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1.
Brain Nerve ; 71(11): 1145-1151, 2019 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-31722301

RESUMO

'Split hand' is dissociated hand muscle atrophy, characterized by preferential atrophies in the thenar and first dorsal interosseous muscles, with relative sparing of the hypothenar muscle. This symptom has been recognized as specific to amyotrophic lateral sclerosis (ALS), and distinct pathomechanisms are assumed to underlie this phenomenon. Recently, characteristic distributions of weakness and symptoms in ALS have been reported. Here, we describe characteristic symptoms of ALS, including split hand, split-hand plus sign, split elbow, split leg, relative preservation of finger flexion. Moreover, through these phenomena, potent mechanisms of motor neuron death in ALS are considered. Revealing the underlying pathophysiology of these symptoms may lead to the development of therapies for ALS.


Assuntos
Esclerose Amiotrófica Lateral/diagnóstico , Atrofia Muscular/fisiopatologia , Esclerose Amiotrófica Lateral/fisiopatologia , Mãos/fisiopatologia , Humanos , Neurônios Motores , Músculo Esquelético/fisiopatologia
2.
Medicine (Baltimore) ; 98(46): e17240, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725601

RESUMO

BACKGROUND: Neck pain is an important cause of disability. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Exercise therapy appears to be effective at decreasing pain and improving function for patients with NP in practice guidelines. Core stability exercise is becoming increasingly popular for NP. However, it is currently unknown whether core stability exercise produces more beneficial effects than general exercise in patients with NP. The aim of this study is to explore the therapeutic effect of core stability exercise for neck pain. METHODS: This review will only include randomized controlled trials (RCTs). Published articles from July 2009 to July 2019 will be identified using electronic searches. Search strategy will be performed in 3 English databases, 1 Chinese database, and the WHO International Clinical Trials Registry Platform. Two reviewers will screen, select studies, extract data, and assess quality independently. The methodological quality including the risk of bias of the included studies will be evaluated using a modified assessment form, which is based on Cochrane assessment tool and Physiotherapy Evidence Database scale. Review Manager Software (Revman5.3) will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis. We will use GRADE system to evaluate the quality of our evidence. RESULTS: We will provide some more practical and targeted results investigating the effect of Core Stability Exercise (CSE) for Neck Pain (NP) in the current meta-analysis. Meanwhile, we will ascertain study progress of Core Stability Exercise for Neck Pain and find out defects or inadequacies of previous studies, so that future researchers could get beneficial guidance for more rigorous study. CONCLUSION: The stronger evidence about Neck Pain's rehabilitative effect and safety will be provided for clinicians and policymakers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017055711. ETHICS AND DISSEMINATION: We do not apply for formal ethical approval from ethics committee because all of the study data in our review will be obtained in an anonymous way. Findings of this study are projected to be disseminated through peer-review publications.


Assuntos
Terapia por Exercício/métodos , Cervicalgia/reabilitação , Exercício/fisiologia , Humanos , Metanálise como Assunto , Força Muscular , Músculo Esquelético/fisiopatologia , Cervicalgia/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto , Tronco/fisiopatologia , Resultado do Tratamento
3.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(5): 720-727, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31631619

RESUMO

To better analyze the problem of abnormal neuromuscular coupling related to motor dysfunction for stroke patients, the functional coupling of the multichannel electromyography (EMG) were studied and the difference between stroke patients and healthy subjects were further analyzed to explore the pathological mechanism of motor dysfunction after stroke. Firstly, the cross-frequency coherence (CFC) analysis and non-negative matrix factorization (NMF) were combined to construct a CFC-NMF model to study the linear coupling relationship in bands and the nonlinear coupling characteristics in different frequency ratios during elbow flexion and extension movement. Furthermore, the significant coherent area and sum of cross-frequency coherence were respectively calculated to quantitatively describe the intermuscular linear and nonlinear coupling characteristics. The results showed that the linear coupling relationship between multichannel muscles was different in frequency bands and the overall coupling was stronger in low frequency band. The linear coupling strength of the stroke patients was lower than that of the healthy subjects in different frequency bands especially in beta and gamma bands. For the nonlinear coupling, the intermuscular coupling strength of stroke patients in different frequency ratios was significantly lower than that of the healthy subjects, and the coupling strength in the frequency ratio 1∶2 was higher than that in the frequency ratio 1∶3. This method can provide a theoretical basis for exploring the intermuscular coupling mechanism of patients with motor dysfunction.


