Increased Muscle Tone Research Articles

Experience of using rhythmic transcranial magnetic stimulation, extracorporeal shock wave therapy and botulinotherapy in individual motor recovery programs in patients with spastic paresis of the lower limb

Walking disorder is one of the most frequent consequences of stroke and traumatic brain injury, occurring in 80% of cases. Spastic paresis of the muscles of the lower extremity is the cause formed in 20-40% of patients within a few weeks after brain damage. In this case, a complex of symptoms occurs: motor deficiency (muscle paresis), increased muscle tone (spasticity), biomechanical changes in muscles, joints and surrounding tissues, contractures. Recovery of walking is a difficult task due to the peculiarities of its organization in the norm. At the same time, changes occurring in the muscles of the lower limb after a stroke, their modular reorganization, the formation of various pathological patterns, violation of the regulation of movements by the central nervous system, rapidly occurring changes in muscles, ligaments, complicate this process. Improving walking is one of the most important priorities of rehabilitation. Already at the second (stationary) stage of rehabilitation, patients have a lack of proper support on the lower limb, which inevitably leads to excessive load on the second limb, a change in the body scheme, incorrect foot placement, violation of the mechanics of walking (moving from heel to toe) due to plantar flexion / turn of the foot, etc. All this makes patients dependent on outside help, and walking unsafe, increases the risk of falls and complications (arthropathy, contracture, etc.). In this regard, it is important to timely diagnose the totality of changes in the lower limb and create optimal comprehensive rehabilitation programs using highly effective treatment methods aimed at reducing the severity of the motor defect, reducing spasticity and preventing complications. The article discusses the place of rhythmic transcranial magnetic stimulation, extracorporeal shock wave therapy and botulinum therapy during rehabilitation in patients with spastic paresis of the lower limb after a stroke. The results of the protocol of clinical approbation «Complex rehabilitation of patients with lower limb spasticity after focal brain damage at the second stage of medical rehabilitation» are presented.

Effect of Extended Toe Range of Motion on Muscle Stiffness after Exercise

Fatigue and high-intensity training induce muscle strain and increase muscle stiffness. Increased muscle tone and muscle stiffness are factors in injury and disability and require prompt palliative care. However, muscle stiffness is not measured in everyday life, leading to injuries and disabilities in the face of disappointment. In looking at routine prevention, we wondered whether muscle stiffness could be reduced from extended toe range of motion. Walking is a complex, continuous movement, but most common shoes on the market compress the plantar arch cap and toes. We conducted a prospective cohort study in which 20 subjects underwent post-load training and then wore flat shoes to measure muscle stiffness. 20 subjects performed a 10-kilometre run, and 30 subjects performed a 30-kilometre run and 20 subjects performed a 30-kilometre run. km of running and 30 min of walking. The intervention group wore flat shoes, while the control group wore their daily shoes. 30-minute preand post-walking muscle stiffness measurements of the lateral head of the gastrocnemius, quadriceps and lumbo-dorsal fascia were taken to test whether the intervention group’s muscle stiffness could be reduced. The results showed that the increase in muscle stiffness of the lateral head of the gastrocnemius muscle in the intervention group was inhibited. In addition, the toe area was found to be extended by wearing flat-shaped shoes.

Generalized Dystonia as Presenting Feature of Wilson Disease: A Case Report

Wilson disease is a rare autosomal recessive genetic disease, caused by the mutation of the ATP7B gene leading to decreased secretion of serum ceruloplasmin in blood and decrease biliary excretion of copper leading to toxic level accumulation in the liver, brain, kidney, and cornea, resulting in development of characteristic liver disease and neuropsychiatric symptoms. Our case presented with mainly clumsiness and gait abnormality without any psychiatric component and any history of liver disease. A 13-year old male, born out of non-consanguineous marriage, presented with clumsy walking and slurring of speech. The child also complained of poor handwriting and slipping of slipper from foot, without any history of abnormal behavior and poor scholastic performance. On examination gait was abnormal with sidewise swaying, increased muscle tone with rigidity and bilateral flexor plantar reflex. Slit lamp examination of eyes revealed bilateral Kayser-Fleischer rings. Serum ceruloplasmin was low (0.03 g/L) and 24-hour urinary copper was high (119.64 μg/day). MRI brain showed B/L putamen hyperintensity and panda sign suggestive of Wilson disease. After the diagnosis of Wilson disease was made, patient was treated with penicillamine and zinc. Child was also followed-up and re-examination showed slight improvement. Though not rare, Wilson disease is an uncommon entity with varied presentations and disabling consequences. Hence high index of suspicion and clinical correlation is required to diagnose it. Early initiation of treatment and good compliance ensure a better outcome.

