These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Spinal Loads during Post-Operative Physiotherapeutic Exercises  

PubMed Central

After spinal surgery, physiotherapeutic exercises are performed to achieve a rapid return to normal life. One important aim of treatment is to regain muscle strength, but it is known that muscle forces increase the spinal loads to potentially hazardous levels. It has not yet been clarified which exercises cause high spinal forces and thus endanger the surgical outcome. The loads on vertebral body replacements were measured in 5 patients during eleven physiotherapeutic exercises, performed in the supine, prone, or lateral position or on all fours (kneeling on the hands and knees). Low resultant forces on the vertebral body replacement were measured for the following exercises: lifting one straight leg in the supine position, abduction of the leg in the lateral position, outstretching one leg in the all-fours position, and hollowing the back in the all-fours position. From the biomechanical point of view, these exercises can be performed shortly after surgery. Implant forces similar or even greater than those for walking were measured during: lifting both legs, lifting the pelvis in the supine position, outstretching one arm with or without simultaneously outstretching the contralateral leg in the all-fours position, and arching the back in the all-fours position. These exercises should not be performed shortly after spine surgery. PMID:24999808

Rohlmann, Antonius; Schwachmeyer, Verena; Graichen, Friedmar; Bergmann, Georg

2014-01-01

2

Treating Back-Related Leg Pain with Spinal Manipulation and Home Exercise  

MedlinePLUS

... and health-related costs than uncomplicated low back pain. Nonpharmacologic interventions, including spinal manipulation, exercise, and education promoting self-management, are increasingly recommended as low-risk treatment strategies. ...

3

Proprioceptive neuropathy affects normalization of the H-reflex by exercise after spinal cord injury  

PubMed Central

The H-reflex habituates at relatively low frequency (10 Hz) stimulation in the intact spinal cord, but loss of descending inhibition resulting from spinal cord transection reduces this habituation. There is a return towards a normal pattern of low-frequency habituation in the reflex activity with cycling exercise of the affected hind limbs. This implies that repetitive passive stretching of the muscles in spinalized animals and the accompanying stimulation of large (Group I and II) proprioceptive fibers has modulatory effects on spinal cord reflexes after injury. To test this hypothesis, we induced pyridoxine neurotoxicity that preferentially affects large dorsal root ganglia neurons in intact and spinalized rats. Pyridoxine or saline injections were given twice daily (IP) for 6 weeks and half of the spinalized animals were subjected to cycling exercise during that period. After 6 weeks, the tibial nerve was stimulated electrically and recordings of M and H waves were made from interosseous muscles of the hind paw. Results show that pyridoxine treatment completely eliminated the H-reflex in spinal intact animals. In contrast, transection paired with pyridoxine treatment resulted in a reduction of the frequency-dependent habituation of the H-reflex that was not affected by exercise. These results indicate that normal Group I and II afferent input is critical to achieve exercise-based reversal of hyper-reflexia of the H-reflex after spinal cord injury. PMID:19913536

Ollivier-Lanvin, Karen; Keeler, Benjamin E.; Siegfried, Rachel; Houlé, John D.; Lemay, Michel A.

2009-01-01

4

Exercise awareness and barriers after spinal cord injury.  

PubMed

Exercise is an essential element in managing several of the non-communicable diseases after spinal cord injury (SCI). Awareness of the importance of prescribing a customized exercise program that meets the goals of persons with SCI should be highly considered in the rehabilitation community. The barriers of implementing specific exercise program as well as the factors that may mask the outcomes of regular exercise regimen need to be continuously addressed as a part of patients' rehabilitation care. The focus of this editorial is to encourage the medical community to consider routine physical activity as one of the necessary vital signs that needs to be routinely checked in patients with SCI. Providing education tips, nutritional counseling and engaging in recreational programs may provide motivational route to the community of SCI. This may result in reinforcing active lifestyle in survivors with SCI as well as to reduce the impact of chronic life threatening medical disorders. PMID:25035817

Gorgey, Ashraf S

2014-07-18

5

Minimally Invasive Treatment of Spinal Metastases: Techniques  

PubMed Central

With improved treatments and increasingly life expectancy, the burden of metastatic disease in the spine is expected to rise. The role of conventional surgery for spinal metastases is well established but often involves procedures of large magnitude. We describe minimally invasive techniques for spinal stabilization and decompression in patients with symptomatic metastatic disease of the spine. PMID:22312512

Rose, Peter S.; Clarke, Michelle J.; Dekutoski, Mark B.

2011-01-01

6

Effects of spinal manipulation versus therapeutic exercise on adults with chronic low back pain: a literature review  

PubMed Central

Background Context: Chronic low back pain (CLBP) is a prevalent disorder that has a significant burden to society in terms of loss of work time and increased economic cost. Two common treatment choices of intervention for CLBP are spinal manipulation and prescribed exercise. Purpose: The purpose of this systematic review was to examine the effectiveness of spinal manipulation vs prescribed exercise for patients diagnosed with CLBP. Studies that compared head-to-head spinal manipulation to an exercise group were included in this review. Methods: A search of the current literature was conducted using a keyword process in CINAHL, Cochrane Register of Controlled Trials Database, Medline, and Embase. The search was conducted on, and included studies available up to August 29th 2014. Studies were included based on PICOS criteria 1) individuals with CLBP defined as lasting 12 weeks or longer; 2) spinal manipulation performed by a health care practitioner; 3) prescribed exercise for the treatment of CLBP and monitored by a health care practitioner; 4) measurable clinical outcomes for reducing pain, disability or improving function; 5) randomized controlled trials. The quality of included articles was determined by the author using the criteria developed and used by the Physiotherapy Evidence Database (PEDro). Results: Three randomized controlled trials met the inclusion criteria of this systematic review and were included in this review. The outcomes used in these studies included Disability Indexes, Pain Scales and function improvement scales. The results included a mix of effects with one study finding spinal manipulation as more effective and another finding the exercises more so. The third study found both interventions offering equal effects in the long term. Conclusion: Based on the findings of this systematic review there is no conclusive evidence that clearly favours spinal manipulation or exercise as more effective in treatment of CLBP. More studies are needed to further explore which intervention is more effective.

Merepeza, Alban

2014-01-01

7

Cardiovascular responses to arm static exercise in men with thoracic spinal cord lesions  

Microsoft Academic Search

Isometric muscle contraction (static exercise) induces circulatory response. Static exercise in individuals with thoracic\\u000a spinal cord injury (TSCI) induces cardiovascular response and blood redistribution to the non-exercising muscles. The aim\\u000a of our study was to determine the circulatory response during arm static exercise in individuals with TSCI and able-bodied\\u000a (AB) controls. Mean blood pressure (MBP), heart rate (HR), cardiac output

Keiko Sakamoto; Takeshi Nakamura; Yasunori Umemoto; Yumi Koike; Yusuke Sasaki; Fumihiro Tajima

8

Spinal manipulation and exercise for low back pain in adolescents: study protocol for a randomized controlled trial  

PubMed Central

Background Low back pain is among the most common and costly chronic health care conditions. Recent research has highlighted the common occurrence of non-specific low back pain in adolescents, with prevalence estimates similar to adults. While multiple clinical trials have examined the effectiveness of commonly used therapies for the management of low back pain in adults, few trials have addressed the condition in adolescents. The purpose of this paper is to describe the methodology of a randomized clinical trial examining the effectiveness of exercise with and without spinal manipulative therapy for chronic or recurrent low back pain in adolescents. Methods/design This study is a randomized controlled trial comparing twelve weeks of exercise therapy combined with spinal manipulation to exercise therapy alone. Beginning in March 2010, a total of 184 participants, ages 12 to 18, with chronic or recurrent low back pain are enrolled across two sites. The primary outcome is self-reported low back pain intensity. Other outcomes include disability, quality of life, improvement, satisfaction, activity level, low back strength, endurance, and motion. Qualitative interviews are conducted to evaluate participants’ perceptions of treatment. Discussion This is the first randomized clinical trial assessing the effectiveness of combining spinal manipulative therapy with exercise for adolescents with low back pain. The results of this study will provide important evidence on the role of these conservative treatments for the management of low back pain in adolescents. Trial registration (ClinicalTrials.gov NCT01096628). PMID:24904748

2014-01-01

9

Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?  

PubMed Central

An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury. PMID:23533315

da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio

2013-01-01

10

Axon regeneration and exercise-dependent plasticity after spinal cord injury  

PubMed Central

Current dogma is that meaningful recovery of function after spinal cord injury (SCI) likely will require a combination of therapeutic interventions comprised of regenerative/neuroprotective transplants, addition of neurotrophic factors, elimination of inhibitory molecules, functional sensorimotor training, and/or stimulation of paralyzed muscles or spinal circuits. We routinely use: (1) peripheral nerve grafts to support and direct axonal regeneration across an incomplete cervical or a complete thoracic transection injury, (2) matrix modulation with chondroitinase (ChABC) to facilitate axonal extension beyond the distal graft-spinal cord interface and (3) exercise, such as forced wheel walking, bicycling or step training on a treadmill. We (and others) have demonstrated an increase in spinal cord levels of endogenous neurotrophic factors with exercise, which may be useful in facilitating elongation and/or synaptic activity of regenerating axons and plasticity of spinal neurons below the level of injury PMID:23531013

Houlé, John D; Côté, Marie-Pascale

2013-01-01

11

The effect of exercise and oxidant–antioxidant intervention on the levels of neurotrophins and free radicals in spinal cord of rats  

Microsoft Academic Search

Study design:This study was designed to investigate the effects of oxidant and antioxidant treatment, as well as regular exercise, on neurotrophin levels in the spinal cord of rats.Objectives:Reactive oxygen species (ROS) play a role in neurodegenerative diseases, but ROS at moderate levels could stimulate biochemical processes through redox-sensitive transcription.Methods:Exercised or sedentary animals were injected subcutaneously with hydrogen peroxide (H2O2), N-tert

S Siamilis; J Jakus; C Nyakas; A Costa; B Mihalik; A Falus; Z Radak

2009-01-01

12

Spinal manipulation for low-back pain: a treatment package agreed by the UK chiropractic, osteopathy and physiotherapy professional associations  

Microsoft Academic Search

Trials of manipulative treatment have been compromised by, amongst other things, different definitions of the therapeutic procedures involved. This paper describes a spinal manipulation package agreed by the UK professional bodies that represent chiropractors, osteopaths and physiotherapists. It was devised for use in the UK Back pain Exercise And Manipulation (UK BEAM) trial—a national study of physical treatments in primary

E. Harvey; A. K. Burton; J. K. Moffett; A. Breen

2003-01-01

13

Exercise Preconditioning Protects against Spinal Cord Injury in Rats by Upregulating Neuronal and Astroglial Heat Shock Protein 72  

PubMed Central

The heat shock protein 72 (HSP 72) is a universal marker of stress protein whose expression can be induced by physical exercise. Here we report that, in a localized model of spinal cord injury (SCI), exercised rats (given pre-SCI exercise) had significantly higher levels of neuronal and astroglial HSP 72, a lower functional deficit, fewer spinal cord contusions, and fewer apoptotic cells than did non-exercised rats. pSUPER plasmid expressing HSP 72 small interfering RNA (SiRNA-HSP 72) was injected into the injured spinal cords. In addition to reducing neuronal and astroglial HSP 72, the (SiRNA-HSP 72) significantly attenuated the beneficial effects of exercise preconditioning in reducing functional deficits as well as spinal cord contusion and apoptosis. Because exercise preconditioning induces increased neuronal and astroglial levels of HSP 72 in the gray matter of normal spinal cord tissue, exercise preconditioning promoted functional recovery in rats after SCI by upregulating neuronal and astroglial HSP 72 in the gray matter of the injured spinal cord. We reveal an important function of neuronal and astroglial HSP 72 in protecting neuronal and astroglial apoptosis in the injured spinal cord. We conclude that HSP 72-mediated exercise preconditioning is a promising strategy for facilitating functional recovery from SCI. PMID:25334068

Chang, Cheng-Kuei; Chou, Willy; Lin, Hung-Jung; Huang, Yi-Ching; Tang, Ling-Yu; Lin, Mao-Tsun; Chang, Ching-Ping

2014-01-01

14

Exercise preconditioning protects against spinal cord injury in rats by upregulating neuronal and astroglial heat shock protein 72.  

PubMed

The heat shock protein 72 (HSP 72) is a universal marker of stress protein whose expression can be induced by physical exercise. Here we report that, in a localized model of spinal cord injury (SCI), exercised rats (given pre-SCI exercise) had significantly higher levels of neuronal and astroglial HSP 72, a lower functional deficit, fewer spinal cord contusions, and fewer apoptotic cells than did non-exercised rats. pSUPER plasmid expressing HSP 72 small interfering RNA (SiRNA-HSP 72) was injected into the injured spinal cords. In addition to reducing neuronal and astroglial HSP 72, the (SiRNA-HSP 72) significantly attenuated the beneficial effects of exercise preconditioning in reducing functional deficits as well as spinal cord contusion and apoptosis. Because exercise preconditioning induces increased neuronal and astroglial levels of HSP 72 in the gray matter of normal spinal cord tissue, exercise preconditioning promoted functional recovery in rats after SCI by upregulating neuronal and astroglial HSP 72 in the gray matter of the injured spinal cord. We reveal an important function of neuronal and astroglial HSP 72 in protecting neuronal and astroglial apoptosis in the injured spinal cord. We conclude that HSP 72-mediated exercise preconditioning is a promising strategy for facilitating functional recovery from SCI. PMID:25334068

Chang, Cheng-Kuei; Chou, Willy; Lin, Hung-Jung; Huang, Yi-Ching; Tang, Ling-Yu; Lin, Mao-Tsun; Chang, Ching-Ping

2014-01-01

15

THE EFFECTS OF EXERCISE TRAINING ON CARDIOVASCULAR REGULATION IN INDIVIUALS WITH SPINAL CORD INJURY  

Microsoft Academic Search

Introduction. Individuals with spinal cord injury (SCI) are prone to severe cardiovascular dysfunction and an increased risk of mortality from various cardiovascular diseases. The underlying mechanisms responsible for the increased cardiovascular risk are not precisely understood, however, the reduced activity levels that accompany SCI certainly contribute. Unfortunately, muscular paralysis (partial or complete) limits the exercise options for individuals with SCI

DAVID DITOR

2003-01-01

16

Cervical Exercise: The Backbone of Spine Treatment  

MedlinePLUS

North American Spine Society Public Education Series Cervical Exercise: The Backbone of Spine Treatment How important is it? What can be done? Important: If you have had an accident that started your neck pain or if ...

17

Use of vibration exercise in spinal cord injury patients who regularly practise sport.  

PubMed

The aim of this study was to evaluate the applicability and effects of mechanical vibration on body composition and mechanical properties of the arm in patients with spinal cord injury (SCI). For this purpose, ten volunteers with thoracic SCI were recruited. Measurements were performed before and after a period of treatment with mechanical vibration applied during forearm flexion in isometric condition. The subjects were tested performing forearm flexion (both right and left side) with increasing loads, corresponding to 5, 8, 10 and 15% of their own body weight. Average velocity (AV), average force (AF) and average power (AP) were calculated. The Functional Independence Measure was used to evaluate daily autonomy at baseline. Total body and segmental (arms) body composition, fat mass, fat-free mass, and bone mineral density, were studied by dual energy X-ray absorptiometry. Functional measurements (AV, AF, AP) and body composition were measured at three time points: after a medical examination and interview (T0); after an interval of 12 weeks without physical therapy or training (T1); and finally after a further 12-week period during which the patients performed segmental vibration exercise (T2). The results showed statistically significant increases in AV and AP on the right (dominant) side (p<0.05); AF also increased, but without the difference reaching statistical significance. Total body composition, did not change whereas the bone mineral density of the arms was higher after treatment, but again without the difference reaching statistical significance. PMID:17925164

Melchiorri, Giovanni; Andreoli, Angela; Padua, Elvira; Sorge, Roberto; De Lorenzo, Antonino

2007-01-01

18

Conservative and Surgical Treatment Improves Pain and Ankle-Brachial Index in Patients with Lumbar Spinal Stenosis  

PubMed Central

Purpose The pathological mechanism of lumbar spinal stenosis is reduced blood flow in nerve roots and degeneration of nerve roots. Exercise and prostaglandin E1 is used for patients with peripheral arterial disease to increase capillary flow around the main artery and improve symptoms; however, the ankle-brachial index (ABI), an estimation of blood flow in the main artery in the leg, does not change after treatment. Lumbar spinal nerve roots contain somatosensory, somatomotor, and unmyelinated autonomic nerves. Improved blood flow by medication with prostaglandin E1 and decompression surgery in these spinal nerve roots may improve the function of nerve fibers innervating muscle, capillary, and main vessels in the lower leg, resulting in an increased ABI. The purpose of the study was to examine whether these treatments can improve ABI. Materials and Methods One hundred and seven patients who received conservative treatment such as exercise and medication (n=56) or surgical treatment (n=51) were included. Low back pain and leg pain scores, walking distance, and ABI were measured before treatment and after 3 months of conservative treatment alone or surgical treatment followed by conservative treatment. Results Low back pain, leg pain, and walking distance significantly improved after both treatments (p<0.05). ABI significantly increased in each group (p<0.05). Conclusion This is the first investigation of changes in ABI after treatment in patients with lumbar spinal stenosis. Improvement of the spinal nerve roots by medication and decompression surgery may improve the supply of blood flow to the lower leg in patients with lumbar spinal stenosis. PMID:23709437

Yamashita, Masaomi; Murata, Yasuaki; Eguchi, Yawara; Aoki, Yasuchika; Ataka, Hiromi; Hirayama, Jiro; Ozawa, Tomoyuki; Morinaga, Tatsuo; Arai, Hajime; Mimura, Masaya; Kamoda, Hiroto; Orita, Sumihisa; Miyagi, Masayuki; Miyashita, Tomohiro; Okamoto, Yuzuru; Ishikawa, Tetsuhiro; Sameda, Hiroaki; Kinoshita, Tomoaki; Hanaoka, Eiji; Suzuki, Miyako; Suzuki, Munetaka; Aihara, Takato; Ito, Toshinori; Inoue, Gen; Yamagata, Masatsune; Toyone, Tomoaki; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Yamauchi, Kazuyo; Takahashi, Kazuhisa

2013-01-01

19

Spinal cord injury: known and possible influences on the immune response to exercise.  

PubMed

A spinal cord injury (SCI) can increase the risk of infection by impacting on many aspects of immune function; one particularly well-documented observation is a reduction in lymphocyte numbers. The vast majority of lymphoid cells express adrenergic receptors. Therefore, autonomic function loss and concomitant alterations in resting and post-exercise catecholamine concentrations, particularly so in individuals with a tetraplegia, may impact directly on immune cells and depress immunity. Other factors are further likely to contribute, examples including altered muscular, endocrine and cardiovascular function following SCI. However, some alterations, such as increases in natural killer cell cytotoxicity following exercise in those with a tetraplegia, are unrelated to the catecholamine response. Likewise, mucosal immunity in individuals with a tetraplegia appears to be similarly influenced by exercise as in the able-bodied population. Indeed, rehabilitation therapy and exercise can increase some measures of immunity and autonomic function in those with an SCI. It is therefore possible that compensatory mechanisms offset disability-related detriments. This may be by way of sympathetic reflex activity, receptor hypersensitivity, or parasympathetic and neuroendocrine adjustments. Future work needs to explore these mechanisms further to clarify the implications of an SCI on the immune response to exercise and susceptibility to infection. In this article, we review the impacts of an SCI on immune, and specifically, exercise immune function. The relevant anatomical and physiological foundations of the immune system are first briefly laid out in order to understand the potential impacts of neural and neuroendocrine dysfunction on the immune system. With the limited number of human studies available, we have then aimed specifically to gather all relevant existing literature on exercise immunology in individuals with an SCI in patient, recreationally active and athlete populations. We believe that an understanding of the impacts of exercise can provide a tool to help maintain or improve health in individuals with an SCI. A comprehensive literature search was conducted using the search engines PubMed, SPORTDiscus, Web of Science and Zetoc, search period June 2012-February 2013. Key words employed included spinal cord injury, immunology, exercise, paraplegic, tetraplegic, upper body exercise, interleukin, immunoglobulin, sympathetic, and parasympathetic. All articles and articles derived from their reference lists were checked for their suitability. PMID:23977725

Leicht, C A; Goosey-Tolfrey, V L; Bishop, N C

2013-01-01

20

Spinal epidural lipomatosis caused by corticosteroid treatment in ulcerative colitis.  

PubMed

Spinal epidural lipomatosis is the result of deposition of unencapsulated fat in the extradural space of the spinal canal. Most commonly, this rare condition is a complication secondary to corticosteroid treatment. We describe a 49-year-old patient with ulcerative colitis who developed paraparesis due to overgrowth of epidural fat tissue. This is the second patient with ulcerative colitis described in the literature who developed symptomatic epidural lipomatosis secondary to corticosteroid treatment. All internists tending patients with chronic diseases that require corticosteroid treatment should be aware of this rare clinical entity. PMID:16490695

Kotilainen, Esa; Hohenthal, Ulla; Karhu, Jari; Kotilainen, Pirkko

2006-03-01

21

Biomaterial Design Strategies for the Treatment of Spinal Cord Injuries  

PubMed Central

Abstract The highly debilitating nature of spinal cord injuries has provided much inspiration for the design of novel biomaterials that can stimulate cellular regeneration and functional recovery. Many experts agree that the greatest hope for treatment of spinal cord injuries will involve a combinatorial approach that integrates biomaterial scaffolds, cell transplantation, and molecule delivery. This manuscript presents a comprehensive review of biomaterial-scaffold design strategies currently being applied to the development of nerve guidance channels and hydrogels that more effectively stimulate spinal cord tissue regeneration. To enhance the regenerative capacity of these two scaffold types, researchers are focusing on optimizing the mechanical properties, cell-adhesivity, biodegradability, electrical activity, and topography of synthetic and natural materials, and are developing mechanisms to use these scaffolds to deliver cells and biomolecules. Developing scaffolds that address several of these key design parameters will lead to more successful therapies for the regeneration of spinal cord tissue. PMID:19698073

Straley, Karin S.; Po Foo, Cheryl Wong

2010-01-01

22

Perspectives on the treatment of the longitudinal spinal cord injury.  

PubMed

The current technique for surgical treatment of the longitudinal spinal cord injury has proven to be successful for restoration of some motor function and alleviation of pain. This has been the first step in finding a cure for spinal cord injuries, but so far there are many obstacles still to be overcome. In this particular injury return of function from spinal cord surgery is only partial. Some of the main remaining problems are related to injury-induced neuronal death, direction and specificity of regeneration and muscle, and receptor disintegration from long time denervation. Currently this is a surgical procedure without any adjuvant treatments. In order to gain further functional improvement combinational therapies developed in basic science experiments are essential. PMID:21206763

Carlstedt, Thomas

2010-01-01

23

Spinal stenosis  

MedlinePLUS

... spinal stenosis; Foraminal spinal stenosis; Degenerative spine disease; Back pain - spinal stenosis ... help your pain during flare-ups. Treatments for back pain caused by spinal stenosis include: Medicines that may ...

24

Intramedullary spinal cord metastases: diagnosis and treatment – an illustrated review  

Microsoft Academic Search

Summary. Background. Intramedullary spinal cord metastases (ISCM) are rare but, with increasing use of magnetic resonance imaging (MRI) are being encountered with increasing frequency. Optimum treatment remains controversial. On the basis of a review of previous reports and experience with a patient with an ISCM from a large cell lung cancer, we propose practical diagnostic and therapeutic approaches. Findings. We

M. Kalayc?; F. Ça?avi; S. Gül; S. Yenidünya; B. Aç?kgöz

2004-01-01

25

Modulation of exercise-induced spinal loop properties in response to oxygen availability.  

PubMed

This study investigated the effects of acute hypoxia on spinal reflexes and soleus muscle function after a sustained contraction of the plantar flexors at 40 % of maximal voluntary isometric contraction (MVC). Fifteen males (age 25.3 ± 0.9 year) performed the fatigue task at two different inspired O2 fractions (FiO2 = 0.21/0.11) in a randomized and single-blind fashion. Before, at task failure and after 6, 12 and 18 min of passive recovery, the Hoffman-reflex (H max) and M-wave (M max) were recorded at rest and voluntary activation (VA), surface electromyogram (RMSmax), M-wave (M sup) and V-wave (V sup) were recorded during MVC. Normalized H-reflex (H max/M max) was significantly depressed pre-exercise in hypoxia compared with normoxia (0.31 ± 0.08 and 0.36 ± 0.08, respectively, P < 0.05). Hypoxia did not affect time to task failure (mean time of 453.9 ± 32.0 s) and MVC decrease at task failure (-18 % in normoxia vs. -16 % in hypoxia). At task failure, VA (-8 %), RMSmax/M sup (-11 %), H max/M max (-27 %) and V sup/M sup (-37 %) decreased (P < 0.05), but with no FiO2 effect. H max/M max restored significantly throughout recovery in hypoxia but not in normoxia, while V sup/M sup restored significantly during recovery in normoxia but not in hypoxia (P < 0.05). Collectively, these findings indicate that central adaptations resulting from sustained submaximal fatiguing contraction were not different in hypoxia and normoxia at task failure. However, the FiO2-induced differences in spinal loop properties pre-exercise and throughout recovery suggest possible specific mediation by the hypoxic-sensitive group III and IV muscle afferents, supraspinal regulation mechanisms being mainly involved in hypoxia while spinal ones may be predominant in normoxia. PMID:25361617

Rupp, Thomas; Racinais, Sébastien; Bringard, Aurélien; Lapole, Thomas; Perrey, Stéphane

2015-03-01

26

Acute Leptin Treatment Enhances Functional Recovery after Spinal Cord Injury  

PubMed Central

Background Spinal cord injury is a major cause of long-term disability and has no current clinically accepted treatment. Leptin, an adipocyte-derived hormone, is best known as a regulator of food intake and energy expenditure. Interestingly, several studies have demonstrated that leptin has significant effects on proliferation and cell survival in different neuropathologies. Here, we sought to evaluate the role of leptin after spinal cord injury. Findings Based on its proposed neuroprotective role, we have evaluated the effects of a single, acute intraparenchymal injection of leptin in a clinically relevant animal model of spinal cord injury. As determined by quantitative Real Time-PCR, endogenous leptin and the long isoform of the leptin receptor genes show time-dependent variations in their expression in the healthy and injured adult spinal cord. Immunohistochemical analysis of post-injury tissue showed the long isoform of the leptin receptor expression in oligodendrocytes and, to a lesser extent, in astrocytes, microglia/macrophages and neurons. Moreover, leptin administered after spinal cord injury increased the expression of neuroprotective genes, reduced caspase-3 activity and decreased the expression of pro-inflammatory molecules. In addition, histological analysis performed at the completion of the study showed that leptin treatment reduced microglial reactivity and increased caudal myelin preservation, but it did not modulate astroglial reactivity. Consequently, leptin improved the recovery of sensory and locomotor functioning. Conclusions Our data suggest that leptin has a prominent neuroprotective and anti-inflammatory role in spinal cord damage and highlights leptin as a promising therapeutic agent. PMID:22536415

Fernández-Martos, Carmen María; González, Pau; Rodriguez, Francisco Javier

2012-01-01

27

[Modern neurological treatment strategies for patients with spinal cord injury].  

PubMed

Modern treatment methods for neurogenic bladder dysfunction take into consideration the primacy of obtaining good bladder storage capacity by merely lowering the leak point pressure. The medical benefit for the patient is seen in the stability of renal function and the social advantage in achieving continence. The development of modern findings on the management of neuro-urological disorders in spinal cord injury as well as the underlying principles, indications, and benefits of the most frequently applied treatment approaches are described. PMID:22269993

Domurath, B; Kutzenberger, J

2012-02-01

28

Development and Treatments of Inflammatory Cells and Cytokines in Spinal Cord Ischemia-Reperfusion Injury  

PubMed Central

During aortic surgery, interruption of spinal cord blood flow might cause spinal cord ischemia-reperfusion injury (IRI). The incidence of spinal cord IRI after aortic surgery is up to 28%, and patients with spinal cord IRI might suffer from postoperative paraplegia or paraparesis. Spinal cord IRI includes two phases. The immediate spinal cord injury is related to acute ischemia. And the delayed spinal cord injury involves both ischemic cellular death and reperfusion injury. Inflammation is a subsequent event of spinal cord ischemia and possibly a major contributor to spinal cord IRI. However, the development of inflammatory mediators is incompletely demonstrated. And treatments available for inflammation in spinal cord IRI are insufficient. Improved understanding about spinal cord IRI and the development of inflammatory cells and cytokines in this process will provide novel therapeutic strategies for spinal cord IRI. Inflammatory cytokines (e.g., TNF-? and IL-1) may play an important role in spinal cord IRI. For treatment of several intractable autoimmune diseases (e.g., rheumatoid arthritis), where inflammatory cytokines are involved in disease progression, anti-inflammatory cytokine antagonist is now available. Hence, there is great potential of anti-inflammatory cytokine antagonist for therapeutic use of spinal cord IRI. We here review the mediators and several possibilities of treatment in spinal cord IRI. PMID:23956505

Zhu, Ping; Li, Jia-xin; Fujino, Masayuki; Zhuang, Jian; Li, Xiao-Kang

2013-01-01

29

Experiences of individuals with chronic low back pain during and after their participation in a spinal stabilisation exercise programme - a pilot qualitative study.  

PubMed

Spinal stabilisation exercises are commonly used in the management of low back pain (LBP). There is limited evidence relating to patients' experiences of their involvement in such programmes. The aim of this study was to explore the experiences of a sample of individuals with chronic LBP who participated in a randomised controlled trial (RCT) investigating the most efficacious dosage and frequency of spinal stabilisation exercises. The qualitative study involved nine participants who took part in focus group discussions. The data were analysed using thematic content analysis and provided insights into the experiences of the participants. Four themes emerged: Physical dimensions of the LBP experience, emotional and psychological dimensions of the LBP experience and perceived effects of the programme and lastly, the impact of the treatment programme on participants' knowledge, understanding and adherence. In conclusion participants' experiences were not limited to the positive effects of stabilisation exercises on pain, functional disability and quality of life, but also reflected increases in confidence, the formulation of self help strategies and the ability to exert better control over their LBP. The findings highlight the importance of well planned associated educational support packages in the treatment of LBP paving the way for future qualitative research. PMID:19939723

Sokunbi, Oluwaleke; Cross, Vinette; Watt, Peter; Moore, Ann

2010-04-01

30

Role of exercise therapy in osteopathic education, treatment and management.  

E-print Network

??Exercise based interventions are common in the treatment of musculoskeletal disorders. These interventions have been investigated in other manual therapy disciplines, but little empirical data… (more)

Zamani, J.

2008-01-01

31

Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury.  

PubMed

We asked whether elastic binding of the abdomen influences respiratory mechanics during wheelchair propulsion in athletes with cervical spinal cord injury (SCI). Eight Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) performed submaximal and maximal incremental exercise tests on a treadmill, both with and without abdominal binding. Measurements included pulmonary function, pressure-derived indices of respiratory mechanics, operating lung volumes, tidal flow-volume data, gas exchange, blood lactate, and symptoms. Residual volume and functional residual capacity were reduced with binding (77 ± 18 and 81 ± 11% of unbound, P < 0.05), vital capacity was increased (114 ± 9%, P < 0.05), whereas total lung capacity was relatively well preserved (99 ± 5%). During exercise, binding introduced a passive increase in transdiaphragmatic pressure, due primarily to an increase in gastric pressure. Active pressures during inspiration were similar across conditions. A sudden, sustained rise in operating lung volumes was evident in the unbound condition, and these volumes were shifted downward with binding. Expiratory flow limitation did not occur in any subject and there was substantial reserve to increase flow and volume in both conditions. V?o2 was elevated with binding during the final stages of exercise (8-12%, P < 0.05), whereas blood lactate concentration was reduced (16-19%, P < 0.05). V?o2/heart rate slopes were less steep with binding (62 ± 35 vs. 47 ± 24 ml/beat, P < 0.05). Ventilation, symptoms, and work rates were similar across conditions. The results suggest that abdominal binding shifts tidal breathing to lower lung volumes without influencing flow limitation, symptoms, or exercise tolerance. Changes in respiratory mechanics with binding may benefit O2 transport capacity by an improvement in central circulatory function. PMID:24855136

West, Christopher R; Goosey-Tolfrey, Victoria L; Campbell, Ian G; Romer, Lee M

2014-07-01

32

Surgical treatment of cervical intramedullary spinal cord tumors.  

PubMed

The aim of this study is to determine if radical microsurgical removal of cervical intramedullary spinal cord tumors (CIMSCT) is achievable without causing respiratory, motor and sphincter deficits. Sixteen consecutive patients, who underwent surgical removal of a cervical intramedullary spinal cord tumor between 1988 and 1997, are presented. Surgical findings and results are analyzed. Patients' pre- and postoperative neurological conditions were evaluated using the clinical/functional scale of McCormick et al. The tumor was totally removed in 15 patients (93%). An improvement in sensory and motor functionality was obtained in 10 patients (63%), five patients (31%) remained stable and only one patient (6%), in whom partial removal was performed, presented a worsening of motor and sphincter functions. None of the patients who underwent total removal have shown MR signs of recurrence. The only patient in whom a partial removal was realized, presented a bulbar diffusion of the tumor and died. Microsurgical total removal can be considered the treatment of choice for CIMSCT. An accurate dissection between tumoral mass and normal spinal cord may allow, in the majority of cases, a total removal of tumor with preservation of spinal cord. Potential alterations of the spine stability must be prevented using internal or external stabilization. PMID:11760875

Maira, G; Amante, P; Denaro, L; Mangiola, A; Colosimo, C

2001-12-01

33

Nanomedicine strategies for treatment of secondary spinal cord injury  

PubMed Central

Neurological injury, such as spinal cord injury, has a secondary injury associated with it. The secondary injury results from the biological cascade after the primary injury and affects previous uninjured, healthy tissue. Therefore, the mitigation of such a cascade would benefit patients suffering a primary injury and allow the body to recover more quickly. Unfortunately, the delivery of effective therapeutics is quite limited. Due to the inefficient delivery of therapeutic drugs, nanoparticles have become a major field of exploration for medical applications. Based on their material properties, they can help treat disease by delivering drugs to specific tissues, enhancing detection methods, or a mixture of both. Incorporating nanomedicine into the treatment of neuronal injury and disease would likely push nanomedicine into a new light. This review highlights the various pathological issues involved in secondary spinal cord injury, current treatment options, and the improvements that could be made using a nanomedical approach.

White-Schenk, Désirée; Shi, Riyi; Leary, James F

2015-01-01

34

Outcomes in Treatment for Intradural Spinal Cord Ependymomas  

SciTech Connect

Purpose: Spinal cord ependymomas are rare tumors, accounting for <2% of all primary central nervous system tumors. This study assessed the treatment outcomes for patients diagnosed with spinal cord ependymomas within the Southern California Kaiser Permanente system. Methods and Materials: We studied 23 patients treated with surgery with or without external beam radiotherapy (EBRT). The local and distant control rates and overall survival rates were determined. Results: The overall local control, overall recurrence, and 9-year overall survival rate was 96%, 17.4%, and 63.9%, respectively. Conclusions: The results of our study indicate that en bloc gross total resection should be the initial treatment, with radiotherapy reserved primarily for postoperative cases with unfavorable characteristics such as residual tumor, anaplastic histologic features, or piecemeal resection. Excellent local control and overall survival rates can be achieved using modern microsurgical techniques, with or without local radiotherapy.

Volpp, P. Brian [Department of Radiation Oncology, Kaiser Permanente, Los Angeles, CA (United States)], E-mail: pvolpp@yahoo.com; Han, Khanh [Huntington Memorial Medical Center, Pasadena, CA (United States); Kagan, A. Robert; Tome, Michael [Department of Radiation Oncology, Kaiser Permanente, Los Angeles, CA (United States)

2007-11-15

35

Increasing blood flow before exercise in spinal cord-injured individuals does not alter muscle fatigue.  

PubMed

Previous studies have shown increased fatigue in paralyzed muscle of spinal cord-injured (SCI) patients (Castro M, Apple D Jr, Hillegass E, and Dudley GA. Eur J Appl Physiol 80: 373-378, 1999; Gerrits H, Hopman MTE, Sargeant A, and de Haan A. Clin Physiol 21: 105-113, 2001). Our purpose was to determine whether the increased muscle fatigue could be due to a delayed rise in blood flow at the onset of exercise in SCI individuals. Isometric electrical stimulation was used to induce fatigue in the quadriceps femoris muscle of seven male, chronic (>1 yr postinjury), complete (American Spinal Injury Association, category A) SCI subjects. Cuff occlusion was used to elevate blood flow before electrical stimulation, and the magnitude of fatigue was compared with a control condition of electrical stimulation without prior cuff occlusion. Blood flow was measured in the femoral artery by Doppler ultrasound. Prior cuff occlusion increased blood flow in the first 30 s of stimulation compared with the No-Cuff condition (1,350 vs. 680 ml/min, respectively; P < 0.001), although blood flow at the end of stimulation was the same between conditions (1,260 +/- 140 vs. 1,160 +/- 370 ml/min, Cuff and No-Cuff condition, respectively; P = 0.511). Muscle fatigue was not significantly different between prior cuff occlusion and the control condition (32 +/- 13 vs. 35 +/- 10%; P = 0.670). In conclusion, increased muscle fatigue in SCI individuals is not associated with the prolonged time for blood flow to increase at the onset of exercise. PMID:14506095

Olive, Jennifer L; Slade, Jill M; Bickel, C Scott; Dudley, Gary A; McCully, Kevin K

2004-02-01

36

Testosterone Plus Finasteride Treatment After Spinal Cord Injury  

ClinicalTrials.gov

Spinal Cord Injury; Spinal Cord Injuries; Trauma, Nervous System; Wounds and Injuries; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Gonadal Disorders; Endocrine System Diseases; Hypogonadism; Genital Diseases, Male

2014-09-22

37

Transient neurologic syndrome after spinal anesthesia with epidural steroid treatment  

PubMed Central

Background: Transient neurologic syndrome (TNS) is a rare complication of spinal and epidural anesthesia. It is defined as paradoxic postoperative back pain radiating to the lower extremities with no neurologic deficits. Because it is a self-limited disease, the treatment is usually symptomatic and consists of NSAIDs and injections of a neuromuscular-blocking drug at the trigger points. The syndrome may be resistant to this treatment regimen and may last for several months, resulting in a long convalescence. Case summary: A 63-year-old Turkish woman (height, 165 cm; weight, 71 kg) underwent hemorrhoidectomy in the jackknife position using spinal anesthesia. No adverse events occurred during puncture or surgery or in the immediate postoperative recovery period. Recovery from the sensory and motor block was normal. Twenty-four hours after surgery, lower limb and plantar pain developed with no sensory or motor deficit. Neurologic examination revealed normal motor and sensory function. Electroneuromyography showed partial denervation potential of muscles innervated by the left sciatic nerve. The symptoms were suggestive of TNS. Combination oral NSAID treatment with amitriptyline (25 mg/d) and gabapentin (1200 mg/d) was initiated. Because the pain still persisted 6 weeks after surgery, epidural steroid injection with triamcinolone acetate (80 mg) with isotonic saline was administered, resulting in definite pain relief (visual analog scale score = 0). Conclusions: Epidural steroid treatment was effective in this patient with TNS resistant to treatment with NSAIDs, amitriptyline, and gabapentin. Future studies are needed to evaluate this treatment. PMID:24683240

Cöcelli, L. Pirbudak; Erkutlu, Ibrahim; Karakurum, Gunhan; Avci, Neslihan; Gül, Rauf; Öner, Ünsal

2009-01-01

38

Submaximal exercise responses in tetraplegic, paraplegic and non spinal cord injured elite wheelchair athletes.  

PubMed

It remains unclear whether similar exercise prescription, based on physiological markers, can be applied to subgroups of wheelchair athletes with different disabilities. Therefore, 25 wheelchair athletes, divided into three subgroups [eight tetraplegic (TETRA), nine paraplegic (PARA) and eight non spinal cord injured (NON-SCI)], performed an exercise test consisting of incremental submaximal stages, covering a range from 40% to 80% peak oxygen uptake (%VO(2peak) ). Oxygen uptake (VO(2)), heart rate (HR), blood lactate concentration (BLa) and rating of perceived exertion (RPE) were obtained for each stage. Expressed as a function of BLa, no differences were found between subgroups with respect to %VO(2peak) (group mean ± SD: 1.0 mmol/L: 53.9 ± 9.9%; 2.0 mmol/L: 70.7 ± 7.5%; 3.0 mmol/L: 78.5 ± 7.7%) and RPE [group mean (lower and upper quartile): 1.0 mmol/L: 10.8 (9.9, 12.2); 2.0 mmol/L: 13.6 (12.7, 14.3); 3.0 mmol/L: 14.9 (13.7, 16.5)]. Furthermore, no differences were found in the coefficient of determination (R(2) ) of the HR-VO(2) relationship in any of the subgroups (TETRA: 0.90 ± 0.12; PARA: 0.97 ± 0.02; NON-SCI: 0.96 ± 0.04). These results suggest that exercise prescription using measurements of VO(2), BLa or RPE can be based on the same recommendations in all the subgroups studied. This finding has added value for TETRA athletes, as it offers alternatives to HR monitoring. PMID:21599755

Leicht, C A; Bishop, N C; Goosey-Tolfrey, V L

2012-12-01

39

Functional changes in deep dorsal horn interneurons following spinal cord injury are enhanced with different durations of exercise training.  

PubMed

Following incomplete spinal cord injury (SCI), collaterals sprout from intact and injured axons in the vicinity of the lesion. These sprouts are thought to form new synaptic contacts that effectively bypass the lesion epicentre and contribute to improved functional recovery. Such anatomical changes are known to be enhanced by exercise training; however, the mechanisms underlying exercise-mediated plasticity are poorly understood. Specifically, we do not know how SCI alone or SCI combined with exercise alters the intrinsic and synaptic properties of interneurons in the vicinity of a SCI. Here we use a hemisection model of incomplete SCI in adult mice and whole-cell patch-clamp recording in a horizontal spinal cord slice preparation to examine the functional properties of deep dorsal horn (DDH) interneurons located in the vicinity of a SCI following 3 or 6 weeks of treadmill exercise training. We examined the functional properties of local and descending excitatory synaptic connections by recording spontaneous excitatory postsynaptic currents (sEPSCs) and responses to dorsal column stimulation, respectively. We find that SCI in untrained animals exerts powerful effects on intrinsic, and especially, synaptic properties of DDH interneurons. Plasticity in intrinsic properties was most prominent at 3 weeks post SCI, whereas synaptic plasticity was greatest at 6 weeks post injury. Exercise training did not markedly affect intrinsic membrane properties; however, local and descending excitatory synaptic drive were enhanced by 3 and 6 weeks of training. These results suggest exercise promotes synaptic plasticity in spinal cord interneurons that are ideally placed to form new intraspinal circuits after SCI. PMID:25344554

Rank, M M; Flynn, J R; Battistuzzo, C R; Galea, M P; Callister, R; Callister, R J

2014-10-24

40

Acute and Prolonged Hindlimb Exercise Elicits Different Gene Expression in Motoneurons than Sensory Neurons after Spinal Cord Injury  

PubMed Central

We examined gene expression in the lumbar spinal cord and the specific response of motoneurons, intermediate gray and proprioceptive sensory neurons after spinal cord injury and exercise of hindlimbs to identify potential molecular processes involved in activity dependent plasticity. Adult female rats received a low thoracic transection and passive cycling exercise for 1 or 4 weeks. Gene expression analysis focused on the neurotrophic factors; brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NT-3), neurotrophin-4 (NT-4), and their receptors because of their potential roles in neural plasticity. We also examined expression of genes involved in the cellular response to injury; heat shock proteins (HSP) -27 and -70, glial fibrillary acidic protein (GFAP) and caspases -3, -7, and -9. In lumbar cord samples, injury increased the expression of mRNA for TrkB, all three caspases and the HSPs. Acute and prolonged exercise increased expression of mRNA for the neurotrophic factors BDNF and GDNF, but not their receptors. It also increased HSP expression and decreased caspase-7 expression, with changes in protein levels complimentary to these changes in mRNA expression. Motoneurons and intermediate grey displayed little change in mRNA expression following injury, but acute and prolonged exercise increased levels of mRNA for BDNF, GDNF and NT-4. In large DRG neurons, mRNA for neurotrophic factors and their receptors were largely unaffected by either injury or exercise. However, caspase mRNA expression was increased by injury and decreased by exercise. Our results demonstrate that exercise affects expression of genes involved in plasticity and apoptosis in a cell specific manner and that these change with increased post-injury intervals and/or prolonged periods of exercise. PMID:22244304

Keeler, Benjamin E.; Liu, Gang; Siegfried, Rachel N.; Zhukareva, Victoria; Murray, Marion; Houlé, John D.

2011-01-01

41

Bacterial contamination of bath-water from spinal cord lesioned patients with pressure ulcers exercising in the water  

Microsoft Academic Search

Aim: To evaluate the bacterial contamination of the water from the microflora of pressure ulcers in para- and tetraplegic patients, when they were exercising in water at 36°C for half an hour.Material: Twelve spinal cord lesioned (SCL) patients with ulcers participated, and six of the 12 SCL patients with healed ulcers constituted a control group.Methods: The evaluation was performed both

F Biering-Sørensen; AK Schröder; M Wilhelmsen; B Lomberg; H Nielsen; N Høiby

2000-01-01

42

The transformation of spinal curvature into spinal deformity: pathological processes and implications for treatment  

Microsoft Academic Search

BACKGROUND: This review summarizes what is known about the pathological processes (e.g. structural and functional changes), by which spinal curvatures develop and evolve into spinal deformities. METHODS: Comprehensive review of articles (English language only) published on 'scoliosis,' whose content yielded data on the pathological changes associated with spinal curvatures. Medline, Science Citation Index and other searches yielded > 10,000 titles

Martha C Hawes; Joseph P O'Brien

2006-01-01

43

The role of exercise in cancer treatment: bridging the gap.  

PubMed

In recent years, there has been a burgeoning amount of evidence-based scientific data demonstrating the benefit of exercise during and following cancer treatment. This compelling evidence has resulted in major stakeholders in cancer management, including the American College of Sports Medicine, American Society of Clinical Oncology, National Comprehensive Cancer Network, American Cancer Society, Oncology Nursing Society, and the Commission on Cancer, advocating exercise as an integral component of cancer care. Despite the acknowledgment of exercise as an essential component, it remains virtually absent in routine cancer treatment. This article discusses the role of exercise in cancer treatment utilizing a community-based program. The rationale presented is that a scalable and replicable standard of care model is a plausible avenue to assimilate exercise into routine oncology practice. PMID:25014390

Kimmel, Gary T; Haas, Barbara K; Hermanns, Melinda

2014-01-01

44

Neuromuscular exercise as treatment of degenerative knee disease.  

PubMed

Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as traditionally used strength or aerobic training but aims to target more closely the sensorimotor deficiencies and functional instability associated with the degenerative knee disease than traditionally used training methods. PMID:25390299

Ageberg, Eva; Roos, Ewa M

2015-01-01

45

Exercise Training and Parkinson's Disease: Placebo or Essential Treatment?  

ERIC Educational Resources Information Center

Exercise training is often recommended for people with Parkinson's disease, though there is debate about the pathophysiologic cause of impaired movement in Parkinsonism which makes it difficult to develop a specific exercise treatment for symptoms that include hypokinesia, tremor, and muscular rigidity. Most published studies show a benefit of…

Reuter, Iris; Engelhardt, Martin

2002-01-01

46

The Effects of Aging and Electrical Stimulation Exercise on Bone after Spinal Cord Injury  

PubMed Central

Age related bone loss predisposes adults to osteoporosis. This is especially true for individuals with spinal cord injury (SCI). The effects of decreased bone loading with older age and paralysis significantly contribute to decreased bone mass and increased risk for fragility fractures. Loading bone via volitional muscle contractions or by using electrical stimulation are common methods for helping to prevent and/or decrease bone loss. However the effectiveness and safety of electrical stimulation activities remain unclear. The purpose of this review is to investigate the factors associated with aging and osteoporosis after SCI, the accuracy of bone measurement, the effects of various forms of bone loading activities with a focus on electrical stimulation activities and the safety of physical exercise with a focus on electrical stimulation cycling. Osteoporosis remains a disabling and costly condition for older adults and for those with paralysis. Both dual energy x-ray absorptiometry and peripheral quantitative computed tomography are valuable techniques for measuring bone mineral density (BMD) with the latter having the ability to differentiate trabecular and cortical bone. Physical activities have shown to be beneficial for increasing BMD however, the extent of the benefits related to aging and paralysis remain undetermined. Electrical stimulation activities administered appropriately are assumed safe due to thousands of documented safe FES cycling sessions. However, specific documentation is needed to verify safety and to development formal guidelines for optimal use. PMID:23730530

Dolbow, James D.; Dolbow, David R.; Gorgey, Ashraf S.; Adler, Robert A.; Gater, David R.

2013-01-01

47

Spinal manipulation as a valid treatment for low back pain.  

PubMed

The practice of chiropractic has been regulated in the State of Delaware since 1937. Since that time, the battle lines in the state between medicine and chiropractic have been drawn. This war has existed on both the political and clinical fronts, and although it has always been believed by the chiropractic profession that once the "scientific evidence" of the benefit of chiropractic was proven, the war would end. This has not occurred to the extent believed. Even with its 1980 victory over the AMA, chiropractic has still been unable to achieve full acceptance as a clinical discipline among other professions. Many hospitals in this country have opened their doors to DCs. This by and large, has solely been for economic reasons and not as a recognition of the clinical benefit of manipulation. There is, however, a growing population of primary care physicians and researchers suggesting the benefit of manipulation for low back pain as well as suggesting that increased cooperation between MDs and DCs could be of extreme benefit to the patient population at large. This group continues to be in the minority. However, with increased knowledge of the benefits of spinal manipulation and the scientific evidence that now exists to support its efficacy, it is now believed that this interprofessional referral pattern will increase. In addition, many managed care programs now require primary care physicians to determine the necessity for referral to a chiropractor, thus causing a need for the primary physician to have some knowledge of spinal manipulation. This paper is presented to inform the physician community of Delaware of some of the evidence pointing to the efficacy of spinal manipulation as a treatment for low back pain. PMID:8867392

Vernon, L F

1996-03-01

48

Spinal segmental stabilisation exercises for chronic low back pain: programme adherence and its influence on clinical outcome  

Microsoft Academic Search

Exercise rehabilitation is one of the few evidence-based treatments for chronic non-specific low back pain (cLBP), but individual\\u000a success is notoriously variable and may depend on the patient’s adherence to the prescribed exercise regime. This prospective\\u000a study examined factors associated with adherence and the relationship between adherence and outcome after a programme of physiotherapeutic\\u000a spine stabilisation exercises. A total of

Anne F. Mannion; Daniel Helbling; Natascha Pulkovski; Haiko Sprott

2009-01-01

49

Dosimetric comparison of metastatic spinal photon treatment techniques  

SciTech Connect

Traditional palliative treatment of metastatic cancer to the vertebral bodies often results in doses to the spinal cord that are higher than the dose prescribed to the target, or gross tumor volume (GTV). This study compares traditional techniques of spine palliation with intensity-modulated radiation therapy (IMRT). The purpose of the study is 2-fold: first, the study demonstrates the benefits of using IMRT to lower the dose to the organs at risk (OAR), particularly for the spinal cord and other nonspecified normal tissues; second, the article provides information regarding the advantages and disadvantages of commonly used conventional techniques for treating the vertebral bodies based on patient anatomy. Because the use of IMRT or other advanced techniques may be prohibitive because of insurance issues, treatment plans were created that compared optimal coverage vs. optimal sparing for single-field, wedged-pair, and opposed-beam arrangements. Fifty-five patients were selected and divided by location of target (cervical, thoracic, and lumbar spine) and also by the measured separation between the anterior and posterior surface of the patient at the level of mid-GTV. Within each anatomic category the patients again were divided into the categories of small, medium, and large based on separation. The patient dataset that most closely represented the average separation within each category was selected, resulting in a total of 9 patients, and the appropriate treatment plan techniques were calculated for each of the 9 patients. The results of the study do show that the use of IMRT is far superior when compared with other techniques, both for coverage and for sparing of the surrounding tissue, regardless of patient size and the section of spine being treated. Based on a combination of both target coverage and sparing of normal tissues, the conventional plan of choice may vary by both the section of spine to be treated and by the size of the patient.

Ewing, Marvene M., E-mail: mewing@iuhealth.org [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Carnes, Samuel M.; Henderson, Mark A.; Das, Indra J. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

2012-01-01

50

Spinal Cord Lesions in Congenital Toxoplasmosis Demonstrated with Neuroimaging, Including Their Successful Treatment in an Adult  

PubMed Central

Neuroimaging studies for persons in the National Collaborative Chicago-Based Congenital Toxoplasmosis Study (NCCCTS) with symptoms and signs referable to the spinal cord were reviewed. Three infants had symptomatic spinal cord lesions, another infant a Chiari malformation, and another infant a symptomatic peri-spinal cord lipoma. One patient had an unusual history of prolonged spinal cord symptoms presenting in middle age. Neuroimaging was used to establish her diagnosis and response to treatment. This 43 year-old woman with congenital toxoplasmosis developed progressive leg spasticity, weakness, numbness, difficulty walking, and decreased visual acuity and color vision without documented re-activation of her chorioretinal disease. At 52 years of age, spinal cord lesions in locations correlating with her symptoms and optic atrophy were diagnosed with 3 Tesla MRI scan. Treatment with pyrimethamine and sulfadiazine decreased her neurologic symptoms, improved her neurologic examination, and resolved her enhancing spinal cord lesions seen on MRI. PMID:23487348

Burrowes, Delilah; Boyer, Kenneth; Swisher, Charles N.; Noble, A. Gwendolyn; Sautter, Mari; Heydemann, Peter; Rabiah, Peter; Lee, Daniel; McLeod, Rima

2012-01-01

51

Cycling Exercise Affects the Expression of Apoptosis-Associated microRNAs after Spinal Cord Injury in Rats  

PubMed Central

There are two major aspects to a spinal cord injury (SCI): an acute, primary mechanical trauma and a progressive phase of secondary tissue damage provoked by inflammation, excitotoxicity, apoptosis and demyelination. MicroRNAs (miRs) are small, ~22 nucleotide, non-protein-coding RNAs that function at the post-transcriptional level to regulate gene expression. They have important roles in homeostatic processes such as cell proliferation and programmed cell death. In the injured rat spinal cord we performed an expression analysis of miRs and their downstream targets involved in apoptotic pathways and used post-injury cycling exercise to test for activity dependent plasticity of miR expression. We show that SCI results in increased expression of miR Let-7a and miR16 while exercise leads to elevated levels of miR21 and decreased levels of miR15b. These changes in miR expression are correlated with changes in expression of their target genes: pro-apoptotic (decreased PTEN, PDCD4 and RAS mRNA) and anti-apoptotic (increased Bcl-2 mRNA) target genes. This is accompanied by a down regulation of mRNA for caspase-7 and caspase-9 and reduced levels of caspase-7 protein. These results indicates possible beneficial effects of exercise through action on multiple miRs and their targets that contribute to the functional regulation of apoptosis after SCI. PMID:20816819

Liu, Gang; Keeler, Benjamin E.; Zhukareva, Victoria; Houlé, John D.

