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Spasticity management

Lianne Remijn, Lenie van den Engel-Hoek, Ton Satink, Bert J M de Swart, Maria W G Nijhuis-van der Sanden
OBJECTIVE: The impact of difficulties with eating and drinking in adolescents and young adults with cerebral palsy is unknown. The purpose of this study is to find out which difficulties adolescents and young adults with cerebral palsy experience with eating and drinking in daily life and how they deal with these difficulties. The study also explores how they think about themselves with respect to eating and what does or does not help regarding social participation. METHOD: We collected the data from ten participants with spastic cerebral palsy (aged 15-23 years) living in the Netherlands...
March 21, 2018: Disability and Rehabilitation
Stephen Ashford, Heather Williams, Ajoy Nair, Samantha Orridge, Lynne Turner-Stokes
BACKGROUND: Goal-classification of person-centred goals, using Goal Attainment Scaling for leg spasticity treatment. METHODS: The study was conducted in two phases: phase I, a retrospective review to evaluate categories of goal set in routine clinical practice. Findings were used to design a goal classification system. Phase II, a multi-centre study to confirm the goal categories. Goals set (n = 270) were analysed from data collected at three centres in the UK (one centre for phase I)...
March 20, 2018: Disability and Rehabilitation
Stephane Olindo, Severine Jeannin, Martine Saint-Vil, Aissatou Signate, Mireille Edimonana-Kaptue, Julien Joux, Harold Merle, Pascale Richard, Samuel Granjeaud, Philippe Cabre, Didier Smadja, Raymond Cesaire, Agnes Lezin
BACKGROUND: Human T-lymphotropic virus type 1 (HTLV-1) has been discovered in 1980 and has been linked to tropical spastic paraparesis (HAM/TSP) in 1985 in Martinique. There is no data on HAM/TSP incidence trends. We report, in the present work, the temporal trends incidence of HAM/TSP in Martinique over 25 years. METHODS: Martinique is a Caribbean French West Indies island deserved by a unique Neurology Department involved in HAM/TSP diagnosis and management. A registry has been set up since 1986 and patients diagnosed for a HAM/TSP were prospectively registered...
March 19, 2018: PLoS Neglected Tropical Diseases
Natasha A Lannin, Louise Ada, Coralie English, Julie Ratcliffe, Maria Crotty
Rationale Although clinical practice guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin-A in conjunction with therapy, there is currently no evidence to support the addition of therapy. Aims To determine the effect and cost-benefit of adding evidence-based movement training to botulinum toxin-A. Sample size estimate A total of 136 participants will be recruited in order to be able to detect a between-group difference of seven points on the Goal Attainment Scale T-score with 80% power at a two-tailed significance level of 0...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Rajani Singh, Rajnish Arora, Raj Kumar
Chiari malformations (CMs) are variant structural setup of cerebellum and brain stem at the craniovertebral junction. Normally the cerebellum and parts of the brain stem lie above the foramen magnum. When the part of the cerebellum and/or brainstem protrudes into the upper spinal canal through foramen magnum, it is defined as CM. Chiari malformations may develop when part of the skull is smaller than normal or misshapen, due to which the cerebellum herniates into spinal canal through foramen magnum. This compresses the cerebellum and brainstem affecting functions controlled by these parts and blocks the flow of cerebrospinal fluid that surrounds and cushions the brain and spinal cord...
March 14, 2018: Journal of Craniofacial Surgery
Zheng-Chao Gao, Bin-Bin Niu, Meng-Chao Gu, Yu-Huan Li, Jian-Tao Liu, Yi-Bin Wang, Xi-Jing He
OBJECTIVE: To systematically evaluate the clinical effect of high frequency repeated transcranial magnetic stimulation(HF rTMS)therapy on dyskinesia in patients with incomplete spinal cord injury. METHODS: Randomized controlled trials(RCTs) about HF rTMS therapy on patients with motor incomplete spinal cord injury were searched electronically in PubMed, Google scholar, Cochrane library, Clinical trial, Medline, Web of science, CNKI, VIP, and Wanfang database before October 2016...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Huiyi H Chang, Jih-Chao Yeh, Ronaldo M Ichiyama, Larissa V Rodriguez, Leif A Havton
Spinal cord epidural stimulation (SCS) represents a form of neuromodulation for the management of spasticity and pain. This technology has recently emerged as a new approach for potentially augmenting locomotion and voiding function in humans and rodents after spinal cord injury. However, the effect of SCS on micturition has not been studied extensively. Here, SCS was first applied as a direct stimulus onto individual segmental levels of the lumbar spinal cord in rats to map evoked external urethral sphincter (EUS) electromyography activity and SCS-induced voiding contractions...
