Upper-limb Areas Research Articles

Occupational Risk Factors for Musculoskeletal Disorders among Workers in Dairy Diversification.

In a changing European agricultural context, diversification of dairy farms is gaining attention. This study seeks to (1) assess musculoskeletal pain prevalence associated with tasks such as butter, yogurt, and cheese production; and (2) analyze associated risks. Observing 31, mostly female, workers, we utilized the ERGOROM questionnaire, a methodology adapted from the Institut National de Recherche et de Sécurité, and Key Indicator Method forms. Findings revealed that tasks like load carrying (42% of workers), manual work (17%), and awkward postures (14%) resulted in musculoskeletal pain, predominantly in the lower back (65%), neck (39%), and dominant upper limb areas (shoulder: 61%, elbow: 26%, and wrist: 65%). While psychosocial risks remained low, concerns arose from workload, hygiene standards, and resource unpredictability. As dairy farming evolves from artisanal to semi-industrial, our study emphasizes the importance of ergonomic adaptations to protect farmers' health and prevent musculoskeletal disorders during diversification.

Analysis of the effectiveness of various methods of rehabilitation of patients with subacromial impingement syndrome

Subacromial impingement syndrome is a common pathology that leads to a persistent decrease in the functioning of the affected limb and, as a consequence, a decrease in the quality of life and work ability of patients. According to various authors, the study of the effectiveness of treatment and rehabilitation of this pathology is quite widely presented in the literature: surgical, including arthroscopic operations, rehabilitation using various factors of physical therapy, manual and other practices. However, the issue of assessing the effectiveness of movement therapy, both alone and in combination with other therapeutic methods, remains relevant. To evaluate the effectiveness of therapeutic gymnastics procedures, both monotherapy and in combination with manual massage according to the therapeutic method and extracorporeal shock wave therapy (ESWT), in patients with subacromial impingement syndrome of the shoulder, in order to reduce pain and improve the function of the shoulder joint. The study included 70 patients whose age was 42.18±10.42 years. Patients were divided into two main groups: group 1 (n=34) and group 2 (n=36). All patients received a course of treatment, including 10 procedures of therapeutic exercises, with recommendations at the end of the course for continuation in the form of independent studies using the proven methodology. The duration of the course of therapeutic exercises (in the form of procedures with a physical therapy instructor and subsequent independent studies) was 30 days. Patients in group 2 were divided into three subgroups: subgroup 2A, in which PH procedures were combined with massage of the cervical-collar area and the upper limb area of the affected side; subgroup 2B, where PH gymnastics was carried out in combination with extracorporeal shock wave therapy (ESWT) procedures; subgroup 2C - a comprehensive program including LH procedures, manual massage and shock wave therapy. 3 months after the end of the course of rehabilitation measures, patients of all groups showed a significant improvement in scores on the ASES and VAS scales, but there were no reliably significant differences between the results of different groups. The study indicates that movement therapy is an effective method of rehabilitation for patients with subacromial impingement syndrome, and conducting complex programs in which PH is combined with other rehabilitation methods (massage, shock wave therapy) doesn't have statistically significant advantages over PH alone within a 3-month observation period.

Vibro-Tactile Stimulation as a Non-Invasive Neuromodulation Therapy for Cervical Dystonia: A Case Study.

