Application of magnetic motor stimulation for measuring conduction time across the lower part of the brachial plexus

<p>Abstract</p> <p>Objective</p> <p>The objective of this study was to calculate central motor conduction time (CMCT) of median and ulnar nerves in normal volunteers. Conduction time across the lower part of the brachial plexus was measured by using magnetic stimulation over the motor cortex and brachial plexus and recording the evoked response in hand muscles.</p> <p>Design</p> <p>This descriptive study was done on 112 upper limbs of healthy volunteers. Forty-six limbs belonging to men and sixty-six belonging to women were studied by magnetic stimulation of both motor cortex and brachial plexus and recording the evoked response in thenar and hypothenar muscles. Stimulation of the motor cortex gives rise to absolute latency of each nerve whereas stimulation of the brachial plexus results in peripheral conduction time. The difference between these two values was considered the central motor conduction time (CMCT).</p> <p>Results</p> <p>In summary the result are as follows; Cortex-thenar latency = 21.4 ms (SD = 1.7), CMCT-thenar = 9.6 ms (SD = 1.9), Cortex-hypothenar latency = 21.3 ms (SD = 1.8), CMCT-hypothenar = 9.4 ms (SD = 1.8).</p> <p>Conclusion</p> <p>These findings showed that there is no meaningful difference between two genders. CMCT calculated by this method is a little longer than that obtained by electrical stimulation that is due to the more distally placed second stimulation. We recommend magnetic stimulation as the method of choice to calculate CMCT and its use for lower brachial plexus conduction time. This method could serve as a diagnostic tool for diagnosis of lower plexus entrapment and injuries especially in early stages.</p

Effects of Neurodevelopmental Therapy on Gross Motor Function in Children with Cerebral Palsy

How to Cite This Article: labaf S, Shamsoddini A, Hollisaz MT, Sobhani V, Shakibaee A . Effects of Neurodevelopmental Therapy on Gross Motor Function in Children with Cerebral Palsy. Iran J Child Neurol. Spring 2015;9(1):37-42.AbstractObjectiveNeurodevelopmental treatments are an advanced therapeutic approach practiced by experienced occupational therapists for the rehabilitation of children with cerebral palsy. The primary challenge in children with cerebral palsy is gross motor dysfunction. We studied the effects of neurodevelopmental therapy on gross motor function in children with cerebral palsy.Materials &amp; MethodsIn a quasi-experimental design, 28 children with cerebral palsy were randomly divided into two groups. Neurodevelopmental therapy was given to a first group (n=15) with a mean age of 4.9 years; and a second group with a mean age 4.4 years (n=13) who were the control group. All children were evaluated with the Gross Motor Function Measure. Treatments were scheduled for three - one-hour sessions per week for 3 months.ResultsWe obtained statistically significant differences in the values between the baseline and post treatment in two groups. The groups were significantly different in laying and rolling (P=0.000), sitting (0.002), crawling and kneeling (0.004), and standing abilities (P=0.005). However, there were no significantdifferences in walking, running, and jumping abilities between the two groups (0.090).ConclusionWe concluded that the neurodevelopmental treatment improved gross motor function in children with cerebral palsy in four dimensions (laying and rolling, sitting, crawling and kneeling, and standing). However, walking, running, and jumping did not improve significantly

A randomized clinical trial comparing hydrocolloid, phenytoin and simple dressings for the treatment of pressure ulcers [ISRCTN33429693]

BACKGROUND: Pressure sores are important and common complications of spinal cord injury. Many preventive and therapeutic approaches have been tried and new trials are evolving. One relatively recent method is application of a hydrocolloid dressing (HD). In this study we compared the therapeutic effects of HD on pressure ulcer healing with two other topical applications, phenytoin cream (PC) and simple dressing (SD). METHODS: Ninety-one stage I and stage II pressure ulcers of 83 paraplegic male victims of the Iran-Iraq war were randomly allocated to three treatment groups. Mean age and weight of the participants were 36.64 ± 6.04 years and 61.12 ± 5.08 kg, respectively. All the patients were managed in long term care units or in their homes for 8 weeks by a team of general practitioners and nurses, and the ulcer status was recorded as "Complete healing", "Partial healing", "Without improvement" and "Worsening". RESULTS: Complete healing of ulcers, regardless of location and stage, was better in the HD group than the PC [23/31(74.19%) vs 12/30(40%); difference: 34.19%, 95% CI = 10.85–57.52, (P < 0.01)] or the SD [23/31(74.19%) vs 8/30(26.66%); difference: 47.53%, 95% CI = 25.45–69.61, (P < 0.005)] groups. Complete healing of stage I ulcers in the HD group [11/13(85%)] was better than in the SD [5/11(45%); difference: 40%, 95% CI = 4.7–75.22, (P < 0.05)] or PC [2/9 (22%); difference: 63%, 95% CI = 29.69–96.3, (P < 0.005)] groups. Complete healing of stage II ulcer in the HD group [12/18 (67%)] was better than in the SD group [3/19(16%); difference: 51%, 95% CI = 23.73–78.26, (P < 0.005)], but not significantly different from the PC group [10/21 (48%); difference: 19%, 95% CI = -11.47–49.47, (P > 0.05)]. We performed a second analysis considering only one ulcer per patient (i.e. 83 ulcers in 83 patients). This "per patient" analysis showed that complete ulcer healing in the HD group was better than in the PC [20/28(71.4%) vs 11/28 (39.3%); difference: 32.1%, 95% CI = 7.4–56.7, (P < 0.01)] or SD [20/28(71.4%) vs 8/27 (29.6%); difference: 41.8%, 95% CI = 17.7–65.8, (P < 0.005)] groups. CONCLUSION: We deduced that HD is the most effective method investigated for treating stage I and II pressure ulcers in young paraplegic men

