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1.
J Stroke Cerebrovasc Dis ; 28(11): 104314, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31409536

RESUMO

BACKGROUND: Deterioration of balance is one of the most common and disabling physical-motor deficits in patients after a stroke that have a negative impact on quality of life and increase the risk of falls. Previous studies have evaluated the effectiveness of the exercises on specific aspects of balance. However, there is no structured exercise program divided by levels for balance impairment in poststroke patients. METHODS: Delphi method was used to design the exercise programme, and then a pilot study was performed. For the pilot study, we included 14 poststroke adults patients (n = 7 in each group), with balance impairment, without previous severe functional dependence, sensorial deficit or dementia. Our 4 weeks intervention (5 times/week) is based on 9 exercise of progressive difficulty, offering a multidimensional approach training (biomechanical constraints, stability limits, anticipatory, postural responses, and sensory orientation). Patients in the intervention arm received 45 minutes of usual rehabilitation plus 15 minutes of the intervention proposed. The usual-care arm received 60 minutes of usual rehabilitation. Balance impairment (Mini BESTest) was assessed at the baseline and at 4 weeks. Differences between groups were analysed using Mann-Whitney U test. RESULTS: The agreement for the intervention designed was reached after 2 rounds. Participants in pilot study were 69 (SD = 9.7) years, 21.4% females. Post-treatment, median improvements in Mini BESTest were 20 (SD = 8) and 11 (SD = 10) points, P < .01 for intervention and control group respectively. CONCLUSION: A multidimensional approach of balance impairments in poststroke patients through the validated exercise programme proposed, may improve balance deficits.


Assuntos
Terapia por Exercício , Equilíbrio Postural , Transtornos das Sensações/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Acidentes por Quedas/prevenção & controle , Idoso , Técnica Delfos , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Recuperação de Função Fisiológica , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/fisiopatologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
3.
Med Hypotheses ; 128: 17-20, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31203902

RESUMO

HYPOTHESIS: Lack of otoconia or otoconial loss may be the major reason for increasing imbalance with age, posttraumatic dizziness and residual dizziness as well as other so far unexplained imbalance affecting probably millions of people. BACKGROUND: It is written in every textbook that we need sensation of gravity for stable gait and stance, especially on two legs. Lack of otoconia is known to cause lifelong balance problems in animals. Loss of otoconia is happening in aging humans, like shown by increasing incidence of benign paroxysmal positional vertigo (BPPV) and in histological sections. While hundreds of papers have been published on BPPV, increasing imbalance with age and increasing falls, none has ever described the loss of otoconia as a major reason for this imbalance. Maybe this is due to the problems to proof this hypothesis in an individual patient. We will explain why otoconial loss may cause dizziness, postural and locomotor instability in patients with no other identifiable cause or in addition to other causes. Several reasons can cause otoconial loss and lead to the described symptoms. We will describe the symptoms and the tests which could in combination support the diagnosis. CONCLUSION: Our hypothesis argues for the new diagnosis in many patients with so far undiagnosed or incorrectly or incompletely diagnosed dizziness or imbalance.


Assuntos
Membrana dos Otólitos/fisiopatologia , Equilíbrio Postural , Transtornos das Sensações/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Vertigem Posicional Paroxística Benigna/diagnóstico , Tontura/diagnóstico , Tontura/fisiopatologia , Marcha , Humanos , Pessoa de Meia-Idade , Modelos Biológicos , Prevalência , Canais Semicirculares/fisiopatologia , Transtornos das Sensações/fisiopatologia , Vertigem/diagnóstico , Vertigem/fisiopatologia , Adulto Jovem
4.
Mymensingh Med J ; 28(2): 405-409, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31086158