Assuntos
Eletromiografia , Músculo Esquelético/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Estudos de Casos e Controles , Humanos
4.
Khirurgiia (Mosk) ; (10): 43-49, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626238

RESUMO

OBJECTIVE: To analyze the effectiveness of complex therapy of necrotizing infection using the original method of stimulation of angiogenesis in patients with chronic arterial insufficiency of the lower extremities. MATERIAL AND METHODS: In 53 patients, operations were performed using the proposed technologies for stimulation of angiogenesis. A control group consisting of 56 patients was formed to compare the results of treatment. They had standard vascular therapy for the correction of ischemia. Morphological studies of the muscles of the lower extremities included assessment of capillary bed density and spatial orientation of the capillaries before and after treatment. Computed angiography of the lower extremities followed by calculation of perfusion index was performed to assess changes in the microvasculature. Clinical evaluation of the results was carried out using R. Rutherford scale. RESULTS: Revascularization resulted significant augmentation of capillary bed density and the number of functioning capillaries in muscular tissue. This was accompanied by increased perfusion index and TcPO2 values. The effect of treatment is observed in 12-14 days after surgery and persists for a long time. The best outcomes are found in patients with ischemia grade IIb-III. Incidence of lower limb amputations was more than 2 times lower in the main group compared with the control group. CONCLUSION: Combined stimulation of angiogenesis including mechanical tunneling of the muscles of the affected limb and administration of platelet rich plasma is effective procedure. This method does not require complex equipment and may be used in the treatment of patients with complications of chronic lower limb ischemia and contraindicated direct arterial reconstruction.


Assuntos
Arteriopatias Oclusivas/cirurgia , Capilares/cirurgia , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/cirurgia , Necrose/cirurgia , Neovascularização Fisiológica , Arteriopatias Oclusivas/fisiopatologia , Capilares/fisiopatologia , Humanos , Infecção/fisiopatologia , Infecção/terapia , Isquemia/fisiopatologia , Isquemia/cirurgia , Extremidade Inferior/fisiopatologia , Microvasos/fisiopatologia , Microvasos/cirurgia , Músculo Esquelético/fisiopatologia , Músculo Esquelético/cirurgia , Necrose/etiologia , Necrose/fisiopatologia , Plasma Rico em Plaquetas/fisiologia , Resultado do Tratamento
5.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 36(8): 809-812, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31400134

RESUMO

OBJECTIVE: To explore the clinical features of a Chinese pedigree affected with skeletal muscle sodium channelopathies due to variation of SCN4A gene. METHODS: Potential variation of the 24 exons of the SCN4A gene was screened using PCR and Sanger sequencing. RESULTS: Four family members were affected with the disease in an autosomal dominant inheritance pattern. Three patients had normekalemic periodic paralysis, while 1 showed paramyotonia congenita. Genetic analysis detected a missense variation c.2078T>C (p.Ile693Thr) in exon 13 of the SCN4A gene in the proband and other 3 affected relatives. CONCLUSION: Normokalemic periodic paralysis and paramyotonia congenita can occur in different family members with skeletal muscle sodium channelopathies due to c.2078T>C(p.Ile693Thr) variation of SCN4A gene.


Assuntos
Canalopatias/genética , Músculo Esquelético/fisiopatologia , Canal de Sódio Disparado por Voltagem NAV1.4/genética , Humanos , Mutação , Linhagem
6.
Br J Nurs ; 28(15): 968-974, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393761

RESUMO

Pelvic floor dysfunction is a common problem, particularly for women. A weakness in the pelvic floor muscles can lead to one or more disorders developing, such as urinary incontinence or a pelvic organ prolapse. To combat this, it is advised that the pelvic floor muscles are exercised to strengthen them and help them become more supportive. However, more than 30% of women are unable to detect their pelvic floor muscles to produce an effective contraction. The introduction of neuromuscular electrical stimulation (NMES) in pelvic healthcare poses a significant benefit in the rehabilitation of the pelvic floor muscles.


