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1.
J Anat ; 237(3): 427-438, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32786168

RESUMEN

Trunk muscles in vertebrates are classified as either dorsal epaxial or ventral hypaxial muscles. Epaxial and hypaxial muscles are defined as muscles innervated by the dorsal and ventral rami of spinal nerves, respectively. Each cluster of spinal motor neurons passing through dorsal rami innervates epaxial muscles, whereas clusters traveling on the ventral rami innervate hypaxial muscles. Herein, we show that some motor neurons exhibiting molecular profiles for epaxial muscles follow a path in the ventral rami. Dorsal deep-shoulder muscles and some body wall muscles are defined as hypaxial due to innervation via the ventral rami, but a part of these ventral rami has the molecular profile of motor neurons that innervate epaxial muscles. Thus, the epaxial and hypaxial boundary cannot be determined simply by the ramification pattern of spinal nerves. We propose that, although muscle innervation occurs via the ventral rami, dorsal deep-shoulder muscles and some body wall muscles represent an intermediate group that lies between epaxial and hypaxial muscles.


Asunto(s)
Neuronas Motoras/citología , Músculo Esquelético/inervación , Somitos/inervación , Nervios Espinales/embriología , Animales , Tipificación del Cuerpo , Embrión de Pollo , Coturnix , Músculo Esquelético/embriología , Tubo Neural , Somitos/embriología , Torso/embriología , Torso/inervación
2.
Int Biomech ; 7(1): 66-75, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33998388

RESUMEN

Psychological pressure during sports competition disturbs the ideal physical movement and causes injury. Baseball batting frequently causes trunk injuries. This study aimed to examine the influence of psychological pressure on the lumbar kinematics and trunk muscle activity during the baseball batting. Fourteen collegiate baseball players participated in this study. The participants performed bat swings under three different psychological conditions (non-pressure, pressure, and emphasized pressure). The lumbar kinematics and trunk muscle activity were measured during each bat swing. One- and two-way analyses of variance were performed to compare the lumbar kinematics and trunk muscle activity among different psychological pressure conditions. The lumbar flexion angle throughout the bat swing in the swing phase, from the moment of ground contact of the lead foot to the moment of ball contact, was significantly larger under the pressure and emphasized pressure conditions than under the non-pressure condition (P<0.05). The bilateral lumbar erector spinae (LES) activities in the swing and follow-through phases were significantly higher under the emphasized pressure condition than under the non-pressure condition (P<0.05). These results indicate that the baseball batting under psychological pressure influenced the lumbar kinematics and bilateral LES activities and may be related to the development of low back pain.


Asunto(s)
Atletas/psicología , Béisbol/psicología , Dolor de la Región Lumbar/fisiopatología , Región Lumbosacra/fisiopatología , Estrés Psicológico/fisiopatología , Torso/fisiopatología , Análisis de Varianza , Béisbol/fisiología , Fenómenos Biomecánicos , Pie/inervación , Pie/fisiología , Humanos , Dolor de la Región Lumbar/etiología , Dolor de la Región Lumbar/psicología , Región Lumbosacra/inervación , Masculino , Músculo Esquelético/inervación , Músculo Esquelético/fisiología , Estrés Psicológico/complicaciones , Torso/inervación , Adulto Joven
3.
J Stroke Cerebrovasc Dis ; 28(4): 994-1000, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30612892

RESUMEN

BACKGROUND: Trunk-activating exercises for balance are important because trunk weakness is relevant to the functional performance of individuals with stroke. This study aimed to explore the effects of three-dimensional balance training using visual feedback on balance and walking ability in subacute stroke patients. METHODS: Twenty-four participants with subacute stroke were randomly assigned to the experimental or control group. Each group underwent twenty sessions (30 min/day, 5 days/week for 4 weeks). Patients were assessed using the Berg balance scale, gait parameters (gait speed, cadence, step length, and double-limb support period) using GAITRite, and activity-specific balance confidence score, before and after the intervention. RESULTS: The three-dimensional balance training using visual feedback exhibited greater changes in the Berg balance scale, gait speed, cadence, step length, double-limb support period, and activity-specific balance confidence compared with the control group. Statistical analyses showed significant differences in Berg balance scale (P = .012; 95% CI, 2.585-6.415), gait speed (P = .001; 95% CI, .079-.155), cadence (P = .001; 95% CI, 1.622-4.392), step length (P = .003; 95% CI, 1.864-3.908), double-limb support period (P = .003; 95% CI, -3.259 to -0.761) and activity-specific confidence (P = .008; 95% CI, 6.964-14.036) between groups. CONCLUSION: Three-dimensional balance training using visual feedback may be more effective than conventional training in improving balance, walking ability, and activity-specific balance confidence in patients with subacute stroke.


