Retraso de la latencia de activación de los músculos de cadera y rodilla en individuos con acortamiento de la banda iliotibial / Latency delay of hip and knee muscles in individuals with iliotibial band tightness

Objetivo: Determinar la latencia de activación de los músculos de cadera y rodilla en participantes con acortamiento de la banda iliotibial (BIT). Material y método: Estudio de casos y controles. Doce participantes masculinos con acortamiento de la BIT y 12 participantes masculinos sin acortamiento de la BIT realizaron una prueba de alteración repentina de los miembros inferiores en dirección anterior, posterior, ipsolateral y contralateral. Se midió la latencia de activación electromiográfica del vasto medial (VM), vasto lateral (VL), tensor de la fascia lata (TFL) y glúteo mayor (GM) durante esta prueba. Se utilizó la prueba t de Student para comparar la latencia muscular entre los grupos. Se consideró un nivel alfa de 0,05. Resultados: Durante una desestabilización anterior se observó un aumento significativo de la latencia del VM (p = 0,0001), VL (p = 0,0163), GM (p = 0,0036) y TFL (p < 0,0001) en los participantes con acortamiento de la BIT. En una desestabilización posterior, se observó un aumento significativo de las latencias de activación de GM (p = 0,0001) y TFL (p < 0,0001) en individuos con acortamiento de la BIT. Durante una desestabilización contralateral a la extremidad evaluada, se observó un aumento de la latencia solo en el TFL (p < 0,0001) en participantes con acortamiento de la BIT. Conclusiones: Los individuos con acortamiento de la BIT presentan un retraso de la latencia de activación de los músculos de cadera y rodilla, principalmente del músculo TFL

Objective: To determinate the onset latency of the hip and knee muscles in participants with iliotibial band (ITB) tightness. Material and methods: A case-control study. Twelve male participants whit ITB tightness and 12 male participants without ITB tightness performed a sudden lower limbs perturbation in anterior, posterior, ipsolateral and contralateral direction. The electromyographic onset latencies of the medial vastus (VM), vastus lateralis (VL), tensor fascia lata (TFL) and gluteus maximus (GM) were measured during this test. The statistical analysis was performed with t-student test. Significance level was established a priori at P < .05. Results: A significant increase of the VM (P = .0001), VL (P = .0163), GM (P = .0036) and TFL (P < .0001) latency was observed in participants with ITB tightness during a sudden anterior perturbation. In a posterior perturbation, a significant increase in the GM (P = .0001) and TFL (P < .0001) latency was observed in participants with ITB tightness. A significant increase of the TFL (P < .0001) latency was observed in participants with ITB tightness during a contralateral limb evaluated perturbation. Conclusions: Individuals with ITB tightness present a delay of knee and hip muscles latencies, mainly the TFL muscle

Rigideces metacarpofalángicas en extensión. ¿Un desafío para el cirujano de mano? / Metacarpophalangeal joint stiffness. Still a challenge for the hand surgeon?

Objetivo. Analizar los resultados obtenidos en el tratamiento quirúrgico de la rigidez metacarpofalángica en extensión mediante tenoartrólisis dorsal en nuestro centro y revisar la literatura al respecto. Material y método. Estudio retrospectivo de 21 rigideces metacarpofalángicas intervenidas. En todos los pacientes se realizó tenoartrólisis dorsal de forma ambulatoria, comenzando la rehabilitación a los diez días postoperatorios. Se registró etiología, variación de la movilidad activa tras la cirugía, complicaciones, cuestionario DASH y una encuesta de satisfacción con el resultado. Resultados. El seguimiento medio fue de 6,5 años y la edad media de 36,5 años. La causa más frecuente fue la fractura de un metacarpiano (52,4%) seguida de los traumatismos complejos de antebrazo (19%). A final del seguimiento la mejoría en la movilidad activa fue de 30,5° pese a obtener una movilidad intraoperatoria de 0-90° en más del 80% de los casos. En el cuestionario DASH la puntuación media fue de 36,9, calificando el resultado como excelente el 10% de nuestros pacientes, bueno el 30%, regular el 40% y malo el 20% restante. En el 9,5% de los casos se produjo un síndrome de dolor regional complejo y en el 14,3% lesión de la musculatura intrínseca. Conclusión. Por su difícil abordaje y pobres resultados, el tratamiento quirúrgico de la rigidez metacarpofalángica en extensión es de gran dificultad mostrándose la tenoartrólisis dorsal como una técnica reproducible en relación con nuestros resultados y a los resultados publicados en la literatura (AU)

