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Toxins Apr 2021The simple definition of tone as the resistance to passive stretch is physiologically a complex interlaced network encompassing neural circuits in the brain, spinal... (Review)
Review
The simple definition of tone as the resistance to passive stretch is physiologically a complex interlaced network encompassing neural circuits in the brain, spinal cord, and muscle spindle. Disorders of muscle tone can arise from dysfunction in these pathways and manifest as hypertonia or hypotonia. The loss of supraspinal control mechanisms gives rise to hypertonia, resulting in spasticity or rigidity. On the other hand, dystonia and paratonia also manifest as abnormalities of muscle tone, but arise more due to the network dysfunction between the basal ganglia and the thalamo-cerebello-cortical connections. In this review, we have discussed the normal homeostatic mechanisms maintaining tone and the pathophysiology of spasticity and rigidity with its anatomical correlates. Thereafter, we have also highlighted the phenomenon of network dysfunction, cortical disinhibition, and neuroplastic alterations giving rise to dystonia and paratonia.
Topics: Animals; Brain; Dystonia; Humans; Muscle Contraction; Muscle Hypertonia; Muscle Rigidity; Muscle Spasticity; Muscle Tonus; Muscle, Skeletal; Neural Pathways; Spinal Cord
PubMed: 33923397
DOI: 10.3390/toxins13040282 -
Clinics in Perinatology Dec 2019Preterm and term neonate pain assessment in neonatal intensive care units is vitally important because of the prevalence of procedural and postoperative pain. Of the 40... (Review)
Review
Preterm and term neonate pain assessment in neonatal intensive care units is vitally important because of the prevalence of procedural and postoperative pain. Of the 40 plus tools available, a few should be chosen for different populations and contexts (2 have been validated in premature infants). Preterm neonates do not display pain behaviors and physiologic indicators as reliably and specifically as full-term infants, and are vulnerable to long-term sequelae of painful experiences. Brain-oriented approaches may become available in the future; meanwhile, neonatal pain assessment tools must be taught, implemented, and their use optimized for consistent, reproducible, safe, and effective treatment.
Topics: Acute Pain; Blood Pressure; Crying; Facial Expression; Gestational Age; Heart Rate; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Muscle Tonus; Neonatal Nursing; Pain; Pain Management; Pain Measurement; Pain, Postoperative; Pain, Procedural; Posture; Sleep
PubMed: 31653303
DOI: 10.1016/j.clp.2019.08.005 -
Lakartidningen Dec 2021Paroxysmal sympathetic hyperactivity (PSH) is a condition mainly described in patients after traumatic brain injury and it is also known under the terms "autonomic...
Paroxysmal sympathetic hyperactivity (PSH) is a condition mainly described in patients after traumatic brain injury and it is also known under the terms "autonomic storm" and "dysautonomia". It affects between 8-10% of patients after traumatic brain injury and can also affect patients after other neurological diseases, such as anoxic brain injury, stroke, tumors or infections. PSH manifests with six main symptoms: tachycardia, tachypnea, hypertension, hyperthermia, hyperhidrosis and increased muscle tonus. It is of outmost importance to exclude other causes for the symptoms and there are diagnostic criteria established to identify and diagnose PSH. The treatment is pharmacological and non-pharmacological and often multimodal. PSH is probably underdiagnosed and increased awareness is needed.
Topics: Autonomic Nervous System Diseases; Brain Injuries; Brain Injuries, Traumatic; Humans; Hypertension; Tachycardia
PubMed: 34914088
DOI: No ID Found -
Cureus Aug 2021Pseudomyopia is an inappropriately excessive accommodation of the eye due to overstimulation or ciliary spasm, which leads to a marked approximation of the far point.... (Review)
Review
Pseudomyopia is an inappropriately excessive accommodation of the eye due to overstimulation or ciliary spasm, which leads to a marked approximation of the far point. Common symptoms of pseudomyopia include eye strain or fatigue, and it is classified as organic or functional. The latter is due to eye strain and functional increase in the ciliary tonus. Pseudomyopia can vary from being a transient condition or continue to progress to myopia. Head trauma is the most common cause followed by psychiatric illnesses, neurologic diseases, and drug-induced causes. There is an association between psychological stress-inducing events and pseudomyopia as it affects the autonomic nervous system. The human body counteracts anxiety by activating the parasympathetic nervous system, causing ciliary muscle contraction. Underlying psychiatric diseases in pseudomyopia patients have been reported in the past in multiple studies. Generalized anxiety disorder is the most common psychiatric illness associated with pseudomyopia with a positive correlation between anxiety-somatization scores and accommodation amount of the eye. It is strongly advised that a psychiatric consultation should be included in the multidisciplinary evaluation of every case. If patients have coexisting anxiety disorders, a multidisciplinary approach using psychiatric consultations, work environment changes, ocular exercises, and cycloplegic drugs can be used. This review aims to shed light on the association of psychiatric disorders such as anxiety with pseudomyopia.
PubMed: 34589322
DOI: 10.7759/cureus.17411 -
IISE Transactions on Occupational... 2022OCCUPATIONAL APPLICATIONSThe coronavirus disease pandemic has changed the setting of many jobs, forcing people to switch to remote work. In turn, telework is associated...
OCCUPATIONAL APPLICATIONSThe coronavirus disease pandemic has changed the setting of many jobs, forcing people to switch to remote work. In turn, telework is associated with an increased risk of musculoskeletal disorders, as it is difficult to ensure an ergonomically correct work environment at home. Complaints of headaches, neck pain, and dizziness are reported by both young and old people. One of the reasons for such complaints might be an incorrect head position and prolonged tension in the neck muscles that is directly correlated with a spatially misaligned computer monitor and peripherals. We examined biomechanical parameters of the sternocleidomastoid muscle and found that it is possible to reduce tension in this muscle by keeping the head in an appropriate angular range to minimize potential health risks.
