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Upper limb spasticity

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https://www.readbyqxmd.com/read/28505986/combined-transcranial-direct-current-stimulation-and-robotic-upper-limb-therapy-improves-upper-limb-function-in-an-adult-with-cerebral-palsy
#1
Kathleen M Friel, Peter Lee, Lindsey V Soles, Ana R P Smorenburg, Hsing-Ching Kuo, Dylan J Edwards
BACKGROUND: Robotic therapy can improve upper limb function in hemiparesis. Excitatory transcranial direct current stimulation (tDCS) can prime brain motor circuits before therapy. OBJECTIVE: We tested safety and efficacy of tDCS plus robotic therapy in an adult with unilateral spastic cerebral palsy (USCP). METHODS: In each of 36 sessions, anodal tDCS (2 mA, 20 min) was applied over the motor map of the affected hand. Immediately after tDCS, the participant completed robotic therapy, using the shoulder, elbow, and wrist (MIT Manus)...
May 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28499657/electrically-assisted-movement-therapy-in-chronic-stroke-patients-with-severe-upper-limb-paresis-a-pilot-single-blind-randomized-crossover-study
#2
Stefano Carda, Andrea Biasiucci, Andrea Maesani, Silvio Ionta, Julien Moncharmont, Stephanie Clarke, Micah M Murray, José Del R Millán
OBJECTIVE: To evaluate the effects of electrically assisted movement therapy (EAMT) in which patients use functional electrical stimulation, modulated by a custom device controlled through the patient's unaffected hand, to produce or assist task-specific upper limb movements, which enables them to engage in intensive goal-oriented training. DESIGN: Randomized, crossover, assessor-blinded, 5-week trial with follow-up at 18 weeks. SETTING: Rehabilitation university hospital...
May 5, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28480944/interdisciplinary-spasticity-management-clinic-outcomes-using-the-goal-attainment-scale-a-retrospective-chart-review
#3
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
#4
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/28471469/influence-of-physician-empathy-on-the-outcome-of-botulinum-toxin-treatment-for-upper-limb-spasticity-in-patients-with-chronic-stroke-a-cohort-study
#5
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
#6
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/28449883/hereditary-spastic-paraplegia-more-than-an-upper-motor-neuron-disease
#7
REVIEW
L Parodi, S Fenu, G Stevanin, A Durr
Hereditary spastic paraplegias (HSPs) are a group of rare inherited neurological diseases characterized by extreme heterogeneity in both their clinical manifestations and genetic backgrounds. Based on symptoms, HSPs can be divided into pure forms, presenting with pyramidal signs leading to lower-limb spasticity, and complex forms, when additional neurological or extraneurological symptoms are detected. The clinical diversity of HSPs partially reflects their underlying genetic backgrounds. To date, 76 loci and 58 corresponding genes [spastic paraplegia genes (SPGs)] have been linked to HSPs...
April 24, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28427709/upper-limb-impairment-is-associated-with-use-of-assistive-devices-and-unemployment-in-multiple-sclerosis
#8
Ruth Ann Marrie, Gary R Cutter, Tuula Tyry, Stacey S Cofield, Robert Fox, Amber Salter
BACKGROUND: Individuals with multiple sclerosis (MS) frequently suffer from impaired sensory function, reduced strength and tremor in the upper limbs, which may interfere with upper limb function. However, upper limb impairment in MS is under-recognized and understudied. We aimed to evaluate the prevalence of upper limb impairment in a large sample of persons with MS; the association between upper limb function and employment status in MS; and the frequency of use of assistive devices aimed at addressing upper limb impairments...
April 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28325000/mechanomyography-signals-in-spastic-muscle-and-the-correlation-with-the-modified-ashworth-scale
#9
E L Santos, M C Santos, E Krueger, G N Nogueira-Neto, P Nohama
The modified Ashworth scale (MAS) is the most widely used measurement technique to assess levels of spasticity. In MAS, the evaluator graduates spasticity considering his/her subjective analysis of the muscular endurance during passive stretching. Therefore, it is a subjective scale. Mechanomyography (MMG) allows registering the vibrations generated by muscle contraction and stretching events that propagate through the tissue until the surface of the skin. With this in mind, this study aimed to investigate possible correlations between MMG signal and muscle spasticity levels determined by MAS...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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
#10
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
#11
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
#12
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/28268662/quantification-of-a-single-score-1-in-the-modified-ashworth-scale-mas-a-clinical-assessment-of-spasticity
#13
Jourdan K Ewoldt, Emily C Lazzaro, Elliot J Roth, Nina L Suresh
The Modified Ashworth Scale (MAS) is an assessment that is often used by clinicians to grade spasticity in the affected limbs of stroke survivors. The MAS is a function of the angle at which the clinician perceives a resistance to stretch and/or a `catch' during a passive joint rotation. The qualitative nature of the assessment in combination with the low resolution of the scale could result in varied grouping of spastic patients, even for a single score. The objective of this pilot study was to develop a method for the quantification of the MAS, which could provide greater resolution and could eventually guide better informed therapeutic interventions...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28265475/improvement-and-neuroplasticity-after-combined-rehabilitation-to-forced-grasping
#14
Michiko Arima, Atsuko Ogata, Kazumi Kawahira, Megumi Shimodozono
The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28264546/sonographic-guide-for-botulinum-toxin-injections-of-the-upper-limb-euro-musculus-usprm-spasticity-approach
#15
Murat Kara, Bayram Kaymak, Alper M Ulaşli, Fatih Tok, Gokhan T Öztürk, Ke-Vin Chang, Ming-Yen Hsiao, Chen-Yu Hung, Arzu Yağiz On, Levent Özçakar
The pertinent literature lacks overt technical data for optimal upper limb muscle botulinum toxin injections using ultrasound (US) imaging. Therefore, this guide is prepared for the commonly injected muscles of the upper limb and the shoulder girdle mainly in spasticity. It includes clinical information, anatomical description and explanation regarding the US imaging of several muscles. The figures have been organized to orient the readers on the innervation zones, injection sites, probe positionings and the US images simultaneously...
