Academic literature on the topic 'Musculoskeletal system Wounds and injuries Patients Rehabilitation'

Background: The increasing incidence of injuries sustained by clients during pulmonary rehabilitation, created a need to develop a prevention strategy. A pre-pulmonary rehabilitation stability exercise class was created based on best practice principles from the orthopaedic literature. It has been discussed in the literature that patients who have COPD have poor stability strategies based on the dominance of the need to drive the respiratory system. If successful, it was felt that this program would decrease the incidence of injury, decrease length stay and help to optimize outcomes. Methods: Six months of data recording the incidence and severity of injuries from participants in the pulmonary rehabilitation program was collected in order to obtain comparative statistics and demonstrate the need for this program. A literature review was performed to determine the risk of injury in this population. In a 6 month period, 17% of COPD clients admitted to the Rehabilitation Centre for pulmonary rehabilitation have had musculoskeletal issues that proved a significant enough barrier to rehabilitation to require treatment or pulmonary rehabilitation modification. Wait list clients for pulmonary rehabilitation were assessed using the PSFS, NPRS, the 6-minute walk test, the Active Straight Leg Raise, Sitting Arm Lift and the non-stop walk test. Clients participated in six one-hour group exercise sessions. The exercises included neck stabilizers, pelvic floor muscles, trunk stabilizers, and scapular stabilizers derived from published literature. Results: Clients were re-evaluated using the same outcome tools as well as noting any injuries sustained and capacity to participate. This data was compared with historical data. Conclusion: The data will help With patient selection for participation in the exercise class as well as refinement of the outcome tools and exercise protocol. This project illustrates the opportunities that exist to share and transfer knowledge from one area of physiotherapy expertise to another to meet the needs of practice. It is essential that this integrated approach to treatment be fostered by clinicians, educators and researchers alike to improve the overall outcomes for the clients.

ABSTRACT Introduction Rehabilitation research of wounded service members (SMs) commonly focuses on physical ability to return to duty (RTD) as a measure of successful recovery. However, numerous factors or barriers may influence a SM’s ability and/or desire to RTD after lower extremity musculoskeletal trauma. SMs themselves as well as the clinical care team that works with them daily, often for years at a time, both offer unique perspectives on the influential factors that weigh into decisions to RTD. The purpose of this study was to identify the intrinsic and extrinsic factors patients and clinicians recognized as influencing the decision to RTD after severe lower extremity trauma. Materials and Methods Thirty-two SMs with severe lower extremity trauma (amputation and lower limb salvage) and 30 providers with at least 2 years’ experience caring for SMs with similar injuries participated separately in either a SM or provider/clinician focus group. Open-ended questions on factors influencing RTD and other rehabilitation success were discussed. Data analysis consisted of qualitative transcription and participatory active sorting, followed by thematic coding and grouping of qualitative data. Results Individual (health condition, personal traits, and career consideration), interpersonal (clinician’s impact, family influence, and peer influence), health care system (systems of care, transdisciplinary rehabilitation, and innovation availability), and institutional (policy, benefits, and unit/commander) themes emerged amongst SM patients and clinicians. Expected frequently occurring themes common to both groups were the influence of the team and family unit, as well as career trajectory options after a severe injury. An unexpected theme was acknowledgment of and dissatisfaction with the recent dismantling of institutional systems that support wounded SMs. Patients placed less emphasis on severity of injury and greater emphasis on system and policy barriers than did clinicians. Conclusions Characterization and classification of these clinician and SM-identified factors that influence the decision to RTD after severe lower extremity trauma is expected to improve the efficacy of future rehabilitation efforts and clinical practice guidelines by providing the clinical team the knowledge necessary to recognize modifiable barriers to patient success. A better understanding of factors influencing RTD decision-making may support policies for mitigating RTD barriers, better monitoring of the changing landscape of RTD after lower extremity trauma, improving systems of health care, and/or reducing turnover and facilitating force readiness.