Asunto(s)
Terapia por Ejercicio/métodos , Retroalimentación Sensorial , Trastornos Neurológicos de la Marcha/rehabilitación , Marcha , Equilibrio Postural , Trastornos de la Sensación/rehabilitación , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Torso/inervación , Adulto , Femenino , Análisis de la Marcha , Trastornos Neurológicos de la Marcha/diagnóstico , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Recuperación de la Función , República de Corea , Trastornos de la Sensación/diagnóstico , Trastornos de la Sensación/etiología , Trastornos de la Sensación/fisiopatología , Método Simple Ciego , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Percepción Visual
4.
Exp Brain Res ; 237(1): 223-236, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30377711

RESUMEN

Reaching for an object is a basic motor skill that requires precise coordination between elbow, shoulder and trunk motion. The purpose of this research study was to examine age-related differences in compensatory arm-trunk coordination during trunk-assisted reaching. To engage the arm and trunk, an older and younger group of participants were asked to (1) maintain a fixed hand position while flexing forward at the trunk [stationary hand task (SHT)] and (2) reach to a within-arm's reach target while simultaneously flexing forward at the trunk [reaching hand task (RHT)] (Raptis et al. in J Neurophysiol 97:4069-4078, 2007; Sibindi et al. in J Vestib Res 23:237-247, 2013). Both tasks were completed with eyes closed. Participants completed the two tasks with their dominant and non-dominant arms, and at both a fast and a preferred speed. On average, young and older participants performed in a similar manner in the SHT, such that they maintained their hand position by compensating for trunk movement with modifications of the elbow and shoulder joints. In the RHT, young and older participants had similar endpoint accuracy. This similarity in performance between young and older participants in the SHT and RHT tasks was observed regardless of the arm used or movement speed. However, for both tasks, movements in older adults were significantly more variable compared to younger adults as shown by the larger variability in arm-trunk coordination performance (gain scores) in the SHT and higher movement time variability in the RHT. Thus, results imply that older adults maintain their ability to coordinate arm and trunk movements efficiently during reaching actions but are not as consistent as younger adults.


Asunto(s)
Envejecimiento/fisiología , Brazo/fisiología , Movimiento/fisiología , Desempeño Psicomotor/fisiología , Rango del Movimiento Articular/fisiología , Torso/fisiología , Adulto , Anciano , Análisis de Varianza , Brazo/inervación , Femenino , Lateralidad Funcional , Humanos , Masculino , Torso/inervación , Adulto Joven
5.
Musculoskelet Sci Pract ; 39: 45-50, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30476827

RESUMEN

BACKGROUND: Decreased neck motion and sensorimotor deficits have been identified in those with neck pain. It is thought that these might be related to altered reflex mechanisms between the neck, eyes and the vestibular system. Trunk, head co-ordination might also be altered in neck pain. OBJECTIVES: This study investigated trunk head co-ordination ability in subjects with neck pain compared to asymptomatic controls. METHOD: Twenty-four subjects with persistent neck pain and twenty-six age and gender matched healthy controls performed 3 trials of 3 trunk movements whilst trying to keep the head still - (1) alternate trunk movement to the left and right (2) trunk movement to the left (3) trunk movement to the right. Wireless motion sensors positioned over the sternum and the forehead measured trunk and head range and velocity of motion. ANALYSIS: ANOVA was used to compare trunk and head range and velocity of motion during the 3 tasks. RESULTS: Neck pain subjects had significantly less trunk movement (p < 0.05) and velocity (p=<0.02) as well as significantly increased head movement (p=<0.03) during most tasks compared to control subjects. DISCUSSION: The results of the study suggest that neck pain subjects have difficulty moving their trunk independently of their head. They are less able to keep the head still while moving the trunk and perform the tasks more slowly. These findings might be related to altered reflex activity of the cervico-collic reflex and sensorimotor control. Further research is required.


