Early Low-Frequency Stimulation of the Pudendal Nerve Can Inhibit Detrusor Overactivity and Delay Progress of Bladder Fibrosis in Dogs With Spinal Cord Injuries.

Early low-frequency stimulation of the pudendal nerve can inhibit detrusor overactivity and delay progress of bladder fibrosis in dogs with spinal cord injuries.

Spinal Cord. 2013 Jun 25;
Li P, Liao L, Chen G, Zhang F, Tian Y

Objectives:To determine the inhibitory effects of pudendal nerve stimulation (5?Hz) on bladder overactivity at the early stage of spinal cord injury (SCI) in dogs, and to explore the possible effects on delayed progression of bladder fibrosis after SCI.Methods:The study was performed using six dogs with spinal cord transection at the T9-T10 level. Group 1 (three dogs) underwent low-frequency electrical stimulation of the pudendal nerve 1 day after spinal cord transection. Group 2 (three dogs) underwent only spinal cord transection. All dogs underwent urodynamic examination at 1 and 3 months after SCI. The bladders were removed for histological examination of fibrosis at 3 months after SCI.Results:Bladder capacity and compliance were significantly increased (P<0.05) by pudendal nerve stimulation in group 1 when compared with group 2 at 1 and 3 months after SCI. Non-voiding contractions (NVCs) were inhibited in group 1 compared with group 2. Collagen fibers were significantly increased and elastic fibers were significantly decreased (P<0.05) in group 2 when compared with group 1.Conclusion:Early low-frequency pudendal nerve stimulation can inhibit detrusor overactivity (DO), increase bladder capacity and delay the progression of bladder fibrosis.Spinal Cord advance online publication, 25 June 2013; advance online publication, 25 June 2013; doi:10.1038/sc.2013.60. HubMed – rehab


A Novel Three-Dimensional Motion Analysis Method for Measuring the Lumbar Spine Range of Motion: Repeatability and Reliability Compared With an Electrogoniometer.

Spine (Phila Pa 1976). 2013 Jun 21;
Tojima M, Ogata N, Yozu A, Sumitani M, Haga N

Study Design. Repeatability and reliability for measuring methods for real time lumbar range of motion.Objective. We established a novel set of marker positions for three-dimensional motion analysis (VICON) to precisely determine lumbar spine range of motion (LROM) and lumbar motion; we compared the repeatability and reliability of VICON with those of an electrogoniometer.Summary of Background Data. The assessment of the LROM using X-ray is still one of the most precise methods, despite the radiation exposure. To avoid this, alternative methods, like the VICON and electrogoniometer, have been widely used. No study has reported the repeatability and reliability of LROM measurements using a VICON and electrogoniometer.Methods. The VICON system and electrogoniometer measured LROM and lumbar motion in seven healthy males over seven days. Differences between both systems were analyzed using Bland-Altman plots. Repeatability and reliability of the LROM measurements was assessed using coefficients of multiple correlations (CMCs) and intraclass correlation coefficients (ICCs), respectively. Standard error of measurement was calculated to quantify the systematic error in LROM measurements.Results. The mean maximum LROM values using the VICON system / electrogoniometer were 42° / 52° for flexion, 17° / 24° for extension, 16° / 16° for lateral bending, and 8° / 2° for axial rotation, respectively. Between VICON and the electrogoniometer, Bland-Altman plots revealed no discrepancies in LROM values except for flexion.CMCs for LROM showed excellent repeatability. LROM measurements with VICON showed excellent reliability for flexion and extension and fair-to-good reliability for other motions. LROM measurements with the electrogoniometer showed excellent reliability for flexion and fair-to-good reliability for other motions. Except for axial rotation, maximum ICCs using VICON were more reliable than the electrogoniometer for measuring lumbar motion.Conclusion. VICON with our novel marker set allows practical and reliable longitudinal assessment of dynamic LROM. HubMed – rehab


Automatic Cobb Angle Determination from X-ray Images.