2010-01-01

52

Effects of a Home Exercise Program on the Self-report Disability Index and Gait Parameters in Patients with Lumbar Spinal Stenosis  

PubMed Central

[Purpose] The present study was performed to identify the effect of a home exercise program on the self-reported disability index and gait parameters in patients with lumbar spinal stenosis (LSS). [Methods] Fifteen patients with LSS were enrolled in this study and were trained in a 4-week home exercise program (40?min/day). All patients were evaluated with three self-reported disability indices (Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Spinal Stenosis Scale), and gait parameters were assessed using a GAITRite system before and after the home exercise program. [Results] Patients with LSS showed significant decreases in the self-reported questionnaire scores and pain intensity after the home exercise program. However, the gait parameters did not significantly change. [Conclusion] These findings suggest that home exercise programs can improve self-reported questionnaire scores and decrease pain in patients with LSS. PMID:24648654

Kim, Eui-Ryong; Kang, Min-Hyeok; Kim, Yang-Gon; Oh, Jae-Seop

2014-01-01

53

Silk peptide treatment can improve the exercise performance of mice  

PubMed Central

Background We previously reported that silk peptide (SP) treatment led to increased resting fat oxidation in exercised mice. However, it was not known whether SP treatment could effectively increase exercise capacity. Accordingly, this study aimed to examine whether SP treatment affected energy metabolism during exercise in addition to exercise performance. Methods We randomized 36 7-week-old male ICR mice into 2 groups: the control (n?=?18) and SP (n?=?18) groups. All mice were trained by treadmill running 5 times per week for 2 weeks. SP was dissolved in distilled water and daily 800-mg/kg body weight doses before the running exercise were oral administered intraperitoneally to the SP group for 2 weeks. V?O2max was measured before and after the 2 weeks training period. We also assessed energy metabolism during exercise for 1 h after the 2 week training period. In addition to blood samples, liver glycogen and gastrocnemius-white and gastrocnemius-red muscle was obtained at the following 3 time points: at rest, immediately after exercise, and 1-hour post exercise. Results The V?O2 max after 2 weeks of training was significantly increased (8%) in the SP group compared to the baseline; a similar result was not observed in the CON group. The sum of fat oxidation during a 1-h period tended to be 13% higher in the SP group than in the CON group (P?exercise but was significantly higher in the SP group than in the CON group during the recovery period (1 h post-exercise completion). Conclusions These results suggest that SP treatment can improve the exercise performance. Therefore, SP is considered to confer beneficial effects upon athletes, in whom exercise abilities are required. PMID:25050085

2014-01-01

54

The transformation of spinal curvature into spinal deformity: pathological processes and implications for treatment  

PubMed Central

Background This review summarizes what is known about the pathological processes (e.g. structural and functional changes), by which spinal curvatures develop and evolve into spinal deformities. Methods Comprehensive review of articles (English language only) published on 'scoliosis,' whose content yielded data on the pathological changes associated with spinal curvatures. Medline, Science Citation Index and other searches yielded > 10,000 titles each of which was surveyed for content related to 'pathology' and related terms such as 'etiology,' 'inheritance,' 'pathomechanism,' 'signs and symptoms.' Additional resources included all books published on 'scoliosis' and available through the Arizona Health Sciences Library, Interlibrary Loan, or through direct contact with the authors or publishers. Results A lateral curvature of the spine–'scoliosis'–can develop in association with postural imbalance due to genetic defects and injury as well as pain and scarring from trauma or surgery. Irrespective of the factor that triggers its appearance, a sustained postural imbalance can result, over time, in establishment of a state of continuous asymmetric loading relative to the spinal axis. Recent studies support the longstanding hypothesis that spinal deformity results directly from such postural imbalance, irrespective of the primary trigger, because the dynamics of growth within vertebrae are altered by continuous asymmetric mechanical loading. These data suggest that, as long as growth potential remains, evolution of a spinal curvature into a spinal deformity can be prevented by reversing the state of continuous asymmetric loading. Conclusion Spinal curvatures can routinely be diagnosed in early stages, before pathological deformity of the vertebral elements is induced in response to asymmetric loading. Current clinical approaches involve 'watching and waiting' while mild reversible spinal curvatures develop into spinal deformities with potential to cause symptoms throughout life. Research to define patient-specific mechanics of spinal loading may allow quantification of a critical threshold at which curvature establishment and progression become inevitable, and thereby yield strategies to prevent development of spinal deformity. Even within the normal spine there is considerable flexibility with the possibility of producing many types of curves that can be altered during the course of normal movements. To create these curves during normal movement simply requires an imbalance of forces along the spine and, extending this concept a little further, a scoliotic curve is produced simply by a small but sustained imbalance of forces along the spine. In fact I would argue that no matter what you believe to be the cause of AIS, ultimately the problem can be reduced to the production of an imbalance of forces along the spine [1]. PMID:16759413

Hawes, Martha C; O'Brien, Joseph P

2006-01-01

55

Exercise in the Treatment of PCOS  

Microsoft Academic Search

The prevalence of insulin resistance, overweight and obesity are increasing at alarming rates world wide but are problems\\u000a which are extremely prevalent in women with PCOS. A decline in energy expenditure through reduced daily activity and physical\\u000a exercise (accompanied by an increase in energy intake) is a major contributor to increases in obesity and insulin resistance.\\u000a Lifestyle interventions that alter

Emma Stevenson

56

Diet, exercise, and complementary therapies after primary treatment for cancer  

Microsoft Academic Search

Every year, more than 10 million people are diagnosed with cancer worldwide. In view of the substantial improvements in early detection and treatment, even more patients can expect to be alive 5 years after diagnosis. With improvements in longevity, the late-occurring adverse eff ects of cancer and its treatment are becoming increasingly apparent. Healthy lifestyle behaviours that encompass regular exercise,

Lee W Jones; Wendy Demark-Wahnefried

2006-01-01

57

Exercise decreases myelin-associated glycoprotein expression in the spinal cord and positively modulates neuronal growth  

Microsoft Academic Search

To successfully grow, neurons need to overcome the effects of hostile environments, such as the inhibitory action of myelin. We have evaluated the potential of exercise to over- come the intrinsic limitation of the central nervous system for axonal growth. In line with the demonstrated ability of exercise to increase the regenerative potential of neurons, here we show that exercise

Cristina A. Ghiani; Zhe Ying; Jean de Vellis; Fernando Gomez-Pinilla

2007-01-01

58

Treatment of infertility in men with spinal cord injury.  

PubMed

Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses, and vacuum constriction devices. In anejaculatory patients who wish to father children, semen retrieval is necessary. Penile vibratory stimulation is recommended as the first line of treatment. Patients who fail penile vibratory stimulation can be referred for electroejaculation. If this approach is not possible, prostate massage is an alternative. Surgical sperm retrieval should be considered as a last resort when other methods fail. Most men with SCI have a unique semen profile characterized by normal sperm count but abnormally low sperm motility. Scientific investigations indicate that accessory gland dysfunction and abnormal semen constituents contribute to the problem. Despite abnormalities, sperm from men with SCI can successfully induce pregnancy. In selected couples, the simple method of intravaginal insemination is a viable option. Another option is intrauterine insemination. The efficacy of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male factor infertility. PMID:20157304

Brackett, Nancy L; Lynne, Charles M; Ibrahim, Emad; Ohl, Dana A; Sønksen, Jens

2010-03-01

59

Treatment and Prevention of Osteoarthritis through Exercise and Sports  

PubMed Central

Osteoarthritis (OA) is a degenerative joint disease with a high prevalence among older people. To date, the pathogenesis of the disease and the link between muscle function and OA is not entirely understood. As there is no known cure for OA, current research focuses on prevention and symptomatic treatment of the disorder. Recent research has indicated that muscle weakness precedes the onset of OA symptoms. Furthermore, several studies show a beneficial effect of land-based aerobic and strengthening exercises on pain relief and joint function. Therefore, current research focuses on the possibility to employ exercise and sports in the prevention and treatment of OA. PMID:21188091

Valderrabano, Victor; Steiger, Christina

2011-01-01

60

Conservative treatment for neck pain: medications, physical therapy, and exercise.  

PubMed

This article offers conservative treatment strategies for patients suffering from musculoskeletal causes of neck pain. Basic pharmacology is reviewed, including that of opioids, nonsteroidal anti-inflammatory drugs, adjuvants, and topical analgesics. Moreover, indications for therapeutic exercise, manual therapy, and modalities are reviewed, along with any supporting literature. Treatment considerations with each category of medication and physical therapy are discussed. This article is meant to serve as a resource for physicians to tailor conservative treatment options to their individual patients. PMID:21824590

Pangarkar, Sanjog; Lee, Paul C

2011-08-01

61

Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being  

Microsoft Academic Search

Study design: Randomized controlled trial of exercise training in persons with spinal cord injury.Objective: The purpose of this study was to examine the effects of 9 months of twice-weekly exercise training on strength, arm ergometry performance, and indices of psychological well-being and quality of life.Setting: Centre for Health Promotion and Rehabilitation, McMaster University, Hamilton, Ontario, Canada.Methods: Thirty-four men and women

A L Hicks; K A Martin; D S Ditor; A E Latimer; C Craven; J Bugaresti; N McCartney

2003-01-01

62

Comparisons of Exercise Dose and Symptom Severity Between Exercisers and Nonexercisers in Women During and After Cancer Treatment  

PubMed Central

Context Although numerous studies of the efficacy of exercise are reported, few studies have evaluated changes in characteristics of exercise dose in women with cancer both during and after cancer treatment. Objectives To describe the characteristics of exercise dose (i.e., frequency, duration, and intensity), and to evaluate for differences in symptom severity (i.e., fatigue, sleep disturbance, depression, pain) between women who did and did not exercise during and after cancer treatment. Methods In a sample of 119 women, two groups were classified: exercisers and nonexercisers. Exercisers were defined as women who met specific criteria for frequency (three times per week), duration (20 minutes per session), intensity (moderate), and mode (aerobic). Nonexercisers were defined as women who did not meet all of these criteria. Evaluation of exercise dose was completed at baseline (T1: the week before chemotherapy cycle two), at the end of cancer treatment (T2), and at the end of the study (T3: approximately one year after the T1 assessment) using self-report exercise questionnaires. Results Approximately 50% of the participants exercised during and 70% exercised after treatment. At T1, exercisers had lower total fatigue, lower behavioral and sensory subscale fatigue scores, and lower depression scores (P =0.038) than nonexercisers. No significant differences in sleep disturbance or pain were found between groups. At T2, exercisers had lower cognitive/mood subscale fatigue and depression scores than nonexercisers (P =0.047). At T3, no significant differences were found between groups in any symptom severity scores. Conclusion Both during and after cancer treatment, achieving or maintaining exercise guideline levels were met by most patients. Further study is needed to examine the link between exercise dose and symptom severity. PMID:22436836

Cho, Maria H.; Dodd, Marylin J.; Cooper, Bruce A.; Miaskowski, Christine

2012-01-01

63

Predictive Ability of Pender's Health Promotion Model for Physical Activity and Exercise in People with Spinal Cord Injuries: A Hierarchical Regression Analysis  

ERIC Educational Resources Information Center

The main objective of this study was to validate Pender's Health Promotion Model (HPM) as a motivational model for exercise/physical activity self-management for people with spinal cord injuries (SCIs). Quantitative descriptive research design using hierarchical regression analysis (HRA) was used. A total of 126 individuals with SCI were recruited…

Keegan, John P.; Chan, Fong; Ditchman, Nicole; Chiu, Chung-Yi

2012-01-01

64

Supervised exercise training combined with ginkgo biloba treatment for patients with peripheral arterial disease  

Microsoft Academic Search

Objectives: To evaluate whether a combination of supervised exercise training and ginkgo biloba treatment is a better treatment than exercise training alone for patients with peripheral arterial disease.Design: A 24-week double-blind, placebo-controlled ginkgo biloba trial with the first 12-week period as a non-exercise control stage and the second 12-week period as an exercise training stage.Setting: Exercise physiology laboratory.Subjects: Twenty-two subjects

Jianxiong Wang; Shi Zhou; Roger Bronks; John Graham; Stephen P Myers

2007-01-01

65

Treatment of Acute Tuberculous Spondylitis by the Spinal Shortening Osteotomy: A Technical Notes and Case Illustrations  

PubMed Central

Surgical treatment for spinal tuberculosis is necessary in particular cases that a large amount of necrotic tissue is encountered and there is spinal cord compression. A spinal shortening osteotomy procedure has previously been described for the correction of the sagittal balance in a late kyphotic deformity, but there have been no reports on this as a surgical treatment in the acute stage. Thus, the aim of this report is to present the surgical techniques and clinical results of 3 patients who were treated with this procedure. Three patients with tuberculous spondylitis at the thoracic spine were surgically treated with this procedure. All the patients presented with severe progressive back pain, kyphotic deformity and neurological deficit. The patients recovered uneventfully from surgery without further neurological deterioration. Their pain was improved and the patients remained free of pain during the follow-up period. In conclusion, posterior spinal shortening osteotomy is an alternative method for the management of tuberculous spondylitis. PMID:22164318

Chanplakorn, Pongsthorn; Chanplakorn, Niramol; Kraiwattanapong, Chaiwat; Laohacharoensombat, Wichien

2011-01-01

66

Epidural steroid injections in the treatment of symptomatic lumbar spinal stenosis associated with epidural lipomatosis.  

PubMed

Epidural lipomatosis has been implicated as a cause or contributor of symptomatic lumbar spinal stenosis. Although epidural steroid injections have been very successful for symptomatic treatment of spinal stenosis; their role in treatment of symptomatic stenosis secondary to epidural lipomatosis is unclear. A review literature (MEDLINE, PubMed) found no reports justifying the use of steroids. We present two patients with lumbar epidural lipomatosis causing or contributing to symptomatic spinal stenosis. Both patients presented with unilateral lower limb radicular symptoms unrelieved with conservative measures such as medications and physical therapy. They were treated with a single transforaminal epidural steroid injection at the symptomatic level. Both had 80-85% pain relief. These reports suggest a beneficial role of epidural steroid injections for patients with symptomatic lumbar spinal stenosis caused by or contributing to epidural lipomatosis. PMID:15624572

Botwin, Kenneth P; Sakalkale, Durgadas P

2004-12-01

67

Incidence of Nocturnal Leg Cramps in Patients with Lumbar Spinal Stenosis before and after Conservative and Surgical Treatment  

PubMed Central

Purpose To examine the effects of conservative and surgical treatments for nocturnal leg cramps in patients with lumbar spinal stenosis (LSS). Nocturnal leg cramps is frequently observed in patients with peripheral neuropathy. However, there have been few reports on the relationship between nocturnal leg cramps and LSS, and it remains unknown whether conservative or surgical intervention has an impact on leg cramps in patients with LSS. Materials and Methods The subjects were 130 LSS patients with low back and leg pain. Conservative treatment such as exercise, medication, and epidural block was used in 66 patients and surgical treatment such as decompression or decompression and fusion was performed in 64 patients. Pain scores and frequency of nocturnal leg cramps were evaluated based on self-reported questionnaires completed before and 3 months after treatment. Results The severity of low back and leg pain was higher and the incidence of nocturnal leg cramps was significantly higher before treatment in the surgically treated group compared with the conservatively treated group. Pain scores improved in both groups after the intervention. The incidence of nocturnal leg cramps was significantly improved by surgical treatment (p=0.027), but not by conservative treatment (p=0.122). Conclusion The findings of this prospective study indicate that the prevalence of nocturnal leg cramps is associated with LSS and severity of symptoms. Pain symptoms were improved by conservative or surgical treatment, but only surgery improved nocturnal leg cramps in patients with LSS. Thus, these results indicate that the prevalence of nocturnal leg cramps is associated with spinal nerve compression by LSS. PMID:24719148

Yamashita, Masaomi; Murata, Yasuaki; Eguchi, Yawara; Aoki, Yasuchika; Ataka, Hiromi; Hirayama, Jiro; Ozawa, Tomoyuki; Morinaga, Tatsuo; Arai, Hajime; Mimura, Masaya; Kamoda, Hiroto; Orita, Sumihisa; Miyagi, Masayuki; Miyashita, Tomohiro; Okamoto, Yuzuru; Ishikawa, Tetsuhiro; Sameda, Hiroaki; Kinoshita, Tomoaki; Hanaoka, Eiji; Suzuki, Miyako; Suzuki, Munetaka; Aihara, Takato; Ito, Toshinori; Inoue, Gen; Yamagata, Masatsune; Toyone, Tomoaki; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Yamauchi, Kazuyo; Takahashi, Kazuhisa

2014-01-01

68

Interleukin-33 treatment reduces secondary injury and improves functional recovery after contusion spinal cord injury.  

PubMed

Interleukin-33 (IL-33) is a member of the interleukin-1 cytokine family and highly expressed in the naïve mouse brain and spinal cord. Despite the fact that IL-33 is known to be inducible by various inflammatory stimuli, its cellular localization in the central nervous system and role in pathological conditions is controversial. Administration of recombinant IL-33 has been shown to attenuate experimental autoimmune encephalomyelitis progression in one study, yet contradictory reports also exist. Here we investigated for the first time the pattern of IL-33 expression in the contused mouse spinal cord and demonstrated that after spinal cord injury (SCI) IL-33 was up-regulated and exhibited a nuclear localization predominantly in astrocytes. Importantly, we found that treatment with recombinant IL-33 alleviated secondary damage by significantly decreasing tissue loss, demyelination and astrogliosis in the contused mouse spinal cord, resulting in dramatically improved functional recovery. We identified both central and peripheral mechanisms of IL-33 action. In spinal cord, IL-33 treatment reduced the expression of pro-inflammatory tumor necrosis factor-alpha and promoted the activation of anti-inflammatory arginase-1 positive M2 microglia/macrophages, which chronically persisted in the injured spinal cord for up to at least 42 days after the treatment. In addition, IL-33 treatment showed a tendency towards reduced T-cell infiltration into the spinal cord. In the periphery, IL-33 treatment induced a shift towards the Th2 type cytokine profile and reduced the percentage and absolute number of cytotoxic, tumor necrosis factor-alpha expressing CD4+ cells in the spleen. Additionally, IL-33 treatment increased expression of T-regulatory cell marker FoxP3 and reduced expression of M1 marker iNOS in the spleen. Taken together, these results provide the first evidence that IL-33 administration is beneficial after CNS trauma. Treatment with IL33 may offer a novel therapeutic strategy for patients with acute contusion SCI. PMID:25153903

Pomeshchik, Yuriy; Kidin, Iurii; Korhonen, Paula; Savchenko, Ekaterina; Jaronen, Merja; Lehtonen, Sarka; Wojciechowski, Sara; Kanninen, Katja; Koistinaho, Jari; Malm, Tarja

2015-02-01

69

Treatment of detrusor-sphincter dyssynergia by pudendal nerve block in patients with spinal cord injury  

Microsoft Academic Search

Tsai S-J, Lew HL, Date E, Bih L-I. Treatment of detrusor-sphincter dyssynergia by pudendal nerve block in patients with spinal cord injury. Arch Phys Med Rehabil 2002;83:714-7. Objective: To study the effects of pudendal nerve block with phenol on detrusor-sphincter dyssynergia in patients with spinal cord injury (SCI). Design: Before-after trial performed by using a consecutive sample. Setting: Rehabilitation hospital

Su-Ju Tsai; Henry L. Lew; Elaine Date; Liu-Ing Bih

2002-01-01

70

Combinational Spinal GAD65 Gene Delivery and Systemic GABA-Mimetic Treatment for Modulation of Spasticity  

PubMed Central

Background Loss of GABA-mediated pre-synaptic inhibition after spinal injury plays a key role in the progressive increase in spinal reflexes and the appearance of spasticity. Clinical studies show that the use of baclofen (GABAB receptor agonist), while effective in modulating spasticity is associated with major side effects such as general sedation and progressive tolerance development. The goal of the present study was to assess if a combined therapy composed of spinal segment-specific upregulation of GAD65 (glutamate decarboxylase) gene once combined with systemic treatment with tiagabine (GABA uptake inhibitor) will lead to an antispasticity effect and whether such an effect will only be present in GAD65 gene over-expressing spinal segments. Methods/Principal Findings Adult Sprague-Dawley (SD) rats were exposed to transient spinal ischemia (10 min) to induce muscle spasticity. Animals then received lumbar injection of HIV1-CMV-GAD65 lentivirus (LVs) targeting ventral ?-motoneuronal pools. At 2–3 weeks after lentivirus delivery animals were treated systemically with tiagabine (4, 10, 20 or 40 mg/kg or vehicle) and the degree of spasticity response measured. In a separate experiment the expression of GAD65 gene after spinal parenchymal delivery of GAD65-lentivirus in naive minipigs was studied. Spastic SD rats receiving spinal injections of the GAD65 gene and treated with systemic tiagabine showed potent and tiagabine-dose-dependent alleviation of spasticity. Neither treatment alone (i.e., GAD65-LVs injection only or tiagabine treatment only) had any significant antispasticity effect nor had any detectable side effect. Measured antispasticity effect correlated with increase in spinal parenchymal GABA synthesis and was restricted to spinal segments overexpressing GAD65 gene. Conclusions/Significance These data show that treatment with orally bioavailable GABA-mimetic drugs if combined with spinal-segment-specific GAD65 gene overexpression can represent a novel and highly effective anti-spasticity treatment which is associated with minimal side effects and is restricted to GAD65-gene over-expressing spinal segments. PMID:22291989

Kakinohana, Osamu; Hefferan, Michael P.; Miyanohara, Atsushi; Nejime, Tetsuya; Marsala, Silvia; Juhas, Stefan; Juhasova, Jana; Motlik, Jan; Kucharova, Karolina; Strnadel, Jan; Platoshyn, Oleksandr; Lazar, Peter; Galik, Jan; Vinay, Laurent; Marsala, Martin

2012-01-01

71

Endovascular treatment of a spinal dural arteriovenous malformation (DAVF).  

PubMed

We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine. The video can be found here: http://youtu.be/SDYNIGNQIW8 . PMID:24983729

Agarwal, Vijay; Zomorodi, Ali; Jabbour, Pascal; Chalouhi, Nohra; Tjoumakaris, Stavropoula; Babu, Ranjith; Back, Adam; Gonzalez, L Fernando

2014-07-01

72

Primary Spinal Germ Cell Tumors: A Case Analysis and Review of Treatment Paradigms  

PubMed Central

Objective. Primary intramedullary spinal germ cell tumors are exceedingly rare. As such, there are no established treatment paradigms. We describe our management for spinal germ cell tumors and a review of the literature. Clinical Presentation. We describe the case of a 45-year-old man with progressive lower extremity weakness and sensory deficits. He was found to have enhancing intramedullary mass lesions in the thoracic spinal cord, and pathology was consistent with an intramedullary germ cell tumor. A video presentation of the case and surgical approach is provided. Conclusion. As spinal cord germinomas are highly sensitive to radiation and chemotherapy, a patient can be spared radical surgery. Diverse treatment approaches exist across institutions. We advocate biopsy followed by local radiation, with or without adjuvant chemotherapy, as the optimal treatment for these tumors. Histological findings have prognostic value if syncytiotrophoblastic giant cells (STGCs) are found, which are associated with a higher rate of recurrence. The recurrence rate in STGC-positive spinal germinomas is 33% (2/6), whereas it is only 8% in STGC-negative tumors (2/24). We advocate limited volume radiotherapy combined with systemic chemotherapy in patients with high risk of recurrence. To reduce endocrine and neurocognitive side effects, cranio-spinal radiation should be used as a last resort in patients with recurrence. PMID:24312128

Loya, Joshua J.; Jung, Henry; Temmins, Caroline; Cho, Nam; Singh, Harminder

2013-01-01

73

A combination therapy of neural and glial restricted precursor cells and chronic quipazine treatment paired with passive cycling promotes quipazine-induced stepping in adult spinalized rats.  

PubMed

Introduction In order to develop optimal treatments to promote recovery from complete spinal cord injury (SCI), we examined the combination of: (1) a cellular graft of neural and glial restricted precursor (NRP/GRP) cells, (2) passive exercise, and (3) chronic quipazine treatment on behavioral outcomes and compared them with the individual treatment elements. NRP/GRP cells were transplanted at the time of spinalization. [Table: see text] Methods Daily passive exercise began 1 week after injury to give sufficient time for the animals to recover. Chronic quipazine administration began 2 weeks after spinalization to allow for sufficient receptor upregulation permitting the expression of its behavioral effects. Behavioral measures consisted of the BBB locomotor score and percent of weight-supported steps and hops on a treadmill. Results Rats displayed an increased response to quipazine (BBB?9) beginning at 8 weeks post-injury in all the animals that received the combination therapy. This increase in BBB score was persistent through the end of the study (12 weeks post-injury). Conclusion Unlike the individual treatment groups which never achieved weight support, the combination therapy animals were able to perform uncoordinated weight-supported stepping without a body weight support system while on a moving treadmill (6.5?m per minute) and were capable of supporting their own weight in stance during open field locomotion testing. No regeneration of descending serotonergic projections into and through the lesion cavity was observed. Furthermore, these results are a testament to the capacity of the lumbar spinal cord, when properly stimulated, to sustain functioning locomotor circuitry following complete SCI. PMID:25329574

Dugan, Elizabeth A; Shumsky, Jed S

2014-10-20

74

Spinal deformity in neurofibromatosis type-1: diagnosis and treatment  

Microsoft Academic Search

Spinal deformity is the commonest orthopaedic manifestation in neurofibromatosis type-1 and is categorized into dystrophic and non-dystrophic types. Management should be based on a meticulous assessment of the spine with plain radiography and magnetic resonance imaging (MRI) to rule out the presence of dysplastic features that will determine prognosis and surgical planning. MRI of the whole spine should also be

Athanasios I. Tsirikos; Asif Saifuddin; M Hilali Noordeen

2005-01-01

75

Facilitation of pain in the human spinal cord by nocebo treatment.  

PubMed

Nocebo hyperalgesia is an increase in subjective pain perception after a patient or subject underwent an inert treatment without any active ingredient. For example, verbal suggestion of increased pain can enhance both pain experience and responses in pain-related cortical brain areas. However, changes in cortical pain responses may be secondary to earlier amplification of incoming pain signals within the spinal cord. To test for a potential early enhancement of pain signals in the dorsal horn of the spinal cord, we combined a nocebo heat pain paradigm with spinal functional magnetic resonance imaging in healthy volunteers. We found that local application of an inert nocebo cream on the forearm increased pain ratings compared with a control cream, and also reduced pain thresholds on the nocebo-treated skin patch. On the neurobiological level, pain stimulation induced a strong activation in the spinal cord at the level of the stimulated dermatomes C5/C6. Comparing pain stimulation under nocebo to a control pain stimulation of the same physical intensity revealed enhanced pain-related activity in the ipsilateral dorsal horn of the spinal cord. Importantly, the activation of the main effect of pain and the nocebo effect spatially overlapped. The current study thus provides direct evidence for a pain-facilitating mechanism in the human spinal cord before cortical processing, which can be activated by cognitive manipulations such as nocebo treatments. PMID:23966699

Geuter, Stephan; Büchel, Christian

2013-08-21

76

Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands.  

PubMed

Objective To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge. Design Prospective cohort study. Subjects Persons with spinal cord injury, aged 18-65 years, and wheelchair dependent at least for long distances. Method Measurements at the start of active rehabilitation, after 3 months, at discharge from inpatient rehabilitation, and 1 and 5 years after discharge. A peak wheelchair exercise test was performed to record peak oxygen uptake (VO2peak) and peak power output (POpeak). Life satisfaction was measured as current life satisfaction and change of life satisfaction in comparison with life after spinal cord injury. Relationships between (changes in) exercise capacity and (changes in) life satisfaction were analyzed random coefficient analysis, corrected for possible confounders (age, gender, level of lesion, functional status, secondary impairments, pain, and sports activity) if necessary. Results Of 225 persons included, 130 attended two or more peak exercise tests, who were include in the analyses. Mean age at start was 39 years, 75% were male, 73% had paraplegia, and 76% had a traumatic lesion. Mean POpeak increased during the study from 32.9 to 55.9 Watts, mean VO2peak from 1.02  to 1.38 l/minute, and mean life satisfaction from 5.7 to 7.8. An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction (P = 0.01). An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction (P = 0.049). Conclusion High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients. PMID:24621019

van Koppenhagen, Casper Floris; Post, Marcel; de Groot, Sonja; van Leeuwen, Christel; van Asbeck, Floris; Stolwijk-Swüste, Janneke; van der Woude, Lucas; Lindeman, Eline

2014-05-01

77

Spinal segmental stabilisation exercises for chronic low back pain: programme adherence and its influence on clinical outcome.  

PubMed

Exercise rehabilitation is one of the few evidence-based treatments for chronic non-specific low back pain (cLBP), but individual success is notoriously variable and may depend on the patient's adherence to the prescribed exercise regime. This prospective study examined factors associated with adherence and the relationship between adherence and outcome after a programme of physiotherapeutic spine stabilisation exercises. A total of 32/37 patients with cLBP completed the study (mean age, 44.0 (SD = 12.3) years; 11/32 (34%) male). Adherence to the 9-week programme was documented as: percent attendance at therapy, percent adherence to daily home exercises (patient diary) and percent commitment to rehabilitation (Sports Injury Rehabilitation Adherence Scale (SIRAS)). The average of these three measures formed a multidimensional adherence index (MAI). Psychological disturbance, fear-avoidance beliefs, catastrophising, exercise self-efficacy and health locus of control were measured by questionnaire; disability in everyday activities was scored with the Roland-Morris disability scale and back pain intensity with a 0-10 graphic rating scale. Overall, adherence to therapy was very good (average MAI score, 85%; median (IQR), 89 (15)%). The only psychological/beliefs variable showing a unique significant association with MAI was exercise self-efficacy (Rho = 0.36, P = 0.045). Pain intensity and self-rated disability decreased significantly after therapy (each P < 0.01). Adherence to home exercises showed a moderate, positive correlation with the reduction in average pain (Rho = 0.54, P = 0.003) and disability (Rho = 0.38, P = 0.036); higher MAI scores were associated with greater reductions in average pain (Rho = 0.48, P = 0.008) and a (n.s.) tendency for greater reductions in disability (Rho = 0.32, P = 0.07) Neither attendance at therapy nor SIRAS were significantly related to any of the outcomes. The benefits of rehabilitation depended to a large extent on the patient's exercise behaviour outside of the formal physiotherapy sessions. Hence, more effort should be invested in finding ways to improve patients' motivation to take responsibility for the success of their own therapy, perhaps by increasing exercise self-efficacy. Whether the "adherence-outcome" interaction was mediated by improvements in function related to the specific exercises, or by a more "global" effect of the programme, remains to be examined. PMID:19609785

Mannion, Anne F; Helbling, Daniel; Pulkovski, Natascha; Sprott, Haiko

2009-12-01

78

Rationale for Using Exercise in the Treatment of Stimulant Use Disorders  

PubMed Central

Novel approaches to the treatment of stimulant abuse and dependence are needed. Clinical data examining the use of exercise as a treatment for the abuse of nicotine, alcohol, and other substances suggest that exercise may be a beneficial treatment for stimulant abuse. In addition, exercise has been associated with improvements in many other health-related areas that may be adversely affected by stimulant use or its treatment, such as sleep disturbance, cognitive function, mood, weight, quality of life, and anhedonia. Neurobiological evidence provides plausible mechanisms by which exercise could positively affect treatment outcomes in stimulant abuse. The National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) CTN-0037 Stimulant Reduction Intervention using Dosed Exercise (STRIDE) study is a multisite randomized clinical trial that compares exercise to health education as potential treatments for stimulant abuse or dependence. If effective, exercise may provide an additional approach to the treatment of stimulant use disorders. PMID:25364477

Greer, Tracy L.; Ring, Kolette M.; Warden, Diane; Grannemann, Bruce D.; Church, Timothy S.; Somoza, Eugene; Blair, Steven N.; Szapocznik, Jose; Stoutenberg, Mark; Rethorst, Chad; Walker, Robrina; Morris, David W.; Kosinski, Andrzej S.; Kyle, Tiffany; Marcus, Bess; Crowell, Becca; Oden, Neal; Nunes, Edward; Trivedi, Madhukar H.

2013-01-01

79

Development of a documentation instrument for the conservative treatment of spinal disorders in the International Spine Registry, Spine Tango  

Microsoft Academic Search

Spine Tango is the first and only International Spine Registry in operation to date. So far, only surgical spinal interventions\\u000a have been recorded and no comparable structured and comprehensive documentation instrument for conservative treatments of\\u000a spinal disorders is available. This study reports on the development of a documentation instrument for the conservative treatment\\u000a of spinal disorders by using the Delphi

J. T. KesslerM; M. Melloh; Thomas Zweig; E. Aghayev; C. Röder

2011-01-01

80

Controversies over spinal treatment in advanced cancer patients  

Microsoft Academic Search

About 10% of patients with cancer pain do not obtain pain relief or experience unacceptable side effects with systemic opioids.\\u000a In some cases a change of the route of administration can improve the balance of analgesia and adverse effects. In this paper\\u000a the use of spinal opioids in such patients is discussed from various aspects: patient selection, epidural vs intrathecal

Sebastiano Mercadante

1998-01-01

81

Thermoelectric device for treatment of radiculitis and spinal massage  

NASA Astrophysics Data System (ADS)

Results of development of a thermoelectric device that enables controlled cyclic temperature impact on the damaged area of human organism are presented. Unlike the existing medical devices employing direct supply current for thermoelectric module, the present device controls supply current according to time dependence of temperature change assigned by doctor. It is established that such a device is an efficient means of therapy at herniation of intervertebral disks with marked radiculitis and tunicary syndromes, at meningitis, other spinal diseases and back traumas.

Anatychuk, L. I.; Kobylyansky, R. R.

2012-06-01

82

Limited effect of fly-wheel and spinal mobilization exercise countermeasures on lumbar spine deconditioning during 90 d bed-rest in the Toulouse LTBR study  

NASA Astrophysics Data System (ADS)

We examined the effect of high-load fly-wheel (targeting the lower-limb musculature and concurrent loading of the spine via shoulder restraints) and spinal movement countermeasures against lumbar spine muscle atrophy, disc and spinal morphology changes and trunk isokinetic torque loss during prolonged bed-rest. Twenty-four male subjects underwent 90 d head-down tilt bed-rest and performed either fly-wheel (FW) exercises every three days, spinal movement exercises in lying five times daily (SpMob), or no exercise (Ctrl). There was no significant impact of countermeasures on losses of isokinetic trunk flexion/extension ( p?0.65). Muscle volume change by day-89 of bed-rest in the psoas, iliacus, lumbar erector spinae, lumbar multifidus and quadratus lumborum, as measured via magnetic resonance imaging (MRI), was statistically similar in all three groups ( p?0.33). No significant effect on MRI-measures of lumbar intervertebral disc volume, spinal length and lordosis ( p?0.09) were seen either, but there was some impact ( p?0.048) on axial plane disc dimensions (greater reduction than in Ctrl) and disc height (greater increases than in Ctrl). MRI-data from subjects measured 13 and 90-days after bed-rest showed partial recovery of the spinal extensor musculature by day-13 after bed-rest with this process complete by day-90. Some changes in lumbar spine and disc morphology parameters were still persistent 90-days after bed-rest. The present results indicate that the countermeasures tested were not optimal to maintain integrity of the spine and trunk musculature during bed rest.

Belavý, Daniel L.; Ohshima, Hiroshi; Bareille, Marie-Pierre; Rittweger, Jörn; Felsenberg, Dieter

2011-09-01

83

[Flexible endoscopy in surgical treatment of spinal adhesive arachnoiditis and arachnoid cysts].  

PubMed

Thecaloscopy is less invasive exploration of spinal subarachnoid space with ultra-thin flexible endoscope and endoscopic fenestration of scars and adhesions. Thecalopscopy was used in Russian neurosurgery at the first time. Since 2009 we operated 32 patients with following diagnosis: 17--spinal adhesive arachnoiditis (8--local forms, 9--diffuse forms), 12--spinal arachnoid cysts (7--posstraumatic cysts, 5--idiopathic cysts), 3--extramedullary tumors (thecaloscopic videoassistance and biopsy). In all cases we realized exploration of subarachnoid space and pathologic lesion with endoscopic perforation of cyst or dissection of adhesions using special instrumentation. Mean follow-up in our group was 11.4 months. Neurological improvement (mean 1.4 by modified Frankel scale, 1.8 by Ashworth spasticity scale) was seen in 87% of patients operated for spinal arachnopathies. Temporary neurological deterioration (mild disturbances of deep sensitivity) was seen in 9% of patients and managed successfully with conservative treatment. 1 (3.1%) patient was operated 3 times because of relapse of adhesions. There were no serious intraoperative complications (e.g., serious bleeding, dura perforation etc). Postoperative complications included 1 CSF leakage and 1 postoperative neuralgic pain. Mean term of hospitalization was 7.6 days. According to our data, we suppose that thecaloscopy is efficient and safe method, and should be widely used for spinal arachnopaties, adhesive arachnoiditis and arachnoid cysts. Taking into account that adhesive spinal arachnoiditis is systemic process and spinal arachnoid cysts can be extended as well, thecaloscopy may be regarded as the most radical and less-invasive way of surgical treatment existing currently in neurosurgery. PMID:24564085

Kashcheev, A A; Arestov, S O; Gushcha, A O

2013-01-01

84

Histone deacetylase inhibitors as potential treatment for spinal muscular atrophy  

PubMed Central

Histone acetylation plays an important role in regulation of transcription in eukaryotic cells by promoting a more relaxed chromatin structure necessary for transcriptional activation. Histone deacetylases (HDACs) remove acetyl groups and suppress gene expression. HDAC inhibitors (HDACIs) are a group of small molecules that promote gene transcription by chromatin remodeling and have been extensively studied as potential drugs for treating of spinal muscular atrophy. Various drugs in this class have been studied with regard to their efficacy in increasing the expression of survival of motor neuron (SMN) protein. In this review, we discuss the current literature on this topic and summarize the findings of the main studies in this field. PMID:24130434

Mohseni, Jafar; Zabidi-Hussin, Z.A.M.H.; Sasongko, Teguh Haryo

2013-01-01

85

Physical exercise is associated with better fat mass distribution and lower insulin resistance in spinal cord injured individuals  

PubMed Central

Objectives The aim of the study was to compare total and regional body composition and their relationship with glucose homeostasis in physically active and non-active individuals with cervical spinal cord injury (c-SCI). Methods Individuals with lesion level between C5–C7 were divided into two groups: physically active (PA; n = 14; who practiced physical exercise for at least 3 months, three times per week or more, minimum of 150 minutes/week): and non-physically active (N-PA n = 8). Total fat mass (t-FM) and regional fat mass (r-FM) were assessed by dual energy X-ray absorptiometry. Fasting plasma insulin (FPI) was determined by enzyme-linked immunosorbent assay. Results PA group present lower (P < 0.01) total fat mass (t-FM), % and kg, regional fat mass (r-FM), % and kg, FPI levels and HOMA index, while they had higher (P < 0.001) total free fat mass (t-FFM), %, and regional free fat mass (r-FFM), %, compared to the N-PA group. In the N-PA group, FPI and HOMA index were negatively (P < 0.05) correlated with FFM% (r = ?0.71, ?0.69, respectively) and positively correlated to trunk-FM (r = 0.71, 0.69, respectively) and trunk-FM:t-FM (kg) ratio (r = 0.83, 0.79, respectively). Conclusion Physical exercise is associated with lower t-FM, r-FM, and insulin resistance, which could contribute to the decrease of the risk of cardiovascular and metabolic conditions in individuals with c-SCI. PMID:24090139

D’Oliveira, Giselle Louise C.; Figueiredo, Flávia A.; Passos, Magna Cottini Fonseca; Chain, Amina; Bezerra, Flávia F.; Koury, Josely Correa

2014-01-01

86

The assessment and treatment of long-term, non-specific spinal pain : behavioural medicine, a cognitive-behavioural perspective.  

E-print Network

??Background: Matching treatment specifically to the needs of long-term, non-specific spinal pain (LTSP) patients might greatly enhance treatment efficacy, but the heterogeneity of patients has… (more)

Bergström, Gunnar

2000-01-01

87

Early microsurgical treatment for spinal hemangioblastomas improves outcome in patients with von Hippel–Lindau disease  

PubMed Central

Background: Spinal hemangioblastomas (HB) are rare, histologically benign, highly vascularized tumors often associated with von Hippel–Lindau (VHL) disease. The aim of the current study is to demonstrate the benefit of early surgical resection of large spinal HBs in selected asymptomatic patients with VHL. Methods: Seventeen patients underwent microsurgical resection of 20 spinal HBs at the Department of Neurosurgery at Helsinki University Central Hospital (HUCH). Thirteen tumors were in the cervical spine, five in thoracic and one patient had two lumbar lesions. MRI tumor showed an associated syrinx in 16 patients (94%). Tumor volume ranged from 27 to 2730 mm3. Out of 17 patients, 11 (65%) tested positive for VHL in mutation analysis. Five of these patients with tumors ranging from 55 to 720 mm3 were treated prophylactically. Results: Complete tumor resection was performed in 16 patients (94%) who were followed up for a median of 57 months (range 2–165 months). No patient had neurological decline on long-term follow-up. Among the patients with VHL, five patients with preoperative sensorimotor deficits showed improvement of their symptoms but never regained full function. One patient who presented with tetraplegia remained the same. Otherwise, all five patients with prophylactic surgery remained neurologically intact. Conclusion: Although documented growth on serial MRIs and the need for pathological diagnosis have been suggested as indications for surgery in otherwise asymptomatic patients, our series showed that a potentially larger group of asymptomatic patients with spinal HB associated with VHL would benefit from microsurgical resection. Long-term results of the surgical management of spinal HB are generally favorable. Our results suggest staging and early treatment for spinal HB larger than 55 mm3, especially in patients with VHL. Small spinal HBs may be followed up. PMID:22347675

Harati, Ali; Satopää, Jarno; Mahler, Lydia; Billon-Grand, Romain; Elsharkawy, Ahmed; Niemelä, Mika; Hernesniemi, Juha

2012-01-01

88

Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up  

Microsoft Academic Search

Objective: To compare spinal manipulation, back school and individual physiotherapy in the treatment of chronic low back pain.Design: Randomized trial, 12-month follow-up.Setting: Outpatient rehabilitation department.Participants: 210 patients with chronic, non-specific low back pain, 140\\/210 women, age 59 ± 14 years.Interventions: Back school and individual physiotherapy scheduled 15 1-hour-sessions for 3 weeks. Back school included: group exercise, education\\/ ergonomics; individual physiotherapy:

Francesca Cecchi; Raffaello Molino-Lova; Massimiliano Chiti; Guido Pasquini; Anita Paperini; Andrea A Conti; Claudio Macchi

2010-01-01

89

Spinal epidural lipomatosis: a review of its causes and recommendations for treatment.  

PubMed

Spinal epidural lipomatosis is most commonly observed in patients receiving long-term exogenous steroid therapy, but can also be seen in patients with endogenous steroid overproduction, obesity, or idiopathic disease. With this condition, there is hypertrophy of the epidural adipose tissue, causing a narrowing of the spinal canal and compression of neural structures. A majority of patients will present with progressive myelopathy, but radicular symptoms are also common. Conservative treatment--weaning from steroids or weight loss--can reverse the hypertrophy of the adipose tissue and relieve the neural compression. If conservative management fails, surgery with decompressive laminectomy is also very successful at improving the patient's neurological symptoms. PMID:15191340

Fassett, Daniel R; Schmidt, Meic H

2004-04-15

90

Chiropractic spinal manipulative treatment of cervicogenic dizziness using Gonstead method: a case study  

PubMed Central

Objective The purpose of this case report is to present the response of a patient with chronic nonresponsive cervicogenic dizziness to chiropractic care. Case report A 29-year-old man had a 10-year history of progressive cervicogenic dizziness with symptoms including a sensation of excessive motion, imbalance, and spinning associated with neck pain and stiffness. After treatment, he reported a reduction in pain and dizziness and an improved quality of life following Gonstead method of chiropractic spinal manipulative therapy. Conclusion This case study suggests that a patient with nonresponsive cervicogenic dizziness might respond to chiropractic spinal manipulative therapy approach using Gonstead method. PMID:22014910

Chaibi, Aleksander; Tuchin, Peter J.

2011-01-01

91

Automatic Finite State Control of FES-Assisted Indoor Rowing Exercise after Spinal Cord Injury.  

PubMed

We modified a commercial indoor rowing machine (Concept 2 Inc., Morrisville, NJ, USA) for a functional electrical stimulation (FES) assisted indoor rowing exercise in which the rowers must repeatedly press the two switches on the handle that stimulate their paralyzed leg muscles. The objective of this study was to automate the delivery of electrical stimulation to prevent potential repetitive strain injuries and to expand the user base to clients with impaired hand function. The modifications for development of the FES rowing machine and clinical trials were all performed in the University of Alberta. A new controller was developed to automatically control the electrical stimulation of the paralyzed leg muscles to perform the lower extremity part of the rowing maneuver while the subject voluntarily performed the upper body part of the maneuver. Two paraplegic users of the older manual control system tested the new automatic controller. The automatic FES controller spent more electrical stimulation per rowing cycle but it did not require repetitive thumb presses, required less concentration, and was preferred by the clients. We conclude FES rowing with the new automatic controller was easier and safer and expanded the user base of the FES rowing exercise to those with affected hand. PMID:22150853

Davoodi, Rahman; Andrews, Brian J; Wheeler, Garry D

2002-10-01

92

Totally extradural spinal en plaque meningiomas – Diagnostic dilemmas and treatment strategies  

PubMed Central

Background: Meningiomas are the second most common intraspinal tumors, constituting ~25% of all intraspinal tumors; however, in the context of extradural spinal lesions, the diagnosis of meningioma is an uncommon one. Purely extradural spinal meningiomas, especially of the en plaque variety, frequently mimic metastatic disease and may result in inadequate therapy. Case Description: We report two cases of totally extradural en-plaque meningiomas of the spine, one each in the cervical and dorsal spine. We present the significant diagnostic dilemmas posed by these cases and discuss the pathogenesis, treatment strategies, and long-term behavior of these uncommon lesions. Conclusion: Attention needs to be drawn to this dangerous preoperative and intraoperative misinterpretation. Intraoperative histopathology support for correct identification, gross total resection at surgery, inclusion of a durotomy to rule out intradural extension, and long-term follow-up are cornerstones for successful management of totally extradural en plaque spinal meningiomas. PMID:25289148

Savardekar, Amey; Chatterjee, Debarshi; Chatterjee, Debajyoti; Dhandapani, Sivashanmugam; Mohindra, Sandeep; Salunke, Pravin

2014-01-01

93

Surgical treatment of lumbar spinal stenosis with microdecompression and interspinous distraction device insertion. A case series  

PubMed Central

Background Interspinous distraction devices (IPDD) are indicated as stand-alone devices for the treatment of spinal stenosis. The purpose of this study is to evaluate the results of patients undergoing surgery for spinal stenosis with a combination of unilateral microdecompression and interspinous distraction device insertion. Methods This is a prospective clinical and radiological study of minimum 2 years follow-up. Twenty-two patients (average age 64.5 years) with low-back pain and unilateral sciatica underwent decompressive surgery for lumbar spinal stenosis. Visual Analogue Scale, Oswestry Disability Index and walking capacity plus radiologic measurements of posterior disc height of the involved level and lumbar lordosis Cobb angle were documented both preoperatively and postoperatively. One-sided posterior subarticular and foraminal decompression was conducted followed by dynamic stabilization of the diseased level with an IPDD (X-STOP). Results The average follow-up time was 27.4 months. Visual Analogue Scale and Oswestry Disability Index improved statistically significantly (p < 0.001) in the last follow-up exam. Also, the walking distance increased in all patients but two. Posterior intervertebral disc height of the diseased level widened average 1.8 mm in the postoperative radiograph compared to the preoperative. No major complication, including implant failure or spinous process breakage, has been observed. Conclusions The described surgical technique using unilateral microdecompression and IPDD insertion is a clinically effective and radiologically viable treatment method for symptoms of spinal stenosis resistant to non-operative treatment. PMID:23107358

2012-01-01

94

TREAD: TReatment with Exercise Augmentation for Depression: study rationale and design  

Microsoft Academic Search

Background Despite recent advancements in the pharmacological treatment of major depressive disorder (MDD), over half of patients who receive treatment with antidepressant medication do not achieve full remission of symptoms. There is evidence that exercise can reduce depressive symptomatology when used as a treatment for MDD. However, no randomized controlled trials have evaluated exercise as an augmentation strategy for patients

Madhukar H Trivedi; Tracy L Greer; Bruce D Grannemann; Timothy S Church; Daniel I Galper; Prabha Sunderajan; Stephen R Wisniewski; Heather O Chambliss; Alexander N Jordan; Carrie Finley; Thomas J Carmody

2006-01-01

95

Pelvic floor muscle exercise for the treatment of stress urinary incontinence: An exercise physiology perspective  

Microsoft Academic Search

The aim of this article is to give an overview of the exercise science related to pelvic floor muscle (PFM) strength training, and to assess the effect of PFM exercises to treat stress urinary incontinence (SUI). Sixteen articles addressing the effect of PFM exercise alone on SUI were compiled by computerized search or found in other review articles. Studies with

K. Bø

1995-01-01

96

Spinal cord stimulation in the treatment of refractory angina: systematic review and meta-analysis of randomised controlled trials  

PubMed Central

Background The aim of this paper was undertake a systematic review and meta-analysis of the use of spinal cord stimulation (SCS) in the management of refractory angina. Methods We searched a number of electronic databases including Medline, Embase and Cochrane Library up to February 2008 to identify randomised controlled trials (RCTs) reporting exercise capacity, ischemic burden, functional class, quality of life, usage of anti-anginal medication, costs and adverse events including mortality. Results were reported both descriptively for each study and using random effects meta-analysis. Given the variety in outcomes reported, some outcome results were pooled as standardised mean differences (SMD) and reported in standard deviation units. Results Seven RCTs were identified in a total of 270 refractory angina patients. The outcomes of SCS were found to be similar when directly compared to coronary artery bypass grafting (CABG) and percutaneous myocardial laser revascularisation (PMR). Compared to a 'no stimulation' control, there was some evidence of improvement in all outcomes following SCS implantation with significant gains observed in pooled exercise capacity (SMD: 0.76, 0.07 to 1.46, p = 0.03) and health-related quality of life (SMD: 0.83, 95% CI: 0.32 to 1.34, p = 0.001). Trials were small and were judged to range considerably in their quality. The healthcare costs of SCS appeared to be lower than CABG at 2-years follow up. Conclusion SCS appears to be an effective and safe treatment option in the management of refractory angina patients and of similar efficacy and safety to PMR, a potential alternative treatment. Further high quality RCT and cost effectiveness evidence is needed before SCS can be accepted as a routine treatment for refractory angina. PMID:19320999

Taylor, Rod S; De Vries, Jessica; Buchser, Eric; DeJongste, Mike JL

2009-01-01

97

Exercise Intensity during Treadmill Walking with Gait Patterned FES among Patients with Incomplete Spinal Cord Injury: Case Series  

E-print Network

SCI. Further investigations are required to determine the clinical relevance of the exercise. Key to maximize the physiological benefits of cardiopulmonary training, exercise at an appropriate intensity- 1 - Exercise Intensity during Treadmill Walking with Gait Patterned FES among Patients

Popovic, Milos R.

98

Effects of Spinal Stabilization Exercise on the Cross-sectional Areas of the Lumbar Multifidus and Psoas Major Muscles, Pain Intensity, and Lumbar Muscle Strength of Patients with Degenerative Disc Disease  

PubMed Central

[Purpose] The aim of this study was to evaluate the efficacy of using spinal stabilizing exercise to reduce atrophy of the multifidus and psoas major muscles, reduce the levels of pain and disability, and increase paraspinal muscle strength in patients with degenerative disc disease (DDD). [Subjects and Methods] In 33 patients (Age range: 25–65?years) diagnosed with DDD, spinal stabilization exercise was conducted for 8 weeks. The levels of pain and disability were measured before and after exercise using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Paraspinal muscular strength in four directions was evaluated with a CENTAUR 3D Spatial Rotation Device. Cross-sectional areas (CSAs) of both the left and right multifidus and the psoas major at the upper endplate of L4 were measured before and after exercise using computed tomography (CT). [Results] After 8 weeks of spinal stabilization exercise, the pain and lumbar disability in subjects decreased significantly from 6.12±1.24 to 2.43±1.14. The ODI score also improved from 20.18±7.14 to 8.81±5.73. In addition, paraspinal muscle strength increased significantly, while the CSAs of the left and right multifidus and psoas major widened as compared with the pre-exercise size. [Conclusion] Spinal stabilization exercise was effective for reducing pain and disability in DDD patients. It was an effective adjunct to aid rehabilitation in these cases. PMID:24764637

Kim, Seongho; Kim, Hyungguen; Chung, Jaeyeop

2014-01-01

99

EXERCISE PREFERENCES OF PATIENTS IN SUBSTANCE ABUSE TREATMENT  

PubMed Central

While emerging studies have demonstrated the benefit of exercise in early recovery from substance use disorders, recruitment and adherence to exercise interventions have been challenging. Tailoring interventions based on patient exercise preferences may address these concerns. Ninety-seven (N=97; age=41.6 years; 44% female) patients were recruited from an intensive substance abuse outpatient program and filled out questionnaires about their exercise preferences. Most (71%) patients were not currently engaged in an exercise program (i.e., exercising less than 20 minutes/day for 3 days/week over the last 6 months). The vast majority (95%) expressed an interest in engaging in an exercise program specifically designed for persons in substance use recovery and 89% reported wanting to initiate an exercise program within the first 3 months of sobriety. Specific exercise preferences regarding type of physical activity, exercise intervention components, and perceived benefits and barriers to exercise differed between males and females. These findings suggest low rates of regular exercise, high level of interest in engaging in exercise during early recovery, and point toward the need to tailor interventions to the unique preferences of individuals. PMID:22125581

Abrantes, Ana M.; Battle, Cynthia L.; Strong, David R.; Ing, Eileen; Dubreuil, Mary Ella; Gordon, Alan; Brown, Richard A.

2011-01-01

100

Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis  

PubMed Central

Background Lumbar spinal stenosis is a common cause of radicular and generalized back pain among older adults. Endoscopic minimally invasive surgery, in contrast to open decompression, may provide the opportunity for a less invasive surgical intervention. Thus, the purpose of this study is to evaluate the safety (operative complications, estimated blood loss, operative room time) and effectiveness (pre- versus postoperative level of disability and pain severity) of minimally invasive surgery using endoscopic laminotomy and foraminotomy among a large sample of patients with lumbar spinal stenosis. Methods This study is composed of 320 consecutive patients with lumbar spinal stenosis who underwent posterior lumbar laminotomy and foraminotomy between 2008 and 2011. Outcome measures consisted of perioperative complications, estimated blood loss, operative room time, level of disability, and pain severity. Pain severity and level of disability were prospectively analyzed to an average of 18 months (12–36 months) post-surgery. Results There was an average estimated blood loss of 39.3 cc and a mean operative room time of 74 min. Seven patients experienced minor operative complications. All patients were discharged the same day as surgery and reported a significantly lower level of disability (p = 0.00) and pain severity (p = 0.00) postoperative compared to preoperative. Conclusions Minimally invasive surgery using endoscopy for the treatment of lumbar spinal stenosis has a short operative time, a low operative complication rate, and minimal estimated blood loss. This study also indicates that MIS for the treatment of LSS can significantly reduce pain and disability level. Thus, minimally invasive surgery using endoscopic laminotomy and foraminotomy appears to be a safe and effective alternative surgical treatment for open decompression surgery in adult patients with lumbar spinal stenosis. PMID:24403742

Polikandriotis, John A.; Hudak, Elizabeth M.; Perry, Michael W.

2013-01-01

101

Recent Advances in Pathophysiology and Treatment of Spinal Cord Injury  

NSDL National Science Digital Library

Thirty years ago, patients with spinal cord injury (SCI) and their families were told "nothing can be done" to improve function. Since the SCI patient population is reaching normal life expectancy through better health care, it has become an obviously worthwhile enterprise to devote considerable research effort to SCI. Targets for intervention in SCI toward improved function have been identified using basic research approaches and can be simplified into a list: 1) reduction of edema and free-radical production, 2) rescue of neural tissue at risk of dying in secondary processes such as abnormally high extracellular glutamate concentrations, 3) control of inflammation, 4) rescue of neuronal/glial populations at risk of continued apoptosis, 5) repair of demyelination and conduction deficits, 6) promotion of neurite growth through improved extracellular environment, 7) cell replacement therapies, 8) efforts to bridge the gap with transplantation approaches, 9) efforts to retrain and relearn motor tasks, 10) restoration of lost function by electrical stimulation, and 11) relief of chronic pain syndromes. Currently, over 70 clinical trials are in progress worldwide. Consequently, in this millennium, unlike in the last, no SCI patient will have to hear "nothing can be done."