Cervical dystonia (CD) is a type of focal dystonia that is characterized by involuntary neck postures. The underlying neurophysiology mechanism of CD is unknown, but there is increasing empirical evidence that motor deficits of CD are associated with somatosensory and proprioceptive deficits in the upper limb area. Vibro-tactile stimulation (VTS) is a non-invasive somatosensory stimulation approach where afferent signals from the vibrated muscle and tactile mechanoreceptors modulate cortical activity. Previous studies have shown that VTS could be an effective neuromodulation therapy for treating laryngeal dystonia. This proof-of-concept study examined the effect of VTS on alleviating the involuntary cervical muscle contractions in a female participant with intermittent torticollis. VTS was applied sequentially on four neck positions: bilateral trapezius (TRP) and bilateral sternocleidomastoid (SCM). Each VTS site was vibrated continuously for six minutes. The kinematics and underlying neck muscle activities during dystonic neck movements were examined with acceleration and surface electromyography (sEMG). To quantify the efficacy of VTS, two acceleration features and one sEMG feature were derived: (1) number of acceleration peaks per minute; (2) peak amplitude of acceleration (PAA); (3) change in power of sEMG after VTS. The frequency of intermittent dystonic neck movements decreased by 60% after VTS. In addition, PAA during dystonic episodes was drastically reduced after VTS when compared to baseline. Third, the effectiveness of VTS in alleviating dystonic muscle spasms depended on the site of vibration. For this participant, the left trapezius muscle was shown as the optimal vibration site reducing sEMG signal power by 15% across all recorded muscles. This case study offered preliminary insight into the assumed effectiveness of neck muscle VTS as a treatment for CD. Our participant experienced pain relief after VTS with measured improvements reflected by electrophysiological and kinematic data. A systematic study with a larger sample size is required in the future to validate the effectiveness of VTS for treating symptoms in CD.

Cellular anatomy of the mouse primary motor cortex

An essential step toward understanding brain function is to establish a structural framework with cellular resolution on which multi-scale datasets spanning molecules, cells, circuits and systems can be integrated and interpreted1. Here, as part of the collaborative Brain Initiative Cell Census Network (BICCN), we derive a comprehensive cell type-based anatomical description of one exemplar brain structure, the mouse primary motor cortex, upper limb area (MOp-ul). Using genetic and viral labelling, barcoded anatomy resolved by sequencing, single-neuron reconstruction, whole-brain imaging and cloud-based neuroinformatics tools, we delineated the MOp-ul in 3D and refined its sublaminar organization. We defined around two dozen projection neuron types in the MOp-ul and derived an input–output wiring diagram, which will facilitate future analyses of motor control circuitry across molecular, cellular and system levels. This work provides a roadmap towards a comprehensive cellular-resolution description of mammalian brain architecture.

Clinical and pathological features of upper limb nerve tumors - four years retrospective study.

Benign peripheral nerve tumors and malignant peripheral nerve tumors are rarely found in patients with upper limb tumors. A four-year retrospective study was conducted on patients with tumors in the upper limb area admitted to the Emergency Clinical Hospital, Bucharest, Romania. Seventeen patients were admitted within this time range, 15 of which were benign and two malignant. All patients required surgical intervention after thorough clinical and imaging evaluation. Benign masses were removed, follow-up examination revealing no local recurrent, as well as good function recovery. On the other hand, malignant tumors due to their highly aggressive features, both determined local recurrence, one requiring upper limb amputation, the other presenting metastases.

Sports Specific Injury Pattern of Sportspersons

Objective: Previous researches on sports injuries primarily focused on specific games or sports or on specific types of injuries. None of them had tried to explore the injury patterns of games and sports altogether. The current study tried to explore the injury patterns of sportspersons over 16 different types of games and sports. Materials and methods: Total of 1008 injury cases (649 male and 369 female, age 21.07±2.78 and 20.81± 3.01 years) between the academic sessions 2008 to 2017 were analysed. Injury data were extracted from the institute injury record book. Apart from age and gender, 'Body site of injury', 'Types of injury' and 'Recurring of injury' were selected as variables for the study. Descriptive statistics, bar and pie diagram were generated using crosstabs function of IBM SPSS. Results: An average 101.80±12.59 injury was reported per year. Footballers were found to be the highest injured sportsperson (19.5%). Injury percentage of male players (63.75%) was higher compared to female (36.25%) counterparts. Lower limb area (45.28%) was found to be the highest affected body site of injury followed by upper limb area (29.47%). Acute injury constituted 50.39% of overall injuries. Most injuries were non-recurring in nature (63.65%). Further different combinations of analysis revealed more insight of injury patterns of sportspersons.

