Postural Tone Research Articles

Glutamatergic neurons of the gigantocellular reticular nucleus shape locomotor pattern and rhythm in the freely behaving mouse.

Because of their intermediate position between supraspinal locomotor centers and spinal circuits, gigantocellular reticular nucleus (GRN) neurons play a key role in motor command. However, the functional contribution of glutamatergic GRN neurons in initiating, maintaining, and stopping locomotion is still unclear. Combining electromyographic recordings with optogenetic manipulations in freely behaving mice, we investigate the functional contribution of glutamatergic brainstem neurons of the GRN to motor and locomotor activity. Short-pulse photostimulation of one side of the glutamatergic GRN did not elicit locomotion but evoked distinct motor responses in flexor and extensor muscles at rest and during locomotion. Glutamatergic GRN outputs to the spinal cord appear to be gated according to the spinal locomotor network state. Increasing the duration of photostimulation increased motor and postural tone at rest and reset locomotor rhythm during ongoing locomotion. In contrast, photoinhibition impaired locomotor pattern and rhythm. We conclude that unilateral activation of glutamatergic GRN neurons triggered motor activity and modified ongoing locomotor pattern and rhythm.

International consensus definitions of video signs of concussion in professional sports

BackgroundThe use of video to assist professional sporting bodies with the diagnosis of sport-related concussion (SRC) has been well established; however, there has been little consistency across sporting codes with...

PENATALAKSANAAN FISIOTERAPI PADA KONDISI ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) DENGAN METODE NEURO SENSO MOTOR REFLEX DEVELOPMENT DAN PLAY THERAPYDI YPAC SURAKARTA

<p>Attention Deficit Hyperactivity Disorder (ADHD) is a behavioral disorder characterized by concentration disorders and impaired concentration, and delayed speech in patients. Factors influencing the occurrence of ADHD are factors prenatal and postnatal prenatal complications, and environmental factors. Problematic on ADHD condition of postural hypotonus, spasm in M. Extensor Trunk, M. Trapesiuz Upper and M. Gastrocnemius, presence of postural hypotonus, sensory impairment with sensory blast, behavioral disorder, presence of reflux, Presence of functional activity disorder.</p><p>Physiotherapy modalities that used under ADHD conditions are by administering <em>Neuro</em><em>Senso Motor Reflex Development &Syncronization</em> modalities and play therapy. In this research use descriptive analytic method, and research design used is case study design. After 6 treatments (1)There is a change of postural tone from sitting 2 seconds to 15 seconds, standing 5 seconds to 10 seconds. (2) there was a decrease of spasm in M. Extensor Trunk, M. Trapesiuz Upper and M. Gastrocnemius on T4-T6. (3) There is a change in sensory examination of visual, auditory, tactile, touch, vestibular, and propioceptive on T4-T6. (4) There is a change in the examination of moro reflex, graps, stnr toward extension and extensor thrust on T4-T6. (5) There is a change in the examination of ADHD Test on T6.</p>From the results obtained can be concluded that using the intervention of physiotherapy with NeuroSenso<em> Motor Reflex Development &Syncronization</em>modality and play therapy can help reduce the problems that arise in Attention Deficit Hyperactyvity Disorder (ADHD).

The use of adaptive neuro-stimulation for rebalancing posture and muscular tone in a soccer team

Posture and somatic structure could positively influence athletic gestures for their biomechanical implications. Working on neuromuscular activity, offers the possibility of intervention on postural control. The aim of this study was to demonstrate the possibility of interacting with the human body system through the spinal reflex pathway, starting from the stimulation of cutaneous receptors. Twenty soccer players were recruited: all were male aged 25.5±10.6 years. Patients were divided using a single-blind criterion into two groups, each containing ten subjects. The experimental group was treated with 2 pre-set programs 4 times a week with an adaptive neuro-stimulation (ANS) able to interact with cutaneous receptors through an ENF Physio® device with a range of electrical frequency of about 15-350 Hz; the placebo-controlled group received the treatment with the device switched off. Patients performed a myometric evaluation with the MyotonPRO® system and a postural one with the Rarog software at T0 before the treatment and at T1 after the four-week treatment. After our intervention, we identified an improvement in muscular tone, in particular in the hamstring muscles (17.69%, right P<0.01 / left P<0.05) and a rebalancing of the principal bone points in the postural system (shoulder 71%, P<0.05, hips 65.6%, P=0.056, sagittal AP and frontal LL center of gravity, respectively 40%, P<0.05 and 52.7%, P=0.01). In conclusion, we could hypothesize the usefulness of an ANS to act on these parameters. ANS could be used not only for treatment of injuries but also in the field of prevention.