Claire E. Hulsebosch (University of Texas Medical Branch Department of Anatomy and Neurosciences)

2002-12-01

102

A Review on Response of Immune System in Spinal Cord Injury and Therapeutic Agents useful in Treatment.  

PubMed

Every year more than 12,000 people in US alone suffer from spinal cord injury. However, complete recovery of physical function is difficult due to multiple factors involved in disease progression. Currently available therapeutic regimens do not address all the factors concerned with the disease progression. The present review focuses mainly on the role of immune cells in progression of spinal cord injury and the drugs that target these immune cells. Literature search shows that inflammatory reactions and subsequent reactions that follow direct injury to spinal cord are sometimes responsible for the severity of the disease. Therefore, for design of proper treatment regimen a deep understanding in this area is required. Understanding the pathophysiology will help in creating delivery system that can target multiple factors involved in progression of spinal cord injury. A combination of various treatment strategies is required to reduce the disability in patients with spinal cord injury. PMID:25374028

Kasinathan, Narayanan; Vanathi, Meenashi B; Subrahmanyam, Volety M; Rao, Josyula V

2015-01-01

103

Spinal cord contusion  

PubMed Central

Spinal cord injury is a major cause of disability with devastating neurological outcomes and limited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result. PMID:25206890

Ju, Gong; Wang, Jian; Wang, Yazhou; Zhao, Xianghui

2014-01-01

104

Effect of puromycin treatment on the regeneration of hemisected and transected rat spinal cord.  

PubMed

The effect of puromycin on spinal cord regeneration was studied following implantation into the site of spinal cord hemi- or transection of Gel-foam saturated with puromycin (1 mM) in a saline carrier, implantation of Gel-foam sponge saturated with saline (carrier control), or lesion alone (lesion control). The spinal cords of 107 rats were studied with light and electron microscopy 7, 14, 30, 60 and 90 days postoperative (DPO). Spinal cord hemisected animals developed a dense cicatrix at the site of lesion replete with connective tissue, blood vessles, and myelinated and unmyelinated nerve fibres which could be traced to peripheral sources. Rostrally at the C.N.S.--cicatrix interface, there were reactive neuroglial cells, occasional nerve fibres and finger-like projections of spinal cord (due to cavitation lesions) which contained neuroglia, axons and dendrites. Implantation of saline in Gel-foam resulted in the same morphology as in hemisected animals except for increased lesion size due to mechanical factors and decreased cicatrix density during the first 30 DPO. Puromycin treatment resulted in a cicatrix with initial decreased cell density but which contained a new class of nerve fibres at 30 DPO. These nerve fibres were oriented in a rostro-caudal direction, were unmyelinated, 0.1-0.2 micron in diameter and had expanded smooth endoplasmic reticulum. Some of these nerve fibres were degenerating at 30 DPO and all were absent by 60 DPO. The puromycin-treated spinal cord within 200 micron rostral to the basal lamina contained nerve terminal conglomerates, which resembled boutons, in fascicles from 30-90 DPO (duration of experiment). Hemisection of the spinal cord by crushing 1-1 1/2 segments rostral to the site of puromycin implantation at 30 DPO resulted in degeneration of these nerve fibres in the cicatrix as well as the degeneration of nerve terminal conglomerates just rostral to the basal lamina. The regenerative capacity of the spinal cord is discussed in relationship to these findings. PMID:274521

Bernstein, J J; Wells, M R; Bernstein, M E

1978-04-01

105

Spinal Cystic Echinococcosis – A Systematic Analysis and Review of the Literature: Part 2. Treatment, Follow-up and Outcome  

PubMed Central

Bone involvement in human cystic echinococcosis (CE) is rare, but affects the spine in approximately 50% of cases. Despite significant advances in diagnostic imaging techniques, surgical treatment and introduction of pharmacological therapy, spinal echinococcosis remains associated with a high degree of morbidity, disability and mortality. We systematically reviewed the published literature of the last five decades to update and summarize the currently existing data on treatment, follow-up and outcome of spinal CE. PMID:24069501

Neumayr, Andreas; Tamarozzi, Francesca; Goblirsch, Sam; Blum, Johannes; Brunetti, Enrico

2013-01-01

106

Exercise  

MedlinePLUS

Exercise - National Multiple Sclerosis Society Skip to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Sign In In Your Area ... now Download now Publication Stretching for People with MS Illustrated manual showing range of motion, stretching, and ...

107

Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review  

PubMed Central

BACKGROUND: Delayed onset muscle soreness (DOMS) is a frequent problem after unaccustomed exercise. No universally accepted treatment exists. Massage therapy is often recommended for this condition but uncertainty exists about its effectiveness. AIM: To determine whether post-exercise massage alleviates the symptoms of DOMS after a bout of strenuous exercise. METHOD: Various computerised literature searches were carried out and located seven controlled trials. RESULTS: Most of the trials were burdened with serious methodological flaws, and their results are far from uniform. However, most suggest that post-exercise massage may alleviate symptoms of DOMS. CONCLUSIONS: Massage therapy may be a promising treatment for DOMS. Definitive studies are warranted. ??? PMID:9773168

Ernst, E.

1998-01-01

108

Strategy in the Surgical Treatment of Primary Spinal Tumors  

PubMed Central

Primary spine tumors are rare, accounting for only 4% of all tumors of the spine. A minority of the more common primary benign lesions will require surgical treatment, and most amenable malignant lesions will proceed to attempted resection. The rarity of malignant primary lesions has resulted in a paucity of historical data regarding optimal surgical and adjuvant treatment and, although we now derive benefit from standardized guidelines of overall care, management of each neoplasm often proceeds on a case-by-case basis, taking into account the individual characteristics of patient operability, tumor resectability, and biological potential. This article aims to provide an overview of diagnostic techniques, staging algorithms and the authors' experience of surgical treatment alternatives that have been employed in the care of selected benign and malignant lesions. Although broadly a review of contemporary management, it is hoped that the case illustrations given will serve as additional “arrows in the quiver” of the treating surgeon. PMID:24353976

Williams, Richard; Foote, Matthew; Deverall, Hamish

2012-01-01

109

Exercise: the brittle cornerstone of type 2 diabetes treatment  

Microsoft Academic Search

Regular exercise has been recommended for diabetes patients for many years; however, it is not widely used clinically. This\\u000a may be because of high costs, lack of reimbursement, low compliance and\\/or absence of proper infrastructure. Alternatively,\\u000a structured exercise therapy may be underutilised because current guidelines do not include detailed information on the preferred\\u000a type and intensity of exercise that should

S. F. E. Praet; L. J. C. van Loon

2008-01-01

110

Exploring exercise as an avenue for the treatment of anxiety disorders  

PubMed Central

Anxiety disorders constitute a significant public health problem. Current gold standard treatments are limited in their effectiveness, prompting the consideration of alternative approaches. In this review, we examine the evidence for exercise as an intervention for anxiety disorders. This evidence comes from population studies, studies of nonclinical anxiety reduction, as well as a limited number of studies of clinically anxious individuals. All of these studies provide converging evidence for consistent beneficial effects of exercise on anxiety, and are consistent with a variety of accounts of the mechanism of anxiety reduction with exercise. Further study of clinical populations is encouraged, as are studies of the mechanism of change of exercise interventions, which have the potential to help refine exercise intervention strategies. Likewise, studies that identify moderators of treatment efficacy will assist clinicians in deciding how and for whom to prescribe exercise. PMID:23002943

DeBoer, Lindsey B; Powers, Mark B; Utschig, Angela C; Otto, Michael W; Smits, Jasper AJ

2012-01-01

111

Treatment with resveratrol attenuates sublesional bone loss in spinal cord-injured rats  

PubMed Central

BACKGROUND AND PURPOSE Sublesional osteoporosis predisposes individuals with spinal cord injury (SCI) to an increased risk of low-trauma fracture. The aim of the present work was to investigate the effect of treatment with resveratrol (RES) on sublesional bone loss in spinal cord-injured rats. EXPERIMENTAL APPROACH Complete SCI was generated by surgical transaction of the cord at the T10–12 level. Treatment with RES (400 mg·kg?1 body mass per day?1, intragastrically) was initiated 12 h after the surgery for 10 days. Then, blood was collected and femurs and tibiae were removed for evaluation of the effects of RES on bone tissue after SCI. KEY RESULTS Treatment of SCI rats with RES prevented the reduction of bone mass including bone mineral content and bone mineral density in tibiae, preserved bone structure including trabecular bone volume fraction, trabecular number, and trabecular thickness in tibiae, and preserved mechanical strength including ultimate load, stiffness, and energy in femurs. Treatment of SCI rats with RES enhanced femoral total sulfhydryl content, reduced femoral malondialdehyde and IL-6 mRNA levels. Treatment of SCI rats with RES suppressed the up-regulation of mRNA levels of PPAR?, adipose-specific fatty-acid-binding protein and lipoprotein lipase, and restored mRNA levels of Wnt1, low-density lipoprotein-related protein 5, Axin2, ctnnb1, insulin-like growth factor 1 (IGF-1) and receptor for IGF-1 in femurs and tibiae. CONCLUSIONS AND IMPLICATIONS Treatment with RES attenuated sublesional bone loss in spinal-cord-injured rats, associated with abating oxidative stress, attenuating inflammation, depressing PPAR? signalling, and restoring Wnt/?-catenin and IGF-1 signalling. PMID:23848300

Wang, Hua-Dong; Shi, Ya-Min; Li, Li; Guo, Ji-Dong; Zhang, Yu-Peng; Hou, Shu-Xun

2013-01-01

112

Evaluation and treatment of the asymptomatic patient with a positive exercise tolerance test  

SciTech Connect

A positive exercise study in an asymptomatic patient presents a clinical dilemma. Many of these asymptomatic positive studies are false-positive, but a subset of these patients have silent coronary artery disease. Other noninvasive tests can be used in conjunction with exercise testing to help identify this subset of patients, but coronary angiography is often ultimately necessary to ensure an accurate diagnosis. An algorithm for the evaluation and treatment of the patient with an asymptomatic positive exercise study is proposed.

Imperi, G.A.; Conti, C.R.

1986-11-01

113

Mesenchymal stem cells in the treatment of spinal cord injuries: A review.  

PubMed

With technological advances in basic research, the intricate mechanism of secondary delayed spinal cord injury (SCI) continues to unravel at a rapid pace. However, despite our deeper understanding of the molecular changes occurring after initial insult to the spinal cord, the cure for paralysis remains elusive. Current treatment of SCI is limited to early administration of high dose steroids to mitigate the harmful effect of cord edema that occurs after SCI and to reduce the cascade of secondary delayed SCI. Recent evident-based clinical studies have cast doubt on the clinical benefit of steroids in SCI and intense focus on stem cell-based therapy has yielded some encouraging results. An array of mesenchymal stem cells (MSCs) from various sources with novel and promising strategies are being developed to improve function after SCI. In this review, we briefly discuss the pathophysiology of spinal cord injuries and characteristics and the potential sources of MSCs that can be used in the treatment of SCI. We will discuss the progress of MSCs application in research, focusing on the neuroprotective properties of MSCs. Finally, we will discuss the results from preclinical and clinical trials involving stem cell-based therapy in SCI. PMID:24772239

Dasari, Venkata Ramesh; Veeravalli, Krishna Kumar; Dinh, Dzung H

2014-04-26

114

Research advances in the application of methylprednisolone in the treatment of acute spinal cord injury.  

PubMed

Acute spinal cord injury(ASCI),mainly caused by traffic accidents and fall injuries,is a catastrophic event that can profoundly affect the trajectory of a patient's life. Debate continues over the medical management of ASCI,in particular the usefulness,dosage,and potential risks of methylprednisolone(MP). Although the results of American National Acute Spinal Cord Injury Study 2 and 3 trials led to the wide adoption of a high-dose MP regimen for ASCI patients,the reliabilities of their study methods and data were still questionable. Based on the currently available literature,we conclude that high-dose MP is no longer a recommended therapy for ASCI;however,due to the lack of effective treatment,it remains a useful option for this condition. PMID:25556746

Kong, Xiang-Yi; Gao, Jun; Yang, Yi; Li, Yong-Ning; Ma, Wen-Bin; Xing, Bing; Wang, Ren-Zhi

2014-12-30

115

Adding exercise training to rosuvastatin treatment: influence on serum lipids and biomarkers of muscle and liver damage  

Microsoft Academic Search

Statin treatment and exercise training can improve lipid profile when administered separately. The efficacy of exercise and statin treatment combined, and its impact on myalgia and serum creatine kinase (CK) have not been completely addressed. The purpose of this study was to determine the effect of statin treatment and the addition of exercise training on lipid profile, including oxidized low-density

Paul M. Coen; Michael G. Flynn; Melissa M. Markofski; Brandt D. Pence; Robert E. Hannemann

2009-01-01

116

A systematic review into the effectiveness of hand exercise therapy in the treatment of rheumatoid arthritis.  

PubMed

Hand exercises are often part of the treatment of hand rheumatoid arthritis; however, it is still unclear whether and what type of exercises is effective in the treatment of this condition. Therefore, a systematic review into the effectiveness of hand exercises in the treatment of hand rheumatoid arthritis has been performed. Studies were identified in the literature databases by predefined search criteria. The eight included studies are peer-reviewed studies published between 2000 and 2014. Hand exercises differed between studies, but always included resistance and/or active range of motion exercises. Grip strength in various grip types (power grip, key pinch, precision pinch and tripod pinch) was found to improve by hand exercise therapy without having adverse effects on pain or disease activity. Adaptations in the range of motion in response to hand exercise therapy were less pronounced. There appears to be some transfer from the improvements on the body functioning level to the level of daily functioning, with the largest improvements found on grip ability. With regard to the intervention content, there was some evidence in favour of a longer therapy duration and a higher therapy intensity. No conclusions could be drawn on the effectiveness of the different types of exercises. Collectively, the studies indicate that hand exercises may have positive effects on strength and some aspects of daily functioning without aggravating disease activity or pain, although caution should be taken for subjects in the exacerbation period. PMID:24952308

Bergstra, S A; Murgia, A; Te Velde, A F; Caljouw, S R

2014-11-01

117

Efficacy of directly observed treatment short-course intermittent regimen in spinal tuberculosis  

PubMed Central

Background: Most important cause of treatment failure and emergence of drug resistance in the treatment of tuberculosis is noncompliance. Compliance can be improved by direct observation of drug intake, intermittent therapy, and short-course treatment. The efficacy of Directly Observed Treatment Short Course (DOTS) strategy advocated by World Health Organization (WHO) in spinal tuberculosis is not yet proven. We conducted a prospective clinical study on a consecutive series of patients with spinal tuberculosis treated by Category I Revised National Tuberculosis Control Programme (RNTCP) regimen based on DOTS strategy of WHO from 2004 to 2007 to evaluate the efficacy. Materials and Methods: Forty-nine consecutive patients of spinal tuberculosis were treated with short-course intermittent chemotherapy under Category I RNTCP/DOTS strategy. Patients were followed up for a minimum period of 2 years. Surgery was done if the patient presented with significant neurologic deficit or when the drug treatment failed. Outcome was assessed by clinical, radiologic, and laboratory criteria, and graded into excellent, good, fair, and poor based on various parameters. Results: 63.4% (n=26) of the patients had excellent results. 14.6% (n=6) of the patients had good and fair results. Three patients (7.3%) had poor results 48.7% (n=20) of the patients had but only one of them was severe enough to warrant change of drug. Conclusions: Efficacy of DOTS was comparable with other standard regimens. There was a significant reduction in adverse side effects when compared with daily regimens. Study showed that the outcome was better in those treated early. PMID:22448050

Valsalan, Rejith; Purushothaman, Rajesh; Raveendran, MK; Zacharia, Balaji; Surendran, Sibin

2012-01-01

118

Intraoperative clinical use of low-power laser irradiation following surgical treatment of the tethered spinal cord  

NASA Astrophysics Data System (ADS)

Based on previous experimental investigations which indicated that low-power laser irradiation has a significant therapeutic effect and treatment potential on the injured nerve tissue, the authors began using this method in clinical practice. This data represents the first clinical results in the treatment of four patients with tethered spinal cord resulting from fibrous adhesions at the site of previous myelomeningocele and lypomyelomeningocele repair, thickened filum terminale and spinal lipoma. After surgical release of the tethered spinal cord, stable evoked responses were recorded and the conus medullaris was subjected to direct laser irradiation (CW He-Ne laser, 632.8nm, 7Jcm2). The findings show intraoperative laser treatment increases evoked responses from 15-52% (mean 26.7%). In a previous work, it was shown that direct laser irradiation promotes restoration of the electrophysiological activity of the severely injured peripheral nerve, prevents degenerative changes in neurons of the spinal cord and induces proliferation of astrocytes and oligodendrocytes. This suggested a higher metabolism in neurons and improved ability for myelin production under the influence of laser treatment. It is well known that tethering of the spinal cord causes mechanical damage to neuronal cell membranes leading to metabolic disturbances in the neurons. For this reason, the authors believe that using low-power laser irradiation may improve neuronal metabolism, prevent neuronal degeneration and promote improved spinal cord function and repair.

Rochkind, S.; Alon, M.; Ouaknine, G. E.; Weiss, S.; Avram, J.; Razon, Nisim; Lubart, Rachel; Friedmann, Harry

1991-05-01

119

Work-rate-guided exercise testing in patients with incomplete spinal cord injury using a robotics-assisted tilt-table.  

PubMed

Abstract Purpose: Robotics-assisted tilt-table (RTT) technology allows neurological rehabilitation therapy to be started early thus alleviating some secondary complications of prolonged bed rest. This study assessed the feasibility of a novel work-rate-guided RTT approach for cardiopulmonary training and assessment in patients with incomplete spinal cord injury (iSCI). Methods: Three representative subjects with iSCI at three distinct stages of primary rehabilitation completed an incremental exercise test (IET) and a constant load test (CLT) on a RTT augmented with integrated leg-force and position measurement and visual work rate feedback. Feasibility assessment focused on: (i) implementation, (ii) limited efficacy testing, (iii) acceptability. Results: (i) All subjects were able follow the work rate target profile by adapting their volitional leg effort. (ii) During the IETs, peak oxygen uptake above rest was 304, 467 and 1378?ml/min and peak heart rate (HR) was 46, 32 and 65 beats/min above rest (subjects A, B and C, respectively). During the CLTs, steady-state oxygen uptake increased by 42%, 38% and 162% and HR by 12%, 20% and 29%. (iii) All exercise tests were tolerated well. Conclusion: The novel work-rate guided RTT intervention is deemed feasible for cardiopulmonary training and assessment in patients with iSCI: substantial cardiopulmonary responses were observed and the approach was found to be tolerable and implementable. Implications for Rehabilitation Work-rate guided robotics-assisted tilt-table technology is deemed feasible for cardiopulmonary assessment and training in patients with incomplete spinal cord injury. Robotics-assisted tilt-tables might be a good way to start with an active rehabilitation as early as possible after a spinal cord injury. During training with robotics-assisted devices the active participation of the patients is crucial to strain the cardiopulmonary system and hence gain from the training. PMID:24712412

Laubacher, Marco; Perret, Claudio; Hunt, Kenneth J

2014-04-01

120

Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial  

Microsoft Academic Search

Summary Background The standard treatment for spinal cord compression caused by metastatic cancer is corticosteroids and radiotherapy. The role of surgery has not been established. We assessed the efficacy of direct decompressive surgery. Methods In this randomised, multi-institutional, non-blinded trial, we randomly assigned patients with spinal cord compression caused by metastatic cancer to either surgery followed by radiotherapy (n=50) or

Roy A Patchell; Phillip A Tibbs; William F Regine; Richard Payne; Stephen Saris; Richard J Kryscio; Mohammed Mohiuddin; Byron Young

2005-01-01

121

Intraspinal neuroblastoma: Treatment options and neurological outcome of spinal cord compression  

PubMed Central

Malignant spinal cord compression (MSCC) is a common complication of cancer. Paraspinal neuroblastoma (NB) in the thoracic, abdominal and pelvic regions may extend into the neural foramina causing compression of nerve roots and even the spinal cord. The prompt initiation of specific treatment can improve the neurological outcome. The aim of the present study was to review the clinical features, the management received and the factors that may affect the outcome of patients with MSCC caused by paraspinal NB. During a period between July 2007 and December 2012, a total of 576 NB patients were treated at the Children’s Cancer Hospital (Cairo, Egypt). Intraspinal disease extension was present in 51 patients (9%). The children with intraspinal disease extension were reviewed for disease pattern, neurological manifestations and treatment outcome. Children with intraspinal disease extension had an equal male to female ratio (1:1), and approximately two-thirds of patients (34/51) had a clinically manifested cord compression. The duration of neurological manifestations was >4 weeks in 58.8% (20/34) of symptomatic patients and ?4 weeks in 41.2% (14/34). Subsequent to starting treatment, neurological manifestations showed a complete recovery in 16 patients (47.1%), partial in 11 (32.4%), and stationary course was found in 7 (20.6%). Manifestations of ?4 weeks in duration carried an improved outcome compared with longer time compression, with a complete recovery in 78.6%, versus 25% for patients with a longer symptom duration (P=0.008). The upfront treatment, patient age and site of the primary tumor did not significantly affect the neurological outcome. Spinal cord compression in NB can be effectively managed with upfront chemotherapy. Initial surgical decompression should be reserved for benign variants only, including ganglioneuroma. Neurological manifestations of <4 weeks duration upon presentation are usually reversible.

FAWZY, MOHAMED; EL-BELTAGY, MOHAMED; SHAFEI, MAGED EL; ZAGHLOUL, MOHAMED SAAD; KINAAI, NAGLAA AL; REFAAT, AMAL; AZMY, SARAH

2015-01-01

122

Effects of exercise on biobehavioral outcomes of fatigue during cancer treatment: results of a feasibility study.  

PubMed

Cancer treatment is associated with decreased hemoglobin (Hb) concentration and aerobic fitness (VO2 max), which may contribute to cancer-related fatigue (CRF) and decreased quality of life (QoL). Endurance exercise may attenuate CRF and improve QoL, but the mechanisms have not been thoroughly investigated. Objectives. To (a) determine the feasibility of conducting an exercise intervention among women receiving treatment for breast cancer; (b) examine the effects of exercise on Hb and VO2 max and determine their association with changes in CRF and QoL; and (c) investigate changes in selected inflammatory markers. Methods. Fourteen women receiving chemotherapy for Stages I-II breast cancer were randomly assigned to exercise (n = 7) or usual care (n = 7). Women in the exercise group performed supervised, individualized treadmill exercise 2-3 times/week for the duration of chemotherapy (9-12 weeks). Data were collected 4 times over 15-16 weeks. Results. Recruitment rate was 45.7%. Sixteen women consented and 14 completed the trial, for a retention rate of 87.5%. Adherence to exercise protocol was 95-97%, and completion of data collection was 87.5-100%. Exercise was well tolerated. VO2 max was maintained at prechemotherapy levels in exercisers but declined in the usual-care group (p < .05). Hb decreased (p < .001) in all participants as they progressed through chemotherapy. Exercise did not have significant effects on CRF or QoL. Changes in inflammatory markers favored the exercise group. Conclusions. Exercise during chemotherapy may protect against chemotherapy-induced decline in VO2 max but not Hb concentration. PMID:25504949

Al-Majid, Sadeeka; Wilson, Lori D; Rakovski, Cyril; Coburn, Jared W

2015-01-01

123

Exercise, Behavioral Therapy Reduce Menopausal Symptoms Caused by Breast Cancer Treatment  

Cancer.gov

Women with breast cancer who were suffering from treatment-related menopausal symptoms experienced symptom relief with cognitive behavioral therapy, physical exercise, or both, according to a Dutch study published October 8, 2012, in the Journal of Clinical Oncology.

124

The role of exercise and alternative treatments for low back pain.  

PubMed

The determination of whether a patient should pursue an active or passive treatment program is often made by medical practitioners. Knowledge about all forms of treatment, including complementary and alternative (CAM) treatments, is essential in the treatment of low back pain. Medical practitioner-directed active treatments that have been shown to be effective for the treatment of low back pain include physical therapy-directed exercise programs such as core stabilization and mechanical diagnosis and therapy (MDT). Based on the current literature, it appears that yoga is the most effective nonphysician-directed active treatment approach to nonspecific low back pain when comparing other CAM treatments. Acupuncture is a medical practitioner-directed passive treatment that has been shown to be a good adjunct treatment. More randomized controlled studies are needed to support both CAM treatments and exercise in the treatment of low back pain. PMID:20977960

Carneiro, Kevin A; Rittenberg, Joshua D

2010-11-01

125

Treatment of spinal cord injury: A review of engineering using neural and mesenchymal stem cells.  

PubMed

Over time, various treatment modalities for spinal cord injury have been trialed, including pharmacological and nonpharmacological methods. Among these, replacement of the injured neural and paraneural tissues via cellular transplantation of neural and mesenchymal stem cells has been the most attractive. Extensive experimental studies have been done to identify the safety and effectiveness of this transplantation in animal and human models. Herein, we review the literature for studies conducted, with a focus on the human-related studies, recruitment, isolation, and transplantation, of these multipotent stem cells, and associated outcomes. Clin. Anat. 28:37-44, 2015. © 2014 Wiley Periodicals, Inc. PMID:25156268

Mortazavi, Martin M; Harmon, Olivia A; Adeeb, Nimer; Deep, Aman; Tubbs, R Shane

2015-01-01

126

Long-term efficacy of heparin exercise treatment for patients with chronic effort angina: evaluation by exercise Tl-201 myocardial scintigraphy.  

PubMed

To determine the effects of heparin exercise treatment on the coronary collateral flow reserve, exercise thallium-201 myocardial perfusion images were obtained with the same work-load before and late after heparin exercise treatment (17 +/- 2 months, mean +/- S.E.). In six patients with stable effort angina, to develop the collateral circulation, treadmill exercise was performed 20 times for 2-3 weeks with pretreatment with a single intravenous dose of heparin (5000 IU). The coronary collateral flow reserve was measured quantitatively as a severity score by analysis of exercise thallium-201 myocardial perfusion images. The severity score was decreased from 11,976 +/- 1722 to 5531 +/- 1967 (P < 0.05) long after heparin exercise treatment. The ST segment depression at the time of peak exercise was also decreased from 0.15 +/- 0.02 mV to 0.05 +/- 0.02 mV. In an additional five medically treated patients, these indexes remained unchanged during 18 +/- 3 months of follow-up period. These findings demonstrate that the coronary collateral flow reserve is significantly enhanced with heparin exercise treatment. These preliminary results lend support for heparin exercise treatment as one of the possible therapeutic modalities for treating patients with chronic stable effort angina. PMID:8349366

Fujita, M; Ohn, A; Miwa, K; Sasayama, S; Futatsuya, R; Seto, H

1993-06-15

127

Red Ginseng Treatment for Two Weeks Promotes Fat Metabolism during Exercise in Mice  

PubMed Central

PURPOSE: Red ginseng (RG) has been reported to improve the blood and organ lipid profile when combined with exercise. However, the effect of RG on energy metabolism during exercise is poorly understood. Therefore, this study was designed to investigate whether RG treatment alters fat utilization during exercise; METHODS: We used seven-week-old ICR mice (n = 42). RG (1 g/kg) was administered orally daily during two weeks of endurance training. All mice were randomized into two groups: training only group (CON group) and training with RG group (RG group). Endurance training consisted of 20~25 m/min on a slope of 8° for one hour five times a week. After a two-week experimental period, we measured substrate utilization during exercise at the same intensity and duration of training using a respiratory calorimetry chamber. Mice were dissected for glycogen measurement of muscles and liver before, immediately after, and one hour after the exercise; RESULT: Fat oxidation during the initial 20 min of the one-hour exercise significantly increased in the RG group compared to the CON group. In addition, the liver glycogen stores significantly decreased immediately after the one-hour exercise compared to at rest in the RG group, but did not differ between immediately after the one-hour exercise and at rest in the RG group. The glycogen concentration in white and red gastrocnemius muscle did not differ between the groups immediately after the one-hour exercise; CONCLUSIONS: These results suggest that RG treatment for two weeks promotes fat oxidation and a glycogen-sparing effect during exercise. This might lead to a delay in peripheral fatigue during endurance exercise performance. PMID:24803098

Hwang, Hyejung; Kim, Jisu; Park, Jonghoon; Yun, Heayeon; Cheon, Woo-Kwang; Kim, Bokyung; Lee, Chi-Ho; Suh, Heajung; Lim, Kiwon

2014-01-01

128

Treatment of Combined Spinal Deformity in Patient with Ollier Disease and Abnormal Vertebrae  

PubMed Central

We report staged treatment of severe combined spinal deformity in an 11-year-old patient with Ollier disease and abnormal cervical vertebra. Combined scoliosis with systemic pathology and abnormal vertebrae is a rare condition and features atypical deformity location and rapid progression rate and frequently involves the rib cage and pelvis, disturbing the function of chest organs and skeleton. Progressive deformity resulted in cachexia and acute respiratory failure. A halo-pelvic distraction device assembled of Ilizarov components was employed for a staged surgical treatment performed for lifesaving indications. After vital functions stabilized, the scoliosis curve of the cervical spine was corrected and fixed with a hybrid system of transpedicular supporting points, connecting rods, and connectors that provided staged distraction during growth. The treatment showed good functional and cosmetic result. PMID:24436859

Ryabykh, S. ?.; Gubin, A. V.; Prudnikova, ?. G.; Kobyzev, ?. ?.

2012-01-01

129

Treatment of urinary tract infection in persons with spinal cord injury: guidelines, evidence, and clinical practice  

PubMed Central

Objectives To investigate current clinical practice in the treatment of urinary tract infections (UTIs) in persons with spinal cord injury (SCI) in SCI centers where German is spoken and to compare it with current guidelines and evidence-based standards evaluated by a literature review. Methods A standardized questionnaire was mailed to 16 SCI rehabilitation centers. The results were compared with a literature review Results Of the 16 centers, 13 responded. Indications for UTI treatment, medications, and treatment duration differed substantially among the individual centers and from the existing guidelines. Antibiotic treatment is regarded as the method of choice. Compared with the existing literature, patients in two center were undertreated, whereas they were overtreated in seven centers. Conclusion Even in specialized centers, treatment of UTI in patients with SCI is based more on personal experience of the treating physicians than on published evidence. This may at least partly be due to the paucity of evidence-based data. The observed tendency toward overtreatment with antibiotics carries substantial future risks, as this strategy may well lead to the induction of multiresistant bacterial strains. Therefore, developing guidelines would be an important step toward a unification of the different treatment strategies, thus reducing unnecessary antibiotic treatment. Furthermore, evidence-based studies evaluating the success of antibiotic treatment as well as the usefulness of alternative strategies are urgently needed. PMID:21528621

Pannek, Juergen

2011-01-01

130

Sustained release of estrogens from PEGylated nanoparticles for treatment of secondary spinal cord injury  

NASA Astrophysics Data System (ADS)

Spinal Cord Injury (SCI) is a debilitating condition which causes neurological damage and can result in paralysis. SCI results in immediate mechanical damage to the spinal cord, but secondary injuries due to inflammation, oxidative damage, and activated biochemical pathways leading to apoptosis exacerbate the injury. The only currently available treatment, methylprednisolone, is controversial because there is no convincing data to support its therapeutic efficacy for SCI treatment. In the absence of an effective SCI treatment option, 17beta-estradiol has gained significant attention for its anti-oxidant, anti-inflammatory, and anti-apoptotic abilities, all events associated with secondary. Sadly, 17beta-estradiol is associated with systemic adverse effects preclude the use of free estrogen even for local administration due to short drug half-life in the body. Biodegradable nanoparticles can be used to increase half-life after local administration and to bestow sustained release. Sustained release using PEGylated biodegradable polymeric nanoparticles constructed from poly(lactic-co-glycolic acid) (PLGA) will endow a consistent, low, but effective dose to be delivered locally. This will limit systemic effects due to local administration and low dose, sustained release. PLGA was chosen because it has been used extensively for sustained release, and has a record of safety in humans. Here, we show the in vitro efficacy of PEGylated nanoparticles loaded with 17beta-estradiol for treatment of secondary SCI. We achieved a high loading efficiency and controlled release from the particles over a several day therapeutic window. The particles also show neuroprotection in two in vitro cell culture models. Both the dose and pretreatment time with nanoparticles was evaluated in an effort to translate the treatment into an animal model for further study.

Barry, John

131

The Clinical Outcomes of Surgical Treatment of Noncontiguous Spinal Tuberculosis: A Retrospective Study in 23 Cases  

PubMed Central

Study design A retrospective clinical study. Objective To evaluate the clinical efficacy of the surgical treatment of noncontiguous spinal tuberculosis (NSTB), and to discuss its therapeutic strategies. Methods We performed a retrospective review of clinical and radiographic data that were prospectively collected on 550 consecutive spinal tubercular patients including 27 patients who were diagnosed and treated as NSTB in our institution from June 2005 to June 2011. Apart from 4 patients being treated conservatively, the remainder received surgery by posterior transforaminal debridement, interbody fusion with instrumentation, posterior instrumentation and anterior debridement with fusion in a single or two-stage operation. The clinical outcomes were evaluated before and after treatment in terms of hematologic and radiographic examinations, bone fusion and neurologic status. The Oswestry Disability Index score was determined before treatment and at the last follow-up visit. Results 23 patients (15 M/8F), averaged 44.6±14.2 years old (range, 19 to 70 yd), who received surgical treatment, were followed up after surgery for a mean of 52.5±19.5 months (range, 24 to 72 months). The kyphotic angle was changed significantly between pre- and postoperation (P<0.05). The mean amount of correction was 12.6±7.2 degrees, with a small loss of correction at last follow-up. All patients achieved solid bone fusion. No patients with neurological deficit deteriorated postoperatively. Neither mortalities nor any major complications were found. There was a significant difference of Oswestry Disability Index scores between preoperation and the final follow-up. Conclusion The outcomes of follow-up showed that posterior and posterior-anterior surgical treatment methods were both viable surgical options for NSTB. Posterior transforaminal debridement, interbody fusion and posterior instrumentation, as a less invasive technique, was feasible and effective to treat specific tubercular foci. PMID:24699518

Huang, Jia; Zhang, Hongqi; Zeng, Kefeng; Gao, Qile

2014-01-01

132

Treatment of a spinal aneurysmal bone cyst using combined image-guided cryoablation and cementoplasty.  

PubMed

The authors describe the case of a 6.6-cm symptomatic spinal aneurysmal bone cyst (ABC) in a 17-year-old athlete treated percutaneously. Surgical treatment was not considered as the first option owing to its invasiveness and associated morbidity. CT-guided cryoablation of the expansile part of the ABC was performed for tumour shrinkage and nerve decompression. Thermal insulation, temperature monitoring and functional control/electrostimulation of the neural structures at risk were applied. Finally, the bony defect was cemented. No complications occurred during the procedure. Complete resolution of the ABC on imaging and clinical improvement were achieved. Percutaneous cryoablation should be considered as an alternative treatment option, especially when tumour size reduction is desired. PMID:25091121

Tsoumakidou, Georgia; Too, Chow Wei; Garnon, Julien; Steib, Jean-Paul; Gangi, Afshin

2015-02-01

133

Analysis of Risk Factors and Management of Cerebrospinal Fluid Morbidity in the Treatment of Spinal Dysraphism  

PubMed Central

Objective Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results The overall median skin lesion area was 36.2 cm2 (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of 64.4±32.5 cm2 versus 27.7±27.8 cm2, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 cm2 or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods. PMID:24278652

Lee, Byung-Jou; Han, Seong-Rok; Choi, Chan-Young; Lee, Dong-Joon; Kang, Jae Heon

2013-01-01

134

Spinal-supraspinal serotonergic circuits regulating neuropathic pain and its treatment with gabapentin.  

PubMed

Not all neuropathic pain patients gain relief from current therapies that include the anticonvulsant, gabapentin, thought to modulate calcium channel function. We report a neural circuit that is permissive for the effectiveness of gabapentin. Substance P-saporin (SP-SAP) was used to selectively ablate superficial dorsal horn neurons expressing the neurokinin-1 receptor for substance P. These neurons project to the brain as shown by retrograde labelling and engage descending brainstem serotonergic influences that enhance spinal excitability via a facilitatory action on 5HT(3) receptors. We show the integrity of this pathway following nerve injury contributes to the behavioural allodynia, neuronal plasticity of deep dorsal horn neurons and the injury-specific actions of gabapentin. Thus SP-SAP attenuated the tactile and cold hypersensitivity and abnormal neuronal coding (including spontaneous activity, expansion of receptive field size) seen after spinal nerve ligation. Furthermore the powerful actions of gabapentin after neuropathy were blocked by either ablation of NK-1 expressing neurones or 5HT(3) receptor antagonism using ondansetron. Remarkably, 5HT(3) receptor activation provided a state-dependency (independent of that produced by neuropathy) allowing GBP to powerfully inhibit in normal uninjured animals. This circuit is therefore a crucial determinant of the abnormal neuronal and behavioural manifestations of neuropathy and importantly, the efficacy of gabapentin. As this spino-bulbo-spinal circuit contacts areas of the brain implicated in the affective components of pain, this loop may represent a route by which emotions can influence the degree of pain in a patient, as well as the effectiveness of the drug treatment. These hypotheses are testable in patients. PMID:16150546

Suzuki, Rie; Rahman, Wahida; Rygh, Lars J; Webber, Mark; Hunt, Stephen P; Dickenson, Anthony H

2005-10-01

135

Melatonin treatment protects against spinal cord injury induced functional and biochemical changes in rat urinary bladder.  

PubMed

Oxidative stress induced by spinal cord injury (SCI) has deleterious effects on the function of several organ systems including the urinary bladder. In this study, we investigated the possible protective actions of melatonin on SCI-induced oxidative damage and urinary bladder dysfunction. Wistar albino rats (n = 24) were divided randomly as control, vehicle- or melatonin (10 mg/kg, ip)-treated SCI groups. To induce SCI, a standard weight-drop method that induced a moderately severe injury at T10 was used. Injured animals were given either vehicle or melatonin 15 min postinjury. One week postinjury, each rat was neurologically examined and then decapitated; blood samples were taken to evaluate neuron-specific enolase (NSE) and soluble protein 100? (S-100?). Spinal cord (SC) and urinary bladder samples were taken for functional studies and histological examination or stored for the measurement of malondialdehyde (MDA), glutathione (GSH) and nerve growth factor (NGF) levels and caspase-3 activity. Isometric contractions in bladder strips were induced by carbachol. In the SCI rats, decreased contractile responses of the bladder strips were found to be restored by melatonin treatment. Serum S-100? levels and NSE activities and tissue MDA levels and caspase-3 activities, all of which were elevated in the vehicle-treated SCI animals as compared to the control values, were reversed by melatonin treatment. On the other hand, reduced GSH and NGF levels due to SCI were restored by melatonin treatment. Furthermore, melatonin treatment improved histological findings. These findings suggest that melatonin reduces SCI-induced tissue injury and improves bladder functions through its effects on oxidative stress and NGF. PMID:22220508

Er?ahin, Mehmet; Özdemir, Zarife; Özsavc?, Derya; Akak?n, Dilek; Ye?en, Berrak Ç; Reiter, Russel J; Sener, Göksel

2012-04-01

136

Exercise-induced cardioprotection is impaired by anabolic steroid treatment through a redox-dependent mechanism.  

PubMed

High doses of anabolic androgenic steroids (AAS) impair the cardioprotective effects of exercise against ischemia/reperfusion (I/R) insult, possibly through cellular redox imbalance. Here, the effect of nandrolone decanoate (DECA) treatment on heart redox metabolism was investigated during I/R in sedentary and exercised rats. DECA treatment significantly reduced superoxide dismutase and glutathione reductase activities in exercised rats after heart reperfusion. Catalase and glutathione peroxidase activities were not affected by DECA in both sedentary and trained rats, regardless the I/R period. DECA also induced myocardial oxidative stress, as evidenced by the reduced levels of total reduced thiols after heart reperfusion in exercised rats treated with the anabolic steroid. These results indicate that cardiotoxic effects of supraphysiological doses of AAS involve reduced heart antioxidant capacity. PMID:23831356

Chaves, Elen A; Fortunato, Rodrigo S; Carvalho, Denise P; Nascimento, José Hamilton M; Oliveira, Marcus F

2013-11-01

137

Use of Fidji Cervical Cage in the Treatment of Cervical Spinal Cord Injury without Radiographic Abnormality  

PubMed Central

Spinal cord injury without radiographic abnormality (SCIWORA) is a rare condition seen in adults. Many interbody fusion cages have been developed for its treatment, but clinical studies of Fidji cervical cage are still scarce. A total number of five patients (four male and one female) were reviewed. The ages of the patients ranged from 40 to 60 years. All the patients underwent neurological and radiological examinations. Neurological and functional outcomes were assessed on the basis of Frankel's grade. Three of the patients were Frankel B, and the rest two were Frankel C. Magnetic resonance imaging was also performed for the evaluation of spinal cord and intervertebral disc injury. Anterior cervical discectomy and Fidji cervical cage fusion were performed for all. The fusion status was evaluated on the basis of X-rays. After surgical intervention, the clinical symptoms improved for all the patients. The disc interspaces in all the patients achieved solid union at final follow-up. Fidji cervical cage is very efficient in achieving cervical fusion in patients with SCIWORA. There are few complications associated with the use of this cage, and the functional and neurological outcomes are satisfactory. PMID:23844369

2013-01-01

138

Exercise as an Adjunct Treatment for Opiate Agonist Treatment: Review of the Current Research and Implementation Strategies  

Microsoft Academic Search

Opiate dependence is a significant public health concern linked to poor quality of life, co-morbid psychiatric disorders, and high costs to society. Current opiate agonist treatments are an effective but limited intervention. Adjunctive interventions could improve and augment opiate agonist treatment outcomes, including drug abstinence, quality of life, and physical health. This article reviews exercise as an adjunctive intervention for

Jeremiah Weinstock; Heather K. Wadeson; Jaci L. VanHeest

2012-01-01

139

The changing role for neurosurgeons and the treatment of spinal deformity.  

PubMed

Spinal deformity has classically and historically been studied by those in the discipline of orthopedic surgery. This may be attributable to the orthopedic interventionalists' experience with osseous fixation for long-bone and other skeletal fractures. Neurosurgeons have maintained a long-standing interest in complex cervical spinal disorders, and their interest in the larger field of complex spinal deformity has been expanding. An understanding of spinal deformity disorders, biomechanics, bone biology, and metallurgy is necessary before clinical, teaching, and research activities can be undertaken within neurosurgery. The authors describe basic and advanced concepts of spinal deformity management with cases to illustrate teaching points. PMID:15796346

Johnson, J Patrick; Pashman, Robert S; Lauryssen, Carl; Anand, Neel; Regan, John J; Bray, Robert S

2005-03-01

140

Minocycline Treatment Reduces Delayed Oligodendrocyte Death, Attenuates Axonal Dieback, and Improves Functional Outcome after Spinal Cord Injury  

Microsoft Academic Search

Minocycline has been demonstrated to be neuroprotective after spinal cord injury (SCI). However, the cellular consequences of minocy- cline treatment on the secondary injury response are poorly understood. We examined the ability of minocycline to reduce oligodendro- cyte apoptosis, microglial\\/macrophage activation, corticospinal tract (CST) dieback, and lesion size and to improve functional outcome after SCI. Adult rats were subjected to

D. P. Stirling; Kourosh Khodarahmi; Jie Liu; Lowell T. Mcphail; Christopher B. Mcbride; John D. Steeves; Matt S. Ramer; Wolfram Tetzlaff

2004-01-01

141

Mechanisms and models of spinal cord stimulation for the treatment of neuropathic pain.  

PubMed

Spinal cord stimulation (SCS) is an established and cost-effective therapy for treating severe chronic pain. However, despite over 40 years of clinical practice and the development of novel electrode designs and treatment protocols, increases in clinical success, defined as the proportion of patients that experience 50% or greater self-reported pain relief, have stalled. An incomplete knowledge of the neural circuits and systems underlying chronic pain and the interaction of SCS with these circuits may underlie this plateau in clinical efficacy. This review summarizes prior work and identifies gaps in our knowledge regarding the neural circuits related to pain and SCS in the dorsal horn, supraspinal structures, and the Pain Matrix. In addition, this review discusses and critiques current experimental and computational models used to investigate and optimize SCS. Further research into the interactions between SCS and pain pathways in the nervous system using animal and computational models is a fruitful approach to improve this promising therapy. PMID:24802658

Zhang, Tianhe C; Janik, John J; Grill, Warren M

2014-06-20

142

SMN-inducing compounds for the treatment of spinal muscular atrophy  

PubMed Central

Spinal muscular atrophy (SMA) is a leading genetic cause of infant mortality. A neurodegenerative disease, it is caused by loss of SMN1, although low, but essential, levels of SMN protein are produced by the nearly identical gene SMN2. While no effective treatment or therapy currently exists, a new wave of therapeutics has rapidly progressed from cell-based and preclinical animal models to the point where clinical trials have initiated for SMA-specific compounds. There are several reasons why SMA has moved relatively rapidly towards novel therapeutics, including: SMA is monogenic; the molecular understanding of SMN gene regulation has been building for nearly 20 years; and all SMA patients retain one or more copies of SMN2 that produces low levels of full-length, fully functional SMN protein. This review primarily focuses upon the biology behind the disease and examines SMN1- and SMN2-targeted therapeutics. PMID:23157239

Lorson, Monique A; Lorson, Christian L

2013-01-01

143

Effectiveness of olfactory ensheathing cell transplantation for treatment of spinal cord injury.  

PubMed

The aim of this study was to determine the effectiveness and safety of transplantation of olfactory ensheathing cells for functional repair of the spinal cord. An olfactory bulb was obtained from a 4- to 5-month-old aborted fetus, and it was digested into single olfactory ensheathing cells and then cultured and purified for 1 to 2 weeks. Under general anesthesia, these single-cell suspensions of olfactory ensheathing cells were injected into the corresponding spinal injury site with 0.45-mm-diameter injections. The American Spinal Injury Association (ASIA) Impairment Scale was used to evaluate spinal function. A total of 15 patients (12 men, 3 women; age range, 18-56 years; mean age, 40) were admitted for obsolete spinal injuries. Spinal functions of the 15 patients were observed and followed postoperatively for a period ranging from 2 weeks to 1 month. All the 15 patients exhibited improvements in spinal function, and the improvement tendencies continued. Twelve patients had obvious spinal function improvement, and three had slight improvement according to the ASIA scale, with an obvious difference between preoperation and postoperation measures (P < 0.05). No fevers, infections, functional deteriorations, or deaths were seen. Thus, transplantation of olfactory ensheathing cells promoted spinal and neurofunctional recovery in patients with malignant spinal injuries, and this therapeutic method was safe. PMID:24938704

Rao, Y J; Zhu, W X; Du, Z Q; Jia, C X; Du, T X; Zhao, Q A; Cao, X Y; Wang, Y J

2014-01-01

144

Does Scoliosis-Specific Exercise Treatment in Adolescence Alter Adult Quality of Life?  

PubMed Central

Objective. Health-related quality of life in adults, who in adolescence participated in a scoliosis-specific exercise program, was not previously studied. Design. Cross-sectional study, with retrospective data collection. Material and Methods. Homogenous groups of 68 persons (43 women) aged 30.10 (25–39) years, with mild or moderate scoliosis, and 76 (38 women) able-bodied persons, aged 30.11 (24–38) years, who 16.5 (12–26) years earlier had completed scoliosis-specific exercise or observation regimes, participated. Their respiratory characteristics did not differ from predicted values. The WHOQOL-BREF questionnaire, Oswestry Disability Questionnaire, and pain scale (VAS) were applied. Results. The transformed WHOQOL-BREF scores ranged from 54.6?±?11.19 in the physical domain in the mild scoliotic subgroup to 77.1?±?16.05 in the social domain in the able-bodied subgroup. The ODQ values did not generally exceed 5.3?±?7.53. Inter- and intragroup differences were nonsignificant. Age, marital status, education, and gender were significantly associated with the ODQ scores. Significant association between the ODQ and WHOQOL-BREF social relationships domain scores with the participation in exercise treatment was found. Conclusions. Participants with the history of exercise treatment generally did not differ significantly from their peers who were only under observation. This study cannot conclude that scoliosis-specific exercise treatment in adolescence alters quality of life in adulthood. PMID:25436225

P?aszewski, Maciej; Cie?li?ski, Igor; Kowalski, Pawe?; Truszczy?ska, Aleksandra; Nowobilski, Roman

2014-01-01

145

Resistance exercise interventions during and following cancer treatment: a systematic review.  

PubMed

Findings from prior systematic reviews suggest that exercise results in meaningful improvements in many clinically relevant physiologic and quality of life (QOL) outcomes during and following cancer treatment. However, the majority of exercise-cancer studies have focused upon the benefits of aerobic exercise (AE) and knowledge of the efficacy of resistance exercise (RE) alone as a supportive care intervention for cancer patients and survivors remains limited. Consequently, the purpose of this review was to provide the first systematic evaluation of the effects of RE alone upon clinically relevant physiologic and QOL outcomes during and following cancer treatment. Literature searches were conducted to identify studies examining RE interventions in cancer patients and survivors. Data were extracted on physiologic (fitness, physical function, and body composition) and QOL (fatigue, psychological well-being, and cancer-specific and global QOL outcomes. Cohen's d effect sizes were calculated for each outcome. A total of 15 studies (6 in samples undergoing active cancer treatment and 9 in samples having completed cancer treatment) involving 1,077 participants met the inclusion criteria. Findings revealed that, on average, RE resulted in large effect-size improvements in muscular strength (d = 0.86), moderate effect-size improvements in physical function (d = 0.66), and small effect-size improvements in body composition (d = 0.28) and QOL (d = 0.25) outcomes. The effect sizes observed following RE are comparable in magnitude to the effects of exercise interventions reported in prior comprehensive reviews of the exercise-cancer literature which primarily focused upon AE. Additionally, the methodologic quality of the studies was generally strong. Taken collectively, results of this systematic review suggest that RE is a promising supportive care intervention that results in meaningful improvements in clinically relevant physiologic and QOL outcomes during and following cancer treatment. PMID:23967493

Focht, Brian C; Clinton, Steven K; Devor, Steven T; Garver, Matthew J; Lucas, Alexander R; Thomas-Ahner, Jennifer M; Grainger, Elizabeth

2013-06-01

146

Chronic neuropathic pain management in spinal cord injury patients. What is the efficacy of pharmacological treatments with a general mode of  

E-print Network

Title Chronic neuropathic pain management in spinal cord injury patients. What is the efficacy of patients with spinal cord injury (SCI) pain remains challenging despite new available drugs. Such treatment shoud always be viewed in the context of global pain management in these patients. To date few clinical

Paris-Sud XI, Université de

147

The neuroprotective mechanism of puerarin in the treatment of acute spinal ischemia-reperfusion injury is linked to cyclin-dependent kinase 5.  

PubMed

Puerarin is shown to exert a variety of pharmacological effects including neuroprotective properties. However, mechanisms of the action are not fully understood. This study was designed to explore the mechanism of puerarin in treatment of acute spinal ischemia-reperfusion injury in rats. Acute spinal ischemia-reperfusion injury was conducted by aortic occlusion in twenty-eight male Sprague-Dawley rats, weighting 230-250g. The animals were randomly divided into four groups. In the animals with puerarin treatment, 50mg/kg of puerarin was injected intraperitoneally after reperfusion, and followed by the same dose of injection every 24h for 2 days. In the animals with roscovitine pre-treatment, 30mg/kg roscovitine was intravenously administrated 60min before spinal ischemia started. After spinal ischemia for 60min followed by 48h of reperfusion, the motor function, spinal infarction volume, apoptosis indices and the activities of Cdk5 and p25 were examined. Acute spinal ischemia-reperfusion resulted in an injury of the spines associated with motor deficit, elevation of Cdk5 and p25 activities, and increase in the spinal apoptosis number and spinal infarction volume. Puerarin improved motor function associated with the decreased apoptosis number, spinal infarction volume, and Cdk5 and p25 activities. The present study indicated that reduction of spinal injury was associated with inhibition of Cdk5 and p25, and that inhibition of Cdk5 and p25 was one of the neuroprotective mechanisms in the puerarin treatment of acute ischemia/reperfusion-induced spinal injury in rats. PMID:25301568

Tian, Feng; Xu, Li-Hui; Wang, Bin; Tian, Li-Jie; Ji, Xiang-Lu

2015-01-01

148

The Cancer Drug Tamoxifen: A Potential Therapeutic Treatment for Spinal Cord Injury  

PubMed Central

Abstract Tamoxifen (TMX) is a selective estrogen receptor modulator that can mimic the neuroprotective effects of estrogen but lacks its systemic adverse effects. We found that TMX (1?mg/day) significantly improved the motor recovery of partially paralyzed hind limbs of male adult rats with thoracic spinal cord injury (SCI), thus indicating a translational potential for this cancer medication given its clinical safety and applicability and the lack of currently available treatments for SCI. To shed light on the mechanisms underlying the beneficial effects of TMX for SCI, we used proteomic analyses, Western blots and histological assays, which showed that TMX treatment spared mature oligodendrocytes/increased myelin levels and altered reactive astrocytes, including the upregulation of the water channels aquaporin 4 (AQP4), a novel finding. AQP4 increases in TMX-treated SCI rats were associated with smaller fluid-filled cavities with borders consisting of densely packed AQP4-expressing astrocytes that closely resemble the organization of normal glia limitans externa (in contrast to large cavities in control SCI rats that lacked glia limitans-like borders and contained reactive glial cells). Based on our findings, we propose that TMX is a promising candidate for the therapeutic treatment of SCI and a possible intervention for other neuropathological conditions associated with demyelination and AQP4 dysfunction. PMID:24004276

Guptarak, Jutatip; Wiktorowicz, John E.; Sadygov, Rovshan G.; Zivadinovic, Dragoslava; Paulucci-Holthauzen, Adriana A.; Vergara, Leoncio

2014-01-01

149

Surgical Treatment for Adult Spinal Deformity: Projected Cost Effectiveness at 5-Year Follow-Up  

PubMed Central

Background In the United States, expenditures related to spine care are estimated to account for $86 billion annually. Policy makers have set a cost-effectiveness benchmark of less than $100,000/quality adjusted life year (QALY), forcing surgeons to defend their choices economically. This study projects the cost/QALY for surgical treatment of adult spinal deformity at 5-year follow-up based on 2-year cost- and health-related quality-of-life (HRQOL) data. Methods In a review of 541 patients with adult spinal deformity, the patients who underwent revision or were likely to undergo revision were identified and cost of surgery was doubled to account for the second procedure; all other patients maintained the cost of the initial surgery. Oswestry Disability Index (ODI) was modeled by revision status based on literature findings. Total surgical cost was based on Medicare reimbursement. Chi square and student t tests were utilized to compare cost-effective and non–cost-effective patients. Results The average cost/QALY at 5-year follow-up was $120,311.73. A total of 40.7% of patients fell under the threshold of a cost/QALY <$100,000. Cost-effective patients had higher baseline ODI scores (45% vs 34% [P=0.001]), lower baseline total Scoliosis Research Society scores (2.89 vs 3.00 [P=0.04]), and shorter fusions (8.23 vs 9.87 [P=0.0001]). Conclusion We found 40.7% of patients to be below the threshold of cost effectiveness. Factors associated with reaching the threshold <$100,000/QALY were greater preoperative disability, diagnosis of idiopathic scoliosis, poor preoperative HRQOL scores, and fewer fusion levels. PMID:24688328

Terran, Jamie; McHugh, Brian J.; Fischer, Charla R.; Lonner, Baron; Warren, Daniel; Glassman, Steven; Bridwell, Keith; Schwab, Frank; Lafage, Virginie

2014-01-01

150

Analysis of the embolization spinal dural arteriovenous fistula and surgical treatments on 52 cases of the patients  

PubMed Central

Background: Spinal dural arteriovenous fistula (SDAVF) highly threatens people’s life and health. Effective methods for the diagnosis and treatment of the disease are badly needed in clinical application. Objective: The objective of the present study was to sum up the diagnosis and treatment method of SDAVF to improve the diagnosis and treatment effect of the disease. Methods: The epidemiological data, imaging data, therapeutic methods and postoperative follow-up data of 52 cases of patients with SDAVF received in our hospital in recent 6 years were collected and retrospectively analyzed. Results: There were 43 male patients and 9 female patients with ages of 39-77 years and average age of 59.6 years. The course of disease was 1 to 48 months with an average disease course of 14.4 months. All the patients had syndromes of lower limb numbness, pain, weakness and other sensory and movement disorders mostly accompanied with defecation dysfunction. Magnetic resonance imaging (MRI) results demonstrated that spinal cord abnormalities were found in spinal cord, which could be diagnosed by digital subtraction angiography (DSA) examination. There were 40 cases received surgical treatment and there was no recurrence in the follow-up. There were 12 patients received embolotherapy, of whom 3 patients were operated the second time and 2 patients had embolization again. After 0.5-6 years of follow-up, postoperative symptoms of the 40 patients were improved in different degrees. The modified Aminoff-Logue function scoring was significantly decreased after treatment. Conclusion: SDAVF is the easily diagnosed and delayed spinal cord vascular lesions in clinical applications. The diagnosis relies mainly on MRI and DSA examinations. The surgical treatment effect is good and is not easily relapsed. The trauma of the interventional embolization treatment is small, but the recurrence rate is high. PMID:25356182

Qi, Xiangqian; Lv, Liquan; Han, Kaiwei; Xu, Zheng; Mei, Qiyong; Chen, Huairui; Huang, Chengguang; Bai, Rulin; Hou, Lijun; Lu, Yicheng

2014-01-01

151

Influenza antiviral treatment in spinal cord injury patients, 2007-2010.  

