Changes In Muscle Tone Research Articles

Present problem of neurororehabilitology: methods for quantitative assessment of pathological increased muscle tone

One of the urgent problems of neurorehabilitation is spasticity ― a motor disorder that depends on the rate of muscle stretching due to the enhancement of tonic stretch reflexes due to a violation of supraspinal inhibitory signals, which is manifested by intermittent or prolonged involuntary muscle activation. In addition to spasticity, the clinical forms of lesions of the upper motor neurons in the form of muscle hypertonicity include rigidity and dystonia.
 Although spasticity is one of the most common occurrences, its precise definition and pathophysiology remain unclear.
 Spasticity reduces the effectiveness of rehabilitation of patients with severe disabling diseases. With organic lesions of the brain, movement disorders are often caused by increased muscle tone, which makes it difficult to perform simple movements. For the correct setting of treatment goals for a patient with spasticity syndrome, including for the development of an individual rehabilitation program with a further assessment of its effectiveness, it is necessary to correctly determine the spasticity and its severity, differentiate from other forms of pathological changes in muscle tone (rigidity, plasticity, contractures), as well as to assess the impact on the active and passive function of the limb, daily life and quality of life of the patient.
 An important issue in the rehabilitation process is the method of quantitative assessment of the pathological increase in muscle tone, for which the collection of complaints and anamnesis, physical neurological examination, scales and various options for instrumental examination are used.
 The review article presents modern and traditional methods for quantifying muscle tone, as well as methods of therapy.

Assessments of Muscle Thickness and Tonicity of the Masseter and Sternocleidomastoid Muscles and Maximum Mouth Opening in Patients with Temporomandibular Disorder.

The purpose of this study was to compare the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and maximum mouth opening (MMO) in subjects with and without temporomandibular disorders (TMD), and perform a correlation comparison on the results of the TMD group. Sixty patients were allocated to the TMD group (n = 30) or the non-TMD group (n = 30). Ultrasound imaging, myotonometer, and vernier calipers were used to determine the related changes in muscle thickness and muscle tone in masseter and SCM, and MMO, respectively. The TMD group revealed a significant decrease than the non-TMD group in the muscle thickness of masseter and SCM, respectively (p < 0.001), with a significant increase in frequency (p < 0.001) and stiffness (p < 0.001) in the masseter muscle tone, with a significant increase in frequency (p < 0.001) and stiffness (p = 0.005) in the SCM muscle tone, a significant decrease in the MMO (p < 0.001). There was a moderate negative correlation between the relaxed state of masseter muscle thickness and stiffness of SCM muscle tone (r = −0.40, p = 0.002), and a moderate negative correlation between the relaxed state of SCM muscle thickness and frequency of SCM muscle tone (r = −0.42, p = 0.001). There was a moderate negative correlation between the clenching state of SCM muscle thickness and the frequency of SCM muscle tone (r = −0.47, p < 0.001). In addition, a moderate negative correlation between MMO and frequency of SCM muscle tone (r = −0.44, p < 0.001). The muscle thickness was decreased, and the muscle tone was increased in the masseter and SCM muscle, respectively. Additionally, MMO was decreased in patients with TMD compared with non-TMD.

Effects of dry needling on gait and muscle tone in Parkinson's disease: a randomized clinical trial.

Alterations in gait and muscular rigidity are common and disabling in persons with Parkinson's disease (PD). The aim of this study was to determine whether a single dry needling (DN) session can promote changes in gait and muscle tone in the lower extremities as well as in the evolution of the disease in persons with PD. A randomized double-blind clinical trial was designed. Participants were randomly assigned to an intervention group (IG) that received a session of DN over the semitendinosus, medial gastrocnemius, soleus and rectus femoris muscles, or to a control group (CG) that received a session of sham DN in the same muscles. The effects of DN were assessed using the timed up and go test (TUG), 10 meter walk test (10MWT), 6 minute walk test (6MWT) and myotonometry before, immediately after, and 7 days after the intervention. Thirty-three participants were analyzed aged 69.9 ± 7.2 years (mean ± SD; 39% female). There were no significant differences between the IG and CG for any outcomes. Significant differences were observed when comparing the Pre and Follow-up values in the IG for functional mobility of gait in the TUG (p = 0.049), gait speed in the 10MWT (p = 0.041) and muscle tone in the lower extremities by myotonometry (frequency (p = 0.027) and stiffness (p = 0.013)). By comparison, there were no significant within-group differences in the CG. A single session of DN had no measurable benefit compared to a single session of sham DN. Within-group changes in the IG suggested improvements in functional mobility of gait and gait speed, as well as changes in the muscle tone in the lower extremities of PD patients, which could be worthy of further exploration by future research.

