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Impact of thermo-tactile stimulation on the speed and efficiency of swallowing: a systematic review.International Journal of Language &... Jul 2018A delayed or absent swallow reflex is common in dysphagia and can have a significant impact on swallow safety. Recent clinical practice survey data have supported the...
BACKGROUND
A delayed or absent swallow reflex is common in dysphagia and can have a significant impact on swallow safety. Recent clinical practice survey data have supported the fact that clinicians continue to use thermo-tactile stimulation (TTS) as a strategy to stimulate key nerve pathways and evoke a swallow reflex for patients with a delayed or absent swallow reflex.
AIMS
To conduct a systematic review of the effectiveness of TTS as a compensatory and/or rehabilitative tool.
METHODS & PROCEDURES
A search performed on CINAHL, Medline and Speech Bite identified 599 articles. After removing duplicates, the titles and abstracts of 458 articles were assessed for eligibility; 426 articles were deemed to be clearly ineligible and the remaining 32 full-text articles were further screened for inclusion. Ten of these studies were included in this review.
MAIN CONTRIBUTION
The results of this review highlight the lack of available evidence in this area and give support to the view that there is only low-level evidence for use of TTS as a compensatory strategy immediately before a swallow.
CONCLUSIONS & IMPLICATIONS
There is low-level evidence to support the use of TTS. Current best practice would be to use TTS on a case-by-case basis, following detailed instrumental assessment and evaluation of its efficacy for an individual.
Topics: Deglutition; Deglutition Disorders; Humans; Physical Stimulation; Reflex; Temperature; Touch
PubMed: 29566298
DOI: 10.1111/1460-6984.12384 -
Pediatric Neurology Jun 2017CAPOS syndrome (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) is a rare disease that has been reported in 22 patients so far.... (Review)
Review
BACKGROUND
CAPOS syndrome (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) is a rare disease that has been reported in 22 patients so far. In all cases, the mutation c.2452G>A (p.Glu818Lys) in the ATP1A3 gene was identified. Patients typically present at an early age with an acute-onset fever-induced episode of ataxia frequently associated with encephalopathy and weakness. They usually present one to three episodes. The acute symptoms improve within days, but most patients show slow progression afterward.
METHODS
We describe three new patients, a woman and her two sons diagnosed with CAPOS syndrome. A systematic review of literature on previously reported patients was performed.
RESULTS
The first son presented with acute-onset ataxia, encephalopathy, and sensorineural hearing loss, induced by febrile illness. The second one developed generalized areflexia and mild instability without an acute episode. The mother had been previously diagnosed with sensorineural hearing loss and optic nerve atrophy. The c.2452G>A mutation in ATP1A3 was found in all three patients.
CONCLUSION
Only 25 Individuals with CAPOS syndrome have been reported, including our family. This is the first time a Spanish family has been described. The fact that both siblings were assessed before the first acute-onset episode contributes to the description of early symptoms and signs of the disease, which could aid early diagnosis and management before the onset of acute episodes.
Topics: Adult; Ataxia; Cerebellar Ataxia; Child; Early Diagnosis; Family; Female; Foot Deformities, Congenital; Hearing Loss, Sensorineural; Humans; Male; Optic Atrophy; Reflex, Abnormal
PubMed: 28483396
DOI: 10.1016/j.pediatrneurol.2017.01.009 -
Developmental Medicine and Child... Mar 2016The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for... (Review)
Review
The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for developmental problems such as cerebral palsy (CP). A literature search was performed using the databases PubMed, Embase, Web of Science, and AMED. Papers on infantile reactions ('primitive reflexes') and postural reactions were included if data were available allowing for calculation of sensitivity, specificity, or positive and negative predictive value for CP or atypical developmental outcome. Our search identified 23 articles on 20 different neurological signs. Properties of six neurological signs were reported in at least three different papers. The data indicated that, in early infancy, an absent Moro or plantar grasp response may be predictive for adverse developmental outcome. After early infancy, persistence of the Moro response and asymmetric tonic neck reflex was clinically significant. Prediction of a delayed emergence of the parachute reaction increases with age. Abnormal performances on the pull-to-sit manoeuvre and vertical suspension test have predictive significance throughout infancy. The neurological signs reviewed have some predictive value in infants at risk. For most of the signs, criteria for abnormality and significance are age-dependent.
Topics: Cerebral Palsy; Humans; Infant; Neurologic Examination; Predictive Value of Tests
PubMed: 27027608
DOI: 10.1111/dmcn.13051 -
International Journal of Oral and... Mar 2016Temporomandibular joint luxation (TMJ) is the excessive anterior translation of the mandibular condyle out of its normal range of movement and away from the glenoid... (Review)
Review
Temporomandibular joint luxation (TMJ) is the excessive anterior translation of the mandibular condyle out of its normal range of movement and away from the glenoid fossa. Once dislocation occurs, the abnormal condylar position generates reflex contractions of the masticatory muscles, which in turn hinder movement of the condyle back to its resting position. Frequent luxation episodes characterize a condition referred to as recurrent TMJ luxation. While there are several surgical and conservative therapeutic options available for recurrent TMJ luxation, a robust, evidence-based rationale for choosing one technique over another is missing. Thus, a systematic review based on the PRISMA statement was proposed in an attempt to determine which therapeutic option results in the longest time to relapse. There is no good quality evidence on which treatment options guarantee the long-term elimination of recurrent TMJ luxation. In cases of post-surgical relapse, eminectomy has often been used as a 'rescue procedure', which may mean that surgeons empirically consider this treatment to be the 'gold standard' for addressing recurrent TMJ luxation.
