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[PMID]: 25150663
[Au] Autor:Griffin C
[Ad] Address:School of Health and Rehabilitation Sciences, The Ohio State University Wexner Medical Center, Columbus, Ohio.
[Ti] Title:Management of the hemiplegic shoulder complex.
[So] Source:Top Stroke Rehabil;21(4):316-8, 2014 Jul-Aug.
[Is] ISSN:1074-9357
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Hemiplegia in the upper limb and shoulder complex is a common secondary impairment resulting from a cerebrovascular event; evidence-based intervention is required for effective treatment. Prior to addressing shoulder movement, biomechanical alignment of the pelvis and trunk must first be assessed. Extreme care must be taken when completing passive range of motion with the hemiplegic shoulder; motion should not exceed beyond 90° of shoulder flexion and abduction without scapular upward rotation and humeral head external rotation. It is recommended that the use of slings with upper limb hemiplegia be limited. A subluxation of the shoulder can be treated with surface neuromuscular electrical stimulation if the recommended protocol of 6 hours daily, 5 days a week, for 6 weeks is utilized. Taping/strapping for a subluxation has conflicting evidence for reducing the development of hemiplegic shoulder pain, and it does not improve upper limb function or range of motion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1310/tsr2104-316

  2 / 11700 MEDLINE  
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[PMID]: 25063365
[Au] Autor:Grelat M; Debaux JB; Sautreaux JL
[Ad] Address:Department of Neurosurgery, Bocage Central, University Hospital of Dijon, 14 rue Paul Gaffarel, Dijon 21000, France. michael.grelat@gmail.com.
[Ti] Title:Posterior reversible encephalopathy syndrome after depletive lumbar puncture: a case report.
[So] Source:J Med Case Rep;8:261, 2014.
[Is] ISSN:1752-1947
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Posterior reversible encephalopathy syndrome is a rare entity. Its pathophysiology is still poorly understood. CASE PRESENTATION: We report the case of a 69-year-old White European woman who presented complete and proportional right hemiplegia, confusion, deviation of her head and eyes to the right, cortical blindness, and generalized tonic-clonic seizure 12 hours following a depletive lumbar puncture. Emergency cerebral magnetic resonance imaging showed bioccipital and left-side basal ganglia hyperintensities in the fluid attenuated inversion recovery and the diffusion-weighted images suggesting a radiological diagnosis of posterior reversible encephalopathy syndrome. CONCLUSIONS: The diagnosis is established on clinical and radiological signs. This is the first report of this kind in the literature. We present a case of posterior reversible encephalopathy syndrome after depletive lumbar puncture and we discuss the pathophysiology.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1186/1752-1947-8-261

  3 / 11700 MEDLINE  
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[PMID]: 24874638
[Au] Autor:Dark J; Sander R
[Ad] Address:University College London.
[Ti] Title:An overview of communication, movement and perception difficulties after stroke.
[So] Source:Nurs Older People;26(5):32-7, 2014 Jun.
[Is] ISSN:1472-0795
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:For many people who have had a stroke, weakness or paralysis on one side - hemiparesis or hemiplegia - is the most obvious symptom. However, brain damage, including stroke, can cause a range of impairments that may be less obvious but equally devastating for people and their families. This article provides an overview of communication, movement and perception difficulties, and the strategies nurses can use to help people cope with any changes to their lives.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1405
[Js] Journal subset:N
[St] Status:In-Process
[do] DOI:10.7748/nop.26.5.32.e567

  4 / 11700 MEDLINE  
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[PMID]: 22898586
[Au] Autor:Naganuma M; Isoda K; Nishi S; Ito K; Hirano T
[Ad] Address:Department of Medicine, Kumamoto Rosai Hospital, Kumamoto, Japan. Electronic address: naganuma@f6.dion.ne.jp....
[Ti] Title:Repeated episodes of ischemic stroke over a short period in a patient with essential thrombocythemia on anticoagulant therapy.
[So] Source:J Stroke Cerebrovasc Dis;23(1):166-8, 2014 Jan.
[Is] ISSN:1532-8511
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:A 69-year-old man who had essential thrombocythemia, for which he was taking no medications, suddenly developed aphasia and right hemiplegia and was admitted to the hospital. He was thought to have had an embolic stroke and was initially treated with warfarin. Although the international normalized ratio was in the therapeutic range, he had 3 additional ischemic stroke episodes with the same symptoms after the index stroke. Magnetic resonance angiographic examinations revealed serial changes in middle cerebral artery stenosis. After administration of an antiplatelet agent and hydroxyurea, he had no additional strokes.
[Mh] MeSH terms primary: Anticoagulants/adverse effects
Anticoagulants/therapeutic use
Brain Ischemia/etiology
Stroke/etiology
Thrombocythemia, Essential/complications
Thrombocythemia, Essential/drug therapy
[Mh] MeSH terms secundary: Aged
Aphasia/etiology
Cerebral Angiography
Diffusion Magnetic Resonance Imaging
Hemiplegia/etiology
Humans
Hydroxyurea/therapeutic use
Infarction, Middle Cerebral Artery/complications
International Normalized Ratio
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Perceptual Disorders/etiology
Platelet Aggregation Inhibitors/therapeutic use
Tetrazoles/therapeutic use
Warfarin/adverse effects
Warfarin/therapeutic use
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Anticoagulants); 0 (Platelet Aggregation Inhibitors); 0 (Tetrazoles); 5Q7ZVV76EI (Warfarin); N7Z035406B (cilostazol); X6Q56QN5QC (Hydroxyurea)
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:140106
[St] Status:MEDLINE