MANAGEMENT OF GUILLAIN BARRE SYNDROME THROUGH AYURVEDA – A CASE STUDY.

Guillain Barre Syndrome is acute paralysis neuropathy. It is evolving reflexes motor paralysis with or without sensory disturbances. Characterised by rapidly developing motor weakness. It is autoimmune in nature and trigger by preceding infections. A 47year female patient was came in OPD of kayachikitsa in our institute with complaining of generalised body weakness, tingling sensation in both hands and legs with bilateral exaggerated reflexes and decrease muscle tone and power. Patient had history of Guillain Barre Syndrome 4 years ago. For this she had taken allopathic medicine like Intra Venous Immunoglobulin in government hospital. Patient started complaint about same symptoms, for this she started Ayurvedic treatment. In Ayurveda Guillain Barre Syndrome is not explain by name hence it is taken under the name of vata vyadhi like sarvangagat vata. While thoroughly understanding Guillain Barre Syndrome through modern as well as Ayurvedic aspect Guillain Barre Syndrome considered as sarvangagata vata vyadhi and managed by Ayurvedic treatment on the basis of basic principles, and found better improvement in this case. Due to Ayurvedic treatment and internal medicine with 15 days with follows up treatment for 1 months gives significant relief in all motor and sensory reflex with increase muscle tone and power

Characteristics of Anal Sphincter Electromyography in Patients with Multiple System Atrophy

In this study, the characteristics of external anal sphincter electromyography (EAS-EMG) in patients with multiple system atrophy (MSA) were analyzed, and its value in the diagnosis of MSA was discussed. The data of 23 patients with MSA who underwent EAS-EMG examination between January 2019 and December 2021 were selected to analyze examination data such as the average duration of motor unit potentials (MUPs), average amplitude, satellite potentials, and the percentage of polyphasic waves, and to explore the correlation between the results of EAS-EMG and autonomic dysfunction in patients with MSA based on their data characteristics. The results of data analysis showed that the most common symptoms in 23 patients with MSA were urination and defecation disorders, sleep disorders, and unsteady walking, the most common signs were increased muscle tone, postural hypotension, and ataxia, and the most common autonomic dysfunction was rectal and bladder dysfunction, orthostatic hypotension, and sexual dysfunction. The average duration of MUPs was 11.6 (10.1-13.9) ms, the average amplitude was 885 (683-1198) μV, and the percentage of polyphasic waves was 26.2 (12.5-50.0)%. Patients with satellite potentials had longer disease duration. There were no significant differences in parameters between different types of autonomic dysfunction. The results suggested that abnormal changes in EAS-EMG may indicate an impaired autonomic function in patients with MSA, and this conclusion may not limit to patients with urination and defecation disorders.

Case Report and Review: An Unusual Case of Fetal Traumatic Brain Injury

We herein report an unusual case of maternal road traffic accident with blunt trauma to the abdomen at 34 weeks of gestation followed by delivery of severely encephalopathic baby and also a brief review of similar previous reports.The baby had near normal transition, then progressively developed severe encephalopathy and multiple organ dysfunction attributed mainly to the intrauterine traumatic injury. The baby had multiple intra and extra axial bleeds,cerebral edema and diffuse axonal injury, as revealed by the CT scan. The baby was managed conservatively with various neuroprotective strategies similar to management in older children and thus cerebral edema/ hematomas subsided. The baby required ventilatory support, prolonged assisted ventilation/oxygen and the metabolic derangements were managed accordingly. The baby was discharged on oral Levetiracetam, multivitamins and nasogastric tube feeds. Baby was followed up sequentially till day 74 and on physical examination had poor head growth and increased muscle tone of the extremities. Neuroimaging revealed diffuse multicystic leukoencephalomalacia, hydrocephalus ex vacuo with cortical thinning. Intrauterine fetal brain injury is an uncommon incidence which causes mortality and significant morbidity in the child. Neuroimaging of the fetus after trauma to the mother can lead to early diagnosis and anticipation. Early vigorous neuroprotective measures and management may prevent mortality and reduce further brain insult in theseneonates. There is paucity of information on management of such cases thus they should be reported in detail forstudy and future references.

