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[PMID]:29437060
[Au] Autor:Laumonerie P; Lapègue F; Reina N; Tibbo M; Rongières M; Faruch M; Mansat P
[Ad] Endereço:Institut Locomoteur, Hôpital Pierre-Paul Riquet, Allée Jean Dausset, Toulouse 31059, France and Anatomy Laboratory, Toulouse Rangueil Faculty of Medicine, 133 Route de Narbonne, Toulouse 31062, France.
[Ti] Título:Degenerative subtalar joints complicated by medial plantar intraneural cysts : cutting the cystic articular branch prevents recurrence.
[So] Source:Bone Joint J;100-B(2):183-189, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The pathogenesis of intraneural ganglion cysts is controversial. Recent reports in the literature described medial plantar intraneural ganglion cysts (mIGC) with articular branches to subtalar joints. The aim of the current study was to provide further support for the principles underlying the articular theory, and to explain the successes and failures of treatment of mICGs. PATIENTS AND METHODS: Between 2006 and 2017, five patients with five mICGs were retrospectively reviewed. There were five men with a mean age of 50.2 years (33 to 68) and a mean follow-up of 3.8 years (0.8 to 6). Case history, physical examination, imaging, and intraoperative findings were reviewed. The outcomes of interest were ultrasound and/or MRI features of mICG, as well as the clinical outcomes. RESULTS: The five intraneural cysts followed the principles of the unifying articular theory. Connection to the posterior subtalar joint (pSTJ) was identified or suspected in four patients. Re-evaluation of preoperative MRI demonstrated a degenerative pSTJ and denervation changes in the abductor hallucis in all patients. Cyst excision with resection of the articular branch (four), cyst incision and drainage (one), and percutaneous aspiration/steroid injection (two) were performed. Removing the connection to the pSTJ prevented recurrence of mIGC, whereas medial plantar nerves remained cystic and symptomatic when resection of the communicating articular branch was not performed. CONCLUSION: Our findings support a standardized treatment algorithm for mIGC in the presence of degenerative disease at the pSTJ. By understanding the pathoanatomic mechanism for every cyst, we can improve treatment that must address the articular branch to avoid the recurrence of intraneural ganglion cysts, as well as the degenerative pSTJ to avoid extraneural cyst formation or recurrence. Cite this article: 2018;100-B:183-9.
[Mh] Termos MeSH primário: Cistos Glanglionares/cirurgia
Articulação Talocalcânea/inervação
Articulação Talocalcânea/patologia
Articulação Talocalcânea/cirurgia
Nervo Tibial/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Cistos Glanglionares/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Procedimentos Neurocirúrgicos
Estudos Retrospectivos
Articulação Talocalcânea/diagnóstico por imagem
Nervo Tibial/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0990.R1


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[PMID]:28710923
[Au] Autor:Kural MA; Karlsson P; Pugdahl K; Isak B; Fuglsang-Frederiksen A; Tankisi H
[Ad] Endereço:Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
[Ti] Título:Diagnostic utility of distal nerve conduction studies and sural near-nerve needle recording in polyneuropathy.
[So] Source:Clin Neurophysiol;128(9):1590-1595, 2017 Sep.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The electrodiagnosis of polyneuropathy (PNP) may benefit from examination using near-nerve needle technique (NNT) and from inclusion of distal nerves. This study compared the diagnostic utility of distal nerve conduction studies (NCS) and NNT recording. METHODS: Bilateral NNT and surface recording of the sural nerve and surface recording of the dorsal sural and medial plantar nerves were prospectively done in 91 patients with clinically suspected PNP. Distal NCS were additionally done in 37 healthy controls. Diagnostic reference standard was the final clinical diagnosis retrieved from the patients medical records after 1-4years. RESULTS: The clinical follow-up diagnosis confirmed PNP in 68 patients. Equally high sensitivities of the dorsal sural (72%), medial plantar (75%), and sural nerve with NNT recording (77%) were seen, while the sensitivity of conventional surface recording of the sural nerve was lower (60%). Sural NCS with both NNT and surface recording and dorsal sural NCS showed high specificities (85-95%) and positive predictive values (94-98%), while a lower specificity was seen for the medial plantar nerve (68%). CONCLUSION: NCS of distal nerves, especially the dorsal sural nerve, have high diagnostic power equalling sural NNT recording. SIGNIFICANCE: The electrodiagnostic evaluation of patients with suspected PNP benefits from NCS of distal nerves.
