-
Journal of Clinical Ultrasound : JCU May 2024We explore the use of shear wave elastography (SWE) for assessing muscle stiffness and treatment response in cerebral palsy (CP) children by way of a systematic review.... (Review)
Review
We explore the use of shear wave elastography (SWE) for assessing muscle stiffness and treatment response in cerebral palsy (CP) children by way of a systematic review. SWE offers real-time muscle stiffness measurements, showing significant differences between CP patients and controls. Studies suggest that SWE can be used to follow muscle stiffness post-botulinum toxin treatment, correlating with clinical improvement. However, methodological variations and small sample sizes prevent comparison between different studies. Standardized protocols could enhance SWE's clinical utility. In conclusion, SWE holds promise for CP management, though standardized methodologies and larger studies are needed to validate its efficacy and integration into clinical practice.
PubMed: 38708803
DOI: 10.1002/jcu.23706 -
Journal of Voice : Official Journal of... Jul 2015Laryngeal palpation is a common clinical method for the assessment of neck and laryngeal muscles in muscle tension dysphonia (MTD). (Review)
Review
BACKGROUND
Laryngeal palpation is a common clinical method for the assessment of neck and laryngeal muscles in muscle tension dysphonia (MTD).
OBJECTIVE
To review the available laryngeal palpation methods used in patients with MTD for the assessment, diagnosis, or document of treatment outcomes.
STUDY DESIGN (METHOD)
A systematic review of the literature concerning palpatory methods in MTD was conducted using the databases MEDLINE (PubMed), ScienceDirect, Scopus, Web of science, Web of knowledge and Cochrane Library between July and October 2013. Relevant studies were identified by one reviewer based on screened titles/abstracts and full texts. Manual searching was also used to track the source literature.
RESULTS
There were five main as well as miscellaneous palpation methods that were different according to target anatomical structures, judgment or grading system, and using tasks. There were only a few scales available, and the majority of the palpatory methods were qualitative. Most of the palpatory methods evaluate the tension at both static and dynamic tasks. There was little information about the validity and reliability of the available methods.
CONCLUSION
The literature on the scientific evidence of muscle tension indicators perceived by laryngeal palpation in MTD is scarce. Future studies should be conducted to investigate the validity and reliability of palpation methods.
Topics: Dysphonia; Humans; Laryngeal Muscles; Muscle Tonus; Palpation; Reproducibility of Results
PubMed: 25795346
DOI: 10.1016/j.jvoice.2014.09.023 -
Disability and Rehabilitation Apr 2017To conduct a systematic review of the evidence for the management of tone in infants 0-24 months of age, with or at risk of developing cerebral palsy. (Comparative Study)
Comparative Study Review
BACKGROUND AND OBJECTIVES
To conduct a systematic review of the evidence for the management of tone in infants 0-24 months of age, with or at risk of developing cerebral palsy.
METHOD
This review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, CINAHL Plus and PsycINFO databases were systematically searched for relevant articles. Inclusion criteria were: children aged 0-24 months, identified as at risk of, or having cerebral palsy; ≥25% of participants ≤24 months, and included a standardized assessment of tone. Only peer reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the PEDro scale for randomized controlled trials and the checklist for assessing the quality of quantitative studies of Kmet, Cook and Lee for non-randomized control trials.
RESULTS
A total of 4838 studies were identified. After removing duplicates and unrelated studies, a total of 56 full text studies were reviewed. A total of five studies met inclusion criteria, two of which were RCTs, two pre-/post-test designs and one retrospective case audit. Interventions included BoNT-A, Oral Baclofen, Neurofacilitation of Developmental Reaction and Neurodevelopmental Therapy. The quality of evidence ranged from limited to moderate.
CONCLUSION
The management of tone in infants and young children is not well described, with a dearth of high-level evidence to support intervention in the 0-24 month age-range. This is in contrast to a recent review completed by Novak et al. (2013) who report high levels of evidence of interventions for children with cerebral palsy, over 2 years of age. Implications for Rehabilitation High level of evidence to support clinical decision making for the management of tone in young children 0-24 months is not available. The lack of available evidence in the management of tone of young children underpins service delivery and intervention and impacts on patient outcomes. In the absence of clear research evidence, the systematic application of sensitive outcome measures is required to confirm treatment effects and generate new evidence. Hypertonia should not be managed in isolation. Consideration needs to be given to all components of the ICF-CY.
