• Title/Summary/Keyword: Neuromuscular function

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The Effects of Sera from Amyotrophic Lateral Sclerosis Patients on Neuromuscular Transmission and Calcium Channels in Mice

  • Yan, Hai-Dun;Kim, Ji-Mok;Jung, Sung-Jun;Kim, Jun
    • The Korean Journal of Physiology and Pharmacology
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    • v.3 no.1
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    • pp.101-117
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    • 1999
  • Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease of unknown etiology in which the upper and lower motor neurons are progressively destroyed. Recent evidences support the role of autoimmune mechanisms in the pathogenesis of ALS. This study investigated the effects of sera from ALS patients on neuromuscular transmission in phrenic nerve-hemidiaphragm preparations and on calcium currents of single isolated dorsal root ganglion (DRG) cells in mice. Mice were injected with either control sera from healthy adults or ALS sera from 18 patients with ALS of sporadic form, for three days. Miniature end plate potential (MEPP) and nerve-evoked end plate potential (EPP) were measured using intracellular recording technique and the quantal content was determined. Single isolated DRG cells were voltage-clamped with the whole-cell configuration and membrane currents were recorded. Sera from 14 of 18 ALS patients caused a significant increase in MEPP frequency in normal Ringer's solution $(4.62{\pm}0.14\;Hz)$ compared with the control $(2.18{\pm}0.15\;Hz).$ In a high $Mg^{2+}/low\;Ca^{2+}$ solution, sera from 13 of 18 ALS patients caused a significant increase in MEPP frequency, from $2.18{\pm}0.31$ Hz to $6.09{\pm}0.38$ Hz. Sera from 11 of 18 patients produced a significant increase of nerve-evoked EPP amplitude, from $0.92{\pm}0.05$ mV to $1.30{\pm}0.04$ mV, while the other seven ALS sera did not alter EPP amplitude. In the ALS group, EPP quantal content was also elevated by the sera of 14 patients (from $1.49{\pm}0.07$ to $2.35{\pm}0.07).$ MEPP frequency and amplitude in wobbler mouse were $4.03{\pm}0.53$ Hz and $1.37{\pm}0.18$ mV, respectively, which were significantly higher than those of wobbler controls (wobblers without the symptoms of wobbler). Sera from ALS patients significantly reduced HVA calcium currents of DRG cells to 42.7% at -10 mV. Furthermore, the inactivation curve shifted to more negative potentials with its half-inactivation potential changed by 6.98 mV. There were, however, significant changes neither in the reversal potential of $I_{Ca}$ nor in the I-V curve. From these results it was concluded that: 1) The serum factors of sporadic ALS patients increase neuromuscular transmission and can alter motor nerve terminal presynaptic function. This suggests that ALS serum factors may play an important role in the early stage of ALS, and 2) Calcium currents in DRG cells were reduced and rapidly inactivated by ALS sera, suggesting that in these cells, ALS serum factors may exert interaction with the calcium channel.

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Effect of Oral Motor Facilitation Technique (OMFT) and Neuromuscular Electrical Stimulation (NMES) Applied to a Patient With Wallenberg's Syndrome: A Case Study (발렌버그 증후군(Wallenberg's Syndrome) 환자에게 적용한 구강운동촉진기술(OMFT)과 신경근전기자극치료(Neuromusclular Electrical Stimulation; NMES) 효과: 단일 사례 연구)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.69-83
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    • 2022
  • Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

The Correlation between Physical Function and Lower Limb Tactile Sense in Children with Spastic Cerebral Palsy (경직형 뇌성마비 아동의 신체기능과 하지 촉각의 상관관계 연구)

  • Hye-Lyeong Yun;Na-Yeon YE;Eun-Ju Lee
    • PNF and Movement
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    • v.21 no.2
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    • pp.265-272
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    • 2023
  • Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