Dominant Heterogeneity of Upper and Lower Motor Neuron Degeneration to Motor Manifestation of Involved Region in Amyotrophic Lateral Sclerosis

The aim of this study was to localize the anatomic distribution of upper motor neuron (UMN) loss through examining cortical thickness at the clinical onset of amyotrophic lateral sclerosis (ALS) and explore motor manifestation in functionally impaired body region attribute to impairment of lower motor neuron (LMN) or UMN or mixed LMN and UMN? The clinical features, cortical thickness of corresponding areas from different body regions in MRI and electromyography (EMG) data were collected from 108 classical ALS patients. The cortical thickness was thinner in ALS group than control group in bilateral head-face and upper-limb areas (p < 0.05). In head-face area, the cortical thickness of bulbar-onset group was significantly lower than that of control groups (p < 0.05). In upper-limb areas, the cortical thickness of cervical-onset group was significantly thinner than that of control group. Notably, the bulbar ALSFRS-R subscore was correlated with cortical thickness in bilateral head-face areas (p < 0.05). The bulbar ALSFRS-R subscore of the positive LMN damage group was lower compared to that of the negative LMN damage group (P < 0.001). The limb ALSFRS-R subscore correlated with compound muscle action potential (CMAP) amplitudes of median, ulnar, peroneal, and tibial nerves (P < 0.001), but was not related to cortical thickness. In conclusion, the UMN degeneration in ALS was derived from focal initiation, bulbar- and cervical-onset may date from head-face and upper-limb areas in motor homunculus cortex, respectively. The bulbar dysfunction was resulted from the mixed UMN and LMN impairment, while limb dysfunction derived mostly from LMN loss.

Analyzing thermoregulation processes in early school-age girls and boys through thermography

The research assessed thermoregulation processes in early school-age children. Thermal maps of the subjects’ bodies were compared before and after general physical exercise and after post-exercise restitution to establish differences between the sexes. The research involved 40 students aged 7, including 20 boys. The subjects participated in interval training which maintained the pulse at 60–80% HRmax. Measurements of body surface temperatures were taken in 12 fields with ThermoVision FLIR SYSTEM T335 camera before exercise, immediately after exercise and after 15 min of restitution. Statistical analysis was based on the Shapiro–Wilk test to verify the normality of variables, multivariate analysis of variance, Student’s t test for independent samples and Duncan’s post hoc test. The level of statistical significance was established at p < 0.05. Analysis of the results showed a difference in the distribution of surface body temperatures in boys and girls depending on the studied area. The highest values were recorded in the trunk area, and the lowest in the lower-limb area. Statistical analysis demonstrated that in both groups there was a statistically significant decrease in post-exercise temperatures. The results revealed greater efficiency of thermoregulation processes during restitution in girls, because the values obtained in all measurement fields in Test 3 were higher than the pre-exercise values. In Tests 2 and 3, differences between the sexes were reported mainly in the upper-limb area.

Remote muscle contraction enhances spinal reflexes in multiple lower-limb muscles elicited by transcutaneous spinal cord stimulation.

Transcutaneous spinal cord stimulation (tSCS) is a useful technique for the clinical assessment of neurological disorders. However, the characteristics of the spinal cord circuits activated by tSCS are not yet fully understood. In this study, we examined whether remote muscle contraction enhances the spinal reflexes evoked by tSCS in multiple lower-limb muscles. Eight healthy men participated in the current experiment, which required them to grip a dynamometer as fast as possible after the presentation of an auditory cue. Spinal reflexes were evoked in multiple lower-limb muscles with different time intervals (50-400ms) after the auditory signals. The amplitudes of the spinal reflexes in all the recorded leg muscles significantly increased at 50-250ms after remote muscle activation onset. This suggests that remote muscle contraction simultaneously facilitates the spinal reflexes in multiple lower-limb muscles. In addition, eight healthy men performed five different tasks (i.e., rest, hand grip, pinch grip, elbow flexion, and shoulder flexion). Compared to control values recorded just before each task, the spinal reflexes evoked at 250ms after the auditory signals were significantly enhanced by the above tasks except for the rest task. This indicates that such facilitatory effects are also induced by remote muscle contractions in different upper-limb areas. The present results demonstrate the existence of a neural interaction between remote upper-limb muscles and spinal reflex circuits activated by tSCS in multiple lower-limb muscles. The combination of tSCS and remote muscle contraction may be useful for the neurological examination of spinal cord circuits.