Topics: Age Factors; Cerebral Palsy; Child, Preschool; Humans; Infant; Infant, Newborn; Muscle Tonus
PubMed: 27027325
DOI: 10.3109/09638288.2016.1153162 -
Sensors (Basel, Switzerland) Feb 2022Spasticity is a disabling characteristic of neurological disorders, described by a velocity-dependent increase in muscle tone during passive stretch. During the last few... (Review)
Review
Spasticity is a disabling characteristic of neurological disorders, described by a velocity-dependent increase in muscle tone during passive stretch. During the last few years, many studies have been carried out to assess spasticity using wearable IMU (inertial measurements unit) sensors. This review aims to provide an updated framework of the current research on IMUs wearable sensors in people living with spasticity in recent studies published between 2017 and 2021. A total of 322 articles were screened, then finally 10 articles were selected. Results show the lack of homogenization of study procedures and missing apparatus information in some studies. Still, most studies performed adequately on measures of reporting and found that IMUs wearable data was successful in their respective purposes and goals. As IMUs estimate translational and rotational body motions, we believe there is a strong potential for these applications to estimate velocity-dependent exaggeration of stretch reflexes and spasticity-related characteristics in spasticity. This review also proposes new directions of research that should be challenged by larger study groups and could be of interest to both researchers as well as clinicians. The use of IMUs to evaluate spasticity is a promising avenue to provide an objective measurement as compared to non-instrumented traditional assessments.
Topics: Humans; Motion; Muscle Spasticity; Muscle Tonus; Reflex, Stretch; Wearable Electronic Devices
PubMed: 35270937
DOI: 10.3390/s22051791 -
Progres En Urologie : Journal de... Sep 2020The anal tone allows the maintenance of anorectal continence. Its regulation depends on spinal segmental mechanisms under supra-sacral control.
INTRODUCTION
The anal tone allows the maintenance of anorectal continence. Its regulation depends on spinal segmental mechanisms under supra-sacral control.
MATERIAL AND METHODS
A systematic review was performed using Medline database, according to PRISMA methodology, using following keywords anal tone ; anal sphincter ; anorectal function ; reflex ; digital rectal examination.
RESULTS
Anal hypertonia is an increase in the muscle's resistance to passive stretching. Muscular hypotonia is a decrease in muscle tone. It is associated with a decrease in resistance to passive mobilization. It is not possible to quantify the prevalence of anal tone alterations in the general population and in specific pathological conditions (urinary disorders, neurogenic or non-neurogenic anorectal disorders). In case of hypotonia, most often due to a lower motor neuron lesion, fecal incontinence may occur. Hypertonia (anal sphincter overactivity) is not always due to perineal spasticity. Indeed, in the majority of the cases, the cause of this anal hypertonia in a neurologic context, can be secondary to an upper motor neuron disease due to spinal or encephalic lesion, leading to recto-anal dyssynergia, giving distal constipation. In another way, this anal hypertonia can be purely behavioral, with no direct pathological significance. The evaluation of anal tone is clinical with validated scores but whose sensitivity is not absolute, and instrumental with, on the one hand, the measurement of anal pressure in manometry and, on the other hand, electrophysiological testing which still require validation in this indication.
CONCLUSION
Anal tone assessment is of interest in clinical practice because it gives diagnostic arguments for the neurological lesion and its level, in the presence of urinary or anorectal symptoms.
Topics: Anal Canal; Humans; Muscle Tonus
PubMed: 32636059
DOI: 10.1016/j.purol.2020.06.004 -
Journal of Voice : Official Journal of... Sep 2018The present study aimed to carry out a systematic review of the effects of voice therapy on individuals diagnosed with muscle tension dysphonia (MTD) or hyperfunctional...
