report a novel mutation that is associated with Leber hereditary optic neuropathy (LHON) within the same family affected by spastic dystonia. DESIGN: Leber hereditary optic neuropathy is a mitochondrial disorder characterized by isolated central visual loss. Of patients with LHON, 95%

  13. Medullar compression caused by vertebral hemangioma

    International Nuclear Information System (INIS)

    This is case of a 41 years old feminine patient in whom a unique primary bone tumor injury was demonstrated, diagnosed as a bone hemangioma, located at T-7, with grew and compressed the spinal cord. These bone vascular and frequently observed in the radiological studies and autopsies, in a sporadic form are only symptomatic, growing and affecting the nervous roots and the spinal cord. The clinical history of the patient is described with the preoperative studies and magnetic resonance 6 years after the surgery: The medical literature of these primary bony injuries is reviewed and as they are treated. Objectives: to present the clinical history of a patient who consults having medullar compression syndrome caused by an unusual extra-medullar tumor injury, of bony origin, primary and benign, with clinical controls 8 years after the operation and without evidence of tumor recurrences. The medical literature of this bone pathology is reviewed. Methodology: the clinical history of the patient is described, who was treated surgically successfully, because spinal cord was decompressed without neurological sequels. Vertebral instability was not observed and nor diagnosed. The patient was periodically taken care of with last control of magnetic resonance 6 years after the surgery and last medical control 8 years later. Medical publications are extensively reviewed

  14. Thoracic cord compression caused by contiguous multilevel ossification of ligamentum flavum in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    WANG Kai; CHEN Xin

    2007-01-01

    Objective:To explore the epidemiology, clinical presentation, radiology and surgical treatment outcome in Chinese patients with myelopathy caused by contiguous multilevel ossification of ligamentum flavum.Methods: Medical notes and imaging data of 18 Chinese patients (14 males and 4 females, aged 43-72 years, mean: 57 years ) with myelopathy caused by contiguous multilevel ossification of ligamentum flavum were studied retrospectively in this article. The diagnosis was based on clinical examination, X-ray films, computerized tomography ( CT) and magnetic resonance imaging (MRI) scanning results and pathological results. Sixteen patients were treated by laminectomy and two by laminoplasty. The average follow-up duration was 34 months ( range, 28-49 months ). The outcome was evaluated by Japanese Orthopaedics Association (JOA) score.Results: The average time for occurring clinical symptoms was 7.5 months (range, 2 days-16 months). All the 18 cases presented with clinical evidences of chronic and progressive thoracic spinal cord compression, which included bilateral leg weakness, spastic gait, numbness in lower limbs, paresthesia in terminal and perineum, and urinary incontinence. Neurological examination revealed severe spastic paraparesis, absence of abdominal reflexes, and reduction of the sensory function below the compression level. The mean JOA score before operation was 3. 6 (range, 0-6). MRI and CT scans of the thoracic spine confirmed the presence of contiguous multilevel ossification of the ligamentum flavum. The mean recovery rate after surgery in terms of JOA score was 66.3% (range, 33.3%-100%), with a mean final JOA score of 8. 3. Thoracic decompression laminectomy or laminoplasty could result in a good postoperative outcome.Conclusions: Contiguous multilevel ossification of the ligamentum flavum is not a common cause of myelopathy in Chinese population and should be treated as early as possible. MRI and CT scan examinations may diagnose the presence of

  15. The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

    Directory of Open Access Journals (Sweden)

    Ashkan Irani

    2012-10-01

    Full Text Available Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divided into two groups. The first lower limb spasticity was assessed by a neurologist, and then by an experienced occupational therapist whitout being aware of research process before the intervention, The experimental group went under treatment using positioning therapeutic intervention and neurodevelopmental treatment, while the control group was treated and only with NDT. The research Instrument used was the Modified Ashworth scale (MAS and the H-Reflex and, H/M ratio in the lower limb spasticity was assessed, Utilizing Experimental pretest - post test with control group design. The data of this study was analyzed using t Test k square test and the findings showed meaningful differences between the two groups.Result: The findings of this study reveraled meaningful differences between the two groups, scores of mean spasticity in interference group was significantly less than control group (p=0/003 Conclusion: Application of Anti spastic Orthosis before rehabilitation exercises is recommended for diplegic spastic children.

  16. Late-onset dysphagia caused by severe spastic peristalsis of a free jejunal graft in a case of hypopharyngeal cancer.

    Science.gov (United States)

    Imai, Takayuki; Goto, Takahiro; Matsumoto, Ko; Kurosawa, Koreyuki; Asada, Yukinori; Saijo, Shigeru; Matsuura, Kazuto

    2016-12-01

    Free jejunal transfer is the main technique used for reconstructing a circumferential defect caused by total pharyngo-laryngo-cervical-esophagectomy in certain cancer cases. We report a rare case of severe late-onset dysphagia caused by autonomous spastic peristalsis, which led to complete obstruction of the free jejunal route. A 70-year-old man underwent treatment for hypopharyngeal cancer involving total pharyngolaryngectomy with free jejunal transfer. After uneventful peri- and postoperative recovery, he developed sudden-onset severe dysphagia 22 months later. Gastrografin fluoroscopy revealed abnormal peristalsis and contraction of the transferred jejunum, leading to complete obstruction. Nutritional treatment, application of depressants of peristalsis, and xylocaine injection into the outer space of the jejunal mucosa all failed to alleviate the dysphagia. Surgical treatment involving a longitudinal incision of the jejunal graft, and interposing a cutaneous flap, as a fixed wall, between the incised jejunal margins to prevent obstruction was performed. After further reconstructive surgery involving using a pectoralis major musculocutaneous flap and a split-thickness skin graft to close a refractory jejunum-skin fistula, the dysphagia was permanently alleviated. To our knowledge, this is the first report of severe dysphagia caused by peristalsis of a free jejunal graft. PMID:27068782

  17. Management of Spasticity in Children with Cerebral Palsy

    OpenAIRE

    Shamsoddini, Alireza; AMIRSALARI, Susan; Hollisaz, Mohammad-Taghi; Rahimnia, Alireza; Khatibi-Aghda, Amideddin

    2014-01-01

    Cerebral palsy is the most common cause of spasticity and physical disability in children and spasticity is one of the commonest problems in those with neurological disease. The management of spasticity in children with cerebral palsy requires a multidisciplinary effort and should be started as early as possible. There are a number of treatments available for the management of spasticity. This article reviews the variety of options available for the clinical management of spasticity.

  18. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke

    OpenAIRE

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-01-01

    Abstract Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases. This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapeziu...

  19. Genetic and structural analyses suggest that a novel SPG3A mutation causes severe phenotypes of hereditary spastic paraplegia

    Institute of Scientific and Technical Information of China (English)

    CHEN Suqin; ZHOU Yan; LI Xunhua; Labu; HUANG Shuang; HUANG Weijun; ZHOU Chunlong; liu; WANG Yiming

    2006-01-01

    Hereditary spastic paraplegia (HSP) is a group of neurodegenerative diseases. The genotypes and phenotypes of HSP are extremely heterogenous. SPG3A is one of the identified genes underlying HSP, and codes for a GTPase, atlastin. Mutations in SPG3A are currently believed to be associated with early onset and mild phenotypes. And most structural predictions could not detect gross changes in the mutant protein. However, in a severely affected HSP family we have identified a novel SPG3A mutation, c.1228G>A (p.G410R), in a Tibetan kindred. The mutation occurred at the highly conserved nucleotide and co-segregated with the disease, and was absent in the control subjects. Structural predictions showed that the Tibetan mutation occurred at the linking part between the guanylate-binding protein domain (GB, the ball region) and the transmembrane helices (TM, the rod region) at the start point of an α-helix, which may disrupt the helix, and cause changes in the overall structure of the transmembrane region of the molecule. Our results indicate that severe phenotypes can also arise from SPG3A mutations and the linking part of the guanylate-binding protein domain and the transmembrane helices might be crucial in determining the severity of the disease. This paper not only presents the first SPG3A mutational report from the Chinese population, but also provides potential evidence for a possible correlation between the severity of the phenotypes of HSP with the extension of the changes in the protein structures of atlastin.

  20. Placebo effects in a multiple sclerosis spasticity enriched clinical trial with the oromucosal cannabinoid spray (THC/CBD): dimension and possible causes.

    Science.gov (United States)

    Di Marzo, Vincenzo; Centonze, Diego

    2015-03-01

    Regulatory authorities admit clinical studies with an initial enrichment phase to select patients that respond to treatment before randomization (Enriched Design Studies; EDSs). The trial period aims to prevent long-term drug exposure risks in patients with limited chances of improvement while optimizing costs. In EDSs for symptom control therapies providing early improvements and without a wash-out period, it is difficult to show further improvements and thus large therapeutic gains versus placebo. Moreover, in trials with cannabinoids, the therapeutic gains can be further biased in the postenrichment randomized phase because of carryover and other effects. The aims of the present review article are to examine the placebo effects in the enrichment and postenrichment phases of an EDS with Δ(9) -tetrahydrocannabinol and cannabidiol (THC/CBD) oromucosal spray in patients with multiple sclerosis (MS) spasticity and to discuss the possible causes of maintained efficacy after randomization in the placebo-allocated patients. The overall mean therapeutic gain of THC/CBD spray over placebo in resistant MS spasticity after 16 weeks can be estimated as a ~1.27-point improvement on the spasticity 0-10 Numerical Rating Scale (NRS; ~-20.1% of the baseline NRS score). We conclude that careful interpretation of the results of EDSs is required, especially when cannabinoid-based medications are being investigated. PMID:25475413

  1. Eagle Syndrome Causing Vascular Compression with Cervical Rotation: Case Report

    Science.gov (United States)

    Demirtaş, Hakan; Kayan, Mustafa; Koyuncuoğlu, Hasan Rıfat; Çelik, Ahmet Orhan; Kara, Mustafa; Şengeze, Nihat

    2016-01-01

    Summary Background Eagle syndrome is a condition caused by an elongated styloid process. Unilateral face, neck and ear pain, stinging pain, foreign body sensation and dysphagia can be observed with this syndrome. Rarely, the elongated styloid process may cause pain by compressing the cervical segment of the internal carotid and the surrounding sympathetic plexus, and that pain spreading along the artery can cause neurological symptoms such as vertigo and syncope. Case Report In this case report we presented a very rare eagle syndrome with neurological symptoms that occurred suddenly with cervical rotation. The symptoms disappeared as suddenly as they occurred, with the release of pressure in neutral position. We also discussed CT angiographic findings of this case. Conclusions Radiological diagnosis of the Eagle syndrome that is manifested with a wide variety of symptoms and causes diagnostic difficulties when it is not considered in the differential diagnosis is easy in patients with specific findings. CT angiography is a fast and effective examination in terms of showing compression in patients with the Eagle syndrome that is considered to be atypical and causes vascular compression. PMID:27354882

  2. Hydrokinezotherapy as the cause of physical rehabilitation of children of preschool age with cerebral paralysis of spastic form.

    Directory of Open Access Journals (Sweden)

    Baybuza I.V.

    2011-06-01

    Full Text Available In this work is considered effective influences of physical exercises in water. The dynamics of development of functional indexes is shown by the kardio-respirator and kinesthesia systems. In an experiment took part 15 children of preschool age with the cerebral paralysis of spastic form. It is well-proven that the most substantial changes happened at the estimation of indexes of dynamic force of muscles and goniometry of lower limbs. Leaning against the got results, it is possible to recommend a hydrokinezotherapy in treatment of patients with this pathology.

  3. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke

    Science.gov (United States)

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-01-01

    Abstract Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases. This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapezius was diagnosed by physical examination and needle electromyographic study. Botulinum toxin was injected into the spastic periscapular muscles under ultrasound imaging guidance. During the 3-week follow-up visit after injection, both patients showed increased shoulder active ROM, without any sign of scapular destabilization. The results suggest that botulinum toxin injection to spastic periscapular muscles can increase shoulder active ROM without causing scapular destabilization in patients with poststroke spastic scapular dyskinesia. PMID:26266368

  4. Pseudoarthrosis following fracture of left lamina of C2 vertebra causing compressive myelopathy

    Directory of Open Access Journals (Sweden)

    B.C.M. Prasad

    2012-04-01

    Full Text Available Pseudoarthrosis involving lamina of C2 vertebra requiring intervention is very rare. We report the unusual case of a 38-year-old man presenting with pseudoarthrosis of an old fracture involving left lamina of C2 vertebra. The patient presented with progressive spastic quadriparesis and history of sustaining injury to his neck 15 years ago. Imaging showed pseudoarthrosis involving the left lamina of C2 vertebra with significant cord compression. Posterior approach was used and decompressive laminectomy was done at C2 and C3 levels with removal of the affected segment with pseudoarthrosis. The postoperative period was uneventful and the neurological recovery was good.

  5. Splicing Defect in Mitochondrial Seryl-tRNA Synthetase Gene Causes Progressive Spastic Paresis Instead of HUPRA Syndrome.

    Science.gov (United States)

    Linnankivi, Tarja; Neupane, Nirajan; Richter, Uwe; Isohanni, Pirjo; Tyynismaa, Henna

    2016-09-01

    Mitochondrial aminoacyl-tRNA synthetases are an important group of disease genes typically underlying either a disorder affecting an isolated tissue or a distinct syndrome. Missense mutations in the mitochondrial seryl-tRNA synthetase gene, SARS2, have been identified in HUPRA syndrome (hyperuricemia, pulmonary hypertension, renal failure in infancy, and alkalosis). We report here a homozygous splicing mutation in SARS2 in a patient with progressive spastic paresis. We show that the mutation leads to diminished levels of the synthetase in patient's fibroblasts. This has a destabilizing effect on the tRNASer(AGY) isoacceptor, but to a lesser degree than in HUPRA syndrome patients. tRNASer(UCN) is largely unaffected in both phenotypes. In conclusion, the level of tRNASer(AGY) instability may be a factor in determining tissue manifestation in patients with SARS2 mutations. This finding exemplifies the sensitivity of the nervous system to partially reduced aminoacylation, which is sufficient in other tissues to maintain respiratory chain function. PMID:27279129

  6. Orthopaedic Management of Spasticity.

    Science.gov (United States)

    Pidgeon, Tyler S; Ramirez, Jose M; Schiller, Jonathan R

    2015-12-01

    Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications. Orthopaedic surgeons manage numerous sequelae of spasticity, including joint contractures, hip dislocations, scoliosis, and deformed extremities. When combined with the efforts of rehabilitation specialists, neurologists, and physical/occupational therapists, the orthopaedic management of spasticity can help patients maintain and regain function and independence as well as reduce the risk of long-tem complications. PMID:26623452

  7. Primary hyperparathyroidism. A rare cause of spinal cord compression.

    Science.gov (United States)

    Haddad, Fares H; Malkawi, Omar M; Sharbaji, Amer A; Jbara, Ibrahim F; Rihani, Hanan R

    2007-05-01

    We report a case of a 62-year-old postmenopausal hypertensive lady who was treated for osteoporosis with calcium and Vitamin D. She presented with progressive lower limb weakness and paresthesia with sensory level at T4. Investigations revealed high parathyroid hormone 1152 ng/dl, calcium 10.9 mg/dl, and low phosphorus of 2.4 mg/dl after stopping calcium supplement. Chest x-ray showed an expansile mass lesion of the right 6th rib confirmed by chest CT. Thoracic MRI showed a mass lesion extending from the T3 vertebral body and compressing the spinal cord. There were multiple lytic lesions of the scalp, ribs, femur, and pelvis suggesting metastatic lesions. A neck ultrasound and SESTA MIBI parathyroid scan confirmed a right lower parathyroid adenoma. Excision biopsy of the rib lesion confirmed a vascular lesion with features of brown tumor BT. Decompression surgery of the thoracic spine was performed, and the histopathology confirmed BT. Two weeks later the patient underwent right parathyroidectomy that proved to be a parathyroid adenoma. She showed a remarkable improvement in her clinical condition and there were some regression of the bony lesions observed 12 months post parathyroidectomy. This case should alert physicians to the association of multiple brown tumors in PHPT and that the presentation may be an aggressive one mimicking metastasis, patients with osteoporosis warrant at least calcium profile to rule out a secondary cause. PMID:17457452

  8. Primary hyperparathyroidism: A rare cause of spinal cord compression

    International Nuclear Information System (INIS)

    We report a case of a 62-year-old postmenopausal hypertensive lady who was treated for osteoporosis with calcium and Vitamin D. She presented with progressive lower limb weakness and paresthesia with sensory level at T4. Investigations revealed high parathyroid hormone 1152 ng/dl, calcium 10.9 mg/dl, and low phosphorus of 2.4 mg/dl after stopping calcium supplement. Chest x-ray showed an expansile mass lesion of the right 6th rib confirmed by chest CT. Thoracic MRI showed a mass lesion extending from the T3 vertebral body and compressing the spinal cord. There were multiple lytic lesions of the scalp, ribs, femur, and pelvis suggesting metastatic lesions. A neck ultrasound and SESTA MIBI parathyroid scan confirmed a right lower parathyroid adenoma. Excision biopsy of the rib lesion confirmed a vascular lesion with features of brown tumor BT. Decompression surgery of the thoracic spine was performed, and the histopathology confirmed BT. Two weeks later the patient underwent right parathyroidectomy that proved to be a parathyroid adenoma. She showed a remarkable improvement in her clinical condition and there were some regression of the bony lesions observed 12 months post parathyroidectomy. This case should alert physicians to the association of multiple brown tumors in PHPT and that the presentation may be an aggressive one mimicking metastasis, patients with osteoporosis warrant at least calcium profile to rule out a secondary cause. (author)

  9. The effect of Sativex in neuropathic pain and spasticity in spinal cord injury

    DEFF Research Database (Denmark)

    Andresen, Sven Robert; Hansen, Rikke Bod Middelhede; Johansen, Inger Lauge;

    2014-01-01

    Introduction: Neuropathic pain and spasticity after spinal cord injury represent significant but still unresolved problems, which cause considerable suffering and reduced quality of life for patients with spinal cord injury. Treatment of neuropathic pain and spasticity is complicated and patients...

  10. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke: Case Series.

    Science.gov (United States)

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-08-01

    Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases.This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapezius was diagnosed by physical examination and needle electromyographic study. Botulinum toxin was injected into the spastic periscapular muscles under ultrasound imaging guidance.During the 3-week follow-up visit after injection, both patients showed increased shoulder active ROM, without any sign of scapular destabilization.The results suggest that botulinum toxin injection to spastic periscapular muscles can increase shoulder active ROM without causing scapular destabilization in patients with poststroke spastic scapular dyskinesia. PMID:26266368

  11. De novo mutations in the motor domain of KIF1A cause cognitive impairment, spastic paraparesis, axonal neuropathy, and cerebellar atrophy

    NARCIS (Netherlands)

    Lee, Jae Ran; Srour, Myriam; Kim, Doyoun; Hamdan, Fadi F.; Lim, So Hee; Brunel-Guitton, Catherine; Décarie, Jean Claude; Rossignol, Elsa; Mitchell, Grant A.; Schreiber, Allison; Moran, Rocio; Van Haren, Keith; Richardson, Randal; Nicolai, Joost; Oberndorff, Karin M E J; Wagner, Justin D.; Boycott, Kym M.; Rahikkala, Elisa; Junna, Nella; Tyynismaa, Henna; Cuppen, Inge; Verbeek, Nienke E.; Stumpel, Connie T R M; Willemsen, Michel A.; de Munnik, Sonja A.; Rouleau, Guy A.; Kim, Eunjoon; Kamsteeg, Erik Jan; Kleefstra, Tjitske; Michaud, Jacques L.

    2015-01-01

    KIF1A is a neuron-specific motor protein that plays important roles in cargo transport along neurites. Recessive mutations in KIF1A were previously described in families with spastic paraparesis or sensory and autonomic neuropathy type-2. Here, we report 11 heterozygous de novo missense mutations (p

  12. Arterial compression of nerve is the primary cause of trigeminal neuralgia

    OpenAIRE

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-ping

    2013-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of...

  13. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  14. Prolactinoma during pregnancy causing compression symptoms responding to bromocriptine therapy.

    OpenAIRE

    Saunders, N. J.

    1985-01-01

    A woman with pituitary macroadenoma causing pressure symptoms and a partial right third cranial nerve palsy during pregnancy is described. Complete resolution occurred using oral bromocriptine therapy alone and the remainder of the pregnancy was uneventful.

  15. CDC WONDER: Compressed Mortality - Underlying Cause of Death

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CDC WONDER Mortality - Underlying Cause of Death online database is a county-level national mortality and population database spanning the years since 1979...

  16. Changes in tropical Late Carboniferous compression floras and their causes

    Energy Technology Data Exchange (ETDEWEB)

    Pfefferkorn, H.W. (Univ. of Pennsylvania, Philadelphia, PA (United States). Dept. of Geology)

    1992-01-01

    In the Late Carboniferous ten biostratigraphic boundaries can be recognized based on compression floras. Some of these boundaries coincide with classical stage boundaries whereas others do not. These boundaries are observable throughout Eurameria. In most cases the same species are involved in North America and Europe. Four boundaries are characterized by extinction events that involve only a few or many taxa. Four boundaries are characterized by origination of single taxa or by changes in the dominance of taxonomic groups. Two boundaries near the base of the Late Carboniferous seem to coincide with different stages in the onset of the ice age on Gondwanaland. However, it has not been clearly demonstrated what the local climatic signals in the tropics were. Three boundaries in the late Late Carboniferous are connected with well established trends toward dryer climate. It appears that many of these floral changes were climatically controlled. The actual triggering condition seems to have been produced by a variable combination of short term (allocyclic) and long term (orogeny, continental movement) effects. In one case the reason for the extinction is not obvious and could be biotic in nature.

  17. Expanding pseudoaneurysm compressing the coronary arteries and causing cardiogenic shock.

    Science.gov (United States)

    Maliske, Seth M; Alshawabkeh, Laith; Schouweiler, Katie; Sigurdsson, Gardar

    2015-01-01

    A 37-year-old man who recently underwent aortic valve replacement after endocarditis presented with cardiogenic shock. A large expansile pseudoaneurysm was subsequently discovered using multiple imaging modalities. Although transesophageal echocardiography is important in diagnosing valve endocarditis, coronary CT angiography of prosthetic valves is feasible and image quality is good. In this case, coronary CT angiography allowed for better understanding of transesophageal echocardiography images and earlier diagnosis of coronary involvement as cause for left ventricular dysfunction.

  18. Nerve compression as an essential factor in causing ischaemic and post-ischaemic paraesthesiae

    Directory of Open Access Journals (Sweden)

    Eros Abrantes Erhart

    1950-03-01

    Full Text Available In order to explain why ischaemia produced by compression at the proximal part of the forearm or at the wrist, does not cause sensory disturbances identical to those observed in compression at the upper arm, several experiments were made on ourselves and other subjects. The method used was essentially that of Lewis and Pochin. Circulation was blocked at different levels of the limb by applying the pressure of 200 mm/Hg with a sphygmomanometer cuff; compression of the median, ulnar and tibial nerve trunks was made with the aid of a small cushion under the cuff. We observed always that the nerve compression is an essential factor in causing ischaemic and post-ischaemic paraesthesiae.

  19. Development of Lumbar Spinal Stenosis Caused by Lumbar Vertebral Compression Fracture

    Directory of Open Access Journals (Sweden)

    Hidayet Sarı

    2004-12-01

    Full Text Available Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which causes mechanical compression of spinal nerve roots.Diagnosis is made by computerized tomography, myelography, or magnetic resonance (MR imaging. The aim of this case report was to present and discuss a patient with degenerative changes in whom spinal canal stenosis developed due to compression fracture and retropulsion of a fragment into the spinal canal following a simple fall.

  20. Intractable vomiting caused by vertebral artery compressing the medulla: A case report

    Directory of Open Access Journals (Sweden)

    Lauren Gorton

    2015-01-01

    Full Text Available Vertebral artery compressing the medulla and causing intractable vomiting has only been reported once previously. We report a case of a 69-year-old woman with intractable nausea and vomiting causing a 50 pound weight loss and who failed medical management and whose symptoms were completely reversed following microvascular decompression (MVD.

  1. Os odontoideum with "free-floating" atlantal arch causing C1-2 anterolisthesis and retrolisthesis with cervicomedullary compression

    Directory of Open Access Journals (Sweden)

    Behari Sanjay

    2010-01-01

    Full Text Available Background: Os odontoideum (OO with C1-2 anterolisthesis and retrolisthesis may cause cervicomedullary injury both from anterior and posterior aspects. We analyzed fourteen such patients for biomechanical issues, radiological features and management of OO with free-floating atlantal arch and review pertinent literature. Materials and Methods: Fourteen patients having nonsyndromic, reducible atlantoaxial dislocation (AAD with orthotopic OO were analyzed. During neck flexion, their C1 anterior arch-os complex displaced anteriorly relative to remnant odontoid-C2 body. The posteriorly directed hypoplastic remnant odontoid sliding below the atlas and forward translation of the C1 posterior arch caused concomitant cervicomedullary compression. During neck extension, there was retrolisthesis of the "free-floating" C1 arch-os complex into spinal canal. Spinal stenosis and lateral C1-2 facet dislocation; Klippel-Feil anomaly; and posterior circulation infarcts were also present in one patient each, respectively. Posterior C1-2 (n=10 or occipitocervical fusion (n=3 was performed in neutral position to stabilize atlantoaxial movements. Results: Follow-up (mean, 3.9 years assessment revealed improvement in spasticity and weakness in 13 patients. One patient had neurological deterioration following C1-2 posterior sublaminar fusion, requiring its conversion to occipitocervical contoured rod fusion. One patient with posterior circulation stroke died prior to any operative intervention. Follow-up lateral view radiographs showed a bony union or a stable construct in these 13 patients. Conclusions: OO with free-floating atlantal arch may precipitate cord injury both during neck flexion and extension. This condition may be overlooked unless lateral radiographs of craniovertebral junction are undertaken in neck extension, along with the usual ones in neutral and flexed positions. Etiological factors include C1 ring-OO unrestrained movements above the hypoplastic

  2. Current evidence for the organic etiology of spastic dysphonia.

    Science.gov (United States)

    Dedo, H H; Townsend, J J; Izdebski, K

    1978-01-01

    For over 100 years it has been universally assumed in the literature that spastic dysphonia is a functional or psychoneurotic voice disorder. In the last few years, new data have accumulated that support the concept that spastic dysphonia is caused by an organic, rather than a functional, abnormality. Histologic examination of segments of the recurrent laryngeal nerve removed from patients with spastic dysphonia has revealed myelin abnormalities in 30% of the nerves examined. Neurologic examination indicated brain stem or basal ganglia disturbances in some patients who had no apparent nerve disease.

  3. Response of a pipeline to ground movements caused by trenching in compressible alluvium

    Science.gov (United States)

    Carder, D. R.; Taylor, M. E.; Pocock, R. G.

    Disturbance of the ground due to work on buried services, such as the renewal, replacement or construction of deep sewers, is likely to cause differential ground movements in the vicinity. This may be a factor contributing to failure in nearby service pipelines such as drainage, gas and water mains. The response of an instrumented shallow buried pipeline to ground movements caused by adjacent deep trenching in a compressible alluvium is described.

  4. Unusual facial pain secondary to inferior alveolar nerve compression caused by impacted mandibular second molar

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2014-01-01

    Full Text Available Symptoms of inferior alveolar nerve (IAN compression are reported during endodontic procedures, placement of implants, third molar surgeries, inferior alveolar nerve block injections, trauma, orthognathic injuries, ablative surgeries or use of medicaments. Presented is a rare case of a 15-year-old girl who reported severe pain in relation to an impacted permanent mandibular left second molar, the roots of which had entrapped the mandibular canal causing compression of IAN. Timely surgical intervention and sectional removal of the impacted molar is indicated to relieve the symptoms and avoid permanent damage to the nerve.

  5. Robotic pilot study for analysing spasticity: clinical data versus healthy controls

    OpenAIRE

    Seth, Nitin; Johnson, Denise; Taylor, Graham W.; Allen, O. Brian; Abdullah, Hussein A

    2015-01-01

    Background Spasticity is a motor disorder that causes significant disability and impairs function. There are no definitive parameters that assess spasticity and there is no universally accepted definition. Spasticity evaluation is important in determining stages of recovery. It can determine treatment effectiveness as well as how treatment should proceed. This paper presents a novel cross sectional robotic pilot study for the primary purpose of assessment. The system collects force and positi...

  6. Myeloid Sarcoma: An Unusual Presentation of Acute Promyelocytic Leukemia Causing Spinal Cord Compression

    OpenAIRE

    Tay Za Kyaw; Jayaranee A.s. Maniam; Ping Chong Bee; Edmund Fui Min Chin; Veera Sekaran Nadarajan; Hemalatha Shanmugam; Khairul Azmi Abd Kadir

    2012-01-01

    Acute promyelocytic leukemia with concurrent myeloid sarcoma is a rare clinical event. Herein we describe a patient that presented with back pain and bilateral leg weakness caused by spinal cord compression due to extramedullary deposition of leukemic cells. Acute promyelocytic leukemia was suspected based on immunophenotypic findings of malignant cells in bone marrow aspirate. The diagnosis was confirmed by the presence of PML-RARα fusion copies. MRI showed multiple hyperintense changes on t...

  7. Elastic stresses and plastic deformations in 'Santa Clara' tomato fruits caused by package dependent compression

    Directory of Open Access Journals (Sweden)

    PEREIRA ADRIANA VARGAS

    2000-01-01

    Full Text Available The objective of this work was to study the fruit compression behavior aiming to develop new tomato packages. Deformations caused by compression forces were observed inside packages and in individual 'Santa Clara' tomato fruit. The forces applied by a transparent acrylic lever to the fruit surface caused pericarp deformation and the flattened area was proportional to the force magnitude. The deformation was associated to the reduction in the gas volume (Vg, caused by expulsion of the air from the loculus cavity and reduction in the intercellular air volume of the pericarp. As ripening advanced, smaller fractions of the Vg reduced by the compressive force were restored after the stress was relieved. The lack of complete Vg restoration was an indication of permanent plastic deformations of the stressed cells. Vg regeneration (elastic recovery was larger in green fruits than in the red ones. The ratio between the applied force and the flattened area (flattening pressure, which depends on cell turgidity, decreased during ripening. Fruit movements associated with its depth in the container were observed during storage in a transparent glass container (495 x 355 x 220 mm. The downward movement of the fruits was larger in the top layers because these movements seem to be driven by a summation of the deformation of many fruits in all layers.

  8. Computed tomography in spastic cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, H.; Taudorf, K.; Melchior, J.C.

    1982-09-01

    Eighty-three children with spastic cerebral palsy (CP) were examined with cranial CT. In 56 cases the CT findings were abnormal. The most frequent abnormality was atrophy, present in 44 patients. The frequency of pathologic CT increased with severity of the CP. Patients with CP of postnatal aetiology more often had abnormal CT than patients with other known causes. Pathologic CT findings were seen more often in patients with seizures than in patients without. Infarctions and hemiatrophy were much more frequent in patients with hemiplegia than in patients with other types of spastic CP. A special kind of central atrophy, called isolated atrophy around the cella media, is described. This condition was seen in 20% of cases, most often in hemi- and paraplegic patients. Early infarctions in the border areas between the vascular territories of the internal carotid and the posterior cerebral artery may be the reason for this kind of atrophy.

  9. Computed tomography in spastic cerebral palsy

    International Nuclear Information System (INIS)

    Eigthy-three children with spastic cerebral plays (CP) were examined with cranial CT. In 56 cases the CT findings were abnormal. The most frequent abnormality was atrophy, present in 44 patients. The frequency of pathologic CT increased with severity of the CP. Patients with CP of postnatal aetiology more often had abnormal CT than patients with other known causes. Pathologic CT findings were seen more often in patients with seizures than in patients without. Infarctions and hemiatrophy were much more frequent in patients with hemiplegia than in patients with other types of spastic CP. A special kind of central atrophy, called isolated atrophy around the cella media, is described. This condition was seen in 20% of cases, most often in hemi- and paraplegic patients. Early infarctions in the border areas between the vasular territories of the internal carotid and the posterior cerebral artery may be the reason for this kind of atrophy. (orig.)

  10. Baclofen in Spastic Cerebral Palsy

    OpenAIRE

    J Akhundian

    2002-01-01

    To evaluate the effect of oral baclofen in spastic cerebral palsy (cp), we studied 40 children with different clinical types of spastic cp. Half of these children served as control group and the others received oral baclofen. All of them were treated with physiotherapy under equal conditions for 6 weeks. We used two methods, modified Ashworth scale and range of motion for evaluation. At the end of therapy we found a significant improvement in the baclofen group compared to control group. As a...

  11. Compressive Optic Neuropathy Caused by Cholesterol Gran-uloma in the Posterior Ethmoid Sinus

    Institute of Scientific and Technical Information of China (English)

    Chun-Chih Lin; Ting-Kuang Chao; Tsu-Hua Chen; Jia-Kang Wang

    2015-01-01

    Purpose:.Cholesterol granuloma is usually associated with chronic middle ear disease..Involvement of the ethmoid sinus by cholesterol granuloma is rare..We describe a case with cholesterol granuloma of the posterior ethmoid sinus causing optic nerve compression..No previous reports were found in our review of the literature. Case report:.A 48-year-old man had impaired visual acuity and a relative afferent pupillary defect in the right eye. Fundus fluorescein angiography showed a swollen optic nerve head and optic disc leakage. Automated perimetry revealed a severe peripheral visual field defect with tunnel vision. Computerized tomography demonstrated an expansile,.isodense mass in the right posterior ethmoid sinus, remodeling of the bony walls of the right sphenoid sinus, and lateral displacement of the optic nerve in the right orbit..Compressive optic neuropathy caused by posterior ethmoid sinus lesion was diagnosed..A transnasal endoscopic exploration of the right ethmoid sinuses demon-strated a soft expansile cystic lesion with a thick yellow cap sule that filled the inside of the posterior ethmoid sinus. Brownish fluid with shiny crystals was drained by fine needle aspiration. The capsule was removed completely, and the mu-cociliary clearance of the sinus was reestablished..The patho-logic pictures confirmed the diagnosis of cholesterol granulo-ma, which included typical cholesterol clefts surrounded by inflammatory cells with focal multi-nucleated giant cells. Visu-al function fully recovered without recurrent lesions after a three-year follow-up. Conclusion:.Compressive optic neuropathy can be rarely caused by cholesterol granuloma in the posterior ethmoid si-nus. The visual prognosis may be good after transnasal endo-scopic decompression in such patients.

  12. An epidural neuroblastoma causing spinal cord compression in a 67-year-old woman

    Directory of Open Access Journals (Sweden)

    Ethan Taub

    2010-04-01

    Full Text Available We report a case of disseminated neuroblastoma (NB causing epidural spinal cord compression in a 67-year-old woman. Because NB is primarily a tumor of infancy and childhood, less is known about its clinical course and optimal treatment in adults. This patient was treated with a thoracic laminectomy and tumor resection; polychemotherapy with one cycle of vindesine, cisplatin, and etoposide; one cycle of vincristine, dacarbazine, ifosfamide, and doxorubicin; and radiotherapy to the spine. She remained able to walk but died 8.5 months later of diffuse systemic tumor progression.

  13. DISTRACTION EXTERNAL FIXATIONS OF PELVIC FRACTURES CAUSED BY A LATERAL COMPRESSION.

    Directory of Open Access Journals (Sweden)

    Pavlin Apostolov

    2011-11-01

    Full Text Available The authors represent a distraction external pelvic fixation technique, which they use in pelvic fractures caused by a lateral compression. They consider the indications and mounting techniques. The authors recommend the early movement activities (on the 3rd - 5th day after the external fixator placement. This method had been used in 8 patients and 3 cases are analyzed in details. The priority of this technique over open reduction and internal fixation (ORIF mainly are: (1 the implementation of good reduction of the fracture preventing the risk of ORIF; (2 the possibility for early movement activities for the patient.

  14. Genetic and phenotypic characterization of complex hereditary spastic paraplegia.

    Science.gov (United States)

    Kara, Eleanna; Tucci, Arianna; Manzoni, Claudia; Lynch, David S; Elpidorou, Marilena; Bettencourt, Conceicao; Chelban, Viorica; Manole, Andreea; Hamed, Sherifa A; Haridy, Nourelhoda A; Federoff, Monica; Preza, Elisavet; Hughes, Deborah; Pittman, Alan; Jaunmuktane, Zane; Brandner, Sebastian; Xiromerisiou, Georgia; Wiethoff, Sarah; Schottlaender, Lucia; Proukakis, Christos; Morris, Huw; Warner, Tom; Bhatia, Kailash P; Korlipara, L V Prasad; Singleton, Andrew B; Hardy, John; Wood, Nicholas W; Lewis, Patrick A; Houlden, Henry

    2016-07-01

    The hereditary spastic paraplegias are a heterogeneous group of degenerative disorders that are clinically classified as either pure with predominant lower limb spasticity, or complex where spastic paraplegia is complicated with additional neurological features, and are inherited in autosomal dominant, autosomal recessive or X-linked patterns. Genetic defects have been identified in over 40 different genes, with more than 70 loci in total. Complex recessive spastic paraplegias have in the past been frequently associated with mutations in SPG11 (spatacsin), ZFYVE26/SPG15, SPG7 (paraplegin) and a handful of other rare genes, but many cases remain genetically undefined. The overlap with other neurodegenerative disorders has been implied in a small number of reports, but not in larger disease series. This deficiency has been largely due to the lack of suitable high throughput techniques to investigate the genetic basis of disease, but the recent availability of next generation sequencing can facilitate the identification of disease-causing mutations even in extremely heterogeneous disorders. We investigated a series of 97 index cases with complex spastic paraplegia referred to a tertiary referral neurology centre in London for diagnosis or management. The mean age of onset was 16 years (range 3 to 39). The SPG11 gene was first analysed, revealing homozygous or compound heterozygous mutations in 30/97 (30.9%) of probands, the largest SPG11 series reported to date, and by far the most common cause of complex spastic paraplegia in the UK, with severe and progressive clinical features and other neurological manifestations, linked with magnetic resonance imaging defects. Given the high frequency of SPG11 mutations, we studied the autophagic response to starvation in eight affected SPG11 cases and control fibroblast cell lines, but in our restricted study we did not observe correlations between disease status and autophagic or lysosomal markers. In the remaining cases, next

  15. Radiation dermatitis caused by a bolus effect from an abdominal compression device.

    Science.gov (United States)

    Connor, Michael; Wei, Randy L; Yu, Suhong; Sehgal, Varun; Klempner, Samuel J; Daroui, Parima

    2016-01-01

    American Association of Physicists in Medicine (AAPM) Task Group 176 evaluated the dosimetric effects caused by couch tops and immobilization devices. The report analyzed the extensive physics-based literature on couch tops, stereotactic body radiation therapy (SBRT) frames, and body immobilization bags, while noting the scarcity of clinical reports of skin toxicity because of external devices. Here, we present a clinical case report of grade 1 abdominal skin toxicity owing to an abdominal compression device. We discuss the dosimetric implications of the utilized treatment plan as well as post hoc alternative plans and quantify differences in attenuation and skin dose/build-up between the device, a lower-density alternative device, and an open field. The description of the case includes a 66-year-old male with HER2 amplified poorly differentiated distal esophageal adenocarcinoma treated with neoadjuvant chemo-radiation and the use of an abdominal compression device. Radiation was delivered using volumetric modulated arc therapy (VMAT) with 2 arcs using abdominal compression and image guidance. The total dose was 50.4Gy delivered over 40 elapsed days. With 2 fractions remaining, the patient developed dermatitis in the area of the compression device. The original treatment plan did not include a contour of the device. Alternative post hoc treatment plans were generated, one to contour the device and a second with anterior avoidance. In conclusion, replanning with the device contoured revealed the bolus effect. The skin dose increased from 27 to 36Gy. planned target volume (PTV) coverage at 45Gy was reduced to 76.5% from 95.8%. The second VMAT treatment plan with an anterior avoidance sector and more oblique beam angles maintained PTV coverage and spared the anterior wall, however at the expense of substantially increased dose to lung. This case report provides an important reminder of the bolus effect from external devices such as abdominal compression. Special

  16. Comparison of Modified Ashworth Scale and Hoffmann Reflex in Study of Spasticity

    Directory of Open Access Journals (Sweden)

    Amir Hassan Kohan

    2010-05-01

    Full Text Available "nSpasticity is one of the common complications in upper motor neuron lesions and without appropriate treatment it causes disturbances in movement pattern. Assessments of patients are effective in patient`s management. Modified Ashworth scale (MAS is one of the criteria in qualitative assessment of spasticity, and there are lots of controversies about its validity. The purpose of this study is to compare MAS with electrophysiological indices of spasticity. The spasticity of upper limb muscles in patients with hemiplegic cerebral palsy are measured and recorded by MAS. Then electrophysiological indices of Hoffmann reflex (H reflex and ratio of maximum range of action potential of combined movement of flexor carpi radialis (FCR for upper limb and soleus for lower limb were estimated. Data of 11 patients with age range 4 to 6 were analyzed. There is no significant correlation between degree of spasticity and electrophysiological indices.

  17. NIPA1 mutation in complex hereditary spastic paraplegia with epilepsy

    DEFF Research Database (Denmark)

    Svenstrup, Kirsten; Møller, R S; Christensen, Jacob;

    2011-01-01

    or signs are found. Mutations in the NIPA1 gene have been reported to cause spastic paraplegia type 6 (SPG6) in 10 families. SPG6 is a rare form of autosomal dominantly inherited HSP associated with a pure phenotype; however, in one complex SPG6 family, idiopathic generalized epilepsy (IGE) has been...... reported missense mutation c.316G>A, p.Gly106Arg, was identified in a complex HSP patient with spastic dysarthria, facial dystonia, atrophy of the small hand muscles, upper limb spasticity, and presumably IGE. The epilepsy co-segregated with HSP in the family. Conclusion: NIPA1 mutations were rare in our...... population of patients with HSP, but can be found in patients with complex HSP. Epilepsy might be more common in SPG6 than in other forms of HSP because of a genetic risk factor closely linked to NIPA1....

  18. Recessive loss-of-function mutations in AP4S1 cause mild fever-sensitive seizures, developmental delay and spastic paraplegia through loss of AP-4 complex assembly

    DEFF Research Database (Denmark)

    Hardies, Katia; May, Patrick; Djémié, Tania;

    2015-01-01

    We report two siblings with infantile onset seizures, severe developmental delay and spastic paraplegia, in whom whole-genome sequencing revealed compound heterozygous mutations in the AP4S1 gene, encoding the σ subunit of the adaptor protein complex 4 (AP-4). The effect of the predicted loss-of-...... in reported patients, highlighting that seizures are part of the clinical manifestation of the AP-4 deficiency syndrome. We also hypothesize that endosomal trafficking is a common theme between heritable spastic paraplegia and some inherited epilepsies....

  19. Spasticity-assessment: a review

    DEFF Research Database (Denmark)

    Biering-Sørensen, F.; Nielsen, Jens Bo; Klinge, Klaus Peter

    2006-01-01

    Study design:Review of the literature on the validity and reliability of assessment of spasticity and spasms.Objectives:Evaluate the most frequently used methods for assessment of spasticity and spasms, with particular focus on individuals with spinal cord lesions.Setting:Clinic for Spinal Cord...... Injuries, Rigshospitalet, University Hospital of Copenhagen, and Department of Medical Physiology, University of Copenhagen, Denmark.Methods:The assessment methods are grouped into clinical, biomechanical and electrophysiological, and the correlation between these is evaluated.Results:Clinical methods: For...... assessment of spasticity, the Ashworth and the modified Ashworth scales are commonly used. They provide a semiquantitative measure of the resistance to passive movement, but have limited interrater reliability. Guidelines for the testing procedures should be adhered to. Spasm frequency scales seem not to...

  20. Four mutations of the spastin gene in Japanese families with spastic paraplegia

    OpenAIRE

    Basri, Rehana; Yabe, Ichiro; Soma, Hiroyuki; Takei, Asako; Nishimura, Hiroyuki; Machino, Yuka; Kokubo, Yasumasa; Kosugi, Masafumi; Okada, Ryuichirou; Yukitake, Motohiro; Tachibana, Hisao; Kuroda, Yasuo; Kuzuhara, Shigeki; Sasaki, Hidenao

    2006-01-01

    Hereditary spastic paraplegia (HSP) is a group of genetically heterogeneous neurodegenerative disorders characterized by slowly progressive spasticity and weakness of the lower limbs. HSP is caused by failure of development or selective degeneration of the corticospinal tracts, which contain the longest axons in humans. The most common form of HSP is caused by mutations of the spastin gene (SPAST), located on chromosome 2p21-p22, which encodes spastin, one of the ATPases associated with diver...

  1. Ventral extradural spinal meningeal cyst causing cord compression: neurosurgical treatment Cisto meníngeo extradural ventral do canal espinhal causando compressão medular: tratamento neurocirúrgico

    Directory of Open Access Journals (Sweden)

    Daniel Monte-Serrat Prevedello

    2005-09-01

    Full Text Available Spinal extradural meningeal cysts are typically formed by a thin fibrotic membranous capsule, macroscopically similar that of an arachnoid membrane, filled by cerebro spinal fluid and related to a nerve root or to the posterior midline. Ventral location is extremely rare and when it occurs they usually cause spinal cord herniation through the ventral dural gap. A 61 year-old man who began with a two years long history of insidious tetraparesis, spasticity and hyperreflexia in lower extremities, and flaccid atrophy of upper limbs, without sensory manifestations, is presented. Investigation through magnetic resonance imaging demonstrated an extensive spinal ventral extradural cystic collection from C6 to T11. The lesion was approached through a laminectomy and a cyst-peritoneal shunt was introduced. The cyst reduced in size significantly and the patient is asymptomatic over a 48 months follow-up. This is the first reported case of a spontaneous ventral extradural spinal meningeal cyst causing cord compression. Cyst-peritoneal shunt was effective in the treatment of the case and it should be considered in cases in which complete resection of the cyst is made more difficult or risky by the need of more aggressive surgical maneuvers.Cistos meníngeos extradurais espinhais são formados tipicamente por estreita cápsula membranosa fibrótica, macroscopicamente semelhante a uma membrana de aracnóide, repleta de líquor e relacionada com uma raiz nervosa ou com a linha média posterior. Eles são extremamente raros em posição anterior e, quando ocorrem, habitualmente causam herniação da medula espinhal pela falha dural ventral. O caso de um homem de 61 anos de idade que iniciou com tetraparesia, espasticidade e hiperreflexia em membros inferiores, e flacidez com hipotrofia nos membros superiores, sem manifestação sensitiva, é apresentado. A investigação com ressonância magnética demonstrou extensa coleção cística extradural ventral

  2. Cerebellar Cognitive Affective Syndrome and Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay : A Report of Two Male Sibs

    NARCIS (Netherlands)

    Verhoeven, Willem M. A.; Egger, Jos I. M.; Ahmed, Amir I. M.; Kremer, Berry P. H.; Vermeer, Sascha; van de Warrenburg, Bart P. C.

    2012-01-01

    Background: Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare neurodegenerative disorder caused by mutations in the SACS gene (13q12) encoding the protein sacsin. It is characterized by early-onset cerebellar ataxia, lower limb spasticity, sensorimotor axonal polyneuropath

  3. Neurophysiologic findings in children with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Ruchi Kothari

    2010-01-01

    Full Text Available Context : Cerebral palsy (CP is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture caused by chronic brain injuries. It is the most common cause of physical disability in childhood; spastic cerebral palsy being the most prevalent of its various forms. There is scanty information about the neurophysiologic investigations in children diagnosed as having spastic CP. Aims : The aim of the study was to investigate the relationship between abnormal VEP and BAEP findings with different clinical parameters in children with spastic cerebral palsy. Materials and Methods : Fifteen children with spastic CP in the age range 4 months to 10 years participated in this study. Evaluation of VEPs, brainstem evoked potentials (BAEPs were performed in all study patients as well as 35 healthy children as controls. The study was conducted after obtaining ethics committee approval and informed consent of parents. Statistical Analysis Used : Significance of difference in the mean values of different parameters in different groups was assessed by Student′s "t" test and the P value <0.05 was considered to be significant. All the values were expressed as mean ± 1 Std. Deviation. Results : A significant difference was found in the VEP latencies and amplitude between the subjects with CP and controls. Striking BAEP abnormalities in CP patients include prolongation of absolute latency of wave V, interpeak latencies of III-V and lowered I-V ratio. Abnormal VEPs and BAEPs in children with bilateral spastic cerebral palsy demonstrated a correlation with the presence of moderate to severe developmental delay. Conclusions : The differences in VEPs and BAEPs were determined between CP children and healthy children. The abnormalities found are probably linked to the neurological deficits present in cases of cerebral palsy.

  4. Leg Spasticity and Ambulation in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Sosnoff, Jacob J.; Pula, John H.; Brian M. Sandroff; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW)...

  5. Hereditary spastic paraplegia with cerebellar ataxia

    DEFF Research Database (Denmark)

    Nielsen, J E; Johnsen, B; Koefoed, P;

    2004-01-01

    Complex forms of hereditary spastic paraplegia (HSP) are rare and usually transmitted in an autosomal recessive pattern. A family of four generations with autosomal dominant hereditary spastic paraplegia (AD-HSP) and a complex phenotype with variably expressed co-existing ataxia, dysarthria, unip...... relatively decreased regional cerebral blood flow in most of the cerebellum. We conclude that this kindred demonstrates a considerable overlap between cerebellar ataxia and spastic paraplegia, emphasizing the marked clinical heterogeneity of HSP associated with spastin mutations....

  6. Diagnosis, investigation and management of hereditary spastic paraplegias in the era of next-generation sequencing

    OpenAIRE

    Hensiek, Anke; Kirker, Stephen; Reid, Evan

    2014-01-01

    The hereditary spastic paraplegias (HSPs) are a group of genetic conditions in which spastic paralysis of the legs is the principal clinical feature. This is caused by a relatively selective distal axonal degeneration involving the longest axons of the corticospinal tracts. Consequently, these conditions provide an opportunity to identify genes, proteins and cellular pathways that are critical for axonal health. In this review, we will provide a brief overview of the classification, clinical ...

  7. Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients.

    OpenAIRE

    Hesse, S; Lücke, D; Malezic, M; Bertelt, C; Friedrich, H. (Hergen); Gregoric, M; Mauritz, K H

    1994-01-01

    Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including...

  8. [Clinical features of spastic dysphonia].

    Science.gov (United States)

    Vasilenko, Iu S; Golubev, V L; Debrianskaia, M B

    1995-01-01

    Clinical, neurological, endoscopic, psychological findings, questionnaire data on vegetative sphere, diaphragm x-ray, articulation test and Viene test system evidence obtained on 25 patients with phonic spasm confirm organic neurological nature of spastic dysphonia as focal muscular dystonia. This condition can be accompanied with tremor, rotatory, winking and writers' spasms, oromandibular dystonia. As indicated by positive treatment outcomes, combined treatment of phonic spasm with GABA-ergic drugs of clonazepam (antelepsin) and baclofen, orthophonic voice correction, physiotherapy is pathogenetically justified.

  9. Pitfalls with the "chest compression-only" approach: the challenge of an unusual cause

    Directory of Open Access Journals (Sweden)

    Reid Bjørn

    2010-08-01

    Full Text Available Abstract Chest compression-only (CC-only is now incorporated in the Norwegian protocol for dispatch guided CPR (cardiopulmonary resuscitation in cardiac arrest of presumed cardiac aetiology. We present a case that is unique and instructive as well as unusual. It reminds us of the challenges that face bystanders, dispatch centres and ambulance services when faced with possible cardiac arrest. This case report describes a 50 year old man in a rural community. He had suffered a heart attack 8 months previously, and was found unconscious with respiratory arrest in his garden one morning. Due to the proximity to the ambulance station, the paramedics were on the scene within three minutes. A chain-saw was lying beside him, but no external injuries were seen. The patient had no radial pulse, central cyanosis and respiratory gasps approximately every 30 seconds. Ventilation with bag and mask was given, and soon a femoral pulse could be palpated. Blood sugar was elevated and ECG (electrocardiogram was normal. GCS (Glasgow Coma Scale was 3. Upon arrival of the physician staffed air ambulance, further examination revealed bilateral miosis of the pupils and continuing bradypnoea. Naloxone was given with an immediate effect and the patient woke up. The patient denied intake of narcotics, but additional information from the dispatch centre revealed that he was hepatitis C positive. After a few hours, the patient admitted to have obtained a fentanyl transdermal patch from an acquaintance, having chewed it before falling unconscious. This case report shows the importance as well as the challenges of identifying a non-cardiac cause of possible cardiac arrest, and the value of providing causal therapy.

  10. Upper limb impairments associated with spasticity in neurological disorders

    Directory of Open Access Journals (Sweden)

    Mirbagheri Mehdi M

    2007-11-01

    Full Text Available Abstract Background While upper-extremity movement in individuals with neurological disorders such as stroke and spinal cord injury (SCI has been studied for many years, the effects of spasticity on arm movement have been poorly quantified. The present study is designed to characterize the nature of impaired arm movements associated with spasticity in these two clinical populations. By comparing impaired voluntary movements between these two groups, we will gain a greater understanding of the effects of the type of spasticity on these movements and, potentially a better understanding of the underlying impairment mechanisms. Methods We characterized the kinematics and kinetics of rapid arm movement in SCI and neurologically intact subjects and in both the paretic and non-paretic limbs in stroke subjects. The kinematics of rapid elbow extension over the entire range of motion were quantified by measuring movement trajectory and its derivatives; i.e. movement velocity and acceleration. The kinetics were quantified by measuring maximum isometric voluntary contractions of elbow flexors and extensors. The movement smoothness was estimated using two different computational techniques. Results Most kinematic and kinetic and movement smoothness parameters changed significantly in paretic as compared to normal arms in stroke subjects (p Conclusion The findings suggest that although the cause and location of injury are different in spastic stroke and SCI subjects, the impairments in arm voluntary movement were similar in the two spastic groups. Our results also suggest that the non-paretic arm in stroke subjects was not distinguishable from the normal, and might therefore be used as an appropriate control for studying movement of the paretic arm.

  11. Strumpellin and Spartin, Hereditary Spastic Paraplegia Proteins, are Binding Partners

    OpenAIRE

    Jiali Zhao; Peter Hedera

    2015-01-01

    Hereditary spastic paraplegia (HSP) is one of the most heterogeneous neurodegenerative diseases with more than 50 identified genes causing a relatively stereotypical phenotypic presentation. Recent studies of HSP pathogenesis have suggested the existence of shared biochemical pathways that are crucial for axonal maintenance and degeneration. We explored possible interactions of several proteins associated with this condition. Here we report interactions of endogenous and overexpressed strumpe...

  12. Hereditary spastic paraplegia with cerebellar ataxia

    DEFF Research Database (Denmark)

    Nielsen, J E; Johnsen, B; Koefoed, P;

    2004-01-01

    Complex forms of hereditary spastic paraplegia (HSP) are rare and usually transmitted in an autosomal recessive pattern. A family of four generations with autosomal dominant hereditary spastic paraplegia (AD-HSP) and a complex phenotype with variably expressed co-existing ataxia, dysarthria, unip...

  13. Short-gap Isolated Esophageal Atresia Causing Stridor Due to Compression of the Trachea.

    Science.gov (United States)

    Sekmenli, Tamer; Ciftci, İlhan; Sivri, Mesut; Koplay, Mustafa

    2015-12-01

    Isolated esophageal atresias are reported always to be associated with long gap in the literature. In this manuscript, we aimed to discuss the imaging and surgical treatment methods of an isolated esophageal atresia case with 'short gap' who had stridor due to compression of the trachea by dilated upper esophageal pouch and had not identified previously in the literature. PMID:26843741

  14. Management of A Patient with Kommerrell's Aneurysm Causing Tracheal and Esophageal Compression

    OpenAIRE

    Ranjith B Karthekeyan; Syama Sundar; Suresh Rao; Mahesh Vakamudi

    2009-01-01

    Summary Tracheal and esophageal compression is a well-recognized complication of aneurysms of the aortic arch. Most of the patients present with dysphagia and/or respiratory insufficiency. In the adult population a right-sided aortic arch is often asymptomatic unless aneurysmal disease develops. This usually occurs at the level of the take-off of an aberrant left subclavian artery and is known as a Kommerell's aneurysm. In spite of its rarity, this condition is clinically relevant because of ...

  15. Treatment of spastic dysphonia by recurrent laryngeal nerve section.

    Science.gov (United States)

    Barton, R T

    1979-02-01

    The problem of management of patients with spastic dysphonia has been complicated by a general resistance to speech therapy, psychotherapy, hypnotherapy, and drug therapy. Dedo introduced the concept of recurrent laryngeal nerve section in an attempt to eliminate the hyperfunction and excessive adduction of the vocal folds. Eleven patients were treated by RLN section with satisfactory results in 8 and some improvement in the other 3. The operation was found to be generally uncomplicated and required on average 4 days of hospitalization. Dedo's theory that spastic dysphonia is caused by a neurotropic viral-induced proprioceptive nerve deficit represents a new search for organic cause. His most recent report of finding unmyelinated fibres in one-third of the resected recurrent laryngeal nerves is of questionable significance. The evidence of deep emotional conflict and/or compulsive life-style is found in the majority of the patients, but the syndrome is not typical of an hysterical or conversion neurosis. Regardless of etiologic theory, RLN section is an effective treatment in selected, long-standing, and resistant instances of spastic dysphonia.

  16. HEREDITARY SPASTIC PARAPLEGIA: FROM GENE TO CLINIC

    Directory of Open Access Journals (Sweden)

    Seyyed Hasan TONEKABONI

    2010-04-01

    Full Text Available ObjectiveHereditary Spastic Paraplegia (HSP is a degenerative disease of genetic origin affecting the corticospinal tracts in the spinal cord. There are three forms of inheritance: Autosomal dominant HSP, Autosomal rececive HSP and X-linked HSP.This disease is characterized by progressive spasticity of leg muscles with varying degrees of stiffness and weakness of other muscle groups. In this review, we will discuss the latest findings on  the pathophysiology of axonal degeneration and all the responsible genetic defects in HSP.Keyword: Hereditary spastic paraplegia, degenerative disease, inheritance

  17. Mechanical Chest Compressions in Prolonged Cardiac Arrest due to ST Elevation Myocardial Infarction Can Cause Myocardial Contusion.

    Science.gov (United States)

    Stechovsky, Cyril; Hajek, Petr; Cipro, Simon; Veselka, Josef

    2016-09-01

    Acute coronary syndrome is a common cause of sudden cardiac death. We present a case report of a 60-year-old man without a history of coronary artery disease who presented with ST-elevation myocardial infarction. During transportation to the hospital, he developed ventricular fibrillation (VF) and later pulseless electrical activity. Chest compressions with LUCAS 2 (Medtronic, Minneapolis, MN) automated mechanical compression-decompression device were initiated. Coronary angiography showed total occlusion of the left main coronary artery and primary percutaneous coronary intervention (PCI) was performed. After the PCI, his heart started to generate effective contractions and LUCAS could be discontinued. Return of spontaneous circulation was achieved after 90 minutes of cardiac arrest. The patient died of cardiogenic shock 11 hours later. An autopsy revealed a transmural anterolateral myocardial infarction but also massive subepicardial hemorrhage and interstitial edema and hemorrhages on histologic samples from regions of the myocardium outside the infarction itself and also from the right ventricle. These lesions were concluded to be a myocardial contusion. The true incidence of myocardial contusion as a consequence of mechanical chest compressions is not known. We speculate that severe myocardial contusion might have influenced outcome of our patient. PMID:27574387

  18. Genetics Home Reference: spastic paraplegia type 11

    Science.gov (United States)

    ... with mental impairment and thin corpus callosum HSP-TCC SPG11-related hereditary spastic paraplegia with thin corpus ... A, Stevanin G, Santorelli FM. Screening of ARHSP-TCC patients expands the spectrum of SPG11 mutations and ...