Clinical and electroneuromyographic peculiarities of spastic syndrome in children with organic lesions of the nervous system

Topicality. Organic lesions of the central nervous system (CNS) are a group of neuropsychiatric disorders caused by various pathological factors affecting the brain. Infantile cerebral palsy (ICP) is the most common neurological disease diagnosed in children at an early age. 80 % of children with ICP suffer from spastic forms, the main symptom of which is an abnormal increase in muscle tone – spasticity. This syndrome can be objectified by electroneuromyographic (ENMG) examination which enables qualitative and quantitative assessments of the nervousmuscular system state.Objective: to determine clinical and electroneuromyographic peculiarities of the spastic syndrome of ICP children depending on the intensity of motor disorders.Materials and methods. 122 ICP children were examined (an average age 8,8 ± 3,7 years) and distributed into groups by the results of Gross Motor Function Classification Expanded & Revised (GMFCS E&R). All the patients underwent careful neurological examination and ENMG examination. To assess suprasegmental and segmental levels of nervous system lesions, the parameters of H-reflex and F-wave were analyzed.Results. Spastic forms of ICP were diagnosed in the majority of the examined children. Orthopedic pathology was found more often among ICP children with marked motor disorders, including equinovalgus position and planovalgus foot deformity. According to ENMG parameters ICP patients presented conduction disorders manifested by increased amplitude of М response, especially in testing the tibial nerve, increased Нmах/Мmах ratio and the amplitudes of Н-reflex and F-wave.Conclusions. According to the results of the conducted study, ENMG parameters changed on the side of deterioration depending on the degree of motor activity disorders by Gross Motor Function Classification.

Application of infrared thermography in the study of the osteopathic correction results in patients with amputation defects of the lower extremities

Introduction. The main medical consequences of amputations are: phantom pain syndrome, degenerative changes in soft tissues, increased muscle tone of the stump, deterioration of microcirculation in the amputated limb. Methods of rehabilitation of such patients are physical therapy, physiotherapy, psychotherapy, mechanotherapy. The search for new methods of rehabilitation of patients with amputation of the lower limb is constantly underway due to the social significance of this disease. Osteopathic correction has proven effects of normalization of muscle tone, improvement of blood circulation, which can be assessed using infrared thermography.Aims: to evaluate the effect of osteopathic correction on blood circulation in the stump in patients with transtibial amputation.Materials and methods. The study includes 30 patients (21 men and 9 women) with transtibial amputation, undergoing diagnostic examination using infrared thermography on an outpatient basis in Albrecht Federal Scientific Centre of Rehabilitation of the Disabled. Patients were divided in two groups in random: main group (n=15), receiving osteopathic correction, and control group, receiving sham therapy. Both groups were divided in subgroups depending on amputation cause: cardiovascular diseases and trauma. Regardless the group infrared thermography was performed before and after first session of therapy or osteopathic correction and before and after second session. On thermograms, the temperature of the distal part of the stump was evaluated, the second limb — in the projection of the distal part of the stump.Results. The method of infrared thermography objectively confirmed the positive effect of osteopathic correction on blood flow in the lower leg stump: in patients with traumatic and vascular genesis of amputation — in the form of a decrease in the severity of distal hypothermia after the first, before the second and after the second session of osteopathic correction compared to the data before osteopathic correction. In the control group, there was also a statistically significant increase in the temperature of the distal part of the stump after the first session and the second sessions of sham therapy, which returned to its original values before the second session, which indicates the short-term nature of the changes.Conclusion. The study showed an improvement in blood circulation in the truncated limb, confirmed by an increase in the temperature of the stump in patients with transtibial amputation of traumatic and vascular genesis, which underwent osteopathic correction.

Comparison study between Russian current and radiofrequency in abdominal flaccidity: Literature review

Introduction: The skin is a biological component and main organ of the external environment and has a viscoelastic action with the property of being remodeled under pressure that operates against the tissue. Muscle flaccidity is due to an increase in muscle tone, with the muscle having less resistance. The handled is handled in the treatment of sagging cut, this resource produces the improvement of the skin by reconditioning the elasticity and the capacity of tension of the tissues generating an elevation of perfection. Russian current, made up of rectangular or sinusoidal, bipolar, symmetrical current pulse trains transmits a frequency of 2,500 hertz modulated by a wave that can alternate from 50 to 80 hertz. Objective: To observe the effectiveness of the use of radiofrequency comparing with the Russian current in improving abdominal flaccidity. Methodology: This is a bibliographic study with comparative articles between the selected bibliographic techniques. Results: selected were selected based on the words, and without the title in question, inclusion and exclusion criteria, and based on analysis which of the chosen techniques were the best. in the literature, they have several satisfactory results in relation to electrostimulation, as it improves the capacity of muscle function and describes the main objectives of the technique. Conclusion: It is concluded that the techniques are studies for abdominal flaccidity, however, there are still few recent studies on the techniques studied.