The present study aimed to carry out a systematic review of the effects of voice therapy on individuals diagnosed with muscle tension dysphonia (MTD) or hyperfunctional dysphonia. This is a systematic literature review on the databases Medline (via PubMed), Cochrane Library, Scopus, and Lilacs using a search strategy related to the theme of the study. The selection included clinical trials that assessed the effects of speech therapy intervention on patients diagnosed with MTD or hyperfunctional dysphonia published over the last 10 years in Portuguese, English, or Spanish. The Physiotherapy Evidence-Based Database (PEDro) Scale was used to assess the methodology of the studies. Of the 634 publications, 12 studies were included in this review, of which three were excluded due to a low score on the PEDro Scale, resulting in a final number of nine publications. Regarding the techniques approached, semioccluded vocal tract exercises (22.22%), nasal sound and frequency modulation (22.22%), maximum phonation time (MPT) technique and vocal hygiene (11.11%), vocal function exercises (11.11%), respiratory exercises along with phonoarticulatory sounds (11.11%), manual laryngeal therapy (11.11%), and manual laryngeal therapy associated with respiratory exercises (11.11%) were identified. These techniques promoted the following effects: improvement in intraoral and subglottal pressure, positive alterations in the glottal contact quotient, significant changes in fundamental frequency measures, increased MPT, and reduced voice roughness. Methodology was identified to be a shortcoming in the studies. The clinical trials reviewed showed positive results in using the therapeutic techniques selected in the speech therapy approach.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dysphonia; Female; Humans; Male; Middle Aged; Muscle Tonus; Phonation; Recovery of Function; Treatment Outcome; Vocal Cords; Voice Quality; Voice Training; Young Adult
PubMed: 28739332
DOI: 10.1016/j.jvoice.2017.06.015 -
Dermatologic Surgery : Official... Jan 2009The unit equivalence between the two main Botulinum neurotoxin A (BoNTA) preparations, Dysport (Ipsen Ltd., Slough, Berkshire, UK) and BOTOX (Allergan Inc., Irvine, CA),... (Review)
Review
BACKGROUND
The unit equivalence between the two main Botulinum neurotoxin A (BoNTA) preparations, Dysport (Ipsen Ltd., Slough, Berkshire, UK) and BOTOX (Allergan Inc., Irvine, CA), is a matter of discussion. The UK assay used to test Dysport is more sensitive than the U.S. assay used for BOTOX, resulting in a different efficacy per unit in both formulations. Ratios ranging from 6:1 to 1:1 can be found in the literature, but the more recently published literature suggests that 1 unit of BOTOX is equivalent to approximately 2 to 4 units of Dysport (ratio 2:1-4:1).
OBJECTIVE
Because the number of BoNTA treatments is constantly increasing, these differences warrant a systematic review of published evidence about the unit equivalence of UK and U.S. formulations.
METHODS
The review is based on a detailed literature research in all relevant databases (MEDLINE, PubMed, Cochrane Library, specialist textbooks).
RESULTS
The present review supports the recent assumption that dose ratios of less than 3:1 (e.g., 2.5:1 or even 2:1) between Dysport and BOTOX are probably more suitable.
CONCLUSIONS
The current evidence is still insufficient, and further investigation of lower dose ratios is recommended.
Topics: Animals; Botulinum Toxins, Type A; Humans; Hyperhidrosis; Muscle Tonus; Skin; Skin Aging
PubMed: 19018816
DOI: 10.1111/j.1524-4725.2008.34375.x -
Ugeskrift For Laeger Feb 2012Spasticity is a frequently used diagnosis, and anti-spastic medication is used widespread. In this systematic review article we highlight difficulties in diagnosing... (Review)
Review
Spasticity is a frequently used diagnosis, and anti-spastic medication is used widespread. In this systematic review article we highlight difficulties in diagnosing spasticity correctly and thus limit the value of the diagnosis in ensuring the best possible treatment. We review recent neuroscience research and conclude that it is necessary to develop better tools for clinical diagnosis of spasticity in order to avoid potential malpractice and to limit treatment with anti-spastic drugs for patients with documented increased reflex-mediated muscle tone as their main annoyance.