Evaluation of Radiation Exposure on Physicians During Angioplasty for Hemodialysis Access Dysfunction.

Percutaneous interventions help patients with various cardiovascular diseases, however radiation exposure is a safety concern for both patients and health care providers. We previously reported that dose area product (DAP) is apparently different in central body and upper-limb areas during percutaneous transluminal angioplasty for arteriovenous shunt dysfunction. In this study, we investigated the precise radiation dose at the patients' back and at the non-targeted organs of the operators. The radiation dose was measured with optically stimulated luminescent dosimeters and DAP on several sites including the backs of the patients, gonads, hands and lens of the operators. The studied populations were categorized into central, upper arm and forearm groups based on the lesion sites. The results indicated that there was a significantly higher radiation dose in the central lesion group than in the upper arm and forearm groups. Conversely, there were no specific differences in total procedure time and fluoroscopy time among groups. The radiation exposure doses in the operators showed that regardless of the site, including lens, hands and gonads of the operators, the radiation dose was significantly higher in the central lesion group. The closer the lesion site to the body center, the higher the radiation exposure in both the patients and operators.

New parameter adjustment with spinal cord stimulation for postherpetic neuralgia treatment: A case report and literature review

Abstract Posterpetic neuralgia (PHN), a common and often severe painful condition, is a kind of refractory neuropathic pain (NP). Although the clinical treatment of PHN including pregabalin, nerve block and pulsed radiofrequency have been devoted with adequate and reasonable efforts, a proportion of people with PHN fail to obtain pain relief. Spinal cord stimulation (SCS) represents an adjustable and nondestructive procedure that considered electrical stimulation as the key mechanism for NP relief and offers an alternative treatment for PHN. SCS parameters, including amplitude, pulse width and frequency, influence the nervous system and the delivery of stimulation charge. Newly proposed stimulation methods such as high-frequency SCS and burst SCS, may offer alternative treatment for NP. In this paper, we reported a case of major pain successfully treated with SCS by adjusting the stimulation parameter and the electrode position using new stimulation method. The patient suffered from severe persistent PHN in the right upper limb area. The temporary SCS electrode was placed in the dorsal root entry zone (DREZ) area with a standard generator. Initially, we programmed the parameters at 360 Hz, 140 μs, and 1.5 V. After multiple setting adjustments with inadequate pain relief, the patient was finally programmed at 40 Hz, 120 μs, and 0.5 V. This parameter setting provided optimal pain alleviation and increased the quality of the patient's life. The visual analogue scale and Hamilton anxiety scores were decreased significantly. These scores showed no significant change during the six-month follow-up. SCS combined with dorsal root entry zone at relatively high frequency and low voltage offers a new method to treat PHN patients.

Comparing the effectiveness of mobilization techniques with movement and myofascial techniques in patients following distal radius fractures treated conservatively

