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Spasticity management

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https://www.readbyqxmd.com/read/29143586/break-out-session-highlights
#1
Kjell-Morten Myhr, Mathias Mäurer, Marisa Martínez Ginés, Federica Esposito, Ralf Linker
A popular feature of the Multiple Sclerosis Experts Summit is interactive break-out sessions to discuss various aspects of multiple sclerosis (MS), including MS spasticity and general management of MS patients. The format encourages participation and active discussion, thus providing attendees with the opportunity to exchange their experiences of the day-to-day management of MS in clinical practice. Following feedback provided by each session leader, key messages are summarized and presented in a plenary session by the Summit chair...
November 2017: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29143581/multiple-sclerosis-symptoms-and-spasticity-management-new-data
#2
Guillermo Izquierdo
Spasticity, perceived by patients as muscle rigidity and spasms, is a common symptom in multiple sclerosis (MS). It is associated with functional impairment that can exacerbate other MS symptoms and reduce quality of life. Pharmacological treatment options are limited and frequently ineffective. Treatment adherence is a key issue to address in these patients. The efficacy and safety of 9-delta-tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray for treatment of MS spasticity were demonstrated in four Phase III trials...
November 2017: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29135566/management-of-hypertonia-in-cerebral-palsy
#3
Nickolas J Nahm, H Kerr Graham, Mark E Gormley, Andrew G Georgiadis
PURPOSE OF REVIEW: The review provides an update on the treatment of hypertonia in cerebral palsy, including physical management, pharmacotherapy, neurosurgical, and orthopedic procedures. RECENT FINDINGS: Serial casting potentiates the effect of Botulinum neurotoxin A injections for spasticity. Deep brain stimulation, intraventricular baclofen, and ventral and dorsal rhizotomy are emerging tools for the treatment of dystonia and/or mixed tone. The long-term results of selective dorsal rhizotomy and the timing of orthopedic surgery represent recent advances in the surgical management of hypertonia...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29134767/availability-and-approval-of-cannabis-based-medicines-for-chronic-pain-management-and-palliative-supportive-care-in-europe-a-survey-of-the-status-in-the-chapters-of-the-european-pain-federation
#4
N Krcevski-Skvarc, C Wells, W Häuser
BACKGROUND: There is considerable public and political interest in the use of cannabis products for medical purposes. METHODS: The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care...
November 13, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29116382/selective-dorsal-rhizotomy-for-the-treatment-of-severe-spastic-cerebral-palsy-efficacy-and-therapeutic-durability-in-gmfcs-grade-iv-and-v-children
#5
Daniel D'Aquino, Ahmad A Moussa, Amr Ammar, Harshal Ingale, Michael Vloeberghs
BACKGROUND: Selective dorsal rhizotomy (SDR) has been established as an effective surgical treatment for spastic diplegia. The applicability of SDR to the full spectrum of spastic cerebral palsy and the durability of its therapeutic effects remain under investigation. There are currently limited data in the literature regarding efficacy and outcomes following SDR in Gross Motor Function Classification System (GMFCS) IV and V patients. Intrathecal baclofen has traditionally been the surgical treatment of choice for these patients...
November 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29101071/subarachnoid-to-subarachnoid-shunt-for-correction-of-nonfunctioning-baclofen-pump-in-a-severe-case-of-chronic-debilitating-post-spinal-cord-injury-spasticity
#6
Adewale A Bakare, Jonathan Weyhenmeyer, Albert Lee
BACKGROUND AND IMPORTANCE: Perhaps the most disabling condition seen in patients with spinal cord injury is spasticity. Spasticity is characterized as hyperreflexia and hypertonicity as a result of damage to the supraspinal tracts in the aftermath of SCI. Intrathecal baclofen (ITB) is the mainstay therapy for spasticity unresponsive to oral baclofen. One of the problems associated with post-SCI spasticity unresponsive to ITB is development of scar tissue that prevents the diffusion of baclofen in the desired spinal cord area...
October 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29094043/hand-passive-mobilization-performed-with-robotic-assistance-acute-effects-on-upper-limb-perfusion-and-spasticity-in-stroke-survivors
#7
Massimiliano Gobbo, Paolo Gaffurini, Laura Vacchi, Sara Lazzarini, Jorge Villafane, Claudio Orizio, Stefano Negrini, Luciano Bissolotti
This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL) function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS) was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29064620/intrathecal-drug-delivery-systems-for-the-management-of-chronic-non-cancer-pain-a-systematic-review-of-economic-evaluations
#8
REVIEW
Rui V Duarte, Tosin Lambe, Jon H Raphael, Sam Eldabe, Lazaros Andronis
BACKGROUND: Intrathecal drug delivery (ITDD) systems are one of a limited number of management options for chronic non-cancer pain, cancer pain and spasticity. Concerns over their effectiveness and high initial costs led NHS England to decommission ITDD for patients with chronic non-cancer pain. However, the extent to which this decision is in line with existing economic evidence is unclear. The aim of this systematic review is to identify and review the existing evidence on the cost-effectiveness of ITDD for chronic non-cancer pain...
