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Ronzoni, Flavio L., Nefele Giarratana, Stefania Crippa, Mattia Quattrocelli, Marco Cassano, Gabriele Ceccarelli, Laura Benedetti i in. "Guide Cells Support Muscle Regeneration and Affect Neuro-Muscular Junction Organization". International Journal of Molecular Sciences 22, nr 4 (16.02.2021): 1939. http://dx.doi.org/10.3390/ijms22041939.
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Muscular regeneration is a complex biological process that occurs during acute injury and chronic degeneration, implicating several cell types. One of the earliest events of muscle regeneration is the inflammatory response, followed by the activation and differentiation of muscle progenitor cells. However, the process of novel neuromuscular junction formation during muscle regeneration is still largely unexplored. Here, we identify by single-cell RNA sequencing and isolate a subset of vessel-associated cells able to improve myogenic differentiation. We termed them ‘guide’ cells because of their remarkable ability to improve myogenesis without fusing with the newly formed fibers. In vitro, these cells showed a marked mobility and ability to contact the forming myotubes. We found that these cells are characterized by CD44 and CD34 surface markers and the expression of Ng2 and Ncam2. In addition, in a murine model of acute muscle injury and regeneration, injection of guide cells correlated with increased numbers of newly formed neuromuscular junctions. Thus, we propose that guide cells modulate de novo generation of neuromuscular junctions in regenerating myofibers. Further studies are necessary to investigate the origin of those cells and the extent to which they are required for terminal specification of regenerating myofibers.
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Oh, Seong-il, Jin-Sung Park, Jung-Joon Sung i Seung Hyun Kim. "Clinical Scales Used in Motor Neuron Disease". Journal of the Korean Neurological Association 39, nr 2 Suppl (1.05.2021): 77–86. http://dx.doi.org/10.17340/jkna.2021.2.22.
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Motor neuron diseases (MND) are heterogeneous spectra of disorders that that primarily affect the motor neurons (MN) resulting in motor nerve and muscle degeneration. The pathophysiological mechanisms of MN cell death are known to be combined with disturbance of proteostasis, ribonucleostasis and exaggerated neuro-inflammation. Amyotrophic lateral sclerosis is the prototypic disease of MND followed by spinal and bulbar muscular atrophy, spinal muscular atrophy, benign focal amyotrophy and other various diseases. Although diverse spectra of these diseases share common symptoms, significant differences are known in their clinical manifestations and their clinical progression. With increasing number of new clinical trials, the importance of selecting appropriate clinical scales for the monitoring of clinical progression in different types of MNDs should be emphasized. The purpose of this review is to illustrate different types of clinical scales and demonstrate how to utilize these in the clinical research field with consensus. With these efforts, we hope to be ready to understand different kinds of clinical scales in MND in participating global standard clinical trials.
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Plata, Odette Guadarrama. "The use of platelet-rich plasma, hyaluronic acid, and botulinum toxin for the treatment of TMJ disorders". Journal of Dental Health, Oral Disorders & Therapy 14, nr 1 (2023): 15–18. http://dx.doi.org/10.15406/jdhodt.2023.14.00588.
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The temporomandibular joint (TMJ) is a synovial joint that connects the mandibular to the skull. Its main function is to facilitate the movement of the jaw and when it suffers any type of damage or injury, it leads to a decrease in mobility and pain in the area. This localized pain is called temporomandibular joint disorders (TMJD), and it can be caused by intraarticular or extraarticular disorders. The most common symptoms include acute pain, decreased mouth opening, tightening of the muscle, headache, and loss of joint function. Nowadays, there are treatments for temporomandibular joint dysfunction from surgical procedures up to less invasive methods, such as the use of splints. Platelet rich plasma (PRP), hyaluronic acid (HA) and botulinum toxin (BTX) injections have been categorized as a complement of primary treatment in TMJD, as well as decrease drug excess in patients. Due to their natural origin, PRP and HA can regenerate tissue in cases of cartilage degeneration, inhibit inflammation, slow down the progression of osteoarthritis and increase the production of natural lubricating fluid in the joint. Its intra-articular application reduces pain due to lubrication and nutrition to the avascular areas of the disc and condylar cartilage. Botulinum toxin (BTX) has been used for years in the medical and cosmetic field, but its use in TMJD refers to injections specifically within masseter muscle, with the objective to reduce the muscular tension TMJ overload, therefore, pain decreases, and movement increases. Over the years these less invasive methods have been increasing in the medical area due to the great pain management in the neuro-muscular and articular complex.