Post-stroke hand synergy formation variant. Clinical case

Pathological synergies are a frequent consequence of cerebrovascular accidents and hinders further recovery. The existing concept of the formation of pathological synergies considers them as a compensatory strategy in response to damage to the pyramidal tract, which, due to paresis and increased muscle tone, has acquired a pathological character. Recent studies in primates have shown that the contralateral hemisphere, in particular the reticulospinal and rubrospinal tracts, may be involved in motor control of the hand. The current hypothesis presents the corticoreticulospinal and corticorubrospinal tracts as a back-up system for neuronal reorganization due to injury.
 This clinical case describes the role of the white matter of the contralateral hemisphere in the mechanism of formation of pathological flexion synergy, based on data from the analysis of movements and neuroimaging.

A practical guide to botulinum neurotoxin treatment of shoulder spasticity 2: Injection techniques, outcome measurement scales, and case studies.

Botulinum neurotoxin type A (BoNT-A) is a first-line treatment option for post-stroke spasticity, reducing pain and involuntary movements and helping to restore function. BoNT-A is frequently injected into the arm, the wrist, the hand, and/or the finger muscles but less often into the shoulder muscles, despite clinical trials demonstrating improvements in pain and function after shoulder BoNT-A injection. In part 2 of this two-part practical guide, we present an experts' consensus on the choice of outcome measurement scales and goal-setting recommendations for BoNT-A in the treatment of shoulder spasticity to increase awareness of shoulder muscle injection with BoNT-A, alongside the more commonly injected upper limb muscles. Expert consensus was obtained from five European experts with a cumulative experience of more than 100 years of BoNT-A use in post-stroke spasticity. Case studies are included as examples of approaches taken in the treatment of shoulder spasticity. Although the velocity-dependent increase in muscle tone is often a focus of patient assessment, it is only one component of spasticity and should be assessed as part of a wider range of measurements. For outcome measurement following BoNT-A injection in shoulder muscles, shoulder-specific scales are recommended. Other scales to be considered include Pain Numerical Rating and/or global functioning, as well as the quality of life and global perception of benefit scores.Goal setting is an essential part of the multidisciplinary management process for spasticity; goals should be patient-centric, realistic, and achievable; functional-focused goal statements and a mixture of short- (3-6 month) and long-term (9-18 month) goals are recommended. These can be grouped into symptomatic, passive function, active function, involuntary movement, and global mobility.Clinical evaluation tools, goal setting, and outcome expectations for the multipattern treatment of shoulder spasticity with BoNT-A should be defined by the whole multidisciplinary team, ensuring patient and caregiver involvement. These recommendations will be of benefit to clinicians who may not be experienced in evaluating and treating spastic shoulders.

Effects of cannabidiol on vacuous chewing movements, plasma glucose and oxidative stress indices in rats administered high dose risperidone

Atypical antipsychotics, despite their rapid dissociation from dopamine receptors and reduced tendency to induce oxidative stress, have been associated with difficult-to-manage movement disorders, including tardive dyskinesia (TD). The study set out to investigate the effects of cannabidiol (CBD), a potent antioxidant, on risperidone-induced behavioural and motor disturbances; namely vacuous chewing movements (VCM), and oxidative stress markers (e.g. superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), malondialdehyde (MDA), Nitric oxide (NO), and DPPH (2,2-diphenyl-1-picrylhydrazyl)). Oral risperidone (10 mg/kg) or oral CBD (5 mg/kg) were administered to six experimental groups. While risperidone alone was administered for 28 days, CBD concomitantly or in sequential order with risperidone, was administered for 28 days; and CBD alone was administered for 21 days. Behavioural, motor, and specific biochemical parameters, which included VCM, muscle tone, fasting blood sugar (FBS), and oxidative stress markers were assessed at different time points after the last dose of medication. Oral CBD (5 mg/kg) significantly reduced risperidone-induced elevated FBS when given after the administration of risperidone. Oral CBD also had effects on VCM when administered before risperidone and similarly, attenuated risperidone-induced increased muscle tone. It was also established that concomitant or sequential administration of CBD and risperidone did not have any adverse effects on cognition or locomotion. Both CBD and risperidone increased the activity of antioxidant enzymes and decreased the activity of pro-oxidant enzymes. This study suggests CBD could mitigate metabolic dysregulation and extrapyramidal side effects associated with risperidone without producing cognitive impairments.

