Europa medicophysica最新文献

{"title":"Neck muscle training in the treatment of chronic neck pain: a three-year follow-up study.","authors":"J Ylinen,&nbsp;A Häkkinen,&nbsp;M Nykänen,&nbsp;H Kautiainen,&nbsp;E-P Takala","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The objective of the trial was to evaluate whether the positive results achieved with a one-year training regimen in patients with chronic nonspecific neck pain would have long-standing effects.</p><p><strong>Methods: </strong>A follow-up study of two neck muscle training groups after a randomized controlled study was carried out. One-hundred and eighteen women included were those who had performed neck strength and endurance exercises in a previous randomised controlled trial. The primary outcome measures were neck pain measured by the visual analogue scale and disability indices. Isometric neck strength, range of motion (ROM) and pressure pain threshold (PPT) were measured and training frequency for the previous month elicited by a questionnaire.</p><p><strong>Results: </strong>At the 3-year follow-up, neck pain and the disability indices showed no statistically discernible change compared to the situation at the 12-month follow-up. Also, gains in neck strength, ROM and PPT achieved during the training year were largely maintained. However, adherence to the specific home training program faltered considerably.</p><p><strong>Conclusion: </strong>The improvements achieved through long-term training were maintained at the 3-year follow-up. Since a 12-month exercise programme shows a long-term effect, exercise may not need to be performed regularly for the remainder of the subject's life.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"161-9"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26743527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future perspectives in functional neuroimaging in stroke recovery.","authors":"N S Ward","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurological damage and stroke in particular is the leading cause of long-term disability worldwide. Recovery of function after stroke is a consequence of many factors including resolution of oedema and survival of the ischaemic penumbra. In addition, there is a growing interest in how reorganisation of the surviving tissue might subserve the improvements in function that are commonly seen over weeks, months, and sometimes years after stroke. Noninvasive techniques such as functional magnetic resonance imaging, electroencephalography, magnetoencephalography and transcranial magnetic stimulation allow the study of this reorganisation in humans. Currently, results suggest that functionally relevant reorganisation does occur in cerebral networks in human stroke patients. This reorganisation can only occur in structurally and functionally intact brain regions. Because these vary depending on the location of the infarction, it is likely that different therapeutic strategies will be required to promote reorganisation depending on residual functional anatomy. This review maps out the attempts to describe functionally relevant adaptive changes in the human brain following focal damage. A greater understanding of how these changes are related to the recovery process will facilitate the development of novel therapeutic techniques designed to minimise impairment based on neurobiological principles and how to target these treatments to individual patients.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"285-94"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26743529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open access in the biomedical field: a unique opportunity for researchers (and research itself).","authors":"E Giglia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aim of this article is to offer an overview of the Open Access strategy and its innovative idea of a free scholarly communication. Following the worldwide debate on the crisis of the scholarly communication and the new opportunities of a networked environment, definitions, purposes and real advantages of the Open Access pathway are presented from a researcher's point of view. To maximize the impact and dissemination, by providing free access to the result of the research, two complementary roads are pointed out and explained self-archiving in open archives and publishing in Open Access journals. To let authors make their choice the most useful tools to find one's way in this new reality are shown: directories, search engines, citation tracking projects. The starting survey being done, the article deals in its conclusions with the Open Access challenges and most debated themes: impact and dissemination, new assessment measures alternative to the Impact Factor, new mandatory policies of the funding agencies, questions related to the copyright issue.