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post-stroke spasticity

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https://www.readbyqxmd.com/read/28528818/patellar-tendon-vibration-reduces-the-increased-facilitation-from-quadriceps-to-soleus-in-post-stroke-hemiparetic-individuals
#1
Eric Maupas, Joseph-Omer Dyer, Sibele de Andrade Melo, Robert Forget
BACKGROUND: Stimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is enhanced and related to co-activation of knee and ankle extensors while sitting and walking. Soleus H-reflex facilitation can be depressed by vibration of the quadriceps in healthy people, but the effects of such vibration have never been studied on the abnormal soleus facilitation observed in people after stroke...
May 18, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28475487/can-somatosensory-electrical-stimulation-relieve-spasticity-in-post-stroke-patients-a-tms-pilot-study
#2
André Salles Cunha Peres, Victor Hugo Souza, João Marcos Yamasaki Catunda, Kelley Cristine Mazzeto-Betti, Taiza Elaine Grespan Santos-Pontelli, Claudia Domingues Vargas, Oswaldo Baffa, Draulio Barros de Araújo, Octávio Marques Pontes-Neto, João Pereira Leite, Marco Antonio Cavalcanti Garcia
Evidence suggests that somatosensory electrical stimulation (SES) may decrease the degree of spasticity from neural drives, although there is no agreement between corticospinal modulation and the level of spasticity. Thus, stroke patients and healthy subjects were submitted to SES (3 Hz) for 30' on the impaired and dominant forearms, respectively. Motor evoked potentials induced by single-pulse transcranial magnetic stimulation were collected from two forearm muscles before and after SES. The passive resistance of the wrist joint was measured with an isokinetic system...
May 5, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28471469/influence-of-physician-empathy-on-the-outcome-of-botulinum-toxin-treatment-for-upper-limb-spasticity-in-patients-with-chronic-stroke-a-cohort-study
#3
Alessandro Picelli, Gabriella Vallies, Elena Chemello, Alessandro Gavras, Paola Castellazzi, Andrea Meschieri, Anna Serina, Marialuisa Gandolfi, Alessio Baricich, Andrea Santamato, Carlo Cisari, Nicola Smania
OBJECTIVE: To examine the relationship between patient-rated physician empathy and outcome of botulinum toxin treatment for post-stroke upper limb spasticity. DESIGN: Cohort study. SUBJECTS: Twenty chronic stroke patients with upper limb spasticity. METHODS: All patients received incobotulinumtoxinA injection in at least one muscle for each of the following patterns: flexed elbow, flexed wrist and clenched fist. Each treatment was performed by 1 of 5 physiatrists with equivalent clinical experience...
April 27, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28455191/electro-acupuncture-for-post-stroke-spasticity-a-systematic-review-and-meta-analysis
#4
REVIEW
Yiyi Cai, Claire Shuiqing Zhang, Shaonan Liu, Zehuai Wen, Anthony Lin Zhang, Xinfeng Guo, Chuanjian Lu, Charlie C Xue
OBJECTIVE: To evaluate the effects and safety of electro-acupuncture (EA) for stroke patients with spasticity. DATA SOURCES: Five English (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and AMED) and four Chinese databases (CBM, CNKI, CQVIP and Wanfang) were searched from their inception to September 2016. DATA SELECTION: Randomized controlled trials were included if they measured spasticity with Modified Ashworth Scale in stroke patients and investigated the add-on effects of electro-acupuncture to routine pharmacotherapy and rehabilitation therapies...
April 25, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28433830/spasticity-management-the-current-state-of-transcranial-neuromodulation
#5
REVIEW
Antonino Leo, Antonino Naro, Francesco Molonia, Provvidenza Tomasello, Ileana Saccà, Alessia Bramanti, Margherita Russo, Placido Bramanti, Angelo Quartarone, Rocco Salvatore Calabrò
This narrative review aims to provide an objective view of the noninvasive neuromodulation (NINM) protocols available for treating spasticity, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). On the basis of the relevant randomized controlled trials, we infer that NINM is more effective in reducing spasticity when combined with the conventional therapies than used as a stand-alone treatment. However, the magnitude of NINM after-effects depends significantly on the applied hemisphere and the underlying pathology...
