The latest medical research on Neurology
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about neurology gathered by our medical AI research bot.
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Upper limb impairments, process skills, and outcome in children with unilateral cerebral palsy.Cerebral Palsy
To examine the relationships between upper limb impairments and independence in self-care (ISC) in children with unilateral cerebral palsy (CP).
One hundred and eight children with unilateral CP (46 females, 62 males; mean age 8y 7mo, SD 3y 9mo) recruited from a population register were assessed for upper limb muscle power, spasticity, sensation, motor control, and process skills, and for ISC as the functional outcome using structural equation modelling.
The model showed good fit indices and explained 90% of the variance in ISC. Direct effects were significant between manual ability and ISC (β=0.47), and process skills and ISC (β=0.63). Sensation had a significant positive indirect effect on ISC through manual ability (β=0.24) and a positive but marginally non-significant indirect effect through process skills (β=0.21, bootstrapped 95% confidence interval -0.05 to 0.55). Spasticity had a significant negative indirect effect on ISC through its effect on manual ability (β=-0.21). Age had a significant positive indirect effect on ISC, as did intellect, through their effect on process skills (β=0.34 and 0.21 respectively).
Process skills and manual ability most strongly positively influence independence in self-care (ISC) in children with unilateral cerebral palsy. Sensation influences ISC through manual ability and process skill.
Characterization of torque generating properties of ankle plantar flexor muscles in ambulant adults with cerebral palsy.Cerebral Palsy
Weakness of plantar flexor muscles is related to reduced push-off and forward propulsion during gait in persons with cerebral palsy (CP). It has not been clarified to what an extent altered muscle contractile properties contribute to this muscle weakness. Here, we investigated the torque generating capacity and muscle fascicle length in the triceps surae muscle throughout ankle range of motion (ROM) in adults with CP using maximal single muscle twitches elicited by electrical nerve stimulation and ultrasonography.
Fourteen adults with CP (age 36, SD 10.6, GMFCS I-III) and 17 neurological intact (NI) adults (age 36, SD 4.5) participated. Plantar flexor torque during supramaximal stimulation of the tibial nerve was recorded in a dynamometer at 8 ankle angles throughout ROM. Medial gastrocnemius (MG) fascicle length was tracked using ultrasonography.
Adults with CP showed reduced plantar flexor torque and fascicle shortening during supramaximal stimulation throughout ROM. The largest torque generation was observed at the ankle joint position where the largest shortening of MG fascicles was observed in both groups. This was at a more plantarflexed position in the CP group.
Reduced torque and fascicle shortening during supramaximal stimulation of the tibial nerve indicate impaired contractile properties of plantar flexor muscles in adults with CP. Maximal torque was observed at a more plantarflexed position in adults with CP indicating an altered torque-fascicle length/ankle angle relation. The findings suggest that gait rehabilitation in adults with CP may require special focus on improvement of muscle contractility.
Emergent Prophylactic, Reparative and Restorative Brain Interventions for Infants Born Preterm With Cerebral Palsy.Cerebral Palsy
Worldwide, an estimated 15 million babies are born preterm (<37 weeks' gestation) every year. Despite significant improvements in survival rates, p...
Experiences of children and parents in MiYoga, an embodied mindfulness yoga program for cerebral palsy: A mixed method study.Cerebral Palsy
A mindfulness yoga program (MiYoga) was developed and trialled with children with cerebral palsy and their parents. This mixed-method study explores the experiences of children and parents who participated in MiYoga, to assess its acceptability, feasibility and implementation.
Of the forty-two child-parent dyads who participated in the MiYoga randomised control trial, 19 children and 22 parents were interviewed individually in a semi-structured way about their experiences of MiYoga. Participants rated their mood on a 5-point scale before and after each session and completed short questionnaires at the end of each session.
Children and parents reported improved mood after each MiYoga session. Parents reported being more aware of their thoughts and feelings and possibly became more aware of their day-to-day mindlessness.
MiYoga significantly improved children and parents' mood. Parents reported gains in awareness as well as challenges of adhering to the home practice.