Study on the correlation of KWOMAC Index(pain, stiffness, physical function) with knee Osteoarthritic patients (퇴행성 슬관절염 환자의 KWOMAC 항목간의 상관관계 연구)

  • Hwang-Bo, Gak;Bae, Sung-soo
    • PNF and Movement
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    • v.2 no.1
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    • pp.1-12
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    • 2004
  • Purpose : The purpose of this study is to demonstrate the correlation of pain, stiffness, and physical function by analyizing the KWOMAC socre of the patients with degenerative knee OA, is the most common disease among senior population. Method : 100 degenerative knee OA patients, diagnosed at the hostpital or clinic located in Degu and Kyung-buk province were participated in the study. Result : This study results in following conclusions. 1. Degenerative knee OA patients complained the pain going up or down stairs, stiffness after getting up in the morning. immediately. 2. They also had significant difficulty ascending or decending stairs, getting in or out of car, rising from sitting, doing chores. 3. There was the high correlation among pain, stiffness, physical function. Conclusions : It may provide information to assess the ADL of knee OA patients and the exercise, outcome for their independent life effectly.

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Molecular mechanisms and therapeutic interventions in sarcopenia

  • Park, Sung Sup;Kwon, Eun-Soo;Kwon, Ki-Sun
    • Osteoporosis and Sarcopenia
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    • v.3 no.3
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    • pp.117-122
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    • 2017
  • Sarcopenia is the degenerative loss of muscle mass and function with aging. Recently sarcopenia was recognized as a clinical disease by the International Classification of Disease, 10th revision, Clinical Modification. An imbalance between protein synthesis and degradation causes a gradual loss of muscle mass, resulting in a decline of muscle function as a progress of sarcopenia. Many mechanisms involved in the onset of sarcopenia include age-related factors as well as activity-, disease-, and nutrition-related factors. The stage of sarcopenia reflecting the severity of conditions assists clinical management of sarcopenia. It is important that systemic descriptions of the disease conditions include age, sex, and other environmental risk factors as well as levels of physical function. To develop a new therapeutic intervention needed is the detailed understanding of molecular and cellular mechanisms by which apoptosis, autophagy, atrophy, and hypertrophy occur in the muscle stem cells, myotubes, and/or neuromuscular junction. The new strategy to managing sarcopenia will be signal-modulating small molecules, natural compounds, repurposing of old drugs, and muscle-specific microRNAs.

Effects of Trunk Pattern Exercise in Proprioceptive Neuromuscular Facilitation Integrated Transcranial Direct Current Stimulation on Function of Lower extremity in Stroke Patients (고유수용성신경근촉진법의 체간 패턴 운동을 병행한 경두개직류자극이 뇌졸중 환자의 하지 기능에 미치는 영향)

  • Cho, Hyuk-Shin;Cha, Hyun-Gyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.11
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    • pp.6767-6773
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    • 2014
  • The study examined the effects of trunk pattern exercise in proprioceptive neuromuscular facilitation (PNF) integrated transcranial direct current stimulation (tDCS) on the muscle activity and balance, walking speed in stroke patient. Thirty-one patients with hemiplegia due to stroke were assigned to either the experimental group (n=15) or control group (n=16). Both groups performed trunk pattern training in PNF for 3 times per week over a 6 week period for 20 minutes per session. The experimental group performed additional tDCS for 20 minutes. A comparison of the two groups after the intervention showed that the exercise program in experimental group had a more significant on the gastrocnemius, tibialis anterior and balance than the control group (p<.05). This showed that trunk pattern exercise in PNF integrated tDCS had a positive effect on the functional recovery of the lower extremity in stroke patients.

