Loss Of Muscle Power Research Articles

Osteopenia after plated and nailed femoral shaft fractures.

Twenty-six patients who had been operated for isolated femoral shaft fractures were studied. Fourteen had been treated with intramedullary nailing and 12 with AO plates. Only nailed patients were allowed early weight-bearing. Bone mineral density and muscle strength in knee extension and flexion were determined. There was a considerable loss of bone mineral in the distal femoral metaphysis and a moderate loss in the tibia. The mean loss was almost identical in the two groups. Muscle power in extension was better preserved in the nailed than in the plated patients. There was a significant correlation between loss of bone mineral and loss of muscle power.

腰部脊柱管狭窄症の術後遠隔成績

Forty-seven patients with lumbar canal stenosis operated were examined by questionaire. Their follow-up period ranged from 5 to 12 years with an average of 8.8 years. The excellent and good results were obtained in 77% of the cases. The results appeared to be correlated with their age, evaluation points, activities of daily living, sensory disturbance, muscle power loss, preoperative ambulatory distance and their follow-up period.

Skeletal deformities in the elderly and their effect on postural sway.

In a group of 151 elderly men and women (age range, 65-85+), postural sway was studied in relation to various physical attributes and skeletal deformities that might be contributory factors. Weight, loss of height (span-height), scoliosis, grip strength, and the knee angle, measured laterally with the subject erect, all proved to be correlated with postural sway. Kyphosis was related to loss of muscle power and other general indications of frailty. Scoliosis appeared to be related to joint disease in the pelvis and lower limbs.

Epidural space pressures during pregnancy

The epidural space pressure in the lumbar region was monitored and recorded in 21 full term pregnant patients, before and during labour and 6-12 hours postpartum, in different positions. The pre-labour epidural pressure was found to be above atmospheric in all patients, being highest when supine, and lowest in the lateral position. Three patients with twin pregnancy showed a greater rise in epidural space pressure in the supine position even with the use of lateral tilt, compared with patients with single fetus pregnancy. It is suggested that the epidural space pressure in the full term pregnant patient is closely related to the degree of inferior vena caval obstruction imposed by the gravid uterus. It is also suggested that when the patient is aware of a uterine contraction, the synchronous rise of the epidural space pressure with the contraction is a result of reflex increase in abdominal muscle tone. With established epidural block, and the parturient unaware of a contraction, such a rise was minimal, and was replaced by a drop in pressure in patients with a single fetus who developed loss of muscle power. The magnitude of the drop in the epidural space pressure immediately after delivery was found to be related to the duration of labour and to the mode of delivery. Epidural pressures measured 6-12 hours after delivery were comparable in all patients.

Effects of Neonatal Thymic Exposure to High Doses of X-irradiation

The thymic region of neonatal Swiss mice was exposed to doses varying from 1000 R to 2000 R of X-irradiation. The animals did not show any signs of wasting syndrome up to 6 months after irradiation. At this time hyperplasia of the thymus with an associated lymphocytosis was evident in irradiated animals. Antibody production to sheep red blood cells (SRBC) was not affected. However, at 12 months post-irradiation the animals showed signs of wasting disease with a progressive increase in their numbers at 18 and 24 months of age. The percentage incidence of animals with wasting disease was dose dependent. At this stage in the majority of the animals with the disease the thymus showed varying degrees of atrophy along with splenomegaly. There were no significant differences in the number of lymphocytes but the number of granulocytes showed a substantial increase. This was more evident in animals exposed to 2000 R to the thymic region. Though one observed a lowered ability to form antibodies to bovine serum albumin (BSA) with advancing age, the thymic irradiation did not affect the immune response to BSA even in animals manifesting wasting disease. An interesting observation has been the development of a severe loss of muscle power and tone in the hind limbs in a large majority of animals.

A SURVEY OF RECENT KNEE INJURIES TREATED BY PHYSIOTHERAPY

The knee is not only the largest joint in the human body, but it is also the most complex (Romanes, 1969). It is an area of considerable importance to the physiotherapist, due to the fact that the knee is the site of frequent injury to both soft tissues and skeletal structures, with a predisposition to complications and a resulting pronounced functional deficit. If acute injuries are not managed correctly, permanent instability and pain may reduce the patient's functional capacity, while the rapid loss of muscle power in the quadriceps may predispose the knee to repeated trauma unless effective management is instituted.

Paramyotonia congenita (Eulenburg). Neurophysiologic studies of a case.