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Fabiś, Jarosław, Marian Danilewicz, Kryspin Niedzielski, Michał Waszczykowski, Anna Fabiś-Strobin i Andrzej Bogucki. "The eccentric mechanotransduction, neuro-muscular transmission, and structural reversibility of muscle fatty infiltration. An experimental advanced disuse muscle-wasting model of rabbit supraspinatus". Archives of Medical Science 17, nr 5 (5.03.2021): 1400–1407. http://dx.doi.org/10.5114/aoms/131956.
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IntroductionFull-thickness rotator cuff tear is present in almost 50% of patients over age 65 years, and its degree is known to be a good predictor of the severity of muscle-wasting (MW) sarcopaenia, also known as fatty degeneration (FD). A FD CT grade > 2° is recognized as a borderline of its reversibility. A disuse model of supraspinatus FD (grade 2) in rabbits provides clinically relevant data. Therefore, the present study evaluates the correlation between eccentric mechanotransduction, neuromuscular transmission (NT), and reversibility of muscle fatty infiltration (MFI) in rabbit supraspinatus FD > 2°.Material and methodsThe supraspinatus tendon was detached from the greater tubercle, infraspinatus, and subscapularis in 16 rabbits. The tendon was reinserted after 12 weeks, and the animals were euthanized 24 weeks after reconstruction. MFI was measured in the middle part of the supraspinatus. Single-fibre EMG (SFEMG) examination of the supraspinatus NT was performed on 4 animals.ResultsThe power of analysis was 99%. Significant differences in MFI volume were found between the operated (4.6 ±1.1%) and the opposite control sides (2.91 ±0.61%) (p < 0.001). SFEMG revealed no significant differences between the disuse and the control supraspinatus muscles (p > 0.05); however, 6.5% of the examined muscle fibres exhibited NT disorders combined with blockade of conduction in 2.5% of muscle fibres.ConclusionsCritical MFI in a disuse model of rabbit supraspinatus FD, CT grade > 2°, is substantially reversible by eccentric training despite subclinical impairment of neuromuscular transmission. In addition, 0.63% reversal of MFI is correlated with 1% hypertrophy of type I and II muscle fibre diameter.
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Kazuo Ikeda, K. I., M. M. Masaki Matsuda, D. Y. Daisuke Yamauchi, K. T. Katsuro Tomita i S. T. Shigenori Tanaka. "GRADUAL NERVE ELONGATION AFFECTS NERVE CELL BODIES AND NEURO-MUSCULAR JUNCTIONS". Hand Surgery 10, nr 01 (lipiec 2005): 7–15. http://dx.doi.org/10.1142/s0218810405002401.
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The purpose of this study is to clarify the reactions of the neuro-muscular junction and nerve cell body to gradual nerve elongation. The sciatic nerves of Japanese white rabbits were lengthened by 30 mm in increments of 0.8 mm/day, 2.0 mm/day and 4.0 mm/day. A scanning electron microscopic examination showed no degenerative change at the neuro-muscular junction, even eight weeks after elongation in the 4-mm group. Hence, neuro-muscular junction is not critical for predicting damage from gradual nerve elongation. There were no axon reaction cells in the 0.8-mm group, a small amount in the 2-mm group, and a large amount in the 4-mm group. The rate of growth associated protein-43 positive nerve cells was significant in the 4-mm group. Hence, the safe speed for nerve cells appeared to be 0.8-mm/day, critical speed to be 2.0-mm/day, and dangerous speed to be 4.0-mm/day in this elongation model.
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WAGH, SWASTI, i D. K. WAGH. "Mathematical modeling of Friedreich’s ataxia – a genetic neuro-muscular degenerative condition". Journal of Ultra Scientist of Physical Sciences Section A 29, nr 2 (2.02.2017): 66–70. http://dx.doi.org/10.22147/jusps-a/290203.
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Piazzi, Manuela, Alberto Bavelloni, Vittoria Cenni, Irene Faenza i William L. Blalock. "Revisiting the Role of GSK3, A Modulator of Innate Immunity, in Idiopathic Inclusion Body Myositis". Cells 10, nr 11 (21.11.2021): 3255. http://dx.doi.org/10.3390/cells10113255.