April 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28431452/-treatment-options-for-neurogenic-drop-foot-a-systematic-literature-research
#6
Eike Jakubowitz, Daiwei Yao, Henning Windhagen, Christina Stukenborg-Colsman, Anna Thomann, Kiriakos Daniilidis
Background Neurogenic drop foot may be caused by central or peripheral lesions of the nervous system. Depending on whether the first or second motor neuron is damaged, a flaccid or spastic drop foot develops. Spastic drop foot persists as a residual long-term complication after stroke in about 14 % of patients. Various conservative and surgical treatment options are available. Methods This article is based on a systematic literature review for medical evidence of functional electrical stimulation (FES) with the keywords "functional electrical stimulation AND drop foot" and "functional electrical stimulation AND gait AND stroke" in PubMed and Cochrane databases...
April 21, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28289789/-medical-care-of-patients-with-spasticity-following-stroke-evaluation-of-the-treatment-situation-in-germany-with-focus-on-the-use-of-botulinum-toxin
#7
L Kerkemeyer, G Lux, A Walendzik, J Wasem, A Neumann
BACKGROUND: Upper limb spasticity is a common complication following stroke. Cohort studies found 19% of post-stroke patients had upper limb spasticity at 3 months and 38% of patients at 12 months. For focal spasticity, intramuscular injections of botulinum toxin are indicated. In Germany, it is assumed that patients with the described indication are undersupplied with botulinum toxin. OBJECTIVE: The aim of the present study is to evaluate the medical care of patients with upper limb spasticity post-stroke with the focus on the use of botulinum toxin as one treatment option...
March 13, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28286053/onabotulinumtoxina-for-lower-limb-spasticity-guidance-from-a%C3%A2-delphi-panel-approach
#8
Alberto Esquenazi, Abraham Alfaro, Ziyad Ayyoub, David Charles, Khashayar Dashtipour, Glenn D Graham, John R McGuire, Ib R Odderson, Atul T Patel, David M Simpson
BACKGROUND: OnabotulinumtoxinA is approved for the treatment of upper and lower limb spasticity in adults. Guidance on common postures and onabotulinumtoxinA injection paradigms for upper limb spasticity has been developed via a Delphi Panel; however, similar guidance for lower limb spasticity has not been established. OBJECTIVE: To define a clinically recommended treatment paradigm for the use of onabotulinumtoxinA for each common posture among patients with poststroke lower limb spasticity (PSLLS) and to identify the most common PSLLS aggregate postures...
March 7, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28285729/evaluation-of-post-stroke-spastic-muscle-stiffness-using-shear-wave-ultrasound-elastography
#9
Chueh-Hung Wu, Yu-Chun Ho, Ming-Yen Hsiao, Wen-Shiang Chen, Tyng-Guey Wang
Current clinical evaluations of post-stroke upper limb spasticity are subjective and qualitative. We proposed a quantitative measurement of post-stroke spastic muscle stiffness by using shear-wave ultrasound elastography and tested its reliability. Acoustic radiation force impulse with shear wave velocity (SWV) detection was used to evaluate stiffness of the biceps brachii muscles at 90° and 0° elbow flexion. In 21 control subjects, SWV did not significantly differ between dominant and non-dominant sides at either flexion angle (0°: p = 0...
June 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28275351/botulinum-toxin-is-effective-in-the-management-of-neurogenic-dysphagia-clinical-electrophysiological-findings-and-tips-on-safety-in-different-neurological-disorders
#10
Enrico Alfonsi, Domenico A Restivo, Giuseppe Cosentino, Roberto De Icco, Giulia Bertino, Antonio Schindler, Massimiliano Todisco, Mauro Fresia, Andrea Cortese, Paolo Prunetti, Matteo C Ramusino, Arrigo Moglia, Giorgio Sandrini, Cristina Tassorelli
Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28272726/-measurement-of-the-outcomes-in-acquired-brain-injury-in-a-neurorehabilitation-unit-a-long-term-study
#11
V Cruz-Guisado, P Diaz-Borrego, B Romero-Romero, M Rodriguez-Pinero Duran
INTRODUCTION: Following sudden brain damage, there is a loss of capabilities that affects the person's autonomy. Recovery from the physical, psychic and cognitive sequelae requires the application of multiple therapies, the outcomes of which need to be measured objectively. Our aim is to analyse the application of standardised instruments in determining the therapeutic outcomes in acquired brain injury. PATIENTS AND METHODS: We conducted a retrospective descriptive observational study lasting 13 months...