PubMed

Objective This study assessed antiviral medication use for treatment of influenza-like illness (ILI) in Veterans with spinal cord injury or disorder (SCI/D) and examined whether antiviral prescribing improved over time. Design Retrospective cohort study of Department of Veterans Affairs (VA) facilities. Participants Veterans with SCI/D and matched non-SCI/D controls (matched by facility and date of visit/admission) who were diagnosed by a clinician with ILI during the period 1 October 2007 to 31 May 2010. Main outcome measures Antiviral receipt and appropriateness were examined. Appropriate antiviral prescribing was defined as patients who received an antiviral medication within 2 days of collection of a sample for diagnostic testing or within 2 days of symptom onset. Results We identified 101 influenza visits/admissions for veterans with SCI/D and 123 for controls. Antiviral prescribing for Veterans with SCI/D increased from 37.1% in 2007/2008 to 67.6% in 2009/2010 (P = 0.01) and appropriate antiviral prescribing increased from 20.0 to 41.2% (P = 0.05). Predictors of antiviral prescribing included being treated in the 2009/2010 influenza season (vs. 2007/2008) and having a cough. Fever, aches/myalgia, or a positive influenza test was associated with appropriate antiviral treatment. SCI/D was an independent predictor of receiving antiviral treatment (adjusted odds ratio = 1.16, 95% confidence interval 1.04-1.29), but having SCI/D was not associated with receiving appropriate treatment. Conclusions Influenza antiviral prescribing increased over time and in a larger proportion in veterans with SCI/D (vs. controls). This suggests that providers treating patients with SCI/D recognize treatment guidelines and their importance in a high-risk population. Continued efforts are needed to improve appropriate influenza antiviral prescribing. PMID:24961594

Evans, Charlesnika T; Rogers, Thea J; Goldstein, Barry; Weaver, Frances M; LaVela, Sherri L

2015-01-01

152

Neuropathic Pain Post Spinal Cord Injury Part 1: Systematic Review of Physical and Behavioral Treatment  

PubMed Central

Background: Neuropathic pain has various physiologic and psychosocial aspects. Hence, there is a growing use of adjunct nonpharmacological therapy with traditional pharmacotherapy to reduce neuropathic pain post spinal cord injury (SCI). Objective: The purpose of this study was to conduct a systematic review of published research on nonpharmacological treatment of neuropathic pain after SCI. Methods: MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched for articles addressing nonpharmacological treatment of pain post SCI. Articles were restricted to the English language. Article selection was conducted by 2 independent reviewers with the following inclusion criteria: the subjects participated in a treatment or intervention for neuropathic pain; at least 50% of the subjects had an SCI; at least 3 subjects had an SCI; and a definable intervention was being studied. Data extracted included study design, study type, subject demographics, inclusion and exclusion criteria, sample size, outcome measures, and study results. Randomized controlled trials (RCTs) were assessed for quality using the Physiotherapy Evidence Database (PEDro) assessment scale. Levels of evidence were assigned to each intervention using a modified Sackett scale. Results: The 16 articles selected for this review fell into 1 of 2 categories of nonpharmacological management of pain after SCI: physical and behavioral treatments. The pooled sample size of all studies included 433 participants. Of the 16 studies included, 7 were level 1, 3 were level 2, and 6 were level 4 studies. Conclusions: Physical interventions demonstrated the strongest evidence based on quality of studies and numbers of RCTs in the nonpharmacological treatment of post-SCI pain. Of these interventions, transcranial electrical stimulation had the strongest evidence of reducing pain. Despite a growing body of literature, there is still a significant lack of research on the use of nonpharmacological therapies for SCI pain. PMID:23678287

2013-01-01

153

Aerobic Exercise Training Reduces Cannabis Craving and Use in Non-Treatment Seeking Cannabis-Dependent  

E-print Network

Aerobic Exercise Training Reduces Cannabis Craving and Use in Non-Treatment Seeking Cannabis of America Abstract Background: Cannabis dependence is a significant public health problem. Because on cannabis craving and use in cannabis dependent adults under normal living conditions. Design: Participants

Palmeri, Thomas

154

Aerobic exercise and cognitive therapy in the treatment of dysphoric moods  

Microsoft Academic Search

This study examined the separate and combined effects of verbal (cognitive) therapy and aerobic exercise for the treatment of individuals experiencing difficulties coping with dysphoric moods. Sixty-one volunteers who scored between 9 and 30 on the Beck Depression Inventory were randomly assigned to one of three conditions: running only, cognitive therapy only, or combined running and therapy. Cognitive therapy was

Jeffrey Fremont; Linda Wilcoxon Craighead

1987-01-01

155

Holistic Treatment Approaches to ADHD: Nutrition, Sleep,and Exercise, Part 7  

ERIC Educational Resources Information Center

This article is part of a series exploring Attention Deficit Hyperactivity Disorder (ADHD). In this seventh installment, the author discusses three holistic treatments for children and adults with ADHD: diet and nutrition, sleep, and exercise. These approaches focus and improve the overall health of ADHD patients. (For Part 6 of this series, see…

Lavoie, Theresa

2009-01-01

156

Lumbar Spinal Stenosis Minimally Invasive Treatment with Bilateral Transpedicular Facet Augmentation System  

SciTech Connect

Purpose. The purpose of this study was to evaluate the effectiveness of a new pedicle screw-based posterior dynamic stabilization device PDS Percudyn System Trade-Mark-Sign Anchor and Stabilizer (Interventional Spine Inc., Irvine, CA) as alternative minimally invasive treatment for patients with lumbar spine stenosis. Methods. Twenty-four consecutive patients (8 women, 16 men; mean age 61.8 yr) with lumbar spinal stenosis underwent implantation of the minimally invasive pedicle screw-based device for posterior dynamic stabilization. Inclusion criteria were lumbar stenosis without signs of instability, resistant to conservative treatment, and eligible to traditional surgical posterior decompression. Results. Twenty patients (83 %) progressively improved during the 1-year follow-up. Four (17 %) patients did not show any improvement and opted for surgical posterior decompression. For both responder and nonresponder patients, no device-related complications were reported. Conclusions. Minimally invasive PDS Percudyn System Trade-Mark-Sign has effectively improved the clinical setting of 83 % of highly selected patients treated, delaying the need for traditional surgical therapy.

Masala, Salvatore, E-mail: salva.masala@tiscali.it [Interventional Radiology and Radiotherapy, University of Rome 'Tor Vergata', Department of Diagnostic and Molecular Imaging (Italy); Tarantino, Umberto [University of Rome 'Tor Vergata', Department of Orthopaedics and Traumatology (Italy); Nano, Giovanni, E-mail: gionano@gmail.com [Interventional Radiology and Radiotherapy, University of Rome 'Tor Vergata', Department of Diagnostic and Molecular Imaging (Italy); Iundusi, Riccardo [University of Rome 'Tor Vergata', Department of Orthopaedics and Traumatology (Italy); Fiori, Roberto, E-mail: fiori.r@libero.it; Da Ros, Valerio, E-mail: valeriodaros@hotmail.com; Simonetti, Giovanni [Interventional Radiology and Radiotherapy, University of Rome 'Tor Vergata', Department of Diagnostic and Molecular Imaging (Italy)

2013-06-15

157

Radioactive bone cement for the treatment of spinal metastases: a dosimetric analysis of simulated clinical scenarios  

NASA Astrophysics Data System (ADS)

Vertebral metastases are a common manifestation of many cancers, potentially leading to vertebral collapse and neurological complications. Conventional treatment often involves percutaneous vertebroplasty/kyphoplasty followed by external beam radiation therapy. As a more convenient alternative, we have introduced radioactive bone cement, i.e. bone cement incorporating a radionuclide. In this study, we used a previously developed Monte Carlo radiation transport modeling method to evaluate dose distributions from phosphorus-32 radioactive cement in simulated clinical scenarios. Isodose curves were generally concentric about the surface of bone cement injected into cadaveric vertebrae, indicating that dose distributions are relatively predictable, thus facilitating treatment planning (cement formulation and dosimetry method are patent pending). Model results indicated that a therapeutic dose could be delivered to tumor/bone within ?4 mm of the cement surface while maintaining a safe dose to radiosensitive tissue beyond this distance. This therapeutic range should be sufficient to treat target volumes within the vertebral body when tumor ablation or other techniques are used to create a cavity into which the radioactive cement can be injected. With further development, treating spinal metastases with radioactive bone cement may become a clinically useful and convenient alternative to the conventional two-step approach of percutaneous strength restoration followed by radiotherapy.

Kaneko, T. S.; Sehgal, V.; Skinner, H. B.; Al-Ghazi, M. S. A. L.; Ramsinghani, N. S.; Marquez Miranda, M.; Keyak, J. H.

2012-07-01

158

Exercise programmes in the treatment of children with learning disabilities.  

PubMed

Learning disability is characterised by a discrepancy between achievement and assessed intellectual ability. Children with this problem commonly (but not invariably) show impaired motor proficiency, as assessed by such instruments as the Bruininks-Oseretsky Test of motor proficiency. It has been hypothesised that poor motor performance and/or poor social skills lead to exclusion from games, creating a vicious cycle of decreasing participation, decreasing competence, a deterioration of self-worth and increasing social maladjustment. Attempts to break the vicious cycle with programmes designed to enhance motor proficiency have been uniformly unsuccessful. There is limited experimental evidence to support the view that structured physical activity programmes with an embedded social skills training component can be an effective method of enhancing both actual motor ability and self-perception of physical and academic competence. However, a controlled comparison with small-group, academic instruction has shown that, from the educational perspective, a physical activity-based intervention is no more effective than other forms of special attention. The main argument for delivering social skills training through a physical activity programme lies not in a unique impact upon learning disability, but rather in terms of the other well-established long term health benefits of exercise. PMID:7740247

Bluechardt, M H; Wiener, J; Shephard, R J

1995-01-01

159

Effect of VEGF Treatment on the Blood-Spinal Cord Barrier Permeability in Experimental Spinal Cord Injury: Dynamic Contrast-Enhanced Magnetic Resonance Imaging  

PubMed Central

Abstract Compromised blood-spinal cord barrier (BSCB) is a factor in the outcome following traumatic spinal cord injury (SCI). Vascular endothelial growth factor (VEGF) is a potent stimulator of angiogenesis and vascular permeability. The role of VEGF in SCI is controversial. Relatively little is known about the spatial and temporal changes in the BSCB permeability following administration of VEGF in experimental SCI. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) studies were performed to noninvasively follow spatial and temporal changes in the BSCB permeability following acute administration of VEGF in experimental SCI over a post-injury period of 56 days. The DCE-MRI data was analyzed using a two-compartment pharmacokinetic model. Animals were assessed for open field locomotion using the Basso-Beattie-Bresnahan score. These studies demonstrate that the BSCB permeability was greater at all time points in the VEGF-treated animals compared to saline controls, most significantly in the epicenter region of injury. Although a significant temporal reduction in the BSCB permeability was observed in the VEGF-treated animals, BSCB permeability remained elevated even during the chronic phase. VEGF treatment resulted in earlier improvement in locomotor ability during the chronic phase of SCI. This study suggests a beneficial role of acutely administered VEGF in hastening neurobehavioral recovery after SCI. PMID:19226205

Patel, Chirag B.; Cohen, David M.; Ahobila-Vajjula, Pallavi; Sundberg, Laura M.; Chacko, Tessy

2009-01-01

160

Enhanced information regarding exercise training as treatment is needed. An interview study in patients with chronic obstructive pulmonary disease.  

PubMed

Abstract Purpose: The purpose of this study is to describe thoughts and attitudes of patients with chronic obstructive pulmonary disease (COPD) when talking about exercise training as treatment. Methods: Semi-structured interviews were performed and analyzed with the grounded theory method. Four men and six women were interviewed (ages 66-84 years), with moderate to severe COPD, and no experience of organized exercise training as treatment for COPD. Results: The analysis resulted in one core category, unknown territory, and three categories, good for those who can, but not for me; fear of future; and mastering. Exercise training as treatment was perceived by the participants as something unknown. It was also described as important for others but not for them. Their perceptions were that they could not perform exercise training, and did not have the knowledge of what or how to perform exercise that was good for them. Conclusions: Patients with COPD, with no previous experience of exercise training as treatment for their disease, describe exercise training as something unknown and unimportant for them. The results provide important knowledge for healthcare professionals regarding how to educate patients with COPD about the content and benefits of exercise training as treatment. Implications for Rehabilitation Exercise training is effective for patients with chronic obstructive pulmonary disease (COPD) with regard to dyspnea, physical capacity, health-related quality of life, and health care use. Patients with COPD perceive a lack of information regarding exercise training as treatment. The information and the presentation of exercise training as treatment might be of importance to get better adherence to this treatment. PMID:25335549

Nordvall Strömberg, Petronella; Fjellman-Wiklund, Anncristine; Wadell, Karin

2014-10-22

161

[Eccentric exercises in the treatment of overuse injuries of the musculoskeletal system].  

PubMed

Overuse injuries of the musculoskeletal system are a common problem in both general population and among athletes. Researches made in the last decade have shown that overuse injuries are mainly caused by degenerative changes and not inflammation, as was thought before. Although they can be present everywhere in musculoskeletal system, overuse injuries are most often seen on tendons. The main goal of this article is to refer to latest guidelines in the treatment of overuse injuries, with special attention to eccentric exercise treatment program for most common tendinopathies (patellar tendinopathy, Achilles tendinopathy and lateral epicondylitis). The main reason is the fact that very good results are accomplished after eccentric exercises in the treatment of tendinopathies and are thus suggested as the first treatment option. PMID:22519251

Dimnjakovi?, Damjan; Bojani?, Ivan; Smoljanovi?, Tomislav; Mahnik, Alan; Barbari?-Perai?, Nevenka

2012-01-01

162

Surgical Treatment of Spinal Stenosis with and without Degenerative Spondylolisthesis: Cost-Effectiveness after 2 Years  

PubMed Central

Background The SPORT (Spine Patient Outcomes Research Trial) reported favorable surgery outcomes over 2 years among patients with stenosis with and without degenerative spondylolisthesis, but the economic value of these surgeries is uncertain. Objective To assess the short-term cost-effectiveness of spine surgery relative to nonoperative care for stenosis alone and for stenosis with spondylolisthesis. Design Prospective cohort study. Data Sources Resource utilization, productivity, and EuroQol EQ-5D score measured at 6 weeks and at 3, 6, 12, and 24 months after treatment among SPORT participants. Target Population Patients with image-confirmed spinal stenosis, with and without degenerative spondylolisthesis. Time Horizon 2 years. Perspective Societal. Intervention Nonoperative care or surgery (primarily decompressive laminectomy for stenosis and decompressive laminectomy with fusion for stenosis associated with degenerative spondylolisthesis). Outcome Measures Cost per quality-adjusted life-year (QALY) gained. Results of Base-Case Analysis Among 634 patients with stenosis, 394 (62%) had surgery, most often decompressive laminectomy (320 of 394 [81%]). Stenosis surgeries improved health to a greater extent than nonoperative care (QALY gain, 0.17 [95% CI, 0.12 to 0.22]) at a cost of $77 600 (CI, $49 600 to $120 000) per QALY gained. Among 601 patients with degenerative spondylolisthesis, 368 (61%) had surgery, most including fusion (344 of 368 [93%]) and most with instrumentation (269 of 344 [78%]). Degenerative spondylolisthesis surgeries significantly improved health versus non-operative care (QALY gain, 0.23 [CI, 0.19 to 0.27]), at a cost of $115 600 (CI, $90 800 to $144 900) per QALY gained. Result of Sensitivity Analysis Surgery cost markedly affected the value of surgery. Limitation The study used self-reported utilization data, 2-year time horizon, and as-treated analysis to address treatment non-adherence among randomly assigned participants. Conclusion The economic value of spinal stenosis surgery at 2 years compares favorably with many health interventions. Degenerative spondylolisthesis surgery is not highly cost-effective over 2 years but could show value over a longer time horizon. PMID:19075203

Tosteson, Anna N.A.; Lurie, Jon D.; Tosteson, Tor D.; Skinner, Jonathan S.; Herkowitz, Harry; Albert, Todd; Boden, Scott D.; Bridwell, Keith; Longley, Michael; Andersson, Gunnar B.; Blood, Emily A.; Grove, Margaret R.; Weinstein, James N.

2009-01-01

163

Transforaminal Decompression and Interbody Fusion in the Treatment of Thoracolumbar Fracture and Dislocation with Spinal Cord Injury  

PubMed Central

Study Design A retrospective clinical study. Objective To evaluate the efficacy and safety of transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury. Methods Twenty-six spinal cord injured patients with thoracolumbar fracture and dislocation were treated by transforaminal decompression and interbody fusion. The operation time, intraoperative blood loss, and complications were recorded; the Cobb angle and compressive rate (CR) of the anterior height of two adjacent vertebrae were measured; and the nerve injury was assessed according to sensory scores and motor scores of the American Spinal Injury Association (ASIA) standards for neurological classification of spinal cord injury. Results The operative time was 250±57 min, and intraoperative blood loss was 440±168 ml. Cerebrospinal leakage was detected and repaired during the operation in two patients. A total of 24 of 26 patients were followed up for more than 2 years. ASIA sensory scores and motor scores were improved significantly at 3 months and 6 months after operation; the Cobb angle and CR of the anterior height of two adjacent vertebrae were corrected and showed a significant difference at post-operation; and the values were maintained at 3 months after operation and the last follow-up. Conclusion We showed that transforaminal decompression together with interbody fusion is an alternative method to treat thoracolumbar fracture and dislocation. PMID:25148221

Wu, Ai-Min; Zheng, Yi-Jing; Lin, Yan; Wu, Yao-Sen; Mao, Fang-Min; Ni, Wen-Fei; Wang, Xiang-Yang; Xu, Hua-Zi

2014-01-01

164

Spinal deformity.  

PubMed

Early results of scoliosis screening programs have demonstrated that mild spinal deformity is common, usually nonprogressive, and often requires no specific treatment. The role of the primary care physician is an important one in identifying the rare case, which is secondary to some underlying disorder which itself requires treatment, and the progressive curves, which should be managed by bracing. The informed physician can make this separation efficiently with minimum cost to the family and minimum radiation exposure to the patient. PMID:7373257

Staheli, L T

1980-06-01

165

Changes in Cross-Sectional Area of Spinal Canal and Vertebral Body Under 2 Years of Teriparatide Treatment: Results from the EUROFORS Study  

Microsoft Academic Search

The treatment of osteoporotic patients with teriparatide is associated with a significant increase in bone formation and gain\\u000a of bone mass. The purpose of this post hoc analysis was to determine if the cross-sectional area (CSA) of the spinal canal\\u000a and the vertebral body is affected by teriparatide treatment. Narrowing of the spinal canal might represent a safety problem,\\u000a while

R. Schnell; C. Graeff; A. Krebs; H. Oertel; C.-C. Glüer

2010-01-01

166

A Systematic Review of Non-Invasive Pharmacologic Neuroprotective Treatments for Acute Spinal Cord Injury  

PubMed Central

Abstract An increasing number of therapies for spinal cord injury (SCI) are emerging from the laboratory and seeking translation into human clinical trials. Many of these are administered as soon as possible after injury with the hope of attenuating secondary damage and maximizing the extent of spared neurologic tissue. In this article, we systematically review the available pre-clinical research on such neuroprotective therapies that are administered in a non-invasive manner for acute SCI. Specifically, we review treatments that have a relatively high potential for translation due to the fact that they are already used in human clinical applications, or are available in a form that could be administered to humans. These include: erythropoietin, NSAIDs, anti-CD11d antibodies, minocycline, progesterone, estrogen, magnesium, riluzole, polyethylene glycol, atorvastatin, inosine, and pioglitazone. The literature was systematically reviewed to examine studies in which an in-vivo animal model was utilized to assess the efficacy of the therapy in a traumatic SCI paradigm. Using these criteria, 122 studies were identified and reviewed in detail. Wide variations exist in the animal species, injury models, and experimental designs reported in the pre-clinical literature on the therapies reviewed. The review highlights the extent of investigation that has occurred in these specific therapies, and points out gaps in our knowledge that would be potentially valuable prior to human translation. PMID:20146558

Okon, Elena; Hillyer, Jessica; Mann, Cody; Baptiste, Darryl; Weaver, Lynne C.; Fehlings, Michael G.; Tetzlaff, Wolfram

2011-01-01

167

Aerobic Exercise Training Reduces Cannabis Craving and Use in Non-Treatment Seeking Cannabis-Dependent Adults  

Microsoft Academic Search

BackgroundCannabis dependence is a significant public health problem. Because there are no approved medications for this condition, treatment must rely on behavioral approaches empirically complemented by such lifestyle change as exercise.AimsTo examine the effects of moderate aerobic exercise on cannabis craving and use in cannabis dependent adults under normal living conditions.DesignParticipants attended 10 supervised 30-min treadmill exercise sessions standardized using

Maciej S. Buchowski; Natalie N. Meade; Evonne Charboneau; Sohee Park; Mary S. Dietrich; Ronald L. Cowan; Peter R. Martin; Antonio Verdejo García

2011-01-01

168

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis.  

PubMed

Lumbar spine surgery is typically performed under general anesthesia, although spinal anesthesia can also be used. Given the prevalence of lumbar spine surgery, small differences in cost between the two anesthetic techniques have the potential to make a large impact on overall healthcare costs. We sought to perform a cost comparison analysis of spinal versus general anesthesia for lumbar spine operations. Following Institutional Review Board approval, a retrospective cohort study was performed from 2009-2012 on consecutive patients undergoing non-instrumented, elective lumbar spine surgery for spondylosis by a single surgeon. Each patient was evaluated for both types of anesthesia, with the decision for anesthetic method being made based on a combination of physical status, anatomical considerations, and ultimately a consensus agreement between patient, surgeon, and anesthesiologist. Patient demographics and clinical characteristics were compared between the two groups. Operating room costs were calculated whilst blinded to clinical outcomes and reported in percentage difference. General anesthesia (n=319) and spinal anesthesia (n=81) patients had significantly different median operative times of 175±39.08 and 158±32.75minutes, respectively (p<0.001, Mann-Whitney U test). Operating room costs were 10.33% higher for general anesthesia compared to spinal anesthesia (p=0.003, Mann-Whitney U test). Complications of spinal anesthesia included excessive movement (n=1), failed spinal attempt (n=3), intraoperative conversion to general anesthesia (n=2), and a high spinal level (n=1). In conclusion, spinal anesthesia can be performed safely in patients undergoing lumbar spine surgery. It has the potential to reduce operative times, costs, and possibly, complications. Further prospective evaluation will help to validate these findings. PMID:25510535

Walcott, Brian P; Khanna, Arjun; Yanamadala, Vijay; Coumans, Jean-Valery; Peterfreund, Robert A

2015-03-01

169

Urinary tract infections in patients with spinal cord lesions: treatment and prevention.  

PubMed

Even though the mortality due to urinary tract complications has decreased dramatically during the last decades in individuals with spinal cord lesions (SCL), urinary tract infections (UTI) still cause significant morbidity in this population. Complicated UTI are caused by a much wider variety of organisms in individuals with SCL than in the general population and are often polymicrobial. Escherichia coli, Pseudomonas spp., Klebsiella spp., Proteus spp., Serratia spp., Providencia spp., enterococci, and staphylococci are the most frequently isolated bacteria in urine specimens taken from individuals with SCL. There is no doubt that the greatest risk for complicated UTI in these individuals is the use of an indwelling catheter. Intermittent catheterisation during the rehabilitation phase has been shown to lower the rate of UTI, and virtually eliminate many of the complications associated with indwelling catheters. Persons with SCL should only be treated for bacteriuria if they have symptoms. Generally, it is advisable to use antibacterial agents with little or no impact on the normal flora. Single agent therapy - in accordance with antimicrobial susceptibility test - is preferred. We advise extending treatment to at least 5 days, and in those with reinfection or relapsing UTI, at least 7 to 14 days, depending on the severity of the infection. The diagnosis of structural and/or functional risk factors is essential in order to plan an optimal treatment for UTI in individuals with SCL, which should include treatment of simultaneously occurring predisposing factors. The treatment of structural risk factors follows general urological principles, aiming for sufficient outlet from the bladder with minimal residual urine and low pressure voiding. For prevention of UTI, general cleanliness and local hygiene should be encouraged. If the patient has a reinfection or relapsing symptomatic UTI, it is important to check for inadequately treated infection and complications, which need special attention, in particular residual urine and urinary stones. No reliable evidence exists of the effectiveness of cranberry juice and other cranberry products. Prophylactic antibacterials should only be used in patients with recurrent UTI where no underlying cause can be found and managed, and in particular if the upper urinary tract is dilated. Antibacterials should not be used for the prevention of UTI in individuals with SCL and indwelling catheters. However, the use of prophylactic antibacterials for individuals with SCL using intermittent catheterisation or other methods of bladder emptying is controversial. PMID:11511022

Biering-Sørensen, F; Bagi, P; Høiby, N

2001-01-01

170

Global Postural Reeducation and Static Stretching Exercises in the Treatment of Myogenic Temporomandibular Disorders: A Randomized Study  

Microsoft Academic Search

ObjectiveThe purpose of this study was to compare 2 different interventions, global postural reeducation (GPR) and static stretching exercises (SS), in the treatment of women with temporomandibular disorders (TMDs).

Sâmia A. Maluf; Bruno G. D. Moreno; Osvaldo Crivello; Cristina M. N. Cabral; Gislaine Bortolotti; Amélia P. Marques

2010-01-01

171

Treadmill Exercise Training Prevents Myocardial Mechanical Dysfunction Induced by Androgenic-Anabolic Steroid Treatment in Rats  

PubMed Central

Elevated concentrations of testosterone and its synthetic analogs may induce changes in cardiovascular function. However, the effects of the combination of anabolic/androgenic steroid (AAS) treatment and exercise training on systolic and diastolic cardiac function are poorly understood. In the present study, we aimed to investigate the effects of low-dose steroid treatment (stanozolol) on cardiac contractile parameters when this steroid treatment was combined with exercise training in rats and the effects of chronic steroid treatment on the Frank-Starling (length-tension curves) relationship. Male Wistar rats were randomly assigned to one of four groups: U (untrained), US (untrained and treated with stanozolol 5 mg/kg/week), T (trained, 16 m/min/1 h) and TS (trained and treated with stanozolol 5 mg/kg/week). Continuous exercise training was conducted 5 days/week for 8 consecutive weeks. The speed of the treadmill was gradually increased to a final setting of 16 m/min/1 h. Experiments were divided into two independent series: 1) central hemodynamic analysis for mean arterial blood pressure (MAP) and cardiac output (CO) measurements and 2) isolated papillary muscle preparation in Krebs solution. Stanozolol treatment significantly increased the MAP and the heart size in untrained and trained rats (U 113±2; T 106±2; US 138±8 and TS 130±7 mmHg). Furthermore, stanozolol significantly decreased developed tension and dT/dt (maximal and minimal) in U rats. However, the developed tension was completely restored by training. The Frank/Starling relationship was impaired in rats treated with stanozolol; however, again, training completely restored diastolic function. Taken together, the present data suggest that AAS treatment is able to decrease cardiac performance (systolic and diastolic functions). The combination of stanozolol and physical training improved cardiac performance, including diastolic and systolic functions, independent of changes in central hemodynamic parameters. Therefore, changes in ventricular myocyte calcium transients may play a cardioprotective role. PMID:24533053

Bocalini, Danilo S.; Beutel, Abram; Bergamaschi, Cássia T.; Tucci, Paulo J.; Campos, Ruy R.

2014-01-01

172

A typology of alcohol use patterns among persons with recent traumatic brain injury or spinal cord injury: Implications for treatment matching  

Microsoft Academic Search

Turner AP, Bombardier CH, Rimmele CT. A typology of alcohol use patterns among persons with recent traumatic brain injury or spinal cord injury: implications for treatment matching. Arch Phys Med Rehabil 2003;84:358-64. Objective: To describe empirically valid and clinically meaningful types of alcohol use among persons with recent traumatic brain or spinal cord injury. Design: Cross-sectional cohort survey. Setting: Acute

Aaron P. Turner; Charles H. Bombardier; Carl T. Rimmele

2003-01-01

173

No effect of forearm band and extensor strengthening exercises for the treatment of tennis elbow: a prospective randomised study  

Microsoft Academic Search

The objective of this prospective randomised study was to analyse the effect of the forearm support band and of strengthening\\u000a exercises for the treatment of tennis elbow. Twenty-nine patients with 30 tennis elbows were randomised into 3 groups of treatment:\\u000a (I) forearm support band, (II) strengthening exercises and (III) both methods. The patients had a standardised examination\\u000a at their first

Rolf Luginbühl; Florian Brunner; Alberto G. Schneeberger

2008-01-01

174

Effects of Acupuncture, Core-stability Exercises, and Treadmill Walking Exercises in Treating a Patient with Postsurgical Lumbar Disc Herniation: A Clinical Case Report.  

PubMed

The objective of this study is to investigate the effects of acupuncture, core-stability exercises, and treadmill 12-minute walking exercises in treating patients with postsurgical lumbar disc herniation. A 34-year-old woman with a history lumbar disc prolapse who had undergone lumbar disc surgery on two different occasions was treated using acupuncture, core-stability exercises, and treadmill walking exercises three times per week for 12 weeks. The outcome measures used in this study were pain intensity, spinal range of movement, and general health. After 12 weeks of treatment, the patient had made improvement in terms of pain, which was reduced from 9/10 to 1/10. In a similar vein, the patient's general health showed improvement of >100% after 12 weeks of treatment. Pre-treatment scores of spinal flexion and left-side flexion, which measured 20 cm and 12 cm, respectively, increased to 25 cm and 16 cm after 12 weeks of treatment. This study showed that acupuncture, core-stability exercises, and treadmill walking exercises were useful in relieving pain, increasing spinal range of movement, and improving the health of a patient with postsurgical lumbar disc herniation. PMID:25660445

Ganiyu, Sokunbi Oluwaleke; Gujba, Kachalla Fatimah

2015-02-01

175

Long-term treatment with PP2 after spinal cord injury resulted in functional locomotor recovery and increased spared tissue  

PubMed Central

The spinal cord has the ability to regenerate but the microenvironment generated after trauma reduces that capacity. An increase in Src family kinase (SFK) activity has been implicated in neuropathological conditions associated with central nervous system trauma. Therefore, we hypothesized that a decrease in SFK activation by a long-term treatment with 4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo[3,4-d]pyramidine (PP2), a selective SFK inhibitor, after spinal cord contusion with the New York University (NYU) impactor device would generate a permissive environment that improves axonal sprouting and/or behavioral activity. Results demonstrated that long-term blockade of SFK activation with PP2 increases locomotor activity at 7, 14, 21 and 28 days post-injury in the Basso, Beattie, and Bresnahan open field test, round and square beam crossing tests. In addition, an increase in white matter spared tissue and serotonin fiber density was observed in animals treated with PP2. However, blockade of SFK activity did not change the astrocytic response or infiltration of cells from the immune system at 28 days post-injury. Moreover, a reduced SFK activity with PP2 diminished Ephexin (a guanine nucleotide exchange factor) phosphorylation in the acute phase (4 days post-injury) after trauma. Together, these findings suggest a potential role of SFK in the regulation of spared tissue and/or axonal outgrowth that may result in functional locomotor recovery during the pathophysiology generated after spinal cord injury. Our study also points out that ephexin1 phosphorylation (activation) by SFK action may be involved in the repulsive microenvironment generated after spinal cord injury.

Rosas, Odrick R.; Torrado, Aranza I.; Santiago, Jose M.; Rodriguez, Ana E.; Salgado, Iris K.; Miranda, Jorge D.

2014-01-01

176

Symptoms, haemodynamics, and exercise capacity during long term treatment of chronic heart failure. Experience with pirbuterol.  

PubMed Central

An open study of long term treatment with an oral beta 2 agonist (pirbuterol 20 mg three times daily) was undertaken in 63 patients with severe chronic heart failure. During three months of treatment 20 (32%) patients died, of whom 16 were taking the drug at the time of death. Mortality was related to initial functional class (New York Heart Association classification: 23% in grade III and 75% in grade IV). Concomitant treatment with digoxin did not affect mortality. The drug was well tolerated by most patients but unwanted side effects necessitated withdrawal of the drug in six (10%). Thirty-five patients were continuing to take the drug after three months, of whom 22 reported symptomatic improvement and only four deterioration. There was a relation between symptomatic improvement and increase in exercise capacity. At initial haemodynamic assessment a single dose of pirbuterol increased the cardiac index by 34% and the stroke index by 21%. Left ventricular filling pressure fell by 23% and systemic vascular resistance by 22%. Haemodynamic reassessment after three months of continuous treatment in 29 patients showed maintained improvement in the group as a whole, although individual variation was considerable. There was no apparent relation between haemodynamic improvement and improvement in exercise duration and symptoms. Severe heart failure has a poor prognosis. Identification of those patients who may derive benefit from treatment with a particular drug is not yet possible. PMID:6137226

Dawson, J R; Canepa-Anson, R; Kuan, P; Reuben, S R; Poole-Wilson, P A; Sutton, G C

1983-01-01

177

Radiation-induced Spinal Cord Glioma Subsequent to Treatment of Hodgkin’s Disease: Case Report and Review  

Microsoft Academic Search

Summary  Radiation-induced neoplasms of the central nervous system generally present as meningioma or sarcoma. Spinal cord glioma after\\u000a radiation therapy is rare and half of the cases documented occurred after treatment of Hodgkin’s disease.\\u000a \\u000a A 39-year-old male presented with a 1-month history of gradually worsening neck ache and paraparesis. The patient had been\\u000a treated for stage IB Hodgkin’s disease 9 years previously

Laurent Riffaud; Marc Bernard; Thierry Lesimple; Xavier Morandi

2006-01-01

178

Spinal fusion  

MedlinePLUS

... Anterior spinal fusion; Spine surgery - spinal fusion; Low back pain - fusion; Herniated disk - fusion ... If you had chronic back pain before surgery, you will likely still have some pain afterward. Spinal fusion is unlikely to take away all your pain ...

179

Treatment of depressive-like behaviour in Huntington's disease mice by chronic sertraline and exercise  

PubMed Central

BACKGROUND AND PURPOSE Depression is the most common psychiatric disorder in Huntington's disease (HD) patients. Women are more prone to develop depression and such susceptibility might be related to 5-hydroxytryptaminergic (serotonergic) dysregulation. EXPERIMENTAL APPROACH We performed tests of depression-related behaviours on female R6/1 HD mice that had been chronically treated with sertraline or provided with running-wheels. Functional assessments of 5-HT1A and 5-HT2A receptors were performed by measuring behavioural and physiological responses following administration of specific agonists, in combination with analysis of hippocampal gene expression. Finally we assessed the effect of exercise on hippocampal cell proliferation. KEY RESULTS Female HD mice recorded increased immobility time in the forced-swimming test, reduced saccharin preference and a hyperthermic response to stress compared with wild-type animals. These alterations were improved by chronic sertraline treatment. Wheel-running also resulted in similar improvements with the exception of saccharin preference but failed to correct the hippocampal cell proliferation deficits displayed by HD mice. The benefits of sertraline treatment and exercise involved altered 5-HT1A autoreceptor function, as demonstrated by modulation of the exaggerated 8-OH-DPAT-induced hypothermia exhibited by female HD mice. On the other hand, sertraline treatment was unable to restore the reduced 5-HT1A and 5-HT2 heteroceptor function observed in HD animals. CONCLUSIONS AND IMPLICATIONS We report for the first time a crucial role for 5-HT1A autoreceptor function in mediating the sex-specific depressive-like phenotype of female R6/1 HD mice. Our data further support a differential effect of chronic sertraline treatment and exercise on hippocampal cell proliferation despite common behavioural benefits. PMID:21718306

Renoir, Thibault; Pang, Terence YC; Zajac, Michelle S; Chan, Grace; Du, Xin; Leang, Leah; Chevarin, Caroline; Lanfumey, Laurence; Hannan, Anthony J

2012-01-01

180

The management of bilateral high hamstring tendinopathy with ASTYM® treatment and eccentric exercise: a case report  

PubMed Central

High hamstring tendinopathy (HHT) is an overuse injury that occurs most commonly in runners. The management of HHT is often challenging and the research supporting many interventions is limited. Eccentric exercise has been proven effective in the treatment of various tendinopathies but has not been thoroughly studied with HHT. Soft tissue mobilization, including ASTYM, is often utilized in the treatment of tendinopathies, though there is limited evidence supporting this approach. The purpose of this paper is to present the case of a patient referred to physical therapy with bilateral HHT. The patient was a 41-year-old recreational runner that had an insidious onset of right buttock pain 12 months prior to initiating therapy and left buttock pain 9 months prior. Her primary complaints included an inability to run, pain with prolonged or brisk walking, and pain with sitting on hard surfaces. The patient was treated in physical therapy two times per week for 16 visits with treatment focused on eccentric hamstring strengthening and ASTYM. By her eighth visit, the patient was able to walk 2·5 miles without pain and by her 12 visit, she was able to jog 1 mile before the onset of pain. After 16 visits, the patient reported that she was approximately 95% improved, was able to run 2·5 miles without pain, and had no pain with sitting on hard surfaces. This case suggests that eccentric exercise combined with ASTYM may be an effective treatment for HHT. PMID:23904753

McCormack, Joshua R

2012-01-01

181

The management of bilateral high hamstring tendinopathy with ASTYM® treatment and eccentric exercise: a case report.  

PubMed

High hamstring tendinopathy (HHT) is an overuse injury that occurs most commonly in runners. The management of HHT is often challenging and the research supporting many interventions is limited. Eccentric exercise has been proven effective in the treatment of various tendinopathies but has not been thoroughly studied with HHT. Soft tissue mobilization, including ASTYM, is often utilized in the treatment of tendinopathies, though there is limited evidence supporting this approach. The purpose of this paper is to present the case of a patient referred to physical therapy with bilateral HHT. The patient was a 41-year-old recreational runner that had an insidious onset of right buttock pain 12 months prior to initiating therapy and left buttock pain 9 months prior. Her primary complaints included an inability to run, pain with prolonged or brisk walking, and pain with sitting on hard surfaces. The patient was treated in physical therapy two times per week for 16 visits with treatment focused on eccentric hamstring strengthening and ASTYM. By her eighth visit, the patient was able to walk 2·5 miles without pain and by her 12 visit, she was able to jog 1 mile before the onset of pain. After 16 visits, the patient reported that she was approximately 95% improved, was able to run 2·5 miles without pain, and had no pain with sitting on hard surfaces. This case suggests that eccentric exercise combined with ASTYM may be an effective treatment for HHT. PMID:23904753

McCormack, Joshua R

2012-08-01

182

Effect of Vascular Endothelial Growth Factor Treatment in Experimental Traumatic Spinal Cord Injury: In Vivo Longitudinal Assessment  

PubMed Central

Abstract Vascular endothelial growth factor (VEGF) is thought to provide neuroprotection to the traumatically injured spinal cord. We examined whether supplementing the injured environment with VEGF165 via direct intraspinal injection into the lesion epicenter during the acute phase of spinal cord injury (SCI) results in improved outcome. The effect of treatment was investigated using longitudinal multi-modal magnetic resonance imaging (MRI), neurobehavioral assays, and end-point immunohistochemistry. We observed on MRI that rats treated with VEGF165 after SCI had increased tissue sparing compared to vehicle-treated animals at the earlier time points. However, these favorable effects were not maintained into the chronic phase. Histology revealed that VEGF165 treatment resulted in increased oligodendrogenesis and/or white matter sparing, and therefore may eventually lead to improved functional outcome. The increase in spared tissue as demonstrated by MRI, coupled with the possible remyelination and increased neurosensory sensitivity, suggests that VEGF165 treatment may play a role in promoting plasticity in the sensory pathways following SCI. However, VEGF-treated animals also demonstrated an increased incidence of persistent allodynia, as indicated on the von Frey filament test. PMID:21299336

Sundberg, Laura M.; Herrera, Juan J.

2011-01-01

183

Spinal tuberculosis: A review  

PubMed Central

Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Genetic susceptibility to spinal tuberculosis has recently been demonstrated. Characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. The thoracic region of vertebral column is most frequently affected. Formation of a ‘cold’ abscess around the lesion is another characteristic feature. The incidence of multi-level noncontiguous vertebral tuberculosis occurs more frequently than previously recognized. Common clinical manifestations include constitutional symptoms, back pain, spinal tenderness, paraplegia, and spinal deformities. For the diagnosis of spinal tuberculosis magnetic resonance imaging is more sensitive imaging technique than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Neuroimaging-guided needle biopsy from the affected site in the center of the vertebral body is the gold standard technique for early histopathological diagnosis. Antituberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. With early diagnosis and early treatment, prognosis is generally good. PMID:22118251

Garg, Ravindra Kumar; Somvanshi, Dilip Singh

2011-01-01

184

The effect of pressure pad location of spinal orthosis on the treatment of adolescent idiopathic scoliosis (AIS).  

PubMed

Patient with moderate AIS is usually prescribed with spinal orthosis aiming to mechanically support and prevent the spine from further deterioration. In the conventional fitting method, pre-brace X-ray is the main reference, thus, the pressure pad of spinal orthosis may not be accurately located to the strategic areas because the spinal deformities could change 3-dimensionally once pressure pad is applied. A high correlation (r > 0.98) between Cobb's angle and spinous process angle (SPA) was found in the recent studies. With the advancements of 3D clinical ultrasound (3D CUS), tracing SPA along a scoliotic spine becomes possible and this can be used to estimate Cobb's angle. This study aimed to evaluate the effect of pressure pad location of spinal orthosis in the treatment of AIS and 3D CUS was used to trace SPA for estimation of Cobb's angle. The in-brace X-rays were assessed for confirmation of treatment effectiveness. The subjects were divided into ultrasound-guided fitting group A (n=21) and conventional fitting group B (n=22). In the group A, pressure pads were tested at 5 locations - the prescribed location as in the conventional fitting (referred to the pre-brace X-ray), and 1 cm and 2 cm above and below the prescribed location, and 3D CUS was applied to trace the SPA in these 5 pad locations, and the pad location with the lowest estimated Cobb's angle was selected in the final fitting. The assessments of in-brace X-rays showed that the mean Cobb's angle of group A decreased from 28.9° (pre-brace) to 18.6° (immediate in-brace) while the mean Cobb's angle of group B decreased from 27.1° (pre-brace) to 22.5° (immediate in-brace). There was a significant difference (p < 0.05) in the correction of Cobb's angle between the two groups. The results showed that accurate pressure pad location does play an important role in the reduction of Cobb's angle and 3D CUS can be considered as a non-invasive and effective assessment tool to improve orthotic treatment of AIS. PMID:22744533

Wong, M S; Li, M; Ng, B; Lam, T P; Ying, M; Wong, A; Cheng, J

2012-01-01

185

[Effectiveness of two aerobic exercise programs in the treatment of metabolic syndrome: a preliminary Study].  

PubMed

The effectiveness of two aerobic exercise programs on the modification of the metabolic syndrome (MS) components and its influence in reducing cardiovascular risk was evaluated in 16 sedentary women (30-66 years old). Patients were randomly divided into two exercise groups: continuous training (CE: 45 minutes at 65-70% of heart rate reserve or HRR) or interval training (IE: 5 x 3 minute intervals at 80-85% HRR with two minutes of active recovery at 65-70% HRR), and each participant gave previous informed consent. The components of MS were assessed according to the criteria for women of the National Cholesterol Education/Third Treatment Adult Panel, and cardiovascular risk factors at baseline and 16 weeks later. Data analyses were performed with the Wilcoxon signed test and the Mann-Whitney U-test (SPSS v. 12.0 Windows: p < 0.05). Both exercise programs were effective in the modification of a number of MS components (triglycerides, systolic/diastolic blood pressure), however IE had a higher percentage of patients without MS diagnosis at the end of the study (62.5%). The CE improved the physical fitness by increasing the VO2peak and METs and decreasing heart rate recovery, which is reflected on the reduction of cardiovascular risk. PMID:25375279

Salas-Romero, Rebeca; Sánchez-Muñoz, Verónica; Franco-Sánchez, José Gilberto; Del Villar-Morales, Ariadna; Pegueros-Pérez, Andrea

2014-01-01

186

Influence of setup errors on spinal cord dose and treatment plan quality for cervical spine tumours: a phantom study for photon IMRT and heavy charged particle radiotherapy  

NASA Astrophysics Data System (ADS)

Tumours partly surrounding the cervical spine may be treated by conformal radiotherapy (RT) using intensity-modulated RT (IMRT) with photons or heavy charged particle RT. For both, a high setup accuracy is required to spare the radiosensitive spinal cord, if a high dose is to be delivered. A phantom study was performed to determine the variation of the dose to the spinal cord surface by predefined setup errors. The measured doses were compared to those calculated by the treatment planning programme. The influence of systematic setup errors on characteristic parameters of the treatment plan quality was quantified. The largest variation of the mean and maximum doses to the spinal cord due to setup errors was significantly larger for carbon ions than for IMRT (mean: 11.9% versus 3.9%, max: 29.2% versus 10.8% of the prescribed dose). For the comparison of measured and calculated doses, mean deviations of 3% (IMRT) and 6% (carbon ions) of the prescribed dose were obtained. These deviations have to be considered, when the spinal cord dose is assessed from the treatment plan and they may also influence the dose prescription. Carbon ions yield better values for coverage (99.9% versus 93.1%) and conformality (110% versus 126%) of the PTV as compared to IMRT, while the spinal cord is better spared. Dose distributions produced with carbon ions, however, are more sensitive to setup errors, which have to be considered during treatment.

Karger, Christian P.; Schulz-Ertner, Daniela; Didinger, Bernd H.; Debus, Jürgen; Jäkel, Oliver

2003-10-01

187

Follow-up of an exercise-based treatment for children with reading difficulties.  

PubMed

This study reports the results of a long-term follow-up of an exercise-based approach to dyslexia-related disorders (Reynolds, Nicolson, & Hambly, Dyslexia, 2003; 9(1): 48-71). In the initial study, children at risk of dyslexia were identified in 3 years of a junior school. One half then undertook a 6 month, home-based exercise programme. Evaluation after 6 months indicated that the exercise group improved significantly more than the controls on a range of cognitive and motor skills. Critics had suggested that the improvement might be attributable to artifactual issues including Hawthorne effects; an initial literacy imbalance between the groups; and inclusion of non-dyslexic participants. The present study evaluated the issue of whether the gains were maintained over the following 18 months, and whether they were in some sense artifactual as postulated by critics of the original study. Comparison of (age-adjusted) initial and follow-up performance indicated significant gains in motor skill, speech/language fluency, phonology, and working memory. Both dyslexic and non-dyslexic low achieving children benefited. There was also a highly significant reduction in the incidence of symptoms of inattention. Interestingly there were no significant changes in speeded tests of reading and spelling, but there was a significant improvement in (age-adjusted) reading (NFER). It is concluded that the gains were indeed long-lasting, and that the alternative hypotheses based on potential artifacts were untenable, and that the exercise treatment therefore achieved its applied purpose. Further research is needed to determine the underlying reasons for the benefits. Possible (and potentially synergistic) explanations include: improved cerebellar function (neural level); improved learning ability and/or attentional ability (cognitive level); improved self-esteem and self-efficacy (affective level); and improved parental/familial support (social level). PMID:17557685

Reynolds, David; Nicolson, Roderick I

2007-05-01

188

Neuropathology of the brainstem and spinal cord in end stage rheumatoid arthritis: implications for treatment.  

PubMed Central

OBJECTIVE--To study the detailed histopathological changes in the brainstem and spinal cord in nine patients with severe end stage rheumatoid arthritis, all with clinical myelopathy and craniocervical compression. METHODS--At necropsy the sites of bony pathology were related exactly to cord segments and histological changes, and correlated with clinical and radiological findings. RESULTS--Cranial nerve and brainstem pathology was rare. In addition to the obvious craniocervical compression, there were widespread subaxial changes in the spinal cord. Pathology was localised primarily to the dorsal white matter and there was no evidence of vasculitis or ischaemic changes. CONCLUSIONS--Myelopathy in rheumatoid arthritis is probably caused by the effects of compression, stretch, and movement, not ischaemia. The additional subaxial compression may be an important component in the clinical picture, and may explain why craniocervical decompression alone may not alleviate neurological signs. Images PMID:8239756

Henderson, F C; Geddes, J F; Crockard, H A

1993-01-01

189

Central Decompressive Laminoplasty for Treatment of Lumbar Spinal Stenosis : Technique and Early Surgical Results  

PubMed Central

Objective Lumbar spinal stenosis is a common degenerative spine disease that requires surgical intervention. Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. The purpose of this study was to present the author's surgical technique and results for decompression of spinal stenosis. Methods The author performed surgery in 57 patients with lumbar spinal stenosis between 2006 and 2010. Data were gathered retrospectively via outpatient interviews and telephone questionnaires. The operation used in this study was named central decompressive laminoplasty (CDL), which allows thorough decompression of the lumbar spinal canal and proximal two foraminal nerve roots by undercutting the lamina and facet joint. Kyphotic prone positioning on elevated curvature of the frame or occasional use of an interlaminar spreader enables sufficient interlaminar working space. Pain was measured with a visual analogue scale (VAS). Surgical outcome was analyzed with the Oswestry Disability Index (ODI). Data were analyzed preoperatively and six months postoperatively. Results The interlaminar window provided by this technique allowed for unhindered access to the central canal, lateral recess, and upper/lower foraminal zone, with near-total sparing of the facet joint. The VAS scores and ODI were significantly improved at six-month follow-up compared to preoperative levels (p<0.001, respectively). Excellent pain relief (>75% of initial VAS score) of back/buttock and leg was observed in 75.0% and 76.2% of patients, respectively. Conclusion CDL is easily applied, allows good field visualization and decompression, maintains stability by sparing ligament and bony structures, and shows excellent early surgical results. PMID:25368762

2014-01-01

190

Effect of combined treatment with melatonin and methylprednisolone on neurological recovery after experimental spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) results in the loss of function below the lesion. Secondary injury following the primary impact includes\\u000a a number of biochemical and cellular alterations leading to tissue necrosis and cell death. Methylprednisolone (MP), by reducing\\u000a edema and protecting the cell membrane against peroxidation, is the only pharmacological agent with a proven clinically beneficial\\u000a effect on SCI. Melatonin,

Suleyman R. Cayli; Ayhan Kocak; Ugur Yilmaz; Ayhan Tekiner; Mine Erbil; Cetin Ozturk; Kadir Batcioglu; Saim Yologlu

2004-01-01

191

Posterior spinal fusion and instrumentation in the treatment of adolescent idiopathic scoliosis.  

PubMed Central

Three hundred and nineteen patients with adolescent idiopathic scoliosis were treated by posterior spinal fusion over an eight year period. The changes in preoperative correction and surgical techniques are reviewed. The anaesthetic technique using induced hypotension and the postoperative routine are described. The amount of deformity and its correction at operation and postoperatively is discussed by reference to Cobb angles. The early and late complications are reviewed. Images fig. 1 fig. 1 (continued) PMID:4051428

Youngman, P. M.; Edgar, M. A.

1985-01-01

192

Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment  

PubMed Central

Classical proinflammatory eicosanoids, and more recently discovered lipid mediators with anti-inflammatory and proresolving bioactivity, exert a complex role in the initiation, control, and resolution of inflammation. Using a targeted lipidomics approach, we investigated circulating lipid mediator responses to resistance exercise and treatment with the NSAID ibuprofen. Human subjects undertook a single bout of unaccustomed resistance exercise (80% of one repetition maximum) following oral ingestion of ibuprofen (400 mg) or placebo control. Venous blood was collected during early recovery (0–3 h and 24 h postexercise), and serum lipid mediator composition was analyzed by LC-MS-based targeted lipidomics. Postexercise recovery was characterized by elevated levels of cyclooxygenase (COX)-1 and 2-derived prostanoids (TXB2, PGE2, PGD2, PGF2?, and PGI2), lipooxygenase (5-LOX, 12-LOX, and 15-LOX)-derived hydroxyeicosatetraenoic acids (HETEs), and leukotrienes (e.g., LTB4), and epoxygenase (CYP)-derived epoxy/dihydroxy eicosatrienoic acids (EpETrEs/DiHETrEs). Additionally, we detected elevated levels of bioactive lipid mediators with anti-inflammatory and proresolving properties, including arachidonic acid-derived lipoxins (LXA4 and LXB4), and the EPA (E-series) and DHA (D-series)-derived resolvins (RvD1 and RvE1), and protectins (PD1 isomer 10S, 17S-diHDoHE). Ibuprofen treatment blocked exercise-induced increases in COX-1 and COX-2-derived prostanoids but also resulted in off-target reductions in leukotriene biosynthesis, and a diminished proresolving lipid mediator response. CYP pathway product metabolism was also altered by ibuprofen treatment, as indicated by elevated postexercise serum 5,6-DiHETrE and 8,9-DiHETrE only in those receiving ibuprofen. These findings characterize the blood inflammatory lipid mediator response to unaccustomed resistance exercise in humans and show that acute proinflammatory signals are mechanistically linked to the induction of a biological active inflammatory resolution program, regulated by proresolving lipid mediators during postexercise recovery. PMID:24089379

Markworth, James F.; Vella, Luke; Lingard, Benjamin S.; Tull, Dedreia L.; Rupasinghe, Thusitha W.; Sinclair, Andrew J.; Maddipati, Krishna Rao

2013-01-01

193

Wilderness Medical Society practice guidelines for treatment of exercise-associated hyponatremia: 2014 update.  