  19. Radiation-induced osteochondroma of the T4 vertebra causing spinal cord compression

    Energy Technology Data Exchange (ETDEWEB)

    Gorospe, Luis; Madrid-Muniz, Carmen; Royo, Aranzazu; Garcia-Raya, Pilar [Department of Radiology, La Paz University Hospital, Madrid (Spain); Alvarez-Ruiz, Fernando [Department of Neurosurgery, La Paz University Hospital, Madrid (Spain); Lopez-Barea, Fernando [Department of Pathology, La Paz University Hospital, Madrid (Spain)

    2002-04-01

    A case of a radiation-induced osteochondroma arising from the vertebral body of T4 in an 18-year-old man is reported. The patient presented with a history of progressive left lower extremity weakness. At 7 years of age, he had undergone resection of a cerebellar medulloblastoma and received adjunctive craniospinal irradiation and systemic chemotherapy. Both CT and MR imaging revealed an extradural mass contiguous with the posteroinferior endplate of the T4 vertebral body. This case indicates that radiation-induced osteochondroma should be considered in the differential diagnosis of patients with symptoms of myelopathy or nerve root compression and a history of radiation therapy involving the spine in childhood. (orig.)

  20. Efficiency of work production by spastic muscles

    OpenAIRE

    Stoquart, Gaëtan; Detrembleur, Christine; Nielens, Henri; Lejeune, Thierry

    2005-01-01

    The present study compared the muscular efficiency in spastic and healthy lower limbs producing the same mechanical work. Sixteen chronic post-stroke hemiparetic and spastic patients and 14 age-matched healthy subjects were submitted to a submaximal stepwise exercise testing on a bicycle ergometer, pedalling with only one lower limb. Net energetic expenditure was computed from oxygen consumption above resting values. Electrical activity of antagonistic muscles in the thigh and in the shank wa...

  1. Prospects for studying how high-intensity compression waves cause damage in human blast injuries

    Science.gov (United States)

    Brown, Katherine; Bo, Chiara; Masouros, Spyros; Ramasamy, Arul; Newell, Nicolas; Bonner, Timothy; Balzer, Jens; Hill, Adam; Clasper, Jon; Bull, Anthony; Proud, William

    2012-03-01

    Since World War I, explosions have accounted for over 70% of all injuries in conflict. With the development of improved personnel protection of the torso, improved medical care and faster aeromedical evacuation, casualties are surviving with more severe injuries to the extremities. Understanding the processes involved in the transfer of blast-induced shock waves through biological tissues is essential for supporting efforts aimed at mitigating and treating blast injury. Given the inherent heterogeneities in the human body, we argue that studying these processes demands a highly integrated approach requiring expertise in shock physics, biomechanics and fundamental biological processes. This multidisciplinary systems approach enables one to develop the experimental framework for investigating the material properties of human tissues that are subjected to high compression waves in blast conditions and the fundamental cellular processes altered by this type of stimuli. Ultimately, we hope to use the information gained from these studies in translational research aimed at developing improved protection for those at risk and improved clinical outcomes for those who have been injured from a blast wave.

  2. Unusual cause for ventriculoperitoneal shunt failure: Carcinoma breast compressing distal catheter

    Directory of Open Access Journals (Sweden)

    Roka Yam

    2010-01-01

    Full Text Available Insertion of a ventriculoperitoneal (VP shunt is one of the most common surgical procedures in any neurosurgery unit worldwide. Distal catheter obstruction outside the peritoneum is a rare cause of shunt failure. We report the first case of distal obstruction in a 70-year old female by carcinoma breast engulfing the catheter and causing kinking. Intraoperatively, the catheter was intratumoral with no flow of cerebrospinal fluid distally. She underwent relocation of a new catheter to the opposite side of the abdomen and modified mastectomy with resolution of the hydrocephalus. The postoperative course has been uneventful.

  3. Mechanisms of postural instability in hereditary spastic paraplegia

    NARCIS (Netherlands)

    Nonnekes, J.; Niet, M. de; Nijhuis, L.B.; Bot, S.T. de; Warrenburg, B.P.C. van de; Bloem, B.R.; Geurts, A.C.H.; Weerdesteyn, V.G.M.

    2013-01-01

    Hereditary spastic paraplegia (HSP) is characterized by progressive lower extremity spasticity and weakness, due to retrograde axonal degeneration of the corticospinal tract and posterior spinal columns. HSP patients fall frequently. We hypothesized that delayed postural responses contribute to thei

  4. Cervical selective dorsal rhizotomy for treating spasticity in upper limb neurosurgical way to neurosurgical technique

    Directory of Open Access Journals (Sweden)

    Yu Duan

    2015-03-01

    Full Text Available Selective dorsal rhizotomy is an effective method to reduce spasticity of the lower limbs. However, functional outcomes in the upper limb following selective dorsal rhizotomy at the cervical level have not been reported. Here we report the clinical course after selective dorsal rhizotomy at the cervical level in a patient with hemiplegic spasticity caused by brain injury. The selective dorsal rootlets at the cervical level were sectioned under electrophysiological monitoring. The patient was followed for 1 year to evaluate the outcome of surgery. The spasticity in the upper limb was reduced and the passive range of motion and function of movement improved. However, the effectiveness and the safety of operation should be studied further in clinical trials.

  5. Unilateral posterior vertebral column resection for severe thoracolumbar kyphotic deformity caused by old compressive vertebrae fracture: a technical improvement.

    Science.gov (United States)

    Wang, Hui; Zhang, Di; Sun, Ya-Peng; Ma, Lei; Ding, Wen-Yuan; Shen, Yong; Zhang, Ying-Ze

    2015-01-01

    Severe thoracolumbar kyphotic deformity caused by old compressive vertebrae fracture remains a big challenge for spine surgeons. When symptoms related to significant deformities cannot be adequately managed conservatively, posterior vertebral column resection (PVCR) is required, but with long operating time and severe blood loss. We develop a UPVCR technique, which is done through a unilateral approach instead of a bilateral approach, vertebral body resection advancing to cross the midline in an abrasive way from an extreme oblique orientation enable the resection of most contralateral vertebral body. In the present study, the effects of UPVCR for severe thoracolumbar kyphotic deformity were investigated. We did find that satisfactory correction of sagittal deformity, functional improvement and pain relief can be achieved by UPVCR, and it has the advantage of shortening surgery time, reducing blood loss and incidence of nerve root impingement over PVCR.

  6. Evaluation of the Effects of Sativex (THC BDS: CBD BDS) on Inhibition of Spasticity in a Chronic Relapsing Experimental Allergic Autoimmune Encephalomyelitis: A Model of Multiple Sclerosis.

    Science.gov (United States)

    Hilliard, A; Stott, C; Wright, S; Guy, G; Pryce, G; Al-Izki, S; Bolton, C; Giovannoni, G

    2012-01-01

    This study investigated the antispasticity potential of Sativex in mice. Chronic relapsing experimental allergic encephalomyelitis was induced in adult ABH mice resulting in hind limb spasticity development. Vehicle, Sativex, and baclofen (as a positive control) were injected intravenously and the "stiffness" of limbs assessed by the resistance force against hind limb flexion. Vehicle alone caused no significant change in spasticity. Baclofen (5 mg/kg) induced approximately a 40% peak reduction in spasticity. Sativex dose dependently reduced spasticity; 5 mg/kg THC + 5 mg/kg CBD induced approximately a 20% peak reduction; 10 mg/kg THC + 10 mg/kg CBD produced approximately a 40% peak reduction in spasticity. Sativex has the potential to reduce spasticity in an experimental mouse model of multiple sclerosis (MS). Baclofen reduced spasticity and served as a positive control. Sativex (10 mg/kg) was just as effective as baclofen, providing supportive evidence for Sativex use in the treatment of spasticity in MS. PMID:22928118

  7. Effect of whole-body vibration on muscle strength, spasticity, and motor performance in spastic diplegic cerebral palsy children

    Directory of Open Access Journals (Sweden)

    Marwa M. Ibrahim

    2014-04-01

    Conclusion: The obtained results suggest that 12-weeks’ intervention of whole-body vibration training can increase knee extensors strength and decrease spasticity with beneficial effects on walking speed and motor development in spastic diplegic CP children.

  8. Leg Spasticity and Ambulation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Swathi Balantrapu

    2014-01-01

    Full Text Available Background. Spasticity of the legs is common in multiple sclerosis (MS, but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal and 4 (contracted. Patients completed the 6-minute walk (6 MW, timed 25 foot walk (T25FW, and timed up-and-go (TUG, and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc. for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12 and wore an accelerometer over a seven-day period. Results. 52% (n=44 of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P=0.0001, d=-0.86, T25FW (P=0.003,d=0.72, TUG (P=0.001, d=0.84, MSWS-12 (P=0.0001,d=1.09, O2 cost of walking (P=0.001, d=0.75, average steps/day (P<0.05, d=-0.45, and walking velocity (P<0.05, d=-0.53 and cadence (P<0.05, d=-0.46. Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

  9. Leg Spasticity and Ambulation in Multiple Sclerosis

    Science.gov (United States)

    Balantrapu, Swathi; Sosnoff, Jacob J.; Pula, John H.; Sandroff, Brian M.; Motl, Robert W.

    2014-01-01

    Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = −0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = −0.45), and walking velocity (P < 0.05, d = −0.53) and cadence (P < 0.05, d = −0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking. PMID:24999434

  10. Surface electromyography activity in the upper limbs of patients following surgery for compressive cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Ananth P Abraham

    2015-01-01

    Conclusion: Surface EMG is an objective tool to detect improvement in spasticity following decompressive surgery for compressive cervical myelopathy even in those patients who showed no improvement on the MMAS.

  11. Compression Myelopathy due to Proliferative Changes around C2 Pars Defects without Instability.

    Science.gov (United States)

    Kimura, Tetsuya; Sakai, Toshinori; Tezuka, Fumitake; Abe, Mitsunobu; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Sairyo, Koichi

    2016-06-01

    We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal. On magnetic resonance imaging, the spinal cord was compressed and intramedullary high signal change was found. A diagnosis of compression myelopathy due to proliferative changes around the C2 pars defects was made. We performed posterior decompression. Postoperatively, symptoms have been alleviated and images revealed sufficient decompression and no apparent instability. In patients with the cervical spondylolysis, myelopathy caused by instability or slippage have been periodically reported. The present case involving C2 spondylolysis is extremely rare. PMID:27340539

  12. Comparing three-dimensional volume-rendered CT images with fibreoptic tracheobronchoscopy in the evaluation of airway compression caused by tuberculous lymphadenopathy in children

    Energy Technology Data Exchange (ETDEWEB)

    Plessis, Jaco du; George, Reena [University of Stellenbosch, Department of Radiology, Tygerberg (South Africa); Goussard, Pierre; Gie, Robert [Tygerberg Children' s Hospital, Department of Paediatrics, Cape Town (South Africa); Andronikou, Savvas [University of Cape Town, Department of Radiology, Cape Town (South Africa)

    2009-07-15

    Lymphobronchial tuberculosis (TB) causes airway compression in 38% of patients. The airway obstruction is conventionally assessed with fibreoptic tracheobronchoscopy (FTB). Multidetector-row spiral computed tomography (MDCT) with three-dimensional volume rendering (3-D VR) has significantly improved the imaging of the airways. No previous studies have assessed the accuracy of 3-D VR in determining the degree of airway compression in children due to TB lymphadenopathy. To compare 3-D VR CT to FTB for the assessment of airway compression due to TB lymphadenopathy in children. Included in the study were 26 children presenting with symptoms of airway compression caused by pulmonary TB. MDCT of the chest and FTB were performed in all patients. Retrospective 3-D VR reconstruction of the major airways was performed from the original CT raw data and used to evaluate the tracheobronchial tree for site and degree of airway compression and then compared to the FTB findings. FTB was used as the reference standard By FTB 87 sites of airway compression were identified. Using the 3-D VR technique, 138 sites of airway compression were identified, of which 78 (90%) matched with the sites identified by FTB. The sensitivity and specificity of 3-D VR when compared with that of FTB was 92% and 85%, respectively. In four patients (15%), severe narrowing of the bronchus intermedius made FTB evaluation of the right middle and right lower lobe bronchi impossible. VR demonstrated significant distal obstruction in three of these four patients 3-D VR demonstrates a very good correlation with FTB in determining airway compression caused by TB lymphadenopathy in children. In combination with FTB, 3-D VR adds confidence to the bronchoscopy findings and complements FTB by adding additional information on the status of the airway distal to severe obstructions unreachable by FTB. (orig.)

  13. Pathophysiology, assessment and management of multiple sclerosis spasticity: an update.

    Science.gov (United States)

    Haas, Judith

    2011-04-01

    Spasticity is one of the most common and disabling symptoms associated with multiple sclerosis (MS). MS spasticity occurs through both myelin and nerve fiber (axonal) degradation, which commence in the early stages of the disease. More than 80% of MS patients experienced spasticity in a large UK survey, with more than 50% of patients reporting their spasticity to be `moderate' or `severe'. Data from a large US registry show that patients with moderate-to-severe MS spasticity experience levels of disability that correlate closely with being wheelchair-bound and/or bedridden. The Ashworth scale is the most commonly used scale for assessing the degree of MS spasticity. However, the validity, reliability and sensitivity of this scale have been challenged and it is not considered an ideal scale for assessing the severity of MS spasticity. The numerical rating scale, a well-established standard pain assessment tool, provides a reliable, valid and simplified scale for patient self-rated assessment of the mean level of spasticity over the previous 24 h (0 = no spasticity, 10 = worst possible spasticity). According to data from the German MS Register, almost a third of MS patients with spasticity were untreated. Despite the availability of oral agents for generalized spasticity (often used in conjunction with physical/rehabilitation management strategies), including baclofen, tizanidine, dantrolene and gabapentin, there is limited clinical evidence to support their use and there is a need for improved and better tolerated pharmacological therapies for MS spasticity. The endocannabinoid system modulator, Sativex(®) (nabiximols, USAN name), provides an alternative therapeutic approach in the management of MS spasticity. PMID:21449853

  14. An investigation of the neurophysiologic effect of tone-reducing AFOs on reflex excitability in subjects with spasticity following stroke while standing.

    Science.gov (United States)

    Ibuki, Aileen; Bach, Timothy; Rogers, Douglas; Bernhardt, Julie

    2010-06-01

    Tone-reducing ankle-foot orthoses (TRAFOs) are said to improve the control and functioning of spastic lower limbs by their biomechanic and neurophysiologic effects. Unfortunately, there is limited evidence in literature to support the theory that TRAFOs can effectively decrease spasticity in the foot and ankle neurophysiologically. The primary purpose of this investigation was to determine the neurophysiologic effect of TRAFOs on soleus muscle reflex excitability in subjects with spasticity following stroke while standing. A repeated-measures intervention study was conducted on 15 adult subjects with stroke who were recruited from the community. Custom-made articulated ankle-foot orthoses (AFOs) and TRAFOs with orthokinetic compression garments (OCGs) were fabricated for each subject. Five conditions were tested: (1) Shoes only, (2) AFO, (3) TRAFO, (4) TRAFO with OCG, (5) shoes only, to determine if the TRAFOs were most effective in decreasing spasticity as assessed by the ratio of maximum Hoffmann reflex amplitude to maximum muscle response amplitude (Hmax:Mmax ratio) of the soleus. The results found that there were no significant treatment effects for the interventions (F = 0.992, df = 2.167, p = 0.388), however, when analysed subject-by-subject, four subjects displayed significant increases in their Hmax:Mmax ratios to at least one treatment condition. Overall, the results demonstrated that the tone-reducing devices had no significant neurophysiologic effect on soleus reflex excitability in subjects with spasticity, however individual responses showed that the TRAFOs increased spasticity in some individuals. PMID:20184503

  15. Radioiodine plus recombinant human thyrotropin do not cause acute airway compression and are effective in reducing multinodular goiter

    Energy Technology Data Exchange (ETDEWEB)

    Albino, C.C., E-mail: ccalbino@uol.com.b [Instituto de Diabetes e Endocrinologia de Maringa, PR (Brazil); Graf, H.; Paz-Filho, G. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Hospital das Clinicas. Servico de Endocrinologia e Metabologia; Diehl, L.A. [Universidade Estadual de Londrina (UEL), PR (Brazil); Olandoski, M.; Sabbag, A. [Pontificia Univ. Catolica do Parana (PUCPR), Curitiba, PR (Brazil). Nucleo de Bioestatistica; Buchpiguel, C. [Universidade de Sao Paulo (USP), SP (Brazil). Dept. de Radiologia

    2006-03-15

    Recombinant human thyrotropin (rhTSH) reduces the activity of radioiodine required to treat multinodular goiter (MNG), but acute airway compression can be a life-threatening complication. In this prospective, randomized, double-blind, placebo-controlled study, we assessed the efficacy and safety (including airway compression) of different doses of rhTSH associated with a fixed activity of {sup 131}I for treating MNG. Euthyroid patients with MNG (69.3 +- 62.0 mL, 20 females, 2 males, 64 +- 7 years) received 0.1 mg (group I, N = 8) or 0.01 mg (group II, N = 6) rhTSH or placebo (group III, N = 8), 24 h before 1.11 GBq {sup 131}I. Radioactive iodine uptake was determined at baseline and 24 h after rhTSH and thyroid volume (TV, baseline and 6 and 12 months after treatment) and tracheal cross-sectional area (TCA, baseline and 2, 7, 180, and 360 days after rhTSH) were determined by magnetic resonance; antithyroid antibodies and thyroid hormones were determined at frequent intervals. After 6 months, TV decreased significantly in groups I (28.5 +- 17.6%) and II (21.6 +- 17.8%), but not in group III (2.7 +- 15.3%). After 12 months, TV decreased significantly in groups I (36.7 +- 18.1%) and II (37.4 +- 27.1%), but not in group III (19.0 +- 24.3%). No significant changes in TCA were observed. T3 and free T4 increased transiently during the first month. After 12 months, 7 patients were hypothyroid (N 3 in group I and N = 2 in groups II and III). rhTSH plus a 1.11-GBq fixed {sup 131}I activity did not cause acute or chronic changes in TCA. After 6 and 12 months, TV reduction was more pronounced among patients treated with rhTSH plus {sup 131}I (author)

  16. Incidence estimate and guideline-oriented treatment for post-stroke spasticity: an analysis based on German statutory health insurance data

    Directory of Open Access Journals (Sweden)

    Egen-Lappe V

    2013-03-01

    Full Text Available Veronika Egen-Lappe, Ingrid Köster, Ingrid SchubertPMV Research Group, Department of Child and Adolescence Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyBackground: Spasticity after stroke has been internationally recognized as an important health problem causing impairment of mobility, deformity, and pain. The aim of this study was to assess the frequency of first-ever and recurrent stroke and of subsequent spastic and flaccid paresis. Factors influencing the development of spasticity were analyzed. A further major aim was to provide a "real-life" assessment of the treatment of spasticity in Germany and to discuss this in view of the treatment recommended by German and international clinical guidelines.Methods: The database used in this study comprised a cohort of 242,090 insurants from a large statutory health insurance fund in the federal state of Hesse, Germany. A first hospital discharge diagnosis in 2009 with any of the International Classification of Diseases, Tenth Revision (ICD-10 codes I60–I64 was used to identify patients with acute stroke (hemorrhage and ischemic. These patients were followed up six months after stroke to monitor whether they developed spastic or flaccid paresis (hospital or ambulatory care diagnoses ICD-10 code G81–G83 [excluding G82.6/G83.4/G83.8]. For patients with spastic paresis after stroke the spasticity treatment was analyzed for a six-month period (physiotherapy, oral muscle relaxants, intrathecal baclofen, and botulinum toxin.Results: Standardized to the population of Germany, 3.7 per 1000 persons suffered a stroke in 2009 (raw 5.2/1000. Of all surviving patients, 10.2% developed spasticity within 6 months. Cox regression revealed no significant influence of patient age, gender, morbidity (diabetes, hypertensive diseases, ischemic heart diseases or type of stroke on development of spasticity. 97% of surviving patients with spasticity received physiotherapy (inpatient care 89

  17. Symptomatic thoracic spinal cord compression caused by postsurgical pseudomeningocele Compressão medular torácica sintomática causada por pseudomeningocele pós-operatória

    OpenAIRE

    Arthur de Azambuja Pereira Filho; Gustavo de David; Gustavo Azambuja Pereira Filho; Albert Vincent Berthier Brasil

    2007-01-01

    We report the first case of symptomatic thoracic spinal cord compression caused by postsurgical pseudomeningocele. A 49-year-old man sought treatment for progressive loss of strength in the lower extremities ten months after full neurological recovery for a thoracic (T11) intradural-extramedullary schwannoma. Magnetic resonance imaging revealed a postsurgical thoracic (T11-T12) pseudomeningocele. The surgical approach showed an inadequate dural closure with spontaneous cerebrospinal fluid fis...

  18. Pharmacologic interventions for reducing spasticity in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R; Soyode, Olufemi

    2005-10-01

    Motor function abnormalities are a key feature of cerebral palsy. Spasticity is one of the main motor abnormalities seen in children with cerebral palsy. Spasticity is a velocity dependent increased resistance to movement. While in some children, spasticity may adversely impact the motor abilities, in others, it may help maintain posture and ability to ambulate. Thus, treatment to reduce spasticity requires careful consideration of various factors. Non-pharmacologic interventions used to reduce spasticity include physiotherapy, occupational therapy, use of adaptive equipment, various orthopedic surgical procedures and neurosurgical procedures. Pharmacologic interventions used for reducing spasticity in children with cerebral palsy reviewed in this article include oral administration of baclofen, diazepam, dantrolene and tizanidine, intrathecal baclofen, and local injections of botulinum toxin, phenol, and alcohol. PMID:16272661

  19. Evaluation of the Effects of Sativex (THC BDS: CBD BDS) on Inhibition of Spasticity in a Chronic Relapsing Experimental Allergic Autoimmune Encephalomyelitis: A Model of Multiple Sclerosis

    OpenAIRE

    Hilliard, A.; Stott, C.; Wright, S; Guy, G.; Pryce, G.; Al-Izki, S.; Bolton, C; Giovannoni, G.

    2012-01-01

    This study investigated the antispasticity potential of Sativex in mice. Chronic relapsing experimental allergic encephalomyelitis was induced in adult ABH mice resulting in hind limb spasticity development. Vehicle, Sativex, and baclofen (as a positive control) were injected intravenously and the “stiffness” of limbs assessed by the resistance force against hind limb flexion. Vehicle alone caused no significant change in spasticity. Baclofen (5 mg/kg) induced approximately a 40% peak reducti...

  20. Mania associated with complicated hereditary spastic paraparesis

    Directory of Open Access Journals (Sweden)

    Raghavendra B Nayak

    2011-01-01

    Full Text Available Hereditary spastic paraparesis (HSP is an inherited group of neurological disorders with progressive lower limb spasticity. HSP can be clinically grouped into pure and complicated forms. Pure HSP is one without any associated neurological/psychiatric comorbidity. Depression is the most common psychiatric comorbidity. Presence of mania or bipolar affective illness with HSP is a rare phenomenon. We report a case of a 17-year-old boy who presented with classical features of HSP with complaints of excessive happiness, irritability, increased self-esteem and decreased sleep since 1 month. The patient also had complex partial seizure ever since he had features of HSP. The patient′s father and younger sister suffer from pure HSP. The patient was diagnosed to have first episode mania with complicated HSP. The details of treatment and possible neurobiology are discussed in this case report.

  1. Defining the psychiatric role in spastic dysphonia.

    Science.gov (United States)

    Ginsberg, B I; Wallack, J J; Srain, J J; Biller, H F

    1988-03-01

    The authors evaluated 11 surgically-treated patients with spastic dysphonia, a phonation disorder of unclear etiology. The results indicate that the illness does not appear to be a somatoform disorder, but that stress may play a role in its expression, and that there may be secondary depression and anxiety. The experience of spastic dysphonics suggests that psychiatric treatments may be inappropriately applied to an illness without clear organic etiology, whereas, conversely, a proper psychiatric role may be rejected when effective medical or surgical treatment is available. The authors recommend that psychiatrists evaluating patients with illnesses of unclear etiology should be cautious in making a primary psychiatric diagnosis unless DSM-III criteria are met.

  2. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  3. Efficiency of work production by spastic muscles.

    Science.gov (United States)

    Stoquart, G G; Detrembleur, C; Nielens, H; Lejeune, T M

    2005-12-01

    The present study compared the muscular efficiency in spastic and healthy lower limbs producing the same mechanical work. Sixteen chronic post-stroke hemiparetic and spastic patients and 14 age-matched healthy subjects were submitted to a submaximal stepwise exercise testing on a bicycle ergometer, pedalling with only one lower limb. Net energetic expenditure was computed from oxygen consumption above resting values. Electrical activity of antagonistic muscles in the thigh and in the shank was recorded and co-contraction was defined as the percentage of the pedalling cycle when antagonistic muscles were activated simultaneously. The efficiency was calculated as the ratio between the mechanical work done on the ergometer and the net energetic expenditure. Spasticity was quantitatively evaluated by measuring passive ankle plantar flexor muscle stiffness. The working capacity of the patients' paretic lower limb was very low (<40W). The energy expenditure increased linearly as a function of work intensity, without statistical difference between the patients paretic lower limb (PPL), the patients healthy lower limb (PHL) and the healthy subjects lower limb (HSL). Shank co-contraction was 2.9 times greater in PPL (p<0.05) and 2.3 times greater in PHL (p<0.05) than in HSL. Thigh co-contraction was also 1.8 times greater in PPL than in HSL (p<0.05). The ankle plantar flexor muscle stiffness was statistically greater in PPL than in PHL and HSL (p<0.05). The efficiency was not statistically different between the three groups (p=0.155). In conclusion, the efficiency of work production by paretic and spastic lower limb muscles was normal ( congruent with 20%) despite significant neurological impairments. PMID:16274915

  4. Extrinsic tracheal compression caused by scoliosis of the thoracic spine and chest wall degormity: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Kyong min Sarah; Lee, Bae Young; Kim, Hyeon Sook; Song, Kyung Sup; Kang, Hyeon Hul; Lee, Sang Haak; Moon, Hwa Sik [St. Paul' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2014-05-15

    Extrinsic airway compression due to chest wall deformity is not commonly observed. Although this condition can be diagnosed more easily with the help of multidetector CT, the standard treatment method has not yet been definitely established. We report a case of an eighteen-year-old male who suffered from severe extrinsic tracheal compression due to scoliosis and straightening of the thoracic spine, confirmed on CT and bronchoscopy. The patient underwent successful placement of tracheal stent but later died of bleeding from the tracheostomy site probably due to tracheo-brachiocephalic artery fistula. We describe the CT and bronchoscopic findings of extrinsic airway compression due to chest wall deformity as well as the optimal treatment method, and discuss the possible explanation for bleeding in the patient along with review of the literature.

  5. Botulinum Toxin Treatment for Limb Spasticity in Childhood Cerebral Palsy

    Science.gov (United States)

    Pavone, Vito; Testa, Gianluca; Restivo, Domenico A.; Cannavò, Luca; Condorelli, Giuseppe; Portinaro, Nicola M.; Sessa, Giuseppe

    2016-01-01

    CP is the most common cause of chronic disability in childhood occurring in 2–2.5/1000 births. It is a severe disorder and a significant number of patients present cognitive delay and difficulty in walking. The use of botulinum toxin (BTX) has become a popular treatment for CP especially for spastic and dystonic muscles while avoiding deformity and pain. Moreover, the combination of physiotherapy, casting, orthotics and injection of BTX may delay or decrease the need for surgical intervention while reserving single-event, multi-level surgery for fixed musculotendinous contractures and bony deformities in older children. This report highlights the utility of BTX in the treatment of cerebral palsy in children. We include techniques for administration, side effects, and possible resistance as well as specific use in the upper and lower limbs muscles. PMID:26924985

  6. Bronchial compression by an enlarged left atrium in infants; a cause of hypovascularity of the left lung

    Energy Technology Data Exchange (ETDEWEB)

    Corr, L.; Hallidie-Smith, K.A.; McCarthy, P.A.; Lavender, J.P.

    1988-09-01

    In three infants seen recently at our institution we noted signs of compression of the left main bronchus associated with enlarged left atria. None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected side. In addition, hypoperfusion of the left lung was noted in each case. We believe that bronchial compression due to an enlarged left atrium, with consequent hypoxic vasoconstriction is a clinically significant entity, which is not well described and may be unappreciated in infants in whom the typical signs of hyperinflation are absent.

  7. Global gene expression analysis of rodent motor neurons following spinal cord injury associates molecular mechanisms with development of post-injury spasticity

    DEFF Research Database (Denmark)

    Wienecke, Jacob; Westerdahl, Ann-Charlotte; Hultborn, Hans;

    2010-01-01

    of endogenous plateau potentials in motor neurons and the development of spasticity after spinalization. To unravel the molecular mechanisms underlying the increased excitability of motor neurons and the return of plateau potentials below a spinal cord injury we investigated changes in gene expression...... in this cell population. We adopted a rat tail-spasticity model with a caudal spinal transection that causes a progressive development of spasticity from its onset after two to three weeks until two months post injury. Gene expression changes of fluorescently identified tail motor neurons were studied 21......Spinal cord injury leads to severe problems involving impaired motor, sensory and autonomic functions. After spinal injury there is an initial phase of hypo-reflexia followed by hyper-reflexia, often referred to as spasticity. Previous studies have suggested a relationship between the reappearance...

  8. Quantitative evaluation for spasticity of calf muscle after botulinum toxin injection in patients with cerebral palsy: a pilot study

    OpenAIRE

    Lin, Yu-Ching; Lin, I-Ling; Chou, Te-Feng Arthur; Lee, Hsin-Min

    2016-01-01

    Background Cerebral palsy (CP) is the most common pediatric disease to cause motor disability. Two common symptoms in CP are spasticity and contracture. If this occurred in the ankle plantar flexors of children with CP, it will impair their gait and active daily living profoundly. Most children with CP receive botulinum toxin type A (BoNT-A) injection to reduce muscle tone, but a knowledge gap exists in the understanding of changes of neural and non-neural components of spasticity after injec...

  9. Reappearance of Cranial Nerve Dysfunction Symptoms Caused by New Artery Compression More than 20 Years after Initially Successful Microvascular Decompression: Report of Two Cases.

    Science.gov (United States)

    Inoue, Hiroto; Kondo, Akinori; Shimano, Hiroshi; Yasuda, Soichiro; Murao, Kenichi

    2016-01-01

    Reappearance of symptoms of cranial nerve dysfunction is not uncommon after successful microvascular decompression (MVD). The purpose of this study was to report two quite unusual cases of recurrent and newly developed hemifacial spasm (HFS) caused by a new conflicting artery more than 20 years after the first successful surgery. In Case 1, the first MVD was performed for HFS caused by the posterior inferior cerebellar artery (PICA) when the patient was 38 years old. After 26 symptom-free years, HFS recurred on the same side of the face due to compression by the newly developed offending AICA. In Case 2, the patient was first operated on for trigeminal neuralgia by transposition of the AICA at 49 years old, but 20 symptom-free years after the first MVD, a new offending PICA compressed the facial nerve on the same side, causing HFS. These two patients underwent reoperation and gained satisfactory results postoperatively. Reappearance of symptoms related to compression of the root exit zone (REZ) by a new offending artery after such a long symptom-free interval since the first effective MVD is rare. Here, we describe two such unusual cases and discuss how to manage and prevent such reappearance of symptoms after a long time interval. PMID:26804190

  10. Spasticity, an impairment that is poorly defined and poorly measured

    NARCIS (Netherlands)

    Malhotra, S.; Pandyan, A.D.; Day, C.R.; Jones, V.M.; Hermens, H.J.

    2009-01-01

    Objective: To explore, following a literature review, whether there is a consistent definition and a unified assessment framework for the term 'spasticity'. The congruence between the definitions of spasticity and the corresponding methods of measurement were also explored. Data sources: The search

  11. New insights into the pathophysiology of post-stroke spasticity

    Directory of Open Access Journals (Sweden)

    Sheng eLi

    2015-04-01

    Full Text Available Spasticity is one of many consequences after stroke. It is characterized by a velocity-dependent increase in resistance during passive stretch, resulting from hyperexcitability of the stretch reflex. The underlying mechanism of the hyperexcitable stretch reflex, however, remains poorly understood. Accumulated experimental evidence has supported supraspinal origins of spasticity, likely from an imbalance between descending inhibitory and facilitatory regulation of spinal stretch reflexes secondary to cortical disinhibition after stroke. The excitability of reticulospinal and vestibulospinal tracts has been assessed in stroke survivors with spasticity using non-invasive indirect measures. There are strong experimental findings that support the reticulospinal hyperexcitability as a prominent underlying mechanism of post-stroke spasticity. This mechanism can at least partly account for clinical features associated with spasticity and provide insightful guidance for clinical assessment and management of spasticity. However, the possible role of VST hyperexcitability can not be ruled out from indirect measures. In vivo measure of individual brainstem nuclei in stroke survivors with spasticity using advanced fMRI techniques in the future is probably able to provide direct evidence of pathogenesis of post-stroke spasticity.

  12. [Treatment of spasticity with a transcutaneous neurostimulator. A pilot study].

    Science.gov (United States)

    Kirkeby, R; Jordt, M; Hansen, E

    1995-04-24

    In this pilot study the neurostimulator KDC 5000 is used with efficacy on seven out of 11 patients with spastic palsy, and treatment was given without any side-effects. No other treatment has sufficiently helped these patients, and we therefore conclude that such treatment with a neuro-stimulator could be beneficial for selected patients with spastic palsy of extremities. PMID:7762102

  13. Recurrent laryngeal nerve histopathology in spastic dysphonia: a preliminary study.

    Science.gov (United States)

    Dedo, H H; Izdebski, K; Townsend, J J

    1977-01-01

    Spastic dysphonia is a severe voice disorder ordinarily described as psychogenic. Organic-neurologic changes secondary to central or peripheral nervous system involvement have also been postulated and led recently to the surgical treatment of spastic dysphonia by unilateral section of the recurrent laryngeal nerve (RLN). This study reports the histologic findings from these resections of the RLN from patients with an average 9.5 years duration of spastic dysphonia. Thirty percent of the RLNs examined demonstrated significant abnormalities as compared to age-matched controls. Although no reactive changes were noted by light microscopy, groups of fibers which did not stain for myelin or axons were found in RLNs from patients with spastic dysphonia. A preliminary ultrastructural study of these areas in one RLN revealed sheets of unmyelinated axons. These findings suggest an organic basis for spastic dysphonia at least in some patients.

  14. Full Body Gait Analysis May Improve Diagnostic Discrimination Between Hereditary Spastic Paraplegia and Spastic Diplegia: A Preliminary Study

    Science.gov (United States)

    Bonnefoy-Mazure, A.; Turcot, K.; Kaelin, A.; De Coulon, G.; Armand, S.

    2013-01-01

    Hereditary spastic paraplegia (HSP) and spastic diplegia (SD) patients share a strong clinical resemblance. Thus, HSP patients are frequently misdiagnosed with a mild form of SD. Clinical gait analysis (CGA) has been highlighted as a possible tool to support the differential diagnosis of HSP and SD. Previous analysis has focused on the lower-body…

  15. Does calf muscle spasticity contribute to postural imbalance? A study in persons with pure hereditary spastic paraparesis

    NARCIS (Netherlands)

    Niet, M. de; Weerdesteyn, V.G.M.; Bot, S.T. de; Warrenburg, B.P.C. van de; Geurts, A.C.H.

    2013-01-01

    OBJECTIVES: The contribution of spasticity to postural imbalance in patients with upper motor neuron syndrome is still unclear. This study aimed to evaluate the responses to support-surface perturbations in patients with hereditary spastic paraparesis (HSP). These patients typically suffer from bila

  16. IgM multiple myeloma presenting with spinal cord compression caused by a plasmacytoma: A case report

    OpenAIRE

    Tahan, Ihssan; Seale, Jim; Edwards, David

    2008-01-01

    Background IgM multiple myeloma is rare disorder, which has clinical, laboratory and radiological manifestations that are consistent with both multiple myeloma and Waldenstrom's macroglobulinaemia. Case presentation An 83 years Welsh lady presented with clinical and radiological features consistent with spinal cord compression. Further investigations confirmed the diagnosis of IgM multiple myeloma. Following localized radiotherapy and five courses of melphalan and prednisolone, the patient ac...

  17. MRI of autosomal dominant pure spastic paraplegia

    DEFF Research Database (Denmark)

    Krabbe, K; Nielsen, J E; Fallentin, E;

    1997-01-01

    We examined 16 patients with autosomal dominant pure spastic paraplegia (HSP) and 15 normal controls matched for age and sex using MRI of the brain and spinal cord. Images were assessed qualitatively by two independent radiologists, blinded to the clinical diagnosis. Areas of the brain and corpus......, might indicate that the disease process in pure HSP is not confined to the spinal cord. The anteroposterior diameters of the spinal cord at T 3 and T 9 were significantly smaller in patients than in controls. This might correspond to the degeneration of the pyramidal tracts and the dorsal columns...

  18. Multilevel botulinum toxin type a as a treatment for spasticity in children with cerebral palsy: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ece Unlu

    2010-01-01

    Full Text Available INTRODUCTION: Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients. OBJECTIVE: The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients. METHODS: Data from 71 cerebral palsy patients (64% male, 36% female, mean age 6.7 ±3.2 years were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88, and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V. Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months. RESULTS: We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p0.05. Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments. CONCLUSION: We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.

  19. [Continuous intrathecal infusion of baclofen. A new therapeutic method for spasticity].

    Science.gov (United States)

    Berg-Johnsen, J; Røste, G K; Solgaard, T; Lundar, T

    1998-09-10

    Intrathecal administration of baclofen is now generally accepted as a powerful treatment of spasticity caused by spinal lesions. 35 patients with severe spasticity, 29 of spinal origin and six of supraspinal origin resistant to conservative treatment, had a programmable pump (Synchromed, Medtronic) for continuous intrathecal baclofen infusion implanted. The patients were followed-up for an average of 29 months (0-68). The initial effect of the treatment was positive for all patients; spasms were less frequent, there was remission of pain caused by cramps, and in some cases improved ambulation. In five patients, however, the pump was later removed: in two patients the pump ceased to be effective, two patients became infected, and one experienced multiple catheter problems. Problems with the catheter was the most common complication experienced, and this was seen in nine patients. Three patients died of the underlying disease. The majority of patients became accommodated to intrathecal baclofen and it was necessary to administer increasingly larger doses to maintain the clinical effect. Long-term control of spinal spasticity by intrathecal baclofen can be achieved in most patients, but close follow-up is necessary for assessing efficacy and refilling the pump. PMID:9772811

  20. Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological-pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Twomey, Eilish L.; Iemsawatdikul, Kriengkrai; Stephens, Boyd G.; Gooding, Charles A. [Department of Radiology, University of California at San Francisco, 505 Parnassus Avenue, Box 0628, 94143-0628, San Francisco, CA (United States)

    2004-08-01

    We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented. (orig.)

  1. Compression of the Right Pulmonary Artery by a Massive Descending Aortic Aneurysm Causing Bilateral Perfusion Defects on Pulmonary Scintigraphy

    OpenAIRE

    Makis, William; Derbekyan, Vilma

    2011-01-01

    A 67-year-old woman, who presented with a 2 month history of dyspnea, had a ventilation and perfusion lung scan that showed absent perfusion of the entire right lung with normal ventilation, as well as a rounded matched defect in the left lower lung adjacent to midline, suspicious for an aortic aneurysm or dissection. CT pulmonary angiography revealed a massive descending aortic aneurysm compressing the right pulmonary artery as well as the left lung parenchyma, accounting for the bilateral p...

  2. The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model

    OpenAIRE

    Belagaje, S. R.; C. Lindsell; Moomaw, C. J.; Alwell, K.; Flaherty, M. L.; Woo, D; Dunning, K; P. Khatri; Adeoye, O.; D. Kleindorfer; Broderick, J.; Kissela, B

    2014-01-01

    Several devices and medications have been used to address poststroke spasticity. Yet, spasticity's impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS) as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was define...

  3. Obturator neurolysis using 65% alcohol for adductor muscle spasticity

    Directory of Open Access Journals (Sweden)

    Anju Ghai

    2012-01-01

    Full Text Available Spasticity is motor alteration characterized by muscle hypertonia and hyperreflexia. It is an important complication of spinal cord injury, traumatic brain injury, cerebral palsy, and multiple sclerosis. If uncorrected, fibrosis and eventually bony deformity lock the joint into a fixed contracture. Chemical neurolysis using various agents is one of the therapeutic possibilities to alleviate spasticity. We are, hereby, reporting 3 patients in whom 65% alcohol was used as neurolytic agent for the treatment of hip adductor spasticity, and the effect lasted for a variable period.

  4. A hereditary spastic paraplegia mutation in kinesin-1A/KIF5A disrupts neurofilament transport

    Directory of Open Access Journals (Sweden)

    Brown Anthony

    2010-11-01

    Full Text Available Abstract Background Hereditary spastic paraplegias are a group of neurological disorders characterized by progressive distal degeneration of the longest ascending and descending axons in the spinal cord, leading to lower limb spasticity and weakness. One of the dominantly inherited forms of this disease (spastic gait type 10, or SPG10 is caused by point mutations in kinesin-1A (also known as KIF5A, which is thought to be an anterograde motor for neurofilaments. Results We investigated the effect of an SPG10 mutation in kinesin-1A (N256S-kinesin-1A on neurofilament transport in cultured mouse cortical neurons using live-cell fluorescent imaging. N256S-kinesin-1A decreased both anterograde and retrograde neurofilament transport flux by decreasing the frequency of anterograde and retrograde movements. Anterograde velocity was not affected, whereas retrograde velocity actually increased. Conclusions These data reveal subtle complexities to the functional interdependence of the anterograde and retrograde neurofilament motors and they also raise the possibility that anterograde and retrograde neurofilament transport may be disrupted in patients with SPG10.

  5. Pain treatment with ziconotide and baclofen in a case of spasticity associated with neuropathic pain

    Directory of Open Access Journals (Sweden)

    Danilo G. Quarta

    2009-03-01

    Full Text Available This study presents the clinical case of a patient with paraparesis, subjected for a long period of time to treatment with intrathecal baclofen and morphine to control spasticity and neuropathic pain, resulting from spinal cord injury due to road trauma. After several years of treatment the pain was not controlled with high doses of intrathecal morphine combined with transmucosal fentanyl that were given when needed. It was therefore decided to switch to intrathecal ziconotide. Starting with high levels of intrathecal morphine, the patient was referred first to weaning from morphine to a gradual titration of ziconotide doses of up to 7.4 mcg/die associated with 680 mcg/die of baclofen. A technical problem related to the infusion pump has led to the abrupt interruption of the administration of ziconotide and baclofen, which did not cause side effects, except for a poorly controlled pain. The spasticity, however, did not recur. After replacing the intrathecal pump and restarting the gradual titration of ziconotide alone, the patient has once again regained a good pain control with no recurrence to date of spasticity.

  6. Functional effects of botulinum toxin type-A treatment and subsequent stretching of spastic calf muscles: a study in patients with hereditary spastic paraplegia

    NARCIS (Netherlands)

    Niet, M. de; Bot, S.T. de; Warrenburg, B.P.C. van de; Weerdesteijn, V.G.M.; Geurts, A.C.H.

    2015-01-01

    OBJECTIVE: Although calf muscle spasticity is often treated with botulinum toxin type-A, the effects on balance and gait are ambiguous. Hereditary spastic paraplegia is characterized by progressive spasticity and relatively mild muscle weakness of the lower limbs. It is therefore a good model to eva

  7. Epidural cement leakage through pedicle violation after balloon kyphoplasty causing paraparesis in osteoporotic vertebral compression fractures - a report of two cases

    Directory of Open Access Journals (Sweden)

    Noh Won

    2010-08-01

    Full Text Available Abstract Kyphoplasty is advantageous over vertebroplasty in terms of better kyphosis correction and diminished risk of cement extravasations. Literature described cement leakage causing neurological injury mainly after vertebroplasty procedure; only a few case reports show cement leakage with kyphoplasty without neurological injury or proper cause of leakage. We present a report two cases of osteoporotic vertebral compression fracture treated with kyphoplasty and developed cement leakage causing significant neurological injury. In both cases CT scan was the diagnostic tool to identify cause of cement leakage. CT scan exhibited violation of medial pedicle wall causing cement leakage in the spinal canal. Both patients displayed clinical improvement after decompression surgery with or without instrumentation. Retrospectively looking at stored fluoroscopic images, we found that improper position of trocar in AP and lateral view simultaneously while taking entry caused pedicle wall violation. We suggest not to cross medial pedicle wall in AP image throughout the entire procedure and keeping the trocar in the center of pedicle in lateral image would be the most important precaution to prevent such complication. Our case reports adds the neurological complications with kyphoplasty procedure and suggested that along with other precautions described in the literature, entry with trocar along the entire procedure keeping the oval shape of pedicle in mind (under C-arm will probably help to prevent such complications.

  8. Stretch reflex regulation in healthy subjects and patients with spasticity

    DEFF Research Database (Denmark)

    Nielsen, Jens Bo; Petersen, Nicolas; Crone, Clarissa;

    2005-01-01

    In recent years, part of the muscle resistance in spastic patients has been explained by changes in the elastic properties of muscles. However, the adaptive spinal mechanisms responsible for the exaggeration of stretch reflex activity also contribute to muscle stiffness. The available data suggest...... of the spastic symptoms. A recent finding also shows no sign of exaggerated stretch reflexes in muscles voluntarily activated by the spastic patient in general. This is easily explained by the control of stretch reflex activity in healthy subjects. In healthy subjects, the stretch reflex activity is increased...... movements, antagonist muscles should remain silent and maximally relaxed. This is ensured by increasing transmission in several spinal inhibitory pathways. In spastic patients, this control is inadequate, and therefore stretch reflexes in antagonist muscles are easily evoked at the beginning of voluntary...

  9. Genetics Home Reference: infantile-onset ascending hereditary spastic paralysis

    Science.gov (United States)

    ... and paraplegia result from degeneration (atrophy) of motor neurons , which are specialized nerve cells in the brain and spinal cord that control muscle movement. Hereditary spastic paraplegias are divided into two types: pure and complicated. The pure types involve only ...

  10. Clinical case reviews in multiple sclerosis spasticity: experiences from around Europe.

    Science.gov (United States)

    Koehler, Jürgen; Amato, Maria P; Oreja-Guevara, Celia; Lycke, Jan

    2013-12-01

    Spasticity is one of the main symptoms associated with multiple sclerosis (MS). Epidemiological studies indicate that approximately two-thirds of MS patients experience spasticity and, in a relevant proportion of this group, spasticity is moderate to severe. Yet, spasticity remains largely undertreated. The most commonly used oral antispasticity agents (e.g., baclofen, tizanidine, gabapentin) generally do not reduce spasticity adequately at dosages that are well tolerated by patients. This review of MS spasticity cases from around Europe presents current knowledge of considerations for administration of a new agent (tetrahydrocannabinol/cannabidiol-based nabiximols [Sativex®] oromucosal spray) for management of MS spasticity, with the aim of ensuring appropriate and optimal use for best outcomes. Assessment of the European clinical experience is intended to provide a better understanding of the prescribing regulations for MS spasticity treatments, facilitate identification of suitable candidate patients for Sativex and increase awareness of alternative management approaches for MS-related spasticity. PMID:24289846

  11. Strumpellin and Spartin, Hereditary Spastic Paraplegia Proteins, are Binding Partners.

    Science.gov (United States)

    Zhao, Jiali; Hedera, Peter

    2015-01-01

    Hereditary spastic paraplegia (HSP) is one of the most heterogeneous neurodegenerative diseases with more than 50 identified genes causing a relatively stereotypical phenotypic presentation. Recent studies of HSP pathogenesis have suggested the existence of shared biochemical pathways that are crucial for axonal maintenance and degeneration. We explored possible interactions of several proteins associated with this condition. Here we report interactions of endogenous and overexpressed strumpellin with another HSP-associated protein, spartin. This biochemical interaction does not appear to be a part of the Wiskott-Aldrich syndrome protein and Scar homologue (WASH) complex because spartin is not co-immunoprecipitated with WASH1 protein. The spartin-strumpellin association does not require the presence of the microtubule interacting and trafficking domain of spartin. Over-expression of mutant forms of strumpellin with the introduced HSP-causing mutations does not alter the colocalization of these two proteins. Knockdown of strumpellin in cultured cortical rat neurons interferes with development of neuronal branching and results in reduced expression of endogenous spartin. Proteosomal inhibition stabilized the levels of spartin and WASH1 proteins, supporting increased spartin degradation in the absence of strumpellin. PMID:25987849

  12. Cardiovascular disease risk in adults with spastic bilateral cerebral palsy

    OpenAIRE

    Slot, Wilma; Roebroeck, Marij; Nieuwenhuijsen, Channah; Bergen, Michael; Stam, Henk; Burdorf, Alex; Berg-Emons, Rita

    2013-01-01

    textabstractObjective: To explore: (i) cardiovascular disease risk factors and the 10-year clustered risk of a fatal cardiovascular event in adults with spastic bilateral cerebral palsy; and (ii) relationships between the 10-year risk and body fat, aerobic fitness and physical activity. Design: Cross-sectional study. Subjects: Forty-three adults with spastic bilateral cerebral palsy without severe cognitive impairment (mean age 36.6 years (standard deviation 6); 27 men). Methods: Biological a...

  13. Peroneal spastic flatfoot in adolescents with accessory talar facet impingement: a preliminary report.

    Science.gov (United States)

    Niki, Hisateru; Aoki, Haruhito; Hirano, Takaaki; Akiyama, Yui; Fujiya, Hiroto

    2015-07-01

    This study analyzed imaging, arthroscopic findings, and treatment responses for peroneal spastic flatfoot (PSFF) caused by talocalcaneal impingement at the accessory anterolateral talar facet (AALTF) (accessory talar facet impingement) in 13 adolescents without histories of trauma and tarsal coalition. The AALTF was determined with computed tomography and MRI. Focal abutting bone marrow edema (FABME) on MRI around the AALTF was confirmed. In seven patients who underwent AALTF resection, subtalar arthroscopy was performed. All experienced alleviation PSFF after treatment; reduction in FABME was observed. AALTF resection alone is beneficial for PSFF caused by accessory talar facet impingement when peroneal spasms are restored by an injection of local anesthesia.

  14. Rehabilitation treatment for 30 cases of compression fracture of vertebral body caused by osteoporosis%骨质疏松性椎体压缩性骨折康复治疗 30例

    Institute of Scientific and Technical Information of China (English)

    兰青; 张海鹏; 孙杰

    2003-01-01

    @@ INTRODUCTION Osteoporosis has become a health protection problem in all over the world.According to American epidemiological statistical data,70% of fractures are caused by osteoporosis in patients over 45 years and fracture of vertebral body is the most common kind of fracture caused by osteoporosis.Nearly 90% of fracture of vertebral body are caused by osteoporosis.If compression fracture of vertebral body isn't treated in time,it will cause pain at chest and waist,vertebral canal might be influenced causing compression on spine and neural symptoms.Traditional treatment on osteoporosis are bed rest,functional exercises of lumbodorsal muscles and fixation of chest and waist by support.But effects of above methods for fracture reduction are not satisfying.In this article,we explore the effects of AF internal fixation system combined with drugs on compression fracture of vertebral body of chest and waist caused by osteoporosis.

  15. Intrathecal baclofen for management of spastic cerebral palsy: multicenter trial.

    Science.gov (United States)

    Gilmartin, R; Bruce, D; Storrs, B B; Abbott, R; Krach, L; Ward, J; Bloom, K; Brooks, W H; Johnson, D L; Madsen, J R; McLaughlin, J F; Nadell, J

    2000-02-01

    Intrathecal baclofen infusion has demonstrated effectiveness in decreasing spasticity of spinal origin. Oral antispasticity medication is minimally effective or not well tolerated in cerebral palsy. This study assessed the effectiveness of intrathecal baclofen in reducing spasticity in cerebral palsy. Candidates were screened by randomized, double-blind, intrathecal injections of baclofen and placebo. Responders were defined as those who experienced an average reduction of 1.0 in the lower extremities on the Ashworth Scale for spasticity. Responders received intrathecal baclofen via the SynchroMed System and were followed for up to 43 months. Fifty-one patients completed screening and 44 entered open-label trials. Lower-extremity spasticity decreased from an average baseline score of 3.64 to 1.90 at 39 months. A decrease in upper extremity spasticity was evidenced over the same study period. Forty-two patients reported adverse events. Most common reports were hypotonia, seizures (no new onset), somnolence, and nausea or vomiting. Fifty-nine percent of the patients experienced procedural or system-related events. Spasticity in patients with cerebral palsy can be treated effectively by continuous intrathecal baclofen. Adverse events, although common, were manageable. PMID:10695888

  16. Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

    OpenAIRE

    Singh Gurpreet; Hughes Peter L; Oo Tun; Soni Bakul M; Vaidyanathan Subramanian; Watt John WH; Sett Pradipkumar

    2003-01-01

    Abstract Background Increased spasms in spinal cord injury (SCI) patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency) drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from...

  17. Experimental Glaucoma Causes Optic Nerve Head Neural Rim Tissue Compression: A Potentially Important Mechanism of Axon Injury

    Science.gov (United States)

    Fortune, Brad; Reynaud, Juan; Hardin, Christy; Wang, Lin; Sigal, Ian A.; Burgoyne, Claude F.

    2016-01-01

    Purpose We tested the hypothesis that experimental glaucoma (EG) results in greater thinning of the optic nerve head (ONH) neural rim tissue than the peripapillary retinal nerve fiber layer (RNFL) tissue. Methods Longitudinal spectral-domain optical coherence tomography (SDOCT) imaging of the ONH and peripapillary RNFL was performed every other week under manometric IOP control (10 mm Hg) in 51 nonhuman primates (NHP) during baseline and after induction of unilateral EG. The ONH parameter minimum rim area (MRA) was derived from 80 radial B-scans centered on the ONH; RNFL cross-sectional area (RNFLA) from a peripapillary circular B-scan with 12° diameter. Results In control eyes, MRA was 1.00 ± 0.19 mm2 at baseline and 1.00 ± 0.19 mm2 at the final session (P = 0.77), while RNFLA was 0.95 ± 0.09 and 0.95 ± 0.10 mm2, respectively (P = 0.96). In EG eyes, MRA decreased from 1.00 ± 0.19 mm2 at baseline to 0.63 ± 0.21 mm2 at the final session (P < 0.0001), while RNFLA decreased from 0.95 ± 0.09 to 0.74 ± 0.19 mm2, respectively (P < 0.0001). Thus, MRA decreased by 36.4 ± 20.6% in EG eyes, significantly more than the decrease in RNFLA (21.7 ± 19.4%, P < 0.0001). Other significant changes in EG eyes included increased Bruch's membrane opening (BMO) nonplanarity (P < 0.05), decreased BMO aspect ratio (P < 0.0001), and decreased MRA angle (P < 0.001). Bruch's membrane opening area did not change from baseline in either control or EG eyes (P = 0.27, P = 0.15, respectively). Conclusions Optic nerve head neural rim tissue thinning exceeded peripapillary RNFL thinning in NHP EG. These results support the hypothesis that axon bundles are compressed transversely within the ONH rim along with glaucomatous deformation of connective tissues. PMID:27564522

  18. Advances in the management of multiple sclerosis spasticity: multiple sclerosis spasticity guidelines.

    Science.gov (United States)

    Gold, Ralf; Oreja-Guevara, Celia

    2013-12-01

    Symptomatic therapy of multiple sclerosis (MS) is an important part of a comprehensive treatment plan that aims to improve patients' quality of life. In the current era of medical progress, several factors have led to the development of guidelines for MS management. There is continued need for an evidence-based approach supported by high-quality data from controlled clinical trials. Most healthcare systems require this approach and include it in the reimbursement process. Guidelines are usually committed by national or continental neurological societies. The Spanish Society of Neurology demyelinating diseases working group has developed a consensus document on spasticity in patients with MS. MS experts from the group used the metaplan method to sum up the most important recommendations about spasticity for inclusion in the guidance. Recommendations were classified according to the Scottish Intercollegiate Guidelines Network system and approved by all members of the group. In Germany, the guideline panel of the German Neurological Society endorsed the national competence network for multiple sclerosis (Krankheitsbezogenes Kompetenznetz Multiple Sklerose) to update the existing recommendations. The most recent fifth edition of the guidelines (dated April 2012) now also includes recommendations for treatment of key symptoms such as spasticity. More than 30 MS neurologists contributed to the new edition reflecting the need for broad expertise. After a first round in which key topics were defined, a web-based decision process was undertaken to further develop individual topics such as symptomatic therapy. The draft manuscript was reviewed once again by the group prior to submission to the official review process. The aims of spasticity treatment are to improve mobility and dexterity, achieve physiological movement patterns, reduce pain, facilitate nursing measures and avoid complications such as contractures. Representative antispasticity medications include baclofen

  19. Genetics Home Reference: autosomal recessive spastic ataxia of Charlevoix-Saguenay

    Science.gov (United States)

    ... Genetics Home Health Conditions ARSACS autosomal recessive spastic ataxia of Charlevoix-Saguenay Enable Javascript to view the ... Open All Close All Description Autosomal recessive spastic ataxia of Charlevoix-Saguenay , more commonly known as ARSACS , ...

  20. Botulinum toxin type A chemodenervation treatment in spastic forms of cerebral palsy

    OpenAIRE

    A. L. Kurenkov; S. S. Nikitin; A. R. Artemenko; B. I. Bursagova; Kuzenkova, L.M.; Petrova, S. A.; O. A. Klochkova; A. M. Mamedyarov

    2015-01-01

    Cerebral palsy (CP) is one of the most serious outcomes of the perinatal lesion of central nervous system and the most common reason for neurological disability in children. Being the key cause of pathological dynamic stereotypes that frequently result in pathological posture and contractures, spasticity is critically important for CP. The use of botulinum toxin type A (BTA) in complex treatment 2-6 years old CP patients allows significantly to improve motor abilities, help to change the surg...

  1. The pathogenesis of tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy

    Directory of Open Access Journals (Sweden)

    Casseb J.