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Idiopathic or sporadic inclusion body myositis (IBM) is the leading age-related (onset >50 years of age) autoimmune muscular pathology, resulting in significant debilitation in affected individuals. Once viewed as primarily a degenerative disorder, it is now evident that much like several other neuro-muscular degenerative disorders, IBM has a major autoinflammatory component resulting in chronic inflammation-induced muscle destruction. Thus, IBM is now considered primarily an inflammatory pathology. To date, there is no effective treatment for sporadic inclusion body myositis, and little is understood about the pathology at the molecular level, which would offer the best hopes of at least slowing down the degenerative process. Among the previously examined potential molecular players in IBM is glycogen synthase kinase (GSK)-3, whose role in promoting TAU phosphorylation and inclusion bodies in Alzheimer’s disease is well known. This review looks to re-examine the role of GSK3 in IBM, not strictly as a promoter of TAU and Abeta inclusions, but as a novel player in the innate immune system, discussing some of the recent roles discovered for this well-studied kinase in inflammatory-mediated pathology.
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Schabron, Bridget, Jaydip Desai i Yimesker Yihun. "Wheelchair-Mounted Upper Limb Robotic Exoskeleton with Adaptive Controller for Activities of Daily Living". Sensors 21, nr 17 (26.08.2021): 5738. http://dx.doi.org/10.3390/s21175738.
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Neuro-muscular disorders and diseases such as cerebral palsy and Duchenne Muscular Dystrophy can severely limit a person’s ability to perform activities of daily living (ADL). Exoskeletons can provide an active or passive support solution to assist these groups of people to perform ADL. This study presents an artificial neural network-trained adaptive controller mechanism that uses surface electromyography (sEMG) signals from the human forearm to detect hand gestures and navigate an in-house-built wheelchair-mounted upper limb robotic exoskeleton based on the user’s intent while ensuring safety. To achieve the desired position of the exoskeleton based on human intent, 10 hand gestures were recorded from 8 participants without upper limb movement disabilities. Participants were tasked to perform water bottle pick and place activities while using the exoskeleton, and sEMG signals were collected from the forearm and processed through root mean square, median filter, and mean feature extractors prior to training a scaled conjugate gradient backpropagation artificial neural network. The trained network achieved an average of more than 93% accuracy, while all 8 participants who did not have any prior experience of using an exoskeleton were successfully able to perform the task in less than 20 s using the proposed artificial neural network-trained adaptive controller mechanism. These results are significant and promising thus could be tested on people with muscular dystrophy and neuro-degenerative diseases.
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Kuzmina, Valentina А., Airat R. Suynduykov, Nikolay S. Nikolaev, Irina V. Mikhailova i Alena V. Nikolaeva. "Effectiveness of intraoperative neurophysiological monitoring during spinal surgery". Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 4, nr 4 (14.12.2016): 33–40. http://dx.doi.org/10.17816/ptors4433-40.
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Aim. To assess the application of intraoperative neurophysiological monitoring (IONM) for spinal surgeries in accordance with the Federal Center of Traumatology, Orthopedics and Endoprosthesis (Cheboksary, Russian Federation)Material and methods. A total of 366 spinal surgeries, Federal Center of Traumatology, Orthopedics and Endoprosthesis from 2009 to 2015. From 2009 to 2013, the wake-up test was used as a control method in 116 (65.9%) cases.Results. Application of IONM revealed time-dependent risks and facilitated a reduction in the incidence of postoperative neurologic complications by 3-fold (from 2.6% to 0.8%). In the second half of 2013, IONM was introduced for use in clinical practice. Since then, 250 surgeries were performed with IONM. Of these, the wake-up test was required in 9 (3.6%) patients. Clinical implementation of IONM extended the benefits of surgery to patients with severe pathologies. The number of surgeries for congenital pathologies increased by 10-fold (from 1% to 10%) and by 2.6-fold for degenerative diseases. IONM possibility allows control of intraoperative neurologic complications among patients with spinal injuries (5%) and neuro and muscular scoliosis.Conclusions. The application of IONM minimized the need for the wake-up test and significantly decreased the incidence of neurological complications caused by injury to the spinal cord and spinal roots during execution of spinal manipulations.
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Orsini, Marco, Mauricio De Sant’ Anna Jr, Marcos RG De Freitas, Marco Felipe Bouzada, Manuel Leite Lopes i Acary Bulle Oliveira. "Exercício terapêutico na esclerose lateral amiotrófica: o que esperamos da relação anabolismo vs. catabolismo?" Fisioterapia Brasil 19, nr 1 (17.03.2018): 1. http://dx.doi.org/10.33233/fb.v19i1.2174.
