Europa medicophysica最新文献

{"title":"Biomechanics of lower limb raising from the supine position.","authors":"R Gatti,&nbsp;M Corti,&nbsp;P Cervi,&nbsp;L Pulici,&nbsp;S Boccardi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>This study analyses the kinematics of the lower limb raising movement from the supine position and the electromyography activity of the muscles involved.</p><p><strong>Methods: </strong>Twenty healthy right hand subjects performed the right lower limb raising from the supine position, starting from the clinical bed plane and up to a 70 degrees inclination of the thigh over the horizontal plane, while the knee was kept flexed at 120 degrees by a soft splint. The same exercise was executed with no resistance and with 2 kg and 8 kg respectively applied to the ankle. The kinematics was recorded utilising an optoelectronic system, whereas the electromyography activity was recorded by a surface electromyography (EMG) applied to the following muscles: right rectus femoris, left biceps femoris, rectus abominalis from both sides and dorsal major from both sides.</p><p><strong>Results: </strong>In all the cases the pelvis performed a backwards rotation retroversion. The highest increase of EMG activation was recorded on the right rectus femoris as well as on the left biceps femoris; the increase was lower in the right rectus abdominis and in the right dorsal major, whereas it was minimum in the left rectus abdominis and in the left dorsal major. A great variability in the activation times was reported in the various muscles of the different subjects, regardless of the trials. The only muscle anticipating the right rectus femoris activation was the left biceps femoris.</p><p><strong>Conclusions: </strong>The research has shown how the simple movement under study is more complex than what is usually described by the text books, both in regard to the kinematics and to muscles' actions. Even the individual variability in utilising the agonist and stabilisation muscles can be of relevance for a more rational utilisation of the physical exercise in motor re-education.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"185-93"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307030","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":"Constraint-induced movement therapy: an original concept in rehabilitation.","authors":"N Smania","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"239-40"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307544","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":"Constraint-induced movement therapy: characterizing the intervention protocol.","authors":"D M Morris,&nbsp;E Taub,&nbsp;V W Mark","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Constraint-induced movement therapy (CI therapy) is a rehabilitation treatment approach that improves more-affected extremity use following a stroke, especially in the life situation. The originators of the approach describe CI therapy as consisting of a family of therapies including a number of treatment components and subcomponents. When thinking of CI therapy, rehabilitation researchers and clinicians frequently cite a restraining mitt on the less affected arm as the main active ingredient behind improvements in motor function. However, substantial data suggest that restraint makes actually a relatively small contribution to treatment outcome. This paper provides a detailed description of the multiple treatment elements included in the CI therapy protocol as used in our research laboratory. Our aim is to improve understanding of CI therapy and the research supporting its use.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"257-68"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307546","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":"Neuroplasticity and constraint-induced movement therapy.","authors":"V W Mark,&nbsp;E Taub,&nbsp;D M Morris","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent years have seen a proliferation of animal and human studies that have associated significant changes in regional brain physiology with sustained altered environmental or somatic stimuli. The behavioral consequences in such instances can be adaptive or maladaptive. As would be expected, constraint-induced movement therapy (CI therapy), which has been found to be beneficial for chronic stroke hemiparesis, has been repeatedly associated with significant plastic brain changes in a variety of studies that have included transcranial magnetic stimulation (TMS), functional magnetic resonance imaging (fMRI), or other approaches. In some instances, the initial degree of brain reorganization occurred in parallel with the improvement in spontaneous, real-world use by the more-affected hand, which suggests that plastic brain changes in some manner support therapeutic effects. However, the studies are also inconsistent with respect to whether the reorganization changes occur more in the lesioned vs unlesioned hemisphere. Interpreting the physiological outcomes post-treatment is compromised by inconsistencies in study design in the nature of treatment administered, participant recruitment, imaging modality, and extent of follow-up. Improved understanding of the biological basis for neuroplasticity in CI therapy may be obtained through rigorous control of study approaches and through evaluating treatment changes with more than one modality in the same patients concurrently. New quantitative structural brain imaging techniques may allow measuring morphological changes following CI therapy to test hypotheses of regional brain recruitment in use-dependent therapy while avoiding the variability of functional imaging and mapping techniques and the difficulties and assumptions imposed by requiring active limb movement during scanning.