    2000-01-01

    Full Text Available Tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy (TSP/HAM is caused by a human T-cell leukemia virus type I (HTLV-I after a long incubation period. TSP/HAM is characterized by a chronic progressive paraparesis with sphincter disturbances, no/mild sensory loss, the absence of spinal cord compression and seropositivity for HTLV-I antibodies. The pathogenesis of this entity is not completely known and involves a multivariable phenomenon of immune system activation against the presence of HTLV-I antigens, leading to an inflammatory process and demyelination, mainly in the thoracic spinal cord. The current hypothesis about the pathogenesis of TSP/HAM is: 1 presence of HTLV-I antigens in the lumbar spinal cord, noted by an increased DNA HTLV-I load; 2 CTL either with their lytic functions or release/production of soluble factors, such as CC-chemokines, cytokines, and adhesion molecules; 3 the presence of Tax gene expression that activates T-cell proliferation or induces an inflammatory process in the spinal cord; 4 the presence of B cells with neutralizing antibody production, or complement activation by an immune complex phenomenon, and 5 lower IL-2 and IFN-gamma production and increased IL-10, indicating drive to a cytokine type 2 pattern in the TSP/HAM subjects and the existence of a genetic background such as some HLA haplotypes. All of these factors should be implicated in TSP/HAM and further studies are necessary to investigate their role in the development of TSP/HAM.

  2. Perceived Impact of Spasticity Is Associated with Spatial and Temporal Parameters of Gait in Multiple Sclerosis

    OpenAIRE

    Swathi Balantrapu; Brian M. Sandroff; Sosnoff, Jacob J.; Motl, Robert W.

    2012-01-01

    Background. Spasticity is prevalent and disabling in persons with multiple sclerosis (MS), and the development of the Multiple Sclerosis Spasticity Scale-88 (MSSS-88) provides an opportunity for examining the perceived impact of spasticity and its association with gait in this population. Purpose. This study examined the association between the perceived impact of spasticity and spatio-temporal parameters of gait in persons with MS. Methods. The sample included 44 adults with MS who completed...

  3. Cost Effectiveness of Oromucosal Cannabis-Based Medicine (Sativex) for Spasticity in Multiple Sclerosis

    OpenAIRE

    Lanting Lu; Hilary Pearce; Chris Roome; James Shearer; Lang, Iain A; Ken Stein

    2012-01-01

    Background:Background: Spasticity is common in patients with multiple sclerosis (MS) and is a major contributor to disability. Sativex, an oromucosal spray containing cannabis-based medicinal products, has been found to be effective in reducing spasticity symptoms. Abstract: Objective:Objective: Our objective was to estimate the cost effectiveness of Sativex plus oral anti-spasticity medicines compared with the current standard treatment for moderate or severe spasticity in MS in the UK. Abst...

  4. Botulinum toxin injection techniques for the management of adult spasticity.

    Science.gov (United States)

    Walker, Heather W; Lee, Michael Y; Bahroo, Laxman B; Hedera, Peter; Charles, David

    2015-04-01

    Spasticity is often experienced by individuals with injury or illness of the central nervous system from etiologies such as stroke, spinal cord injury, brain injury, multiple sclerosis, or other neurologic conditions. Although spasticity may provide benefits in some patients, it more often leads to complications negatively impacting the patient. Nonpharmacologic treatment options often do not provide long-term reduction of spasticity, and systemic interventions, such as oral medications, can have intolerable side effects. The use of botulinum neurotoxin injections is one option for management of focal spasticity. Several localization techniques are available to physicians that allow for identification of the selected target muscles. These methods include anatomic localization in isolation or in conjunction with electromyography guidance, electrical stimulation guidance, or ultrasound guidance. This article will focus on further description of each of these techniques in relation to the treatment of adult spasticity and will discuss the advantages and disadvantages of each technique, as well as review the literature comparing the techniques. PMID:25305369

  5. Modulation of the soleus H-reflex during pedalling in normal humans and in patients with spinal spasticity.

    OpenAIRE

    Boorman, G.; Becker, W J; Morrice, B L; Lee, R. G.

    1992-01-01

    Soleus H-reflexes were recorded in 10 normal subjects and seven patients with spasticity caused by incomplete spinal cord injury while they pedalled on a stationary bicycle which had been modified to trigger electrical stimuli to the tibial nerve at eight precise points in the pedal cycle. Stimulus strength was adjusted to yield M-waves of constant amplitude at each pedal position. During active pedalling, all normal subjects showed modulation of the H-reflex with the amplitude being increase...

  6. Inter-rater Reliability of the Modified Ashworth Scale for Spasticity in Hemiplegic Patients.

    Science.gov (United States)

    Sloan, R. L.; And Others

    1992-01-01

    This study tested the interrater reliability of the Modified Ashworth Scale in measuring upper and lower limb spasticity in 34 hemiplegic adult patients examined by 2 physiotherapists and 2 doctors. Findings indicated satisfactory reliability for upper limb spasticity but less satisfactory results for lower limb spasticity. (DB)

  7. Correlations between risk factors and functional evolution in patients with spastic quadriplegia.

    Science.gov (United States)

    Rogoveanu, O C; Tuțescu, N C; Kamal, D; Alexandru, D O; Kamal, C; Streba, L; Trăistaru, M R

    2016-01-01

    Cerebral palsy is the most common cause of developing neuro-motor disability in children, in many cases, the triggering cause remaining unknown. Quadriplegia is the most severe spastic cerebral palsy, characterized by severe mental retardation and bi-pyramidal syndrome. The purpose of this paper was to demonstrate the importance of knowing the risk factors and the psychosomatic ones, determining to what extent they influence the functional evolution in patients diagnosed with spastic quadriplegia. 23 children diagnosed with spastic quadriplegia were included in the study, being aged between 1 year and half and 12 years. Patients were assessed at baseline (T1), at one year (T2) and after two years at the end of the study (T3). Patients received a comprehensive rehabilitation program for the motor and sensory deficits throughout the study. Initially, a comprehensive evaluation (etiopathogenic, clinical and functional) that started from a thorough medical history of children (the older ones), was conducted but chose parents to identify the risk factors, and a complete physical exam. At each assessment, joint and muscle balance was conducted. To assess functionality, the gross motor function classification systems (GMFCS) and manual ability (MACS) were used. Many risk factors that were classified according to the timeline in prenatal factors, perinatal and postnatal, were identified from a thorough history. A direct correlation was noticed between the decrease of coarse functionality and manual ability, both initially and in dynamic and low APGAR scores, low gestational age, low birth weight and a higher body mass index of the mother. A direct link was observed between the gross motor function and the manual ability. A significant improvement in the MACS score was noticed in patients with a better GMFCS score.

  8. Novel missense mutation in the L1 gene in a child with corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus

    NARCIS (Netherlands)

    Sztriha, L; Frossard, P; Hofstra, RMW; Verlind, E; Nork, M

    2000-01-01

    Corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus (CRASH syndrome) is an X-linked recessive disorder caused by mutations in the neuronal cell adhesion molecule L1 (L1CAM) gene. L1 plays a key role in axon outgrowth and pathfinding during the development o

  9. Management of primary spinal chondrosarcoma: report of two cases causing cord compression Manejo dos condrosarcomas espinhais primários: relato de dois casos causando compressão medular

    Directory of Open Access Journals (Sweden)

    Daniel Monte-Serrat Prevedello

    2004-09-01

    Full Text Available Chondrosarcomas are malignant tumors that rarely grow inside the spinal canal. Prognosis depends on histological features, patient's age and surgical margins free from tumor. Response to radio and chemotherapy is poor. Ideal treatment consists of total " en-block" resection, not always achievable due to limitation of location, compromise of stability and risk of inducing neurological deficits. Two cases of spinal chondrosarcoma causing cord compression are reported, located in the cervical and thoracic spine. Microsurgical technique consisted of initial debulking followed by removal of margins until limits free from tumor were obtained. Total resection was accomplished and neurological function improved in both cases. Follow-up has been seven and one year respectively, with no evidence of recurrence and preserved neurological functions. Association between chondrosarcoma and estrogen-dependent tumor has been confirmed in this report. Although " en-block" resection of a chondrosarcoma should be tried whenever possible, tumor fragmentation should be considered in difficult cases, as in the present report, in which a long period free from recurrence with good quality of life can be obtained.Os condrosarcomas são tumores malignos, raramente localizados no interior do canal espinhal, com prognóstico dependente do grau histológico do tumor, idade do paciente e margens cirúrgicas livres. Esses tumores apresentam pouca resposta à radio e quimioterapia. O tratamento ideal consiste em ressecção tumoral em bloco, condição particularmente difícil em se tratando de tumores causando compressão medular, devido à localização da lesão, comprometimento da estabilidade axial e necessidade da manutenção ou recuperação da integridade da função neurológica do paciente. Relatamos dois casos de condrossarcomas causando compressão medular, um na coluna cervical e outro na torácica, submetidos a cirurgia com esvaziamento tumoral seguido de remo

  10. In Vivo Evidence for Lysosome Depletion and Impaired Autophagic Clearance in Hereditary Spastic Paraplegia Type SPG11.

    Directory of Open Access Journals (Sweden)

    Rita-Eva Varga

    2015-08-01

    Full Text Available Hereditary spastic paraplegia (HSP is characterized by a dying back degeneration of corticospinal axons which leads to progressive weakness and spasticity of the legs. SPG11 is the most common autosomal-recessive form of HSPs and is caused by mutations in SPG11. A recent in vitro study suggested that Spatacsin, the respective gene product, is needed for the recycling of lysosomes from autolysosomes, a process known as autophagic lysosome reformation. The relevance of this observation for hereditary spastic paraplegia, however, has remained unclear. Here, we report that disruption of Spatacsin in mice indeed causes hereditary spastic paraplegia-like phenotypes with loss of cortical neurons and Purkinje cells. Degenerating neurons accumulate autofluorescent material, which stains for the lysosomal protein Lamp1 and for p62, a marker of substrate destined to be degraded by autophagy, and hence appears to be related to autolysosomes. Supporting a more generalized defect of autophagy, levels of lipidated LC3 are increased in Spatacsin knockout mouse embryonic fibrobasts (MEFs. Though distinct parameters of lysosomal function like processing of cathepsin D and lysosomal pH are preserved, lysosome numbers are reduced in knockout MEFs and the recovery of lysosomes during sustained starvation impaired consistent with a defect of autophagic lysosome reformation. Because lysosomes are reduced in cortical neurons and Purkinje cells in vivo, we propose that the decreased number of lysosomes available for fusion with autophagosomes impairs autolysosomal clearance, results in the accumulation of undegraded material and finally causes death of particularly sensitive neurons like cortical motoneurons and Purkinje cells in knockout mice.

  11. Dysesthesia perceived as painful spasticity: A report of 3 cases.

    Science.gov (United States)

    Ordia, J I; Fischer, E; Adamski, E; Spatz, E L

    2001-05-01

    Lesions of the central nervous system often involve the pyramidal tracts and the sensory pathways to produce spasticity, paresthesias, and dysesthesia. Three patients with intractable spasticity were treated with intrathecal baclofen. Two had an implanted Medtronic SynchroMed pump for long-term delivery of the muscle relaxant. The third patient had undergone a screening trial in which the baclofen was delivered into the intrathecal space through a lumbar catheter. All had excellent relief of spasms on clinical examination, but they reported painful spasms particularly at night. Two of the patients were successfully treated for dysesthesia. PMID:11346852

  12. Modulation of the soleus H-reflex during pedalling in normal humans and in patients with spinal spasticity.

    Science.gov (United States)

    Boorman, G; Becker, W J; Morrice, B L; Lee, R G

    1992-12-01

    Soleus H-reflexes were recorded in 10 normal subjects and seven patients with spasticity caused by incomplete spinal cord injury while they pedalled on a stationary bicycle which had been modified to trigger electrical stimuli to the tibial nerve at eight precise points in the pedal cycle. Stimulus strength was adjusted to yield M-waves of constant amplitude at each pedal position. During active pedalling, all normal subjects showed modulation of the H-reflex with the amplitude being increased during the downstroke portion of the pedal cycle and the reflex suppressed or absent during the upstroke. This modulation was not present during passive pedalling, with the experimenter cranking the pedals by hand, or when the pedals were locked at each of the eight positions. In five of the seven patients with spasticity, there was reduced or absent modulation of the H-reflex during active pedalling and the reflex remained large during pedal upstroke. It is concluded that descending motor commands that produce patterned voluntary activity during pedalling normally cause cyclical gating of spinal reflexes by either presynaptic or postsynaptic inhibitory mechanisms. Loss of supraspinal control over these spinal inhibitory systems could result in failure to produce appropriate suppression of reflexes during patterned voluntary movements such as pedalling or walking, and may be an important factor contributing to the functional disability in spasticity. PMID:1479394

  13. Review of Intrathecal Baclofen Therapy for Spastic and Rigidity Disorders

    Science.gov (United States)

    Obringer, S. John; Coffey, Kenneth M.

    2002-01-01

    Intrathecal baclofen therapy, a treatment for cerebral palsy and other spastic and rigidity disorders, is showing promise as an effective intervention. This article synthesizes both the medical and rehabilitation conceptual literature to update educators and related service providers as to the efficacy of this intervention. Implications for…

  14. A retrospective neurocognitive study in children with spastic diplegia

    NARCIS (Netherlands)

    Pirila, S; van der Meere, J; Korhonen, P; Ruusu-Niemi, P; Kyntaja, M; Nieminen, P; Korpela, R

    2004-01-01

    The study presents the results on neonatal cranial ultrasonography (US) and later intelligence (Wechsler Intelligence Scale-Third Edition and Wechsler Preschool and Primary Scale of Intelligence-Revised) and Neuropsychological assessments of 15 children with spastic diplegia. The assessments were un

  15. Altered sense of agency in children with spastic cerebral palsy

    DEFF Research Database (Denmark)

    Ritterband-Rosenbaum, Anina; Christensen, Mark S; Kliim-Due, Mette;

    2011-01-01

    ABSTRACT: Background Children diagnosed with spastic Cerebral Palsy (CP) often show perceptual and cognitive problems, which may contribute to their functional deficit. Here we investigated if altered ability to determine whether an observed movement is performed by themselves (sense of agency...

  16. Effect of treatment with botulinum toxin on spasticity.

    OpenAIRE

    Das, T K; Park, D M

    1989-01-01

    Botulinum toxin, a product of Clostridium botulinum, produces presynaptic neuromuscular block by preventing release of acetylcholine from nerve endings. The toxin was injected directly into the skeletal muscles of six patients with severe spasticity due to stroke-related hemiplegia. It produced both subjective and objective improvement. The toxin injections were well tolerated and no significant side effect was reported.

  17. Operant Control of Pathological Tongue Thrust in Spastic Cerebral Palsy.

    Science.gov (United States)

    Thompson, George A., Jr.

    1979-01-01

    The behavior modification procedure, carried out at mealtime with a ten-year-old retarded boy who had spastic cerebral palsy, consisted of differential reinforcement and punishment, and resulted in substantial decreases in tongue thrust (reverse swallowing) and food expulsion, and a large increase in observed chewing. (Author/DLS)

  18. Treatment of the spasticity in children with cerebral palsy.

    Science.gov (United States)

    Meholjić-Fetahović, Ajsa

    2007-11-01

    Botulinum toxin is a natural purified protein and one of the strongest biological poisons--neurotoxin. It is produced by the bacterium Clostridium botulinum. Its medical usage started in USA in 1981 and in Europe in 1992. There are seven different immune types of the toxin: A, B, C1, D, E, F and G. Toxin types A and B are used to decrease muscular spasticity. Botulinum toxin prevents the formation of acetylcholine from cholinergic nerve tissues in muscles, which in the end irreversibly destroys neuromuscular synapses. It is called temporary local chemodenervation. It does not affect the synthesis of acetylcholine. As it affects neuromuscular bond it also affects one of the symptoms of cerebral palsy--spasticity. Decreasing the spasticity of children with cerebral palsy leads to the improvement of conscious movements, muscles are less toned, passive mobility is improved, orthosis tolerance is also improved, and the child is enabled to perform easier and better motor functions such as crawling, standing and walking. Since the action of Botulinum toxin is limited to 2-6 months, new neural collaterals are formed and neuromuscular conductivity is reestablished which in the end once again develops a muscular spasm. This leads to a conclusion that botulinum toxin should again be applied into spastic muscles. It is very important for good effect of Botulinum toxin to set the goals of the therapy in advance. The goals include improvement of a function, prevention of contractions and deformities, ease of care and decrease of pain for children with cerebral palsy. After application of botulinum toxin, it is necessary to perform adequate and intensive physical treatment with regular monitoring of effects. This work shows a case of a boy with spastic form of cerebral palsy. After being rehabilitated using Vojta therapy and Bobath concept and the conduct of certain physical procedures, botulinum toxin is administered into his lower limbs' muscles and kinesiotherapy is

  19. The adverse effect of spasticity on 3-month poststroke outcome using a population-based model.

    Science.gov (United States)

    Belagaje, S R; Lindsell, C; Moomaw, C J; Alwell, K; Flaherty, M L; Woo, D; Dunning, K; Khatri, P; Adeoye, O; Kleindorfer, D; Broderick, J; Kissela, B

    2014-01-01

    Several devices and medications have been used to address poststroke spasticity. Yet, spasticity's impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS) as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question "Did you have spasticity following your stroke?" on direct interview at 3 months from stroke onset. Patients who had expired by 90 days (n = 30) or did not have spasticity data available (n = 102) were excluded. Spasticity affected the 3-month functional status (β = 0.420, 95 CI = 0.194 to 0.645) after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model's R (2) changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors. PMID:25147752

  20. A comparison of the effect of doxorubicin and phenol on the skeletal muscle. May doxorubicin be a new alternative treatment agent for spasticity?

    Science.gov (United States)

    Cullu, Emre; Ozkan, Ilhan; Culhaci, Nil; Alparslan, Bulent

    2005-03-01

    Since spasticity is still an unsolved problem for orthopaedic surgeons, different chemical agents are tried before surgery. Phenol is a chemical agent which has been used for spasticity treatment for a long time. Doxorubicin is an antitumoral agent that has recently been used for chemomyectomy. The intramuscular effects of phenol and two different dose of doxorubicin were compared in that experimental study. In the first group 0.5 mg/0.5 cm3 doxorubicin, in the second group 1 mg/0.5 doxorubicin and in the third group 5% aqueous solution of fenol/0.5 injection were applied into left quadriceps muscle of rats. Degeneration areas were wider in the high dose doxorubicin group (29.9%; 8.5-61), in comparison with the low dose doxorubicin group (6.4%; 3.1-12) and phenol group (4%; 0-14) after 6 weeks. Differences in degeneration area among three groups were statistically significant (P<0.001). The difference was significant between the high dose doxorubicin group and the phenol group (P=0.001) and also between the high dose doxorubicin group and the low dose doxorubicin group (P<0.001). The results of this study suggested that doxorubicin could provide an alternative treatment modality for neuromuscular disease causing spasticity and it has a dose-dependent effect. Further studies are needed for long-term comparison and clinical use of doxorubicin for spasticity treatment. PMID:15703526

  1. Sativex in the Management of Multiple Sclerosis-Related Spasticity: Role of the Corticospinal Modulation

    OpenAIRE

    Margherita Russo; Rocco Salvatore Calabrò; Antonino Naro; Edoardo Sessa; Carmela Rifici; Giangaetano D’Aleo; Antonino Leo; Rosaria De Luca; Angelo Quartarone; Placido Bramanti

    2015-01-01

    Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS). This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to bett...

  2. [Hereditary ataxias, spastic parapareses and neuropathies in Eastern Canada].

    Science.gov (United States)

    Dupré, N; Chrestian, N; Thiffault, I; Brais, B; Rouleau, G A; Bouchard, J-P

    2008-01-01

    It has been demonstrated, for many inherited diseases, that historical events have shaped the various regional gene pools of Eastern Canada. In so doing, it has given rise to the increased prevalence of some rare diseases due, to founder effects. The following neurogenetic disorders were first identified in patients from Eastern Canada: AOA-2, Arsacs, HSN-2, Arca-1, HMSN/ACC and Arsal. The population of Eastern Canada, we are convinced, will still allow the identification of new rare forms of hereditary ataxias, spastic parapareses and neuropathies as well as contribute to the uncovering of their mutated genes. We have summarized our current knowledge of the various hereditary ataxias, spastic parapareses and neuropathies in Eastern Canada. The study of the more common and homogenous features of these diseases has been largely completed.

  3. Hereditary spastic paraplegia with a thin corpus callosum

    Energy Technology Data Exchange (ETDEWEB)

    Somasundaram, Sivaraman; Kesavadas, Chandrasekharan [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India); Raghavendra, Seetharam; Singh, Atampreet; Nair, Muraleedharan [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Neurology, Trivandrum (India)

    2007-05-15

    We report a 15-year-old boy with autosomal recessive complicated hereditary spastic paraplegia with a thin corpus callosum (HSP-TCC). The involvement of the corpus callosum was characteristic with the genu and body predominantly affected with relative sparing of the splenium. HSP-TCC is being increasingly recognized over a wider geographical area than earlier believed. We now report a case of HSP-TCC from the Indian subcontinent. (orig.)

  4. RESULTS OF ADDUCTORS MUSCLE TENOTOMY IN SPASTIC CEREBRAL PALSY

    OpenAIRE

    Guglielmetti, Luiz Gabriel Betoni; Santos, Ruy Mesquita Maranhao; Mendonça, Rodrigo Góes Medea de; Yamada, Helder Henzo; Assumpçao, Rodrigo Montezuma César de; Fucs, Patricia Maria de Moraes Barros

    2015-01-01

    Objective: Radiographic evaluation of the evolution of hips that underwent soft-tissue release. Methods: This was a retrospective evaluation on 101 spastic cerebral palsy patients who underwent soft-tissue release between 1991 and 2006. Forty-four patients met the inclusion criteria: 23 boys and 21 girls; 34 diparetic and 10 quadriparetic. Functionally, 29 were non-walkers, five were able to walk at home and 10 were able to walk within the community. Reimers' index (RI) and the acetabular ind...

  5. Leg-robot with MR clutch to realize virtual spastic movements

    International Nuclear Information System (INIS)

    In this study, we propose a leg-robot with an MR clutch to realize virtual haptic control for spastic movements of brain-injured patients. This system can be used in the practical training for trainees of physical therapy. Additionally, we will study to figure out the physiological mechanism of spastic movements of human with the process to simulate patientlike spastic motion by this robot. In this paper, basic structure and mechanism of the leg-robot with the MR clutch are explained. Finally, experimental results of some kinds of haptic control for spastic movements are described.

  6. Leg-robot with MR clutch to realize virtual spastic movements

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, T; Oda, K; Yamaguchi, S; Furusho, J [Osaka University, Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

    2009-02-01

    In this study, we propose a leg-robot with an MR clutch to realize virtual haptic control for spastic movements of brain-injured patients. This system can be used in the practical training for trainees of physical therapy. Additionally, we will study to figure out the physiological mechanism of spastic movements of human with the process to simulate patientlike spastic motion by this robot. In this paper, basic structure and mechanism of the leg-robot with the MR clutch are explained. Finally, experimental results of some kinds of haptic control for spastic movements are described.

  7. The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model

    Directory of Open Access Journals (Sweden)

    S. R. Belagaje

    2014-01-01

    Full Text Available Several devices and medications have been used to address poststroke spasticity. Yet, spasticity’s impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question “Did you have spasticity following your stroke?” on direct interview at 3 months from stroke onset. Patients who had expired by 90 days (n=30 or did not have spasticity data available (n=102 were excluded. Spasticity affected the 3-month functional status (β=0.420, 95 CI=0.194 to 0.645 after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model’s R2 changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors.

  8. Cannabinoids in the management of spasticity associated with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Anna Maria Malfitano

    2008-08-01

    Full Text Available Anna Maria Malfitano, Maria Chiara Proto, Maurizio BifulcoDipartimento di Scienze Farmaceutiche, Università degli Studi di SalernoAbstract: The endocannabinoid system and cannabinoid-based treatments have been involved in a wide number of diseases. In particular, several studies suggest that cannabinoids and endocannabinoids may have a key role in the pathogenesis and therapy of multiple sclerosis (MS. In this study we highlight the main findings reported in literature about the relevance of cannabinoid drugs in the management and treatment of MS. An increasing body of evidence suggests that cannabinoids have beneficial effects on the symptoms of MS, including spasticity and pain. In this report we focus on the effects of cannabinoids in the relief of spasticity describing the main findings in vivo, in the mouse experimental allergic encephalomyelitis model of MS. We report on the current treatments used to control MS symptoms and the most recent clinical studies based on cannabinoid treatments, although long-term studies are required to establish whether cannabinoids may have a role beyond symptom amelioration in MS.Keywords: cannabinoids, multiple sclerosis, spasticity

  9. Muscle synergies in cycling after incomplete spinal cord injury: correlation with clinical measures of motor function and spasticity

    Directory of Open Access Journals (Sweden)

    Filipe O. Barroso

    2016-01-01

    synergies presented correlation with some spasticity symptoms measured by Penn, Modified Ashworth and SCATS scales.Conclusion: Overall, the results of this study support the hypothesis that the analysis of muscle synergies during cycling can provide detailed quantitative assessment of functional motor impairments and symptoms of spasticity caused by abnormal spatiotemporal muscle co-activation following iSCI.

  10. Effects of low-level laser therapy (LLLT 808 nm) on lower limb spastic muscle activity in chronic stroke patients.

    Science.gov (United States)

    das Neves, Marcele Florêncio; Dos Reis, Mariana César Ribeiro; de Andrade, Eliana Aparecida Fonseca; Lima, Fernanda Pupio Silva; Nicolau, Renata Amadei; Arisawa, Emília Ângela Loschiavo; Andrade, Adriano Oliveira; Lima, Mário Oliveira

    2016-09-01

    A cerebrovascular accident (CVA) may affect basic motor functions, including spasticity that may be present in the upper extremity and/or the lower extremity, post-stroke. Spasticity causes pain, muscle force reduction, and decreases the time to onset of muscle fatigue. Several therapeutic resources have been employed to treat CVA to promote functional recovery. The clinical use of low-level laser therapy (LLLT) for rehabilitation of muscular disorders has provided better muscle responses. Thus, the aim of this study was to evaluate the effect of the application of LLLT in spastic muscles in patients with spasticity post-CVA. A double-blind clinical trial was conducted with 15 volunteer stroke patients who presented with post-stroke spasticity. Both males and females were treated; the average age was 51.5 ± 11.8 years old; the participants entered the study ranging from 11 to 48 months post-stroke onset. The patients participated in three consecutive phases (control, placebo, and real LLLT), in which all tests of isometric endurance of their hemiparetic lower limb were performed. LLLT (diode laser, 100 mW 808 nm, beam spot area 0.0314 cm(2), 127.39 J/cm(2)/point, 40 s) was applied before isometric endurance. After the real LLLT intervention, we observed significant reduction in the visual analogue scale for pain intensity (p = 0.0038), increased time to onset of muscle fatigue (p = 0.0063), and increased torque peak (p = 0.0076), but no significant change in the root mean square (RMS) value (electric signal in the motor unit during contraction, as obtained with surface electromyography). Our results suggest that the application of LLLT may contribute to increased recruitment of muscle fibers and, hence, to increase the onset time of the spastic muscle fatigue, reducing pain intensity in stroke patients with spasticity, as has been observed in healthy subjects and athletes. PMID:27299571

  11. Zdravljenje spastičnosti z intratekalnim baklofenom: Intrathecal baclofen therapy of spasticity: Intrathecal baclofen therapy of spasticity:

    OpenAIRE

    Bošnjak, Roman; Grabljevec, Klemen; Gregorič, Milan

    2009-01-01

    In some patients, severe spasticity of cerebral or spinal origin cannot be treated succesfully with conventional oral medication or physical modalities. Intrathecal baclofen therapy with implanted pump represents an effective treatment since mid 80's. Baclofen (Lioresal) is a muscle relaxant and potent GABA agonist that acts via GABAb receptors at the posterior coloumns of spinal cord level to inhibit the release of excitatory neurotransmiters by inhibiting calcium ions influx into presynapti...

  12. A Case of Purple Urine Bag Syndrome in a Spastic Partial Quadriplegic Male.

    Science.gov (United States)

    Tul Llah, Sibghat; Khan, Salman; Dave, Atman; Morrison, Amelia Jane A; Jain, Swapna; Hermanns, David

    2016-01-01

    Purple bag urine syndrome (PUBS) is a benign and unique phenomenon of the urine turning a deep violet color within the urinary catheter tubing and bag. This phenomenon is commonly encountered in patients indicated with long-term catheter placement or, in certain conditions like chronic constipation, alkaline urine, limited ambulation, and, in terms of gender distribution, the female sex, predominates. PUBS gets its name from a unique phenomenon that takes places inside the gut where tryptophan (an amino acid) is metabolized, producing blue and red hues which together emanate a deep violet color. Here, the case of a middle-aged male patient with a suprapubic catheter in situ, following trauma causing spastic partial quadriplegia, is being presented with PUBS due to UTI secondary to Proteus vulgaris. The risk factors, in this case, include chronic constipation and recurrent urinary tract infections (UTIs).​. PMID:27182466

  13. Clinical and genetic heterogeneity in hereditary spastic paraplegias: From SPG1 to SPG72 and still counting

    OpenAIRE

    Klebe, Stephan; Stevanin, Giovanni; Depienne, Christel

    2015-01-01

    International audience; Hereditary spastic paraplegias (HSPs) are genetically determined neurodegenerative disorders characterized by progressive weakness and spasticity of lower limbs, and are among the most clinically and genetically heterogeneous human diseases. All modes of inheritance have been described, and the recent technological revolution in molecular genetics has led to the identification of 76 different spastic gait disease-loci with 59 corresponding spastic paraplegia genes. Aut...

  14. The hereditary spastic paraplegia protein strumpellin: Characterisation in neurons and of the effect of disease mutations on WASH complex assembly and function

    OpenAIRE

    Freeman, Caroline; Seaman, Matthew N J; Reid, Evan

    2013-01-01

    Mutations in the gene encoding strumpellin cause autosomal dominant hereditary spastic paraplegia (HSP), in which there is degeneration of corticospinal tract axons. Strumpellin is a component of the WASH complex, an actin-regulating complex that is recruited to endosomes by interactions with the retromer complex. The WASH complex and its relationship to retromer have not been fully characterised in neurons, and the molecular pathological mechanism of strumpellin mutation is unclear. Here we ...

  15. Clinical assessment of spasticity in children with cerebral palsy: A critical review of available instruments

    NARCIS (Netherlands)

    V.A.B. Scholtes; J.G. Becher; A. Beelen; G.J. Lankhorst

    2006-01-01

    This study reviews the instruments used for the clinical assessment of spasticity in children with cerebral palsy, and evaluates their compliance with the concept of spasticity, defined as a velocity-dependent increase in muscle tone to passive stretch. Searches were performed in Medline, Embase, an

  16. Prevalence and risk factors for epilepsy in children with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Dedy Rahmat

    2010-03-01

    Conclusions The prevalence of epilepsy in spastic CP is 39%. The risk factors for epilepsy in spastic CP are post central nervous system infection, and ocurrence of seizure in the first year of life. [Paediatr Indones. 2010;50:11-7].

  17. Botulinum therapy for poststroke spasticity of the lower extremity (clinical cases

    Directory of Open Access Journals (Sweden)

    L. V. Krylova

    2014-01-01

    Full Text Available The paper deals with the topical problem – the medical rehabilitation of patients with poststroke spasticity. It describes clinical cases of patients with poststroke spasticity of the upper and lower extremities who have received combined therapy using botulinum toxin type A (Botox injections.

  18. Spasticity : Revisiting the role and the individual value of several pharmacological treatments

    NARCIS (Netherlands)

    Lapeyre, Eric; Kuks, Jan B. M.; Meijler, Andwillem J.

    2010-01-01

    Though in the last few decades only a few new drugs have come available for the treatment of spasticity, new insights may revise the role and individual value of several pharmacological treatments. Diazepam, baclofen and tizanidine are the most prescribed drugs for the treatment of spasticity. Intra

  19. Compressed Teleportation

    CERN Document Server

    Jaffe, Arthur; Wozniakowski, Alex

    2016-01-01

    In a previous paper we introduced holographic software for quantum networks, inspired by work on planar para algebras. This software suggests the definition of a compressed transformation. Here we utilize the software to find a CT protocol to teleport compressed transformations. This protocol serves multiple parties with multiple persons.

  20. Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity.

    Science.gov (United States)

    Leussink, Verena Isabell; Husseini, Leila; Warnke, Clemens; Broussalis, Erasmia; Hartung, Hans-Peter; Kieseier, Bernd C

    2012-09-01

    A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebo-controlled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of Δ-9-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, received approval for treating MS-related spasticity in various countries around the globe. In this article we review the current understanding of cannabinoid biology and the value of cannabinoids as a symptomatic treatment option addressing spasticity in patients with MS. PMID:22973422

  1. Effect of Sativex on spasticity-associated symptoms in patients with multiple sclerosis.

    Science.gov (United States)

    Meuth, Sven G; Vila, Carlos; Dechant, Kerry L

    2015-01-01

    Individuals with multiple sclerosis (MS) spasticity may experience a range of symptoms, such as bladder dysfunction, pain, impaired sleep quality and mobility restrictions that worsen as spasticity severity increases. In this review, the effects of Sativex(®) oromucosal spray on symptoms and functional impairment associated with MS-related spasticity were examined. Across Sativex studies, there was a clear trend for improvement in spasticity-associated symptoms that was more pronounced and sustained over time in Sativex responders. Meaningful symptomatic improvement was achieved within the recommended dosage limit of ≤12 sprays per day. In appropriate patients, Sativex has the potential to minimize the consequences of spasticity-related symptoms on quality of life and reduce the economic burden on healthcare systems. PMID:26166264

  2. Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Svetlana Pundik

    2014-01-01

    Full Text Available Background. Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed. Objective. To investigate brain function correlates of spasticity in chronic stroke and to identify specific regional functional brain changes related to rehabilitation-induced mitigation of spasticity. Methods. 23 stroke survivors (>6 months were treated with an arm motor learning and spasticity therapy (5 d/wk for 12 weeks. Outcome measures included Modified Ashworth scale, sensory tests, and functional magnetic resonance imaging (fMRI for wrist and hand movement. Results. First, at baseline, greater spasticity correlated with poorer motor function (P=0.001 and greater sensory deficits (P=0.003. Second, rehabilitation produced improvement in upper limb spasticity and motor function (P<0.0001. Third, at baseline, greater spasticity correlated with higher fMRI activation in the ipsilesional thalamus (rho=0.49, P=0.03. Fourth, following rehabilitation, greater mitigation of spasticity correlated with enhanced fMRI activation in the contralesional primary motor (r=-0.755, P=0.003, premotor (r=−0.565, P=0.04, primary sensory (r=−0.614, P=0.03, and associative sensory (r=−0.597, P=0.03 regions while controlling for changes in motor function. Conclusions. Contralesional motor regions may contribute to restoring control of muscle tone in chronic stroke.

  3. Single-level selective dorsal rhizotomy for spastic cerebral palsy

    Science.gov (United States)

    Graham, David; Cawker, Stephanie; Paget, Simon; Wimalasundera, Neil

    2016-01-01

    The management of cerebral palsy (CP) is complex and requires a multidisciplinary approach. Selective dorsal rhizotomy (SDR) is a neurosurgical technique that aims to reduce spasticity in the lower limbs. A minimally invasive approach to SDR involves a single level laminectomy at the conus and utilises intraoperative electromyography (EMG). When combined with physiotherapy, SDR is effective in selected children and has minimal complications. This review discusses the epidemiology of CP and the management using SDR within an integrated multidisciplinary centre. Particular attention is given to the single-level laminectomy technique of SDR and its rationale, and the patient workup, recovery and outcomes of SDR. PMID:27757432

  4. A single microvascular decompression surgery cures a patient with trigeminal neuralgia, hemifacial spasm, tinnitus, hypertension, and paroxysmal supraventricular tachycardia caused by the compression of a vertebral artery.

    Science.gov (United States)

    Jia, Yin; Wenhua, Wang; Quanbin, Zhang

    2013-01-01

    This report presents a 72-year-old woman with posterior cranial fossa neurovascular compression syndrome that included paroxysmal supraventricular tachycardia. The patient underwent surgical exploration of the posterior cranial fossa, and a gross left vertebral artery was identified as the offending vessel. The neurovascular conflicts were associated with the cranial nerves V, VII, VIII, IX, and X. The patient experienced significant postoperative relief. Probably this is the first report of a single microvascular decompression, having cured such a high number of syndromes, including paroxysmal supraventricular tachycardia.

  5. Botulinum Toxin Type A Injection Combined With Cast Immobilization for Treating Recurrent Peroneal Spastic Flatfoot Without Bone Coalitions: A Case Report and Review of the Literature.

    Science.gov (United States)

    Xu, Jian; Muhammad, Hassan; Wang, Xu; Ma, Xin

    2015-01-01

    Peroneal spastic flatfoot is an uncommon condition. It often presents as a rigid and usually painful valgus deformity in the hindfoot with peroneal muscles spasms. Although tarsal coalition is an important cause, a few patients have not undergone bone coalitions. We describe a 27-year-old female who experienced recurrent peroneal spastic flatfoot after an injury. She was treated successfully with a combination of botulinum toxin type A and immobilization of the foot in a neutral position with a cast. After 3 years, the condition had not recurred, and she was pain free and walked normally, with no increase in muscle tone. This unique treatment could be of potential use to treat many patients with such conditions.

  6. Numerical analysis of hemodynamics in spastic middle cerebral arteries.

    Science.gov (United States)

    Wen, Jun; Wang, Qingfeng; Wang, Qingyuan; Khoshmanesh, Khashayar; Zheng, Tinghui

    2016-11-01

    Cerebral vasospasm (CVS) is the most common serious complication of subarachnoid hemorrhage. Among the many factors that are associated with the pathogenesis of CVS, hemodynamics plays an important role in the initiation and development of CVS. Numerical simulation was carried out to obtain the flow patterns and wall shear stress (WSS) distribution in spastic middle cerebral arteries. The blood was assumed to be incompressible, laminar, homogenous, Newtonian, and steady. Our simulations reveal that flow velocity and WSS level increase at the stenosis segment of the spastic vessels, but further downstream of stenosis, the WSS significantly decreases along the inner wall, and flow circulation and stagnation are observed. The hydrodynamic resistance increases with the increase of vessel spasm. Moreover, the change of flow field and hydrodynamic forces are not linearly proportional to the spasm level, and the rapid change of hemodynamic parameters is observed as the spasm is more than 50%. Accordingly, in the view of hemodynamic physiology, vessels with less than 30% stenosis are capable of self-restoration towards normal conditions. However, vessels with more than 50% stenosis may eventually lose their capacity to adapt to differing physiologic conditions due to the extreme non-physilogic hemodynamic environment, and the immediate expansion of the vessel lumen might be needed to minimize serious and non-reversible effects. PMID:26942314

  7. Manual Linear Movements to Assess Spasticity in a Clinical Setting

    Science.gov (United States)

    Marinelli, Lucio; Trompetto, Carlo; Mori, Laura; Vigo, Gabriele; Traverso, Elisabetta; Colombano, Federica; Abbruzzese, Giovanni

    2013-01-01

    In a clinical setting, where motor-driven systems are not readily available, the major difficulty in the assessment of the stretch reflex lies in the control of passive limb displacement velocity. A potential approach to this problem arises from the use of manual sinusoidal movements (made by continuous alternating flexions and extensions) paced by an external stimulus. Unfortunately, there are conditions in which sinusoidal movements induce interfering phenomena such as the shortening reaction or postactivation depression. In the present paper, a novel manual method to control the velocity of passive linear movements is described and the results obtained from both healthy subjects and spastic patients are reported. This method is based on the synchronisation of movements with tones played by a metronome at different speeds. In a first set of experiments performed in healthy subjects, we demonstrated consistent control of velocity during passive limb movements using this method. Four joints usually examined during muscle tone assessment were tested: wrist, elbow, knee and ankle joints. Following this, we conducted a longitudinal assessment of the stretch reflex amplitude in wrist flexor muscles in patients with spasticity treated with botulinum toxin type A. The evaluators were not only able to vary the movement velocity based on the metronome speed, but also could reproduce the respective speeds two weeks later, despite the changing degree of hypertonia. This method is easy to perform in a clinical setting and hardware requirements are minimal, making it an attractive and robust procedure for the widespread clinical assessment of reflex hypertonia. PMID:23335966

  8. Gait analysis of children with spastic hemiplegic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    Xin Wang; Yuexi Wang

    2012-01-01

    An experiment was carried out in the key laboratory for Technique Diagnosis and Function Assessment of Winter Sports of China to investigate the differences in gait characteristics between healthy children and children with spastic hemiplegic cerebral palsy. With permission of their parents, 200 healthy children aged 3 to 6 years in the kindergarten of Northeastern University were enrolled in this experiment. Twenty children aged 3 to 6 years with spastic hemiplegic cerebral palsy from Shengjing Hospital, China were also enrolled in this experiment. Standard data were collected by simultaneously recording gait information from two digital cameras.DVracker was used to analyze the standard data. The children with hemiplegic cerebral palsy had a longer gait cycle, slower walking speed, and longer support phase than did the healthy children.The support phase was longer than the swing phase in the children with hemiplegic cerebral palsy. There were significant differences in the angles of the hip, knee, and ankle joint between children with cerebral palsy and healthy children at the moment of touching the ground and buff -ering, and during pedal extension. Children with hemiplegic cerebral palsy had poor motor coordination during walking, which basically resulted in a short stride, high stride frequency to maintain speed, more obvious swing, and poor stability.

  9. Development, Test and Validation of a Mechatronic Device for Spasticity Quantification

    Directory of Open Access Journals (Sweden)

    João F. Ferreira

    2013-05-01

    Full Text Available Spasticity is a common pathological phenomenon in clinical practices, frequently expressed as a stroke, multiple sclerosis or cerebral palsy. The accurate quantification of spasticity allows early action to prevent the potentially irreversible consequences. The aim of this work is to develop and implement a mechatronic device for the accurate quantification of spasticity, which is able to differentiate spasticity from other motor disorders. The proposed method is based on the quantification of the tonic stretch reflex threshold (TSRT for the assessment of the range of motion of the limb affected by spasticity. In order to validate the developed device, experimental trials have been conducted, considering the flexor muscle of the elbow joint. The developed device was tested, first in a laboratory environment with healthy subjects and secondly, in a clinical environment with the collaboration of patients with spasticity. The evaluations in th clinical environment were performed on three different days in order to evaluate the reproducibility of the obtained results. The experimental trials confirm the sensibility, reproducibility and reliability of spasticity quantification based on the TSRT method. This project has been developed in cooperation with the Hospital of Braga and Fisimaia rehabilitation clinic, both in Portugal.

  10. Assessing competency in spasticity management: a method of development and assessment.

    Science.gov (United States)

    Escaldi, Steven V; Cuccurullo, Sara J; Terzella, Matthew; Petagna, Ann Marie; Strax, Thomas E

    2012-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with spasticity and other sequelae of the upper motor neuron syndrome. It further sought to verify acquired competencies in spasticity management through objective evaluation methodology. A physical medicine and rehabilitation board-certified physician with 10 yrs clinical experience in spasticity management trained 16 residents using a standardized competency-based module. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. The 16 residents successfully demonstrated proficiency in every segment of the evaluation module by the end of the Postgraduate Year 3 spasticity management rotation. Objective measures compared resident scores on an institution-specific standardized test administered before and after training. Resident proficiency in the skills and knowledge pertaining to spasticity management was objectively verified after completion of the standardized educational module. Validation of the assessment tool is evidenced by significantly improved postrotational institution-specific standardized test scores (mean pretest score, 61.1%; mean posttest score, 95.4%) as well as oral testing. In addition, the clinical development tool was validated by residents being individually observed performing skills and deemed competent by a board-certified physical medicine and rehabilitation physician specializing in spasticity management. The standardized educational module and evaluation methodology provide a potential framework for the definition of baseline competency in the clinical skill area of spasticity management. PMID:22173081

  11. Effects of static bicycle training on gross motor function, muscle strength and spasticity of adolescents with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    CHRISTOS TSIGKANOS

    2013-01-01

    Full Text Available The purpose of the present study was to examine the effects of an 8- week lower limb strengthening program on gross motor function, muscle strength and spasticity levels of both the quadriceps and hip adductors of adolescents 14 to 19 years of age with spastic cerebral palsy using a specific static bicycle (Thera-Vital exerciser. Eight students were assigned to the experimental group and another 8 to the control group. The strengthening program took place 3 times a week (6 sets of 10 to 15 full cycling circles. The Gross Motor Function Measure (GMFM (dimensions D and E, an isometric hand-held dynamometer and Asworth scale were the measurement instruments used in the study. A multivariance analysis of variance (MANOVA was applied for identifying the statistical importance of the results of the intervention protocol. A statistically significant improvement in both gross motor function (p = 0.016 and muscle strength (p = 0.039 was found without a statistically significant alteration of the muscle tone of the quadriceps and hip adductors of the participants (p = 0.13 and p = 0.33. The results of the present study indicate that static bicycle is a safe and effective means of exercise since it improves the gross motor function of adolescents with cerebral palsy without increasing the muscle tone of the lower limb.

  12. Outcomes in spasticity after repetitive transcranial magnetic and transcranial direct current stimulations

    Institute of Scientific and Technical Information of China (English)

    Aysegul Gunduz; Hatice Kumru; Alvaro Pascual-Leone

    2014-01-01

    Non-invasive brain stimulations mainly consist of repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Repetitive transcranial magnetic stimulation exhib-its satisfactory outcomes in improving multiple sclerosis, stroke, spinal cord injury and cerebral palsy-induced spasticity. By contrast, transcranial direct current stimulation has only been studied in post-stroke spasticity. To better validate the effcacy of non-invasive brain stimulations in im-proving the spasticity post-stroke, more prospective cohort studies involving large sample sizes are needed.

  13. Abnormal Paraplegin Expression in Swollen Neurites, τ- and α-Synuclein Pathology in a Case of Hereditary Spastic Paraplegia SPG7 with an Ala510Val Mutation

    Directory of Open Access Journals (Sweden)

    Dietmar R. Thal

    2015-10-01

    Full Text Available Mutations in the SPG7 gene are the most frequent cause of autosomal recessive hereditary spastic paraplegias and spastic ataxias. Ala510Val is the most common SPG7 mutation, with a frequency of up to 1% in the general population. Here we report the clinical, genetic, and neuropathological findings in a homozygous Ala510Val SPG7 case with spastic ataxia. Neuron loss with associated gliosis was found in the inferior olivary nucleus, the dentate nucleus of the cerebellum, the substantia nigra and the basal nucleus of Meynert. Neurofilament and/or paraplegin accumulation was observed in swollen neurites in the cerebellar and cerebral cortex. This case also showed subcortical τ-pathology in an unique distribution pattern largely restricted to the brainstem. α-synuclein containing Lewy bodies (LBs were observed in the brainstem and the cortex, compatible with a limbic pattern of Braak LB-Disease stage 4. Taken together, this case shows that the spectrum of pathologies in SPG7 can include neuron loss of the dentate nucleus and the inferior olivary nucleus as well as neuritic pathology. The progressive supranuclear palsy-like brainstem predominant pattern of τ pathology and α-synuclein containing Lewy bodies in our SPG7 cases may be either coincidental or related to SPG7 in addition to neuron loss and neuritic pathology.

  14. Three Case Reports of Successful Vibration Therapy of the Plantar Fascia for Spasticity Due to Cerebral Palsy-Like Syndrome, Fetal-Type Minamata Disease.

    Science.gov (United States)

    Usuki, Fusako; Tohyama, Satsuki

    2016-04-01

    Fetal-type Minamata disease is caused by the exposure to high concentrations of methylmercury in the fetal period and shows cerebral palsy-like clinical features. Relief of spasticity is a major task of rehabilitation to improve their activities of daily living. Here we report the effect of long-term vibration therapy on bilateral lower-limb spasticity in 3 patients with fetal-type Minamata disease. We used a simple, inexpensive, and noninvasive approach with hand-held vibration massagers, which were applied to the plantar fascia at 90 Hz for 15 minutes. The effect was observed soon after the first treatment and resulted in better performance of the repetitive facilitation. Vibration therapy for 1 year improved Modified Ashworth Scale for the ankle flexors in 2 cases. The labored gait improved and gait speed increased in another case. Continued vibration therapy for another 1 year further improved Modified Ashworth Scale score and range of motion of ankle dorsiflexion in 1 case. This case showed the decreased amplitude of soleus H-reflex after the 15-minute vibration therapy, suggesting that α-motor neuron excitability was suppressed. Vibration therapy using a hand-held vibration massager may offer safe and effective treatment for lower-limb spasticity in patients with chronic neurological disorders.

  15. Surgical Treatment Guidelines for Digital Deformity Associated With Intrinsic Muscle Spasticity (Intrinsic Plus Foot) in Adults With Cerebral Palsy.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C

    2015-01-01

    Intrinsic plus foot deformity has primarily been associated with cerebral palsy and involves spastic contracture of the intrinsic musculature with resultant toe deformities. Digital deformity is caused by a dynamic imbalance between the intrinsic muscles in the foot and extrinsic muscles in the lower leg. Spastic contracture of the toes frequently involves curling under of the lesser digits or contracture of the hallux into valgus or plantarflexion deformity. Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. Four different patterns of intrinsic plus foot deformity have been observed by the authors that likely relate to the different patterns of muscle involvement. Case examples are provided of the 4 patterns of intrinsic plus foot deformity observed, including global intrinsic plus lesser toe deformity, isolated intrinsic plus lesser toe deformity, intrinsic plus hallux valgus deformity, and intrinsic plus hallux flexus deformity. These case examples are presented to demonstrate each type of deformity and our approach for surgical management according to the contracture pattern. The surgical approach has typically involved tenotomy, capsulotomy, or isolated joint fusion. The main goals of surgical treatment are to relieve pain and reduce pressure points through digital realignment in an effort to decrease the risk of pressure sores and allow more effective bracing to ultimately improve the patient's mobility. PMID:25154656

  16. SIMULATION APPROACH FOR NON LINEAR BEHAVIOUR IN SPASTICITY

    Directory of Open Access Journals (Sweden)

    B. Mohan

    2013-05-01

    Full Text Available We examined ankle clonus in spastic subjects to determine whether this oscillatory behavior has the properties of a limit cycle, and also the effects of changes in motoneuron threshold and increasing loop delay on the stability of the stretch reflex in man. By developing a computer model representative of the ankle stretchreflex pathway, we could simulate a wide range of physiological conditions in order to better understand how each affect reflex behavior and determine the possible mechanisms underlying clonus. We hypothesize that clonus arises when two conditions occur simultaneously. First, the reflex pathway contain long transport delaytimes, and second, the excitability of the motoneurons is enhanced through reductions in synaptic current threshold.The feasibility of these modulations are verified Matlab/SImulink software and simulation results are presented.

  17. Motor activation in SPG4-linked hereditary spastic paraplegia

    DEFF Research Database (Denmark)

    Scheuer, KH; Nielsen, JE; Krabbe, Katja;

    2006-01-01

    ) and between-group comparisons of movement vs. rest (group x behavioural state interaction) were performed using a random effects approach and statistical parametric mapping (SPM99). RESULTS: Patterns of motor activation were generally comparable between groups during both tasks, although patients had......OBJECTIVE: The aim of this study was to investigate the extent of motor cortical functional reorganisation in patients with SPG4-linked hereditary spastic paraplegia by exploring cortical motor activation related to movements of clinically affected (lower) and unaffected (upper) limbs. METHODS...... a tendency towards more widespread activation in sensorimotor cortical and cerebellar regions. Statistically significant differences were restricted to the ankle movement response, however, where patients showed significantly increased regional cerebral blood flow in the right and left primary motor cortices...

  18. Decreased contribution from afferent feedback to the soleus muscle during walking in patients with spastic stroke

    DEFF Research Database (Denmark)

    Mazzaro, Nazarena; Nielsen, Jørgen F.; Grey, Michael James;

    2007-01-01

    We investigated the contribution of afferent feedback to the soleus (SOL) muscle activity during the stance phase of walking in patients with spastic stroke. A total of 24 patients with hemiparetic spastic stroke and age-matched healthy volunteers participated in the study. A robotic actuator...... with the healthy volunteers (1.0 +/- 0.3, P = .05). Second, fast plantar flexion perturbations were applied during the stance phase to unload the plantar flexor muscles, thus, removing the afferent input from these muscles to the SOL motoneurons. These perturbations produced a distinct decrease in SOL activity...... by the Ashworth score. These results indicate that although the stretch reflex response is facilitated during spastic gait, the contribution of afferent feedback to the ongoing locomotor SOL activity is depressed in patients with spastic stroke....

  19. Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

    Science.gov (United States)

    Pozzilli, Carlo

    2013-12-01

    Although spasticity of varying severity affects up to 80% of patients with multiple sclerosis (MS) during the course of their disease, the symptom is often overlooked and undertreated. Despite the availability of oral antispasticity treatments (baclofen, tizanidine and others), approximately one-third of MS patients in Europe and the USA experience moderate or severe nonfocalized spasticity. At present, a thorough clinical evaluation of MS-related spasticity that takes into account the patient's own perception of spasms, spasticity-related pain and other associated symptoms is not common in daily neurological practice. Some of the usual spasticity scales, such as the Ashworth and modified Ashworth scales, reflect the observer's measurement of spasticity at a particular point in time. Herbal (smoked) cannabis has long been recognized as a possible option for relief of spasticity and neuropathic pain, but pertinent concerns about psychoactive effects and addiction risk have prevented its common use. An innovative method of benefiting from the mode of action of cannabinoids while limiting their drawbacks is to reduce peak plasma levels of 9-delta-tetrahydrocannabinol and counteract psychoactivity with higher than naturally occurring proportions of a second cannabinoid, cannabidiol. Sativex® oromucosal spray (1:1 ratio of 9-delta-tetrahydrocannabinol/cannabidiol) has recently been approved in a number of EU countries and elsewhere for use in patients with MS-related spasticity who are resistant to treatment with other antispasticity medications. In clinical trials, Sativex provided initial relief of spasticity symptoms within the first 4 weeks of treatment (trial period) in up to about half of patients resistant to other available oral antispasticity medications and demonstrated clinically significant improvement in spasticity (30% or higher reduction from baseline) in three-quarters of the initial responders. Adverse events were limited mainly to mild or moderate

  20. Conserved pharmacological rescue of hereditary spastic paraplegia-related phenotypes across model organisms.

    Science.gov (United States)

    Julien, Carl; Lissouba, Alexandra; Madabattula, Surya; Fardghassemi, Yasmin; Rosenfelt, Cory; Androschuk, Alaura; Strautman, Joel; Wong, Clement; Bysice, Andrew; O'sullivan, Julia; Rouleau, Guy A; Drapeau, Pierre; Parker, J Alex; Bolduc, François V

    2016-03-15

    Hereditary spastic paraplegias (HSPs) are a group of neurodegenerative diseases causing progressive gait dysfunction. Over 50 genes have now been associated with HSP. Despite the recent explosion in genetic knowledge, HSP remains without pharmacological treatment. Loss-of-function mutation of the SPAST gene, also known as SPG4, is the most common cause of HSP in patients. SPAST is conserved across animal species and regulates microtubule dynamics. Recent studies have shown that it also modulates endoplasmic reticulum (ER) stress. Here, utilizing null SPAST homologues in C. elegans, Drosophila and zebrafish, we tested FDA-approved compounds known to modulate ER stress in order to ameliorate locomotor phenotypes associated with HSP. We found that locomotor defects found in all of our spastin models could be partially rescued by phenazine, methylene blue, N-acetyl-cysteine, guanabenz and salubrinal. In addition, we show that established biomarkers of ER stress levels correlated with improved locomotor activity upon treatment across model organisms. Our results provide insights into biomarkers and novel therapeutic avenues for HSP. PMID:26744324

  1. The Effect of Electrical Passive Cycling on Spasticity in War Veterans with Spinal Cord Injury

    OpenAIRE

    Seyed M Rayegani; Hadi eShojaee; Leyla eSedighipour; Mohammad Reza eSoroush; Mohmmad eBaghbani; Omm’Ol Banin eAmirani

    2011-01-01

    Introduction: Muscle atrophy, spasticity, and deformity are among long term complication of spinal cord injury (SCI) veterans. There are numerous studies evaluating effect of functional electrical stimulation on muscle properties of SCI people, but less research has focused on the benefits of passive cycling in the management of spasticity and improving ROM of lower limbs in individuals with SCI. Aims: To evaluate the effect of electrical passive cycling on passive range of movement spasticit...

  2. Presurgical 3D gait analysis findings in four children with spastic cerebral palsy

    OpenAIRE

    Smith, Víctor Manuel; Postigo, Sergio; Postigo, María José; Prado, María; Núñez, María José; Ros, Bienvenido; Fernández, Victoria

    2014-01-01

    Introduction: Children with spastic palsy present usually with an altered gait pattern. This pattern presents various superimposed alterations, due to spasticity and due to musculosqueletal deformities; some of them are principal and some of them are compensatory mechanisms developed by the patient. Due to the complexity of the clinical analysis of these patients, automatic gait analysis is a very usefull tool Material y methods: We have studied four children: 2 of 5, one of 4 and another ...

  3. Lasting reduction of severe spasticity after ending chronic treatment with intrathecal baclofen.

    OpenAIRE

    Dressnandt, J; Conrad, B

    1996-01-01

    OBJECTIVE--To investigate whether the dose of intrathecal baclofen necessary for a sufficient reduction of muscle tone and spasms changes during treatment of severe spasticity. METHODS--A group of 27 patients received intrathecal baclofen for 61 (SD 18) months. RESULTS--Spasticity remained absent or strongly reduced after stopping the intrathecal baclofen infusion in seven patients. The dose of baclofen could be reduced to 40% of that dose which was originally necessary in 10 patients. The do...

  4. Effects of Prolonged Standing on Gait in Children with Spastic Cerebral Palsy

    Science.gov (United States)

    Salem, Yasser; Lovelace-Chandler, Venita; Zabel, Reta J.; McMillan, Amy Gross

    2010-01-01

    The purpose of this study was to determine the effects of prolonged standing on gait characteristics in children with spastic cerebral palsy. Six children with spastic cerebral palsy participated in this study with an average age of 6.5 years (SD = 2.5, range = 4.0-9.8 years). A reverse baseline design (A-B-A) was used over a 9-week period. During…

  5. Effects of interactive games on motor performance in children with spastic cerebral palsy

    OpenAIRE

    AlSaif, Amer A.; Alsenany, Samira

    2015-01-01

    [Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Method...

  6. Spasticity and Electrophysiologic Changes after Extracorporeal Shock Wave Therapy on Gastrocnemius

    OpenAIRE

    Sohn, Min Kyun; Cho, Kang Hee; Kim, Young-Jae; Hwang, Seon Lyul

    2011-01-01

    Objective To evaluate the spasticity and electrophysiologic effects of applying extracorporeal shock wave therapy (ESWT) to the gastrocnemius by studying F wave and H-reflex. Method Ten healthy adults and 10 hemiplegic stroke patients with ankle plantarflexor spasticity received one session of ESWT on the medial head of the gastrocnemius. The modified Ashworth scale (MAS), tibial nerve conduction, F wave, and H-reflex results were measured before and immediately after the treatment. The Visua...

  7. Compressive beamforming

    DEFF Research Database (Denmark)

    Xenaki, Angeliki; Mosegaard, Klaus

    2014-01-01

    Sound source localization with sensor arrays involves the estimation of the direction-of-arrival (DOA) from a limited number of observations. Compressive sensing (CS) solves such underdetermined problems achieving sparsity, thus improved resolution, and can be solved efficiently with convex...

