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The contribution of small and large sensory afferents to postural control in patients with peripheral neuropathy

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Journal of Sport and Health Science 2019年第3期8卷 218-227页

作者： Li Li Shuqi Zhang John Dobson College of Physical Education Hunan Normal University Department of Health Sciences and Kinesiology Georgia Southern University Department of Kinesiology and Physical Education Northern Illinois University

Peripheral neuropathy(PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioceptive sensation that progresses in a distal to proximal manner. Balance also tends to deteriorate as the disorder becomes more severe, and those afflicted are substantially more likely to fall while walking compared with those who are healthy. Most patients with PN walk more cautiously and with greater stride variability than age-matched controls, but the majority of their falls occur when they must react to a perturbation such as a slippery or uneven surface. The purpose of this study was to first describe the role of somatosensory feedback in the control of posture and then discuss how that relationship is typically affected by the most common types of PN. A comprehensive review of the scientific literature was conducted using MEDLINE, and the relevant information was synthesized. The evidence indicates that the proprioceptive feedback that is conveyed primarily through larger type I afferents is important for postural control. However, the evidence indicates that the tactile feedback communicated through smaller type II afferents is particularly critical to the maintenance of balance. Many forms of PN often lead to chronic tactile desensitization in the soles of the feet and, although the central nervous system seems to adapt to this smaller type II afferent dysfunction by relying on more larger type I afferent reflex loops, the result is still decreased stability. We propose a model that is intended both to help explain the relationship between stability and the smaller type II afferent and the larger type I afferent feedback that may be impaired by PN and to assist in the development of pertinent rehabilitative interventions.

关键词： Balance Biomechanics Neuroplasticity Peripheral neuropathy postural control Rehabilitation

Vascular dysfunction of postural tachycardia syndrome in children

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World Journal of Pediatrics 2018年第1期14卷 13-17页

作者： Wei Bai Si-Yao Chen Hong-Fang Jin Jun-Bao Du Department of Pediatrics Peking University First HospitalBeijing100034China Department of Cardiac Surgery Guangdong CardiovascularInstituteGuangdong General Hospital and GuangdongAcademy of Medical SciencesGuangzhouChina

Background postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance, and its incidence in children is approximately 6.8% (1)The pathogenesis of POTS is complex with multiple, overlapping, interacting pathophysi-ological mechanisms. Although the specific pathogenic mechanism has remained perplexing, with the discovery of various gasotransmitters and biological peptides, the vascular dysfunction has aroused overwhelming attention. Data sources On the basis of searching in a wide range of recent original literatures, we reviewed the pathogenesis of vas-cular dysfunction in children with POTS. Results The flow-mediated vasodilation of POTS patients was greater than that of healthy controls, and the vasodilator factors were increased in patients with POTS under basal condition or under a standing position, while the vasoconstriction factors were reduced. Conclusions Vascular dysfunction, as one of pathogenesis in pediatric POTS patients, affects the occurrence and develop-ment of diseases through a variety of factors.

关键词： Children postural orthostatic tachycardia syndrome Vasodilation

Reversible postural orthostatic tachycardia syndrome

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World Journal of Clinical Cases 2015年第7期3卷 655-660页

作者： Aza Abdulla Thirumagal Rajeevan Department of Care of the Elderly Princess Royal University HospitalKing’s College Hospital NHS Foundation Trust Department of Care of the Elderly St Peter’s Hospital

postural orthostatic tachycardia syndrome(POTS) is a relatively rare syndrome recognised since 1940. It is a heterogenous condition with orthostatic intolerance due to dysautonomia and is characterised by rise in heart rate above 30 bpm from base line or to more than 120 bpm within 5-10 min of standing with or without change in blood pressure which returns to base line on resuming supine position. This condition present with various disabling symptoms such as light headedness, near syncope, fatigue, nausea, vomiting, tremor, palpitations and mental clouding, etc. However there are no identifiable signs on clinical examination and patients are often diagnosed to have anxiety disorder. The condition predominantly affects young female between the ages of 15-50 but is rarely described in older people. We describe an older patient who developed POTS which recovered over 12 mo. Recognising this condition is important as there are treatment options available to alleviate the disabling symptoms.

