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Spasticity management

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https://www.readbyqxmd.com/read/28607753/a-group-delivered-self-management-program-reduces-spasticity-in-people-with-multiple-sclerosis-a-randomized-controlled-pilot-trial
#1
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
#2
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
#3
Waqar Ahmed Awan, Tahir Masood
OBJECTIVE: 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
https://www.readbyqxmd.com/read/28579820/cannabis-and-intractable-chronic-pain-an-explorative-retrospective-analysis-of-italian-cohort-of-614-patients
#4
Guido Fanelli, Giuliano De Carolis, Claudio Leonardi, Adele Longobardi, Ennio Sarli, Massimo Allegri, Michael E Schatman
BACKGROUND: Despite growing interest in the therapeutic use of cannabis to manage chronic pain, only limited data that address these issues are available. In recent years, a number of nations have introduced specific laws to allow patients to use cannabis preparations to treat a variety of medical conditions. In 2015, the Italian government authorized the use of cannabis to treat several diseases, including chronic pain generally, spasticity in multiple sclerosis, cachexia and anorexia among AIDS and cancer patients, glaucoma, Tourette syndrome, and certain types of epilepsy...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28566775/orthopedic-surgery-in-cerebral-palsy-instructional-course-lecture
#5
Deepak Sharan
Orthopedic surgery (OS) plays an important role in the management of cerebral palsy (CP). The objectives of OS are to optimize functions and prevent deformity. Newer developments in OS for CP include emphasis on hip surveillance, minimally invasive procedures, use of external fixators instead of plates and screws, better understanding of lever arm dysfunctions (that can only be corrected by bony OS), orthopedic selective spasticity-control surgery, and single-event multilevel lever arm restoration and anti spasticity surgery, which have led to significant improvements in gross motor function and ambulation, especially in spastic quadriplegia, athetosis, and dystonia...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28549726/spasticity-dyskinesia-and-ataxia-in-cerebral-palsy-are-we-sure-we-can-differentiate-them
#6
H Eggink, D Kremer, O F Brouwer, M F Contarino, M E van Egmond, A Elema, K Folmer, J F van Hoorn, L A van de Pol, V Roelfsema, M A J Tijssen
OBJECTIVE: Cerebral palsy (CP) can be classified as spastic, dyskinetic, ataxic or combined. Correct classification is essential for symptom-targeted treatment. This study aimed to investigate agreement among professionals on the phenotype of children with CP based on standardized videos. METHODS: In a prospective, observational pilot study, videos of fifteen CP patients (8 boys, mean age 11 ± 5 y) were rated by three pediatric neurologists, three rehabilitation physicians and three movement disorder specialists...
May 9, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28542281/gait-asymmetry-ankle-spasticity-and-depression-as-independent-predictors-of-falls-in-ambulatory-stroke-patients
#7
Ta-Sen Wei, Peng-Ta Liu, Liang-Wey Chang, Sen-Yung Liu
BACKGROUND: Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed. METHODS: This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses...
2017: PloS One
https://www.readbyqxmd.com/read/28541901/changes-of-shoulder-elbow-and-wrist-stiffness-matrix-post-stroke
#8
Li-Qun Zhang, Jongsang Son, Hyung-Soon Park, Sang Hoon Kang, Yunju Lee, Yupeng Ren
Stroke affects multiple joints in the arm with stereotypical patterns of arm deformity involving the shoulder, elbow, wrist and hand and with disrupted coordination of multiple joints in active movements. However, there is a lack of systematic methods to evaluate multi-joints and multi-degree of freedoms (DOF) neuromechanical changes, especially for complex systems with three or more joints/DOFs involved. This study used a novel systematic method to characterize dynamics and control of the shoulder, elbow and wrist of the human arm individually and simultaneously, including the couplings across the multiple joints during controlled movements...
