1/35. A novel method for locomotion training.This article describes a novel therapeutic system for locomotion training and learning for patients with a wide range of neurological and musculoskeletal disorders. The technique embraces the notion that locomotion therapy should be goal oriented and task specific. The task specificity includes a partial weight-bearing device that permits the posture/equilibrium, movement, and weight-bearing components of gait function to operate concurrently, even in patients with serious deficits. In addition, it allows interaction with therapists and others to facilitate locomotion control, particularly during the early stages of gait therapy. Neurobiological bases for this technique and early clinical results are discussed, and two case studies of patients with traumatic brain injury (TBI) are presented. Although well-designed efficacy studies are needed, clearly this therapeutic approach to locomotor disorders among TBI patients meets the various criteria for recovery of gait function established in this article.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/35. Bilateral contemporaneous posteroventral pallidotomy for the treatment of Parkinson's disease: neuropsychological and neurological side effects. Report of four cases and review of the literature.The authors report the underestimated cognitive, mood, and behavioral complications in patients who have undergone bilateral contemporaneous pallidotomy, as seen in their early experience with functional neurosurgery for Parkinson's disease (PD) that is accompanied by severe motor fluctuations before pallidal stimulation. Four patients, not suffering from dementia, with advanced (Hoehn and Yahr Stages III-IV), medically untreatable PD featuring severe "on-off" fluctuations underwent bilateral contemporaneous posteroventral pallidotomy (PVP). All patients were evaluated according to the Core Assessment Program for Intracerebral Transplantations (CAPIT) protocol without positron emission tomography scans but with additional neuropsychological cognitive, mood, and behavior testing. For the first 3 to 6 months postoperatively, all patients showed a mean improvement of motor scores on the Unified Parkinson's disease Rating Scale (UPDRS), in the best "on" (21%) and worst "off" (40%) UPDRS III motor subscale, a mean 30% improvement in the UPDRS II activities of daily living (ADL) subscore, and 60% on the UPDRS IV complications of treatment subscale. Dyskinesia disappeared almost completely, and the mean daily duration of the off time was reduced by an average of 60%. Despite these good results in the CAPIT scores, one patient experienced a partially regressive corticobulbar syndrome with dysphagia, dysarthria, and increased drooling. No emotional lability was found in this patient, but he did demonstrate severe bilateral postoperative pretarsal blepharospasm (apraxia of eyelid opening), which interfered with walking and which required treatment with high-dose subcutaneous injections of botulinum toxin. No patient showed visual field defects or hemiparesis, but postoperative depression, changes in personality, behavior, and executive functions were seen in two individuals. Postoperative abulia was reported by the family of one patient, who lost his preoperative aggressiveness and drive in terms of ADL, speech, business, family life, and hobbies, and became more sleepy and fatigued. One patient reported postoperative mental automatisms, such as compulsive mental counting, and circular thoughts and reasoning during off phases; postoperative depression was found in two patients. However, none of the patients demonstrated these symptoms during intraoperative microelectrode stimulation. These findings are compatible with previous reports on bilateral pallidal lesions. A progressive lowering of UPDRS subscores was seen after 12 months, consistent with the progression of the disease. Bilateral simultaneous pallidotomy may be followed by emotional, behavioral, and cognitive deficits such as depression, obsessive-compulsive disorders, and loss of psychic autoactivation-abulia, as well as disabling corticobulbar dysfunction and apraxia of eyelid opening, in addition to previously described motor and visual field deficits, which make this surgery undesirable even though significant improvement in motor deficits can be achieved.- - - - - - - - - - ranking = 0.28571428571429keywords = motion (Clic here for more details about this article) |