March 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28211822/robot-assisted-end-effector-based-gait-training-in-chronic-stroke-patients-a%C3%A2-multicentric-uncontrolled-observational-retrospective-clinical-study
#12
Stefano Mazzoleni, Antonella Focacci, Marco Franceschini, Andreas Waldner, Chiara Spagnuolo, Elena Battini, Donatella Bonaiuti
BACKGROUND: Until now studies report inconclusive results as regards the effectiveness of exclusive use of robot-assisted training and clinical indications in stroke patients. OBJECTIVE: To evaluate if the only robot-assisted end-effector-based gait training can be feasible in chronic stroke subjects in terms of gait recovery. METHODS: Five rehabilitation centers participated and one hundred chronic post-stroke patients were recruited. Patients underwent a robot-assisted end-effector-based gait training as only rehabilitation treatment...
February 15, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28145396/a-randomized-controlled-trial-on-the-immediate-and-long-term-effects-of-arm-slings-on-shoulder-subluxation-in-stroke-patients
#13
Anke VAN Bladel, Gert Lambrecht, Kristine M Oostra, Guy Vanderstraeten, Dirk Cambier
BACKGROUND: Arm slings are often used in clinical practice to support the hemiplegic arm aiming to prevent or treat glenohumeral subluxation. Evidence supporting the corrective effect of slings on subluxation is scarce and long-term studies are lacking. AIM: To determine both the immediate and long-term effect on acromiohumeral distance using the Actimove® sling (BSN medical SA-NV, Leuven, Belgium) and Shoulderlift (V!GO, Belgium) and to determine the effect of slings on pain and passive range of motion of the shoulder in stroke patients with glenohumeral subluxation...
January 30, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28131185/combined-therapy-using-botulinum-toxin-a-and-single-joint-hybrid-assistive-limb-for-upper-limb-disability-due-to-spastic-hemiplegia
#14
Kazuya Saita, Takashi Morishita, Koichi Hyakutake, Hiroyuki Fukuda, Etsuji Shiota, Yoshiyuki Sankai, Tooru Inoue
We investigated the combination of robot-assisted rehabilitation (RT) using a single-joint hybrid assistive limb (HAL-SJ) and botulinum toxin A (BTX-A) as therapy for paretic arm with spasticity in post-stroke patients. Participants were seven patients (4 females, 3 males; mean (±SD) age: 60.6±8.4years) who had spastic hemiplegia following chronic stroke. On the day following BTX-A injection, we started RT, which was performed for 20 sessions of 60min each over a two-week period. Clinical outcome measures, including Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Disability Assessment Scale (DAS), and cortical activity were evaluated at baseline, and two weeks, and four months following BTX-A injection...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28118733/safety-and-efficacy-of-letibotulinumtoxina-botulax%C3%A2-in-treatment-of-post-stroke-upper-limb-spasticity-a-randomized-double-blind-multi-center-phase-iii-clinical-trial
#15
Kyung Hee Do, Min Ho Chun, Nam-Jong Paik, Yoon Ghil Park, Shi-Uk Lee, Min-Wook Kim, Don-Kyu Kim
OBJECTIVE: To investigate a new botulinum neurotoxin type A, termed letibotulinumtoxinA(Botulax(®)) and compare its efficacy and safety for post-stroke upper limb spasticity with that of onabotulinumtoxinA(Botox(®)). DESIGN: A prospective, double-blinded, multicenter, randomized controlled clinical study. SETTING: Six university hospitals in Korea. SUBJECTS: A total of 187 stroke participants with upper limb spasticity...
