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Pathophysiology
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
Regarding common clinical examination signs, which of the following statements are true and which are false? Testing the bicep reflex tests the C5, C6 nerve root.The Achilles reflex tests the S4 nerve root.The Moro reflex normally disappears within the first year of life.A normal Babinski response is extensor plantar response and fanning of toes.Fasciculations are a sign of an upper motor neurone lesion.
The Myofascial Pain Syndrome
Published in Gary W. Jay, Practical Guide to Chronic Pain Syndromes, 2016
Some of the most common endocrine problems associated with myofascial include the Hypothyroidism: secondary to a lack of thyroid hormone production [levothyroxine (T4) and liothyronine (T3)] secondary to a problem with the hypothalamic-pituitary-thyroid (HPT) axis. Clinically, patients are frequently overweight. Their eyelids may be puffy, their voice hoarse. The thyroid gland may be enlarged. Their muscles are stiff, tender, and, on occasion, weak. They may display muscle hypertrophy. TRPs are common. Their primary complaint may be diffuse muscle tenderness. The Achilles reflex may show delayed relaxation. Laboratory testing typically shows low serum thyroxine (T4), free thyroxine index, and a high thyroid-stimulating hormone (TSH) level.
Myofascial Pain Syndrome
Published in Gary W. Jay, Chronic Pain, 2007
Hypothyroidism is secondary to a lack of thyroid hormone production [levothyroxine (T4) and liothyronine (T3)] secondary to a problem with the hypothalamic–pituitary–thyroid (HPT) axis. Clinically, the patients are frequently overweight. Their eyelids may be puffy, their voice hoarse. The thyroid gland may be enlarged. Their muscles are stiff, tender, and, on occasion, weak. They may display muscle hypertrophy. TrPs are common. Their primary complaint may be diffuse muscle tenderness. The Achilles reflex may show delayed relaxation. Laboratory testing typically shows low serum thyroxine (T4), free thyroxine index, and a high thyroid-stimulating hormone (TSH) level.
The early history of the knee-jerk reflex in neurology
Published in Journal of the History of the Neurosciences, 2022
Reasons for their misjudgments of reflex component durations had to do with several factors, including (a) the preliminary level of their research on reflexes, (b) their neurophysiological ignorance, and (c) their technical skills and their methodological approach. The preliminary level of their research is seen in their scattered approach. A variety of myotatic reflexes were investigated by this time (knee jerk, planter reflex, Achilles reflex, ankle clonus, eye blink) by multiple investigators, and within a variety of research species (frogs, rabbits, dogs, humans) using different experimental approaches (body movements, muscle contractions, muscle stretches). Their approaches was neither organized nor standardized. Their theoretical reflex component analyses, therefore, incorporated available information opportunistically, necessarily compounding error and ignorance.
Utilization of manual therapy to the lumbar spine in conjunction with traditional conservative care for individuals with bilateral lower extremity complex regional pain syndrome: A case series
Published in Physiotherapy Theory and Practice, 2020
Zachary Walston, Luis Hernandez, Dale Yake
Treatment was immediately initiated after the examination and included soft tissue mobilization along his lumbar paraspinals and gluteus medius, followed by non-thrust mobilization targeting the lumbar spine in side-lying. Graded mobilizations (grades 3 and 4) were performed unilaterally from T12 to S1 for durations of 30 seconds at each level (Maitland, Hengeveld, Banks, and English, 2001). Following soft tissue mobilization and lumbar mobilization, the patient could perform lumbar extension without pain in sitting and displayed normal patellar reflexes. However, the patient still had absent Achilles reflexes. Treatment was then focused on lumbar hypomobility resulting in decrease lumbar extension and hip extension throughout the stance phase of his gait. In addition, some desensitization therapy was performed to his LE to address his specific LE symptoms. Following the intervention on day 1, the patient reported that his LE pain had decreased to 4/10. He did not display an improvement of his patellar or Achilles reflex bilaterally, but the patient was able to perform active lumbar extension in sitting with normal Gillet’s test displaying normal SI motion. The patient was instructed in home exercises, including self-mobilization of the spine (side-lying rotation and spinal extension), seated anterior pelvic tilts in order to engage his lumbar multifidi and seated nerve glides for both lower extremities (Kavlak and Uygur, 2011). The patient was compliant with the prescribed HEP during the plan of care.
Translation and cultural validation of clinical observational scales – the Fugl-Meyer assessment for post stroke sensorimotor function in Colombian Spanish
Published in Disability and Rehabilitation, 2019
Nubia E. Barbosa, Sandra M. Forero, Claudia P. Galeano, Edgar D. Hernández, Nancy S. Landinez, Katharina S. Sunnerhagen, Margit Alt Murphy
Another concern that arises from previous translation studies of FMA is the modifications made to the original scale. For example, in some translations, the items of the Hand subscale, the hook grasp and thumb adduction [31,33,34], and the spherical grasp [31] show differences from the original description. Another modification is that the patient is asked to make an active grasp of the tested object that is presented on the table [34]. In the original FMA, the objects are interposed close to the patient’s hand and the patient’s ability to open the finger and hand to the size of the object and ability to grasp around the object and hold the object is assessed. Coordination/speed items are in some translations done with eyes open [34], in contrary to original FMA in which the eyes are closed. In the same subscale, the scoring is different from original FMA for tremor and dysmetria in some translations [14,32,34], in which a patient with complete paralysis is able to obtain full score of 2 when tremor or dysmetria cannot be observed anywhere else on the body. Another modification that has been published in different translations of the FMA-LE applies on the reflex activity. In these translations, only the Patella and Achilles reflex activity is included [34]. In the original FMA, the Patella and Achilles tendon reflexes are both considered as reflex activity of the extensors, and the reflex activity in flexors is assessed in knee flexors. In all these translations, the modifications are not addressed as modification to the original FMA, even when the original reference to Fugl-Meyer et al. has often but not always been provided.