RESUMO

Globus sensation is a subjective feeling of a lump or foreign body in the throat without interfering swallowing of food. It is a persistent and distressing sensation in throat. It affects about 6% of population. But cause of globus is still unknown. Exact aetiology of globus is considered to be multifactorial. Some other studies also show association between globus and psychological distress including anxiety and depression. As there is no established pharmacological treatment, adequate investigations with negative result could reassure patients and improve their symptoms. In this prospective study consecutive patients with globus symptoms examined by upper GIT endoscopy with attention to larynx, epiglottis, base of tongue, both pyriform fossa and hypo-pharynx using Olympus forward viewing video Gastroscope (GIF Q-150 & GIF Q-170) to exclude organic lesion and was conducted in the department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and North East Medical College, Sylhet from 1st July 2014 to 31 December 2016. Their psychological status and epidemiological information including personal and family history were noted in a pre-designed data sheet. Total 104 patients were examined, among them definite anxiety was found in 36(34.95%) and borderline feature of anxiety was found in 19(18.44%) and 48(46.60%) were free of anxiety. Incidence of anxiety was significantly higher among females and was more prevalent among housewife, married people and people from rural community. In this series, 13(12.5%) patients had definite depression and 29(27.9%) patients had borderline depression, while 61(59.2%) patients had no feature of depression. Incidence of depression was significantly higher among females, housewife and married people. Organic lesion is rare in patients with globus symptoms. Globus sensation is more common among females. Psychological factors like anxiety and depression are frequently associated with globus sensation.


Assuntos
Transtornos da Motilidade Esofágica/diagnóstico , Esofagoscopia , Faringe/inervação , Transtornos das Sensações/etiologia , Sensação/fisiologia , Ansiedade/epidemiologia , Bangladesh/epidemiologia , Endoscopia , Transtornos da Motilidade Esofágica/epidemiologia , Feminino , Humanos , Prevalência , Estudos Prospectivos , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/epidemiologia
5.
Arch Orthop Trauma Surg ; 139(7): 1021-1023, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31011794

RESUMO

Nerve injuries, mostly to the median nerve, are common following distal radius fractures. Ulnar nerve injuries are rarely encountered, with only few case reports of motor or motor and sensory loss described in the literature. In this paper, we report two consecutive cases of young patients with a distal radius fracture and a pure sensory ulnar neuropathy. Both patients had a radially displaced fracture and presented with sensory loss and paresthesia in the distribution of the dorsal cutaneous branch of the ulnar nerve (DCBUN), which resolved after fracture reduction. We believe this clinical scenario is the result of traction or compressive neuropraxia of the DCBUN in the subcutaneous tissue around the ulnar styloid-a neurologic injury which had not yet been described for distal radius fractures.


Assuntos
Redução Fechada/métodos , Fratura-Luxação , Traumatismos dos Nervos Periféricos , Fraturas do Rádio , Transtornos das Sensações , Nervo Ulnar/lesões , Punho/diagnóstico por imagem , Adulto , Fratura-Luxação/complicações , Fratura-Luxação/diagnóstico , Fratura-Luxação/fisiopatologia , Fratura-Luxação/cirurgia , Fixação de Fratura/métodos , Humanos , Masculino , Exame Neurológico , Parestesia/diagnóstico , Parestesia/etiologia , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/fisiopatologia , Traumatismos dos Nervos Periféricos/terapia , Radiografia/métodos , Fraturas do Rádio/complicações , Fraturas do Rádio/diagnóstico , Fraturas do Rádio/fisiopatologia , Fraturas do Rádio/cirurgia , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Pele/inervação , Tato , Resultado do Tratamento
7.
J Stroke Cerebrovasc Dis ; 28(4): 994-1000, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30612892

RESUMO

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.