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A esclerose lateral amiotrófica (ELA) pode ser definida como uma doença neurológica progressiva, degenerativa e inexorável, cuja gênese ainda é de difícil entendimento. Fatores vários contribuem na desprogramação e morte celular precoces. A busca por uma melhor inter-relação, em novos marcadores e associações com tipos celulares e\ou moleculares distintos parece o grande desafio. O delineamento de pesquisas clinicas em (ELA), com informações a respeito de tipo, ação e dose de medicamentos emergem à medida que novas teorias são apresentadas e somadas ao modelo atual [1,2].Definitivamente a ELA é uma doença multifatorial. O estresse oxidativo, excitotoxicidade mediada pelo glutamato, efeitos causados pela mutação do superóxido dismutase, agregação anormal proteíco-especifica, desestruturação de neuro-filamentos intermediários, alteração do transporte axonal anterógrado e retrógrado, ativação microglial, inflamação e transtornos nos fatores de crescimento, têm sido considerados como potenciais agressores aos neurônios motores. Fatores genéticos, influxo excessivo de cálcio intracelular e apoptose também fazem parte desse compreensível mas ainda indecifrável modelo teórico [3].Baseado no exposto sobre a fisiopatologia da ELA, bem como sobre as manifestações clínicas dessa doença, torna-se evidente a necessidade de atuação multidisciplinar, em especial do fisioterapeuta desde o momento do diagnóstico clínico, e que será o responsável pela prescrição dos exercícios terapêuticos.Mas o que esperamos da relação anabolismo vs. catabolismo, uma vez que desde a fase inicial da ELA preconiza-se a realização de exercício terapêuticos das mais diversas naturezas (aeróbicos, resistido, respiratórios etc), porém a cadeia de eventos devastadores inerentes à fisiopatologia da ELA já estão em franca evolução? Respeitando tanto os objetivos terapêuticos como as fases da ELA, a prescrição do fortalecimento muscular e o recondicionamento físico tornam-se componentes do programa de tratamento estabelecido pela da fisioterapia, e diversos estudos são encontrados na literatura, e que sustentam sua prática, porém com resultados controversos [4-6]. Podemos dividir o gasto energético diário em três componentes: taxa metabólica basal, efeito térmico do alimento e gasto energético associado com a atividade física. A realização de um exercício físico promove aumento do gasto energético total, tanto aguda, quanto cronicamente. No que tange o efeito agudo, encontra-se bem estabelecido que após o término da atividade, o consumo de oxigênio (VO2) não retorna aos valores de repouso, imediatamente. Essa demanda energética durante o período de recuperação após o exercício, que é necessária para “quitar a divida metabólica assumida durante a realização da atividade” é definida como excess post-erxercise oxygen consumption ou consumo excessivo de oxigênio após o exercício (EPOC) [7,8]. Em virtude do grande desajuste metabólico que envolve a ELA, e do franco estado catabólico, o questionamento que deve ser feito é, se a intensidade do exercício prescrito não irá gerar um efeito EPOC, que pode vir a ser prejudicial a esse grupo de pacientes? Seria então essa “dívida metabólica” mais um trabalho a ser executado por um organismo deveras debilitado e em franco catabolismo? Existem novas possibilidades terapêuticas num arcabouço fisiopatológico ainda em construção, uma delas é a proposta do protocolo Deanna [9] que sugere a suplementação de arginina-alfa-cetoglurarato, complexo B, dentre outras poderiam atenuar a disfunção mitocondrial, excitotoxicidade do glutamato e estresse oxidativo. É fundamental que a prescrição do exercício seja em intensidade submáxima (40 -60% VO2pico, ou 60 – 85% FCmáx ou 10-13 na escala de Borg) tanto pelo aspecto que envolve o efeito EPOC, assim como pelos efeitos diretamente relacionados ao metaborreflexo da musculatura periférica e respiratória. Pautados nesses conceitos não contra indicamos a prescrição do fortalecimento muscular e o recondicionamento físico e portadores de ELA, porém sugerimos que todos esses aspectos sejam contemplados na prescrição.
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Orsini, Marco, Marco Antonio Alves Azizi, Acary Bulle Oliveira, Adriana Leico Oda i Mauricio De Sant´Anna Jr. "Assistência ventilatória em pacientes com esclerose lateral amiotrófica. Quando iniciar?" Fisioterapia Brasil 21, nr 1 (8.03.2020): 1. http://dx.doi.org/10.33233/fb.v21i1.3966.