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"269-84"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307547","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":"A randomised controlled cross-over trial of aerobic training versus Qigong in advanced Parkinson's disease.","authors":"D Burini,&nbsp;B Farabollini,&nbsp;S Iacucci,&nbsp;C Rimatori,&nbsp;G Riccardi,&nbsp;M Capecci,&nbsp;L Provinciali,&nbsp;M G Ceravolo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effects of an aerobic training in subjects with Parkinson's disease (PD) as compared to a medical Chinese exercise (Qigong).</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>randomized controlled trial with a cross over design.</p><p><strong>Setting: </strong>PD out-patients referred to a Neurorehabilitation facility for the management of motor disability.</p><p><strong>Subjects: </strong>26 PD patients in Hoehn and Yahr stage II to III under stable medication were randomly allocated to either Group AT1+QG2 (receiving 20 aerobic training sessions followed by 20 ''Qigong'' group sessions with 2 month interval between the interventions), or Group QG1+AT2 (performing the same treatments with an inverted sequence).</p><p><strong>Main outcome measures: </strong>clinical effects of treatment were sought through the Unified Parkinson's Disease Rating Scale (UPDRS), Brown's Disability Scale (B'DS), six-Minute Walking Test (6MWT), Borg scale for breathlessness, Beck Depression Inventory (BDI) and Parkinson's Disease Questionnaire-39 items (PDQ-39). A spirometry test and maximum cardiopulmonary exercise test (CPET) were also performed to determine the pulmonary function, the metabolic and cardio-respiratory requests at rest and under exercise. All measures were taken immediately before and at the completion of each treatment phase.</p><p><strong>Results: </strong>The statistical analysis focusing on the evolution of motor disability and quality of life revealed a significant interaction effect between group and time for the 6MWT (time x group effect: F: 5.4 P=0.002) and the Borg scale (time x group effect: F: 4.2 P=0.009). Post hoc analysis showed a significant increase in 6MWT and a larger decrease in Borg score after aerobic training within each subgroup, whereas no significant changes were observed during Qigong. No significant changes over time were detected through the analysis of UPDRS, B'DS, BDI and PDQ-39 scores. The analysis of cardiorespiratory parameters showed significant interaction effects between group and time for the Double Productpeak (time x group effect: F: 7.7 P=0.0003), the VO(2peak) (time x group effect: F: 4.8 P=0.007), and the VO(2)/kg ratio (time x group effect: F: 4.3 P=0.009), owing to their decrease after aerobic training to an extent that was never observed after Qigong treatment.</p><p><strong>Conclusions: </strong>Aerobic training exerts a significant impact on the ability of moderately disabled PD patients to cope with exercise, although it does not improve their self-sufficiency and quality of life.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"231-8"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307543","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":"Quality of life and aphasia. Multicentric standardization of a questionnaire.","authors":"L Posteraro,&nbsp;A Formis,&nbsp;E Grassi,&nbsp;M Bighi,&nbsp;P Nati,&nbsp;C Proietti Bocchini,&nbsp;E Todeschini,&nbsp;C Bidini,&nbsp;D Corsini,&nbsp;M Agosti,&nbsp;M Franceschini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>It is important to assess aphasics' quality of life in order to plan a rehabilitation treatment. To date such a tool is still missing for Italian patients. This paper reports normative data of the Italian version of SAQOL-39, a British questionnaire aimed to assess aphasics' quality of life. It consists of 39 items, divided into 4 subdomains (Physical, Communication, Psychosocial and Energy).</p><p><strong>Methods: </strong>Forty-two patients coming from 3 different Speech Therapy Services were enrolled. All patients completed speech therapy before examination. They were submitted to the Italian SAQOL-39 and 2 screening tests for aphasia: 1) Communication Assessment Scale according Goodglass and Kaplan; 2) Franchay Aphasia Screening Test (FAST). A receptive FAST score of 7 out of 15 was used as a cut-off score for SAQOL-39 administration.