scholarly journals Myofascial syndrome as a pathogenetic mechanism for formation of scoliosis in people with multiple sclerosis

2017 ◽  
Vol 8 (2) ◽  
pp. 197-203
Author(s):  
Y. Lysenko
Keyword(s):  
Multiple Sclerosis ◽  
Muscle Tone ◽  
Medical Center ◽  
Motor Units ◽  
Trigger Points ◽  
Pathogenetic Mechanism ◽  
Subjective Pain ◽  
Minimum Amplitude ◽  
Clinical Changes ◽  
Myofascial Syndrome

The purpose of this research was to conduct a comprehensive analysis of clinical changes and electroneuro­myographic indices in people with multiple sclerosis in combination with various types of functional disorders of posture. The study involved 105 people with multiple sclerosis aged 26–58 who were undergoing rehabilitation at a specialized medical center. The degree of spasticity of the muscles was determined by the modified Ashworth scale. To assess the intensity and nature of pain, a neurologic examination was performed using a visual analogue scale and a McGilovsky pain questionnaire. Interference and stimulation electroneuromyography was used to characterize the functional state of the peripheral neuromotor apparatus of skeletal muscles, the results of which determined the maximum arbitrary contraction of the muscle using quantitative analysis of time, amplitude and frequency parameters, and also determined the speed of the pulse, the amplitude and duration of the F wave, latent period and polyphase M-wave, monosynaptic testing (H-reflex) was carried out. The percentage of Hmax/Mmax was calculated from the electroneuro­myographic results. By the ratio between the maximum and minimum amplitude of the M-response, the number of motor units was calculated. To analyze the denervation-reinvational processes of motor units and degenerative-restorative changes in the muscle fibers, spontaneous fibrillation potentials and positive acute waves were recorded. By the stage of manifestation of pain myofascial syndrome, all patients were divided into three groups, in which the force characteristics decreased by 10.2%, 25.0% and 30.2%, respectively. It is well understood in clinic-instrumental research, that in 67.3% cases of multiple sclerosis the patient also suffers from functional scoliosis. This pathological symptom complex contributes to the creation of not only muscular, but also fascial-ligamental trigger points. They, in turn, are the source of the formation of secondary trigger loci. In terms of the degree of manifestation of subjective pain in the presence of myo-fascial syndrome, all patients were divided into three groups, and depending on the value of individual indicators, three stages of spontaneous fibrillation potentials were identified that clearly correlate with the degree of fibromyalgic syndrome and manifest specific electroneuromyographic disorders in each of these stages. The main pathogenetic mechanism that contributes to the formation of pathological bends of the spine in people with multiple sclerosis is a painful muscular-fascial syndrome. It is provoked by myofascial hypertonia and takes part in the development of cross syndromes, which is also manifested by clear changes in electroneuromyographic parameters in the form of asymmetric muscle tone. This article discusses clinical variants of the course of local muscular-tonic syndromes. Pathogenetic approaches to the prevention of posture disorders in patients with multiple sclerosis are presented here. 

Osteopathic support of sportsmen during the annual training process

2020 ◽  
pp. 37-43 ◽  
Author(s):  
R. A. Yakupov ◽  
G. I. Safiullina ◽  
A. A. Safiullina ◽  
E. R. Burganov
Keyword(s):  
Musculoskeletal Diseases ◽  
Muscle Tone ◽  
The Body ◽  
Training Process ◽  
Health Maintenance ◽  
Osteopathic Treatment ◽  
Leading Position ◽  
Myofascial Syndrome ◽  
Sports Activities ◽  
Timely Treatment

Introduction. Modern sports places high demands on the functional systems of the body at all stages of the training and competitive processes. High loads create signifi cant background for the occurrence of musculoskeletal diseases, among which the myofascial syndrome (MFS) holds the leading position. MFS negatively affects the functional readiness of the sportsman′s body and is a risk factor for injuries of the musculoskeletal system. In this regard, timely treatment of MFS is important. It creates the conditions for the improvement of sports achievements, for health maintenance and sports longevity. Treatment of patients with MFS should include methods that normalize trophism and muscle tone. Given the problem of doping, the use of non-drug methods, including osteopathy, is preferable. The goal of research — to develop a system of monitoring and osteopathic correction of myofascial disorders (MFD) and to introduce it into the practice of medical and biological support for sportsmen of different categories and levels during the annual training process.Materials and methods. 93 sportsmen (45 women and 48 men), mean age 22,1±1,1 years, representing diffe rent sports were examined. The essence of the proposed system is regular clinical and electroneurophysiological monitoring of the body condition and preventive correction of myofascial disorders in order to exclude their infl uence on the success of sports activities.Results. It was established that the proposed system of monitoring and osteopathic correction led to a signifi cant reduction in clinical and electroneurophysiological manifestations both in local and in extensive forms of myofascial disorders, which allowed to maintain the optimal functional readiness of sportsmen throughout the entire annual training cycle.Conclusion. The system of monitoring and correction of MFS with the use of osteopathic treatment can be one of the elements of medical and biological support for sportsmen during the annual training process.