Paediatric emergency department presentations due to feeding tube complications in children with cerebral palsy.Cerebral Palsy
To describe the characteristics of emergency department (ED) presentations due to complications from gastrostomy or gastrojejunal feeding tubes among children with cerebral palsy (CP), the complexity of complications and the management approaches taken.
The Victorian CP Register was linked to the ED databases of Victoria's two tertiary paediatric hospitals, and data on presentations due to feeding tube complications were identified based on discharge diagnosis codes. Additional data on presentations were extracted from medical records.
Over 5 years, there were 234 ED presentations due to feeding tube-related complaints among a CP cohort (n = 2183). ED notes were located for 183 of the 234 presentations. The majority of presentations (90%) involved children with severe gross motor impairment. A total of 46% of presentations (n = 84) was triaged as lower urgency, and 68% (n = 124) took place between 08:00 am and 06:00 pm. The most common presenting complaint was tube dislodgement (n = 105; 70%). No investigations were recorded in the majority of cases, and in almost 90% of cases, the feeding tube was successfully replaced in the ED, usually by an ED physician (n = 74) and less frequently by a surgeon (n = 9), gastroenterologist (n = 2) or nurse (n = 8); 9% (n = 17) resulted in a hospital admission.
Most ED presentations due to feeding tube complaints in children with CP are in children with severe gross motor impairment but are able to be managed in the ED. As such, it is likely that care givers and other health professionals could manage some of the complications experienced in primary health-care settings closer to home.
Do adolescents with cerebral palsy meet recommendations for healthy weight and physical activity behaviours?Cerebral Palsy
Describe physical activity energy expenditure, body composition, and nutritional intake in adolescents with cerebral palsy (CP) in the context of health recommendations.
A cross-sectional study of 12 adolescents, aged 12-19 years, with CP, classified as Gross Motor Function Classification System levels II-V. Actiheart® accelerometry assessed daily physical activity energy expenditure; Dual Energy X-ray Absorptiometry (DXA) and skinfold assessment measured percentage body fat; the Modified Nutrition Questionnaire for children aged 12-18 years assessed nutritional intake.
These adolescents spent per day a median of 413.3 min in sedentary (range: 90.0-621.9), 206.2 min in light activity (range: 48.4-509.5), and 65.5 min in moderate-vigorous physical activity (MVPA) (range: 9.4-363.9). Sixty-four percent of the participants met guidelines for time spent in MVPA, only one participant (9%) met the target for sedentary behaviour, and one (9%) participant reached all of the nutritional targets. Participants had a median percentage body fat of 43% by DXA and 40.3% by skinfold assessment. Seventy-three percent of the participants were classed as having a potentially unhealthy body composition according to percentage body fat.
Adolescents with CP may have a high percentage body fat, and high levels of both sedentary activity and moderate-vigorous physical activity. Implications for rehabilitation Cerebral palsy specific strategies to decrease time in sedentary activity need to be determined as adolescents were not meeting national guidelines, however, most did meet guidelines for time spent in moderate to vigorous physical activity. Percentage body fat should be monitored in adolescents with cerebral palsy, as adolescents with cerebral palsy tend to have a high body fat ratio, despite some recording Body Mass Index within a healthy range. Triceps and subscapular skinfold assessment accurately assess percentage body fat in adolescents with cerebral palsy.
Normative data of muscle fiber diameter of vastus lateralis during childhood: a field test.Cerebral Palsy
Currently, our knowledge of standard data for muscle morphology in children is largely limited to the 1969 paper of Brooke and Engel (BE). In 2016 we reported normal muscle morphology from vastus lateralis biopsies in ambulant children with cerebral palsy (CP). This report compares our normal biopsy results against BE standard value criteria.
A single blind prospective cross-sectional study design.
Biopsies taken in ambulant children with CP were normal on morphometry, light and electron microscopy, however only 5 of 10 fulfilled the BE standard value criteria.
This short report highlights the need for contemporary age specific normative data from a larger number of biopsies, including typically developing children. Review of the literature suggests biopsy material may be available from typically developing children who were control patients in research trials. This morphometric data could contribute to expanding the normative data set. This article is protected by copyright. All rights reserved.