Effects of a Traction Device for Head Weight Reduction and Neutral Alignment during Sedentary Visual Display Terminal (VDT) Work on Postural Alignment, Muscle Properties, Hemodynamics, Preference, and Working Memory Performance.

The forward head posture of visual display terminal (VDT) users induces various physical and cognitive clinical symptoms. However, few studies have been conducted to identify and solve problems associated with VDT posture. This study aimed to examine the adverse effects of VDT posture and the positive effects of traction-combined workstations by measuring postural alignment, muscle properties, blood velocity, preference, and working memory. Thirty-four healthy VDT users (18 males and 16 females aged 20-30 years) participated in the experiment at three workstations, including conventional (VDT_C), head support (VDT_S), and upright (VDT_U) workstations. They conducted 2-back working memory task. The craniovertebral angle (CVA), muscle tone and stiffness, blood velocity and visual analogue discomfort scale (VADS) were measured to examine the influence of workstations. VDT_C showed increased muscle tone or stiffness in the levator scapulae (LS), suboccipital muscle (SM), and sternocleidomastoid muscle (SCM) and an increased reaction time (RT) in working memory. However, VDT_S showed decreased stiffness and tone of SM and improved comfort. In addition, VDT_U showed decreased stiffness or tone of the LS and SCM and improved blood velocity and RT. In conclusion, maintaining neutral alignment significantly improved working memory performance, muscle properties, and blood velocity.

Experience of using gait adaptability training in medical rehabilitation of patients after cerebrovascular accident in the late recovery period

The article presents the treatment data of 80 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the lower limb due to spasticity. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics: group 1 included patients who, in addition to standard treatment, had gait adaptability training with video reconstruction on the C–Mill biofeedback system (BFB), and group 2 consisted of 40 people who underwent a course of standard drug therapy and medical rehabilitation (exercise therapy and medical massage). The characteristics of the main static and locomotor parameters were assessed according to the C–Mill data and the Tinetti assessment tool, and the range of motion in the lower extremities was assessed according to goniometry data at all control points (before and after treatment, 3 and 6 months after treatment). The obtained data indicate the benefit of including gait adaptability training in the standard complex of medical rehabilitation of patients who have undergone acute cerebrovascular accident with motor disorders in the form of hemiparesis with post-stroke spasticity of the lower extremity. This was confirmed by the normalization of the parameters of the gait adaptability, namely, a decrease in the duration of free gait (step cycle) by an average of 32 %, an increase in the frequency of a free gait step by an average of 30 % and in the length of a free gait step by 16 % immediately after treatment, with the results maintained at all control points.

Synergistic augmentation of rhythmic myogenic contractions of human stomach by arginine vasopressin and adrenaline: Implications for the induction of nausea.

Nausea is associated with the hormonal secretion of vasopressin and adrenaline, although their actions in inducing nausea is poorly understood. Here, we have investigated their actions on human stomach muscle. Muscle strips were suspended in tissue baths and neuronal-/non-neuronally-mediated contractions were measured. Custom software analysed eight motility parameters defining spontaneous phasic non-neuronally mediated contractions. Receptor distributions were assessed by qPCR and immunofluorescence. V1A receptors and α1 -adrenoceptors were located on muscle as well as interstitial cells of Cajal (ICCs). Myogenic contractions of human proximal and distal stomach (respectively, 2.6 ± 0.1 and 2.7 ± 0.0 per minute; n = 44) were larger in the distal area (1.1 ± 0.1 and 5.0 ± 0.1 mN), developing relatively slowly (proximal) or rapidly (distal). Vasopressin caused tonic (proximal) or short-lived (distal) increases in muscle tone and increased myogenic contraction amplitude, frequency and rate (acting at V1A receptors; thresholds 10-11 -10-10 M); by contrast, cholinergically mediated contractions were unaffected. Oxytocin acted similarly to vasopressin but less potently, at OT receptors). Adrenaline increased (10-10 -10-5 M; α1 -adrenoceptors) and decreased (≥10-6 M; β-adrenoceptors) muscle tone and enhanced/reduced myogenic contractions. Cholinergically mediated contractions were reduced (α2 -adrenoceptors). Combined, vasopressin (10-9 M) and adrenaline (10-8 M) increased muscle tone and phasic myogenic activity in a synergistic manner. Vasopressin and adrenaline increased human gastric tone and myogenic contraction amplitude, rate of contraction and frequency. In combination, their actions were further increased in a synergistic manner. Such activity may promote nausea.