The effect of dry needling of myofascial trigger points on muscle stiffness and motoneuron excitability in healthy subjects

2021 ◽  
pp. 096452842110275
Author(s):  
Carolina Jiménez-Sánchez ◽  
Julio Gómez-Soriano ◽  
Elisabeth Bravo-Esteban ◽  
Orlando Mayoral-del Moral ◽  
Pablo Herrero-Gállego ◽  
...  
Keyword(s):  
Muscle Tone ◽  
Intervention Group ◽  
Trigger Points ◽  
Muscle Stiffness ◽  
Invasive Technique ◽  
Control Group ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Motoneuron Excitability

Background: Myofascial trigger points (MTrPs) are hypersensitive nodules in a taut band (TB) of skeletal muscle. Dry needling (DN) is an invasive technique recommended for the treatment of MTrPs. However, to our knowledge, no studies have investigated the influence of the DN technique on modification of muscle stiffness and neurophysiological properties of MTrPs. Objective: The objective was to examine the effect of DN on muscle stiffness and motoneuron excitability of a latent medial MTrP (nodule and TB) of the soleus muscle in non-injured subjects. Methods: A double-blinded randomised controlled trial of 46 subjects with latent medial MTrPs of the soleus was conducted, in which all received one session of DN. The intervention group (n = 23) were subjected to DN into the MTrP (the nodule), while the control group (n = 23) were subjected to DN into the TB. Assessment was carried out at baseline (pre-test), after the intervention (post-test) and 1 week after the intervention (follow-up). Biomechanical variables (muscle resistive force at 10°/s and 180°/s, muscle extensibility and strength), as measured with an isokinetic dynamometer, and neurophysiological variables (H-reflex), were recorded. Results: There were no statistically significant differences in biomechanical or neurophysiological assessments between groups. Considering the intra-group analysis, subjects in the intervention group exhibited increased maximal isometric voluntary force to ankle plantarflexion (MIVFp) at both post-intervention and follow-up assessment (p < 0.0125; 0.2 < d < 0.5), while no changes were found in the control group. Conclusion: One session of DN targeting latent MTrPs did not change muscle stiffness, muscle extensibility or motoneuron excitability. Further research on subjects with muscle tone disorders should be considered to better address the impact of DN on muscle tone. Trial registration number: NCT02575586 (ClinicalTrials.gov).

scholarly journals SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts

2017 ◽  
Vol 24 (11) ◽  
pp. 1485-1498 ◽  
Author(s):  
Riley Bove ◽  
Tanuja Chitnis ◽  
Bruce AC Cree ◽  
Mar Tintoré ◽  
Yvonne Naegelin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
San Francisco ◽  
Medical Center ◽  
Clinically Isolated Syndrome ◽  
American University ◽  
American University Of Beirut ◽  
Longitudinal Investigation ◽  
American Academic

Background: There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Objective: Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient’s course. Methods: Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women’s Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d’Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). Results and conclusion: We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

Long-lasting excitability changes of soleus alpha-motoneuron induced by midpontine stimulation in decerebrate, standing cat

1986 ◽  
Vol 55 (3) ◽  
pp. 449-468 ◽  
Author(s):  
T. Sakamoto ◽  
Y. Atsuta ◽  
S. Mori
Keyword(s):  
Muscle Tone ◽  
Motor Units ◽  
Input Resistance ◽  
Extensor Muscle ◽  
Membrane Excitability ◽  
Peak Voltage ◽  
Resistance Change ◽  
Time To Peak ◽  
Dorsal Portion ◽  
Force Reduction