[Mh] Termos MeSH primário: Agulhas
Condução Nervosa/fisiologia
Polineuropatias/diagnóstico
Polineuropatias/fisiopatologia
Nervo Sural/fisiopatologia
Nervo Tibial/fisiopatologia
[Mh] Termos MeSH secundário: Potenciais de Ação/fisiologia
Adulto
Idoso
Eletrodiagnóstico/instrumentação
Eletrodiagnóstico/métodos
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170716
[St] Status:MEDLINE


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[PMID]:28703936
[Au] Autor:van der Wilt AA; Giuliani G; Kubis C; van Wunnik BPW; Ferreira I; Breukink SO; Lehur PA; La Torre F; Baeten CGMI
[Ad] Endereço:Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
[Ti] Título:Randomized clinical trial of percutaneous tibial nerve stimulation versus sham electrical stimulation in patients with faecal incontinence.
[So] Source:Br J Surg;104(9):1167-1176, 2017 Aug.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim was to assess the effects of percutaneous tibial nerve stimulation (PTNS) in the treatment of faecal incontinence (FI) by means of an RCT. METHODS: Patients aged over 18 years with FI were included in a multicentre, single-blinded RCT. The primary endpoint was reduction in the median or mean number of FI episodes per week. Secondary endpoints were changes in measures of FI severity, and disease-specific and generic quality of life. Outcomes were compared between PTNS and sham stimulation after 9 weeks of treatment. RESULTS: A higher proportion of patients in the PTNS (13 of 29) than in the sham (6 of 30) group showed a reduction of at least 50 per cent in the median number of FI episodes/week (incidence rate ratio (IRR) 2·40, 95 per cent c.i. 1·10 to 5·24; P = 0·028), but not in the mean number of episodes/week (10 of 29 versus 8 of 30; IRR 1·42, 0·69 to 2·92; P = 0·347). The absolute median number of FI episodes per week decreased in the PTNS but not in the sham group (IRR 0·66, 0·44 to 0·98; P = 0·041), as did the mean number (IRR 0·65 (0·45 to 0·97); P = 0·034). Scores on the Cleveland Clinic Florida faecal incontinence scale decreased significantly in both groups, but more steeply in the PTNS group (mean difference -1·3, 95 per cent c.i. -2·6 to 0·0; P = 0·049). The aggregated mental component score of Short Form 36 improved in the PTNS but not in the sham group (mean difference 5·1, 0·5 to 9·6; P = 0·028). CONCLUSION: PTNS may offer a small advantage in the clinical management of FI that is insufficiently responsive to conservative treatment. The key challenge will be to identify patients who may benefit most from this minimally invasive surgical procedure. Registration number: NCT00974909 (http://www.clinicaltrials.gov).
[Mh] Termos MeSH primário: Incontinência Fecal/terapia
Nervo Tibial
Estimulação Elétrica Nervosa Transcutânea/métodos
[Mh] Termos MeSH secundário: Idoso
Estimulação Elétrica/efeitos adversos
Estimulação Elétrica/métodos
Feminino
Seres Humanos
Masculino
Meia-Idade
Cooperação do Paciente
Qualidade de Vida
Método Simples-Cego
Estimulação Elétrica Nervosa Transcutânea/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.10590


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[PMID]:28438166
[Au] Autor:Ursu D; Nedic A; Urbanchek M; Cederna P; Gillespie RB
[Ad] Endereço:Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA. danursu@umich.edu.
[Ti] Título:Adjacent regenerative peripheral nerve interfaces produce phase-antagonist signals during voluntary walking in rats.
[So] Source:J Neuroeng Rehabil;14(1):33, 2017 Apr 24.