  8. Wellhead compression

    Energy Technology Data Exchange (ETDEWEB)

    Harrington, Joe [Sertco Industries, Inc., Okemah, OK (United States); Vazquez, Daniel [Hoerbiger Service Latin America Inc., Deerfield Beach, FL (United States); Jacobs, Denis Richard [Hoerbiger do Brasil Industria de Equipamentos, Cajamar, SP (Brazil)

    2012-07-01

    Over time, all wells experience a natural decline in oil and gas production. In gas wells, the major problems are liquid loading and low downhole differential pressures which negatively impact total gas production. As a form of artificial lift, wellhead compressors help reduce the tubing pressure resulting in gas velocities above the critical velocity needed to surface water, oil and condensate regaining lost production and increasing recoverable reserves. Best results come from reservoirs with high porosity, high permeability, high initial flow rates, low decline rates and high total cumulative production. In oil wells, excessive annulus gas pressure tends to inhibit both oil and gas production. Wellhead compression packages can provide a cost effective solution to these problems by reducing the system pressure in the tubing or annulus, allowing for an immediate increase in production rates. Wells furthest from the gathering compressor typically benefit the most from wellhead compression due to system pressure drops. Downstream compressors also benefit from higher suction pressures reducing overall compression horsepower requirements. Special care must be taken in selecting the best equipment for these applications. The successful implementation of wellhead compression from an economical standpoint hinges on the testing, installation and operation of the equipment. Key challenges and suggested equipment features designed to combat those challenges and successful case histories throughout Latin America are discussed below.(author)

  9. A total of 220 patients with autosomal dominant spastic paraplegia do not display mutations in the SLC33A1 gene (SPG42)

    OpenAIRE

    Schlipf, Nina A; Beetz, Christian; Schüle, Rebecca; Stevanin, Giovanni; Erichsen, Anne Kjersti; Forlani, Sylvie; Zaros, Cécile; Karle, Kathrin; Klebe, Stephan; Klimpe, Sven; Durr, Alexandra; Otto, Susanne; Tallaksen, Chantal M. E.; Riess, Olaf; Brice, Alexis

    2010-01-01

    The most frequent causes of autosomal dominant (AD) hereditary spastic paraplegias (HSP) (ADHSP) are mutations in the SPAST gene (SPG4 locus). However, roughly 60% of patients are negative for SPAST mutations, despite their family history being compatible with AD inheritance. A mutation in the gene for an acetyl-CoA transporter (SLC33A1) has recently been reported in one Chinese family to cause ADHSP-type SPG42. In this study, we screened 220 independent SPAST mutation-negative ADHSP samples ...

  10. Association between Severe Upper Limb Spasticity and Brain Lesion Location in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Alessandro Picelli

    2014-01-01

    Full Text Available Association between the site of brain injury and poststroke spasticity is poorly understood. The present study investigated whether lesion analysis could document brain regions associated with the development of severe upper limb poststroke spasticity. A retrospective analysis was conducted on 39 chronic stroke patients. Spasticity was assessed at the affected upper limb with the modified Ashworth scale (shoulder, elbow, wrist, and fingers. Brain lesions were traced from magnetic resonance imaging performed within the first 7 days after stroke and region of interest images were generated. The association between severe upper limb spasticity (modified Ashworth scale ≥2 and lesion location was determined with the voxel-based lesion-symptom mapping method implemented in MRIcro software. Colored maps representing the z statistics were generated and overlaid onto the automated anatomical labeling and the Johns Hopkins University white matter templates provided with MRIcron. Thalamic nuclei were identified with the Talairach Daemon software. Injuries to the insula, the thalamus, the basal ganglia, and white matter tracts (internal capsule, corona radiata, external capsule, and superior longitudinal fasciculus were significantly associated with severe upper limb poststroke spasticity. Further advances in our understanding of the neural correlates of spasticity may lead to early targeted rehabilitation when key regions are damaged.

  11. Perceived Impact of Spasticity Is Associated with Spatial and Temporal Parameters of Gait in Multiple Sclerosis

    Science.gov (United States)

    Balantrapu, Swathi; Sandroff, Brian M.; Sosnoff, Jacob J.; Motl, Robert W.

    2012-01-01

    Background. Spasticity is prevalent and disabling in persons with multiple sclerosis (MS), and the development of the Multiple Sclerosis Spasticity Scale-88 (MSSS-88) provides an opportunity for examining the perceived impact of spasticity and its association with gait in this population. Purpose. This study examined the association between the perceived impact of spasticity and spatio-temporal parameters of gait in persons with MS. Methods. The sample included 44 adults with MS who completed the MSSS-88 and 4 walking trials on a 26-foot GAITRiteTM electronic walkway for measurement of spatio-temporal components of gait including velocity, cadence, base of support, step time, single support, double support, and swing phase. Results. The overall MSSS-88 score was significantly associated with velocity (r = −0.371), cadence (r = −0.306), base of support (r = 0.357), step time (r = 0.305), single leg support (r = −0.388), double leg support (r = 0.379), and swing phase (r = −0.386). Conclusions. The perceived impact of spasticity coincides with alterations of the spatio-temporal parameters of gait in MS. This indicates that subsequent interventions might target a decrease in spasticity or its perceived impact as an approach for improving mobility in MS. PMID:22462022

  12. Sativex in the Management of Multiple Sclerosis-Related Spasticity: Role of the Corticospinal Modulation

    Directory of Open Access Journals (Sweden)

    Margherita Russo

    2015-01-01

    Full Text Available Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS. This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect. The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability.

  13. Sativex in the management of multiple sclerosis-related spasticity: role of the corticospinal modulation.

    Science.gov (United States)

    Russo, Margherita; Calabrò, Rocco Salvatore; Naro, Antonino; Sessa, Edoardo; Rifici, Carmela; D'Aleo, Giangaetano; Leo, Antonino; De Luca, Rosaria; Quartarone, Angelo; Bramanti, Placido

    2015-01-01

    Sativex is an emergent treatment option for spasticity in patients affected by multiple sclerosis (MS). This oromucosal spray, acting as a partial agonist at cannabinoid receptors, may modulate the balance between excitatory and inhibitory neurotransmitters, leading to muscle relaxation that is in turn responsible for spasticity improvement. Nevertheless, since the clinical assessment may not be sensitive enough to detect spasticity changes, other more objective tools should be tested to better define the real drug effect. The aim of our study was to investigate the role of Sativex in improving spasticity and related symptomatology in MS patients by means of an extensive neurophysiological assessment of sensory-motor circuits. To this end, 30 MS patients underwent a complete clinical and neurophysiological examination, including the following electrophysiological parameters: motor threshold, motor evoked potentials amplitude, intracortical excitability, sensory-motor integration, and Hmax/Mmax ratio. The same assessment was applied before and after one month of continuous treatment. Our data showed an increase of intracortical inhibition, a significant reduction of spinal excitability, and an improvement in spasticity and associated symptoms. Thus, we can speculate that Sativex could be effective in reducing spasticity by means of a double effect on intracortical and spinal excitability. PMID:25699191

  14. Alterations in body composition and spasticity following subtetanic neuromuscular electrical stimulation training in spinal cord injury

    Directory of Open Access Journals (Sweden)

    Louis Crowe, MB, BCh, BAO

    2013-04-01

    Full Text Available The objective of this prospective cohort study was to investigate alterations in body composition variables and spasticity following subtetanic neuromuscular electrical stimulation (NMES training in an adult population with spinal cord injury (SCI. Fourteen sedentary adults with SCI (thoracic [T]4–T11; American Spinal Injury Association Impairment Scale A/B; time since injury: 10.17 +/– 11.17 yr were recruited from the National SCI database. Four adhesive electrodes (175 cm2 each were placed bilaterally on the proximal and distal quadriceps and hamstrings muscle groups and subtetanic contractions were elicited using a handheld NMES device. Lean body mass (LBM and other body composition variables were measured using dual-energy X-ray absorptiometry. Spasticity was measured using the Spinal Cord Assessment Tool for Spastic Reflexes (SCATs and visual analog scales. Verbal and written feedback was obtained to subjectively evaluate spasticity. LBM and spasticity measurements were taken before and after an 8 wk NMES training program in order to assess change. A statistically significant increase in lower-limb LBM, i.e., muscle tissue (p > 0.001, and a reduction in SCATs (p < 0.001 score, indicating reduced spasticity, was observed. Subjective responses were positive. Improvements in body composition and SCATs scores indicate that subtetanic NMES training elicits favorable responses and may have important clinical implications for an SCI population.

  15. Hereditary spastic paraplegia with cerebellar ataxia: a complex phenotype associated with a new SPG4 gene mutation

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Erik; Johnson, B; Koefoed, Pernille;

    2004-01-01

    Complex forms of hereditary spastic paraplegia (HSP) are rare and usually transmitted in an autosomal recessive pattern. A family of four generations with autosomal dominant hereditary spastic paraplegia (AD-HSP) and a complex phenotype with variably expressed co-existing ataxia, dysarthria, unip...... relatively decreased regional cerebral blood flow in most of the cerebellum. We conclude that this kindred demonstrates a considerable overlap between cerebellar ataxia and spastic paraplegia, emphasizing the marked clinical heterogeneity of HSP associated with spastin mutations...

  16. Split tendon transfers for the correction of spastic varus foot deformity: a case series study

    Directory of Open Access Journals (Sweden)

    Dimitriadis Dimitris

    2010-12-01

    Full Text Available Abstract Background Overactivity of anterior and/or posterior tibial tendon may be a causative factor of spastic varus foot deformity. The prevalence of their dysfunction has been reported with not well defined results. Although gait analysis and dynamic electromyography provide useful information for the assessment of the patients, they are not available in every hospital. The purpose of the current study is to identify the causative muscle producing the deformity and apply the most suitable technique for its correction. Methods We retrospectively evaluated 48 consecutive ambulant patients (52 feet with spastic paralysis due to cerebral palsy. The average age at the time of the operation was 12,4 yrs (9-18 and the mean follow-up 7,8 yrs (4-14. Eigtheen feet presented equinus hind foot deformity due to gastrocnemius and soleus shortening. According to the deformity, the feet were divided in two groups (Group I with forefoot and midfoot inversion and Group II with hindfoot varus. The deformities were flexible in all cases in both groups. Split anterior tibial tendon transfer (SPLATT was performed in Group I (11 feet, while split posterior tibial tendon transfer (SPOTT was performed in Group II (38 feet. In 3 feet both procedures were performed. Achilles tendon sliding lengthening (Hoke procedure was done in 18 feet either preoperatively or concomitantly with the index procedure. Results The results in Group I, were rated according to Hoffer's clinical criteria as excellent in 8 feet and satisfactory in 3, while in Group II according to Kling's clinical criteria were rated as excellent in 20 feet, good in 14 and poor in 4. The feet with poor results presented residual varus deformity due to intraoperative technical errors. Conclusion Overactivity of the anterior tibial tendon produces inversion most prominent in the forefoot and midfoot and similarly overactivity of the posterior tibial tendon produces hindfoot varus. The deformity can be

  17. Pregnancy in a quadriplegic patient treated with continuous intrathecal baclofen infusion to manage her severe spasticity. Case report.

    Science.gov (United States)

    Delhaas, E M; Verhagen, J

    1992-07-01

    A report on pregnancy in a quadriplegic patient treated with a high dose of 1000 mcg/24 h continuous intrathecal baclofen infusion using an implanted drug delivery system (Synchromed, Medtronic, USA). Spasticity could be managed up to the 35th week of gestation. However, uterine contractions evoke enormous spastic symptoms which we, even with maximum values of the spasticity scales, could not classify. The recurrence of spasticity was associated with autonomic dysregulation. With continuous epidurally infused bupivacaine (11.25 mg/h) adequate relaxation could be reached and gestation was terminated by a primary caesarean section. A healthy girl was born (2040 g, Apgar 9 and 10). PMID:1508570

  18. Possible etiologies for tropical spastic paraparesis and human T lymphotropic virus I-associated myelopathy

    Directory of Open Access Journals (Sweden)

    V. Zaninovic'

    2004-01-01

    Full Text Available The epidemiology of tropical spastic paraparesis/human T lymphotropic virus I (HTLV-I-associated myelopathy (TSP/HAM is frequently inconsistent and suggests environmental factors in the etiology of these syndromes. The neuropathology corresponds to a toxometabolic or autoimmune process and possibly not to a viral disease. Some logical hypotheses about the etiology and physiopathology of TSP and HAM are proposed. Glutamate-mediated excitotoxicity, central distal axonopathies, cassava, lathyrism and cycad toxicity may explain most cases of TSP. The damage caused to astrocytes and to the blood-brain barrier by HTLV-I plus xenobiotics may explain most cases of HAM. Analysis of the HTLV-I/xenobiotic ratio clarifies most of the paradoxical epidemiology of TSP and HAM. Modern neurotoxicology, neuroimmunology and molecular biology may explain the neuropathology of TSP and HAM. It is quite possible that there are other xenobiotics implicated in the etiology of some TSP/HAMs. The prevention of these syndromes appears to be possible today.

  19. Low dose tubulin-binding drugs rescue peroxisome trafficking deficit in patient-derived stem cells in Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Yongjun Fan

    2014-05-01

    Full Text Available Hereditary Spastic Paraplegia (HSP is a genetically heterogeneous group of disorders, diagnosed by progressive gait disturbances with muscle weakness and spasticity, for which there are no treatments targeted at the underlying pathophysiology. Mutations in spastin are a common cause of HSP. Spastin is a microtubule-severing protein whose mutation in mouse causes defective axonal transport. In human patient-derived olfactory neurosphere-derived (ONS cells, spastin mutations lead to lower levels of acetylated α-tubulin, a marker of stabilised microtubules, and to slower speed of peroxisome trafficking. Here we screened multiple concentrations of four tubulin-binding drugs for their ability to rescue levels of acetylated α-tubulin in patient-derived ONS cells. Drug doses that restored acetylated α-tubulin to levels in control-derived ONS cells were then selected for their ability to rescue peroxisome trafficking deficits. Automated microscopic screening identified very low doses of the four drugs (0.5 nM taxol, 0.5 nM vinblastine, 2 nM epothilone D, 10 µM noscapine that rescued acetylated α-tubulin in patient-derived ONS cells. These same doses rescued peroxisome trafficking deficits, restoring peroxisome speeds to untreated control cell levels. These results demonstrate a novel approach for drug screening based on high throughput automated microscopy for acetylated α-tubulin followed by functional validation of microtubule-based peroxisome transport. From a clinical perspective, all the drugs tested are used clinically, but at much higher doses. Importantly, epothilone D and noscapine can enter the central nervous system, making them potential candidates for future clinical trials.

  20. Compressive myelopathy in fluorosis: MRI

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, R.K. [MR Section, Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014 (India); Agarwal, P. [MR Section, Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014 (India); Kumar, S. [MR Section, Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014 (India); Surana, P.K. [Department of Neurology, SGPGIMS, Lucknow-226014 (India); Lal, J.H. [MR Section, Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014 (India); Misra, U.K. [Department of Neurology, SGPGIMS, Lucknow-226014 (India)

    1996-05-01

    We examined four patients with fluorosis, presenting with compressive myelopathy, by MRI, using spin-echo and fast low-angle shot sequences. Cord compression due to ossification of the posterior longitudinal ligament (PLL) and ligamentum flavum (LF) was demonstrated in one and ossification of only the LF in one. Marrow signal was observed in the PLL and LF in all the patients on all pulse sequences. In patients with compressive myelopathy secondary to ossification of PLL and/or LF, fluorosis should be considered as a possible cause, especially in endemic regions. (orig.). With 2 figs., 1 tab.

  1. Clinical and neuroimaging profile of congenital brain malformations in children with spastic cerebral palsy

    International Nuclear Information System (INIS)

    Purpose: Analysis of the incidence of congenital brain malformations in children with spastic cerebral palsy (CP) in a hospital based study. Material and Methods: The present study included 74 boys and 56 girls with spastic tetraplegia, diplegia, and hemiplegia CP. Magnetic resonance imaging MRI findings were analyzed in children with CP. Results: Significant abnormalities relevant to the CP were evident on MRI in 124 (95.3%) subjects. Periventicular leukomalacia (PVL) was detected more frequently in children with spastic diplegia than in patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 15 (10.7%) children with spastic CP. Brain malformations included: schizencephaly (5), agenesis corpus callosum (4), polymicrogyria (2), holoprosencephaly (2) and lissencephaly (2). Intractable epilepsy and mental retardation were observed more often in children with brain anomalies. Twelve patients with congenital brain malformations were born at term and three born at preterm. Conclusions: Neuroimaging results in children with CP may help determine the etiology and make better prognosis of CP. (authors)

  2. The effects of Robotic-Assisted Locomotor training on spasticity and volitional control.

    Science.gov (United States)

    Mirbagheri, M M; Ness, L L; Patel, C; Quiney, K; Rymer, W Z

    2011-01-01

    We studied the effects of Robotic-Assisted Locomotor (LOKOMAT) Training on spasticity and volitional control of the spastic ankle in persons with incomplete Spinal Cord Injury (SCI). LOKOMAT training was performed 3 days/week during a 1-hr period including set-up time with up to 30 minutes of training during a single session. The training was provided for 4 weeks and subjects were evaluated before and after 1, 2, and 4 weeks of training. Spasticity was charterized in terms of neuromuscular abnormalities associated with the spastic joint. A system identification technique was used to quantify the effects of LOKOMAT training on these neuromuscular abnormalities. The effect of LOKOMAT training on volitional control was determined by measuring isometric maximum voluntary contraction (MVC) of ankle extensor and flexor muscles. Our results indicated that the reflex stiffness, abnormally increases in SCI, was significantly reduced (up to 65%) following 4-weeks of LOKOMAT training. Similarly, intrinsic (muscular) stiffness, which also abnormally increases in SCI, decreased significantly (up to 60%). MVCs were increased substantially (up to 93% in extensors and 180% in flexors) following 4-week training. These findings demonstrate that LOKOMAT training is effective in reducing spasticity and improving volitional control in SCI.

  3. Clinical efficacy and effectiveness of Sativex, a combined cannabinoid medicine, in multiple sclerosis-related spasticity.

    Science.gov (United States)

    Oreja-Guevara, Celia

    2012-04-01

    Multiple sclerosis (MS) is associated with a wide range of disease symptoms and amongst these, spasticity is one of the most disabling and has the greatest impact on patient well-being and quality of life. Until now, available drug therapies for spasticity appear to have limited benefit and are often associated with poor tolerability. In a recent Spanish survey it was noted that multidrug therapy and a low control rate were common features for a large proportion of patients with MS-related spasticity, suggesting that currently available monotherapies lack significant activity. Sativex is a 1:1 mixture of δ-9-tetrahydrocannabinol and cannabidiol derived from Cannabis sativa chemovars, which is available as an oromucosal spray. Clinical experience with Sativex in patients with MS-related spasticity is steadily accumulating. Results from randomized, controlled trials have reported a reduction in the severity of symptoms associated with spasticity, leading to a better ability to perform daily activities and an improved perception of patients and their carers regarding functional status. These are highly encouraging findings that provide some much needed optimism for the treatment of this disabling and often painful symptom of MS. PMID:22509985

  4. The effect of penile vibratory stimulation on male fertility potential, spasticity and neurogenic detrusor overactivity in spinal cord lesioned individuals

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Læssøe, Line; Sønksen, J;

    2005-01-01

    Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS).......Present the possibility for treatment of male infertility, spasticity, and neurogenic detrusor overactivity in spinal cord lesioned (SCL) individuals with penile vibratory stimulation (PVS)....

  5. Passive Range of Motion in a Population-Based Sample of Children with Spastic Cerebral Palsy Who Walk

    Science.gov (United States)

    McDowell, Brona C.; Salazar-Torres, Jose J.; Kerr, Claire; Cosgrove, Aidan P.

    2012-01-01

    -While passive range of motion (PROM) is commonly used to inform decisions on therapeutic management, knowledge of PROM of children with spastic cerebral palsy (CP) is limited. A population-based sample of 178 children with spastic CP (110 male; unilateral, n = 94; bilateral, n = 84; age range 4-17 years) and 68 typically developing children (24…

  6. [The efficacy of botulinum toxin therapy in patients with upper limb spasticity due to traumatic brain injury].

    Science.gov (United States)

    Akulov, M A; Khat'kova, S E; Mokienko, O A; Orlova, O R; Usachev, D Yu; Zakharov, V O; Orlova, A S; Tomsky, A A

    2016-01-01

    Spasticity is a type of muscle hyperactivity that occurs in patients after focal lesions of the Central nervous system due to various diseases: stroke, traumatic brain injury or spinal cord injury, neurosurgical intervention, as well as multiple sclerosis and other diseases of the Central nervous system and is the most disability manifestation of the syndrome of upper motor neuron (UMNS). Focal spasticity of the upper limb requires a complex treatment. Botulinum toxin therapy is an effective treatment for focal/multifocal spasticity in reducing muscle tone and improving function with the highest level of evidence according to the latest American and European guidelines for treatment of spasticity. There are many publications devoted to BTA use in post-stroke patients. This article provides a review of the BTA use in patients with the upper limb spasticity due to severe traumatic brain injury. Some local data on the BTA efficacy in the cohort of patients with traumatic brain injury are also presented. PMID:27635608

  7. Muscle specific changes in length-force characteristics of the calf muscles in the spastic Han-Wistar rat

    DEFF Research Database (Denmark)

    Olesen, Annesofie Thorup; Jensen, Bente Rona; Uhlendorf, Toni L;

    2014-01-01

    , the extent of this interaction was not different in the spastic rats. In conclusion, the effects of spasticity on length-force characteristics were muscle specific. The changes seen for GA and PL muscles are consistent with the changes in limb mechanics reported for human patients. Our results indicate......The purpose of the present study was to investigate muscle mechanical properties and mechanical interaction between muscles in the lower hindlimb of the spastic mutant rat. Length-force characteristics of gastrocnemius (GA), soleus (SO) and plantaris (PL) were assessed in anesthetized spastic...... and normally-developed Han-Wistar rats. In addition, the extent of epimuscular myofascial force transmission between synergistic GA, SO and PL, as well as between the calf muscles and antagonistic tibialis anterior (TA) was investigated. Active length-force characteristics of spastic GA and PL were narrower...

  8. Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

    Directory of Open Access Journals (Sweden)

    Singh Gurpreet

    2003-03-01

    Full Text Available Abstract Background Increased spasms in spinal cord injury (SCI patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from intrathecal space. Case Presentation A 44-year-old male sustained a fracture of C5/6 and incomplete tetraplegia at C-8 level. Medtronic Synchromed pump for intrathecal baclofen therapy was implanted 13 months later to control severe spasticity. The tip of catheter was placed at T-10 level. The initial dose of baclofen was 300 micrograms/day of baclofen, administered by a simple continuous infusion. During a nine-month period, he required increasing doses of baclofen (875 micrograms/day to control spasticity. X-ray of abdomen showed multiple radio opaque shadows in the region of urinary bladder. No malfunction of the pump was detected. Therefore, increased spasticity was attributed to bladder stones. Electrohydraulic lithotripsy of bladder stones was carried out successfully. Even after removal of bladder stones, this patient required further increases in the dose of intrathecal baclofen (950, 1050, 1200 and then 1300 micrograms/day. Careful evaluation of pump-catheter system revealed that the catheter had extruded spontaneously and was lying in the paraspinal space at L-4, where the catheter had been anchored before it entered the subarachnoid space. A new catheter was passed into the subarachnoid space and the tip of catheter was located at T-8 level. The dose of intrathecal baclofen was decreased to 300 micrograms/day. Conclusion Vesical calculi acted as red herring for resurgence of spasticity. The real cause for increased spasms was spontaneous extrusion

  9. Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

    Science.gov (United States)

    Vaidyanathan, Subramanian; Soni, Bakul M; Oo, Tun; Hughes, Peter L; Singh, Gurpreet; Watt, John WH; Sett, Pradipkumar

    2003-01-01

    Background Increased spasms in spinal cord injury (SCI) patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency) drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from intrathecal space. Case Presentation A 44-year-old male sustained a fracture of C5/6 and incomplete tetraplegia at C-8 level. Medtronic Synchromed pump for intrathecal baclofen therapy was implanted 13 months later to control severe spasticity. The tip of catheter was placed at T-10 level. The initial dose of baclofen was 300 micrograms/day of baclofen, administered by a simple continuous infusion. During a nine-month period, he required increasing doses of baclofen (875 micrograms/day) to control spasticity. X-ray of abdomen showed multiple radio opaque shadows in the region of urinary bladder. No malfunction of the pump was detected. Therefore, increased spasticity was attributed to bladder stones. Electrohydraulic lithotripsy of bladder stones was carried out successfully. Even after removal of bladder stones, this patient required further increases in the dose of intrathecal baclofen (950, 1050, 1200 and then 1300 micrograms/day). Careful evaluation of pump-catheter system revealed that the catheter had extruded spontaneously and was lying in the paraspinal space at L-4, where the catheter had been anchored before it entered the subarachnoid space. A new catheter was passed into the subarachnoid space and the tip of catheter was located at T-8 level. The dose of intrathecal baclofen was decreased to 300 micrograms/day. Conclusion Vesical calculi acted as red herring for resurgence of spasticity. The real cause for increased spasms was spontaneous extrusion of whole length of

  10. Sativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosis.

    Science.gov (United States)

    Leocani, Letizia; Nuara, Arturo; Houdayer, Elise; Schiavetti, Irene; Del Carro, Ubaldo; Amadio, Stefano; Straffi, Laura; Rossi, Paolo; Martinelli, Vittorio; Vila, Carlos; Sormani, Maria Pia; Comi, Giancarlo

    2015-11-01

    Despite the proven efficacy of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol) oromucosal spray in reducing spasticity symptoms in multiple sclerosis (MS), little is known about the neurophysiological correlates of such effects. The aim of the study was to investigate the effects of Sativex on neurophysiological measures of spasticity (H/M ratio) and corticospinal excitability in patients with progressive MS. This was a randomized, double-blind, placebo-controlled, crossover study. Consecutive subjects with progressive MS and lower limb spasticity referred to our center were randomized to 4 weeks' treatment (including 2 weeks' titration) with Sativex or placebo, with crossover after a 2-week washout. Clinical and neurophysiological measures (H/M ratio and cortical excitability) of spasticity were assessed. The H/M ratio was the primary outcome, with sample size calculation of 40 patients. Of 44 recruited patients, 34 were analyzed due to 6 drop-outs and 4 exclusions, which lowered the power of the study to show differences between treatments. Neurophysiological measures did not differ significantly according to treatment and did not correlate significantly with clinical response. Response on the modified Ashworth scale (at least 20 % improvement) was significantly more frequent after Sativex than placebo (50 vs 23.5 %; p = 0.041; McNemar). Side effects did not differ significantly according to treatment. Our findings confirm the clinical benefit of Sativex on MS spasticity. The lack of corresponding changes in corticospinal excitability and on the monosynaptic component, of the stretch reflex, although in a limited sample size, points to the involvement of other spinal and supraspinal mechanisms in the physiopathology of spasticity in progressive MS. PMID:26289497

  11. Reduced regional cerebral blood flow in SPG4-linked hereditary spastic paraplegia

    DEFF Research Database (Denmark)

    Scheuer, Kristin H; Nielsen, Jørgen E; Krabbe, Katja;

    2005-01-01

    Hereditary spastic paraplegia (HSP) linked to the spastic gait gene 4 (SPG4) is controversial, as the "pure" form traditionally has been considered confined to the long axons of the spinal cord. However, recent immunolabeling experiments have demonstrated extensive Spastin expression in the cortex...... were observed in a separate analysis of the most disabled individuals. The neuropsychological assessment revealed only significantly impaired recognition memory for faces. In summary, the findings support cerebral pathology in SPG4-linked HSP, although the decreased rCBF in fronto-temporal cortex...

  12. Asphyxia-related risk factors and their timing in spastic cerebral palsy

    DEFF Research Database (Denmark)

    Nielsen, Lene F.; Schendel, Diana; Grove, Jakob;

    2008-01-01

    Objective To investigate the association of asphyxia-related conditions (reducing blood flow or blood oxygen levels in the fetus) with spastic cerebral palsy (CP) considering different gestational age groups and the timing of risk. Design Population-based case-control study. Setting Danish Cerebral...... Palsy Register in eastern Denmark and Danish Medical Birth Register. Population or Sample 271 singletons with spastic CP and 217 singleton controls, frequency matched by gestational age group, born 1982-1990 in eastern Denmark. Methods Data were abstracted from medical records, and a priori asphyxia...

  13. A nullimorphic ERLIN2 mutation defines a complicated hereditary spastic paraplegia locus (SPG18).

    Science.gov (United States)

    Alazami, Anas M; Adly, Nouran; Al Dhalaan, Hisham; Alkuraya, Fowzan S

    2011-11-01

    Hereditary Spastic Paraplegia (HSP) is a clinically and genetically heterogeneous group of neurological disorders that are characterized by progressive spasticity of the lower extremities. We describe an extended consanguineous Saudi family in which HSP is linked to SPG18, a previously reported autosomal recessive locus, and show that it is associated with a nullimorphic deletion of ERLIN2, a component of endoplasmic reticulum associated degradation. This finding adds to the growing diversity of cellular functions that are now known to be involved in the maintenance of the corticospinal tract neurons.

  14. REEPing the benefits of an animal model of hereditary spastic paraplegia

    OpenAIRE

    Deutch, Ariel Y.; Hedera, Peter; Roger J Colbran

    2013-01-01

    The hereditary spastic paraplegias (HSPs) are characterized by spasticity of the leg muscles due to axonal degeneration of corticospinal neurons. Beetz et al. report that the core motor phenotype and axonal pathology of HSPs are recapitulated in mice lacking the HSP-associated gene Reep1. REEP1 is shown to regulate ER structure in motor cortex neurons. The Reep1 knockout mouse should be a very useful model in which to study the mechanisms of progressive axon loss in HSPs and other disorders.

  15. Development of spasticity with age in a total population of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Wagner Philippe

    2008-11-01

    Full Text Available Abstract Background The development of spasticity with age in children with cerebral palsy (CP has, to our knowledge, not been studied before. In 1994, a register and a health care program for children with CP in southern Sweden were initiated. In the programme the child's muscle tone according to the modified Ashworth scale is measured twice a year until six years of age, then once a year. We have used this data to analyse the development of spasticity with age in a total population of children with cerebral palsy. Methods All measurements of muscle tone in the gastrocnemius-soleus muscle in all children with CP from 0 to 15 years during the period 1995–2006 were analysed. The CP subtypes were classified according to the Surveillance of Cerebral Palsy in Europe network system. Using these criteria, the study was based on 6218 examinations in 547 children. For the statistical analysis the Ashworth scale was dichotomized. The levels 0–1 were gathered in one category and levels 2–4 in the other. The pattern of development with age was evaluated using piecewise logistic regression in combination with Akaike's An Information Criterion. Results In the total sample the degree of muscle tone increased up to 4 years of age. After 4 years of age the muscle tone decreased each year up to 12 years of age. A similar development was seen when excluding the children operated with selective dorsal rhizotomy, intrathecal baclofen pump or tendo Achilles lengthening. At 4 years of age about 47% of the children had spasticity in their gastro-soleus muscle graded as Ashworth 2–4. After 12 years of age 23% of the children had that level of spasticity. The CP subtypes spastic bilateral and spastic unilateral CP showed the same pattern as the total sample. Children with dyskinetic type of CP showed an increasing muscle tone up to age 6, followed by a decreasing pattern up to age 15. Conclusion In children with CP, the muscle tone as measured with the Ashworth

  16. Mutations in DARS Cause Hypomyelination with Brain Stem and Spinal Cord Involvement and Leg Spasticity

    OpenAIRE

    Taft, Ryan J.; Vanderver, Adeline; Leventer, Richard J.; Damiani, Stephen A.; Simons, Cas; Grimmond, Sean M.; Miller, David; Schmidt, Johanna; Lockhart, Paul J.; Pope, Kate; Ru, Kelin; Crawford, Joanna; Rosser, Tena; de Coo, Irenaeus F.M.; Juneja, Monica

    2013-01-01

    Inherited white-matter disorders are a broad class of diseases for which treatment and classification are both challenging. Indeed, nearly half of the children presenting with a leukoencephalopathy remain without a specific diagnosis. Here, we report on the application of high-throughput genome and exome sequencing to a cohort of ten individuals with a leukoencephalopathy of unknown etiology and clinically characterized by hypomyelination with brain stem and spinal cord involvement and leg sp...

  17. Percutaneous radiofrequency lesions adjacent to the dorsal root ganglion alleviate spasticity and pain in children with cerebral palsy: pilot study in 17 patients

    Directory of Open Access Journals (Sweden)

    van Rhijn Lodewijk W

    2010-06-01

    Full Text Available Abstract Background Cerebral palsy (CP may cause severe spasticity, requiring neurosurgical procedures. The most common neurosurgical procedures are continuous infusion of intrathecal baclofen and selective dorsal rhizotomy. Both are invasive and complex procedures. We hypothesized that a percutaneous radiofrequency lesion of the dorsal root ganglion (RF-DRG could be a simple and safe alternative treatment. We undertook a pilot study to test this hypothesis. Methods We performed an RF-DRG procedure in 17 consecutive CP patients with severe hip flexor/adductor spasms accompanied by pain or care-giving difficulties. Six children were systematically evaluated at baseline, and 1 month and 6 months after treatment by means of the Modified Ashworth Scale (MAS, Gross Motor Function Measure (GMFM and a self-made caregiver's questionnaire. Eleven subsequent children were evaluated using a Visual Analogue Scale (VAS for spasticity, pain and ease of care. Results A total of 19 RF-DRG treatments were performed in 17 patients. We found a small improvement in muscle tone measured by MAS, but no effect on the GMFM scale. Despite this, the caregivers of these six treated children unanimously stated that the quality of life of their children had indeed improved after the RF-DRG. In the subsequent 11 children we found improvements in all VAS scores, in a range comparable to the conventional treatment options. Conclusion RF-DRG is a promising new treatment option for severe spasticity in CP patients, and its definitive effectiveness remains to be defined in a randomised controlled trial.

  18. Fractal image compression

    OpenAIRE

    Žemlo, Gražina

    2004-01-01

    One of the images compression methods – fractal image compression is analyzed in the work. After work carried out, it is possible to state, that selecting parameters of method of fractal compression depends on user’s demands.

  19. Adaptive GIS Image Compression and Restoration Using Neural Networks

    OpenAIRE

    Al-Bastaki, Yousif

    2003-01-01

    This study aims to describe research into the field of GIS image compression, decompression and restoration. Geographical Information System (GIS) data comprises huge size into memory. For this purpose, it needs compression, which has high compression rate. But high compression rate cause of some distortion and losses. Restoration is a process by which an image suffering some form of distortion or degradation can be recovered to its original form. The proposed windows-based image compression ...

  20. Compression limits in cascaded quadratic soliton compression

    DEFF Research Database (Denmark)

    Bache, Morten; Bang, Ole; Krolikowski, Wieslaw;

    2008-01-01

    Cascaded quadratic soliton compressors generate under optimal conditions few-cycle pulses. Using theory and numerical simulations in a nonlinear crystal suitable for high-energy pulse compression, we address the limits to the compression quality and efficiency.......Cascaded quadratic soliton compressors generate under optimal conditions few-cycle pulses. Using theory and numerical simulations in a nonlinear crystal suitable for high-energy pulse compression, we address the limits to the compression quality and efficiency....

  1. Satellite data compression

    CERN Document Server

    Huang, Bormin

    2011-01-01

    Satellite Data Compression covers recent progress in compression techniques for multispectral, hyperspectral and ultra spectral data. A survey of recent advances in the fields of satellite communications, remote sensing and geographical information systems is included. Satellite Data Compression, contributed by leaders in this field, is the first book available on satellite data compression. It covers onboard compression methodology and hardware developments in several space agencies. Case studies are presented on recent advances in satellite data compression techniques via various prediction-

  2. Cortical somatosensory reorganization in children with spastic cerebral palsy: a multimodal neuroimaging study

    Directory of Open Access Journals (Sweden)

    CHRISTOS ePAPADELIS

    2014-09-01

    Full Text Available Although cerebral palsy (CP is among the most common causes of physical disability in early childhood, we know little about the functional and structural changes of this disorder in the developing brain. Here, we investigated with three different neuroimaging modalities (magnetoencephalography (MEG, diffusion tension imaging (DTI, and resting state fMRI whether spastic CP is associated with functional and anatomical abnormalities in the sensorimotor network. Ten children participated in the study: four with diplegic CP (DCP, three with hemiplegic CP (HCP, and three typically-developing (TD children. Somatosensory evoked fields (SEFs were recorded in response to pneumatic stimuli applied to digits D1, D3, and D5 of both hands. Several parameters of water diffusion were calculated from DTI between the thalamus and the precentral and postcentral gyri in both hemispheres. The sensorimotor resting state networks (RSNs were examined by using an independent component analysis method. Tactile stimulation of the fingers elicited the first prominent cortical response at ~50 ms, in all except one child, localized over the primary somatosensory cortex (S1. In five CP children, abnormal somatotopic organization was observed in the affected (or more affected hemisphere. Euclidean distances were markedly different between the two hemispheres in the HCP children, and between DCP and TD children for both hemispheres. DTI analysis revealed decreased fractional anisotropy and increased apparent diffusion coefficient for the thalamocortical pathways in the more affected compared to less affected hemisphere in CP children. Rs-fMRI results indicated absent and/or abnormal sensorimotor RSNs for children with HCP and DCP consistent with the severity and location of their lesions. Our findings suggest an abnormal somatosensory processing mechanism in the sensorimotor network of children with CP possibly as a result of diminished thalamocortical projections.

  3. Electrophysiological and clinical evaluation of the effects of transcutaneous electrical nerve stimulation on the spasticity in the hemiplegic stroke patients.

    Science.gov (United States)

    Karakoyun, Ahmet; Boyraz, İsmail; Gunduz, Ramazan; Karamercan, Ayşe; Ozgirgin, Nese

    2015-11-01

    To investigate whether transcutaneous electrical nerve stimulation (TENS) mitigates the spasticity of hemiplegic stroke patients, as assessed by electrophysiological variables, and the effects, if any, on the clinical appearance of spasticity. [Subjects and Methods] Twenty-seven subjects who had acute hemiplegia and 24 healthy people as the control group, were enrolled in this study. Some of the acute cerebrovascular disease patients could walk. Subjects who did not have spasticity, who were taking antispasticity medicine, or had a previous episode of cerebrovascular disease were excluded. The walking speed of the patients was recorded before and after TENS. EMG examinations were performed on the healthy controls and in the affected side of the patients. A 30-minute single session of TENS was applied to lower extremity. At 10 minutes after TENS, the EMG examinations were repeated. [Results] A statistically significant decrease in the spasticity variables, and increased walking speed were found post-TENS. The lower M amplitude and higher H reflex amplitude, H/M maximum amplitude ratio, H slope, and H slope/M slope ratio on the spastic side were found to be statistically significant. [Conclusion] TENS application for hemiplegic patients with spastic lower extremities due to cerebrovascular disease resulted in marked improvement in clinical scales of spasticity and significant changes in the electrophysiological variables.

  4. The relationship between spasticity in young children (18 months of age with cerebral palsy and their gross motor function development

    Directory of Open Access Journals (Sweden)

    Verschuren Olaf

    2009-09-01

    Full Text Available Abstract Background It is thought that spasticity has an influence on the development of functional motor abilities among children with cerebral palsy (CP. The extent to which spasticity is associated with the change in motor abilities in young children with CP has not been established. The objective of this study is to evaluate the relationship of initial spasticity in young children with CP and their gross motor function development over one year. Methods Fifty children with CP aged 18 months, GMFCS-levels I-V participated in a longitudinal observational study. Change in gross motor functioning (GMFM-66 was measured over one year. The level of spasticity measured at the first assessment was determined with the Modified Tardieu Scale in three muscle groups of the lower extremity (adductor muscles, the hamstrings and the m. gastrocnemius. The Spasticity Total Score per child was calculated with a maximum score of 12 points. Results Spearman's Rho Correlation (-0.28 revealed a statistically significant relationship (p Conclusion Our findings indicate that when measured over one year, spasticity is marginally related to gross motor function development in infants with CP. The initial level of spasticity is only one of the many child, environmental and family factors that determines gross motor development of a young child with CP.

  5. Post-activation depression of soleus stretch reflexes in healthy and spastic humans

    DEFF Research Database (Denmark)

    Grey, Michael James; Klinge, Klaus; Crone, Clarissa;

    2007-01-01

    -reflexes were evoked by electrical stimulation of the tibial nerve in the popliteal fossa. The stretch reflex and H-reflex responses of 30 spastic participants (with multiple sclerosis or spinal cord injury) were compared with those of 15 healthy participants. In the healthy participants, the magnitude...

  6. Clinical Observation on Acupuncture Treatment for Post-stroke Spastic Hemiplegia

    Institute of Scientific and Technical Information of China (English)

    Zhang Yan; Liu Guo-cheng; Wang Jin-yu; Sun Yun-guang; Yang Liu-jiang

    2013-01-01

    Objective:To observe the clinical effect of contralateral needling plus rehabilitation for post-stroke spastic hemiplegia.Methods:Thirty-six patients with post-stroke spastic hemiplegia were randomly divided into a treatment group and a control group,18 cases in each group.The two groups were all given rehabilitation training.The contralateral needling was adopted in the treatment group on the acupoints group of brain-refreshing and orifice-opening needling method.The routine acupuncture was applied in the control group on the same acupoints.Respectively before and after the treatment,the modified Ashworth scale (MAS) and clinical spasticity index (CSI) were used to assess the therapeutic effects.Results:The total effective rate was 94.4% in the treatment group and 67.7% in the control group,with a statistical difference in comparison of the two groups (P<0.05).In comparison of MAS and CSl scores after the treatment between the treatment group and control group,the differences were statistically significant (P<0.05).Conclusion:The contralateral needling plus rehabilitation training is an effective method for the treatment of post-stroke spastic hemiplegia.

  7. Evaluation of clinical spasticity assessment in cerebral palsy using inertial sensors

    NARCIS (Netherlands)

    Noort, van den J.C.; Scholtes, V.A.B.; Harlaar, J.

    2009-01-01

    Spasticity is clinically assessed using goniometry to measure the joint angle of the catch (AOC) during fast passive muscle stretch. The precision and accuracy of the goniometric AOC measurements are questionable, because of the inevitable joint repositioning after occurrence of the catch. This stud

  8. Possibilities of applying the method of radiofrequency (RFthermal destruction to correct spasticity in childrenwith cerebral palsy

    Directory of Open Access Journals (Sweden)

    Alexey Vasilievich Zvozil

    2015-03-01

    Full Text Available For the treatment of focal spasticity in the TurnerInstitute we developed and applied the approach toreduce spasticity in children with cerebral palsy byapplying the method of radiofrequency thermal de-struction of peripheral nerves and muscle motorpoints. This method is based on the effect of heatrelease during the passage through biological tissueof radiofrequency currents. The procedure was totally performed in 112 patients aged 1,2 to 14 yearsold with a level of spasticity over 3 points on a scaleAshworth. In order to reduce hypertonia of femuradductors, the target for RF ablation was obturatornerve; we targeted on the motor point of the gastrocnemius muscle in equinus, to reduce forearm flexorhypertonia we targeted on the musculo-cutaneousnerve, flexor muscles of the hand we intervened on their motor points. A positive result was maintained at follow-up of 6 months to one year in all patients, maximum - 2 years. The obtained results are preliminary and subject to further statistical processing, but they are quite comparable with the results of the use of type A botulinum toxin preparations. The proposed method of treatment is minimally invasive, virtually devoid of the risk of postoperative complications, can cut one stage spasticity in the muscles of various motor segments in children with cerebral palsy of great age range, including children up to 2 years old.

  9. Rapidly deteriorating course in Dutch hereditary spastic paraplegia type 11 patients

    NARCIS (Netherlands)

    de Bot, Susanne T.; Burggraaff, Rogier C.; Herkert, Johanna C.; Schelhaas, Helenius J.; Post, Bart; Diekstra, Adinda; van Vliet, Reinout O.; van der Knaap, Marjo S.; Kamsteeg, Erik-Jan; Scheffer, Hans; van de Warrenburg, Bart P.; Verschuuren-Bemelmans, Corien C.; Kremer, Hubertus P. H.

    2013-01-01

    Although SPG11 is the most common complicated hereditary spastic paraplegia, our knowledge of the long-term prognosis and life expectancy is limited. We therefore studied the disease course of all patients with a proven SPG11 mutation as tested in our laboratory, the single Dutch laboratory providin

  10. Effects of an aquatic program on gross motor function of children with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    NIKOLAOS CHRYSAGIS; ANGELIKI DOUKA; MICHAIL NIKOPOULOS; FOTEINI APOSTOLOPOULOU; DIMITRA KOUTSOUKI

    2009-01-01

    Full Text Available The purpose of the present study was to examine the effects of a 10-week aquatic program on the gross motor function, on the range of motion and on spasticity of childrenwith cerebral palsy (CP. Six students served as subjects for the experimental group and another 6 were assigned to the control group. The aquatic program was taking place twice a week and consisted of a warm up, the main training session and a cool down phase. Measuring instruments were the Gross Motor Function Measure (GMFM (dimensions D and E, a goniometer and the modified Ashworth Scale. Pre-test and Post-test were executed before and after the intervention program. Significant interaction effect was found with respect to: the active shoulder flexion (p=.052, the active shoulder abduction (p=.052, the passive hip abduction (p=.001 and the passive knee extension (p=.045. Interaction effect was found for spasticity of the hip adductors (p=.002 and knee flexors (p=.049. Results of the present study indicated that an aquatic program might have a positive effect in gross motor function as well as in range of motion and spasticity in students with spastic cerebral palsy.

  11. Cost analysis of the treatment of severe spinal spasticity with a continuous intrathecal baclofen infusion system

    NARCIS (Netherlands)

    Postma, TJBM; Oenema, D; Terpstra, S; Bouma, J; Kuipers-Upmeijer, H; Staal, MJ; Middel, BJ

    1999-01-01

    Objective: The purpose of our study was to analyse and evaluate the costs of continuous intrathecal baclofen administration as a modality in the treatment of severe spasticity in the Netherlands. Design: A cost analysis was conducted as part of a prospective, multicentre, multidisciplinary, randomis

  12. Exome sequencing is a useful diagnostic tool for complicated forms of hereditary spastic paraplegia

    NARCIS (Netherlands)

    Bettencourt, C.; Lopez-Sendon, J. L.; Garcia-Caldentey, J.; Rizzu, P.; Bakker, I. M. C.; Shomroni, O.; Quintans, B.; Davila, J. R.; Bevova, M. R.; Sobrido, M-J; Heutink, P.; de Yebenes, J. G.

    2014-01-01

    Hereditary spastic paraplegias constitute a heterogeneous group of neurodegenerative diseases encompassing pure and complicated forms, for which at least 52 loci and 31 causative genes have been identified. Although mutations in the SPAST gene explain approximately 40% of the pure autosomal dominant

  13. Reproducibility and validity of video screen measurements of gait in children with spastic cerebral palsy

    NARCIS (Netherlands)

    S. Grunt; P.J. van Kampen; M.M. van der Krogt; M.A. Brehm; C.A.M. Doorenbosch; J.G. Becher

    2010-01-01

    PURPOSE: To determine the reproducibility and validity of video screen measurement (VSM) of sagittal plane joint angles during gait. METHODS: 17 children with spastic cerebral palsy walked on a 10m walkway. Videos were recorded and 3d-instrumented gait analysis was performed. Two investigators measu

  14. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    Science.gov (United States)

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that…

  15. Tendon structure and extracellular matrix components are affected by spasticity in cerebral palsy patients

    OpenAIRE

    Gagliano, Nicoletta; Menon, Alessandra; Martinelli, Carla; Pettinari, Letizia; Panou, Artemisia; Milzani, Aldo; Dalle-Donne, Isabella; Portinaro, Nicola Marcello

    2013-01-01

    We studied the effect of spasticity-induced overload on tendons from the gracilis and semitendinosus muscles from cerebral palsy (CP) and healthy subjects (CT) stained with haematoxylineosin, Sirius red and Alcian blue. Vascularity was also characterized using an anti-CD34 antibody.

  16. Cost-effectiveness of Sativex in multiple sclerosis spasticity: new data and application to Italy.

    Science.gov (United States)

    Slof, John; Ruiz, Leonardo; Vila, Carlos

    2015-06-01

    Multiple sclerosis (MS) is a chronic progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and contributes to MS-related disability. This study aims to evaluate the cost-effectiveness of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol oromucosal spray) when used as add-on therapy for management of resistant MS-related spasticity in the context of the Italian healthcare system. A previously published Markov model-based analysis for the German and Spanish context was replicated, adapting it to the Italian setting. Model parameters were updated to reflect recent findings about MS-related spasticity and use of Sativex in daily clinical practice. The base case incremental cost-effectiveness ratio for Sativex use in Italy over a 5-year period was estimated to be €4968 per quality-adjusted life-year gained (year of costing: 2013). Sativex remained an efficient option in the Italian healthcare context - below the commonly accepted incremental threshold of €30,000 per quality-adjusted life-year gained - when deterministic and probabilistic sensitivity analyses were conducted. Sativex can be regarded as a cost-effective treatment option for patients with MS-related spasticity in Italy. PMID:25771713

  17. Prospective Randomized Study of Oral Diazepam and Baclofen on Spasticity in Cerebral Palsy

    Science.gov (United States)

    Laisram, Nonica; Wadhwa, Ranjan Kumar; Kothari, Shashank Yashwant

    2016-01-01

    Introduction Spastic cerebral palsy (CP) is the most common form of CP. Diazepam and Baclofen are the most commonly used oral drugs to manage spasticity. Study was designed to evaluate and compare their effects and safety in CP children. Aim Study was aimed to assess and compare outcome of oral Diazepam and Baclofen in spastic cerebral palsy children in terms of extent of reduction of spasticity and side effects profile. Materials and Methods Randomized prospective follow-up study was done for one year after giving Diazepam and Baclofen in weekly incremental doses upto recommended maximum dose to 60 children for three months. Two primary outcome measures were spasticity reduction and adverse effect profile. Spasticity reduction was measured by Modified Ashworth’s Scale (MAS) and Range of Motion improvement (ROM). Results After random allocation, there was no baseline difference between groups. Mean MAS score improved from 1.96±0.4 at baseline to 1.63±0.40 and 1.41± 0.36 at 1 month and 3 months for Diazepam and from 1.84±0.64 to 1.57±0.59 and 1.31± 0.48 respectively for Baclofen. Within the group reduction was significant with p-value = 0.0001. Intergroup comparison showed no statistically significant difference with p-value of 0.48 and 0.22 at 1 and 3 months. Baseline ROM showed significant improvement at 1 and 3 months with p value of 0.004 and 0.001 for Diazepam and 0.01 and 0.000 for Baclofen respectively with no statistically significant difference among two groups. Drowsiness was most common observed side effect in both the groups. Conclusion Patients showed significant improvement in spasticity as measured by Mean MAS score and range of motion in Diazepam as well as Baclofen group. Both drugs were found safe for use in children. Study couldn’t establish any difference between the two drugs. However studies with bigger sample size and longer follow- up assessing functional improvement in patients will be required in near future. PMID:27504360

  18. Combinational spinal GAD65 gene delivery and systemic GABA-mimetic treatment for modulation of spasticity.

    Directory of Open Access Journals (Sweden)

    Osamu Kakinohana

    Full Text Available BACKGROUND: Loss of GABA-mediated pre-synaptic inhibition after spinal injury plays a key role in the progressive increase in spinal reflexes and the appearance of spasticity. Clinical studies show that the use of baclofen (GABA(B receptor agonist, while effective in modulating spasticity is associated with major side effects such as general sedation and progressive tolerance development. The goal of the present study was to assess if a combined therapy composed of spinal segment-specific upregulation of GAD65 (glutamate decarboxylase gene once combined with systemic treatment with tiagabine (GABA uptake inhibitor will lead to an antispasticity effect and whether such an effect will only be present in GAD65 gene over-expressing spinal segments. METHODS/PRINCIPAL FINDINGS: Adult Sprague-Dawley (SD rats were exposed to transient spinal ischemia (10 min to induce muscle spasticity. Animals then received lumbar injection of HIV1-CMV-GAD65 lentivirus (LVs targeting ventral α-motoneuronal pools. At 2-3 weeks after lentivirus delivery animals were treated systemically with tiagabine (4, 10, 20 or 40 mg/kg or vehicle and the degree of spasticity response measured. In a separate experiment the expression of GAD65 gene after spinal parenchymal delivery of GAD65-lentivirus in naive minipigs was studied. Spastic SD rats receiving spinal injections of the GAD65 gene and treated with systemic tiagabine showed potent and tiagabine-dose-dependent alleviation of spasticity. Neither treatment alone (i.e., GAD65-LVs injection only or tiagabine treatment only had any significant antispasticity effect nor had any detectable side effect. Measured antispasticity effect correlated with increase in spinal parenchymal GABA synthesis and was restricted to spinal segments overexpressing GAD65 gene. CONCLUSIONS/SIGNIFICANCE: These data show that treatment with orally bioavailable GABA-mimetic drugs if combined with spinal-segment-specific GAD65 gene overexpression can

  19. Neural tension technique is no different from random passive movements in reducing spasticity in patients with traumatic brain injury

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Nielsen, Dorthe; Holm, Karl;

    2012-01-01

    by three raters before and after a single treatment session. Results: Objective stiffness measured with the hand-held device showed no significant changes for the NTT or RPM (p = 0.09-0.79). The subjective measures showed significant changes after the NTT for the non-blinded rater (MAS: p ...Purpose: Neural tension technique (NTT) is a therapy believed to reduce spasticity and to increase range of motion (ROM). This study compared the ability of NTT and random passive movements (RPMs) to reduce spasticity in the knee flexors in 10 spastic patients with brain injury. Methods: An RCT...

  20. Intramuscular Connective Tissue Differences in Spastic and Control Muscle: A Mechanical and Histological Study

    Science.gov (United States)

    de Bruin, Marije; Smeulders, Mark J.; Kreulen, Michiel; Huijing, Peter A.; Jaspers, Richard T

    2014-01-01

    Cerebral palsy (CP) of the spastic type is a neurological disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks. Secondary to the spasticity, muscle adaptation is presumed to contribute to limitations in the passive range of joint motion. However, the mechanisms underlying these limitations are unknown. Using biopsies, we compared mechanical as well as histological properties of flexor carpi ulnaris muscle (FCU) from CP patients (n = 29) and healthy controls (n = 10). The sarcomere slack length (mean 2.5 µm, SEM 0.05) and slope of the normalized sarcomere length-tension characteristics of spastic fascicle segments and single myofibre segments were not different from those of control muscle. Fibre type distribution also showed no significant differences. Fibre size was significantly smaller (1933 µm2, SEM 190) in spastic muscle than in controls (2572 µm2, SEM 322). However, our statistical analyses indicate that the latter difference is likely to be explained by age, rather than by the affliction. Quantities of endomysial and perimysial networks within biopsies of control and spastic muscle were unchanged with one exception: a significant thickening of the tertiary perimysium (3-fold), i.e. the connective tissue reinforcement of neurovascular tissues penetrating the muscle. Note that this thickening in tertiary perimysium was shown in the majority of CP patients, however a small number of patients (n = 4 out of 23) did not have this feature. These results are taken as indications that enhanced myofascial loads on FCU is one among several factors contributing in a major way to the aetiology of limitation of movement at the wrist in CP and the characteristic wrist position of such patients. PMID:24977410

  1. Intramuscular connective tissue differences in spastic and control muscle: a mechanical and histological study.

    Directory of Open Access Journals (Sweden)

    Marije de Bruin

    Full Text Available Cerebral palsy (CP of the spastic type is a neurological disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks. Secondary to the spasticity, muscle adaptation is presumed to contribute to limitations in the passive range of joint motion. However, the mechanisms underlying these limitations are unknown. Using biopsies, we compared mechanical as well as histological properties of flexor carpi ulnaris muscle (FCU from CP patients (n = 29 and healthy controls (n = 10. The sarcomere slack length (mean 2.5 µm, SEM 0.05 and slope of the normalized sarcomere length-tension characteristics of spastic fascicle segments and single myofibre segments were not different from those of control muscle. Fibre type distribution also showed no significant differences. Fibre size was significantly smaller (1933 µm2, SEM 190 in spastic muscle than in controls (2572 µm2, SEM 322. However, our statistical analyses indicate that the latter difference is likely to be explained by age, rather than by the affliction. Quantities of endomysial and perimysial networks within biopsies of control and spastic muscle were unchanged with one exception: a significant thickening of the tertiary perimysium (3-fold, i.e. the connective tissue reinforcement of neurovascular tissues penetrating the muscle. Note that this thickening in tertiary perimysium was shown in the majority of CP patients, however a small number of patients (n = 4 out of 23 did not have this feature. These results are taken as indications that enhanced myofascial loads on FCU is one among several factors contributing in a major way to the aetiology of limitation of movement at the wrist in CP and the characteristic wrist position of such patients.

  2. Intramuscular connective tissue differences in spastic and control muscle: a mechanical and histological study.

    Science.gov (United States)

    de Bruin, Marije; Smeulders, Mark J; Kreulen, Michiel; Huijing, Peter A; Jaspers, Richard T

    2014-01-01

    Cerebral palsy (CP) of the spastic type is a neurological disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks. Secondary to the spasticity, muscle adaptation is presumed to contribute to limitations in the passive range of joint motion. However, the mechanisms underlying these limitations are unknown. Using biopsies, we compared mechanical as well as histological properties of flexor carpi ulnaris muscle (FCU) from CP patients (n = 29) and healthy controls (n = 10). The sarcomere slack length (mean 2.5 µm, SEM 0.05) and slope of the normalized sarcomere length-tension characteristics of spastic fascicle segments and single myofibre segments were not different from those of control muscle. Fibre type distribution also showed no significant differences. Fibre size was significantly smaller (1933 µm2, SEM 190) in spastic muscle than in controls (2572 µm2, SEM 322). However, our statistical analyses indicate that the latter difference is likely to be explained by age, rather than by the affliction. Quantities of endomysial and perimysial networks within biopsies of control and spastic muscle were unchanged with one exception: a significant thickening of the tertiary perimysium (3-fold), i.e. the connective tissue reinforcement of neurovascular tissues penetrating the muscle. Note that this thickening in tertiary perimysium was shown in the majority of CP patients, however a small number of patients (n = 4 out of 23) did not have this feature. These results are taken as indications that enhanced myofascial loads on FCU is one among several factors contributing in a major way to the aetiology of limitation of movement at the wrist in CP and the characteristic wrist position of such patients.

  3. Spinal cord compression due to ethmoid adenocarcinoma.

    Science.gov (United States)

    Johns, D R; Sweriduk, S T

    1987-10-15

    Adenocarcinoma of the ethmoid sinus is a rare tumor which has been epidemiologically linked to woodworking in the furniture industry. It has a low propensity to metastasize and has not been previously reported to cause spinal cord compression. A symptomatic epidural spinal cord compression was confirmed on magnetic resonance imaging (MRI) scan in a former furniture worker with widely disseminated metastases. The clinical features of ethmoid sinus adenocarcinoma and neoplastic spinal cord compression, and the comparative value of MRI scanning in the neuroradiologic diagnosis of spinal cord compression are reviewed.