Stimulation of the dorsal portion of the caudal tegmental field (DTF) in the pons resulted in hyperpolarization of extensor alpha-motoneurons (alpha-MNs) that persisted for several minutes after cessation of the stimulation. The resulting inhibition of alpha-MN discharge led to a progressive reduction in the number of active motor units. Renshaw cells, persistently active at high levels of extensor muscle tone, were abruptly silenced by DTF stimulation. Active discharge was renewed at the time of cessation of the stimulation but at a frequency reduced in proportion to the persistently lowered level of extensor muscle tone. Ia primary afferents were tonically active during the high extensor tonus of reflex standing. DTF stimulation was accompanied by a brief, slight increase in Ia discharge frequency followed by a reduction in frequency variably correlated to the magnitude of extensor force reduction. Orthodromically elicited Ia EPSPs in the soleus alpha-MNs were reduced in peak voltage, time to peak, and half width during the hyperpolarization accompanying DTF stimulation. All of these parameters recovered beyond their prestimulus values with the cessation of DTF stimulation in spite of the persisting hyperpolarization. Antidromically initiated invasion of the somatodendritic (SD) segment of the motoneuron membrane was delayed and sometimes blocked during DTF stimulation. At the same time, the peak voltage of the SD action potential was reduced. There was an immediate recovery of these changes on termination of DTF stimulation, although the poststimulus hyperpolarization persisted. Intracellular injection of depolarizing current steps during DTF stimulation revealed a depression of membrane excitability that persisted during the hyperpolarization that followed the termination of the DTF stimulation. Depolarizing and hyperpolarizing steps of intracellular current were used to demonstrate a reduction of cellular input resistance during DTF stimulation. The resistance values rapidly returned to prestimulus levels following the cessation of DTF stimulation. It was demonstrated that the degree of resistance change is greater and that the magnitude of DTF-induced hyperpolarization is smaller for low-resistance cells than for high-resistance cells. Iontophoretically induced increase in intracellular Cl- resulted in a reversal of both Ia IPSPs and the hyperpolarization induced by DTF stimulation. The hyperpolarization enduring after DTF stimulation was not affected by the Cl- injection.

Impact of myofascial mobilization on pain and mobility of the spine in people with pain and increased muscle tone of the cervical spine

2019 ◽  
Vol XXIII (2) ◽  
pp. 49-60
Author(s):  
Marta NIEDBAŁA ◽  
Grzegorz MAGOŃ
Keyword(s):  
Cervical Spine ◽  
Muscle Tone ◽  
Muscle Tension ◽  
Pain Syndrome ◽  
Trigger Points ◽  
Cervical Region ◽  
Neck Muscle ◽  
Pain Level ◽  
Linear Measurements ◽  
Myofascial Trigger Points

<b>Introduction.</b> Manual therapy is a standard method of physiotherapy to deactivate the interfering potential of the trigger points thus eliminate the subsequent tension within the area of the connective tissue. <b>Aims.</b> The aim of the study is the evaluation of the influence of the myofascial trigger points therapy on the increased neck muscle tension, pain and ROM in people who suffer from cervical pain. <b>Material and methods.</b> A diagnostic method was linear measurements of ROM of the cervical spine and a visual analogue scale (VAS) to assess the pain level. The examination included 35 people aged 25-55, performing whitecollar work in sitting position, selected by a neurologist or orthopedist, with identified increased muscle tension in the cervical region. Achieved results were statistically evaluated. To show the importance of the differences in cervical ROM, the intensity of pain and disability level before and after rehabilitation, a non-parametric signedrank test was utilized. The differences were found as significant for p<0,05. <b>Results and conclusions.</b> A comprehensive physiotherapy of myofascial painfull points results in decrease the pain level in patients suffering from pain syndrome of the cervical spine. Proposed physiotherapy plan lead to improved movement of the cervical spine in all directions.

scholarly journals Characterization of the first symptoms of multiple sclerosis in a Brazilian center: cross-sectional study

2017 ◽  
Vol 135 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Vitor Breseghello Cavenaghi ◽  
Fernanda Martinho Dobrianskyj ◽  
Guilherme Sciascia do Olival ◽  
Rafael Paternò Castello Dias Carneiro ◽  
Charles Peter Tilbery
Keyword(s):  
Multiple Sclerosis ◽  
Medical Center ◽  
Cranial Nerves ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Cross Sectional ◽  
Immune Mediated ◽  
Initial Symptoms ◽  
Mean Time

ABSTRACT CONTEXT AND OBJECTIVE: Multiple sclerosis (MS) is a chronic, immune-mediated and degenerative central nervous system (CNS) disease with well-established diagnostic criteria. Treatment can modify the course of the disease. The objective of this study was to describe the initial symptoms of multiple sclerosis in a Brazilian medical center. DESIGN AND SETTING: Descriptive study, conducted in a Brazilian reference center for multiple sclerosis treatment. METHODS: Data on 299 patients with confirmed diagnoses of MS were included in the study. Their medical files were evaluated and the data were analyzed. RESULTS: The most common symptom involved the cranial nerves (50.83%) and unifocal manifestation was presented by the majority of this population (73.91%). The mean time between the first symptom and the diagnosis was 2.84 years. Unifocal symptoms correlated with longer time taken to establish the diagnosis, with an average of 3.20 years, while for multifocal symptoms the average time taken for the diagnosis was 1.85 years. Unifocal onset was related to greater diagnostic difficulty. CONCLUSIONS: MS is a heterogeneous disease and its initial clinical manifestation is very variable.