3/35. music therapy for children with rett syndrome.The rett syndrome is good reactivity for sound and music. We enforced active music therapy (MT) individual session to patients with rett syndrome. The patients were 4, 5 and 6-year-old. The active music therapy and individual session of 30 min/week were performed. It was recorded in video and description, and using the original evaluation list, six items of fact. On largest problem that is hand operation with purpose in childhood of rett syndrome, we recorded the longest duration and frequency of hand grasping time in one session. There was the improvement of 35.0% of listening music, 33.3% play music, 13.3% singing music, 11.7% minute motion, 11.7% language, and 20.0% personal relation and sociality. The longest duration of hand grasping time was improved from 2 to 12 s in case 2 and from 7 to 80 s in case 3. Grasp frequency which showed the volition rapidly increased from 3 to 41 times, though the elongation for the duration of grasping was little for case 2. rett syndrome is the disease in which the psychomotor performance regresses with the age, but the aspect that surely developed in the session could be evaluated. rett syndrome has the ability understanding the music, and music therapy is suitable for them.- - - - - - - - - - ranking = 0.14285714285714keywords = motion (Clic here for more details about this article) |
4/35. rehabilitation outcome in a patient awakened from prolonged coma.BACKGROUND: This article describes the rehabilitation of a patient recovering from a prolonged coma (defined as lasting longer than 4 weeks). The case is noteworthy because it exemplifies the possibilities and difficulties entailed in treating these patients, who are often regarded as too severely impaired to justify intensive rehabilitation efforts. CASE REPORT: The patient is a 28-year old Polish male, unmarried, who suffered serious closed head injuries in an automobile accident in April of 1999. He was in a comatose state for more than two months, with a GCS score of 5. When admitted for rehabilitation he was bedridden, with global aphasia, agraphia, limb apraxia, and executive dysfunction. The rehabilitation program developed for him is described in detail. RESULTS: Over the course of rehabilitation, which began in December 1999 and continues to this writing, the patient has regained locomotion capabilities (though with impairments), and his speech has improved considerably. The apraxia has largely resolved, and he is able to write his name and copy words. He is now capable of performing many activities of daily living. CONCLUSIONS: A comprehensive program of rehabilitation characterized by a strategic, heuristic approach is capable of achieving a good outcome even in very difficult cases, such as prolonged coma.- - - - - - - - - - ranking = 0.14285714285714keywords = motion (Clic here for more details about this article) |
5/35. Treatment of pain and limited movement of the shoulder in hemiplegic patients with botulinum toxin a in the subscapular muscle.Three poststroke hemiplegic patients were treated by injecting Botulinum toxin A (BtxA) into the subscapularis muscle, to reduce pain and increase the range of motion in the shoulder. According to the described procedure, 250 units of Dysport toxin were injected through a 0.8-mm diameter needle with electrostimulation guidance. In the 3 cases, injection of BtxA reduced pain and improved the range of motion, especially abduction and external rotation, of the hemiplegic shoulder. This result confirms the role of spasticity in hemiplegic shoulder pain and the beneficial effects of Botulinum toxin injection into the subscapularis muscle deserve to be confirmed in further series.- - - - - - - - - - ranking = 0.28571428571429keywords = motion (Clic here for more details about this article) |
6/35. Troubled reaching after right occipito-temporal damage.We encountered a man with an unusual reaching disturbance due to a stroke in the right occipito-temporal cortex and subjacent white matter. We studied his behavior in detail including vision and hand control. He had a left homonymous hemianopia. In his remaining fields static visual acuity and stereoacuity were normal, but he could not detect a coherent motion signal or follow moving targets with smooth pursuit. Transduction of limb movements using an optoelectronic technique showed abnormal morphology, increased variability and markedly prolonged latencies for transport to external visual targets, yet he achieved these targets with precision. Reaching to self-bound targets, and to the remembered locations of external targets with vision blocked was 5 x faster. The findings may be explained by: (1) damage in regions homologous to areas TF and TH in the monkey, which provide visual inputs to hand and forelimb representations in the cortex; (2) injury in human regions homologous to the monkey's MT complex, with inability to use visual information on the movement of the limb due to a visual motion processing defect; and (3) disruption of visual cortical-subcortical connections mediating crucial transformations among limb and target representations.- - - - - - - - - - ranking = 0.28571428571429keywords = motion (Clic here for more details about this article) |