Objectives. The aim of this study is to analyse the outcomes of the surgical treatment of metacarpophalangeal stiffness by dorsal teno-arthrolysis in our centre, and present a review the literature. Material and methods. This is a retrospective study of 21 cases of metacarpophalangeal stiffness treated surgically. Dorsal teno-arthrolysis was carried out on all patients. A rehabilitation programme was started ten days after surgery. An evaluation was performed on the aetiology, variation in pre- and post-operative active mobility, complications, DASH questionnaire, and a subjective satisfaction questionnaire. Results. The mean age of the patients was 36.5 years and the mean follow-up was 6.5 years. Of the 21 cases, the most common cause was a metacarpal fracture (52.4%), followed by complex trauma of the forearm (19%). Improvement in active mobility was 30.5°, despite obtaining an intra-operative mobility 0-90° in 80% of cases. Mean DASH questionnaire score was 36.9 points. The outcome was described as excellent in 10% of our patients, good in 30%, poor in 40%, and bad in the remaining 20%. There was a complex regional pain syndrome in 9.5% of cases, and intrinsic muscle injury in 14.3%. Conclusion. Because of its difficult management and poor outcomes, surgical treatment of metacarpophalangeal stiffness in extension is highly complex, with dorsal teno-arthrolysis being a reproducible technique according to our results, and the results reported in the literature (AU)

Effects of power training in mechanical stiffness of the lower limbs in soccer players / / Efeitos do treinamento de potência sobre rigidez mecânica dos membros inferiores em atletas de futebol / / Efectos del entrenamiento de potencia sobre la rigidez mecánica de miembros inferiores en jugadores de fútbol

Objetivo. El objetivo de este estudio fue evaluar si la rigidez de la pierna (Kleg) cambia después de un período de entrenamiento de potencia. Métodos. Cuarenta jugadores profesionales de fútbol se dividieron en 2 grupos (20 se asignaron al grupo entrenado y 20 al grupo control). Se realizó un estudio cuasi-experimental con pre-post intervención para estimar Kleg antes (periodo 1) y después de 6 semanas de entrenamiento de potencia (período 2). Se cuantificó Kleg mediante la reconstrucción de imágenes en 3 dimensiones mientras los sujetos corrían en una cinta a 13 km/h. Se midieron las alturas de squat jumps (SJ) y countermovment jumps (CMJ) y se calculó el pre-stretch augmentation (PSA) antes y después del período de entrenamiento para ambos grupos. Resultados. Se encontró un aumento significativo en Kleg después del programa de entrenamiento. Se encontraron correlaciones lineales positivas entre Kleg y la altura de los SJ en ambos períodos para los 2 grupos, mientras que la altura CMJ no se correlacionó con Kleg únicamente en el grupo entrenado durante el periodo 2. No se encontraron relaciones significativas entre Kleg y PSA. Conclusiones. Llegamos a la conclusión de que Kleg puede cambiar significativamente como producto del entrenamiento de potencia. Basados en nuestros resultados y considerando estudios previos sugerimos que estos cambios podrían estar asociados principalmente con adaptaciones a nivel del control muscular (AU)