Asunto(s)
Movimientos de la Cabeza/fisiología , Cabeza/fisiología , Dolor de Cuello/fisiopatología , Cuello/fisiología , Desempeño Psicomotor , Torso/fisiología , Adulto , Análisis de Varianza , Estudios de Casos y Controles , Femenino , Cabeza/inervación , Humanos , Masculino , Percepción de Movimiento/fisiología , Actividad Motora , Cuello/inervación , Músculos del Cuello/inervación , Propiocepción/fisiología , Reflejo/fisiología , Torso/inervación
6.
Somatosens Mot Res ; 35(3-4): 178-182, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30592431

RESUMEN

PURPOSE: The frequency of chewing disorders increases with decreasing level of gross motor function in children with cerebral palsy (CP). Besides its frequency, the severity of chewing disorders is also important. The aim of this study was to determine the relationship between chewing performance level and gross motor function, and trunk postural control in children with CP. MATERIALS AND METHODS: The study included 119 children with CP (age 2-10 years). Chewing performance level was determined by the Karaduman Chewing Performance Scale (KCPS). The Gross Motor Function Classification System (GMFCS) was used to determine the level of gross motor function. Segmental Assessment of Trunk Control (SATCo) was used to measure trunk control. RESULTS: Children with spastic CP with a median age of 4 years were evaluated, of which 50.4% were male. The percentages of patients classified to GMFCS levels I to V were 43.7%, 6.7%, 9.2%, 5.0%, and 35.3%, respectively. The median KCPS score was 3 (min = 0, max = 4). A good correlation was found between KCPS and GMFCS (p < .001, r = 0.70). Negative, excellent correlations between KCPS and SATCo static, SATCo active, and SATCo reactive postural controls were found (p < .001, r = -0.75, r = -0.77, r = -0.79; respectively). CONCLUSIONS: The severity of chewing disorders is related to the level of gross motor function and trunk postural control in children with CP. Clinical trial number: NCT03241160.


Asunto(s)
Parálisis Cerebral/complicaciones , Masticación/fisiología , Trastornos del Movimiento/etiología , Torso/inervación , Niño , Preescolar , Correlación de Datos , Femenino , Humanos , Masculino , Índice de Severidad de la Enfermedad
7.
Top Stroke Rehabil ; 25(8): 561-568, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30281417

RESUMEN

OBJECTIVES: Weight-bearing (WB) on the lower extremities is an important outcome parameter in the rehabilitation of poststroke hemiparesis. However, the patients often regain this ability by compensatory movement patterns. METHODS: Our goal was to characterize with a simple method the trunk alignment of healthy subjects and stroke patients (n = 17 for both groups) during standing and following lateral weight shift (WS). To describe trunk alignment, five markers were placed on the subjects' back, and the angles of the trunk at both sides were defined by the lines drawn from the posterior angle of the acromion and the iliac crest on the same body side to the seventh thoracic spinal process. Weight distributions on the lower extremities during standing and lateral WS were determined with a force platform. RESULTS: The patients had significantly limited WB capacity on their paretic limb, which was accompanied with significant asymmetry in the trunk alignment during standing and following WS to the paretic side. DISCUSSION: Our results show that this patient population tends to use abnormal compensatory movement patterns to optimize weight shifting, and changes of trunk alignment play a key role in this. This should be taken into consideration during rehabilitation.


Asunto(s)
Equilibrio Postural/fisiología , Posición de Pie , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/fisiopatología , Torso/inervación , Soporte de Peso , Correlación de Datos , Femenino , Humanos , Extremidad Inferior/fisiopatología , Masculino , Persona de Mediana Edad
8.
Complement Ther Med ; 40: 61-63, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30219470

RESUMEN

BACKGROUND: Pilates exercises help stabilize the vertebral segments by recruiting the abdominal and spinal muscles. Pilates training may increase joint stability and improve neuromuscular efficiency (NME). OBJECTIVE: This study aimed to evaluate NME of the multifidus (MU) muscle through electromyography (EMG) analysis and torque test, applied to practitioners and non-practitioners of Pilates. METHODS: Participants included thirty women: Pilates practitioners (n = 15) and non-practitioners (n = 15). They were tested for trunk extension. Their right and left MU muscles were submitted to EMG to estimate NME. Results concerning torque, EMG, and NME from all participants were compared. RESULTS: Statistical analysis concerning isometric torque peak (p = 0.0275) and NME (p = 0.0062) showed significant difference (Student t test; p < 0.05) between practitioners and control. No significant difference (p = 0.3387) in EMG was observed. CONCLUSION: Our results suggest Pilates exercises is effective in training spinal muscles to improve NME in women.