It has been a few decades since neurological rehabilitation is recognized as a formal technique for therapeutic treatment of stroke patients or individuals suffering disabilities following spinal cord injuries. Despite the nervous system having a plasticity mechanism that facilitates spontaneous recovery to some extent, it is essential for most patients to receive specialized treatment protocol, to restore their motor function, including physical therapy and occupational therapy. More recently, experts of neurological rehabilitation have inculcated specialized therapies making use of computer and electronic devices to positively influence cortical excitability of damaged parts of cerebral hemispheres in order to improve neuroplasticity.1 The advancements aim to take advantage of the functionally preserved neuromuscular structures in compensating for the functions of the damaged areas as well as restoring function of the affected brain tissue; something for which the use of technology was not seen being implemented around two decades back.1, 2 While traditional approach to neuro-rehabilitation would focus on preventing worsening of a functional limitation through exercises such as passive range of motion and stretching,2 a better understanding of neuroplasticity has swung the rehabilitation pendulum in favor of use of several electrotherapeutic devices including transcranial magnetic stimulation modality, robot for limb training, robotic lower extremity orthoses and brain-computer interfaces which offer benefits for patients with neuronal injury.1 Non-invasive brain stimulation facilitates perceptual learning as well motor and cognitive performance in case of brain lesions.2 In order to ensure adherence to various therapies in the process of rehabilitation, interactive treatment strategies are being developed. These include the application of virtual and augmented reality systems which not only motivate the patient but make the repetitive exercise interesting in a controlled environment.3, 4 This approach has challenged the traditional paradigm by the use of biosensors as biofeedback tools to enlighten the patients about internal activities by them visualizing their muscle activity eventually helping them control their bodies better by knowing which muscles to contract to produce the correct movement.5 A proven successful mode of rehabilitation includes virtual reality (VR) technology, which is practical to use at homes, however, requires professional input when it comes to software development and application. Along with ensuring safety and effectiveness, new strategies are being developed which would allow clinicians who do not hold programming expertise to create game-based VR tasks and make further advancements in the field of neurological rehabilitation.6 Amongst the many causes of disability including trauma and musculoskeletal degenerative changes, nervous system disorders are most prevalent resulting in physical, cognitive, linguistic and behavioral issues all at the same time. According to a report by World Health Organization in year 2006, up to 1 billion people are suffering from neurological disorders worldwide constituting around 6% of the global burden of disease and is only escalating since then. Lower-income countries are significantly more affected than high-income countries as 80% disability- stricken individuals live in low-income countries.7 Considering rehabilitation, particularly the neurological aspect, as being relatively young medical specialty, improvement have been made in the years especially in the developed world with better quality rehabilitation services being offered by multidisciplinary teams consisting of highly trained physicians and physical therapists along with supporting staff.8 We are gradually, however, surely moving in the direction of figuring out new and effective approaches to neurorehabilitation by not only compensating for disabilities following neurological injuries but trying to reduce T Rehabili. J. Volume 03, Issue 02 2019 106 impairments by restoring neuronal structure and function.2 The technological advancements made in the developing countries are slow paced; however, keeping in mind the available resources, the responsibility lies with the clinicians to select and provide a comprehensive rehabilitation program which cost-efficient and easy to implement in the long run 9. In a nutshell, a truly effective neuro-rehabilitative program would focus on strategies to fully enable an individual to carry out activities of daily life, increase mobility, improve the ability to function independently and be an integral part of society.

Category: Ankle; Sports Introduction/Purpose: The isokinetic test has been used diffusely as a way to evaluate the functional results after the rehabilitation of musculoskeletal injuries. In the ankle, in particular, most studies are related to lateral ligament injuries and Achilles tendon's injuries. However, different protocols are used and a lack of normative values is observed in the literature. The aim of this work is to perform a global isokinetic evaluation on healthy ankles in order to propose reference values for future patients. Methods: We evaluated 100 participants (200 ankles) using the Biodex 3 System for the eversion, inversion, dorsiflexion and plantar flexion movements of the ankle. The sample consisted of individuals aged 20-60 years, with an active life and practice of recreational physical activity (non-athlete) and without previous injuries. Five repetitions for strength (N / m) and work (J) at a speed of 30° / sec and 10 repetitions for power (W) at a speed of 120° / sec were performed in our protocol. Agonist / antagonist ratio and the Muscle Deficiency Index, which globally assesses the balance between the sides for each movement, were also evaluated, as well as the demographic variables. Different statistical analyzes were performed for each parameter. Results: The mean age was 38.5 years and BMI 25.8 (CI 2.7 and 0.8 respectively). The non-dominant side was consistently stronger (higher peak torque) in all movements (p <0.001 -). The mean values obtained for force in each movement were 29.9N / m (CI 1.4) for eversion, 34.8N / m (CI 1.6) for inversion, 48.6N / m (2.0) for dorsiflexion and 140.2 N / m (CI 6.1) for plantar flexion. There was no correlation between age or BMI with the maximum torque (N / m). The ratio of eversors / inverters was 88.8% (CI 3.1) and that of dorsiflexors / plantar flexors was 36.1% (1.3). The Muscle Deficiency Index showed a balance between the sides for each movement (p 0.062), with an average global difference of less than 10% between them (eversion 8.66 [CI 3.17], inversion 4.2 [3, 48], dorsiflexion 3.41 [3.04] and plantar flexion 5.18 [2.51]. Conclusion: As far as we know, this is the largest isokinetic assessment of normal ankles ever performed. The sample, although not stratified, was considered homogeneous (coefficient of variation <50%), which allows to propose several normative values for a non-athlete population in the isokinetic evaluation. It would be interesting to compare these data in the future with the functional results in patients after the treatment of certain injuries.

