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Spasticity management

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https://www.readbyqxmd.com/read/28817499/nurse-practitioner-lead-pediatric-baclofen-pump-program-impact-on-safety-and-quality-of-care
#1
Kristin Buxton, Ann Morgan, Jayne Rogers
Children with cerebral palsy experience spasticity that can be debilitating and cause significant pain and contractures. Intrathecal baclofen (ITB) therapy can help relieve this spasticity and improve the quality of life for these patients, but it comes with risk. Withdrawal from the medication in case of abrupt discontinuation of delivery can be life-threatening. Regular maintenance of the system is mandatory. Having a program in place to manage the device and support patients helps to ensure their safety...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28816119/clinical-presentation-and-management-of-dyskinetic-cerebral-palsy
#2
REVIEW
Elegast Monbaliu, Kate Himmelmann, Jean-Pierre Lin, Els Ortibus, Laura Bonouvrié, Hilde Feys, R Jeroen Vermeulen, Bernard Dan
Cerebral palsy is the most frequent cause of severe physical disability in childhood. Dyskinetic cerebral palsy (DCP) is the second most common type of cerebral palsy after spastic forms. DCP is typically caused by non-progressive lesions to the basal ganglia or thalamus, or both, and is characterised by abnormal postures or movements associated with impaired tone regulation or movement coordination. In DCP, two major movement disorders, dystonia and choreoathetosis, are present together most of the time. Dystonia is often more pronounced and severe than choreoathetosis, with a major effect on daily activity, quality of life, and societal participation...
September 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28813809/development-of-elbow-spasticity-model-for-objective-training-of-spasticity-assessment-of-patients-post-stroke
#3
Jeong-Ho Park, Kwang-Jae Lee, Yong-Soon Yoon, Eun-Ji Son, Ji-Sun Oh, Si Hyun Kang, Heesang Kim, Hyung-Soon Park
Reliable assessment is essential for the management of spasticity, one of the most frequent complication of various neurological diseases. For the spasticity assessment, several clinical tools have been developed and widely used in clinics. The most popular one is modified Ashworth scale (MAS). It has a simple protocol, but is subjective and qualitative. To improve its reliability, quantitative measurement and consistent training would be needed. This study presents an elbow spasticity simulator which mimics spastic response of adult post stroke survivors...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28810281/-hyponatremia-differential-diagnosis-and-treatment
#4
Heiner Mönig, Alexander Arlt
Hyponatremia is the most common electrolyte abnormality seen in hospitalized patients, with up to 30 % having a plasma sodium concentration below 135 mmol/l. It is now clear that the clinical problem extends beyond the neurological symptoms, which can be explained by intracerebral osmotic fluid shifts and brain edema. Instead, chronic hyponatremia is associated with impaired gait stability and an increased risk of bone fragility fractures. Moreover, hyponatremia has been demonstrated to be an indicator of poor prognosis in a variety of conditions...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28806237/botulinum-toxin-use-in-rehabilitation-clinics-a-survey-to-highlight-differences-and-similarities
#5
Rajiv Singh
Spasticity is a complex condition and its management is multifaceted, involving physical therapies as well as interventions with botulinum toxin. There is currently no standard for best practice and also wide variation in spasticity service set-ups and the background of clinicians involved in treatment. This could potentially cause large differences in practice. The aim of this survey was to attempt to identify some of the common elements of service delivery as well as highlight any significant variations in service models...
August 11, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28805237/adult-spasticity-international-registry-study-methodology-and-baseline-patient-health-care-provider-and-caregiver-characteristics
#6
Gerard E Francisco, Daniel S Bandari, Ganesh Bavikatte, Wolfgang H Jost, Aubrey Manack Adams, Joan Largent, Alberto Esquenazi
OBJECTIVE: The main aim of this study was to determine the utilization patterns and effectiveness of onabotulinumtoxinA (Botox®) for treatment of spasticity in clinical practice. DESIGN: An international, multicentre, prospective, observational study at selected sites in North America, Europe, and Asia. PATIENTS: Adult patients with newly diagnosed or established focal spasticity, including those who had previously received treatment with onabotulinum-toxin A...