October 24, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29060740/assessment-of-elbow-spasticity-with-surface-electromyography-and-mechanomyography-based-on-support-vector-machine
#9
Hui Wang, Lei Wang, Yun Xiang, Ning Zhao, Xiangxin Li, Shixiong Chen, Chuang Lin, Guanglin Li
The Modified Ashworth Scale (MAS) is the gold standard in clinical for grading spasticity. However, its results greatly depend on the physician evaluations and are subjective. In this study, we investigated the feasibility of using support vector machine (SVM) to objectively assess elbow spasticity based on both surface electromyography (sEMG) and mechanomyography (MMG). sEMG signals and tri-axial accelerometer mechanomyography (ACC-MMG) signals were recorded simultaneously on patients' biceps and triceps when they extended or bended elbow passively...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059659/-post-stroke-spasticity-management-including-a-chosen-physiotherapeutic-methods-and-improvements-in-motor-control-review-of-the-current-scientific-evidence
#10
Robert Dymarek, Kuba Ptaszkowski, Lucyna Słupska, Małgorzata Paprocka-Borowicz, Jakub Taradaj, Tomasz Halski, Joanna Rosińczuk
Cerebrovascular diseases based on stroke etiology concern millions of people worldwide, and annual rates of disease are still increasing. In the era of an aging society and suffering from a number of risk factors, in particular those modifiable, strokes and muscles' spastic paresis, subsequently resulting in damage of upper motor neuron structures will become a serious problem for the entire health care system. Effective management and physiotherapy treatment for post-stroke spasticity persisted, both in the acute and chronic, is still a significant medical problem in the interdisciplinary aspect...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29055461/sativex-in-the-management-of-multiple-sclerosis-related-spasticity-an-overview-of-the-last-decade-of-clinical-evaluation
#11
REVIEW
Sabrina Giacoppo, Placido Bramanti, Emanuela Mazzon
BACKGROUND: Spasticity is a common symptom of multiple sclerosis (MS) affecting about 80% of MS patients. Numerous lines of evidence suggest that spasticity due to its complexity is not adequately managed with conventional anti-spastic therapies. Therefore, in order to improve the outcomes for the majority of MS patients, alternative approaches are needed to be discovered. Over the last years, the use of cannabinoid compounds as a potential treatment for MS-related symptoms has aroused great interest, owing to encouraging preclinical and clinical studies...
October 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29055449/successful-long-term-management-of-spasticity-in-patients-with-multiple-sclerosis-using-a-software-application-app-a-pilot-study
#12
Rainer Ehling, Michael Edlinger, Kay Hermann, Kerstin Dröge, Yvonne Seidinger, Ursula Miller, Hannes Franz Alber, Christian Brenneis
BACKGROUND: Spasticity is a very common syndrome in patients with multiple sclerosis (pwMS), but available treatments lead to sufficient symptom control only in one third. OBJECTIVE: To investigate the impact of an individualized training program on improving spasticity in a prospective pilot trial in pwMS suffering from moderate spasticity (defined as ≥ 4 on a normative rating scale; NRS). METHODS: PwMS were familiarized with predefined exercises targeting spasticity while undergoing inpatient rehabilitation (IR)...
October 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29042299/non-pharmacological-interventions-for-spasticity-in-adults-an-overview-of-systematic-reviews
#13
REVIEW
Fary Khan, Bhasker Amatya, Djamel Bensmail, Alain Yelnik
OBJECTIVES: Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes. METHODS: Data sources: a literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15th June 2017...