January 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28071962/the-feasibility-of-functional-electrical-stimulation-to-improve-upper-extremity-function-in-a-two-year-old-child-with-perinatal-stroke-a-case-report
#16
Kristin E Musselman, Patricia Manns, Jaclyn Dawe, Rhina Delgado, Jaynie F Yang
AIMS: To evaluate the effectiveness and feasibility (i.e. tolerability, adherence) of functional electrical stimulation (FES) for the upper extremity (UE) in a two-year-old child with perinatal stroke. METHODS: Forty hours of FES over eight weeks was prescribed. FES to the hemiplegic triceps, extensor carpi radialis longus and brevis, extensor carpi ulnaris and extensor digitorum was timed with reaching during play. Assessments were performed before, during, and two months post-intervention...
January 10, 2017: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/27940322/an-improved-approach-for-measuring-the-tonic-stretch-reflex-response-of-spastic-muscles
#17
Maristella Borges Silva, Andrei Nakagawa Silva, Eduardo Lázaro Martins Naves, Evanisi Teresa Palomari, Alcimar Barbosa Soares
We propose a new method for detecting the onset of the stretch reflex response for assessment of spasticity based on the Tonic Stretch Reflex Threshold (TSRT). Our strategy relies on a three-stage approach to detect the onset of the reflex EMG activity: (i) Reduction of baseline activity by means of Empirical Mode Decomposition; (ii) Extraction of the complex envelope of the EMG signal by means of Hilbert Transform (HT) and; iii) A double threshold decision rule. Simulated and real EMG data were used to evaluate and compare our method (TSRT-EHD) against three other popular methods described in the literature to assess TSRT ('Kim', 'Ferreira' and 'Blanchette')...
December 2, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27880052/functional-impact-of-different-muscle-localization-techniques-for-botulinum-neurotoxin-a-injections-in-clinical-routine-management-of-post-stroke-spasticity
#18
Kirsten E Zeuner, Arne Knutzen, Carina Kühl, Bettina Möller, Helge Hellriegel, Nils G Margraf, Günther Deuschl, Henning Stolze
BACKGROUND: Treatment options for spasticity include intramuscular botulinum neurotoxin A (BoNT-A) injections. Both ultrasound (US) or electromyographic (EMG) guided BoNT-A injections are employed to isolate muscles. To date, most studies have included patients naïve to BoNT-A or following a prolonged wash out phase. OBJECTIVE: To determine the impact of US/EMG guided BoNT-A injections on function in outpatients with spasticity receiving an established re-injection regime...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27879456/hindlimb-spasticity-after-unilateral-motor-cortex-lesion-in-rats-is-reduced-by-contralateral-nerve-root-transfer
#19
Haiyang Zong, Fenfen Ma, Laiyin Zhang, Huiping Lu, Jingru Gong, Min Cai, Haodong Lin, Yizhun Zhu, Chunlin Hou
Lower extremity spasticity is a common sequela among patients with acquired brain injury. The optimum treatment remains controversial. The aim of our study was to test the feasibility and effectiveness of contralateral nerve root transfer in reducing post stroke spasticity of the affected hindlimb muscles in rats. In our study, we for the first time created a novel animal hindlimb spastic hemiplegia model in rats with photothrombotic lesion of unilateral motor cortex and we established a novel surgical procedure in reducing motor cortex lesion-induced hindlimb spastic hemiplegia in rats...
December 2016: Bioscience Reports
https://www.readbyqxmd.com/read/27871449/botulinum-toxin-as-early-intervention-for-spasticity-after-stroke-or-non-progressive-brain-lesion-a-meta-analysis
#20
Raymond L Rosales, Fran Efendy, Ericka Sa Teleg, Mary Md Delos Santos, Mary Ce Rosales, Marc Ostrea, Michelle J Tanglao, Arlene R Ng
Spasticity is a functionally limiting disorder that commonly occurs following stroke or severe brain injury, and may lead to disability and pain. In tandem with neurorehabilitation, botulinum toxin type A (BoNT-A) is the recommended first-line treatment for spasticity and, to date, the majority of trials have reported BoNT-A use in patients >6months after ictus. The present meta-analysis aimed to evaluate the effects of early BoNT-A injection for post-stroke spasticity on improvements in hypertonicity, disability, function and associated pain...
December 15, 2016: Journal of the Neurological Sciences
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