August 14, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28764279/to-evaluate-the-effectiveness-of-tbts-a-novel-device-to-do-self-stretching-of-gastroc-soleus-muscle-in-patients-with-equinus-deformity
#7
Tufail Muzaffar, Abdul Hamid Rather, Kaleem Ul Haque, Sheikh Javeed Ahmad
INTRODUCTION: Various methods have been used for management of equinus deformity. However, stretching gastroc-soleus muscle and achilles tendon is a difficult task. It is labour intensive, which makes the provision of treatment difficult for many patients. AIM: To study the effectiveness of Tension Bar Tendon Stretch (TBTS) compared to conventional stretching in patients with equinus deformity in terms of improvement in equinus angle and spasticity. MATERIALS AND METHODS: A prospective randomised case control study was done on 16 patients of both the sexes in the age group four years to 56 years...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763462/sativex-in-resistant-multiple-sclerosis-spasticity-discontinuation-study-in-a-large-population-of-italian-patients-sa-fe-study
#8
Silvia Messina, Claudio Solaro, Isabella Righini, Roberto Bergamaschi, Simona Bonavita, Roberto Bruno Bossio, Vincenzo Brescia Morra, Gianfranco Costantino, Paola Cavalla, Diego Centonze, Giancarlo Comi, Salvatore Cottone, Maura Chiara Danni, Ada Francia, Alberto Gajofatto, Claudio Gasperini, Mauro Zaffaroni, Loredana Petrucci, Elisabetta Signoriello, Giorgia Teresa Maniscalco, Gabriella Spinicci, Manuela Matta, Massimiliano Mirabella, Graziella Pedà, Letizia Castelli, Marco Rovaris, Edoardo Sessa, Daniele Spitaleri, Damiano Paolicelli, Alfredo Granata, Mario Zappia, Francesco Patti
BACKGROUND: The approval of Sativex for the management of multiple sclerosis (MS) spasticity opened a new opportunity to many patients. In Italy, the healthcare payer can be fully reimbursed by the involved pharma company with the cost of treatment for patients not responding after a 4 week (28 days) trial period (Payment by Results, PbR), and 50% reimbursed with the cost of 6 weeks (42 days) treatment for other patients discontinuing (Cost Sharing, CS). The aim of our study was to describe the Sativex discontinuation profile from a large population of spasticity treated Italian MS patients...
2017: PloS One
https://www.readbyqxmd.com/read/28761432/effects-of-pulsed-radiofrequency-on-spasticity-in-patients-with-spinal-cord-injury-a-report-of-two-cases
#9
Min Cheol Chang, Yun Woo Cho
Spasticity following spinal cord injury (SCI) results in functional deterioration and reduced quality of life. Herein, we report two SCI patients who presented with good response to pulsed radiofrequency (PRF) for the management of spasticity in the lower extremities. Patient 1 (a 47-year-old man) had complete thoracic cord injury and showed a phasic spasticity on the extensor of both knees (3-4 beats clonus per every 30 seconds) and tonic spasticity (Modified Ashworth Scale: 3) on both hip adductors. Patient 2 (a 64-year-old man) had incomplete cervical cord injury and showed a right ankle clonus (approximately 20 beats) when he walked...
