RESUMO
Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.
Assuntos
Ablação por Cateter/métodos , Nervo Tibial/patologia , Nervo Tibial/fisiologia , Animais , Ablação por Cateter/instrumentação , Gatos , Estimulação Elétrica/instrumentação , Estimulação Elétrica/métodos , Eletrodos , Coelhos , Transdutores de PressãoRESUMO
With the advent of new approaches to upper extremity recovery after stroke and spinal cord injury, the quantitative evaluation of hand function has become a crucial component of outcome evaluation. Recently we developed a workstation, the ReJoyce (Rehabilitation Joystick for Computer Exercise) on which subjects perform a variety of movement tasks while playing computer games. An important feature of the system is the ReJoyce Automated Hand Function Test (RAHFT). In this study we compared and validated the RAHFT against two widely-used clinical tests, the Action Research Arm Test (ARAT) [1][2] and the Fugl-Meyer Assessment (FMA) [3]. All three tests were performed in 34 separate sessions in 13 tetraplegic individuals. Principal component and regression analyses revealed that both the ARAT and the RAHFT correlated well with the first principle component fitted to the scores of the three tests. The FMA was less well correlated. These data help validate the RAHFT as a quantitative, automated alternative to the ARAT and FMA. The RAHFT is the first comprehensive test of hand function that does not depend on human judgment.
Assuntos
Reabilitação do Acidente Vascular Cerebral , Extremidade Superior/fisiologia , Automação , Desenho de Equipamento , Mãos/fisiologia , Humanos , Sistemas Homem-Máquina , Atividade Motora/fisiologia , Movimento/fisiologia , Análise de Componente Principal , Quadriplegia/fisiopatologia , Recuperação de Função Fisiológica/fisiologia , Análise de Regressão , Reprodutibilidade dos Testes , Interface Usuário-ComputadorRESUMO
Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in stroke and spinal cord injury (SCI) survivors and individuals who suffer from multiple sclerosis. In previous published experiments we have shown that Direct Current (DC), when used to lesion nerves, can attenuate muscle force in a gradual manner, and this attenuation can last for several months. In this paper we present initial experimental results that profile the current required to cause controlled nerve ablation.