May 23, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28539691/goals-set-by-patients-using-the-icf-model-before-receiving-botulinum-injections-and-their-relation-to-spasticity-distribution
#9
Kevin Choi, Jaclyn Peters, Andrew Tri, Elizabeth Chapman, Ayako Sasaki, Farooq Ismail, Chris Boulias, Shannon Reid, Chetan P Phadke
Purpose: Goal Attainment Scaling (GAS) is used to assess functional gains in response to treatment. Specific characteristics of the functional goals set by individuals receiving botulinum toxin type A (BoNTA) injections for spasticity management are unknown. The primary objectives of this study were to describe the characteristics of the goals set by patients before receiving BoNTA injections using the International Classification of Functioning, Disability and Health (ICF) and to determine whether the pattern of spasticity distribution affected the goals set...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/28537343/practice-patterns-for-spasticity-management-with-phenol-neurolysis
#10
Jay Karri, Manuel F Mas, Gerard E Francisco, Sheng Li
OBJECTIVE: To present practice patterns for phenol neurolysis procedures conducted for spasticity management. DESIGN: A retrospective review of 185 persons with spasticity who underwent phenol neurolysis procedures (n = 293) at an academic rehabilitation hospital and clinic. Patient demographics, concomitant spasticity treatments, and procedure relevant information were collected. RESULTS: The cohort included 71.9% males and 61.6% inpatient procedures...
May 24, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28512616/surgical-management-of-syringomyelia-associated-with-spinal-adhesive-arachnoiditis-a-late-complication-of-tuberculous-meningitis-a-case-report
#11
Jun Seok Lee, Geun Sung Song, Dong Wuk Son
Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28509356/assessments-of-pain-in-children-and-adolescents-with-cerebral-palsy-a-retrospective-population-based-registry-study
#12
Lena Westbom, Amanda Rimstedt, Eva Nordmark
AIM: To explore pain screening in CPUP, a follow-up surveillance programme for people with cerebral palsy (CP), specifically to describe reported pain prevalence, localizations, patterns of distribution; to compare with studies using psychometrically sound assessment instruments; and to assess agreement between pain documented in CPUP and medical records. METHOD: Registry study of a population with CP, born 1993 to 2008, living in Skåne, Sweden in 2013. Descriptive data, cross-tabulations, and chi-square tests to characterize and compare the study groups...
May 16, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28497442/-myths-and-evidence-on-the-use-of-botulinum-toxin-spasticity-in-adults-and-in-children-with-cerebral-palsy
#13
J C Martinez-Castrillo, J L Pena-Segura, P Sanz-Cartagena, X Alonso-Curco, J M Arbelo-Gonzalez, G Arriola-Pereda, M D Coll-Bosch, J A Conejero-Casares, A Garcia-Ribes, S Jauma-Classen, J Pagonabarraga, J Vidal-Valls, P J Garcia-Ruiz
INTRODUCTION: Spasticity is a medical problem with a high incidence that significantly impact on the quality of life of patients and their families. AIM: To analyze and to answer different questions about the use of botulinum toxin type A (BTA) in our clinical practice. DEVELOPMENT: A group of experts in neurology develop a list of topics related with the use of BTA. Two big groups were considered: spasticity in adults and in children with cerebral palsy...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28484733/per-oral-endoscopic-myotomy-for-achalasia-cardia-outcomes-in-over-400-consecutive-patients
#14
Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Rakesh Kalapala, Santosh Darisetty, Guduru Venkat Rao, Nageshwar Reddy
Background and study aims Per-oral endoscopic myotomy (POEM) has emerged as an efficacious treatment modality for the management of achalasia cardia (AC) and non-achalasia spastic esophageal motility disorders. Initial results are encouraging. We analyzed the safety and efficacy of POEM in a large cohort of patients with AC. Patients and methods The data from patients who underwent POEM (from January 2013 to June 2016) was prospectively collected and analyzed. Clinical success was defined as Eckardt score ≤ 3 after POEM procedure...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28480944/interdisciplinary-spasticity-management-clinic-outcomes-using-the-goal-attainment-scale-a-retrospective-chart-review
#15
Amy Hanlan, Patricia Mills, Rachel Lipson, Heather Finlayson
OBJECTIVE: To generate practice-based evidence of outcomes in an interdisciplinary spasticity management clinic using practical application of the Goal Attainment Scale (GAS). DESIGN: Retrospective chart review. PATIENTS: A total of 225 adult patients who were referred for spasticity management at a tertiary rehabilitation hospital and returned for follow-up between 2010 and 2013. METHODS: GAS scores were determined for all patients...