关键词： postural Orthostatic Tachycardia Dysautonomia Hypotension postural tachycardia syndrome Older person

Adaptability of anticipatory postural adjustments associated with voluntary movement

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World Journal of Orthopedics 2012年第6期3卷 75-86页

作者： Eric Yiou Teddy Caderby Tarek Hussein Laboratory Complexité InnovationActivités Motrices et Sportives Team Risque InterventionMouvement Equilibre UFR STAPS University of Paris-sud91440 Orsay Cedex France UFR of Human and Environmental Sciences University of La Réunion97430 Le Tampon Reunion IslandFrance

The control of balance is crucial for efficiently performing most of our daily motor tasks, such as those involving goal-directed arm movements or whole body displacement. The purpose of this article is twofold. Firstly, it is to recall how balance can be maintained despite the different sources of postural perturbation arising during voluntary movement. The importance of the so-called "anticipatory postural adjustments"(APA), taken as a "line of defence" against the destabilizing effect induced by a predicted perturbation, is emphasized. Secondly, it is to report the results of recent studies that questioned the adaptability of APA to various constraints imposed on the postural system. The postural constraints envisaged here are classified into biomechanical(postural stability, superimposition of motor tasks),(neuro) physiological(fatigue), temporal(time pressure) and psychological(fear of falling, emotion). Overall, the results of these studies point out the capacity of the central nervous system(CNS) to adapt the spatio-temporal features of APA to each of theseconstraints. However, it seems that, depending on the constraint, the "priority" of the CNS was focused on postural stability maintenance, on body protection and/or on maintenance of focal movement performance.

关键词： Anticipatory postural adjustments Adaptability Voluntary movement Balance Biomechanics Motor control

postural instability after lumbar spinal surgery:are there any predictive factors? A case control study

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Chinese Neurosurgical Journal 2019年第1期5卷 1-5页

作者： Domenico Chirchiglia Pasquale Chirchiglia Domenico Murrone Department of Neurosurgery University of CatanzaroCampus GermanetoVLE Europa88100 CatanzaroItaly Department of Neurosurgery Divenere Hospital70121 BariItaly

Background:The surgical spinal degenerative pathology mainly concerns the herniated intervertebral *** is indicated when the pain becomes chronic and intense,and when motor signs *** results are positive in about 90%of cases,leading to the solution of the ***,an estimated percentage of 4%to 20%reported residual pain and postural instability after the surgical treatment of ***:We have examined a sample of patients,retrospectively registered,undergoing surgical treatment for degenerative lumbar *** of them developed postural *** were subjected to cycles of postural *** gymnastics has proved to be a tool capable of solving unstable post-surgical *** included an exercise of breathing,one or two of muscular distension,one of muscular reinforcement,and one of postural *** used an evaluation form we created in agreement with the physiatrist for postural exercises that was based on some basic parameters such as muscle and respiratory *** each cycle,a score was attributed to the performance of muscular and respiratory exercise to evaluate the function and therefore the degree of instability(1–3=mild,4–7=medium,8–10=severe).Results:Results were satisfactory,with return to normal *** improvement of postural instability has been demonstrated both by the score of the evaluation forms that have highlighted the transition from a state of severe intensity to one of normality and by a clinical aspect,concerning the static and dynamic ***:The postural instability has a multifactorial genesis,and different mechanisms are involved:the vertebral bone structures and the pelvis,the paraspinal muscular structures,and the nerve *** structures are altered after surgery due to predisposing factors,and for the action of conditions acquired as obesity.

关键词： Spine disease Lumbar pain postural instability

Prevalence of Musculoskeletal Pain and postural Deformity in Papad Making Women —A Cross-Sectional Observational Study

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Pain Studies and Treatment 2019年第2期7卷 21-31页

作者： Rekha B. Marbate Tejaswini C. Gedam Shobha Bhave Umanjali Damke P. T. School and Center Govt. Medical College Nagpur MUHS Nashik

Aim and Objective: To study musculoskeletal problems like musculoskeletal pain, postural deformity and nerve radiculopathy in women engaged in Papad making by clinical assessment. Methodology: A cross-sectional observational survey carried out at Shri. Mahila Gruh Udyog Lijjat Papad, Nandanvan, Nagpur (2014). 50 female subjects were selected for the study. After taking permission from factory in-charge, the survey was conducted at the factory site and subjects were explained about the study in details in language they can understand. Consent form was obtained by subjects to participate. Data were collected by interview and clinical examination of women engaged in this occupation, As per proforma of musculoskeletal examination. Result: Almost 37 subjects out of 50 complaints about low back pain as a chief complaint followed by neck pain in 34, thoracic kyphosis was more profound postural deviation seen in 10 subjects. Paraspinal and calf muscle spasm is more common. Radiating pain and numbness more in dominant hand suggestive of involvement of median nerve were confirmed by Upper Limb Traction Test [ULTT]. Discussion: Socioeconomic status greatly influences the working needs of women. Shri. Mahila Gruh Udyog Lijjat Papad factory provides a platform for Women Empowerment. Faulty posture adoption for longer duration during work gives rise to various musculoskeletal problems. Conclusion: 74% of the study population has low back pain as a chief musculoskeletal problem. 34% present with postural deviation and 82% belong to poor socioeconomic scale.