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A Esclerose Lateral Amiotrófica (ELA), também conhecida como doença de Lou Gehrig ou doença de Charcot, é uma enfermidade crônico-degenerativa, inexorável, idiopática, que acomete neurônios motores do neuro-eixo (córtex cerebral, tronco encefálico e medula espinal). Apresenta manifestações clínicas características de lesões da via piramidal (hiperreflexia, espasticidade, clônus, sinal de Babinski) e da ponta anterior da medula espinhal (arreflexia \hiporreflexia, hipotonia, fasciculações, paresia, amiotrofia) [1].O comprometimento do sistema respiratório é a causa mais comum de morte em pacientes portadores de ELA. Em uma análise cronológica, todos os pacientes, num dado momento evoluirão com deterioração desse sistema. Em virtude de ainda não haver cura, a terapêutica destina-se ao suporte, visando a sobrevida e melhor qualidade de vida dos pacientes [2,3].A troca gasosa nos pacientes com ELA não é afeta por alterações de ordem pulmonar ou de vias aéreas. A disfunção ocorre na musculatura ventilatória, levando a um grande comprometimento de sua função [4,5].Quando se inicia a disfunção da musculatura inspiratória, o paciente passa a apresentar maior risco para o surgimento de colapsos alveolares e hipoventilação. Neste momento inicia-se a elevação nas taxas de CO2 acarretando dispnéia. Tais mecanismos podem desencadear o surgimento de insuficiência respiratória em virtude da hipercápnica [6].Um dos pontos de corte sugeridos para o início da ventilação não invasiva (VNI) em portadores de ELA é quando a capacidade vital forçada (CVF), evidenciada através de espirometria encontra-se abaixo de 50% do previsto, além da redução da força muscular respiratória, porém alguns centros têm sugerido a implementação da VNI mais precocemente. Os efeitos benéficos quanto à qualidade vida assim como sobrevida dos pacientes com ELA é bem descrito na literatura. Cabe ressaltar que a VNI não está indicada apenas para pacientes com bulbares e que o modo ventilatório que oferece maior conforto é o BI-level Positive Airway Pressure (Bipap) [6-8].Normalmente a VNI, inicia-se como suporte noturno, sendo estendido ao período diurno com o avançar da ELA [9,10]. Algumas características como alteração do humor, cefaleia, aumento da fadiga e sonolência diurna, podem indicar alterações de oxigenação no período noturno e consequentemente a necessidade de utilização de VNI por um período mais prolongado.Com o avanço da doença, o comprometimento bulbar torna-se o grande responsável pela falha ventilatória e o paciente, mesmo na vigência de VNI por longos períodos, evolui com a necessidade da utilização de uma via aérea artificial, a cânula de traqueostomia. Porém esse é um assunto que merece ser discutido em outro momento. Quando sugerir a traqueostomia...?
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Dziak, L. A., O. O. Shulha i V. M. Suk. "Factors of lumbosacral radiculopathy chronicity". Zaporozhye Medical Journal 25, nr 2 (28.03.2023): 122–29. http://dx.doi.org/10.14739/2310-1210.2023.2.273614.
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Assessment of chronic factors of acute lumbosacral radiculopathy is an urgent problem due to the disease impact on the quality of life of patients, possible loss of work capacity and disability. The aim of the work is to identify chronicity factors of acute compressive lumbosacral radiculopathy depending on the severity of degenerative-dystrophic changes in the spine and pathomorphological changes in the zone of disc-radicular conflict based on complex clinical-neurological, neuro-orthopedic, neuroimaging, neurophysiological and statistical methods of examination. Materials and methods. 100 patients with acute lumbosacral radiculopathy were examined. The patients were divided into two groups: 45 patients with radiculopathy and both discogenic pathology and stenotic process in the spinal canal and/or lateral openings, and 55 patients with radiculopathy developed secondary to a pathology between the vertebral disc at the level of one vertebromotor segment. All the patients underwent neurological, neuroorthopedic, neurophysiological examinations. The study was conducted in two stages – 3–7 days and one months after the disease onset. Results. On the basis of comprehensive clinical, neuroimaging, neurophysiological examinations and statistical processing of the obtained data, factors affecting the chronicity of acute compressive lumbosacral radiculopathy were identified: age (rs = 0.25, P = 0.012), sex (rs = 0.25, P = 0.012), pain syndrome severity according to the VAS (rs = 0.25, P = 0.011), the presence of a neuropathic component of pain according to the PainDETECT questionnaire (rs = 0.74, P < 0.001), biomechanical disorders of the spine during the Schober test (rs = -0.41, P < 0.001), lateroflexion (rs = -0.30, P = 0.003), extension (rs = 0.28, p = 0.004), damage to Aβ fibers (rs = -0.36, P = 0.009), Aδ-fibers (rs = -0.38, P = 0.006), C-fibers (rs = -0.37, P = 0.008), allodynia (rs = 0.38, P < 0.001), hyperalgesia (rs = -0.24, p = 0.014), muscular-tonic syndrome index (rs = 0.26, p = 0.008), the presence of lumbar canal stenosis (rs = 0.42, P < 0.001), spondyloarthrosis (rs = 0.22, P = 0.028), spondylolisthesis (rs = 0.20, P = 0.047). Conclusions. The conducted study has revealed the main factors contributing to the development of acute lumbosacral radiculopathy chronicity. The presence of a neuropathic component of pain in the mechanism of pain syndrome development in the acute period of the disease and the involvement of C-fibers in the pathological process in the late stages of the disease are among the important markers contributing to the disease prolongation. Assessment of the factors that determine the chronicity of the course in the acute period of the disease allows to prescribe complex differential therapy at the early stage of the disease.