This study presents health statistics for a specialized trauma department in a large pediatric hospital in St. Petersburg. Data relating to patients treated in the trauma department for any injuries and with injuries of the musculoskeletal system were analyzed separately. Injuries of the musculoskeletal system, accounted for 67.3% of all children hospitalized in the trauma department. We also identified patients with injuries of the musculoskeletal system who were treated in non-specialized departments of the hospital (accounting for 4.1% of patients in these departments). Detailed characteristics of the pediatric trauma departments, the characteristics of children hospitalized with injuries of the musculoskeletal system, methods for diagnosis, treatment, and rehabilitation are described. The challenges of rehabilitation for children with injuries and the need to increase the hospital capacity are also described.

Orthopedic care in Germany provides for the prevention, diagnosis and treatment of congenital and acquired functional disorders, diseases, injuries and consequences of injuries of the musculoskeletal system, as well as rehabilitation treatment (rehabilitation) of patients with pathology of the musculoskeletal system, i.e. in its content, orthopedics as a discipline in Germany corresponds to traumatology and orthopedics in Russia.

Diseases of the musculoskeletal system and injuries are identified as one of the main causes of disability of the country's population, which leads to a permanent loss of working capacity of adults. This leads to an increase in production losses, an increase in social benefits, an increase in the share of costs for restorative treatment and ensuring an adequate quality of life for the particular part of the population. Strengthening the rehabilitation direction in the health care system may be a possible solution to the problem. A systematic analysis of the levels of primary disability of the population as a result of injuries and diseases of the musculoskeletal system can become a reliable basis for determining the need for rehabilitation services in the region and planning the appropriate amount of resources for their provision. The aim: to study the features of changes in the levels of disability of the population of the Transcarpathian region during 2011-2020 and to provide an assessment of the needs for rehabilitation services for people with injuries and diseases of the musculoskeletal system in the region. Materials and methods. The data of the Centre for Medical and Social Expertise of the Transcarpathian region for the years from 2011 to 2020 served as research materials. The medical-statistical method and the method of structural-logical analysis were used during the study. The results. It was established that in the region the third and fourth places in the structure of causes of disability for ten years were stably taken by diseases of the musculoskeletal system (13.0-16.9%) and injuries (9.4-10.8%). In total, 3,807 people were recognized as disabled for the first time as a result of these pathologies, and their average annual number was 983±49 people. The positive increase in the absolute number of cases of disability due to diseases of the musculoskeletal system and injuries during 2011-2019 outweighed the negative by 37.8%. With a fairly insignificant increase in the number of cases of newly established disability due to diseases of the musculoskeletal system, their share in the structure of causes of general disability increased from 13.0% to 16.9%, and the decrease of 23.6% in cases of annual disability due to injuries was also accompanied by a decrease in their share in the structure of causes of disability from 10.2% to 9.7%, which is connected with the trends of changes in the total number of cases of disability. The results of the analysis showed the preservation of the relevance of diseases of the musculoskeletal system and injuries as causes of permanent disability, which requires the response of the health care system of the Transcarpathian region by creating effective methods to improve the situation, one of which can be the provision of timely, full-fledged and high-quality rehabilitation assistance to such patients. The used methodological approach to the analysis and interpretation of the dynamics of the population's disability levels can serve as a management tool for regular calculations of the region's population's need for rehabilitation services. Conclusions. Disability of the population of the Transcarpathian region due to injuries and diseases of the musculoskeletal system remains an important issue for the regional health care system, which causes a high level of rehabilitation needs. Administrative analysis of the average annual number of people with a newly established disability for the specified reasons and a detailed interpretation of the dynamics of disability levels will allow to plan the rehabilitation services and their resource provision in accordance with the needs of the population.