Assuntos
Terapia por Estimulação Elétrica , Força Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Diafragma da Pelve/fisiopatologia , Terapia por Exercício/métodos , Feminino , Humanos , Masculino , Contração Muscular/fisiologia , Guias de Prática Clínica como Assunto , Resultado do Tratamento , Incontinência Urinária/terapia
7.
J Electromyogr Kinesiol ; 48: 197-204, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31442925

RESUMO

PURPOSE: People with Joint Hypermobility Syndrome (JHS) suffer with fatigue. The purpose of this project was to investigate the contribution of central and peripheral fatigue. METHODS: Electrical stimulation of the musculocutaneous nerve to biceps brachii, and transcranial magnetic stimulation over the motor cortex supplying biceps brachii were used. Peripheral and central fatigue were assessed during a control, fatiguing and recovery phase protocol. RESULTS: JHS participants perceived greater fatigue during the protocol compared to a control group and did not recover. Central and peripheral fatigue did not occur in the control group. However, the JHS group showed central fatigue. MEP amplitude increased in the JHS group during the fatiguing protocol (p < 0.01) before recovering. Superimposed twitch amplitude increased in the JHS group during the fatiguing protocol and stayed elevated during the recovery phase (p < 0.04). Time to peak (TTP) amplitude of the torque generated by the TMS was longer in the JHS group (p < 0.05). RMS during MVCs decreased during the fatiguing protocol reaching significance during the recovery phase (p < 0.01). CONCLUSION: JHS participants suffered central but not peripheral fatigue. A modified strength programme to target this is discussed.


Assuntos
Fadiga/etiologia , Instabilidade Articular/fisiopatologia , Córtex Motor/fisiopatologia , Fadiga Muscular , Nervos Periféricos/fisiopatologia , Adulto , Fadiga/fisiopatologia , Feminino , Humanos , Instabilidade Articular/complicações , Masculino , Músculo Esquelético/inervação , Músculo Esquelético/fisiopatologia , Torque
8.
J Pediatr Orthop ; 39(8): e641-e646, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31393309

RESUMO

BACKGROUND: Osteogenesis imperfecta (OI) is a congenital connective tissue disorder often characterized by orthopaedic complications that impact normal gait. As such, mobility is of particular interest in the OI population as it is associated with multiple aspects of participation and quality of life. The purpose of the current study was to identify and describe common gait deviations in a large sample of individuals with type I OI and speculate the etiology with a goal of improving function. METHODS: Gait analysis was performed on 44 subjects with type I (11.7±3.08 y old) and 30 typically developing controls (9.54±3.1 y old ). Spatial temporal, kinematic, and kinetic gait data were calculated from the Vicon Plug-in-Gait Model. Musculoskeletal modeling of the muscle tendon lengths (MTL) was done in OpenSim 3.3 to evaluate the MTL of the gastrocnemius and gluteus maximus. The gait deviation index, a dimensionless parameter that evaluates the deviation of 9 kinematic gait parameters from a control database, was also calculated. RESULTS: Walking speed, single support time, stride, and step length were lower and double support time was higher in the OI group. The gait deviation index score was lower and external hip rotation angle was higher in the OI group. Peak hip flexor, knee extensor and ankle plantarflexor moments, and power generation at the ankle were lower in the OI group. MTL analysis revealed no significant length discrepancies between the OI group and the typically developing group. CONCLUSIONS: Together, these findings provide a comprehensive description of gait characteristics among a group of individuals with type I OI. Such data inform clinicians about specific gait deviations in this population allowing clinicians to recommend more focused interventions. LEVEL OF EVIDENCE: Level III-case-control study.