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Oppelt, Konrad, Aidan Hogan, Felix Stief, Paul Alfred Grützner i Ursula Trinler. "Movement Analysis in Orthopedics and Trauma Surgery – Measurement Systems and Clinical Applications". Zeitschrift für Orthopädie und Unfallchirurgie 158, nr 03 (10.07.2019): 304–17. http://dx.doi.org/10.1055/a-0873-1557.
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Abstract Background Technical development lead to an enhancement of clinical movement analysis in the last few decades and expanded its research and clinical applications. Since the mid 20th century, human movement analysis has made its way into clinical practice, e.g. in treating poliomyelitis and infantile cerebral palsy. Today, it has a wide range of applications in various clinical areas. The aim of this narrative review is to illustrate the variety of camera-based systems for human movement analysis and their clinical applications, specifically in the field of orthopaedics and trauma surgery (O/U). Benefits and limitations of each system are shown. Future development and necessary improvements are discussed. Material and Methods A selective literature review was undertaken with the databases PubMed and Google Scholar using keywords related to clinical human movement analysis in the field of orthopaedics and trauma surgery. Furthermore standard book references were included. Results Common video camera systems (VS) are used for basic visual movement analysis. Instrumented movement analysis systems include marker-based systems (MBS), markerless optical systems (MLS) and rasterstereographic analysis systems (VRS). VS, MBS and MLS have clinical use for dynamic examination of patients with various disorders in movement and gait. Among such are e.g. neuro-orthopaedic disorders, muscular insufficiencies, degenerative and post-trauma deficiencies with e.g. resultant pathologic leg axis. Besides the measurement of kinematic data by MBS and MLS, the combination with kinetic measurements to detect abnormal loading patterns as well as the combination with electromyography (EMG) to detect abnormal muscle function is a great advantage. Validity and reliability of kinematic measurements depend on the camera systems (MBS, MLS), the applied marker models, the joints of interest and the observed movement plane. Movements in the sagittal plane of the hip and knee joint, pelvic rotation and tilt as well as hip abduction are generally measured with high reliability. In the frontal and transverse planes of the knee and ankle joint substantial angular variabilities were noted due to the small range of motion of the joints in these planes. Soft tissue artefacts and marker placement are the biggest sources of errors. So far MLS did not improve these limitations. MBS are most accurate and remain the gold-standard in clinical and scientific movement analysis. VRS is used clinically for static 3D-analysis of the trunk posture and spine deformities. Current systems allow the dynamic measurement and visualisation of trunk and spine movement in 3D during gait and running. Planar x-ray-imaging (Cobbʼs angle) and to some extent cross sectional imaging with CT-scan or MRI are commonly used for the evaluation of patients with spinal deformities. VRS offers functional 3D data of trunk and spine deformities without radiation exposure, thus allowing safer clinical monitoring of the mainly infantile and adolescent patients. The accuracy, validity and reliability of measurements of different VRS-systems for the clinical use has been proven by several studies. Conclusion The instrumented movement analysis is an additional tool that aids clinical practitioners of O/U in the dynamic assessment of pathologic movement and loading patterns. In conjunction with common radiologic imaging it aids in the planning of type and extent of corrective surgical interventions. In the field of orthopaedics and trauma surgery movement analysis can help as an additional diagnostic tool to develop therapeutic strategies and evaluate clinical outcomes.
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Lassmann, Christian, Winfried Ilg, Tim W. Rattay, Ludger Schöls, Martin Giese i Daniel F. B. Haeufle. "Dysfunctional neuro-muscular mechanisms explain gradual gait changes in prodromal spastic paraplegia". Journal of NeuroEngineering and Rehabilitation 20, nr 1 (15.07.2023). http://dx.doi.org/10.1186/s12984-023-01206-8.
