Descripción de la afectación de la destreza y función manual en pacientes con distonía focal de la mano / Alterations in dexterity and manual function in patients with focal hand dystonia

Introducción: La distonía focal de la mano es un trastorno del movimiento cuya sintomatología produce una alteración en el desempeño de tareas que requieren un nivel de destreza alto. Actualmente no se dispone de un modelo de interpretación de la enfermedad y son escasos los estudios que identifican las dificultades de las personas con distonía al desempeñar las actividades de la vida diaria (AVD). Por todo ello, el objetivo del estudio es describir la destreza manipulativa y su influencia en las AVD de los pacientes con distonía focal de la mano.Material y métodoSe realizó un estudio observacional, transversal, tipo casos y controles. Se reclutaron 24 participantes: 12 pacientes y 12 sujetos control. Los pacientes fueron derivados por el Servicio de Neurología del Hospital Ramón y Cajal. Se obtuvieron datos sociodemográficos y clínicos retrospectivos en el grupo de casos. Posteriormente, se administraron pruebas de evaluación, en el siguiente orden: Nine Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT) y Jebsen-Taylor Test of Hand Function (JTTHF).ResultadosEn la muestra del estudio participaron un total de 24 personas, siete mujeres y 17 hombres, con una media de edad de 50,79 ± 14,40 años. Del total de participantes con distonía focal se observó que, aunque la mitad de la muestra no identificó signos de afectación neuromuscular, ni problemas psicoemocionales, un menor porcentaje de estos pacientes identificaron dificultades asociadas con el hombro derecho (25%) y el estado ansioso (33,3%).ConclusionesLos hallazgos encontrados en el presente trabajo señalan que la distonía focal de la mano afecta a la destreza manipulativa de estos pacientes, presentando una peor ejecución y requiriendo más tiempo para su ejecución. (AU)

Introduction: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia.Materials and methodsWe performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF).ResultsThe study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%).ConclusionsOur results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks. (AU)

Alterations in dexterity and manual function in patients with focal hand dystonia.

INTRODUCTION: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. MATERIALS AND METHODS: We performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). RESULTS: The study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). CONCLUSIONS: Our results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

Alterations in dexterity and manual function in patients with focal hand dystonia. / Descripción de la afectación de la destreza y función manual en pacientes con distonía focal de la mano.

INTRODUCTION: Focal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. MATERIALS AND METHODS: We performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). RESULTS: The study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). CONCLUSIONS: Our results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

[Effectiveness of the virtual reality in the rehabilitation of the upper limb in the spinal cord injury. A systematic review]. / Efectividad de la realidad virtual en la rehabilitacion del miembro superior en la lesion de la medula espinal. Revision sistematica.

INTRODUCTION: Spinal cord injury is a complex and life-disrupting condition. The functional recovery of the upper limb has been considered as an important objective in tetraplegia because it improves significantly the quality of living in these patients. Virtual reality is a new emerging tool of rehabilitation in spinal cord injured patients. AIM: To carry out a systematic review about the information about the application of these systems in spinal cord injury in the rehabilitation of the upper limb. PATIENTS AND METHODS: This review includes clinical trials dated until April 2018, which investigate the functional recovery of the upper limb through virtual reality systems in patients with complete or incomplete tetraplegia. The following databases were used to search for those clinical trials: Scopus, Web of Science, PubMed, Medline Complete, Science Direct, CINHAL and Brain. RESULTS: Five articles were selected for this review, including randomized clinical trials and clinical trials. The main results show a good tendency on the functional recovery with the combination of virtual reality systems and conventional therapy. CONCLUSIONS: The main limitations and the low quality of the studies show the necessity of further investigations with this new tool of rehabilitation. However, the incorporation of virtual reality systems as a rehabilitation supplement might be a beneficial tool on the functional recovery in spinal cord injury.