Assuntos
Análise da Marcha , Instabilidade Articular , Articulações/fisiopatologia , Osteogênese Imperfeita , Qualidade de Vida , Adolescente , Fenômenos Biomecânicos , Estudos de Casos e Controles , Criança , Feminino , Análise da Marcha/métodos , Análise da Marcha/estatística & dados numéricos , Humanos , Instabilidade Articular/diagnóstico , Instabilidade Articular/etiologia , Masculino , Músculo Esquelético/fisiopatologia , Osteogênese Imperfeita/complicações , Osteogênese Imperfeita/fisiopatologia , Osteogênese Imperfeita/psicologia , Amplitude de Movimento Articular , Velocidade de Caminhada
9.
Int J Sports Med ; 40(11): 696-703, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31445504

RESUMO

There is a well-conceived notion that rate of recovery from strenuous exercise gets slower with age. However, it is unclear whether older adults who exercise habitually demonstrate slower rates of recovery. We determined whether older adults who are physically active demonstrate slower rates of recovery from unaccustomed strenuous exercise compared with younger peers. Healthy young sedentary (n=10, 28±2 years), young endurance-trained (n=15, 27±2 years), and older endurance-trained (n=14, 58±2 years) men and women were studied. Participants performed 45 min of downhill running at 65% of their maximal oxygen consumption. Visual analog pain scores of muscle groups increased at 24, 48, and 72 h in all three groups (p<0.05), and changes in the muscular pain scale of the legs was smaller in the older trained group than in the young trained group. Maximum isometric strengths at 90° decreased in all groups at 24 h, but the recovery rates were not different at 72 h among the groups. Plasma creatine kinase activity and myoglobin concentration increased at 24 h following downhill running and returned to baseline at 48 h in both the young and older trained groups. The present findings are not consistent with the prevailing notion that older trained adults have a slower rate of recovery from strenuous exercise.


Assuntos
Envelhecimento/fisiologia , Mialgia/fisiopatologia , Resistência Física/fisiologia , Aptidão Física/fisiologia , Corrida/fisiologia , Adulto , Creatina Quinase/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Mialgia/etiologia , Mioglobina/sangue , Consumo de Oxigênio/fisiologia , Amplitude de Movimento Articular , Corrida/lesões
10.
Int J Sports Med ; 40(12): 762-767, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31466082

RESUMO

This study compared internal load variable dynamics across three consecutive football matches and investigated its relationship with the number of sprints performed by players. Twenty-three male players had blood and salivary samples collected for hormonal concentration (testosterone, cortisol, and testosterone-cortisol ratio), and serum analysis (interleukin-6, interleukin-1-beta, and c-reactive-protein), respectively. Sprints were measured through Global Position System devices. Testosterone and testosterone-cortisol-ratio presented a decreasing behavior up to the second match, and all other indicators presented an increasing behavior during the same period, c-reactive-protein was the only indicator observed to significantly rise up to the third match as well (0.38±0.02 mg/L; 0.49±0.05 mg/L; 0.69±0.05 mg/L; 0.89±0.08 mg/L). C-reactive-protein showed strong correlations with sprints in the second and third matches (p<0.01, r=0.71 and 0.79), and weak-to-moderate in the first one (p<0.05, r=0.59). Interleukin-6 and interleukin-1-beta presented weak-to-moderate correlation in every match (p<0.05, r=0.48 to 0.51; r=0.51 to 0.55) while testosterone-cortisol ratio presented weak-to-moderate correlation only in the third one (p<0.05, r=0.42). Multilevel linear regression showed that c-reactive-protein had a higher R2 than other biomarker in any regression model (R2=0.624; p<0.001). Therefore, c-reactive-protein can be a valid and reliable indicator of sprinting in competitive football. Future research should explore longer periods of monitoring and/or others external load variables so that other behaviors may arise to knowledge.


Assuntos
Proteína C-Reativa/metabolismo , Comportamento Competitivo/fisiologia , Corrida/fisiologia , Futebol/fisiologia , Adolescente , Biomarcadores/sangue , Biomarcadores/metabolismo , Humanos , Hidrocortisona/sangue , Hidrocortisona/metabolismo , Interleucina-1beta/sangue , Masculino , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Receptores de Interleucina-6/sangue , Saliva/metabolismo , Testosterona/sangue , Testosterona/metabolismo , Adulto Jovem
11.
Adv Exp Med Biol ; 1158: 143-182, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31452140