</p><p><strong>Results: </strong>The Italian SAQOL-39 showed good internal consistency (full scale Cronbach's alpha 0.939). Cronbach's alpha for every subdomains ranged from 0.950 (Communication) to 0.720 (Energy). Fluent aphasics gave significantly higher scores than nonfluent ones on full scale, and all out of Energy subdomains. Furthermore gravity of aphasia correlated with both full scale and Communication subdomain scores.</p><p><strong>Conclusions: </strong>In authors' opinion, the Italian SAQOL-39 shares many psychometric features with the English one. This questionnaire seems to be suitable for clinical practice.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"227-30"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307542","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":"Persistence of range of motion in dorsiflexion, when the triceps surae muscles weaken, worsens stance and gait in Charcot-Marie-Tooth disease. A case report.","authors":"P Vinci","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Charcot-Marie-Tooth disease is a genetically heterogeneous disorder, characterized by length dependent degeneration of motor and sensory nerve fibers. The variability in clinical severity is typical, and is considered the result of environmental factors interacting with the genotype. We report the case of 2 sisters who present the same muscle involvement, with complete atrophy below the knees, but a very different degree of disability: the milder affected sister can walk independently for 1 km, the more severe for 50 m only. The factor, responsible for the different functional impairment, is the persistence of ankle dorsiflexion. This is the result of prolonged stretching of the heel cords in the more severely affected sister, which destabilizes stance and ambulation. On the contrary, the milder affected sister presents a slight equinus deformity well compensated by wearing shoes with a bit of heel. The presented cases and biomechanics suggest that the persistence of range of motion in dorsiflexion, when the triceps surae muscles weaken beyond a certain degree, represents an important negative factor of clinical variability in Charcot-Marie-Tooth disease; this can be averted by correct rehabilitation management.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"219-22"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307540","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":"Falls in a rehabilitation setting: functional independence and fall risk.","authors":"A Saverino,&nbsp;E Benevolo,&nbsp;M Ottonello,&nbsp;E Zsirai,&nbsp;P Sessarego","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>With this study we wanted to determine the incidence, characteristics and consequences of falls in our rehabilitation setting.</p><p><strong>Methods: </strong>An observational study was carried out in a rehabilitation setting for postacute orthopedic and neurological inpatients. Three-hundred and twenty patients were enrolled. Falls risk factors (Downton index [DI] and other known parameters), disability (functional independence measure [FIM]) and balance (Berg balance scale [BBS]) were assessed at admission. Falls that occurred during the rehabilitation stay were prospectively classified (St. Louis Older Adult Service and Information System [OASIS] system) and analyzed.</p><p><strong>Results: </strong>Forty patients experienced a fall (12.5%). The faller group was characterized by a major clinical complexity; 70% of fallers were neurological patients and 30% presented cognitive impairment (mini mental state examination [MMSE] <24). They presented a statistically significant worse score on FIM (motor and cognitive), BBS and DI at admission, with 74% predictability of falls as measured by total FIM score and age. Falls recorded with the OASIS classification showed a prevalence (52.5%) for not bipedal (wheelchair transfer) and self-generated falls; 35% were intrinsic falls (caused by subject-specific factors) and 12.5% extrinsic falls (caused by environmental factors). Falls resulted in only minor clinical consequences, except for one rib fracture, but led to a significant increase in length of stay.</p><p><strong>Conclusions: </strong>In a rehabilitation centre, for good management of resources and safe prescriptions of a patient's independence in activities of daily living, fall risk is better evaluated with appropriate scales.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"179-84"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307029","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":"Pain relief in early rehabilitation of rotator cuff tendinitis: any role for indirect suprascapular nerve block?","authors":"L Di Lorenzo,&nbsp;M Pappagallo,&nbsp;R Gimigliano,&nbsp;E Palmieri,&nbsp;E Saviano,&nbsp;A Bello,&nbsp;A Forte,&nbsp;E DeBlasio,&nbsp;C Trombetti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of the trial was to evaluate the efficacy of suprascapular nerve block (SSNB) to relieve the shoulder pain, ameliorate recovery after physiotherapy and reduce disability due to a rotator cuff tendinitis (RCT). A prospective, randomized, comparison cross over investigation was performed in the setting of a large inpatient rehabilitation unit with more than 200 admissions annually.