PubMed

Exercise-associated hyponatremia (EAH) is defined by a serum or plasma sodium concentration below the normal reference range of 135 mmol/L that occurs during or up to 24 hours after prolonged physical activity. It is reported to occur in individual physical activities or during organized endurance events conducted in austere environments in which medical care is limited and often not available, and patient evacuation to definitive care is often greatly delayed. Rapid recognition and appropriate treatment are essential in the severe form to ensure a positive outcome. Failure in this regard is a recognized cause of event-related fatality. In an effort to produce best practice guidelines for EAH in the austere environment, the Wilderness Medical Society convened an expert panel. The panel was charged with the development of evidence-based guidelines for management of EAH. Recommendations are made regarding the situations when sodium concentration can be assessed in the field and when these values are not known. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Treatment of Exercise-Associated Hyponatremia published in Wilderness & Environmental Medicine 2013;24(3):228-240. PMID:25498260

Bennett, Brad L; Hew-Butler, Tamara; Hoffman, Martin D; Rogers, Ian R; Rosner, Mitchell H

2014-12-01

194

The relationship between self-monitoring, outcome expectancies, difficulties with eating and exercise, and physical activity and weight loss treatment outcomes  

Microsoft Academic Search

Background\\/Purpose: During a behavioral weight loss program (BWLP), weight loss and exercise can vary considerably from week to week. Weekly\\u000a fluctuations in outcome expectancies and perceived difficulties with eating and exercise may be associated with weekly variability\\u000a in weight loss and exercise. Also, inconsistent self-monitoring of exercise may be associated with poor weight loss and physical\\u000a activity treatment outcomes.Methods:Forty obese,

Robert A. Carels; Lynn A. Darby; Sofia Rydin; Olivia M. Douglass; Holly M. Cacciapaglia; William H. O’Brien

2005-01-01

195

Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

... Braingate" research? What is the status of stem-cell research? How would stem-cell therapies work in the treatment of spinal cord injuries? What does stem-cell research on animals tell us? When can we ...

196

MRI evaluation of topical heat and static stretching as therapeutic modalities for the treatment of eccentric exercise-induced muscle damage  

Microsoft Academic Search

The aim of this study was to monitor the effects of topical heat and\\/or static stretch treatments on the recovery of muscle damage by eccentric exercise. For this purpose, 32 untrained male subjects performed intense eccentric knee extension exercise, followed by 2 weeks of treatment (heat, stretch, heat plus stretch) or no treatment (control, n=8\\/group). Isometric strength testing, pain ratings,

R. C. Jayaraman; R. W. Reid; J. M. Foley; B. M. Prior; G. A. Dudley; K. W. Weingand; R. A. Meyer

2004-01-01

197

Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper 2005  

PubMed Central

Background Based on a recognized need for research to examine the premise that nonsurgical approaches can be used effectively to treat signs and symptoms of scoliosis, a scientific society on scoliosis orthopaedic and rehabilitation treatment (SOSORT) was established in Barcelona in 2004. SOSORT has a primary goal of implementing multidisciplinary research to develop quantitative, objective data to address the role of conservative therapies in the treatment of scoliosis. This international working group of clinicians and scientists specializing in treatment of scoliosis met in Milan, Italy in January 2005. Methods As a baseline for developing a consensus for language and goals for proposed multicenter clinical studies, we developed questionnaires to examine current beliefs, before and after the meeting, regarding (1) the aims of physical exercises; (2) standards of treatment; and (3) the impact of such treatment performed by specialists in the field. Results The responses to the questionnaires show that, in principle, specialists in scoliosis physiotherapy do not disagree and that several features can be regarded, currently, as standard features in the rehabilitation of scoliosis patients. These features include autocorrection in 3D, training in ADL, stabilizing the corrected posture, and patient education. PMID:16759360

Weiss, Hans-Rudolf; Negrini, Stefano; Hawes, Martha C; Rigo, Manuel; Kotwicki, Tomasz; Grivas, Theodoros B; Maruyama, Toru

2006-01-01

198

Systems Biology Investigation of cAMP Modulation to Increase SMN Levels for the Treatment of Spinal Muscular Atrophy  

PubMed Central

Spinal muscular atrophy (SMA), a leading genetic cause of infant death worldwide, is an autosomal recessive disorder caused by the loss of SMN1 (survival motor neuron 1), which encodes the protein SMN. The loss of SMN1 causes a deficiency in SMN protein levels leading to motor neuron cell death in the anterior horn of the spinal cord. SMN2, however, can also produce some functional SMN to partially compensate for loss of SMN1 in SMA suggesting increasing transcription of SMN2 as a potential therapy to treat patients with SMA. A cAMP response element was identified on the SMN2 promoter, implicating cAMP activation as a step in the transcription of SMN2. Therefore, we investigated the effects of modulating the cAMP signaling cascade on SMN production in vitro and in silico. SMA patient fibroblasts were treated with the cAMP signaling modulators rolipram, salbutamol, dbcAMP, epinephrine and forskolin. All of the modulators tested were able to increase gem formation, a marker for SMN protein in the nucleus, in a dose-dependent manner. We then derived two possible mathematical models simulating the regulation of SMN2 expression by cAMP signaling. Both models fit well with our experimental data. In silico treatment of SMA fibroblasts simultaneously with two different cAMP modulators resulted in an additive increase in gem formation. This study shows how a systems biology approach can be used to develop potential therapeutic targets for treating SMA. PMID:25514431

Mack, Sean G.; Cook, Daniel J.; Dhurjati, Prasad; Butchbach, Matthew E. R.

2014-01-01

199

Differential effects of anti-Nogo-A antibody treatment and treadmill training in rats with incomplete spinal cord injury.  

PubMed

Locomotor training on treadmills can improve recovery of stepping in spinal cord injured animals and patients. Likewise, lesioned rats treated with antibodies against the myelin associated neurite growth inhibitory protein, Nogo-A, showed increased regeneration, neuronal reorganization and behavioural improvements. A detailed kinematic analysis showed that the hindlimb kinematic patterns that developed in anti-Nogo-A antibody treated versus treadmill trained spinal cord injured rats were significantly different. The synchronous combined treatment group did not show synergistic effects. This lack of synergistic effects could not be explained by an increase in pain perception, sprouting of calcitonin gene-related peptide (CGRP) positive fibres or by interference of locomotor training with anti-Nogo-A antibody induced regeneration and sprouting of descending fibre tracts. The differential mechanisms leading to behavioural recovery during task-specific training and in regeneration or plasticity enhancing therapies have to be taken into account in designing combinatorial therapies so that their potential positive interactive effects can be fully expressed. PMID:19372269

Maier, Irin C; Ichiyama, Ronaldo M; Courtine, Grégoire; Schnell, Lisa; Lavrov, Igor; Edgerton, V Reggie; Schwab, Martin E

2009-06-01

200

Teamwork approach to prevention and treatment of skin breakdown in spinal cord patients.  

PubMed

Pressure ulcers, which are localized injuries to skin and underlying tissue resulting from prolonged pressure, are a significant complication among patients with spinal cord injury. They threaten patients' quality of life, prolong stays at health care facilities, and pose a burden on the overall health care system through increased costs. Familiarity with the risk factors for developing pressure ulcers and the methods used to treat them is paramount to decreasing their occurrence and lessening the negative impact from both a human and economic standpoint. PMID:25651227

Ponce de Leon, Marcus

2015-02-01

201

Exercise-mimicking treatment fails to increase Fndc5 mRNA & irisin secretion in primary human myotubes.  

PubMed

Irisin, myokine secreted by skeletal muscle, was suggested to mediate some of exercise health benefits via "browning" of white adipose tissue. However, mounting evidence contradicts the regulatory role of exercise for muscle irisin production/secretion in humans. Thus, we explored the direct effect of exercise-mimicking treatment on irisin in human primary muscle cells in vitro. Human primary muscle cell cultures were established from lean, obese prediabetic and type-2-diabetic individuals. Complex metabolic phenotyping included assessment of insulin sensitivity (euglycemic hyperinsulinemic clamp) and adiposity content&distribution (MRI&MRS). In vitro exercise-mimicking treatment (forskolin+ionomycin) was delivered in 1-h pulse/day during differentiation. Fndc5 mRNA (qRT-PCR) and secreted irisin (ELISA) were determined in cells and media. Exercise-mimicking treatment more than doubled Pgc1? mRNA in differentiated muscle cells. Nevertheless, Fndc5 mRNA was reduced by 18% and irisin in media by 20%. Moreover, Fncd5 mRNA was increased in myotubes derived from individuals with type-2-diabetes, independent on exercise-mimicking treatment. Fndc5 mRNA in cells was positively related to fasting glycemia (p=0.0001) and negatively to whole-body insulin sensitivity (p<0.05). Collectively, our data do not support the role of exercise-related signaling pathways in irisin regulation in human skeletal muscle and confirm our previous observations on increased Fndc5 expression in muscle cells from individuals with type-2-diabetes. PMID:24642356

Kurdiova, Timea; Balaz, Miroslav; Mayer, Alexander; Maderova, Denisa; Belan, Vitazoslav; Wolfrum, Christian; Ukropec, Jozef; Ukropcova, Barbara

2014-06-01

202

Exercise-induced laryngeal obstruction: natural history and effect of surgical treatment.  

PubMed

The current follow-up study concerning the supraglottic type of exercise-induced laryngeal obstruction (EILO) was performed to reveal the natural history of supraglottic EILO and compare the symptoms, as well as the laryngeal function in conservatively versus surgically treated patients. A questionnaire-based survey was conducted 2-5 years after EILO was diagnosed by a continuous laryngoscopy exercise (CLE) test in 94 patients with a predominantly supraglottic obstruction. Seventy-one patients had been treated conservatively and 23 with laser supraglottoplasty. The questionnaire response rate was 70 and 100% in conservatively treated (CT) and surgically treated (ST) patients, respectively. A second CLE test was performed in 14 CT and 19 ST patients. A visual analogue scale on symptom severity indicated improvements in both the groups, i.e. mean values (± standard deviations) declined from 73 (20) to 53 (26) (P < 0.001) in the CT group and from 87 (26) to 25 (27) (P < 0.001) in the ST group. At follow-up, ST patients reported lower scores regarding current level of complaints, and higher ability to perform exercise, as well as to push themselves physically, all compared to CT patients (P < 0.001). CLE scores were normalized in 3 of 14 (21%) CT and 16 of 19 (84%) ST patients (Z = -3.6; P < 0.001). In conclusion, symptoms of EILO diagnosed in adolescents generally decreased during 2-5 years follow-up period but even more after the surgical treatment. Patients with supraglottic EILO may benefit from supraglottoplasty both as to laryngeal function and symptom relief. PMID:21643933

Maat, Robert Christiaan; Hilland, Magnus; Røksund, Ola Drange; Halvorsen, Thomas; Olofsson, Jan; Aarstad, Hans Jørgen; Heimdal, John-Helge

2011-10-01

203

Effects of aquatic exercise and CES treatment on the changes of cognitive function, BDNF, IGF-1, and VEGF of persons with intellectual disabilities  

PubMed Central

[Purpose] The purpose of this study was to investigate the effects of aquatic exercise and CES treatment on the cognitive function by using K-WAB and BDNF, IGF-1, and VEGF of persons with intellectual disabilities. [Methods] All subjects were 15 male with intellectual disabilities who were participating in the aquatic training program and CES treatment during 12 weeks at rehabilitation center. The subjects were divided into control group, exercise group, and exercise+CES group. Blood samples for BDNF, IGF-1, and VEGF were taken from brachial vein at rest between before and after treatment. [Results] The results are summarized as follows: Cognitive function level increased significantly in the exercise+CES group compared to those in the exercise and control group. The changes of blood IGF-1 concentration were no significant difference among groups. The changes of blood BDNF and VEGF concentration were significantly increased in exercise group and exercise+CES group than control group. However, blood BDNF and VEGF concentration were significantly difference between exercise group and exercise+CES group. [Conclusion] In conclusion, it can be concluded that CES treatment with exercise can amend cognitive function of persons with intellectual disabilities more effectively and increase of BDNF and VEGF by exercise can explain the cognitive function improvement of persons with intellectual disabilities.

Lee, In Ho; Seo, Eun Jung; Lim, In Soo

2014-01-01

204

Early versus late treatment of spinal cord compression with long-term intrathecal enzyme replacement therapy in canine mucopolysaccharidosis type I  

PubMed Central

Enzyme replacement therapy (ERT) with intravenous recombinant human alpha-l-iduronidase (IV rhIDU) is a treatment for patients with mucopolysaccharidosis I (MPS I). Spinal cord compression develops in MPS I patients due in part to dural and leptomeningeal thickening from accumulated glycosaminoglycans (GAG). We tested long-term and every three month intrathecal (IT) and weekly IV rhIDU in MPS I dogs age 12-15 months (Adult) and MPS I pups age 2-23 days (Early) to determine whether spinal cord compression could be reversed, stabilized, or prevented. Five treatment groups of MPS I dogs were evaluated (n=4 per group): IT+IV Adult, IV Adult, IT+IV Early, 0.58 mg/kg IV Early and 1.57 mg/kg IV Early. IT+IV rhIDU (Adult and Early) led to very high iduronidase levels in cervical, thoracic, and lumber spinal meninges (3,600-29,000% of normal), while IV rhIDU alone (Adult and Early) led to levels that were 8.2-176% of normal. GAG storage was significantly reduced from untreated levels in spinal meninges of IT+IV Early (p<0.001), IT+IV Adult (p=0.001), 0.58 mg/kg IV Early (p=0.002) and 1.57 mg/kg IV Early (p<0.001) treatment groups. Treatment of dogs shortly after birth with IT+IV rhIDU (IT+IV Early) led to normal to near-normal GAG levels in the meninges and histologic absence of storage vacuoles. Lysosomal storage was reduced in spinal anterior horn cells in 1.57 mg/kg IV Early and IT+IV Early animals. All dogs in IT+IV Adult and IV Adult groups had compression of their spinal cord at 12-15 months of age determined by magnetic resonance imaging and was due to protrusion of spinal disks into the canal. Cord compression developed in 3 of 4 dogs in the 0.58 mg/kg IV Early group; 2 of 3 dogs in the IT+IV Early group; and 0 of 4 dogs in the 1.57 mg/kg IV Early group by 12-18 months of age. IT+IV rhIDU was more effective than IV rhIDU alone for treatment of meningeal storage, and it prevented meningeal GAG accumulation when begun early. High-dose IV rhIDU from birth (1.57 mg/kg weekly) appeared to prevent cord compression due to protrusion of spinal disks. PMID:20655780

Dickson, Patricia I.; Hanson, Stephen; McEntee, Michael F.; Vite, Charles H.; Vogler, Carole A.; Mlikotic, Anton; Chen, Agnes H.; Ponder, Katherine P.; Haskins, Mark E.; Tippin, Brigette L.; Le, Steven Q.; Passage, Merry B.; Guerra, Catalina; Dierenfeld, Ashley; Jens, Jackie; Snella, Elizabeth; Kan, Shih-hsin; Ellinwood, N. Matthew

2010-01-01

205

Combining metformin and aerobic exercise training in the treatment of type 2 diabetes and NAFLD in OLETF rats.  

PubMed

Here, we sought to compare the efficacy of combining exercise and metformin for the treatment of type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) in hyperphagic, obese, type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. OLETF rats (age: 20 wk, hyperglycemic and hyperinsulinemic; n = 10/group) were randomly assigned to sedentary (O-SED), SED plus metformin (O-SED + M; 300 mg·kg(-1)·day(-1)), moderate-intensity exercise training (O-EndEx; 20 m/min, 60 min/day, 5 days/wk treadmill running), or O-EndEx + M groups for 12 wk. Long-Evans Tokushima Otsuka (L-SED) rats served as nonhyperphagic controls. O-SED + M, O-EndEx, and O-EndEx + M were effective in the management of type 2 diabetes, and all three treatments lowered hepatic steatosis and serum markers of liver injury; however, O-EndEx lowered liver triglyceride content and fasting hyperglycemia more than O-SED + M. In addition, exercise elicited greater improvements compared with metformin alone on postchallenge glycemic control, liver diacylglycerol content, hepatic mitochondrial palmitate oxidation, citrate synthase, and ?-HAD activities and in the attenuation of markers of hepatic fatty acid uptake and de novo fatty acid synthesis. Surprisingly, combining metformin and aerobic exercise training offered little added benefit to these outcomes, and in fact, metformin actually blunted exercise-induced increases in complete mitochondrial palmitate oxidation and ?-HAD activity. In conclusion, aerobic exercise training was more effective than metformin administration in the management of type 2 diabetes and NAFLD outcomes in obese hyperphagic OLETF rats. Combining therapies offered little additional benefit beyond exercise alone, and findings suggest that metformin potentially impairs exercise-induced hepatic mitochondrial adaptations. PMID:24326426

Linden, Melissa A; Fletcher, Justin A; Morris, E Matthew; Meers, Grace M; Kearney, Monica L; Crissey, Jacqueline M; Laughlin, M Harold; Booth, Frank W; Sowers, James R; Ibdah, Jamal A; Thyfault, John P; Rector, R Scott

2014-02-01

206

Spinal dural arteriovenous fistula with lipomyelodysplasia.  

PubMed

A 72-year-old man presented with a very rare case of spinal dural arteriovenous fistula (AVF) with lipomyelodysplasia manifesting as progressive paraparesis and bladder dysfunction. Magnetic resonance imaging revealed a spinal lipoma associated with tethered cord and spinal cord swelling with dilated perimedullary veins. Embolization of the spinal dural AVF was successfully performed, and is an optional treatment for coexisting spinal dural AVF and lipomyelocele in adults. PMID:23438662

Sato, Masayuki; Takigawa, Tomoji; Shiigai, Masanari; Tamura, Goichiro; Masumoto, Tomohiko; Nakai, Yasunobu; Zaboronok, Alexander; Tsurushima, Hideo; Matsumura, Akira

2013-01-01

207

Holospinal epidural abscess of the spinal axis: two illustrative cases with review of treatment strategies and surgical techniques.  

PubMed

Despite the increasing prevalence of spinal infections, the subcategory of holospinal epidural abscesses (HEAs) is extremely infrequent and requires unique management. Panspinal imaging (preferably MRI), modern aggressive antibiotic therapy, and prompt surgical intervention remain the standard of care for all spinal axis infections including HEAs; however, the surgical decision making on timing and extent of the procedure still remain ill defined for HEAs. Decompression including skip laminectomies or laminoplasties is described, with varied clinical outcomes. In this review the authors present the illustrative cases of 2 patients with HEAs who were treated using skip laminectomies and epidural catheter irrigation techniques. The discussion highlights different management strategies including the role of conservative (nonsurgical) management in these lesions, especially with an already identified pathogen and the absence of mass effect on MRI or significant neurological defects. Among fewer than 25 case reports of HEA published in the past 25 years, the most important aspect in deciding a role for surgery is the neurological examination. Nearly 20% were treated successfully with medical therapy alone if neurologically intact. None of the reported cases had an associated cranial infection with HEA, because the dural adhesion around the foramen magnum prevented rostral spread of infection. Traditionally a posterior approach to the epidural space with irrigation is performed, unless an extensive focal ventral collection is causing cord compression. Surgical intervention for HEA should be an adjuvant treatment strategy for all acutely deteriorating patients, whereas aspiration of other infected sites like a psoas abscess can determine an infective pathogen, and appropriate antibiotic treatment may avoid surgical intervention in the neurologically intact patient. PMID:25081960

Smith, Gabriel A; Kochar, Arshneel S; Manjila, Sunil; Onwuzulike, Kaine; Geertman, Robert T; Anderson, James S; Steinmetz, Michael P

2014-08-01

208

Apamin-mediated actively targeted drug delivery for treatment of spinal cord injury: more than just a concept.  

PubMed

Faced with the complex medical challenge presented by spinal cord injuries (SCI) and considering the lack of any available curative therapy, the development of a novel method of delivering existing drugs or candidate agents can be perceived to be as important as the development of new therapeutic molecules. By combining three ingredients currently in clinical use or undergoing testing, we have designed a central nervous system targeted delivery system based on apamin-modified polymeric micelles (APM). Apamin, one of the major components of honey bee venom, serves as the targeting moiety, poly(ethylene glycol) (PEG) distearoylphosphatidylethanolamine (DSPE) serves as the drug-loaded material, and curcumin is used as the therapeutic agent. Apamin was conjugated with NHS (N-hydroxysuccinimide)-PEG-DSPE in a site-specific manner, and APM were prepared by a thin-film hydration method. A formulation comprising 0.5 mol % targeting ligand with 50 nm particle size showed strong targeting efficiency in vivo and was evaluated in pharmacodynamic assays. A 7-day treatment by daily intravenous administration of low doses of APM (corresponding to 5 mg/kg of curcumin) was performed. Significantly enhanced recovery and prolonged survival was found in the SCI mouse model, as compared to sham-treated groups, with no apparent toxicity. A single dose of apamin-conjugated polymers was about 700-fold lower than the LD50 amount, suggesting that APM and apamin have potential for clinical applications as spinal cord targeting ligand for delivery of agents in treatment of diseases of the central nervous system. PMID:25098949

Wu, Jin; Jiang, Hong; Bi, Qiuyan; Luo, Qingsong; Li, Jianjun; Zhang, Yan; Chen, Zhangbao; Li, Chong

2014-09-01

209

An Injectable, Calcium Responsive Composite Hydrogel for the Treatment of Acute Spinal Cord Injury  

PubMed Central

Immediately following spinal cord injury, further injury can occur through several secondary injury cascades. As a consequence of cell lysis, an increase in extracellular Ca2+ results in additional neuronal loss by inducing apoptosis. Thus, hydrogels that reduce extracellular Ca2+ concentration may reduce secondary injury severity. The goal of this study was to develop composite hydrogels consisting of alginate, chitosan, and genipin that interact with extracellular Ca2+ to enable in situ gelation while maintaining an elastic modulus similar to native spinal cord (?1000 Pa). It was hypothesized that incorporation of genipin and chitosan would regulate hydrogel electrostatic characteristics and influence hydrogel porosity, degradation, and astrocyte behavior. Hydrogel composition was varied to create hydrogels with statistically similar mechanical properties (?1000 Pa) that demonstrated tunable charge characteristics (6-fold range in free amine concentration) and degradation rate (complete degradation between 7 and 28 days; some blends persist after 28 days). Hydrogels demonstrate high sensitivity to Ca2+ concentration, as a 1 mM change during fabrication induced a significant change in elastic modulus. Additionally, hydrogels incubated in a Ca2+-containing solution exhibited an increased linear viscoelastic limit (LVE) and an increased elastic modulus above the LVE limit in a time dependent manner. An extension of the LVE limit implies a change in hydrogel cross-linking structure. Attachment assays demonstrated that addition of chitosan/genipin to alginate hydrogels induced up to a 4-fold increase in the number of attached astrocytes and facilitated astrocyte clustering on the hydrogel surface in a composition dependent manner. Furthermore, Western blots demonstrated tunable glial fibrillary acid protein (GFAP) expression in astrocytes cultured on hydrogel blends, with some hydrogel compositions demonstrating no significant increase in GFAP expression compared to astrocytes cultured on glass. Thus, alginate/chitosan/genipin hydrogel composites show promise as scaffolds that regulate astrocyte behavior and for the prevention of Ca2+-related secondary neuron damage during acute SCI. PMID:24397537

2015-01-01

210

Metastatic Spinal Tumor  

PubMed Central

In accordance with extending survival periods of cancer patients, number of consecutively developing metastatic spinal tumor is also increasing. There have been improvements in the treatment results of metastatic spine tumor by virtue of the developments in diagnostic radiology, chemotherapy, adjuvant treatment, operative device and technique, discrete preoperative plan, and standardized operation. Accordingly, surgical indication has also increased. Clinically, in case of metastatic spine tumor, treatment of tumor itself should be focused on pain relief, preservation of neurologic function, prevention of pathologic fracture, prevention of pathologic fracture, and correction of spinal instability for improving quality of life, rather than for extension of survival. Additionally, etiology of spinal tumor, correct diagnosis and subsequent treatment principles should be thoroughly understood before establishing treatment plans for effective treatments. PMID:22439092

Jung, Chul-Hee

2012-01-01

211

Overcoming Limitations in Previous Research on Exercise as a Smoking Cessation Treatment: Rationale and Design of the “Quit for Health” Trial  

PubMed Central

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)—an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants’ natural environments. PMID:24246818

Williams, David M.; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J.; Monti, Peter M.; Emerson, Jessica

2013-01-01

212

Translating Empirically Supported Strategies into Accessible Interventions: The Potential Utility of Exercise for the Treatment of Panic Disorder  

ERIC Educational Resources Information Center

Many patients suffering from panic disorder do not receive adequate care. Advances in the conceptualization and treatment of panic disorder encourage innovative strategies for targeting core fears (fears of anxiety sensations) that underlie this disorder. In this article, we discuss the use of exercise as a potential strategy for therapeutic…

Smits, Jasper A. J.; Powers, Mark B.; Berry, Angela C.; Otto, Michael W.

2007-01-01

213

Acetyl-L-carnitine treatment following spinal cord injury improves mitochondrial function correlated with remarkable tissue sparing and functional recovery.  

PubMed

We have recently documented that treatment with the alternative biofuel, acetyl-L-carnitine (ALC, 300 mg/kg), as late as 1 h after T10 contusion spinal cord injury (SCI), significantly maintained mitochondrial function 24 h after injury. Here we report that after more severe contusion SCI centered on the L1/L2 segments that are postulated to contain lamina X neurons critical for locomotion (the "central pattern generator"), ALC treatment resulted in significant improvements in acute mitochondrial bioenergetics and long-term hind limb function. Although control-injured rats were only able to achieve slight movements of hind limb joints, ALC-treated animals produced consistent weight-supported plantar steps 1 month after injury. Such landmark behavioral improvements were significantly correlated with increased tissue sparing of both gray and white matter proximal to the injury, as well as preservation of choline acetyltransferase (ChAT)-positive neurons in lamina X rostral to the injury site. These findings signify that functional improvements with ALC treatment are mediated, in part, by preserved locomotor circuitry rostral to upper lumbar contusion SCI. Based on beneficial effects of ALC on mitochondrial bioenergetics after injury, our collective evidence demonstrate that preventing mitochondrial dysfunction acutely "promotes" neuroprotection that may be associated with the milestone recovery of plantar, weight-supported stepping. PMID:22445934

Patel, S P; Sullivan, P G; Lyttle, T S; Magnuson, D S K; Rabchevsky, A G

2012-05-17

214

Sex differences in the Nociceptin/Orphanin FQ system in rat spinal cord following chronic morphine treatment.  

PubMed

Nociceptin/Orphanin FQ (N/OFQ) appears to contribute to the development of morphine tolerance, as blockade of its actions will block or reverse the process. To better understand the contribution of N/OFQ to the development of morphine tolerance, this study examined the effect of chronic morphine treatment on levels of N/OFQ and levels and activity of the N/OFQ peptide (NOP) receptor in spinal cord (SC) from male and female rats. Both male and female Wistar rats showed less responsiveness to morphine after subcutaneous injection of escalating doses of morphine (10, 20, 40, 60 and 80 mg/kg, respectively) twice daily for five consecutive days. Male rats were more tolerant to the antinociceptive actions of morphine than females. The N/OFQ content of SC extracts was higher in females than in males, regardless of treatment; following chronic morphine treatment the difference in N/OFQ levels between males and females was more pronounced. N/OFQ content in cerebrospinal fluid (CSF) was reduced 40% in male and 16% in female rats with chronic morphine exposure, but increased in periaqueductal grey of both sexes. Chronic morphine treatment increased NOP receptor levels 173% in males and 137% in females, while decreasing affinity in both. Chronic morphine increased the efficacy of N/OFQ-stimulated [³?S]GTP?S binding to SC membranes from male rats, consistent with increased receptor levels. Taken together, these findings demonstrate sex differences in N/OFQ-NOP receptor expression and NOP receptor activity following chronic morphine treatment. They also suggest interplay between endogenous N/OFQ and chronic morphine treatment that results in nociceptive modulation. PMID:22575074

Zhang, Yong; Donica, Courtney L; Standifer, Kelly M

2012-09-01

215

Clinical Assessment Of Stereotactic IGRT: Spinal Radiosurgery  

Microsoft Academic Search

The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited because of the availability of effective target immobilization devices. Recent advances in stereotactic IGRT have allowed for spinal applications. Large clinical experience with spinal radiosurgery to properly assess clinical outcomes has previously been limited. At

Peter C. Gerszten; Steven A. Burton

2008-01-01

216

[Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia].  

PubMed

Maternal hypotension is a common complication after spinal anesthesia for cesarean section, with deleterious effects on the fetus and mother. Among the strategies aimed at minimizing the effects of hypotension, vasopressor administration is the most efficient. The aim of this study was to compare the efficacy of phenylephrine, metaraminol, and ephedrine in the prevention and treatment of hypotension after spinal anesthesia for cesarean section. Ninety pregnant women, not in labor, undergoing cesarean section were randomized into three groups to receive a bolus followed by continuous infusion of vasopressor as follows: phenylephrine group (50?g+50?g/min); metaraminol group (0.25mg+0.25mg/min); ephedrine group (4mg+4mg/min). Infusion dose was doubled when systolic blood pressure decreased to 80% of baseline and a bolus was given when systolic blood pressure decreased below 80%. The infusion dose was divided in half when systolic blood pressure increased to 120% and was stopped when it became higher. The incidence of hypotension, nausea and vomiting, reactive hypertension, bradycardia, tachycardia, Apgar scores, and arterial cord blood gases were assessed at the 1st and 5th minutes. There was no difference in the incidence of hypotension, bradycardia, reactive hypertension, infusion discontinuation, atropine administration or Apgar scores. Rescue boluses were higher only in the ephedrine group compared to metaraminol group. The incidence of nausea and vomiting and fetal acidosis were greater in the ephedrine group. The three drugs were effective in preventing hypotension; however, fetal effects were more frequent in the ephedrine group, although transient. PMID:25168433

Aragão, Fábio Farias de; Aragão, Pedro Wanderley de; Martins, Carlos Alberto de Souza; Salgado Filho, Natalino; Barroqueiro, Elizabeth de Souza Barcelos

2014-01-01

217

Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia.  

PubMed

Maternal hypotension is a common complication after spinal anesthesia for cesarean section, with deleterious effects on the fetus and mother. Among the strategies aimed at minimizing the effects of hypotension, vasopressor administration is the most efficient. The aim of this study was to compare the efficacy of phenylephrine, metaraminol, and ephedrine in the prevention and treatment of hypotension after spinal anesthesia for cesarean section. Ninety pregnant women, not in labor, undergoing cesarean section were randomized into three groups to receive a bolus followed by continuous infusion of vasopressor as follows: phenylephrine group (50 ?g+50 ?g/min); metaraminol group (0.25mg+0.25mg/min); ephedrine group (4 mg+4 mg/min). Infusion dose was doubled when systolic blood pressure decreased to 80% of baseline and a bolus was given when systolic blood pressure decreased below 80%. The infusion dose was divided in half when systolic blood pressure increased to 120% and was stopped when it became higher. The incidence of hypotension, nausea and vomiting, reactive hypertension, bradycardia, tachycardia, Apgar scores, and arterial cord blood gases were assessed at the 1st and 5th minutes. There was no difference in the incidence of hypotension, bradycardia, reactive hypertension, infusion discontinuation, atropine administration or Apgar scores. Rescue boluses were higher only in the ephedrine group compared to metaraminol group. The incidence of nausea and vomiting and fetal acidosis were greater in the ephedrine group. The three drugs were effective in preventing hypotension; however, fetal effects were more frequent in the ephedrine group, although transient. PMID:25171977

Aragão, Fábio Farias de; Aragão, Pedro Wanderley de; Martins, Carlos Alberto de Souza; Salgado Filho, Natalino; Barroqueiro, Elizabeth de Souza Barcelos

2014-01-01

218

Adjacent Segment Pathology Following Anterior Decompression and Fusion Using Cage and Plate for the Treatment of Degenerative Cervical Spinal Diseases  

PubMed Central

Study Design Retrospective study. Purpose To analyze the incidence and prevalence of clinical adjacent segment pathology (CASP) following anterior decompression and fusion with cage and plate augmentation for degenerative cervical diseases. Overview of Literature No long-term data on the use of cage and plate augmentation have been reported. Methods The study population consisted of 231 patients who underwent anterior cervical discectomy and fusion (ACDF) with cage and plate for degenerative cervical spinal disease. The incidence and prevalence of CASP was determined by using the Kaplan-Meier survival analysis. To analyze the factors that influence CASP, data on preoperative and postoperative sagittal alignment, spinal canal diameter, the distance between the plate and adjacent disc, extent of fusion level, and the presence or absence of adjacent segment degenerative changes by imaging studies were evaluated. Results CASP occurred in 15 of the cases, of which 9 required additional surgery. At 8-year follow-up, the average yearly incidence was 1.1%. The rate of disease-free survival based on Kaplan-Meier survival analysis was 93.6% at 5 years and 90.2% at 8 years. No statistically significant differences in CASP incidence based on radiological analysis were observed. Significantly high incidence of CASP was observed in the presence of increased adjacent segment degenerative changes (p<0.001). Conclusions ACDF with cage and plate for the treatment of degenerative cervical disease is associated with a lower incidence in CSAP by 1.1% per year, and the extent of preoperative adjacent segment degenerative changes has been shown as a risk factor for CASP.

Song, Kyung-Jin; Kim, Jong-Kil

2014-01-01

219

Surgical correction of spinal deformities following spinal cord injury occurring in childhood.  

PubMed

This article reports on the surgical treatment of 14 consecutive patients with paralytic spinal deformities secondary to spinal cord injury occurring in childhood. Eleven patients underwent a posterior spinal fusion and three patients underwent a combined anterior and posterior spinal arthrodesis. Luque rods were used in all but one patient. The spinal fusion extended to the sacrum in 10 patients. No patient developed postoperative wound infections or medical complications. Four patients (28.6%) who underwent initially a posterior spinal arthrodesis developed pseudarthrosis. This was treated successfully by a combined anterior and posterior spinal fusion in two patients. The remaining patients underwent a revision posterior spinal fusion with recurrence of the nonunion in one patient. A combined anterior and posterior spinal arthrodesis could be considered the treatment of choice for patients with severe deformities who can tolerate anterior surgery. If pseudarthrosis develops following posterior spinal fusion, this can be best treated by a combined anterior and posterior revision procedure with instrumentation. PMID:18053399

Tsirikos, Athanasios I; Markham, Philip; McMaster, Michael J

2007-01-01

220

Web-based therapeutic exercise resource center as a treatment for knee osteoarthritis: a prospective cohort pilot study  

PubMed Central

Background Although beneficial effects of exercise in the management of knee osteoarthritis (OA) have been established, only 14 -18% of patients with knee OA receive an exercise from their primary care provider. Patients with knee OA cite lack of physician exercise advice as a major reason why they do not exercise to improve their condition. The purpose of this pilot study was to investigate use of a web-based Therapeutic Exercise Resource Center (TERC) as a tool to prescribe strength, flexibility and aerobic exercise as part of knee OA treatment. It was hypothesized that significant change in clinical outcome scores would result from patients’ use of the TERC. Methods Sixty five individuals diagnosed with mild/moderate knee OA based on symptoms and radiographs were enrolled through outpatient physician clinics. Using exercise animations to facilitate proper technique, the TERC assigned and progressed patients through multiple levels of exercise intensity based on exercise history, co-morbidities and a validated measure of pain and function. Subjects completed a modified short form WOMAC (mSF-WOMAC), World Health Organization Quality of Life (WHO-QOL) and Knee Self-Efficacy Scale (K-SES) at baseline and completion of the 8 week program, and a user satisfaction survey. Outcomes were compared over time using paired t-tests and effect sizes calculated using partial point biserial (pr). Results Fifty two participants completed the 8 week program with average duration of knee pain 8.0?±?11.0 yrs (25 females; 61.0?±?9.4 yrs; body mass index, 28.8?±?6.3 kg/m2). During the study period, all outcome measures improved: mSF-WOMAC scores decreased (better pain and function) (p?exercise animations were especially helpful). Conclusion This pilot study demonstrated the web-based TERC to be feasible and efficacious in improving clinical outcomes for patients with mild/moderate knee OA and supports future studies to compare TERC to current standard of care, such as educational brochures. PMID:24884547

2014-01-01

221

[Rehabilitative treatment of patients with complicated spinal injuries and trophic disorders in specialized neurological center].  

PubMed

The analysis of treatment results 132 patients with consequences with spine injury and the presence of venous disorders which in conditions of specialized health resort management system applied in complex restorative treatment, which includes patogeneti no-reasonable comprehensive preparation, surgery and further restorative treatment. Based on the analysis and systematization of the results developed diagnostic and therapeutic algorithm and algorithm for planning surgical tactics. PMID:24908972

Khashchuk, A V; Bur'ianov, O A; Nen'ko, A M; Laksha, A M

2014-01-01

222

Metabolic Consequences of Dieting and Exercise in the Treatment of Obesity.  

ERIC Educational Resources Information Center

Investigated the effects of dieting and exercise on resting metabolic rate (RMR) in overweight women (N=10). Results showed that dieting lowered RMR by nearly double that expected on the basis of resulting weight loss; and that exercise caused RMR to rise to a level appropriate to prevailing body weight. (LLL)

Donahoe, Clyde P.; And Others

1984-01-01

223

Physical exercise prior and during treatment reduces sub-chronic doxorubicin-induced mitochondrial toxicity and oxidative stress.  

PubMed

Doxorubicin (DOX) is an anti-cancer agent whose clinical usage results in a cumulative and dose-dependent cardiotoxicity. We have previously shown that exercise performed prior to DOX treatment reduces the resulting cardiac(mito) toxicity. We sought to determine the effects on cardiac mitochondrial toxicity of two distinct chronic exercise models (endurance treadmill training-TM and voluntary free-wheel activity-FW) when used prior and during DOX treatment. Male-young Sprague-Dawley rats were divided into six groups (n=6 per group): SAL+SED (saline sedentary), SAL+TM (12-weeks TM), SAL+FW (12-weeks FW), DOX+SED (7-weeks of chronic DOX treatment 2mg/kg per week), DOX+TM and DOX+FW. DOX administration started 5weeks after the beginning of the exercise protocol. Heart mitochondrial ultrastructural alterations, mitochondrial function (oxygen consumption and membrane potential), semi-quantification of oxidative phosphorylation (OXPHOS) proteins and their in-gel activity, as well as proteins involved in mitochondrial oxidative stress (SIRT3, p66shc and UCP2), biogenesis (PGC1? and TFAM), acetylation and markers for oxidative damage (carbonyl groups, MDA,SH, aconitase, Mn-SOD activity) were evaluated. DOX treatment resulted in ultrastructural and functional alterations and decreased OXPHOS. Moreover, DOX decreased complex I activity and content, mitochondrial biogenesis (TFAM), increased acetylation and oxidative stress. TM and FW prevented DOX-induced alteration in OXPHOS, the increase in oxidative stress, the decrease in complex V activity and in complex I activity and content. DOX-induced decreases in TFAM and SIRT3 content were prevented by TM only. Both chronic models of physical exercise performed before and during the course of sub-chronic DOX treatment translated into an improved mitochondrial bioenergetic fitness, which may result in part from the prevention of mitochondrial oxidative stress and damage. PMID:25446396

Marques-Aleixo, Inês; Santos-Alves, Estela; Mariani, Diogo; Rizo-Roca, David; Padrão, Ana I; Rocha-Rodrigues, Sílvia; Viscor, Ginés; Torrella, J Ramon; Ferreira, Rita; Oliveira, Paulo J; Magalhães, José; Ascensão, António

2015-01-01

224

Resistance Versus Aerobic Exercise  

PubMed Central

OBJECTIVE In type 1 diabetes, small studies have found that resistance exercise (weight lifting) reduces HbA1c. In the current study, we examined the acute impacts of resistance exercise on glycemia during exercise and in the subsequent 24 h compared with aerobic exercise and no exercise. RESEARCH DESIGN AND METHODS Twelve physically active individuals with type 1 diabetes (HbA1c 7.1 ± 1.0%) performed 45 min of resistance exercise (three sets of seven exercises at eight repetitions maximum), 45 min of aerobic exercise (running at 60% of Vo2max), or no exercise on separate days. Plasma glucose was measured during and for 60 min after exercise. Interstitial glucose was measured by continuous glucose monitoring 24 h before, during, and 24 h after exercise. RESULTS Treatment-by-time interactions (P < 0.001) were found for changes in plasma glucose during and after exercise. Plasma glucose decreased from 8.4 ± 2.7 to 6.8 ± 2.3 mmol/L (P = 0.008) during resistance exercise and from 9.2 ± 3.4 to 5.8 ± 2.0 mmol/L (P = 0.001) during aerobic exercise. No significant changes were seen during the no-exercise control session. During recovery, glucose levels did not change significantly after resistance exercise but increased by 2.2 ± 0.6 mmol/L (P = 0.023) after aerobic exercise. Mean interstitial glucose from 4.5 to 6.0 h postexercise was significantly lower after resistance exercise versus aerobic exercise. CONCLUSIONS Resistance exercise causes less initial decline in blood glucose during the activity but is associated with more prolonged reductions in postexercise glycemia than aerobic exercise. This might account for HbA1c reductions found in studies of resistance exercise but not aerobic exercise in type 1 diabetes. PMID:23172972

Yardley, Jane E.; Kenny, Glen P.; Perkins, Bruce A.; Riddell, Michael C.; Balaa, Nadia; Malcolm, Janine; Boulay, Pierre; Khandwala, Farah; Sigal, Ronald J.

2013-01-01

225

Mechanistic investigation of adult myotube response to exercise and drug treatment in vitro using a multiplexed functional assay system.  

PubMed

The ability to accurately measure skeletal muscle functional performance at the single-cell level would be advantageous for exercise physiology studies and disease modeling applications. To that end, this study characterizes the functional response of individual skeletal muscle myotubes derived from adult rodent tissue to creatine treatment and chronic exercise. The observed improvements to functional performance in response to these treatments appear to correlate with alterations in hypertrophic and mitochondrial biogenesis pathways, supporting previously published in vivo and in vitro data, which highlights the role of these pathways in augmenting skeletal muscle output. The developed system represents a multiplexed functional in vitro assay capable of long-term assessment of contractile cellular outputs in real-time that is compatible with concomitant molecular biology analysis. Adoption of this system in drug toxicity and efficacy studies would improve understanding of compound activity on physical cellular outputs and provide more streamlined and predictive data for future preclinical analyses. PMID:25301895

McAleer, C W; Smith, A S T; Najjar, S; Pirozzi, K; Long, C J; Hickman, J J

2014-12-01

226

Treatment of Rat Spinal Cord Injury with the Neurotrophic Factor Albumin-Oleic Acid: Translational Application for Paralysis, Spasticity and Pain  

PubMed Central

Sensorimotor dysfunction following incomplete spinal cord injury (iSCI) is often characterized by the debilitating symptoms of paralysis, spasticity and pain, which require treatment with novel pleiotropic pharmacological agents. Previous in vitro studies suggest that Albumin (Alb) and Oleic Acid (OA) may play a role together as an endogenous neurotrophic factor. Although Alb can promote basic recovery of motor function after iSCI, the therapeutic effect of OA or Alb-OA on a known translational measure of SCI associated with symptoms of spasticity and change in nociception has not been studied. Following T9 spinal contusion injury in Wistar rats, intrathecal treatment with: i) Saline, ii) Alb (0.4 nanomoles), iii) OA (80 nanomoles), iv) Alb-Elaidic acid (0.4/80 nanomoles), or v) Alb-OA (0.4/80 nanomoles) were evaluated on basic motor function, temporal summation of noxious reflex activity, and with a new test of descending modulation of spinal activity below the SCI up to one month after injury. Albumin, OA and Alb-OA treatment inhibited nociceptive Tibialis Anterior (TA) reflex activity. Moreover Alb-OA synergistically promoted early recovery of locomotor activity to 50±10% of control and promoted de novo phasic descending inhibition of TA noxious reflex activity to 47±5% following non-invasive electrical conditioning stimulation applied above the iSCI. Spinal L4–L5 immunohistochemistry demonstrated a unique increase in serotonin fibre innervation up to 4.2±1.1 and 2.3±0.3 fold within the dorsal and ventral horn respectively with Alb-OA treatment when compared to uninjured tissue, in addition to a reduction in NR1 NMDA receptor phosphorylation and microglia reactivity. Early recovery of voluntary motor function accompanied with tonic and de novo phasic descending inhibition of nociceptive TA flexor reflex activity following Alb-OA treatment, mediated via known endogenous spinal mechanisms of action, suggests a clinical application of this novel neurotrophic factor for the treatment of paralysis, spasticity and pain. PMID:22046257

Avila-Martin, Gerardo; Galan-Arriero, Iriana; Gómez-Soriano, Julio; Taylor, Julian

2011-01-01

227

[Late effects of tumour treatment. Structural changes in the spinal column seen on X-rays].  

PubMed

Cure rates are increasing in pediatric oncology; simultaneously the numbers of late effects of therapy are also increasing. 64 children with malignant neoplastic disease in whom the spine had been partially or totally exposed during X-ray treatment were re-investigated for radiographically visible irradiation effects on the vertebral column. 140 different abnormalties were found in 56 children of which scolioses were the most important. Irradiation for Wilms' tumour produced more numerous changes than direct irradiation of the vertebral column. In spite of the unexpectedly high number of growth defects rigorous X-ray treatment is indicated in certain circumstances. The growth abnormalities were of only minor clinical significance. PMID:179773

Gutjahr, P; Greinacher, I; Kutzner, J

1976-06-25

228

Evaluation of spinal cord injury animal models  

PubMed Central

Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies. PMID:25598784

Zhang, Ning; Fang, Marong; Chen, Haohao; Gou, Fangming; Ding, Mingxing

2014-01-01

229

Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Recreational Athletes With Chronic Achilles Tendinopathy  

Microsoft Academic Search

Background: Eccentric exercises (EEs) are recommended for the treatment of Achilles tendinopathy, but the clinical effect from EE has a slow onset.Hypothesis: The addition of low-level laser therapy (LLLT) to EE may cause more rapid clinical improvement.Study Design: Randomized controlled trial; Level of evidence, 1.Methods: A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were randomized to groups

Apostolos Stergioulas; Marianna Stergioula; Reidar Aarskog; Rodrigo A. B. Lopes-Martins; Jan M. Bjordal

2008-01-01

230

Cost Analysis of the Treatment of Severe Spinal Spasticity With a Continuous Intrathecal Baclofen Infusion System  

Microsoft Academic Search

Objective: The purpose of our study was to analyse and evaluate the costs of continuous intrathecal baclofen administration as a modality in the treatment of severe spasticity in the Netherlands. Design: A cost analysis was conducted as part of a prospective, multicentre, multidisciplinary, randomised and placebo-controlled clinical trial. The study covered the period from December 1991 to September 1995. The

M. Postma; Dettie Oenema; Symon Terpstra; Jelte Bouma; Hannah Kuipers-Upmeijer; Michiel J. Staal; Berry J. Middel

1999-01-01

231

Nelson's wound: treatment of spinal cord injury in 19th and early 20th century military conflicts.  

PubMed

During the first half of the 19th century, warfare did not provide a background for a systematic analysis of spinal cord injury (SCI). Medical officers participating in the Peninsular and Crimean Wars emphasized the dismal prognosis of this injury, although authors of sketchy civil reports persuaded a few surgeons to operate on closed fractures. The American Medical and Surgical History of the War of the Rebellion was the first text to provide summary of results in 642 cases of gunshot wounds of the spine. The low incidence of this injury (0.26%) and the high mortality rate (55%) discouraged the use of surgery in these cases. Improvements in diagnoses and the introduction of x-ray studies in the latter half of the century enabled Sir G. H. Makins, during the Boer War, to recommend delayed intervention to remove bone or bullet fragments in incomplete injuries. The civil experiences of Elsberg and Frazier in the early 20th century promoted a meticulous approach to treatments, whereas efficient transport of injured soldiers during World War I increased the numbers of survivors. Open large wounds or cerebrospinal fluid leakage, signs of cord compression in recovering patients, delayed clinical deterioration, or intractable pain required surgical exploration. Wartime recommendations for urological and skin care prevented sepsis, and burgeoning pension systems provided specialized longterm rehabilitation. By the Armistice, the effective surgical treatment and postoperative care that had developed through decades of interaction between civil and military medicine helped reduce incidences of morbidity and dispel the hopelessness surrounding the combatant with an SCI. PMID:15264782

Hanigan, William C; Sloffer, Chris

2004-01-15

232

Modeling spinal cord biomechanics  

NASA Astrophysics Data System (ADS)

Regeneration after spinal cord injury is a serious health issue and there is no treatment for ailing patients. To understand regeneration of the spinal cord we used a system where regeneration occurs naturally, such as the lamprey. In this work, we analyzed the stress response of the spinal cord to tensile loading and obtained the mechanical properties of the cord both in vitro and in vivo. Physiological measurements showed that the spinal cord is pre-stressed to a strain of 10%, and during sinusoidal swimming, there is a local strain of 5% concentrated evenly at the mid-body and caudal sections. We found that the mechanical properties are homogeneous along the body and independent of the meninges. The mechanical behavior of the spinal cord can be characterized by a non-linear viscoelastic model, described by a modulus of 20 KPa for strains up to 15% and a modulus of 0.5 MPa for strains above 15%, in agreement with experimental data. However, this model does not offer a full understanding of the behavior of the spinal cord fibers. Using polymer physics we developed a model that relates the stress response as a function of the number of fibers.

Luna, Carlos; Shah, Sameer; Cohen, Avis; Aranda-Espinoza, Helim

2012-02-01

233

Comparison of reduction of edema after rest and after muscle exercises in treatment of chronic venous insufficiency  

PubMed Central

Aim The aim of this work was to compare the reduction in edema obtained in the conservative treatment of phlebopathies after resting and after performing a muscle exercise program in the Trendelenburg position. Methods Twenty-eight limbs of 24 patients with venous edema of distinct etiologies and classified as between C3 and C5 using CEAP classification. Volumetric evaluation by water displacement was carried out before and after resting in the Trendelenburg position and after performing programmed muscle exercises 24 hours later under identical conditions of time, position and temperature. For the statistical analysis the paired t-test was used with an alpha error of 5% being considered acceptable. Results The average total volume of the lower limbs was 3,967.46 mL. The mean reduction in edema obtained after resting was 92.9 mL, and after exercises it was 135.4 mL, giving a statistically significant difference (p-value = 0.0007). Conclusion In conclusion, exercises are more efficient to reduce the edema of lower limbs than resting in the Trendelenburg position. PMID:19602249

Quilici, Belczak Cleusa Ema; Gildo, Cavalheri; de Godoy, Jose Maria Pereira; Quilici, Belczak Sergio; Augusto, Caffaro Roberto

2009-01-01

234

Spinal Stenosis  

MedlinePLUS

... more quickly when walking up or down a hill, a ramp or steps. Usually, it is relieved by sitting down or leaning over. However, not all patients with spinal narrowing develop symptoms—and we still don't understand why. Because of this, the term "spinal ...

235

Efficacy of ?yurvedic treatment using Pañcakarma combined with balance exercises for disability and balance in progressive supranuclear palsy.  

PubMed

A 55-year-old female presented at Department of Pañcakarma with diagnosis of progressive supranuclear palsy (PSP). For assessing disability, progressive supranuclear palsy rating scale (PSPRS) was used and balance was assessed by using Tetrax Interactive Balance System (IBS) posturography. ?yurvedic treatment was given along with Pañcakarma and balance exercises for 3 months. As part of ?yurvedic treatment, first Virecana karma was done with classical method and then M?tr? basti, ?irobasti, and other palliative treatment was given for 3 months. Amanatidine was not continued during Virecana karma but started thereafter. On comparison with pre-intervention scores, there was a significant improvement in the patient post-treatment. The features which mainly showed improvement were: Eye movements, spontaneous episodes of laughing, dysphagia, dysarthria, double vision, and neck rigidity. Balance showed significant improvement and there was a remarkable decrease in the postural sway. This case study may present new possibilities for treatment of neurodegenerative diseases by ?yurveda. PMID:23929996

Jindal, Nitin; Shamkuwar, Manoj K; Kaur, Jaskirat; Berry, Sadhan

2012-07-01

236

Efficacy of ?yurvedic treatment using Pañcakarma combined with balance exercises for disability and balance in progressive supranuclear palsy  

PubMed Central

A 55-year-old female presented at Department of Pañcakarma with diagnosis of progressive supranuclear palsy (PSP). For assessing disability, progressive supranuclear palsy rating scale (PSPRS) was used and balance was assessed by using Tetrax Interactive Balance System (IBS) posturography. ?yurvedic treatment was given along with Pañcakarma and balance exercises for 3 months. As part of ?yurvedic treatment, first Virecana karma was done with classical method and then M?tr? basti, ?irobasti, and other palliative treatment was given for 3 months. Amanatidine was not continued during Virecana karma but started thereafter. On comparison with pre-intervention scores, there was a significant improvement in the patient post-treatment. The features which mainly showed improvement were: Eye movements, spontaneous episodes of laughing, dysphagia, dysarthria, double vision, and neck rigidity. Balance showed significant improvement and there was a remarkable decrease in the postural sway. This case study may present new possibilities for treatment of neurodegenerative diseases by ?yurveda. PMID:23929996

Jindal, Nitin; Shamkuwar, Manoj K.; Kaur, Jaskirat; Berry, Sadhan

2012-01-01

237

Spinal Myoclonus After Spinal Cord Injury  

PubMed Central

Background/Objective: In the course of examining spinal motor function in many hundreds of people with traumatic spinal cord injury, we encountered 6 individuals who developed involuntary and rhythmic contractions in muscles of their legs. Although there are many reports of unusual muscle activation patterns associated with different forms of myoclonus, we believe that certain aspects of the patterns seen with these 6 subjects have not been previously reported. These patterns share many features with those associated with a spinal central pattern generator for walking. Methods: Subjects in this case series had a history of chronic injury to the cervical spinal cord, resulting in either complete (ASIA A; n = 4) or incomplete (ASIA D; n = 2) quadriplegia. We used multi-channel electromyography recordings of trunk and leg muscles of each subject to document muscle activation patterns associated with different postures and as influenced by a variety of sensory stimuli. Results: Involuntary contractions spanned multiple leg muscles bilaterally, sometimes including weak abdominal contractions. Contractions were smooth and graded and were highly reproducible in rate for a given subject (contraction rates were 0.3–0.5 Hz). These movements did not resemble the brief rapid contractions (ie, "jerks") ascribed to some forms of spinal myoclonus. For all subjects, the onset of involuntary muscle contraction was dependent upon hip angle; contractions did not occur unless the hips (and knees) were extended (ie, subjects were supine). In the 4 ASIA A subjects, contractions occurred simultaneously in all muscles (agonists and antagonists) bilaterally. In sharp contrast, contractions in the 2 ASIA D subjects were reciprocal between agonists and antagonists within a limb and alternated between limbs, such that movements in these 2 subjects looked just like repetitive stepping. Finally, each of the 6 subjects had a distinct pathology of their spinal cord, nerve roots, distal trunk, or thigh; in 4 of these subjects, treatment of the pathology eliminated the involuntary movements. Conclusion: The timing, distribution, and reliance upon hip angle suggest that these movement patterns reflect some elements of a central pattern generator for stepping. Emergence of these movements in persons with chronic spinal cord injury is extremely rare and appears to depend upon a combination of the more rostrally placed injury and a pathologic process leading to a further enhancement of excitability in the caudal spinal cord. PMID:17044393

Calancie, Blair

2006-01-01

238

Blood cell exchange in the treatment of exercise-induced rhabdomyolysis in a patient with sickle cell trait.  

PubMed

We report the use of red blood cell exchange (RBCex) to treat rhabdomyolysis complicated by acute kidney injury in a 16-year-old African-American female with sickle cell trait (SCT). Treatment with aggressive fluid and electrolyte management failed to stem the rise in her creatine kinase, and RBCex was instituted 27 hours after symptom onset. She had a transient improvement in her creatine kinase following this treatment although it failed to resolve a developing lower extremity compartment syndrome, requiring bilateral lower extremity fasciotomies. The mechanism of exercise-induced rhabdomyolysis in individuals with SCT is theorized to result from localized hypoxia and acidosis within exercising muscle significant enough to cause a localized sickling crisis with resultant rhabdomyolysis. Despite the unique pathophysiology of rhabdomyolysis in individuals with SCT, there is a paucity of adjunctive treatment options beyond fluid and electrolyte therapy. To the best of our knowledge, RBCex for treatment of rhabdomyolysis in a patient with SCT has been described only once before by Huang et al. We report here a second case in the use of RBCex in the treatment of rhadbomyolysis in a patient with SCT. PMID:25562874

Papacostas, Michael F; McLean, Matthew

2015-01-01

239

Contralateral treatment with lidocaine reduces spinal neuronal activity in mononeuropathic rats.  