The case of a 71 years old male patient with paramyotonia congenita is described. There was no occurence of spontaneous paresis at room temperature. Lowering the temperature, a loss of muscle power became perceivable in the mechanogram while, at the beginning there was only a slight depression in amplitude of the evoked action potential. After termination of the cooling paresis became even more pronounced. Electric activity too faded away almost entirely. Repetitive stimulation showed a marked fatigability of the muscle. — The findings seem to indicate a direct influence of low temperature on the contractible substance of the muscle.

Surface electromyography during sustained isometric contractions.

Surface electromyography during sustained isometric contractions.

PRIMARY INTRASPINAL TUMOURS: THEIR CLINICAL PRESENTATION AND DIAGNOSIS

1. An analysis has been made of the clinical features and investigations in ninety-five cases of primary intraspinal tumours. 2. Loss of muscle power was the commonest symptom, and was often ignored until late in the course of the disease. 3. Two-thirds of the patients had no pain in the spinal region, although five of these had either extensive growths or radiographical evidence of bone erosion by tumour. 4. One-third of the patients had urinary symptoms, and two of them had acute retention initially attributed to prostatic obstruction. 5. In eighteen cases posture and gait were abnormal. The case histories of five of these patients are recorded, and they emphasise the importance of recognising lumbar spasm and hamstring tightness in young patients as signs of a cauda equina neoplasm. 6. All patients had some detectable sensory, motor, or reflex changes, and these were mostly bilateral. 7. Radiography, and cerebrospinal fluid manometry and analysis, were helpful in establishing the diagnosis. 8. Hysteria should not be diagnosed until all efforts have been made to prove otherwise.

Congenital total hypertrophy of the rightupper limb: “Right-armed acromegaly”

Summary 1. A case of true segmental hypertrophyof the right upper limb is recorded. 2. Except for some diminution in ability to perform fine digital movements, no tendency to loss of muscle power has become apparent at the age of 9 years.

THE CONSERVATIVE TREATMENT OF SCIATIC PAIN BY IMMOBILISATION IN A PLASTER JACKET

1. Between 1936 and 1945, 525 patients with sciatic pain were treated at the Princess Elizabeth Orthopaedic Hospital, Exeter. Of these, 225 had neurological signs and they were selected for review; 147 were traced. 2. Of these, 123 were treated by means of plaster jackets and twenty-four were treated by other methods. The late results of treatment in the two groups were about the same, roughly one-third being "cured," one-third "relieved," and one-third "not relieved." 3. Nevertheless examination of the immediate results suggests that protection by means of a plaster jacket had at least a palliative effect, relieving acute symptoms and allowing early rehabilitation. Moreover it should be emphasised that in limiting the investigation to cases of sciatica with evidence of nerve root pressure only the more severe cases have been included. 4. Permanent relief after immobilisation in plaster was greatest when the duration of symptoms was short, and when the patient was treated during his first attack. It was least in patients who showed all three signs of nerve root pressure—diminished ankle jerks, hypo-aesthesia, and muscle hypotonicity. 5. Absence of tendon reflexes due to nerve root pressure, and areas of hypo-aesthesia, tend to remain permanently; but diminution of reflexes and loss of muscle power may recover.

VITAMIN E IN PROGRESSIVE MUSCULAR DYSTROPHY

Progressive muscular dystrophy is a disorder of muscle presumed to be due to some primary degenerative process within the muscle tissue itself rather than to be a disturbance secondary to a lesion of the nervous system. The term includes a number of variations in type; the affected muscles in many instances are enlarged (pseudohypertrophic) but in others are normal or even atrophic in appearance. The cause of the condition is unknown, but the hereditary and familial occurrence are noteworthy. As its name indicates, the disease is distinguished by progressive weakness of the skeletal musculature, making its appearance, as a rule, in early childhood. The progress is slow in some cases but usually is rapid, and the disease is often fatal in early life. Unpreventable deformities of the extremities frequently interfere with walking long before the actual loss of muscle power would prevent locomotion. The pathologic effects of the disease appear

END-RESULTS OF OPERATION FOR CORRECTION OF DROP-FOOT

Drop-foot is the inability to dorsiflex the ankle joint or foot, and is the result of any agent that impairs or abolishes the muscular power in the anterior group of leg muscles. The etiologic factors are: destructive changes in the muscles and tendons, toxic neuritis, as in lead poisoning, trauma to the external popliteal nerve, spastic paralysis and, most frequently, poliomyelitis, or infantile paralysis. Drop-foot may be simple, when only the anterior muscles of the leg are involved, or it may be associated with varus, valgus or flail-foot, if loss of muscle power is more extensive. As the anterior muscles of the leg are more frequently paralyzed than any other muscle group as a sequela of poliomyelitis, inability to dorsiflex the foot is a very common disability. In June, 1923, I1described before the American Orthopedic Association a surgical operation for the correction of drop-foot in connection with other