Asunto(s)
Técnicas de Ejercicio con Movimientos , Personal de Salud/estadística & datos numéricos , Músculos Paraespinales/inervación , Músculos Paraespinales/fisiología , Adulto , Electromiografía , Femenino , Humanos , Torque , Torso/inervación , Torso/fisiología , Adulto Joven
9.
Top Stroke Rehabil ; 25(6): 424-431, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30028661

RESUMEN

Background Stroke represents the largest cause of chronic disability resulting in muscle weakness and instability in the trunk muscles. Despite the reliable measures from isokinetic devices for upper/lower limb muscles, there is a lack of measures for trunk muscles in post-stroke hemiparesis. Objectives To investigate the reliability of the strength and endurance measures from an isokinetic dynamometer for able-bodied and post-stroke hemiparesis people. Methods The measures were taken from both groups (control/hemiparesis) performing antagonistic movements (flexion/extension) during different protocols (seated-compressed and semi-standing) to assess strength (60º/s) and endurance (120º/s). The intra-class correlation coefficient (ICC) and limits of agreement (LOA) defined the quality and magnitude of reliability on the measurements plotted with 95% confidence interval (95% CI) by Bland-Altman method. Results ICC ranged from 0.58 to 0.99, with few ICC values classified as moderate when repeated by raters during test and a single value during retest. The total work was the only variable to present LOA higher than the limits. Conclusion Results indicate acceptable reliability, in two different protocols, confirming the repeatability of the isokinetic measures for trunk muscles in able-bodied and post-stroke hemiparesis.


Asunto(s)
Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Paresia/rehabilitación , Resistencia Física/fisiología , Torso/inervación , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dinamómetro de Fuerza Muscular , Paresia/etiología , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Accidente Cerebrovascular/complicaciones
10.
Parkinsonism Relat Disord ; 52: 1-5, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29907329

RESUMEN

INTRODUCTION: Camptocormia is characterized by a pathological forward flexion of the trunk, which is reversible when lying and worsened by standing and walking. So far there is no consensus on how to measure the angle of flexion, and studies therefore give differing results. Harmonization is needed for both research and clinical practice. Orthopedic measures are not useful for this purpose. METHODS: Two expert raters independently analyzed the photographs of 39 Parkinson patients with camptocormia while standing. They used four different methods to determine the camptocormia angle. The results were compared statistically. An international Consensus Group reviewed the results and drafted recommendations. RESULTS: The four methods yielded camptocormia angles that differed by up to 50% in the same patient. Inter-rater reliability and test-retest reliability also differed, but were satisfactory to excellent. CONCLUSION: This Consensus Group concluded that two of the methods qualified as reliable measures of the trunk angles in standing patients based on their clinimetric properties. They propose that the 'total camptocomia angle' be the angle between the line from the lateral malleolus to the L5 spinous process and the line between the L5 spinous process and the spinous process of C7. They also propose that the 'upper camptocormia angle' be the angle of the lines between the vertebral fulcrum to the spinous processes of L5 and C7, respectively. An app is provided on the web for these measurements (http://www.neurologie.uni-kiel.de/de/axial-posturale-stoerungen/camptoapp).


Asunto(s)
Consenso , Atrofia Muscular Espinal/diagnóstico , Atrofia Muscular Espinal/fisiopatología , Curvaturas de la Columna Vertebral/diagnóstico , Curvaturas de la Columna Vertebral/fisiopatología , Posición de Pie , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Masculino , Enfermedad de Parkinson/complicaciones , Rango del Movimiento Articular/fisiología , Índice de Severidad de la Enfermedad , Torso/inervación
11.
J Neurophysiol ; 120(5): 2595-2602, 2018 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-29847230

