scholarly journals HIV encephalopathy with bilateral lower limb spasticity: upper limb motor function and level of activity and participation

2016 ◽  
Vol 59 (4) ◽  
pp. 412-419 ◽  
Author(s):  
Theresa N Mann ◽  
Kirsten A Donald ◽  
Barbara Laughton ◽  
Robert P Lamberts ◽  
Nelleke G Langerak
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Hiv Encephalopathy ◽  
Level Of Activity ◽  
Bilateral Lower Limb ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

Long-term functional outcome after selective posterior rhizotomy

2002 ◽  
Vol 97 (2) ◽  
pp. 315-325 ◽  
Author(s):  
Sandeep Mittal ◽  
Jean-Pierre Farmer ◽  
Borhan Al-Atassi ◽  
Joanne Gibis ◽  
Eileen Kennedy ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Functional Outcome ◽  
Motor Function ◽  
Lower Limb ◽  
Content Type ◽  
Limb Spasticity ◽  
Lower Limb Spasticity ◽  
Selective Posterior Rhizotomy ◽  
Fine Print

Object. Selective posterior rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal rhizotomy accompanied by intraoperative electrophysiological monitoring. Methods. The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, range of motion, and functional muscle strength at 1 year after SPR. The preoperative, 1-, 3-, and 5-year values for the global score of the Gross Motor Function Measure were 64.6, 70.8, 80, and 85.6, respectively. The greatest improvement occurred in the dimensions reflecting lower-extremity motor function, where the mean change was 10.1% at 1 year, 19.9% at 3 years, and 34.4% at the 5-year follow-up review in comparison with the baseline value. This was associated with a lasting improvement in alignment and postural stability during developmental positions, as well as increased ability to perform difficult transitional movements. Conclusions. The results of this study support the presence of significant improvements in lower-limb functional motor outcome 1 year after SPR, and the improvements persist at 3 and 5 years. The authors conclude that SPR in conjunction with intraoperative stimulation is valuable for permanently alleviating lower-limb spasticity while augmenting motor function.

scholarly journals Efficacy and Safety of Botulinum Toxin Type A for Limb Spasticity after Stroke: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Li-Chun Sun ◽  
Rong Chen ◽  
Chuan Fu ◽  
Ying Chen ◽  
Qianli Wu ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Muscle Tone ◽  
Meta Analysis ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Physician Global Assessment ◽  
Randomized Controlled ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

Background. Inconsistent data have been reported for the effectiveness of intramuscular botulinum toxin type A (BTXA) in patients with limb spasticity after stroke. This meta-analysis of available randomized controlled trials (RCTs) aimed to determine the efficacy and safety of BTXA in adult patients with upper and lower limb spasticity after stroke. Methods. An electronic search was performed to select eligible RCTs in PubMed, Embase, and the Cochrane library through December 2018. Summary standard mean differences (SMDs) and relative risk (RR) values with corresponding 95% confidence intervals (CIs) were employed to assess effectiveness and safety outcomes, respectively. Results. Twenty-seven RCTs involving a total of 2,793 patients met the inclusion criteria, including 16 and 9 trials assessing upper and lower limb spasticity cases, respectively. For upper limb spasticity, BTXA therapy significantly improved the levels of muscle tone (SMD=-0.76; 95% CI -0.97 to -0.55; P<0.001), physician global assessment (SMD=0.51; 95% CI 0.35-0.67; P<0.001), and disability assessment scale (SMD=-0.30; 95% CI -0.40 to -0.20; P<0.001), with no significant effects on active upper limb function (SMD=0.49; 95% CI -0.08 to 1.07; P=0.093) and adverse events (RR=1.18; 95% CI 0.72-1.93; P=0.509). For lower limb spasticity, BTXA therapy was associated with higher Fugl-Meyer score (SMD=5.09; 95%CI 2.16-8.01; P=0.001), but had no significant effects on muscle tone (SMD=-0.12; 95% CI -0.83 to 0.59; P=0.736), gait speed (SMD=0.06; 95% CI -0.02 to 0.15; P=0.116), and adverse events (RR=1.01; 95% CI 0.71-1.45; P=0.949). Conclusions. BTXA improves muscle tone, physician global assessment, and disability assessment scale in upper limb spasticity and increases the Fugl-Meyer score in lower limb spasticity.

scholarly journals The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (9) ◽  
pp. 4424
Author(s):  
Rosa Cabanas-Valdés ◽  
Jordi Calvo-Sanz ◽  
Pol Serra-Llobet ◽  
Joana Alcoba-Kait ◽  
Vanessa González-Rueda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Meta Analysis ◽  
Stroke Survivors ◽  
Randomized Controlled Clinical Trials ◽  
Therapeutic Massage ◽  
Limb Spasticity ◽  
Conventional Physiotherapy

Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I2 = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I2 = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I2 = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.

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