Assuntos
Terapia por Exercício/métodos , Retroalimentação Sensorial , Transtornos Neurológicos da Marcha/reabilitação , Marcha , Equilíbrio Postural , Transtornos das Sensações/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Tronco/inervação , Adulto , Feminino , Análise da Marcha , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Recuperação de Função Fisiológica , República da Coreia , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Transtornos das Sensações/fisiopatologia , Método Simples-Cego , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Percepção Visual
8.
J Clin Neurophysiol ; 36(3): 224-228, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30694944

RESUMO

PURPOSE: Patients presenting with pain, numbness, or paresthesias frequently have normal electrodiagnostic studies. Supranormal sensory nerve action potential amplitudes may be a potential biomarker of sensory nerve hyperexcitability. METHODS: A retrospective chart review of 400 consecutive patients with normal electromyography reports between July and November 2016 was performed. Patients were divided into tertiles based on the degree of sensory nerve action potential amplitudes above lower limits of normal (<2×, 2-3×, and >3×). Patient demographics and sensory symptom quality were assessed. Multivariate analysis assessed for an association between sensory symptoms and sensory nerve action potential amplitudes, age, or gender. RESULTS: After controlling for age and gender, subjects in the 2-3× and >3× normal tertiles had a higher association with multifocal symptoms, whereas those in the >3× normal tertile had a lower association with distal symptoms compared with the <2× normal tertile. CONCLUSION: The association of supranormal sensory nerve action potential amplitudes with multifocal symptoms may be an indicator of diffuse hyperexcitability.


Assuntos
Potenciais de Ação/fisiologia , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/fisiopatologia , Adulto , Idoso , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Condução Nervosa/fisiologia , Estudos Retrospectivos
9.
J Stroke Cerebrovasc Dis ; 28(4): 935-943, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30630753

RESUMO

BACKGROUND: Although perturbation-based balance training (PBT) may be effective in improving reactive balance control and/or reducing fall risk in individuals with stroke, the characteristics of reactive balance responses that improve following PBT have not yet been identified. This study aimed to determine if reactive stepping characteristics and timing in response to support-surface perturbations improved to a greater extent following PBT, compared to traditional balance training. MATERIALS AND METHODS: This study represents a substudy of a multisite randomized controlled trial. Sixteen individuals with chronic stroke were randomly assigned to either perturbation-based or traditional balance training, and underwent 6-weeks of training as a part of the randomized controlled trial. Responses to support-surface perturbation were evaluated pre- and post-training, and 6-months post-training. Reactive stepping characteristics and timing were compared between sessions within each group, and between groups at post-training and 6-months post-training while controlling for each measure at the pre-training session. RESULTS: The frequency of extra steps in response to perturbations decreased from pre-training to post-training for the PBT group, but not for the control group. CONCLUSIONS: Improvements in reactive balance control were identified after PBT in individuals with chronic stroke. Findings provide insight into the mechanism by which PBT improves reactive balance control poststroke, and support the use of PBT in balance rehabilitation programs poststroke.


Assuntos
Acidentes por Quedas/prevenção & controle , Terapia por Exercício/métodos , Transtornos Neurológicos da Marcha/reabilitação , Marcha , Equilíbrio Postural , Transtornos das Sensações/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Feminino , Análise da Marcha , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Recuperação de Função Fisiológica , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Transtornos das Sensações/fisiopatologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
10.
J Stroke Cerebrovasc Dis ; 28(4): 954-962, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30630757

RESUMO

OBJECTIVE: Fast and scaled muscular activation is required to recover body balance following an external perturbation. An issue open to investigation is the extent to which the cerebral hemisphere lesioned by stroke leads to asymmetric deficits in postural reactive responses. In this experiment, we aimed to compare muscular responses to unanticipated stance perturbations between individuals who suffered unilateral stroke either to the right or to the left cerebral hemisphere. METHODS: Stance perturbations were produced by releasing a load attached to the participant's trunk, inducing fast forward body oscillation. Electromyography was recorded from the gastrocnemius medialis and biceps femoris muscles. Muscular activation from age-matched healthy individuals was taken as reference. RESULTS: Analysis indicated that damage to the right hemisphere induced delayed activation onset, and lower rate and magnitude of activation of the proximal and distal muscles of the paretic leg. Those deficits were associated with stronger activation of the nonparetic leg. Comparisons between left hemisphere damage and controls showed deficits limited to activation of the biceps femoris of the paretic leg. Manipulation of visual information led to no significant effects on muscular responses. CONCLUSIONS: These results suggest that right cerebral hemisphere damage by stroke leads to more severe deficits in the generation of reactive muscular responses to stance perturbation than damage to the left cerebral hemisphere regardless of visual information.