Introduction: Fractures of the distal radius are one of the most common types in the upper limb area. They lead to significant reduction in range of mobility, muscle weakness and the occurrence of serious pain. Material and methods: The research involved 20 patients from the Specialist Hand Rehabilitation Centre in Krakow, who were rehabilitated after fractures to the distal radial bone. They were randomly divided into two groups. In group A (n = 10), there were patients who underwent mobilization techniques with movement according to the Mulligan concept as part of their manual work. Group B (n = 10) consisted of patients subjected to myofascial techniques. Functional examination of the hand was carried out twice before and after beginning rehabilitation. The range of active mobility, muscle strength and superficial feeling were examined. Based on the obtained results, functional loss was calculated according to Swanson’s method, Total Active Motion and the sensory index. The obtained results were subjected to statistical analysis using the Excel 10 programme. Results: Significant improvement in hand and muscle strength was noted in both groups. In the group of patients treated with myofascial techniques, better rates of improvement for the tested parameters were obtained than in the group treated with the use of joint mobilization techniques. Conclusions: 1. The applied programme of rehabilitating patients following fracture of the distal radial bone is characterized by statistically significant improvement in hand function. 2. The use of soft-tissue techniques is a more effective method of hand function restitution than the method of mobilization with movement. myofascial techniques, forearm fractures, physiotherapy

Myofascial Induction Effects on Neck-Shoulder Pain in Breast Cancer Survivors: Randomized, Single-Blind, Placebo-Controlled Crossover Design

ObjectivesTo (1) investigate the immediate effects of myofascial induction (MI), with placebo electrotherapy as a control, on perceived pain, cervical/shoulder range of motion (ROM), and mood state in breast cancer survivors (BCSs) with shoulder/arm morbidity; and (2) examine the relationships between pain modifications and cervical/shoulder ROM on the side affected by breast cancer. DesignRandomized, single-blind, placebo-controlled crossover study. SettingPhysical therapy laboratory. ParticipantsBCSs (N=21) who had a diagnosis of stage I–IIIA breast cancer and had completed adjuvant therapy (except hormonal treatment). InterventionDuring each session, the BCSs received either an MI (fascial unwinding) intervention focused on the upper limb area following the Pilat approach or placebo pulsed shortwave therapy (control group). Each session lasted 30 minutes, and an adequate washout period of 4 weeks between sessions was established. Main Outcome MeasuresThe visual analog scale (VAS) for pain and anxiety, shoulder-cervical goniometry for ROM, the Profile of Mood States for psychological distress, and the Attitudes Towards Massage Scale were used. ResultsAn analysis of covariance (ANCOVA) revealed significant time × group interactions for VAS affected arm (P=.031) but not for VAS cervical (P=.332), VAS nonaffected arm (P=.698), or VAS anxiety (P=.266). The ANCOVA also revealed significant interactions for affected shoulder flexion (P<.001), abduction (P<.001), external rotation (P=.004), and internal rotation (P=.001). Significant interactions for affected cervical rotation (P=.022) and affected cervical lateral flexion (P=.038) were also found. A significant negative correlation was found between changes in VAS affected arm and shoulder/arm internal rotation ROM (r=−.46; P=.03). ConclusionsA single MI session decreases pain intensity and improves neck-shoulder ROM to a greater degree than placebo electrotherapy for BCSs experiencing pain.

Scalp acupuncture and electromagnetic convergence stimulation for patients with cerebral infarction: study protocol for a randomized controlled trial.

