PARALYSIS

Therapeutic horse riding is often employed for disabled children. The aim of the present paper was to determine the influence of exercise in a mechanical saddle, imitating horse's walk, on the skin temperature responses in lower limbs in children with cerebral palsy. Sixteen children, aged 14-16, were enrolled into the study. Skin surface temperature was assessed with thermography, using an infrared thermovision camera, AGEMA 550, before and directly after 20 +/-5 min of exercise. The findings demonstrate that mechanical hippotherapy provides an exercise stimulus that is capable of inducing a visible change in skin temperature of paralyzed limbs. The change, however, is one of a decrease in skin temperature, which points to acute vasoconstrictive effects of exercise and to decreased skin blood flow. The results, therefore, do not support the use of mechanical hippotherapy in children suffering from cerebral palsy, with a hope to stimulate blood circulation to spastically altered...

Many healthy subjects and patients are taking natural bioactive products for the prevention and treatment of multiple conditions, including gastrointestinal disorders. Based on current evidence, the scientific validity of the use of many of these commercial compounds by the ...

Temporal lobe epilepsy (TLE) is the most common form of intractable partial epilepsy in adults. Surgery (lobectomy or amygdalohippocampectomy) is effective in most patients. However, some complications can occur and brain shift, hematoma into the post operative cavity and occulomotor nerve palsy have been reported due to the surgical technic. We report the technique, safety and efficacy of temporal disconnection in nonlesional TLE. Forty-seven patients (18 males, 29 females; handedness: 12 left, 33 right; aged 35 years+/-10; mean duration of epilepsy: 24+/-10 years) underwent temporal disconnection (20 left, 27 right) guided by neuronavigation. Sixteen patients (35 %) underwent additional presurgical evaluation with SEEG. The outcome was assessed using Engel's classification. At the two-year follow-up, 85 % of the patients were seizure-free (Engel I), 26 (58 %) of whom were Ia. Postoperative persistent morbidity included mild hemiparesis (n=1), mild facial paresis (n=1), quadran...

This study explored the social experience of wheelchair rugby from the perspective of the players. Eleven national level rugby players (10 males, 1 female with a mean age of 33 years) shared their experiences through the phenomenological methods of semistructured focus group interviews and artifacts. Three themes emerged from the thematic analysis (a) it's okay to be a quad, (b) don't tell us we can't, and (c) the power of wheelchair rugby. The athletes identified with a shared sense of community and the membership, fulfillment of need, influence, and shared emotional connections they used to authentically express themselves through their sport. The implications of the findings were interpreted within the theoretical context of psychological sense of community.

Physical rehabilitation following spinal cord injury-related paralysis has traditionally focused on teaching compensatory techniques, thus enabling the individual to achieve day-to-day function despite significant neurological deficits. But the concept of an irreparable central nervous system (CNS) is slowly being replaced with evidence related to CNS plasticity, repair, and regeneration, all related to persistently maintaining appropriate levels of neurological activity both below and above the area where the damage occurred. It is now possible to envision functional repair of the nervous system by implementing rehabilitative interventions. Making the transition from "bench to bedside" requires careful analysis of existing basic science evidence, strategic focus of clinical research, and pragmatic implementation of new therapeutic tools. Activity, defined as both function specific motor task and exercise appears to be a necessity for optimization of functional, metabolic,...

This case study describes an example of a rare disorder which applies to alternating facial nerve palsy in Melkersson-Rosenthal Syndrome. The first description of this case was published in 1928, when Ernst G. Melkersson observed a disease which was characterised by recurring lips edema and facial nerve palsy. Then, in 1931 Curt Rosenthal added fissured tongue to the fundamental features of the syndrome. Unsatisfactory treatment results have prompted a search for interdisciplinary rehabilitation which could improve the functioning of the patient, aesthetics of the appearance, and effectiveness of the treatment. As it turns out, the PNF method, proprioreceptive neuromuscular facilitation stretching, along with neurologopedic therapy bring the most beneficial improvement for the patients.