  4. Impaired motor planning and motor imagery in children with unilateral spastic cerebral palsy: challenges for the future of pediatric rehabilitation.

    NARCIS (Netherlands)

    Steenbergen, B.; Jongbloed-Pereboom, M.; Spruijt, S.; Gordon, A.M.

    2013-01-01

    Compromised action performance is one of the most characteristic features of children with unilateral spastic cerebral palsy (USCP). Current rehabilitation efforts predominantly aim to improve the capacity and performance of the affected arm. Recent evidence, however, suggests that compromised motor

  5. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization

    Science.gov (United States)

    Corleto, Jose A.; Bravo-Hernández, Mariana; Kamizato, Kota; Kakinohana, Osamu; Santucci, Camila; Navarro, Michael R.; Platoshyn, Oleksandr; Cizkova, Dasa; Lukacova, Nadezda; Taylor, Julian; Marsala, Martin

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection model of muscle spasticity in Sprague-Dawley (SD) rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i) ankle-rotation-evoked peripheral muscle resistance (PMR) and corresponding electromyography (EMG) activity, ii) Hoffmann reflex, and iii) EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist), tizanidine (α2-adrenergic agonist) and NGX424 (AMPA receptor antagonist) was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  6. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization.

    Directory of Open Access Journals (Sweden)

    Jose A Corleto

    Full Text Available The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI. The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9 complete transection model of muscle spasticity in Sprague-Dawley (SD rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i ankle-rotation-evoked peripheral muscle resistance (PMR and corresponding electromyography (EMG activity, ii Hoffmann reflex, and iii EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist, tizanidine (α2-adrenergic agonist and NGX424 (AMPA receptor antagonist was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  7. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study

    Institute of Scientific and Technical Information of China (English)

    Yong Wook Kim; Ji Cheol Shin; Jeong-Gyu Yoon; Yong-Kyun Kim; Sang Chul Lee

    2013-01-01

    Background There are not many studies about treatment of shoulder spasticity.Although botulinum toxin injection has been reported to be effective for shoulder spasticity,the effectiveness was judged by pain and limited motion change,but not the spasticity itself.Shoulder spasticity is considered to play an important role in hemiplegic frozen shoulder.However,the subscapularis muscle,unlike the pectoralis major muscle,is located deep beneath scapula,where conventional injection is difficult to perform.As extracorporeal shock wave therapy (ESWT) has been reported to be effective for spasticity relief,and we thought spasticity of subscapularis muscle located deep beneath the scapula would be a good candidate for ESWT treatment.This study was to evaluate the beneficial effects of radial ESWT (rESWT) on spastic subscapularis muscle in stroke patients.Methods This is an uncontrolled,prospective,unicenter,clinical pilot study.Stroke patients (n=57; mean age 55.4years) with spastic shoulders were recruited between June 2011 and February 2012 at the University Rehabilitation Hospital.rESWT was administered to each patient every two or three days for two weeks (five total treatments).Evaluation consisted of 11 measurements for each patient; at the start of each of the five treatments and once per week during the following six weeks.Spasticity was measured at external rotator muscles of the shoulder using the modified Ashworth scale (MAS),and passive range of motion (ROM) of the shoulder in external rotation was recorded.Pain was measured using a visual analogue scale (VAS) during passive ROM of the shoulder in external rotation,and was additionally recorded for patients who preserved cognitive and communicative ability (Pain group).Results Reduction in MAS and VAS and improvement of ROM during and after rESWT treatments were prominent compared to baseline.The reduction in MAS and VAS and improvement of ROM continued four weeks after the last treatment and the effects of the

  8. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization.

    Science.gov (United States)

    Corleto, Jose A; Bravo-Hernández, Mariana; Kamizato, Kota; Kakinohana, Osamu; Santucci, Camila; Navarro, Michael R; Platoshyn, Oleksandr; Cizkova, Dasa; Lukacova, Nadezda; Taylor, Julian; Marsala, Martin

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection model of muscle spasticity in Sprague-Dawley (SD) rats. Isoflurane-anesthetized rats received a Th9 laminectomy and the spinal cord was transected using a scalpel blade. After the transection the presence of muscle spasticity quantified as stretch and cutaneous hyper-reflexia was identified and quantified as time-dependent changes in: i) ankle-rotation-evoked peripheral muscle resistance (PMR) and corresponding electromyography (EMG) activity, ii) Hoffmann reflex, and iii) EMG responses in gastrocnemius muscle after paw tactile stimulation for up to 8 months after injury. To validate the clinical relevance of this model, the treatment potency after systemic treatment with the clinically established anti-spastic agents baclofen (GABAB receptor agonist), tizanidine (α2-adrenergic agonist) and NGX424 (AMPA receptor antagonist) was also tested. During the first 3 months post spinal transection, a progressive increase in ankle rotation-evoked muscle resistance, Hoffmann reflex amplitude and increased EMG responses to peripherally applied tactile stimuli were consistently measured. These changes, indicative of the spasticity syndrome, then remained relatively stable for up to 8 months post injury. Systemic treatment with baclofen, tizanidine and NGX424 led to a significant but transient suppression of spinal hyper-reflexia. These data demonstrate that a chronic Th9 spinal transection model in adult SD rat represents a reliable experimental platform to be used in studying the

  9. [A case of hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome with spastic paraparesis and severe distal muscle atrophy of lower limbs].

    Science.gov (United States)

    Shigeto, H; Yamada, T; Kobayashi, T; Goto, I

    1992-07-01

    A 16-year-old boy with hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome was reported. He was the second child of first-cousin consanguineous parents. Since childhood, he was mentally retarded and had frequent episodes of vomiting but no unconsciousness attack. Because of progressive gait disturbance since the age of 15, he was admitted to Kyushu University Hospital. Neurological examination revealed mental defect and spastic paraparesis with bilateral positive pathological reflexes. Moreover, severe muscle atrophy and moderate weakness were observed in the distal portion of lower extremities. The diagnosis of HHH syndrome was made by the examination of amino acids in the serum and urine and by the incorporation study of radioactive ornithine into cultured fibroblasts. EMG and nerve biopsy studies suggested that the muscle atrophy seen in this patient was caused by the degeneration of spinal anterior horn cells. Amino acid imbalance, especially elevation of glutamine and glutamic acid in the CSF, may cause dysfunction of neuronal system including anterior horn cells.

  10. Changing the main indicators to assess motor function in children with cerebral palsy spastic form by hydrokinesitherapy

    OpenAIRE

    Taran I.V.

    2013-01-01

    The aim of the study is to identify the efficiency of the developed technique hydrokinetic system of physical rehabilitation for children 3-5 years old with cerebral palsy spastic form. Examined the impact of comparing the effectiveness of exercise in the water by two techniques: the author and accepted. In experiment involved 24 people aged 3-5 years old with cerebral palsy spastic form. The experiment lasted one year, classes were held hydrokinesitherapy 2 times a week. In the study recorde...

  11. Evaluationof efficiency of methods of neuromodulation in the treatment of spastic syndromes in patients with spinal cord injury

    OpenAIRE

    Smolkin А.А.; Ninel V.G.; Korshunova G.A.

    2014-01-01

    Objective: to evaluate the efficiency of the neuromodulation methods and to determine their role in complex rehabilitation of patients with spastic syndromes after spinal cord injury. Material and methods: Based on the study and treatment of 105 patients with spastic syndromes after injury of the spinal cord, electrical stimulation of the spinal cord, epidural drug therapy in combination with electrical nerve stimulation and local hypothermia spinal cord have been consistently applied for the...

  12. Somatosensory inputs by application of KinesioTaping: Effects on spasticity, balance, and gait in chronic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Federica eTamburella

    2014-05-01

    Full Text Available Introduction: Leg paralysis, spasticity, reduced inter limb coordination and impaired balance are considered the chief limitations to overground ambulation in subjects with incomplete spinal cord injury (SCI. In the last years KinesioTaping (KT application has been proposed for enhancing sensory inputs, decreasing spasticity via proprioception feedback and relieving abnormal muscle tension. No studies addressed KT technique on SCI subjects: our goal was to analyze effects of ankle joint KT application on spasticity, balance and gait. Material and Methods: A randomized cross-over case control design was used to compare KT and conventional non-elastic silk tape (ST application’s effects in 11 chronic SCI subjects, AIS level D, with soleus/gastrocnemius (S/G muscles’ spasticity , balance and gait impairments. Treatment: 48 hours of either KT or ST treatment was followed after 1 week interval by a reverse protocol. Patient treated with KT were subjected to 48 hours of ST treatment and viceversa. Single Y-stripe of Cure©tape (KT and ST were applied to S and G with 0% stretch. Before and after 48 hours of KT and ST application, clinical data of range of motion (ROM, spasticity, clonus, pain, balance and gait were collected. Stabilometric platform assessment of Centre of Pressure (COP movements, bi-dimensional gait analysis and electromyograpich (EMG activity of S, G, Tibialis Anterior and Extensor Hallicus Lungus muscles were also collected. Results: Only After KT treatment significant effects on spasticity, clonus and COP movements, kinematic gait parameters and EMG activities were recorded. Comparison between KT and ST improvements pointed out significant differences for ROM, spasticity, clonus, pain, COP parameters and most of all kinematic gait data. Discussion: KT short term application reduces spasticity and pain and improves balance and gait performances in chronic incomplete SCI subjects.

  13. Thoracic 9 Spinal Transection-Induced Model of Muscle Spasticity in the Rat: A Systematic Electrophysiological and Histopathological Characterization

    OpenAIRE

    Corleto, Jose A.; Mariana Bravo-Hernández; Kota Kamizato; Osamu Kakinohana; Camila Santucci; Navarro, Michael R.; Oleksandr Platoshyn; Dasa Cizkova; Nadezda Lukacova; Julian Taylor; Martin Marsala

    2015-01-01

    The development of spinal hyper-reflexia as part of the spasticity syndrome represents one of the major complications associated with chronic spinal traumatic injury (SCI). The primary mechanism leading to progressive appearance of muscle spasticity is multimodal and may include loss of descending inhibitory tone, alteration of segmental interneuron-mediated inhibition and/or increased reflex activity to sensory input. Here, we characterized a chronic thoracic (Th 9) complete transection mode...

  14. Identification of the neural component of torque during manually-applied spasticity assessments in children with cerebral palsy

    OpenAIRE

    Bar-On, Lynn; Desloovere, Kaat; Molenaers, Guy; Harlaar, J.; Kindt, T; Aertbeliën, Erwin

    2014-01-01

    Clinical assessment of spasticity is compromised by the difficulty to distinguish neural from non-neural components of increased joint torque. Quantifying the contributions of each of these components is crucial to optimize the selection of anti-spasticity treatments such as botulinum toxin (BTX). The aim of this study was to compare different biomechanical parameters that quantify the neural contribution to ankle joint torque measured during manually-applied passive stretches to the gastrocs...

  15. A new multiple sclerosis spasticity treatment option: effect in everyday clinical practice and cost-effectiveness in Germany.

    Science.gov (United States)

    Flachenecker, Peter

    2013-02-01

    Sativex® (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain), a cannabinoid oromucosal spray containing a 1:1 ratio of 9-δ-tetrahydrocannabinol and cannabidiol, has been licensed in Germany since July 2011 as add-on therapy for moderate-to-severe multiple sclerosis (MS) treatment-resistant spasticity symptoms. The 'MOVE 2' study evaluated clinical outcomes, treatment satisfaction, quality of life (QoL) and provision of care in MS patients with spasticity receiving Sativex in everyday clinical practice. Data from 300 patients were collected from 42 specialized MS centers across Germany and were available for this analysis. Assessments, including the MS spasticity 0-10 numerical rating scale, modified Ashworth scale, patients' and physicians' clinical impressions, and QoL scales were rated at baseline and at 1 and 3 months after starting treatment with Sativex. Sativex provided relief of MS-related spasticity in the majority of patients who were previously resistant to treatment. In addition, clear improvements were noted in MS spasticity-associated symptoms (e.g., sleep quality, bladder function and mobility), activities of daily living and QoL. Sativex was generally well tolerated. The majority of patients (84%) reported no adverse events, and there was only a limited risk of serious adverse reactions. Furthermore, based on data from Sativex clinical trials, a Markov model-based analysis has shown that Sativex is a cost-effective treatment option for patients with MS spasticity in Germany. PMID:23369055

  16. Influence of Botulinum Toxin Therapy on Postural Control and Lower Limb Intersegmental Coordination in Children with Spastic Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Bernard Dan

    2013-01-01

    Full Text Available Botulinum toxin injections may significantly improve lower limb kinematics in gait of children with spastic forms of cerebral palsy. Here we aimed to analyze the effect of lower limb botulinum toxin injections on trunk postural control and lower limb intralimb (intersegmental coordination in children with spastic diplegia or spastic hemiplegia (GMFCS I or II. We recorded tridimensional trunk kinematics and thigh, shank and foot elevation angles in fourteen 3–12 year-old children with spastic diplegia and 14 with spastic hemiplegia while walking either barefoot or with ankle-foot orthoses (AFO before and after botulinum toxin infiltration according to a management protocol. We found significantly greater trunk excursions in the transverse plane (barefoot condition and in the frontal plane (AFO condition. Intralimb coordination showed significant differences only in the barefoot condition, suggesting that reducing the degrees of freedom may limit the emergence of selective coordination. Minimal relative phase analysis showed differences between the groups (diplegia and hemiplegia but there were no significant alterations unless the children wore AFO. We conclude that botulinum toxin injection in lower limb spastic muscles leads to changes in motor planning, including through interference with trunk stability, but a combination of therapies (orthoses and physical therapy is needed in order to learn new motor strategies.

  17. Clinical exome sequencing for cerebellar ataxia and spastic paraplegia uncovers novel gene–disease associations and unanticipated rare disorders

    Science.gov (United States)

    van de Warrenburg, Bart P; Schouten, Meyke I; de Bot, Susanne T; Vermeer, Sascha; Meijer, Rowdy; Pennings, Maartje; Gilissen, Christian; Willemsen, Michèl AAP; Scheffer, Hans; Kamsteeg, Erik-Jan

    2016-01-01

    Cerebellar ataxia (CA) and hereditary spastic paraplegia (HSP) are two of the most prevalent motor disorders with extensive locus and allelic heterogeneity. We implemented clinical exome sequencing, followed by filtering data for a ‘movement disorders' gene panel, as a generic test to increase variant detection in 76 patients with these disorders. Segregation analysis or phenotypic re-evaluation was utilized to substantiate findings. Disease-causing variants were identified in 9 of 28 CA patients, and 8 of 48 HSP patients. In addition, possibly disease-causing variants were identified in 1 and 8 of the remaining CA and HSP patients, respectively. In 10 patients with CA, the total disease-causing or possibly disease-causing variants were detected in 8 different genes, whereas 16 HSP patients had such variants in 12 different genes. In the majority of cases, the identified variants were compatible with the patient phenotype. Interestingly, in some patients variants were identified in genes hitherto related to other movement disorders, such as TH variants in two siblings with HSP. In addition, rare disorders were uncovered, for example, a second case of HSP caused by a VCP variant. For some patients, exome sequencing results had implications for treatment, exemplified by the favorable L-DOPA treatment in a patient with HSP due to ATP13A2 variants (Parkinson type 9). Thus, clinical exome sequencing in this cohort of CA and HSP patients suggests broadening of disease spectra, revealed novel gene–disease associations, and uncovered unanticipated rare disorders. In addition, clinical exome sequencing results have shown their value in guiding practical patient management. PMID:27165006

  18. Computed tomographic findings in children with spastic diplegia; Correlation with the severity of their motor abnormality

    Energy Technology Data Exchange (ETDEWEB)

    Yokochi, Kenji; Horie, Masayo; Inukai, Kazuhisa; Kito, Hideyuki (Seirei-Mikatabara General Hospital, Shizuoka (Japan)); Shimabukuro, Satoshi; Kodama, Kazuo

    1989-08-01

    Computed tomographic findings of 46 children with spastic diplegia examined at nine months to three years of age corrected for preterm births were analyzed. Both the size of the lateral ventricles measured by the width of the anterior horns, and the volume of the extracerebral low-density areas were enlarged in some patiens. Both enlargements did not, however, correlate to the severity of the motor abnormality in the patients. The low-density areas of the periventricular white matter, especially adjacent to the trigone, were reduced in many children, probably due to the atrophy of the cerebral white matter having periventricular leukomalacia. The anterior expansion of the white matter reduction from the trigone corresponded to the severer motor abnormality in the children with spastic diplegia. (author).

  19. Botulinum toxin injection improved voluntary motor control in selected patients with post-stroke spasticity

    Institute of Scientific and Technical Information of China (English)

    Shuo-Hsiu Chang; Gerald E Francisco; Sheng Li

    2012-01-01

    The effect of botulinum toxin type A injection on voluntary grip control was examined in a 53-year-old female, who sustained a hemorrhagic right middle cerebral artery stroke 3 years previously, which resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injection each to the motor points (2 sites/muscle) of the left flexor digitorum superficialis and flexor digitorum profundus, respectively. Botulinum toxin injection led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor electromyography activity, and improved release time likely correlated with blocked co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

  20. Laser acupuncture as an adjunctive therapy for spastic cerebral palsy in children.

    Science.gov (United States)

    Dabbous, Ola A; Mostafa, Yousry M; El Noamany, Hossam A; El Shennawy, Shrouk A; El Bagoury, Mohammed A

    2016-08-01

    Laser acupuncture is widely used as an alternative line of treatment in several chronic pediatric diseases. To investigate whether biostimulation by low-level laser on acupuncture points adds a clinical benefit to conventional physiotherapy in hemiplegic spastic cerebral palsy (CP) children. Forty spastic hemiplegic cerebral palsy children by age 1-4 years were chosen from the pediatric outpatient clinic of the National Institute of Laser Enhanced Sciences (NILES), Cairo University, and Menofyia University hospitals. They were randomly divided into control and study groups; 20 children each. Both groups received physiotherapy for 3 months, while only the study group also received laser acupuncture (low-level laser 650 nm with 50 mW power was applied at each acupoint for 30 s giving an energy density of 1.8 J/cm(2)). Preassessment and postassessment of muscle tone, the range of motion (ROM), and gross motor function measurements (GMFMs) were obtained, and the results were statistically analyzed. Comparison between posttreatment measures for the control vs. study groups showed significant difference in muscle tone (wrist flexors and plantar flexors) in favor of the study group, while range of motion showed no significant differences. GMFM showed no significant difference in total score while there was a significant difference in goal total score (sum of % scores for each dimension identified as goal area divided by number of goal areas) in favor of the study group. Laser acupuncture has a beneficial effect on reducing spasticity in spastic cerebral palsy and may be helpful in improving their movement. PMID:27147077

  1. Pain treatment with ziconotide and baclofen in a case of spasticity associated with neuropathic pain

    OpenAIRE

    Danilo G. Quarta; Allegra Cionini Ciardi; Daniela Clerici; Patrizia Spina; Luigi Parigi

    2009-01-01

    This study presents the clinical case of a patient with paraparesis, subjected for a long period of time to treatment with intrathecal baclofen and morphine to control spasticity and neuropathic pain, resulting from spinal cord injury due to road trauma. After several years of treatment the pain was not controlled with high doses of intrathecal morphine combined with transmucosal fentanyl that were given when needed. It was therefore decided to switch to intrathecal ziconotide. Starting with ...

  2. Impacted cisterna magna without syringomyelia associated with spastic paraparesis: case report

    Directory of Open Access Journals (Sweden)

    Gonçalves da Silva José Alberto

    2006-01-01

    Full Text Available We report on a 49 year old man with impacted cisterna magna without the presence of syringohydromyelie (SM. The clinical picture was characterized by spastic paraparesis. Magnetic resonance imaging depicted a cisterna magna filled by the cerebellar tonsils. Six months after osteodural-neural decompression of the posterior fossa there was resolution of neurological symptoms and signs with the exception of hyperactive patellar and Achilles reflexes.

  3. Contribution of thixotropy, spasticity, and contracture to ankle stiffness after stroke

    OpenAIRE

    Vattanasilp, W.; Ada, L.; Crosbie, J.

    2000-01-01

    OBJECTIVES—Increased resistance to stretch of muscles after stroke may be the result of centrally mediated neural factors such as spasticity or local, peripheral factors such as muscle contracture or thixotropy. The aim was to investigate evidence for an abnormal thixotropic response and compare this with two other factors—contracture and spasticity—which could potentially contribute to muscle stiffness after stroke.
METHODS—Thirty patients with stroke whose calf muscles ...

  4. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    OpenAIRE

    Cristina Castro-Fernández; Manuel Arias; Patricia Blanco-Arias; Luis Santomé-Collazo; Jorge Amigo; Ángel Carracedo; Maria-Jesús Sobrido

    2015-01-01

    Next generation sequencing (NGS) is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this...

  5. Split tendon transfers for the correction of spastic varus foot deformity: a case series study

    OpenAIRE

    Dimitriadis Dimitris; Vlachou Maria

    2010-01-01

    Abstract Background Overactivity of anterior and/or posterior tibial tendon may be a causative factor of spastic varus foot deformity. The prevalence of their dysfunction has been reported with not well defined results. Although gait analysis and dynamic electromyography provide useful information for the assessment of the patients, they are not available in every hospital. The purpose of the current study is to identify the causative muscle producing the deformity and apply the most suitable...

  6. Effect of intrathecal baclofen on gait control in human hereditary spastic paraparesis.

    OpenAIRE

    Dan, Bernard; Bouillot, Ethel; Bengoetxea, Ana; Chéron, Guy

    2000-01-01

    The covariation between thigh, shank and foot elevation angles during locomotion was analysed by means of orthogonal planar regression in a patient with pure hereditary spastic paraparesis before and after an intrathecal bolus of baclofen and in seven healthy subjects. The size, shape and spatial orientation of the loop defining patient's planar covariation (thigh angle vs. shank angle vs. foot angle) significantly differed from the controls' before baclofen, whereas these features resumed no...

  7. Management of severe spasticity with intrathecal baclofen delivered by a manually operated pump.

    OpenAIRE

    Patterson, V; Watt, M.; Byrnes, D; Crowe, D; Lee, A.

    1994-01-01

    Intrathecal baclofen abolishes spasticity in many patients with neurological diseases but there are few studies on its long-term effectiveness. Since 1986 a manually operated subcutaneous pump has been used to deliver baclofen intrathecally in 21 patients with a follow up of at least one year. Most patients had multiple sclerosis and all were wheelchair-bound. Sixteen patients had a complete and sustained benefit. In four other patients the treatment was effective in the short term but not in...

  8. [Tropical spastic paraparesis in the tropics and Brazil. A historical analysis].

    Science.gov (United States)

    de Castro-Costa, C M; Carton, H; Goubau, P; de Figueiredo, E G; Giffoni, S D

    1994-03-01

    The tropical spastic paraparesis (TSP) is a chronic myelopathy, predominant in the tropics, recently known to be of retroviral origin (HTLV-I). This paper aims at delineating the clinico-etiological evolution of this entity. The historical analysis of it showed that the TSP has had, along decades, many different denominations and the discovery of the retroviral origin for some of them has stimulated new paths of research and epidemiological interest in the tropics and Brazil. PMID:8002798

  9. Cost analysis of the treatment of severe spinal spasticity with a continuous intrathecal baclofen infusion system

    OpenAIRE

    Postma, TJBM; Oenema, D.; Terpstra, S.; Bouma, J; Kuipers-Upmeijer, H; Staal, MJ; Middel, BJ

    1999-01-01

    Objective: The purpose of our study was to analyse and evaluate the costs of continuous intrathecal baclofen administration as a modality in the treatment of severe spasticity in the Netherlands. Design: A cost analysis was conducted as part of a prospective, multicentre, multidisciplinary, randomised and placebo-controlled clinical trial. The study covered the period from December 1991 to September 1995. The data on medical consumption and costs were collected over a 3-year period from diffe...

  10. Correlation of knee proprioception with muscle strength and spasticity in stroke patients

    OpenAIRE

    Yang, Jin-Mo; Kim, Suhn-yeop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the relationship of knee proprioception with muscle strength and spasticity in stroke patients. [Subjects and Methods] The subjects were 31 stroke patients. The subjects received an explanation of the procedures and methods and provided informed consent before the experiment. A measurement board was used to determine the the proprioception deficit of the knee as a proprioception test. The proprioception test consisted of a passive and act...

  11. Overlapping molecular pathological themes link Charcot-Marie-Tooth neuropathies and hereditary spastic paraplegias.

    Science.gov (United States)

    Timmerman, Vincent; Clowes, Virginia E; Reid, Evan

    2013-08-01

    In this review we focus on Charcot-Marie-Tooth (CMT) neuropathies and hereditary spastic paraplegias (HSPs). Although these diseases differ in whether they primarily affect the peripheral or central nervous system, both are genetically determined, progressive, long axonopathies that affect motor and sensory pathways. This commonality suggests that there might be similarities in the molecular pathology underlying these conditions, and here we compare the molecular genetics and cellular pathology of the two groups.

  12. A Compressive Superresolution Display

    KAUST Repository

    Heide, Felix

    2014-06-22

    In this paper, we introduce a new compressive display architecture for superresolution image presentation that exploits co-design of the optical device configuration and compressive computation. Our display allows for superresolution, HDR, or glasses-free 3D presentation.

  13. Pseudoelastic Nitinol-Based Device for Relaxation of Spastic Elbow in Stroke Patients

    Science.gov (United States)

    Viscuso, S.; Pittaccio, S.; Caimmi, M.; Gasperini, G.; Pirovano, S.; Villa, E.; Besseghini, S.; Molteni, F.

    2009-08-01

    A compliant brace (EDGES) promoting spastic elbow relaxation was designed to investigate the potentialities of pseudoelastic NiTi in orthotics. By exploiting its peculiar characteristics, EDGES could improve elbow posture without constraining movements and thus avoiding any pain to the patient. A commercial Ni50.7-Ti49.3 alloy heat treated at 400 °C 1 h + WQ was selected for this application. A prototype of EDGES was assembled with two thermoplastic shells connected by polycentric hinges. Four 2-mm-diameter NiTi bars were encastred in the upper-arm shell and let slide along tubular fixtures on the forearm. Specially designed bending tests demonstrated suitable moment-angle characteristics. Two post-stroke subjects (aged 62 and 64, mild elbow flexors spasticity) wore EDGES for 1 week, at least 10 h a day. No additional treatment was applied during this period or the following week. A great improvement (20° ± 5°) of the resting position was observed in both patients as early as 3 h after starting the treatment. Acceptability was very good. A slight decrease in spasticity was also observed in both subjects. All the effects disappeared 1 week after discontinuation. EDGES appears to be a good alternative to traditional orthoses in terms of acceptability and effectiveness in improving posture, especially whenever short-term splinting is planned.

  14. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy

    Science.gov (United States)

    Karabicak, Gul Oznur; Balcı, Nilay Comuk; Gulsen, Mustafa; Ozturk, Basar; Cetin, Nuri

    2016-01-01

    [Purpose] The aim of the study was to investigate the relationships between femoral anteversion and functional balance and postural control in children with spastic cerebral palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ± 4.5) with grosss motor functional classification system levels I, II, and III were recruited for this study. Functional balance was evaluated using the Pediatric Balance Scale, postural control was evaluated using the Trunk Control Measurement Scale, and femoral anteversion was assessed with a handheld goniometer using the great trochanter prominence method. [Results] The results indicated that there was significant correlation between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score. There were no significant correlation between femoral anteversion and the Trunk Control Measurement Scale static sitting balance, Trunk Control Measurement Scale selective movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale results. [Conclusion] Increased femoral anteversion has not correlation with functional balance, static sitting, and selective control of the trunk. Femoral anteversion is related to dynamic reaching activities of the trunk, and this may be the result of excessive internal pelvic rotation. It is important for the health professionals to understand that increased femoral anteversion needs to be corrected because in addition to leading to femoral internal rotation during walking, it also effects dynamic reaching activities of spastic children with cerebral palsy. PMID:27390397

  15. Effects of Abnormal Oral Reflexes on Speech Articulation in Persian Speaking Children with Spastic Cerebral Palsy

    Science.gov (United States)

    DADGAR, Hooshang; HADIAN, Mohammad Reza; LIRA, Ortega Adriana

    2016-01-01

    Objective The purpose of this study was to investigate the relationship between the presence of abnormal oral reflexes and speech sound production in children with severe cerebral palsy. Materials & Methods Seven oral reflexes such as, rooting, mouth-opening, biting, chewing, lip, tongue, and suckling were examined in 52Persian-speaking monolingual children with spastic cerebral palsy (ages 5-10 yr).Phonetic information tests were administered to investigate their ability for articulation of the speech sounds. Results A significant relationship between three (i.e. the chewing, lip, and biting reflexes) out of the seven abnormal oral reflexes and the speech articulation was noticed. The presence of the chewing reflex was associated with deficits in production of /s, z, š,č/ sounds. The lip reflex was associated with deficits in the production of /p, m, r, j, f, č/ sounds. The biting reflex was associated with deficits in the production of /z, l, y and š/ sounds. No significant relationship was found between the rooting, mouth-opening, tongue, and suckling reflexes and sound articulation. Conclusion The presence of abnormal reflexes in the children with spastic cerebral palsy would suggest a correlation between these reflexes and sound articulation in Iranian children with spastic cerebral palsy. Hence, these observations might suggest some disturbances in normal speech development. PMID:27375753

  16. Establishing a rat model of spastic cerebral palsy by targeted ethanol injection

    Institute of Scientific and Technical Information of China (English)

    Yadong Yu; Liang Li; Xinzhong Shao; Fangtao Tian; Qinglu Sun

    2013-01-01

    Spastic cerebral palsy is general y considered to result from cerebral cortical or pyramidal tract damage. Here, we precisely targeted the left pyramidal tract of 2-month-old Sprague-Dawley rats placed on a stereotaxic instrument under intraperitoneal anesthesia. Based on the rat brain ste-reotaxic map, a 1-mm hole was made 10 mm posterior to bregma and 0.8 mm left of sagittal suture. A microsyringe was inserted perpendicularly to the surface of the brain to a depth of 9.7 mm, and 15μL of ethanol was slowly injected to establish a rat model of spastic cerebral palsy. After modeling, the rats appeared to have necrotic voids in the pyramidal tract and exhibited typical signs and symptoms of flexion spasms that lasted for a long period of time. These findings indicate that this is an effective and easy method of establishing a rat model of spastic cerebral palsy with good re-producibility. Ethanol as a chemical ablation agent specifical y and thoroughly damages the pyra-midal tract, and therefore, the animals display flexion spasms, which are a typical symptom of the disease.

  17. Emerging treatment options for spasticity in multiple sclerosis – clinical utility of cannabinoids

    Directory of Open Access Journals (Sweden)

    Ashton JC

    2011-06-01

    Full Text Available John C AshtonDepartment of Pharmacology and Toxicology, Otago School of Medical Sciences, University of Otago, Dunedin, New ZealandAbstract: Multiple sclerosis (MS is a widespread and common disabling autoimmune disease of the central nervous system. The main disabling symptom is muscle spasticity, which occurs in most patients. Treatment of spasticity with existing drugs is often poor, and there is a need for new and additional treatments. This article reviews the use of cannabinoids for the treatment of symptoms in MS, focusing on the pharmacology of Δ9-tetrahydrocannabinol (Δ9-THC, cannabidiol and analog drugs in various formulations, the rationale for their use, and their efficacy and safety in the treatment of MS. It is concluded that of all currently available formulations, only sublingual spray containing Δ9-THC has a sufficient evidence base to justify its use in treatment of spasticity and patient quality of life, particularly in patients' refractory to current treatments.Keywords: MS, Δ9-tetrahydrocannabinol, Δ9-THC, cannabis

  18. New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids

    Directory of Open Access Journals (Sweden)

    Paul F Smith

    2010-02-01

    Full Text Available Paul F SmithDepartment of Pharmacology and Toxicology, School of Medical Sciences, University of Otago, Dunedin, New ZealandAbstract: Cannabinoids such as Cannabis-based medicinal extracts (CBMEs are increasingly being used in the treatment of spasticity associated with multiple sclerosis (MS. They have been shown to have a beneficial effect on spasticity; however, this evidence is largely based on subjective rating scales. Objective measurements using the Ashworth scale have tended to show no significant effect; however, the validity of this scale has been questioned. The available clinical trial data suggest that the adverse side effects associated with using CBMEs are generally mild, such as dry mouth, dizziness, somnolence, nausea and intoxication. However, most of these trials were run over a period of months and it is possible that other adverse side effects could develop with long-term use. There may be reason to be concerned about the use of therapeutic cannabinoids by adolescents, people predisposed to psychosis and pregnant women.Keywords: multiple sclerosis, spasticity, cannabinoids, Cannabis

  19. Effects of interactive games on motor performance in children with spastic cerebral palsy.

    Science.gov (United States)

    AlSaif, Amer A; Alsenany, Samira

    2015-06-01

    [Purpose] Motor control and muscle strength impairments are the prime reasons for motor behavior disorders in children with spastic cerebral palsy. These impairments lead to histological changes in muscle growth and the learning of motor skills. Therefore, such children experience reduced muscle force generation and decreased muscle flexibility. We investigated the effect of training with Nintendo Wii Fit games on motor performance in children with spastic cerebral palsy. [Subjects and Methods] Forty children with cerebral palsy spastic diplegia aged 6-10 years diagnosed with level-3 functional capabilities according to the Gross Motor Classification System (GMFCS) were enrolled. Participants were divided randomly into equal groups: group (A) that practiced with the Nintendo Wii Fit game for at least 20 minutes/day for 12 weeks and group (B) that underwent no training (control group). The Movement Assessment Battery for Children-2 (mABC-2) was used to assess motor performance, because it mainly involves motor tasks very similar to those involved in playing Nintendo Wii Fit games, e.g., goal-directed arm movements, balancing, and jumping. [Results] There were significant improvements in the subscales of the motor performance test of those who practiced with the Nintendo Wii, while the control group showed no significant changes. [Conclusion] Using motion interactive games in home rehabilitation is feasible for children with cerebral palsy. PMID:26180367

  20. Three-dimensional head and trunk movement characteristics during gait in children with spastic diplegia.

    Science.gov (United States)

    Heyrman, L; Feys, H; Molenaers, G; Jaspers, E; Monari, D; Meyns, P; Desloovere, K

    2013-09-01

    This study uses a recently developed trunk model to determine which head and trunk kinematic parameters differentiate children with spastic diplegia from typically developing (TD) children while walking. Differences in head and trunk parameters in relation to the severity of the motor involvement (GMFCS levels) were additionally examined. The trunk model consisted of five segments (pelvis, thorax, head, shoulder line, spine). Discrete kinematic parameters (ROM, mean position) and angular waveforms were compared between 20 children with spastic diplegia (age 9.8 years±2.9 years; GMFCS I: n=10, GMFCS II: n=10) and 20 individually age-matched TD children (9.7 years±3 years). A new measure for overall trunk pathology, the trunk profile score (TPS), was proposed and included in the comparative analysis. Compared to TD children, children with GMFCS II showed a significantly higher TPS and increased ROM for pelvis tilt, for thorax and head in nearly all planes, and the angle of kyphosis. In children with GMFCS I, only ROM of thorax lateral bending was significantly increased. Sagittal ROM differentiated best between GMFCS levels, with higher ROM found in children with GMFCS II. Current results provide new insights into head and trunk kinematics during gait in children with spastic diplegia.

  1. MUSCLE TONICITY OF CHILDREN WITH SPASTIC CEREBRAL PALSY: HOW EFFECTIVE IS SWEDISH MASSAGE?

    Directory of Open Access Journals (Sweden)

    V. Alizad

    2009-06-01

    Full Text Available ObjectiveMassage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of Swedish massage on the muscle tonicity of children with spastic cerebral palsy (CP.Materials & MethodsThis study was a single blind clinical trial conducted on forty children with spastic CP, recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. Routine occupational therapy techniques were performed during a 3 monthperiod in both groups, while the intervention group also received Swedish massage for 30 minutes before every rehabilitation session. Muscle tonicity was evaluated at the beginning of the study and 3 months later using the Modified Ashworth Scale. ResultsThe average ages of children in the intervention (n=13 and control (n=14 groups were 49.5 and 42.1 months respectively. Although after intervention, tonicity of upper and lower limbs, trunk and neck in the intervention group in comparison with controls had no significant differences, there were statistically significant differences in reduction rate of tonicity in upper limbs and trunk between the two groups (P <0.05.ConclusionMassage therapy is not a panacea for improvement of spasticity in children with CP but the encouraging results of other studies on children with CP indicate that further studies are needed for more definite results.

  2. Current situation of clinical research in acupuncture and moxibustion treatment of apoplexy spastic paralysis%针灸治疗中风后痉挛性瘫痪临床研究现状

    Institute of Scientific and Technical Information of China (English)

    罗杨飞; 韩舰华; 徐嘉营

    2013-01-01

    中风痉挛性瘫痪是由于脑卒中(脑梗死或脑出血)导致皮层运动投射区和上运动中枢性瘫神经元径路(皮层脊髓束和皮层脑干束)损害而引起。临床以瘫痪患者的肌肉张力增高、腱反射亢进、浅反射消失为特点。对近5年来针灸治疗中风后痉挛性瘫痪疗效的临床研究文献进行总结。针灸治疗中风后痉挛性瘫痪的治法多样、操作方便、无不良反应,纵观文献,体针、头针、腹针及其他特殊针刺疗法,显示出针灸治疗中风后痉挛性瘫痪具有其独特优势,并已证实有显著的疗效。%Apoplexy spastic paralysis is due to the damage caused by stroke(infarction or cerebral hemorrhage),which induced the impairment in motor cortex projection area and upper motor neuron pathway. Apoplexy spastic paralysis is clinically characterized by increased muscle tone,hyperreflexia and decreased superficial reflex. This study summarized the past five-year-literatures on clinical research of acupuncture treatment for apoplexy spastic paralysis. There are varied methods in the acupuncture treatment of spastic paralysis after stroke. It is easy to operate and no adverse reactions. Throughout the literature,there are body acupuncture,scalp acupuncture,abdominal acupuncture and other special acupuncture. All of these acupuncture therapies show the unique advantages and significant effect on the spastic paralysis after stroke.

  3. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Graham Laura

    2008-10-01

    Full Text Available Abstract Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group or upper limb therapy alone (control group. Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT. Secondary outcomes include: spasticity (Modified Ashworth Scale; grip strength; dexterity (Nine Hole Peg Test; disability (Barthel Activities of Daily Living Index; quality of life (Stroke Impact Scale, Euroqol EQ-5D and attainment of patient-selected goals (Canadian Occupational Performance Measure. Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment

  4. Hyperspectral data compression

    CERN Document Server

    Motta, Giovanni; Storer, James A

    2006-01-01

    Provides a survey of results in the field of compression of remote sensed 3D data, with a particular interest in hyperspectral imagery. This work covers topics such as compression architecture, lossless compression, lossy techniques, and more. It also describes a lossless algorithm based on vector quantization.

  5. Compressed gas manifold

    Science.gov (United States)

    Hildebrand, Richard J.; Wozniak, John J.

    2001-01-01

    A compressed gas storage cell interconnecting manifold including a thermally activated pressure relief device, a manual safety shut-off valve, and a port for connecting the compressed gas storage cells to a motor vehicle power source and to a refueling adapter. The manifold is mechanically and pneumatically connected to a compressed gas storage cell by a bolt including a gas passage therein.

  6. Spastic paraparesis as a complication of percutaneous nephrolithothripsy (PNL) on a calyceal calculus of the left kidney.

    Science.gov (United States)

    Pellegrinelli, Moira; Castiglioni, Claudia; Morini, Osvaldo; Franzini, Aldo

    2007-12-01

    A patient developed spastic paraparesis after surgery with ultrasound lithothripsy and litholapaxy of fragments of a renal calyceal calculus in middle-upper diverticulum. It was first assumed that the event could be due to transient spinal ischemia, caused by vasospasm of Adamkiewicz artery, secondary to blood engorgement of the area around the vessel. In order to clarify possible implications of medical liability, the Authors took into account the etio-pathogenetic mechanisms of the complication and analyzed the medico-legal aspects, with particular reference to the indication for surgery, which was not absolute in the case under scrutiny. In connection with the latter aspect, the Authors considered the conclusions of a recent sentence of the Court of Milan, whereby, despite the negative opinion of the experts specifically appointed, a case of medical liability was identified as a consequence of algodystrophy resulting from a cardiosurgical intervention. According to the Court, it is for the medical staff to demonstrate that they did all they could to prevent the complication and that such complication did not arise from a mistake on their part.

  7. Selection of acupoints for managing upper-extremity spasticity in chronic stroke patients

    Directory of Open Access Journals (Sweden)

    Wang BH

    2014-01-01

    Full Text Available Bi-Huei Wang,1,* Chien-Lin Lin,1,2,* Te-Mao Li,2,3 Shih-Din Lin,3 Jaung-Geng Lin,2 Li-Wei Chou1,2,4 1Department of Physical Medicine and Rehabilitation, China Medical University Hospital; 2School of Chinese Medicine, College of Chinese Medicine; 3Graduate Institute of Acupuncture Science, 4Acupuncture Research Center, China Medical University, Taichung, Taiwan *These authors contributed equally to this work Background: This study investigated the clinical efficacy of electroacupuncture (EA in inhibiting upper-extremity spasticity in chronic stroke patients, and also in mapping a unique preliminary acupoint-selection protocol. Methods: Fifteen patients were divided into two groups: patients in the control group (n=6 received minimal acupuncture (MA, and those in the experimental group (n=9 received EA. Four acupoints, which include Neiguan (PC6, Shaohai (HT3, Zeqian (Ex-UE, A32, and Shounizhu (EX-UE, were treated near the motor points of the muscles for elbow flexion, forearm pronation, and finger flexion. Both groups were treated for twelve sessions, 20 minutes per session, for 6 weeks (two sessions per week. The outcome measures in this study included angle of muscle reaction (R1, passive range of motion (R2, and dynamic component (R2–R1. Results: In the experimental group, the R2–R1 of the elbow joint was significantly decreased at 1 (P=0.0079, 3 (P=0.0013, and 6 weeks (P=0.0149 after treatment compared with pretreatment levels (P<0.05. The between-group difference in the R2–R1 of the elbow joint after the 6-week treatment was statistically significant. Conclusion: Combining the 6-week EA and standard rehabilitation treatment reduced the spasticity of the elbow for chronic stroke survivors. However, no significant effect was observed in the spasticity of the wrist joints. The choice of acupoints and the frequency of EA have to be taken into account to achieve a positive treatment effect. The correlation between acupoints and motor points

  8. Comparative study of muscular tonus in spastic tetra paretic cerebral palsy in children with predominantly cortical and subcortical lesions in computerized tomography of the skull

    International Nuclear Information System (INIS)

    The objective was to compare distribution and intensity of muscular tonus in spastic tetra paretic cerebral palsy (CP), correlating the clinical data with lesion location in the central nervous system. Twelve children aged two to four years old with predominantly cortical lesions (six children) and subcortical lesions (six children) were included. The tonus was analyzed in the upper (UULL) and lower limbs (LLLL) based on Durigon and Piemonte protocol. The result showed that there was no significant difference regarding tonus intensity and distribution in the UULL and LLLL in both groups. Comparing the upper and lower limbs of subjects in the same group, the LLLL presented more asymmetry and higher tonus intensity than the UULL. It was concluded that in this study children with CP as a result of predominantly cortical or subcortical lesions present a similar deficit in tonus modulation, causing a symmetric and homogeneous distribution of hypertonicity, which is predominant in the LLLL. (author)

  9. Temporal Resolution Enhancement in Compressed Video Sequences

    Directory of Open Access Journals (Sweden)

    Robertson Mark A

    2001-01-01

    Full Text Available Compressed video may possess a number of artifacts, both spatial and temporal. Spatial compression artifacts arise as a result of quantization of the transform-domain coefficients, and are often manifested as blocking and ringing artifacts. Temporal limitations in compressed video occur when the encoder, in an effort to reduce bandwidth, drops frames. Omitting frames decreases the reconstructed frame rate, which can cause motion to appear jerky and uneven. This paper discusses a method to increase the frame rate of video compressed with the DCT by inserting images between received frames of the sequence. The Bayesian formulation of the restoration prevents spatial compression artifacts in the received frames from propagating to the reconstructed frames.

  10. Spinal Cord Kinking in Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

    Institute of Scientific and Technical Information of China (English)

    Ting Wang; Min Pan; Chu-Qiang Yin; Xiu-Jun Zheng; Ya-Nan Cong; De-Chun Wang; Shu-Zhong Li

    2015-01-01

    Background:Ossification of the ligamentum flavum (OLF) is being increasingly recognized as a cause of thoracic myelopathy.This study was to describe a rare clinical entity of spinal cord kinking (SK) in thoracic myelopathy secondary to OLF.Methods:The data of 95 patients with thoracic myelopathy secondary to OLF were analyzed retrospectively.The incidence and location of SK were determined using preoperative magnetic resonance imaging (MRI).The clinical presentation and radiological characteristics in patients with SK were analyzed.Posterior en bloc laminectomy with OLF was performed,and the surgical results were evaluated.Results:SK was found in seven patients (7.4%) based on preoperative MRI.The patients included one male and six females with an average age of 55.6 years (range,48-64 years).Five patients presented with radiculomyelopathy and two presented with typical thoracic myelopathy of spastic paraparesis.In all cases,the kinking was located just above the end of the spinal cord where the conus medullaris (CM) was compressed by the OLF.The degree of SK varied from mild to severe.The tip of the CM was located between the upper third of T1 1 to the lower third of L 1,above the lower edge of L 1.With an average follow-up of 30.4 months,the modified Japanese Orthopedic Association score significantly improved from 5.7 ± 1.8 preoperatively to 8.9 ± 1.4 postoperatively (t =12.05;P < 0.0001) with an improvement rate of 63.1 ± 12.3%.Conclusions:SK is a rare radiological phenomenon.It is typically located at the thoracolumbar junction,where the CM is compressed by the OLF.Our findings indicate that these patients may benefit from a posterior decompressive procedure.

  11. Insulin growth factors may explain relationship between spasticity and skeletal muscle size in men with spinal cord injury

    Directory of Open Access Journals (Sweden)

    David R. Gater, MD, PhD

    2012-04-01

    Full Text Available The major objectives of this cross-sectional study were to (1 measure insulin-like growth factor-1 (IGF-1 in individuals with complete spinal cord injury (SCI and spasticity and (2 determine the relationships between IGF-1 and cross-sectional areas (CSAs of thigh skeletal muscle groups. Eight individuals with motor complete SCI underwent magnetic resonance imaging to measure the CSA of the whole thigh, knee extensor, and knee flexor skeletal muscle groups and dual-emission X-ray absorptiometry to measure fat-free mass. After participants fasted for 12 h, we measured their IGF-1 levels and determined spasticity using the Modified Ashworth Scale (MAS. Spearman rho correlations were used to test for the relationships among the tested variables, and independent t-tests were used to determine the difference in plasma IGF-1. Plasma IGF-1 was 44% greater in those with MAS scores of 2 or higher (p < 0.05. Plasma IGF-1 was positively related to knee extensor skeletal muscle CSA (r = 0. 83, p < 0.01. IGF-1 was strongly related to knee extensor and flexor spasticity (r = 0.88, p < 0.004. The findings suggest that IGF-1 is greater in SCI individuals with increased spasticity, and this may explain the strong positive relationships that were noted between spasticity and skeletal muscle CSA.

  12. Femoral compressive neuropathy from iliopsoas haematoma complicating dengue hemorrhagic fever

    Institute of Scientific and Technical Information of China (English)

    Sneha Ganu; Yesha Mehta

    2013-01-01

    Dengue fever is a debilitating mosquito-borne disease caused by dengue virus. We reported a case of femoral compression neuropathy due to iliopsoas hematoma complicating dengue hemorrhagic fever. Iliopsoas muscle hematoma can cause femoral neuropathy with resultant pain and paralysis. Such manifestations are not well documented in the literature. The pathogenesis of hematoma and compressive neuropathy with its appropriate management is discussed.

  13. Compressed Sensing in Astronomy

    CERN Document Server

    Bobin, J; Ottensamer, R

    2008-01-01

    Recent advances in signal processing have focused on the use of sparse representations in various applications. A new field of interest based on sparsity has recently emerged: compressed sensing. This theory is a new sampling framework that provides an alternative to the well-known Shannon sampling theory. In this paper we investigate how compressed sensing (CS) can provide new insights into astronomical data compression and more generally how it paves the way for new conceptions in astronomical remote sensing. We first give a brief overview of the compressed sensing theory which provides very simple coding process with low computational cost, thus favoring its use for real-time applications often found on board space mission. We introduce a practical and effective recovery algorithm for decoding compressed data. In astronomy, physical prior information is often crucial for devising effective signal processing methods. We particularly point out that a CS-based compression scheme is flexible enough to account ...

  14. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  15. Impact of Sativex(®) on quality of life and activities of daily living in patients with multiple sclerosis spasticity.

    Science.gov (United States)

    Arroyo, Rafael; Vila, Carlos; Dechant, Kerry L

    2014-07-01

    In individuals with multiple sclerosis (MS) spasticity, associated symptoms such as spasms, pain, mobility restrictions and sleep disturbances can interfere with the ability to perform activities of daily living and reduce quality of life (QoL). Recent cross-sectional studies from Europe have confirmed that advancing severity of MS spasticity correlates directly with worsening QoL. The treatment effect of Sativex(®) (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain) on QoL has been evaluated in randomized controlled trials, observational studies conducted under everyday clinical practice conditions and a survey in long-term users. Symptomatic relief of MS spasticity in responders to Sativex was associated with quantifiable improvements in QoL and activities of daily living that were maintained over time. Benefits were perceived by both patients and caregivers. PMID:25275238

  16. ADVANCED RECIPROCATING COMPRESSION TECHNOLOGY (ARCT)

    Energy Technology Data Exchange (ETDEWEB)

    Danny M. Deffenbaugh; Klaus Brun; Ralph E. Harris; J. Pete Harrell; Robert J. Mckee; J. Jeffrey Moore; Steven J. Svedeman; Anthony J. Smalley; Eugene L. Broerman; Robert A Hart; Marybeth G. Nored; Ryan S. Gernentz; Shane P. Siebenaler

    2005-12-01

    The U.S. natural gas pipeline industry is facing the twin challenges of increased flexibility and capacity expansion. To meet these challenges, the industry requires improved choices in gas compression to address new construction and enhancement of the currently installed infrastructure. The current fleet of installed reciprocating compression is primarily slow-speed integral machines. Most new reciprocating compression is and will be large, high-speed separable units. The major challenges with the fleet of slow-speed integral machines are: limited flexibility and a large range in performance. In an attempt to increase flexibility, many operators are choosing to single-act cylinders, which are causing reduced reliability and integrity. While the best performing units in the fleet exhibit thermal efficiencies between 90% and 92%, the low performers are running down to 50% with the mean at about 80%. The major cause for this large disparity is due to installation losses in the pulsation control system. In the better performers, the losses are about evenly split between installation losses and valve losses. The major challenges for high-speed machines are: cylinder nozzle pulsations, mechanical vibrations due to cylinder stretch, short valve life, and low thermal performance. To shift nozzle pulsation to higher orders, nozzles are shortened, and to dampen the amplitudes, orifices are added. The shortened nozzles result in mechanical coupling with the cylinder, thereby, causing increased vibration due to the cylinder stretch mode. Valve life is even shorter than for slow speeds and can be on the order of a few months. The thermal efficiency is 10% to 15% lower than slow-speed equipment with the best performance in the 75% to 80% range. The goal of this advanced reciprocating compression program is to develop the technology for both high speed and low speed compression that will expand unit flexibility, increase thermal efficiency, and increase reliability and integrity

  17. Wavelet image compression

    CERN Document Server

    Pearlman, William A

    2013-01-01

    This book explains the stages necessary to create a wavelet compression system for images and describes state-of-the-art systems used in image compression standards and current research. It starts with a high level discussion of the properties of the wavelet transform, especially the decomposition into multi-resolution subbands. It continues with an exposition of the null-zone, uniform quantization used in most subband coding systems and the optimal allocation of bitrate to the different subbands. Then the image compression systems of the FBI Fingerprint Compression Standard and the JPEG2000 S

  18. Compressed sensing & sparse filtering

    CERN Document Server

    Carmi, Avishy Y; Godsill, Simon J

    2013-01-01

    This book is aimed at presenting concepts, methods and algorithms ableto cope with undersampled and limited data. One such trend that recently gained popularity and to some extent revolutionised signal processing is compressed sensing. Compressed sensing builds upon the observation that many signals in nature are nearly sparse (or compressible, as they are normally referred to) in some domain, and consequently they can be reconstructed to within high accuracy from far fewer observations than traditionally held to be necessary. Apart from compressed sensing this book contains other related app

  19. Chest compressions for bradycardia or asystole in neonates.

    Science.gov (United States)

    Kapadia, Vishal; Wyckoff, Myra H

    2012-12-01

    When effective ventilation fails to establish a heart rate of greater than 60 bpm, cardiac compressions should be initiated to improve perfusion. The 2-thumb method is the most effective and least fatiguing technique. A ratio of 3 compressions to 1 breath is recommended to provide adequate ventilation, the most common cause of newborn cardiovascular collapse. Interruptions in compressions should be limited to not diminishing the perfusion generated. Oxygen (100%) is recommended during compressions and can be reduced once adequate heart rate and oxygen saturation are achieved. Limited clinical data are available to form newborn cardiac compression recommendations.

  20. Spinal cord magnetic resonance imaging in autosomal dominant hereditary spastic paraplegia

    Energy Technology Data Exchange (ETDEWEB)

    Hedera, P. [University of Michigan, Department of Neurology, Ann Arbor, MI (United States); Vanderbilt University, Department of Neurology, Nashville, TN (United States); Eldevik, O.P.; Maly, P. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Rainier, S. [University of Michigan, Department of Neurology, Ann Arbor, MI (United States); Fink, J.K. [University of Michigan, Department of Neurology, Ann Arbor, MI (United States); Ann Arbor Veterans Affairs Medical Center, Geriatric Research Education and Clinical Center, Ann Arbor, MI (United States)

    2005-10-01

    Hereditary spastic paraplegia (HSP) is a genetically heterogeneous group of neurodegenerative disorders characterized by progressive lower extremity weakness and spasticity. HSP pathology involves axonal degeneration that is most pronounced in the terminal segments of the longest descending (pyramidal) and ascending (dorsal columns) tracts. In this study, we compared spinal cord magnetic resonance imaging (MRI) in 13 HSP patients with four different types of autosomal dominant hereditary spastic paraplegia (SPG3A, SPG4, SPG6, and SPG8) with age-matched control subjects. The cross-section area of HSP subjects at cervical level C2 was 59.42{+-}12.57 mm{sup 2} and at thoracic level T9 was 28.58{+-}5.25 mm{sup 2}. Both of these values were less than in the healthy controls (p<0.001). The degree of cord atrophy was more prominent in patients with SPG6 and SPG8 who had signs of severe cord atrophy (47.60{+-}6.58 mm{sup 2} at C2, 21.40{+-}2.4 mm{sup 2} at T9) than in subjects with SPG3 and SPG4 (66.0{+-}8.94 mm{sup 2} at C2, p<0.02; 31.75{+-}2.76 mm{sup 2} at T9, p<0.001). These observations indicate that spinal cord atrophy is a common finding in the four genetic types of HSP. Spinal cord atrophy was more severe in SPG6 and SPG8 HSP subjects than in other types of HSP we studied. This may suggest a different disease mechanism with more prominent axonal degeneration in these two types of HSP when compared with HSP due to spastin and atlastin mutations. (orig.)

  1. Autosomal dominant familial spastic paraplegia: Tight linkage to chromosome 15q

    Energy Technology Data Exchange (ETDEWEB)

    Fink, J.K.; Wu, C.T.B.; Jones, S.M.

    1994-09-01

    Familial spastic paraplegia (FSP) (MIM No.18260) constitutes a clinically and genetically diverse group of disorders that share the primary feature of progressive, severe, lower extremity spasticity. FSP is classified according to the mode of inheritance and whether progressive spasticity occurs in isolation ({open_quotes}uncomplicated FSP{close_quotes}) or with other neurologic abnormalities ({open_quotes}complicated FSP{close_quotes}), including optic neuropathy, retinopathy, extrapyramidal disturbance, dementia, ataxia, ichthyosis, mental retardation, or deafness. Recently, autosomal dominant, uncomplicated FSP was shown to be genetically heterogeneous and tightly linked to a group of microsatellite markers on chromosome 14q in one large kindred. We examined 126 members of a non-consanguineous North American kindred of Irish descent. FSP was diagnosed in 31 living subjects who developed insidiously progressive gait disturbance between ages 12 and 35 years. Using genetic linkage analysis to microsatellite DNA polymorphisms, we showed that the FSP locus on chromosome 14q was exluded from linkage with the disorder in our family. Subsequently, we searched for genetic linkage between the disorder and microsatellite DNA polymorphisms spanning approximately 50% of the genome. We observed significantly positive, two-point maximum lod scores (Z) for markers on chromosome 15q: D15S128 (Z=9.70, {theta}=0.05), D15S165 (Z=3.30, {theta}=0.10), and UT511 (Z=3.86, {theta}=0.10). Our data clearly establishes that one locus for autosomal dominant, uncomplicated FSP is mapped to the pericentric region of chromosome 15q. Identifying genes responsible for chromosome 15q-linked and chromosome 14q-linked FSP will greatly advance our understanding of this condition and hopefully other inherited and degenerative brain and spinal cord disorders that are also characterized by axonal degeneration.

  2. Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity

    Science.gov (United States)

    Patti, F; Messina, S; Solaro, C; Amato, M P; Bergamaschi, R; Bonavita, S; Bruno Bossio, R; Brescia Morra, V; Costantino, G F; Cavalla, P; Centonze, D; Comi, G; Cottone, S; Danni, M; Francia, A; Gajofatto, A; Gasperini, C; Ghezzi, A; Iudice, A; Lus, G; Maniscalco, G T; Marrosu, M G; Matta, M; Mirabella, M; Montanari, E; Pozzilli, C; Rovaris, M; Sessa, E; Spitaleri, D; Trojano, M; Valentino, P; Zappia, M

    2016-01-01

    Background The approval of 9-δ-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex) for the management of treatment-resistant multiple sclerosis (MS) spasticity opened a new opportunity for many patients. The aim of our study was to describe Sativex effectiveness and adverse events profile in a large population of Italian patients with MS in the daily practice setting. Methods We collected data of all patients starting Sativex between January 2014 and February 2015 from the mandatory Italian medicines agency (AIFA) e-registry. Spasticity assessment by the 0–10 numerical rating scale (NRS) scale is available at baseline, after 1 month of treatment (trial period), and at 3 and 6 months. Results A total of 1615 patients were recruited from 30 MS centres across Italy. After one treatment month (trial period), we found 70.5% of patients reaching a ≥20% improvement (initial response, IR) and 28.2% who had already reached a ≥30% improvement (clinically relevant response, CRR), with a mean NRS score reduction of 22.6% (from 7.5 to 5.8). After a multivariate analysis, we found an increased probability to reach IR at the first month among patients with primary and secondary progressive MS, (n=1169, OR 1.4 95% CI 1.04 to 1.9, p=0.025) and among patients with >8 NRS score at baseline (OR 1.8 95% CI 1.3–2.4 p<0.001). During the 6 months observation period, 631(39.5%) patients discontinued treatment. The main reasons for discontinuation were lack of effectiveness (n=375, 26.2%) and/or adverse events (n=268, 18.7%). Conclusions Sativex can be a useful and safe option for patients with MS with moderate to severe spasticity resistant to common antispastic drugs. PMID:27160523

  3. Management of spastic cerebral palsy through multiple Ayurveda treatment modalities

    OpenAIRE

    Bhinde, Sagar M.; Patel, Kalpana S.; Kori, Virendra Kumar; Rajagopala, S.