BackgroundScalp acupuncture (SA) and repetitive transcranial magnetic stimulation (rTMS) are effective for treating cerebral infarction. This study aims to examine the efficacy and safety of SA and electromagnetic convergence stimulation (SAEM-CS), which was developed through collaboration between conventional medical physicians and doctors who practice traditional Korean medicine. SAEM-CS was designed to improve function in patients with cerebral infarction, compared to the improvement after conventional stroke rehabilitation, SA, and rTMS therapeutic approaches.Methods/designThis study is a prospective, outcome assessor-blinded, randomized controlled clinical trial with a 1:1:1:1 allocation ratio. Participants with motion or sensory disabilities caused by a first-time cerebral infarction (n = 60) that had occurred within 1 month of the study onset will be randomly assigned to control, SA, rTMS, or SAEM-CS groups. All groups will receive two sessions of conventional rehabilitation treatment per day. The SA group will receive SA on the upper limb area of MS6 and MS7 (at the lesional hemisphere) for 20 min, the rTMS group will receive low-frequency rTMS (LF-rTMS) treatment on the hot spot of the M1 region (motor cortex at the contralesional hemisphere) for 20 min, and the SAEM-CS group will receive LF-rTMS over the contralesional M1 region hot spot while receiving simultaneous SA stimulation on the lesional upper limb area of MS6 and MS7 for 20 min. SA, rTMS, and SAEM-CS treatments will be conducted once/day, 5 days/week (excluding Saturdays and Sundays) for 3 weeks, for a total of 15 sessions. The primary outcome will be evaluated using the Fugl‐Meyer Assessment, while other scales assessing cognitive function, activities of daily living, walking, quality of life, and stroke severity are considered secondary outcome measures. Outcome measurements will be conducted at baseline (before intervention), 3 weeks after the first intervention (end of intervention), and 4 weeks after intervention completion.DiscussionThis study aims to explore the efficacy and safety of SAEM-CS on cerebral infarction. Collaborative research combined traditional Korean and conventional medicines, which can be useful in developing new treatment technologies.Trial registration KCT0001768. Registered on 14 January 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1611-y) contains supplementary material, which is available to authorized users.

The Study on Sports Injury of Coaches in Boxing Training Environment

The aim of this study was to investigate and analyze causes, times, regions, types, situations, first aid and treatment conditions of the injuries the boxing coaches. This study was conducted with a total of 80 subjects, who are currently active boxing coaches for middle school, high school, university, professional and national division. The tool used to investigate the nature of sports injuries of the boxing leaders based on the training environment was questionnaire, which is composed of 39 questions on age, sex, social background including leadership career, cause and time of injuries during training, type of region of injuries, injury regions based on type of training, first aid and treatment for injuries during training, and prevention of injuries. The questionnaire utilizes self-administered method. First, the form of training that exhibited highest injury rate during training was sparring, where attack type that most likely led to injuries was powerful hook. Second, the region of injury that exhibited highest injury rate during training was ligament injury, where upper limb area was more frequently observed than lower limb area. Third, most preferred emergency prevention method was ice packaging, and the most preferred hospital for treatment was western medicine based hospitals. Fourth, most of the coaches generally performed stretching before and after trainings. 16.25% of the coaches reported that they did not wear protection gears during training. In conclusion, this study that focused on causes, types, regions, first aid and treatment conditions of injuries for the coaches based on the training environment could aid in planning efficient measures for sports injuries of the boxing coaches and provide basic information to formulate treatment measures after injuries.

Automation of Force Assessment Generated by Upper Limb for Ergonomic System EAWS

Ergonomic assessment systems were created for possibility of prediction and risk detection at workplace. Ergonomic assessment system EAWS (European Assembly Work-Sheet) includes assessment of body postures, action forces, weight of carrying loads and frequently recurring upper limb loads assessment. Assessment of action forces (forces generated by upper limb defined by EAWS) is problematic and there is a lack of means for effective assessment. This paper deals with design of electronic device for assessment of action forces generated by upper limb defined by EAWS with using of thin film FSR (force sensing resistor). The paper deals with identification of upper limb areas, where the generated forces are important for assessment by EAWS, deployment of sensors in identified areas, calibration of FSR sensor with regard to simply program implementation in microcontroller, determination of action forces in every by EAWS defined action force application and construction of sensing and evaluating part of electronic device.

Recovery of upper-limb function due to enhanced use-dependent plasticity in chronic stroke patients