Brief resolved unexplained events: a new diagnosis, with implications for evaluation and management.

Brief resolved unexplained events (BRUE) are concerning episodes of short duration (typically < 1min) characterized by a change in breathing, consciousness, muscle tone (hyper- or hypotonia), and/or skin color (cyanosis or pallor). The episodes occur in a normal-appearing infant in the first year of life, self-resolve, and have no readily identifiable explanation for the cause of the event. Previously called apparent life-threatening events (ALTE), the term BRUE was first defined by the American Academy of Pediatrics (AAP) in 2016. The criteria for BRUE carry greater specificity compared to that of ALTE and additionally are indicative of a diagnosis of exclusion. While most patients with BRUE will have a benign clinical course, important etiologies, including airway, cardiac, gastrointestinal, genetic, infectious, neurologic, and traumatic conditions (including nonaccidental), must be carefully considered. A BRUE is classified as either lower- or higher-risk based on patient age, corrected gestational age, event duration, number of events, and performance of cardiopulmonary resuscitation at the scene. The AAP clinical practice guideline provides recommendations for the management of lower-risk BRUEs, advocating against routine admission, blood testing, and imaging for infants with these events, though a short period of observation and/or an electrocardiogram may be advisable. While guidance exists for higher-risk BRUE, more data are required to better identify proportions and risk factors for serious outcomes among these patients. Conclusion: BRUE is a diagnosis with greaterspecificity relative to prior definitions and is now a diagnosis of exclusion. Additional research is needed, particularly in theevaluation of higher-risk events. Recent data suggest that the AAP guidelines for the management of lower-risk infants can besafely implemented.This review article summarizes the history, definitional changes, current guideline recommendations, and future research needs for BRUE. What is Known: • BRUE, first described in 2016, is a diagnosis used to describe a well-appearing infant who presents with change in breathing, consciousness, muscle tone (hyper- or hypotonia), and/or skin color (cyanosis or pallor). • BRUE can be divided into higher- and lower-risk events. Guidelines have been published for lower-risk events, with expert recommendations for higher-risk BRUE. What is New: • BRUE carries a low rate of serious diagnoses(< 5%), with the most common representing seizures and airway abnormalities. • Prior BRUE events are associated with serious diagnoses and episode recurrence.

Correlation Between Joint Position Sense, Threshold To Detection of Passive Motion of The Knee Joint And Walking Speed of Post-Stroke Patient

Background: Sensori motor dysfunction such as muscle weakness, impaired sensation, changes in muscle tone, reduced movement control are common in stroke patients. Locomotion function requires continuous afferent sensory input. Impairment of sensory function can hinder the ability to recruit muscles during walking. Patients generally walk slowly, cadence, step and stride length are shorter and the double phase of support increases. Goal: Analyzing the correlation between the propioceptive function of the knee joint and walking speed in post-stroke patients, who are treated at the Outpatient Medical Rehabilitation Clinic of RSU Dr.Soetomo Surabaya. Methode: An observational analytic cross sectional study, nine subjects measured walking speed (10MWT), joint position sense (JPS) and threshold to detetction of passive motion (TTDPM) of the knee joint, in the period March - November 2020.. Results: There is a moderate correlation between 10MWT and JPS 150 on the non-paretic side (r 0.676; p=0.045) and JPS 300 on the paretic side (r 0.668; p=0.049). And there is a strong correlation between 10MWT and JPS 600 on the paretic side (r 0.824; p=0.006). However, there is no significant correlation between 10MWT and TTDPM. Conclusion: There is correlation between the propioceptive function of the knee joint and the walking speed of post-stroke patients. The smaller the percentage of joint position error, the stronger the correlation with walking speed.