RESUMO

Mitochondrial dysfunction is discussed as a key player in the pathogenesis of type 2 diabetes mellitus (T2Dm), a highly prevalent disease rapidly developing as one of the greatest global health challenges of this century. Data however about the involvement of mitochondria, central hubs in bioenergetic processes, in the disease development are still controversial. Lipid and protein homeostasis are under intense discussion to be crucial for proper mitochondrial function. Consequently proteomics and lipidomics analyses might help to understand how molecular changes in mitochondria translate to alterations in energy transduction as observed in the healthy and metabolic diseases such as T2Dm and other related disorders. Mitochondrial lipids integrated in a tool covering proteomic and functional analyses were up to now rarely investigated, although mitochondrial lipids might provide a possible lynchpin in the understanding of type 2 diabetes development and thereby prevention. In this chapter state-of-the-art analytical strategies, pre-analytical aspects, potential pitfalls as well as current proteomics and lipidomics-based knowledge about the pathophysiological role of mitochondria in the pathogenesis of type 2 diabetes will be discussed.


Assuntos
Biologia Computacional , Diabetes Mellitus Tipo 2 , Fígado , Mitocôndrias , Músculo Esquelético , Proteômica , Diabetes Mellitus Tipo 2/fisiopatologia , Humanos , Metabolismo dos Lipídeos , Fígado/fisiopatologia , Mitocôndrias/metabolismo , Músculo Esquelético/fisiopatologia
12.
Bone Joint J ; 101-B(7): 867-871, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256676

RESUMO

AIMS: Improvements in the evaluation of outcomes following peripheral nerve injury are needed. Recent studies have identified muscle fatigue as an inevitable consequence of muscle reinnervation. This study aimed to quantify and characterize muscle fatigue within a standardized surgical model of muscle reinnervation. PATIENTS AND METHODS: This retrospective cohort study included 12 patients who underwent Oberlin nerve transfer in an attempt to restore flexion of the elbow following brachial plexus injury. There were ten men and two women with a mean age of 45.5 years (27 to 69). The mean follow-up was 58 months (28 to 100). Repeated and sustained isometric contractions of the elbow flexors were used to assess fatigability of reinnervated muscle. The strength of elbow flexion was measured using a static dynamometer (KgF) and surface electromyography (sEMG). Recordings were used to quantify and characterize fatigability of the reinnervated elbow flexor muscles compared with the uninjured contralateral side. RESULTS: The mean peak force of elbow flexion was 7.88 KgF (sd 3.80) compared with 20.65 KgF (sd 6.88) on the contralateral side (p < 0.001). Reinnervated elbow flexor muscles (biceps brachialis) showed sEMG evidence of fatigue earlier than normal controls with sustained (60-second) isometric contraction. Reinnervated elbow flexor muscles also showed a trend towards a faster twitch muscle fibre type. CONCLUSION: The assessment of motor outcomes must involve more than peak force alone. Reinnervated muscle shows a shift towards fast twitch fibres following reinnervation with an earlier onset of fatigue. Our findings suggest that fatigue is a clinically relevant characteristic of reinnervated muscle. Adoption of these metrics into clinical practice and the assessment of outcome could allow a more meaningful comparison to be made between differing forms of treatment and encourage advances in the management of motor recovery following nerve transfer. Cite this article: Bone Joint J 2019;101-B:867-871.


Assuntos
Plexo Braquial/lesões , Fadiga Muscular , Músculo Esquelético/fisiopatologia , Transferência de Nervo , Traumatismos dos Nervos Periféricos/cirurgia , Complicações Pós-Operatórias/diagnóstico , Adulto , Idoso , Plexo Braquial/cirurgia , Articulação do Cotovelo/fisiologia , Eletromiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Dinamômetro de Força Muscular , Músculo Esquelético/inervação , Músculo Esquelético/cirurgia , Complicações Pós-Operatórias/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica/fisiologia , Estudos Retrospectivos , Resultado do Tratamento
14.
J Electromyogr Kinesiol ; 48: 112-120, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31325672