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"203-13"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26794109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do we get better outcome with botulinum toxin in the treatment of children with spastic hemiplegia?","authors":"A I Dai","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"296-7; author reply 297"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26794115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The constraint induced movement therapy: a systematic review of randomised controlled trials on the adult stroke patients.","authors":"D Bonaiuti, L Rebasti, P Sioli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to analyse the evidence of effectiveness on adult stroke patients of the Constraint Induced Movement Therapy (CIMT), an original rehabilitation method that consists in strongly encouraging patients to use the affected arm, mainly immobilising the unaffected arm.</p><p><strong>Methods: </strong>We only took into account the randomised controlled trials on CIMT where the experimental treatment was compared with a conventional treatment without any discrepancy of organization or session duration. As we could not measure the statistical significance of differences between treated and control patients, we compared their respective post-treatment percent changes and computed the minimal clinically important difference (MCID), defined as a change of at least 10% of the maximum score of the scale used.</p><p><strong>Results: </strong>The literature search found 13 randomised controlled trials (RCTs), 4 of which were excluded because they aimed at comparing different intensity of CIMT. The 9 RCTs finally included into the review applied the CIMT in either acute, subacute or chronic stroke patients and according to different modalities. Findings were positive in all studies, but the MCID was reached only in smaller ones, which may have been influenced by patients' characteristics.</p><p><strong>Conclusion: </strong>Although all studies achieved positive results, it is impossible to draw any clear-cut conclusion on the effectiveness of the CIMT. The main limitations are the lack of homogeneity in the outcome measures used, the inadequacy of data provided and the small samples' size. Multicentre studies, using robust outcome measures and considering both motor- and sensory-disabled patients are needed.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"139-46"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26743528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase of the heat pain threshold during and after high-frequency transcutaneous peripheral nerve stimulation in a group of normal subjects.","authors":"M Buonocore,&nbsp;N Camuzzini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Transcutaneous electrical nerve stimulation (TENS) is used worldwide for pain relief, but its mechanisms of action are not completely understood. High frequency transcutaneous peripheral nerve stimulation (HF-TPNS) is a term describing a type of TENS where a peripheral nerve is stimulated transcutaneously. The aim of the investigation was to verify the hypothesis that HF-TPNS increases the heat pain threshold in the skin territory of the stimulated nerve, during and after stimulation.</p><p><strong>Methods: </strong>Eighteen volunteers (8 men, 10 women) participated in 2 sessions conducted on different days. In each session their heat pain thresholds were measured in basal conditions and after 5, 10, 15, 25, 40, 70 min. In one session, HF-TPNS was delivered for 10 min immediately after basal evaluation (HF-TPNS session). In the other session the heat pain thresholds only were measured (control session). The superficial radial nerve was stimulated at the wrist (frequency of 100 Hz, pulse duration of 0.1 ms). The heat pain threshold was studied using a contact thermode (surface of 12.5 cm(2)) placed in the cutaneous area of the stimulated nerve at the site where the paresthesia evoked by electrical stimulation could be felt.</p><p><strong>Results: </strong>HF-TPNS significantly increased the heat pain threshold both during and after stimulation.</p><p><strong>Conclusion: </strong>This study confirms that HF-TPNS induces an important hypoalgesic effect. The prolonged duration of poststimulation hypoalgesia (60 min) indicates that continuous stimulation is probably unnecessary. Further studies are needed to test the hypothesis that intermittent HF-TPNS is able to maintain its hypoalgesic effectiveness over time.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"155-60"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26292896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation of unilateral spatial neglect and neuroimaging.","authors":"N U Arene,&nbsp;A E Hillis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We review the literature on current knowledge of the role of unilateral spatial neglect as an independent predictor of poor functional outcome after right brain injury, the neural mechanisms and neural substrates that are responsible for the manifestation of neglect behaviors, and the available rehabilitation techniques for neglect amelioration. We focus on the neuroimaging correlates of these rehabilitation techniques and rehabilitation amelioration, their mode of action and their potential to make a difference in functional outcomes, by assessing their potential to improve patients' performance