Spinal Cord Compromise: An Important but Underdiagnosed Condition in People with Mental Retardation

Curtis, Rod; Freitag, Per; LaGuardia, James J.; Thornton, Steven; Vicari, Sandra; Markwell, Stephen

doi:10.1016/j.phr.2004.05.003

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…Clinical and epidemiological research is needed to determine the risk profile for this drug for women with disabilities and to explore alternative treatment protocols for girls or women who need safe and reliable contraception or are experiencing significant menstrual problems related to their disabilities. Current or past use of DMPA should be considered a risk factor for fracture and be taken into account in decisions regarding screening for risk factors and bone density among women who have DD.While use of AEDs for seizures is unavoidable, our findings reinforce previous work such as that of Curtis et al (2004) which points to the need for earlier screening of bone density in those using AEDs. Risk for fracture among this group is high, particularly among those older than 55 years of age.…”

supporting

confidence: 79%

“…Clinical records indicated that the level of mental retardation of the 48 adults ranged from mild to severe. Investigation of functional decline of these individuals led to identification of previously undiagnosed spinal cord compromise in 30 residents (Curtis et al, 2004). This compromise was attributed in each case to either spinal stenosis/degenerative disease, prolapsed disc, or spinal cord compression.…”

Section: Discussionmentioning

confidence: 99%

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Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities

Watson

Lentz

Cain

2006

Women's Health Issues

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Purpose-To evaluate any association between incidence of osteoporotic fractures and use of depot medroxyprogesterone acetate (DMPA) and/or anti-epileptic drugs (AEDs) among women and girls with developmental disabilities.Methods-Cross-sectional population-based observational study of all non-institutionalized females with developmental disabilities age thirteen and older who received fee-for-service Medicaid in Washington State during 2002 (N=6773), using administrative data.Main Findings-In a sample of 6,773 females, 140 women (2%) had an osteoporotic fracture during 2002. Among 340 users of DMPA, 13 (3.8%) had an osteoporotic fracture with an odds ratio of 2.4 (CI 95%, 1.3-4.4) for fracture compared to non-users. Among 1909 users of AEDs, 60 (3.1%) had an osteoporotic fracture with an odds ratio of 1.9 (CI 95%, 1.3-2.6) for fracture compared to non-users. We controlled for age and race (as Caucasian or non-Caucasian).Conclusions-Use of either AEDs or DMPA by women with developmental disabilities is associated with significantly increased incidence of fracture. Women and girls who have developmental disabilities may be poor candidates for DMPA use due to increased risk of fractures. Further research is indicated (1) to determine the specific risks profile of DMPA for this population, (2) to explore alternative means of managing significant menstrual problems and contraceptive needs in this population and (3) to screen current and previous users of DMPA and chronic users of AEDs for osteoporosis risk, regardless of age.Correspondence to: Kathleen C. Watson, watsonkc@u.washington.edu. Support for this study was provided by NINR NIH 5 T32 NR07106-07 and by NINR NIH P30 NR04001.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. People who have developmental disabilities (DD) are at increased risk of fractures due to cooccurrence of low BMD (Aspray et al. 1998;Jaffe, Timell, & Gulanski, 2001;Lohiya, TanFigueroa, & Iannucci, 2004) and increased incidence of falls and other trauma (Hsieh, Heller & Miller, 2001). Developmental disabilities are severe and chronic disabilities which begin before age 22 and are the result of mental retardation, cerebral palsy, epilepsy, autism or a similar condition (U.S. code Title 42, chapter 75, section 6001.5.1, 1992). They include a wide range of both physical and cognitive disabilities and many have associated health problems. NIH Public AccessDocumented risks for low BMD include limited mobility (Lohiya et al. 2004;Tyler, Snyder & Zyzanski, 2000;Jaffe, Timell, Elolia & Thatcher, 2005), use of anti-epileptic drugs (AEDs) (Ray, Papaioan...