October 16, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28983422/speech-language-pathology-evaluation-and-management-of-hyperkinetic-disorders-affecting-speech-and-swallowing-function
#14
REVIEW
Julie M Barkmeier-Kraemer, Heather M Clark
BACKGROUND: Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech-language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations. METHODS: A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/28980624/amyotrophic-lateral-sclerosis
#15
REVIEW
Orla Hardiman, Ammar Al-Chalabi, Adriano Chio, Emma M Corr, Giancarlo Logroscino, Wim Robberecht, Pamela J Shaw, Zachary Simmons, Leonard H van den Berg
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, is characterized by the degeneration of both upper and lower motor neurons, which leads to muscle weakness and eventual paralysis. Until recently, ALS was classified primarily within the neuromuscular domain, although new imaging and neuropathological data have indicated the involvement of the non-motor neuraxis in disease pathology. In most patients, the mechanisms underlying the development of ALS are poorly understood, although a subset of patients have familial disease and harbour mutations in genes that have various roles in neuronal function...
October 5, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28953044/research-on-prevalence-of-secondary-conditions-in-individuals-with-disabilities-an-overview
#16
Metka Moharić
Individuals with disabilities may be at increased risk of a number of secondary conditions. Secondary conditions influence health status and quality of life. Many of these conditions are preventable and their consequences can be managed. Knowledge of the prevalence, course, and association with age of secondary conditions is needed for better prevention and management. The aim of present study was to review the available literature on the prevalence of secondary conditions in individuals with disability. We performed searches of electronic databases for studies published between 1980 and 2017 that provided information on the prevalence of secondary conditions in individuals with disabilities...
September 25, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28951579/expert-consensus-document-advances-in-the-management-of-oesophageal-motility-disorders-in-the-era-of-high-resolution-manometry-a-focus-on-achalasia-syndromes
#17
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Mark Fox, C Prakash Gyawali, Sabine Roman, André J P M Smout, John E Pandolfino
High-resolution manometry (HRM) and new analysis algorithms, summarized in the Chicago Classification, have led to a restructured classification of oesophageal motility disorders. This advance has led to increased detection of clinically relevant disorders, in particular achalasia. It has become apparent that the cardinal feature of achalasia - impaired lower oesophageal sphincter (LES) relaxation - can occur in several disease phenotypes: without peristalsis (type I), with pan-oesophageal pressurization (type II), with premature (spastic) distal oesophageal contractions (type III), or with preserved peristalsis (outlet obstruction)...
November 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28948486/efficacy-and-tolerability-of-phytomedicines-in-multiple-sclerosis-patients-a-review
#18
REVIEW
Mohammad Hosein Farzaei, Zahra Shahpiri, Roodabeh Bahramsoltani, Marjan Moghaddam Nia, Fariba Najafi, Roja Rahimi
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disorder of the central nervous system (CNS) that can cause cognition, mobility, and sensory impairments. It is considered one of the most common non-traumatic causes of disability in the world. The aim of the present article was to review the clinical evidence related to medicinal plants in the management of MS symptoms. Electronic databases, including the Cochrane Library, Pubmed, and Scopus, were searched for entries from 1966 to February 2017...
October 2017: CNS Drugs
https://www.readbyqxmd.com/read/28919982/effective-management-of-spasticity-and-impacts-on-weight-change-and-resting-energy-expenditure-in-a-female-with-spinal-cord-injury-a-case-report
#19
Amy N Nevin, Khanh Nguyen, Sridhar Atresh, Angela Vivanti, Ingrid J Hickman
INTRODUCTION: The impact of muscle spasticity on weight change and energy expenditure after spinal cord injury (SCI) is not well understood. CASE PRESENTATION: This case study reports changes to body weight and resting energy expenditure (REE) in a 36-year-old female (T3 AIS A SCI; 80 kg; body mass index=28 kg m(-)(2) at injury) requiring escalating therapies to manage severe spasticity. Body weight, spasticity medications and fasted REE (measured using indirect calorimetry, canopy hood) were recorded at 4, 16, 17, 20 and 44 months post injury...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28914131/safety-and-efficacy-of-repeat-open-label-abobotulinumtoxina-treatment-in-pediatric-cerebral-palsy
#20
Mauricio R Delgado, Marcin Bonikowski, Jorge Carranza, Edward Dabrowski, Dennis Matthews, Barry Russman, Ann Tilton, Juan Carlos Velez, Anne-Sophie Grandoulier, Philippe Picaut
This was a prospective, repeat-treatment, open-label study (NCT01251380) of abobotulinumtoxinA for the management of lower limb spasticity in children who had completed a double-blind study. Children (2-17 years) received injections into the gastrocnemius-soleus complex, and other distal and proximal muscles as required (maximum total dose per injection cycle: 30 U/kg or 1000U). A total of 216 of the 241 double-blind patients entered the extension study and 207 received ≥1 open label injection into the gastrocnemius-soleus; 17-24% of patients also had injections into the hamstrings...
November 2017: Journal of Child Neurology
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