in activities of daily living. We recognize that there is no consensus on efficacious treatments for neglect rehabilitation, and acknowledge that the lack of complete clarity of the neural substrates and mechanisms underlying neglect phenomena may hinder the development of efficacious rehabilitation techniques. We discuss current opinions on the neural mechanisms of hemispatial neglect and delved into the neural substrates of neglect based on functional and structural imaging. We explore the role of damage or dysfunction within specific right hemisphere structures in generating certain neglect subtypes and discussed how such knowledge may guide treatments for the rehabilitation of unilateral neglect. From this foundation, we proceed to explore the available rehabilitation techniques for neglect amelioration and how neuroimaging may guide the choice of therapies for different forms of unilateral neglect. We discuss cognitive rehabilitation approaches which form the bedrock of most traditional rehabilitation programs and follow with a description of other available, but less well utilized methods of neglect rehabilitation, including sensory stimulation, sensorimotor adaptation to visual perturbations by prism adaptation, and pharmacological agents (mainly dopamine agonists) that might augment rehabilitation. We also discuss the efficacy of these techniques in neglect rehabilitation and compare the potential of these diverse techniques to ameliorate not only the different symptoms of neglect, but also the different subtypes of neglect. Finally, we make suggestions about future research that could enhance the rehabilitation of neglect.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"255-69"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26794112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the symmetric, patient-oriented, rigid, three-dimensional, active (SPoRT) concept of bracing for scoliosis: a prospective study of the Sforzesco versus Lyon brace.","authors":"S Negrini,&nbsp;G Marchini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Bracing is considered to be effective in the treatment of adolescent idiopathic scoliosis. The concept prevailing today includes an asymmetrical construction, mainly using a mechanical three-point system. We developed the new Sforzesco brace, based on the SPoRT concept (Symmetric, Patient-oriented, Rigid, Three-dimensional, active). The aim of this study is to verify the results of this concept and brace, compared to three-point classical systems.</p><p><strong>Methods: </strong>We performed a prospective, pair-controlled study. It was possible to match 15 patients, out of the first 18 consecutively treated with the Sforzesco brace (Group SPoRT), with previous patients treated with the Lyon brace (Group LY). SPoRT included 14.2+/-1.7 year old patients, with 47+/-7 degrees Cobb worst curves, and 11+/-4 degrees Bunnell; LY included 13.6+/-1.6 year old patients, with 43+/-7 degrees Cobb and 12+/-5 degrees Bunnell. The brace had to be worn 23 h per day and patients were evaluated after 6 months both clinically and radiographically (without the brace). Appropriate statistics were used.</p><p><strong>Results: </strong>At the baseline there were slight differences between the groups, with SPoRT worse than LY. All radiographic and clinical parameters decreased significantly with treatment in both groups, apart from thoracic Cobb degrees in LY. SPoRT had better results than LY (P<0.05) radiographically (worst curve -10+/-5 degrees vs -5+/-7 degrees, all curves -8+/-7 degrees vs -6+/-7 degrees), for sagittal profile (distance from plumbline: T12 -6+/-9 mm vs +2+/-8 and L3 -7+/-12 vs 0+/-10) and aesthetics of the shoulders (9 improved and 6 unchanged vs 5 and 8) and waists (10 improved and 5 unchanged vs 5 and 8). Finally, clinical results in terms of patient recovery were better in SPoRT than LY (12 improved and 3 unchanged vs 8 and 5).</p><p><strong>Conclusion: </strong>When a new treatment is introduced, it is not possible to wait years (end of therapy) before verifying its utility, and in scoliosis bracing a short term study already gives very important clues. This study confirms the immediate efficacy of brace treatment (even in such high degree cases) whatever the brace concept used, with only 2 (out of 30) progressed curves. In SPoRT we had no progressions, and obtained a statistically significant 80% better radiographic results than LY in the worst scoliosis curve, and 40% in the average of all curves, as well as improved aesthetics and sagittal profile (that is crucial in scoliosis bracing). The Sforzesco brace should be used, and the SPoRT concept explored in the long term to verify if the classical three-point system should be totally (or partially) abandoned.