Dalfampridine improves walking speed, walking endurance, and community participation in veterans with multiple sclerosis: a longitudinal cohort study

2013 ◽  
Vol 20 (6) ◽  
pp. 733-738 ◽  
Author(s):  
Michelle H Cameron ◽  
Mary Fitzpatrick ◽  
Shannon Overs ◽  
Charles Murchison ◽  
Jane Manning ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Community Participation ◽  
Walking Speed ◽  
Medical Center ◽  
Community Integration ◽  
Short Term ◽  
Relapsing Remitting ◽  
One Year ◽  
Walking Endurance

Background: In short-term trials, dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS). The tolerability and effects of dalfampridine-ER in clinical practice have not been reported. Objectives: The objective of this paper is to determine the clinical tolerability and effects of dalfampridine on walking and community participation. Methods: All patients at the Portland VA Medical Center prescribed dalfampridine-ER over one year completed the Timed 25-Foot Walk (T25FW), Multiple Sclerosis Walking Scale-12 (MSWS-12), Two-Minute Timed Walk (2MTW), and Community Integration Questionnaire (CIQ) at baseline and follow-up clinic visits. Ongoing use and measures over one year were analyzed. Results: A total of 39 patients (mean age 56.5 years, mean disease duration 19.5 years, 82% male, 38% relapsing–remitting MS, 62% progressive MS) were prescribed dalfampridine-ER. Twenty-four (62%) continued to take dalfampridine-ER. At initial follow-up, all measures improved significantly from baseline (T25FW: –2.7 s, p = 0.004; 2MTW: 41 feet (ft), p = 0.002; MSWS12: –11, p < 0.001; CIQ: 1.2, p = 0.003). At one year, walking endurance and self-perceived walking were still significantly improved (2MTW: 33 ft, p = 0.03; MSWS-12: 5.9, p = 0.007). Conclusions: Dalfampridine-ER was associated with short-term improvements in walking speed and community participation, and sustained improvements in walking endurance and self-perceived impact of MS on walking for one year. Our study supports the utility of this medication in late MS.

scholarly journals Efficacy of the dry needling of myofascial syndrome in the trapezius muscle: A systematic review

2020 ◽  
pp. 17-37
Author(s):  
Gabriel Otero-Pérez ◽  
Raquel Leirós-Rodríguez
Keyword(s):  
Web Of Science ◽  
Trigger Point ◽  
Trapezius Muscle ◽  
Trigger Points ◽  
Cervical Pain ◽  
Inclusion Criteria ◽  
Dry Needling ◽  
Study Objective ◽  
Jadad Scale ◽  
Myofascial Syndrome

Objective: To analyze the efficacy of the dry needling technique in the treatment of trigger points of the trapezius muscle. Material & Methods: A systematic search was carried out in the databases: PubMed, Scopus and Web of Science with the terms neck pain, trapezius, dry needling and acupuncture therapy. The results were analyzed following two inclusion criteria: studies published after 2014, and studies that aimed to evaluate the effects of dry needling on trapezius muscle. Seventeen articles were obtained, which were evaluated according to their methodological quality with the JADAD Scale and analyzed according to: study objective, experimental design, sample, intervention applied, variables analyzed, instruments used to quantify the results and results obtained. Results: Thirteen articles were selected in which, practically all, show that dry needling decreases pain intensity, improves range of motion, increases the painful threshold to pressure and eliminates, in most cases, trigger points. Conclusions: The dry needling has effects on cervical pain and disability, generated by myofascial dysfunction, have been identified. This technique did not show significant improvements compared to other techniques analyzed, but it did prove to be a treatment as valid as other more conventional ones. Keywords: Dry needling; Trigger point; Cervical pain; Trapezius; Rehabilitation

Evoked potentials predict the clinical changes in a multiple sclerosis drug study

Neurology ◽  
1987 ◽  
Vol 37 (11) ◽  
pp. 1754-1754 ◽  
Author(s):  
M. R. Nuwer ◽  
J. W. Packwood ◽  
L. W. Myers ◽  
G. W. Ellison
Keyword(s):  
Multiple Sclerosis ◽  
Evoked Potentials ◽  
Drug Study ◽  
Clinical Changes
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