Defining Risk Factors for Children Following a BRUE: The Need to Revisit the AAP BRUE Guideline.

Defining Risk Factors for Children Following a BRUE: The Need to Revisit the AAP BRUE Guideline.

Neurological profile of low-risk children at 3–4 years of age

Background. Nervous system diseases and neurodevelopmental disorders are detected in children of preschool and school age approximately thrice as frequently as nervous system disorders in neonates. To investigate this dynamic, we admitted the necessity of standard neurological assessment of children in the interim period, that is at the age of 3–4 years old.Objective. The aim of the present research is practical testing of standard neurological assessment method for children at the approximate age of 3.5 years old.Design and methods. We studied neurological status characteristics in 26 low-risk children at the age 31–48 months with the adapted standard Neurological Profile of B. C. L. Touwen.Results. It is shown that in neurological status of children of the specified age, qualified as «neurologically healthy», not less than two deviations from optimal values were detected. The most common deviations were impaired sitting up from supine position, reduction of reaction to push in sitting position and passive muscle tone changes. The average neurological profile for these children was received. The detected neurological status deviations have correlation with speech development disorders (speech development milestones and phrase speech) (r = 0.69–0.74). At the same time, we noted dissociation between values of some neurological functions and development, and that may suggest individual of development.Conclusion. Comparison of neurological morbidity in neonatal period and in early preschool age, data about influence of neurological deviations at the approximate age of 3.5 years old on the future cognitive and behavioral disorders, as well as the findings obtained in the present research about prevalence and character of individual deviations in low-risk children, may suggest a probable mechanism of neurological, cognitive, and behavioral disorders increase in elder children.

신체활동 참여가 발달장애인의 하지 근 긴장도 변화와 신체 균형능력에 미치는 영향

The purpose of this study was to investigate the effects of physical activity on changes in lower limb muscle tone and body balance ability in people with developmental disabilities. In this study, subjects with developmental disabilities who showed voluntary participation as those diagnosed as developmental disabilities through medical examination were selected as subjects. These subjects were randomly assigned to the trampoline group (n=10) and the yoga group (n=10) as those who did not participate in the recent regular exercise program. The trampoline and yoga were performed twice a week for a total of 20 times for 10 weeks with 60 minutes each. The intensity of exercise was divided into 3 steps, and rating of perceived exertion(RPE) of 8-9, 10-11, and 12-13 were performed, respectively. Muscle tone was measured at rest in a total of three muscle groups of the quadriceps muscle, hamstring, and calf. Also, one leg standing test was used to test the static balance ability, and linear gait test was performed to test dynamic balance ability. Based on the results of the study, the following results were obtained. First, in the trampoline and yoga group, the quadriceps muscle tone increased(p<.05) significantly, and the hamstring(p=.056) and calf muscle tone increased(p<.05) only in the trampoline group. Second, the static balance ability was significantly increased(p<.01) in the trampoline and yoga group. Third, the dynamic balance ability S1 & S2 was significantly increased(p<.05) in the trampoline group, but increased(p=.07) only in the dynamic balance ability S1 in the yoga group. Therefore, a physical activity program using trampoline and yoga can be an effective intervention to improve muscle tone, and it is considered appropriate as an alternative physical activity to improve balance and exercise performance for people with developmental disabilities in the future.

Sharp Changes in Muscle Tone in Humans Under Simulated Microgravity

A decrease in muscle tone induced by space flight requires a standardized assessment of changes to control the state of the neuromuscular system. This study is a step toward the development of a unified protocol, aimed at determining the initial effect of the presence or withdrawal of support on muscle tone, the effects of a 2-h supportlessness in Dry Immersion (DI) experiments, and the changes in muscle tone depending on the site of measurement. To perform measurements of changes in muscle tone, we used a MyotonPRO device. The list of muscles that we assessed includes: trunk – mm. deltoideus posterior, trapezius, erector spinae; leg – mm. biceps femoris, rectus femoris, tibialis anterior, soleus, gastrocnemius; foot – m. flexor digitorum brevis, tendo Achillis, aponeurosis plantaris. The study involved 12 healthy volunteers (6 men, 6 women) without musculoskeletal disorders and aged 32.8 ± 1.6 years. At the start of DI, there was a significant decrease in muscle tone of the following muscles: mm. tibialis anterior (−10.9%), soleus (−9.6%), erector spinae (−14.4%), and the tendo Achillis (−15.3%). The decrease continued to intensify over the next 2 h. In contrast, the gastrocnemius muscle demonstrated an increase in muscle tone (+7.5%) 2 h after the start of DI compared to the immediate in-bath baseline. Muscle tone values were found to be site-dependent and varied in different projections of mm. erector spinae and soleus. In previous experiments, we observed a high sensitivity of the myotonometry technique, which was confirmed in this study. To make it possible to compare data from different studies, a standardized protocol for measuring muscle tone for general use in gravitational physiology needs to be developed.