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supporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities

Watson

Lentz

Cain

2006

Women's Health Issues

View full text Add to dashboard Cite

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“…However, future studies should identify the supraspinal versus spinal origin of such activation impairment since individuals with ID may have some abnormalities within their spinal cord (Curtis et al . ). Altogether, the results of the present study indicated that, in comparison with sedentary healthy controls, reduced isometric knee extensors strength production in sedentary adults with ID comprised both muscular and neural impairments, whereas it mainly arises from a neural failure in IDTG.…”

Section: Discussionmentioning

confidence: 97%

Neuromuscular characteristics in trained vs. sedentary male adults with intellectual disability

Zghal

Borji

Colson

et al. 2019

J intellect Disabil Res

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Background This study aimed to explore muscle strength production and its underlying neuromuscular characteristics in sedentary and trained individuals with intellectual disability (ID) compared with healthy sedentary individuals. Methods Three adult groups (age: 25.07 ± 0.70) consisting of sedentary individuals with ID (IDSG), trained individuals with ID (IDTG) and a control group (CONT) participated in the present study. Peak torque (PT) during maximal voluntary isometric contraction, voluntary activation level (VAL), surface electromyography (sEMG) recordings, electrophysiological (Mmax) and potentiated twitch torque (PTT responses) of the knee extensor muscles and thigh muscle volume were assessed. Results Compared with CONT and IDTG, respectively, IDSG presented significantly lower PT (−48% and −42%), VAL (−24% and −9%), sEMG (−49% and −29%), Mmax (−41% and −39%) and PTT (−32% and −28%) values. These deficits were reduced between IDTG compared with CONT (i.e. PT: −10%; VAL: −16%; and sEMG: −28%) or did not differ anymore (PTT and Mmax). Normalising PT to thigh muscle volume and/or computing theoretical PT value overwhelm strength production differences between IDTG and CONT. Training background influences the outcomes with IDTG exhibiting greater PT, VAL, sEMG, Mmax and PTT than IDSG. Conclusions Strength production deficit in IDSG was related to both muscular and neural characteristics compared with healthy controls whereas this deficit mainly arises from neural characteristics for IDTG.

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“…Indeed, in these individuals reduction in number of neurons, dendritic abnormalities, and neurotransmitter system dysfunction have been reported,21, 22, 30 which could impair the descending neural drive 31 . In addition, individuals with ID may suffer from other abnormalities within the spinal cord32, 33 that may impair motor units recruitment during muscle contraction. Beyond the greater magnitude of central fatigue, the ID group displayed a slow recovery from this central fatigue compared to individuals with typical development.…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular fatigue and recovery profiles in individuals with intellectual disability

Borji

Zghal

Zarrouk

et al. 2019

Journal of Sport and Health Science

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International audiencePurpose: This study aimed to explore neuromuscular fatigue and recovery profiles in individuals with intellectual disability (ID) after exhausting submaximal contraction.Methods: Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief (3 s) isometric maximal voluntary contraction (IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during 33 min after an exhausting submaximal isometric task at 15% of the IMVC. Force, voluntary activation level (VAL), potentiated resting twitch (Ptw), and electromyography (EMG) signals were measured during IMVC and then analyzed.Results: Individuals with ID developed lower baseline IMVC, VAL, Ptw, and RMS/Mmax ratio (root-mean-square value normalized to the maximal peak-to-peak amplitude of the M-wave) than controls (p < 0.05). Nevertheless, the time to task failure was significantly longer in ID vs. controls (p < 0.05). The 2 groups presented similar IMVC decline and recovery kinetics after the fatiguing exercise. However, individuals with ID presented higher VAL and RMS/Mmax ratio declines but lower Ptw decline compared to those without ID. Moreover, individuals with ID demonstrated a persistent central fatigue but faster recovery from peripheral fatigue.Conclusion: These differences in neuromuscular fatigue profiles and recovery kinetics should be acknowledged when prescribing training programs for individuals with ID

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Spinal Cord Compromise: An Important but Underdiagnosed Condition in People with Mental Retardation

Cited by 6 publications

References 15 publications

Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities

Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities

Neuromuscular characteristics in trained vs. sedentary male adults with intellectual disability

Neuromuscular fatigue and recovery profiles in individuals with intellectual disability

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