[Specific Features of Rehabilitation in Patients With Gluten-Sensitivity Celiac Disease].

[Specific features of rehabilitation in patients with gluten-sensitivity celiac disease].

Ter Arkh. 2013; 85(1): 42-7

To elaborate recommendations for rehabilitation of patients with gluten-sensitivity celiac disease (GCD) on the basis of a long-term follow-up.Eighty-seven patients with GCD were followed up for as long as 31 years. Of those, 72.4% of the patients kept strictly to their gluten-free diet (GFD) throughout the follow-up; 9.2% did not follow the diet periodically; and 18.4% did not at all. The sera from 71 patients were tested for IgA and IgG anti-gliadin antibodies (AGAb) and anti-tissue transglutaminase antibodies (ATTGAb) at as long as 19-year follow-up. AGAb and ATTGAb were estimated by enzyme immunoassay (IMMCO Diagnostics). All the patients underwent endoscopic and histological examinations of the small bowel mucosa (SBM).To support the validity of keeping to the GFD, the time course of clinical, laboratory, and morphological changes were analyzed in 63 and 24 GFD followers and non-followers, respectively. The GFD non-followers were more frequently found to have diarrheic syndrome, symptoms of malabsorption syndrome, lower serum concentrations of hemoglobin, total protein, iron, and calcium; no SBM structural recovery was seen in any patient. When the GFD was long adhered to, there was also a reduction in detection rates and AGAb and ATTGAb concentrations.The adherence to the GFD was ascertained to contribute to fuller rehabilitation in the patients. However, even the patients who had strictly kept to their GFD showed periods of an exacerbation and incomplete SBM structural recovery. Therefore, the rehabilitation system for patients with GCD must involve diagnostic, therapeutic, and organizational measures that promote not only rapid clinical recovery, but also better quality of life in these patients. HubMed – rehab


Mechanomyogram for Muscle Function Assessment: A Review.

PLoS One. 2013; 8(3): e58902
Islam MA, Sundaraj K, Ahmad RB, Ahamed NU

Mechanomyography (MMG) has been extensively applied in clinical and experimental practice to examine muscle characteristics including muscle function (MF), prosthesis and/or switch control, signal processing, physiological exercise, and medical rehabilitation. Despite several existing MMG studies of MF, there has not yet been a review of these. This study aimed to determine the current status on the use of MMG in measuring the conditions of MFs.Five electronic databases were extensively searched for potentially eligible studies published between 2003 and 2012. Two authors independently assessed selected articles using an MS-Word based form created for this review. Several domains (name of muscle, study type, sensor type, subject’s types, muscle contraction, measured parameters, frequency range, hardware and software, signal processing and statistical analysis, results, applications, authors’ conclusions and recommendations for future work) were extracted for further analysis. From a total of 2184 citations 119 were selected for full-text evaluation and 36 studies of MFs were identified. The systematic results find sufficient evidence that MMG may be used for assessing muscle fatigue, strength, and balance. This review also provides reason to believe that MMG may be used to examine muscle actions during movements and for monitoring muscle activities under various types of exercise paradigms.Overall judging from the increasing number of articles in recent years, this review reports sufficient evidence that MMG is increasingly being used in different aspects of MF. Thus, MMG may be applied as a useful tool to examine diverse conditions of muscle activity. However, the existing studies which examined MMG for MFs were confined to a small sample size of healthy population. Therefore, future work is needed to investigate MMG, in examining MFs between a sufficient number of healthy subjects and neuromuscular patients. HubMed – rehab


Transfer of ballistic motor skill between bilateral and unilateral contexts in young and older adults: neural adaptations and behavioural implications.

J Neurophysiol. 2013 Mar 27;
Hinder MR, Carroll TJ, Summers JJ

Bilateral movement rehabilitation is gaining popularity as an approach not only to improve the recovery of bimanual function, but also of unilateral motor tasks. While the neural mechanisms mediating the transfer of bilateral training gains into unimanual contexts are not fully understood, converging evidence from behavioural, neurophysiological and imaging studies suggests that bimanual movements are not simply the superposition of unimanual tasks undertaken with both (upper) limbs. Here we investigated the neural responses in both hemispheres to bilateral ballistic motor training, and the extent to which performance improvements transferred to a unimanual task. Since aging influences interhemispheric interactions during movement production, both young (n=9; mean age 19.4 years; 6 female) and older (n=9; 66.3 years; 7 female) adults practiced a bilateral motor task requiring simultaneous ‘fast-as-possible’ abductions of their left and right index fingers. Changes in bilateral and unilateral performance, and in corticospinal excitability and intracortical inhibition, were assessed. Strong transfer was observed between bimanual and unimanual contexts for both age groups. However, in contrast to previous reports of substantial bilateral cortical adaptations following unilateral training, increases in corticospinal excitability following bilateral training were not statistically reliable, and a release of intracortical inhibition was only observed for older adults. The results indicate that the neural mechanisms of motor learning for bilateral ballistic tasks differ from those that underlie unimanual ballistic performance improvement, but that ageing results in a greater overlap of the neural mechanisms mediating bilateral and unilateral ballistic motor performance. HubMed – rehab


A silent acute abdomen in a patient with spinal cord injury.

BMJ Case Rep. 2013; 2013(mar27_1):
Malhotra R, Ee G, Pang SY, Kumar N

A 52-year-old man with cervical spondylosis sustained a hyperextension injury to the neck and subsequently developed central cord syndrome after 2 weeks. The diagnosis was confirmed clinically and on MRI. During the admission he was febrile from Streptococcus anginosus bacteraemia from a gum infection and was started on penicillin. This resulted in pseudomembranous colitis with abdominal distension and bloody diarrhoea but a lack of expected abdominal complaints. Unfortunately his neurology deteriorated and a repeat MRI showed a discitis at C5-C7 which required a 2-level discectomy, debridement and instrumented fusion. Owing to his spinal cord injury, an abdominal perforation was initially missed owing to the lack of clinical features of an acute abdomen. He underwent a right hemi-colectomy for ascending colon perforation and eventually made a good recovery and was discharged to a spinal rehabilitation unit. By one year follow-up he had returned to full neurological function. HubMed – rehab