Muscle temperature is least altered during total sleep deprivation in rats.

It has often been said that the brain is mostly benefitted from sleep. To understand the importance of sleep, extensive studies on other organs are too required. One such unexplored area is the understanding of muscle physiology during the sleep-wake cycle. Changes in muscle tone with different sleep phases are evident from the rapid eye movement sleep muscle atonia. There is variation in brain and body temperature during sleep stages, the brain temperature being higher during rapid eye movement sleep than slow-wave sleep. However, the change in muscle temperature with different sleep stages is not known. In this study, we have implanted pre-calibrated K-type thermocouples in the hypothalamus and the dorsal nuchal muscle, and a peritoneal transmitter to monitor the hypothalamic, muscle, and body temperature respectively in rats during 24h sleep-wake cycle. The changes in muscle, body, and hypothalamic temperature during total sleep deprivation were also monitored. During normal sleep-wake stages, the temperature in the decreasing order was that of the hypothalamus, body, and muscle. Total sleep deprivation by gentle handling caused a significant increase in hypothalamic and body temperature, while there was least change in the muscle temperature. The circadian rhythm of the hypothalamic and body temperature in the sleep-deprived rats was disrupted, while the same was preserved in the muscle temperature. The results of our study show that muscle atonia during rapid eye movement sleep is a physiologically regulated thermally quiescent muscle state offering a conducive environment for muscle rest and repair.

Effects of Self Exercise Program on Leg Length and Balance in Subjects with Leg-Length Discrepancy

Background: If there is a difference in leg length, the center of gravity shifts unilaterally toward the short leg, causing loss of balance and secondary postural imbalance, trunk muscle tone changes, gait abnormalities and pelvic imbalance.Objectives: To investigate effects of self exercise program on leg length, balance in adults with leg-length discrepancy.Design: Single blind randomized controlled trial.Methods: Twenty-eight participants were selected and divided into resistance exercise, flexibility exercise, and core exercise. Each exercise was performed for 40 minutes, 3 times a week for 6 weeks. Leg length and balance before and after exercise were measured and analyzed.Results: Following the interventions, resistance exercise group showed significant improvement in balance, but leg length difference did not show significant results. Flexibility exercise group showed significant improvement in leg length difference, but balance did not show significant results. Core exercise group showed significant improvement in leg length difference and balance. There was no significant difference in the comparison between the three groups.Conclusion: This study suggests that customized exercise according to the patient's level is beneficial to the patients.

Relation between spasticity in patients with multiple sclerosis with the degree of disability, neurofunctional and neuropsychological disorders

Objective — to analyze the relationship between the level of spasticity in patients with MS with the degree of neurological deficit by the EDSS scale and the results of neurofunctional and neuropsychological research.Methods and subjects. We examined 100 patients with a clinical diagnosis of MS with spasticity symptoms. The Modified Ashwort Scale was used to quantify the severity of changes in muscle tone. The EDSS scale was used to assess the degree of disability. T25‑FW and 9‑HPT tests were performed to assess the functional status of the upper and lower extremities. Neuropsychological tests were performed to assess pain on the VAS scale, fatigue on the MFIS scale, and EuroQol‑5D quality of life.Results. The highest level of total spasticity score was in the group of patients with the highest degree of disability 5.5 — 7.0 points and was 6.29 ± 0.82 points. The correlation and regression analysis confirmed that the following factors have the greatest correlation with the total score of spasticity: the level of total EDSS (coefficient of determination D = 42.1 %), pyramidal disorders (D = 50.7 %) and pelvic dysfunction (D = 44.4 %).Conclusions. There was a significant strong correlation between total spasticity and the degree of disability of patients with MS on the EDSS scale (rs = 0.649; p &lt; 0.05), primarily pyramidal (rs = 0.712; p &lt; 0.05) and pelvic disorders. As spasticity increases, the quality of life decreases and the level of fatigue increases. Mean correlations with the level of total spasticity were found with the MFIS scales and 2 EuroQol scales (rs = 0.555, 0.53 and 0.583, respectively, p &lt; 0.05).The sensation of pain in patients increases (rs = 0.192; p &lt; 0.05) with increasing spasticity level.

