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1.
IntroductionHip displacement is common in cerebral palsy (CP) and is related to the severity of neurological and functional impairment. It is a silent, but progressive disease, and can result in significant morbidity and decreased quality of life, if left untreated. The pathophysiology of hip displacement in CP is a combination of hip flexor-adductor muscle spasticity, abductor muscle weakness, and delayed weight-bearing, resulting in proximal femoral deformities and progressive acetabular dysplasia. Due to a lack of symptoms in the early stages of hip displacement, the diagnosis is easily missed. Awareness of this condition and regular surveillance by clinical examination and serial radiographs of the hips are the key to early diagnosis and treatment.Hip surveillance programmesSeveral population-based studies from around the world have demonstrated that universal hip surveillance in children with CP allows early detection of hip displacement and appropriate early intervention, with a resultant decrease in painful dislocations. Global hip surveillance models are based upon the patients’ age, functional level determined by the Gross Motor Function Classification system (GMFCS), gait classification, standardized clinical exam, and radiographic indices such as the migration percentage (MP), as critical indicators of progressive hip displacement.ConclusionDespite 25 years of evidence showing the efficacy of established hip surveillance programmes, there is poor awareness among healthcare professionals in India about the importance of regular hip surveillance in children with CP. There is a need for professional organizations to develop evidence-based guidelines for hip surveillance which are relevant to the Indian context. 相似文献
2.
Esin Benli Küçük Ercan Kaydok Kürsad Ramazan Zor Gamze Yıldırım Biçer 《Topics in stroke rehabilitation》2020,27(8):630-635
ABSTRACT Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group. Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared. Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group. Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients. 相似文献
3.
Michaelsen SM Jacobs S Roby-Brami A Levin MF 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》2004,157(2):162-173
Previous studies have shown that patients with arm and hand paresis following stroke recruit an additional degree of freedom (the trunk) to transport the hand during reaching and use alternative strategies for grasping. The few studies of grasping parameters of the impaired hand have been case studies mainly focusing on describing grasping in the presence of particular impairments such as hemi-neglect or optic ataxia and have not focussed on the role of the trunk in prehension. We hypothesized that the trunk movement not only ensures the transport of the hand to the object, but it also assists in orienting the hand for grasping when distal deficits are present. Nineteen patients with chronic hemiparesis and seven healthy subjects participated in the study. Patients had sustained a stroke of non-traumatic origin 6–82 months previously (31±22 months) and had mild or moderate to severe arm paresis. Using a whole hand grasp, subjects reached and grasped a cylinder (35 mm) that was placed sagittally (T1) or at a 45° angle to the sagittal midline in the ipsilateral workspace (T2), both at about 90% arms length (10 trials per target). Eight infrared emitting diodes were placed on bony landmarks of the hand, arm and trunk and kinematic data were recorded by an optical motion analysis system (Optotrak) for 2–5 s at 120 Hz. Hand position and orientation were recorded by a Fastrack Polhemus system. Our results show that during goal-directed prehension tasks, individuals with hemiparesis oriented the hand more frontally for grasping and used more trunk anterior displacement or rotation to transport the hand to the target compared to healthy subjects. Despite these changes, the major characteristics of reaching and grasping such as grip aperture size, temporal coordination between hand transport and aperture formation and the relative timing of grip aperture were largely preserved. For patients with more severe distal impairments, the amount of trunk displacement was also correlated with a more frontal hand orientation for grasping. Furthermore, in healthy subjects and patients without distal impairments, the trunk movement was mostly related to proximal arm movements while in those with distal impairments, trunk movement was related to both proximal and distal arm movements. Data support the hypothesis that the trunk movement is used to assist both arm transport and hand orientation for grasping when distal deficits are present. 相似文献
4.
Effect of brain and spinal cord injuries on motor imagery 总被引:1,自引:0,他引:1
Jean Decety Dominique Boisson 《European archives of psychiatry and clinical neuroscience》1990,240(1):39-43
Summary The timing of mentally executed movements was measured in ten patients with hemiplegia, tetraplegia and paraplegia. In hemiplegic patients a significant difference in mental duration times was found between the paralysed and the normal represented limb. The paralysed limb was mentally much slower than the healthy one. In contrast, movement times in tetraplegic and paraplegic patients did not differ from those in normal subjects. All patients reported a sensation of subjective effort accompanying the execution of the mental tasks. These observations are compatible with an outflow processing underlying motor imagery. 相似文献
5.