Small interstitial 9p24.3 deletions principally involving KANK1 are likely benign copy number variants.Cerebral Palsy
A small heterozygous deletion involving KANK1 was originally reported in 2005 to cause cerebral palsy in one large Israeli family of Jewish Morocca...
The Role of Wearable Devices in Multiple Sclerosis.Multiple Sclerosis International
Multiple sclerosis (MS) is the most common neurological disorder in young adults. The prevalence of walking impairment in people with MS (pwMS) is ...
What Are the Participants' Perspectives of Taking Melatonin for the Treatment of Nocturia in Multiple Sclerosis? A Qualitative Study Embedded within a Double-Blind RCT.Multiple Sclerosis International
Multiple Sclerosis (MS) is a chronic neurological disorder caused by neurodegeneration within the central nervous system. It results in impaired physical, cognitive, and psychological functioning and can also lead to lower urinary tract symptoms including nocturia. While clinical trials have suggested an association between nocturia and melatonin secretion, to our knowledge, no qualitative research has been conducted on the experience of taking melatonin to treat nocturia in progressive MS within a clinical trial.
17 semistructured qualitative interviews were conducted as part of a double-blind, randomised, placebo controlled, crossover, clinical trial with consenting adults with MS. Interviews explored participants' experiences of nocturia associated with MS and their experience of taking melatonin as a trial treatment for nocturia versus a placebo. Data was analysed using a thematic analysis.
Themes on the experience of nocturia revealed participants' understandings of nocturia, the impact it had on their night, and increased daily fatigue. Themes on the intervention showed perceived improvements to nocturia, sleep, and energy and negative effects including lethargy, a lack of significant change, and physical side effects including vivid dreams.
This qualitative exploration revealed an association between nocturia and increased levels of fatigue during the day by those with MS. However, perspectives towards the effectiveness of melatonin as a potential treatment varied as both placebo and melatonin were perceived as having very similar effects.
Anti-Myelin Oligodendrocyte Glycoprotein and Human Leukocyte Antigens as Markers in Pediatric and Adolescent Multiple Sclerosis: on Diagnosis, Clinical Phenotypes, and Therapeutic Responses.Multiple Sclerosis International
Early-onset (pediatric and adolescent) multiple sclerosis (MS) is a well-established demyelinating disease that accounts for approximately 3-5% of ...
Effects of Rehabilitation on Gait Pattern at Usual and Fast Speeds Depend on Walking Impairment Level in Multiple Sclerosis.International Journal MS Care
Physical rehabilitation can improve walking capacity in persons with multiple sclerosis (MS). However, changes in spatiotemporal gait parameters after rehabilitation are not frequently evaluated, and it is unknown to what extent potential effects depend on baseline disability level. The objective was to investigate the effectiveness of rehabilitation programs on gait parameters at usual and fastest speeds in persons with MS categorized according to walking speed.
This nonrandomized multinational study in "real-world" settings evaluated participants before and after conventional rehabilitation. Outcome measurements included spatiotemporal gait parameters assessed by an electronic walkway (at usual and fastest speeds), walking capacity tests (Timed 25-Foot Walk test, 2-Minute Walk Test, 6-Minute Walk Test), and the patient-reported 12-item Multiple Sclerosis Walking Scale. Patients were allocated into three subgroups based on walking speed (<0.82 m/s and >1.14 m/s) and MS center. Results were calculated for the total group and subgroups.
Forty-two persons with MS (26 women; mean ± SD age, 44.6 ± 11.0 years; mean ± SD Expanded Disability Status Scale score, 3.5 ± 1.5) receiving rehabilitation treatment were enrolled. After rehabilitation treatment, the group demonstrated a significant decrease in double support time and an increase in stride length and step length (left leg) at usual and fastest speeds. Velocity and step length (right leg) increased only at usual speed. Subgroup analysis revealed greatest and clinically meaningful improvements in more disabled persons with MS.
Physical rehabilitation induced changes in spatiotemporal gait parameters in persons with MS. The magnitude of improvement was greater in participants with more walking impairment.