  5 / 11700 MEDLINE  
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[PMID]: 24371469
[Au] Autor:Sugita N; Yoshizawa M; Kojima Y; Abe M; Homma N; Seki K; Handa N
[Ad] Address:Graduate School of Engineering, Tohoku University, Sendai, Miyagi 980-8579, Japan....
[Ti] Title:Evaluation of motor performances of hemiplegic patients using a virtual cycling wheelchair: an exploratory trial.
[So] Source:Comput Math Methods Med;2013:512965, 2013.
[Is] ISSN:1748-6718
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Cycling is known to be an effective rehabilitation exercise for hemiplegic patients who face difficulty during walking because of stroke or other brain disorders. A cycling wheelchair (CWC) is a useful tool to provide exercise for these patients and improve their quality of life. In previous studies, our group developed a system that allows patients to safely practice driving a CWC in a virtual environment. However, it has been difficult to check their motor performances and determine the effects of the exercise on a daily basis. This study is an exploratory trial for developing a method to evaluate the motor performances of users based on their CWC pedaling patterns. An experiment with some hemiplegic patients and healthy subjects was conducted and their pedaling patterns were analyzed. Results showed a significant difference between the hemiplegic patients and healthy subjects in an index that reflects pedaling balance between the feet. This result indicates a possible method of evaluating the motor performances of users based on their pedaling patterns.
[Mh] MeSH terms primary: Hemiplegia/rehabilitation
Wheelchairs
[Mh] MeSH terms secundary: Aged
Algorithms
Automatic Data Processing
Bicycling
Disabled Persons
Equipment Design
Exercise
Exercise Therapy/methods
Female
Healthy Volunteers
Humans
Male
Middle Aged
Motor Skills
Reproducibility of Results
Signal Processing, Computer-Assisted
Stroke/physiopathology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:131227
[St] Status:MEDLINE
[do] DOI:10.1155/2013/512965

  6 / 11700 MEDLINE  
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[PMID]: 24072225
[Au] Autor:Figueiredo PR; Silva PL; Avelar BS; Chagas PS; Oliveira LC; Mancini MC
[Ad] Address:Universidade Federal de Minas Gerais, School of Physical Education, Belo HorizonteMG, Brazil.
[Ti] Title:Assessment of gait in toddlers with normal motor development and in hemiplegic children with mild motor impairment: a validity study.
[So] Source:Braz J Phys Ther;17(4):359-66, 2013 Jul-Aug.
[Is] ISSN:1809-9246
[Cp] Country of publication:Brazil
[La] Language:eng; por
[Ab] Abstract:BACKGROUND: The optimization of gait performance is an important goal in the rehabilitation of children with cerebral palsy (CP) who present a prognosis associated with locomotion. Gait analysis using videos captured by digital cameras requires validation. OBJECTIVE: To evaluate the validity of a method that involves the analysis of videos captured using a digital camera for quantifying the temporal parameters of gait in toddlers with normal motor development and children with CP. METHOD: Eleven toddlers with normal motor development and eight children with spastic hemiplegia who were able to walk without assistive devices were asked to walk through a space contained in the visual field of two instruments: a digital camera and a three-dimensional motion analysis system, Qualisys Pro-Reflex. The duration of the stance and swing phases of gait and of the entire gait cycle were calculated by analyzing videos captured by a digital camera and compared to those obtained by Qualisys Pro-Reflex, which is considered a highly accurate system. RESULTS: The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement (ICC>0.90) between the two procedures for all measurements, except for the swing phase of the normal toddlers (ICC=0.35). The standard error of measurement was less than 0.02 seconds for all measures. CONCLUSIONS: The results reveal similarities between the two instruments, suggesting that digital cameras can be valid instruments for quantifying two temporal parameters of gait. This congruence is of clinical and scientific relevance and validates the use of digital cameras as a resource for helping the assessment and documentation of the therapeutic effects of interventions targeted at the gait of children with CP.
[Mh] MeSH terms primary: Cerebral Palsy/physiopathology
Gait
Hemiplegia/physiopathology
[Mh] MeSH terms secundary: Female
Humans
Infant
Male
Psychomotor Performance
Severity of Illness Index
Video Recording
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:130927
[St] Status:MEDLINE