Objetivo. O objetivo deste estudo foi avaliar mudanças na rigidez da perna (Kleg) após um período de treinamento de potência. Método. Quarenta jogadores de futebol profissionais foram divididos em 2 grupos (foram designados 20 ao grupo treinado e 20 ao grupo controle). Se realizou um estudo quase experimental com uma intervenção pré/pós teste para estimar a Kleg antes (período 1) e após 6 semanas de treinamento de potência (período 2). A Kleg foi quantificada através de um método de filmagem tridimensional enquanto os sujeitos corriam em uma esteira a 13 km/h. Foram medidas as alturas nos testes squat jumps (SJ) e countermovment jumps (CMJ), e foi medido e calculado o aumento pré-estiramento (PSA), antes e depois do período de treinamento para ambos os grupos. Resultados. Foi encontrado um aumento significativo em Kleg após o programa de treinamento. Foi encontrado uma correlação linear positiva entre a Kleg e a altura do SJ em ambos os períodos para os dois grupos, enquanto a altura do CMJ somente não se correlacionou com a Kleg no grupo treinado durante o período 2. Não foram encontradas relações significativas entre a Kleg e o PSA. Conclusão. Chegamos à conclusão que a Kleg pode mudar significativamente como resultado ao treinamento de potencia de curta duração. Com base em nossos resultados e considerando estudos anteriores, sugerimos que estas alterações podem estar associadas, principalmente, com adaptações a nível de controle muscular (AU)

Objective. The aim of this study was evaluate whether leg stiffness (Kleg) changes after power training. Methods. Forty professional soccer players were divided into 2 groups (20 were assigned to the trained group and 20 to the control group). A quasi-experimental study with pre–post intervention was conducted to estimate Kleg before (period 1) and after a six-week period of power training (period 2). Leg stiffness was measured using a three-dimensional filming method while soccer players ran on a treadmill at 13 km/h. The heights of squat jumps (SJ) and countermovement jumps (CMJ) were measured and the pre-stretch augmentation (PSA) was calculated before and after the training period in both groups. Results. We found a significant increase in Kleg after the power training program. Significant positive linear relationships between Kleg and SJ height were found in both periods and groups, while CMJ height was not correlated with Kleg in the trained group during period 2. No significant relationships were found between Kleg and PSA in either case. Conclusions. We concluded that Kleg can change significantly after a short power training program. Based on our results and previous studies, we suggest that these changes could be mainly associated with adaptions at muscle control level (AU)

Interval training-induced alleviation of rigidity and hypertonia in patients with Parkinson's disease is accompanied by increased basal serum brain-derived neurotrophic factor.

OBJECTIVE: To examine the effects of cycloergometric interval training on parkinsonian rigidity, relaxed biceps brachii muscle tone in affected upper extremities, and serum level of brain-derived neurotrophic factor. DESIGN: Case series, repeated-measures design, pilot study. SUBJECTS/PATIENTS: Eleven patients with mild-to-moderate Parkinson's disease (Hoehn & Yahr scale 2.3 ± 0.72), recruited from a neurological clinic, underwent cycle training and were tested along with non-trained, healthy control subjects (n = 11) in a motor control laboratory. METHODS: Patients underwent 8 weeks of interval training (3 × 1-h sessions weekly, consisting of a 10-min warm-up, 40 min of interval exercise, and 10-min cool-down) on a stationary cycloergometer. Parkinsonian rigidity (Unified Parkinson's Disease-Rating-Scale) in the upper extremity, resting biceps brachii muscle tone (myometric stiffness and frequency), and brain-derived neurotrophic factor level were measured 1-3 days before interval training cycle started and 6-10 days after the last training session. RESULTS: Training resulted in a decrease in rigidity (p = 0.048) and biceps brachii myometric muscle stiffness (p = 0.030) and frequency (p = 0.006), and an increase in the level of brain-derived neurotrophic factor (p = 0.035) relative to pre-training values. The increase in brain-derived neurotrophic factor level correlated with improvements in parkinsonian rigidity (p = 0.025), biceps brachii myometric stiffness (p = 0.001) and frequency (p = 0.002). CONCLUSION: Training-induced alleviation of parkinsonian rigidity and muscle tone decrease may be associated with neuroplastic changes caused by a training-induced increase in the level of brain-derived neurotrophic factor.

Neural targets for relieving parkinsonian rigidity and bradykinesia with pallidal deep brain stimulation.