[Is] ISSN:1743-0003
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Regenerative Peripheral Nerve Interfaces (RPNIs) are neurotized muscle grafts intended to produce electromyographic signals suitable for motorized prosthesis control. Two RPNIs producing independent agonist/antagonist signals are required for each control axis; however, it is unknown whether signals from adjacent RPNIs are independent. The purpose of this work was to determine signaling characteristics from two adjacent RPNIs, the first neurotized by a foot dorsi-flexor nerve and the second neurotized by a foot plantar-flexor nerve in a rodent model. METHODS: Two Control group rats had electrodes implanted onto the soleus (tibial nerve) and extensor digitorum longus (peroneal nerve) muscles in the left hind limb. Two Dual-RPNI group rats had two separate muscles grafted to the left thigh and each implanted with electrodes: the extensor digitorum longus was neurotized with a transected fascicle from the tibial nerve, and the tibialis anterior was implanted with a transected peroneal nerve. Four months post-surgery, rats walked on a treadmill, were videographed, and electromyographic signals were recorded. Amplitude and periodicity of all signals relative to gait period were quantified. To facilitate comparisons across groups, electromyographic signals were expressed as a percent of total stepping cycle activity for each stance and swing gait phase. Independence between peroneal and tibial nerve activations were assessed by statistical comparisons between groups during stance and swing. RESULTS: Electromyographic activity for Control and Dual-RPNI rats displayed alternating activation patterns coinciding with stance and swing. Significant signal amplitude differences between the peroneal and tibial nerves were found in both the Control and Dual-RPNI groups. Non-inferiority tests performed on Dual-RPNI group signal confidence intervals showed that activation was equivalent to the Control group in all but the peroneal RPNI construct during stance. The similar electromyographic activity obtained for Control and RPNI suggests the latter constructs activate independently during both stance and swing, and contain minimal crosstalk. CONCLUSIONS: In-vivo myoelectric RPNI activity encodes neural activation patterns associated with gait. Adjacent RPNIs neurotized with agonist/antagonist nerves display activity amplitudes similar to Control during voluntary walking. The distinct and expected activation patterns indicate the RPNI may provide independent signaling in humans, suitable for motorized prosthesis control.
[Mh] Termos MeSH primário: Regeneração Nervosa/fisiologia
Nervos Periféricos/fisiologia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Animais
Eletrodos Implantados
Eletromiografia
/inervação
/fisiologia
Marcha/fisiologia
Membro Posterior/inervação
Membro Posterior/fisiologia
Masculino
Músculo Esquelético/inervação
Músculo Esquelético/fisiologia
Nervo Fibular/fisiologia
Ratos
Ratos Endogâmicos F344
Nervo Tibial/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1186/s12984-017-0243-0


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[PMID]:28432188
[Au] Autor:Vaeggemose M; Pham M; Ringgaard S; Tankisi H; Ejskjaer N; Heiland S; Poulsen PL; Andersen H
[Ad] Endereço:Department of Neurology, Aarhus University Hospital, Aarhus, Denmark mivaeg@clin.au.dk.
[Ti] Título:Magnetic Resonance Neurography Visualizes Abnormalities in Sciatic and Tibial Nerves in Patients With Type 1 Diabetes and Neuropathy.
[So] Source:Diabetes;66(7):1779-1788, 2017 Jul.