RESUMEN

A voluntary contraction of muscles with one arm increases the excitability of corticospinal projections to the contralateral resting arm, a phenomenon known as crossed facilitation. Although many motor tasks engage simultaneous activation of the arm and trunk, interactions between corticospinal projections targeting these segments remain largely unknown. Using transcranial magnetic stimulation over the trunk representation of the primary motor cortex, we examined motor-evoked potentials (MEPs) in the resting erector spinae (ES) muscle when the contralateral arm remained at rest or performed 20% of isometric maximal voluntary contraction (MVC) into index finger abduction, thumb abduction, elbow flexion, and elbow extension. We found that MEP size in the ES increased during all voluntary contractions, with greater facilitation occurring during elbow flexion and index finger abduction. To further examine the origin of changes in MEP size, we measured short-interval intracortical inhibition (SICI) and cervicomedullary MEPs (CMEPs) in the ES muscle during elbow flexion and index finger abduction and when the arm remained at rest. Notably, SICI decreased and CMEPs remained unchanged in the ES during both voluntary contractions compared with rest, suggesting a cortical origin for the effects. Our findings reveal crossed facilitatory interactions between trunk extensor and proximal and distal arm muscles, particularly for elbow flexor and index finger muscles, likely involving cortical mechanisms. These interactions might reflect the different role of these muscles during functionally relevant arm and trunk movements. NEW & NOTEWORTHY Many of the tasks of daily life involve simultaneous activation of the arm and trunk. We found that responses in the erector spinae muscles evoked by motor cortical stimulation increased in size during elbow flexion and extension and during index finger abduction and thumb abduction. Crossed facilitation with the trunk was more pronounced during elbow flexion and index finger abduction. These results might reflect the different role of these muscles during arm and trunk movements.


Asunto(s)
Brazo/fisiología , Corteza Motora/fisiología , Músculo Esquelético/fisiología , Tractos Piramidales/fisiología , Torso/fisiología , Adulto , Brazo/inervación , Potenciales Evocados Motores , Femenino , Humanos , Contracción Isométrica , Masculino , Corteza Motora/diagnóstico por imagen , Movimiento , Músculo Esquelético/inervación , Torso/inervación
12.
J Clin Neurophysiol ; 35(2): 130-132, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29112523

RESUMEN

INTRODUCTION: The authors compared the electrophysiological results of the frontal branch over the main trunk stimulation of the facial nerve in normal subjects. METHODS: Nerve conduction studies of the main trunk and frontal branch of the facial nerve were performed on both sides of 31 healthy subjects, recording the compound muscle action potential (CMAP) from the frontalis muscle. RESULTS: A good quality CMAP was obtained in all subjects after stimulation of the frontal branch, but only in 64.5% of nerves after stimulation of the main trunk of the facial nerve. Furthermore, nerve conduction studies of the frontal branch required less intense stimuli and were better tolerated. CONCLUSIONS: The authors suggest that stimulation of the frontal branch is a simple, reliable and well-tolerated technique to evaluate the facial nerve.


Asunto(s)
Estimulación Eléctrica/métodos , Potenciales Evocados Motores/fisiología , Músculos Faciales/fisiología , Nervio Facial/fisiología , Conducción Nerviosa/fisiología , Adulto , Anciano , Biofisica , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Torso/inervación
13.
Top Stroke Rehabil ; 25(2): 96-113, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29078743

RESUMEN

Background Compensatory movements are commonly employed by stroke survivors, and their use can have negative effects on motor recovery. Current practices to reduce them rely on strapping a person to a chair. The use of technology to substitute or supplement this methodology has not being thoroughly investigated. Objective To compare the use of Scores + Visual + Force and Visual + Force feedback for reducing trunk compensation. Methods Fourteen hemiparetic stroke survivors performed bimanual reaching movements while receiving feedback on trunk compensation. Participants held onto two robotic arms and performed movements in the anterior/posterior direction toward a target displayed on a monitor. A motion-tracking camera tracked trunk compensation; the robots provided force feedback; the monitor displayed the visual feedback and scores. Kinematic variables, a post-test questionnaire, and system usability were analyzed. Results Both conditions reduced trunk compensation from baseline: Scores + Visual + Force: 51.7% (40.8), p = 0.000; Visual + Force: 55.2% (40.9), p = 0.000. No statistically significant difference was found between modalities. Secondary outcome measures were not improved. Most participants would like to receive game scores to reduce trunk compensation, and the usability of the system was rated "Good." Conclusions Multimodal feedback about stroke survivors' trunk compensation levels resulted in reduced trunk displacement. No difference between feedback modalities was obtained. The positive effects of including game scores might not have been observed in a short-term intervention. Longer studies should investigate if the use of game scores could result in trunk compensation improvements when compared to trunk restraint strategies. Clinical Trial Registration Clinicaltrials.gov, NCT02912923, https://clinicaltrials.gov/ct2/show/NCT02912923?term=reaching+in+stroke&rank=2 .