  7 / 11700 MEDLINE  
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[PMID]: 24641911
[Au] Autor:Catanzarite T; Rambachan A; Mueller MG; Pilecki MA; Kim JY; Kenton K
[Ad] Address:Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois....
[Ti] Title:Risk factors for 30-day perioperative complications after le fort colpocleisis.
[So] Source:J Urol;192(3):788-92, 2014 Sep.
[Is] ISSN:1527-3792
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: We identified rates of and risk factors for complications after colpocleisis using the American College of Surgeons NSQIP® database. MATERIALS AND METHODS: Women treated with Le Fort colpocleisis from 2005 to 2011 were identified in the database. Primary outcomes were 30-day complication rates. Secondary outcomes were risk factors for complications and the impact of age and a concomitant sling on morbidity. Clinical and procedural characteristics were compared using the chi-square test and 1-way ANOVA. RESULTS: We identified 283 women, of whom 23 (8.1%) experienced complications. The most common complication was urinary tract infection in 18 women (6.4%). There was 1 death for a 0.4% mortality rate. Increased complications were associated with age less than 75 years (p = 0.03), chronic obstructive pulmonary disease (p = 0.03), hemiplegia (p = 0.03), disseminated cancer (p = 0.03) and open wound infection (p = 0.02). Six patients (2.1%) required return to the operating room within 30 days. Complication rates did not differ based on operative time (p = 0.78), inpatient status (p = 0.24), resident involvement (p = 0.35), concomitant sling placement (p = 0.81) or anesthesia type (p = 0.27). Women undergoing colpocleisis without (191) and with (92) a sling had similar baseline characteristics. Colpocleisis without and with a sling had similar rates of complications (7.9% vs 8.7%, p = 0.81), urinary tract infection (5.8% vs 7.6%, p = 0.55), return to the operating room (2.1% vs 2.2%, p = 0.97) and mortality (0% vs 1.1%, p = 0.15). CONCLUSIONS: Mortality and complication rates after colpocleisis are low with urinary tract infection being the most common postoperative complication. Concomitant sling placement does not increase 30-day complication rates.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review

  8 / 11700 MEDLINE  
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[PMID]: 24996492
[Au] Autor:Vila-Pueyo M; Pons R; Raspall-Chaure M; Marcé-Grau A; Carreño O; Sintas C; Cormand B; Pineda-Marfà M; Macaya A
[Ad] Address:Grup de Recerca en Neurologia Pediàtrica, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain....
[Ti] Title:Clinical and genetic analysis in alternating hemiplegia of childhood: Ten new patients from Southern Europe.
[So] Source:J Neurol Sci;344(1-2):37-42, 2014 Sep 15.
[Is] ISSN:1878-5883
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Alternating hemiplegia of childhood (AHC) is a rare neurodevelopmental disorder featuring attacks of hemiplegia and other paroxysmal and non-paroxysmal manifestations leading to progressive neurological impairment. De novo mutations in ATP1A3 have been identified in up to 80% of patients. AHC is also associated with rare mutations in other genes involved in episodic neurological disorders. We sought to find mutations in ATP1A3, CACNA1A, ATP1A2, SCN1A and SLC2A1 in a cohort of ten unrelated patients from Spain and Greece. All patients fulfilled AHC diagnostic criteria. All five genes were amplified by PCR and Sanger sequenced. Copy number variation (CNV) analysis of SLC2A1 and CACNA1A was performed using two different approaches. We identified three previously described heterozygous missense ATP1A3 mutations (p.Asp801Asn, p.Glu815Lys and p.Gly947Arg) in five patients. No disease-causing mutations were found in the remaining genes. All mutations occurred de novo; carriers presented on average earlier than non-carriers. Intellectual disability was more severe with the p.Glu815Lys variant. A p.Gly947Arg carrier harbored a maternally-inherited CACNA1A p.Ala454Thr variant. Of note, three of our patients exhibited remarkable clinical responses to the ketogenic diet. We confirmed ATP1A3 mutations in half of our patients. Further AHC genetic studies will need to investigate large rearrangements in ATP1A3 or consider greater genetic heterogeneity than previously suspected.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1408
[Js] Journal subset:IM
[St] Status:In-Data-Review