Clinical evidence has suggested that subtle changes in deep brain stimulation (DBS) settings can have differential effects on bradykinesia and rigidity in patients with Parkinson's disease. In this study, we first investigated the degree of improvement in bradykinesia and rigidity during targeted globus pallidus DBS in three 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated rhesus macaques. Behavioral outcomes of DBS were then coupled with detailed, subject-specific computational models of neurons in the globus pallidus internus (GPi), globus pallidus externus (GPe), and internal capsule (IC) to determine which neuronal pathways when modulated with high-frequency electrical stimulation best correlate with improvement in motor symptoms. The modeling results support the hypothesis that multiple neuronal pathways can underlie the therapeutic effect of DBS on parkinsonian bradykinesia and rigidity. Across all three subjects, improvements in rigidity correlated most strongly with spread of neuronal activation into IC, driving a small percentage of fibers within this tract (<10% on average). The most robust effect on bradykinesia resulted from stimulating a combination of sensorimotor axonal projections within the GP, specifically at the site of the medial medullary lamina. Thus the beneficial effects of pallidal DBS for parkinsonian symptoms may occur from multiple targets within and near the target nucleus.

Measurement of muscle stiffness using robotic assisted gait orthosis in children with cerebral palsy: a proof of concept.

PURPOSE: To evaluate the feasibility and reliability of a novel stiffness assessment tool implemented in the driven gait orthosis Paediatric Lokomat; to investigate the influence of single robotic-assisted gait training (RAGT) on muscle stiffness in children with cerebral palsy (CP). METHODS: Ten children with spastic CP conducted a single standard RAGT session and stiffness was assessed before and after the RAGT. Nine of the ten subjects were tested twice on the same day to investigate test-retest reliability, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), coefficient of variation of the method error (CV(ME)) and resistive torques during passive leg movements (stiffness in Nm/°) were calculated. RESULTS: ICCs showed high reliability (0.83-0.97) for hip and knee movements. SEM and CV(ME) indicated 0.028-0.085 Nm/°, 9.5-23.0% of test-retest variability in hip and 0.018-0.064 Nm/°, 13.3-43.5% in knee measures. Using the assessment tool, a significant decrease in muscle stiffness in participants, especially in children with high levels of muscle tone, could be shown after a single session of RAGT. CONCLUSIONS: The assessment tool L-STIFF is a feasible tool for automated measurement of stiffness in children with CP, but it is not sensitive enough to record small changes in muscle tone.

Short-term effects of vibration therapy on motor impairments in Parkinson's disease.

Recent studies have suggested that vibration therapy may have a positive influence on motor symptoms in individuals with Parkinson's disease (PD). However, quantitative evidence of these benefits is scarce, and the concept of "whole-body" vibration in these studies is vague. The objectives of the current study were to evaluate the influence of vibration on motor symptoms and functional measures in PD by delivering sound waves to the entire body. We delivered whole body sound wave vibration to 40 individuals with PD using a Physioacoustic Chair, a piece of equipment with speakers spaced throughout the chair permitting a series of programmed low frequency sound waves through the body. Using a parallel cross-over design we utilized the Unified Parkinson's Disease Rating Scale (UPDRS), quantitative gait assessments, and a grooved pegboard for upper limb control. Improvements were seen in all symptom, motor control and functional outcome measures at the time of assessment. Specifically, a significant decrease in rigidity, and tremor were shown, as well as a significant increase in step length and improved speed on the grooved pegboard task. Results of this initial investigation provide support for vibration therapy as a non-pharmacological treatment alternative. Long-term benefits of vibration therapy will require further research.