Hip fractures with damage to the pelvic bones are one of the most severe combined injuries of the musculoskeletal system. This article presents the results of our studies in 130 patients, which demonstrated that the active tactics of minimally invasive methods of treatment of femoral fractures combined with pelvic bone fractures looks quite reasonable. In favor of early stabilization of fractures, such strong arguments are put forward as the possibility of early activation of the patient, the prevention of threatening hypostatic complications. Combining the terms of consolidation and rehabilitation contributed to obtaining positive functional results, which significantly reduced the number of patients with severe consequences of injuries to the musculoskeletal system.

The problem of providing a continuous staged rehabilitation treatment of patients with severe associated injuries musculoskeletal system is an urgent and important task. This article describes two clinical cases of successful comprehensive medical rehabilitation of disabled persons with severe combined trauma and multiple injuries skeleton in need of long-term continuous rehabilitation program which was successfully launched at the stage of hospital care and continued remotely, through on - line technologies in a familiar patient home medium. As a result of rehabilitation treatment was observed: increased mobility of patients and level of independence in daily life, increased range of motion in the affected joints, increase muscle strength of the affected limbs, improving psycho - emotional status of patients resocialization and adaptation to the familiar home environment.

Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across distributed areas of the nervous system may help to improve outcomes in patients with chronic musculoskeletal disorders.

The purpose of this study was to document the effects that a regular yoga therapy practice has on the quality of life for a paraplegic individual. Due to the unique nature of spinal cord injury (SCI), this was a case study with one participant. For 5 weeks the subject practiced a standardized yoga routine three times a week with a yoga teacher, receiving private instruction. Interview questions were asked before and after the intervention to document the participant's quality of life. Each week, the subject completed a modified SF-36 questionnaire as well as Cohen's Perceived Stress Survey. Perceived pain and perceived stress were the two primary variables monitored in the study. The results of this study demonstrated a slight reduction in perceived stress, a reduction in perceived pain, and an improvement in overall quality of life. Additionally, the subject increased her strength significantly from the beginning to the end of the study. Based on the findings in this study, it appears that a regular adapted yoga routine is beneficial for paraplegic individuals.

Добродій, Р. Б. Особливості життєстійкості у хворих з травмами опорно-рухового апарату та її психокорекція : магістерська робота : 231 Соціальна робота / Р. Б. Добродій ; керівник роботи Філіпович В. М. ; Національний університет «Чернігівська політехніка», кафедра креативних індустрій та соціальних інновацій. – Чернігів, 2020. – 79 с.
Актуальність дослідження адаптаційних ресурсів особистості в психологічному колі наукових досягнень зростає з кожним роком. Однією з комплексних категорій психології особистості, яка визначає її адаптаційний потенціал, є життєстійкість. Преший розділ присвячено теоретико-методологічним засадам дослідження особливості життєстійкості хворих з травмами опорно-рухового апарату: розглянуто психологічні особливості хворих з травмами опорно-рухового апарату та сучасні алгоритми реабілітації хворих з травмами опорно-рухового апарату. В другому розділі проведено емпіричне дослідження особливостей життєстійкості у хворих з травмами опорно-рухового апарату. В третьому розділі надається комплекс заходів з психокорекції життєстійкості у хворих з травмами опорно-рухового апарату. Наукова новизна одержаних результатів полягає в тому, що визначено сутність концепції особистісної життєстійкості та її структурно-динамічні особливості у пацієнтів з травмами опорно-рухового апарату; визначено особливості порушень психіки у пацієнтів з травмами опорно-рухового апарату та їхній зв'язок з особистісною життєстійкостю; емпірично дослідити особливості життєстійкості у хворих з травмами опорно-рухового апарату; розроблено систему психокорекції життєстійкості хворим з травмами опорно-рухового апарату.
The relevance of the study of adaptive resources of the individual in the psychological circle of scientific advances is growing every year. One of the complex categories of personality psychology, which determines its adaptive potential, is viability. The first section is devoted to the theoretical and methodological principles of the study of the viability of patients with musculoskeletal injuries: the psychological characteristics of patients with musculoskeletal injuries and modern algorithms for rehabilitation of patients with musculoskeletal injuries. In the second section, an empirical study of the features of viability in patients with injuries of the musculoskeletal system. The scientific novelty of the obtained results is that the essence of the concept of personal vitality and its structural and dynamic features in patients with injuries of the musculoskeletal system are determined; the peculiarities of mental disorders in patients with injuries of the musculoskeletal system and their connection with personal vitality are determined; empirically investigate the features of vitality in patients with injuries of the musculoskeletal system; developed a system of psychocorrection of vitality in patients with injuries of the musculoskeletal system.