RESUMO

BACKGROUND: Adaptation to split-belt treadmill walking differs between individual stroke survivors. Many discussions only address spatiotemporal parameters that are related to movement, and the changes in interlimb spatiotemporal parameters as a consequence of adaptation are poorly understood. OBJECTIVES: To investigate symmetry of the center of pressure (CoP) position relative to the center of mass (CoM), and ascertain whether this can be used to identify differences in adaptation of interlimb spatiotemporal parameters among stroke survivors during split-belt walking. METHODS: Twenty-two chronic post-stroke patients and nine elderly controls walked in tied- then split-belt (2:1 ratio of fast:slow) conditions. Spatiotemporal parameters were compared within groups to assess symmetry of the CoM-CoP angle at foot contact. RESULTS: Asymmetry of the CoM-CoP angle was associated with asymmetry of spatiotemporal parameters. Re-establishment of symmetry of CoM-CoP angle was reflected in re-established symmetry of spatiotemporal parameters in post-stroke and control participants. CONCLUSIONS: Post-stroke patients who re-establish symmetry of the COM-COP angle are able to adapt their walking for split-belt perturbation. This suggests that predictively symmetric foot placements on the fast and slow sides are necessary for adaptation in walking. Symmetrical foot placement is achieved by interlimb coordination and may contribute to dynamic stability.


Assuntos
Adaptação Fisiológica , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Caminhada , Idoso , Feminino , Pé/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia
15.
J Electromyogr Kinesiol ; 48: 145-151, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31357112

RESUMO

Persons with upper limb loss (ULL) experience a high prevalence of falls, with the majority of falls occurring when walking. This issue may be related to altered arm dynamics, which play an important role in proactive mechanisms of locomotor stability. This study investigated effects of ULL and prosthesis use on proactive stability mechanisms, particularly if matching the mass and inertia of the impaired limb to the sound limb would enhance locomotor stability. Gait data were collected on adults with unilateral ULL during level walking while: (1) not wearing a prosthesis, (2) wearing their customary prosthesis, (3) wearing a mock prosthesis that matched the sound limb mass and inertia. Main and interaction effects of limb side and condition on trunk rotations, arm swing, step width, free vertical moment, and margin-of-stability were analyzed. Across conditions, arm swing, free vertical moment, and margin-of-stability were 2.27, 1.13, and 1.20 times greater, respectively, on the sound limb side than the impaired limb side. Persons with ULL display asymmetry in proactive mechanisms of locomotor stability with potentially greater medial-lateral stability on the sound limb side irrespective of prosthesis use, but heavier prostheses reduced the walking base of support. This bias may enhance fall risk on the impaired side if the prosthetic limb is used inappropriately to regain balance following a disturbance. Research is warranted to explore the consequences of this asymmetry on perturbation response.


Assuntos
Membros Artificiais/efeitos adversos , Marcha , Equilíbrio Postural , Extremidade Superior/fisiopatologia , Adulto , Amputados , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia
16.
J Electromyogr Kinesiol ; 48: 152-160, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31357113

RESUMO

Research in pattern recognition (PR) for myoelectric control of the upper limb prostheses has been extensive. However, there has been limited attention to the factors that influence the clinical translation of this technology. A relevant factor of influence in clinical performance of EMG PR-based control of prostheses is the variation in muscle activation level, which modifies the EMG patterns even when the amputee attempts the same movement. To decrease the effect of muscle activation level variations on EMG PR, this work proposes to use dynamic time warping (DTW) and is validated on two databases. The first database, which has data from ten intact-limbed subjects, was used to test the baseline performance of DTW, resulting in an average classification accuracy of more than 90%. The second database comprised data from nine upper limb amputees recorded at three levels of force for six hand grips. The results showed that DTW trained at a single force level achieved an average classification accuracy of 60 ±â€¯9%, 70 ±â€¯8%, and 60 ±â€¯7% at the low, medium and high force levels respectively across all amputee subjects. The proposed scheme with DTW achieved a significant 10% improvement in classification accuracy when trained at a low force level when compared to the traditional time-dependent power spectrum descriptors (TD-PSD) method.


Assuntos
Membros Artificiais/normas , Eletromiografia/métodos , Mãos/fisiologia , Reconhecimento Automatizado de Padrão/métodos , Adulto , Eletromiografia/normas , Mãos/fisiopatologia , Humanos , Masculino , Movimento , Músculo Esquelético/fisiologia , Músculo Esquelético/fisiopatologia , Reconhecimento Automatizado de Padrão/normas
17.
NeuroRehabilitation ; 44(4): 587-597, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31256089