The development of the physical qualities of freestyle wrestlers, which separate the sectional employment from the greater initial pledge

Freestyle wrestling is a bright, dynamic and spectacular type of sports competition in the program of the Olympic Games. A type of sport in which the winning result will depend on the athlete's physical qualities and preparation for active physical, functional and competitive activities. Modern wrestling is characterized by very high and comprehensive requirements for the aspects of sports preparation, which makes it possible to predict the choice of relevant, justified and adequate means and methods of training. One of the main places for the training of freestyle wrestlers during their studies in higher educational institutions is classes in the section on this type of wrestling. Sectional classes contribute to the full-fledged physical development of students after the school day, provide an opportunity for emotional relief. The main task in the training of wrestlers during sectional classes is the harmonious development of the athletes' physical qualities. And that is why this stage is a guarantee of better assimilation of technical and tactical actions, which in the future will contribute to the rapid formation of motor skills and skills and their implementation during competitive activities. Accordingly, this opens up a wide range of innovative ways and approaches to improve and optimize the development of the physical abilities of fellow wrestlers, contrary to traditional methods. In the control group, training sessions were held in accordance with the freestyle wrestling curriculum. The training process in the experimental group was implemented according to the recommendations of the complex with ZFP and SFP developed by us. The recommended exercises were incorporated into the warm-up part of the training sessions, the achievement of which contributed to the development of the physical qualities of the wrestlers, increased muscle tone and tended to increase the learned information in the main part of the training sessions. According to the results of the pedagogical experiment, the level of physical qualities in the experimental group improved, which is within 28.9%. Comparing with the beginning of the study, the indicators of the "Reaction" and "Recovery" tests have increased, their result reaches 21%. The special endurance of the young wrestlers of the experimental group increased by 17.9%. The results of the flexibility indicators of the athletes who participated in the study improved by as much as 13%.
 Accordingly, the control group, which works according to the training program in freestyle wrestling, has a small positive dynamic of special endurance data, which increased by 4%. The best improvements were found after testing force and reaction, which were 6.8% and 7.8%. The improvements in the flexibility of athletes were smaller, which amounted to 1.3%.

Faktor-Faktor Yang Berhubungan Dengan Kejadian Ikterus Pada Bayi Baru Lahir Di RSU UMMI

Jaundice is one of the contributors to infant morbidity in Indonesia because it can cause the baby's body to become weak and refuse to suck, increased muscle tone, stiff neck, muscle spasms, seizures, sensory disturbances, mental retardation, disability and even death. The purpose of this study was to determine Factors Related To Icterus Incident On Newborn Baby At Ummi Hospital. The method used is an analytical research design with a cross sectional approach. The sample in this study are 55 mothers who have newborn babies and chosen by using accidental sampling technique. This study uses SPSS with a chi-square bivariate statistical test. The results of the univariate analysis showed that most of the respondents were not LBW, most were not ABO incompatibility, the frequency of breastfeeding was more than 8 times and most were not jaundiced. The results of the bivariate analysis showed that there was a relationship between low birth weight, breastfeeding frequency, ABO incompatibility with the incidence of jaundice in newborns (p 0.000). Researchers suggest that Public Health Center is expected to provide information about health, especially about jaundice.