Assuntos
Cérebro/fisiopatologia , Lateralidade Funcional , Músculo Esquelético/inervação , Paresia/fisiopatologia , Equilíbrio Postural , Transtornos das Sensações/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Percepção Visual , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Avaliação da Deficiência , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paresia/diagnóstico , Paresia/etiologia , Paresia/psicologia , Estimulação Luminosa , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Transtornos das Sensações/psicologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/psicologia
11.
J Autism Dev Disord ; 49(4): 1570-1585, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30547258

RESUMO

Gender variance (GV) and autism spectrum disorder (ASD) frequently co-occur in clinical populations. We investigated GV in association with ASD characteristics in nonclinical children and in children with developmental/mental health diagnoses. In 6-12-year-olds (N = 2445; 51% birth-assigned boys), the Gender Identity Questionnaire for Children measured GV and the Children's Social Behavior Questionnaire measured six subdomains of ASD characteristics. Among nonclinical children, GV was associated with parent-reported difficulties orienting socially and stereotyped behaviors. GV was also associated with parent-reported clinical diagnoses of ASD, sensory processing disorder, and oppositional defiant disorder. These findings suggest associations between specific ASD characteristics and GV in nonclinical children. Also, childhood GV should be further examined in a range of clinical populations, including ASD individuals.


Assuntos
Transtorno do Espectro Autista/psicologia , Pais/psicologia , Inquéritos e Questionários , Pessoas Transgênero/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/epidemiologia , Transtornos das Sensações/psicologia , Comportamento Estereotipado/fisiologia
12.
Muscle Nerve ; 59(3): 342-347, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30549060

RESUMO

INTRODUCTION: We evaluated diagnostic value of sensory tests during recovery from iatrogenic sensory neuropathy using intraoperatively verified nerve injury with subjective symptoms as gold standard. METHODS: Inferior alveolar nerves were monitored neurophysiologically throughout mandibular osteotomy in 19 patients. Sensory disturbance was registered and sensation tested using clinical and quantitative sensory (QST) and neurophysiologic tests postoperatively at 1, 3, 6, and 12 months. Sensitivity, specificity, and predictive values were calculated for all tests. RESULTS: The sensitivity of clinical tests was at best 37%, with 100% specificity, but they lost diagnostic value at chronic stages. Best diagnostic accuracy (highest combination of sensitivity and specificity) at different time points was achieved by combining neurophysiologic and thermal QST or tactile and thermal QST. The single most accurate test was sensory neurography. CONCLUSIONS: Neurography or combinations of neurophysiologic and quantitative tests enables most reliable early and late diagnosis. Clinical sensory examination is inadequate for accurate diagnosis. Muscle Nerve 59:342-347, 2019.


Assuntos
Neuralgia/diagnóstico , Doenças do Sistema Nervoso Periférico/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Transtornos das Sensações/diagnóstico , Adolescente , Adulto , Eletromiografia , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Masculino , Nervo Mandibular/fisiopatologia , Osteotomia Mandibular/efeitos adversos , Pessoa de Meia-Idade , Neuralgia/etiologia , Doenças do Sistema Nervoso Periférico/etiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Sensação , Transtornos das Sensações/complicações , Sensibilidade e Especificidade , Sensação Térmica , Adulto Jovem
13.
Phys Med Rehabil Clin N Am ; 30(1): 155-170, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30470419

RESUMO

Neurosensory deficits after traumatic brain injury can frequently lead to disability; therefore, diagnosis and treatment are important. Posttraumatic headaches typically resemble migraines and are managed similarly, but adjuvant physical therapy may be beneficial. Sleep-related issues are treated pharmacologically based on the specific sleep-related complaint. Fatigue is difficult to treat; cognitive behavioral therapy and aquatic therapy can be beneficial. Additionally, methylphenidate and modafinil have been used. Peripheral and central vestibular dysfunction causes dizziness and balance dysfunction, and the mainstay of treatment is vestibular physical therapy. Visual dysfunction incorporates numerous different diagnoses, which are frequently treated with specific rehabilitation programs.


Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Traumatismo Múltiplo/reabilitação , Transtornos das Sensações/etiologia , Transtornos das Sensações/reabilitação , Veteranos , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico , Gerenciamento Clínico , Humanos , Traumatismo Múltiplo/complicações , Traumatismo Múltiplo/diagnóstico , Transtornos das Sensações/diagnóstico
14.
Phys Occup Ther Pediatr ; 39(1): 94-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29465281

RESUMO

AIMS: This study examined the validity of a new measure of sensory processing for children, the Sensory Processing 3-Dimensions Scale (SP-3D). The SP-3D is a performance-based measure for children ages three to thirteen years, designed to assess sensory processing abilities, and identify the three patterns of sensory processing disorder (SPD) and related subtypes, including sensory modulation, sensory discrimination, and sensory-based motor disorders. METHODS: Age trends were explored using descriptive statistics and graphing techniques with a sample of children with and without SPD. SP-3D scores were correlated with scores from the Sensory Processing Measure (SPM) to examine criterion-related validity. Discriminant validity was assessed by comparing SP-3D scores from children with and without SPD. RESULTS: Age trends of SP-3D scores supported sensory discrimination, praxis and postural functions as developmental constructs. Several mild to moderate correlations were found between the scores of the SP-3D and the SPM, indicating that the tools are measuring similar constructs, and supporting the SP-3D as a measure of sensory processing. Modulation and Motor Behavior Scores from the SP-3D discriminated typically developing children from those with SPD, while results from subtests measuring sensory discrimination, postural and praxis were mixed regarding capacity for discrimination suggesting revision to several items. CONCLUSION: The study provides preliminary evidence of the SP-3D as a valid measure of sensory processing abilities and dysfunction. Further research regarding the reliability and validity of the SP-3D are needed.


Assuntos
Desenvolvimento Infantil/fisiologia , Técnicas de Diagnóstico Neurológico , Psicometria/métodos , Transtornos das Sensações/diagnóstico , Sensação/fisiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
15.
Clin Exp Optom ; 102(1): 63-69, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29938826

RESUMO

BACKGROUND: Visual impairment is globally among the most prevalent disabilities. Research concerning the health consequences of visual deficits is challenged by confounding effects of age, because visual impairment becomes more prevalent with age. This study investigates the influence of visual deficits on visual, musculoskeletal and balance symptoms in adults with and without visual impairment, while controlling for age effects. METHODS: Thirty-nine patients with visual impairment, aged 18-72 years, were compared to 37 age-matched controls with normal vision, allocated to two age groups: < 45 and ≥ 45 years. Self-reported symptoms were measured using the Visual, Musculoskeletal and Balance Symptoms Questionnaire and compared with demographic and optometric variables. RESULTS: In total, patients with visual impairment reported more symptoms than age-matched normally sighted controls. Younger adults in the control group were almost free from symptoms, whereas younger adults with visual impairment reported levels of symptoms equal to older adults with visual impairment. Multiple logistic regression modelling identified use of eyeglasses, magnifying aids and presence of anisometropia to be the most influential risk factors for reporting visual, musculoskeletal and balance symptoms, with accentuated influence on balance symptoms. CONCLUSIONS: People with visual impairments and people with age-related normal visual deficits are both predisposed to report visual, musculoskeletal and balance symptoms relative to people without visual defects or need for eye-wear correction. Age-related variations in symptoms were observed in the control groups but not in the visual impairment groups, with younger visual impairment patients reporting as many symptoms as older visual impairment patients. These findings indicate a need for a wider interdisciplinary perspective on eye care concerning people with visual impairment and people with need for habitual daily use of eye wear correction.