Topics: Humans; Joint Dislocations; Mandibular Condyle; Recurrence; Temporomandibular Joint Disorders
PubMed: 26616027
DOI: 10.1016/j.ijom.2015.10.022 -
International Archives of Occupational... Feb 2016In the occupational environment, there are a considerable number of stressors that can affect physical performance in job tasks. Whole-body vibration (WBV), which arises... (Review)
Review
INTRODUCTION
In the occupational environment, there are a considerable number of stressors that can affect physical performance in job tasks. Whole-body vibration (WBV), which arises from vehicle transit, is one such stressor that has been demonstrated to alter human function in several ways. This study identifies the known physical changes to human function which result from WBV, to comment on changes which may translate to performance in physically demanding occupational tasks.
METHODS
A systematic review is performed on the literature relating to changes in the neuromuscular, physiological and biomechanical properties of the human body, when exposed to WBV. Selection criteria are constructed to synthesise articles which strictly relate to in-vehicle WBV and physical responses.
RESULTS
In total, 29 articles were identified which satisfied the criteria for inclusion. A range of physical responses produced from WBV are presented; however, little consistency exists in study design and the responses reported.
DISCUSSION
Given the inconsistency in the reported responses, the precise changes to human function remain unknown. However, there is sufficient evidence to warrant the design of studies which investigate occupationally relevant physical performance changes following WBV.
Topics: Heart Rate; Humans; Muscle Fatigue; Muscle, Skeletal; Occupational Exposure; Postural Balance; Reflex, Abnormal; Respiratory Function Tests; Vibration
PubMed: 26012875
DOI: 10.1007/s00420-015-1062-x -
Seminars in Arthritis and Rheumatism Dec 2014Rheumatoid arthritis (RA) is a chronic inflammatory condition with increased all-cause and cardiovascular mortality. Accumulating evidence indicates that the immune and... (Review)
Review
OBJECTIVES
Rheumatoid arthritis (RA) is a chronic inflammatory condition with increased all-cause and cardiovascular mortality. Accumulating evidence indicates that the immune and autonomic nervous systems (ANS) are major contributors to the pathogenesis of cardiovascular disease. We performed the first systematic literature review to determine the prevalence and nature of ANS dysfunction in RA and whether there is a causal relationship between inflammation and ANS function.
METHODS
Electronic databases (MEDLINE, Central and Cochrane Library) were searched for studies of RA patients where autonomic function was assessed.
RESULTS
A total of 40 studies were included. ANS function was assessed by clinical cardiovascular reflex tests (CCTs) (n = 18), heart rate variability (HRV) (n = 15), catecholamines (n = 5), biomarkers of sympathetic activity (n = 5), sympathetic skin responses (n = 5), cardiac baroreflex sensitivity (cBRS) (n = 2) and pupillary light reflexes (n = 2). A prevalence of ~60% (median, range: 20-86%) of ANS dysfunction (defined by abnormal CCTs) in RA was reported in 9 small studies. Overall, 73% of studies (n = 27/37) reported at least one of the following abnormalities in ANS function: parasympathetic dysfunction (n = 20/26, 77%), sympathetic dysfunction (n = 16/30, 53%) or reduced cBRS (n = 1/2, 50%). An association between increased inflammation and ANS dysfunction was found (n = 7/19, 37%), although causal relationships could not be elucidated from the studies available to date.
CONCLUSIONS
ANS dysfunction is prevalent in ~60% of RA patients. The main pattern of dysfunction is impairment of cardiovascular reflexes and altered HRV, indicative of reduced cardiac parasympathetic (strong evidence) activity and elevated cardiac sympathetic activity (limited evidence). The literature to date is underpowered to determine causal relationships between inflammation and ANS dysfunction in RA.
Topics: Adult; Arthritis, Rheumatoid; Autonomic Nervous System; Autonomic Nervous System Diseases; Cardiovascular Diseases; Female; Humans; Immune System; Male; Middle Aged; Prevalence
PubMed: 25151910
DOI: 10.1016/j.semarthrit.2014.06.003 -
Laryngo- Rhino- Otologie Jul 2014Laryngeal Adductor Reflex Background: A rapid closure of the vocal folds is necessary, whenever foreign materials or food particles penetrate into the larynx. Otherwise... (Review)
Review
BACKGROUND
Laryngeal Adductor Reflex Background: A rapid closure of the vocal folds is necessary, whenever foreign materials or food particles penetrate into the larynx. Otherwise a passage of these particles into the trachea or the lower respiratory tract would be imminent. An aspiration could mechanically block the respiratory tract and cause severe dyspnoea or cause aspiration pneumonia.