    2014-01-01

    Background: Cerebral palsy (CP) is a leading cause of childhood disability affecting function and development. The global incidence of CP is 2:1000. It has been reported that children with CP and their caretaker have impaired health-related quality of life (QOL). Of the many types and subtypes of CP, none has any known cure. For a detailed description of the disease CP, though, there is no one to one correlation in Ayurvedic classics; it can be taken as Vata Vyadhi as far as its etiology and ...

  4. Cervical vestibular evoked myogenic potentials in children with spastic cerebral palsy and normal children with 7-12 years of age

    Directory of Open Access Journals (Sweden)

    Nazila Akbarfahimi

    2014-10-01

    Full Text Available Background and Aim: Cervical vestibular-evoked myogenic potential (cVEMP is one of the diagnostic tests used in assessing vestibular function. Two aims of this study were to investigate implications of cervical vestibular evoked myogenic potential in children with spastic cerebral palsy (7-12 years, and to compare vestibular function in these children and normal children.Methods: In this cross-sectional study, myogenic potential was recorded in 31 children with spastic cerebral palsy (8 girls, 23 boys,7-12 years of age, with mean age of 8.77 years old and standard deviation of 1.52 years and 31 normal children (13 girls, 18 boys with mean age of 8.77 years and standard deviation of 1.52 years. Cervical vestibular evoked myogenic potential was recorded with 500 Hz tone burst. The recorded parameters included p13 and n23 latency, p13-n23 pick to pick amplitude, and threshold.Results: Myogenic Potential was recorded in 31 normal children. They had bilateral responses. In children with cerebral palsy, 21 children showed bilateral responses, 3 children had only right-sided responses, 8 children had only left-sided responses, and two children did not show any responses. The statistical significant differences were shown between the two groups in n23, p13-n23 pick to pick amplitude, and threshold (p<0.05.Conclusion: These findings showed that cervical vestibular evoked myogenic potential can be used in children with cerebral palsy. There were significant differences in myogenic potential parameters between the two groups. More studies are needed to investigate the causes of these differences.

  5. The Intra- and Inter-Rater Reliability of an Instrumented Spasticity Assessment in Children with Cerebral Palsy

    Science.gov (United States)

    Schless, Simon-Henri; Desloovere, Kaat; Aertbeliën, Erwin; Molenaers, Guy; Huenaerts, Catherine; Bar-On, Lynn

    2015-01-01

    Aim Despite the impact of spasticity, there is a lack of objective, clinically reliable and valid tools for its assessment. This study aims to evaluate the reliability of various performance- and spasticity-related parameters collected with a manually controlled instrumented spasticity assessment in four lower limb muscles in children with cerebral palsy (CP). Method The lateral gastrocnemius, medial hamstrings, rectus femoris and hip adductors of 12 children with spastic CP (12.8 years, ±4.13 years, bilateral/unilateral involvement n=7/5) were passively stretched in the sagittal plane at incremental velocities. Muscle activity, joint motion, and torque were synchronously recorded using electromyography, inertial sensors, and a force/torque load-cell. Reliability was assessed on three levels: (1) intra- and (2) inter-rater within session, and (3) intra-rater between session. Results Parameters were found to be reliable in all three analyses, with 90% containing intra-class correlation coefficients >0.6, and 70% of standard error of measurement values stretch repetitions. The parameters were more reliable when the same rater, rather than different raters performed the evaluation. Standardisation and training should be further improved to reduce extrinsic error when different raters perform the measurement. Errors were also muscle specific, or related to the measurement set-up. They need to be accounted for, in particular when assessing pre-post interventions or longitudinal follow-up. The parameters of the instrumented spasticity assessment demonstrate a wide range of applications for both research and clinical environments in the quantification of spasticity. PMID:26134673

  6. Growing concern following compression mammography.

    Science.gov (United States)

    van Netten, Johannes Pieter; Hoption Cann, Stephen; Thornton, Ian; Finegan, Rory

    2016-01-01

    A patient without clinical symptoms had a mammogram in October 2008. The procedure caused intense persistent pain, swelling and development of a haematoma following mediolateral left breast compression. Three months later, a 9×11 cm mass developed within the same region. Core biopsies showed a necrotizing high-grade ductal carcinoma, with a high mitotic index. Owing to its extensive size, the patient began chemotherapy followed by trastuzumab and later radiotherapy to obtain clear margins for a subsequent mastectomy. The mastectomy in October 2009 revealed an inflammatory carcinoma, with 2 of 3 nodes infiltrated by the tumour. The stage IIIC tumour, oestrogen and progesterone receptor negative, was highly HER2 positive. A recurrence led to further chemotherapy in February 2011. In July 2011, another recurrence was removed from the mastectomy scar. She died of progressive disease in 2012. In this article, we discuss the potential influence of compression on the natural history of the tumour. PMID:27581236

  7. Similar barriers and facilitators to physical activity across different clinical groups experiencing lower limb spasticity.

    Science.gov (United States)

    Hundza, Sandra; Quartly, Caroline; Kim, Jasmine M; Dunnett, James; Dobrinsky, Jill; Loots, Iris; Choy, Kim; Chow, Brayley; Hampshire, Alexis; Temple, Viviene A

    2016-07-01

    Purpose Given the importance of physical activity in maintaining health and wellness, an improved understanding of physical activity patterns across different clinical populations is required. This study examines the facilitators for, and barriers to, participation in physical activity across multiple contexts for three clinical groups with chronic lower limb spasticity (individuals with stroke, multiple sclerosis and incomplete spinal cord injury). Method This cross-sectional study employed quantitative measures for spasticity, ankle range of motion, pain, falls, cognition, mobility, and physical activity as well as qualitative semi-structured interviews. Results There were similar impairments in body functions and structures and limitations in activities across the clinical groups. These impairments and limitations negatively impacted participation in physical activity, which was low. Environmental and personal factors exacerbated or mitigated the limiting effects of body functions and structures and activities on physical activity in many areas of life. Conclusions In this population, participation in physical activity includes activities such as housework which are different than what is typically considered as physical activity. Further, the presence of similar barriers and facilitators across the groups suggests that support and services to promote valued forms of physical activity could be organised and delivered based on limitations in mobility and functioning rather than clinical diagnosis. Implications for rehabilitation Physical activity is of utmost importance in maintaining health and wellness in clinical populations. This research highlights the desired and actual physical activity for these populations can look different than what may traditionally be considered as physical activity (e.g. housework is not typically considered participation physical activity). Therefore, rehabilitation interventions need to be directly designed to enhance clients

  8. The effect of electrical passive cycling on spasticity in war veterans with SCI (Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Seyed M Rayegani

    2011-06-01

    Full Text Available Introduction: Muscle atrophy, spasticity and deformity are among long term complication of Spinal Cord Injury(SCI veterans. There are numerous studies evaluating effect of functional electrical stimulation (FES on muscle properties of SCI people, but less research has focused on the benefits of passive cycling in the management of spasm and improving ROM of lower limbs in individuals with SCI. Aims: To evaluate the effect of electrical passive cycling on passive range of movement spasticity and electrodiagnostic parameters in SCI veterans. Methods: 64 SCI veterans referred to two clinical and research center in Tehran were recruited in this prospective clinical trial. The subjects were divided into 2 groups according to electrical passive cycling usage: 1 patients who didn’t use pedal exercise(control group, 2 patients used Electrical passive cycling up to optimal level (intervention group . Main outcome measures included hip, knee and ankle rang of motion, spacticity scale, and electrodiagnostic parameters including F-Wave Consistency, F-Wave Amplitude, H/M Ratio, F/M Ratio, H Reflex Onset Latency and H Reflex Amplitude. Data were recorded at the time of receiving and one year after pedal exercise usage. Results : Sixty four SCI patients including 95.3% male, 4.7% female with mean age 43 years old were included in this study. All patients except one had complete SCI suffered from complete SCI. The involved spinal levels were cervical(17.2%, upper thoracic (34.4%, lower thoracic (45.3% and lumbar (3.1%. Spasticity scale decreased significantly after passive cycling in group 2 and 3. Also hip, knee and ankle ROM in group 2 and 3 were significantly improved after pedal exercise. There was a significant difference in H max/M max (RT< and F/M ratio after versus before electric passive cycling system in group 2. Conclusion: These findings suggest that passive rythmic leg exercise can lead to decrease in spasticity ,increase in passive ROM of low

  9. Hereditary spastic paraplegia is not associated with C9ORF72 repeat expansions in a Danish cohort

    DEFF Research Database (Denmark)

    Nielsen, T T; Svenstrup, K; Duno, M;

    2014-01-01

    OBJECTIVES: Hereditary spastic paraplegia (HSP) is a heterogeneous group of neurodegenerative disorders characterized by a progressive gait disorder, lower limb spasticity, hyper-reflexia, weakness and extensor plantar responses. Recently, large intronic hexanucleotide repeat expansions (GGGGCC...... that C9ORF72 expansions might be a genetic risk factor or modifier of HSP. METHODS: Clinically characterized HSP patients were investigated for elongations in the hexanucleotide repeat of C9ORF72. RESULTS: Upon analyses of the repeat lengths in the C9ORF72 gene in a Danish cohort of HSP patients, we...

  10. Compression Ratio Adjuster

    Science.gov (United States)

    Akkerman, J. W.

    1982-01-01

    New mechanism alters compression ratio of internal-combustion engine according to load so that engine operates at top fuel efficiency. Ordinary gasoline, diesel and gas engines with their fixed compression ratios are inefficient at partial load and at low-speed full load. Mechanism ensures engines operate as efficiently under these conditions as they do at highload and high speed.

  11. Arabic Short Text Compression

    Directory of Open Access Journals (Sweden)

    Eman Omer

    2010-01-01

    Full Text Available Problem statement: Text compression permits representing a document by using less space. This is useful not only to save disk space, but more importantly, to save disk transfer and network transmission time. With the continues increase in the number of Arabic short text messages sent by mobile phones, the use of a suitable compression scheme would allow users to use more characters than the default value specified by the provider. The development of an efficient compression scheme to compress short Arabic texts is not a straight forward task. Approach: This study combined the benefits of pre-processing, entropy reduction through splitting files and hybrid dynamic coding: A new technique proposed in this study that uses the fact that Arabic texts have single case letters. Experimental tests had been performed on short Arabic texts and a comparison with the well known plain Huffman compression was made to measure the performance of the proposed schema for Arabic short text. Results: The proposed schema can achieve a compression ratio around 4.6 bits byte-1 for very short Arabic text sequences of 15 bytes and around 4 bits byte-1 for 50 bytes text sequences, using only 8 Kbytes overhead of memory. Conclusion: Furthermore, a reasonable compression ratio can be achieved using less than 0.4 KB of memory overhead. We recommended the use of proposed schema to compress small Arabic text with recourses limited.

  12. A NOVEL MULTIDICTIONARY BASED TEXT COMPRESSION

    Directory of Open Access Journals (Sweden)

    Y. Venkataramani

    2012-01-01

    Full Text Available The amount of digital contents grows at a faster speed as a result does the demand for communicate them. On the other hand, the amount of storage and bandwidth increases at a slower rate. Thus powerful and efficient compression methods are required. The repetition of words and phrases cause the reordered text much more compressible than the original text. On the whole system is fast and achieves close to the best result on the test files. In this study a novel fast dictionary based text compression technique MBRH (Multidictionary with burrows wheeler transforms, Run length coding and Huffman coding is proposed for the purpose of obtaining improved performance on various document sizes. MBRH algorithm comprises of two stages, the first stage is concerned with the conversion of input text into dictionary based compression .The second stage deals mainly with reduction of the redundancy in multidictionary based compression by using BWT, RLE and Huffman coding. Bib test files of input size of 111, 261 bytes achieves compression ratio of 0.192, bit rate of 1.538 and high speed using MBRH algorithm. The algorithm has attained a good compression ratio, reduction of bit rate and the increase in execution speed.

  13. Fractal image compression

    Science.gov (United States)

    Barnsley, Michael F.; Sloan, Alan D.

    1989-01-01

    Fractals are geometric or data structures which do not simplify under magnification. Fractal Image Compression is a technique which associates a fractal to an image. On the one hand, the fractal can be described in terms of a few succinct rules, while on the other, the fractal contains much or all of the image information. Since the rules are described with less bits of data than the image, compression results. Data compression with fractals is an approach to reach high compression ratios for large data streams related to images. The high compression ratios are attained at a cost of large amounts of computation. Both lossless and lossy modes are supported by the technique. The technique is stable in that small errors in codes lead to small errors in image data. Applications to the NASA mission are discussed.

  14. Spectral Animation Compression

    Institute of Scientific and Technical Information of China (English)

    Chao Wang; Yang Liu; Xiaohu Guo; Zichun Zhong; Binh Le; Zhigang Deng

    2015-01-01

    This paper presents a spectral approach to compress dynamic animation consisting of a sequence of homeomor-phic manifold meshes. Our new approach directly compresses the field of deformation gradient defined on the surface mesh, by decomposing it into rigid-body motion (rotation) and non-rigid-body deformation (stretching) through polar decompo-sition. It is known that the rotation group has the algebraic topology of 3D ring, which is different from other operations like stretching. Thus we compress these two groups separately, by using Manifold Harmonics Transform to drop out their high-frequency details. Our experimental result shows that the proposed method achieves a good balance between the reconstruction quality and the compression ratio. We compare our results quantitatively with other existing approaches on animation compression, using standard measurement criteria.

  15. Ossified Posterior Longitudinal Ligament With Massive Ossification of the Anterior Longitudinal Ligament Causing Dysphagia in a Diffuse Idiopathic Skeletal Hyperostosis Patient.

    Science.gov (United States)

    Murayama, Kazuhiro; Inoue, Shinichi; Tachibana, Toshiya; Maruo, Keishi; Arizumi, Fumihiro; Tsuji, Shotaro; Yoshiya, Shinichi

    2015-08-01

    Descriptive case report.To report a case of a diffuse idiopathic skeletal hyperostosis (DISH) patient with both massive ossification of the anterior longitudinal ligament (OALL) leading to severe dysphagia as well as ossification of the posterior longitudinal ligament (OPLL) causing mild cervical myelopathy, warranting not only an anterior approach but also a posterior one.Although DISH can cause massive OALL in the cervical spine, severe dysphagia resulting from DISH is a rare occurrence. OALLs are frequently associated with OPLL. Treatment for a DISH patient with OPLL in setting of OALL-caused dysphagia is largely unknown.A 70-year-old man presented with severe dysphagia with mild cervical myelopathy. Neurological examination showed mild spastic paralysis and hyper reflex in his lower extremities. Plane radiographs and computed tomography of the cervical spine revealed a discontinuous massive OALL at C4-5 and continuous type OPLL at C2-6. Magnetic resonance imaging revealed pronounced spinal cord compression due to OPLL at C4-5. Esophagram demonstrated extrinsic compression secondary to OALL at C4-5.We performed posterior decompressive laminectomy with posterior lateral mass screw fixation, as well as both resection of OALL and interbody fusion at C4-5 by the anterior approach. We performed posterior decompressive laminectomy with posterior lateral mass screw fixation, as well as both resection of OALL and interbody fusion at C4-5 by the anterior approach. Severe dysphagia markedly improved without any complications.We considered that this patient not only required osteophytectomy and fusion by the anterior approach but also required decompression and spinal fusion by the posterior approach to prevent both deterioration of cervical myelopathy and recurrence of OALL after surgery. PMID:26266365

  16. Compression asphyxia from a human pyramid.

    Science.gov (United States)

    Tumram, Nilesh Keshav; Ambade, Vipul Namdeorao; Biyabani, Naushad

    2015-12-01

    In compression asphyxia, respiration is stopped by external forces on the body. It is usually due to an external force compressing the trunk such as a heavy weight on the chest or abdomen and is associated with internal injuries. In present case, the victim was trapped and crushed under the falling persons from a human pyramid formation for a "Dahi Handi" festival. There was neither any severe blunt force injury nor any significant pathological natural disease contributing to the cause of death. The victim was unable to remove himself from the situation because his cognitive responses and coordination were impaired due to alcohol intake. The victim died from asphyxia due to compression of his chest and abdomen. Compression asphyxia resulting from the collapse of a human pyramid and the dynamics of its impact force in these circumstances is very rare and is not reported previously to the best of our knowledge.

  17. PMCA4 (ATP2B4 mutation in familial spastic paraplegia.

    Directory of Open Access Journals (Sweden)

    Miaoxin Li

    Full Text Available Familial spastic paraplegia (FSP is a heterogeneous group of disorders characterized primarily by progressive lower limb spasticity and weakness. More than 50 disease loci have been described with different modes of inheritance. In this study, we identified a novel missense mutation (c.803G>A, p.R268Q in the plasma membrane calcium ATPase (PMCA4, or ATP2B4 gene in a Chinese family with autosomal dominant FSP using whole-exome sequencing and confirmed with Sanger sequencing. This mutation co-segregated with the phenotype in the six family members studied and is predicted to be pathogenic when multiple deleteriousness predictions were combined. This novel R268Q mutation was not present in over 7,000 subjects in public databases, and over 1,000 Han Chinese in our database. Prediction of potential functional consequence of R268Q mutation on PMCA4 by computational modeling revealed that this mutation is located in protein aggregation-prone segment susceptible to protein misfolding. Analysis for thermodynamic protein stability indicated that this mutation destabilizes the PMCA4 protein structure with higher folding free energy. As PMCA4 functions to maintain neuronal calcium homeostasis, our result showed that calcium dysregulation may be associated with the pathogenesis of FSP.

  18. Evaluation on the Therapeutic Effects of Digital Acupoint Pressure for Obstetric Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To probe the evaluation methods for effects of TCM treatment of cerebral palsy through clinical observation on the digital acupoint pressure in treating obstetric spastic cerebral palsy. From 1998-2003,40 cases of spastic cerebral palsy were treated with digital acupoint pressure therapy. Ten indexes including intelligence, language, salivation, hand-grasping, thumb-adduction, turnover, sitting, standing,walking, and scissors-gait were divided into the 4 grades of normal, mild abnormal, moderate abnormal,and severe abnormal (dysfunction), respectively marked as 6, 4, 2, and 0 point, with 2 points increased for improving each grade of each item after the treatment. Meanwhile, the ranges were recorded and evaluated before and after the treatment on shoulder-abduction, elbow-extension, wrist-extension,forearm-backward-rotation, hip-abduction, straight-leg-lifting, knee-extension, and ankle-dorsiflexion.Those with the improvement of 10° , 15° , 20° , 25° , and 30° in the range of movement of their contractured joints would obtain respectively 1, 2, 3, 4, and 5 points. There were significant differences before and after the treatment in the 18 items under observation except for intelligence, with obvious improvement shown after the treatment (P<0.01), the effective rate being 92.5%. The therapeutic criteria set in this research are well established in reflecting the functional improvements of the patient.

  19. Complicated spastic paraplegia in patients with AP5Z1 mutations (SPG48)

    Science.gov (United States)

    Hirst, Jennifer; Madeo, Marianna; Smets, Katrien; Edgar, James R.; Schols, Ludger; Li, Jun; Yarrow, Anna; Deconinck, Tine; Baets, Jonathan; Van Aken, Elisabeth; De Bleecker, Jan; Datiles, Manuel B.; Roda, Ricardo H.; Liepert, Joachim; Züchner, Stephan; Mariotti, Caterina; De Jonghe, Peter; Blackstone, Craig

    2016-01-01

    Objective: Biallelic mutations in the AP5Z1 gene encoding the AP-5 ζ subunit have been described in a small number of patients with hereditary spastic paraplegia (HSP) (SPG48); we sought to define genotype–phenotype correlations in patients with homozygous or compound heterozygous sequence variants predicted to be deleterious. Methods: We performed clinical, radiologic, and pathologic studies in 6 patients with biallelic mutations in AP5Z1. Results: In 4 of the 6 patients, there was complete loss of AP-5 ζ protein. Clinical features encompassed not only prominent spastic paraparesis but also sensory and motor neuropathy, ataxia, dystonia, myoclonus, and parkinsonism. Skin fibroblasts from affected patients tested positive for periodic acid Schiff and autofluorescent storage material, while electron microscopic analysis demonstrated lamellar storage material consistent with abnormal storage of lysosomal material. Conclusions: Our findings expand the spectrum of AP5Z1-associated neurodegenerative disorders and point to clinical and pathophysiologic overlap between autosomal recessive forms of HSP and lysosomal storage disorders.

  20. Hereditary spastic paraplegia: LOD-score considerations for confirmation of linkage in a heterogeneous trait

    Energy Technology Data Exchange (ETDEWEB)

    Dube, M.P.; Kibar, Z.; Rouleau, G.A. [McGill Univ., Quebec (Canada)] [and others

    1997-03-01

    Hereditary spastic paraplegia (HSP) is a degenerative disorder of the motor system, defined by progressive weakness and spasticity of the lower limbs. HSP may be inherited as an autosomal dominant (AD), autosomal recessive, or an X-linked trait. AD HSP is genetically heterogeneous, and three loci have been identified so far: SPG3 maps to chromosome 14q, SPG4 to 2p, and SPG4a to 15q. We have undertaken linkage analysis with 21 uncomplicated AD families to the three AD HSP loci. We report significant linkage for three of our families to the SPG4 locus and exclude several families by multipoint linkage. We used linkage information from several different research teams to evaluate the statistical probability of linkage to the SPG4 locus for uncomplicated AD HSP families and established the critical LOD-score value necessary for confirmation of linkage to the SPG4 locus from Bayesian statistics. In addition, we calculated the empirical P-values for the LOD scores obtained with all families with computer simulation methods. Power to detect significant linkage, as well as type I error probabilities, were evaluated. This combined analytical approach permitted conclusive linkage analyses on small to medium-size families, under the restrictions of genetic heterogeneity. 19 refs., 1 fig., 1 tab.

  1. Therapeutic Efficacy Analysis of Balancing Yin-yang Manipulation for Post-stroke Upper Limb Spasticity

    Institute of Scientific and Technical Information of China (English)

    Cui Hua-feng; Gao Guo-qiang; Wang Yan-li; Yu Xiao-hua; Guo Li; Ren Shuo

    2014-01-01

    Objective: To observe the effect of balancing yin-yang needling manipulation on post-stroke upper limb spasticity and changes of electromyography (EMG) after treatment. Methods: A total of 60 eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Based on routine medication, cases in the control group were treated with conventional needling manipulation, whereas cases in the observation group were treated with balancing yin-yang manipulation. After the courses of treatment were completed, the therapeutic efficacies were evaluated using modified Ashworth scale and clinical spasticity index (CSI), coupled with the integrated electromyography (IEMG) and root mean square (RMS) value of biceps in passive flexion of the elbow joint during isokinetic testing recorded with the surface EMG. Results: The total effective rate in the observation group was 86.7%, versus 53.3% in the control group, showing a statistical significance (P Conclusion:Balancing yin-yang and conventional needling manipulations can both improve upper limb spasm and reduce CSI as well as IEMG and RMS values in stroke patients;however, balancing yin-yang manipulation is better than conventional manipulation in clinical effect.

  2. Retinal nerve fibre layer loss in hereditary spastic paraplegias is restricted to complex phenotypes

    Directory of Open Access Journals (Sweden)

    Wiethoff Sarah

    2012-11-01

    Full Text Available Abstract Background Reduction of retinal nerve fibre layer (RNFL thickness was shown as part of the neurodegenerative process in a range of different neurodegenerative pathologies including Alzheimer′s disease (AD, idiopathic Parkinson’s disease (PD, spinocerebellar ataxia (SCA and multiple system atrophy (MSA. To further clarify the specificity of RNFL thinning as a potential marker of neurodegenerative diseases we investigated RNFL thickness in Hereditary Spastic Paraplegia (HSP, an axonal, length-dependent neurodegenerative pathology of the upper motor neurons. Methods Spectral domain optical coherence tomography (OCT was performed in 28 HSP patients (clinically: pure HSP = 22, complicated HSP = 6; genetic subtypes: SPG4 = 13, SPG5 = 1, SPG7 = 3, genetically unclassified: 11 to quantify peripapillary RNFL thickness. Standardized examination assessed duration of disease, dependency on assistive walking aids and severity of symptoms quantified with Spastic Paraplegia Rating Scale (SPRS. Results HSP patients demonstrated no significant thinning of global RNFL (pglobal = 0.61. Subgroup analysis revealed significant reduction in temporal and temporal inferior sectors for patients with complex (p Conclusion Clinically pure HSP patients feature no significant reduction in RNFL, whereas complex phenotypes display an abnormal thinning of temporal and temporal inferior RNFL. Our data indicate that RNFL thinning does not occur unspecifically in all neurodegenerative diseases but is in HSP restricted to subtypes with multisystemic degeneration.

  3. Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity

    Directory of Open Access Journals (Sweden)

    Jessica Maria D'Amico

    2014-05-01

    Full Text Available The state of areflexia and muscle weakness that immediately follows a spinal cord injury is gradually replaced by the recovery of neuronal and network excitability, leading to both improvements in residual motor function and the development of spasticity. In this review we summarize recent animal and human studies that describe how motoneurons and their activation by sensory pathways become hyperexcitable to compensate for the reduction of descending and movement-induced sensory inputs and the eventual impact on the muscle. We discuss how replacing lost patterned activation of the spinal cord by activating synaptic inputs via assisted movements, pharmacology or electrical stimulation may help to recover lost spinal inhibition. This may lead to a reduction of uncontrolled activation of the spinal cord and thus, improve its controlled activation by synaptic inputs to ultimately normalize circuit function. Increasing the excitation of the spinal cord below an injury with spared descending and/or peripheral functional synaptic activation, instead of suppressing it pharmacologically, may provide the best avenue to improve residual motor function and manage spasticity after spinal cord injury.

  4. Changes in spastic muscles of patients with infantile cerebral palsy according to ultrasound findings

    Directory of Open Access Journals (Sweden)

    S. V. Vlasenko

    2016-01-01

    Full Text Available Infantile cerebral palsy (ICP occupies a leading position in its prevalence among childhood disabling neurological diseases.Objective: to investigate the structure of spastic muscles in patients with ICP using ultrasonography (USG.Patients and methods. A total of 196 patients with ICP (spastic diplegia who received a cycle of sanatorium-and-spa treatment underwent clinical, neurological, electromyographic examinations and lower limb muscle USG.Results. It was established that USG could reliably estimate the degree of structural changes in lower limb muscles. An average correlation was found between the level of development, by using the Gross Motor Function Classification System for Cerebral Palsy (GMFCS, and age at contracture formation (R=0.60; p=0.001. Analysis of USG and electromyographic findings in patients with ICP revealed a strong negative correlation with the amplitude and rates (R=-0.81; p=0.002; R=-0.77; p=0.001, respectively and weak reciprocity-adequacy correlations (R=0.21; p=0.071; R=0.24; p=0.043, respectively.Conclusion. Based on the findings, the authors formed rehabilitation approaches for motor disorders in children with ICP in relation to the magnitude of structural changes in the muscular system.

  5. Management of the spastic wrist and hand in cerebral palsy.

    Science.gov (United States)

    Leafblad, Nels D; Van Heest, Ann E

    2015-05-01

    Research from the last 5 years on the pathophysiology and treatment of upper extremity sequelae of cerebral palsy (CP) is presented. The development of new treatments of CP-affected limbs, utilizing the brain's inherent neuroplasticity, remains an area of promising and active research. Functional magnetic resonance imaging scans have evaluated the role of neuroplasticity in adapting to the initial central nervous system insult. Children with CP appear to have greater recruitment of the ipsilateral brain for motor and sensory functions of the affected upper limb. Studies have also shown that constraint-induced movement therapy results in localized increase in gray matter volume of the sensorimotor cortex contralateral to the affected arm targeted during rehabilitation. Recent therapy interventions have emphasized the role of home therapy programs, the transient effects of splinting, and the promise of constraint-induced movement therapy and bimanual hand training. The use of motion laboratory analysis to characterize the movement pattern disturbances in children with CP continues to expand. Classification systems for CP upper limb continue to expand and improve their reliability, including use of the House Classification, the Manual Ability Classification System, and the Shriner's Hospital Upper Extremity Evaluation. Surgical outcomes have greater patients' satisfaction when they address functional limitations, also in addition to aesthetics, which may improve patients' self-esteem. Surgical techniques for elbow, wrist, fingers, and thumb continue to be refined. Research into each of these areas continues to expand our understanding of the nervous system insults that cause CP, how they may be modified, and how hand surgeons can continue to serve patients by improving their upper limb function and aesthetics. PMID:25841769

  6. Genetic disorders producing compressive radiculopathy.

    Science.gov (United States)

    Corey, Joseph M

    2006-11-01

    Back pain is a frequent complaint seen in neurological practice. In evaluating back pain, neurologists are asked to evaluate patients for radiculopathy, determine whether they may benefit from surgery, and help guide management. Although disc herniation is the most common etiology of compressive radiculopathy, there are many other causes, including genetic disorders. This article is a discussion of genetic disorders that cause or contribute to radiculopathies. These genetic disorders include neurofibromatosis, Paget's disease of bone, and ankylosing spondylitis. Numerous genetic disorders can also lead to deformities of the spine, including spinal muscular atrophy, Friedreich's ataxia, Charcot-Marie-Tooth disease, familial dysautonomia, idiopathic torsional dystonia, Marfan's syndrome, and Ehlers-Danlos syndrome. However, the extent of radiculopathy caused by spine deformities is essentially absent from the literature. Finally, recent investigation into the heritability of disc degeneration and lumbar disc herniation suggests a significant genetic component in the etiology of lumbar disc disease. PMID:17048153

  7. Genetic disorders producing compressive radiculopathy.

    Science.gov (United States)

    Corey, Joseph M

    2006-11-01

    Back pain is a frequent complaint seen in neurological practice. In evaluating back pain, neurologists are asked to evaluate patients for radiculopathy, determine whether they may benefit from surgery, and help guide management. Although disc herniation is the most common etiology of compressive radiculopathy, there are many other causes, including genetic disorders. This article is a discussion of genetic disorders that cause or contribute to radiculopathies. These genetic disorders include neurofibromatosis, Paget's disease of bone, and ankylosing spondylitis. Numerous genetic disorders can also lead to deformities of the spine, including spinal muscular atrophy, Friedreich's ataxia, Charcot-Marie-Tooth disease, familial dysautonomia, idiopathic torsional dystonia, Marfan's syndrome, and Ehlers-Danlos syndrome. However, the extent of radiculopathy caused by spine deformities is essentially absent from the literature. Finally, recent investigation into the heritability of disc degeneration and lumbar disc herniation suggests a significant genetic component in the etiology of lumbar disc disease.

  8. Reliability of the Modified Ashworth Scale in the Assessment of Plantarflexor Muscle Spasticity in Patients with Traumatic Brain Injury.

    Science.gov (United States)

    Allison, S. C.; And Others

    1996-01-01

    This attempt to determine the reliability of the Modified Ashworth Scale for assessing the severity of muscle spasticity for ankle plantarflexors in 30 patients with traumatic brain injury concluded that the reliability was minimally adequate to support the scale's continued use. Interrater reliability was less than that previously reported for…

  9. Soleus Stretch Reflex Inhibition in the Early Swing Phase of Gait Using Deep Peroneal Nerve Stimulation in Spastic Stroke Participants

    NARCIS (Netherlands)

    Voormolen, Marco M.; Ladouceur, Michel; Veltink, Peter H.; Sinkjaer, Thomas

    2000-01-01

    Objectives: To investigate the feasibility of inhibiting the stretch reflex of the soleus muscle by a conditioning stimulus applied to the deep peroneal nerve in spastic stroke participants during the early swing phase of gait. - Materials and Methods: This study investigated the effect of an electr

  10. Inhibition of the triceps surae stretch reflex by stimulation of the deep peroneal nerve in persons with spastic stroke

    NARCIS (Netherlands)

    Veltink, Peter H.; Ladouceur, Michel; Sinkjaer, Thomas

    2000-01-01

    Inhibition of the triceps surae stretch reflex by stimulation of the deep peroneal nerve in persons with spastic stroke. Arch Phys Med Rehabil 2000;81:1016-24. Objective: To reduce the triceps surae stretch reflex by electrical stimulation of the deep peroneal nerve. Design: Intervention study. Sett

  11. The Use of Botulinum Toxin for the Treatment of Muscle Spasticity in the First 2 Years of Life

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    Although there are sound theoretical reasons for the use of botulinum toxin (Btx) as early as possible in the management of severe childhood muscle spasticity, the experience with its safety in children younger than 2 years of age is limited and information about its possible effects on the development and maturation of the human motor system…

  12. Intrathecal Baclofen in Children with Spastic Cerebral Palsy: A Double-Blind, Randomized, Placebo-Controlled, Dose-Finding Study

    Science.gov (United States)

    Hoving, Marjanke A.; van Raak, Elisabeth P. M.; Spincemaille, Geert H. J. J.; Palmans, Liesbeth J.; Sleypen, Frans A. M.; Vles, Johan S. H.

    2007-01-01

    Intrathecal baclofen (ITB) therapy can be very effective in the treatment of intractable spasticity, but its effectiveness and safety have not yet been thoroughly studied in children with cerebral palsy (CP). The aims of this double-blind, randomized, placebo-controlled, dose-finding study were to select children eligible for continuous ITB…

  13. Changes in Muscle Activation Following Ankle Strength Training in Children with Spastic Cerebral Palsy: An Electromyography Feasibility Case Report

    Science.gov (United States)

    Olsen, Jamie E.; Ross, Sandy A.; Foreman, Matthew H.; Engsberg, Jack R.

    2013-01-01

    Children with cerebral palsy (CP) are likely to experience decreased participation in activities and less competence in activities of daily living. Studies of children with spastic CP have shown that strengthening programs produce positive results in strength, gait, and functional outcomes (measured by the Gross Motor Function Measure). No…

  14. Classification of Posture in Poststroke Upper Limb Spasticity: A Potential Decision Tool for Botulinum Toxin A Treatment?

    Science.gov (United States)

    Hefter, Harald; Jost, Wolfgang H.; Reissig, Andrea; Zakine, Benjamin; Bakheit, Abdel Magid; Wissel, Jorg

    2012-01-01

    A significant percentage of patients suffering from a stroke involving motor-relevant central nervous system regions will develop a spastic movement disorder. Hyperactivity of different muscle combinations forces the limbs affected into abnormal postures or movement patterns. As muscular hyperactivity can effectively and safely be treated with…

  15. Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial.

    NARCIS (Netherlands)

    Aarts, P.B.M.; Jongerius, P.H.; Geerdink, Y.A.; Limbeek, J. van; Geurts, A.C.H.

    2010-01-01

    BACKGROUND: In children with unilateral spastic cerebral palsy (CP), there is only limited evidence for the effectiveness of modified constraint-induced movement therapy (mCIMT). OBJECTIVE: To investigate whether 6 weeks of mCIMT followed by 2 weeks of bimanual task-specific training (mCIMT-BiT) in

  16. Deficits in Upper Limb Position Sense of Children with Spastic Hemiparetic Cerebral Palsy Are Distance-Dependent

    Science.gov (United States)

    Smorenburg, Ana R. P.; Ledebt, Annick; Deconinck, Frederik J. A.; Savelsbergh, Geert J. P.

    2012-01-01

    This study examined the arm position sense in children with Spastic Hemiparetic Cerebral Palsy (SHCP) and typically developing children (TD) by means of a contralateral matching task. This task required participants to match the position of one arm with the position of the other arm for different target distances and from different starting…

  17. Physical Therapy in the Management of Pelvic Floor Muscles Hypertonia in a Woman with Hereditary Spastic Paraplegia

    Directory of Open Access Journals (Sweden)

    Aline Moreira Ribeiro

    2014-01-01

    Full Text Available Background. Pelvic floor (PF hypertonic disorders are a group of conditions that present with muscular hypertonia or spasticity, resulting in a diminished capacity to isolate, contract, and relax the PF. Their presentation includes voiding and sexual dysfunctions, pelvic pain, and constipation. Various factors are associated, such as complicated vaginal birth, muscular injury, scar tissue formation, and neuropathies. Study Design. The case of a single patient will be presented, together with the management strategies employed. Case Description. A woman with hereditary spastic paraparesis and a history of muscle spasticity and urinary and fecal complaints since childhood. She presented to this institution seeking treatment for pelvic pain, pain during intercourse, constipation, and micturition problems. A physical therapy protocol was developed, with the trial of several treatment modalities. Outcome. After some failed attempts, perineal and pelvic floor stretching proved to be very efficacious therapies for this patient’s complaint, leading to improved pain during intercourse, constipation, pelvic pain, and urinary stream. Discussion. PF spasticity can lead to severe disability and interfere with daily basic functions, such as micturition and evacuation. Physical therapy plays an essential role in the management of these patients and can lead to significant improvement in quality of life.

  18. THC and CBD oromucosal spray (Sativex®) in the management of spasticity associated with multiple sclerosis.

    Science.gov (United States)

    Sastre-Garriga, Jaume; Vila, Carlos; Clissold, Stephen; Montalban, Xavier

    2011-05-01

    People with multiple sclerosis may present with a wide range of disease symptoms during the evolution of the disease; among these, spasticity can have a marked impact on their well-being and quality of life. Symptom control, including spasticity, remains a key management strategy to improve the patient's well-being and functional status. However, available drug therapies for spasticity sometimes have limited benefit and they are often associated with poor tolerability. Sativex is a 1:1 mix of 9-delta-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, which is available as an oromucosal spray. Clinical experience with Sativex in patients with multiple sclerosis is accumulating steadily. Results from randomized, controlled trials have reported a reduction in the severity of symptoms associated with spasticity, leading to a better ability to perform daily activities and an improved perception of patients and their carers regarding functional status when Sativex was added to the current treatment regimen. Adverse events such as dizziness, diarrhea, fatigue, nausea, headache and somnolence occur quite frequently with Sativex, but they are generally of mild-to-moderate intensity and their incidence can be markedly reduced by gradual 'uptitration'. In summary, initial well-controlled studies with Sativex oromucosal spray administered as an add-on to usual therapy have produced promising results and highlight encouraging avenues for future research. PMID:21456949

  19. Correlation between the selective control assessment of lower extremity and pediatric balance scale scores in children with spastic cerebral palsy

    Science.gov (United States)

    Lim, Hyoungwon

    2015-01-01

    [Purpose] The purpose of this study was to investigate the correlation between the Selective Control Assessment of Lower Extremity (SCALE) and Pediatric Balance Scales (PBS) in children with spastic cerebral palsy and further to test whether the SCALE is a valid tool to predict the PBS. [Subjects and Methods] A cross-sectional study was conducted to evaluate the SCALE and PBS in 23 children (9 females, 14 males, GMFCS level I–III) with spastic cerebral palsy. [Results] Both the SCALE and PBS scores for children with spastic hemiplegia were significantly higher than those for children with spastic diplegia. The scores for SCALE items were low for distal parts. The PBS items that were difficult for the participants to perform were items 8, 9, 10, and 14 with the highest difficulty experienced for item 8 followed by items 9, 10, and 14. The correlation coefficient (0.797) between the SCALE and PBS scores was statistically significant. The correlations between each SCALE item and the PBS scores were also statistically significant. SCALE items were significantly correlated with two PBS dimensions (standing and postural change). [Conclusion] In SCALE assessment, more severe deficits were observed in the distal parts. Standing and postural changes in the PBS method were difficult for the participants to perform. The two tests, that is, the SCALE and PBS, were highly correlated. Therefore, the SCALE is useful to prediction of PBS outcomes and is also applicable as a prognostic indicator for treatment planning. PMID:26834323

  20. Preclinical models of muscle spasticity: valuable tools in the development of novel treatment for neurological diseases and conditions.

    Science.gov (United States)

    Bespalov, Anton; Mus, Liudmila; Zvartau, Edwin

    2016-05-01

    Poor validity of preclinical animal models is one of the most commonly discussed explanations for the failures to develop novel drugs in general and in neuroscience in particular. However, there are several areas of neuroscience such as injury-induced spasticity where etiological factor can be adequately recreated and models can focus on specific pathophysiological mechanisms that likely contribute to spasticity syndrome in humans (such as motoneuron hyperexcitability and spinal hyperreflexia). Methods used to study spasticity in preclinical models are expected to have a high translational value (e.g., electromyogram (EMG)-based electrophysiological tools) and can efficiently assist clinical development programs. However, validation of these models is not complete yet. First, true predictive validity of these models is not established as clinically efficacious drugs have been used to reverse validate preclinical models while newly discovered mechanisms effective in preclinical models are yet to be fully explored in humans (e.g., 5-HT2C receptor inverse agonists, fatty acid amid hydrolase inhibitors). Second, further efforts need to be invested into cross-laboratory validation of study protocols and tools, adherence to the highest quality standards (blinding, randomization, pre-specified study endpoints, etc.), and systematic efforts to replicate key sets of data. These appear to be readily achievable tasks that will enable development not only of symptomatic but also of disease-modifying therapy of spasticity, an area that seems to be currently not in focus of research efforts. PMID:26861550

  1. Substantial effects of epimuscular myofascial force transmission on muscular mechanics have major implications on spastic muscle and remedial surgery

    NARCIS (Netherlands)

    Yucesoy, Can A.; Huijing, Peter A.

    2007-01-01

    The specific aim of this paper is to review the effects of epimuscular myofascial force transmission on muscular mechanics and present some new results on finite element modeling of non-isolated aponeurotomized muscle in order to discuss the dependency of mechanics of spastic muscle, as well as surg

  2. Compressed Data Transmission Among Nodes in BigData

    OpenAIRE

    Thirunavukarasu B; Sudhahar V M; VasanthaKumar U; Dr Kalaikumaran T; Dr.Karthik.S

    2014-01-01

    Many organizations are now dealing with large amount of data. Traditionally they used relational data. But nowadays they are supposed to use structured and semi structured data. To work effectively these organizations uses virtualization, parallel processing in compression etc., out of which the compression is most effective one. The data transmission of high volume usually causes high transmission time. This compression of unstructured data is immediately done when the data is being trans...

  3. Impedance of tissue-mimicking phantom material under compression

    OpenAIRE

    Barry Belmont; Dodde, Robert E.; Shih, Albert J.

    2013-01-01

    The bioimpedance of tissues under compression is a field in need of study. While biological tissues can become compressed in a myriad of ways, very few experiments have been conducted to describe the relationship between the passive electrical properties of a material (impedance/admittance) during mechanical deformation. Of the investigations that have been conducted, the exodus of fluid from samples under compression has been thought to be the cause of changes in impedance, though until now ...

  4. The use of botulinum toxin and epidural analgesia for the treatment of spasticity and pain in a patient with maple syrup urine disease

    Directory of Open Access Journals (Sweden)

    Abdullah M Kaki

    2012-01-01

    Full Text Available A 7-year-old boy, weighing 18 kg, was diagnosed with maple syrup urine disease (MSUD. He suffered from spasticity of the lower limbs and pain that did not respond to oral medications. Injections of botulinum toxin A (BTX-A at 10 sites and epidural analgesia with 0.125% bupivacaine were used to treat spasticity with good results. We conclude that BTX-A combined with epidural analgesia may be a useful treatment option for incapacitating, painful spasticity related to MSUD. This treatment modality allowed a comprehensive rehabilitation program to be completed and it lasted longer than 9 months.

  5. Focus on Compression Stockings

    Science.gov (United States)

    ... therapy may be recommended as part of a treatment plan. There are several situations when compression may be helpful, including: tired legs, varicose veins, chronic venous insufficiency (CVI), lymphedema, or deep vein thrombosis (DVT). This brochure focuses ...

  6. LZW Data Compression

    Directory of Open Access Journals (Sweden)

    Dheemanth H N

    2016-07-01

    Full Text Available Lempel–Ziv–Welch (LZW is a universal lossless data compression algorithm created by Abraham Lempel, Jacob Ziv, and Terry Welch. LZW compression is one of the Adaptive Dictionary techniques. The dictionary is created while the data are being encoded. So encoding can be done on the fly. The dictionary need not be transmitted. Dictionary can be built up at receiving end on the fly. If the dictionary overflows then we have to reinitialize the dictionary and add a bit to each one of the code words. Choosing a large dictionary size avoids overflow, but spoils compressions. A codebook or dictionary containing the source symbols is constructed. For 8-bit monochrome images, the first 256 words of the dictionary are assigned to the gray levels 0-255. Remaining part of the dictionary is filled with sequences of the gray levels.LZW compression works best when applied on monochrome images and text files that contain repetitive text/patterns.

  7. Shocklets in compressible flows

    Institute of Scientific and Technical Information of China (English)

    袁湘江; 男俊武; 沈清; 李筠

    2013-01-01

    The mechanism of shocklets is studied theoretically and numerically for the stationary fluid, uniform compressible flow, and boundary layer flow. The conditions that trigger shock waves for sound wave, weak discontinuity, and Tollmien-Schlichting (T-S) wave in compressible flows are investigated. The relations between the three types of waves and shocklets are further analyzed and discussed. Different stages of the shocklet formation process are simulated. The results show that the three waves in compressible flows will transfer to shocklets only when the initial disturbance amplitudes are greater than the certain threshold values. In compressible boundary layers, the shocklets evolved from T-S wave exist only in a finite region near the surface instead of the whole wavefront.

  8. Efficacy and safety of nabiximols (Sativex(®)) on multiple sclerosis spasticity in a real-life Italian monocentric study.

    Science.gov (United States)

    Ferrè, Laura; Nuara, Arturo; Pavan, Giulia; Radaelli, Marta; Moiola, Lucia; Rodegher, Mariaemma; Colombo, Bruno; Keller Sarmiento, Ignacio Juan; Martinelli, Vittorio; Leocani, Letizia; Martinelli Boneschi, Filippo; Comi, Giancarlo; Esposito, Federica

    2016-02-01

    Multiple sclerosis (MS) patients frequently suffer from limb spasticity and pain despite antispastic treatments. To investigate nabiximols efficacy and safety in a real-world monocentric Italian cohort, the following data were collected at baseline, week 4, 14 and 48: Ambulation Index (AI), 10-min walking test (10MWT), combined Modified Ashworth scale (cMAS), scores at numerical rating scale for spasticity (sNRS) and pain (pNRS). Responder status was defined as a ≥20 % reduction in sNRS after 4 weeks of treatment. 144 MS patients (123 progressive and 21 relapsing-remitting) complaining of moderate-to-severe spasticity (mean sNRS: 7.5) were included: 138 (95.8 %) completed the first month of therapy and were classified as follows-23.2 % were non-responders, 5.1 % were responders but discontinued treatment due to side effects, 71.7 % were responders with a mean 32 % reduction in sNRS (p < 0.001). In responders sNRS further decreased between 4 and 14 weeks (p = 0.03). Similarly, pNRS improvement was seen during the first month and between 4 and 14 weeks (p < 0.001 and p = 0.004, respectively). Moreover, at 4 weeks responders showed a significant (p < 0.05) improvement in cMAS, AI and 10MWT, which was maintained at 14 weeks. At 1-year follow-up, a benefit was still evident on spasticity and painful symptoms with a low drop-out rate. Confusion/ideomotor slowing, fatigue and dizziness were the most frequent side effects; no major adverse events were reported. Shorter disease duration at treatment start was associated with better response. This real-world study confirms nabiximols efficacy and safety in the treatment of MS-related spasticity and pain, which is maintained up to 48 weeks. PMID:26474875

  9. Fingerprint Image Compression

    OpenAIRE

    Mansi Kambli,; Shalini Bhatia

    2010-01-01

    Modified Set Partitioning in Hierarchical Tree with Run Length Encoding is a new framework proposed for fingerprint image compression. The Proposed method is better because more number of images related to the fingerprint image are retrieved. Experiments on an image database of grayscale bitmap images show that the proposed technique performs well in compression and decompression. We use Peak Signal to noise ratio [3] and Mean Square Error [3] to compute the picture quality of fingerprint ima...

  10. Joint Angular Velocity in Spastic Gait and the Influence of Muscle-Tendon Lengthening*

    Science.gov (United States)

    GRANATA, KEVIN P.; ABEL, MARK F.; DAMIANO, DIANE L.

    2006-01-01

    Background Joint angular velocity (the rate of flexion and extension of a joint) is related to the dynamics of muscle activation and force generation during walking. Therefore, the goal of this research was to examine the joint angular velocity in normal and spastic gait and changes resulting from muscle-tendon lengthening (recession and tenotomy) in patients who have spastic cerebral palsy. Methods The gait patterns of forty patients who had been diagnosed with spastic cerebral palsy (mean age, 8.3 years; range, 3.7 to 14.8 years) and of seventy-three age-matched, normally developing subjects were evaluated with three-dimensional motion analysis and electromyography. The patients who had cerebral palsy were evaluated before muscle-tendon lengthening and nine months after treatment. Results The gait patterns of the patients who had cerebral palsy were characterized by increased flexion of the knee in the stance phase, premature plantar flexion of the ankle, and reduced joint angular velocities compared with the patterns of the normally developing subjects. Even though muscle-tendon lengthening altered sagittal joint angles in gait, the joint angular velocities were generally unchanged at the hip and knee. Only the ankle demonstrated modified angular velocities, including reduced dorsiflexion velocity at foot-strike and improved dorsiflexion velocity through midstance, after treatment. Electromyographic changes included reduced amplitude of the gastrocnemius-soleus during the loading phase and decreased knee coactivity (the ratio of quadriceps and hamstring activation) at toe-off. Principal component analyses showed that, compared with joint-angle data, joint angular velocity was better able to discriminate between the gait patterns of the normal and cerebral palsy groups. Conclusions This study showed that muscle-tendon lengthening corrects biomechanical alignment as reflected by changes in sagittal joint angles. However, joint angular velocity and

  11. Mantakassa: an epidemic of spastic paraparesis associated with chronic cyanide intoxication in a cassava staple area of Mozambique. 1. Epidemiology and clinical and laboratory findings in patients. Ministry of Health, Mozambique.

    Science.gov (United States)

    1984-01-01

    Investigation of an epidemic of more than 1000 cases of spastic paraparesis in a drought-striken cassava staple area of Mozambique strongly suggests an association between this disease (called mantakassa), chronic cyanide intoxication, and cassava consumption. In previous reports of neurological disease with similar associations, the disease affected an older age group with usually a gradual onset, and the predominant clinical feature was an ataxic neuropathy. In mantakassa the onset was acute, and mostly women of reproductive age and children were affected. Serum thiocyanate levels in these patients were much higher than previously reported; while spastic paraparesis of unknown etiology occurs in many tropical countries, it has not previously been linked with raised thiocyanate levels. The present evidence linking cassava consumption to the disease is circumstantial, and dietary deficiency is also probably involved. Cassava is an important food crop and a major source of energy for people in many parts of the world. In these areas, when there is a shortage of food production, e.g., during a drought, the inhabitants may be exposed to the risk of dietary cyanide intoxication. Further research is needed on the causes of mantakassa so that a repetition of this disaster could be prevented.

  12. Systematics of compression of hard materials

    International Nuclear Information System (INIS)

    Hard materials have the remarkable property that relatively little internal energy of shock compression is deposited as temperature and associated thermal pressure. As a result, the Hugoniot curve is nearly coincident with the 0-K isotherm. Since the isentrope is intermediate between isotherm and Hugoniot, all three curves of a given hard material are nearly coincident. Published data for diamond and Gd3Ga5O12 (GGG) show this to be the case up to 600 GPa and 80 GPa, respectively. Above 100 GPa on the Hugoniot the incompressibilities, defined to be the derivative of pressure with respect to compression, of GGG, other oxides and even CaF2 are significantly greater than that of diamond. In fact, above 100 GPa CaF2 might well be the least compressible of any known material. Little EOS data of weakly compressible materials have been measured in a diamond anvil cell (DAC) above a few tens of GPa at 300 K because these materials often become amorphous, which means density in a DAC cannot be measured by X-ray diffraction. Amorphization suggests the onset of a sluggish phase transition. On the other hand, Hugoniot experiments readily measure density changes caused by compression and phase transitions independent of material structure. Hugoniots of weakly compressible materials suggest experiments to determine structures and compressibilities in laser-heated DACs at 100 GPa pressures, as has been done with TiO2 and perovskite, and Hugoniot data might provide estimates of compressions of oxides representative of the deep interiors of rocky planets in other solar systems

  13. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11.

    Science.gov (United States)

    Castro-Fernández, Cristina; Arias, Manuel; Blanco-Arias, Patricia; Santomé-Collazo, Luis; Amigo, Jorge; Carracedo, Ángel; Sobrido, Maria-Jesús

    2015-06-01

    Next generation sequencing (NGS) is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this group of disorders includes gene panel and exome sequencing, in this sample only the spatacsin gene region was captured and subsequently searched for mutations. Two probably pathogenic variants were quickly and clearly identified, confirming the diagnosis of SPG11. This case illustrates how combination of expert clinical characterization with highly oriented NGS protocols leads to a fast, cost-efficient diagnosis, minimizing the risk of findings with unclear significance.

  14. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    Directory of Open Access Journals (Sweden)

    Cristina Castro-Fernández

    2015-06-01

    Full Text Available Next generation sequencing (NGS is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this group of disorders includes gene panel and exome sequencing, in this sample only the spatacsin gene region was captured and subsequently searched for mutations. Two probably pathogenic variants were quickly and clearly identified, confirming the diagnosis of SPG11. This case illustrates how combination of expert clinical characterization with highly oriented NGS protocols leads to a fast, cost-efficient diagnosis, minimizing the risk of findings with unclear significance.

  15. Genetic mapping of a susceptibility locus for disc herniation and spastic paraplegia on 6q23.3-q24.1

    OpenAIRE

    Zortea, M.; Vettori, A; Trevisan, C; Bellini, S.; Vazza, G.; Armani, M; Simonati, A; Mostacciuolo, M

    2002-01-01

    It has been suggested that a genetic factor(s) or a familial predisposition may contribute to the clinical manifestations of disc herniation; moreover, no genetic linkage between spinal disc herniation and spastic paraplegia has ever been described.

  16. The Impacts of Spastic Cerebral Palsy Children on Dynamic Balance Performance

    Directory of Open Access Journals (Sweden)

    M.S. Saba

    2006-07-01

    Full Text Available Introduction & Objective: Despite of many studies on cerebral palsy (CP, the impacts of this disease on musculoskeletal function especially on the dynamic balance of the CP patients is not well understood. This information can improve the quality of the treatment. The objectives of this study were to evaluate the differences between the dynamic balance performance of normal and CP children in different conditions.Materials & Methods: Ten children with spastic diplegia cerebral palsy between 8 to15 years of age and with mean weight and height of 30.8±5.7kg and 1.35±0.09m respectively, underwent an exercise therapy program for 12 weeks. A stability platform system was used to measure the deviation on the mean point of the application of the center of gravity (COG from the center of base of support (COBOS. The balance tests were repeated on stable and unstable base of support as well as with and without shoes. Results: It was shown that the mean deviation of COG of the CP children improves about 25% after exercise therapy (p=0.001. The most improvement was in mid-stable and unstable of base of support as well as in AP direction. Mean deviations of COG was near to natural pattern Conclusion: The mean deviation of COG of the CP patients was significantly increased in dynamic standing which shows the poor function of the proprioceptive system in these children. Exercise therapy improves the mean deviation of COG in dynamic standing. These results show the importance of the shoes on the treatment procedures of the spastic CP children.

  17. Cerebellar stimulation for spastic cerebral palsy: preliminary report; on-going double blind study.

    Science.gov (United States)

    Schulman, J H; Davis, R; Nanes, M

    1987-01-01

    To date, June 1, 1986, 33 spastic cerebral palsy (CP) patients have taken part in a double blind study testing the safety and efficacy of chronic cerebellar stimulation (CCS) for reduction of spasticity and improvement in function. Seven U.S. surgical centers involving ten neurosurgeons have implanted the Neurolith 601 cerebellar stimulator supplied by Pacesetter Systems Inc. (Sylmar, CA). A pilot study was run with three patients at Stanford University (Stanford, CA) using taped-on real (strong) and dummy (weak) magnets to control the ON-OFF status. Following the pilot study, a magnetically controllable switch was placed in line between the Neurolith stimulator and the cerebellar lead to allow more reliable switching sequences for the study. The test battery included joint angle measurements (passive and active), motor performance testing, reaction time, hand dynamometry, grooved peg board placement, hand/foot tapping, and rotary pursuit testing. Testing only was done at presurgery. Testing and ON-OFF switching was performed following recovery from surgery and at one, two, and four months. After four months, the switch was left turned ON. Of the 30 patients using the implanted switch, 11 were dropped from the study and seven are still in progress. Of the 11 dropped from the study, four were due to switch problems and three were due to double blind protocol violations, i.e., the participants discovered the stimulus status. The remaining four were removed because of a broken lead, infection, or unrelated medical problems, or refusal to participate after implant. A preliminary analysis indicated that three-quarters of the patients have a demonstrable quantitative improvement during the time the stimulation was "ON." Three patients showed no significant change.

  18. The effect of hippotherapy on gait in patients with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    Veronika Fízková

    2013-12-01

    Full Text Available BACKGROUND: Disorders of motor skills, especially regarding gait, are prevalent in nearly all forms of cerebral palsy. Through a horse’s back movement, the patient is exposed to proprioceptive stimulation, thus improvement in gait performance could be expected. OBJECTIVE: The aim of our study was to determine the effect of hippotherapy on gait in patients with spastic cerebral palsy. METHODS: Eleven subjects (age 14.3 ± 4.8 years, height 148.2 ± 17.6 cm, weight 43.3 ± 20.2 kg with spastic cerebral palsy participated in the study. Gait assessment was performed before and after a weeklong stay. The hippotherapy was conducted daily. Kinematic data from three trials for each child was obtained using the Vicon MX system (seven infrared cameras, frequency 200 Hz. Comparison of ankle, knee, hip and pelvis movement before and after hippotherapy intervention was performed in Statistica (version 10.0 using the Wilcoxon test. To determine the effect size, Cohen’s d was used. RESULTS: After completing the short-term hippotherapy intervention, we observed a decrease in the second plantar flexion during initial swing (p < .05, decrease in knee flexion during the stance phase (p < .05, decrease in the hip range of motion in sagittal plane (p < .05 and decrease in the pelvic obliquity (p < .05. The effect size for all statistically significant differences was low. CONCLUSIONS: Hippotherapy combined with individually defined physiotherapy can lead to some changes in bipedal locomotion in terms of improvement and thus contribute to greater self-sufficiency, self-reliance and independence of patients with cerebral palsy.