RESUMO

BACKGROUND: Downslope walking (DSW) is an eccentric-based exercise intervention that promotes neuroplasticity of spinal reflex circuitry by inducing depression of Soleus Hoffman (H)-reflexes in young, neurologically unimpaired adults. OBJECTIVE: The objective of the study was to evaluate the effects of DSW on spinal excitability (SE) and walking function (WF) in people with multiple sclerosis (PwMS). METHODS: Our study comprised two experiments on 12 PwMS (11 women; 45.3±11.8 years). Experiment 1 evaluated acute effects of a single 20-minute session of treadmill walking at three different walking grades on SE, 0% or level walking (LW), - 7.5% DSW, and - 15% DSW. Experiment 2 evaluated the effects of 6 sessions of DSW, at - 7.5% DSW (with second session being - 15% DSW) on SE and WF. RESULTS: Experiment 1 showed significantly greater acute % H-reflex depression following - 15% DSW compared to LW (p = 0.02) and - 7.5% DSW (p = 0.05). Experiment 2 demonstrated significant improvements in WF. PwMS who showed greater acute H-reflex depression during the - 15% DSW session also demonstrated greater physical activity, long-distance WF, and the ability to have greater H-reflex depression after DSW training. Significant changes were not observed in regards to SE. CONCLUSIONS: Though significant changes were not observed in SE after DSW training, we observed an improvement in WF which merits further investigation of DSW in PwMS.


Assuntos
Teste de Esforço/métodos , Reflexo H/fisiologia , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/terapia , Caminhada/fisiologia , Adulto , Idoso , Eletromiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico , Músculo Esquelético/fisiopatologia , Plasticidade Neuronal/fisiologia , Resultado do Tratamento , Adulto Jovem
18.
Intern Med ; 58(13): 1851-1858, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31257275

RESUMO

Objective Amyotrophic lateral sclerosis (ALS) is an adult-onset neurodegenerative disease characterized by the progressive loss of the upper and lower motor neurons that progresses to paralysis of almost all skeletal muscles of the extremities, bulbar, and respiratory system. Although most ALS cases are sporadic, about 10% are dominantly inherited. We herein report an atypical phenotype of familial ALS (fALS). To elucidate the phenotype-genotype correlation of this atypical phenotype of fALS, clinical and genetic investigations were performed. Methods and Patients Five sibling patients (three men, two women) from a Japanese family and one healthy sibling (a woman) were clinically interviewed and examined. Genetic analyses, including genome-wide linkage analyses and whole-exome sequencing, were performed using genomic DNA extracted from the peripheral blood samples of these siblings. Results The clinical features of fALS are characterized by slow progression (mean duration of the disease±standard deviation [SD]: 19.6±3.9 years) and lower extremities-predominant late-onset muscular weakness (mean onset of muscular weakness±SD: 52.8±2.6 years). Genetic analyses revealed novel heterozygous missense mutations of c.2668C>T, p.R890C in the PLEC gene and c.421G>C, p.V141L in the ST3GAL6 gene in all affected siblings. Conclusion A new atypical fALS family with a benign clinical course is herein reported. We identified two candidate gene mutations of PLEC and ST3GAL6 linked to this phenotype.


Assuntos
Esclerose Amiotrófica Lateral/genética , Esclerose Amiotrófica Lateral/mortalidade , Predisposição Genética para Doença , Neurônios Motores/fisiologia , Debilidade Muscular/fisiopatologia , Doenças Neurodegenerativas/genética , Doenças Neurodegenerativas/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Esclerose Amiotrófica Lateral/fisiopatologia , Grupo com Ancestrais do Continente Asiático , Evolução Fatal , Feminino , Genótipo , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Mutação , Doenças Neurodegenerativas/mortalidade , Fenótipo
19.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 35(3): 223-227, 2019 May 28.
Artigo em Chinês | MEDLINE | ID: mdl-31257803