Introduction This thesis evaluates the effect of an early intervention programme on the physical and psychological health status of people with mild to moderate musculoskeletal injuries following road traffic crashes, and examines the influence of accident fault status and compensation claim status on recovery. Methods A sequential cohort of patients presenting to emergency departments in the Australian Capital Territory for treatment of mild to moderate musculoskeletal injuries sustained in road traffic crashes were recruited. A control group of 95 patients received the usual care provided. An Intervention group of 98 patients were referred to a specialist clinic for assessment, during which an individualised, proactive rehabilitation plan was established. Both physical and psychological health status were measured at baseline, six months and 12 months post-crash using the Short Form 36 (SF-36; Physical Component Score and Mental Component Score); the Hospital Anxiety and Depression Scale (HADS); and Functional Rating Index (FRI). Three analyses were performed using the health outcome data obtained. Firstly, the influence of fault status on baseline physical and psychological health was evaluated by comparing the health outcomes scores of patients who caused the crash in which they were involved with scores from patients who were not at fault. Secondly, the effect of claiming compensation was evaluated for the control group by comparing SF-36, HADS and FRI scores between patients of the control group who had claimed compensation and those who did not claim compensation. Finally, the effect of the early intervention programme was evaluated by comparing health outcome scores of the control and intervention groups. Results Patients were enrolled a mean of 9.3 days following the crash. In the immediate post-crash period, the cohort was characterised by severe disability (FRI 55.5, SD 21.04), moderate levels of pain (pain intensity sub-scale of the FRI 2.0, SD 0.81) and high levels of anxiety (HADS-a9.1, SD 4.55). Fault status had no effect on physical health; however, people that were not at fault had significantly worse psychological health at baseline as measured by SF-36 Mental Component Score. Claiming compensation was associated with a worse SF-36 Physical Component Score, greater HADS-anxiety and worse FRI. Retention of a lawyer was significantly associated with a lower SF-36 Mental Component Score at 12 months. The early intervention programme resulted in a statistically significant reduction in anxiety at 12 months. However, neither anxiety, nor any of the other measures of physical or psychological health were considered to be improved to a clinically significant level by the intervention. Conclusion Compensation status and psychological factors are independent determinants of longer term health following mild to moderate musculoskeletal injuries sustained in road traffic crashes. The early specialist assessment and proactive treatment planning implemented as part of this thesis, failed to improve health outcomes over usual care alone. Overall, recovery is influenced by both physical and psychological factors, and models of care need to address both of these components.