Physiotherapy methods in the complex of cognitive rehabilitation of patients in the late recovery period in patients after ischemic stroke

BACKGROUND: For the purpose of early and late medical rehabilitation in recent decades, non-drug methods of physiotherapy have been actively used to restore patients who have had an ischemic stroke.
 AIMS: substantiation of the inclusion of multimodal physiotherapeutic effects from the Alpha LED Ohu Light_Spa apparatus and low-frequency electrostatic massage from the Khivamat apparatus for the correction of cognitive impairment in patients who have suffered an ischemic stroke, with motor disorders in the form of hemiparesis, increased muscle tone by the type of spasticity in the late recovery period.
 MATERIALS AND METHODS: The study included 120 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the form of spasticity in the late recovery period. Patients of group 3 (40 people) were prescribed standard drug therapy and medical rehabilitation, patients of group 1 (40 people in addition to standard therapy and rehabilitation, multimodal physiotherapeutic effects were used from the Alpha LED Oxy Light-Spa device and patients of group 2 (40 people) a low-frequency electrostatic massage from the Khivamat apparatus was added to the standard complex.
 RESULTS: At all control points after the course of treatment, after 6 and 12 months, in addition to general clinical studies, we assessed indicators of cognitive functions (according to the Montreal Cognitive Assessment Scale) and psycho-emotional state according to the HADS scale. In dynamics, it was revealed that in groups 1 and 2, where the developed rehabilitation programs were carried out, there was a significant improvement in cognitive functions (attention, memory, fluency, generalization, etc.), to a greater extent in group 1, while in patients who, against the background of drug therapy, underwent standard medical rehabilitation, only a positive trend was noted.
 CONCLUSION: The inclusion in the medical rehabilitation of patients who have suffered an ischemic stroke, to a greater extent, multimodal physiotherapeutic effects and to a somewhat lesser extent, low-frequency electrostatic massage contributes to a significant improvement in cognitive functions and a reduction in anxiety and depression.

Assessment of Viscoelastic Parameters of Muscles in Children Aged 4-9 Months with Minor Qualitative Impairment of the Motor Pattern after Vojta Therapy Implementation.

The aim of this study was to assess if there are any objective changes in the viscoelastic parameters of the erector spinae muscle after Vojta stimulation. The study involved 22 healthy children at an average age of 7 months and with an Apgar score of 8–10 points, who were referred for rehabilitation due to a slight delay in the phases of psychomotor development. The first group consisted of 11 children with increased muscle tone (IMT) and the second group consisted of 11 children with non-increased muscle tone (nonIMT). All study participants received a one-time Vojta therapy session, which was continued for 4 weeks by parents at home. The viscoelastic parameters of the dorsal extensor muscle were measured three times. In the first study group, changes in the viscoelastic parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination, whereas changes in the supporting and extensor function of the limbs occurred in both groups at the second examination. Analysis featuring an objective assessment allows physiotherapists to diagnose local changes in the viscoelastic parameters after the implementation of therapy. These studies are the first pilot studies to be continued with a 30- or 60-day follow-up.

Intrathecal morphine exacerbates paresis with increasing muscle tone of hindlimbs in rats with mild thoracic spinal cord injury but without damage of lumbar α-motoneurons.

Adverse effects of morphine on locomotor function after moderate to severe spinal cord injury (SCI) have been reported; however, the effects after mild SCI without damage of lumbar α-motoneurons have not been investigated. We investigated the effects of lumbar intrathecal morphine on locomotor function after mild thoracic SCI and the involvement of classic opioid receptor activation. A mild thoracic contusive SCI was induced in adult rats at the T9-T10 spine level under sevoflurane anesthesia. We evaluated the effects of single doses of intrathecal morphine and selective μ-, δ-, and κ-opioid receptor agonists, continuous infusion of intrathecal morphine for 72 hours, and administration of physiological saline on locomotor function and muscle tone in the hindlimbs. The numbers of damaged and total α-motoneurons in the lumbar spinal cord were also investigated. Single doses of morphine aggravated residual locomotor function after SCI but did not affect functional recovery. Single doses of morphine and μ- and δ-opioid receptor agonists significantly aggravated residual locomotor function with increases in muscle tone after SCI, and the effects of the drugs were reversed by naloxone. In contrast, continuous infusion of morphine led to persistent decline in locomotor function with increased muscle tone, which was not reversed by naloxone, but did not increase the number of damaged lumbar α-motoneurons. These results indicate that a single dose of morphine at an analgesic dose transiently increases muscle tone of the hindlimbs via activation of spinal μ- and δ- opioid receptors, resulting in further deterioration of locomotor function in the acute phase of mild SCI. Our results also suggest that an increased dose of morphine with prolonged administration leads to persistent decline in locomotor function with increased muscle tone via mechanisms other than direct activation of classical opioid receptors. Morphine should be used cautiously even after mild SCI.