The purpose of this study was to compare refractions measured with an autorefractor and by retinoscopy with and without cycloplegia. The objective refractions were performed in 199 right eyes from 199 healthy young adults with a mean age of 21.6 ± 2.66 years. The measurements were performed first without cycloplegia and repeated 30 min later with cycloplegia. Data were analysed using Fourier decomposition of the power profile. More negative values of component M and J0 were given by non-cycloplegic autorefraction compared with cycloplegic autorefraction (p < 0.0001). However more positive values for the J45 vector were given by non-cycloplegic autorefraction, although this difference was not statistically significant (p = 0.233). By retinoscopy, more negative values of component M were obtained with non-cycloplegic retinoscopy (p < 0.0001); for the cylindrical vectors J0 and J45 the retinoscopy without cycloplegia yields more negative values (p = 0.234; p = 0.112, respectively). Accepting that differences between cycloplegic and non-cycloplegic retinoscopy are only due to the accommodative response, the present results confirm that when performed by an experienced clinician, retinoscopy is a more reliable method to obtain the objective starting point for refraction under non-cycloplegic conditions.

Many studies have investigated the notion of utopia in history, philosophy and literature. However, little attention has been devoted to its negative counterpart. Dystopia is the “utopia’s twentieth-century doppelgänger” (Gordin et al., 2010:1). This essay claims the deconstruction of traditional opposites by using Dystopology. This multifocal literary theory expands the dystopian analysis to other genres. Additionally, this paper will provide a dystopological overview of literature to better understand the pure dystopias of the era of social deception, conceiving not only the genesis of a new literature, but also another way of perceiving reality, through comics, cinema and other arts. The new millennium secured the fears of the dystopian trilogy ‒Huxley, Orwell and Bradbury. Therefore, when dystopia turns into reality, the only solution for contemporary authors is apocalypse. Following anarchic ideals, the coming generations see the destruction of society as the only opportunity for humanity to be reborn again.

BackgroundGrade II hypoxic ischemic encephalopathy (GII-HIE) in newborns produces neurological sequelae in approximately 50% of patients. Neuro-rehabilitation offers rational therapeutic approaches in patients at risk of neurological damage; however, there is little information on comparison of different rehabilitation therapies.
Objective

Evaluate and compare results of Vojta therapy versus an early intervention program on the neurological and electrophysiological development of infants diagnosed with GII-HIE.

Methods

Controlled, randomized, simple blinded trial with term newborn patients diagnosed with GII-HIE, based on Sarnat-Sarnat criteria, aged 1-4 months. Thirty patients were recruited from the neonatology departments of two general hospitals in Mexico City. All patients underwent: Gesell Development Coefficient and evoked auditory, visual and somatosensorial potentials before therapy, and at 3 and 6 months of treatment. Therapy was applied by a therapist trained in the specific procedure for 30-40 minutes twice a week, for 6 months. The early intervention program includes proprioceptive and exteroceptive techniques that cover tactile stimulation (sucking, massage), vestibular stimulation, auditory stimulation (music, etc.), and visual stimulation (environment decoration, mobile elements).

Results

Twenty-seven patients finished the study, 13 girls and 14 boys, with an average age of 1.6 months; 12 had Vojta therapy and 15 early intervention. The Vojta therapy group had significantly higher scores in the Gesell test and its four neurological development areas (Mann-Whitney U, Gesell global, p=0.032; motor, p=0.04, language, p=0.01, adaptive, p= 0.01 and personal social, p= 0.02); in addition, there was also significant shortening (0.08 milliseconds) of the I-V interval in evoked auditory potential of the brain stem (p=0.05).Conclusions
Patients submitted to both therapies showed clinical and electrophysiological improvement, but the Vojta group had greater improvement in both the four areas of neurological development and in the I-V interval of evoked auditory potential.