Initial Effect of Taping Technique on Wrist Extension and Grip Strength and Pain of Individuals with Lateral Epicondylitis

Objectives: Aim of this study is to investigate the initial effect of taping technique on wrist extension and grip strength and pain of Individuals with tennis elbow. Methods: fifteen patients (10 men and 5 women with 42.53 years) on their dominant arm participated in this study. Outcome measures were wrist extension and grip strength and pain taken before and immediately after application of tape. The unaffected arm served as a control. Used of hand-held dynamometer and jammar dynamometer for evaluated of wrist extension and grip strength. Also, visual analog scale (VAS) used for evaluated of pain Results: Among the variables, significant differences were found in wrist extension strength between effected and unaffected arm (P=0.006). Also, changes in grip strength shows statically significant improve in effect arm than unaffected arm (P=0.001). Changes in pain in impaired arm were positive. Discussion: Taping technique, as applied in this study demonstrated an impressive effect on wrist extension and grip strength and pain in individuals with tennis elbow. Therefore, it is recommended that this method may be useful in the management of this condition during exercise and functional rehabilitation

Efficacy of physiotherapy compared to steroid injection for adductor muscle strain

Introduction: Adductor muscle strain or sportsman hernia (SH) is one of the most common disorders in cases who underwent heavy physical activity. An injection of corticosteroids is used to treat inflammation on the last step. Recently, physiotherapy (PT) considered as one of the most effective treatment for muscle strain. The aim of this study was the evaluation of the efficacy of steroid injection compared physiotherapy in adductor muscle strain. Materials and Methods: This cohort study was conducted on the patients who have presented to the physical medicine clinic of Baqiyatallah hospital with chronic groin pain definitely diagnosed SH. Other cause of unilateral groin pain was overruled, and the patients were divided into the two groups accidentally. Patients at the first group underwent 40 mg prednisolone injection and follow-up of 4 weeks later, and at the second group, the patients underwent PT containing stretching adductor muscle lasting 30 seconds 3 times per week for 2 weeks. Results: Seventy-six male patients with the mean age of 24.62 ± 3.49 including 24 athletes, 26 soldiers, and 26 martials were enrolled whom 37 of them divided into the first group and 39 into the second one. The mean ± SD of Visual Analogue Scale (VAS) before and after treatment in first group was 7.784 ± 0.492 and 3.340 ± 0.836, respectively and in second group equals to 8.008 ± 0.457 and 3.370 ± 0.297, respectively. These differences between and within groups were statistically significant. (P < 0.05). Conclusion: Both therapeutic protocols were effectively repressed the pain scores (VAS) although PT protocol was more effective than prednisolone injection. We suggest PT protocol as the first choice of SH treatment

Immediate Effects of Counterforce Forearm Brace on Grip Strength and Wrist Extension Force in Patients With Lateral Epicondylosis

ObjectiveAlthough the effectiveness of counterforce braces has been reported in patients with lateral epicondylosis over the elbow, its immediate effect is limited. This research was to study the immediate effects of counterforce forearm brace on grip strength and wrist extension force in patients.MethodsFifteen patients (9 women and 6 men) with lateral epicondylosis (M ± SD, 8.1 ± 1.1 weeks) on their dominant arm participated in this study. We tested grip strength, wrist extension muscle force and range of motion (ROM) wrist extension immediately after application of counterforce forearm brace in the affected and unaffected arms.ResultsAmong the variables, significant differences were found in grip strength (p = .02) and wrist extension muscle force (p = .001), but changes in ROM of wrist extension were not statistically significant (p = .98).ConclusionUsing the counterforce forearm brace increased the rate of grip strength and wrist extension muscle force in patients with lateral epicondylosis. However, our findings did not support the use of the counterforce brace in increasing ROM in wrist extension