Asunto(s)
Adaptación Fisiológica , Biorretroalimentación Psicológica/métodos , Juegos Experimentales , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/fisiopatología , Torso/inervación , Adulto , Anciano , Fenómenos Biomecánicos , Estudios Cruzados , Femenino , Lateralidad Funcional , Humanos , Masculino , Persona de Mediana Edad , Desempeño Psicomotor/fisiología , Índice de Severidad de la Enfermedad
14.
Exp Brain Res ; 236(2): 619-628, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29279981

RESUMEN

Studies examining recovery from SLIPS and TRIPS indicate higher incidence of falls during SLIPS than TRIPS however, differences in the recovery mechanisms during these opposing perturbations have not been examined. We therefore aimed to compare the reactive balance responses contributing to fall risk during SLIPS and TRIPS at comparable perturbation intensity among community-dwelling healthy adults and chronic stroke survivors. Younger adults (N = 11), age-matched adults (N = 11) and chronic stroke survivors (N = 12) were exposed to a single SLIP and TRIP through a motorized treadmill (16 m/s2, 0.20 m). Center of mass (COM) state stability was measured by recording COM position and velocity relative to base of support, i.e., D COM/BOS and X COM/BOS, respectively. Trunk and compensatory step kinematics were also recorded. During SLIPS, the incidence of falls among stroke survivors was greater than healthy adults (53.83% vs. 0%), however not for TRIPS. All groups showed higher change in postural stability from liftoff to touchdown during TRIPS than SLIPS. Among healthy adults higher change in D COM/BOS during TRIPS was accompanied by the ability to control trunk flexion at step touchdown and lower peak trunk velocity as compared with SLIPS, with no significant differences in compensatory step length between the perturbations (p > 0.05). Chronic stroke survivors increased compensatory step length during TRIPS versus SLIPS (p < 0.05) contributing to greater stability change. They were unable to control trunk excursion and peak trunk velocity as compared with the healthy adults leading to lower stability than healthy younger and age-matched adults during SLIPS and lower stability than younger adults during TRIPS. Difficulty in trunk control during SLIPS among all individuals and compensatory step length  among stroke survivors emphasizes higher fall risk for SLIPS than TRIPS among these populations.


Asunto(s)
Accidentes por Caídas , Equilibrio Postural/fisiología , Postura/fisiología , Accidente Cerebrovascular/fisiopatología , Sobrevivientes , Adulto , Anciano , Análisis de Varianza , Fenómenos Biomecánicos , Estudios de Casos y Controles , Enfermedad Crónica , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Torso/inervación , Adulto Joven
15.
Biomed Res Int ; 2017: 7920438, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29226148

RESUMEN

Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described. Here we describe ultrasound-guided methods for hydrodissection of deep nerve structures in the upper torso, including the stellate ganglion, brachial plexus, cervical nerve roots, and paravertebral spaces. We retrospectively reviewed the outcomes of 100 hydrodissection treatments in 26 consecutive cases with a neuropathic pain duration of 16 ± 12.2 months and the mean Numeric Pain Rating Scale (NPRS) 0-10 pain level of 8.3 ± 1.3. The mean percentage of analgesia during each treatment session involving D5W injection without anesthetic was 88.1% ± 9.8%. The pretreatment Numeric Pain Rating Scale score of 8.3 ± 1.3 improved to 1.9 ± 0.9 at 2 months after the last treatment. Patients received 3.8 ± 2.6 treatments over 9.7 ± 7.8 months from the first treatment to the 2-month posttreatment follow-up. Pain improvement exceeded 50% in all cases and 75% in half. Our results confirm the analgesic effect of D5W injection and suggest that hydrodissection using D5W provides cumulative pain reduction.