The Facial Aging Process From the "Inside Out".

The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. With this evidence-based paper, the authors aim to provide a comprehensive overview of the latest research on the etiology and progression of facial aging by explaining the aging process from the “inside out,” that is, from the bony platform to the skin envelope. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. This is followed by an in-depth analysis of specific aging regions by facial thirds (upper, middle, and lower thirds). This review may help aesthetic physicians in the interpretation of the aging process and in prioritizing and rationalizing treatment decisions to establish harmonious facial balance in younger patients or to restore balance lost with age in older patients.

Effect of a Novel Perturbation-Based Pinch Task Training on Sensorimotor Performance of Upper Extremity for Patients With Chronic Stroke: A Pilot Randomized Controlled Trial

ObjectiveTo investigate the effects of perturbation-based pinch task training on the sensorimotor performance of the upper extremities of patients with chronic stroke via a novel vibrotactile therapy system. DesignA single-blinded randomized controlled trial. SettingA university hospital. ParticipantsPatients with chronic stroke (N=19) randomly assigned into either an experimental group or a control group completed the study. InterventionsIn addition to 10 minutes of traditional sensorimotor facilitation, each participant in the experimental group received 20 minutes of perturbation-based pinch task training in each treatment session, and the controls received 20 minutes of task-specific motor training twice a week for 6 weeks. Main Outcome MeasuresThe scores for the primary outcome, Semmes-Weinstein monofilament (SWM), and those for the secondary outcomes, Fugl-Meyer Assessment (FMA), amount of use, quality of movement (QOM) on the Motor Activity Log (MAL) scale, and box and block test (BBT), were recorded. All outcome measures were recorded at pretreatment, post treatment, and 12-week follow-up. ResultsThere were statistically significant between-group differences in the training-induced improvements revealed in the SWM results (P=.04) immediately after training and in the BBT results (P=.05) at the 12-week follow-up. The changes in muscle tone and in the QOM, SWM, and BBT scores indicated statistically significant improvements after 12 sessions of treatment for the experimental group. For the control group, a significant statistical improvement was found in the wrist (P<.001) and coordination (P=.01) component of the FMA score. ConclusionsThis study indicated that the perturbation-based pinch task training has beneficial effects on sensory restoration of the affected thumb in patients with chronic stroke.

Sleep disordered breathing and chronic obstructive pulmonary disease: a narrative review on classification, pathophysiology and clinical outcomes.

Chronic obstructive pulmonary disease (COPD) causes load-capacity-drive imbalance in both wakefulness and sleep, principally driven by expiratory flow limitation and hyperinflation. Sleep imposes additional burdens to the respiratory muscle pump, driven by changes in respiratory muscle tone, neural respiratory drive and consequences of the supine position. COPD patients are therefore at higher risk of decompensation during sleep, which may manifest as altered sleep architecture, isolated nocturnal desaturation, sleep hypoventilation and restless legs. Each form of sleep disordered breathing in COPD is associated with adverse clinical and patient-reported outcomes, including increased risk of exacerbations, hospitalisation, cardiovascular events, reduced survival and poorer quality of life. COPD-obstructive sleep apnoea (OSA) overlap syndrome represents a distinct clinical diagnosis, in which clinical outcomes are significantly worse than in either disease alone, including increased mortality, risk of cardiovascular events, hospitalisation and exacerbation frequency. Sleep disordered breathing is under-recognised by COPD patients and their clinicians, however early diagnosis and management is crucial to reduce the risk of adverse clinical outcomes. In this narrative review, we describe the pathophysiology of COPD and physiological changes that occur during sleep, manifestations and diagnosis of sleep disordered breathing in COPD and associated clinical outcomes.

