Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Apr 2000
Pursed lips breathing improves ventilation in myotonic muscular dystrophy.
To determine the effects of pursed lips breathing on ventilation, chest wall mechanics, and abdominal muscle recruitment in myotonic muscular dystrophy (MMD). ⋯ Pursed lips breathing and deep breathing are effective and easily employed strategies that significantly improve tidal volume and oxygen saturation in subjects with MMD. Abdominal muscle recruitment does not explain the ventilatory improvements, but reduced end-expiratory lung volume may increase the elastic recoil of the chest wall. Further clinical studies are needed to ascertain if the ventilatory improvements with pursed lips breathing and deep breathing improve pulmonary outcomes in MMD.
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Lyme neuroborreliosis is diagnostically challenging because of its diverse manifestations. The well-documented neurologic spectrum includes lymphocytic meningitis, cranial neuropathy, and radiculoneuritis in the early disseminated stage; and peripheral neuropathy, chronic encephalomyelitis, and mild encephalopathy in the late persistent stage. This case report describes a 74-year-old man who developed progressive left hemiparesis and facial palsy. ⋯ The patient was treated with intravenous ceftriaxone and responded with rapid clinical and functional recovery. Lyme neuroborreliosis presenting as hemiparesis has rarely been reported. Prompt diagnosis and treatment appear to facilitate symptomatic relief and prevent persistent neurologic deficits.
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Arch Phys Med Rehabil · Mar 2000
Stretch reflex adaptation in elbow flexors during repeated passive movements in unilateral brain-injured patients.
To evaluate the effects of repeated, externally imposed, flexion-extension movements of the elbow on the resulting stretch reflex response in hemiparetic spastic brain-injured patients. These effects were compared within a recording session and across sessions for the same subject to determine the impact of movement history on the quantification of spastic hypertonia using the stretch reflex response. ⋯ Stretch reflex adaptation must be taken into consideration when spastic hypertonia is quantified using repeated joint motion, as is often the case. The magnitude of intersession variation in spastic hypertonia measures suggests that ideally, such measurements should be made across multiple sessions before conclusions are made regarding the efficacy of spastic hypertonia interventions. This study provides quantitative evidence that repeated joint movements may have a significant short-term beneficial effect on spastic hypertonia.
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Arch Phys Med Rehabil · Mar 2000
Randomized Controlled Trial Clinical TrialA controlled study on the effects of transcutaneous electrical nerve stimulation and interferential therapy upon the RIII nociceptive and H-reflexes in humans.
To study the effect of transcutaneous electrical nerve stimulation (TENS) and interferential therapy (IFT) upon the RIII nociceptive reflex and H-reflex. ⋯ These results suggest that neither type of electrical stimulation (TENS or IFT) affects the RIII or H-reflexes, at least using the parameters and application time in this study.
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Over the past three decades there has been increasing interest in acute weakness syndromes in critically ill mechanically ventilated patients. Many of these patients require rehabilitation, and some understanding of potential etiologies and functional outcomes for these syndromes is useful to rehabilitation practitioners. A clearer understanding of these syndromes has evolved over time, as has the terminology to describe these conditions. This article will review commonly encountered causes of acute weakness in critically ill patients, including disorders of the peripheral nerves, the neuromuscular junction, and muscle.