Assuntos
Doenças Musculoesqueléticas/fisiopatologia , Equilíbrio Postural/fisiologia , Transtornos das Sensações/fisiopatologia , Transtornos da Visão/fisiopatologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/diagnóstico , Prevalência , Fatores de Risco , Transtornos das Sensações/diagnóstico , Inquéritos e Questionários , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia , Acuidade Visual/fisiologia , Pessoas com Deficiência Visual , Adulto Jovem
16.
Acta Orthop Traumatol Turc ; 53(1): 56-60, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30573173

RESUMO

OBJECTIVE: The aim of the study was to assessment the impact of hip osteoarthritis on postural stability. METHODS: One hundred and twenty-five randomly selected women 20-85 years old (mean age of 49 ± 24.4 years) were assigned to three groups based on age, health status and activity level. Group 1 (cases) - elderly women with diagnosed hip osteoarthritis, group 2 (control) - women without hip osteoarthritis, and group 3 (control) - healthy young women. Assessment of postural stability were measured using a WIN-POD Pel 38 electronic podometer. Statistica 10 software was used to perform t-test resulting in significance level of p < 0.05. RESULTS: Significant differences in pedobarographic balance measurements were observed between the study groups with eyes opened or closed (deviation length eyes open: group 1-3 and 2-3 p < 0.0001; eyes closed group 1-2 p = 0.19; 1-3 and 2-3 p < 0.0001; deviation area eyes open: group 1-3 and 2-3 p < 0.0001; eyes closed group 1-3 and 2-3 p < 0.0001; deviation velocity eyes open: group1-3 and 2-3 p < 0.0001; eyes closed group 1-2 p < 0.010, 1-3 and 2-3 p < 0.0001). The poorest postural stability was observed in patients with hip osteoarthritis (deviation length eyes open vs eyes closed 180.8/201.7 p = 0.028, deviation area 128.7/145.7 p = 0.771, deviation velocity 5.1/6.1 p < 0.0001), and the best postural stability was observed in young women (deviation length 111.3/137.5 p < 0.0001, deviation area 57/76.9 p = 0.003, deviation velocity 3.4/4.2 p < 0.0001). CONCLUSION: (1) Osteoarthritic degeneration of the hip joint results in a significant disturbance in proprioception. This finding was reflected by the inferior stability parameters collected from subjects with hip osteoarthritis when asked to stand with their eyes closed. These finding were not observed in the other groups. (2) The disorder of the body stability of people with osteoarthritis may be a relative indication for the implantation of hip arthroplasty.


Assuntos
Cinestesia , Osteoartrite do Quadril , Equilíbrio Postural , Propriocepção , Adulto , Idoso , Estudos de Casos e Controles , Gerenciamento Clínico , Feminino , Articulação do Quadril/patologia , Articulação do Quadril/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/fisiopatologia , Polônia , Distribuição Aleatória , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Transtornos das Sensações/fisiopatologia
17.
J Psychiatr Pract ; 24(4): 230-238, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30427806

RESUMO

Motor dysfunction is commonly present in children with neurodevelopmental disorders. Developmental changes in voluntary control of motor skills include improvements in speed and motor coordination as well as reduced frequency of neurological soft signs (NSS) that are commonly observed in typically developing younger children. NSS are motor and sensory conditions that cannot be linked to specific cerebral lesions. The persistence of NSS into later childhood and adolescence is linked with an increased risk of psychiatric disorders. This finding gives support to the neurodevelopmental model of NSS in which minor neurological impairments may be viewed as potential signs of deviant brain development and might represent trait markers of vulnerability for neurodevelopmental disorders. Given that NSS are easily detectable, it is important that clinicians increase their knowledge of the clinical presentation and research implications of the relationship between NSS and childhood neurodevelopmental disorders. To the best of our knowledge, this is the first review article to give an updated overview of the current knowledge of NSS in the most common neuropsychiatric disorders of childhood/adolescence, such as attention-deficit/hyperactivity disorder, autism spectrum disorder, obsessive-compulsive disorder, bipolar disorder, and first episode of psychosis. The article also presents key points for future research studies on this topic.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Espectro Autista/diagnóstico , Transtorno Bipolar/diagnóstico , Transtornos das Habilidades Motoras/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtornos Psicóticos/diagnóstico , Transtornos das Sensações/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/fisiopatologia , Transtorno Bipolar/complicações , Transtorno Bipolar/fisiopatologia , Criança , Pré-Escolar , Humanos , Transtornos das Habilidades Motoras/etiologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtornos Psicóticos/complicações , Transtornos Psicóticos/fisiopatologia , Transtornos das Sensações/etiologia , Transtornos das Sensações/fisiopatologia
18.
Hand Clin ; 34(4): 537-545, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30286968

