Wrist Spasticity Research Articles

Central control insufficiency. III. Disturbed motor control and sensation: a treatment approach emphasizing upper extremity orthoses.

In the discussion of the problems, the selection of patients, and some of the approaches to treatment, three major areas need emphasis. 1. Guidelines are necessary to select patients who require and can respond to treatment. The patients who will benefit the most must be identified and provided with structured therapy programs. 2. Effective bracing of the severely spastic wrist and hand may not be possible. The orthoses described are used to prevent deformity and relieve pain. 3. All motor control available to a patient must be incorporated immediately into the patient's daily activities.

Patterns of neuromuscular activity following tendon transfer in the upper limb: A preliminary study

Early results of a continuing study of the electrical activity of muscles after transfer, with an integrated system of electromyographic and video tape recording, recorded motions of the simple voluntary type, mostly with isometric contractions. A triceps-to-biceps transfer showed activity in the new motion one day after operation. A partial transfer of the pectoralis major (Clark) demonstrated isolated activity of the transfer after one year. A superficialis transfer to clawed ring and little fingers functioned to flex the metacarpophalangeal joints and to extend the interphalangeal joints. Transfer of superficialis to finger extensors showed that antagonists acted to provide unresisted extension. The original phasic activity of a muscle was retained in a study of extensor indicis proprius to thumb for opposition. New phasic activity was shown in transfer of extensor carpi radialis longus to digital flexors. In two instances of transfer of spastic wrist flexors to wrist extensors, the original phasic activity was retained, but in only one was the function assumed by the transfer even though wrist extension was improved.