关键词： Women Working in Papad Making Industry Musculoskeletal Pain postural Deviation

The Effect of Giving Intervention 12 Balance Exercise on postural Balance in Elderly

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Open Journal of Nursing 2019年第5期9卷 534-540页

作者： Ninik Murtiyani Hartin Suidah Department of Nursing Nursing Academy Dian Husada Mojokerto Indonesia

Elderly is an age group that has a high risk of experiencing health problems. One risk that can be experienced by the elderly is the risk of falling. One of the risk factors for falling in the elderly is decreasing in postural balance of the elderly. One of the non-pharmacological therapies developed to reduce the risk of falling in the elderly is to improve the ability of the elderly, especially in controlling postural balance. The purpose of this study was to determine the effectiveness of 12 balance exercises to improve postural balance in the elderly. This type of research is quasi experiments with static group comparison. The research data are obtained by researchers using observation sheet, then the data are tabulated. This study involved two research groups namely the control group (the group not given the intervention) and the treatment group (the group that was given the 12 balance exercise intervention). From the results of Paired samples, t-test with significance level α = 0.05 is obtained by the significance value (p) of 0.025. This study shows that the provision of 12 balance therapy exercise strategy is effective to improve postural balance in the elderly as a preventive effort from the risk of falling.

关键词： Elderly postural Balance 12 Balance Exercise

Why Voluntary postural Training Improves Recovery of Mental and Motor Functions in Patients with Traumatic Brain Injury?

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Journal of Behavioral and Brain Science 2013年第6期3卷 463-473页

作者： L. Zhavoronkova A. Zharikova O. Maksakova Burdenko Neurosurgery Institute Department of Neurorehabilitation Russian Academy of Medical Sciences Moscow Russia Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences Moscow Russia Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences Moscow Russia Burdenko Neurosurgery Institute Department of Neurorehabilitation Russian Academy of Medical Sciences Moscow Russia

There are data about the positive effect of rehabilitation with postural training in traumatic brain injury (TBI) patients. Brain mechanisms of functional recovery have been investigated insufficiently. In this study, functional recovery was examined in TBI patients with primary motor (20 patients) or higher mental impairment (10 patients)—post-traumatic Korsakov syndrome compared to healthy volunteers (n = 20). Integral clinical, stabilographic, and EEG approach was used as a tool for estimation of functional deficit in TBI patients before and after rehabilitation course. Specific alterations of stabilographic and EEG parameters were observed in TBI patients with primary motor or mental deficit before rehabilitation. Rehabilitation course with postural training improved recovery of all functions in both patient groups. To understand brain mechanisms of rehabilitation, we examined EEG findings during standing and postural task performance in healthy volunteers (n = 10). EEG coherence increase was marked for different spectral bands predominantly in the right hemisphere and more in alpha-2 and beta bands during postural task performance. These EEG findings were discussed in relation to rehabilitation effect on TBI patients and proved that postural training with visual feedback may provoke primary activation of the right hemisphere and can serve as a trigger for integration of cortical and subcortical structures and for recovery of motor and higher mental function in TBI patients.

关键词： Traumatic Brain Injury Rehabilitation postural Control EEG Coherence

Effect of Aging on Anticipatory postural Adjustment and Reaction Times in the Pre-Crossing Phase of Obstacle Negotiation

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Advances in Aging Research 2015年第5期4卷 161-167页

作者： Maryam Hayati Saeed Talebian Hassan Ashayeri Behrouz Attarbashi Moghadam Department of Physical Therapy School of Rehabilitation Tehran University of Medical Sciences Tehran Iran Department of Basic Sciences School of Rehabilitation Iran University of Medical Sciences Tehran Iran

Background: Obstacle crossing is the common reason of falling in older adults. Anticipatory postural adjustments phase (APAP) and reaction time phase (RTP) are two important factors in falling prediction. According to previous studies, these parameters increase in older adults at high risk falling. This study explored the effect of aging on APAP and RTP in obstacle negotiation. Method: Nineteen older adults (mean age: 66.73 ± 3.38 years) and twelve young adults (mean age: 26.5 ± 4.37 years), participated in this study. Participants take part in gait initiation task from a starting position on a force platform under two conditions, unobstructed and obstructed (obstacle placed at 1 m from the initial position). RTP and APAP were measured and Timed “Up” & “Go” test (TUG) as a functional test, recorded for all participants. Results: There was no significant difference between healthy young and older adults in RTP and APAP in the unobstructed and obstructed conditions. TUG test was the most sensitive indicator of falling between two groups. Conclusion: Information processing capacity for motor planning and proper strategy selection in pre crossing phase of obstacle negotiation did not have significant difference in healthy old and young groups. Maybe in respect to select healthy older adults without any neurological disorders and cognitive impairments, low attention demand of well learned walking and obstacle negotiation tasks, lead to perform both postural task more automatically and without any significant difference detection.

关键词： Obstacle Negotiation Fall Anticipatory postural Adjustment Phase Aging Reaction Time Phase