Penyembuhan Baby Blues Syndrome dan Post-Partum Depression Melalui Chandra Namaskara dan Brahmari Pranayama

&lt;p&gt;Babies born through both normal and caesarean (sc) procedures, 50-80% make the mother face the risk of baby blues syndrome and post-partum depression. Baby blues syndrome, occurs in the first 2 weeks after giving birth, triggered by physical changes such as swelling of the breast, pain in the area around the birth canal and uterus, changes in muscle tone, physical and mental fatigue that the mother feels. While post-partum depression lasts several months to many years later, this syndrome begins with a psychiatric disorder suffered by the mother before pregnancy, psychosocial stress, inadequate social support, and premenstrual dysphoric disorder. For that, this condition needs to be addressed immediately, through the healing techniques of Chandra namaskara and Brahmari Pranayama. Chandra namaskara arouses the feminine energy, the lunar energy in the mother’s body, keeping the cerebral circulation fresh so that the sympathetic nerve activity diminishes. The effect of massage on the organs in the abdomen, increase peristaltic activity in the intestine, the lateral wall of the heart stretched perfectly so that no ischaemia occurs. Alteration of arthritis of the spinal joint can be removed by stretching the spinal muscles and ligaments between the vertebral bones through this series of asanas. While brahmari pranayama stimulates the brain part of the hypothalamus to activate the adrenal cortex system by sending signals to the pituitary gland so as not to secrete adrenocorticotropin (ACTH), so that ACTH, which had previously stimulated the outer layer of the adrenal glands (the adrenal cortex) to release a group of hormones (cortisol) did not secrete cortisol, but instead produced by the brain is actually the endhorpine that works for the body’s immune, regulate emotions, relax of the body and be able to eliminate depression.&lt;/p&gt;&lt;p&gt;&lt;br /&gt;&lt;br /&gt;&lt;/p&gt;

Changes in Muscle Tone, Function, and Pain in the Chronic Hemiparetic Shoulder after Dry Needling Within or Outside Trigger Points in Stroke Patients: A Crossover Randomized Clinical Trial.

To investigate the effects of applying dry needling into a trigger point (TrP) or non-TrP area in people who have suffered a stroke and to investigate if the effects of dry needling are maintained at six-week follow-up. A controlled, repeated-measures, crossover, double-blinded randomized trial was conducted. Nineteen patients with hemiparetic shoulder pain after a stroke event were randomly assigned to receive a single multimodal treatment session combined with TrP dry needling or non-TrP dry needling. The neuro-rehabilitation session included modulatory interventions targeting the central nervous system. Spasticity (Modified Ashworth Scale), shoulder pain intensity (numerical pain rate scale, 0-10), and upper extremity function (Motor Evaluation Scale for Upper Extremity in Stroke [MESUPES], Reaching Performance Scale [RPS]) were assessed before (baseline) and one, two, three, four, five, and six weeks after the treatment session by a blinded assessor. All participants received both sessions in a randomized order where they were followed up for six weeks before receiving the opposite treatment and then followed up for another six weeks. Changes in muscle tone (all P > 0.266) and upper extremity function (MESUPES: F = 0.544, P = 0.465; RPS close task: F = 0.820, P = 0.371; RPS far task: 0.830, P = 0.368) were similar after both interventions at all follow-up periods. The decrease in shoulder pain was higher within the TrP dry needling group as compared with the non-TrP dry needling group, particularly at two and four weeks (P = 0.01). The effect of dry needling on muscle tone (spasticity) and upper extremity function is not related to its application in or outside of a TrP area. The effect of dry needling on shoulder pain was slightly superior when applied over a TrP in poststroke people. These effects were maintained six weeks after treatment.

Modeling acute blood flow responses to a major arterial occlusion.