Spine (Phila Pa 1976). 2013 Jun 21;
Sardjono TA, Wilkinson MH, Veldhuizen AG, van Ooijen PM, Purnama KE, Verkerke GJ

Study Design. Automatic Cobb angle measurement of scoliotic patients.Objective. To test the accuracy of an automatic Cobb angle determination from frontal X-ray images.Summary of Background Data. 36 Frontal X-ray images of scoliotic patients.Methods. A modified charged particle model is used to determine the curvature on x-ray spinal images. Three curve fitting methods, piece-wise linear, splines and polynomials, each with three variants were used and evaluated for the best fit. The Cobb angle was calculated out of these curve fit lines and compared with a manually determined Cobb angle. The best automated method is determined based on the lowest mean absolute error and standard deviation, and the highest RResults. The error of the manual Cobb angle determination among the three observers, determined as the mean of the standard deviations of all sets of measurements, was 3.37°. For the automatic method, the best piece-wise linear method is the 3 segments method. The best spline method is the 10-steps method. The best polynomial method is poly 6.Overall, the best automatic methods are the piece-wise linear method using 3 segments and the polynomial method using poly 6 with a mean absolute error of 4,26° and 3,91° a standard deviation of 3,44° and 3,60°, and a R of 0,9124 and 0,9175. The standard measurement error is significantly lower than the upper bound found in the literature (11.8°).Conclusion. The automatic Cobb angle method appeared to be better than the manual methods described in the literature. The piece-wise linear using 3 segments and polynomial using poly 6 are the two best results, since the mean absolute error, standard deviation and R are the best of all methods. HubMed – rehab


Inhibition of Nitric Oxide Mediated Protein Nitration: Therapeutic Implications in Experimental Radiculopathy.

Spine (Phila Pa 1976). 2013 Jun 21;
Lee SJ, Kim TU, Park JS, Ra JY

Study Design. Experimental animal studyObjective. This study investigated whether NO mediated protein nitration is involved in the pathogenesis of radiculopathy and whether the symptoms can be relieved by its suppression.Summary of Background Data. It has been reported that nitration of protein mediated by Nitric Oxide (NO) is involved in the degenerative neurologic disorders, but its involvement is not clear in the radiculopathy.Methods. Two kinds of rat models of radiculopathy were used. Radiculopathy was induced either by ligation of spinal nerve roots or transplantation of autologous nucleus pulposus (NP). In separate groups of rats, aminoguanidine (AG), a potent nitric oxide synthetase (NOS) inhibitor, was administered just before induction of radiculopathy, to suppress NO production and resultant nitration of protein. Sensation of the hind limb was evaluated by plantar stimulation test, and motor weakness was assessed by observation of gait pattern. Nitrotyrosine, product of protein nitration, was assayed quantitatively by Western immunoblotting.Results. Mechanical allodynia was observed in both compression and NP groups, but motor weakness was observed only in the compression group. Preoperative administration of AG attenuated mechanical allodynia and motor weakness. Optical densities of nitrotyrosine bands increased significantly in radiculopathy groups, but they were lowered by administration of AG.Conclusions. NO mediated protein nitration contributes to the development of both types of radiculopathies. Suppression of NO production can decrease protein nitration and relieve neural dysfunctions of radiculopathy. HubMed – rehab


Smooth Pursuit Eye Movement Training Promotes Recovery From Auditory and Visual Neglect: A Randomized Controlled Study.

Neurorehabil Neural Repair. 2013 Jun 24;
Kerkhoff G, Reinhart S, Ziegler W, Artinger F, Marquardt C, Keller I

. No treatment for auditory neglect and no randomized controlled trial evaluating smooth pursuit eye movement therapy (SPT) for multimodal neglect are available.. To compare the effects of SPT and visual scanning therapy (VST) on auditory and visual neglect in chronic stroke patients with neglect.. A randomized, prospective trial was conducted. Fifty patients with left auditory and visual neglect were randomly assigned. Twenty-four patients completed SPT therapy and 21 patients VST. Five patients (4 VST, 1 SPT) were lost. Each group received 1-hour sessions of neglect therapy for 5 consecutive days totaling 5 hours. Outcome measures in visual neglect (digit cancellation, visuoperceptual- and motor line bisection, paragraph reading) and auditory neglect (auditory midline) were assessed twice before therapy, thereafter, and at 2-week follow-up. The SPT group practiced smooth pursuit eye movements while tracking stimuli moving leftward. The VST group systematically scanned the same but static stimuli. Both groups were divided into subgroups, and effects were separately investigated for mild and severe neglect.. Both groups did not differ before therapy in clinical/demographic variables or neglect severity (auditory/visual). After treatment, the SPT group showed significant and lasting improvements in all visual measures and normal performance in the auditory midline. Neither visual nor auditory neglect impairments changed significantly after VST. Moreover, the treatment effect sizes (Cohen’s d) were considerably higher for visual and auditory neglect after SPT versus VST, both for mild and severe neglect.. Repetitive contralesional, smooth pursuit training induces superior, multimodal therapeutic effects in mild and severe neglect. HubMed – rehab