RESUMO

OBJECTIVE: To investigate the therapeutic effects of massage on denervated skeletal muscle atrophy in rats and its mechanism. METHODS: Forty-eight male SD rats were randomly divided into model group (n=24) and massage group (n=24). Gastrocnemius muscle atrophy model was established by transecting the right tibial nerve of rat. On the second day after operation, the gastrocnemius muscle of the rats in the massage group was given manual intervention and the model group was not intervened. Six rats were sacrificed at the four time points of 0 d, 7 d, 14 d and 21 d. The gastrocnemius of the rats were obtained and measured the wet mass ratio after weighing. Cross-sectional area and diameter of the muscle fiber were measured after HE staining. The relative expressions of miR-23a, Akt, MuRF1 and MAFbx mRNA were tested with qPCR. RESULTS: Compared with 0 d, the wet weight ratio, cross-sectional area and diameter of gastrocnemius muscle showed a progressive decline in the model group and massage group. The wet weight ratio, cross-sectional area and diameter of gastrocnemius muscle in the massage group were higher than those in the model group on 7 d, 14 d and 21 d (P<0.05, P<0.01). Compared with 0 d, the expressions of MuRF1, MAFbx and Akt mRNA were increased first and then were decreased in the model group and massage group. The expression of MuRF1 mRNA in massage group was lower than that in model group on 7 d and 21 d (P<0.05, P<0.01). The expression of MAFbx mRNA in massage group was lower than that in model group on 7 d, 14 d and 21 d (P<0.01, P<0.05, P<0.01). The expression of Akt mRNA in massage group was higher than that in model group on 7 d, 14 d and 21 d (P<0.05, P<0.01). Compared with 0 d, the expression of miR-23a mRNA was increased in the model group and massage group on 21 d, and the expression of miR-23a mRNA in massage group was higher than that in model group (P< 0.05). CONCLUSION: Massage can delay the atrophy of denervated skeletal muscle. The mechanism may be related to up-regulation of the expression of miR-23a and Akt mRNA, down-regulation of the expressions of MuRF1 and MAFbx mRNA, inhibition of protein degradation rate, and reduction of skeletal muscle protein degradation.


Assuntos
Massagem , Músculo Esquelético/fisiopatologia , Atrofia Muscular/terapia , Animais , Masculino , MicroRNAs/metabolismo , Fibras Musculares Esqueléticas , Proteínas Musculares/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Sprague-Dawley , Proteínas Ligases SKP Culina F-Box/metabolismo , Proteínas com Motivo Tripartido/metabolismo , Ubiquitina-Proteína Ligases/metabolismo
20.
Phys Ther ; 99(6): 739-747, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31155665

RESUMO

BACKGROUND AND PURPOSE: Cerebral palsy (CP) is characterized by decreased passive joint range-of-motion and impaired walking, resulting in progressive loss of function. Typical gait training interventions for children with CP appear insufficient to mitigate these effects. The purpose of this case report is to describe the use of a new treadmill-based gait training intervention using active correction with functional electrical stimulation (FES) in 2 adolescents with CP. CASE DESCRIPTION: Two participants with CP (13-year-old girls, Gross Motor Function Classification System [GMFCS] level II and III) trained by walking on a treadmill, with FES assistance, for 30 minutes, 3 times per week, for 12 weeks. The intervention used a feedback control system to detect all 7 phases of gait in real time and triggered FES to the appropriate muscle groups (up to 5 bilaterally) based on the detected gait phase. Joint kinematics, step width, stride length, walking endurance, peak oxygen uptake ($\dot{v}^{o}_{2}$), and oxygen (O2) cost of walking were evaluated preintervention and postintervention. OUTCOMES: Both participants showed improved knee and ankle angles and step width relative to children who are typically developing, and both exhibited increased stride length. One participant (GMFCS III) improved peak $\dot{v}^{o}_{2}$and walking endurance but not O2 cost of walking at her original self-selected walking speed. The other participant (GMFCS II) improved O2 cost of walking but not peak $\dot{v}^{o}_{2}$ or walking endurance. These differences are partly explained by differences in gait type, functional abilities, and initial fitness levels. Most improvements persisted at follow-up, indicating short-term neurotherapeutic effects. DISCUSSION: Most improvements persisted at follow-up, suggesting short-term neurotherapeutic effects. This case series demonstrates the promising utility of FES-assisted gait-training interventions, tailored to target individual gait deviations, in improving walking performance.


Assuntos
Paralisia Cerebral/reabilitação , Terapia por Exercício/métodos , Marcha/fisiologia , Caminhada/fisiologia , Adolescente , Feminino , Análise da Marcha/métodos , Humanos , Músculo Esquelético/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Velocidade de Caminhada/fisiologia
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