医疗体操对脑卒中肢体运动功能的影响 总被引:6,自引:0,他引:6
目的 :观察以神经肌肉促通技术为理论基础的医疗体操对脑卒中患者运动功能的影响。方法 :脑卒中偏瘫患者 94例 ,分成早期体操组、后期体操组、对照组。分别于发病一个月内、一个月后按医疗体操编排的动作进行训练 ,采用Fugl Meger评价法评定肢体运动功能、上肢关节疼痛、关节活动度。结果 :1.体操组肢体运动功能治疗后较治疗前改善 ,早期体操组较对照组改善明显 (P <0 .0 0 1)。 2 .早期体操组关节疼痛发生程度较对照组减轻 (P <0 .0 1)。 3、关节活动度受限的发生较对照组明显减少 (P <0 .0 0 1) ,对关节活动度已受限的患者有明显的扩大作用 (P<0 .0 0 1)。结论 :医疗体操能有效地维持和扩大关节活动度 ,提高肢体运动功能 ,对关节疼痛有一定的防治作用。适用于脑卒中肢体功能障碍患者普及康复治疗 相似文献
6.
腹针治疗脑血管病后痉挛性瘫痪的疗效观察 总被引:19,自引:0,他引:19
目的:探讨治疗脑血管病后痉挛性瘫痪的最佳针刺组穴配方.方法:将60例脑血管病后痉挛性瘫痪的患者按入院先后随机分为腹针组及体针组各30例,均每周治疗5次,连续治疗3周观察疗效.结果:腹针组患者痉挛得到明显改善,相关指标有统计学意义,体针组患者痉挛也有改善,相关指标无统计学意义.两组疗效比较腹针组疗效优于体针组,差异有显著性意义.结论:腹针疗法治疗脑血管病后痉挛性瘫痪是一种安全有效的治疗方法. 相似文献
7.
不同针刺方案对偏瘫早期康复作用的临床观察 总被引:8,自引:0,他引:8
目的:观察两种针刺方案对中风偏瘫早期的康复作用.方法:将70例中风偏瘫早期患者随机分为2组.治疗组每日2次分别针刺健患侧腧穴,对照组每日1次针刺患侧腧穴.以简式的Fugl-Meyer运动量表和修订的Barthel指数为指标进行疗效评定.结果:治疗组患肢肢体运动功能分级达Ⅳ级以上为68.6%,日常生活活动能力的良好率为74.3%;对照组分别为31.4%和42.8%,治疗组疗效明显高于对照组(P<0.01,P<0.05).结论:与常规针刺方案相比,每日2次健患侧腧穴交替应用的针刺方案更有利于中风偏瘫患者运动功能和日常生活能力的恢复. 相似文献
8.
9.
浮针配合电针治疗中风偏瘫痉挛状态疗效观察 总被引:1,自引:0,他引:1
目的:观察浮针配合电针治疗中风偏瘫痉挛状态的临床疗效。方法:将 120 例中风偏瘫肢体痉挛患者随机分为治疗组和对照组,每组 60 例。治疗组采用浮针配合电针治疗,对照组采用单纯电针治疗。分别于治疗前、治疗 30 d 后采用 Ashworth 量表评定肢体痉挛状态,采用简化 Fugl-Meyer 运动功能评分法评定肢体运动功能,采用改良 Barthel 指数(Barthel Index, BI)评定日常生活能力(Activity of Daily Living,ADL)。结果:治疗后,治疗组 Ashworth 评分、Fugl-Meyer 运动功能评分、BI 评分均明显高于对照组(P〈0.05)。浮针配合电针可明显缓解偏瘫肢体的痉挛并且优于对照组。结论:浮针配合电针可有效地缓解脑卒中偏瘫的痉挛状态。 相似文献
10.
头针配合运动疗法对偏瘫体感诱发电位的影响 总被引:1,自引:1,他引:1
目的观察头针同步进行运动疗法对脑卒中后偏瘫患者体感诱发电位(SEP)波幅的影响。方法选择48例脑卒中患者,随机分为治疗组24例(采用头针配合运动疗法),对照组24例(采用运动疗法)。疗程结束后,以体感诱发电位(SEP)波幅变化为客观评定指标,数据进行统计学处理。结果治疗前两组患侧SEP的N20波幅差异无统计学意义(P〉0.05),两组治疗后都能提高患侧SEP的N20波幅,与治疗前比较差异均有统计学意义(P〈0.01),且治疗后两组间SEP的N20波幅提升差异有统计学意义(P〈0.01)。结论头针配合运动疗法对脑卒中后偏瘫患者脑功能的恢复比单纯运动疗法更有效。 相似文献