June 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28730252/morphological-imaging-and-surgical-aspects-in-a-complex-case-of-uterine-leiomyosarcoma-case-report-and-review-of-the-literature
#10
Aida TincuŢa Petca, Simona Vlădăreanu, Dan Cristian Radu, Mihaela BoŢ, Costin Berceanu, Bogdan Stelian Mastalier Manolescu, Cosmin Medar, Răzvan Cosmin Petca
Leiomyosarcoma is a rare condition so there are relatively few and small case series and no prospective studies to provide clear guidelines regarding management. We report on a case that presents some particularities that further underline diagnostic and treatment difficulties posed by the affliction of such a rare tumor. This is the case of a 43-year-old woman who had a large tumor arising from the uterus, with a spectacular growth rate over a short period. The patient, with congenital spastic tetraparesis and hydrocephalus, came for belly enlargement with rapid increase in size over the previous two months...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28716516/hypertonia
#11
Sarah Helen Evans, Mark William Cameron, Justin Michael Burton
Hypertonia is the abnormal increase in muscle tone as a result of upper motor neuron lesions. There are three following clinical types: spasticity, dystonia, and rigidity. Management of hypertonia is individualized and should be directed by the patient and/or family׳s goals of care as well as the underlying cause of the hypertonia. Treatment options include stretching, strengthening, positioning, oral medications, botulinum toxin injections, phenol injections, as well as surgical procedures. Without effective management, hypertonia can result in muscle imbalance, abnormal movement patterns, pain, joint contracture, joint deformity, and ultimately negatively impact a patient׳s function...
July 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28713039/efficacy-of-ankle-foot-orthoses-types-on-walking-in-children-with-cerebral-palsy-a-systematic-review
#12
REVIEW
Atefeh Aboutorabi, Mokhtar Arazpour, Monireh Ahmadi Bani, Hassan Saeedi, John S Head
BACKGROUND: Ankle foot orthoses (AFOs) are orthotic devices that can be used to normalize the walking pattern of children with cerebral palsy (CP). One of the aims of orthotic management is to produce a more normal gait pattern by positioning joints in the proper position to reduce pathological reflex or spasticity. OBJECTIVE: To conduct a systematic review of the literature and establish the effect of treatment with various types of AFOs on gait patterns of children with CP...
July 13, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28698802/gait-analysis-in-children-with-cerebral-palsy
#13
Stéphane Armand, Geraldo Decoulon, Alice Bonnefoy-Mazure
Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations.Clinical gait analysis (CGA) is needed to identify, understand and support the management of gait deviations in CP. CGA assesses a large amount of quantitative data concerning patients' gait characteristics, such as video, kinematics, kinetics, electromyography and plantar pressure data.Common gait deviations in CP can be grouped into the gait patterns of spastic hemiplegia (drop foot, equinus with different knee positions) and spastic diplegia (true equinus, jump, apparent equinus and crouch) to facilitate communication...
December 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28694601/spastic-quadriparesis-due-to-pathological-fracture-of-odontoid-secondary-to-carcinoma-prostate-a-rare-presentation
#14
Maneet Gill, M N Swamy, Vikas Maheshwari, T S Lingaraju, Aishik Mukherjee
Prostate carcinoma presenting as symptomatic metastases to atlantoaxial spine is extremely rare. Spastic quadriparesis due to pathological fracture of odontoid as the only initial manifestation without symptoms of primary malignancy is rarer still. We report a 64-year-old male who presented with progressive spastic quadriparesis along with urinary retention of 3 weeks duration. Computed tomography and magnetic resonance imaging cervical spine and craniovertebral junction showed type III pathological fracture of odontoid with anterior translation of C1 with spinal cord compression...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28676144/ixcellence-network%C3%A2-an-international-educational-network-to-improve-current-practice-in-the-management-of-cervical-dystonia-or-spastic-paresis-by-botulinum-toxin-injection
#15
Klemens Fheodoroff, Roongroj Bhidayasiri, Luis Jorge Jacinto, Tae Mo Chung, Kailash Bhatia, Therese Landreau, Carlo Colosimo
Botulinum toxin is a well-established treatment for a number of conditions involving muscle hyperactivity, such as focal dystonia and spastic paresis. However, current injection practice is not standardized and there is a clear need for structured training. An international group of experts in the management of patients with cervical dystonia (CD) and spastic paresis created a steering committee (SC). For each therapeutic area, the SC developed a core slide set on best practice, based on the literature. International sites of expertise were identified for training and courses were designed to include lectures and casebased learning...