7/35. Cervical involvement in juvenile-onset ankylosing spondylitis with bone scintigraphy.Juvenile-onset ankylosing spondylitis is an unusual disorder which can present with either peripheral arthritis or more classic hip girdle and back symptoms. A 12-year-old child with this disease was admitted with walking disorder, cervical pain, restricted cervical motion, and right ankle swelling. Diffusely increased accumulation of radioactivity in the cervical spine, focally increased accumulation in bilateral sacroiliac joints, and diminished irregular uptake in thoracal spine were detected on technetium 99m methylene diphosphonate bone scintigraphy. As a result, this imaging technique may give important information for diagnosis and differential diagnosis in juvenile chronic arthritis.- - - - - - - - - - ranking = 0.14285714285714keywords = motion (Clic here for more details about this article) |
8/35. Feasibility of electromyography-triggered neuromuscular stimulation as an adjunct to constraint-induced movement therapy.BACKGROUND AND PURPOSE: The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT). CASE DESCRIPTION: The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours. OUTCOMES: The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements were paralleled by a change in the size and location of the extensor digitorum communis muscle representation in the primary motor cortex, as measured by transcranial magnetic stimulation mapping. DISCUSSION: These changes suggest that using EMG-stim as an adjunct to CIMT should be further investigated in individuals who have low functional abilities following stroke.- - - - - - - - - - ranking = 0.14285714285714keywords = motion (Clic here for more details about this article) |
9/35. Dystonic rabbit syndrome from citalopram.OBJECTIVE: Two cases are described of dystonic rabbit syndrome induced by citalopram. This syndrome is a movement disorder with a 5-Hz rhythmic vertical motion of the mouth and lips without involvement of the tongue. METHOD: The patients were interviewed and examined, and additional history was taken from the medical records. The Naranjo adverse drug reaction rating scale was applied. Relevant literature was reviewed. RESULTS: Two patients developed dystonic rabbit syndrome soon after starting escitalopram 10 mg/day or citalopram 5 mg/day. Neither patient had any past or current exposure to a dopamine-blocking drug or any history of movement disorder. [Es]citalopram discontinuation led to disappearance of the movement disorder. The Naranjo scale indicates high probability of dystonic rabbit syndrome from citalopram. CONCLUSION: citalopram can rapidly induce dystonic rabbit syndrome. This effect suggests that for some patients citalopram has neuropsychiatric effects similar to those of a dopamine-blocking antipsychotic drug. This might be of concern with patients who cannot communicate well (eg, young children; patients with dementia, developmental disabilities, or aphasia).- - - - - - - - - - ranking = 0.14285714285714keywords = motion (Clic here for more details about this article) |
10/35. Global motion mechanisms compensate local motion deficits in a patient with a bilateral occipital lobe lesion.Successive stages of cortical processing encode increasingly more complex types of information. In the visual motion system this increasing complexity, complemented by an increase in spatial summation, has proven effective in characterizing the mechanisms mediating visual perception. Here we report psychophysical results from a motion-impaired stroke patient, WB, whose pattern of deficits over time reveals a systematic shift in spatial scale for processing speed. We show that following loss in sensitivity to low-level motion direction WB's representation of speed shifts to larger spatial scales, consistent with recruitment of intact high-level mechanisms. With the recovery of low-level motion processing WB's representation of speed shifts back to small spatial scales. These results support the recruitment of high-level visual mechanisms in cases where lower-level function is impaired and suggest that, as an experimental paradigm, spatial summation may provide an important avenue for investigating functional recovery in patients following damage to visually responsive cortex.- - - - - - - - - - ranking = 1.7142857142857keywords = motion (Clic here for more details about this article) |
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