Clinics in Developmental Medicine

Assistive devices for balance and mobility: Benefits, demands, and adverse consequences

Stroke survivors are at high risk for falls in all poststroke stages. Falls may have severe consequences, both physically and psychosocially. Individuals with stroke have an increased risk for hip fractures, and after such a fracture, they less often regain independent mobility. In addition, fear of falling is a common consequence of falls, which may lead to decreased physical activity, social deprivation and, eventually, loss of independence. Important risk factors for falls are balance and gait deficits. Stroke-related balance deficits comprise reduced postural stability during quiet standing and delayed and less coordinated responses to both self-induced and external balance perturbations. Gait deficits include reduced propulsion at push-off, decreased hip and knee flexion during the swing phase, and reduced stability during the stance phase. Interventions addressing these deficits can be expected to prevent falls more successfully. Preliminary evidence shows that task-specific exercise programs targeting balance and gait deficits can indeed reduce the number of falls in individuals with stroke. Technological advances in assistive devices are another promising area. More research is needed, however, to provide conclusive evidence of the efficacy of these interventions regarding the prevention of falls in individuals with stroke.

/pdf/falls-in-individuals-with-stroke-18f71l39al.pdf

Falls in individuals with stroke

Review of enigmatic MTrPs as a common cause of enigmatic musculoskeletal pain and dysfunction.

If you really want to be smarter, reading can be one of the lots ways to evoke and realize. Many people who like reading will have more knowledge and experiences. Reading can be a way to gain information from economics, politics, science, fiction, literature, religion, and many others. As one of the part of book categories, nerves and nerve injuries always becomes the most wanted book. Many people are absolutely searching for this book. It means that many love to read this kind of book.

Nerves and Nerve Injuries.

Hsieh Y-L, Kao M-J, Kuan T-S, Chen S-M, Chen J-T, Hong C-Z: Dry needling to a key myofascial trigger point may reduce the irritability of satellite myofascial trigger points. Am J Phys Med Rehabil 2007;86:397‐403. Objective: To investigate the changes in pressure pain threshold of the secondary (satellite) myofascial trigger points (MTrPs) after dry needling of a primary (key) active MTrP. Design: Single blinded within-subject design, with the same subjects serving as their own controls (randomized). Fourteen patients with bilateral shoulder pain and active MTrPs in bilateral infraspinatus muscles were involved. An MTrP in the infraspinatus muscle on a randomly selected side was dry needled, and the MTrP on the contralateral side was not (control). Shoulder pain intensity, range of motion (ROM) of shoulder internal rotation, and pressure pain threshold of the MTrPs in the infraspinatus, anterior deltoid, and extensor carpi radialis longus muscles were measured in both sides before and immediately after dry needling. Results: Both active and passive ROM of shoulder internal rotation, and the pressure pain threshold of MTrPs on the treated side, were significantly increased (P 0.01), and the pain intensity of the treated shoulder was significantly reduced (P 0.001) after dry needling. However, there were no significant changes in all parameters in the control (untreated) side. Percent changes in the data after needling were also analyzed. For every parameter, the percent change was significantly higher in the treated side than in the control side. Conclusions: This study provides evidence that dry needle‐evoked inactivation of a primary (key) MTrP inhibits the activity in satellite MTrPs situated in its zone of pain referral. This supports the concept that activity in a primary MTrP leads to the development of activity in satellite MTrPs and the suggested spinal cord mechanism responsible for this phenomenon.

Dry needling to a key myofascial trigger point may reduce the irritability of satellite MTrPs.

https://www.archives-pmr.org/article/S0003-9993(99)90227-7/pdf

Hemiplegic gait of stroke patients: the effect of using a cane.

Chen JT, Chung KC, Hou CR, Kuan CR, Chen SM, Hong CZ: Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Am J Phys Med Rehabil 2000;80:729 –735. Objective: Dry needling of myofascial trigger points can relieve myofascial pain if local twitch responses are elicited during needling. Spontaneous electrical activity (SEA) recorded from an active locus in a myofascial trigger point region has been used to assess the myofascial trigger point sensitivity. This study was to investigate the effect of dry needling on SEA. Design: Nine adult New Zealand rabbits were studied. Dry needling with rapid insertion into multiple sites within the myofascial trigger spot region was performed to the biceps femoris muscle to elicit sufficient local twitch responses. Very slow needle insertion with minimal local twitch response elicitation was conducted to the other biceps femoris muscle for the control study. SEA was recorded from 15 different active loci of the myofascial trigger spot before and immediately after treatment for both sides. The raw data of 1-sec SEA were rectified and integrated to calculate the average integrated value of SEA. Results: Seven of nine rabbits demonstrated significantly lower normalized average integrated value of SEA in the treatment side compared with the control side (P 0.05). The results of two-way analysis of variance show that the mean of the normalized average integrated value of SEA in the treatment group (0.565 0.113) is significantly (P 0.05) lower than that of the control (0.983 0.121). Conclusions: Dry needling of the myofascial trigger spot is effective in diminishing SEA if local twitch responses are elicited. The local twitch response elicitation, other than trauma effects of needling, seems to be the primary inhibitory factor on SEA during dry needling.

Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle.

To elucidate the correlating factors and clinical significance of flexible flatfoot (FF) in preschool children of Taiwan, a cross-sectional study was conducted in a research laboratory equipped with a gait analysis facility. Altogether, 377 preschool children (201 boys, 176 girls), ranging in age from 2 to 6 years, were enrolled in this investigation. The results show that age, height, weight, foot progression angle, occurrence of physical knock-knee, and joint laxity score correlate with FF. Children with FF, compared with children without, performed physical tasks poorly and walked slowly, as determined by gait parameters. The FF should not simply be regarded as a problem of static alignment of the ankle and foot complex, but may be the consequence of a dynamic functional change of the lower extremity. Better understanding of the correlating factors and the clinical relevance of FF may prove helpful in deciding on the most appropriate treatment for a particular patient.

Correlating factors and clinical significance of flexible flatfoot in preschool children.

Tsai C-T, Hsieh L-F, Kuan T-S, Kao MJ, Chou L-W, Hong C-Z: Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle.Objective:To investigate the remote effect of dry needling on the irritability of a myofascial trigger point in the uppe

Ta Shen Kuan

Papers

Dry needling to a key myofascial trigger point may reduce the irritability of satellite MTrPs.

Hemiplegic gait of stroke patients: the effect of using a cane.

Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle.

Correlating factors and clinical significance of flexible flatfoot in preschool children.

Remote effects of dry needling on the irritability of the myofascial trigger point in the upper trapezius muscle.