1/19. alien hand syndrome: report of two cases.alien hand syndrome (AHS) refers to the occurrence of apparently purposeful movements in the hand which are independent of volitional control. Two subtypes of AHS have been proposed: frontal AHS, with grasp reflex and compulsive manipulation of tools by the dominant hand, and callosal AHS, which occurs in the nondominant hand and is characterized mainly by intermanual conflict. Here, we report two cases of frontal-type alien hand syndrome with symptoms of reflexive grasping, impulsive groping, and apraxia (in case 1), and compulsive manipulation of tools (in case 2). brain computed tomography revealed a left anterior cerebral artery (ACA) territory infarct and multiple small infarcts of both hemispheres in patient 1 and a left ACA infarct in patient 2. The involuntary movements were bothersome to these patients in their daily activities. Both patients attended conventional physical and occupational therapies, and patient 2 received additional biofeedback training. follow-up studies showed the spontaneous grasping behavior was still present in patient 1 and AHS had subsided in patient 2. We also describe a potentially effective technique involving biofeedback for patients with alien hand syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/19. Partial weight-bearing gait retraining for persons following traumatic brain injury: preliminary report and proposed assessment scale.The objectives of this investigation were to (1) document the recovery patterns of walking ability in two patients recovering from traumatic brain injury receiving partial weight-bearing gait retraining, and (2) introduce a new assessment scale of gait progress for patients receiving partial weight support therapy. The two patients were categorized as acute (< 6 months) and chronic (> 2 years) injury. Each patient received extensive in-patient rehabilitation, including physical therapy designed with twice-weekly partial body support gait training. The subjects made improvements in all measured indicators of gait ability (i.e. muscle strength, spasticity, standing balance). However, assessment of their improvement using standard assessment scales showed little progress. The newly devised missouri Assisted gait (MAG) scale, which includes developmental components of gait ability measured dramatic gains. This added precision of measurement was useful in communicating progress to both patients and providers.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/19. Orthodontic treatment in handicapped children: report of four cases.Mentally and physically handicapped children show in the orofacial system motor-sensitivity disturbances and malocclusions of varying severity. These dysfunctions affect the breathing and speech ability and inhibit the food intake. Myotherapeutic exercises for strengthening of lip and tongue muscles and orthodontic treatment of the malocclusions help provide esthetic and functional improvements in these patients. The limited compliance necessitates a differentiated procedure during the diagnostic and therapeutic process and demands compromises in some cases.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/19. Thalamic hand: a late onset sequela of stroke and its influence on physical function after rehabilitation: two cases report.Thalamic hemorrhage or infarction is one of the common causes of stroke. People who suffer from this type of cerebrovascular disease may develop thalamic syndrome which includes sensory disturbance, motor deficit and psychological problems. In this report, we introduce two cases of thalamic hemorrhage followed up for more than a half year after stroke. Delayed rigidity and choreodystonic type of involuntary movement over their paretic hand developed gradually. The metacarpophalangeal joints of the affected hand were kept flexed and the proximal and distal interphalangeal joints became extended. Thalamic hand is demonstrated in the appended pictures. Once the patient develops a thalamic hand, activities of daily living will be affected due to poor hand performance despite of high motor recovery stage. Early recognition and proper rehabilitation program for the patients with thalamic hand are emphasized.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
5/19. Psychogenic movement disorders in children.A common problem in neurology is the existence of disorders that present with neurologic symptoms but do not have an identifiable neurologic basis. These disorders are often thought to have a psychologic basis. Abnormal movements are among the most frequent symptoms in psychogenic neurologic disorders. Although these disorders have not been studied extensively in children, clinical experience in our busy pediatric movement disorders clinic and many case reports support their existence in this age group. elements of history, physical examination, and therapeutic intervention must be combined to construct a clear diagnosis of a psychogenic movement disorder. This article reviews the diagnosis and treatment of these disorders and includes two illustrative cases. review of the current literature reveals a need for prospective trials to provide a solid foundation for better diagnosis and treatment of these disorders.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/19. diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism.low back pain (LBP) is a very common but largely self-limiting condition. The problem arises however, when LBP disorders do not resolve beyond normal expected tissue healing time and become chronic. Eighty five percent of chronic low back pain (CLBP) disorders have no known diagnosis leading to a classification of 'non-specific CLBP' that leaves a diagnostic and management vacuum. Even when a specific radiological diagnosis is reached the underlying pain mechanism cannot always be assumed. It is now widely accepted that CLBP disorders are multi-factorial in nature. However the presence and dominance of the patho-anatomical, physical, neuro-physiological, psychological and social factors that can influence the disorder is different for each individual. classification of CLBP pain disorders into sub-groups, based on the mechanism underlying the disorder, is considered critical to ensure appropriate management. It is proposed that three broad sub-groups of CLBP disorders exist. The first group of disorders present where underlying pathological processes drive the pain, and the patients' motor responses in the disorder are adaptive. A second group of disorders present where psychological and/or social factors represent the primary mechanism underlying the disorder that centrally drives pain, and where the patient's coping and motor control strategies are mal-adaptive in nature. Finally it is proposed that there is a large group of CLBP disorders where patients present with either movement impairments (characterized by pain avoidance behaviour) or control impairments (characterized by pain provocation behaviour). These pain disorders are predominantly mechanically induced and patients typically present with mal-adaptive primary physical and secondary cognitive compensations for their disorders that become a mechanism for ongoing pain. These subjects present either with an excess or deficit in spinal stability, which underlies their pain disorder. For this group, physiotherapy interventions that are specifically directed and classification based, have the potential to impact on both the physical and cognitive drivers of pain leading to resolution of the disorder. Two case studies highlight the different mechanisms involved in patients with movement and control impairment disorder outlining distinct treatment approaches involved for management. Although growing evidence exists to support this approach, further research is required to fully validate it.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |
7/19. 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 = 1keywords = physical (Clic here for more details about this article) |
8/19. Treatment of limited shoulder motion using an elevation splint.This article describes the management of a patient with limited shoulder range of motion (ROM) by use of an elevation splint. The limited ROM was believed to be due to structural changes in the tissues surrounding the glenohumeral joint following a Magnuson-Stack repair for anterior glenohumeral instability. The patient's ROM plateaued approximately 6 months postoperatively and did not improve with a variety of physical therapy techniques. Use of an inexpensive, easily fabricated elevation splint was begun 8 months postoperatively, and subsequent improvements in ROM were observed. The rationale and suggestions for clinical use of the splint are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/19. Intensive postoperative mydeton therapy of traumatological patients.The effect of high-dose oral Mydeton therapy has been examined during the postoperative treatment of 73 patients who had undergone traumatological operations. By controlling the most characteristic parameters it has been observed that due to its myotonolytic and lymph flow improving action Mydeton improves significantly motor function and articular movement, shortens the postoperative therapeutic period, and facilitates the performance of curative physical exercise. Since the drug is well tolerated by the patients its use may be recommended as a routine in the above mentioned traumatological indications.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/19. Angelman's (happy puppet) syndrome: clinical, CT scan and serial electroencephalographic study.Of four patients having Angelman's syndrome admitted to a state mental facility who were clinically and electroencephalographically evaluated, 2 patients had CT scan studies of the brain. The most impressive and striking features that help in the diagnosis are the mental and physical retardation, nondevelopment of speech despite adequate visual and auditory function, various types of seizures, and episodic uncontrollable laughter. The CT scans of the brain did not offer any clue as to the pathogenesis. The EEGs appeared to fall into two groups: in one an arrest of electrical maturation occurred between ages 1 and 3 and in the other a slow but progressive maturation was evident.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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