Cáncer del tracto aerodigestivo superior: biomecánica postquirúrgica del complejo cervicobraquial. Tratamiento fisioterápico de las secuelas / Cancer of the superior aerodigestive tract: postsurgical biomechanics of the cervicobrachial complex. Physiotherapeutical treatment of the sequelae

En los pacientes intervenidos por una afección de cáncer de cuello suele producirse una disfunción de hombro con limitación de la movilidad, que suele ir acompañada de dolor, y con frecuencia aparece también rigidez de cuello y edema facial, razones por las cuales llegan al servicio de fisioterapia. En este artículo se pretende profundizar en las razones mecánicas que provocan la deficiencia de la movilidad en la articulación del hombro, así como del dolor que se experimenta en el mismo

Patients treated surgically for head and neck cancer was often produced a shoulder dysfunction with limited range of movement. This alteration was often accompained by pain and frequent neck rigidity and facial oedema.These symptoms were brough to the attention of the physiotherapy service. This article try to explain the mechanical reasons that cause a deficiency in the shoulders mobility, and the pain felt within this area

The effects of random whole-body-vibration on motor symptoms in Parkinson's disease.

It is well known that applying vibrations to men influences multiple physiological functions. The authors analysed post effects of whole-body-vibration (WBV) on motor symptoms in Parkinson's disease (PD). Sixty-eight persons with PD were randomly subdivided into one experimental and one control group. Motor symptoms were assessed by the UPDRS (Unified Parkinson's Disease Rating Scale) motor score. A cross-over design was used to control treatment effects. The treatment consisted of 5 series of whole-body-vibration taking 60 seconds each. On average a highly significant (p<0.01) improvement of 16.8% in the UPDRS motor score was found in the treatment group. Only marginal changes (p>0.05) were found in the control group. The cross-over procedure showed comparable treatment effects (14.7% improvement after treatment). With respect to different symptom clusters only small changes were found in limb akinesia and cranial symptoms. By contrast, tremor and rigidity scores were improved by 25% and 24%, respectively. According to the structure of symptom changes it is unlikely that these effects are explainable on peripheral sensory level, exclusively. With respect to the findings of other studies one can speculate about changes in activation of the supplementary motor area and in neurotransmitter functions.

Los principios generales de la osteosíntesis / General Principles of Osteosynthesis

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Ejercicio aeróbico e hidrocinesiterapia en el síndrome fibromiálgico / Aerobic exercise and acuatic exercise in fibromyalgia syndrome

Objetivo. Revisar el efecto de la hidrocinesiterapia y del ejercicio aeróbico en pacientes con fibromialgia en la bibliografía consultada. Métodos. Se realizó una búsqueda en distintas bases de datos a partir del año 1977. Se encontraron 78 trabajos, de los cuales se seleccionó y accedió a 28. Conclusión. El ejercicio aeróbico y la hidrocinesiterapia mejoran el dolor, la rigidez, el dolor de los "tender points" y aumenta la calidad de vida y la capacidad aeróbica en pacientes con fibromialgia

Objective. Review the effect of acuatic and aerobic exercise on patients with fibromyalgia at the consulted bibliography. Methods. A search was made in some databases since year 1977. Seventy-eight articles were found, which from 28 were selected and accessed. Conclusion. Aerobic exercise an acuatic exercise improves pain, stiffness, pain of tender points, and increase the quality of life and aerobic ability on patients with fibromyalgia

Lumbar segmental rigidity: can its identification with facet injections and stretching exercises be useful?