[Is] ISSN:1939-327X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study evaluates whether diffusion tensor imaging magnetic resonance neurography (DTI-MRN), T2 relaxation time, and proton spin density can detect and grade neuropathic abnormalities in patients with type 1 diabetes. Patients with type 1 diabetes ( = 49) were included-11 with severe polyneuropathy (sDPN), 13 with mild polyneuropathy (mDPN), and 25 without polyneuropathy (nDPN)-along with 30 healthy control subjects (HCs). Clinical examinations, nerve conduction studies, and vibratory perception thresholds determined the presence and severity of DPN. DTI-MRN covered proximal (sciatic nerve) and distal (tibial nerve) nerve segments of the lower extremity. Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) were calculated, as were T2 relaxation time and proton spin density obtained from DTI-MRN. All magnetic resonance findings were related to the presence and severity of neuropathy. FA of the sciatic and tibial nerves was lowest in the sDPN group. Corresponding with this, proximal and distal ADCs were highest in patients with sDPN compared with patients with mDPN and nDPN, as well as the HCs. DTI-MRN correlated closely with the severity of neuropathy, demonstrating strong associations with sciatic and tibial nerve findings. Quantitative group differences in proton spin density were also significant, but less pronounced than those for DTI-MRN. In conclusion, DTI-MRN enables detection in peripheral nerves of abnormalities related to DPN, more so than proton spin density or T2 relaxation time. These abnormalities are likely to reflect pathology in sciatic and tibial nerve fibers.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/diagnóstico por imagem
Neuropatias Diabéticas/diagnóstico por imagem
Nervo Isquiático/diagnóstico por imagem
Nervo Tibial/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Diabetes Mellitus Tipo 1/complicações
Neuropatias Diabéticas/etiologia
Neuropatias Diabéticas/fisiopatologia
Imagem de Difusão por Ressonância Magnética
Imagem de Tensor de Difusão
Feminino
Seres Humanos
Processamento de Imagem Assistida por Computador
Masculino
Meia-Idade
Condução Nervosa
Nervo Isquiático/fisiopatologia
Limiar Sensorial
Índice de Gravidade de Doença
Nervo Tibial/fisiopatologia
Vibração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170423
[St] Status:MEDLINE
[do] DOI:10.2337/db16-1049


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[PMID]:28394682
[Au] Autor:Trignano E; Fallico N; Zingone G; Rubino C; Santanelli di Pompeo F; Campus GV
[Ti] Título:Combined Treatment of Diabetic Foot Ulcer with Tarsal Tunnel Release and Perilesional Injections of Peripheral Blood Mononuclear Cells.
[So] Source:J Am Podiatr Med Assoc;107(2):171-174, 2017 03.
[Is] ISSN:1930-8264
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Pé Diabético
Leucócitos Mononucleares
[Mh] Termos MeSH secundário:
Seres Humanos
Síndrome do Túnel do Tarso
Nervo Tibial
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.7547/15-098


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[PMID]:28271375
[Au] Autor:Arakawa T; Kondo T; Tsutsumi M; Watanabe Y; Terashima T; Miki A
[Ad] Endereço:Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, 654-0142, Japan. arakawa@people.kobe-u.ac.jp.
[Ti] Título:Multiple muscular variations including tenuissimus and tensor fasciae suralis muscles in the posterior thigh of a human case.
[So] Source:Anat Sci Int;92(4):581-584, 2017 Sep.
[Is] ISSN:1447-073X
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:The posterior thigh muscles on the right side of an 81-year-old male cadaver had multiple variations, denoted muscles I-IV. Muscle I originated from the posteromedial surface of the greater trochanter and divided into two muscle bellies. These muscle bellies fused with the long head of the biceps femoris and were innervated by two branches from muscular branches of the semitendinosus and the long head of the biceps. Muscle II separated from the medial surface of the long head of the biceps in the proximal third and fused with the semitendinosus in the distal fourth. Muscle III was a biventer muscle. Its superior belly separated from the medial surface of the long head of the biceps in the distal third. The inferior belly of this muscle fused with the posterior surface of the crural fascia and was innervated by the tibial nerve. Muscle IV separated from the adductor magnus muscle, passed between the long and short heads of the biceps, fused with the inferior belly of muscle III, and was innervated by the muscular branch of the common fibular nerve to the short head of the biceps. Peeling off the epineurium of the muscular branches to the inferior belly of muscle III showed that this nerve fascicle divided from the common trunk with branches to the gastrocnemius and soleus muscles. The inferior bellies of muscle III and muscle IV were thought to be equivalent to the tensor fasciae suralis and tenuissimus muscles, respectively.
[Mh] Termos MeSH primário: Variação Anatômica
Cadáver
Músculo Esquelético/anatomia & histologia
Coxa da Perna/anatomia & histologia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Seres Humanos
Masculino
Músculo Esquelético/inervação
Nervo Fibular/anatomia & histologia
Nervo Tibial/anatomia & histologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1007/s12565-017-0396-8


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[PMID]:28267009
[Au] Autor:Helewa RM; Moloo H; Williams L; Foss KM; Baksh-Thomas W; Raiche I
[Ad] Endereço:1 Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada 2 The Ottawa Hospital, Ottawa, Ontario, Canada 3 Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
[Ti] Título:Perspectives From Patients and Care Providers on the Management of Fecal Incontinence: A Needs Assessment.