March 9, 2018: Experimental Neurology
Lenore Hawley, Jessica M Ketchum, Clare Morey, Kathleen Collins Pharm D, Susan Charlifue
OBJECTIVE: To describe the prevalence of cannabis use in an adult sample with spinal cord injury (SCI) or traumatic brain injury (TBI) in Colorado, and to describe the self-reported reasons and side effects of cannabis use in this sample. DESIGN: Mixed methods observational study, using focus group data and telephone survey SETTING: Community PARTICIPANTS: Colorado adults who have sustained SCI or moderate to severe TBI and have received services through the rehabilitation hospital conducting the study...
March 7, 2018: Archives of Physical Medicine and Rehabilitation
Irene Pulido-Valdeolivas, David Gómez-Andrés, Juan Andrés Martín-Gonzalo, Irene Rodríguez-Andonaegui, Javier López-López, Samuel Ignacio Pascual-Pascual, Estrella Rausell
The Hereditary Spastic Paraplegias (HSP) are a group of heterogeneous disorders with a wide spectrum of underlying neural pathology, and hence HSP patients express a variety of gait abnormalities. Classification of these phenotypes may help in monitoring disease progression and personalizing therapies. This is currently managed by measuring values of some kinematic and spatio-temporal parameters at certain moments during the gait cycle, either in the doctor´s surgery room or after very precise measurements produced by instrumental gait analysis (IGA)...
2018: PloS One
Samuel K van de Velde, Megan Cashin, Ratna Johari, Rachel Blackshaw, Abhay Khot, H Kerr Graham
AIM: The prevalence of severely symptomatic deformities of the first metatarsophalangeal (MTP) joint in adolescents with cerebral palsy (CP) requiring arthrodesis is unknown. Recent literature regarding these deformities is limited. We studied the presentation of severe, symptomatic deformities of the first ray in a large population of children and adolescents with CP and their association with gross motor function, CP subtype, and other musculoskeletal deformities. METHOD: We identified 41 patients with CP and a symptomatic deformity of the first MTP joint, managed by arthrodesis, from a large population based database over a 21-year period...
March 8, 2018: Developmental Medicine and Child Neurology
Hideyuki Yanagi, Hiroto Terashi, Yoshimitsu Takahashi, Katsuyuki Okabe, Katsumi Tanaka, Chu Kimura, Norihiko Ohura, Takahiro Goto, Ichiro Hashimoto, Madoka Noguchi, Junichi Sasayama, Kenichi Shimada, Ayumi Sugai, Mitsuko Tanba, Takeo Nakayama, Ryoji Tsuboi, Junko Sugama, Hiromi Sanada
OBJECTIVE: To clarify the surgical indications and the appropriate perioperative management of ischial pressure ulcers (PUs). METHOD: A two-year prospective, nationwide registry study was carried out across 26 medical institutions in Japan. All participating institutions managed ischial PUs according to the standardisation of total management and surgical application for the refractory decubitus (STANDARDS-I) perioperative protocol. Analysis was conducted on a range of clinically or statistically important variables for the achievement of primary or secondary endpoints: complete wound healing and hospital discharge at three months, and complete wound healing at one month after surgery, respectively...
March 2, 2018: Journal of Wound Care
Mireia Raluy-Callado, Andrew Cox, Sharon MacLachlan, Abdel M Bakheit, A Peter Moore, Jerome Dinet, Sylvie Gabriel
OBJECTIVE: Post-stroke spasticity (PSS) is a common complication following stroke. This study describes the differences in healthcare resource utilization between patients who do and do not develop PSS in the United Kingdom. METHODS: Adults registered in The Health Improvement Network database with a recorded stroke between 2007 and 2011 were included. PSS was identified through Read codes; machine learning was used to retrospectively identify unrecorded PSS events...
February 28, 2018: Current Medical Research and Opinion
P J Garcia-Ruiz, P Sanz-Cartagena, J C Martinez-Castrillo, B Ares-Pensado, I Aviles-Olmos, M Blazquez-Estrada, S Fanjul-Arbos, J Garcia-Caldentey, J Gazulla, J Gutierrez-Garcia, B Huete-Anton, C Lucas-Rodenas, M R Luquin, I Martinez-Torres, P Medialdea-Natera, A Mendoza-Rodriguez, P Mir-Rivera, I J Posada, J Ruiz-Martinez, P Sanchez-Alonso, J M Trejo-Gabriel Y Galan, L Vela, J L Pena-Segura
INTRODUCTION: Botulinum toxin type A (BTA) is a bacterial endotoxin, whose therapeutic use has had a dramatic impact on different neurological disorders, such as dystonia and spasticity. AIM: To analyze and summarize different questions about the use of BTA in our clinical practice. DEVELOPMENT: A group of experts in neurology developed a list of topics related with the use of BTA. Two groups were considered: neuropharmacology and dystonia...