The effect of hip joint strengthening exercise using proprioceptive neuromuscular facilitation on balance, sit to stand and walking ability in a person with traumatic brain injury: a case report

  • Jung, Du Kyo;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.96-104
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    • 2017
  • Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

The Effect of Closed Kinetic Chain Exercise Using PNF on Hand Function and Activities of Daily Living of Patient with Incomplete Spinal Cord Injure : Single Subject Design (PNF를 이용한 닫힌사슬운동이 불완전 경수 손상 환자의 손 기능과 일상생활동작에 미치는 영향 : 단일사례연구)

  • Jung, Du-Kyo;Lee, Jae-Han
    • PNF and Movement
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    • v.12 no.1
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    • pp.45-50
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    • 2014
  • Purpose: Deficits in upper-extremity function in individuals with tetraplegia are primarily due to the loss of motor pathways. The purpose of this case report is to describe the effect of closed kinetic chain exercise using PNF on hand function and ADL of patient with incomplete spinal cord injure. Methods: Patient was a 53-year-old man with C4 tetraplegia and hand and upper extremity impairment who participated in this training intervention for 10 weeks. Results: Patient demonstrated improvements in upper extremity strength, hand function and performance of ADL. Outcome measures(ASIA motor scale, Hand power, Jebsen-Taylor Hand Function test, SCIM) were measured before and after the training program. Conclusion: The results of this case suggests that an closed kinetic chain exercise program in incomplete spinal cord injury patient may induce Hand function and ADL.

Effects of Goal-Oriented Functional Tasks on Gross Motor Function and Activities of Daily Living in Children with Cerebral Palsy -A Single Case Study-

  • Lee, Eun-Jung;Kwon, Hae-Yeon
    • PNF and Movement
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    • v.18 no.2
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    • pp.159-172
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    • 2020
  • Purpose: The study sought to determine whether goal achievement, performance, satisfaction, activities of daily living, and gross motor function in children with spastic cerebral palsy are positive affected by goal-oriented functional task training. Methods: In a single case study, two 7-year-old girls diagnosed with spastic cerebral palsy were given functional task training based on individualized goals for 24 60-minute sessions over a period of 6 months. The individualized goals reflected the needs of both children and parents. The Canadian occupational performance measure (COPM) and the goal attainment scale (GAS) were used to measure goal performance and satisfaction before and after intervention. Independence of activities of daily living before and after intervention were assessed using the functional independence measure for children (Wee-FIM). And change of gross motor function were assessed using gross motor function measure (GMFM). Results: Clinically significant changes were observed in COPM and GAS, as well as positive changes in independence of gross motor function and activities of daily living. Conclusion: The findings indicate that goal-oriented functional task training addresses the needs of children with spastic cerebral palsy, which increases treatment satisfaction and has a positive effect on independent activities and participation in daily life.

Effect of Extracorporeal Shock-wave Therapy on Pain, Grip Strength, and Upper-extremity Function in Patients with Lateral Epicondylitis (체외충격파치료가 팔꿉관절 가쪽위관절염 환자의 통증과 악력 및 팔 기능에 미치는 영향)

  • Song, Min-Jeong;Kang, Tae-Woo;Kim, Beom-Ryong
    • PNF and Movement
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    • v.18 no.1
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    • pp.117-126
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    • 2020
  • Purpose: The purpose of this study was to investigate the effects of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in patients diagnosed with lateral epicondylitis and to provide an effective intervention method for lateral epicondylitis. Methods: Twenty patients with lateral epicondylitis were randomly assigned to the ESWT group (n = 10) and the stretching exercise group (n = 10). Interventions in both groups were performed six times twice a week for three weeks. The visible analog scale (VAS) was used to measure pain change. A dynamometer was used to measure grip strength (GS). Patient-rated tennis elbow evaluation (PRTEE) was used to measure the upper-extremity function. Results: There were significant differences in pain, grip strength, and upper-extremity function in both groups before and after intervention (p < 0.05). There were also significant differences in pain, grip strength, and upper-extremity function between the groups after intervention (p < 0.05). Conclusion: This study showed very positive improvement in pain, grip strength, and upper-extremity function after ESWT in patients with lateral epicondylitis. Therefore, ESWT can be recommended for patients with lateral epicondylitis.