OBJECTIVES: To describe a method for observing lumbar segmental rigidity and to show how motion measurements and pain/disability questionnaires can be used to evaluate outcomes of combined facet injections and stretching exercises. DESIGN: Preliminary 2-part study: (1) presentation of a technique for, identifying lumbar segmental rigidity based on physical observation of the spine's lateral bending; and (2) repeated measures of motion and pain/disability self-report in a chronic lumbar spinal disorder cohort, performed before and after treatment with combined facet injections and stretching exercises. SETTING: An outpatient tertiary rehabilitation facility providing interdisciplinary functional restoration for chronic disabling work-related spinal disorders. PATIENTS: Chronically disabled patients with lumbar spinal disorder (n = 39; mean age, 41yr; 82% male) with segmental rigidity at 1 or more levels on physical examination. Subjects averaged 20 months of disability, and 51% had preinjection spine surgery (average, 1.7 procedures involving up to 3 spinal segments). Thirty-nine percent of the cohort had a fusion at levels 1 or 2. INTERVENTIONS: Bilateral facet injections were administered under fluoroscopy to all patients, and 2 or 3 levels were performed in 93% of cases (range, levels 1-4). Patients were instructed in an unsupervised stretching program and were reassessed 2 to 4 weeks later. After an intensive supervised resistance exercise training program as part of interdisciplinary functional restoration, a third set of motion, pain, and disability measures were collected. MAIN OUTCOME MEASURES: Changes in true lumbar sagittal and coronal motion (T12-S1), measured with inclinometers, and pain/disability self-report were compared statistically. RESULTS: Patients' mobility improved significantly (p < .01-.0001) across all 4 motions. A large majority (71%-97%) of individuals improved on motion. According to self-reports made over the postinjection period, most patients improved their disability (83%) and pain intensity (63%) ratings. CONCLUSIONS: A simple physical examination technique for assessing lumbar spine segmental rigidity was used in this preliminary study to select patients and levels for combined facet injection and stretching exercise, with resultant improvements in mobility and self-reported pain/disability that may extend beyond the pharmacologic duration of the corticosteroid. The efficacy of either the facet injection or stretching components alone in achieving objective mobility improvements cannot be determined from the present study, but warrants future investigation.

"On" freezing in Parkinson's disease: resistance to visual cue walking devices.

OBJECTIVE: To measure "on" freezing during unassisted walking (UW) and test if two devices, a modified inverted stick (MIS) and a visual laser beam stick (LBS) improved walking speed and number of "on" freezing episodes in patients with Parkinson's disease (PD). BACKGROUND: Multiple visual cues can overcome "off' freezing episodes and can be useful in improving gait function in parkinsonian patients. These devices have not been specifically tested in "on" freezing, which is unresponsive to pharmacologic manipulations. METHODS: Patients with PD, motor fluctuations and freezing while "on," attempted walking on a 60-ft track with each of three walking conditions in a randomized order: UW, MIS, and LBS. Total time to complete a trial, number of freezes, and the ratio of walking time to the number of freezes were compared using Friedman's test. RESULTS: Twenty-eight patients with PD, mean age 67.81 years (standard deviation [SD] 7.54), mean disease duration 13.04 years (SD 7.49), and mean motor Unified Parkinson's Disease Rating Scale score "on" 32.59 (SD 10.93), participated in the study. There was a statistically significant correlation of time needed to complete a trial and number of freezes for all three conditions (Spearman correlations: UW 0.973, LBS 0.0.930, and MIS 0.842). The median number of freezes, median time to walk in each condition, and median walking time per freeze were not significantly different in pairwise comparisons of the three conditions (Friedman's test). Of the 28 subjects, six showed improvement with the MIS and six with the LBS in at least one outcome measure. CONCLUSION: Assisting devices, specifically based on visual cues, are not consistently beneficial in overcoming "on" freezing in most patients with PD. Because this is an otherwise untreatable clinical problem and because occasional subjects do respond, cautious trials of such devices under the supervision of a health professional should be conducted to identify those patients who might benefit from their long-term use.

Sport stretching: effect on passive muscle stiffness of short hamstrings.

OBJECTIVE: To evaluate the effects of one 10-minute stretch on muscle stiffness in subjects with short hamstrings. DESIGN: Randomized control trial. SETTING: Laboratory for human movement sciences in the department of rehabilitation of a university hospital. SUBJECTS: Sixteen students from the Department of Human Movement Sciences participated with informed consent in the experiment. Subjects were limited to men and women without a history of neurological and orthopedic disorders. To select subjects with short hamstrings, the finger-ground distance had to be greater than 0cm (unable to touch the floor when bending forward) and the manual leg lifting was not to exceed 80 degrees. One group of 10 subjects performed static stretching exercises during 10 minutes interspersed with relaxing, whereas the untreated group of 6 subjects was used as a control. MAIN OUTCOME MEASURES: The instrumental straight-leg-raising set-up enables the measurement of the force needed to lift the leg, range of motion (ROM), pelvic-femoral angle, and the electromyogram of the hamstrings. These variables provide information about the stiffness, elongation, and state of activity of the hamstring muscles. RESULTS. One 10-minute sport stretch resulted in a significant increase in passive muscle moment, ROM, and elongation of the hamstrings. There was no significant change in the course of the passive muscle stiffness curve with respect to the prestretch stiffness curve. CONCLUSIONS: One session of static stretching does not influence the course of the passive muscle stiffness curve. The increased ROM, i.e., the extensibility of the hamstrings, results from an increase in the stretch tolerance.