Asunto(s)
Analgésicos/administración & dosificación , Dolor/tratamiento farmacológico , Torso/inervación , Agua/administración & dosificación , Anestesia de Conducción/métodos , Femenino , Humanos , Inyecciones/métodos , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/métodos , Tejido Nervioso/efectos de los fármacos , Estudios Retrospectivos , Ultrasonografía/métodos
16.
Neuroscience ; 358: 37-48, 2017 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-28663091

RESUMEN

The current decerebration procedures discard the role of the thalamus in the motor control and decortication only rules out the brain cortex part, leaving a gap between the brain cortex and the subthalamic motor regions. In here we define a new preparation denominated Brain Cortex-Ablated Cat (BCAC), in which the frontal and parietal brain cortices as well as the central white matter beneath them were removed, this decerebration process may be considered as suprathalamic, since the thalamus remained intact. To characterize this preparation cat hindlimb electromyograms (EMG), kinematics and cutaneous reflexes (CR) produced by electrical stimulation of sural (SU) or saphenous (SAPH) nerves were analyzed during locomotion in intact and in BCAC. In cortex-ablated cats compared to intact cats, the hindlimb EMG amplitude was increased in the flexors, whereas in most extensors the amplitude was decreased. Bifunctional muscle EMGs presented complex and speed-dependent amplitude changes. In intact cats CR produced an inhibition of extensors, as well as excitation and inhibition of flexors, and a complex pattern of withdrawal responses in bifunctional muscles. The same stimuli applied to BCAC produced no detectable responses, but in some cats cutaneous reflexes produced by electrical stimulation of saphenous nerve reappeared when the locomotion speed increased. In BCAC, EMG and kinematic changes, as well as the absence of CR, imply that for this cat preparation there is a partial compensation due to the subcortical locomotor apparatus generating close to normal locomotion.


Asunto(s)
Corteza Cerebral/fisiología , Decorticación Cerebral , Potenciales Evocados Motores/fisiología , Locomoción/fisiología , Reflejo/fisiología , Animales , Fenómenos Biomecánicos , Gatos , Electromiografía , Músculo Esquelético/fisiología , Torso/inervación
17.
Plast Reconstr Surg ; 140(4): 747-756, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28609352

RESUMEN

BACKGROUND: Upper trunk obstetric brachial plexus injury can cause profound shoulder and elbow dysfunction. Although neuroma excision with interpositional sural nerve grafting is the current gold standard, distal nerve transfers have a number of potential advantages. The goal of this study was to compare the clinical outcomes and health care costs between nerve grafting and distal nerve transfers in children with upper trunk obstetric brachial plexus injury. METHODS: In this prospective cohort study, children who underwent triple nerve transfers were followed with the Active Movement Scale for 2 years. Their outcomes were compared to those of children who underwent nerve graft reconstruction. To assess health care use, a cost analysis was also performed. RESULTS: Twelve patients who underwent nerve grafting were compared to 14 patients who underwent triple nerve transfers. Both groups had similar baseline characteristics and showed improved shoulder and elbow function following surgery. However, the nerve transfer group displayed significantly greater improvement in shoulder external rotation and forearm supination 2 years after surgery (p < 0.05). The operative time and length of hospital stay were significantly lower (p < 0.05), and the overall cost was approximately 50 percent less in the nerve transfer group. CONCLUSION: Triple nerve transfer for upper trunk obstetric brachial plexus injury is a feasible option, with better functional shoulder external rotation and forearm supination, faster recovery, and lower cost compared with traditional nerve graft reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Asunto(s)
Traumatismos del Nacimiento/cirugía , Neuropatías del Plexo Braquial/cirugía , Plexo Braquial/lesiones , Transferencia de Nervios/métodos , Procedimientos de Cirugía Plástica/métodos , Nervio Sural/trasplante , Torso/inervación , Plexo Braquial/cirugía , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Estudios Prospectivos , Recuperación de la Función/fisiología , Resultado del Tratamiento
18.
Top Stroke Rehabil ; 24(6): 457-462, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28335701