  9 / 11700 MEDLINE  
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[PMID]: 24981060
[Au] Autor:Meadmore KL; Exell TA; Hallewell E; Hughes AM; Freeman CT; Kutlu M; Benson V; Rogers E; Burridge JH
[Ad] Address:Faculty of Physical Sciences and Engineering, University of Southampton, Southampton, UK. klm@ecs.soton.ac.uk.
[Ti] Title:The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study.
[So] Source:J Neuroeng Rehabil;11:105, 2014.
[Is] ISSN:1743-0003
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Functional electrical stimulation (FES) during repetitive practice of everyday tasks can facilitate recovery of upper limb function following stroke. Reduction in impairment is strongly associated with how closely FES assists performance, with advanced iterative learning control (ILC) technology providing precise upper-limb assistance. The aim of this study is to investigate the feasibility of extending ILC technology to control FES of three muscle groups in the upper limb to facilitate functional motor recovery post-stroke. METHODS: Five stroke participants with established hemiplegia undertook eighteen intervention sessions, each of one hour duration. During each session FES was applied to the anterior deltoid, triceps, and wrist/finger extensors to assist performance of functional tasks with real-objects, including closing a drawer and pressing a light switch. Advanced model-based ILC controllers used kinematic data from previous attempts at each task to update the FES applied to each muscle on the subsequent trial. This produced stimulation profiles that facilitated accurate completion of each task while encouraging voluntary effort by the participant. Kinematic data were collected using a Microsoft Kinect, and mechanical arm support was provided by a SaeboMAS. Participants completed Fugl-Meyer and Action Research Arm Test clinical assessments pre- and post-intervention, as well as FES-unassisted tasks during each intervention session. RESULTS: Fugl-Meyer and Action Research Arm Test scores both significantly improved from pre- to post-intervention by 4.4 points. Improvements were also found in FES-unassisted performance, and the amount of arm support required to successfully perform the tasks was reduced. CONCLUSIONS: This feasibility study indicates that technology comprising low-cost hardware fused with advanced FES controllers accurately assists upper limb movement and may reduce upper limb impairments following stroke.
[Mh] MeSH terms primary: Electric Stimulation Therapy/methods
Recovery of Function
Stroke/rehabilitation
Upper Extremity/physiopathology
[Mh] MeSH terms secundary: Adult
Biomechanical Phenomena
Elbow/physiopathology
Feasibility Studies
Female
Hemiplegia/etiology
Hemiplegia/physiopathology
Hemiplegia/rehabilitation
Humans
Male
Middle Aged
Shoulder/physiopathology
Stroke/complications
Stroke/physiopathology
Wrist/physiopathology
[Pt] Publication type:CLINICAL TRIAL; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:140708
[St] Status:MEDLINE
[do] DOI:10.1186/1743-0003-11-105

  10 / 11700 MEDLINE  
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[PMID]: 24739234
[Au] Autor:Liang JN; Brown DA
[Ad] Address:Department of Physical Therapy and Human Movement Sciences, Suite 1100, 645 N, Michigan Avenue, Chicago, IL 60611, USA. JN-Liang@u.northwestern.edu.
[Ti] Title:Foot force direction control during a pedaling task in individuals post-stroke.
[So] Source:J Neuroeng Rehabil;11:63, 2014.
[Is] ISSN:1743-0003
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Appropriate magnitude and directional control of foot-forces is required for successful execution of locomotor tasks. Earlier evidence suggested, following stroke, there is a potential impairment in foot-force control capabilities both during stationary force generation and locomotion. The purpose of this study was to investigate the foot-pedal surface interaction force components, in non-neurologically-impaired and stroke-impaired individuals, in order to determine how fore/aft shear-directed foot/pedal forces are controlled. METHODS: Sixteen individuals with chronic post-stroke hemiplegia and 10 age-similar non-neurologically-impaired controls performed a foot placement maintenance task under a stationary and a pedaling condition, achieving a target normal pedal force. Electromyography and force profiles were recorded. We expected generation of unduly large magnitude shear pedal forces and reduced participation of multiple muscles that can contribute forces in appropriate directions in individuals post-stroke. RESULTS: We found lower force output, inconsistent modulation of muscle activity and reduced ability to change foot force direction in the paretic limbs, but we did not observe unduly large magnitude shear pedal surface forces by the paretic limbs as we hypothesized. CONCLUSION: These findings suggested the preservation of foot-force control capabilities post-stroke under minimal upright postural control requirements. Further research must be conducted to determine whether inappropriate shear force generation will be revealed under non-seated, postural demanding conditions, where subjects have to actively control for upright body suspension.
[Mh] MeSH terms primary: Foot/physiopathology
Motor Activity/physiology
Muscle, Skeletal/physiopathology
Stroke/physiopathology
[Mh] MeSH terms secundary: Electromyography
Female
Humans
Male
Middle Aged
Paresis/etiology
Paresis/physiopathology
Stroke/complications
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1408
[Js] Journal subset:IM
[Da] Date of entry for processing:140424
[St] Status:MEDLINE
[do] DOI:10.1186/1743-0003-11-63


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