Influence of different sitting positions and abduction orthoses on leg muscle activity in children with cerebral palsy.

A surface electromyogram (EMG) was recorded from four leg muscles to measure the effects of various seat inclinations and an abduction orthosis on eight children with cerebral palsy and controls during performance of an upper-extremity task and while listening to a story. EMG responses were lowest in the forward-leaning and horizontal positions with the abduction orthosis, and highest in reclined and horizontal positions without the orthosis for both groups of children during the performance of an upper-extremity task. While listening to a story, there was no median EMG activity in any muscles of the controls, but there were wide variations in those of the children with cerebral palsy. The results indicate that the use of an abduction orthosis and horizontal and forward-leaning seats decrease lower-extremity muscle activity, and so it is possible that it might also improve upper-extremity function.

[The effect of cryo- and cryoelectrotherapy on neuromuscular function in coxarthrosis patients]. / Vliianie krio- i krioélektroterapii na sostoianie nervno-myshechnogo apparata bol'nykh koksartrozom.

Cryotherapy (CT) and cryoelectrotherapy (CET) in combination with therapeutic exercise were assessed for neuromuscular effects in patients with coxarthritis and necrosis of caput femoris. The above complex is found effective in reducing the rigidity of the muscles and joints, in attenuation of functional contractures. It increases muscle strength nearby the affected joints. The best results were achieved with CET. Single CT and CET procedures increase the amplitude of muscular bioelectrical activity at maximal muscular tension, the highest effect being observed at the sites of the direct exposure. Marked analgetic activity of the physical factors was confirmed by electroneuromyographic findings.

Ulceras por decúbito e Hidroterapia en las termas de Copahue / Decubitus ulcers and hydrotherapy in the Copahue Thermal Complex

Se presenta el caso de una niña de 9 años con paraparesia y escaras por decúbito de más de 6 meses de evolución, tratada con hidroterapia integral en las Termas de Copahue (Neuquén-Argentina). Mediante esta terapeútica pudimos observar una rápida y excelente respuesta, tanto de las lesiones cutáneas como de su cuadro general

Ulceras por decúbito e Hidroterapia en las termas de Copahue / Decubitus ulcers and hydrotherapy in the Copahue Thermal Complex

Se presenta el caso de una niña de 9 años con paraparesia y escaras por decúbito de más de 6 meses de evolución, tratada con hidroterapia integral en las Termas de Copahue (Neuquén-Argentina). Mediante esta terapeútica pudimos observar una rápida y excelente respuesta, tanto de las lesiones cutáneas como de su cuadro general

Rehabilitation in progressive supranuclear palsy: case report.

Progressive supranuclear palsy (PSP) is a distinct clinicopathologic entity characterized by supranuclear ophthalmoplegia, pseudobulbar palsy, axial dystonia in extension, and subcortical dementia. Although relatively rare, PSP is disabling, thus rehabilitation techniques and management are indicated in nearly every case. This report describes the neurologic presentation, rehabilitation management, and outcome of treatment of a patient with PSP during a 12-month period. The patient required thorough neuromuscular, neuropsychological, speech, swallowing, vision, and social service evaluations prior to the implementation of a rehabilitation program. Therapeutic rehabilitation techniques focused on limb coordination activities, tilt board balancing, ambulation activities, and activities to improve route finding and visual scanning ability. Prism lenses were introduced to compensate for deficits in vertical eye movements. Treatment improved the patient's functional status. Later, as the patient's neurologic status deteriorated, it became necessary to educate the family and caretakers in the ongoing rehabilitation management of the patient.