We analyzed the twitch and summated torque (tetanus) during repetitive activation and recovery of the human soleus muscle in individuals with spinal cord injury. Thirteen individuals with complete paralysis (9 chronic, 4 acute) had the tibial nerve activated every 1,500 ms with a 20-Hz train (7 stimuli) for 300 ms and a single pulse at 1,100 ms. The stimulation protocol lasted 3 min and included 120 twitches and 120 tetani. Minimal changes were found for the acute group. The chronic group showed a significant reduction in the torque and a significant slowing of the contractile speeds of both the twitch and tetanus. The decrease in the peak twitch torque was significantly greater than the decrease in the peak tetanus torque early during the fatigue protocol for the chronic group. The twitch time to peak and half relaxation time were prolonged during fatigue, which was associated with improved fusion of the tetanus torque. At the end of the fatigue protocol, the decrease in the peak t...

Traumatic brachial plexus injuries are devastating and management is complex. Treatment involves a multidisciplinary approach. Primary reconstruction involves nerve repair, grafting, and transfer techniques. Secondary reconstruction includes microneurovascular free-functioning muscle transfer, tendon transfers, and arthrodesis to improve or restore function. These procedures are indicated when patients present more than 12 months from injury or when primary reconstruction procedures fail, and should focus on elbow flexion and shoulder stability. A free-functioning muscle transfer is often indicated for elbow flexion, with double free-functioning muscle transfers providing possible prehension. Shoulder reconstruction focuses on restoring stability to the glenohumeral joint and restoring abduction. This article outlines these techniques, their principles, and important details.

The paper aims to help people affected by drop foot syndrome to walk efficiently without dragging their foot. This paper also suggests a method to keep the nervous system active, till professional medical help is administered, when a person is about to be attacked by paralysis.

The extent to which the motor innervation regulates the embryonic development of skeletal muscle was investigated by comparing changes in normal, aneural, and paralyzed superior oblique muscle of the duck embryo. The muscle was made aneural by permanently destroying the trochlear motor neurons with electrocautery on day 7 i.e., three days prior to innervation. Embryos were paralyzed by daily application of α-bungarotoxin onto the chorioallantoic membrane from day 10 onwards. The differentiation of myoblasts and myotubes in the aneural muscle was severely affected and did not progress to the myofiber stage. A mass of dead cells in the aneural muscle was replaced by connective tissue. Although the differentiation of myoblasts and myotubes was also retarded in the paralyzed muscle, numerous muscle cells progressed to the myofiber stage. Neuromuscular junctions of normal ultrastructure were seen in all paralyzed muscles. Degeneration of some cells in the paralyzed muscle occurred but there was no evidence of a massive wave of cell death similar to that observed in the aneural muscle. These observations suggest that both the trophic factors from the nerve and the nerve-evoked muscle activity are essential for the execution of the developmental program of the muscle. Trophic factors may play a larger role in differentiation, and maintenance of the muscle than muscle activity.

Minimally invasive plate osteosynthesis (MIPO) has been advocated as a safe approach to humeral shaft fracture management. We evaluated the reproducibility of this technique in a regional hospital. Thirty-five patients underwent MIPO of humerus shaft fractures. Fifteen patients had an open fracture, six a preoperative radial nerve palsy, and nine a concomitant thoracic, musculoskeletal or vascular injury. At an average 12-month follow-up, 91% of fractures healed after a mean of 12 weeks (range, 8–16). Two infections occurred. Final alignment averaged 4° of varus (range, 5° of valgus to 20° of varus). Active elbow ROM averaged 114° (range, 60–135°) and was less than 100° in nine elbows. Five of six preoperative radial nerve injuries recovered spontaneously. Healing and infection rates in this study are consistent with those reported in the literature. Lower elbow ROM and higher fracture angulation at healing were nevertheless found. MIPO is technically demanding and requires adequate intraoperative imaging and surgical experience in order to obtain adequate fracture alignment. Brachialis muscle scarring and inadequate postoperative rehabilitation may be involved in limited elbow range of motion.