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Abstract Background In Hereditary Spastic Paraplegia (HSP) type 4 (SPG4) a length-dependent axonal degeneration in the cortico-spinal tract leads to progressing symptoms of hyperreflexia, muscle weakness, and spasticity of lower extremities. Even before the manifestation of spastic gait, in the prodromal phase, axonal degeneration leads to subtle gait changes. These gait changes - depicted by digital gait recording - are related to disease severity in prodromal and early-to-moderate manifest SPG4 participants. Methods We hypothesize that dysfunctional neuro-muscular mechanisms such as hyperreflexia and muscle weakness explain these disease severity-related gait changes of prodromal and early-to-moderate manifest SPG4 participants. We test our hypothesis in computer simulation with a neuro-muscular model of human walking. We introduce neuro-muscular dysfunction by gradually increasing sensory-motor reflex sensitivity based on increased velocity feedback and gradually increasing muscle weakness by reducing maximum isometric force. Results By increasing hyperreflexia of plantarflexor and dorsiflexor muscles, we found gradual muscular and kinematic changes in neuro-musculoskeletal simulations that are comparable to subtle gait changes found in prodromal SPG4 participants. Conclusions Predicting kinematic changes of prodromal and early-to-moderate manifest SPG4 participants by gradual alterations of sensory-motor reflex sensitivity allows us to link gait as a directly accessible performance marker to emerging neuro-muscular changes for early therapeutic interventions.
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Kaur, J., C. Gera, M. Malik i A. Pawalia. "Knee pain – thinking beyond degeneration: a systematic review". Comparative Exercise Physiology, 3.05.2023, 1–6. http://dx.doi.org/10.3920/cep230006.
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Knee pain is the most common and challenging pain, that affects the performance and activities of daily living. Apart from the bones, the surrounding neuromuscular structures too are an integral part of the knee joint. The development of knee pain due to these surrounding neuromuscular structures, i.e. hip joint and ankle-foot complex is studied in this literature review. This systematic review was done for the purpose to summarise the literature mainly related to various neuromuscular factors related to neuro-muscle imbalances that affect knee pain other than degeneration. Observational studies related to knee pain published up to 2020 were reviewed in this paper. Strength of hip muscles and foot alignment were included in the study. We searched electronic database online for articles on ‘muscular imbalance that causes knee pain’ from Google scholar & PubMed the quality of the selected researches was measured by using PEDro scale. Of the total, 14 selected studies demonstrated that individuals with knee pain had decreased muscular strength for hip abduction, external rotation and extension on the affected side compared with healthy individuals. Flat foot, abnormal Q angle and over pronation or supination of foot can also results in knee pain. This review concluded that hip muscle weakness and abnormal subtalar mal-alignment place extra stress on knee and create muscular imbalance leading to knee pain. This should be prevented by either proper posture or strengthening programs.
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Nalapur, Sravani, i Rangarao Ambati. "A Review on Neurotoxins from Clostridium botulinum against Neuro-muscular Disorders". Journal of Advances in Biology & Biotechnology, 17.08.2021, 7–14. http://dx.doi.org/10.9734/jabb/2021/v24i730223.
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Neuro-muscular disorders cause a series of serious complications in the human body, where some lead to considerable morbidity and mortality ocassionally. Neurological diseases result in dystrophy, inhibited growth, etc. This present review aimed to emphasize the employment of neurotoxins against neuro degenerative disorders. The source of neurotoxins includes botulinum (Clostridium botulinum), snakes like Vespa orientalis and some medically important arthropods like hornets and spiders. The review not only describes the potential of the neurotoxins in the treatment but also elucidates the mechanism of action of lethal toxins like botulinum. Safety and dosage regimens of various toxins with the help of proven study data would aid in endorsing researchers for further research on toxins making them more superior targeted drugs.
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Inbaraj, Ganagarajan, Krishnamurthy Arjun, Adoor Meghana, Veeramani Preethish-Kumar, Anu P. John, Kiran Polavarapu, Saraswati Nashi i in. "Neuro-Cardio-Autonomic Modulations in Children with Duchenne Muscular Dystrophy". Journal of Neuromuscular Diseases, 18.02.2023, 1–13. http://dx.doi.org/10.3233/jnd-221621.