Risk Stratification and the Outcome in Patients with Syncope Pre and Post Implementation of European Society Guidelines in Emergency Department in Ismailia Hospitals, Egypt.

Introduction: one of the common clinical problem is a syncope in the emergency department (ED), accounting for 1- 6% of the hospital admissions and 0.5-3% of ED visits. Multiple studies revealed that no applied guidelines in evaluations for syncope result in low diagnostic yield and high costs when compared to evaluations that follow standardized guidelines protocol. Aim: to improve management processes and the outcome of syncope patients by implementation of European society guidelines (published in 2009) in ED. Methods: the study is Interventional study included 90 Patients for each group attending Emergency Department in Xs hospitals with syncope (loss of postural tone lead to transient loss of consciousness, which caused by diffuse cerebral ischemia , usually associated with spontaneous, rapid and complete recovery). With follow-up short outcome for 7 days and meets inclusion and exclusion criteria. Results: in pre-implementation of the guidelines group. 40% of the studied patients discharged, 60% admitted, 44.4% equally admitted at cardiology and neurology departments and the outcome 53.3% did not have any adverse events within 7 days follow up. While 73.3% of the studied patients post-implementation discharged, 26.7% admitted. 100% admitted at cardiology department and 73.3% did not have any adverse events. Conclusion: The number of appropriate discharges and admission higher in post- implementation group than in pre-implementation group. The dangerous complications in the appropriately discharged group was significantly lesser than in the appropriately admitted group.

Vértigo como presentación clínica de asa vascular de la arteria cerebelosa antero inferior

El vértigo es un frecuente motivo de consulta cuyo origen puede ser periférico o central; causas poco frecuentes de este último son las asas vasculares que afectan el VIII par craneal llevando a acúfenos, pérdida de la audición y mareo. Se presenta una mujer de 47 años de edad, quien consulta por un cuadro de mareo, náuseas, pérdida del tono postural, cefalea y parestesia facial, cuyo examen físico revela signos de vértigo periférico, iniciándose tratamiento con antieméticos, anticinetósicos y vasodilatadores que llevan a empeoramiento del cuadro, por lo que se sospecha de patología a nivel de sistema nervioso central (SNC) que ejerce compresión con la vasodilatación. Se realiza una resonancia magnética que muestra un asa vascular en la arteria cerebelosa inferior anterior (AICA) que ingresa al conducto auditivo interno (CAI) explicando la sintomatología y cuyo efecto compresivo de los nervios centrales genera un efecto paradójico con la toma de vasodilatadores

Syncope risk factors among military training soldiers; A case-control study.

BACKGROUNDSyncope is a transient brief loss of consciousness accompanied with loss of postural tone. Of common places in which people experience syncope, military barracks can be named where training soldiers spend their military courses. The current study aimed to assess etiology and risk factors of syncope among military training soldiers.METHODSThis was a retrospective case-control study conducted on training soldiers of Army-501 hospital in Tehran, Iran, during the years 2017-2018. Cases were consisted of 50 soldiers who experienced syncope during military training, and controls were 150 soldiers who had not experienced syncope during their military training. Demographic data were recorded for cases and controls.RESULTSMembers of case and control groups were not statistically different regarding age (P = 0.46) and height (P = 0.70). Logistic regression test was performed and considering crude model, weight [odds ratio (OR): 0.94; 95% of confidence interval (95%CI): 0.90-0.98], body mass index (BMI) (OR: 0.72; 95%CI: 0.61-0.85), standing duration (OR: 1.007; 95%CI: 1.00-1.01), history of syncope (OR: 15.47; 95%CI: 4.15-57.60), positive family history of syncope (OR: 5.94; 95%CI: 1.66-21.25), smoking (OR: 3.5; 95%CI: 1.54-7.91), medical problems (OR: 7.97; 95%CI: 1.98-32.17), anxiety (OR: 2.02; 95%CI: 1.13-4.26), stress (OR: 6.68; 95%CI: 3.28-13.57), and depression (OR: 4.25; 95%CI: 2.15-8.39) were detected as significant predictors of syncope occurrence.CONCLUSIONBased on the findings of this study, lower BMI, positive history of syncope, smoking, depression, and stress were significant risk factors of syncope occurrence among training soldiers. Higher BMI has protective role in syncope occurrence.