RESUMO

Surgery is one element of the rehabilitative care of the spastic upper limb. Different surgical techniques have been advocated to address each of the common deformities and underlying causes, including muscle spasticity, joint contracture, and paralysis. Partial neurectomy of motor nerves has been shown to reduce spasticity in the target muscles. It is effective only for the spastic component of the deformity, which underscores the importance of a preliminary thorough clinical examination. Hyperselective neurectomy, which involves performing a partial division of each motor ramus at its entry point into the target muscle, results in improved selectivity, reliable partial muscle denervation, and durable results.


Assuntos
Denervação Muscular , Espasticidade Muscular/cirurgia , Extremidade Superior/cirurgia , Toxinas Botulínicas/administração & dosagem , Contratura/diagnóstico , Contraindicações de Procedimentos , Avaliação da Deficiência , Humanos , Deformidades Articulares Adquiridas/diagnóstico , Espasticidade Muscular/fisiopatologia , Neurotoxinas/administração & dosagem , Paralisia/diagnóstico , Exame Físico , Cuidados Pré-Operatórios , Transtornos das Sensações/diagnóstico , Extremidade Superior/fisiopatologia
19.
J Clin Neurosci ; 56: 175-177, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30318072

RESUMO

A 64 years-old woman presented subacute onset distal paraesthesia concurrently with cold-induced urticaria, a rare form of physical urticaria. Both the disturbances developed a fortnight after an upper respiratory tract infection. EMG confirmed an exclusively sensory polyneuropathy, with prolongation of distal latencies and reduction of amplitudes. Anti-GQ1b and anti-GT1a antigangliosides antibodies were found in serum. The clinical workout included CSF analysis, cryoglobulin and paraprotein search, neurotropic infective agents, neoplastic markers and extensive autoimmune disease antibodies analysis, all of which resulted negative. Intravenous immunoglobulins were administered, leading to progressive resolution of the sensory disturbance, while a combination of steroid and anti-histaminics treatment was used for the urticaria. The positivity for anti-ganglioside search with an EMG pattern characterized by a mixture of demyelinating and axonal features may suggest a nodo-paranodopathy at early stages. This is the first case of an association between an acute sensory neuropathy and cold urticaria, two immune mediated conditions apparently due to very different hypersensitivity pathways. A proposed mechanism for the co-occurence of these two conditions is presented, whereas this case expands the clinical spectrum of autoimmune diseases associated with anti-GQ1b and anti-GT1a antibodies.


Assuntos
Temperatura Baixa/efeitos adversos , Gangliosídeos/sangue , Parestesia/sangue , Infecções Respiratórias/sangue , Urticária/sangue , Idoso , Autoanticorpos/sangue , Biomarcadores/sangue , Feminino , Humanos , Pessoa de Meia-Idade , Parestesia/diagnóstico , Parestesia/etiologia , Infecções Respiratórias/complicações , Infecções Respiratórias/diagnóstico , Transtornos das Sensações/sangue , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Urticária/diagnóstico , Urticária/etiologia
20.
Rev. andal. med. deporte ; 11(3): 0-0, sept. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-181210