METHOD
For this systematic review a selective literature research in PubMed and Scopus using the keywords "laryngeal adductor reflex" and "vocal fold closure" has been carried out.
RESULTS
Apart from the oesophago-glottal and pharyngo-glottal closure reflexes, the laryngeal adductor reflex (LAR) has been investigated in particular. The LAR qualifies as a reflectory laryngeal adductor mechanism and involves early, presumably di- or oligosynaptic ipsilateral LAR1 as well as late polysynaptic ipsi- and contralateral LAR2 components. In clinical routine diagnostic settings of dysphagia, LAR is only assessed qualitatively and usually triggered by air pulses or tactile stimulation.
DISCUSSION
Dysphagiologists often find that not only the laryngeal sensibility in general is impaired, but especially the protective laryngeal adduction mechanism, which results in a higher risk of aspiration. Thus, it appears mandatory to test the LAR not only qualitatively but also quantitatively. Unfortunately a valid and reliable method that can be employed in clinical practice has not yet been put forward.
Topics: Deglutition; Deglutition Disorders; Gagging; Humans; Pneumonia, Aspiration; Reference Values; Reflex, Abnormal; Vocal Cords
PubMed: 24999664
DOI: 10.1055/s-0034-1370928 -
Pediatric Neurology Sep 2013There have been very few studies concerning the Babkin reflex-opening of the mouth and flexion of the arms in response to stimulation of the palms. We attempted to... (Review)
Review
BACKGROUND
There have been very few studies concerning the Babkin reflex-opening of the mouth and flexion of the arms in response to stimulation of the palms. We attempted to clarify the clinical significance and neural mechanism of the reflex through systematic review.
METHODS
Searches were conducted on Medline, Embase, and Google Scholar from their inception through August 2012.
RESULTS
In normal term infants, the Babkin reflex can be elicited from the time of birth, becomes increasingly suppressed with age, and disappears in the great majority by the end of the fifth month of age. A marked response in the fourth or fifth month of age and persistence of the reflex beyond the fifth month of age are generally regarded as abnormal. On the other hand, because there are some normal infants showing no response during the neonatal period or early infancy, the absence of the response during these periods is not necessarily an abnormal finding.
CONCLUSIONS
Infants with these abnormal findings should be carefully observed for the appearance of neurological abnormalities including cerebral palsy and mental retardation. It is most likely that the Babkin reflex is mediated by the reticular formation of the brainstem, which receives inputs from the nonprimary motor cortices. On the basis of the hand-mouth reflex, more adaptive movement develops as control of the nonprimary motor cortices over the reflex mechanism in the reticular formation increases. Soon it evolves into the voluntary eye-hand-mouth coordination necessary for food intake as the control of the prefrontal cortex over the nonprimary motor cortices becomes predominant.
Topics: Brain; Humans; Infant; Neural Pathways; Reflex, Babinski
PubMed: 23953951
DOI: 10.1016/j.pediatrneurol.2013.04.005 -
Ophthalmology Nov 2013To assess the accuracy of using pupillary light reflex (PLR) in detecting glaucoma. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the accuracy of using pupillary light reflex (PLR) in detecting glaucoma.
CLINICAL RELEVANCE
Glaucoma is a specific disease of the optic nerve and is often more severe in 1 eye. When large enough, this asymmetry in disease severity can cause a relative afferent pupillary defect (RAPD). Better detection of RAPDs may be one way to identify persons with glaucoma.
METHODS
We searched Medline and Embase through June 2012 and searched bibliographies for relevant studies for additional references. Two authors independently reviewed all articles and selected studies that assessed PLRs in patients with glaucoma. We analyzed data using mixed-effect bivariate summary receiver operating characteristic meta-analysis models.
RESULTS
A total of 30 studies were included in this review. An RAPD was observed in 9% to 82% of patients with glaucoma. Eleven studies with a total of 7271 participants were included in the analysis, and the pooled estimate corresponded to a sensitivity of 0.63 (95% confidence interval [CI], 0.43-0.80) and a specificity of 0.93 (95% CI, 0.85-0.97). After excluding 2 studies that used the swinging flashlight test, the sensitivity increased to 0.74 (95% CI, 0.59-0.85) with a specificity of 0.85 (95% CI, 0.77-0.90). Study designs and different pupil measurement techniques explained part of the heterogeneity between studies.
CONCLUSIONS
Patients with glaucoma frequently have an abnormal PLR and comparing the responses between the 2 eyes can in part distinguish between those with glaucoma and those without the disease. Newer instruments and analytic approaches to assess pupil function may improve the performance of pupil screening.
Topics: Databases, Factual; Glaucoma; Humans; Pupil; Pupil Disorders; ROC Curve; Reflex, Pupillary; Reproducibility of Results
PubMed: 23809274
DOI: 10.1016/j.ophtha.2013.04.012 -
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