PubMed

In anaesthetised and paralysed rats with chronic constriction of the sciatic nerve, the effects of subcutaneous contralateral lidocaine (100 microl) on the activity of lumbar (L(4)-L(5)) wide dynamic range neurons ipsilateral to the constriction have been investigated. The results show reduction of the spontaneous hyperactivity for 60 min; suppression or reduction of the responses to contralateral noxious stimulation for 60 min; lack of effect on the responses to ipsilateral noxious stimulation, except for the afterdischarge duration, reduced for 60 min. The finding that the altered neuronal activity following peripheral nerve injury associated to behavioural signs of neuropathic pain, can be reduced by contralateral treatment, may provide further suggestions to neuropathic pain mechanisms and management. PMID:11578818

Bileviciute-Ljungar, I; Biella, G; Bellomi, P; Sotgiu, M L

2001-10-01

240

[Diagnostics and therapy of spinal disc herniation].  

PubMed

Degenerative processes in a movement segment of the vertebral column, which can potentially give rise to herniation of elements of the nucleus pulposus, are complex and of variable clinical and radiological dimensions; however the mere assumption that degenerative changes precede disc herniation remains a matter of debate. By definition, spinal disc herniation (SDH) refers to components of the gelatinous nucleus pulposus protruding beyond the dorsal level of the vertebral body margin through tears in the annulus fibrosus. Clinical presentation may include pain, paresis and sensory disturbances. Magnetic resonance imaging (MRI) is considered the gold standard in the diagnosis of SDH. In the majority of patients a conservative approach with physical therapy exercises and adequate analgesic and antiphlogistic medical treatment results in a substantial improvement of symptoms. PMID:25398570

Zimmer, A; Reith, W

2014-11-01

241

Bortezomib treatment produces nocifensive behavior and changes in the expression of TRPV1, CGRP, and substance P in the rat DRG, spinal cord, and sciatic nerve.  

PubMed

To investigate neurochemical changes associated with bortezomib-induced painful peripheral neuropathy (PN), we examined the effects of a single-dose intravenous administration of bortezomib and a well-established "chronic" schedule in a rat model of bortezomib-induced PN. The TRPV1 channel and sensory neuropeptides CGRP and substance P (SP) were studied in L4-L5 dorsal root ganglia (DRGs), spinal cord, and sciatic nerve. Behavioral measures, performed at the end of the chronic bortezomib treatment, confirmed a reduction of mechanical nociceptive threshold, whereas no difference occurred in thermal withdrawal latency. Western blot analysis showed a relative increase of TRPV1 in DRG and spinal cord after both acute and chronic bortezomib administration. Reverse transcriptase-polymerase chain reaction revealed a decrease of TRPV1 and CGRP mRNA relative levels after chronic treatment. Immunohistochemistry showed that in the DRGs, TRPV1-, CGRP-, and SP-immunoreactive neurons were mostly small- and medium-sized and the proportion of TRPV1- and CGRP-labeled neurons increased after treatment. A bortezomib-induced increase in density of TRPV1- and CGRP-immunoreactive innervation in the dorsal horn was also observed. Our findings show that bortezomib-treatment selectively affects subsets of DRG neurons likely involved in the processing of nociceptive stimuli and that neurochemical changes may contribute to development and persistence of pain in bortezomib-induced PN. PMID:24877063

Quartu, M; Carozzi, V A; Dorsey, S G; Serra, M P; Poddighe, L; Picci, C; Boi, M; Melis, T; Del Fiacco, M; Meregalli, C; Chiorazzi, A; Renn, C L; Cavaletti, G; Marmiroli, P

2014-01-01

242

Bortezomib Treatment Produces Nocifensive Behavior and Changes in the Expression of TRPV1, CGRP, and Substance P in the Rat DRG, Spinal Cord, and Sciatic Nerve  

PubMed Central

To investigate neurochemical changes associated with bortezomib-induced painful peripheral neuropathy (PN), we examined the effects of a single-dose intravenous administration of bortezomib and a well-established “chronic” schedule in a rat model of bortezomib-induced PN. The TRPV1 channel and sensory neuropeptides CGRP and substance P (SP) were studied in L4-L5 dorsal root ganglia (DRGs), spinal cord, and sciatic nerve. Behavioral measures, performed at the end of the chronic bortezomib treatment, confirmed a reduction of mechanical nociceptive threshold, whereas no difference occurred in thermal withdrawal latency. Western blot analysis showed a relative increase of TRPV1 in DRG and spinal cord after both acute and chronic bortezomib administration. Reverse transcriptase-polymerase chain reaction revealed a decrease of TRPV1 and CGRP mRNA relative levels after chronic treatment. Immunohistochemistry showed that in the DRGs, TRPV1-, CGRP-, and SP-immunoreactive neurons were mostly small- and medium-sized and the proportion of TRPV1- and CGRP-labeled neurons increased after treatment. A bortezomib-induced increase in density of TRPV1- and CGRP-immunoreactive innervation in the dorsal horn was also observed. Our findings show that bortezomib-treatment selectively affects subsets of DRG neurons likely involved in the processing of nociceptive stimuli and that neurochemical changes may contribute to development and persistence of pain in bortezomib-induced PN. PMID:24877063

Quartu, M.; Carozzi, V. A.; Dorsey, S. G.; Serra, M. P.; Poddighe, L.; Picci, C.; Boi, M.; Melis, T.; Del Fiacco, M.; Meregalli, C.; Chiorazzi, A.; Renn, C. L.; Cavaletti, G.; Marmiroli, P.

2014-01-01

243

Spinal Stenosis  

MedlinePLUS

... For example: Continued followup of participants in the SPORT trial will assess long-term outcomes and the cost effectiveness of surgical or nonsurgical management of spinal stenosis and other back problems. SPORT ...

244

Spinal Tap  

MedlinePLUS

... the area. The sample is sent to a lab for analysis and testing. Your doctor might ask you to lie on your back for a few hours after the procedure. Safety A spinal tap is considered a safe procedure ...

245

[Spinal epidural lipomatosis].  

PubMed

Spinal epidural lipomatosis (SEL) is a rare condition affecting the thoracic and lumbar spine, characterized by a hypertrophy and hyperplasia of the rich vascularized fat tissue inside the spinal canal. The etiology of SEL is unknown. A high number of cases are associated with obesity, corticosteroid intake and a dysbalance in adrenocorticotropic hormone (ACTH)-cortisone metabolism. It can be an incidental radiographic finding or present with symptoms, such as low back pain, weakness of the lower limbs, dysesthesia, radiculopathy, claudication or even cauda equina syndrome. The interdisciplinary treatment consists of weight reduction, weaning from corticosteroids and in persisting cases or neurologic alterations in surgical decompression of the spinal canal. The following article presents a current review and a case report of this rare entity. PMID:22772944

Artner, J; Leucht, F; Cakir, B; Reichel, H; Lattig, F

2012-11-01

246

Randomized trial comparing exercise therapy, alternating cold and hot therapy, and low intensity laser therapy for chronic lumbar muscle strain  

NASA Astrophysics Data System (ADS)

The purpose of this study was to compare the effects of exercise therapy, alternating cold and hot (ACH) therapy and low intensity laser (LIL) therapy in patients with chronic lumbar muscle strain (CLMS). Thirty-two patients were randomly allocated to four groups: exercise group, ACH group, LIL group, and combination group of exercise, ACH and LIL, eight in each group. Sixteen treatments were given over the course of 4 weeks. Lumbar muscle endurance, flexion and lateral flexion measures, visual analogue scale (VAS) and lumbar disability questionnaire (LDQ) were used in the clinical and functional evaluations before, immediately after, and 4 weeks after treatment. It was found that the values of endurance, VAS and LDQ in all groups were significantly improved from before to after treatment (P < 0.01). The combination group showed significantly larger reduction on pain level and functional disability than the other groups immediately and 4 weeks after treatment (P < 0.01). Pain level reduced significantly more in the ACH group than in the exercise group or the LIL group immediately and 4 weeks after treatment (P < 0.05). Lumbar muscle endurance and spinal ranges of motion in all groups were improved after treatment but there was no significant difference between any therapy groups. In conclusion, exercise therapy, ACH therapy and LIL therapy were effective in the treatment of CLMS. ACH therapy was more effective than exercise therapy or LIL therapy. The combination therapy of exercise, ACH and LIL had still better rehabilitative effects on CLMS.

Liu, Xiaoguang; Li, Jie; Liu, Timon Chengyi; Yuan, Jianqin; Luo, Qingming

2008-12-01

247

Patellofemoral stressA prospective analysis of exercise treatment in adolescents and adults  

Microsoft Academic Search

Thirty patients, 13 skeletally immature individuals and 17 adults, participated in a prospective study designed to evaluate the effect of isometric quadriceps strength ening exercises on patellofemoral pain. Of the 30 pa tients with anatomically normal lower extremity align ment and no history of previous knee trauma or sur gery, there were 34 knees that had a decrease in peripatellar

Daniel B. ONeill; Lyle J. Micheli; Jon P. Warner

1992-01-01

248

Aerobic Interval Training Versus Continuous Moderate Exercise as a Treatment for the Metabolic Syndrome  

E-print Network

--Individuals with the metabolic syndrome are 3 times more likely to die of heart disease than healthy counterparts. Exercise to variables associated with cardiovascular function and prognosis in patients with the metabolic syndrome. Methods and Results--Thirty-two metabolic syndrome patients (age, 52.3 3.7 years; maximal oxygen uptake [V

Brand, Paul H.

249

Prognostic value of predischarge low-level exercise thallium testing after thrombolytic treatment of acute myocardial infarction  

SciTech Connect

Low-level exercise thallium testing is useful in identifying the high-risk patient after acute myocardial infarction (AMI). To determine whether this use also applies to patients after thrombolytic treatment of AMI, 64 patients who underwent early thrombolytic therapy for AMI and 107 patients without acute intervention were evaluated. The ability of both the electrocardiogram and thallium tests to predict future events was compared in both groups. After a mean follow-up of 374 days, there were 25 and 32% of cardiac events in the 2 groups, respectively, with versus without acute intervention. These included death, another AMI, coronary artery bypass grafting or angioplasty with 75% of the events occurring in the 3 months after the first infarction. The only significant predictors of outcome were left ventricular cavity dilatation in the intervention group and ST-segment depression and increased lung uptake in the nonintervention group. The sensitivity of exercise thallium was 55% in the intervention group and 81% in the nonintervention group (p less than 0.05). Therefore, in patients having thrombolytic therapy for AMI, nearly half the events after discharge are not predicted by predischarge low-level exercise thallium testing. The relatively weak correlation of outcome with unmasking ischemia in the laboratory before discharge may be due to an unstable coronary lesion or rapid progression of disease after the test. Tests considered useful for prognostication after AMI may not necessarily have a similar value if there has been an acute intervention, such as thrombolytic therapy.

Tilkemeier, P.L.; Guiney, T.E.; LaRaia, P.J.; Boucher, C.A. (Massachusetts General Hospital, Boston (USA))

1990-11-15

250

The history of spinal biomechanics.  

PubMed

The history of spinal biomechanics has its origins in antiquity. The Edwin Smith surgical papyrus, an Egyptian document written in the 17th century BC, described the difference between cervical sprain, fracture, and fracture-dislocation. By the time of Hippocrates (4th century BC), physical means such as traction or local pressure were being used to correct spinal deformities but the treatments were based on only a rudimentary knowledge of spinal biomechanics. The Renaissance produced the first serious attempts at understanding spinal biomechanics. Leonardo da Vinci (1452-1519) accurately described the anatomy of the spine and was perhaps the first to investigate spinal stability. The first comprehensive treatise on biomechanics, De Motu Animalium, was published by Giovanni Borelli in 1680, and it contained the first analysis of weight bearing by the spine. In this regard, Borelli can be considered the "Father of Spinal Biomechanics." By the end of the 19th century, the basic biomechanical concepts of spinal alignment and immobilization were well entrenched as therapies for spinal cord injury. Further anatomic delineation of spinal stability was sparked by the anatomic analyses of judicial hangings by Wood-Jones in 1913. By the 1960s, a two-column model of the spine was proposed by Holdsworth. The modern concept of Denis' three-column model of the spine is supported by more sophisticated testing of cadaver spines in modern biomechanical laboratories. The modern explosion of spinal instrumentation stems from a deeper understanding of the load-bearing structures of the spinal column. PMID:8880756

Sanan, A; Rengachary, S S

1996-10-01

251

The surgical management of spinal deformity in children with a Fontan circulation: The development of an algorithm for treatment.  

PubMed

The management of spinal deformity in children with univentricular cardiac pathology poses significant challenges to the surgical and anaesthetic teams. To date, only posterior instrumented fusion techniques have been used in these children and these are associated with a high rate of complications. We reviewed our experience of both growing rod instrumentation and posterior instrumented fusion in children with a univentricular circulation. Six children underwent spinal corrective surgery, two with cavopulmonary shunts and four following completion of a Fontan procedure. Three underwent growing rod instrumentation, two had a posterior fusion and one had spinal growth arrest. There were no complications following surgery, and the children undergoing growing rod instrumentation were successfully lengthened. We noted a trend for greater blood loss and haemodynamic instability in those whose surgery was undertaken following completion of a Fontan procedure. At a median follow-up of 87.6 months (interquartile range (IQR) 62.9 to 96.5) the median correction of deformity was 24.2% (64.5° (IQR 46° to 80°) vs 50.5° (IQR 36° to 63°)). We believe that early surgical intervention with growing rod instrumentation systems allows staged correction of the spinal deformity and reduces the haemodynamic insult to these physiologically compromised children. Due to the haemodynamic changes that occur with the completed Fontan circulation, the initial scoliosis surgery should ideally be undertaken when in the cavopulmonary shunt stage. PMID:24395318

Evans, S; Ramasamy, A; Marks, D S; Spilsbury, J; Miller, P; Tatman, A; Gardner, A C

2014-01-01

252

Epidural Steroid Injections Are Associated with Less Improvement in the Treatment of Lumbar Spinal Stenosis: A subgroup analysis of the SPORT  

PubMed Central

Summary of Background Data Lumbar spinal stenosis is a common incidental finding among adults over the age of 60, The use of ESI in these patients is common, although there is little evidence in the literature to demonstrate the long-term benefit of ESI in the treatment of lumbar stenosis. Objective The hypothesis of this study was that patients who received epidural steroid injections (ESI) during initial treatment as part of the Spine Patient Outcomes Research Trial (SPORT) would have improved clinical outcomes and a lower rate of crossover to surgery compared to patients who did not receive ESI. Methods Patients with lumbar spinal stenosis who received epidural steroid injections within the first three months of enrollment in SPORT (ESI) were compared to patients who did not receive epidural injections during the first three months of the study (No ESI). Results There were 69 ESI patients and 207 No-ESI patients. There were no significant differences in demographic factors, baseline clinical outcome scores, or operative details although there was a significant increase in baseline preference for nonsurgical treatment among ESI patients (62% vs. 33%, p <0.001). There was an average 26 minute increase in operative time and an increased length of stay by 0.9 days among the ESI patients who ultimately underwent surgical treatment. Averaged over four years, there was significantly less improvement in SF36 PF among surgically treated ESI patients (ESI 14.8 vs. No-ESI 22.5, p=0.025). In addition, there was also significantly less improvement among the nonsurgically treated patients in SF36 BP (ESI 7.3 vs. No-ESI 16.7, p=0.007) and SF36 PF (ESI 5.5 vs. No-ESI 15.2, p=0.009). Of the patients assigned to surgical treatment, there was a significantly increased crossover to nonsurgical treatment among patients who received an ESI (ESI 33% vs. No ESI 11%, p=0.012). Of the patients assigned to non-operative treatment, there was a significantly increased crossover to surgical treatment in the ESI patients (ESI 58% vs. No ESI 32%, p=0.003). Conclusion Despite equivalent baseline status, ESI were associated with significantly less improvement at four years among all patients with spinal stenosis in SPORT. Furthermore, ESI were associated with longer duration of surgery and longer hospital stay. There was no improvement in outcome with ESI whether patients were treated surgically or nonsurgically. PMID:23238485

Radcliff, Kris; Kepler, Christopher; Hilibrand, Alan; Rihn, Jeffrey; Zhao, Wenyan; Lurie, Jon; Tosteson, Tor; Vaccaro, Alexander; Albert, Todd; Weinstein, James

2013-01-01

253

Clinical Treatment of Orthostatic Hypotension after Spinal Cord Injury with Standing Training Coupled with a Remote Monitoring System  

PubMed Central

Background The treatment for orthostatic hypotension (OH) after spinal cord injury (SCI) is an important part of rehabilitation in late-stage SCI. Electric uprise bed training is a relatively commonly used method in treating OH, and how to carry out uprise bed training safely and effectively is an urgent problem. In the early stage of SCI, we used a remote monitoring system to monitor the whole process of uprise bed training, and we explored a safe and efficient method of electric uprise bed training. Material/Methods The experimental group consisted of 36 patients diagnosed with orthostatic hypotension (OH) after SCI and who received training with an electric uprise bed coupled with remote monitoring system, and the control group of 18 subjects who used a traditional training method. Results There were no differences in baseline data between the 2 groups. There were no severe symptoms during training in the experimental group, but 3 patients had severe symptoms in the control group. Among the 32 enrolled subjects reaching upright training status within 30 days (17 subjects in the experimental group and 15 subjects in the control group), time interval of training from horizontal position to erect position in the experimental group was 18.00±3.12 days and 21.40±4.95 days in the control group. Time interval in the experimental group was significantly less than in the control group. However, among all 36 subjects, by combining results of follow-up, there was no significant difference of time interval of training from horizontal position to erect position between the experimental group and the control group. In the experimental group 90.52% of patients finished training compared to 78.19% in the control group (P<0.01). After training, values of OCs and OCd of the experimental group were lower than in the control group. There was no significant difference between groups in number of re-diagnosed OH. Conclusions Implementation of training with electric uprise bed coupled with remote monitoring system is generally safe for patients with OH after SCI. For patients who could reach standing training status within 30 days, implementation can improve efficiency of training by shortening time interval of training from horizontal position to erect position. It can increase orthostatic blood pressure change during position change. PMID:25529992

Shen, Dantong; Huang, Huai; Yuan, Hui; Zhang, Xu; Li, Min

2014-01-01

254

A treatment-refractory spinal dural arteriovenous fistula sharing arterial origin with the Artery of Adamkiewicz: Repeated endovascular treatment after failed microsurgery  

PubMed Central

Background: Effective management of a spinal dural arteriovenous fistula (SDAVF) can be accomplished with either microsurgery or endovascular embolization, but there is a consensus that in patients in whom a radiculomedullary artery supplying the anterior spinal artery (ASA) originates from the same feeding artery as the SDAVF, the endovascular approach is to be avoided. Case Description: The patient was a 46-year-old woman with progressive lower limb paraparesis, sensory deficit, and sphincter dysfunction. Magnetic resonance imaging (MRI) and spinal angiography showed an SDAVF fed by a branch from the left second lumbar segmental artery, and the artery of Adamkiewicz (AA), a major ASA supplier, originating from the same segmental artery just proximal to the SDAVF. Microsurgical disconnection of the SDAVF was attempted, but failed. Embolization with cyanoacrylates was done in two occasions, the first time through a microcatheter placed just distal to the origin of the AA and the second time through another feeder coming from the same segmental artery that could not be visualized in the previous angiographies. All procedures were neurologically uncomplicated. Magnetic resonance imaging (MRI) 1 month after the last embolization showed resolution of the spinal cord edema. MRI scan taken 68 months after embolization revealed a slightly atrophic spinal cord with visible central canal and no recurrence of medullary edema. The patient presented good, but incomplete neurological improvement. Conclusion: Microsurgery is the first choice for an SDAVF branching off the same radiculomedullary artery supplying the ASA, but uncomplicated embolization can be feasible after failed surgery. PMID:25071941

Eneling, Johanna; Karlsson, Per M.; Rossitti, Sandro

2014-01-01

255

Improvement of exercise capacity of rats with chronic heart failure by long-term treatment with trandolapril  

PubMed Central

The effects of long-term treatment with trandolapril, an angiotensin I-converting enzyme inhibitor, on exercise capacity of rats with chronic heart failure (CHF) following coronary artery ligation were examined. CHF was developed by 8 weeks after the coronary artery ligation. The running time of rats with CHF in the treadmill test was shortened to approximately 65% of that of sham-operated rats (16.3±1.2 vs 25.1±1.6?min, n=7; P<0.05). ATP, creatine phosphate (CP), and lactate contents of the gracilis muscle of rats with CHF were similar to those of sham-operated rats before running. After running, ATP and CP were decreased and lactate was increased in both rats with CHF and sham-operated rats. There were no significant differences in the levels of energy metabolites between rats with CHF and sham-operated rats. The rates of decrease in ATP and CP and rate of increase in lactate in the gracilis muscle of rats with CHF during exercise were greater than those of sham operated rats (2.5, 2.0 and 1.5 fold high, respectively), suggesting wastage of energy during exercise in the animals with CHF. Myofibrillar Ca2+-stimulated ATPase (Ca-ATPase) activity of skeletal muscle of rats with CHF was increased over that of the sham-operated control (62.03±1.88 vs 52.34±1.19??mol?Pi?mg?1 protein h?1 n=7; P<0.05). The compositions of myosin heavy chain (MHC) isoforms of gracilis muscle were altered by CHF; decreases in MHC types I and IIb and an increase in MHC type IIa were found (P<0.05). Rats with CHF were treated with 1?mg?kg?1 day?1 trandolapril from the 2nd to 8th week after surgery. Treatment with trandolapril prolonged the running time, reversed the rates of decrease in ATP and CP and the rate of increase in lactate, and restored the Ca-ATPase activity (51.11±0.56??mol?Pi?mg?1 protein h?1, n=7; P<0.05) and composition ratio of MHC isoforms in the gracilis muscle. The results suggest that long-term trandolapril treatment of rats with CHF may restore their ability to utilize energy without wastage and thus improve exercise capacity. PMID:10323590

Yamaguchi, Fuminari; Kawana, Ken-ichiro; Tanonaka, Kouichi; Kamano, Isamu; Igarashi, Takahiro; Gen, Eigyoku; Fujimoto, Yoko; Maki, Toshiyuki; Sanbe, Atsushi; Nasa, Yoshihisa; Takeo, Satoshi

1999-01-01

256

Repeated 100 Hz TENS for the Treatment of Chronic Inflammatory Hyperalgesia and Suppression of Spinal Release of Substance P in Monoarthritic Rats  

PubMed Central

Transcutaneous electrical nerve stimulation (TENS) has been shown to be an effective measure for pain relief. The aim of the present study was to determine the optimal intensity and interval of repeated 100 Hz TENS for the treatment of chronic inflammatory hyperalgesia in a monoarthritic pain model of the rat, and to assess the changes of the spinal substance P (SP) release in response to TENS treatment. A reliable, reproducible chronic monoarthritic pain model was produced by intra-articular injection of complete Freund's adjuvant (CFA) at single ankle joint. The efficacy of 100 Hz TENS treatments with different frequencies and intensities was compared. In the acute period (within 3 weeks) of monoarthritis, twice-a-week schedule of TENS reduced the swelling of the inflamed ankle significantly. In the stable period (4–9 weeks), however, once-a-week schedule produced a significantly better therapeutic effect on both inflammation and arthritic hyperalgesia than that of twice- or five-times-a-week schedule. Using three levels of intensity of TENS, we found that the weaker (1-1-2 mA) stimulation produced significantly better therapeutic effects. Repeated TENS produced a reduction of SP content in spinal perfusate in parallel with the progressive reduction of the arthritic pain scores. Our results suggest that (i) consecutive TENS treatments produced cumulative effect for chronic hyperalgesia, (ii) for chronic inflammatory hyperalgesia, a weaker intensity and more sparsely arranged treatment schedule may produce better therapeutic effect and (iii) a decrease in SP release may serve as one of the possible neurochemical mechanisms underlying the therapeutic effects of multiple TENS treatments on chronic inflammatory hyperalgesia. PMID:17342243

Liu, Hong-Xiang; Tian, Jin-Bin; Luo, Fei; Jiang, Yu-Hui; Deng, Zu-Guo; Xiong, Liang; Liu, Cheng; Wang, Jin-Shu

2007-01-01

257

Operational Applications of Autogenic Feedback Training Exercise as a Treatment for Airsickness in the Military  

NASA Technical Reports Server (NTRS)

Airsickness is experienced by about 50% of military aviators some time in their career. Aviators who suffer from recurrent episodes of airsickness are typically referred to the Naval Aerospace Medical Institute (NAMI) at Pensacola where they undergo extensive evaluation and 8 weeks of training in the Self-Paced Airsickness Desensitization (SPAD) program. Researchers at NASA Ames have developed an alternative mitigation training program, Autogenic Feedback Training Exercise (AFTE) that has demonstrated an 80% success rate for improving motion sickness tolerance.

Gebreyesus, Fiyore; Cowings, Patricia S.; Toscano, William B.

2012-01-01

258

Effects of an 8-weeks erythropoietin treatment on mitochondrial and whole body fat oxidation capacity during exercise in healthy males.  

PubMed

Abstract The present investigation was performed to elucidate if the non-erythropoietic ergogenic effect of a recombinant erythropoietin treatment results in an impact on skeletal muscle mitochondrial and whole body fatty acid oxidation capacity during exercise, myoglobin concentration and angiogenesis. Recombinant erythropoietin was administered by subcutaneous injections (5000 IU) in six healthy male volunteers (aged 21 ± 2 years; fat mass 18.5 ± 2.3%) over 8 weeks. The participants performed two graded cycle ergometer exercise tests before and after the intervention where VO2max and maximal fat oxidation were measured. Biopsies of the vastus lateralis muscle were obtained before and after the intervention. Recombinant erythropoietin treatment increased mitochondrial O2 flux during ADP stimulated state 3 respiration in the presence of complex I and II substrates (malate, glutamate, pyruvate, succinate) with additional electron input from ?-oxidation (octanoylcarnitine) (from 60 ± 13 to 87 ± 24 pmol · s(-1) · mg(-1) P < 0.01). ?-hydroxy-acyl-CoA-dehydrogenase activity was higher after treatment (P < 0.05), whereas citrate synthase activity also tended to increase (P = 0.06). Total myoglobin increased by 16.5% (P < 0.05). Capillaries per muscle area tended to increase (P = 0.07), whereas capillaries per fibre as well as the total expression of vascular endothelial growth factor remained unchanged. Whole body maximal fat oxidation was not increased after treatment. Eight weeks of recombinant erythropoietin treatment increases mitochondrial fatty acid oxidation capacity and myoglobin concentration without any effect on whole body maximal fat oxidation. PMID:25259652

Guadalupe-Grau, Amelia; Plenge, Ulla; Helbo, Signe; Kristensen, Marianne; Andersen, Peter Riis; Fago, Angela; Belhage, Bo; Dela, Flemming; Helge, Jørn Wulff

2015-03-01

259

BOLD MRI of the human cervical spinal cord at 3 tesla  

Microsoft Academic Search

The feasibility of functional MRI of the spinal cord was investi- gated by carrying out blood oxygen-level dependent (BOLD) imaging of the human cervical spinal cord at a field of 3 T. BOLD imaging of the cervical spinal cord showed an average intensity increase of 7.0% during repeated exercise with the dominant hand with a return to baseline during rest

P. W. Stroman; P. W. Nance; L. N. Ryner

1999-01-01

260

The pathophysiology, classification, treatment, and prognosis of a spontaneous thoracic spinal cord herniation: A case study with literature review  

PubMed Central

Background: Spinal cord herniation was first described in 1974. It generally occurs in middle-aged adults in the thoracic spine. Symptoms typically include back pain and progressive paraparesis characterized by Brown-Séquard syndrome. Surgical reduction of the hernia improves the attendant symptoms and signs, even in patients with longstanding deficits. Case Description: A 66-year-old female with back pain for 7 years, accompanied by paresthesias and a progressive paraparesis, underwent a thoracic MRI which documented a ventral spinal cord herniation at the T4 level. Following a laminectomy, with reduction of the hernia and ventral dural repair, the patient improved. Conclusion: Herniation of the thoracic cord, documented on MR, may produce symptomatic paraparesis which may resolve following laminectomy with ventral dural repair.

De Souza, Rodrigo Becco; De Aguiar, Guilherme Brasileiro; Daniel, Jefferson Walter; Veiga, José Carlos Esteves

2014-01-01

261

Use of Autologous Mesenchymal Stem Cells Derived from Bone Marrow for the Treatment of Naturally Injured Spinal Cord in Dogs  

PubMed Central

The use of stem cells in injury repair has been extensively investigated. Here, we examined the therapeutic effects of autologous bone marrow mesenchymal stem cells (MSC) transplantation in four dogs with natural traumatic spinal cord injuries. MSC were cultured in vitro, and proliferation rate and cell viability were evaluated. Cell suspensions were prepared and surgically administered into the spinal cord. The animals were clinically evaluated and examined by nuclear magnetic resonance. Ten days after the surgical procedure and MSC transplantation, we observed a progressive recovery of the panniculus reflex and diminished superficial and deep pain response, although there were still low proprioceptive reflexes in addition to a hyperreflex in the ataxic hind limb movement responses. Each dog demonstrated an improvement in these gains over time. Conscious reflex recovery occurred simultaneously with moderate improvement in intestine and urinary bladder functions in two of the four dogs. By the 18th month of clinical monitoring, we observed a remarkable clinical amelioration accompanied by improved movement, in three of the four dogs. However, no clinical gain was associated with alterations in magnetic resonance imaging. Our results indicate that MSC are potential candidates for the stem cell therapy following spinal cord injury. PMID:24723956

Penha, Euler Moraes; Meira, Cássio Santana; Guimarães, Elisalva Teixeira; Mendonça, Marcus Vinícius Pinheiro; Gravely, Faye Alice; Pinheiro, Cláudia Maria Bahia; Pinheiro, Taiana Maria Bahia; Barrouin-Melo, Stella Maria; Ribeiro-dos-Santos, Ricardo; Soares, Milena Botelho Pereira

2014-01-01

262

MRI findings, surgical treatment and follow-up of a myelomeningocele with tethered spinal cord syndrome in a cat.  

PubMed

A 7-month-old male neutered cat was referred for paraparesis and painful sensation at the level of T13 vertebra where a dermal cyst was observed. Spine radiographs and magnetic resonance imaging (MRI) showed a well-encapsulated cyst communicating with the meninges and spinal cord, suggestive of hydromyelia and myelodysplasia. Dorsal laminectomy was performed and the cyst was completely removed. The day after surgery, the cat was ambulatory paraparetic. Involuntary defecation was observed for only a few days. The surgical specimen was cystic and covered by skin. Microscopic examination revealed a hollow hemispheric mass of glial fibrillary acidic protein (GFAP)-positive neural tissue lined by ependyma and formed of glia and vascular structures consistent with myelomeningocele (MMC). Only anecdotal descriptions of MMC have been published in the veterinary literature, mainly in the lumbosacral spinal cord. To the authors' knowledge, this is the first report of a MMC with tethered spinal cord syndrome in a cat successfully treated surgically. PMID:21439878

Ricci, Emanuele; Cherubini, Giunio B; Jakovljevic, Samuel; Aprea, Francesco; Cantile, Carlo

2011-06-01

263

Botulinum A toxin as a treatment of detrusor- sphincter dyssynergia in patients with spinal cord injury: MRI controlled transperineal injections  

PubMed Central

OBJECTIVES—To correlate clinical and urodynamic findings with MRI in patients with spinal cord injury and detrusor-sphincter dyssynergia who were consecutively treated with transperineal injections of botulinum-A toxin (BTX-A) under EMG control.?METHODS—Six patients with spinal cord injury and upper motor neuron bladder dysfunction associated with detrusor- sphincter dyssynergia were prospectively analysed. One hundred international units (IU) BTX-A (Botox® in 1 ml normal saline without preservative) diluted 1 to 1 with 1 ml gadopentetate were injected transperineally under EMG control. MRI was started immediately after needle withdrawal.?RESULTS—In all six patients gadopentetate was located in the external urethral sphincter on MRI. In no patient did traces of gadopentetate appear in the perineal musculature located in the vicinity of the external urethral sphincter. No patient developed resistance to BTX-A. All patients showed an (ongoing) improvement of their voiding function after BTX-A injections.?CONCLUSIONS—Transperineal injections of BTX-A under EMG control are efficient in the release or amelioration of lower urinary tract obstruction due to detrusor sphincter dyssynergia in patients with spinal cord injury. Despite well described methods, EMG of the external urethral sphincter is difficult and it is not possible to definitively exclude false recordings of the surrounding perineal musculature. By the use of MRI it was shown that both the EMG recordings and transperineal injection method are precise.?? PMID:9343126

Schurch, B.; Hodler, J.; Rodic, B.

1997-01-01

264

The functional exercise capacity and its correlates in obese treatment-seeking people with binge eating disorder: an exploratory study.  

PubMed

Abstract Purpose: The primary aim was to compare the functional exercise capacity between obese treatment-seeking people with and without binge eating disorder (BED) and non-obese controls. The secondary aim was to identify clinical variables including eating and physical activity behaviour, physical complaints, psychopathology and physical self-perception variables in obese people with BED that could explain the variability in functional exercise capacity. Methods: Forty people with BED were compared with 20 age-, gender- and body mass index (BMI)-matched obese persons without BED and 40 age and gender matched non-obese volunteers. A 6-minute walk test (6MWT), the Baecke physical activity questionnaire, the Symptom Checklist-90, the Physical Self-Perception Profile and the Eating Disorder Inventory were administered. Physical complaints before and after the 6MWT were also documented. Results: The distance achieved on the 6MWT was significantly lower in obese participants with BED (512.1?±?75.8?m versus 682.7?±?98.4, p?exercise capacity assessment. Clinicians involved in the rehabilitation of people with binge eating disorder should consider depression and lower self-esteem as potential barriers. Clinicians should take into account the frequently observed physical discomfort when developing rehabilitation programmes for people with binge eating disorder. PMID:25030711

Vancampfort, Davy; De Herdt, Amber; Vanderlinden, Johan; Lannoo, Matthias; Adriaens, An; De Hert, Marc; Stubbs, Brendon; Soundy, Andrew; Probst, Michel

2014-07-17

265

The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain.  

PubMed

Dysfunction of spinal stability seems to be one of the causes of low back pain (LBP). It is thought that a large number of muscles have a role in spinal stability including the pelvic floor muscle (PFM). The purpose of this study was to investigate the effect of PFM exercise in the treatment of chronic LBP. After ethical approval, a randomized controlled clinical trial was carried out on 20 women with chronic LBP. Patients were randomly allocated into two groups: an experimental and a control group. The control group was given routine treatment including electrotherapy and general exercises; and the experimental group received routine treatment and additional PFM exercise. Pain intensity, functional disability and PFM strength and endurance were measured before, immediately after intervention and at 3 months follow-up. In both groups pain and functional disability were significantly reduced following treatment (p<0.01), but no significant difference was found between the two groups (p>0.05). All measurements were improved in both groups (p<0.01) although patients in the experimental group showed greater improvement in PFM strength and endurance (p<0.01). It seems that the PFM exercise combined with routine treatment was not superior to routine treatment alone in patients with chronic LBP. PMID:21147422

Mohseni-Bandpei, Mohammad A; Rahmani, Nahid; Behtash, Hamid; Karimloo, Masoud

2011-01-01

266

Endovascular treatment of chronic cerebro spinal venous insufficiency in patients with multiple sclerosis modifies circulating markers of endothelial dysfunction and coagulation activation: a prospective study.  

PubMed

We performed a monocentric observational prospective study to evaluate coagulation activation and endothelial dysfunction parameters in patients with multiple sclerosis undergoing endovascular treatment for cerebro-spinal-venous insufficiency. Between February 2011 and July 2012, 144 endovascular procedures in 110 patients with multiple sclerosis and chronical cerebro-spinal venous insufficiency were performed and they were prospectively analyzed. Each patient was included in the study according to previously published criteria, assessed by the investigators before enrollment. Endothelial dysfunction and coagulation activation parameters were determined before the procedure and during follow-up at 1, 3, 6, 9, 12, 15 and 18 months after treatment, respectively. After the endovascular procedure, patients were treated with standard therapies, with the addition of mesoglycan. Fifty-five percent of patients experienced a favorable outcome of multiple sclerosis within 1 month after treatment, 25% regressed in the following 3 months, 24.9% did not experience any benefit. In only 0.1% patients, acute recurrence was observed and it was treated with high-dose immunosuppressive therapy. No major complications were observed. Coagulation activation and endothelial dysfunction parameters were shown to be reduced at 1 month and stable up to 12-month follow-up, and they were furthermore associated with a good clinical outcome. Endovascular procedures performed by a qualified staff are well tolerated; they can be associated with other currently adopted treatments. Correlations between inflammation, coagulation activation and neurodegenerative disorders are here supported by the observed variations in plasma levels of markers of coagulation activation and endothelial dysfunction. PMID:24806325

Napolitano, Mariasanta; Bruno, Aldo; Mastrangelo, Diego; De Vizia, Marcella; Bernardo, Benedetto; Rosa, Buonagura; De Lucia, Domenico

2014-10-01

267

Intradural approach to selective stimulation in the spinal cord for treatment of intractable pain: design principles and wireless protocol  

NASA Astrophysics Data System (ADS)

We introduce an intradural approach to spinal cord stimulation for the relief of intractable pain, and describe the biophysical rationale that underlies its design and performance requirements. The proposed device relies on wireless, inductive coupling between a pial surface implant and its epidural controller, and we present the results of benchtop experiments that demonstrate the ability to transmit and receive a frequency-modulated 1.6 MHz carrier signal between micro-coil antennae scaled to the ? 1 cm dimensions of the implant, at power levels of about 5 mW. Plans for materials selection, microfabrication, and other aspects of future development are presented and discussed.

Howard, M. A.; Utz, M.; Brennan, T. J.; Dalm, B. D.; Viljoen, S.; Jeffery, N. D.; Gillies, G. T.

2011-08-01

268

The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease  

Microsoft Academic Search

Regular exercise reduces the risk of chronic metabolic and cardiorespiratory diseases, in part because exercise exerts anti-inflammatory effects. However, these effects are also likely to be responsible for the suppressed immunity that makes elite athletes more susceptible to infections. The anti-inflammatory effects of regular exercise may be mediated via both a reduction in visceral fat mass (with a subsequent decreased

Nicolette C. Bishop; David J. Stensel; Martin R. Lindley; Sarabjit S. Mastana; Myra A. Nimmo; Michael Gleeson

2011-01-01

269

Exercise Treatment for Bipolar Disorder: Potential Mechanisms of Action Mediated through Increased Neurogenesis and Decreased Allostatic Load  

Microsoft Academic Search

Outcomes are frequently suboptimal for patients with bipolar disorder who are treated with pharmacotherapy alone. Adjunct exercise has the potential to substantially improve acute and long-term outcomes, although how exercise would improve the course of bipolar disorder needs to be elucidated. We propose that exercise may improve mood and functioning by increasing neurogenesis and reducing allostatic load. We review data

Louisa G. Sylvia; Rebecca M. Ametrano; Andrew A. Nierenberg

2010-01-01

270

Primary spinal epidural Hodgkin's lymphoma  

PubMed Central

Primary spinal epidural Hodgkin's lymphoma is very rare. We will discuss the clinical features and treatment of primary spinal epidural Hodgkin's lymphoma. In this paper, a 30-year-old male patient who presented with spinal epidural tumor at the T9–11 level is reported. Subtotal resection of the tumor was performed and the histological examination of the tumor specimen revealed Hodgkin's lymphoma. All other examinations were negative for an occult disease. Six courses of chemotheraphy containing adriamycin, bleomycin, vinblastine and dacarbazine were given to the patient. Surgery is the first therapeutic approach in malignancies compressing the spinal cord. Hodgkin's lymphoma is a very chemo- and radio-sensitive tumor. The indications for surgery were reduced and limited to laminectomy or even biopsy only, leaving the major role to chemo- and radiotheraphy. PMID:24964329

Yaman, Onur; Özdemir, Nail; Sevin, ?smail Ertan; Özer, Füsun Demirçivi; Ünlüo?lu, Saime

2013-01-01

271

Spinal manipulative therapy versus Graston Technique in the treatment of non-specific thoracic spine pain: Design of a randomised controlled trial  

PubMed Central

Background The one year prevalence of thoracic back pain has been estimated as 17% compared to 64% for neck pain and 67% for low back pain. At present only one randomised controlled trial has been performed assessing the efficacy of spinal manipulative therapy (SMT) for thoracic spine pain. In addition no high quality trials have been performed to test the efficacy and effectiveness of Graston Technique® (GT), a soft tissue massage therapy using hand-held stainless steel instruments. The objective of this trial is to determine the efficacy of SMT and GT compared to a placebo for the treatment of non specific thoracic spine pain. Methods Eighty four eligible people with non specific thoracic pain mid back pain of six weeks or more will be randomised to one of three groups, either SMT, GT, or a placebo (de-tuned ultrasound). Each group will receive up to 10 supervised treatment sessions at the Murdoch University Chiropractic student clinic over a 4-week period. Treatment outcomes will be measured at baseline, one week after their first treatment, upon completion of the 4-week intervention period and at three, six and twelve months post randomisation. Outcome measures will include the Oswestry Back Pain Disability Index and the Visual Analogue Scale (VAS). Intention to treat analysis will be utilised in the statistical analysis of any group treatment effects. Trial Registration This trial was registered with the Australia and New Zealand Clinical Trials Registry on the 7th February 2008. Trial number: ACTRN12608000070336 PMID:18959807

Crothers, Amy; Walker, Bruce; French, Simon D

2008-01-01

272

The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis  

PubMed Central

Background: Osteoporosis is a major public health problem affecting the elderly population, particularly women. The objective of the study was to evaluate the effects of adding weight-bearing exercise as opposed to nonweight-bearing programs to the medical treatment of bone mineral density (BMD) and health-related quality of life (HRQoL) of elderly patients with osteoporosis. Materials and Methods: Participating in the study were 40 elderly osteoporotic patients (27 females and 13 males), with ages ranging from 60 to 67 years, who were receiving medical treatment for osteoporosis. They were assigned randomly into two groups: Group-I: Twenty patients practiced weight-bearing exercises. Group-II: Twenty patients did nonweight-bearing exercises. All patients trained for 45-60 min/session, two sessions/week for 6 months. BMD of the lumbar spine, right neck of femur, and right distal radial head of all patients were measured by dual-energy X-ray absorptiometry before and after both treatment programs. In addition, the QoL was measured by means of the HRQoL “ECOS-16” questionnaire. Results: T-tests proved that mean values of BMD of the lumbar spine, right neck of femur and right distal radial head were significantly increased in both groups with greater improvement in the weight-bearing group. The QoL was significantly improved in both groups, but the difference between them was not significant. Conclusion: Addition of weight-bearing exercise program to medical treatment increases BMD more than nonweight-bearing exercise in elderly subjects with osteoporosis. Furthermore, both weight-bearing and nonweight-bearing exercise programs significantly improved the QoL of patients with osteoporosis. PMID:25374469

Shanb, Alsayed A.; Youssef, Enas F.

2014-01-01

273

Spreading depression features and Iba1 immunoreactivity in the cerebral cortex of developing rats submitted to treadmill exercise after treatment with monosodium glutamate.  

PubMed

Physical exercise and excessive consumption of monosodium glutamate (MSG) can affect the morphological and electrophysiological organization of the brain during development. However, the interaction of both factors remains unclear. We analyzed the effect of this interaction on the excitability-related phenomenon known as cortical spreading depression (CSD) and the microglial reaction expressed as Iba1-immunolabeled cells in the rat motor cortex. MSG (2g/kg or 4g/kg) was administered every other day during the first 14 postnatal days. Treadmill exercise started at 21-23 days of life and lasted 3 weeks, 5 days/week, for 30min/day. At 45-60 days, CSD was recorded for 4h at two cortical points and the CSD parameters (velocity, amplitude, and duration of the negative potential change) calculated. Confirming previous observations, exercised rats presented with lower CSD velocities (3.29±0.18mm/min) than the sedentary group (3.80±0.18mm/min; P<0.05). MSG increased CSD velocities in the exercised rats compared to saline-treated and exercised animals in a dose-dependent manner (3.49±0.19, 4.05±0.18, and 3.27±0.26 for 2g/kg MSG, 4g/kg MSG, and saline, respectively; P<0.05). The amplitude (ranging from 14.3±5.9 to 18.7±6.2mV) and duration (46.7±11.1 to 60.5±11.6s) of the negative slow potential shift of the CSD were similar in all groups. Both exercise and MSG treatment increased Iba1 immunolabeling. The results confirm that physical exercise decelerates CSD propagation. However, it does not impede the CSD-accelerating action of MSG. These effects were accompanied by a cortical microglia reaction. Therefore, the data suggest that treadmill exercise early in life can influence the development of cortical electrical activity. PMID:24374255

Lima, Cássia Borges; Soares, Georgia de Sousa Ferreira; Vitor, Suênia Marcele; Andrade-da-Costa, Belmira Lara da Silveira; Castellano, Bernardo; Guedes, Rubem Carlos Araujo

2014-04-01

274

Treatment Integrity Enhancement via Performance Feedback Conceptualized as an Exercise in Social Influence  

ERIC Educational Resources Information Center

This commentary is in response to the article "Effects of Verbal and Written Performance Feedback on Treatment Adherence" (Kaufman, Codding, Markus, Tryon, & Kyse, this issue). The overall recommendation to those who study treatment integrity using performance feedback methods is to incorporate theories and research on social…

Erchul, William P.

2013-01-01

275

A Comparative Evaluation of Cognitive-Behavioral Therapy (CBT) Versus Exercise Therapy (ET) for the Treatment of Body Image DisturbancePreliminary Findings  

Microsoft Academic Search

Cognitive-behavioral therapy (CBT) was compared to a combination of aerobic\\/anaerobic exercise therapy (ET) for the treatment of elevated levels of body image disturbance in college females. CBT consisted of a modification of the 1987 Butters and Cash procedure that was tailored for group intervention; ET consisted of weightlifting and aerobic dancing. Using a counterbalancing procedure, the same therapists conducted both

Erik Fisher; J. Kevin Thompson

1994-01-01

276

Spinal Bracing  

NASA Technical Reports Server (NTRS)

Dr. Arthur Copes of the Copes Foundation, Baton Rouge, LA, says that 35 percent of the 50 technical reports he received from the NASA/Southern University Industrial Applications Center in Baton Rouge and the Central Industrial Applications Center, Durant, OK, were vital to the development of his Copes Scoliosis Braces, which are custom designed and feature a novel pneumatic bladder that exerts constant corrective pressure to the torso to slowly reduce or eliminate the spinal curve.

1991-01-01

277

Spinal Infarcts  

Microsoft Academic Search

In the last decade typical signs of spinal cord ischemia have been reported. Confirming and supporting signs of acute ischemic\\u000a myelomalacia are vertebral body infarction and the pathognomonic contrast enhancement of the cauda equina in the course of\\u000a the disease. Moreover, bone infarction strongly indicates the proximal occlusion and the level of the affected segmental artery.\\u000a Cartilaginous disc embolism, embolism

Michael Mull; Armin Thron

278

Spinal Metastases  

Microsoft Academic Search

Spinal cord metastases are a common complication of systemic malignancy, most commonly from lung, breast, and prostate cancer.\\u000a Patients may present with a variety of symptoms, most notably pain and weakness. The ultimate goals in managing these patients\\u000a include maximizing neurologic function, length of survival, and quality of life. These goals can best be reached via early,\\u000a accurate diagnosis followed

Jonathan H. Sherman; Dawit G. Aregawi; Mark E. Shaffrey; David Schiff

279

Questionable Exercises.  

ERIC Educational Resources Information Center

This publication presents general guidelines for exercise prescription that have an anatomical basis but also consider the exerciser's ability to do the exercise correctly. It reviews various common questionable exercises, explaining how some exercises, especially those designed for flexibility and muscle fitness, can cause harm. Safer…

Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

1999-01-01

280

A novel five-category multimodal T1-weighted and T2-weighted magnetic resonance imaging-based stratification system for the selection of spinal arachnoid cyst treatment: a 15-year experience of 81 cases  

PubMed Central

Background Idiopathic spinal arachnoid cysts are rare cystic masses of the spinal canal generally classified as intra- or extradural, based on anatomical presentation. However, this system may not effectively indicate treatment. Objective To investigate the incidence, resection modality, and prognosis of spinal arachnoid cyst in a 15-year case series. Patients and methods A retrospective study was conducted in 81 spinal arachnoid cyst patients (male:female 34:47, mean age 36.5 years, age range 6–66 years) classified using a novel five-category T1-weighted and T2-weighted magnetic resonance imaging (MRI) classification system (intramedullary, subdural extramedullary, subdural/epidural, intraspinal epidural, or intraspinal/extraspinal). Conservative treatment failed in all patients. They underwent spinal surgery between January 1995 and December 2010 and were followed up for 69 (range 3–187) months. Performance outcomes were assessed using the Fugl-Meyer (FM) scale 90 days after operation. Recurrences and deaths were recorded. Results Subdural/epidural and intraspinal epidural cysts accounted for 66.7% (54 of 81) of patients, but exhibited relatively lower rates of postsurgical improvement using FM, with only 66.7% (36 of 54) of patients showing improvements. Excellent outcomes using the FM scale were reached in 100% (eight of eight) of intramedullary, intraspinal/extraspinal, and subdural extramedullary cyst patients, 86.7% (13 of 15) of subdural extramedullary cyst patients, and 66.7% (36 of 54) of epidural intraspinal cyst patients. Conclusion The proposed five-category multimodal MRI-based stratification system for spinal arachnoid cyst patients may more effectively allow clinicians to select the appropriate surgical intervention, and may help to predict outcomes. PMID:24672241

Qi, Ji; Yang, Jun; Wang, Guihuai

2014-01-01

281

[Exercise-induced asthma].  

PubMed

Exercise-induced asthma is characterized by a transient rise of the airways resistances, associated with asthmatic symptoms, 5 to 10 minutes after the end of a submaximal effort. The treatment is based on a pre-effort warming, cover the mouth with a mask (when the weather is cold), the use of beta-mimetic bronchodilators before exercise and, chronic treatment with antiinflammatory drugs. When the patient is not controlled, an evaluation of the lung function is required with a postbronchodilator control or an exercise challenge test. If the patient remains uncontrolled despite the treatment, others diagnostics should be excluded, such as vocal cords dysfunction or left heart failure. PMID:21089401

Michel, O

2010-09-01

282

Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.  

PubMed

Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment. PMID:24831378

Zhou, Heng-Jun; Zhan, Ren-Ya; Chen, Man-Tao; Cao, Fei; Zheng, Xiu-Jue

2014-01-01

283

Appropriate Use of Exercise Testing Prior to Administration of Drugs for Treatment of Erectile Dysfunction  

Microsoft Academic Search

Selective inhibitors of phosphodiesterase type 5 prevent the breakdown of cyclic guanosine monophosphate resulting in enhanced penile erection and are used for the treatment of erectile dysfunction. Those agents, by way of vasodilator effects could interact with the systemic vasculature and could potentially affect the cardiac patient. During sexual intercourse, heart rate and blood pressure increase as with other forms

Adelaide M. Arruda-Olson; Patricia A. Pellikka

2003-01-01

284

Antidepressant treatment with MAO-inhibitors during general and regional anesthesia: a review and case report of spinal anesthesia for lower extremity surgery without discontinuation of tranylcypromine.  

PubMed

Monoamine oxidase-(MAO)-inhibitors are a treatment of last resort in treatment resistant depression, which is regarded as a condition of increased psychiatric risk. General and regional anesthesia for elective surgery during use of long-term MAO-inhibitors remains a matter of debate because of an increased risk of drug interactions and decreased sympathetic stability. A series of case reports and new comparative studies reveal the safety of anesthesia/analgesia in non-cardiac surgery without discontinuation of the MAO-inhibitor if best effort is made for maintenance of sympathetic homeostasis and if known drug interactions are avoided. Very few reports with severe adverse incidents have been noted. Severe cardiovascular morbidity, a contraindication of MAO-inhibitors, probably contributed to peri- and postoperative complications. According to new studies, the risk of pharmacokinetic drug interactions is lower for tranylcypromine than for phenelzine. In the present case, a 66-year-old psychiatric patient on permanent treatment with 20 mg/day tranylcypromine was admitted for forefoot surgery. Anesthetic premedication consisted of 7.5 mg oral midazolam. Intravenous midazolam (0.5 mg) was dispensed for intraoperative sedation. After local anesthesia of the puncture site with 30 mg isobar prilocaine, spinal anesthesia was achieved by a single shot of 13.5 mg hyperbar bupivacaine (0.5%) intrathecally. Postoperative regional and general analgesia were accomplished by a peripheral nerve block with 50 mg isobar bupivacaine as well as oral etoricoxib and oxycodone. No peri- or postoperative complications were encountered. It is concluded that general or regional anesthesia for noncardiac surgery without discontinuation of MAO-inhibitor treatment may be a safe intervention after careful evaluation of an individual's perioperative and psychiatric risk. The increased psychiatric risk in patients treated with MAO-inhibitors outweighs the increased, however manageable, perioperative risk from continuing treatment during surgery. PMID:23993253

Krings-Ernst, Ilana; Ulrich, Sven; Adli, Mazda

2013-10-01

285

A Pilot Study to Evaluate the Role of the Spinal Cord Impairment Pressure Ulcer Monitoring Tool (SCI-PUMT) in Clinical Decisions for Pressure Ulcer Treatment.  

PubMed

The Spinal Cord Impairment Pressure Ulcer Monitoring Tool (SCI-PUMT) was designed to assess pressure ulcer (PrU) healing in the spinal cord impaired (SCI) population. The tool contains 7 variables: wound surface area, depth, edges, tunneling, undermining, exudate type, and necrotic tissue amount. A 2-phased, quantitative pilot study based on the Theory of Reasoned Action and Theory of Planned Behavior was conducted at a large SCI/Disorders Center in the Department of Veterans Affairs (VA). In the first phase of the study, a convenience sample of 5 physicians, 3 advanced practice registered nurses, and 3 certified wound care nurses (CWCN) was surveyed using a 2-part questionnaire to assess use of the SCI-PUMT instrument, its anticipated improvement in PrU assessment, and intent to use the SCI-PUMT in clinical practice. Attitudes, subjective norms, perceived behavioral controls, and barriers related to the intent to use the SCI-PUMT were evaluated using a 5-point Likert scale (range: 1= extremely likely, 5 = extremely unlikely). In the second phase of the study, the electronic health records (EHR) of 24 veterans (with 30 PrUs) who had at least 2 completed SCI-PUMT scores during a 4-week period were used to evaluate whether an association existed between magnitudes of change of total SCI-PUMT scores and ordered changes in PrU treatment. The overall mean score for intent to use SCI-PUMT was 1.80 (SD 0.75). The least favorable scores were for convenience and motivation to use the SCI-PUMT. Analysis of EHR data showed no significant difference in magnitudes of change in the SCI-PUMT score and changes in PrU treatment recommendations made by the CWCNs. The significance was not affected regardless of an increase or no change in the score (?2 with 1 degree of freedom = 1.158, P = 0.282) or for a decrease in the score (?2 with 1 degree of freedom = 0.5, P = 0.478). In this pilot study, the expressed intent to use the SCI-PUMT in making clinical decisions was generally positive but reservations remain. Additional research is being conducted to determine the barriers and facilitators to SCI-PUMT implementation. The SCI-PUMT was the first tool found to be valid, reliable, and sensitive to assess PrU healing in persons with SCI, and studies to examine the prospective validity of using this instrument on ulcer treatment decisions and outcomes are warranted. PMID:25485550

Thomason, Susan S; Graves, Barbara Ann; Madaris, Linda

2014-12-01

286

The cost-effectiveness of a treatment-based classification system for low back pain: design of a randomised controlled trial and economic evaluation  

Microsoft Academic Search

BACKGROUND: Systematic reviews have shown that exercise therapy and spinal manipulation are both more effective for low back pain (LBP) than no treatment at all. However, the effects are at best modest. To enhance the clinical outcomes, recommendations are to improve the patient selection process, and to identify relevant subgroups to guide clinical decision-making. One of the systems that has

Adri T Apeldoorn; Raymond W Ostelo; Hans van Helvoirt; Julie M Fritz; Henrika CW de Vet; Maurits W van Tulder

2010-01-01

287

Recovery of pulmonary structure and exercise capacity by treatment with granulocyte-colony stimulating factor (G-CSF) in a mouse model of emphysema.  

