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Sustained pressure stimulation of the body surface has been used in several physiotherapeutic techniques, such as reflex locomotion therapy. Clinical observations of global motor responses and subsequent motor behavioral changes after stimulation in certain sites suggest modulation of central sensorimotor control, however, the neuroanatomical correlates remain undescribed. We hypothesized that different body sites would specifically influence the sensorimotor system during the stimulation. We tested the hypothesis using functional magnetic resonance imaging (fMRI) in thirty healthy volunteers (mean age 24.2) scanned twice during intermittent manual pressure stimulation, once at the right lateral heel according to reflex locomotion therapy, and once at the right lateral ankle (control site). A flexible modeling approach with finite impulse response basis functions was employed since non-canonical hemodynamic response was expected. Subsequently, a clustering algorithm was used to separate areas with differential timecourses. Stimulation at both sites induced responses throughout the sensorimotor system that could be mostly separated into two anti-correlated subsystems with transient positive or negative signal change and rapid adaptation, although in heel stimulation, insulo-opercular cortices and pons showed sustained activation. In direct voxel-wise comparison, heel stimulation was associated with significantly higher activation levels in the contralateral primary motor cortex and decreased activation in the posterior parietal cortex. Thus, we demonstrate that the manual pressure stimulation affects multiple brain structures involved in motor control and the choice of stimulation site impacts the shape and amplitude of the blood oxygenation level-dependent response. We further discuss the relationship between the affected structures and behavioral changes after reflex locomotion therapy.

Most physiotherapy students chose their course because of an interest in physiotherapy. They were not familiar with employment possibilities for graduates, and believed that it is easier to find work in other EU countries. Both factors may further aggravate the problem of unemployment among physiotherapists.

Authors present a hardware and software which enable to enlarge the practical application of the method of spectral analysis of R-R intervals variability, used for the evaluation of heart rate regulation in which autonomic nervous system and sympathetic and vagal effects play an important role. This developing method, applied and veri'ed by many authors, is at present realized with the help of expensive monitoring Jystems, the fact preventing its more general use. To solve the problem, the authors used a microcomputer measuring system, type TF-3, with telemetric transfer of values of R-R intervals, equipped with a special software including the procedures of measuring, jiltration and calculation of parameters of spectral analysis. The results of analyses make it possible to depict and quanti& the manifestations of factors influencing the variability of heart rate, including the sympathetic and vagal effects and their relationship during the speci'ed functional load, drug application etc.

No abstract