</p><p><strong>Methods: </strong>A total of 40 potential study subjects, who complained of shoulder pain from a RCT, were enrolled and randomly assigned to standard rehabilitation treatment plus SSNB (Group A) or to standard rehabilitation treatment alone (Group B). The UCLA shoulder rating scale was used to assess the shoulder mobility on admission and discharge, and to calculate the percentage of potential improvement achieved during rehabilitation (effectiveness). A pain visual analogic scale was used to serially assess pain. At the end of the trial, a self-report questionnaire evaluated whether patients could sleep and achieve activity of day life carry out everyday activities better than they could before treatment.</p><p><strong>Results: </strong>Forty patients suffering from RCT entered the study. Those receiving nerve block from the beginning of the treatment in addition to standard rehabilitation therapy reported significantly less pain during physiotherapy and better final outcomes. During treatment with SSNBs, patients reported a more significant reduction in the intensity of pain and a better reduction of pain during sleep and rehabilitation exercises in comparison to with the standard therapy alone. A statistically significant inverse correlation was found between shoulder pain and mobility.</p><p><strong>Conclusions: </strong>The results indicate that combining nerve block with standard rehabilitative therapy may improve the final outcome of painful RCT. It decreased the severity and frequency of the perceived pain, improved the compliance with physiotherapy, restored more normal sleep patterns, and increased compliance with the rehabilitation program. This result proves to be an effective, safe and inexpensive therapeutic option for patients suffering from painful disabling shoulder tendinitis.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"195-204"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307031","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 learned nonuse phenomenon: implications for rehabilitation.","authors":"E Taub,&nbsp;G Uswatte,&nbsp;V W Mark,&nbsp;D M M Morris","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Research on monkeys with a single forelimb from which sensation is surgically abolished demonstrates that such animals do not use their deafferented limb even though they possess sufficient motor innervation to do so, a phenomenon labeled learned nonuse. This dissociation also occurs after neurological injury in humans. Instruments that measure these two aspects of motor function are discussed. The effects of a neurological injury may differ widely in regard to motor ability assessed on a laboratory performance test in which movements are requested and actual spontaneous use of an extremity in real-world settings, indicating that these parameters need to be evaluated separately. The methods used in Constraint-Induced Movement therapy (CI therapy) research to independently assess these two domains are reliable and valid. We suggest that these tests have applicability beyond studies involving CI therapy for stroke and may be of value for determining motor status in other types of motor disorders and with other types of treatment. The learned nonuse formulation also predicts that a rehabilitation treatment may have differential effects on motor performance made on request and actual spontaneous amount of use of a more affected upper extremity in the life situation. CI therapy produces improvements in the former, but focuses attention on the latter and, in fact, spontaneous use of the limb is where this intervention has by far its greatest effect. The evidence suggests that this result is driven by use of a ''transfer package'' of techniques, which can be used with other therapies to increase the transfer of improvements made in the clinic to the life situation. The use of CI therapy in humans began with the upper extremity after stroke and was then extended for the upper extremity to cerebral palsy in young children (8 months to 8 years old) and traumatic brain injury. A form of CI therapy was developed for the lower extremities and was used effectively after stroke, spinal cord injury, and fractured hip. Adaptations of CI therapy have also been developed for aphasia (CI aphasia therapy), focal hand dystonia in musicians and phantom limb pain. The range of these applications suggests that CI therapy is not only a treatment for stroke, for which it is most commonly used, but for learned nonuse in general, which manifests as excess motor disability in a number of conditions which until now have been refractory to treatment.</p>","PeriodicalId":87180,"journal":{"name":"Europa medicophysica","volume":"42 3","pages":"241-56"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307545","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}