TITLE: Efectividad de la realidad virtual en la rehabilitacion del miembro superior en la lesion de la medula espinal. Revision sistematica.Introduccion. La lesion de la medula espinal es un estado funcional complejo que limita gravemente la vida de la persona. Por ello, la recuperacion de la funcionalidad del miembro superior en la tetraplejia se considera un objetivo primordial, ya que mejora significativamente la calidad de vida de estas personas. Ademas de las terapias convencionales, la realidad virtual supone un nuevo enfoque terapeutico en la rehabilitacion del lesionado medular. Objetivo. Realizar una revision sistematica sobre la efectividad de la rehabilitacion del miembro superior en pacientes con lesion medular a traves de la realidad virtual. Pacientes y metodos. Se recopilaron datos de ensayos clinicos hasta abril de 2018 que investigaran la rehabilitacion con sistemas de realidad virtual en los miembros superiores de pacientes con lesion medular completa e incompleta. Las bases de datos consultadas en esta revision incluyeron: Scopus, Web of Science, PubMed, Medline Complete, Science Direct, CINHAL y Brain. Resultados. Se analizaron cinco articulos, los cuales incluyeron ensayos controlados aleatorizados y ensayos clinicos. Los principales resultados de los estudios muestran buena tendencia de la rehabilitacion a traves de la realidad virtual en combinacion con terapia convencional. Conclusiones. Las limitaciones encontradas en los estudios, asi como su baja calidad metodologica, suponen la necesidad de mayores investigaciones acerca de la efectividad de esta nueva herramienta. Aun asi, la buena tendencia de los estudios se considera de interes para futuras investigaciones.

Eficacia de un programa intensivo de terapia ocupacional para niños amputados / Efficacy of an intensive occupational therapy programme for amputated children

Objetivo: Analizar si los niños con prótesis mioeléctricas pueden mejorar sus destrezas motoras necesarias para la realización de las actividades de la vida diaria (AVD) de manera independiente. Material y método: Se realizó un programa estructurado de terapia ocupacional, basado en actividades de coordinación motora fina y gruesa, así como un refuerzo constante de las AVD, durante 6 días en 10 niños amputados (4 chicos y 6 chicas) usuarios de prótesis mioeléctricas, con edades comprendidas entre 4-0 años. Se administró el Assessment of Process and Motor Skills (AMPS) para evaluar las destrezas motoras al inicio y al finalizar la estancia en el campamento. Resultados: En la primera valoración y en la segunda obtuvieron respectivamente los siguientes resultados por destrezas: alcanza (2,0-1,4), se inclina (1,8-1,2), manipula (2,1-1,6), coordina (2,3-2,0), mueve (2,1-1,7), posiciona (2,0-1,7), camina (1,2-1,1), transporta (1,7-1,6). Todos los participantes mejoraron en las habilidades referidas a la posición corporal, obtener y sujetar objetos, y movilización de si mismos y de los objetos. Conclusiones: Los programas intensivos de terapia ocupacional en los niños usuarios de prótesis mioeléctricas son eficaces, ya que mejoran la calidad en la realización de las AVD lo que redunda en la mejora de la autoestima y en la calidad de vida de los niños (AU)

Objective: To analyse myoelectric prostheses in amputated children on fulfilling activities of daily life (ADL) independently. Material and method: A structured occupational therapy programme was performed, based on fine and gross motor coordination activities as well as constant reinforcement of ADL for 6 days in 10 amputated children (4 boys and 6 girls) using myoelectric prostheses, aged within 4-0 years. The Assessment of Process and Motor Skills (AMPS) was administered to evaluate motor skills at the start and at the end of stay in the camp. Results: The following results were obtained in the first and the second assessment, by skills, respectively: reaches (2.0-1.4), bends (1.8-1.2), manipulates (2.1-1.6), coordinates (2.3-2.0), moves (2.1-1.7), positions (2.0- 1.7), walks (1.2-1.1), carries (1.7-1.6). All participants improved their skills referring to body position, obtaining and holding objects and moving themselves and objects. Conclusion: Invasive occupational therapy programmes in children using myoelectric prostheses are effective, as they improve quality in fulfilling ADL, leading to an improved self-esteem and quality of life of children (AU)