研究目的：脊髓損傷是中樞神經系統的嚴重創傷，致殘率高。脊髓損傷後的再生修復一直是當前醫學的難題。迄今為止，脊髓損傷依然缺乏一種有效地治療方法。既往研究證明，胰島素樣生長因子-1對鼠和兔脊髓損傷有保護作用，為了進一步把這些發現應用到臨床方面，我們採用與人類生理更相近的豬只作為實驗動物，構建與臨床相似的脊髓損傷動物模型，并以此為基礎，系統性研究胰島素樣生長因子-1的脊髓保護作用，評估該治療的功效。
研究方法：以運動誘發電位為指導，通過直接壓迫和牽拉造成脊髓損傷。18頭猪只隨機分為3組：胰島素樣生長因子-1治療組、生長激素治療組及生理鹽水對照組。脊髓損傷后1小時、24小時及48小時經鞘內注射給藥。于術後第1天、第3天及第21天收集腦脊液檢測胰島素樣生長因子-1和生長激素濃度。連續21天使用修正的 Tarlov 評分標準對動物的運動功能進行評估。第21天處死動物並取材，檢測脊髓中NeuN, GFAP, caspase-3 的活性，并通過TUNEL染色觀察細胞凋亡情況，比較各組之間有無差別。
研究結果：通過這種方法建立的脊髓損傷動物模型穩定可靠，各組之間無明顯差異。鞘內給藥24小時及48小時后，腦脊液中胰島素樣生長因子-1和生長激素濃度明顯升高，術後21天檢測，其濃度恢復至基礎值。胰島素樣生長因子-1治療組的運動功能的恢復優於其它各組。與生理鹽水對照組比較，胰島素樣生長因子-1治療組可以明顯提高脊髓損傷后神經元的存活數量，抑制星形膠質細胞增生，減少細胞凋亡。而生長激素治療組僅抑制星形膠質細胞增生，其它方面與生理鹽水對照組無明顯差別。
結論：胰島素樣生長因子-1通過提高神經元存活數量，抑制星形膠質細胞增生，以及減少細胞凋亡促進脊髓損傷的恢復。
Objective: Spinal cord injury is a devastating condition that leads to long-term disabilities. Currently, there is no effective treatment that minimizes spinal cord damage or enhances neurological recovery. Recent studies in rats or rabbits suggested that neurologic recovery after spinal cord injury could be improved with the administration of neurotropic hormones, such as insulin-like growth factor-1 (IGF-1). In order to apply such bench-side discovery to clinical practice, we conducted a study in a higher animal model, akin to human physiology, to evaluate the effectiveness of intrathecal injections of IGF-1to improve neurological recovery in a porcine model of acute traumatic spinal cord injury.
Methods: Traumatic spinal cord injury model was produced by controlled compression and distraction of the exposed T12 segment of the spinal cord. Eighteen pigs were randomly assigned to receive intrathecal injections of either IGF-1, growth hormone or saline at 1, 24 and 48 hours after spinal cord injury. Locomotor function was assessed daily using the validated modified Tarlov’s scale for 21 days. Spinal cord segments were then harvested and the survival of neurons, reactive astrogliosis and apoptosis were determined using neuronal-specific nuclear protein (NeuN), glial fibrillary acidic protein (GFAP), cleaved caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assays.
Results: Intrathecal injections of IGF-1 and growth hormone significantly increase the concentrations of the neurotropic hormones in the cerebrospinal fluid after injury (p < 0.01). These concentrations returned to baseline by 21 days after drug delivery. Motor deficits on the first day after injury were comparable between animals in the treatment and control groups. By the end of the third week, neurologic recovery was better in animals receiving IGF-1 treatment (p < 0.05). Immunohistological and western blot studies of the injured segments of spinal cord showed that treatment with both IGF-1 and growth hormone prevented reactive astrogliosis (p < 0.05) while only IGF-1 improved the survival of mature neurons (p < 0.05). IGF-1 also inhibited apoptosis after spinal cord injury (p < 0.05).
Conclusions: In our clinically relevant model of traumatic spinal cord injury in pigs, intrathecal injection of IGF-1 demonstrated beneficial effects on neurological and histological recovery.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Wang, Qinzhou.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2012.
Includes bibliographical references (leaves 105-122).
Abstract also in Chinese.
Declaration of origination --- p.I
Abstract --- p.II
Acknowledgements --- p.VI
Table of Contents --- p.VIII
List of Tables --- p.XII
List of Figures --- p.XIII
Abbreviations --- p.XVIII
Chapter Part 1 --- Spinal Cord Injury: A Review --- p.1
Chapter Chapter 1-1 --- Acute Spinal Cord Injury: Epidemiology, Socioeconomic Impact --- p.2