PubMed

Emphysema is a chronic obstructive pulmonary disease characterized abnormal dilatation of alveolar spaces, which impairs alveolar gas exchange, compromising the physical capacity of a patient due to airflow limitations. Here we tested the effects of G-CSF administration in pulmonary tissue and exercise capacity in emphysematous mice. C57Bl/6 female mice were treated with elastase intratracheally to induce emphysema. Their exercise capacities were evaluated in a treadmill. Lung histological sections were prepared to evaluate mean linear intercept measurement. Emphysematous mice were treated with G-CSF (3 cycles of 200 ?g/kg/day for 5 consecutive days, with 7-day intervals) or saline and submitted to a third evaluation 8 weeks after treatment. Values of run distance and linear intercept measurement were expressed as mean ± SD and compared applying a paired t-test. Effects of treatment on these parameters were analyzed applying a Repeated Measures ANOVA, followed by Tukey's post hoc analysis. p < 0.05 was considered statistically significant. Twenty eight days later, animals ran significantly less in a treadmill compared to normal mice (549.7 ± 181.2 m and 821.7 ± 131.3 m, respectively; p < 0.01). Treatment with G-CSF significantly increased the exercise capacity of emphysematous mice (719.6 ± 200.5 m), whereas saline treatment had no effect on distance run (595.8 ± 178.5 m). The PCR cytokines genes analysis did not detect difference between experimental groups. Morphometric analyses in the lung showed that saline-treated mice had a mean linear intercept significantly higher (p < 0.01) when compared to mice treated with G-CSF, which did not significantly differ from that of normal mice. Treatment with G-CSF promoted the recovery of exercise capacity and regeneration of alveolar structural alterations in emphysematous mice. PMID:23603459

Fortunato, Gustavo; Vidal, Daniel T A; Klein, Wilfried; Neto, Alberto; Angrizani, André; Vasconcelos, Juliana F; Kaneto, Carla; Souza, Bruno Solano de Freitas; Ribeiro-dos-Santos, Ricardo; Soares, Milena B P; Macambira, Simone G

2014-04-01

288

CHRONIC PAIN FOLLOWING SPINAL CORD INJURY  

PubMed Central

Most patients with insults to the spinal cord or central nervous system suffer from excruciating, unrelenting, chronic pain that is largely resistant to treatment. This condition affects a large percentage of spinal cord injury patients, and numerous patients with multiple sclerosis, stroke and other conditions. Despite the recent advances in basic science and clinical research the pathophysiological mechanisms of pain following spinal cord injury remain unknown. Here we describe a novel mechanism of loss of inhibition within the thalamus that may predispose for the development of this chronic pain and discuss a potential treatment that may restore inhibition and ameliorate pain. PMID:23281514

Masri, Radi; Keller, Asaf

2013-01-01

289

Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique®, ART®, eccentric exercise, and cryotherapy  

PubMed Central

Objective To describe the subjective pain and functional improvements of a patient with chronic Achilles tendinopathy following a treatment plan incorporating active and passive tissue warm-up, followed respectively by soft tissue mobilization utilizing both Graston Technique® and Active Release Techniques®, eccentric exercise, and static stretching in combination with cryotherapy. Background The primary characterization of chronic Achilles tendinopathy is gradual onset of pain and dysfunction focused in one or both Achilles tendons arising secondary to a history of repetitive use or excessive overload. Intervention and Outcome Conservative treatment is commonly the initial strategy for patient management. Tissue heating, soft tissue mobilization, eccentric training, and static stretching with cryotherapy were implemented to reduce pain and improve function. Summary A specific protocol of heat, soft tissue mobilization, eccentric exercise, stretching, and cryotherapy appeared to facilitate a rapid and complete recovery from chronic Achilles tendinopathy. PMID:22131563

Miners, Andrew L.; Bougie, Tracy L.

2011-01-01

290

Which Treatment is More Effective for Functional Ankle Instability: Strengthening or Combined Muscle Strengthening and Proprioceptive Exercises?  

PubMed Central

[Purpose] The purpose of this study was to implement combined muscle strengthening and proprioceptive exercises to examine the effects of combined exercises on functional ankle instability. [Subjects and Methods] Experiments were conducted with 30 adult males and females. The study subjects were randomly assigned to either a control group (Group A), a muscle strengthening exercise group (Group B), or a combined muscle strengthening and proprioceptive exercise group (Group C) consisting of 10 subjects each. In Group A, measurements were only conducted before and after the experiment without any intervention, whereas the exercise programs for Group B and Group C were implemented three days per week for four weeks. [Results] Muscle strength showed significant increases in Groups B and C compared with the control group during plantar flexion, dorsiflexion, inversion, and eversion. The Cumberland ankle instability tool showed significant increases in Group B and Group C compared with Group A and significant increases in Group C compared with Group B. [Conclusion] Applying combined muscle strengthening and proprioceptive exercises to those who have functional ankle instability is more effective than applying only muscle strengthening exercises. PMID:24707089

Kim, Ki-Jong; Kim, Young-Eok; Jun, Hyun-Ju; Lee, Jin-Su; Ji, Sung-Ha; Ji, Sang-Goo; Seo, Tae-Hwa; Kim, Young-Ok

2014-01-01

291

Long-term follow-up of tailored behavioural treatment and exercise based physical therapy in persistent musculoskeletal pain: A randomized controlled trial in primary care.  

PubMed

This study examined long-term effects of a tailored behavioural treatment protocol (TBT), as compared with an exercise based physical therapy protocol (EBT). One-hundred and twenty-two patients who, due to persistent musculoskeletal pain, consulted physical therapists in primary care were originally randomized to either of the two conditions. Follow-up assessments two-year post-treatment were completed by 65 participants. According to per-protocol analyses, short-term effects were maintained in both groups for the primary outcome, pain-related disability. The TBT-group reported lower disability levels compared with the EBT-group. Intention-to-treat analyses (ITT) conveyed similar results. Secondary outcomes of pain intensity, pain control, and functional self-efficacy were maintained over the 2-year post-treatment, but previous group differences were levelled out according to the most conservative method of ITT. Fear of movement/(re)injury increased in the EBT-group, and EBT participants reported higher fear of movement/(re)injury two years post-treatment compared to TBT. The study supports tailoring of treatments in concordance with patients' needs and preferences of activity goals and functional behavioural analyses including predictors of pain-related disability, for successful immediate outcomes and their maintenance in the long run. Exercise-based treatments resulted in somewhat smaller immediate treatment effects but had similar maintenance of effects over the 2-year follow-up period. PMID:19268614

Senlöf, Pernilla; Denison, Eva; Lindberg, Per

2009-11-01

292

Can exercise prevent cognitive decline?  

PubMed

As the tolerability of pharmacological agents decreases with age, exercise may be particularly helpful as a possible treatment or stabiliser of mood and cognitive function in older age. Exercise has been most commonly evaluated for the treatment of depression. Exercise interventions designed primarily for treatment of physical conditions in the elderly do appear to confer psychological benefits as well, with reduction in depressive symptoms over the course of treatment. The effects of exercise on reducing depressive symptoms are not dissimilar to the effects of antidepressant drugs and cognitive behaviour therapy. Exercise may be a useful low-tech intervention for people with mild to moderate depression. In particular, exercise may be helpful in the elderly and in patients who have had insufficient response to, or are intolerant of, pharmacotherapy. Mastery of a new skill and positive feedback from others may increase feelings of self-esteem and improve mood. Exercise may distract participants from persistent negative thoughts. Exercise has been shown to improve executive function acutely in adults of all ages. It is possible that dance routines or other exercise regimens requiring some cognitive input may confer additional benefit to cognitive function. Exercise has a moderate effect on the ability of people with dementia to perform activities of daily living and may improve cognitive function. Midlife exercise may also have an impact on later cognitive function. PMID:24617099

Behrman, Sophie; Ebmeier, Klaus P

2014-01-01

293

Rehabilitation in spinal infection diseases  

PubMed Central

Spinal cord infections were the diseases defined by Hypocrite yet the absence of modern medicine and there was not a real protocol in rehabilitation although there were many aspects in surgical treatment options. The patients whether surgically or conservatively treated had a lot of neurological, motor, and sensory disturbances. Our clinic has quite experience from our previous researchs. Unfortunately, serious spinal cord infections are still present in our region. In these patients the basic rehabilitation approaches during early, pre-operation, post-operation period and in the home environment will provide significant contributions to improve the patients’ sensory and motor skills, develop the balance and proriocaption, increase the independence of patients in daily living activities and minimize the assistance of other people. There is limited information in the literature related with the nature of the rehabilitation programmes to be applied for patients with spinal infections. The aim of this review is to share our clinic experience and summarise the publications about spinal infection rehabilitation. There are very few studies about the rehabilitation of spinal infections. There are still not enough studies about planning and performing rehabilitation programs in these patients. Therefore, a comprehensive rehabilitation programme during the hospitalisation and home periods is emphasised in order to provide optimal management and prevent further disability. PMID:25621205

Nas, Kemal; Karakoç, Mehmet; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-01

294

Rehabilitation in spinal infection diseases.  

PubMed

Spinal cord infections were the diseases defined by Hypocrite yet the absence of modern medicine and there was not a real protocol in rehabilitation although there were many aspects in surgical treatment options. The patients whether surgically or conservatively treated had a lot of neurological, motor, and sensory disturbances. Our clinic has quite experience from our previous researchs. Unfortunately, serious spinal cord infections are still present in our region. In these patients the basic rehabilitation approaches during early, pre-operation, post-operation period and in the home environment will provide significant contributions to improve the patients' sensory and motor skills, develop the balance and proriocaption, increase the independence of patients in daily living activities and minimize the assistance of other people. There is limited information in the literature related with the nature of the rehabilitation programmes to be applied for patients with spinal infections. The aim of this review is to share our clinic experience and summarise the publications about spinal infection rehabilitation. There are very few studies about the rehabilitation of spinal infections. There are still not enough studies about planning and performing rehabilitation programs in these patients. Therefore, a comprehensive rehabilitation programme during the hospitalisation and home periods is emphasised in order to provide optimal management and prevent further disability. PMID:25621205

Nas, Kemal; Karakoç, Mehmet; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-18

295

Validation of a Score Predicting Post-Treatment Ambulatory Status After Radiotherapy for Metastatic Spinal Cord Compression  

SciTech Connect

Purpose: A score predicting post-radiotherapy (RT) ambulatory status was developed based on 2,096 retrospectively evaluated metastatic spinal cord compression (MSCC) patients. This study aimed to validate the score in a prospective series. Methods and Materials: The score included five factors associated with post-RT ambulatory status: tumor type, interval tumor diagnosis to MSCC, visceral metastases, pre-RT motor function, time developing motor deficits. Patients were divided into five groups: 21-28, 29-31, 32-34, 35-37, 38-44 points. In this study, 653 prospectively followed patients were divided into the same groups. Furthermore, the number of prognostic groups was reduced from five to three (21-28, 29-37, 38-44 points). Post-RT ambulatory rates from this series were compared with the retrospective series. Additionally, this series was compared with 104 patients receiving decompressive surgery plus RT (41 laminectomy, 63 laminectomy plus stabilization of vertebrae). Results: In this study, post-RT ambulatory rates were 10.6% (21-28 points), 43.5% (29-31 points), 71.0% (32-34 points), 89.5% (35-37 points), and 98.5% (38-44 points). Ambulatory rates from the retrospective study were 6.2%, 43.5%, 70.0%, 86.1%, and 98.7%. After regrouping, ambulatory rates were 10.6% (21-28 points), 70.9% (29-37 points), and 98.5% (38-44 points) in this series, and 6.2%, 68.4%, and 98.7% in the retrospective series. Ambulatory rates were 0%, 62.5%, and 90.9% in the laminectomy plus RT group, and 14.3%, 83.9%, and 100% in the laminectomy + stabilization plus RT group. Conclusions: Ambulatory rates in the different groups in this study were similar to those in the retrospective study demonstrating the validity of the score. Using only three groups is simplier for clinical routine.

Rades, Dirk, E-mail: Rades.Dirk@gmx.ne [Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lubeck (Germany); Douglas, Sarah; Huttenlocher, Stefan [Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lubeck (Germany); Rudat, Volker [Department of Radiation Oncology, Saad Specialist Hospital, Al Khobar (Saudi Arabia); Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf (Germany); Veninga, Theo [Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg (Netherlands); Stalpers, Lukas J.A. [Department of Radiotherapy, Academic Medical Center, Amsterdam (Netherlands); Basic, Hiba [Department of Radiation Oncology, University Hospital Sarajevo (Bosnia and Herzegowina); Karstens, Johann H. [Department of Radiation Oncology, Medical School Hannover (Germany); Hoskin, Peter J. [Department of Clinical Oncology, Mount Vernon Cancer Center, Northwood (United Kingdom); Adamietz, Irenaeus A. [Department of Radiation Oncology, Ruhr University Bochum (Germany); Schild, Steven E. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States)

2011-04-01

296

Spinal subdural abscess following epidural steroid injection.  

PubMed

The authors report the case of a 58-year-old man who presented with a cervicothoracolumbosacral spinal subdural abscess about a month after receiving an epidural steroid injection for management of low-back pain due to L5-S1 disc herniation. Although he presented with symptoms concerning for a spinal etiology, the subdural empyema was not evident on the initial MRI study and was observed on imaging 5 days later. This patient was successfully managed with surgical intervention and antibiotic treatment, and he is doing well more than 21 months after the operation. It is possible that a prior history of disc herniation or other spinal abnormality may increase a patient's risk of developing spinal subdural empyema. This case illustrates the risk of infection following spinal epidural steroid injections and the importance of early recognition and intervention to successfully treat an extensive subdural abscess. PMID:25343407

Kraeutler, Matthew J; Bozzay, Joseph D; Walker, Matthew P; John, Kuruvilla

2015-01-01

297

Spinal Cord Ischemia Secondary to Hypovolemic Shock  

PubMed Central

A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable.

Kapoor, Siddhant; Koh, Roy KM; Yang, Eugene WR; Hee, Hwan-Tak

2014-01-01

298

Carrier testing for spinal muscular atrophy  

PubMed Central

Spinal muscular atrophy is the most common fatal hereditary disease among newborns and infants. There is as yet no effective treatment. Although a carrier test is available, currently there is disagreement among professional medical societies who proffer standards of care as to whether or not carrier screening for spinal muscular atrophy should be offered as part of routine reproductive care. This leaves health care providers without clear guidance. In fall 2009, a meeting was held by National Institutes of Health to examine the scientific basis for spinal muscular atrophy carrier screening and to consider the issues that accompany such screening. In this article, the meeting participants summarize the discussions and conclude that pan-ethnic carrier screening for spinal muscular atrophy is technically feasible and that the specific study of implementing a spinal muscular atrophy carrier screening program raises broader issues about determining the scope and specifics of carrier screening in general. PMID:20808230

Gitlin, Jonathan M.; Fischbeck, Kenneth; Crawford, Thomas O.; Cwik, Valerie; Fleischman, Alan; Gonye, Karla; Heine, Deborah; Hobby, Kenneth; Kaufmann, Petra; Keiles, Steven; MacKenzie, Alex; Musci, Thomas; Prior, Thomas; Lloyd-Puryear, Michele; Sugarman, Elaine A.; Terry, Sharon F.; Urv, Tiina; Wang, Ching; Watson, Michael; Yaron, Yuval; Frosst, Phyllis; Howell, R. Rodney

2014-01-01

299

Aerobic Exercise Prescription for Rheumatoid Arthritics.  

ERIC Educational Resources Information Center

The use of exercise as a general treatment for rheumatoid arthritics (RA) has included range of motion, muscular strength, water exercise and rest therapy while virtually ignoring possible benefits of aerobic exercise. The purposes of this project were to examine the guidelines for exercise prescription in relation to this special population and…

Evans, Blanche W.; Williams, Hilda L.

300

General Information about Childhood Brain and Spinal Cord Tumors  

MedlinePLUS

... symptoms that begin before diagnosis and continue for months or years. Childhood brain and spinal cord tumors ... after treatment. Some cancer treatments cause side effects months or years after treatment has ended. These are ...

301

Overview of Spinal Cord Disorders  

MedlinePLUS

... or anterior root) contains nerve fibers that carry impulses (signals) from the spinal cord to muscles to ... Down the Spinal Cord Spinal nerves carry nerve impulses to and from the spinal cord through two ...

302

The muscle mass, omega-3, diet, exercise and lifestyle (MODEL) study – a randomised controlled trial for women who have completed breast cancer treatment  

PubMed Central

Background Loss of lean body mass (LBM) is a common occurrence after treatment for breast cancer and is related to deleterious metabolic health outcomes [Clin Oncol, 22(4):281–288, 2010; Appl Physiol Nutr Metab, 34(5):950–956, 2009]. The aim of this research is to determine the effectiveness of long chain omega-3 fatty acids (LCn-3s) and exercise training alone, or in combination, in addressing LBM loss in breast cancer survivors. Methods/design A total of 153 women who have completed treatment for breast cancer in the last 12 months, with a Body Mass Index (BMI) of 20 to 35 kg/m2, will be randomly assigned to one of 3 groups: 3g/d LCn-3s (N-3), a 12-week nutrition and exercise education program plus olive oil (P-LC) or the education program plus LCn-3s (EX+N-3). Participants randomised to the education groups will be blinded to treatment, and will receive either olive oil placebo (OO+N-3) or LCn-3 provision, while the N-3 group will be open label. The education program includes nine 60-75min sessions over 12 weeks that will involve breast cancer specific healthy eating advice, plus a supervised exercise session run as a resistance exercise circuit. They will also be advised to conduct the resistance training and aerobic training 5 to 7 days per week collectively. Outcome measures will be taken at baseline, 12-weeks and 24-weeks. The primary outcome is % change in LBM as measured by the air displacement plethysmograhy. Secondary outcomes include quality of life (FACT-B?+?4) and inflammation (C-Reactive protein: CRP). Additional measures taken will be erythrocyte fatty acid analysis, fatigue, physical activity, menopausal symptoms, dietary intake, joint pain and function indices. Discussion This research will provide the first insight into the efficacy of LCn-3s alone or in combination with exercise in breast cancer survivors with regards to LBM and quality of life. In addition, this study is designed to improve evidence-based dietetic practice, and how specific dietary prescription may link with appropriate exercise interventions. Trials registration ACTRN12610001005044; and World Health Organisation Universal trial number: U1111-1116-8520. PMID:24739260

2014-01-01

303

Two-year clinical outcomes of a multicenter randomized controlled trial comparing two interspinous spacers for treatment of moderate lumbar spinal stenosis  

PubMed Central

Background Interspinous spacers are a minimally invasive surgical alternative for patients with lumbar spinal stenosis (LSS) unresponsive to conservative care. The purpose of this prospective, multicenter, randomized, controlled trial was to compare 2-year clinical outcomes in patients with moderate LSS treated with the Superion® (Experimental) or the X-Stop®, a FDA-approved interspinous spacer (Control). Methods A total of 250 patients with moderate LSS unresponsive to conservative care were randomly allocated to treatment with the Experimental (n?=?123) or Control (n?=?127) interspinous spacer and followed through 2 years post-treatment. Complication data were available for all patients and patient-reported outcomes were available for 192 patients (101 Experimental, 91 Control) at 2 years. Results Zurich Claudication Questionnaire (ZCQ) Symptom Severity and Physical Function scores improved 34% to 36% in both groups through 2 years (all p?

2014-01-01

304

Is a single anterolateral screw-plate fixation sufficient for the treatment of spinal fractures in the thoracolumbar junction? A Biomechanical in vitro Investigation  

Microsoft Academic Search

Controversy exists about the indications, advantages and disadvantages of various surgical techniques used for anterior interbody fusion of spinal fractures in the thoracolumbar junction. The purpose of this study was to evaluate the stabilizing effect of an anterolateral and thoracoscopically implantable screw-plate system. Six human bisegmental spinal units (T12–L2) were used for the biomechanical in vitro testing procedure. Each specimen

Ulrich Schreiber; Tibor Bence; Thomas Grupp; Erwin Steinhauser; Thomas Mückley; Wolfram Mittelmeier; Rudolf Beisse

2005-01-01

305

Clinical assessment of stereotactic IGRT: spinal radiosurgery.  

PubMed

The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited because of the availability of effective target immobilization devices. Recent advances in stereotactic IGRT have allowed for spinal applications. Large clinical experience with spinal radiosurgery to properly assess clinical outcomes has previously been limited. At our institution, we have developed a successful multidisciplinary spinal radiosurgery program in which 542 spinal lesions (486 malignant and 56 benign lesions) were treated with a single-fraction radiosurgery technique. Patient ages ranged from 18 to 85 years (mean 56 years). Lesion location included 92 cervical, 234 thoracic, 130 lumbar, and 86 sacral. The most common metastatic tumors were renal cell (89 cases), breast (74 cases), and lung (71 cases). The most common benign tumors were neurofibroma (24 cases), schwannoma (13 cases), and meningioma (7 cases). Eighty-nine cervical lesions were treated using skull tracking. Thoracic, lumbar, and sacral tumors were tracked relative to either gold or stainless steel fiducial markers. The maximum intratumoral dose ranged from 12.5 to 30 Gy (mean 20 Gy). Tumor volume ranged from 0.16 to 298 mL (mean 47 mL). Three hundred thirty-seven lesions had received prior external beam irradiation with spinal cord doses precluding further conventional irradiation. The primary indication for radiosurgery was pain in 326 cases, as a primary treatment modality in 70 cases, for tumor radiographic tumor progression in 65 cases, for post-surgical treatment in 38 cases, for progressive neurological deficit in 35 cases, and as a radiation boost in 8 cases. Follow-up period was at least 3 to 49 months. Axial and/or radicular pain improved in 300 of 326 cases (92%). Long-term tumor control was demonstrated in 90% of lesions treated with radiosurgery as a primary treatment modality and in 88% of lesions treated for radiographic tumor progression. Thirty of 35 patients (85%) with progressive neurological deficits experienced at least some improvement after treatment. Spinal stereotactic radiosurgery is now a feasible, safe, and clinically effective technique for the treatment of a variety of spinal lesions. The potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with essentially no recovery time and excellent symptomatic response. This technique offers a new therapeutic modality for the primary treatment of a variety of spinal lesions, including the treatment of neoplasms in medically inoperable patients, previously irradiated sites, for lesions not amenable to open surgical techniques, and as an adjunct to surgery. PMID:18456162

Gerszten, Peter C; Burton, Steven A

2008-01-01

306

Best practices for the treatment and prevention of urinary tract infection in the spinal cord injured population: The Alberta context  

PubMed Central

The purpose of this review of clinical guidelines and best practices literature is to suggest prevention options and a treatment approach for intermittent catheter users that will minimize urinary tract infections (UTI). Recommendations are based both on evidence in the literature and an understanding of what is currently attainable within the Alberta context. This is done through collaboration between both major tertiary care centres (Edmonton and Calgary) and between various professionals who regularly encounter these patients, including nurses, physiatrists and urologists. PMID:23671527

Hill, Timothy C.; Baverstock, Richard; Carlson, Kevin V.; Estey, Eric P.; Gray, Gary J.; Hill, Denise C.; Ho, Chester; McGinnis, Rosemary H.; Moore, Katherine; Parmar, Raj

2013-01-01

307

Spinal Muscular Atrophy  

MedlinePLUS

NINDS Spinal Muscular Atrophy Information Page Synonym(s): Werdnig-Hoffman Disease, Kugelberg-Welander Disease Condensed from Spinal Muscular ... of symptoms. Type I (also known as Werdnig-Hoffman disease, or infantile-onset SMA) is evident at ...

308

New treatment strategy for cupulolithiasis associated with benign paroxysmal positional vertigo of the lateral canal: the head-tilt hopping exercise.  

PubMed

This study was performed to determine whether a novel treatment was effective against cupulolithiasis associated with benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal, which is characterized by apogeotropic direction-changing nystagmus. We herein describe our head-tilt hopping (HtH) exercise, which is designed to release otoconial debris strongly adhered to the cupula. The subjects were trained to hop while tilting their heads laterally. They completed 3 to 5 exercise sessions per day over a 4-week period. Each session ended with a 20-hop trial. The HtH exercises were performed by 27 patients with intractable lateral canal BPPV who exhibited positional vertigo and persistent nystagmus beating toward the uppermost ear for more than 4 weeks, despite performing therapeutic head shaking in the horizontal plane maneuver. All the patients were subjected to the supine roll test before and immediately after the first trial as well as after 1 and 4 weeks of the program to evaluate the effect of the treatment on their apogeotropic nystagmus. Nystagmus of 9 (33.3 %) patients disappeared immediately after the first training session. After 1 and 4 weeks of the training, the number of patients that had experienced either of these improvements had increased to 15 (55.6 %) and 19 (70.4 %) subjects, respectively. These results suggest that HtH exercises aimed at releasing otoconial debris from the cupula are feasible as a new therapy for cupulolithiasis associated with intractable lateral canal BPPV. However, further studies for comparison with control are required to confirm these preliminary results. PMID:24232831

Yamanaka, Toshiaki; Sawai, Yachiyo; Murai, Takayuki; Okamoto, Hideyuki; Fujita, Nobuya; Hosoi, Hiroshi

2014-12-01

309

Embolisation of spinal dural arteriovenous fistulae with Onyx  

Microsoft Academic Search

Surgery is currently the standard treatment for spinal dural arteriovenous fistulae (DAVF). Endovascular embolisation of these lesions using N-butyl cyanoacrylate (NBCA) has a high success rate. Onyx is a new liquid embolic agent whose viscosity makes it suitable for treatment of spinal DAVF where penetration into the proximal radicular vein is required. It is delivered with greater control than NBCA

D. R. Warakaulle; R. I. Aviv; D. Niemann; A. J. Molyneux; J. V. Byrne; P. Teddy

2003-01-01

310

A new in vivo screening model for posterior spinal bone formation: comparison of ten calcium phosphate ceramic material treatments.  

PubMed

This study presents a new screening model for evaluating the influence of multiple conditions on the initial process of bone formation in the posterior lumbar spine of a large animal. This model uses cages designed for placement on the decorticated transverse process of the goat lumbar spine. Five conduction channels per cage, each be defined by a different material treatment, are open to both the underlying bone and overlying soft tissue. The model was validated in ten adult Dutch milk goats, with each animal implanted with two cages containing a total of ten calcium phosphate material treatments according to a randomized complete block design. The ten calcium phosphate ceramic materials were created through a combination of material chemistry (BCP, TCP, HA), sintering temperature (low, medium, high), calcination and surface roughness treatments. To monitor the bone formation over time, fluorochrome markers were administered at 3, 5 and 7 weeks and the animals were sacrificed at 9 weeks after implantation. Bone formation in the conduction channels was investigated by histology and histomorphometry of non-decalcified sections using traditional light and epifluorescent microscopy. According to both observed and measured bone formation parameters, materials were ranked in order of increasing magnitude as follows: low sintering temperature BCP (rough and smooth) approximately medium sintering temperature BCP approximately = TCP > calcined low sintering temperature HA > non-calcined low sintering temperature HA > high sintering temperature BCP (rough and smooth) > high sintering temperature HA (calcined and non-calcined). These results agree closely with those obtained in previous studies of osteoconduction and bioactivity of ceramics thereby validating the screening model presented in this study. PMID:16111745

Wilson, Clayton E; Kruyt, Moyo C; de Bruijn, Joost D; van Blitterswijk, Clemens A; Oner, F Cumhur; Verbout, Abraham J; Dhert, Wouter J A

2006-01-01

311

A diagnosis-based clinical decision rule for spinal pain part 2: review of the literature  

Microsoft Academic Search

BACKGROUND: Spinal pain is a common and often disabling problem. The research on various treatments for spinal pain has, for the most part, suggested that while several interventions have demonstrated mild to moderate short-term benefit, no single treatment has a major impact on either pain or disability. There is great need for more accurate diagnosis in patients with spinal pain.

Donald R Murphy; Eric L Hurwitz; Craig F Nelson

2008-01-01

312

Uncommon Progression of an Extradural Spinal Meningioma  

PubMed Central

Extradural spinal meningiomas are rare. Our understanding of purely extradural spinal meningiomas is still incomplete and they may be easily confused with malignant neoplasms, much more common in this location. We report a rare case of a purely extradural thoracic spine meningioma in a 70-year-old man, with an unusual progression. In addition we discuss the pathogenesis of these tumors and the potential pitfalls in differential diagnosis and review the relevant literature concerning their treatment and outcome. PMID:25243091

Boughamoura, Mohamed; Mahmoudi, Houda; Kilani, Mohamed; Hattab, Nejib

2014-01-01

313

What Are the Key Statistics about Brain and Spinal Cord Cancers?  

MedlinePLUS

... and spinal cord tumors? What are the key statistics about brain and spinal cord tumors? The American ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

314

Physical exercise : effects in cancer patients  

Microsoft Academic Search

Physical exercise plays an important role in cancer prevention as well as in the prevention and treatment of cancer related fatigue during and after treatment. Some of these effects are presented in the thesis of M.J. Velthuis. In Part I effects of physical exercise on anthropometric measurements are examined in the Sex Hormones and Physical Exercise (SHAPE) study, a randomised

M. J. Velthuis

2010-01-01

315

[Spinal canal stenosis].  

PubMed

Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. PMID:25398571

Papanagiotou, P; Boutchakova, M

2014-11-01

316

Idiopathic spinal epidural lipomatosis.  

PubMed

Spinal epidural lipomatosis is a rare disorder characterized by the pathological overgrowth of epidural fat and often causes extradural compression which may mimic other spinal disorders. Steroid administration is a well-documented etiology. We report a case of spinal epidural lipomastosis without history of steroid administration. The initial manifestation was bizarre and was misdiagnosed as a degenerative vertebral or disc disease for long. Posterior decompression with debulking of the extradural fat successfully and thoroughly relieved his symptoms. We emphasize the importance of taking this disease into consideration for a markedly obese patient with persisting back pain or symptoms suggesting spinal cord or other spinal neural elements compression. PMID:15357116

Fan, Cheng-Yu; Wang, Shih-Tien; Liu, Chien-Lin; Chang, Ming-Chau; Chen, Tain-Hsiung

2004-05-01

317

Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer  

Microsoft Academic Search

Side effects accompanying androgen deprivation therapy (ADT), including sarcopenia, loss of bone mass and reduction in muscle strength, can compromise physical function, particularly in older patients. Exercise, specifically resistance training, may be an effective and cost-efficient strategy to limit or even reverse some of these adverse effects during and following therapy. In this review, we discuss common morphological and physiological

D A Galvão; Dennis Taaffe; Nigel Spry; Robert Newton

2007-01-01

318

Effects of Treadmill Exercise Combined with MK 801 Treatment on Neuroblast Differentiation in the Dentate Gyrus in Rats  

Microsoft Academic Search

N-methyl-d-aspartate receptor (NR) is involved in activity-dependent synaptic plasticity, such as associative long-term potentiation,\\u000a and in related central functions, such as learning and memory. In this study, we observed effects of treadmill exercise on\\u000a NR1 and doublecortin (DCX, a marker for neuroblast differentiation) in the subgranular zone of the dentate gyrus (DG). At\\u000a 6 weeks of age, rats were put on

Jung Hoon Choi; Ki-Yeon Yoo; Choong Hyun Lee; Sun Shin Yi; Dae Young Yoo; Je Kyung Seong; Yeo Sung Yoon; In Koo Hwang; Moo-Ho Won

2011-01-01

319

Collateral Sprouting of Uninjured Primary Afferent A-Fibers into the Superficial Dorsal Horn of the Adult Rat Spinal Cord after Topical Capsaicin Treatment to the Sciatic Nerve  

Microsoft Academic Search

That terminals of uninjured primary sensory neurons terminat- ing in the dorsal horn of the spinal cord can collaterally sprout was first suggested by Liu and Chambers (1958), but this has since been disputed. Recently, horseradish peroxidase conju- gated to the B subunit of cholera toxin (B-HRP) and intracellular HRP injections have shown that sciatic nerve section or crush produces

Richard J. Mannion; Tim P. Doubell; Richard E. Coggeshall; Clifford J. Woolf

1996-01-01

320

The role of nutritional supplements in the prevention and treatment of resistance exercise-induced skeletal muscle injury.  

PubMed

The topic of exercise-induced skeletal muscle injury has received considerable attention in recent years. Likewise, strategies to minimise the injury resulting from heavy resistance exercise have been studied. Over the past 15 years, several investigations have been performed focused on the role of nutritional supplements to attenuate signs and symptoms of muscle injury. Of these, some have reported favourable results, while many others have reported no benefit of the selected nutrient. Despite these mixed findings, recommendations for the use of nutritional supplements for the purposes of attenuating muscle injury are rampant within the popular fitness media and athletic world, largely without scientific support. Those nutrients include the antioxidant vitamin C (ascorbic acid) and vitamin E (tocopherol), N-acetyl-cysteine, flavonoids, L-carnitine, astaxanthin, beta-hydroxy-beta-methylbutyrate, creatine monohydrate, essential fatty acids, branched-chain amino acids, bromelain, proteins and carbohydrates. A discussion of all published peer-reviewed articles in reference to these nutrients and their impact on resistance exercise-induced skeletal muscle injury is presented, in addition to a brief view into the potential mechanism of action for each nutrient.Based on the current state of knowledge, the following conclusions can be made with regard to nutritional supplements and their role in attenuating signs and symptoms of skeletal muscle injury occurring as a consequence of heavy resistance exercise: (i) there appears to be a potential role for certain supplements (vitamin C, vitamin E, flavonoids, and L-carnitine); (ii) these supplements cannot effectively eliminate muscle injury, only attenuate certain signs and symptoms; (iii) it is presently unclear what the optimal dosage of these nutrients is (whether used alone or in combination); (iv) it is unclear what the optimal pretreatment period is; and (v) the effectiveness is largely specific to non-resistance trained individuals.Ultimately, because so few studies have been conducted in this area, it is difficult to recommend with confidence the use of selected nutrients for the sole purpose of minimising signs and symptoms of resistance exercise-induced muscle injury, in particular with regard to resistance-trained individuals. PMID:17503877

Bloomer, Richard J

2007-01-01

321

Clinical Treatment of Orthostatic Hypotension After Spinal Cord Injury with Training Based on Electric Uprise Bed Coupled with Remote ECG and BP Monitor.  

PubMed

Background The treatment for orthostatic hypotension (OH) after spinal cord injury (SCI) is an important part of rehabilitation in late-stage SCI. Electric uprise bed training is a relatively commonly used method in treating OH, and how to carry out uprise bed training safely and effectively is an urgent problem. In the early stage of SCI, we used a remote monitoring system to monitor the whole process of uprise bed training, and we explored a safe and efficient method of electric uprise bed training. Material and Methods The experimental group consisted of 36 patients diagnosed with orthostatic hypotension (OH) after SCI and who received training with an electric uprise bed coupled with remote monitoring system, and the control group of 18 subjects who used a traditional training method. Results There were no differences in baseline data between the 2 groups. There were no severe symptoms during training in the experimental group, but 3 patients had severe symptoms in the control group. Among the 32 enrolled subjects reaching upright training status within 30 days (17 subjects in the experimental group and 15 subjects in the control group), time interval of training from horizontal position to erect position in the experimental group was 18.00±3.12 days and 21.40±4.95 days in the control group. Time interval in the experimental group was significantly less than in the control group. However, among all 36 subjects, by combining results of follow-up, there was no significant difference of time interval of training from horizontal position to erect position between the experimental group and the control group. In the experimental group 90.52% of patients finished training compared to 78.19% in the control group (P<0.01). After training, values of OCs and OCd of the experimental group were lower than in the control group. There was no significant difference between groups in number of re-diagnosed OH. Conclusions Implementation of training with electric uprise bed coupled with remote monitoring system is generally safe for patients with OH after SCI. For patients who could reach standing training status within 30 days, implementation can improve efficiency of training by shortening time interval of training from horizontal position to erect position. It can increase orthostatic blood pressure change during position change. PMID:25529992

Shen, Dantong; Huang, Huai; Yuan, Hui; Zhang, Xu; Li, Min

2014-01-01

322

DISCUSSION ON SPINAL INJURIES  

PubMed Central

(1).—Varieties of spinal injuries, the three groups of common usage: fractures, dislocations, fracture-dislocations. Shall not refer in detail to fractures of the spinous or transverse processes. (2) Mechanics of injury to vertebræ. Two variables: (1) the nature of the bones; (2) the qualities of the force. Spinal injury usually caused by indirect violence. (3) The different results of injuries applied to the head; may break skull, failing that, the neck. Atlas fracture. Difference in qualities of the force causing atlas fracture and low cervical dislocation. (4) The compound nature of the vertebral body. The two columns, anterior, spongy; posterior, compact. The nature of wedge-compression of the vertebral body. Variations in the shape of the wedge. Reasons. Occur at all levels, including cervical spine. (5) Frequency of injury at different levels of vertebral column. “Localization” of injury. The two places of the graph of injury. The cervical at C. 5. Reason. The thoracic-lumbar peak at T. 12, L. 1 industrial. Is there a third peak at C. 2? (6) The effects of violent flexion of the spine: cervical flexion causes luxation at C. 5 or so. Extension causes fracture of odontoid. Violent flexion and extension therefore cause injury at very different levels. Thoracic region, why is there no “peak” of injury at T.6, 7? Lumbar region. (7) Displacement of fragments. Continuation of violence after the essential injury has been effected. Kümmell's disease, no inflammatory process involved. (8) Injury to the intervertebral discs, essential for displacement. Imperfect rupture a cause for difficulty in reducing luxations. The worst cases those in which it is most easily done, but most of these have cord damage. (9) Spinal injury from minimal violence. Examples of trivial cases, diving, brushing hair and so forth. Vertebral displacement in disease a much more serious thing. (10) Curious stability of many cervical luxations. Reasons. Locking of the inferior zygaphophyses. (11) Injury to nervous elements left principally to other speakers. Cord compression very rare. Immediate and irremediable damage. Root injuries. Falling mortality of modern statistics due to better diagnosis. (12) Primary operation for fractures of spine relegated to oblivion. Rarity of indications for open operation. Reduction the best treatment. ImagesFig. 5Fig. 6 PMID:19986314

1928-01-01

323

Bridging spinal cord injuries  

E-print Network

Minireview Bridging spinal cord injuries James W Fawcett Address: Cambridge University Centre for Brain Repair, Robinson Way, Cambridge CB2 0PY, UK. Email: jf108@cam.ac.uk Repair of the injured spinal cord has been one of the great quests... why not transplant Abstract One strategy for spinal cord injury repair is to make cellular bridges that support axon regeneration. However, the bridging cells often fail to integrate with host tissue and may lead to increased pain sensitivity. Recent...

2008-10-15

324

The relative effectiveness of spinal manipulation in conjunction with core stability exercises as opposed to spinal manipulation alone in the treatment of post-natal mechanical low back pain.  

E-print Network

??Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 xvii, 176 leaves Core strengthening has become a major trend in the rehabilitation of patients suffering… (more)

Wilson, Dean Paul Charles

2006-01-01

325

Volcanological Exercises  

NSDL National Science Digital Library

This homework exercise, which builds on knowledge gained in previous homework exercises located at the same site, asks students in an undergraduate class at Tulane University to answer some basic questions about volcanoes, and to determine the volcanic hazards associated with Mt. Rainier, Washington; Montserrat, West Indies; and Long Valley Caldera, California by searching the World Wide Web.

Nelson, Stephen

326

Budget Exercise.  

ERIC Educational Resources Information Center

Following a discussion of the factors to be considered in constructing feasible college budgets, an exercise in budget development is presented involving a hypothetical community college with 2,500 full-time equivalent (FTE) students, 500 in developmental education, 750 each in transfer and technical programs, and 500 undecided. Exercise

Clowes, Darrel A.

327

Spinal palpatory diagnostic procedures utilized by practitioners of spinal manipulation: annotated bibliography of content validity and reliability studies  

PubMed Central

The diagnosis of spinal neuro-musculoskeletal dysfunction is a pre-requisite for application of spinal manual therapy. Different disciplines rely on palpatory procedures to establish this diagnosis and design treatment plans. Over the past 30 years, the osteopathic, chiropractic, physical therapy and allopathic professions have investigated the validity and reliability of spinal palpatory procedures. We explored the literature from all four disciplines looking for scientific papers studying the content validity and reliability of spinal palpatory procedures. Thirteen databases were searched for relevant papers between January 1966 and October 2001. An annotated bibliography of these articles is presented and organized by the type of test used.

Seffinger, Michael; Adams, Alan; Najm, Wadie; Dickerson, Vivian; Mishra, Shiraz I; Reinsch, Sibylle; Murphy, Linda

2003-01-01

328

Feasibility of isometric spinal muscle training in patients with bone metastases under radiation therapy - first results of a randomized pilot trial  

PubMed Central

Background Spinal bone metastases are commonly diagnosed in cancer patients. The consequences are pain both at rest and under exercise, impairment of activities of daily life (ADL), reduced clinical performance, the risk of pathological fractures, and neurological deficits. The aim of this randomized, controlled pilot trial was to investigate the feasibility of muscle-training exercises in patients with spinal bone metastases under radiotherapy. Secondary endpoints were local control, pain response and survival. Methods This study was a prospective, randomized, monocentre, controlled explorative intervention trial to determine the multidimensional effects of exercises for strengthening the paravertebral muscles. On the days of radiation treatment, patients in the control group were physically treated in form of respiratory therapy. Sixty patients were randomized between September 2011 and March 2013 into one of the two groups: differentiated resistance training or physical measure with thirty patients in each group. Results The resistance training of the paravertebral muscles was feasible in 83.3% of patients (n?=?25). Five patients died during the first three months. The exercise group experienced no measurable side effects. “Chair stand test” in the intervention group was significant enhanced with additionally improved analgesic efficiency. Patients in intervention group improved in pain score (VAS, 0–10) over the course (p?spinal bone metastases. The results offer a rationale for future large controlled investigations to confirm these findings. Trial registration Clinical trial identifier NCT01409720. PMID:24499460

2014-01-01

329

Intranasal nerve growth factor bypasses the blood-brain barrier and affects spinal cord neurons in spinal cord injury  

PubMed Central

The purpose of this work was to investigate whether, by intranasal administration, the nerve growth factor bypasses the blood-brain barrier and turns over the spinal cord neurons and if such therapeutic approach could be of value in the treatment of spinal cord injury. Adult Sprague-Dawley rats with intact and injured spinal cord received daily intranasal nerve growth factor administration in both nostrils for 1 day or for 3 consecutive weeks. We found an increased content of nerve growth factor and enhanced expression of nerve growth factor receptor in the spinal cord 24 hours after a single intranasal administration of nerve growth factor in healthy rats, while daily treatment for 3 weeks in a model of spinal cord injury improved the deficits in locomotor behaviour and increased spinal content of both nerve growth factor and nerve growth factor receptors. These outcomes suggest that the intranasal nerve growth factor bypasses blood-brain barrier and affects spinal cord neurons in spinal cord injury. They also suggest exploiting the possible therapeutic role of intranasally delivered nerve growth factor for the neuroprotection of damaged spinal nerve cells. PMID:25206755

Aloe, Luigi; Bianchi, Patrizia; De Bellis, Alberto; Soligo, Marzia; Rocco, Maria Luisa

2014-01-01

330

Psychological Changes in Exercising COPD Patients.  

ERIC Educational Resources Information Center

Fifteen adults with chronic obstructive pulmonary disease were divided into treatment subjects who participated in a 28-week exercise regime and control subjects who participated in a 14-week exercise program. Analyses showed the aerobic exercise to have little impact on state-trait anxiety or depression scores. (Author/JDD)

Gayle, Richard C.; And Others

1988-01-01

331

Cooling athletes with a spinal cord injury.  

PubMed

Cooling strategies that help prevent a reduction in exercise capacity whilst exercising in the heat have received considerable research interest over the past 3 decades, especially in the lead up to a relatively hot Olympic and Paralympic Games. Progressing into the next Olympic/Paralympic cycle, the host, Rio de Janeiro, could again present an environmental challenge for competing athletes. Despite the interest and vast array of research into cooling strategies for the able-bodied athlete, less is known regarding the application of these cooling strategies in the thermoregulatory impaired spinal cord injured (SCI) athletic population. Individuals with a spinal cord injury (SCI) have a reduced afferent input to the thermoregulatory centre and a loss of both sweating capacity and vasomotor control below the level of the spinal cord lesion. The magnitude of this thermoregulatory impairment is proportional to the level of the lesion. For instance, individuals with high-level lesions (tetraplegia) are at a greater risk of heat illness than individuals with lower-level lesions (paraplegia) at a given exercise intensity. Therefore, cooling strategies may be highly beneficial in this population group, even in moderate ambient conditions (~21 °C). This review was undertaken to examine the scientific literature that addresses the application of cooling strategies in individuals with an SCI. Each method is discussed in regards to the practical issues associated with the method and the potential underlying mechanism. For instance, site-specific cooling would be more suitable for an athlete with an SCI than whole body water immersion, due to the practical difficulties of administering this method in this population group. From the studies reviewed, wearing an ice vest during intermittent sprint exercise has been shown to decrease thermal strain and improve performance. These garments have also been shown to be effective during exercise in the able-bodied. Drawing on additional findings from the able-bodied literature, the combination of methods used prior to and during exercise and/or during rest periods/half-time may increase the effectiveness of a strategy. However, due to the paucity of research involving athletes with an SCI, it is difficult to establish an optimal cooling strategy. Future studies are needed to ensure that research outcomes can be translated into meaningful performance enhancements by investigating cooling strategies under the constraints of actual competition. Cooling strategies that meet the demands of intermittent wheelchair sports need to be identified, with particular attention to the logistics of the sport. PMID:25119157

Griggs, Katy E; Price, Michael J; Goosey-Tolfrey, Victoria L

2015-01-01

332

Spinal cord malformations.  

PubMed

Malformations of the spinal cord are one of the most frequent malformations. They should be clearly divided into two completely different families of malformations: open dysraphisms and occult dysraphisms. Open dysraphism mostly consists in myelomeningocele (MMC). Its incidence is 1/1000 live births with a wide variation. Folic acid supplementation has been shown to reduce its risk. In most cases, the diagnosis is done prenatally by serum screening and ultrasound and may lead to termination of pregnancy. In case of decision to continue pregnancy, surgical treatment must be achieved during the first days of life, and in 50 to 90% of cases, a ventricular shunt must be installed. The follow-up of these children must be continued throughout life looking for late complications (Chiari II and syringomyelia, vertebral problems, neuropathic bladder, tethered cord). Occult dysraphisms are a heterogeneous group of malformations. Lipomas (filum and conus) are the most frequent and their treatment remains controversial. Diastematomyelia, neurenteric cysts, dermal sinus, and more complex forms (Currarino syndrome) belong to this group. Most of them can and must be diagnosed prenatally or at birth by careful examination of the lower back for the cutaneous stigmata of the disease to decrease the risk of neurological, urological, or orthopedic permanent handicap. PMID:23622306

Zerah, Michel; Kulkarni, Abhaya V

2013-01-01

333

Spinal Cord Infarction  

MedlinePLUS

... prevent and treat them. NIH Patient Recruitment for Spinal Cord Infarction Clinical Trials At NIH Clinical Center Throughout the U.S. and Worldwide NINDS Clinical Trials Organizations Column1 Column2 ... National Spinal Cord Injury Association 75-20 Astoria Blvd Suite ...

334

Intramedullary spinal cord astrocytomas  

Microsoft Academic Search

Intramedullary spinal cord tumors (IMSCT) are rare lesions and can occur in any age group. They are the most common intramedullary spinal cord tumors in children and the second most common in adults. Most of these astrocytomas are low-grade and may present after a symptomatic period of months to years. They can become symptomatic with back or neck pain, radicular

Scott P. Sanderson; Paul R. Cooper

2003-01-01

335

Athletic Trainers and Exercise Physiologists  

MedlinePLUS

... and EPs must be sympathetic while providing treatments. Decision-making skills . Athletic trainers and exercise physiologists must be able to make informed clinical decisions that could affect the health or livelihood of ...

336

Exercise therapy for craniomandibular disorders  

Microsoft Academic Search

Nicolakis P, Erdogmus B, Kopf A, Djaber-Ansari A, Piehslinger E, Fialka-Moser V. Exercise therapy for craniomandibular disorders. Arch Phys Med Rehabil 2000;81:1137-42. Objective: To evaluate the use of exercise therapy for the treatment of craniomandibular disorders (CMDs). Design: Before-after trial. All patients were assigned to a waiting list, serving as a no-treatment control period. Setting: Outpatient clinic for physical medicine

Peter Nicolakis; Burak Erdogmus; Andreas Kopf; Andreas Djaber-Ansari; Eva Piehslinger; Veronika Fialka-Moser

2000-01-01

337

Decision making in surgical treatment of chronic low back pain: the performance of prognostic tests to select patients for lumbar spinal fusion.  

PubMed

Chronic low back pain (CLBP) is one of the main causes of disability in the western world with a huge economic burden to society. As yet, no specific underlying anatomic cause has been identified for CLBP. Imaging often reveals degenerative findings of the disc or facet joints of one or more lumbar motion segments. These findings, however, can also be observed in asymptomatic people. It has been suggested that pain in degenerated discs may be caused by the ingrowth of nerve fibers into tears or clefts of the annulus fibrosus or nucleus pulposus, and by reported high levels of pro-inflammatory mediators. As this so-called discogenic pain is often exacerbated by mechanical loading, the concept of relieving pain by spinal fusion to stabilise a painful spinal segment, has been developed. For some patients lumbar spinal fusion indeed is beneficial, but its results are highly variable and hard to predict for the individual patient. To identify those CLBP patients who will benefit from fusion, many surgeons rely on tests that are assumed to predict the outcome of spinal fusion. The three most commonly used prognostic tests in daily practice are immobilization in a lumbosacral orthosis, provocative discography and trial immobilization by temporary external transpedicular fixation. Aiming for consensus on the indications for lumbar fusion and in order to improve its results by better patient selection, it is essential to know the role and value of these prognostic tests for CLBP patients in clinical practice. The overall aims of the present thesis were: 1) to evaluate whether there is consensus among spine surgeons regarding the use and appreciation of prognostic tests for lumbar spinal fusion; 2) to verify whether a thoracolumbosacral orthosisis (TLSO) truly minimises lumbosacral motion; 3) to verify whether a TLSO can predict the clinical outcome of fusion for CLBP; 4) to assess whether provocative discography of adjacent segments actually predicts the long-term clinical outcome fusion; 5) to determine the incidence of postdiscography discitis, and whether there is a need for routine antibiotic prophylaxis; 6) to assess whether temporary external transpedicular fixation (TETF) can help to predict the outcome of spinal fusion; 7) to determine the prognostic accuracy of the most commonly used tests in clinical practice to predict the outcome of fusion for CLBP. The results of a national survey among spine surgeons in the Netherlands were presented in Study I. The surgeons were questioned about their opinion on prognostic factors and about the use of predictive tests for lumbar fusion in CLBP patients. The comments were compared with findings from the prevailing literature. The survey revealed a considerable lack of uniformity in the use and appreciation of predictive tests. Prognostic factors known from the literature were not consistently incorporated in the surgeons' decision making process either. This heterogeneity in strategy is most probably caused by the lack of sound scientific evidence for current predictive tests and it was concluded that currently there is not enough consensus among spine surgeons in the Netherlands to create national guidelines for surgical decision making in CLBP. In Study II, the hypothesized working mechanism of a pantaloon cast (i.e., minimisation of lumbosacral joint mobility) was studied. In patients who were admitted for a temporary external transpedicular fixation test (TETF), infrared light markers were rigidly attached to the protruding ends of Steinman pins that were fixed in two spinal levels. In this way three-dimensional motion between these levels could be analysed opto-electronically. During dynamic test conditions such as walking, a plaster cast, either with or without unilateral hip fixation, did not significantly decrease lumbosacral joint motion. Although not substantiated by sound scientific support, lumbosacral orthoses or pantaloon casts are often used in everyday practice as a predictor for the outcome of fusion. A systematic review of the literature supplemented with a prospec

Willems, Paul

2013-02-01

338

Exercise Habit  

MedlinePLUS

... bicycle the next. Consider activities like dancing and racquet sports, and even chores like vacuuming or mowing the ... on a regular basis. How can I prevent injuries? To avoid injuring yourself during exercise, don’t ...

339

Seismological Exercises  

NSDL National Science Digital Library

This homework exercise, which was designed for an undergraduate level geology class at Tulane University, asks the student to make evaluations about the Loma Prieta Earthquake and other earthquakes using seismograms, time travel curves, maps and other information.

Nelson, Stephen

340

[Instruments for spinal cord stimulation].  

PubMed

Development of instruments for spinal cord stimulation is remarkable. We can implant two cylinder-type stimulation electrodes in parallel into the spinal epidural space. We call this method for dual-lead SCS. Dual lead-SCS is useful to induce paresthesia over the painful area, and the success rate of pain reduction induced by dual-lead SCS is increasing. For dual-lead stimulation, the RestoreSensor, the EonMini, and the Precision Plus are suitable and useful for the treatment of intractable pain. Based on the results of a drug-challenge test with ketamine, we applied dual-SCS for the treatment of various kinds of neuropathic pain. Comparing with the results of single-lead SCS, dual-lead SCS has obvious advantages to evoke paresthesia over the painful area, and showed a remarkable effects for pain reduction. Dual-lead SCS combined with low-dose ketamine drip infusion method is useful for the treatment of various kinds of neuropathic pain. Even if the direct effect of ketamine is transient, effects that provide release from central sensitization and the wind-up phenomenon may be important to increase the effects of dual-lead SCS. Based on the development of dual-lead SCS, SCS therapy has become an important and powerful method for the treatment of intractable pain. PMID:25098136

Yamamoto, Takamitsu; Fukaya, Chikashi; Yoshino, Atsuo

2014-07-01

341

Humanized animal exercise model for clinical implication.  

PubMed

Exercise and physical activity function as a patho-physiological process that can prevent, manage, and regulate numerous chronic conditions, including metabolic syndrome and age-related sarcopenia. Because of research ethics and technical difficulties in humans, exercise models using animals are requisite for the future development of exercise mimetics to treat such abnormalities. Moreover, the beneficial or adverse outcomes of a new regime or exercise intervention in the treatment of a specific condition should be tested prior to implementation in a clinical setting. In rodents, treadmill running (or swimming) and ladder climbing are widely used as aerobic and anaerobic exercise models, respectively. However, exercise models are not limited to these types. Indeed, there are no golden standard exercise modes or protocols for managing or improving health status since the types (aerobic vs. anaerobic), time (morning vs. evening), and duration (continuous vs. acute bouts) of exercise are the critical determinants for achieving expected beneficial effects. To provide insight into the understanding of exercise and exercise physiology, we have summarized current animal exercise models largely based on aerobic and anaerobic criteria. Additionally, specialized exercise models that have been developed for testing the effect of exercise on specific physiological conditions are presented. Finally, we provide suggestions and/or considerations for developing a new regime for an exercise model. PMID:24647666

Seo, Dae Yun; Lee, Sung Ryul; Kim, Nari; Ko, Kyung Soo; Rhee, Byoung Doo; Han, Jin

2014-09-01

342

Optical monitoring and detection of spinal cord ischemia.  

