Physiospot Neurology

Physiospot Redirect

All of our Physiospot blogs can now be found together at www.physiospot.com

You will need to sign up to the new RSS feeds and email updates to continue receiving regular updates on all the latest clinically relevant research.

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New Year, New Start!

With the expansion in the number of Physispot blogs available in 2007 it has become quite a large task to continually juggle them all and is not conducive to an effective service for our readers. We have therefore made the decision to amalgamate all the blogs into one place at www.physiospot.com.  Whilst you will be able to read all the  articles that have been selected as clinically relevant and posted we have developed separate areas of the site for research in different clinical areas. 

By making the management process more efficient not only will we be able to devote more time to actually posting articles but it will also provide a number of additional benefits:

• Each clinical area can be easily accessed from the navigation bar at the top of each page, no more flicking between different blogs.
• Articles can be tagged with more than one clinical area thereby adding more articles to each individual clinical area.
• The search function will search across all clinical areas so that you will be looking for what you need amongst all the articles posted.
• More easily keep up-to-date with recent additions in multiple clinicl areas by freely subscribing to one or more of our update options.
• Authors can easily work in more than one clinical area which may be useful for their own professional development and evidence based practice.

There is one small inconvenience to our readers which can be easily overcome.  As of today the email alerts and feeds for all the old physispot blogs will cease to function.  You will need to sign up again to receive the update alerts that you are interested in.  Go to the update options page to sign up now for your RSS feed and Email Alerts.  You can also download our toolbar to receive updates straight to your desktop and follow us on Twitter from this page.

We hope that all our readers are happy with the developments and that you enjoy the site and continue to find it useful, had we not done this we may not have been able to carry on with the juggling!  Visit the new site at www.physiospot.com

Taking a Break!

With a couple of e-learning projects that require some dedicated time, I will be taking a break from writing on the CPDspot and Physiospot blogs for the rest of November and December.  There may continue to be some posts from our other authors but I will be going quiet until the New Year.  When I return in 2009 I will be refreshed and ready to get writing again.  I will also have had some time to consider some of the ideas for new projects that have been mulling around for a while now, so you can expect some exciting developments next year.

Roles of Reflex Activity and Co-contraction During Assessments of Spasticity of the Knee Flexor and Knee Extensor Muscles in Children With Cerebral Palsy and Different Functional Levels

Pierce S, Barbe M, Barr A, Shewokis P, Lauer R

A common clinical feature of Cerebral Palsy (CP) is spasticity, which impacts the level of achievable functional activity. This study aimed to assess spasticity of both knee flexors and extensors in children with CP, focusing on differences in passive resistive torque, reflex activity, co-activation and reciprocal facilitation.  

The study group consisted of 20 children with CP, which were further divided into two subgroups using the Gross Motor Function Classification Scale (GMFCS)
An isokinetic dynamometer and electromyography of vastus lateralis and medial hamstring muscles was used to assess the previously stated variables during passive knee flexion through various ranges.

The study concluded that children with CP demonstrate more knee flexor spasticity than children with ‘typical development’. However, results showed that in some children with CP there was an increase in reflex activity with no increase in torque, suggesting that reflex activity plays a less important role in spasticity.

Physical Therapy, 2008, 88(10), 1124-1134

Link to Abstract

A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease.

Morris ME, Iansek R, Kirkwood B

This randomized controlled clinical trial was conducted to compare the effects of movement rehabilitation strategies and exercise therapy in hospitalized patients with idiopathic Parkinson's disease. Participants were randomly assigned to a group that received movement strategy training or musculoskeletal exercises during 2 consecutive weeks of hospitalization. The movement strategy group showed improvements on several outcome measures from admission to discharge, including the UPDRS, 10 m walk, 2 minute walk, balance, and PDQ39. However, from discharge to follow up there was significant regression in performance on the 2 minute walk and PDQ39. For the exercise group, quality of life improved significantly during inpatient hospitalization and this was retained at follow-up.

Inpatient rehabilitation produces short term reductions in disability and improvements in quality of life in people with Parkinson's disease.

Movement Disorders, Oct 21, online article ahead of print

Link to Abstract

Related Articles The effect of functional electrical stimulation on the physiological cost of gait in people with multiple sclerosis.

Paul L, Rafferty D, Young S, Miller L, Mattison P, McFadyen A

The aim of the study was to investigate the effects of FES, in terms of speed and physiological cost of gait, in people with multiple sclerosis (pwMS). Twelve pwMS and 12 healthy matched controls walked at their own preferred walking speed (PWS) for 5 min around a 10 m elliptical course. Subjects with MS completed the protocol with and without using their FES. In addition, control subjects completed the protocol twice more walking at the same PWS of the pwMS to which they were matched. Wearing FES lead to a significant improvement in walking speed and a significant reduction in the physiological cost of gait. The speed of walking, oxygen uptake, and physiological cost were significantly different between pwMS and controls both at preferred and matched speeds.

Although people with multiple sclerosis exhibit a higher physiological cost of walking, FES offers an orthotic benefit to pwMS and should be considered as a possible treatment option.

Multiple  Sclerosis, 2008, 14(7), 954-61

Link to Abstract

Efficacy of treatment with a kinaesthetic ability training device on balance and mobility after stroke: a randomized controlled study

Gok, H., Geler-Kulcu, D., Alptekin, N., Dincer, G.

The objective of this study was to investigate whether the addition of a kinaesthetic ability training device could enhance the effect of a conventional rehabilitation programme on balance and mobility in hemiparetic patients late after stroke.  The control group participated in a conventional rehabilitation programme. The experimental group participated in balance training with a kinaesthetic ability training device in addition to a conventional rehabilitation programme for four weeks, five days a week.

Kinaesthetic ability training in addition to a conventional rehabilitation programme is effective in improving balance late after stroke. However, this improvement is not reflected in individual functional status.

Clinical Rehabilitation, 2008, 22(10-11), 922-930

Link to Abstract

Does functional strength training of the leg in subacute stroke improve physical performance? A pilot randomized controlled trial

Bale, M., Inger Strand, L.

The purpose of this study was to examine the effect of functional strength training in subacute stroke.  Eighteen patients in the subacute phase post stroke, randomly allocated to a functional strength training (intervention) group and a training-as-usual (comparison) group.  The functional strength training group participated in functional progressive strength training of the affected lower extremity. The training-as-usual group had traditional training, excessive muscle power being avoided to prevent associated reactions. All trained 50 minutes five days a week for four weeks.

This pilot study indicates that functional strength training of lower extremities improves physical performance more than traditional training.

Clinical Rehabilitation, 2008, 22(10-11), 911-921

Link to Abstract

Test--retest reliability of the StepWatch Activity Monitor outputs in individuals with chronic stroke

Mudge, S., Stott, N. S.

The objective of this test was to examine the test—retest reliability of the StepWatch Activity Monitor outputs over two periods in participants with stroke.  Forty participants more than six months post stroke were included and total step count, number of steps at high medium and low stepping rates, sustained activity indices, peak activity index were measured.

Total step count, highest step rate in 1 minute, highest step rate in 5 minutes and peak activity index have good test—retest reliability over a three-day monitoring period, with lower reliability shown by the other StepWatch outputs. In general, monitoring over one or two days is less reliable.

Clinical Rehabilitation, 2008, 22(10-11), 871-877

Link to Abstract