The present study shows that thinning of the CC is correlated with lower FA value and that it is more pronounced in preterm children. In addition, the isthmus was found to be the most vulnerable subdivision in preterm children.
ObjectiveTo describe a hand-stretching device that was developed for the management of hand spasticity in chronic hemiparetic stroke patients, and the effects of this device on hand spasticity.MethodsFifteen chronic hemiparetic stroke patients with finger flexor spasticity were recruited and randomly assigned to an intervention group (8 patients) or a control group (7 patients). The stretching device consists of a resting hand splint, a finger and thumb stretcher, and a frame. In use, the stretched state was maintained for 10 minutes per exercise session, and the exercise was performed twice daily for 4 weeks. Spasticity of finger flexor muscles in the two groups was assessed 3 times, 4 weeks apart, using the Modified Ashworth Scale (MAS). Patients in the intervention group were assessed twice (pre-1 and pre-2) before and once (post-1) after starting the stretching program.ResultsMean MAS (mMAS) scores at initial evaluations were not significantly different at pre-1 in the intervention group and at 1st assessment in the control group (p>0.05). In addition, no significant differences were observed between mMAS scores at pre-1 and pre-2 in the intervention group (p>0.05). However, mMAS scores at post-1 were significantly lower than that at pre-2 in the intervention group (p<0.05). Within the control group, no significant changes in mMAS scores were observed between 1st, 2nd, and 3rd assessments (p>0.05). In addition, mMAS scores at post-1 in the intervention group were significantly decreased compared with those at the 3rd assessment in the control group (p<0.05).ConclusionThe devised stretching device was found to relieve hand spasticity effectively in chronic hemiparetic stroke patients.
Background: Little research has been expended on the use of bipolar radiofrequency (RF)
lesioning of sacral nerves in spinal cord injured (SCI) patients with neurogenic detrusor overactivity
(NDO), and no study has been undertaken to demonstrate its long-term effect.
Objective: To investigated the effect of bipolar RF ablation of the second and third sacral nerves
over 2 years in SCI patients with NDO.
Study Design: A prospective, randomized controlled feasibility study.
Setting: The outpatient clinic of a single academic medical center in Korea.
Methods: Ten SCI patients with NDO were recruited. These patients were randomly assigned
to 2 groups; the intervention group (n = 5) and the control group (n = 5). Control group
members received optimized conventional treatment. International Consultation on Incontinence
Questionnaire (ICIQ), 3-day voiding diary, and the urinary incontinence quality of life scale (I-QOL)
data were obtained at baseline and at 6, 12, and 24 months after intervention. Urodynamic study
(UDS) was performed at baseline and 24 months after intervention. In the intervention group,
percutaneous bipolar RF neurotomy was performed on both S2 and S3 nerves in each patient.
Results: Frequency of urinary incontinence and ICIQ and IQOL scores showed significant effects
for time and for the group x time interaction (P < 0.05). Daily mean volume of urinary incontinence
showed only a significant group effect. In UDS parameters, comparisons of values at baseline and
at 24 months revealed all variables showed significant intergroup differences (P < 0.05).
Limitation: A small number of patients was recruited.
Conclusion: Percutaneous bipolar RF ablation of sacral nerves S2 and S3 effectively reduces
urinary incontinence and improves quality of life (QoL) in SCI patients with NDO and the effects
lasted over 2 years.
Key words: Neurogenic detrusor overactivity, bipolar RF neurotomy, sacral nerves, urinary
incontinence, maximal detrusor pressure, maximum cystometric capacity
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