RESUMEN

BACKGROUND: The use of a whole-body vibration (WBV) therapy has recently been applied and investigated as a rehabilitation method for subacute stroke patients. OBJECTIVE: To evaluate the effects of a WBV therapy on recovery of balance in subacute stroke patients who were unable to gain sitting balance. METHODS: The conventional rehabilitation group (CG) received conventional physical therapy, including sitting balance training by a physical therapist, for 30 min a one session, for twice a day for five days a week for two weeks. The whole-body vibration group (VG) received one session of conventional physical therapy, and received WBV therapy instead of conventional physical therapy for 30 min a day for five days a week for two weeks. RESULTS: There were 15 patients in the CG and 15 patients in the VG who completed the two-week therapy. After the two-week therapy, both groups showed functional improvement. Patients in the VG improved functional ambulation categories, Berg balance scale, trunk impairment scale scores. But, no statistically significant correlations between the therapeutic methods and outcomes were observed in either group. CONCLUSION: Our results suggest that WBV therapy led to improvement of the recovery in balance recovery for subacute stroke patients. Because the WBV therapy was as effective as conventional physical therapy, we can consider a WBV therapy as a clinical method to improve the sitting balance of subacute stoke patients.


Asunto(s)
Equilibrio Postural/fisiología , Trastornos de la Sensación/etnología , Trastornos de la Sensación/rehabilitación , Accidente Cerebrovascular/complicaciones , Torso/inervación , Vibración/uso terapéutico , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Manipulaciones Musculoesqueléticas , Recuperación de la Función/fisiología , Estadísticas no Paramétricas , Resultado del Tratamiento
19.
Exp Brain Res ; 235(4): 995-1005, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28028583

RESUMEN

One of the most immediate and overt ways in which people respond to music is by moving their bodies to the beat. However, the extent to which the rhythmic complexity of groove-specifically its syncopation-contributes to how people spontaneously move to music is largely unexplored. Here, we measured free movements in hand and torso while participants listened to drum-breaks with various degrees of syncopation. We found that drum-breaks with medium degrees of syncopation were associated with the same amount of acceleration and synchronisation as low degrees of syncopation. Participants who enjoyed dancing made more complex movements than those who did not enjoy dancing. While for all participants hand movements accelerated more and were more complex, torso movements were more synchronised to the beat. Overall, movements were mostly synchronised to the main beat and half-beat level, depending on the body-part. We demonstrate that while people do not move or synchronise much to rhythms with high syncopation when dancing spontaneously to music, the relationship between rhythmic complexity and synchronisation is less linear than in simple finger-tapping studies.


Asunto(s)
Percepción de Movimiento/fisiología , Movimiento/fisiología , Música , Periodicidad , Desempeño Psicomotor/fisiología , Síncope/fisiopatología , Estimulación Acústica , Adulto , Baile , Femenino , Mano/fisiología , Humanos , Masculino , Torso/inervación , Adulto Joven
20.
Klin Khir ; (1): 61-3, 2017.
Artículo en Ucraniano | MEDLINE | ID: mdl-30272922

RESUMEN

Results of 242 patients treatment, suffering the trunk and extremities covering tissues defects, which have had occur as a consequence of mechanical injury in a 2008 ­ 2016 yrs period, were analyzed. There were 697 оperative interventions performed, of them 492 (70.6%) ­ aiming to restore the tissues injured. The choice of method of the correcting intervention and the tissues defects covering have depended upon the wound dimension and depth, as well as peculiarities of hemodynamics in the area injured. Application of differentiated approach to choice of method for the wound surfaces closure, which were created as a consequence of mechanical injury, have had permitted to achieve satisfactory results in 98.75% of patients.


Asunto(s)
Procedimientos Quirúrgicos Dermatologicos/métodos , Extremidades/cirugía , Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Torácicos/métodos , Torso/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Traumatismos del Brazo/patología , Traumatismos del Brazo/cirugía , Extremidades/irrigación sanguínea , Extremidades/lesiones , Extremidades/inervación , Femenino , Fracturas Óseas/patología , Fracturas Óseas/cirugía , Hemodinámica , Humanos , Traumatismos de la Pierna/patología , Traumatismos de la Pierna/cirugía , Masculino , Traumatismo Múltiple/patología , Traumatismo Múltiple/cirugía , Medicina de Precisión , Traumatismos de los Tejidos Blandos/patología , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos , Traumatismos Torácicos/patología , Traumatismos Torácicos/cirugía , Torso/irrigación sanguínea , Torso/lesiones , Torso/inervación
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