RESUMO

Objective: To compare the behavior of the spinal levels for the accelerometric analysis and thus to define a proper placement point. Method: Using three triaxial accelerometers (in dorsal and in lumbar regions) and a video camera, of 66 older women through one leg balance and standing tests with open and closed eyes, in static and dynamic conditions and gait repeated three times each trial. Results: The accelerometer located in L5 explain the 88% and the 73% of the results obtained with the accelerometers located in the dorsal region and L4, respectively. The results have also showed a high correlation between the age and the average acceleration for dynamic one leg balance. Furthermore, an increase of the acceleration vector in the course of the trials (except in normal gait) was observed. Conclusions: Although, the accelerometric data obtained in L4 and L5 have often been used arbitrarily for balance evaluation, actually there are differences in the records that made. Therefore, choosing the L4 not only reduces the kinematics information provided by the accelerometers but also simplifies the process of evaluation and analysis


Objetivo: Comparar el comportamiento de los diferentes niveles de la columna vertebral para el análisis acelerométrico y así definir el punto de colocación adecuado de los mismos. Método: Usando 3 acelerómetros triaxiales (uno en zona dorsal y 2 en la lumbar) y una cámara de vídeo, fueron evaluadas 66 mujeres mayores a través de pruebas de equilibrio en diferentes condiciones, bipedestación y apoyo monopodal, ojos abiertos y cerrados, condiciones dinámicas y estáticas, y de la marcha. Cada prueba se repitió 3 veces. Resultados: El acelerómetro situado en L5 explica el 88% y el 73% de los resultados obtenidos con los acelerómetros situados en la zona dorsal y L4, respectivamente. Los resultados también mostraron una alta correlación entre la edad y la aceleración media para el equilibrio dinámico monopodal. Por otra parte, se observó un aumento del vector aceleración en el curso de las 3 repeticiones (excepto en la marcha normal). Conclusiones: Aunque los datos obtenidos en L4 y L5 se han empleado en numerosos estudios de manera aleatoria, en realidad hay diferencias en los registros que proporcionan. Los datos obtenidos confirman que no existen diferencias significativas entre la elección de la cuarta o la quinta vértebra lumbar para la colocación de estos dispositivos. Por lo tanto, la elección de la L4 no solo no reduce la información cinemática proporcionada por los acelerómetros sino que también simplifica el proceso de evaluación y análisis


Objetivo: comparar o comportamento dos diferentes níveis da coluna vertebral para a análise acelerométrica e assim definir o ponto de colocação adequado dos mesmos. Método: Usando três acelerómetros triaxiais (um na zona dorsal e dois na lombar) e uma câmera de vídeo, foram avaliadas 66 mulheres idosas através de testes de equilíbrio em condições diferentes, apoio com um e dois pés, olhos abertos e fechados, condições dinâmicas e estáticas, e da marcha. Cada teste foi repetido três vezes. Resultados: O acelerómetro situado na L5 explicaram 88% e 73% dos resultados obtidos com os acelerómetros localizados na região dorsal e L4, respectivamente. Os resultados também mostraram uma alta correlação entre a idade e a aceleração média para o equilíbrio dinâmico monopodal. Além disso, se observou um aumento do vetor de aceleração no decurso de três repetições (exceto marcha normal). Conclusões: Apesar dos dados obtidos em L4 e L5 têm sido usados em numerosos estudos de maneira aleatória, na realidade existem diferenças nos registos que fornecem. Os dados obtidos confirmam que existem diferenças significativas entre a escolha da quarta ou da quinta vértebra lombar para colocação destes dispositivos. Portanto, a escolha de L4 não só reduz as informações cinemática fornecida pelos acelerómetros mas também simplifica o processo de avaliação e análise


Assuntos
Humanos , Feminino , Idoso , Equilíbrio Postural/fisiologia , Transtornos das Sensações/diagnóstico , Acelerometria/métodos , Sensação Gravitacional/fisiologia , Antropometria/métodos , Pesos e Medidas Corporais/estatística & dados numéricos , Saúde do Idoso , Estudos Transversais
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