Topics: Humans; Neck Muscles; Muscle Tonus; Musculoskeletal System; Neck Pain; Headache
PubMed: 36308294
DOI: 10.1080/24725838.2022.2141369 -
British Journal of Sports Medicine Sep 2020To systematically review risk factors for hamstring strain injury (HSI). (Meta-Analysis)
Meta-Analysis
Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport.
OBJECTIVE
To systematically review risk factors for hamstring strain injury (HSI).
DESIGN
Systematic review update.
DATA SOURCES
Database searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI.
METHOD
Search result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI.
RESULTS
The 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury.
SUMMARY/CONCLUSION
Older age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.
Topics: Age Factors; Anterior Cruciate Ligament Injuries; Athletic Injuries; Electromyography; Hamstring Muscles; Humans; Muscle Strength; Muscle Tonus; Muscle, Skeletal; Risk Factors; Running; Sprains and Strains
PubMed: 32299793
DOI: 10.1136/bjsports-2019-100983 -
Neurological Sciences : Official... Sep 2021Focal hand dystonia (FHD) is usually adult-onset focal dystonia that can be associated with marked occupational and functional disability leading to reduced quality of... (Review)
Review
BACKGROUND
Focal hand dystonia (FHD) is usually adult-onset focal dystonia that can be associated with marked occupational and functional disability leading to reduced quality of life.
METHODS
Relevant studies on treatment options for FHD, their limitations, and current recommendations were reviewed using the PubMed search until March 31, 2021. Besides, the reference lists of the retrieved publications were manually searched to explore other relevant studies.
RESULTS
and conclusion Currently, botulinum toxin has the best evidence for treatment of FHD, and 20-90% of patients experience symptomatic improvement. However, its benefit is often limited by the reduction of muscle tonus acting on the muscle spindle. Different surgical modalities that have been used to treat focal hand dystonia include lesional surgery, deep brain stimulation, and magnetic resonance-guided focused ultrasound thalamotomy. Recent studies exploring the role of behavioral techniques, sensorimotor training, and neuromodulation for the treatment of focal hand dystonia have reported good outcomes, but larger studies are required before implementing these interventions in practice.
Topics: Adult; Botulinum Toxins; Dystonic Disorders; Humans; Magnetic Resonance Imaging; Quality of Life
PubMed: 34213695
DOI: 10.1007/s10072-021-05432-7 -
JAMA Otolaryngology-- Head & Neck... Sep 2022
Topics: Dysphonia; Hoarseness; Humans; Laryngeal Muscles; Muscle Tonus; Voice Quality
PubMed: 35900756
DOI: 10.1001/jamaoto.2022.1944 -
The Journal of Neuroscience Nursing :... Apr 2021BACKGROUND: Muscle weakness is a debilitating condition that can lead to frailty, falls, and functional decline. Muscle weakness is found across many diseases;...
BACKGROUND: Muscle weakness is a debilitating condition that can lead to frailty, falls, and functional decline. Muscle weakness is found across many diseases; therefore, understanding what constitutes this condition is paramount. The National Library of Medicine provides 2 definitions of muscle weakness, both from a disease perspective. These definitions are narrow and do not account for overlapping causes of muscle weakness. Nurses are holistic practitioners, so they need to understand the clinical characteristics of muscle weakness, regardless of underlying disease processes. METHODS: Secondary analysis of data from an earlier qualitative study. Using content analysis of transcripts of semistructured interviews with a multidisciplinary group of 12 experts in the management of muscle disorders, we identified characteristics of muscle weakness from the clinicians' perspectives. RESULTS: Muscle weakness has characteristics of debility, loss of function, and asymmetry. The characteristics of debility include lack of strength, atrophy, and fatigue. Muscle weakness does coexist with muscle tightness. CONCLUSIONS: The characteristics of muscle weakness identified in our study are markedly different from those included in National Library of Medicine definitions. As a condition, muscle weakness has both subjective and objective traits. Therefore, clinician assessment and patient input combined capture the comprehensive nature of muscle weakness. Nurses' awareness of what constitutes muscle weakness, regardless of diagnosis, is the first step in optimal management of this condition.
Topics: Humans; Muscle Tonus; Muscle Weakness; Paresis; Qualitative Research; United States
PubMed: 33538459
DOI: 10.1097/JNN.0000000000000574 -
Seminars in Fetal & Neonatal Medicine Aug 2019Hospitalized newborn infants experience pain that can have negative short- and long-term consequences and thus should be prevented and treated. National and... (Review)
Review
Hospitalized newborn infants experience pain that can have negative short- and long-term consequences and thus should be prevented and treated. National and international guidelines state that adequate pain management requires valid pain assessment. Nociceptive signals cause a cascade of physical and behavioral reactions that alone or in combination can be observed and used to assess the presence and intensity of pain. Units that are caring for newborn infants must adopt sufficient pain assessment tools to cover the gestational ages and pain types that occurs in their setting. Pain assessment should be performed on a regular basis and any detection of pain should be acted on. Future research should focus on developing and validating pain assessment tools for specific situations.
Topics: Biomarkers; Blood Pressure; Catecholamines; Crying; Electroencephalography; Facial Expression; Heart Rate; Humans; Infant, Newborn; Muscle Tonus; Pain Measurement; Pain Perception; Reflex; Respiratory Rate
PubMed: 30987943
DOI: 10.1016/j.siny.2019.04.003