Syncope; the Initial Manifestation of Pulmonary Embolism: A Case Report

Syncope is the state of lack of consciousness and temporal loss of postural tone. Syncope might be in association with a variety of benign and life-threatening conditions. Pulmonary embolism (PE) has been shown to be associated with syncope in 13-30 percent of cases. This article presents a novel case report of PE whom syncope was his only manifestation.

Age-dependent semiology of frontal lobe seizures

IntroductionFrontal lobe epilepsy is the second most frequent origin of focal epilepsy. Various studies have discussed localizing aspects of ictal signs in frontal lobe epilepsy; the effect of age on semiological manifestations has, however, not been analyzed so far. Material and methodsWe retrospectively analyzed video-documented semiological signs in a cohort of 122 consecutive patients aged 0–70 years (mean age: 24.9 years) with EEG/MR evidence for frontal lobe epilepsy undergoing video-EEG telemetry assessment between 1999 und 2016. ResultsIn this patient cohort, most common etiologies were focal cortical dysplasia (48%) and tumors (16%). Most frequent ictal manifestations overall were impaired language comprehension (60.3%), unilateral tonic posturing (58.9%), unilateral cloni (46.6%), versive movements (44.5%), vocalization (42.5%) and impaired reactivity to non-verbal stimuli (40.4%). With increasing age, sign of four (p = 0.019), dystonic posturing (p = 0.026), changes in heart rate (p = 0.014) and impaired reactivity to non-verbal stimuli (p = 0.009) occurred significantly more frequently. In contrast, myoclonic components were significantly less frequent observed in the higher age group (p = 0.037). ConclusionsFrontal lobe seizures can be categorized into different behavioral manifestations related to involved symptomatic brain regions, including clonic, bilateral asymmetric tonic seizures and complex motor phenomena. In this cross-sectional study, we found age-related changes in the frequency of both, motor and non-motor semiological elements. Especially simple lateralized motor signs like dystonic posturing, sign of four and version were more common with increasing age. Age-dependent alterations in phenomenology may reflect maturation in connectivity and seizure propagation within and beyond the frontal lobe, and affect the localizing and lateralizing value of ictal phenomena.

Differential diagnosis of nonepileptic twilight state with convulsive manifestations after febrile seizures

BackgroundNonepileptic twilight state with convulsive manifestations (NETC) is a nonepileptic state following a febrile seizure (FS), which may be misdiagnosed as a prolonged seizure and result in overtreatment. We aimed to describe clinical manifestations of NETC and to determine characteristics that are helpful to distinguish NETC from other pathological conditions. MethodsWe conducted a retrospective chart review from January 2010 to December 2016 and selected the patients who presented with symptoms resembling status epilepticus with fever and a confirmed diagnosis using an electroencephalogram (EEG). We compared the NETC clinical features and venous blood gas analysis results with those of other conditions that mimic NETC. We also compared the characteristics of NETC with past reports. ResultsOur NETC patients presented with short durations of the preceding generalized convulsions followed by tonic posturing, closed eyes, no cyanosis, responsiveness to painful stimulation, and no accumulation of CO2 in the venous blood gas. Most of these characteristics were consistent with past reports. Prolonged FS or acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) showed several of these features, but all the characteristics were not consistent with our study. ConclusionsProlonged FS and AESD need to be differentiated from NETC, and close clinical observation makes it possible to partially distinguish NETC from the other conditions. EEG is recommended for patients with symptoms that are inconsistent with these features.