  19. THC:CBD spray and MS spasticity symptoms: data from latest studies.

    Science.gov (United States)

    Rekand, Tiina

    2014-01-01

    New clinical experience with 9-delta-tetrahydocannabinol (THC) and cannabidiol (CBD) oromucosal spray (Sativex®) involving more than an additional 1,000 patients with MS spasticity (approximately 150 in clinical studies and 900 in post-marketing surveillance studies) have become available in 2013 and are reviewed. A randomized, placebo controlled long-term follow-up clinical trial with THC:CBD spray versus placebo demonstrated that it was not associated with cognitive decline, depression or significant mood changes after 12 months of treatment. Furthermore, in a prospective observational pilot study involving 33 patients (60% female) aged 33-68 years and a mean disease duration of 6.6 years, THC:CBD oromucosal spray did not adversely influence standard driving ability in patients with moderate to severe MS spasticity. Other new long term observational data about the use of THC:CBD oromucosal spray in clinical practice are available from patient registries in the UK, Germany and Spain. Findings to date reinforce the efficacy and safety observed in Phase III clinical trials. It is of interest that in practice average dosages used by patients tended to be lower than those reported in clinical studies (5-6.4 vs. >8 sprays/day), and effectiveness was maintained in the majority of patients. Importantly, no additional safety concerns were identified in the registry studies which included findings from patients who have been treated for prolonged periods (in the German/UK registry 45% of patients had >2 years exposure). Thus, these new data support a positive benefit-risk relationship for THC:CBD oromucosal spray during longer-term use. PMID:24457846

  20. Watermark Compression in Medical Image Watermarking Using Lempel-Ziv-Welch (LZW) Lossless Compression Technique.

    Science.gov (United States)

    Badshah, Gran; Liew, Siau-Chuin; Zain, Jasni Mohd; Ali, Mushtaq

    2016-04-01

    In teleradiology, image contents may be altered due to noisy communication channels and hacker manipulation. Medical image data is very sensitive and can not tolerate any illegal change. Illegally changed image-based analysis could result in wrong medical decision. Digital watermarking technique can be used to authenticate images and detect as well as recover illegal changes made to teleradiology images. Watermarking of medical images with heavy payload watermarks causes image perceptual degradation. The image perceptual degradation directly affects medical diagnosis. To maintain the image perceptual and diagnostic qualities standard during watermarking, the watermark should be lossless compressed. This paper focuses on watermarking of ultrasound medical images with Lempel-Ziv-Welch (LZW) lossless-compressed watermarks. The watermark lossless compression reduces watermark payload without data loss. In this research work, watermark is the combination of defined region of interest (ROI) and image watermarking secret key. The performance of the LZW compression technique was compared with other conventional compression methods based on compression ratio. LZW was found better and used for watermark lossless compression in ultrasound medical images watermarking. Tabulated results show the watermark bits reduction, image watermarking with effective tamper detection and lossless recovery.

  1. Watermark Compression in Medical Image Watermarking Using Lempel-Ziv-Welch (LZW) Lossless Compression Technique.

    Science.gov (United States)

    Badshah, Gran; Liew, Siau-Chuin; Zain, Jasni Mohd; Ali, Mushtaq

    2016-04-01

    In teleradiology, image contents may be altered due to noisy communication channels and hacker manipulation. Medical image data is very sensitive and can not tolerate any illegal change. Illegally changed image-based analysis could result in wrong medical decision. Digital watermarking technique can be used to authenticate images and detect as well as recover illegal changes made to teleradiology images. Watermarking of medical images with heavy payload watermarks causes image perceptual degradation. The image perceptual degradation directly affects medical diagnosis. To maintain the image perceptual and diagnostic qualities standard during watermarking, the watermark should be lossless compressed. This paper focuses on watermarking of ultrasound medical images with Lempel-Ziv-Welch (LZW) lossless-compressed watermarks. The watermark lossless compression reduces watermark payload without data loss. In this research work, watermark is the combination of defined region of interest (ROI) and image watermarking secret key. The performance of the LZW compression technique was compared with other conventional compression methods based on compression ratio. LZW was found better and used for watermark lossless compression in ultrasound medical images watermarking. Tabulated results show the watermark bits reduction, image watermarking with effective tamper detection and lossless recovery. PMID:26429361

  2. Transverse Compression of Tendons.

    Science.gov (United States)

    Salisbury, S T Samuel; Buckley, C Paul; Zavatsky, Amy B

    2016-04-01

    A study was made of the deformation of tendons when compressed transverse to the fiber-aligned axis. Bovine digital extensor tendons were compression tested between flat rigid plates. The methods included: in situ image-based measurement of tendon cross-sectional shapes, after preconditioning but immediately prior to testing; multiple constant-load creep/recovery tests applied to each tendon at increasing loads; and measurements of the resulting tendon displacements in both transverse directions. In these tests, friction resisted axial stretch of the tendon during compression, giving approximately plane-strain conditions. This, together with the assumption of a form of anisotropic hyperelastic constitutive model proposed previously for tendon, justified modeling the isochronal response of tendon as that of an isotropic, slightly compressible, neo-Hookean solid. Inverse analysis, using finite-element (FE) simulations of the experiments and 10 s isochronal creep displacement data, gave values for Young's modulus and Poisson's ratio of this solid of 0.31 MPa and 0.49, respectively, for an idealized tendon shape and averaged data for all the tendons and E = 0.14 and 0.10 MPa for two specific tendons using their actual measured geometry. The compression load versus displacement curves, as measured and as simulated, showed varying degrees of stiffening with increasing load. This can be attributed mostly to geometrical changes in tendon cross section under load, varying according to the initial 3D shape of the tendon. PMID:26833218

  3. Differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy in comparison with normal controls

    OpenAIRE

    Kwon, Yong Hyun; Lee, Hye Young

    2015-01-01

    [Purpose] The purpose of this study was to determine differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy (CP) in comparison with children with normal development. [Subjects and Methods] Fourteen children with spastic diplegic CP, 11 children with hemiplegic CP, and 14 children with normal development were recruited. Respiratory pressure was measured and the pulmonary function test (PFT) was performed to evaluate the str...

  4. Geometric Signal Compression

    Institute of Scientific and Technical Information of China (English)

    Kun Zhou; Hu-Jun Bao; Jiao-Ying Shi; Qun-Sheng Peng

    2004-01-01

    Compression of mesh attributes becomes a challenging problem due to the great need for efficient storage and fast transmission. This paper presents a novel geometric signal compression framework for all mesh attributes, including position coordinates, normal, color, texture, etc. Within this framework, mesh attributes are regarded as geometric signals defined on mesh surfaces. A planar parameterization algorithm is first proposed to map 3D meshes to 2D parametric meshes. Geometric signals are then transformed into 2D signals, which are sampled into 2D regular signals using an adaptive sampling method. The JPEG2000 standard for still image compression is employed to effectively encode these regular signals into compact bit-streams with high rate/distortion ratios. Experimental results demonstrate the great application potentials of this framework.

  5. SYMBOLIC VERSOR COMPRESSION ALGORITHM

    Institute of Scientific and Technical Information of China (English)

    Li Hongbo

    2009-01-01

    In an inner-product space, an invertible vector generates a reflection with re-spect to a hyperplane, and the Clifford product of several invertible vectors, called a versor in Clifford algebra, generates the composition of the corresponding reflections, which is an orthogonal transformation. Given a versor in a Clifford algebra, finding another sequence of invertible vectors of strictly shorter length but whose Clifford product still equals the input versor, is called versor compression. Geometrically, versor compression is equivalent to decomposing an orthogoual transformation into a shorter sequence of reflections. This paper proposes a simple algorithm of compressing versors of symbolic form in Clifford algebra. The algorithm is based on computing the intersections of lines with planes in the corresponding Grassmann-Cayley algebra, and is complete in the case of Euclidean or Minkowski inner-product space.

  6. Chronic nerve root entrapment: compression and degeneration

    Science.gov (United States)

    Vanhoestenberghe, A.

    2013-02-01

    Electrode mounts are being developed to improve electrical stimulation and recording. Some are tight-fitting, or even re-shape the nervous structure they interact with, for a more selective, fascicular, access. If these are to be successfully used chronically with human nerve roots, we need to know more about the possible damage caused by the long-term entrapment and possible compression of the roots following electrode implantation. As there are, to date, no such data published, this paper presents a review of the relevant literature on alternative causes of nerve root compression, and a discussion of the degeneration mechanisms observed. A chronic compression below 40 mmHg would not compromise the functionality of the root as far as electrical stimulation and recording applications are concerned. Additionally, any temporary increase in pressure, due for example to post-operative swelling, should be limited to 20 mmHg below the patient’s mean arterial pressure, with a maximum of 100 mmHg. Connective tissue growth may cause a slower, but sustained, pressure increase. Therefore, mounts large enough to accommodate the root initially without compressing it, or compliant, elastic, mounts, that may stretch to free a larger cross-sectional area in the weeks after implantation, are recommended.

  7. Graph Compression by BFS

    Directory of Open Access Journals (Sweden)

    Alberto Apostolico

    2009-08-01

    Full Text Available The Web Graph is a large-scale graph that does not fit in main memory, so that lossless compression methods have been proposed for it. This paper introduces a compression scheme that combines efficient storage with fast retrieval for the information in a node. The scheme exploits the properties of the Web Graph without assuming an ordering of the URLs, so that it may be applied to more general graphs. Tests on some datasets of use achieve space savings of about 10% over existing methods.

  8. Compressive Shift Retrieval

    Science.gov (United States)

    Ohlsson, Henrik; Eldar, Yonina C.; Yang, Allen Y.; Sastry, S. Shankar

    2014-08-01

    The classical shift retrieval problem considers two signals in vector form that are related by a shift. The problem is of great importance in many applications and is typically solved by maximizing the cross-correlation between the two signals. Inspired by compressive sensing, in this paper, we seek to estimate the shift directly from compressed signals. We show that under certain conditions, the shift can be recovered using fewer samples and less computation compared to the classical setup. Of particular interest is shift estimation from Fourier coefficients. We show that under rather mild conditions only one Fourier coefficient suffices to recover the true shift.

  9. Isentropic compression of argon

    Energy Technology Data Exchange (ETDEWEB)

    Veeser, L.R.; Ekdahl, C.A.; Oona, H. [and others

    1997-06-01

    The compression was done in an MC-1 flux compression (explosive) generator, in order to study the transition from an insulator to a conductor. Since conductivity signals were observed in all the experiments (except when the probe is removed), both the Teflon and the argon are becoming conductive. The conductivity could not be determined (Teflon insulation properties unknown), but it could be bounded as being {sigma}=1/{rho}{le}8({Omega}cm){sub -1}, because when the Teflon breaks down, the dielectric constant is reduced. The Teflon insulator problem remains, and other ways to better insulate the probe or to measure the conductivity without a probe is being sought.

  10. Image compression in local helioseismology

    CERN Document Server

    Löptien, Björn; Gizon, Laurent; Schou, Jesper

    2014-01-01

    Context. Several upcoming helioseismology space missions are very limited in telemetry and will have to perform extensive data compression. This requires the development of new methods of data compression. Aims. We give an overview of the influence of lossy data compression on local helioseismology. We investigate the effects of several lossy compression methods (quantization, JPEG compression, and smoothing and subsampling) on power spectra and time-distance measurements of supergranulation flows at disk center. Methods. We applied different compression methods to tracked and remapped Dopplergrams obtained by the Helioseismic and Magnetic Imager onboard the Solar Dynamics Observatory. We determined the signal-to-noise ratio of the travel times computed from the compressed data as a function of the compression efficiency. Results. The basic helioseismic measurements that we consider are very robust to lossy data compression. Even if only the sign of the velocity is used, time-distance helioseismology is still...

  11. The possibilities of compressed sensing based migration

    KAUST Repository

    Aldawood, Ali

    2013-09-22

    Linearized waveform inversion or Least-square migration helps reduce migration artifacts caused by limited acquisition aperture, coarse sampling of sources and receivers, and low subsurface illumination. However, leastsquare migration, based on L2-norm minimization of the misfit function, tends to produce a smeared (smoothed) depiction of the true subsurface reflectivity. Assuming that the subsurface reflectivity distribution is a sparse signal, we use a compressed-sensing (Basis Pursuit) algorithm to retrieve this sparse distribution from a small number of linear measurements. We applied a compressed-sensing algorithm to image a synthetic fault model using dense and sparse acquisition geometries. Tests on synthetic data demonstrate the ability of compressed-sensing to produce highly resolved migrated images. We, also, studied the robustness of the Basis Pursuit algorithm in the presence of Gaussian random noise.

  12. A型肉毒毒素治疗痉挛型脑瘫的研究进展%Research progress of botulinum toxin type A in treatment of spastic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    刘春明(综述); 刘芸(审校)

    2015-01-01

    Cerebral palsy refers to brain injury caused by various reasons from before birth to 1 month after birth or movement disorders and abnormal posture caused by brain developmental defects. Children cerebral palsy is divided into 5 kinds in the clinic:spastic type, dyskinetic type, ataxia type, muscle hypotonia type and mixed type. Among them, the spastic type accounts for 60% ~70% , and is the main type which causes children physical disabilities. Once diagnosed, the comprehensive treatment method is ap-plied, including functional training, physical therapy, acupuncture, massage, medicine treatment, and so on. In recent years, the lo-cal injection of botulinum toxin A is used for treating the children with spastic cerebral palsy. A large number of clinical studies show that the drug is safe and effective; however, in the course of treatment, it should strictly control the drug indications and contraindica-tions. Especially, the dosage choice and the accurate localization of target muscle is the key factor to influence the treatment effect.%脑瘫是指出生前到出生后1个月内各种原因所引起的脑损伤或发育缺陷所致的运动障碍及姿势异常。小儿脑瘫临床上分为痉挛型,不随意运动型,共济失调型,肌张力低下型及混合型5种,其中,痉挛型占60%~70%,是造成儿童肢体残疾的最主要脑瘫类型。脑瘫一旦确诊多采用综合的治疗方法包括功能训练,物理疗法,中医针刺,按摩,药物治疗等。近年来,临床上开始广泛使用毒杆菌毒素 A(botuli-num toxin A,BTX-A)局部注射治疗痉挛型脑瘫儿童,大量临床研究结果显示该药安全、有效,但在治疗过程中应该严格掌握使用该药的适应证,禁忌证,而剂量的选择和靶肌的准确定位是影响治疗效果的关键因素。

  13. Changing the main indicators to assess motor function in children with cerebral palsy spastic form by hydrokinesitherapy

    Directory of Open Access Journals (Sweden)

    Taran I.V.

    2013-06-01

    Full Text Available The aim of the study is to identify the efficiency of the developed technique hydrokinetic system of physical rehabilitation for children 3-5 years old with cerebral palsy spastic form. Examined the impact of comparing the effectiveness of exercise in the water by two techniques: the author and accepted. In experiment involved 24 people aged 3-5 years old with cerebral palsy spastic form. The experiment lasted one year, classes were held hydrokinesitherapy 2 times a week. In the study recorded the performance evaluation of basic motor functions to the experiment, six months later, and after the experiment. It is shown that an important component of physical rehabilitation of patients is hydrokinesotherapy. Shows the direction of the development of motor skills of children 3-5 years old. Study of the development of indicators basic motor functions.

  14. INTERFERON BETA-1A TREATMENT IN HTLV-1-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Graça Maria de Castro Viana

    2014-09-01

    Full Text Available Here a young patient (< 21 years of age with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP, and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF. Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved.

  15. Effects of botulinum toxin type A for spastic foot in post-stroke patients enrolled in a rehabilitation program

    Directory of Open Access Journals (Sweden)

    Leonardo Halley Carvalho Pimentel

    2014-01-01

    Full Text Available The objective of this study was to evaluate the effects of botulinum toxin type A (BTX-A on spastic foot in stroke patients in a rehabilitation program. Method: Hemiparetic stroke patients (n=21 enrolled in a rehabilitation program were divided into two groups. The first group (n=11 received a total of 300UI BTX-A, and the second group (n=10 received 100 UI BTX-A. All patients were assessed at baseline and 2, 4, 8 and 12 weeks after injection for Modified Ashworth Score, time walking 10 meters, and the Functional Independence Measure (mFIM motor score. Results: The higher-dose group exhibited a significant improvement in spasticity, and both groups showed an improvement in time walking 10 meters and mFIM, with no significant differences between them. Conclusions: Our findings suggest that gains in gait velocity and functional independence were not correlated to BTX-A dose.

  16. Multiple snapshot compressive beamforming

    DEFF Research Database (Denmark)

    Gerstoft, Peter; Xenaki, Angeliki; Mecklenbrauker, Christoph F.;

    2015-01-01

    For sound fields observed on an array, compressive sensing (CS) reconstructs the multiple source signals at unknown directions-of-arrival (DOAs) using a sparsity constraint. The DOA estimation is posed as an underdetermined problem expressing the field at each sensor as a phase-lagged superposition...

  17. Compressive CFAR Radar Processing

    NARCIS (Netherlands)

    Anitori, L.; Rossum, W.L. van; Otten, M.P.G.; Maleki, A.; Baraniuk, R.

    2013-01-01

    In this paper we investigate the performance of a combined Compressive Sensing (CS) Constant False Alarm Rate (CFAR) radar processor under different interference scenarios using both the Cell Averaging (CA) and Order Statistic (OS) CFAR detectors. Using the properties of the Complex Approximate Mess

  18. Compressive CFAR radar detection

    NARCIS (Netherlands)

    Anitori, L.; Otten, M.P.G.; Rossum, W.L. van; Maleki, A.; Baraniuk, R.

    2012-01-01

    In this paper we develop the first Compressive Sensing (CS) adaptive radar detector. We propose three novel architectures and demonstrate how a classical Constant False Alarm Rate (CFAR) detector can be combined with ℓ1-norm minimization. Using asymptotic arguments and the Complex Approximate Messag

  19. Fingerprints in Compressed Strings

    DEFF Research Database (Denmark)

    Bille, Philip; Cording, Patrick Hagge; Gørtz, Inge Li;

    2013-01-01

    The Karp-Rabin fingerprint of a string is a type of hash value that due to its strong properties has been used in many string algorithms. In this paper we show how to construct a data structure for a string S of size N compressed by a context-free grammar of size n that answers fingerprint queries...

  20. Fiber Effects on Compressibility of Peat

    Science.gov (United States)

    Johari, N. N.; Bakar, I.; Razali, S. N. M.; Wahab, N.

    2016-07-01

    Fibers found in the soil, especially in peaty soil play an important role in the determination of soil compressibility. Peat soils are the results from the decomposition of organic matter and the type of peat can be classified based on the fibrous material in the soil. In the engineering field, peat soil was mostly known as soils that has a serious settlement with high compressibility index. From the previous research, fibers in the soil were influenced in compressibility in terms of size, shape, fibric, soil arrangement and etc. Hence, this study attempts the determination of fibers effects on the compressibility of peat using a 1-D oedometer consolidation test. The reconstituted peat samples of different particle sizes were used to determine the consolidation parameters and the results obtained from reconstituted samples were also compared with the undisturbed sample. 1-D oedometer consolidation tests were performed on the samples by using the load increment method. The results shows, the higher particle size (R3.35), give higher moisture content (w = 401.20%) and higher initial void ratio (eo = 5.74). In settlement prediction, the higher the fiber content will results the higher the compression index, therefore, it will cause high of settlement.

  1. Estimation of motive possibilities and manipulative activity of children with cerebral paralysis of spastic form 3-5 years

    OpenAIRE

    Baybuza I.V.

    2012-01-01

    In this work the conducted estimation of motive possibilities and manipulative activity of children is with the cerebral paralysis of spastic form 3-5 years accordingly standard norms. The experiment was attended by 30 children. Proven lack of fine motor skills and basic static and motor skills decreased muscle strength and improve muscle tone. Providing a more objective assessment of physical development of patients with this pathology would contribute a program hydrokinesotherapy as a means...

  2. A gene for autosomal recessive symmetrical spastic cerebral palsy maps to chromosome 2q24-25.

    OpenAIRE

    McHale, D P; Mitchell, S.; Bundey, S; Moynihan, L; Campbell, D. A.; Woods, C G; LENCH, N. J.; Mueller, R F; Markham, A F

    1999-01-01

    Cerebral palsy has an incidence of approximately 1/500 births, although this varies between different ethnic groups. Genetic forms of the disease account for approximately 1%-2% of cases in most countries but contribute a larger proportion in populations with extensive inbreeding. We have clinically characterized consanguineous families with multiple children affected by symmetrical spastic cerebral palsy, to locate recessive genes responsible for this condition. The eight families studied we...

  3. EFFECTS OF AN EXERCISE-ORIENTED REHABILITATION PROGRAM ON MECHANICAL EFFICIENCIY AND AEROBIC CAPACITY IN CHILDREN WITH SPASTIC CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    M. Izadi

    2008-10-01

    Full Text Available AbstractObjectiveChildren suffering from Cerebral Palsy (CP, exhibit movement limitations and physiological abnormalities as compared to normal individuals.The objective of this study was to assess mechanical efficiency and certain cardiovascular indices before and after an exercise-rehabilitation program in children with dipelegia spastic cerebral palsy (experimental group in comparison with able-bodied children(controls. Material and MethodsIn this study, 15 spastic cerebral palsy (dipelegic children participated in an exercise-rehabilitation program, three days a week for three months with an average 144bpm of heart rate. The mechanical efficiency (net, gross, rest and submaximal heart rate and maximal oxygen consumption(VO2max weremeasured before (pretest and after (posttest exercise program on the cycle ergometer according to the Macmaster ergometer protocol. Then control group, of 18 normal children underwent the exercise program and were assessed, following which results of the 2 groups were compared using SPSS for statistical analysis (P ResultsMechanical efficiency (net, gross increased significantly in CP patients after the exercise-rehabilitation program; reults did not alter significantly for the controls.Rest and submaximal heart rate in CP patients decreased significantly after exercise program. Maximal oxygen consumption, which remained unchanged in patients following the exercise program, was similar in patients and controls after the program. ConclusionCerebral palsy patients, because of their high muscle tone, severe degree of spasticity, and involuntary movements are physically more incapacitated and need more energy than normal able-bodied individuals.Rehabilitation and aerobic exercise can be effective in improving their cardiovascular fitness and muscle function and increasing their mechanical efficiency.Keywords: spastic cerebral palsy, maximal oxygen consumption, heart rate, mechanical efficiency, rehabilitation.

  4. A Randomized Controlled Trial Comparing Botulinum Toxin A Dosage in the Upper Extremity of Children with Spasticity

    Science.gov (United States)

    Kawamura, Anne; Campbell, Kent; Lam-Damji, Sophie; Fehlings, Darcy

    2007-01-01

    This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group…

  5. Contribution of Galvanic Vestibular Stimulation for the Diagnosis of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

    OpenAIRE

    Matos Cunha, Luciana Cristina; Campelo Tavares, Maurício; Tierra Criollo, Carlos Julio; Labanca, Ludimila; Cardoso dos Santos Couto Paz, Clarissa; Resende Martins, Henrique; de Freitas Carneiro-Proietti, Anna Bárbara; Utsch Goncalves, Denise

    2013-01-01

    Background and Purpose Galvanic vestibular stimulation (GVS) is a low-cost and safe examination for testing the vestibulospinal pathway. Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a slowly progressive disease that affects the vestibulospinal tract early in its course. This study compared the electromyographic (EMG) responses triggered by GVS of asymptomatic HTLV-1-infected subjects and subjects with HAM/TSP. Methods Bipolar galvanic s...

  6. Evaluation of low-level laser therapy in the treatment of masticatory muscles spasticity in children with cerebral palsy

    Science.gov (United States)

    Santos, Maria Teresa Botti Rodrigues; Diniz, Michele Baffi; Gouw-Soares, Sheila Cynthia; Lopes-Martins, Rodrigo Alvaro Brandão; Frigo, Lucio; Baeder, Fernando Martins

    2016-02-01

    Spasticity is a motor disorder frequently present in individuals with cerebral palsy (CP). This study aimed to evaluate the effect of low-level laser therapy (LLLT) on the spasticity of the masseter and anterior temporal muscle fibers in children with CP over three weeks of intermittent laser exposures. The bite force (BF) of the masticatory muscles and the amplitude of mouth opening were evaluated before and after laser irradiation in 30 children with CP. Both sides of the masseter and temporalis muscles were irradiated with low-intensity diode laser pulses of 808-nm wavelength six times over three consecutive weeks. During the subsequent three weeks of postlaser exposures, although no laser treatment was applied, the evaluation parameters were measured and recorded. A significant improvement in the amplitude of mouth opening and a decrease in the BF were observed in the weeks following LLLT (Plow-level energy exposures from a 808-nm diode laser to be an effective short-term therapeutic tool. This method increased the amplitude of mouth opening and decreased the muscle tonus of children with spastic CP over a time course of three weeks of intermittent laser applications.

  7. Effects of Soft Tissue Surgery on Pelvic and Hip Rotation in Patients with Spastic Diplegia: A Meta-Analysis

    Science.gov (United States)

    Jung, Hun Jae; Yoon, Ji Yeon; Oh, Min Kyung; Kim, Young Chang; Kim, Jae Hyun; Eom, Tae Woong

    2016-01-01

    Background There are several different opinions regarding the improvements seen on the transverse plane after soft tissue surgery alone in independently ambulant patients with cerebral palsy. We performed a meta-analysis using data from previous studies to identify the effects of soft tissue surgery alone on pelvic and hip rotation in children with spastic diplegia. Methods We conducted a pilot study to evaluate the improvement in pelvic and hip rotation after muscle-tendon lengthening surgery in children with spastic diplegia. We also searched EMBASE and PubMed and selected 2 previous studies using the same test conditions with kinematic data on the pelvis and hip joints. A meta-analysis of the results of these 3 studies, including this pilot study, was then performed. Results The meta-analysis results showed an external rotation decrease (p = 0.005) in the mean difference of pelvic rotation of -3.61 (95% confidence interval [CI], -6.13 to –1.09) and a mean difference in hip rotation of 6.60 (95% CI, 3.34 to 9.86), indicating a significant increase in the hip external rotation after surgery (p < 0.001). Conclusions In independently community-ambulant pediatric patients with spastic diplegia, pelvic retraction and hip internal rotation could be improved after soft tissue surgery. PMID:27247745

  8. The effects of stretching and stabilization exercise on the improvement of spastic shoulder function in hemiplegic patients.

    Science.gov (United States)

    You, Young Youl; Her, Jin Gang; Woo, Ji-Hea; Ko, Taesung; Chung, Sin Ho

    2014-04-01

    [Purpose] This study investigated the effects of stretching and joint stabilization exercises applied to spastic shoulder joints on improving shoulder dysfunction in hemiplegic patients. [Subjects and Methods] Hemiplegic patients were classified into three groups: one group received 30 min of traditional exercise therapy for the spastic shoulder joint; one group received 30 min stretching; and one group received 15 min of stretching and 15 min of joint stabilization exercises. The exercises were performed once a day, five times per week for eight weeks. Changes in the pathologic thickness of tendons and recovery of shoulder function were compared among the three groups. Differences among the three groups before the experiment, at four weeks, and at eight weeks were analyzed using repeated measures ANOVA. [Results] The stretching and joint stabilization exercise therapy group showed greater improvement in shoulder function than the traditional exercise therapy group and the stretching only group. This group also showed greater decreases in the pathologic thickness of tendons, than the other groups. [Conclusion] This study demonstrated that an exercise therapy program that combined stretching and joint stabilization exercise was more effective than other exercises for improvement of spastic shoulder joint dysfunction in hemiplegic patients.

  9. Autosomal recessive spastic paraplegia (SPG45) with mental retardation maps to 10q24.3-q25.1.

    Science.gov (United States)

    Dursun, Umut; Koroglu, Cigdem; Kocasoy Orhan, Elif; Ugur, Sibel Aylin; Tolun, Aslihan

    2009-10-01

    Hereditary spastic paraplegias (HSPs) are characterized by progressive spasticity in the lower limbs. They are clinically heterogeneous, and pure forms as well as complicated forms with other accompanying clinical findings are known. HSPs are also genetically heterogeneous. We performed clinical and genetic studies in a consanguineous family with five affected members. A genome scan using 405 microsatellite markers for eight members of the family identified candidate gene loci, and subsequent fine mapping in 16 members identified the gene locus responsible for the HSP. The clinical manifestations were very early onset spastic paraplegia (SPG) accompanied by mental retardation and ocular signs. The gene locus was identified as the interval 102.05-106.64 Mbp on chromosome 10. Gene MRPL43 was analyzed in the patients. No mutation but high levels of mRNA were detected. We have mapped a novel autosomal recessive complicated form of HSP (SPG45) to a 4.6-Mbp region at 10q24.3-q25.1 with multipoint logarithm of odds scores >4.5.

  10. Clinical Observation on Treatment of Spastic Cerebral Palsy with Tuina plus Music Therapy

    Institute of Scientific and Technical Information of China (English)

    马美美; 刘振寰; 赵勇; 罗冠君; 李诺; 招文健; 万瑞平; 韩丑萍

    2009-01-01

    目的:观察小儿推拿结合音乐疗法对改善痉挛型小儿脑性瘫痪患者踝关节活动度及下肢肌肉痉挛的作用.方法:对符合小儿脑性瘫痪诊断标准的286例痉挛型患儿,在背景音乐下进行通督循经点穴推拿、益肾健脾推拿、捏脊疗法、足底推拿、节段性推拿、促肌力恢复推拿及关节活动度推拿7种推拿治疗,每次25~30min,每日1~2次.30天为1个疗程.于治疗前后进行股内收肌角、足背屈角和综合痉挛量表(CompositeSpastic@Scale,CSS)评分,以评价疗效.结果:治疗前后足背屈角、股内收肌角、CSS评分统计学处理,差异有统计学意义(P<0.01).总体疗效为显效106例,有效172例,无效8例.结论:推拿结合音乐疗法治疗痉挛型小儿脑瘫,有滑利关节,松解肌腱挛缩,缓解肌肉痉挛作用,能改善剪刀步态和尖足步态.对患儿坐、跪、站、行大运动功能恢复有极积治疗作用.%Objective: To observe the effect oftuina plus music therapy on range of motion of ankle joints and muscle spasm of lower limbs in children with spastic cerebral palsy. Method:All of 286 cases that conformed to the diagnostic criteria of infantile cerebral palsy were treated with 7 types of tuina manipulations respectively to unblock the Governor Vessel, reinforce the kidney and strengthen the spleen, pinch along the spine, stimulate specific foot-reflex area and different spinal segments, accelerate recovery of muscle strength and increase joint range of motion, 25-30 rain each treatment, once or twice a day, 30 d constitute a course of treatment.After this, the efficacy on femoral medial adduction and dorsiflexion angle and composite spasticity score (CSS) was evaluated. Result: The statistical analysis showed significant differences in dorsiflexion and femoral medial adduction angle and CCS scores (P<0.01) after the treatments. Conclusion: Tuina plus music therapy can lubricate the joints, relax contraction of tendons, alleviate

  11. TEM Video Compressive Sensing

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, Andrew J.; Kovarik, Libor; Abellan, Patricia; Yuan, Xin; Carin, Lawrence; Browning, Nigel D.

    2015-08-02

    One of the main limitations of imaging at high spatial and temporal resolution during in-situ TEM experiments is the frame rate of the camera being used to image the dynamic process. While the recent development of direct detectors has provided the hardware to achieve frame rates approaching 0.1ms, the cameras are expensive and must replace existing detectors. In this paper, we examine the use of coded aperture compressive sensing methods [1, 2, 3, 4] to increase the framerate of any camera with simple, low-cost hardware modifications. The coded aperture approach allows multiple sub-frames to be coded and integrated into a single camera frame during the acquisition process, and then extracted upon readout using statistical compressive sensing inversion. Our simulations show that it should be possible to increase the speed of any camera by at least an order of magnitude. Compressive Sensing (CS) combines sensing and compression in one operation, and thus provides an approach that could further improve the temporal resolution while correspondingly reducing the electron dose rate. Because the signal is measured in a compressive manner, fewer total measurements are required. When applied to TEM video capture, compressive imaging couled improve acquisition speed and reduce the electron dose rate. CS is a recent concept, and has come to the forefront due the seminal work of Candès [5]. Since the publication of Candès, there has been enormous growth in the application of CS and development of CS variants. For electron microscopy applications, the concept of CS has also been recently applied to electron tomography [6], and reduction of electron dose in scanning transmission electron microscopy (STEM) imaging [7]. To demonstrate the applicability of coded aperture CS video reconstruction for atomic level imaging, we simulate compressive sensing on observations of Pd nanoparticles and Ag nanoparticles during exposure to high temperatures and other environmental

  12. Randomness Testing of Compressed Data

    CERN Document Server

    Chang, Weiling; Yun, Xiaochun; Wang, Shupeng; Yu, Xiangzhan

    2010-01-01

    Random Number Generators play a critical role in a number of important applications. In practice, statistical testing is employed to gather evidence that a generator indeed produces numbers that appear to be random. In this paper, we reports on the studies that were conducted on the compressed data using 8 compression algorithms or compressors. The test results suggest that the output of compression algorithms or compressors has bad randomness, the compression algorithms or compressors are not suitable as random number generator. We also found that, for the same compression algorithm, there exists positive correlation relationship between compression ratio and randomness, increasing the compression ratio increases randomness of compressed data. As time permits, additional randomness testing efforts will be conducted.

  13. Data Compression for Helioseismology

    Science.gov (United States)

    Löptien, Björn

    2015-10-01

    Efficient data compression will play an important role for several upcoming and planned space missions involving helioseismology, such as Solar Orbiter. Solar Orbiter, to be launched in October 2018, will be the next space mission involving helioseismology. The main characteristic of Solar Orbiter lies in its orbit. The spacecraft will have an inclined solar orbit, reaching a solar latitude of up to 33 deg. This will allow, for the first time, probing the solar poles using local helioseismology. In addition, combined observations of Solar Orbiter and another helioseismic instrument will be used to study the deep interior of the Sun using stereoscopic helioseismology. The Doppler velocity and continuum intensity images of the Sun required for helioseismology will be provided by the Polarimetric and Helioseismic Imager (PHI). Major constraints for helioseismology with Solar Orbiter are the low telemetry and the (probably) short observing time. In addition, helioseismology of the solar poles requires observations close to the solar limb, even from the inclined orbit of Solar Orbiter. This gives rise to systematic errors. In this thesis, I derived a first estimate of the impact of lossy data compression on helioseismology. I put special emphasis on the Solar Orbiter mission, but my results are applicable to other planned missions as well. First, I studied the performance of PHI for helioseismology. Based on simulations of solar surface convection and a model of the PHI instrument, I generated a six-hour time-series of synthetic Doppler velocity images with the same properties as expected for PHI. Here, I focused on the impact of the point spread function, the spacecraft jitter, and of the photon noise level. The derived power spectra of solar oscillations suggest that PHI will be suitable for helioseismology. The low telemetry of Solar Orbiter requires extensive compression of the helioseismic data obtained by PHI. I evaluated the influence of data compression using

  14. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy.

    Directory of Open Access Journals (Sweden)

    Lynn Bar-On

    Full Text Available The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n = 35/19; 10.8 ± 3.8 yrs; bilateral/unilateral involvement n =  32/22; Gross Motor Functional Classification Score I-IV of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01. The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between

  15. Tree compression with top trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Landau, Gad M.;

    2013-01-01

    We introduce a new compression scheme for labeled trees based on top trees [3]. Our compression scheme is the first to simultaneously take advantage of internal repeats in the tree (as opposed to the classical DAG compression that only exploits rooted subtree repeats) while also supporting fast...

  16. Tree compression with top trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Landau, Gad M.;

    2015-01-01

    We introduce a new compression scheme for labeled trees based on top trees. Our compression scheme is the first to simultaneously take advantage of internal repeats in the tree (as opposed to the classical DAG compression that only exploits rooted subtree repeats) while also supporting fast...

  17. Compressible motion fields

    OpenAIRE

    Ottaviano, Giuseppe; Kohli, Pushmeet

    2013-01-01

    Traditional video compression methods obtain a compact representation for image frames by computing coarse motion fields defined on patches of pixels called blocks, in order to compensate for the motion in the scene across frames. This piecewise constant approximation makes the motion field efficiently encodable, but it introduces block artifacts in the warped image frame. In this paper, we address the problem of estimating dense motion fields that, while accurately predicting one frame from ...

  18. Compression-based similarity

    OpenAIRE

    Vitányi, Paul

    2011-01-01

    First we consider pair-wise distances for literal objects consisting of finite binary files. These files are taken to contain all of their meaning, like genomes or books. The distances are based on compression of the objects concerned, normalized, and can be viewed as similarity distances. Second, we consider pair-wise distances between names of objects, like "red" or "christianity." In this case the distances are based on searches of the Internet. Such a search can be performed by any search...

  19. Compressibility of solids

    Science.gov (United States)

    Vinet, P.; Ferrante, J.; Rose, J. H.; Smith, J. R.

    1987-01-01

    A universal form is proposed for the equation of state (EOS) of solids. Good agreement is found for a variety of test data. The form of the EOS is used to suggest a method of data analysis, which is applied to materials of geophysical interest. The isothermal bulk modulus is discussed as a function of the volume and of the pressure. The isothermal compression curves for materials of geophysical interest are examined.

  20. Compression of Cake

    Science.gov (United States)

    Nason, Sarah; Houghton, Brittany; Renfro, Timothy

    2012-03-01

    The fall university physics class, at McMurry University, created a compression modulus experiment that even high school students could do. The class came up with this idea after a Young's modulus experiment which involved stretching wire. A question was raised of what would happen if we compressed something else? We created our own Young's modulus experiment, but in a more entertaining way. The experiment involves measuring the height of a cake both before and after a weight has been applied to the cake. We worked to derive the compression modulus by applying weight to a cake. In the end, we had our experimental cake and, ate it too! To cite this abstract, use the following reference: http://meetings.aps.org/link/BAPS.2012.TSS.B1.1 APS Home | APS Meetings | Join APS | Help | Contact APS Meetings var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); try var pageTracker = gat.getTracker("UA-324916-13"); pageTracker.trackPageview(); catch(err)

  1. Scale adaptive compressive tracking.

    Science.gov (United States)

    Zhao, Pengpeng; Cui, Shaohui; Gao, Min; Fang, Dan

    2016-01-01

    Recently, the compressive tracking (CT) method (Zhang et al. in Proceedings of European conference on computer vision, pp 864-877, 2012) has attracted much attention due to its high efficiency, but it cannot well deal with the scale changing objects due to its constant tracking box. To address this issue, in this paper we propose a scale adaptive CT approach, which adaptively adjusts the scale of tracking box with the size variation of the objects. Our method significantly improves CT in three aspects: Firstly, the scale of tracking box is adaptively adjusted according to the size of the objects. Secondly, in the CT method, all the compressive features are supposed independent and equal contribution to the classifier. Actually, different compressive features have different confidence coefficients. In our proposed method, the confidence coefficients of features are computed and used to achieve different contribution to the classifier. Finally, in the CT method, the learning parameter λ is constant, which will result in large tracking drift on the occasion of object occlusion or large scale appearance variation. In our proposed method, a variable learning parameter λ is adopted, which can be adjusted according to the object appearance variation rate. Extensive experiments on the CVPR2013 tracking benchmark demonstrate the superior performance of the proposed method compared to state-of-the-art tracking algorithms. PMID:27386298

  2. Compressed sensing electron tomography

    Energy Technology Data Exchange (ETDEWEB)

    Leary, Rowan, E-mail: rkl26@cam.ac.uk [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge CB2 3QZ (United Kingdom); Saghi, Zineb; Midgley, Paul A. [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge CB2 3QZ (United Kingdom); Holland, Daniel J. [Department of Chemical Engineering and Biotechnology, University of Cambridge, New Museums Site, Pembroke Street, Cambridge CB2 3RA (United Kingdom)

    2013-08-15

    The recent mathematical concept of compressed sensing (CS) asserts that a small number of well-chosen measurements can suffice to reconstruct signals that are amenable to sparse or compressible representation. In addition to powerful theoretical results, the principles of CS are being exploited increasingly across a range of experiments to yield substantial performance gains relative to conventional approaches. In this work we describe the application of CS to electron tomography (ET) reconstruction and demonstrate the efficacy of CS–ET with several example studies. Artefacts present in conventional ET reconstructions such as streaking, blurring of object boundaries and elongation are markedly reduced, and robust reconstruction is shown to be possible from far fewer projections than are normally used. The CS–ET approach enables more reliable quantitative analysis of the reconstructions as well as novel 3D studies from extremely limited data. - Highlights: • Compressed sensing (CS) theory and its application to electron tomography (ET) is described. • The practical implementation of CS–ET is outlined and its efficacy demonstrated with examples. • High fidelity tomographic reconstruction is possible from a small number of images. • The CS–ET reconstructions can be more reliably segmented and analysed quantitatively. • CS–ET is applicable to different image content by choice of an appropriate sparsifying transform.

  3. Ultraspectral sounder data compression review

    Institute of Scientific and Technical Information of China (English)

    Bormin HUANG; Hunglung HUANG

    2008-01-01

    Ultraspectral sounders provide an enormous amount of measurements to advance our knowledge of weather and climate applications. The use of robust data compression techniques will be beneficial for ultraspectral data transfer and archiving. This paper reviews the progress in lossless compression of ultra-spectral sounder data. Various transform-based, pre-diction-based, and clustering-based compression methods are covered. Also studied is a preprocessing scheme for data reordering to improve compression gains. All the coding experiments are performed on the ultraspectral compression benchmark dataset col-lected from the NASA Atmospheric Infrared Sounder (AIRS) observations.

  4. Proprioceptive neuromuscular facilitation in HTLV-I-associated myelopathy/tropical spastic paraparesis

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Santos de Britto

    2014-01-01

    Full Text Available Introduction: Human T cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP can impact the independence and motricity of patients. The aims of this study were to estimate the effects of physiotherapy on the functionality of patients with HAM/TSP during the stable phase of the disease using proprioceptive neuromuscular facilitation (PNF and to compare two methods of treatment delivery. Methods: Fourteen patients with human T cell lymphotropic virus type I (HTLV-I were randomly allocated into two groups. In group I (seven patients, PNF was applied by the therapist, facilitating the functional activities of rolling, sitting and standing, walking and climbing and descending stairs. In group II (seven patients, PNF was self-administered using an elastic tube, and the same activities were facilitated. Experiments were conducted for 1h twice per week for 12 weeks. Low-back pain, a modified Ashworth scale, the functional independence measure (FIM and the timed up and go test (TUG were assessed before and after the interventions. Results: In the within-group evaluation, low-back pain was significantly reduced in both groups, the FIM improved in group II, and the results of the TUG improved in group I. In the inter-group analysis, only the tone was lower in group II than in group I. Conclusions: Both PNF protocols were effective in treating patients with HAM/TSP.

  5. Electrophysiologic and Behavioral Assessment of Hearing Status in Children with Spastic Diplegia

    Directory of Open Access Journals (Sweden)

    Mohammad Kamali

    2011-06-01

    Full Text Available Background and Aim: High incidence of speech disorders in children with cerebral palsy could be related to a deficiency in processing of auditory stimuli. So it is vital to check out any peripheral or central disorders in auditory system using behavioral and electrophysiological auditory tests.Methods: In a cross-sectional study, 15 children with spastic diplegia, mean age 5.77, SD 2.26 years, and 15 normal children, mean age 5.33, SD 1.80 years, were tested using pure tone audiometry, immittance and auditory brainstem responses. The results were compared between the two groups.Results: Hearing thresholds and middle ear status were in normal range in all participants; however, contralateral acoustic reflex thresholds were mostly elevated. Comparing absolute latency and interpeak latency intervals of auditory brainstem responses between the two groups, absolute latency interval of later waves, and in specific the V wave, was significantly longer in diplegic children (p=0.04 resulting in a longer III-V interpeak latency intervals (p=0.02.Conclusion: Neurological disorders in ponto-reticulo-spinal pathway, pontine reticular nuclei and upper pons which are adjacent to auditory nuclei of lateral leminiscus and inferior colliculus result in auditory dys-synchrony and increased latency intervals in latter waves of auditory brainstem responses. This could also attributed to functional disorders in wave-generating sites in these patients.

  6. MRI in spastic cerebral palsy - correlations with motor development and mental retardation

    International Nuclear Information System (INIS)

    The introduction of magnetic resonance (MR) has improved our understanding of the pathophysiology and early diagnosis of cerebral palsy (CP). The aim of this study was to evaluate types of lesions on MR in children with CP in correlations with motor development, cognitive impairment and risk factors. Twenty-two children aged 4-17 years (boys 12, girls 10) with CP diplegia - 16 and tetraplegia - 6 were studied. Routine MR images were performed in all children. Results: All patients had periventricular leukomalacia (PVL) in MR findings. In addition three different degrees of MRI lesion patterns were defined: a mild pattern (nucleus lentiformis and thalamus) moderate (nucleus lentiformis, thalamus and pericentral region)and a severe pattern (nucleus lentiformis , thalamus, pericentral region and hippocampus). Significant correlations of the MR findings with the motor development and mental retardation were found. No significant relationships between the MR findings and the etiological factors (prematurity, low birthweight, Apgar score, sepsis, seizures, pre-eclamsia , and gestational age) were noted. MR imaging is useful in the evaluation structural abnormalities in the brains in the children with spastic diplegia and tetraplegia. (author)

  7. Comparison of colonic transit time findings between spastic pelvic floor syndrome and normal on defecogram

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Kwon; Choi, Sang Hee; Chung, Il Gyu; Lim, Hyo Keun; Choo, Sung Wook; Rhee, Poong Lyul [Samsung Medical Center, Seoul (Korea, Republic of)

    1998-05-01

    The purpose of this study is to evaluate colonic transit time (CTT) in patients with spastic pelvic floor syndrome (SPFS) diagnosed by defecography and compare findings with those of patients with normal defecography. Over a recent 15-month period, 140 patients underwent both defecography and CTT test because of chronic idiopathic constipation. Of these, 54 with SPFS diagnosed by defecography and 49 controls with normal defecography were included in our study. CTT test involved the radiopaque marker method. Subjects ingested 24 markers at 9:00 Am on three consecutive days and a plain film of the abdomen was obtained on day 4. We calculated total and segmental CTT test findings in the two groups. Delayed total CTT was found in 35% of patients (19/54) with SPFS. Segmental CTT in the right, left and rectosigmoid colon was delayed in 31 % of patients (15/49) with SPFS. Segmental CTT in the right, left and rectosigmoid colon was delayed in 19 % (10/54), 44 % (24/54), and 31 % of cases (17/54), respectively. Total CTT was delayed in 31 % of patients (15/49) with normal defecography. In this group, segmental CTT in the left colon was delayed in 39 % of cases. There was no significant difference in CTT findings between the SPFS and normal groups on defecogram. (author). 18 refs., 2 tabs., 5 figs.

  8. Recommended frequency of ABPI review for patients wearing compression hosiery.

    Science.gov (United States)

    Furlong, Winnie

    2015-11-11

    This paper is a sequel to the article 'How often should patients in compression have ABPI recorded?' ( Furlong, 2013 ). Monitoring ankle brachial pressure index (ABPI) is essential, especially in those patients wearing compression hosiery, as it can change over time ( Simon et al, 1994 ; Pankhurst, 2004 ), particularly in the presence of peripheral arterial disease (PAD). Leg ulceration caused by venous disease requires graduated compression ( Wounds UK, 2002 ; Anderson, 2008). Once healed, compression hosiery is required to help prevent ulcer recurrence ( Vandongen and Stacey, 2000 ). The Royal College of Nursing ( RCN, 2006 ) guidelines suggest 3-monthly reviews, including ABPI, with no further guidance. Wounds UK (2002) suggests that patients who have ABPI<0.9, diabetes, reduced mobility or symptoms of claudication should have at least 3/12 Doppler, and that those in compression hosiery without complications who are able to report should have vascular assessment yearly. PMID:26559232

  9. Compressed Data Transmission Among Nodes in BigData

    Directory of Open Access Journals (Sweden)

    Thirunavukarasu B

    2014-06-01

    Full Text Available Many organizations are now dealing with large amount of data. Traditionally they used relational data. But nowadays they are supposed to use structured and semi structured data. To work effectively these organizations uses virtualization, parallel processing in compression etc., out of which the compression is most effective one. The data transmission of high volume usually causes high transmission time. This compression of unstructured data is immediately done when the data is being transmitted from client to DataNode. Initially once unstructured or semi-structured data is ready for transmission, the data is compressed using some software tools or procedures. This compressed data is transmitted through certain medium that undertakes an effective transmission.

  10. The Impacts of Hinged and Solid Ankle-Foot Orthoses on Standing and Walking in Children with Spastic Diplegia

    Directory of Open Access Journals (Sweden)

    Hamid DALVAND

    2013-11-01

    Full Text Available How to Cite This Article: Dalvand H, Dehghan L, Feizi A, Hosseini SA, Amirsalari S. Iran J Child Neurol. 2013 Autumn; 7(4:12-19.AbstractObjective The purpose of this study was to examine the impacts of hinged and solid anklefoot orthoses (AFOs on standing and walking abilities in children with spastic diplegia.Materials & MethodsIn a quasi-experimental design, 30 children with spastic diplegia, aged 4-6 years were recruited. They were matched in terms of age, IQ, and level of GMFCS E&R. Children were randomly assigned into 3 groups: a hinged AFO group (n=10 plus occupational therapy (OT, a solid AFO group (n=10 plus OT, a control group who used only OT for three months. Gross motor abilities weremeasured using Gross Motor Measure Function (GMFM.ResultsWe obtained statistically significant differences in the values between baseline and after treatment in all groups. The groups were also significantly different in total GMFM after intervention. Furthermore, there were differences between hinged AFOs and solid AFOs groups, and between hinged AFOs and control groups.ConclusionWe concluded that gross motor function was improved in all groups; however, hinged AFOs group appears to improve the gross motor function better than solid AFOs and control groups.ReferencesMiller F. Cerebral palsy. 1st ed. New York: Springer Science & Business Media; 2005.Wren TL, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: Influence of cerebral palsy subtype, age, and previous surgery. J Pediat Orthoped 2005;25(1:79-83.Knutosn L, Clark D. Orthotic devices for ambulation in children with cerebral palsy and myelomeningocele. Phys Ther 1991;71:947-60.Figueiredo EM, Ferreira GB, Maia Moreira RC, Kirkwood R, Fetters L. Efficacy of Ankle-Foot Orthoses on Gait of Children with Cerebral Palsy: Systematic Review of Literature. Pediat Phys Ther 2008; 20(3:207-23.Brehm MA, Harlaar J, Schwartz M. Effect of ankle

  11. Carpal tunnel syndrome caused by cysticercosis

    OpenAIRE

    Sharma S; Sharma Nalini; Yeolekar M

    2010-01-01

    We present a case of carpal tunnel syndrome (CTS) due to compression of the median nerve within the carpal tunnel, caused by cysticercosis. Nerve conduction studies revealed severe CTS. Magnetic resonance imaging suggested an inflammatory mass compressing the median nerve in carpal tunnel. The histological diagnosis was consistent with cysticercosis. The case resolved with conservative treatment. Such solitary presentation of entrapment median neuropathy as CTS caused by cysticercosis is extr...

  12. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  13. Comparative data compression techniques and multi-compression results

    International Nuclear Information System (INIS)

    Data compression is very necessary in business data processing, because of the cost savings that it offers and the large volume of data manipulated in many business applications. It is a method or system for transmitting a digital image (i.e., an array of pixels) from a digital data source to a digital data receiver. More the size of the data be smaller, it provides better transmission speed and saves time. In this communication, we always want to transmit data efficiently and noise freely. This paper will provide some compression techniques for lossless text type data compression and comparative result of multiple and single compression, that will help to find out better compression output and to develop compression algorithms

  14. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS-II Study

    Directory of Open Access Journals (Sweden)

    Klemens Fheodoroff

    2015-04-01

    Full Text Available In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A treatment in 456 adults with post-stroke upper limb spasticity (ULS. Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001, contractures (soft tissue shortening [STS] (p = 0.006 and spasticity (p = 0.02 than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001, contracture (p < 0.0001, spasticity (p < 0.001 and shorter time since stroke (p = 0.001. Patients setting goals for pain were older (p = 0.01 with more contractures (p = 0.008. The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (≤1 year vs. longer-term (>1 year post-stroke (80.0% vs. 79.2% or presence or absence of severe contractures (76.7% vs. 80.6%, although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  15. Analysis by compression

    DEFF Research Database (Denmark)

    Meredith, David

    MEL is a geometric music encoding language designed to allow for musical objects to be encoded parsimoniously as sets of points in pitch-time space, generated by performing geometric transformations on component patterns. MEL has been implemented in Java and coupled with the SIATEC pattern...... discovery algorithm to allow for compact encodings to be generated automatically from in extenso note lists. The MEL-SIATEC system is founded on the belief that music analysis and music perception can be modelled as the compression of in extenso descriptions of musical objects....

  16. Compressive Fatigue in Wood

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben;

    1999-01-01

    An investigation of fatigue failure in wood subjected to load cycles in compression parallel to grain is presented. Small clear specimens of spruce are taken to failure in square wave formed fatigue loading at a stress excitation level corresponding to 80% of the short term strength. Four...... frequencies ranging from 0.01 Hz to 10 Hz are used. The number of cycles to failure is found to be a poor measure of the fatigue performance of wood. Creep, maximum strain, stiffness and work are monitored throughout the fatigue tests. Accumulated creep is suggested identified with damage and a correlation...

  17. An unusual cause of trochlear nerve palsy and brainstem compression

    Directory of Open Access Journals (Sweden)

    Jasmit Singh

    2016-01-01

    Full Text Available Schwannoma originates from the Schwann cells at the Obersteiner-Redlich zone, which marks the junction of central and peripheral myelin of the cranial nerves. Most frequently affected are the vestibular, trigeminal, and facial nerves followed by the lower cranial nerves. Trochlear schwannoma in the absence of neurofibromatosis is a rare entity. The purpose of this report is to serve as a reminder to consider trochlear nerve schwannoma in the list of differential diagnosis of such tumors as the outcome is far better than the intraaxial tumor in that location.

  18. Vascular ring causing tracheal compression in an adult patient.

    Science.gov (United States)

    Greiner, Andreas; Perkmann, Reinhold; Rieger, Michael; Neuhauser, Beate; Fraedrich, Gustav

    2003-06-01

    A 65-year-old woman was referred for evaluation because of a few years' history of inspiratory obstruction without dysphagia. A right aortic arch with mirror image bracheocephalic vessels narrowing the trachea was considered to be the reason for the dyspnea. Immediate decompression of the trachea and symptomatic relief was achieved through surgical treatment.

  19. Ultrasound beamforming using compressed data.

    Science.gov (United States)

    Li, Yen-Feng; Li, Pai-Chi

    2012-05-01

    The rapid advancements in electronics technologies have made software-based beamformers for ultrasound array imaging feasible, thus facilitating the rapid development of high-performance and potentially low-cost systems. However, one challenge to realizing a fully software-based system is transferring data from the analog front end to the software back end at rates of up to a few gigabits per second. This study investigated the use of data compression to reduce the data transfer requirements and optimize the associated trade-off with beamforming quality. JPEG and JPEG2000 compression techniques were adopted. The acoustic data of a line phantom were acquired with a 128-channel array transducer at a center frequency of 3.5 MHz, and the acoustic data of a cyst phantom were acquired with a 64-channel array transducer at a center frequency of 3.33 MHz. The receive-channel data associated with each transmit event are separated into 8 × 8 blocks and several tiles before JPEG and JPEG2000 data compression is applied, respectively. In one scheme, the compression was applied to raw RF data, while in another only the amplitude of baseband data was compressed. The maximum compression ratio of RF data compression to produce an average error of lower than 5 dB was 15 with JPEG compression and 20 with JPEG2000 compression. The image quality is higher with baseband amplitude data compression than with RF data compression; although the maximum overall compression ratio (compared with the original RF data size), which was limited by the data size of uncompressed phase data, was lower than 12, the average error in this case was lower than 1 dB when the compression ratio was lower than 8. PMID:22434817

  20. Statistical Mechanical Analysis of Compressed Sensing Utilizing Correlated Compression Matrix

    CERN Document Server

    Takeda, Koujin

    2010-01-01

    We investigate a reconstruction limit of compressed sensing for a reconstruction scheme based on the L1-norm minimization utilizing a correlated compression matrix with a statistical mechanics method. We focus on the compression matrix modeled as the Kronecker-type random matrix studied in research on multi-input multi-output wireless communication systems. We found that strong one-dimensional correlations between expansion bases of original information slightly degrade reconstruction performance.

  1. Functional influence of botulinum neurotoxin type A treatment (Xeomin® of multifocal upper and lower limb spasticity on chronic hemiparetic gait

    Directory of Open Access Journals (Sweden)

    Maurizio Falso

    2012-05-01

    Full Text Available This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment.

  2. The usage of playing studies for development of spatial reasoning of 5-8-year-old children with spastic diplegi.

    Directory of Open Access Journals (Sweden)

    Shlapachenko O.A.

    2012-09-01

    Full Text Available In the article is shown the influence of rehabilitation-correction program with the usage of outdoor games on the level of influence of spatial thinking and constructive activity of 5-8-year-old children with spastic diplegi. 64 children took part in the experiment, all had main diagnosis - children cerebral paralysis, spastic diplegi. The experiment was conducted in a few phases during the year. It is proved that conducting of outdoor games promote positive influence on forming the level of influence of spatial thinking of children, increasing capacity of work. It is revealed that the level of development of spatial thinking of children with spastic diplegi depends on clinical display of an illness. It is mentioned that involving parents for participation in games with children promote rehabilitation of children in home conditions.

  3. Clinical Observation on Therapeutic Effects of the Point-Penetrating Method in Acupuncture Treatment of Spastic Hemiparalysis Due to Cerebrovascular Disorders

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the therapeutic effects of different acupuncture methods for spastic hemiparalysis due to cerebrovascular disorders. Methods: 90 cases of spastic hemiparalysis after wind-stroke were randomly divided into a control group of 30 cases, a body acupuncture group of 30 cases and a point-penetrating acupuncture group of 30 cases. All the patients were given 4 courses of treatment, with 7 sessions constituting one therapeutic course and with a one-day interval between courses. The evaluations were made 3 times, i.e. once before treatment and once every 15 days during the treatment. Results: The therapeutic effects in the point-penetrating acupuncture group were obviously superior to those of both the control group and the body acupuncture group. Conclusion: The point-penetrating acupuncture is an effective therapy for treating spastic hemiparalysis due to cerebrovascular disorders.

  4. ATXN2 with intermediate-length CAG/CAA repeats does not seem to be a risk factor in hereditary spastic paraplegia

    DEFF Research Database (Denmark)

    Nielsen, Troels Tolstrup; Svenstrup, Kirsten; Budtz-Jørgensen, Esben;

    2012-01-01

    Hereditary spastic paraplegia (HSP) confines a group of heterogeneous neurodegenerative disorders characterized by progressive spasticity and lower limb weakness. Age of onset is highly variable even in familial cases with known mutations suggesting that the disease is modulated by other yet...... unknown parameters. Although progressive gait disturbances, lower limb spasticity and extensor plantar responses are hallmarks of HSP these characteristics are also found in other neurodegenerative disorders, e.g. amytrophic lateral sclerosis (ALS). HSP has been linked to ALS and frontotemporal...... in spinocerebellar ataxia type 2, has been shown to be a modulator of TDP-43 induced toxicity in ALS animal and cell models. Finally, it has been shown that ATXN2 with non-pathogenic intermediate-length CAG/CAA repeat elongations (encoding the polyglutamine tract) is a genetic risk factor of ALS. Considering...

