Application of LC-MS/MS Analysis of Plasma Amino Acids Profiles in Children With Autism.
Application of LC-MS/MS analysis of plasma amino acids profiles in children with autism.
Filed under: Rehab Centers
J Clin Biochem Nutr. 2012 Nov; 51(3): 248-9
Tu WJ, Chen H, He J
Back seat driving: hindlimb corticospinal neurons assume forelimb control following ischaemic stroke.
Filed under: Rehab Centers
Brain. 2012 Nov; 135(Pt 11): 3265-81
Starkey ML, Bleul C, Zörner B, Lindau NT, Mueggler T, Rudin M, Schwab ME
Whereas large injuries to the brain lead to considerable irreversible functional impairments, smaller strokes or traumatic lesions are often associated with good recovery. This recovery occurs spontaneously, and there is ample evidence from preclinical studies to suggest that adjacent undamaged areas (also known as peri-infarct regions) of the cortex ‘take over’ control of the disrupted functions. In rodents, sprouting of axons and dendrites has been observed in this region following stroke, while reduced inhibition from horizontal or callosal connections, or plastic changes in subcortical connections, could also occur. The exact mechanisms underlying functional recovery after small- to medium-sized strokes remain undetermined but are of utmost importance for understanding the human situation and for designing effective treatments and rehabilitation strategies. In the present study, we selectively destroyed large parts of the forelimb motor and premotor cortex of adult rats with an ischaemic injury. A behavioural test requiring highly skilled, cortically controlled forelimb movements showed that some animals recovered well from this lesion whereas others did not. To investigate the reasons behind these differences, we used anterograde and retrograde tracing techniques and intracortical microstimulation. Retrograde tracing from the cervical spinal cord showed a correlation between the number of cervically projecting corticospinal neurons present in the hindlimb sensory-motor cortex and good behavioural recovery. Anterograde tracing from the hindlimb sensory-motor cortex also showed a positive correlation between the degree of functional recovery and the sprouting of neurons from this region into the cervical spinal cord. Finally, intracortical microstimulation confirmed the positive correlation between rewiring of the hindlimb sensory-motor cortex and the degree of forelimb motor recovery. In conclusion, these experiments suggest that following stroke to the forelimb motor cortex, cells in the hindlimb sensory-motor area reorganize and become functionally connected to the cervical spinal cord. These new connections, probably in collaboration with surviving forelimb neurons and more complex indirect connections via the brainstem, play an important role for the recovery of cortically controlled behaviours like skilled forelimb reaching.
HubMed – rehab
Force on the sacrococcygeal and ischial areas during posterior pelvic tilt in seated posture.
Filed under: Rehab Centers
Prosthet Orthot Int. 2012 Nov 20;
Kemmoku T, Furumachi K, Shimamura T
Background:Most posture problems encountered in persons who use wheelchairs in a seated posture for extended periods are related to sacral sitting due to posterior pelvic tilt. Posterior pelvic tilt places pressure and shearing force on the sacrococcygeal area that can lead to pressure ulcers, but the relationship between pelvic tilt and force applied to the sacrococcygeal and ischial tuberosity areas has not yet been investigated.Objective:To investigate the relationships of posterior pelvic tilt in a seated posture with vertical force and horizontal force on the sacrococcygeal and ischial tuberosity areas.Study Design:Repeated measures design.Methods:Thirty male and female subjects aged ?60 years sat in a measurement chair at varying pelvic tilt angles, and force on the sacrococcygeal and ischial tuberosity areas was measured.Results:The pressure on the sacrococcygeal area increased with pelvic tilt in all subjects, with vertical force averaging 19% of the body weight at a pelvic tilt angle of 30°. The horizontal force on the sacrococcygeal area increased in 93% of the subjects, with an average increase equal to 3% of the body weight.Conclusions:We confirmed changes in vertical and horizontal forces on the sacrococcygeal and ischial tuberosity areas with a change in seated posture (pelvic tilt).Clinical relevance:We propose guidelines for rehabilitation practitioners working with wheelchair users to suggest improved ways of sitting in wheelchairs that avoid pelvic tilt angles that might promote pressure ulcers on the buttocks.
HubMed – rehab
Outcome quality of in-patient cardiac rehabilitation in elderly patients – identification of relevant parameters.
Filed under: Rehab Centers
Eur J Prev Cardiol. 2012 Nov 20;
Salzwedel A, Nosper M, Röhrig B, Linck-Eleftheriadis S, Strandt G, Völler H
Background: Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome.Methods: From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation.Results: The majority of patients (61.1%) were referred for rehabilitation after cardiac surgery, 38.9% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale).Conclusion: The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.
HubMed – rehab
The relationship between acceptance, catastrophizing and illness representations in chronic pain.
Filed under: Rehab Centers
Eur J Pain. 2012 Nov 21;
Gillanders DT, Ferreira NB, Bose S, Esrich T
BACKGROUND: Cognitive- and acceptance-based approaches are used to help people live with chronic pain. Little is known about how these constructs relate to each other. In this study, we examined how cognitive representations of chronic pain relate to interpersonal styles such as catastrophizing and the behavioural process of acceptance of chronic pain. This study further examined how these processes relate to emotional and physical functioning in chronic pain. METHODS: A cross-sectional design, employing validated questionnaires, was used to measure pain, emotional and physical dysfunction, illness representations, catastrophizing and acceptance in a heterogeneous sample of 150 chronic pain sufferers. RESULTS: The psychological variables significantly mediated the impact of pain severity on both emotional and physical dysfunction. In addition, a distinct pattern of mediation was observed. The relationship between pain and emotional dysfunction was mediated by representations of pain as a highly emotive experience and by catastrophizing; acceptance did not mediate this relationship. By contrast, the relationship between pain and physical dysfunction was mediated by acceptance and representations of high consequences of chronic pain, but not by catastrophizing. CONCLUSIONS: Pain severity itself is a relatively poor predictor of emotional and physical dysfunction in chronic pain states. These relationships are significantly mediated by psychological variables. Different approaches to chronic pain rehabilitation emphasize different targets (changing illness representations and reducing catastrophizing vs. acceptance and behavioural activation). This cross-sectional study suggests that these processes may differentially influence outcomes, but that they are complex and overlapping. Theoretical and clinical implications are discussed.
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