May 16, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28478825/do-flexible-inter-injection-intervals-improve-the-effects-of-botulinum-toxin-a-treatment-in-reducing-impairment-and-disability-in-patients-with-spasticity
#16
Carlo Trompetto, Lucio Marinelli, Laura Mori, Luca Puce, Elisa Pelosin, Carlo Serrati, Francesco Fattapposta, Steno Rinalduzzi, Giovanni Abbruzzese, Antonio Currà
In patients treated with botulinum toxin-A (BoNT-A), toxin-directed antibody formation was related to the dosage and frequency of injections, leading to the empirical adoption of minimum time intervals between injections of 3months or longer. However, recent data suggest that low immunogenicity of current BoNT-A preparations could allow more frequent injections. Our hypothesis is that a short time interval between injections may be safe and effective in reducing upper limb spasticity and related disability...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28471471/pathophysiology-diagnostic-work-up-and-management-of-balance-impairments-and-falls-in-patients-with-hereditary-spastic-paraplegia
#17
Jorik Nonnekes, Bas van Lith, Bart P van de Warrenburg, Vivian Weerdesteyn, Alexander C H Geurts
INTRODUCTION: Balance impairments are common in patients with hereditary spastic paraplegia and are among the most debilitating symptoms, as they frequently result in falls and fall-related injuries. Several features of hereditary spastic paraplegia contribute to balance impairments and multiple treatment options exist. However, an overview of these underlying mechanisms and their treatment is currently lacking. METHODS: This paper reviews the pathophysiology, diagnostic workup, and management of balance impairments in hereditary spastic paraplegia...
April 27, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28463855/noncardiac-chest-pain-diagnosis-and-management
#18
Takahisa Yamasaki, Ronnie Fass
PURPOSE OF REVIEW: Noncardiac chest pain (NCCP) has been defined as recurrent chest pain that is indistinguishable from ischemic heart pain after excluding a cardiac cause. NCCP is a common and highly challenging clinical problem in Gastrointestinal practice that requires targeted diagnostic assessment to identify the underlying cause of the symptoms. Treatment is tailored according to the cause of NCCP: gastroesophageal reflux disease (GERD), esophageal dysmotility or functional chest pain...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28458952/intrathecal-baclofen-pump-infection-treated-by-adjunct-intrareservoir-teicoplanin-instillation
#19
Rovlias Aristedis, Papoutsakis Dimitrios, Paidakakos Nikolaos, Blionas Alexandros
BACKGROUND: The delivery of intrathecal baclofen via pumps is gaining increasing use in the management of intractable spasticity. One of the rare but devastating complications of this method is infection. In the majority of cases, removal of the device is required, despite appropriate intravenous antibiotic therapy. We report a case that highlights the use of intrareservoir teicoplanin to achieve sterilization of the infected pump system in a patient in whom removal of the pump was not an easy option...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28451697/assessment-and-treatment-of-spastic-equinovarus-foot-after-stroke-guidance-from-the-mont-godinne-interdisciplinary-group
#20
Thierry Deltombe, Delphine Wautier, Philippe De Cloedt, Michèle Fostier, Thierry Gustin
OBJECTIVE: To present interdisciplinary practical guidance for the assessment and treatment of spastic equinovarus foot after stroke. RESULTS: Clinical examination and diagnostic nerve block with anaesthetics determine the relative role of the factors leading to spastic equinovarus foot after stroke: calf spasticity, triceps surae - Achilles tendon complex shortening and dorsiflexor muscles weakness and/or imbalance. Diagnostic nerve block is a mandatory step in determining the cause(s) of, and the most appropriate treatment(s) for, spastic equinovarus foot...
April 26, 2017: Journal of Rehabilitation Medicine
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