The development of earlier and less invasive treatments for peripheral arterial disease requires a more complete understanding of vascular responses following a major arterial occlusion. A mechanistic model of the vasculature of the rat hindlimb is developed to predict acute (immediate) changes in vessel diameters and smooth muscle tone following femoral arterial occlusion. Vascular responses of collateral arteries and distal arterioles to changes in pressure, shear stress, and metabolism are assessed before and after occlusion. The effects of exercise are also simulated and compared with venous flow measurements from WKY rats. The model identifies collateral arteries as the primary contributors to flow compensation following occlusion. Increasing the number of capillaries has minimal effect on blood flow while increasing the number of collateral arteries significantly increases flow, since the primary site of resistance shifts upstream to the collateral arteries following occlusion. Despite significant collateral dilation, calf flow remains below pre-occlusion levels and the deficit becomes more severe with increased activity. Although unable to compensate fully for an occlusion, the model demonstrates the importance of the shear response in collateral arteries and the metabolic response in the distal microcirculation in acute adaptations to a major arterial occlusion.

Flexors activity of affected upper extremity in stroke patients during different standing conditions and their relationships with clinical scales: a cross-sectional study

ABSTRACTPurpose: To explore the flexors activity of affected upper extremity in stroke patients during different standing conditions and their relationships with clinical scales.Materials and methods: Sixteen stroke patientswere recruited, all subjects stood on balance equipment with four different standing postures. The electromyogram (EMG) simultaneously recorded the muscle activity of bilateral biceps brachii, triceps brachii, flexor carpi radialis and extensor carpi radialis and their integrated electromyogram were figured out the contraction rate of elbow flexors(biceps brachii/triceps brachii) and wrist flexors(flexor carpi radialis/extensor carpi radialis). All subjects were assessed using Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Berg Balance Scale (BBS), Barthel Index (BI) and Modified Ashworth Scale (MAS).Results: The contraction rate of affected elbow flexors in the condition of feet together on soft surface was significantly higher than that in the condition of feet separatedon hard surface (P < 0.05). The contraction rate of affected elbow flexors in four standing conditions tended to increase, all the values of which were greater than numerical value1. The difference in the contraction rate of elbow flexor between the affected side and the unaffected side was statistically significant (P < 0.05). No correlation was observed between the contraction rate of the elbow flexor and the results of MAS, FMA-UE, BBS and BI regardless of the standing conditions.Conclusions: The contraction rates of elbowflexor in the affected side increase with the difficulty in different standing postures,and it may be a good index to reflect the changes of muscle tone in postural control.

The Impact of Trunk Rotation Movements on Increased Muscle Tone and Functional Movements for Patients after Stroke

Experienced stroke causes malfunction not only in arm or leg movements, but also the ability to manage torso posture and complete torso movements performed by the torso muscles. Abnormal muscle tone is one of the stroke damage areas. The most common residual effects of stroke are paresis, spasticity and functional movement disorder. Muscle tone regulation acts as a relevant task for the theory and practice of physical therapy. This paper investigates the most effective method of increased muscle tone and its reduction for patients after stroke. It also provides a methodology which could be fully benefited by the entire rehabilitation team. Aim of research: to define the impact of trunk rotational movements on increased muscle tone and functional movements for patients after stroke. The study included patients after stroke and those who had increased muscle tone. The same patients received two means of decreasing the muscle tone: the 1st one based on the trunk rotational movements, the 2nd – stretching exercises for the limbs. The research focused on muscle tone of: flexor carpi radialis, biceps brachii, gastrocnemius and quadriceps femoris. The effectiveness of physiotherapy was assessed by evaluating the change in muscle tone using a Myoton-3 tone meter. Moreover, a change in functional movements before and after physiotherapy was evaluated using Rivermed’s scale for movement assessment. Evaluation group consisted of 15 patients (n = 15). Conclusions: 1. Trunk rotation movements statically significantly decrease an increased muscle tone of: flexor carpi radialis, biceps brachii, gastrocnemius and quadriceps femoris (p &lt; 0.05) 2. The average change in muscle tone for trunk rotation movements was statically significantly higher using the method of trunk rotational movements than using stretching exercises (p &lt; 0.05). 3. Both, trunk rotational movements and stretching exercises, improve the functional movements (p &lt; 0.05), however, trunk rotational movements have a higher impact than stretching exercises (p &lt; 0.05). 4. Trunk rotational movements decrease muscle tone and improve functional movements for patients after stroke (p &lt; 0.05).Keywords: stroke, hypertonus, decreased spasticity.