  5. Compressive Sensing DNA Microarrays

    Directory of Open Access Journals (Sweden)

    Richard G. Baraniuk

    2009-01-01

    Full Text Available Compressive sensing microarrays (CSMs are DNA-based sensors that operate using group testing and compressive sensing (CS principles. In contrast to conventional DNA microarrays, in which each genetic sensor is designed to respond to a single target, in a CSM, each sensor responds to a set of targets. We study the problem of designing CSMs that simultaneously account for both the constraints from CS theory and the biochemistry of probe-target DNA hybridization. An appropriate cross-hybridization model is proposed for CSMs, and several methods are developed for probe design and CS signal recovery based on the new model. Lab experiments suggest that in order to achieve accurate hybridization profiling, consensus probe sequences are required to have sequence homology of at least 80% with all targets to be detected. Furthermore, out-of-equilibrium datasets are usually as accurate as those obtained from equilibrium conditions. Consequently, one can use CSMs in applications in which only short hybridization times are allowed.

  6. Compressive Bilateral Filtering.

    Science.gov (United States)

    Sugimoto, Kenjiro; Kamata, Sei-Ichiro

    2015-11-01

    This paper presents an efficient constant-time bilateral filter that produces a near-optimal performance tradeoff between approximate accuracy and computational complexity without any complicated parameter adjustment, called a compressive bilateral filter (CBLF). The constant-time means that the computational complexity is independent of its filter window size. Although many existing constant-time bilateral filters have been proposed step-by-step to pursue a more efficient performance tradeoff, they have less focused on the optimal tradeoff for their own frameworks. It is important to discuss this question, because it can reveal whether or not a constant-time algorithm still has plenty room for improvements of performance tradeoff. This paper tackles the question from a viewpoint of compressibility and highlights the fact that state-of-the-art algorithms have not yet touched the optimal tradeoff. The CBLF achieves a near-optimal performance tradeoff by two key ideas: 1) an approximate Gaussian range kernel through Fourier analysis and 2) a period length optimization. Experiments demonstrate that the CBLF significantly outperforms state-of-the-art algorithms in terms of approximate accuracy, computational complexity, and usability. PMID:26068315

  7. Splines in Compressed Sensing

    Directory of Open Access Journals (Sweden)

    S. Abhishek

    2016-07-01

    Full Text Available It is well understood that in any data acquisition system reduction in the amount of data reduces the time and energy, but the major trade-off here is the quality of outcome normally, lesser the amount of data sensed, lower the quality. Compressed Sensing (CS allows a solution, for sampling below the Nyquist rate. The challenging problem of increasing the reconstruction quality with less number of samples from an unprocessed data set is addressed here by the use of representative coordinate selected from different orders of splines. We have made a detailed comparison with 10 orthogonal and 6 biorthogonal wavelets with two sets of data from MIT Arrhythmia database and our results prove that the Spline coordinates work better than the wavelets. The generation of two new types of splines such as exponential and double exponential are also briefed here .We believe that this is one of the very first attempts made in Compressed Sensing based ECG reconstruction problems using raw data.  

  8. Compressive sensing in medical imaging.

    Science.gov (United States)

    Graff, Christian G; Sidky, Emil Y

    2015-03-10

    The promise of compressive sensing, exploitation of compressibility to achieve high quality image reconstructions with less data, has attracted a great deal of attention in the medical imaging community. At the Compressed Sensing Incubator meeting held in April 2014 at OSA Headquarters in Washington, DC, presentations were given summarizing some of the research efforts ongoing in compressive sensing for x-ray computed tomography and magnetic resonance imaging systems. This article provides an expanded version of these presentations. Sparsity-exploiting reconstruction algorithms that have gained popularity in the medical imaging community are studied, and examples of clinical applications that could benefit from compressive sensing ideas are provided. The current and potential future impact of compressive sensing on the medical imaging field is discussed.

  9. libpolycomp: Compression/decompression library

    Science.gov (United States)

    Tomasi, Maurizio

    2016-04-01

    Libpolycomp compresses and decompresses one-dimensional streams of numbers by means of several algorithms. It is well-suited for time-ordered data acquired by astronomical instruments or simulations. One of the algorithms, called "polynomial compression", combines two widely-used ideas (namely, polynomial approximation and filtering of Fourier series) to achieve substantial compression ratios for datasets characterized by smoothness and lack of noise. Notable examples are the ephemerides of astronomical objects and the pointing information of astronomical telescopes. Other algorithms implemented in this C library are well known and already widely used, e.g., RLE, quantization, deflate (via libz) and Burrows-Wheeler transform (via libbzip2). Libpolycomp can compress the timelines acquired by the Planck/LFI instrument with an overall compression ratio of ~9, while other widely known programs (gzip, bzip2) reach compression ratios less than 1.5.

  10. Speech Compression Using Multecirculerletet Transform

    Directory of Open Access Journals (Sweden)

    Sulaiman Murtadha

    2012-01-01

    Full Text Available Compressing the speech reduces the data storage requirements, leading to reducing the time of transmitting the digitized speech over long-haul links like internet. To obtain best performance in speech compression, wavelet transforms require filters that combine a number of desirable properties, such as orthogonality and symmetry.The MCT bases functions are derived from GHM bases function using 2D linear convolution .The fast computation algorithm methods introduced here added desirable features to the current transform. We further assess the performance of the MCT in speech compression application. This paper discusses the effect of using DWT and MCT (one and two dimension on speech compression. DWT and MCT performances in terms of compression ratio (CR, mean square error (MSE and peak signal to noise ratio (PSNR are assessed. Computer simulation results indicate that the two dimensions MCT offer a better compression ratio, MSE and PSNR than DWT.

  11. Data compression on the sphere

    CERN Document Server

    McEwen, J D; Eyers, D M; 10.1051/0004-6361/201015728

    2011-01-01

    Large data-sets defined on the sphere arise in many fields. In particular, recent and forthcoming observations of the anisotropies of the cosmic microwave background (CMB) made on the celestial sphere contain approximately three and fifty mega-pixels respectively. The compression of such data is therefore becoming increasingly important. We develop algorithms to compress data defined on the sphere. A Haar wavelet transform on the sphere is used as an energy compression stage to reduce the entropy of the data, followed by Huffman and run-length encoding stages. Lossless and lossy compression algorithms are developed. We evaluate compression performance on simulated CMB data, Earth topography data and environmental illumination maps used in computer graphics. The CMB data can be compressed to approximately 40% of its original size for essentially no loss to the cosmological information content of the data, and to approximately 20% if a small cosmological information loss is tolerated. For the topographic and il...

  12. Does Poststroke Lower-Limb Spasticity Influence the Recovery of Standing Balance Control? A 2-Year Multilevel Growth Model.

    Science.gov (United States)

    Singer, Jonathan C; Nishihara, Kanako; Mochizuki, George

    2016-08-01

    Background Poststroke lower-limb spasticity (LLS) has been shown to degrade standing balance control by disrupting the temporal synchronization between individual limb centers of pressure (COPs). Time-varying changes in standing balance control associated with alterations in the extent of LLS have yet to be documented and are important to informing treatment strategies to improve such functional outcomes. Objective The present work aimed to understand the natural recovery of standing balance control among stroke survivors with LLS using limb-specific indices of standing balance control. Furthermore, we sought to understand if time-varying changes in LLS were associated with alterations in standing balance control. Methods A retrospective analysis of 92 participants was performed; 47 participants never exhibited LLS during the study (No_LLS), and 45 participants exhibited LLS during at least 1 testing session (LLS). Quiet standing for a duration of 30 s on 2 force platforms was recorded. Temporal synchrony and spatial symmetry of COP displacements were assessed, along with interlimb weight-bearing symmetry. Results All variables, except spatial symmetry, indicated initial improvement followed by deceleration in the rate of balance control recovery. Limb-specific measures indicated that individuals with LLS exhibited deficits in balance control. The recovery trajectories were not different between groups, suggesting a similar rate, but reduced extent, of balance control recovery among the LLS relative to the No_LLS group. Only temporal synchrony was altered by time-varying changes in spasticity. Conclusions The present results suggest that the reduction in spasticity may be beneficial to balance control recovery.

  13. "An Investigation Into The Interrater Reliability Of The Modified Ashworth Scale In The Assessment Of Muscle Spasticity In Hemiplegic Patients "

    Directory of Open Access Journals (Sweden)

    N. Nokhostin-Ansari

    2006-06-01

    Full Text Available Background and Aim: Spasticity is a velocity-dependent increase in tonic stretch reflexes (muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. The measurement of spasticity is necessary to determine the effect of treatments. The Modified Ashworth Scale is the most widely used method for assessing muscle spasticity in clinical practice and research. The purpose of this study was to investigate the interrater reliability of Modified Ashworth Scale in hemiplegic patients. Materials and Methods: Thirty subjects (16 males, 14 females with a mean age of 59.40 (SD =14.013 recruited. Shoulder adductor , elbow flexor , wrist dorsiflexor , hip adductor , knee extensor and ankle plantarflexor on the hemiplegic side were tested by two physiotherapists. Results: In the upper limb, the interrater reliability for shoulder adductor and elbow flexor muscles was fair (0.372 and 0.369, respectively. The reliability for the wrist flexors was good (0.612. The difference in Kappa value for the proximal muscle (shoulder adductor; 0.372 and the distal muscle (wrist flexor; 0.612 was significant (²X=33.87, df=1, p0.05. The mean value for the upper limb (0.505 and the lower limb (0,.516 was not significantly different (²X=0.1407, df=1, p>0.05. Conclusion: The interrater reliability of Modified Ashworth Scale was not good . The limb, upper or lower, had no significant effect on the reliability. In the upper limb, the reliability for the proximal and distal muscle was significantly different. However. The difference in the lower limb was not significant.When using the scale, one should consider it's limitation.

  14. Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosis.

    Science.gov (United States)

    Serpell, Michael G; Notcutt, William; Collin, Christine

    2013-01-01

    Sativex is an endocannabinoid system modulator principally containing Δ(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD). During a 6-week randomised controlled trial, Sativex had a clinically relevant effect on spasticity associated with multiple sclerosis (MS). Patients self-titrated oromucosal Sativex to symptom relief or maximum tolerated dose (maximum of 130 mg THC and 120 mg CBD daily). The primary objective was to evaluate the safety and tolerability of long-term treatment by recording the incidence and severity of adverse events (AEs). Secondary outcomes were to determine evidence of developing tolerance and to assess the long-term dosing profile of Sativex. A validated 11-point Numerical Rating Scale of spasticity severity was used to assess efficacy. A total of 146 patients elected to enter this open-label follow-up safety trial. Mean treatment exposure was 334 days (standard deviation, SD = 209 days), and patients administered on average 7.3 (SD = 4.42) actuations per day. Fifty-two (36 %) patients withdrew from the study in the first year, 14 % due to AEs and 9 % due to lack of efficacy. Most AEs were mild/moderate in severity. Common (>10 %) treatment-related AEs were dizziness (24.7 %) and fatigue (12.3 %). Serious AEs occurred in five patients (3.4 %), with two psychiatric events reported by one patient. No psychoses, psychiatric AE trends, or withdrawal symptoms occurred following abrupt cessation of treatment. Baseline symptoms including spasticity did not deteriorate but were maintained to study completion in those patients who did not withdraw. No new safety concerns were identified with chronic Sativex treatment, and serious AEs were uncommon. There was no evidence of tolerance developing, and patients who remained in the study reported continued benefit. PMID:22878432

  15. A new locus (SPG46) maps to 9p21.2-q21.12 in a Tunisian family with a complicated autosomal recessive hereditary spastic paraplegia with mental impairment and thin corpus callosum.

    Science.gov (United States)

    Boukhris, Amir; Feki, Imed; Elleuch, Nizar; Miladi, Mohamed Imed; Boland-Augé, Anne; Truchetto, Jérémy; Mundwiller, Emeline; Jezequel, Nadia; Zelenika, Diana; Mhiri, Chokri; Brice, Alexis; Stevanin, Giovanni

    2010-10-01

    Hereditary spastic paraplegia (HSP) with thin corpus callosum (TCC) and mental impairment is a frequent subtype of complicated HSP, often inherited as an autosomal recessive (AR) trait. It is clear from molecular genetic analyses that there are several underlying causes of this syndrome, with at least six genetic loci identified to date. However, SPG11 and SPG15 are the two major genes for this entity. To map the responsible gene in a large AR-HSP-TCC family of Tunisian origin, we investigated a consanguineous family with a diagnosis of AR-HSP-TCC excluded for linkage to the SPG7, SPG11, SPG15, SPG18, SPG21, and SPG32 loci. A genome-wide scan was undertaken using 6,090 SNP markers covering all chromosomes. The phenotypic presentation in five patients was suggestive of a complex HSP that associated an early-onset spastic paraplegia with mild handicap, mental deterioration, congenital cataract, cerebellar signs, and TCC. The genome-wide search identified a single candidate region on chromosome 9, exceeding the LOD score threshold of +3. Fine mapping using additional markers narrowed the candidate region to a 45.1-Mb interval (15.4 cM). Mutations in three candidate genes were excluded. The mapping of a novel AR-HSP-TCC locus further demonstrates the extensive genetic heterogeneity of this condition. We propose that testing for this locus should be performed, after exclusion of mutations in SPG11 and SPG15 genes, in AR-HSP-TCC families, especially when cerebellar ataxia and cataract are present.

  16. Delta-9-tetrahydrocannabinol/cannabidiol (Sativex®): a review of its use in patients with moderate to severe spasticity due to multiple sclerosis.

    Science.gov (United States)

    Syed, Yahiya Y; McKeage, Kate; Scott, Lesley J

    2014-04-01

    Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) [Sativex®] is an oromucosal spray formulation that contains principally THC and CBD at an approximately 1:1 fixed ratio, derived from cloned Cannabis sativa L. plants. The main active substance, THC, acts as a partial agonist at human cannabinoid receptors (CB1 and CB2), and thus, may modulate the effects of excitatory (glutamate) and inhibitory (gamma-aminobutyric acid) neurotransmitters. THC/CBD is approved in a number of countries, including Germany and the UK, as an add-on treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy. In the largest multinational clinical trial that evaluated the approved THC/CBD regimen in this population, 12 weeks' double-blind treatment with THC/CBD significantly reduced spasticity severity (primary endpoint) compared with placebo in patients who achieved a clinically significant improvement in spasticity after 4 weeks' single-blind THC/CBD treatment, as assessed by a patient-rated numerical rating scale. A significantly greater proportion of THC/CBD than placebo recipients achieved a ≥ 30% reduction (a clinically relevant reduction) in spasticity severity. The efficacy of THC/CBD has been also shown in at least one everyday clinical practice study (MOVE 2). THC/CBD was generally well tolerated in clinical trials. Dizziness and fatigue were reported most frequently during the first 4 weeks of treatment and resolved within a few days even with continued treatment. Thus, add-on THC/CBD is a useful symptomatic treatment option for its approved indication. PMID:24671907

  17. Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke: A Prospective, Randomized, Single Blind, Controlled Trial.

    Science.gov (United States)

    Li, Tsung-Ying; Chang, Chih-Ya; Chou, Yu-Ching; Chen, Liang-Cheng; Chu, Heng-Yi; Chiang, Shang-Lin; Chang, Shin-Tsu; Wu, Yung-Tsan

    2016-05-01

    Recently, studies have reported that extracorporeal shock wave therapy (ESWT) is a safe, noninvasive, alternative treatment for spasticity. However, the effect of ESWT on spasticity cannot be determined, because most studies to date have enrolled small patient numbers and have lacked placebo-controlled groups and/or long-term follow-up. In addition, whether varying the number of ESWT sessions would affect the duration of the therapeutic effect has not been investigated in a single study. Hence, we performed a prospective, randomized, single blind, placebo-controlled study to investigate the long-term effect of radial ESWT (rESWT) in patients with poststroke spasticity and surveyed the outcome of functional activity.Sixty patients were randomized into 3 groups. Group A patients received 1 session of rESWT per week for 3 consecutive weeks; group B patients received a single session of rESWT; group C patients received one session of sham rESWT per week for 3 consecutive weeks. The primary outcome was Modified Ashworth Scale of hand and wrist, whereas the secondary outcomes were Fugl-Meyer Assessment of hand function and wrist control. Evaluations were performed before the first rESWT treatment and immediately 1, 4, 8, 12, and 16 weeks after the last session of rESWT.Compared to the control group, the significant reduction in spasticity of hand and wrist lasted at least 16 and 8 weeks in group A and B, respectively. Three sessions of rESWT had a longer-lasting effect than one session. Furthermore, the reduction in spasticity after 3 sessions of rESWT may be beneficial for hand function and wrist control and the effect was maintained for 16 and 12 weeks, respectively.rESWT may be valuable in decreasing spasticity of the hand and wrist with accompanying enhancement of wrist control and hand function in chronic stroke patients.

  18. Introduction to compressible fluid flow

    CERN Document Server

    Oosthuizen, Patrick H

    2013-01-01

    IntroductionThe Equations of Steady One-Dimensional Compressible FlowSome Fundamental Aspects of Compressible FlowOne-Dimensional Isentropic FlowNormal Shock WavesOblique Shock WavesExpansion Waves - Prandtl-Meyer FlowVariable Area FlowsAdiabatic Flow with FrictionFlow with Heat TransferLinearized Analysis of Two-Dimensional Compressible FlowsHypersonic and High-Temperature FlowsHigh-Temperature Gas EffectsLow-Density FlowsBibliographyAppendices

  19. Dementia in SPG4 hereditary spastic paraplegia: clinical, genetic, and neuropathologic evidence.

    LENUS (Irish Health Repository)

    Murphy, S

    2012-02-01

    BACKGROUND: Cognitive impairment and dementia has been reported in autosomal dominant hereditary spastic paraparesis (HSP) linked to the SPG4 locus. There has only been one postmortem examination described; not all accept that progressive cognitive decline is a feature of this disorder. OBJECTIVE: A family with SPG4-HSP known to have a deletion of exon 17 in the spastin gene (SPG4delEx17) was cognitively assessed over a 7-year period. The index family member died and a postmortem examination was performed. METHODS: Thirteen family members older than 40 years were clinically and cognitively assessed using the Cambridge Cognitive Assessment over a 7-year period. The presence of SPG4delEx17 was assessed; a neuropathologic examination of the brain of the index family member was performed. RESULTS: Cognitive decline occurred in 6 of the 13 family members and in all 4 older than 60 years. Two genetic deletions were identified: SPG4delEx17 in 12 of the 13 family members and a deletion of SPG6 (SPG6del) in 5. Eight individuals had the SPG4delEx17 deletion only; 4 had evidence of progressive cognitive impairment. Four family members had both SPG4delEx17 and SPG6del; 2 of these had cognitive impairment. One family member with the SPG6del alone had neither HSP nor cognitive impairment. The index case with both deletions died with dementia; the brain showed widespread ubiquitin positivity within the neocortex and white matter. CONCLUSION: Cognitive decline and dementia is a feature of SPG4-HSP due to a deletion of exon 17 of the spastin gene.

  20. Leg and Joint Stiffness in Children with Spastic Diplegic Cerebral Palsy during Level Walking.

    Directory of Open Access Journals (Sweden)

    Ting-Ming Wang

    Full Text Available Individual joint deviations are often identified in the analysis of cerebral palsy (CP gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in children with diplegic CP in terms of their leg stiffness, both skeletal and muscular components, and associated joint stiffness during gait. Twelve children with spastic diplegia CP and 12 healthy controls walked at a self-selected pace in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, mid-stance, terminal stance and pre-swing. For calculating the leg stiffness, each of the lower limbs was modeled as a non-linear spring, connecting the hip joint center and the corresponding center of pressure, with varying stiffness that was calculated as the slope (gradient of the axial force vs. the deformation curve. The leg stiffness was further decomposed into skeletal and muscular components considering the alignment of the lower limb. The ankle, knee and hip of the limb were modeled as revolute joints with torsional springs whose stiffness was calculated as the slope of the moment vs. the angle curve of the joint. Independent t-tests were performed for between-group comparisons of all the variables. The CP group significantly decreased the leg stiffness but increased the joint stiffness during stance phase, except during terminal stance where the leg stiffness was increased. They appeared to rely more on muscular contributions to achieve the required leg stiffness, increasing the muscular demands in maintaining the body posture against collapse. Leg stiffness plays a critical role in modulating the kinematics and kinetics of the locomotor system during gait in the diplegic CP.

  1. Estimation of motive possibilities and manipulative activity of children with cerebral paralysis of spastic form 3-5 years

    Directory of Open Access Journals (Sweden)

    Baybuza I.V.

    2012-03-01

    Full Text Available In this work the conducted estimation of motive possibilities and manipulative activity of children is with the cerebral paralysis of spastic form 3-5 years accordingly standard norms. The experiment was attended by 30 children. Proven lack of fine motor skills and basic static and motor skills decreased muscle strength and improve muscle tone. Providing a more objective assessment of physical development of patients with this pathology would contribute a program hydrokinesotherapy as a means of gradual formation of motor skills.

  2. Effect of r-TMS over standard therapy in decreasing muscle tone of spastic cerebral palsy patients.

    Science.gov (United States)

    Gupta, Meena; Lal Rajak, Bablu; Bhatia, Dinesh; Mukherjee, Arun

    2016-01-01

    Spastic cerebral palsy (CP) is the one of most common neurological disorders occurring due to damage to the immature brain or any other brain lesion at the time of birth. To aid in making the life of the CP patient meaningful, several interventions such as medical, surgical and rehabilitation have been employed to date. Besides these, recently repetitive Transcranial magnetic stimulation (r-TMS) is a new found approach which is being employed for treating various neurological and psychological conditions. The aim of this study was to observe the effects of r-TMS on muscle spasticity in CP patients by stimulating the motor cortex area of the brain, which is responsible for muscle movements. In this study, 20 subjects diagnosed with CP were recruited and 10 each were placed in two groups, namely the research group (RG) (mean age, height and weight were 7.99 (SD = 4.66) years, 116.7 (SD = 23.57) cm and 21.40 (SD = 10.95) kg, respectively) and the control group (CG) (mean age, height and weight were 8.41 (SD = 4.32) years, 107.9 (SD = 26.33) cm, 21.40 (SD = 12.63) kg, respectively). r-TMS frequencies of 5 Hz and 10 Hz were administered for 15 min daily to patients in RG followed by standard therapy (ST) of 1 h duration daily for 20 days. Moreover, the patients in the control group (CG) were given only standard therapy (ST) of 1 h duration for 20 days. Modified Ashworth Scale (MAS) was used as an outcome measure to determine the level of muscle spasticity. A pre- assessment of MAS score was performed on both RG and CG to determine the level of spasticity prior to starting therapy; and similarly post-assessment after 20 days was done to observe the changes post-therapy. Statistical analysis of pre vs post MAS scores showed that few muscles showed reduction in muscle tightness after administering only ST in the CG. On the contrary, the RG that underwent r-TMS therapy combined with ST showed a significant decrease (p < 0.05) in muscle tightness for all the

  3. ADVANCED RECIPROCATING COMPRESSION TECHNOLOGY (ARCT). FINAL REPORT

    International Nuclear Information System (INIS)

    The U.S. natural gas pipeline industry is facing the twin challenges of increased flexibility and capacity expansion. To meet these challenges, the industry requires improved choices in gas compression to address new construction and enhancement of the currently installed infrastructure. The current fleet of installed reciprocating compression is primarily slow-speed integral machines. Most new reciprocating compression is and will be large, high-speed separable units. The major challenges with the fleet of slow-speed integral machines are: limited flexibility and a large range in performance. In an attempt to increase flexibility, many operators are choosing to single-act cylinders, which are causing reduced reliability and integrity. While the best performing units in the fleet exhibit thermal efficiencies between 90% and 92%, the low performers are running down to 50% with the mean at about 80%. The major cause for this large disparity is due to installation losses in the pulsation control system. In the better performers, the losses are about evenly split between installation losses and valve losses. The major challenges for high-speed machines are: cylinder nozzle pulsations, mechanical vibrations due to cylinder stretch, short valve life, and low thermal performance. To shift nozzle pulsation to higher orders, nozzles are shortened, and to dampen the amplitudes, orifices are added. The shortened nozzles result in mechanical coupling with the cylinder, thereby, causing increased vibration due to the cylinder stretch mode. Valve life is even shorter than for slow speeds and can be on the order of a few months. The thermal efficiency is 10% to 15% lower than slow-speed equipment with the best performance in the 75% to 80% range. The goal of this advanced reciprocating compression program is to develop the technology for both high speed and low speed compression that will expand unit flexibility, increase thermal efficiency, and increase reliability and integrity

  4. Compressive sensing of sparse tensors.

    Science.gov (United States)

    Friedland, Shmuel; Li, Qun; Schonfeld, Dan

    2014-10-01

    Compressive sensing (CS) has triggered an enormous research activity since its first appearance. CS exploits the signal's sparsity or compressibility in a particular domain and integrates data compression and acquisition, thus allowing exact reconstruction through relatively few nonadaptive linear measurements. While conventional CS theory relies on data representation in the form of vectors, many data types in various applications, such as color imaging, video sequences, and multisensor networks, are intrinsically represented by higher order tensors. Application of CS to higher order data representation is typically performed by conversion of the data to very long vectors that must be measured using very large sampling matrices, thus imposing a huge computational and memory burden. In this paper, we propose generalized tensor compressive sensing (GTCS)-a unified framework for CS of higher order tensors, which preserves the intrinsic structure of tensor data with reduced computational complexity at reconstruction. GTCS offers an efficient means for representation of multidimensional data by providing simultaneous acquisition and compression from all tensor modes. In addition, we propound two reconstruction procedures, a serial method and a parallelizable method. We then compare the performance of the proposed method with Kronecker compressive sensing (KCS) and multiway compressive sensing (MWCS). We demonstrate experimentally that GTCS outperforms KCS and MWCS in terms of both reconstruction accuracy (within a range of compression ratios) and processing speed. The major disadvantage of our methods (and of MWCS as well) is that the compression ratios may be worse than that offered by KCS.

  5. Lossless Compression of Broadcast Video

    DEFF Research Database (Denmark)

    Martins, Bo; Eriksen, N.; Faber, E.;

    1998-01-01

    We investigate several techniques for lossless and near-lossless compression of broadcast video.The emphasis is placed on the emerging international standard for compression of continous-tone still images, JPEG-LS, due to its excellent compression performance and moderatecomplexity. Except for one...... artificial sequence containing uncompressible data all the 4:2:2, 8-bit test video material easily compresses losslessly to a rate below 125 Mbit/s. At this rate, video plus overhead can be contained in a single telecom 4th order PDH channel or a single STM-1 channel. Difficult 4:2:2, 10-bit test material...

  6. Modelling of pressure-strain correlation in compressible turbulent flow

    Institute of Scientific and Technical Information of China (English)

    Siyuan Huang; Song Fu

    2008-01-01

    Previous studies carried out in the early 1990s conjectured that the main compressible effects could be associated with the dilatational effects of velocity fluctuation.Later,it was shown that the main compressibility effect came from the reduced pressure-strain term due to reduced pressure fluctuations.Although better understanding of the compressible turbulence is generally achieved with the increased DNS and experimental research effort,there are still some discrepancies among these recent findings.Analysis of the DNS and experimental data suggests that some of the discrepancies are apparent if the compressible effect is related to the turbulent Mach number,Mt.From the comparison of two classes of compressible flow,homogenous shear flow and inhomogeneous shear flow(mixing layer),we found that the effect of compressibility on both classes of shear flow can be characterized in three categories corresponding to three regions of turbulent Mach numbers:the low-Mt,the moderate-Mt and high-Mt regions.In these three regions the effect of compressibility on the growth rate of the turbulent mixing layer thickness is rather different.A simple approach to the reduced pressure-strain effect may not necessarily reduce the mixing-layer growth rate,and may even cause an increase in the growth rate.The present work develops a new second-moment model for the compressible turbulence through the introduction of some blending functions of Mt to account for the compressibility effects on the flow.The model has been successfully applied to the compressible mixing layers.

  7. Schwannosis induced medullary compression in VACTERL syndrome.

    LENUS (Irish Health Repository)

    Treacy, A

    2011-10-21

    A 7-year-old boy with a history of VACTERL syndrome was found collapsed in bed. MRI had shown basilar invagination of the skull base and narrowing of the foramen magnum. Angulation, swelling and abnormal high signal at the cervicomedullary junction were felt to be secondary to compression of the medulla. Neuropathologic examination showed bilateral replacement of the medullary tegmentum by an irregularly circumscribed cellular lesion which was composed of elongated GFAP\\/S 100-positive cells with spindled nuclei and minimal atypia. The pathologic findings were interpreted as intramedullary schwannosis with mass effect. Schwannosis, is observed in traumatized spinal cords where its presence may represent attempted, albeit aberrant, repair by inwardly migrating Schwann cells ofperipheral origin. In our view the compressive effect of the basilar invagination on this boy\\'s medulla was of sufficient magnitude to have caused tumoral medullary schwannosis with resultant intermittent respiratory compromise leading to reflex anoxic seizures.

  8. Waves and compressible flow

    CERN Document Server

    Ockendon, Hilary

    2016-01-01

    Now in its second edition, this book continues to give readers a broad mathematical basis for modelling and understanding the wide range of wave phenomena encountered in modern applications.  New and expanded material includes topics such as elastoplastic waves and waves in plasmas, as well as new exercises.  Comprehensive collections of models are used to illustrate the underpinning mathematical methodologies, which include the basic ideas of the relevant partial differential equations, characteristics, ray theory, asymptotic analysis, dispersion, shock waves, and weak solutions. Although the main focus is on compressible fluid flow, the authors show how intimately gasdynamic waves are related to wave phenomena in many other areas of physical science.   Special emphasis is placed on the development of physical intuition to supplement and reinforce analytical thinking. Each chapter includes a complete set of carefully prepared exercises, making this a suitable textbook for students in applied mathematics, ...

  9. Population attribute compression

    Science.gov (United States)

    White, James M.; Faber, Vance; Saltzman, Jeffrey S.

    1995-01-01

    An image population having a large number of attributes is processed to form a display population with a predetermined smaller number of attributes that represent the larger number of attributes. In a particular application, the color values in an image are compressed for storage in a discrete look-up table (LUT). Color space containing the LUT color values is successively subdivided into smaller volumes until a plurality of volumes are formed, each having no more than a preselected maximum number of color values. Image pixel color values can then be rapidly placed in a volume with only a relatively few LUT values from which a nearest neighbor is selected. Image color values are assigned 8 bit pointers to their closest LUT value whereby data processing requires only the 8 bit pointer value to provide 24 bit color values from the LUT.

  10. Central cooling: compressive chillers

    Energy Technology Data Exchange (ETDEWEB)

    Christian, J.E.

    1978-03-01

    Representative cost and performance data are provided in a concise, useable form for three types of compressive liquid packaged chillers: reciprocating, centrifugal, and screw. The data are represented in graphical form as well as in empirical equations. Reciprocating chillers are available from 2.5 to 240 tons with full-load COPs ranging from 2.85 to 3.87. Centrifugal chillers are available from 80 to 2,000 tons with full load COPs ranging from 4.1 to 4.9. Field-assemblied centrifugal chillers have been installed with capacities up to 10,000 tons. Screw-type chillers are available from 100 to 750 tons with full load COPs ranging from 3.3 to 4.5.

  11. Compression Using Wavelet Transform

    Directory of Open Access Journals (Sweden)

    Aisha-Hassan A. Hashim

    2008-11-01

    Full Text Available Audio compression has become one of the basic technologies of the multimedia age. The change in the telecommunication infrastructure, in recent years, from circuit switched to packet switched systems has also reflected on the way that speech and audio signals are carried in present systems. In many applications, such as the design of multimedia workstations and high quality audio transmission and storage, the goal is to achieve transparent coding of audio and speech signals at the lowest possible data rates. In other words, bandwidth cost money, therefore, the transmission and storage of information becomes costly. However, if we can use less data, both transmission and storage become cheaper. Further reduction in bit rate is an attractive proposition in applications like remote broadcast lines, studio links, satellite transmission of high quality audio and voice over internet.

  12. Adaptively Compressed Exchange Operator

    CERN Document Server

    Lin, Lin

    2016-01-01

    The Fock exchange operator plays a central role in modern quantum chemistry. The large computational cost associated with the Fock exchange operator hinders Hartree-Fock calculations and Kohn-Sham density functional theory calculations with hybrid exchange-correlation functionals, even for systems consisting of hundreds of atoms. We develop the adaptively compressed exchange operator (ACE) formulation, which greatly reduces the computational cost associated with the Fock exchange operator without loss of accuracy. The ACE formulation does not depend on the size of the band gap, and thus can be applied to insulating, semiconducting as well as metallic systems. In an iterative framework for solving Hartree-Fock-like systems, the ACE formulation only requires moderate modification of the code, and can be potentially beneficial for all electronic structure software packages involving exchange calculations. Numerical results indicate that the ACE formulation can become advantageous even for small systems with tens...

  13. Does botulinum toxin improve the function of the patient with spasticity after stroke? Toxina botulínica proporciona melhora funcional em pacientes com espasticidade secundária a acidente vascular cerebral?

    Directory of Open Access Journals (Sweden)

    Eduardo Cardoso

    2007-09-01

    Full Text Available Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI, Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (pEspasticidade secundária a acidente vascular cerebral (AVC é importante causa de incapacidade em adultos. O prognóstico para estes pacientes depende de vários fatores como tratamento precoce e terapia física adequada, evitando encurtamento muscular, dor e outras conseqüências. Vários estudos têm demonstrado que aplicacões intramusculares de toxina botulínica do tipo A (TxB-A reduzem a espasticidade após AVC, entretanto poucos autores observaram melhora funcional de membros superiores com esta terapêutica. Para determinar se aplicações individualizadas de TxB-A melhoram a função no membro superior espástico de pacientes com hemiparesia secundária a AVC, acompanhamos 20 pacientes com história de AVC entre 6 meses

  14. Adaptive compressive sensing camera

    Science.gov (United States)

    Hsu, Charles; Hsu, Ming K.; Cha, Jae; Iwamura, Tomo; Landa, Joseph; Nguyen, Charles; Szu, Harold

    2013-05-01

    We have embedded Adaptive Compressive Sensing (ACS) algorithm on Charge-Coupled-Device (CCD) camera based on the simplest concept that each pixel is a charge bucket, and the charges comes from Einstein photoelectric conversion effect. Applying the manufactory design principle, we only allow altering each working component at a minimum one step. We then simulated what would be such a camera can do for real world persistent surveillance taking into account of diurnal, all weather, and seasonal variations. The data storage has saved immensely, and the order of magnitude of saving is inversely proportional to target angular speed. We did design two new components of CCD camera. Due to the matured CMOS (Complementary metal-oxide-semiconductor) technology, the on-chip Sample and Hold (SAH) circuitry can be designed for a dual Photon Detector (PD) analog circuitry for changedetection that predicts skipping or going forward at a sufficient sampling frame rate. For an admitted frame, there is a purely random sparse matrix [Φ] which is implemented at each bucket pixel level the charge transport bias voltage toward its neighborhood buckets or not, and if not, it goes to the ground drainage. Since the snapshot image is not a video, we could not apply the usual MPEG video compression and Hoffman entropy codec as well as powerful WaveNet Wrapper on sensor level. We shall compare (i) Pre-Processing FFT and a threshold of significant Fourier mode components and inverse FFT to check PSNR; (ii) Post-Processing image recovery will be selectively done by CDT&D adaptive version of linear programming at L1 minimization and L2 similarity. For (ii) we need to determine in new frames selection by SAH circuitry (i) the degree of information (d.o.i) K(t) dictates the purely random linear sparse combination of measurement data a la [Φ]M,N M(t) = K(t) Log N(t).

  15. Application specific compression : final report.

    Energy Technology Data Exchange (ETDEWEB)

    Melgaard, David Kennett; Byrne, Raymond Harry; Myers, Daniel S.; Harrison, Carol D.; Lee, David S.; Lewis, Phillip J.; Carlson, Jeffrey J.

    2008-12-01

    With the continuing development of more capable data gathering sensors, comes an increased demand on the bandwidth for transmitting larger quantities of data. To help counteract that trend, a study was undertaken to determine appropriate lossy data compression strategies for minimizing their impact on target detection and characterization. The survey of current compression techniques led us to the conclusion that wavelet compression was well suited for this purpose. Wavelet analysis essentially applies a low-pass and high-pass filter to the data, converting the data into the related coefficients that maintain spatial information as well as frequency information. Wavelet compression is achieved by zeroing the coefficients that pertain to the noise in the signal, i.e. the high frequency, low amplitude portion. This approach is well suited for our goal because it reduces the noise in the signal with only minimal impact on the larger, lower frequency target signatures. The resulting coefficients can then be encoded using lossless techniques with higher compression levels because of the lower entropy and significant number of zeros. No significant signal degradation or difficulties in target characterization or detection were observed or measured when wavelet compression was applied to simulated and real data, even when over 80% of the coefficients were zeroed. While the exact level of compression will be data set dependent, for the data sets we studied, compression factors over 10 were found to be satisfactory where conventional lossless techniques achieved levels of less than 3.

  16. Data Compression with Prime Numbers

    OpenAIRE

    Chalmers, Gordon

    2005-01-01

    A compression algorithm is presented that uses the set of prime numbers. Sequences of numbers are correlated with the prime numbers, and labeled with the integers. The algorithm can be iterated on data sets, generating factors of doubles on the compression.

  17. Assessment of effects of lossy compression of hyperspectral image data

    Science.gov (United States)

    Su, Jonathan K.; Hsu, Su May; Orloff, Seth

    2004-08-01

    Hyperspectral imaging (HSI) sensors provide imagery with hundreds of spectral bands, typically covering VNIR and/or SWIR wavelengths. This high spectral resolution aids applications such as terrain classification and material identification, but it can also produce imagery that occupies well over 100 MB, which creates problems for storage and transmission. This paper investigates the effects of lossy compression on a representative HSI cube, with background classification serving as an example application. The compression scheme first performs principal components analysis spectrally, then discards many of the lower-importance principal-component (PC) images, and then applies JPEG2000 spatial compression to each of the individual retained PC images. The assessment of compression effects considers both general-purpose distortion measures, such as root mean square difference, and statistical tests for deciding whether compression causes significant degradations in classification. Experimental results demonstrate the effectiveness of proper PC-image rate allocation, which enabled compression at ratios of 100-340 without producing significant classification differences. Results also indicate that distortion might serve as a predictor of compression-induced changes in application performance.

  18. Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy

    Science.gov (United States)

    Nada, Mohamed; Mahran, Mahmoud A.; Aboud, Ahmed; Mahran, Moustafa G.; Nasef, Marwa A.A.; Gaber, Mohamed; Sabry, Tamer; Ibrahim, Mohamed H.; Taha, Mohamed H.

    2016-01-01

    BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study. Clinical outcome measurements were recorded preoperatively and were evaluated at 2, 6, and 12 months postoperatively. The operative techniques were performed by laminotomy from L1-S1, and intraoperative monitoring was used in all cases. All patients underwent intensive postoperative physiotherapy programs. RESULTS: Changes in muscle tone, joint range of motion, and dystonia were significant (P = .000) at postoperative assessment visits. CONCLUSION: This study demonstrated the potential of combined anterior and posterior lumbar rhizotomies to improve activities of daily living in children with CP and with mixed spasticity and dystonia. ABBREVIATIONS: BAD, Barry-Albright Dystonia Scale CAPR, combined anterior and posterior lumbar rhizotomy CP, cerebral palsy ITB, intrathecal baclofen MAS, modified Ashworth Scale ROM, range of motion SDR, selective dorsal rhizotomy PMID:27244465

  19. The Role of Exercise – Rehabilitation on Energy Cost and Metabolic Efficiency in Dipelegic Spastic Cerebral Palsy Children

    Directory of Open Access Journals (Sweden)

    M. Izadi

    2005-07-01

    Full Text Available Introduction & Objective: The aim of this study was to compare the resting energy expenditure and metabolic efficiency before and after of aerobic exercise in spastic cerebral palsy children (mean age of 11 years and also to compare with those of normal children. Materials & Methods : Fifteen dipelegia spastic cerebral palsy children (experimental group participated in exercise–rehabilitation program by voluntarily and the peers eighteen able body children(control group were selected randomly. The experimental group(cp performed rehabilitation program for 3 months,3 session in week with work intensity(%HRR=462.5equal to144bpm of heart rate. The values were measured on tantory cycle ergometer according to Macmaster protocol.Results: Rest and exercise heart rate and exercise intensity(%HRR in patients decreased after rehabilitation program(P<0.05. The resting energy expenditure was similar in cp and normal groups. The rate of oxygen cost of patients decreased in post test(P<0.05 that showed increasing in metabolic efficiency.Conclusion: cerebral palsy children have greater exercise energy cost and lower cardiovascular fitness than normal children and exercise–rehabilitation leads to enhance of metabolic efficiency in this patients that is remarkable from clinical perception.

  20. Modeling the Step-like Response in the Upper Limbs of Hemiplegic Subjects for Evaluation of Spasticity

    Science.gov (United States)

    Uchiyama, Takanori; Uchida, Ryusei

    The purpose of this study is to develop a new modeling technique for quantitative evaluation of spasticity in the upper limbs of hemiplegic patients. Each subject lay on a bed, and his forearm was supported with a jig to measure the elbow joint angle. The subject was instructed to relax and not to resist the step-like load which was applied to extend the elbow joint. The elbow joint angle and electromyogram (EMG) of the biceps muscle, triceps muscle and brachioradialis muscle were measured. First, the step-like response was approximated with a proposed mathematical model based on musculoskeletal and physiological characteristics by the least square method. The proposed model involved an elastic component depending on both muscle activities and elbow joint angle. The responses were approximated well with the proposed model. Next, the torque generated by the elastic component was estimated. The normalized elastic torque was approximated with a dumped sinusoid by the least square method. The reciprocal of the time constant and the natural frequency of the normalized elastic torque were calculated and they varied depending on the grades of the modified Ashworth scale of the subjects. It was suggested that the proposed modeling technique would provide a good quantitative index of spasticity as shown in the relationship between the reciprocal of the time constant and the natural frequency.

  1. Late-onset spastic paraplegia type 10 (SPG10) family presenting with bulbar symptoms and fasciculations mimicking amyotrophic lateral sclerosis.

    Science.gov (United States)

    Kaji, Seiji; Kawarai, Toshitaka; Miyamoto, Ryosuke; Nodera, Hiroyuki; Pedace, Lucia; Orlacchio, Antonio; Izumi, Yuishin; Takahashi, Ryosuke; Kaji, Ryuji

    2016-05-15

    Pathogenic mutations in the KIF5A-SPG10 gene, encoding the kinesin HC5A, can be associated with autosomal dominant hereditary spastic paraplegia (ADHSP). It accounts for about 10% of the complicated forms of ADHSP. Peripheral neuropathy, distal upper limb amyotrophy, and cognitive decline are the most common additional clinical features. We examined a 66-year-old Japanese woman manifesting gait disturbance and spastic dysarthria for 6years with positive family history. She showed evidence of upper and lower motor neuron involvement and fasciculations, thus mimicking amyotrophic lateral sclerosis (ALS). Genetic analysis revealed a heterozygous variant in KIF5A (c.484C>T, p.Arg162Trp) in 2 symptomatic members. The mutation was also identified in 4 asymptomatic members, including 2 elderly members aged over 78years. Electromyography in the 2 symptomatic members revealed evidence of lower motor neuron involvement and fasciculation potentials in distal muscles. This report describes the first known Asian family with a KIF5A mutation and broadens the clinical and electrophysiological spectrum associated with KIF5A-SPG10 mutations. Given that our cases showed pseudobulbar palsy, fasciculation and altered penetrance, KIF5A-SPG10 might well be considered as a differential diagnosis of sporadic ALS. PMID:27084214

  2. Evaluation of the effect of the reduction of the hip spastic dislocation in adolescent and young adult with cerebral paralysis

    International Nuclear Information System (INIS)

    We present the results obtained in the Instituto de Ortopedia Infantil Roosevelt for the treatment of the hip dislocation in adolescent patients and young adults with spastic cerebral palsy with the open reduction of the hip, accompanied by femoral osteotomy and, if as necessary, pelvic osteotomy. 14 hips (10 patients) were intervened from January of 1996 to July of 2003. Pain was completely released in 54 percent and improved in 36 percent of cases. Abduction improved in 63 percent of patients allowing the perinea cleaning in 63 percent and better tolerance to scar in 64% of the cases. Our complications were one patient developed a sacred pressure ulcer with the spica cast treated with a free flap transposition; one hip had redislocation at 31 months from surgery; another hip had instability without clinical repercussion; one patient had a not displaced supracondylar femoral fracture treated with immobilization. The results of our study showed that the open reduction of the spastic hip in adolescents and young adults is a procedure that improves, in most of the cases, the stability, mobility and pain of the hip and provides better quality life for these patients

  3. CYP2U1 mutations in two Iranian patients with activity induced dystonia, motor regression and spastic paraplegia

    Science.gov (United States)

    Kariminejad, A.; Schöls, L.; Schüle, R.; Tonekaboni, S.H.; Abolhassani, A.; Fadaee, M.; Rosti, R.O.; Gleeson, J.G.

    2016-01-01

    Hereditary spastic paraplegia (HSP) is a heterogeneous condition characterized by progressive spasticity and weakness in the lower limbs. It is divided into two major groups, complicated and uncomplicated, based on the presence of additional features such as intellectual disability, ataxia, seizures, peripheral neuropathy and visual problems. SPG56 is an autosomal recessive form of HSP with complicated and uncomplicated manifestations, complicated being more common. CYP2U1 gene mutations have been identified as responsible for SPG56. Intellectual disability, dystonia, subclinical sensory motor neuropathy, pigmentary degenerative maculopathy, thin corpus callosum and periventricular white-matter hyperintensities were additional features noted in previous cases of SPG56. Here we identified two novel mutations in CYP2U1 in two unrelated patients by whole exome sequencing. Both patients had complicated HSP with activity-induced dystonia, suggesting dystonia as an additional finding in SPG56. Two out of 14 previously reported patients had dystonia, and the addition of our patients suggests dystonia in a quarter of SPG56 patients. Developmental regression has not been reported in SPG56 patients so far but both of our patients developed motor regression in infancy. PMID:27292318

  4. Video Compression Using Neural Network

    Directory of Open Access Journals (Sweden)

    Sangeeta Mishra

    2012-08-01

    Full Text Available Apart from the existing technology on image compression represented by series of JPEG, MPEG and H.26x standards, new technology such as neural networks and genetic algorithms are being developed to explore the future of image coding. Successful applications of neural networks to basic propagation algorithm have now become well established and other aspects of neural network involvement in this technology. In this paper different algorithms were implemented like gradient descent back propagation, gradient descent with momentum back propagation, gradient descent with adaptive learning back propagation, gradient descent with momentum and adaptive learning back propagation and Levenberg-Marquardt algorithm. The size of original video clip is 25MB and after compression it becomes 21.3MB giving the compression ratio as 85.2% and compression factor of 1.174. It was observed that the size remains same after compression but the difference is in the clarity.

  5. Analytical model for ramp compression

    Science.gov (United States)

    Xue, Quanxi; Jiang, Shaoen; Wang, Zhebin; Wang, Feng; Hu, Yun; Ding, Yongkun

    2016-08-01

    An analytical ramp compression model for condensed matter, which can provide explicit solutions for isentropic compression flow fields, is reported. A ramp compression experiment can be easily designed according to the capability of the loading source using this model. Specifically, important parameters, such as the maximum isentropic region width, material properties, profile of the pressure pulse, and the pressure pulse duration can be reasonably allocated or chosen. To demonstrate and study this model, laser-direct-driven ramp compression experiments and code simulation are performed successively, and the factors influencing the accuracy of the model are studied. The application and simulation show that this model can be used as guidance in the design of a ramp compression experiment. However, it is verified that further optimization work is required for a precise experimental design.

  6. Compressive sensing exploiting wavelet-domain dependencies for ECG compression

    Science.gov (United States)

    Polania, Luisa F.; Carrillo, Rafael E.; Blanco-Velasco, Manuel; Barner, Kenneth E.

    2012-06-01

    Compressive sensing (CS) is an emerging signal processing paradigm that enables sub-Nyquist sampling of sparse signals. Extensive previous work has exploited the sparse representation of ECG signals in compression applications. In this paper, we propose the use of wavelet domain dependencies to further reduce the number of samples in compressive sensing-based ECG compression while decreasing the computational complexity. R wave events manifest themselves as chains of large coefficients propagating across scales to form a connected subtree of the wavelet coefficient tree. We show that the incorporation of this connectedness as additional prior information into a modified version of the CoSaMP algorithm can significantly reduce the required number of samples to achieve good quality in the reconstruction. This approach also allows more control over the ECG signal reconstruction, in particular, the QRS complex, which is typically distorted when prior information is not included in the recovery. The compression algorithm was tested upon records selected from the MIT-BIH arrhythmia database. Simulation results show that the proposed algorithm leads to high compression ratios associated with low distortion levels relative to state-of-the-art compression algorithms.

  7. Impedance of tissue-mimicking phantom material under compression

    Directory of Open Access Journals (Sweden)

    Barry Belmont

    2013-02-01

    Full Text Available The bioimpedance of tissues under compression is a field in need of study. While biological tissues can become compressed in a myriad of ways, very few experiments have been conducted to describe the relationship between the passive electrical properties of a material (impedance/admittance during mechanical deformation. Of the investigations that have been conducted, the exodus of fluid from samples under compression has been thought to be the cause of changes in impedance, though until now was not measured directly. Using a soft tissue-mimicking phantom material (tofu whose passive electrical properties are a function of the conducting fluid held within its porous structure, we have shown that the mechanical behavior of a sample under compression can be measured through bioimpedance techniques.

  8. Compressibility of the fluid

    Directory of Open Access Journals (Sweden)

    Jablonská Jana

    2014-03-01

    Full Text Available The presence of air in the liquid causes the dynamic system behaviour. When solve to issue of the dynamics we often meet problems of cavitation. Cavitation is an undesirable phenomenon, since it causes a disruption of the surrounding material and material destruction. Cavitation is accompanied by loud sound effects and reduces the efficiency of such pumps, etc. Therefore, it is desirable to model systems in which the cavitation might occur. A typical example is a solution of water hammer.

  9. Compressibility of the fluid

    OpenAIRE

    Jablonská Jana

    2014-01-01

    The presence of air in the liquid causes the dynamic system behaviour. When solve to issue of the dynamics we often meet problems of cavitation. Cavitation is an undesirable phenomenon, since it causes a disruption of the surrounding material and material destruction. Cavitation is accompanied by loud sound effects and reduces the efficiency of such pumps, etc. Therefore, it is desirable to model systems in which the cavitation might occur. A typical example is a solution of water hammer.

  10. Compressive Sensing for Quantum Imaging

    Science.gov (United States)

    Howland, Gregory A.

    This thesis describes the application of compressive sensing to several challenging problems in quantum imaging with practical and fundamental implications. Compressive sensing is a measurement technique that compresses a signal during measurement such that it can be dramatically undersampled. Compressive sensing has been shown to be an extremely efficient measurement technique for imaging, particularly when detector arrays are not available. The thesis first reviews compressive sensing through the lens of quantum imaging and quantum measurement. Four important applications and their corresponding experiments are then described in detail. The first application is a compressive sensing, photon-counting lidar system. A novel depth mapping technique that uses standard, linear compressive sensing is described. Depth maps up to 256 x 256 pixel transverse resolution are recovered with depth resolution less than 2.54 cm. The first three-dimensional, photon counting video is recorded at 32 x 32 pixel resolution and 14 frames-per-second. The second application is the use of compressive sensing for complementary imaging---simultaneously imaging the transverse-position and transverse-momentum distributions of optical photons. This is accomplished by taking random, partial projections of position followed by imaging the momentum distribution on a cooled CCD camera. The projections are shown to not significantly perturb the photons' momenta while allowing high resolution position images to be reconstructed using compressive sensing. A variety of objects and their diffraction patterns are imaged including the double slit, triple slit, alphanumeric characters, and the University of Rochester logo. The third application is the use of compressive sensing to characterize spatial entanglement of photon pairs produced by spontaneous parametric downconversion. The technique gives a theoretical speedup N2/log N for N-dimensional entanglement over the standard raster scanning technique

  11. The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy

    NARCIS (Netherlands)

    Jelsma, Jennifer; Pronk, Marieke; Ferguson, Gillian; Jelsma-Smit, Dorothee

    2013-01-01

    Objective: To study the impact of training using the Nintendo Wii Fit in 14 children with spastic hemiplegic cerebral palsy. Methods: A single-subject single blinded design with multiple subjects and baselines was utilised. Interactive video gaming (IVG) in lieu of regular physiotherapy was given fo

  12. Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity

    DEFF Research Database (Denmark)

    Willerslev-Olsen, Maria; Lorentzen, Jakob; Sinkjær, Thomas;

    2013-01-01

    AIM: Clinical determination of spasticity is confounded by the difficulty in distinguishing reflex from passive contributions to muscle stiffness. There is, therefore, a risk that children with cerebral palsy (CP) receive antispasticity treatment unnecessarily. To investigate this, we aimed to de...

  13. Relationship between the Modified Modified Ashworth Scale and the Biomechanical Measure in Assessing Knee Extensor Muscle Spasticity in Patients with Post-Stroke Hemiparesia:A Pilot Study

    Directory of Open Access Journals (Sweden)

    N. Nakhostin Ansari

    2014-07-01

    Full Text Available Introduction & Objective: The Modified Modified Ashworth Scale (MMAS is a clinical meas-ure that has been recently developed for the assessment of muscle spasticity. There is a dearth of research on the validity of the MMAS. The aim of the present study was to investi-gate the relationship between the MMAS and the biomechanical measure of work-velocity slope in assessing knee extensor muscle spasticity in patients with hemiparesia. Materials & Methods: Fourteen patients with post-stroke hemiparesia were included in this cross sectional study. Knee extensor spasticity was assessed with MMAS. An isokinetic dy-namometer was used to impose knee passive flexion with the angular velocity of 10, 30, 60, and 90 °/Sec to measure Torque-angle data. Work (Joule was calculated at each velocity to determine the slope of the work-velocity curves as the biomechanical measure of muscle spasticity. Results: The mean work decreased as the velocity increased but was not statistically signifi-cant (P = 0.07. The mean slope was – 0.35 [J /(°/Sec]. There was no significant correlation between the MMAS and the work-velocity slope (r =0.31, P = 0.28. Conclusion: There was no significant relationship between the MMAS and the biomechanical measure of work-velocity slope. Further studies with larger sample size are suggested. (Sci J Hamadan Univ Med Sci 2014; 21 (2: 131-136

  14. The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

  15. Effect of intrathecal baclofen delivered by an implanted programmable pump on health related quality of life in patients with severe spasticity

    NARCIS (Netherlands)

    Middel, B.; Kuipers-Upmeijer, H.; Bouma, J.; Staal, M.J.; Oenema, D.G.; Postma, T.J.B.M.; Terpstra, S.; Stewart, R.

    1997-01-01

    Objectives-To compare clinical effectiveness and health related quality of life in patients with severe spasticity who received intrathecal baclofen or a placebo. Methods-In a double blind, randomised, multicentre trial 22 patients were followed up during 13 weeks and subsequently included in a 52 w

  16. MULTILEVEL SOFT TISSUE WITH BONY CORRECTIVE SURGERY IN LOWER LIMB DEFORMITIES AS ONE SITTING PROCEDURE IN SPASTIC CEREBRAL PALSY: AN EXPERIENCE FROM FREE DISABLED SURGICAL CAMPS

    Directory of Open Access Journals (Sweden)

    Antony R

    2015-06-01

    Full Text Available The study was intended to assess the results of multilevel soft tissue with bony corrective surgery as one sitting procedure on static deformities and contractures in lower limbs with patients of spastic cerebral palsy at free disabled surgical camps at Chhattisgarh state. In our study 30 patients were included with sixty percent male and forty percent female , within 4 - 16 years age group. Almost all patients had diplegia and only few patients had quadriplegia with grade 3 power in both upper limbs. Improvement in functional ability and locomotion of all operated patients were asse ssed by gross motor functional classification scale and with physical examination. Almost all patients who were operated in our study showed significant improvement in functional abilities and locomotion after surgery. All patients were maintaining functional abilities at follow up duration of 2 years (24 months, with 70%. excellent cases gait of patient were normal or mild spastic but they were walking without support , with 20% good cases gait of patients were spastic but patients comfortably walk with short knee braces and with 10% fair cases gait of patients were scissors but patients walked comfortably with long knee braces . Our study shows that, promising results can be obtained in spastic cerebral palsy patients with static deformities and cont ractures of joints in lower limbs with multilevel soft tissue and bony corrective surgery. We believe that it’s a team effort of the surgeon , paramedical and rehabilitation staff in postoperative period for the achievement of better results.

  17. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients

    NARCIS (Netherlands)

    Niet, M. de; Latour, H.; Hendricks, H.T.; Geurts, A.C.H.; Weerdesteijn, V.G.M.

    2011-01-01

    de Niet M, Latour H, Hendricks H, Geurts AC, Weerdesteyn V. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients. OBJECTIVE: To identify whether a relationship exists between stretch and activity of the calf muscles du

  18. Genetic and biochemical impairment of mitochondrial complex I activity in a family with Leber hereditary optic neuropathy and hereditary spastic dystonia

    NARCIS (Netherlands)

    DeVries, DD; Went, LN; Bruyn, GW; Scholte, HR; Hofstra, RMW; Bolhuis, PA; vanOost, BA

    1996-01-01

    A rare form of Leber hereditary optic neuropathy (LHON) that is associated with hereditary spastic dystonia has been studied in a large Dutch family. Neuropathy and ophthalmological lesions were present together in some family members, whereas only one type of abnormality was found in others. mtDNA

  19. Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients

    Directory of Open Access Journals (Sweden)

    Luc Terreaux

    2014-01-01

    Full Text Available Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle. Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in Hmax⁡ /Mmax⁡ and T/Mmax⁡ ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified.

  20. Advances in compressible turbulent mixing

    International Nuclear Information System (INIS)

    This volume includes some recent additions to original material prepared for the Princeton International Workshop on the Physics of Compressible Turbulent Mixing, held in 1988. Workshop participants were asked to emphasize the physics of the compressible mixing process rather than measurement techniques or computational methods. Actual experimental results and their meaning were given precedence over discussions of new diagnostic developments. Theoretical interpretations and understanding were stressed rather than the exposition of new analytical model developments or advances in numerical procedures. By design, compressibility influences on turbulent mixing were discussed--almost exclusively--from the perspective of supersonic flow field studies. The papers are arranged in three topical categories: Foundations, Vortical Domination, and Strongly Coupled Compressibility. The Foundations category is a collection of seminal studies that connect current study in compressible turbulent mixing with compressible, high-speed turbulent flow research that almost vanished about two decades ago. A number of contributions are included on flow instability initiation, evolution, and transition between the states of unstable flow onset through those descriptive of fully developed turbulence. The Vortical Domination category includes theoretical and experimental studies of coherent structures, vortex pairing, vortex-dynamics-influenced pressure focusing. In the Strongly Coupled Compressibility category the organizers included the high-speed turbulent flow investigations in which the interaction of shock waves could be considered an important source for production of new turbulence or for the enhancement of pre-existing turbulence. Individual papers are processed separately