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Annals of Physical and Rehabilitation... May 2020Muscle contractures are common after stroke and their treatment usually involves stretching. However, recent meta-analyses concluded that stretching does not increase...
BACKGROUND
Muscle contractures are common after stroke and their treatment usually involves stretching. However, recent meta-analyses concluded that stretching does not increase passive joint amplitudes in patients with stroke. The effectiveness of treatment is usually evaluated by measuring range of motion alone; however, assessing the effects of stretching on the structural and mechanical properties of muscle by evaluating the torque-angle relationship can help in understanding the effects of stretching. Although several studies have evaluated this, the effects remain unclear.
OBJECTIVE
A systematic review of the literature on the effectiveness of stretching procedures for which the outcomes included a measurement of torque associated with range of motion or muscle structure (e.g., fascicle length) in stroke survivors.
METHODS
PubMed, ScienceDirect and PEDro databases were searched by 2 independent reviewers for relevant studies on the effects of chronic stretching interventions (>4 weeks) that evaluated joint angle and passive torque or muscle structure or stiffness. The quality of the studies was assessed with the PEDro scale.
RESULTS
Eight randomized clinical trials (total of 290 participants) met the inclusion criteria, with highly variable sample characteristics (at risk/existing contractures), program objectives (prevent/treat contractures) and duration (from 4 to 52 weeks) and volume of stretching (1 to 586 hr). All studies were classified as high quality (>6/10 PEDro score). Six studies focused on the upper limb. Many programs were less than 12 weeks (n=7 studies) and did not change mechanical/structural properties. The longest intervention (52 weeks) increased muscle fascicle length and thickness (plantar flexors).
CONCLUSION
Long interventions involving high stretching volumes and/or loads may have effects on muscle/joint mechanical properties, for preventing/treating contractures after stroke injury, but need to be further explored before firm conclusions are drawn.
Topics: Aged; Biomechanical Phenomena; Contracture; Female; Humans; Male; Middle Aged; Muscle Contraction; Muscle Stretching Exercises; Muscle, Skeletal; Randomized Controlled Trials as Topic; Stroke; Stroke Rehabilitation; Treatment Outcome
PubMed: 31981838
DOI: 10.1016/j.rehab.2019.12.003 -
Case Reports in Genetics 2020Shprintzen-Goldberg craniosynostosis syndrome (SGS) is a rare autosomal dominant condition that was first documented in literature in 1982. The disorder is caused by...
Shprintzen-Goldberg craniosynostosis syndrome (SGS) is a rare autosomal dominant condition that was first documented in literature in 1982. The disorder is caused by pathogenic variants in the proto-oncogene gene, a known suppressor of TGF- activity, located on chromosome 1p36. There is considerable phenotypic overlap with Marfan and Loeys-Dietz syndromes. Common clinical features of SGS include craniosynostosis, marfanoid habitus, hypotonia, dysmorphic facies, cardiovascular anomalies, and other skeletal and connective tissue abnormalities. Ocular manifestations may include hypertelorism, downslanting palpebral fissures, proptosis, myopia, and ectopia lentis. We describe a 25-year-old male with the syndrome. Genetic analysis revealed a novel c.350G>A (p.Arg117His) variant, which was predicted to be pathogenic by the CTGT laboratory. The patient presented with dysmorphic features, marfanoid habitus, severe joint contractures, mitral valve insufficiency, aortic root dilatation, and a history of seizures. His ocular manifestations included hypertelorism, downslanting palpebral fissures, bilateral ptosis, and high myopia. Ophthalmic manifestations are an integral component of the syndrome; however, they have not been well characterized in the literature. From a systematic review of previously published cases to date, we summarize the eye and ocular adnexa manifestations reported.
PubMed: 33628537
DOI: 10.1155/2020/7353452