Topics: Concept Formation; Humans; Muscle Relaxants, Central; Muscle Spasticity; Muscle Tonus; Physical Therapy Modalities; Reflex, Abnormal
PubMed: 22369906
DOI: No ID Found -
Advances in Mind-body MedicineMassage is a widely used alternative therapy among health professionals and parents for children with cerebral palsy (CP).
CONTEXT
Massage is a widely used alternative therapy among health professionals and parents for children with cerebral palsy (CP).
OBJECTIVE
The review intended to determine the effects of massage on the rehabilitation of children with CP.
DESIGN
The research team conducted a literature review that examined the use of massage for children with various types of CP, such as ataxia, using relevant keywords. It included articles published up to December 2019. The research team searched the electronic databases PubMed, MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials.
SETTING
The study took place at Eastern Mediterranean University in Famagusta, Cyprus.
PARTICIPANTS
Participants in the reviewed studies were children with CP.
OUTCOME MEASURES
The strength of the research designs was rated using Sackett's Levels of Evidence. The Physiotherapy Evidence Database (PEDro) scale was used to assess the studies' methodological quality. The outcome measures were classified according to the International Classification of Functioning, Disability, and Health (ICF).
RESULTS
Eleven studies that included 297 CP children were reviewed. According to the PEDro scores, 5 studies had high methodological quality; 5 studies had fair quality; and one study had poor quality. No study investigated the effects of massage for all classifications of the ICF. Muscle tone was decreased significantly in the reviewed studies, either between the groups or within the massage group (P < .05). No consensus existed about the other effects of massage due to the limited research.
CONCLUSIONS
This study is a first review in this area and can be an important guide for professionals and caregivers who want properly use massage for children with CP. Massage as an adjunct to traditional therapies should be used to reduce muscle tone in spastic-type CP. More clear methods and relevant outcome measures should be used in future studies. Further studies with randomized controlled trials are required to determine massage type, massage applier, and oil for this population and to investigate immediate and long-term effects of massage on all ICF's domains.
Topics: Cerebral Palsy; Child; Cyprus; Humans; Massage; Muscle Tonus; Physical Therapy Modalities
PubMed: 32822329
DOI: No ID Found -
Clinical Rehabilitation Nov 2020To investigate the effects of cycling with functional electrical stimulation on walking, muscle power and tone, balance and activities of daily living in subacute stroke... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the effects of cycling with functional electrical stimulation on walking, muscle power and tone, balance and activities of daily living in subacute stroke survivors.
DATA SOURCES
Ten electronic databases were searched from inception to February 2020.
REVIEW METHODS
Inclusion criteria were: subacute stroke survivors (<6 months since stroke), an experimental group performing any type of cycling training with electrical stimulation, alone or in addition to usual care, and a control group performing usual care alone. Two reviewers assessed eligibility, extracted data and analyzed the risks of bias. Standardized Mean Difference (SMD) or Mean Difference (MD) with 95% Confidence Intervals (CI) were estimated using fixed- or random-effects models to evaluate the training effect.
RESULTS
Seven randomized controlled trials recruiting a total of 273 stroke survivors were included in the meta-analyses. There was a statistically significant, but not clinically relevant, effect of cycling with electrical stimulation compared to usual care on walking (six studies, SMD [95% CI] = 0.40 [0.13, 0.67]; = 0.004), capability to maintain a sitting position (three studies, MD [95% CI] = 7.92 [1.01, 14.82]; = 0.02) and work produced by the paretic leg during pedaling (2 studies, MD [95% CI] = 8.13 [1.03, 15.25]; = 0.02). No significant between-group differences were found for muscular power, tone, standing balance, and activities of daily living.
CONCLUSIONS
Cycling training with functional electrical stimulation cannot be recommended in terms of being better than usual care in subacute stroke survivors. Further investigations are required to confirm these results, to determine the optimal training parameters and to evaluate long-term effects.
Topics: Activities of Daily Living; Bicycling; Electric Stimulation; Humans; Muscle Strength; Muscle Tonus; Postural Balance; Stroke Rehabilitation
PubMed: 32613859
DOI: 10.1177/0269215520938423