[So] Source:Dis Colon Rectum;60(4):408-415, 2017 Apr.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A large proportion of Canadians experience fecal incontinence, with no avenue for effective treatments. The Ottawa Hospital has recently started a percutaneous tibial nerve stimulation program for patients who have not improved with conservative efforts. OBJECTIVE: As part of this program implementation, a qualitative needs assessment was undertaken to better define successful outcomes and to identify barriers for program sustainability. DESIGN: This was a cross-sectional, qualitative study involving standardized, semistructured interviews. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: Patients experiencing fecal incontinence, as well as nurses, physical therapists, and physicians, were enrolled in the study. MAIN OUTCOME MEASURES: Interview questions revolved around success definitions, barriers, and promoters of fecal incontinence care. Transcripts were analyzed to develop themes surrounding fecal incontinence care. RESULTS: Twelve interviews were undertaken raising a total of 17 different themes. Barriers to fecal incontinence care included education for both the care provider and patients. Access issues for treatments were also highlighted. Promoters of fecal incontinence care were reflected by the impact that it has on quality of life, personal hygiene, psychological burden, and activity and productivity. The definition of fecal incontinence success was focused on improvements in quality of life rather than a numerical reduction of incontinence episodes. LIMITATIONS: This study was limited in its small number of interviews conducted. We were unable to identify patients who were unable to seek out care for fecal incontinence. CONCLUSIONS: Patient and care provider education surrounding fecal incontinence is lacking. Furthermore, access for effective treatments is a real barrier for Canadians experiencing fecal incontinence. Programs should focus on improvement of overall quality of life rather than a reduction of incontinence episodes.
[Mh] Termos MeSH primário: Terapia por Estimulação Elétrica
Incontinência Fecal/terapia
Conhecimentos, Atitudes e Prática em Saúde
Acesso aos Serviços de Saúde
Determinação de Necessidades de Cuidados de Saúde
Qualidade de Vida
Nervo Tibial
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Canadá
Efeitos Psicossociais da Doença
Estudos Transversais
Eficiência
Incontinência Fecal/psicologia
Custos de Cuidados de Saúde
Seres Humanos
Enfermeiras e Enfermeiros
Cooperação do Paciente
Fisioterapeutas
Médicos
Avaliação de Programas e Projetos de Saúde
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000768


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[PMID]:28258435
[Au] Autor:Mrachacz-Kersting N; Geertsen SS; Stevenson AJ; Nielsen JB
[Ad] Endereço:Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Aalborg University, Fredrik Bajers Vej 7 D-3, 9220, Aalborg, Denmark. nm@hst.aau.dk.
[Ti] Título:Convergence of ipsi- and contralateral muscle afferents on common interneurons mediating reciprocal inhibition of ankle plantarflexors in humans.
[So] Source:Exp Brain Res;235(5):1555-1564, 2017 May.
[Is] ISSN:1432-1106
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Recent studies have shown that afferents arising from muscle receptors located on one side can affect the activity of muscles on the contralateral side. In animal preparations, evidence supports that afferent pathways originating from one limb converge onto interneurons mediating disynaptic reciprocal Ia inhibition of the opposite limb. This study was designed to investigate whether this pathway is similar in humans to that described in animals. Thirteen healthy volunteers participated in one of two experiments. In experiment 1, the effects of ipsilateral posterior tibial nerve (iPTN) stimulation were assessed on the reciprocal Ia inhibition of the contralateral soleus (cSOL) motoneuronal pool (n = 8). Across all participants, iPTN stimulation intensity was 1.69 ± 0.3 × Motor Threshold (MT) and contralateral common peroneal (cCPN) stimulation intensity was 0.86 ± 0.16 × MT. iPTN and cCPN stimulation were delivered separately or in combination and changes in the ongoing electromyography (EMG) quantified. In experiment 2, the amplitude of a test SOL H-reflex elicited by contralateral PTN (cPTN) stimulation was quantified following iPTN, cCPN or iPTN + cCPN nerve stimulation (n = 5). Intensities used during the H-reflex conditioning experiment were 1.79 ± 0.4 × MT for the iPTN stimulation and 0.88 ± 0.16 × MT for cCPN stimulation. Across all participants, the onset of the cSOL EMG suppression was 42 ± 4, 44 ± 3 and 44 ± 3 ms for iPTN, cCPN and iPTN + cCPN conditions, respectively. The inhibition from the combined iPTN and cCPN stimulation was significantly greater compared to the algebraic sum of their separate effects. When conditioning the cSOL H-reflex, the ISI between the test cPTN and the iPTN or cCPN stimulus was 5.4 ± 0.5 and 2.6 ± 0.5, respectively. The combined stimulation induced a significantly greater inhibition compared to their separate effects. These data provide evidence of convergence on common inhibitory interneurons by muscle afferents activated by iPTN and cCPN stimulation during sitting. Since the inhibition elicited by cCPN stimulation is known to be mediated by the disynaptic Ia inhibitory pathway, this suggests that the crossed inhibition of cSOL motoneurones elicited by muscle afferents from the ipsilateral plantarflexor muscles is at least partly mediated by Ia inhibitory interneurons in the contralateral human spinal cord. This is similar to what has been observed in the cat.