March 6, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28231063/bone-age-in-unilateral-spastic-cerebral-palsy-is-there-a-correlation-with-hand-function-and-limb-length
#16
Je-Sang Lee, Im Jeong Choi, Myung Jun Shin, Jin-A Yoon, Sung Hwa Ko, Yong Beom Shin
BACKGROUND: The purpose of this study was to analyze the bone age and the upper extremity segmental lengths between the affected and the unaffected side and to reveal the correlation between the difference of bone age and the upper limb length discrepancy in the unilateral spastic cerebral palsy (CP). We also evaluated the relationship between difference of bone age and hand function. METHODS: Seventy-eight patients participated in this study. The bone ages of hand-wrists of the patients were determined by the Greulich and Pyle atlas...
March 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28227340/mechanomyography-signals-in-spastic-muscle-and-the-correlation-with-the-modified-ashworth-scale
#17
E L Santos, M C Santos, E Krueger, G N Nogueira-Neto, P Nohama, E L Santos, M C Santos, E Krueger, G N Nogueira-Neto, P Nohama, G N Nogueira-Neto, M C Santos, E Krueger, E L Santos, P Nohama
The modified Ashworth scale (MAS) is the most widely used measurement technique to assess levels of spasticity. In MAS, the evaluator graduates spasticity considering his/her subjective analysis of the muscular endurance during passive stretching. Therefore, it is a subjective scale. Mechanomyography (MMG) allows registering the vibrations generated by muscle contraction and stretching events that propagate through the tissue until the surface of the skin. With this in mind, this study aimed to investigate possible correlations between MMG signal and muscle spasticity levels determined by MAS...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226846/quantification-of-a-single-score-1-in-the-modified-ashworth-scale-mas-a-clinical-assessment-of-spasticity
#18
Jourdan K Ewoldt, Emily C Lazzaro, Elliot J Roth, Nina L Suresh, Jourdan K Ewoldt, Emily C Lazzaro, Elliot J Roth, Nina L Suresh, Emily C Lazzaro, Elliot J Roth, Jourdan K Ewoldt, Nina L Suresh
The Modified Ashworth Scale (MAS) is an assessment that is often used by clinicians to grade spasticity in the affected limbs of stroke survivors. The MAS is a function of the angle at which the clinician perceives a resistance to stretch and/or a `catch' during a passive joint rotation. The qualitative nature of the assessment in combination with the low resolution of the scale could result in varied grouping of spastic patients, even for a single score. The objective of this pilot study was to develop a method for the quantification of the MAS, which could provide greater resolution and could eventually guide better informed therapeutic interventions...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28188024/robotic-assisted-gait-training-improves-walking-abilities-in-diplegic-children-with-cerebral-palsy
#19
L Wallard, G Dietrich, Y Kerlirzin, J Bredin
The robotic-assisted gait training therapy (RAGT), based on intensity and repetition of movement, presents beneficial effects on recovery and improvement of postural and locomotor functions of the patient. This study sought to highlight the effect of this RAGT on the dynamic equilibrium control during walking in children with Cerebral Palsy (CP) by analyzing the different postural strategies of the fullbody (upper/lower body) before and after this RAGT in order to generate forward motion while maintaining balance...
May 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28174188/cervical-spine-arteriovenous-fistula-associated-with-hereditary-haemorrhagic-telangiectasia
#20
Iain John McGurgan, Roisin Lonergan, Ronan Killeen, Christopher McGuigan
Reported is a case of a man aged 55 years who presented with progressive spastic paraparesis. Examination demonstrated multiple cutaneous telangiectases. Subsequent development of upper limb weakness, acute urinary retention and eventual respiratory compromise resulted in the requirement for intensive care unit admission and mechanical ventilation. MRI spine revealed diffuse T2 hyperintensity in the cervical cord with enhancement and cord expansion. Immunomodulatory therapy for a presumed diagnosis of transverse myelitis yielded no response, so a vascular aetiology was suspected...
February 7, 2017: BMJ Case Reports
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