March 1, 2018: Revista de Neurologia
Michael G Z Ghali, Visish M Srinivasan, Vikas Y Rao, Ibrahim Omeis
Idiopathic spinal cord herniation represents an uncommon and unique diagnostic entity, most commonly affecting middle-aged individuals, with a nearly twofold female predilection. It most characteristically affects the mid-thoracic spine, with the herniation occurring ventrally or ventrolaterally. Clinical presentation is typically a slowly-progressive myelopathy, with Brown-Séquard syndrome occurring more frequently than spastic paraparesis. Diagnosis is made by imaging, with high-resolution or phase-contrast MR sequences and/or CT myelography...
February 19, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Marco Franceschini, Michela Goffredo, Sanaz Pournajaf, Stefano Paravati, Maurizio Agosti, Francesco De Pisi, Daniele Galafate, Federico Posteraro
BACKGROUND: Upper limb recovery is one of the main goals of post-stroke rehabilitation due to its importance for autonomy in Activities of Daily Living (ADL). Although the efficacy of upper limb Robot-assisted Therapy (RT) is well established in literature, the impact of the initial status of the patient on the effects of RT is still understudied. This paper aims to identify whether demographic, clinical and motor characteristics of stroke patients may influence the ability to independently perform ADL after RT...
2018: PloS One
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
Anand V Nene, Alexandre Rainha Campos, Klemen Grabljevec, Arminda Lopes, Bengt Skoog, Anthony S Burns
A thorough assessment of the extent and severity of spasticity, and its impact on functioning, is central to the effective management of spasticity in persons with spinal cord damage (SCD). These individuals, however, do not always receive adequate assessment of their spasticity. Inadequate assessment compromises management when the impact of spasticity and/or need for intervention are not fully recognized. Assessment is also central to determining treatment efficacy. A barrier to spasticity assessment has been the lack of consensus on clinical and functional measures suitable for routine clinical practice...
February 9, 2018: Archives of Physical Medicine and Rehabilitation
Indira Lanig, Peter New, Anthony S Burns, Gerald Bilsky, Jesus Benito-Penalva, Djamel Bensmail, Michael Yochelson
The recognition, evaluation and management of disabling spasticity in persons with spinal cord damage (SCD) is a challenge for healthcare providers, health systems and patients. To guide the assessment and management of disabling spasticity in individuals with SCD, the Ability Network, an international panel of clinical experts, developed a clinical care pathway. The aim of this pathway is to facilitate treatment decisions that take into account the impact of disabling spasticity on health status, individual preferences and treatment goals, tolerance for adverse events, and burden on caregivers...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
Aisha Lofters, Maha Chaudhry, Morgan Slater, Andree Schuler, James Milligan, Joseph Lee, Sara J T Guilcher
OBJECTIVE: Context/Objective: Family physicians may lack the knowledge or resources to adequately support patients with spinal cord injury (SCI). Our objectives were to determine patterns of preventive care for patients with SCI in a primary care setting (i.e. cancer screening, influenza vaccinations, general physicals, bone mineral density tests), and determine physicians' level of comfort with providing primary care to patients with SCI. DESIGN: i) Retrospective chart review, ii) Survey of physicians in the family practice...
February 9, 2018: Journal of Spinal Cord Medicine
Mohamed Albakaye, Halima Belaïdi, Fatiha Lahjouji, Leila Errguig, Callixte Kuate, Youssoufa Maiga, Seybou Hassane Diallo, Najib Kissani, Reda Ouazzani
INTRODUCTION: The hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome is a rare consequence of febrile seizures during childhood. It is characterized by the presence of prolonged unilateral clonic seizures occurring during febrile illness in a child less than 4years of age. Then, a flaccid unilateral hemiplegia with variable duration occurs. OBJECTIVES: The objective of the study was to describe the clinical, electroencephalogram (EEG), and neuroimaging treatment and outcome of series of cases of HHE syndrome followed for 10years in our clinical neurophysiology department of the specialty hospital of Rabat...
January 26, 2018: Epilepsy & Behavior: E&B
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