[Mh] Termos MeSH primário: Tornozelo/fisiologia
Lateralidade Funcional/fisiologia
Reflexo H/fisiologia
Interneurônios/fisiologia
Músculo Esquelético/fisiologia
Inibição Neural/fisiologia
[Mh] Termos MeSH secundário: Adulto
Vias Aferentes
Análise de Variância
Estimulação Elétrica
Eletromiografia
Seres Humanos
Masculino
Contração Muscular/fisiologia
Nervo Tibial/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE
[do] DOI:10.1007/s00221-016-4871-6


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[PMID]:28209507
[Au] Autor:Wu YT; Chang CY; Chou YC; Yeh CC; Li TY; Chu HY; Chen LC
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiw
[Ti] Título:Ultrasound-Guided Pulsed Radiofrequency Stimulation of Posterior Tibial Nerve: A Potential Novel Intervention for Recalcitrant Plantar Fasciitis.
[So] Source:Arch Phys Med Rehabil;98(5):964-970, 2017 May.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the therapeutic benefit of ultrasound-guided pulsed radiofrequency (PRF) stimulation at the posterior tibial nerve (PTN) in patients with recalcitrant plantar fasciitis (PF). DESIGN: A prospective, randomized, double-blinded, placebo-controlled trial (12-wk follow-up). SETTING: Outpatient local medical center settings. PARTICIPANTS: Patients (N=36) with recalcitrant PF underwent randomization, and all were included in the final data analysis. INTERVENTIONS: Patients in the PRF group were treated with 1 dose of ultrasound-guided PRF stimulation at the PTN, and those in the control group received 1 dose of 2% lidocaine, 0.5mL, injected at the PTN under ultrasound guidance. MAIN OUTCOME MEASURES: The visual analog scale (first-step and overall pain), American Orthopedic Foot-Ankle Society (AOFAS) ankle-hindfoot scale, and ultrasonographic thickness of the plantar fascia were evaluated at 1, 4, 8, and 12 weeks after treatment. RESULTS: Thirty-six patients (20 feet per group) completed the study. The PRF group had a significantly larger improvement in first-step pain, overall pain, and AOFAS score (all P<.001), as well as plantar fascia thickness (P<.05), compared with those of the control group at all observed time points. CONCLUSIONS: This study shows that ultrasound-guided PRF stimulation at the PTN is effective for treating recalcitrant PF. This simple, reproducible method could be a novel strategy for managing recalcitrant PF.
[Mh] Termos MeSH primário: Fasciíte Plantar/reabilitação
Tratamento por Radiofrequência Pulsada/métodos
Nervo Tibial
[Mh] Termos MeSH secundário: Adulto
Anestésicos Locais/uso terapêutico
Método Duplo-Cego
Feminino
Seres Humanos
Lidocaína/uso terapêutico
Masculino
Meia-Idade
Medição da Dor
Estudos Prospectivos
Ultrassonografia de Intervenção/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local); 98PI200987 (Lidocaine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE



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