Postural Disorders in Young Athletes

Research background and hypothesis. Athletes across all sports face sports injuries stemming from the overuse of specific muscle groups for that particular sport. It was hypothesised that athletes from each sport would show similar muscular-skeletal changes allowing a postural stereotype for each sport to be allocated. The aim of this study was to determine the peculiarities of postural changes of young athletes in accordance with postural tone and phasic contraction muscles.Research methods. The participants of this study were 92 young Latvian athletes aged 14–17 and having different preparation level, i. e. 20 swimmers, 20 ice-hockey players and 19 basketball players, 17 handball players and 16 cyclists. Tests were completed using methods of visual diagnostics (Васильева, 1996) and muscular functional testing (Kendall, M. O., Kendall, F. P., 1982).Research results. The lower cross syndrome is a common feature for athletes of sports requiring complicated coordination at high rates of workloads on lower extremities. Individual decline from a neutral posture in the sagittal plane is a characteristic feature for individuals of various kinds of sport due to overload of some muscle groups.Discussion and conclusions. The presence of a postural stereotype indicates that these muscular-skeletal changes are beneficial to athletes. How much benefit the athletes gain from these postural changes before injury occurs, is open to debate. It is purposeful to distinguish muscles according to their tone to postural and contracting muscles. The postural muscles that form posture have rather high tone, but if these muscles are overloaded, the tone pathologically increases and the muscle cannot contract nor relax effectively enough to allow the antagonist to work.Keywords: sport event specifics, postural stereotypes, functional postural changes.

Differentiating motor phenomena in tilt-induced syncope and convulsive seizures.

We assessed motor phenomena in syncope and convulsive seizures to aid differential diagnosis and understand the pathophysiologic correlates. We studied video-EEG recordings of tilt-induced syncope and convulsive seizures in participants aged 15 years and older. Syncope was defined as (1) loss of consciousness (video-assessed), (2) circulatory changes (accelerating blood pressure decrease with or without bradycardia/asystole), and (3) EEG changes ("slow" or "slow-flat-slow"). We assessed myoclonic jerks and tonic postures of the arms and noted time of occurrence, laterality, synchrony, and rhythmicity (mean consecutive differences of interclonic intervals). Video-EEG records of 65 syncope cases and 50 convulsive seizures were included. In syncope, postures occurred in 42 cases (65%) and jerks in 33 (51%). Fewer jerks occurred in syncope (median 2, range 1-19) compared to convulsive seizures (median 48, range 20-191; p < 0.001). Jerks were more rhythmic in seizures compared to syncope (p < 0.001). Atonia was seen in all syncope cases, while this was not observed in any seizure. Jerks predominantly occurred during the slow and postures during the flat EEG phase. Jerks and tonic postures were common in syncope, but semiology differed from convulsive seizures. The lack of overlap in the number of jerks suggests that less than 10 indicates syncope and more than 20 a convulsive seizure: the "10/20 rule." Loss of tone strongly favors syncope. The EEG correlates imply that jerks in syncope are likely of cortical origin, whereas tonic postures may result from brainstem disinhibition.

Диагностическая информативность огибающей ЭМГ поверхностных паравертебральных мышц в постуральных стереотипах у пациентов со сколиозом III–IV степени

Asymmetry of paraspinal muscle tone is incorporated in pathogenesis for spinal deformities having diagnosis information value and it can be hypothesised to be involved in curve aggravation. Objective To evaluate diagnostic information value of EMG envelope algorithm for paraspinal muscles in postural stereotypes of patients with scoliosis grades III and IV. Material and methods Profiles of postural asymmetry (computer optical topography) and bioelectrical tone (EMG envelope algorithm) of paraspinal muscles were reviewed in 115 patients with scoliosis grades III and IV of different etiology using V.D.Chaklin methodology. The patients aged 6 to 32 years with mean age of 16.2 ± 6.14 years). Results The sampling population showed normal symmetrical distribution of profiles in the asymmetry of superficial paraspinal muscle tone with evidently asymmetrical distribution of spinal curve. Surgical elimination of spinal deformity resulting in appropriate correction of postural profiles made no statistically significant impact on orthostatics distributing quantitative and qualitative bioelectrical parameters of paraspinal muscles. No contingency and specific differences were observed in paraspinal muscle tone depending on postural asymmetry and etiology of the curve. Conclusion The hypothesis that asymmetry of superficial paraspinal muscle tone aggravates with the curve progression is not supported. No correlation between profiles of postural and muscle tone asymmetry was observed in patients with scoliosis grades III and IV. Diagnostic information value of EMG envelope algorithm is patient-specific and be identified in the postural systems that cannot support motor stereotypes using motor programmes without additional compensation muscle activity due to particular circumstances.

Transient Alpha and Beta Synchrony Underlies Preparatory Recruitment of Directional Motor Networks.