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Background and Objective: Duchenne muscular dystrophy (DMD) is a degenerative X-linked muscle disease. Death frequently results from complications in cardiopulmonary systems. Preclinical/early diagnosis of cardiac autonomic abnormalities may aid initiate cardioprotective therapy and enhance prognosis. Methods: A cross sectional, prospective study of 38 DMD boys compared with 37 age-matched healthy controls was conducted. Lead II electrocardiography and beat-to-beat blood pressure were recorded to assess heart rate variability (HRV), blood pressure variability (BPV), and baroreceptor sensitivity (BRS) in a standardized environment. Data were analysed and correlated with disease severity and genotype. Results: In the DMD group, the median age at assessment was 8 years [IQR 7–9 years], the median age at disease onset was 3 years [IQR, 2–6 years], and the mean duration of illness was 4 years [IQR, 2.5–5]. DNA sequencing showed deletions in 34/38 (89.5 %) and duplications in 4/38 (10.5%) patients. The median heart rate in DMD children was significantly higher [101.19 (Range, 94.71–108.49)] /min compared to controls [81 (Range, 76.2–92.76)] /min (p < 0.05). All the assessed HRV and BPV parameters were significantly impaired in DMD cases except for the coefficient of variance of systolic blood pressure. Further, BRS parameters were also significantly reduced in DMD, excluding alpha-LF. A positive correlation was found between alpha HF with age at onset and duration of illness. Conclusion: This study demonstrates a distinct early impairment of neuro-cardio-autonomic regulation in DMD. Simple yet effective non-invasive techniques such as HRV, BPV, and BRS may help identify cardiac dysfunction in a pre-clinical state, paving the way for early cardio-protective therapies and limiting disease progression in DMD patients.
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Sandoval-Munoz, Catalina P., i Ziyad S. Haidar. "Neuro-Muscular Dentistry: the “diamond” concept of electro-stimulation potential for stomato-gnathic and oro-dental conditions". Head & Face Medicine 17, nr 1 (26.01.2021). http://dx.doi.org/10.1186/s13005-021-00257-3.
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AbstractOro-Pharyngeal Dysphagia - or simply dysphagia - is the difficulty (persistent) in swallowing/passing food and/or liquid from the mouth to the pharynx into the esophagus and finally the stomach; a deglutition disorder (a symptom, by definition, often due to neuro-degenerative/−muscular, drug-induced or localized structural pathologies such as head and neck tumors, lesions and associated surgical and/or radiation injuries) linked to severe consequences on Quality of Life (QoL), including malnutrition, dehydration, and even sudden death. Likewise, Temporo-Mandibular Jaw and Joint disorder(s) – or simply TMD – is a multifactorial etiological condition, regularly encountered in the dental office. Whether due to malocclusion, bruxism, stress and/or trauma, TMD destabilizes the whole cranio-mandibular system structurally and functionally, via affecting mastication, teeth, supporting structures, comfort and aesthetics, and thus, QoL, again. While several treatment regimens do exist for such conditions, some of which have been standardized for use over the years, most continue to lack proper evidence-based literature support. Hence, (1) caution is to be exercised; and (2) the need for alternative therapeutic strategies is amplified, subsequently, the door for innovation is wide open. Indeed, neuromuscular electrical stimulation or “NMES”, is perhaps a fine example. Herein, we present the interested oro-dental health care provider with an up-dated revision of this therapeutic modality, its potential benefits, risks and concerns, to best handle the dysphagic patient: an intra-disciplinary approach or strategy bridging contemporary dentistry with speech and language therapy; a rather obscure and un-discovered yet critical allied health profession. A pre-clinical and clinical prospectus on employing inventive NMES-based regimens and devices to manage TMD is also highlighted.
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"ALT Speech Recognition System using F0 Improvement and Spectral Tilt Method". International Journal of Engineering and Advanced Technology 8, nr 6 (30.08.2019): 3556–61. http://dx.doi.org/10.35940/ijeat.f9348.088619.
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Human Beings use voice as the medium for communication. Human Speech is a very complex signal with multiple frequencies, amplitudes and intensities that mix up to convey specific information. In international terminology, voice disorders are described as dysphonia. Various dysphonia’s are clearly organic origin due to nervous, muscular, neuro or cellular degenerative disease affecting the body or it is from local laryngeal changes. Other dysphonia’s having no visible laryngeal causes are grouped as non organic involving habitual dysphonia’s that arise from faulty speaking habits or the psycho genic dysphonia’s that stem from emotional causes. This paper looks at a speech recognition system for disordered speech generated by Physically Disabled people using Artificial Larynx Transducer (ALT) device from the perspective of Speech Signal Processing. From the ALT speech features like formant, pitch and spectral tilt is estimated. For formant frequency estimation RNN technique is used. Before training the system pitch frequency improvement is accomplished. Now the features and homomorphic based coefficients are used for training the system. The same operation is performed during the test phase and compared with the training set. Comparison and decision making is accomplished using distance estimator.