Mode of hand training determines cortical reorganisation: A randomized controlled study in healthy adults

Objective: To evaluate two commonly used forms of hand training with respect to influence on dexterity and cortical reorganization. Subjects: Thirty healthy volunteers (mean age 24.2 years). Methods: The subjects were randomized to 25 min of shaping exercises or general activity training of the non-dominant hand. The dexterity and the cortical motor maps (number of excitable positions) of the abductor pollicis brevis muscle were evaluated pre- and post-training by the Purdue Peg Board test and transcranial magnetic stimulation, respectively. Results: After shaping exercises the dexterity increased significantly (p <= 0.005) for both hands, mostly so in the non-dominant hand. The cortical motor map of the abductor pollicis brevis muscle shifted forwardly into the pre-motor area without expanding. After general activity training, no significant improvements in dexterity were found for the non-dominant hand. The cortical motor map of the non-dominant abductor pollicis brevis muscle expanded significantly (p = 0.03) in the posterior (sensory) direction. Conclusion: These results indicate that shaping exercises, but not general activity training, increase dexterity of the trained non-dominant hand in parallel with a shift of location of active transcranial magnetic stimulation positions. Shifts of active cortical areas might be important for the interpretation of brain plasticity in common behavioural tasks

Three Clusters of Different Properties Characterize Women with Chronic Trapezius Myalgia

Objectives: A correlative study on data from 14 women with unilateral chronic shoulder pain was undertaken. Methods: Data were obtained on evoked pain and pressure pain thresholds [PPTs] changes upon muscle exertion and biopsy findings on capillary density and Muscular pathology. The PPTs were measured in the trapezius muscle, before and after a static abduction endurance test of the shoulder [electronic algometer]. Holding time and pain intensity was registered. Capillarization and ragged red fibers, cytochrome-c-oxidase negative fibers, and moth-eaten muscle fibers were analyzed in the same trapezius muscles. Results: Principal component analysis was used for multivariate analysis, showing a model with three statistically significant components. The first component explained 33 percent of the variation. Pressure pain threshold changes were positively correlated with capillarization, and negatively correlated with prevalence of moth-eaten fibers and cytochrome-c-oxidase negative fibers. The second component explained 23 percent of the variation, and reflected the correlations between holding time, differences in pain and PPTs, i.e., between various aspects of perceived pain after exertion. The third component explained 19 percent of the variation. The pain difference correlated positively with the prevalence of cytochrome-c-oxidase negative fibers and raggedred fibers; subjects with high prevalence of these two fiber types presented increased pain. In summary, Our results suggest that not only capillarization and histopathological findings of the trapezius muscle, but also centrally modulated pain intensity and PPT changes after muscle exertion are associated. Conclusions: Three clusters of different properties were revealed in women with trapezius myalgia, highlighting the multifactorial mechanisms responsible. These components may have prognostic value.Original Publication:Ann L Persson, Bengt H Sjolund and Britt Larsson, Three Clusters of Different Properties Characterize Women with Chronic Trapezius Myalgia, 2008, JOURNAL OF MUSCULOSKELETAL PAIN, (16), 4, 287-297.http://dx.doi.org/10.1080/10582450802479768Copyright: New York; Haworth Medical Presshttp://www.haworthpressinc.com

White Book on Physical and Rehabilitation Medicine in Europe Introductions, Executive Summary, and Methodology

The White Book (WB) of Physical and Rehabilitation Medicine (PRM) in Europe is produced by the 4 European PRM Bodies (European Academy of Rehabilitation Medicine - EARM, European Society of PRM - ESPRM, European Union of Medical Specialists - PRM Section, European College of PRM-ECPRM served by the European Union of Medical Specialists-PRM Board) and constitutes the reference book for PRM physicians in Europe. It has now reached its third edition; the first was published in 1989 and the second in 2006/2007. The WB has multiple purposes, including providing a unifying framework for European countries, to inform decision-makers on European and national level, to offer educational material for PRM trainees and physicians and information about PRM to the medical community, other rehabilitation professionals and the public