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"171-81; discussion 183-4"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26239181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear medicine in the rehabilitative treatment evaluation in stroke recovery. Role of diaschisis resolution and cerebral reorganization.","authors":"J M Mountz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There has recently been a tremendous increase in imaging technology and imaging methodology enabling noninvasive exploration of brain function to such an intricate degree as to enable measurements of very small spatial and short temporal cerebral operations responsible for neurological and functional recovery after stroke. This has allowed conceptualization of rehabilitation strategies designed to maximally enhance rehabilitation protocols tailored to the individual patient's deficits. Rehabilitation strategies may now be designed and optimized by employing methods to synchronize functional training of brain regions ascribed to those areas innately undergoing neuronal plasticity change responsible for stroke recovery. In order to effectively apply these noninvasive imaging methods, one must have a clear understanding of the physics and technique of the imaging methodologies and how these are best applied to understand brain physiology during the stroke recovery process to provide a solid rationale for development of rehabilitation protocols. Nuclear medicine imaging is first presented as a diagnostic method to assess the stroke process. The initial brain damage and resulting neurological disability can be primarily assessed in terms of changes in the vascular and hemodynamic status of the cerebral circulation in addition to alterations in the metabolic status around the infarction region. Techniques for assessing perfusion and metabolism include regional cerebral blood flow (rCBF), single photon emission computed tomography (SPECT), and F-18 2-Fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography (PET). In addition, hemodynamic vascular insufficiency can be assessed using O-15 O2 oxygen extraction PET and rest and Diamox rCBF SPECT. The status of the peri-infarction region can be characterized in terms of components of diaschisis and ischemia using proton magnetic resonance spectroscopy imaging ((1)H MRSI) and rest/stress rCBF assessment of cerebral vascular reserve. As the brain recovers from cerebral infarction, areas of reorganization and energy utilization by the brain can be measured using oxygen extraction methods with PET, F-18 FDG glucose utilization by PET, and functional magnetic resonance imaging (fMRI) measures using the blood oxygenation level dependent (BOLD) technique. In addition, high field MRI imaging of the brain is now able to provide detailed fractional anisotropy (FA) maps to characterize changes in white matter by fiber tracking mapping using diffusion tensor imaging. Imaging of the stroke recovery process focuses on the physiologic model of stroke characterized by rCBF, metabolism, 1H spectroscopic measures of N-acetyl aspartate (NAA), choline (Ch) and creatine (Cr) in the peri-infarction zone as well as in the extended stroke penumbra including areas of distant ''pure'' diaschisis unencumbered with the confound of cerebral ischemia. Data is presented describing the results of application of imaging method","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"221-39"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26525992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension: short-term functional assessment in a longitudinal study.","authors":"L Petrucci,&nbsp;E Carlisi,&nbsp;S Ricotti,&nbsp;C Klersy,&nbsp;A M D'Armini,&nbsp;M Viganò,&nbsp;E Dalla Toffola","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Presently, the surgical treatment choice in chronic thromboembolic pulmonary hypertension (CTEPH) consists in a pulmonary endarterectomy (PEA). The aim of the present study is the functional assessment of patients submitted to PEA both preoperatively and shortly after the intervention. A longitudinal study was developed to study the quality and quantity of functional performance possible in these subjects.</p><p><strong>Methods: </strong>Twenty-two subjects were assessed immediately prior to PEA and 3 months later in order to obtain quantitative measurements of short-term functional recovery. The functional assessment included the 6-min walk test (6mWT), the measurement of the oxygen percent saturation (HbS%O(2)) and the degree of dyspnea subjectively perceived by each patient.</p><p><strong>Results: </strong>Three months after the surgical intervention, there was a definite increase in the number of meters walked during the 6mWT with respect to preintervention; the difference between the distances walked in the 6mWT (6mWD) in the pre and post-PEA was statistically significant (Paired t-test P<0.001).</p><p><strong>Conclusion: </strong>In this study the 6mWT resulted to be a useful tool in the functional evaluation of patients affected by CTEPH and submitted to PEA. The average 6mWD significantly improved already at 3 months after the intervention, thus reaching the minimum limit of the range predicted for the healthy control, but remains lower than the average theoretical value predicted (about 75% of the same).</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"43 2","pages":"147-53"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26688785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}