Modulations in motor cortical beta and alpha activity have been implicated in the preparation, execution, and termination of voluntary movements. The functional role of motor cortex beta activity is yet to be defined, though two opposing theories prevail. The idling cortex theory suggests that large-scale motor networks, in the absence of input, revert to an intrinsic oscillatory state. The alternative theory proposes that beta activity promotes postural tone at the expense of voluntary movement. These theories are primarily based on observations of event-related desynchronization associated with movement onset. Here, we explore the changes in alpha and beta oscillatory activity associated with the specific behavioral patterns during an established directional uncertainty paradigm. We demonstrate that, consistent with current proposals, alpha and beta desynchronization reflects a process of disengagement from existing networks to enable the creation of functional assemblies. We demonstrate that, following desynchronization, a novel signature of transient alpha synchrony underlies the recruitment of functional assemblies required for directional control. Although alpha and beta desynchronization are dependent upon the number of cues presented, they are not predictive of movement preparation. However, the transient alpha synchrony occurs only when participants have sufficient information to prepare for movement and shows a direct relationship with behavioral performance measures.

The influence of anticoagulant and antiagregant therapy during pregnancy on clinical characteristics and outcomes of periventricular hemorrhages in newborns

To evaluate the characteristics of periventricular hemorrhages (PVH) in newborns of mothers receiving antiplatelet and anticoagulation therapy during pregnancy with hypercoagulation syndrome. One hundred and twelve newborns with PVH were evaluated: group 1 - 37 children, born after a pregnancy with hypercoagulation syndrome and antithrombotic therapy; group 2 - 55 children, born after a pregnancy without hypercoagulation syndrome and with preventive antithrombotic therapy; group 3 - 20 children, born after a pregnancy without hypercoagulation syndrome and without antithrombotic therapy. All newborns underwent clinical and neurologic examinations combined with assessment using special scales and intracranial ultrasound evaluation. Maternal anticoagulation therapy during pregnancy in groups I and 2 was associated with more severe condition of newborns with PVH (significantly prolonged artificial lung ventilation, more premature births, larger hemorrhage) compared to newborns in group 3. Follow-up of infants in groups I and 2 demonstrated a significantly slower progress of postural muscle tone, psychological and psychomotor development compared to infants in group 3. Hypercoagulation syndrome treatment during pregnancy significantly affects the severity of newborn's condition at birth and the development of severe neurological impairments in long-term period.

Syncope; the Initial Manifestation of Pulmonary Embolism: A Case Report

Syncope is the state of lack of consciousness and temporal loss of postural tone. Syncope might be in association with a variety of benign and life-threatening conditions. Pulmonary embolism (PE) has been shown to be associated with syncope in 13-30 percent of cases. This article presents a novel case report of PE whom syncope was his only manifestation.

Initial clinical presentation of young children with N-methyl-d-aspartate receptor encephalitis.

Autoimmune encephalitis with anti-N-methyl-d-aspartate receptor autoantibodies (NMDA-R-Abs) is a recently described disease affecting adult and pediatric patients. Symptoms of the disease are now perfectly described in the adult population but the clinical presentation is less known in young children. The aim of the present study was to describe the clinical presentation and the specificities of symptoms presented by young children with NMDA-R-Abs encephalitis to improve diagnosis of this disease, and to compare these to a series of previously published female adult patients. Fifty cases of children younger than twelve years of age diagnosed with NMDA-R-Abs encephalitis between January 1, 2007 and December 31, 2016 (27 females and 23 males) were retrospectively studied. The first neurological symptoms observed in young children with NMDA-R-Abs encephalitis were characterized by seizure (72%), especially focal seizure (42%), within a median of 15 days before other encephalitis symptoms; other patients mostly had behavioral disorders (26%). The seizures were frequently difficult to diagnose because of the transient unilateral dystonic or tonic posturing presentation or sudden unilateral pain in the absence of clonic movements. A post-ictal motor deficit was also frequently observed. This clinical presentation is different from that observed in adult females with NMDA-R-Abs encephalitis who initially present mainly psychiatric disorders (67%) or cognitive impairment (19%), and less frequently seizures (14%). The diagnosis of NMDA-R-Abs encephalitis should be systematically considered in young children of both sexes who present neurological symptoms suggesting recent seizures (focal or generalized) without obvious other etiology.

Role of Cerebellar Dentate Functional Connectivity in Balance Deficits in Patients with Multiple Sclerosis.