Chapter 1.1.1 --- Epidemiology of Spinal Cord Injury --- p.2
Chapter 1.1.2 --- Socioeconomic Impact of Acute Spinal Cord Injury --- p.5
Chapter Chapter 1-2 --- Mechanisms of Spinal Cord Injury --- p.6
Chapter Chapter 1-3 --- Putative Treatments for Spinal Cord Injury --- p.8
Chapter 1.3.1 --- Methylprednisolone --- p.8
Chapter 1.3.2 --- Stem Cell Therapy --- p.11
Chapter 1.3.3 --- Riluzole --- p.11
Chapter 1.3.4 --- Other Pharmacological Therapies for Spinal Cord Injury --- p.12
Chapter Chapter 1-4 --- Insulin-like Growth Factor-1 for the Treatment of Spinal Cord Injury --- p.13
Chapter Chapter 1-5 --- Summary --- p.17
Chapter Part 2 --- Insulin-like Growth Factor-1 and Growth Hormone for Spinal Cord Injury --- p.18
Chapter Chapter 2-1 --- Hypothesis and Objectives --- p.19
Chapter Chapter 2-2 --- Establishment of Animal Models for Acute Spinal Cord Injury --- p.22
Chapter 2.2.1 --- Introduction --- p.22
Chapter 2.2.2 --- Experimental Animals --- p.22
Chapter 2.2.3 --- Anesthesia --- p.23
Chapter 2.2.4 --- Transcranial Electrical Motor Evoked Potential --- p.26
Chapter 2.2.5 --- Surgery --- p.28
Chapter 2.2.6 --- Statistics --- p.34
Chapter 2.2.7 --- Results --- p.34
Chapter 2.2.8 --- Discussion --- p.38
Chapter Chapter 2-3 --- Optimal Stimulation Protocols for Transcranial Electrical Motor Evoked Potential. --- p.42
Chapter 2.3.1 --- Introduction --- p.42
Chapter 2.3.2 --- Methods --- p.42
Chapter 2.3.2.1 --- Experimental Animals and Anesthesia --- p.42
Chapter 2.3.2.2 --- Transcranial Electrical Motor Evoked Potential Recording --- p.44
Chapter 2.3.2.3 --- Stimulation Protocol --- p.44
Chapter 2.3.3 --- Analyses --- p.44
Chapter 2.3.4 --- Results --- p.45
Chapter 2.3.5 --- Discussion --- p.52
Chapter Chapter 2-4 --- Evaluation of the Efficacy of Insulin-like Growth Factor-1 and Growth Hormone in a Porcine Model --- p.54
Chapter 2.4.1 --- Introduction --- p.54
Chapter 2.4.2 --- Materials and Methods --- p.54
Chapter 2.4.2.1 --- Study Design --- p.54
Chapter 2.4.2.2 --- Intrathecal Injection and Collection of Cerebrospinal Fluid --- p.58
Chapter 2.4.2.3 --- Measurements --- p.58
Chapter 2.4.2.3.1 --- Clinical Evaluation --- p.58
Chapter 2.4.2.3.2 --- Biochemical Assessments --- p.58
Chapter 2.4.2.3.3 --- Spinal Cord Section, Histological and Immunochemical Staining --- p.63
Chapter 2.4.2.3.4 --- Western Blot --- p.69
Chapter 2.4.3 --- Statistical Analysis and Sample Size Calculation --- p.72
Chapter 2.4.3.1 --- General Analysis --- p.72
Chapter 2.4.3.2 --- Sample Size --- p.72
Chapter 2.4.4 --- Results --- p.73
Chapter 2.4.4.1 --- Changes of TceMEP --- p.73
Chapter 2.4.4.2 --- Motor Deficit after Spinal Cord Injury at Baseline --- p.75
Chapter 2.4.4.3 --- Insulin-like Growth Factor-1 and Growth Hormone in Cerebrospinal Fluid --- p.77
Chapter 2.4.4.4 --- Clinical Assessment --- p.80
Chapter 2.4.4.5 --- Demyelination, Neuron Survival and Astrocyte Reaction --- p.85
Chapter 2.4.4.6 --- Apoptosis --- p.89
Chapter 2.4.5 --- Discussion --- p.93
Chapter 2.4.5.1 --- Principal Findings --- p.93
Chapter 2.4.5.2 --- Insulin-like Growth Factor-1 and Neuroprotection after Spinal Cord Injury --- p.93
Chapter 2.4.5.3 --- Growth Hormone and Neuroprotection after Spinal Cord Injury --- p.95
Chapter 2.4.5.4 --- Strengths and Limitations of Our Study --- p.96
Chapter 2.4.5.5 --- Summary --- p.97
Chapter Part 3 --- Summary and Future Directions --- p.99
Chapter Chapter 3-1 --- Summary --- p.100
Chapter Chapter 3-2 --- Future Directions --- p.103
Chapter Part 4 --- References and appendixes --- p.104
References --- p.105
Appendixes --- p.123