PubMed

Spinal cord ischemia can lead to paralysis or paraparesis, but if detected early it may be amenable to treatment. Current methods use evoked potentials for detection of spinal cord ischemia, a decades old technology whose warning signs are indirect and significantly delayed from the onset of ischemia. Here we introduce and demonstrate a prototype fiber optic device that directly measures spinal cord blood flow and oxygenation. This technical advance in neurological monitoring promises a new standard of care for detection of spinal cord ischemia and the opportunity for early intervention. We demonstrate the probe in an adult Dorset sheep model. Both open and percutaneous approaches were evaluated during pharmacologic, physiological, and mechanical interventions designed to induce variations in spinal cord blood flow and oxygenation. The induced variations were rapidly and reproducibly detected, demonstrating direct measurement of spinal cord ischemia in real-time. In the future, this form of hemodynamic spinal cord diagnosis could significantly improve monitoring and management in a broad range of patients, including those undergoing thoracic and abdominal aortic revascularization, spine stabilization procedures for scoliosis and trauma, spinal cord tumor resection, and those requiring management of spinal cord injury in intensive care settings. PMID:24358279

Mesquita, Rickson C; D'Souza, Angela; Bilfinger, Thomas V; Galler, Robert M; Emanuel, Asher; Schenkel, Steven S; Yodh, Arjun G; Floyd, Thomas F

2013-01-01

343

N-methyl-D-aspartate receptor antagonist MK-801 prevents apoptosis in rats that have undergone fetal spinal cord transplantation following spinal hemisection  

PubMed Central

Spinal cord injury is the main cause of paraplegia, but effective therapies for it are lacking. Embryonic spinal cord transplantation is able to repair spinal cord injury, albeit with a large amount of neuronal apoptosis remaining in the spinal cord. MK-801, an N-methyl-D-aspartate (NMDA) receptor antagonist, is able to reduce cell death by decreasing the concentration of excitatory amino acids and preventing extracellular calcium ion influx. In this study, the effect of MK-801 on the apoptosis of spinal cord neurons in rats that have received a fetal spinal cord (FSC) transplant following spinal hemisection was investigated. Wistar rats were divided into three groups: Spinal cord hemisection injury with a combination of FSC transplantation and MK-801 treatment (group A); spinal cord hemisection injury with FSC transplantation (group B); and spinal cord injury with insertion of a Gelfoam pledget (group C). The rats were sacrificed 1, 3, 7 and 14 days after the surgery. Apoptosis in spinal slices from the injured spinal cord was examined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling reaction, and the expression of B-cell lymphoma-2 (Bcl-2) was measured by immunohistochemistry. The positive cells were quantitatively analyzed using a computer image analysis system. The rate of apoptosis and the positive expression of Bcl-2 protein in the spinal cord neurons in the three groups decreased in the following order: C>B>A (P<0.05) and A>B>C (P<0.05), respectively. This indicates that treatment with the NMDA receptor antagonist MK-801 prevents apoptosis in the spinal cord neurons of rats that have undergone FSC transplantation following spinal hemisection. PMID:25371724

ZHANG, QIANG; SHAO, YANG; ZHAO, CHANGSONG; CAI, JUAN; SUN, SHENG

2014-01-01

344

Complications in the management of metastatic spinal disease  

PubMed Central

Metastatic spine disease accounts for 10% to 30% of new cancer diagnoses annually. The most frequent presentation is axial spinal pain. No treatment has been proven to increase the life expectancy of patients with spinal metastasis. The goals of therapy are pain control and functional preservation. The most important prognostic indicator for spinal metastases is the initial functional score. Treatment is multidisciplinary, and virtually all treatment is palliative. Management is guided by three key issues; neurologic compromise, spinal instability, and individual patient factors. Site-directed radiation, with or without chemotherapy is the most commonly used treatment modality for those patients presenting with spinal pain, causative by tumours which are not impinging on neural elements. Operative intervention has, until recently been advocated for establishing a tissue diagnosis, mechanical stabilization and for reduction of tumor burden but not for a curative approach. It is treatment of choice patients with diseaseadvancement despite radiotherapy and in those with known radiotherapy-resistant tumors. Vertebral resection and anterior stabilization with methacrylate or hardware (e.g., cages) has been advocated.Surgical decompression and stabilization, however, along with radiotherapy, may provide the most promising treatment. It stabilizes the metastatic deposited areaand allows ambulation with pain relief. In general, patients who are nonambulatory at diagnosis do poorly, as do patients in whom more than one vertebra is involved. Surgical intervention is indicated in patients with radiation-resistant tumors, spinal instability, spinal compression with bone or disk fragments, progressive neurologic deterioration, previous radiation exposure, and uncertain diagnosis that requires tissue diagnosis. The main goal in the management of spinal metastatic deposits is always palliative rather than curative, with the primary aim being pain relief and improved mobility. This however, does not come without complications, regardless of the surgical intervention technique used. These complication range from the general surgical complications of bleeding, infection, damage to surrounding structures and post operative DT/PE to spinal specific complications of persistent neurologic deficit and paralysis. PMID:22919567

Dunning, Eilis Catherine; Butler, Joseph Simon; Morris, Seamus

2012-01-01

345

Activation of Wnt Signaling Using Lithium Chloride: Inquiry-Based Undergraduate Laboratory Exercises  

PubMed Central

Abstract Zebrafish provide researchers and students alike with an excellent model of vertebrate nervous system development due to a high degree of conserved developmental mechanisms and transparent embryos that develop in synchrony. In these laboratory exercises, undergraduate students explore cell biological concepts while performing hypothesis-driven novel research utilizing methodologies such as immunofluorescence, confocal microscopy, image analysis, pharmacology, and basic statistics. In the first block of exercises, students perform anti-acetylated tubulin (anti-AT) immunofluorescence, identify spinal tracts and neuronal subtypes, and perform conventional and confocal microscopy. Building on knowledge acquired in the first block of exercises, during the second block, students subsequently perform pharmacological activation of Wnt signaling through lithium chloride treatments, and assess nervous system integrity through anti-AT immunofluorescence. Students perform various quantitative methods and apply statistics to determine outcomes of Wnt activation. In their final laboratory report, students contextualize their results with foundations of molecular mechanisms of nervous system development. In sum, these exercises offer undergraduate students a model of independent research at the graduate level. PMID:23098089

Ross, Andrew William

2012-01-01

346

Advanced therapy learning algorithm for spinal cord stimulation  

E-print Network

Spinal Cord Stimulation (SCS) is a technique used to treat chronic pain and has been shown to be an effective method of treatment, both financially and socioeconomically. Stimulating electrodes are surgically implanted ...

Gaudreau Balderrama, Amanda Dawn

2010-01-01

347

Exercise rehabilitation for smartphone addiction  

PubMed Central

Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction. PMID:24409425

Kim, Hyunna

2013-01-01

348

Characteristics of lateral electrical surface stimulation (LESS) and its effect on the degree of spinal deformity in idiopathic scoliosis  

NASA Astrophysics Data System (ADS)

Clinical studies were carried out in the period of 2003-2006 at the Provincial Children's Rehabilitation Hospital in Ameryka near Olsztyn (Poland). The study involved a group of children and youth exhibiting spinal deformity progression in idiopathic scoliosis (IS) of more than 5° per year according to the Cobb scale. Four hundred and fifty patients between 4 and 15 years of age were divided into three groups (n = 150). Group I and group II received 2-hour and 9-hour lateral electrical surface stimulation (LESS), respectively, whereas group III (control) was treated only with corrective exercises for 30 minutes twice a day. LESS was performed with the use of a battery-operated SCOL-2 stimulator manufactured by Elmech, Warsaw, Poland. The effectiveness of this method was confirmed in the treatment of spinal IS in children and youth, especially when the initial spinal deformity did not exceed 20° according to the Cobb scale. A short-duration electrostimulation (2 hours daily) was found to produce results similar to those obtained after overnight (9 h) electrostimulation. Moreover, the analysis of the Harrington prognostic index F confirms the positive effect of LESS in both groups of patients (2 h and 9 h of LESS).

Kowalski, Ireneusz M.; Palko, Tadeusz; Pasniczek, Roman; Szarek, Jozef

2009-01-01

349

Major Surgical Treatment of Osteoporotic Vertebral Fractures in the Elderly: A Comparison of Anterior Spinal Fusion, Anterior-Posterior Combined Surgery and Posterior Closing Wedge Osteotomy  

PubMed Central

Study Design A retrospective study. Purpose To clarify the differences among the three major surgeries for osteoporotic vertebral fractures based on the clinical and radiological results. Overview of Literature Minimally invasive surgery like balloon kyphoplasty has been used to treat osteoporotic vertebral fractures, but major surgery is necessary for severely impaired patients. However, there are controversies on the surgical procedures. Methods The clinical and radiographic results of patients who underwent major surgery for osteoporotic vertebral fracture were retrospectively compared, among anterior spinal fusion (group A, 9 patients), single-stage combined anterior-posterior procedure (group AP, 8 patients) and posterior closing wedge osteotomy (group P, 9 patients). Patients who underwent revision surgery were evaluated just before the revision surgery, and the other patients were evaluated at the final follow-up examination, which was defined as the end point of the evaluations for the comparison. Results The operation time was significantly longer in group AP than in the other two groups. The postoperative correction of kyphosis was significantly greater in group P than in group A. Although the differences were not significant, better outcomes were obtained in group P in: back pain relief at the end point; ambulatory ability at the end point; and average loss of correction. Conclusions The posterior closing wedge osteotomy demonstrated better surgical results than the anterior spinal fusion procedure and the single-stage combined anterior-posterior procedure. PMID:24967046

Mukai, Yoshihiro; Hosono, Noboru; Fuji, Takeshi

2014-01-01

350

Development of AMPA receptor and GABA B receptor-sensitive spinal hyper-reflexia after spinal air embolism in rat: a systematic neurological, electrophysiological and qualitative histopathological study  

PubMed Central

Decompression sickness results from formation of bubbles in the arterial and venous system, resulting in spinal disseminated neurodegenerative changes and may clinically be presented by motor dysfunction, spinal segmental stretch hyper-reflexia (i.e., spasticity) and muscle rigidity. In our current study, we describe a rat model of spinal air embolism characterized by the development of similar spinal disseminated neurodegenerative changes and functional deficit. In addition, the anti-spastic potency of systemic AMPA receptor antagonist (NGX424) or GABA B receptor agonist (baclofen) treatment was studied. To induce spinal air embolism, animals received an intra-aortic injection of air (50–200 ?l/kg). After embolism, the development of spasticity was measured using computer-controlled ankle rotation. Animals receiving 150 or 200 ?l of intra-aortic air injections displayed motor dysfunction with developed spastic (50–60% of animals) or flaccid (25–35% of animals) paraplegia at 5–7 days. MRI and spinal histopathological analysis showed disseminated spinal cord infarcts in the lower thoracic to sacral spinal segments. Treatment with NGX424 or baclofen provided a potent anti-spasticity effect (i.e., stretch hyper-reflexia inhibition). This model appears to provide a valuable experimental tool to study the pathophysiology of air embolism-induced spinal injury and permits the assessment of new treatment efficacy targeted to modulate neurological symptoms resulting from spinal air embolism. PMID:22721766

Kakinohana, Osamu; Scadeng, Miriam; Corleto, Jose A.; Sevc, Juraj; Lukacova, Nadezda; Marsala, Martin

2012-01-01

351

What Is Spinal Stenosis?  

MedlinePLUS

... publication. To order the Spinal Stenosis Q&A full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit ... NIAMS Site NIH… Turning Discovery Into Health ® Home | ...

352

Change in central kinin B2 receptor density after exercise training in rats  

Microsoft Academic Search

Cardiovascular responses elicited by the stimulation of kinin B2 receptors in the IV cerebral ventricle, paratrigeminal nucleus or in the thoracic spinal cord are similar to those observed during an exercise bout. Considering that the kalikrein–kinin system (KKS) could act on the cardiovascular modulation during behavioral responses as physical exercise or stress, this study evaluated the central B2 receptor densities

Ariadiny Lima Caetano; Tania Araujo Viel; Maria Fernanda Queiroz Prado Bittencourt; Mariana Silva Araujo; Katia De Angelis; Hudson Sousa Buck

2010-01-01

353

Isolation and Characterization of Adult Spinal Disc Stem Cells from Healthy Human Spinal Disc Tissues  

PubMed Central

This report details the isolation, culture, and characterization of spinal disc stem cells derived from human adult spinal disc tissue specimens. Using stem cell suspension culture methods and biology, human adult spinal disc stem cells were isolated and monoclonally cultured into multicellular sphere-like clusters (discospheres). Discospheres from the first culture series were collected, processed, and replated as single stem cells for serial expansion studies using suspension culture, demonstrating linear expansion was possible. Discospheres and adult spinal disc stem cells were plated on matrix coated culture surfaces in stem cell media for several hours to allow fixation, and assayed for the stem cell biomarkers. Discospheres and adult spinal disc stem cells were plated on laminin-coated culture surfaces in chondrogenic media and culture conditions for 14 days to differentiate them into NP cells. NP cells cultured from these experiments demonstrated NP morphology and phenotype; NP biomarker expression, secretion of extracellular matrix, and the ability to be serially passaged with large volume expansion possible. Tissue engineering studies using the “burst kinetic assay”, demonstrated that discospheres have remarkable intrinsic developmental and tissue engineering biology that is robust and organized. In summary, adult disc stem cells and NP cells have been isolated, cultured, and characterized, from healthy spinal disc tissues. These findings demonstrate the important potential to be explored for using stem cell based tissue engineering for the treatment of degenerative disc disease (DDD).

Duntsch, Christopher; Dillard, Erika; Akbar, Umar

2015-01-01

354

Spinal Injury: Regeneration, Recovery, and a Possible New Approach  

SciTech Connect

Spinal injury is most frequent in young healthy men, desperate to walk. Most treatments have focused on regeneration of the injured axons, but no one has as yet achieved success with this approach. However, in the lamprey, a primitive fish with a spinal cord having all the critical features of the human spinal cored, spinal injury is followed by complete regeneration of injured axons. Additionally, the animal recovers the ability to swim, and in many, the swimming is normal. Unfortunately, in most others, it is highly abnormal. This talk will review evidence from the abnormal regeneration, why it bespeaks difficulties heretofore not considered, and suggest an alternate approach for the near future. In so doing, the speaker will introduce the normal function of the spinal cord, what happens in normal and abnormal regeneration, and the new techniques that employ methods from neuromorphic engineering, a synthesis of neuroscience and engineering to engineer smart devices.

Cohen, Avis (U of Maryland, Dept of Biology) [U of Maryland, Dept of Biology

2009-02-04

355

Intracranial metastasis from primary spinal primitive neuroectodermal tumor  

PubMed Central

Primary spinal primitive neuroectodermal tumors (PNET) are rare tumors, with only 94 cases reported till date. Metastasis to brain from a spinal PNET is even rarer. In the present report, we evaluate the pathology and treatment of solitary intracranial metastasis from spinal PNET in a 22-year-old female who presented with headache and left hemiparesis and was diagnosed to have right parietal parasagittal tumor. She has been previously diagnosed to have cervicothoracic primary spinal PNET, and was treated by surgery, radiotherapy, and chemotherapy seven years back. The intracranial tumor has been removed and pathological examination confirmed as PNET. She received radiotherapy and chemotherapy with ifosfamide and etoposide, following surgery for the right parietal PNET. At 20 months follow-up, patient is stable and has no recurrence of the disease. Critical review of reported cases of primary spinal PNET metastsising to brain was done. PMID:23741262

Ghanta, Rajesh Kumar; Koti, Kalyan; Ghanta, Venkata Sateesh K.; Teegala, Ramesh

2013-01-01

356

Restoring function after spinal cord injury: towards clinical translation of experimental strategies.  

PubMed

Spinal cord injury is currently incurable and treatment is limited to minimising secondary complications and maximising residual function by rehabilitation. Improved understanding of the pathophysiology of spinal cord injury and the factors that prevent nerve and tissue repair has fuelled a move towards more ambitious experimental treatments aimed at promoting neuroprotection, axonal regeneration, and neuroplasticity. By necessity, these new options are more invasive. However, in view of recent advances in spinal cord injury research and demand from patients, clinicians, and the scientific community to push promising experimental treatments to the clinic, momentum and optimism exist for the translation of candidate experimental treatments to clinical spinal cord injury. The ability to rescue, reactivate, and rewire spinal systems to restore function after spinal cord injury might soon be within reach. PMID:25453463

Ramer, Leanne M; Ramer, Matt S; Bradbury, Elizabeth J

2014-12-01

357

Spinal Loads during Cycling on an Ergometer  

PubMed Central

Cycling on an ergometer is an effective exercise for improving fitness. However, people with back problems or previous spinal surgery are often not aware of whether cycling could be harmful for them. To date, little information exists about spinal loads during cycling. A telemeterized vertebral body replacement allows in vivo measurement of implant loads during the activities of daily living. Five patients with a severe compression fracture of a lumbar vertebral body received these implants. During one measurement session, four of the participants exercised on a bicycle ergometer at various power levels. As the power level increased, the maximum resultant force and the difference between the maximum and minimum force (force range) during each pedal revolution increased. The average maximum-force increases between the two power levels 25 and 85 W were 73, 84, 225 and 75 N for the four patients. The corresponding increases in the force range during a pedal revolution were 84, 98, 166 and 101 N. There were large variations in the measured forces between the patients and also within the same patient, especially for high power levels. In two patients, the maximum forces during high-power cycling were higher than the forces during walking measured on the same day. Therefore, the authors conclude that patients with back problems should not cycle at high power levels shortly after surgery as a precaution. PMID:24743577

Rohlmann, Antonius; Zander, Thomas; Graichen, Friedmar; Schmidt, Hendrik; Bergmann, Georg

2014-01-01

358

[Metabolic intolerance to exercise].  

PubMed

Exercise intolerance (EI) is a frequent cause of medical attention, although it is sometimes difficult to come to a final diagnosis. However, there is a group of patients in whom EI is due to a metabolic dysfunction. McArdle's disease (type V glucogenosis) is due to myophosphorylase (MPL) deficiency. The ischemic exercise test shows a flat lactate curve. The most frequent mutations in the PYGM gene (MPL gene) in Spanish patients with MPL deficiency are R49X and W797R. Carnitine palmitoyltransferase (CPT) II deficiency is invariably associated to repetitive episodes of myoglobinuria triggered by exercise, cold, fever or fasting. The diagnosis depends on the demonstration of CPT II deficiency in muscle. The most frequent mutation in the CPT2 gene is the S113L. Patients with muscle adenylate deaminase deficiency usually show either a mild myopathy or no symptom. The diagnosis is based on the absence of enzyme activity in muscle and the lack of rise of ammonia in the forearm ischemic exercise test. The mutation Q12X in the AMPD1 gene is strongly associated with the disease. Exercise intolerance is a common complaint in patients with mitochondrial respiratory chain (MRC) deficiencies, although it is often overshadowed by other symptoms and signs. Only recently we have come to appreciate that exercise intolerance can be the sole presentation of defects in the mtDNA, particularly in complex I, complex III, complex IV, or in some tRNAs. In addition, myoglobinuria can be observed in patients under statin treatment, particularly if associated with fibrates, due to an alteration in the assembly of the complex IV of the MRC. PMID:12838448

Arenas, J; Martín, M A

2003-01-01

359

Activity-dependent plasticity in spinal cord injury  

PubMed Central

The adult mammalian central nervous system (CNS) is capable of considerable plasticity, both in health and disease. After spinal neurotrauma, the degrees and extent of neuroplasticity and recovery depend on multiple factors, including the level and extent of injury, postinjury medical and surgical care, and rehabilitative interventions. Rehabilitation strategies focus less on repairing lost connections and more on influencing CNS plasticity for regaining function. Current evidence indicates that strategies for rehabilitation, including passive exercise, active exercise with some voluntary control, and use of neuroprostheses, can enhance sensorimotor recovery after spinal cord injury (SCI) by promoting adaptive structural and functional plasticity while mitigating maladaptive changes at multiple levels of the neuraxis. In this review, we will discuss CNS plasticity that occurs both spontaneously after SCI and in response to rehabilitative therapies. PMID:18566941

Lynskey, James V.; Belanger, Adam; Jung, Ranu

2008-01-01

360

Reciprocal effects of exercise and nutrition treatment-induced weight loss with improved body image and physical self-concept.  

PubMed

Improvements in self-image and mood are often reported as outcomes of obesity interventions. However, they may also concurrently influence weight loss, suggesting a reciprocal effect. Although previously reported for overweight women, such relationships were untested in morbidly obese women whose psychosocial responses to treatment may be different, and health-risks greater. Women (N = 161, Meanage = 42 years) with morbid obesity (MeanBMI = 45.1 kg/m(2)) participated in a 6-month, behaviorally based physical activity and nutrition treatment. Significant within-group improvements in weight-loss behaviors (physical activity and eating), weight, body satisfaction, physical self-concept, and depression were found. After controlling for age, mediation analyses indicated that, as a result of the treatment, weight loss was both an outcome and mediator of improvements in body-areas satisfaction and physical self-concept (reciprocal effects), but not depression. Results replicated findings from women with lower degrees of overweight, and suggested that weight-loss treatments emphasize changes in self-perception. PMID:24965514

Annesi, James J; Porter, Kandice J

2015-01-01

361

Spontaneous spinal epidural hemorrhage from intense piano playing.  

PubMed

Spontaneous spinal epidural hematoma (SSEH) is a rare but real neurosurgical emergency. It is caused by atraumatic rupture of the vertebral epidural vein that results in nerve root or spinal cord compression. Most cases of SSEH have a multifactorial etiology, including congenital and acquired coagulopathies; platelet dysfunction; vascular malformation; tumors; uncontrolled hypertension; pregnancy; and, very rarely, activities requiring Valsalva. Herein we reported the case of a young pianist who was attacked by SSEH during piano practice. Playing the piano is a joyful, relaxing entertainment; however, this musical activity can be a highly demanding physical and mental exercise for pianists. Emotional and expressive performance, especially in professional performing, has been reported to result in significant increase of sympathetic and decrease of parasympathetic activities and thus influence the cardiorespiratory variables. The increased biomechanical stress from fluctuating hemodynamics was thought to trigger the rupture of her spinal arteriovenous malformation. PMID:24418452

Chang, Hui-Ju; Su, Fang Jy; Huang, Ying C; Chen, Shih-Han

2014-06-01

362

Spinal dural ossification causing neurological signs in a cat.  

PubMed

A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat's locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats. PMID:23777582

Antila, Johanna M; Jeserevics, Janis; Rakauskas, Mindaugas; Anttila, Marjukka; Cizinauskas, Sigitas

2013-01-01

363

History of the development of intraoperative spinal cord monitoring  

PubMed Central

In the early 1970s, spinal instrumentation and aggressive surgical technology came into wide use for the treatment of severe spinal deformities. This background led to the development of intraoperative spinal cord monitoring by orthopaedic spine surgeons themselves. The author's group (T.T.) and Kurokawa's group invented a technology in 1972 to utilize the spinal cord evoked potential (SCEP) after direct stimulation of the spinal cord. In the United States, Nash and his group started to use SEPs. Following these developments, the Royal National Orthopaedic Hospital group of Stanmore, UK employed spinal somatosensory evoked potential in 1983. However, all of these methods were used to monitor sensory mediated tracts in the spinal cord. The only way to monitor motor function was the Wake up test developed by Vauzelle and Stagnara. In 1980, Merton and Morton reported a technology to stimulate the brain transcranially and opened the doors for motor tract monitoring. Presently, in the operating theatre, monitoring of motor-related functions is routinely performed. We have to remember that multidisciplinary support owing to the development of hardware and, software and the evolution of anesthesiology has made this possible. Furthermore, no single method can sufficiently cover the complex functions of the spinal cord. Multimodality combinations of the available technologies are considered necessary for practical and effective intra-operative monitoring (IOM). In this article, the most notable historic events and articles that are regarded as milestones in the development of IOM are reviewed. PMID:17668250

Kubota, Seiji

2007-01-01

364

History of the development of intraoperative spinal cord monitoring.  

PubMed

In the early 1970s, spinal instrumentation and aggressive surgical technology came into wide use for the treatment of severe spinal deformities. This background led to the development of intraoperative spinal cord monitoring by orthopaedic spine surgeons themselves. The author's group (T.T.) and Kurokawa's group invented a technology in 1972 to utilize the spinal cord evoked potential (SCEP) after direct stimulation of the spinal cord. In the United States, Nash and his group started to use SEPs. Following these developments, the Royal National Orthopaedic Hospital group of Stanmore, UK employed spinal somatosensory evoked potential in 1983. However, all of these methods were used to monitor sensory mediated tracts in the spinal cord. The only way to monitor motor function was the Wake up test developed by Vauzelle and Stagnara. In 1980, Merton and Morton reported a technology to stimulate the brain transcranially and opened the doors for motor tract monitoring. Presently, in the operating theatre, monitoring of motor-related functions is routinely performed. We have to remember that multidisciplinary support owing to the development of hardware and, software and the evolution of anesthesiology has made this possible. Furthermore, no single method can sufficiently cover the complex functions of the spinal cord. Multimodality combinations of the available technologies are considered necessary for practical and effective intra-operative monitoring (IOM). In this article, the most notable historic events and articles that are regarded as milestones in the development of IOM are reviewed. PMID:17668250

Tamaki, Tetsuya; Kubota, Seiji

2007-11-01

365

Flooding Exercises  

NSDL National Science Digital Library

This homework exercise, developed for an undergraduate geology course at Tulane University, leads students through the steps involved in determining the probability that a flood of a given discharge will occur in any given year. Students retrieve discharge data from U.S. Geological Services Internet sites for Dry Creek, LA, Rapid Creek, SD and Red River, ND to make their calculations.

Nelson, Stephen

366

Exercise apparatus  

NASA Technical Reports Server (NTRS)

An apparatus and method for exercising whereby the user is supported by various mechanisms in such as way that the user's shoulder area is free to translate and rotate; the user's pelvic area is free to translate and rotate; or in any combination.

Schaffner, Grant (Inventor); Bentley, Jason R. (Inventor); Loehr, James A. (Inventor); Gundo, Daniel P. (Inventor)

2006-01-01

367

Quality of life and fatigue of patients with spinal bone metastases under combined treatment with resistance training and radiation therapy- a randomized pilot trial  

PubMed Central

Background The aim of this trial was to compare the effects of resistance training versus passive physical therapy on quality of life (QoL), fatigue, and emotional distress outcomes during radiation therapy in patients with spinal bone metastases under radiotherapy (RT). Methods In this randomized trial, 60 patients were treated from September 2011 until March 2013 into one of the two groups: isometric resistance training or physical therapy with thirty patients in each group during RT. EORTC QLQ-BM22, EORTC QLQ-FA13, and FBK-R10 were assessed at baseline, three months, and six months after RT. Results Psychosocial aspects in resistance training group (Arm A) were significantly improved after three (p?=?0.001) and six months (p?=?0.010). Other rated items of the QLQ-BM22 painful site, and pain characteristics were without significant differences. Functional interference showed a positive trend after six months (p?=?0.081). After six months, physical fatigue (p?=?0.013), and interference with daily life (p?=?0.006) according to the QLQ-FA13 assessment improved in Arm A significantly. Emotional distress was in Arm A lower after six months (p?=?0.016). The Cohen’s effect size confirmed the clinically significant improvement of these findings. Conclusions In this group of patients we were able to show that guided isometric resistance training of the paravertebral muscles can improve functional capacity, reduce fatigue and thereby enhance QoL over a 6-months period in patients with stable spinal metastases. The results offer a rationale for future large controlled investigations to confirm these findings. Trial registration Clinical trial identifier NCT01409720 PMID:24998293

2014-01-01

368

[Evidence for exercise prescription].  

PubMed

This brief review includes recent evidences regarding the etiology of obesity and metabolic syndrome with a special reference to autonomic nervous system activity. The role of exercise in prevention and treatment of obesity in adults and children is described in conjunction with MONA LISA Hypothesis put forth by Bray (1991). Finally, recent topics of myokines, i.e., muscle activity-derived cytokines are briefly discussed. PMID:19202914

Moritani, Toshio

2009-02-01

369

Brain-Derived Neurotrophic Factor Stimulates Hindlimb Stepping and Sprouting of Cholinergic Fibers after Spinal Cord Injury  

Microsoft Academic Search

Neurotrophic factors have been proposed as a therapeutic treatment for traumatic brain and spinal cord injury. The present study determined whether exogenous administration of one such factor, brain-derived neurotrophic factor (BDNF), could effect behavioral recovery and\\/or histopathological changes after spinal cord injury. Adult rats received a mild or moderate contusion injury or complete transection of the midthoracic spinal cord. Immediately

Lyn B. Jakeman; Ping Wei; Zhen Guan; Bradford T. Stokes

1998-01-01

370

Cardiovascular benefits of exercise.  

PubMed

Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460-377 BC) wrote "in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one's strength and staying healthy, and the best way to do so is through physical exercise." Plato (427-347 BC) referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129-217 AD) penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases. PMID:22807642

Agarwal, Shashi K

2012-01-01

371

Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during upper limb strength exercises  

PubMed Central

Background The addition of Swiss balls to conventional exercise programs has recently been adopted. Swiss balls are an unstable surface which may result in an increased need for force output from trunk muscles to provide adequate spinal stability or balance. The aim of the study was to determine whether the addition of a Swiss ball to upper body strength exercises results in consistent increases in trunk muscle activation levels. Methods The myoelectric activity of four trunk muscles was quantified during the performance of upper body resistance exercises while seated on both a stable (exercise bench) and labile (swiss ball) surface. Participants performed the supine chest press, shoulder press, lateral raise, biceps curl and overhead triceps extension. A repeated measures ANOVA with post-hoc Tukey test was used to determine the influence of seated surface type on muscle activity for each muscle. Results & Discussion There was no statistically significant (p < .05) difference in muscle activity between surface conditions. However, there was large degree of variability across subjects suggesting that some individuals respond differently to surface stability. These findings suggest that the incorporation of swiss balls instead of an exercise bench into upper body strength training regimes may not be justified based only on the belief that an increase spinal stabilizing musculature activity is inherent. Biomechanically justified ground based exercises have been researched and should form the basis for spinal stability training as preventative and therapeutic exercise training regimes. Conclusion Selected trunk muscle activity during certain upper limb strength training exercises is not consistently influenced by the replacement of an exercise bench with a swiss ball. PMID:15935097

Lehman, Gregory J; Gordon, Trish; Langley, Jo; Pemrose, Patricia; Tregaskis, Sara

2005-01-01

372

Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury  

PubMed Central

Clinical studies have shown that hyperbaric oxygen therapy improves motor function in patients with spinal cord injury. In the present study, we explored the mechanisms associated with the recovery of neurological function after hyperbaric oxygen therapy in a rat model of spinal cord injury. We established an acute spinal cord injury model using a modification of the free-falling object method, and treated the animals with oxygen at 0.2 MPa for 45 minutes, 4 hours after injury. The treatment was administered four times per day, for 3 days. Compared with model rats that did not receive the treatment, rats exposed to hyperbaric oxygen had fewer apoptotic cells in spinal cord tissue, lower expression levels of aquaporin 4/9 mRNA and protein, and more NF-200 positive nerve fibers. Furthermore, they had smaller spinal cord cavities, rapid recovery of somatosensory and motor evoked potentials, and notably better recovery of hindlimb motor function than model rats. Our findings indicate that hyperbaric oxygen therapy reduces apoptosis, downregulates aquaporin 4/9 mRNA and protein expression in injured spinal cord tissue, improves the local microenvironment for nerve regeneration, and protects and repairs the spinal cord after injury.

Wang, Yang; Zhang, Shuquan; Luo, Min; Li, Yajun

2014-01-01

373

Spinal surgery -- cervical - series (image)  

MedlinePLUS

Cervical spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral ... spinal column around the spinal cord. Symptoms of cervical spine problems include: pain that interferes with daily activities ...

374

Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery  

PubMed Central

The second, internet-based multicenter study (MCSII) of the Spine Study Group of the German Association of Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie) is a representative patient collection of acute traumatic thoracolumbar (T1–L5) injuries. The MCSII results are an update of those obtained with the first multicenter study (MCSI) more than a decade ago. The aim of the study was to assess and bring into focus: the (1) epidemiologic data, (2) surgical and radiological outcome, and (3) 2-year follow-up (FU) results of these injuries. According to the Magerl/AO classification, there were 424 (57.8%) compression fractures (A type), 178 (24.3%) distractions injuries (B type), and 131 (17.9%) rotational injuries (C type). B and C type injuries carried a higher risk for neurological deficits, concomitant injuries, and multiple vertebral fractures. The level of injury was located at the thoracolumbar junction (T11–L2) in 67.0% of the case. 380 (51.8%) patients were operated on by posterior stabilization and instrumentation alone (POSTERIOR), 34 (4.6%) had an anterior procedure (ANTERIOR), and 319 (43.5%) patients were treated with combined posteroanterior surgery (COMBINED). 65% of patients with thoracic (T1–T10) and 57% with lumbar spinal (L3–L5) injuries were treated with a single posterior approach (POSTERIOR). 47% of the patients with thoracolumbar junction (T11–L2) injuries were either operated from posterior or with a combined posterior–anterior surgery (COMBINED) each. Short angular stable implant systems have replaced conventional non-angular stable instrumentation systems to a large extent. The posttraumatic deformity was restored best with COMBINED surgery. T-spine injuries were accompanied by a higher number and more severe neurologic deficits than TL junction or L-spine injuries. At the same time T-spine injuries showed less potential for neurologic recovery especially in paraplegic (Frankel/AISA A) patients. 5% of all patients required revision surgery for perioperative complications. Follow-up data of 558 (76.1%) patients were available and collected during a 30-month period from 1 January 2004 until 31 May 2006. On average, a posterior implant removal was carried out in a total of 382 COMBINED and POSTERIOR patients 12 months after the initial surgery. On average, the rehabilitation process required 3–4 weeks of inpatient treatment, followed by another 4 months of outpatient therapy and was significantly shorter when compared with MCSI in the mid-1990s. From the time of injury until FU, 80 (60.6%) of 132 patients with initial neurological deficits improved at least one grade on the Frankel/ASIA Scale; 8 (1.3%) patients deteriorated. A higher recovery rate was observed for incomplete neurological injuries (73%) than complete neurological injuries (44%). Different surgical approaches did not have a significant influence on the neurologic recovery until FU. Nevertheless, neurological deficits are the most important factors for the functional outcome and prognosis of TL spinal injuries. POSTERIOR patients had a better functional and subjective outcome at FU than COMBINED patients. However, the posttraumatic radiological deformity was best corrected in COMBINED patients and showed significantly less residual kyphotic deformity (biseg GDW ?3.8° COMBINED vs. ?6.1° POSTERIOR) at FU (p = 0.005). The sagittal spinal alignment was better maintained when using vertebral body replacement implants (cages) in comparison to iliac strut grafts. Additional anterior plate systems did not have a significant influence on the radiological FU results. In conclusion, comprehensive data of a large patient population with acute thoracolumbar spinal injuries has been obtained and analyzed with this prospective internet-based multicenter study. Thus, updated results and the clinical outcome of the current operative treatment strategies in participating German and Austrian trauma centers have been presented. Nevertheless, it was

Knop, C.; Beisse, R.; Audigé, L.; Kandziora, F.; Pizanis, A.; Pranzl, R.; Gercek, E.; Schultheiss, M.; Weckbach, A.; Bühren, V.; Blauth, M.

2010-01-01

375

Vascular dysfunctions following spinal cord injury  

PubMed Central

The aim of this article is to analyze the vascular dysfunctions occurring after spinal cord injury (SCI). Vascular dysfunctions are common complications of SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. Neuroanatomy and physiology of autonomic nervous system, sympathetic and parasympathetic, is reviewed. SCI implies disruption of descendent pathways from central centers to spinal sympathetic neurons, originating in intermediolateral nuclei of T1–L2 cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant vascular dysfunction. Spinal shock occurs during the acute phase following SCI and it is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe arterial hypotension and bradycardia. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a life–threatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5–T6). Arterial hypotension with orthostatic hypotension occurs in both acute and chronic phases. The etiology is multifactorial. We described a few factors influencing the orthostatic hypotension occurrence in SCI: sympathetic nervous system dysfunction, low plasma catecholamine levels, rennin–angiotensin–aldosterone activity, peripheral alpha–adrenoceptor hyperresponsiveness, impaired function of baroreceptors, hyponatremia and low plasmatic volume, cardiovascular deconditioning, morphologic changes in sympathetic neurons, plasticity within spinal circuits, and motor deficit leading to loss of skeletal muscle pumping activity. Additional associated cardiovascular concerns in SCI, such as deep vein thrombosis and long–term risk for coronary heart disease and systemic atherosclerosis are also described. Proper prophylaxis, including non–pharmacologic and pharmacological strategies, diminishes the occurrence of the vascular dysfunction following SCI. Each vascular disturbance requires a specific treatment. PMID:20945818

Popa, F; Grigorean, VT; Onose, G; Sandu, AM; Popescu, M; Burnei, G; Strambu, V; Sinescu, C

2010-01-01

376

Intradural extramedullary tuberculoma of the spinal cord: a case report.  

PubMed

Intradural extramedullary (IDEM) tuberculoma of the spinal cord is uncommon entity and moreover, few reports have been documented on concurrent IDEM and intracranial tuberculomas. Authors report a case of IDEM spinal tuberculoma having intracranial lesion simultaneously. A 49-year-old woman suffered from paraparesis and urinary incontinence while being given medical treatment for tuberculous meningitis. Magnetic resonance imaging (MRI) revealed an IDEM mass lesion between the T1 and T2 spinal levels, and multiple intracranial tuberculous granulomas. Surgical resection of the IDEM tuberculoma followed by anti-tuberculous medication resulted in good outcome. PMID:10895985

Kim, M S; Kim, K J; Chung, C K; Kim, H J

2000-06-01

377

Intradural extramedullary tuberculoma of the spinal cord: a case report.  

PubMed Central

Intradural extramedullary (IDEM) tuberculoma of the spinal cord is uncommon entity and moreover, few reports have been documented on concurrent IDEM and intracranial tuberculomas. Authors report a case of IDEM spinal tuberculoma having intracranial lesion simultaneously. A 49-year-old woman suffered from paraparesis and urinary incontinence while being given medical treatment for tuberculous meningitis. Magnetic resonance imaging (MRI) revealed an IDEM mass lesion between the T1 and T2 spinal levels, and multiple intracranial tuberculous granulomas. Surgical resection of the IDEM tuberculoma followed by anti-tuberculous medication resulted in good outcome. PMID:10895985

Kim, M. S.; Kim, K. J.; Chung, C. K.; Kim, H. J.

2000-01-01

378

[Steroid-induced spinal epidural lipomatosis in pediatric patients].  

PubMed

We describe three adolescent patients with chronic autoimmune disorders who developed back pain and, in two cases, spinal symptoms several months after initiating chronic treatment with glucocorticoids. In all cases, MRI showed extensive spinal epidural lipomatosis, a rare but classic untoward effect of chronic glucocorticoid therapy. Analysis of these three, as well as 11 other pediatric cases extracted from the international literature, revealed that spinal epidural lipomatosis manifests most commonly with back pain and within a mean of 1.3 years (range, 3 month-6.5 years) after initiation of therapy with corticosteroids. It frequently remits after reduction of the corticosteroid dose. PMID:20213089

Möller, J; Girschick, H J; Hahn, G; Pessler, F

2010-07-01

379

Exercise training and selenium or a combined treatment ameliorates aberrant expression of glucose and lactate metabolic proteins in skeletal muscle in a rodent model of diabetes  

PubMed Central

Exercise training (ET) and selenium (SEL) were evaluated either individually or in combination (COMBI) for their effects on expression of glucose (AMPK, PGC-1?, GLUT-4) and lactate metabolic proteins (LDH, MCT-1, MCT-4, COX-IV) in heart and skeletal muscles in a rodent model (Goto-Kakisaki, GK) of diabetes. Forty GK rats either remained sedentary (SED), performed ET, received SEL, (5 µmol·kg body wt-1·day-1) or underwent both ET and SEL treatment for 6 wk. ET alone, SEL alone, or COMBI resulted in a significant lowering of lactate, glucose, and insulin levels as well as a reduction in HOMA-IR and AUC for glucose relative to SED. Additionally, ET alone, SEL alone, or COMBI increased glycogen content and citrate synthase (CS) activities in liver and muscles. However, their effects on glycogen content and CS activity were tissue-specific. In particular, ET alone, SEL alone, or COMBI induced upregulation of glucose (AMPK, PGC-1?, GLUT-4) and lactate (LDH, MCT-1, MCT-4, COX-IV) metabolic proteins relative to SED. However, their effects on glucose and lactate metabolic proteins also appeared to be tissue-specific. It seemed that glucose and lactate metabolic protein expression was not further enhanced with COMBI compared to that of ET alone or SEL alone. These data suggest that ET alone or SEL alone or COMBI represent a practical strategy for ameliorating aberrant expression of glucose and lactate metabolic proteins in diabetic GK rats. PMID:21779523

Kim, Seung-Suk; Koo, Jung-Hoon; Kwon, In-Su; Oh, Yoo-Sung; Lee, Sun-Jang; Kim, Eung Joon; Kim, Won-Kyu; Lee, Jin

2011-01-01

380

9 CFR 3.8 - Exercise for dogs.  

Code of Federal Regulations, 2011 CFR

...2011-01-01 false Exercise for dogs. 3.8 Section 3.8 Animals...Care, Treatment, and Transportation of Dogs and Cats 1 Animal Health and Husbandry Standards § 3.8 Exercise for dogs. Dealers, exhibitors, and...

2011-01-01

381

9 CFR 3.8 - Exercise for dogs.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Exercise for dogs. 3.8 Section 3.8 Animals...Care, Treatment, and Transportation of Dogs and Cats 1 Animal Health and Husbandry Standards § 3.8 Exercise for dogs. Dealers, exhibitors, and...

2010-01-01

382

Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis.  

PubMed

The authors report a case of adhesive arachnoiditis (AA) and arachnoid cyst successfully treated by subarachnoid to subarachnoid bypass (S-S bypass). Arachnoid cysts or syringes sometimes compress the spinal cord and cause compressive myelopathy that requires surgical treatment. However, surgical treatment for AA is challenging. A 57-year-old woman developed leg pain and gait disturbance. A dorsal arachnoid cyst compressed the spinal cord at T7-9, the spinal cord was swollen, and a small syrinx was present at T9-10. An S-S bypass was performed from T6-7 to T11-12. The patient's gait disturbance resolved immediately after surgery. Two years later, a small arachnoid cyst developed. However, there was no neurological deterioration. The myelopathy associated with thoracic spinal AA, subarachnoid cyst, and syrinx improved after S-S bypass. PMID:25170651

Tachibana, Toshiya; Moriyama, Tokuhide; Maruo, Keishi; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

2014-11-01

383

Dosimetric Comparison Between 2-Dimensional Radiation Therapy and Intensity Modulated Radiation Therapy in Treatment of Advanced T-Stage Nasopharyngeal Carcinoma: To Treat Less or More in the Planning Organ-At-Risk Volume of the Brainstem and Spinal Cord  

SciTech Connect

The aim of this study is to evaluate the deficiencies in target coverage and organ protection of 2-dimensional radiation therapy (2DRT) in the treatment of advanced T-stage (T3-4) nasopharyngeal carcinoma (NPC), and assess the extent of improvement that could be achieved with intensity modulated radiation therapy (IMRT), with special reference to of the dose to the planning organ-at-risk volume (PRV) of the brainstem and spinal cord. A dosimetric study was performed on 10 patients with advanced T-stage (T3-4 and N0-2) NPC. Computer tomography (CT) images of 2.5-mm slice thickness of the head and neck were acquired with the patient immobilized in semi-extended-head position. A 2D plan based on Ho's technique, and an IMRT plan based on a 7-coplanar portals arrangement, were established for each patient. 2DRT was planned with the field borders and shielding drawn on the simulator radiograph with reference to bony landmarks, digitized, and entered into a planning computer for reconstruction of the 3D dose distribution. The 2DRT and IMRT treatment plans were evaluated and compared with respect to the dose-volume histograms (DVHs) of the targets and the organs-at-risk (OARs), tumor control probability (TCP), and normal tissue complication probabilities (NTCPs). With IMRT, the dose coverage of the target was superior to that of 2DRT. The mean minimum dose of the GTV and PTV were increased from 33.7 Gy (2DRT) to 62.6 Gy (IMRT), and 11.9 Gy (2DRT) to 47.8 Gy (IMRT), respectively. The D{sub 95} of the GTV and PTV were also increased from 57.1 Gy (2DRT) to 67 Gy (IMRT), and 45 Gy (2DRT) to 63.6 Gy (IMRT), respectively. The TCP was substantially increased to 78.5% in IMRT. Better protection of the critical normal organs was also achieved with IMRT. The mean maximum dose delivered to the brainstem and spinal cord were reduced significantly from 61.8 Gy (2DRT) to 52.8 Gy (IMRT) and 56 Gy (2DRT) to 43.6 Gy (IMRT), respectively, which were within the conventional dose limits of 54 Gy for brainstem and of 45 Gy for spinal cord. The mean maximum doses deposited on the PRV of the brainstem and spinal cord were 60.7 Gy and 51.6 Gy respectively, which were above the conventional dose limits. For the chiasm, the mean dose maximum and the dose to 5% of its volume were reduced from 64.3 Gy (2DRT) to 53.7 Gy (IMRT) and from 62.8 Gy (2DRT) to 48.7 Gy (IMRT), respectively, and the corresponding NTCP was reduced from 18.4% to 2.1%. For the temporal lobes, the mean dose to 10% of its volume (about 4.6 cc) was reduced from 63.8 Gy (2DRT) to 55.4 Gy (IMRT) and the NTCP was decreased from 11.7% to 3.4%. The therapeutic ratio for T3-4 NPC tumors can be significantly improved with IMRT treatment technique due to improvement both in target coverage and the sparing of the critical normal organ. Although the maximum doses delivered to the brainstem and spinal cord in IMRT can be kept at or below their conventional dose limits, the maximum doses deposited on the PRV often exceed these limits due to the close proximity between the target and OARs. In other words, ideal dosimetric considerations cannot be fulfilled in IMRT planning for T3-4 NPC tumors. A compromise of the maximal dose limit to the PRV of the brainstem and spinal cord would need be accepted if dose coverage to the targets is not to be unacceptably compromised. Dosimetric comparison with 2DRT plans show that these dose limits to PRV were also frequently exceeded in 2DRT plans for locally advanced NPC. A dedicated retrospective study on the incidence of clinical injury to neurological organs in a large series of patients with T3-4 NPC treated by 2DRT may provide useful reference data in exploring how far the PRV dose constraints may be relaxed, to maximize the target coverage without compromising the normal organ function.

Chau, Ricky [Department of Clinical Oncology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong (China)], E-mail: S033928@mailserv.cuhk.edu.hk; Teo, Peter [Department of Clinical Oncology, Sanatorium Hospital, Hong Kong (China); Kam, Michael; Leung, S.F.; Cheung, K.Y.; Chan, Anthony [Department of Clinical Oncology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong (China)

2007-01-01

384

Synthesis and biological evaluation of novel 2,4-diaminoquinazoline derivatives as SMN2 promoter activators for the potential treatment of spinal muscular atrophy.  

PubMed

Proximal spinal muscular atrophy (SMA) is an autosomal recessive disorder characterized by death of motor neurons in the spinal cord that is caused by deletion and/or mutation of the survival motor neuron gene ( SMN1). Adjacent to SMN1 are a variable number of copies of the SMN2 gene. The two genes essentially differ by a single nucleotide, which causes the majority of the RNA transcripts from SMN2 to lack exon 7. Although both SMN1 and SMN2 encode the same Smn protein amino acid sequence, the loss of SMN1 and incorrect splicing of SMN2 have the consequence that Smn protein levels are insufficient for the survival of motor neurons. The therapeutic goal of our medicinal chemistry effort was to identify small-molecule activators of the SMN2 promoter that, by up-regulating gene transcription, would produce greater quantities of full-length Smn protein. Our initial medicinal chemistry effort explored a series of C5 substituted benzyl ether based 2,4-diaminoquinazoline derivatives that were found to be potent activators of the SMN2 promoter; however, inhibition of DHFR was shown to be an off-target activity that was linked to ATP depletion. We used a structure-guided approach to overcome DHFR inhibition while retaining SMN2 promoter activation. A lead compound 11a was identified as having high potency (EC50 = 4 nM) and 2.3-fold induction of the SMN2 promoter. Compound 11a possessed desirable pharmaceutical properties, including excellent brain exposure and long brain half-life following oral dosing to mice. The piperidine compound 11a up-regulated expression of the mouse SMN gene in NSC-34 cells, a mouse motor neuron hybrid cell line. In type 1 SMA patient fibroblasts, compound 11a induced Smn in a dose-dependent manner when analyzed by immunoblotting and increased the number of intranuclear particles called gems. The compound restored gems numbers in type I SMA patient fibroblasts to levels near unaffected genetic carriers of SMA. PMID:18205293

Thurmond, John; Butchbach, Matthew E R; Palomo, Marty; Pease, Brian; Rao, Munagala; Bedell, Louis; Keyvan, Monica; Pai, Grace; Mishra, Rama; Haraldsson, Magnus; Andresson, Thorkell; Bragason, Gisli; Thosteinsdottir, Margret; Bjornsson, Jon Mar; Coovert, Daniel D; Burghes, Arthur H M; Gurney, Mark E; Singh, Jasbir

2008-02-14

385

Rehabilitation of spinal cord injuries.  

PubMed

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-18

386

Rehabilitation of spinal cord injuries  

PubMed Central

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients’ family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-01

387

Spinal instability and deformity due to neoplastic conditions.  

PubMed

In addition to tumor resection, a major goal of spine surgery involving tumors is the preservation or achievement of spinal stability. The criteria defining stability, originally developed for use in trauma, are not directly applicable in the setting of neoplasia. The authors discuss the most common patterns of tumor-related instability and deformity at all levels of the spinal column and review the surgical options for treatment. PMID:15766225

Fourney, Daryl R; Gokaslan, Ziya L

2003-01-15

388

Microbiology and Epidemiology of Infectious Spinal Disease  

PubMed Central

Objective Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy. PMID:25289121

Jeong, Se-Jin; Youm, Jin-Young; Kim, Hyun-Woo; Ha, Ho-Gyun; Yi, Jin-Seok

2014-01-01

389

Percutaneous interspinous distraction device for the treatment of lumbar spinal canal stenosis: Clinical and radiographic results at 2-year follow-up  

PubMed Central

Objective To evaluate the effectiveness of the In- space (Synthes, Umkirch, Germany) and the correlation between radiographic parameters and clinical outcome in patients with lumbar spinal canal stenosis (LSS). Methods Between June 2009 and May 2013, 56 patients with LSS underwent In-space by one senior surgeon. All of the patients were evaluated both clinically and radiographic measurements before the procedure and each visit at the postoperative follow-up. Preoperative and postoperative X-ray imaging was performed before the procedure and at follow-up to assess the correlation with the clinical outcome. Radiological measurements and clinical outcomes were recorded to establish a relationship between the radiographic parameters and clinical outcome of this procedure. All patients had at least 2 years of follow-up. Results The mean VAS score of back pain decreased significantly (p < 0.05). Conclusions Our data suggest that percutaneous interspinous devices are a good alternative to treat LSS. The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms. The increased intervertebral foramenal space explains the improvement of leg pain, but the mechanism of back pain relief remains unclear. A very weak correlation between the radiographic changes and improvement of pain was found. PMID:25694917

Chaichankul, Chaiyos; Limthongkul, Worawat

2014-01-01

390

PGE(1) treatment of severe intermittent claudication (short-term versus long-term, associated with exercise)--efficacy and costs in a 20-week, randomized trial.  

PubMed

The efficacy, safety, and cost of prostaglandin E1 (PGE1) in the treatment of severe intermittent claudication was studied comparing a long-term treatment protocol (LTP) with a short-term treatment protocol (STP) in a randomized 20-week study. The study included 980 patients (883 completed the study) with an average total walking distance of 85.5 +/-10 m (range 22-119). Phase 1 was a 2-week run-in phase (no treatment) for both protocols. In LTP, phase 2 was the main treatment phase. In the LTP, treatment was performed with 2-hour infusions (60 microg PGE1, 5 days each week for 4 weeks. In phase 3 (4-week interval period) PGE1 was administered twice a week (same dosage). In phase 4 (monitoring lasting 3 months, from week 9 to 20) no drugs were used. In STP phase 2 treatment was performed in 2 days by a 2-hour infusion (first day: morning 20 microg, afternoon 40 microg; second day morning and afternoon 60 microg). The reduced dosage was used only at the first cycle (week 0) to evaluate tolerability or side effects. Full dosage (60 microg bid) was used for all other cycles. The same cycle was repeated at the beginning of weeks 4, 8, and 12. The observation period was between weeks 12 and 20. A treadmill test was performed at inclusion, at the beginning of each phase, and at the end of 20th week. A similar progressive physical training plan (based on walking) and a reduction in risk factors levels plan was used in both groups. Intention-to-treat analysis indicated an increase in walking distance, which improved at 4 weeks and at 20 weeks in the STP more than in the LTP group. At 4 weeks the variation (increase) in pain-free walking (PFWD) was 167.8% (of the initial value) in the LTP group and 185% in the STP group (p<0.05). At 4 weeks the variation (increase) in total walking distance (TWD) was 227.6% of the initial value in the LTP group and 289% in the STP group (p<0.05). At 20 weeks the increase in PFWD was 496% of the initial value in the LTP group vs 643% in the STP group (147% difference; p<0.02). The increase in TWD was 368% in the LTP group and 529% in the STP group (161% difference; p<0.02). In both groups there was a significant increase in PFWD and TWD at 4 and 20 weeks, but results obtained with STP are better considering both walking distances. No serious drug-related side effects were observed. Local, mild adverse reactions were seen in 6.3% of the treated subjects in the LTP and 3% in the STP. Average cost of LTP was 6,664 Euro; for STP the average costs was approximately 1,820 E. The cost to achieve an improvement in walking distance of 1 m was 45.8 E with the LTP and 8.5 E with the STP (18% of the LTP cost; p<0.02). For an average 100% increase in walking distance the LTP cost was 1,989 E vs. 421 E with STP (p<0.02). Between-group analysis favors STP considering walking distance and costs. Results indicate good efficacy and tolerability of PGE, treatment. With STP less time is spent in infusion and more in the exercise program. STP reduces costs, speeds rehabilitation, and may be easily used in a larger number of nonspecialized units. PMID:10959507

Belcaro, G; Nicolaides, A N; Agus, G; Cesarone, M R; Geroulakos, G; Pellegrini, L; De Sanctis, M T; Incandela, L; Ricci, A; Mondani, P; De Angelis, R; Ippolito, E; Barsotti, A; Vasdekis, S; Ledda, A; Christopoulos, D; Errichi, B M; Helmis, H; Cornelli, U; Ramaswami, G; Dugall, M; Bucci, M; Martines, G; Ferrari, P G; Corsi, M; Di Francescantonio, D

2000-08-01

391

Orthostasis: exercise and exercise training  

NASA Technical Reports Server (NTRS)

There are two major problems here that are not independent. One is the more practically oriented problem of determining the effect of various modes of exercise training on gravitational tolerances, i.e., the point of syncope (unconsciousness) usually estimated from the time of appearance of presyncopal signs and symptoms. The other is more theoretical and concerns the mechanism of blood pressure failure that results in syncope. In many experimental designs these two problems or purposes have been intermingled, with equivocal results.

Geelen, G.; Greenleaf, J. E.

1993-01-01

392

Spinal Cord Injury Without Radiological Abnormality in Adult Thoracic Spinal Trauma  

PubMed Central

Introduction: Spinal cord injury without radiological abnormality (SCIWORA) is a rare entity and usually involves the cervical spine. Thoracic spine involvement is very rare due to the stability provided by the rib cage. The mechanisms of injury and pathophysiology are still debatable. Case Presentation: We present a case of an adult male who had road traffic accident and presented with paraplegia. The initial radiological investigations carried out in the emergency department were reported to be normal, however, subsequent magnetic resonance imaging revealed spinal cord contusion without vertebral column disruption. The patient recovered partially with conservative treatment measures including bed rest and methylprednisolone. Conclusions: Spinal trauma patients presenting with neurological deficit but no radiological abnormality should be treated as a case of SCIWORA. PMID:25599065

Khatri, Kavin; Farooque, Kamran; Gupta, Ankit; Sharma, Vijay

2014-01-01

393