Purpose To prospectively investigate, by using resting-state functional magnetic resonance (MR) imaging, cerebellar dentate nuclei (DNs) functional connectivity abnormalities in multiple sclerosis (MS) to explore their impact on balance impairment in patients with MS, considering the role of DNs and their projections in maintaining balance, posture, and muscle tone, Materials and Methods All subjects provided written informed consent, and the protocol was approved by the university institutional review board. Twenty-five patients with relapsing-remitting MS and 20 healthy control subjects underwent a 3-T resting-state functional MR imaging and static posturography. The seed-based method was applied to identify the cerebellar DNs resting-state network; first-level and high-level analyses were performed by using software tools. Results Compared with control subjects, patients had worse postural stability and altered patterns of cerebellar DNs connectivity network, with decreased connectivity in caudate nuclei and thalami and increased connectivity in the cerebellum, pons, left amygdala, and orbitofrontal cortices (cluster level, family-wise error corrected, P < .05, z threshold > 2.3). In patients, the decreased connectivity in the left caudate nucleus was related with worse balance performance (cluster level, family-wise error corrected P < .05, z threshold > 1.96) regardless of age, lesion burden, and global clinical disability. Conclusion These results reveal abnormalities of corticocerebellar circuit connectivity in patients with MS as compared with control subjects and suggest that the decreased connectivity between the DN and the left caudate nucleus could play a role in balance impairment in MS. © RSNA, 2017.

Syncope in Pediatric Practice.

Syncope is defined as a sudden, self-limited loss of consciousness and postural tone followed by spontaneous and complete recovery without any neurological sequelae. It is one of the most common paroxysmal disorders in children and adolescents. The three major causes of syncope in children are neural, cardiovascular and other non-cardiovascular causes. The common unifying mechanism is transient global hypoperfusion of the brain. The diagnosis is primarily clinical and objective laboratory investigations add little to the diagnosis in children especially in neurocardiogenic subtype. Specific management depends on the underlying cause of syncope in children. For cardiac causes, management includes early referral to the pediatric cardiology specialist. When paroxysmal non-epileptic events are suspected, child psychology or psychiatry consultation should be sought to identify the stressors and counseling. For neurocardiogenic syncope, the main objective of treatment is to prevent recurrent events to improve the quality of life, psychological stress and school absenteeism by behavior and lifestyle modifications followed by drugs in refractory cases. The prognosis is excellent for neurocardiogenic syncope and is variable based on the underlying pathology in cardiogenic cases. As syncope is not a disease in itself but a symptom of an underlying disorder; hence, all children with syncope require assessment to exclude an underlying life-threatening cardiac or non-cardiac disorder.

Correction of Abdominal Distention by Biofeedback-Guided Control of Abdominothoracic Muscular Activity in a Randomized, Placebo-Controlled Trial

Abdominal distention is produced by abnormal somatic postural tone. We developed an original biofeedback technique based on electromyography-guided control of abdominothoracic muscular activity. We performed a randomized, placebo-controlled study to demonstrate the superiority of biofeedback to placebo for the treatment of abdominal distention. At a referral center in Spain, we enrolled consecutive patients with visible abdominal distention who fulfilled the Rome III criteria for functional intestinal disorders (47 women, 1 man; 21-74 years old); 2 patients assigned to the placebo group withdrew and 2 patients assigned to biofeedback were not valid for analysis. Abdominothoracic muscle activity was recorded by electromyography. The patients in the biofeedback group were shown the signal and instructed to control muscle activity, whereas patients in the placebo received no instructions and were given oral simethicone. Each patient underwent 3 sessions over a 10-day period. The primary outcomes were subjective sensation of abdominal distention, measured by graphic rating scales for 10 consecutive days before and after the intervention. Patients in the biofeedback group effectively learned to reduce intercostal activity (by a mean 45% ± 3%), but not patients in the placebo group (reduced by a mean 5% ± 2%; P < .001). Patients in the biofeedback group learned to increase anterior wall muscle activity (by a mean 101% ± 10%), but not in the placebo group (decreased by a mean 4% ± 2%; P < .001). Biofeedback resulted in a 56% ± 1% reduction of abdominal distention (from a mean score of 4.6 ± 0.2 to 2.0 ± 0.2), whereas patients in the placebo group had a reduction of only 13% ± 8% (from a mean score of 4.7 ± 0.1 to 4.1 ± 0.4) (P < .001). In a randomized trial of patients with a functional intestinal disorder, we found that abdominal distention can be effectively corrected by biofeedback-guided control of abdominothoracic muscular activity, compared with placebo. ClincialTrials.gov no: NCT01205100.