Patients with chronic stroke often show increased flexor hypertonia in their affected upper limbs. Although an intervention strategy targeting the extensors of the affected upper limb might thus be expected to have benefits for functional recovery, conventional repetitive motor training has limited clinical utility. Recent studies have shown that repetitive transcranial magnetic stimulation could induce motor recovery. The present study tested whether 5 Hz repetitive transcranial magnetic stimulation of the upper-limb area of the primary motor cortex, combined with extensor motor training, had a greater effect on motor recovery than either intervention alone in stroke hemiparesis. Nine patients with chronic subcortical stroke and nine age-matched healthy subjects completed the crossover study. In separate sessions, we examined the single intervention effect of repetitive wrist and finger extension exercises aided by neuromuscular stimulation, the single intervention effect of 5 Hz repetitive transcranial magnetic stimulation and the combined effect of the two interventions. The motor functions were evaluated behaviourally in patients (Experiment 1) and electrophysiologically in healthy subjects (Experiment 2), both before and after the intervention. In addition, we tested the long-term effect by repeating the combined interventions 12 times in patients (Experiment 3). The motor functions were measured again 2 weeks after the end of the repetitive intervention period. In Experiment 1, the combined intervention, but neither of the single interventions, resulted in an improvement of extensor movement (P < 0.0001) and grip power (P < 0.05), along with a reduction of flexor hypertonia (P < 0.01), in their paretic upper limbs. In Experiment 2, only the combined intervention resulted in selective plastic changes of cortico-spinal excitability (P < 0.01), motor threshold (P < 0.001) and silent period (P < 0.01) for the extensors. In Experiment 3, we also confirmed long-term beneficial effects of the combined intervention in patients. These findings indicate that combining motor training with repetitive transcranial magnetic stimulation can facilitate use-dependent plasticity and achieve functional recovery of motor impairments that cannot be attained by either intervention alone. This method could be a powerful rehabilitative approach for patients with hemiparetic stroke.

Excitability of the lower-limb area of the motor cortex in Parkinson's disease

The excitability of the lower-limb area of the motor cortex was investigated in patients with Parkinson's disease (PD) and in control subjects. Our results were compared to literature data assessing upper-limb cortical area. We analysed the effect of dopaminergic substitution therapy (DST). Motor evoked potential (MEP) were assessed with transcranial magnetic stimulation (TMS) in 24 PD patients with (ON) and without (OFF) DST, and nine age-matched controls. Resting motor threshold (RMT), active motor threshold (AMT), cortical silent period (CSP), MEP amplitude and area did not differ significantly between groups and medication states. A paired-pulse TMS study revealed normal short-interval intracortical inhibition (SICI) but impaired intracortical facilitation (ICF) in PD OFF, partially normalized under DST. Post-hoc analysis uncovered two opposite effects of DST on MEP amplitude, separating the population in two groups. The paired-pulse study confirmed this division, showing that both groups exhibited distinct intracortical functioning, which was differently influenced by DST. The lower-limb motor cortical areas of PD patients essentially exhibited an ICF reduction whereas in upper-limb areas, literature data demonstrated impairment of both SICI and ICF. Our data revealed two groups of patients showing different excitability states and opposite responses to DST. The defective ICF in lower-limb areas could play a key role in the pathophysiology of gait disorders in PD. The fact that two cortical excitability states are inversely influenced by DST may reflect different conditions of denervation and compensatory mechanisms progression.

Estimation of influence of myofascial release techniques on esophageal pressure in patients after total laryngectomy

In patients after total laryngectomy, increased tension in myofascial neck and arm areas might be observed. Via fascial continuity it has an adverse impact on the superior esophageal constrictor forming the "mouth of the oesophagus", which hinders learning of esophageal speech. The aim is to assess the effect of manual myofascial release techniques on esophageal pressure in patients after total laryngectomy. Forty patients (12 F, 28 M), aged 43-75 (mean 56.8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node resection, 38 patients (95%) after radiotherapy. Esophageal pressure was assessed using modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limb areas. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. Statistically significant decrease of the mean esophageal pressure was observed after the physiotherapy treatment. The average pressure among the examined patients decreased from 37.9 to 26.6 mmHg. The application of myofascial manual techniques decreases esophageal pressure, thus allowing patients to learn esophagus speech at a faster pace.

Stress reaction of the humerus in tennis players

Background:Overuse injuries are a frequent occurrence among competitive athletes. When analysing the incidence of overuse injuries in tennis players, it has been determined that a significant number of these injures...