April 2017: Functional Neurology
https://www.readbyqxmd.com/read/28676142/the-italian-real-life-post-stroke-spasticity-survey-unmet-needs-in-the-management-of-spasticity-with-botulinum-toxin-type-a
#16
A Picelli, A Baricich, C Cisari, Stefano Paolucci, Nicola Smania, Giorgio Sandrini
The present national survey seeking to identify unmet needs in the management of spasticity with botulinum toxin type A focused on the use of OnabotulinumoxinA, since this is the brand with the widest range of licensed indications in Italy. Physicians from twenty-four Italian neurorehabilitation units compiled a questionnaire about "real-life" post-stroke spasticity management. OnabotulinumtoxinA was reported to be used in the following average doses: upper limb 316.7 ± 79.1 units; lower limb 327.8 ± 152...
April 2017: Functional Neurology
https://www.readbyqxmd.com/read/28641445/subcutaneous-botulinum-toxin-injection-for-post-thoracotomy-pain-syndrome-in-palliative-care-a-case-report
#17
Saima Rashid, Amanda R Fields, Steven J Baumrucker
Post-thoracotomy pain syndrome (PTPS) is a traumatic neuropathy that can affect as many as 50% of patients undergoing thoracotomy. Patients are often refractory to conservative management and may require multiple analgesics for adequate pain control. Botulinum toxin, derived from Clostridium botulinum, has many uses in treating conditions involving spasticity, dystonia, chronic migraine, and a variety of pain disorders including neuropathies. Botulinum toxin type A injections may provide an alternative or adjunct to improve symptom management in patients with PTPS...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28607753/a-group-delivered-self-management-program-reduces-spasticity-in-people-with-multiple-sclerosis-a-randomized-controlled-pilot-trial
#18
Cinda L Hugos, Dennis Bourdette, Yiyi Chen, Zunqiu Chen, Michelle Cameron
BACKGROUND: Spasticity affects more than 80% of people with multiple sclerosis (MS), affecting activity, participation, and quality of life. Based on an international guideline, an MS spasticity group education and stretching program, MS Spasticity: Take Control (STC), has been developed. OBJECTIVE: The objective of this paper is to determine whether STC with home stretching is associated with greater changes in spasticity than usual care (UC), consisting of an illustrated stretching booklet and home stretching but without group instruction or support, in people with MS...
January 2017: Multiple Sclerosis Journal—Experimental, Translational and Clinical
https://www.readbyqxmd.com/read/28604190/the-use-of-a-stent-retriever-to-cause-mechanical-dilatation-of-a-vasospasm-secondary-to-iatrogenic-subarachnoid-haemorrhage
#19
Pervinder Bhogal, Dimitris Paraskevopoulos, Hegoda Ld Makalanda
Objective To report the use of a stent-retriever in the management of vasospasm secondary to craniopharyngioma resection. Postoperative improvement was seen both clinically and on perfusion imaging. Methods A patient was admitted for resection of a large craniopharygioma. On day 6 postoperatively the patient had an acute hemiparesis. A computed tomography angiogram and perfusion scan demonstrated acute right-sided cerebral vasospasm and a perfusion defect in the territory of the middle cerebral artery (MCA)...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28586619/role-of-stretching-exercises-in-the-management-of-constipation-in-spastic-cerebral-palsy
#20
Waqar Ahmed Awan, Tahir Masood
BACKGROUND: Constipation is considered as one of the most common non-motor manifestations in cerebral palsy (CP). Along with other reasons, spasticity also contributes in developing constipation in CP, by decreasing mobility of trunk and lower extremities and abdominal viscera. Stretching exercises of upper extremities, trunk and lower extremities are routine management of spasticity in CP children. The objective of the study was to determine the role of stretching exercises in improving constipation symptoms in children with spastic cerebral palsy and to explore the association between spasticity and constipation among cerebral palsy children...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
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