The characteristics and state of knowledge of bioelectric signals such as ECG, EEG, and EMG are initially discussed. This serves as the basis for exploration of the degree of scholastic coverage and ...understanding of the level of clinical acceptance of respective bioelectric signal subtypes during the last 60 or so years. The review further proceeds to discuss surface EMG (sEMG). The status of the field in terms of teaching and academic training related to sEMG is examined, and its clinical acceptance in several areas of medicine and kinesiology, including neurology, psychology, psychiatry, physiatry, physical medicine and rehabilitation, biomechanics and motor control, and gnathology, is evaluated. A realistic overview of the clinical utility of the measurement of sEMG signals and their interpretation and usage, as well as of perspectives on its development, are then provided. The main focus is on the state of the field in Croatia. EMG signals are viewed as "windows" into the function of the neuro-muscular system, a complex and hierarchically organized system that controls human body posture and gross body movement. New technical and technological means to enable the detection and measurement of these signals will contribute to increased clinical acceptance, provided current scientific, educational, and financial obstacles can be removed.
S-Adenosylhomocysteine hydrolase deficiency (SAHHD) is a rare inherited multisystemic disease with muscle involvement as one of the most prominent and poorly understood features. To get better ...insight into muscle involvement, skeletal muscles were analyzed by magnetic resonance imaging (MRI) and MR spectroscopy (MRS) in three brothers with SAHHD in the different age group.
The study was based on analysis of MRI and MRS of skeletal muscles of the lower and the proximal muscle groups of the upper extremities in three SAHHD patients.
Three siblings presented in early infancy with similar signs and symptoms, including motor developmental delay. All manifested myopathy, more pronounced in the lower extremities and the proximal skeletal muscle groups, and permanently elevated creatine kinase. At the time of MRI and MRS study, the brothers were at the age of 13, 11, and 8 years, respectively. MRI revealed lipid infiltration, and the MRS curve showed an elevated muscle lipid fraction (higher peak of lipid), which increased with age, and was more prominent in the proximal skeletal muscles of the lower extremities. These results were consistent with muscle biopsy findings in two of them, while the third patient had no specific pathological changes in the examined muscle tissue.
These findings demonstrate that an accessible and non-invasive method of MRI and MRS is useful for an insight into the extent of muscle involvement, monitoring disease progression, and response to treatment in SAHHD.
Rehabilitation of amputees represents a complex process during the course of which an amputee receives professional aid and support, so as to adapt to the use of prosthesis, i.e. an artificial ...supplement for the lost body part. The process aims at achieving an independent performance of the amputee in all areas of everyday life and as high quality of life as possible. The rehabilitation encompasses not only the pre-amputation, postoperative, pre-prosthetic and prosthetic stage, within which an amputee is provided with a prosthetic
aiding device, but also the subsequent long-term monitoring and follow-up. The implementation of the rehabilitation process runs in line with the biopsychosocial model and requires a multidisciplinary and an interdisciplinary approach, so as to achieve a successful reintegration of an amputee and allow for a lifestyle resembling the pre-amputation one as much as possible.
The article brings the causes and types of amputation, the principles
underpinning contemporary amputation surgery, prosthetics and rehabilitation during preoperative, postoperative, pre-prosthetic and prosthetic stages, as well as the stage goals and MOs of their attainment. Principles of evaluation of prosthetic rehabilitation outcomes in limb amputees, which make use of appraisal questionnaires, have been discussed as well.
Presented study gives findings of temporal-spatial kinematic gait analysis in 12 male adults, war trauma transtibial (TT) amputees fitted with prosthesis compared to 12 able-bodied persons. Results ...disclose asymmetries between the amputated, prosthetic and healthy legs of amputees, as well as between TT amputees and non-disabled persons. Amputees in comparison with able-bodied persons, generally, showed significantly increased swing-time (ms) (p < 0.01). Prosthetic, right legs of amputees showed decreased stance-phase (ms and % GC) (p < 0.01) and increased swing-time (ms) (p < 0.05), compared with right legs of able-bodied persons while statistical significance was reached (p < 0.01) for decreased stance-time (% stride and ms), increased swing-time (% stride and ms), decreased swing velocity (m/s), increased anterior step length and decreased stride length (p < 0.05), compared with contra lateral, left legs of amputees. Our conclusion is that instrumented kinematic gait analysis study is able to provide assessment about the way prosthetic TT amputees walk.
Kada kod starijih osoba nastanu funkcijska ograničenja kao posljedica
fiziološkog starenja i/ili sekvela bolesti ili ozljeda, gerijatrijska rehabilitacija
ih sveobuhvatnim, polimodalnim postupcima ...ublažava, a osobi pomaže da
postigne što veću samostalnost u aktivnostima svakodnevnog života i što bolju
kvalitetu života. Starije osobe predstavljaju vrlo heterogenu skupinu npr. po
razlici u dobi (npr. između 65 i 85 godina) ili po općem stanju (npr. relativno
zdravih i onih s težim bolestima). Cilj rehabilitacije se za svakog bolesnika i
planira i ostvaruje individualno, u granicama koje su određene posljedicama
procesa starenja, kao i aktualnog zdravstvenog stanja.
Gerijatrijska rehabilitacija najvećim dijelom pokriva tri područja: fiziološko
starenje zbog istrošenosti i dekondicioniranja; posljedice bolesti krvožilnog
sustava i bolesna stanja koštano-zglobnog sustava. Primarno starenje je
očekivano, fiziološko i nezaustavljivo s postupno progresivnim ireverzibilnim
promjenama svih organskih sustava. Sekundarno, tj. patološko starenje ovisi
o načinu života, psihosocijalnim, ekonomskim i zdravstvenim čimbenicima,
a posebno o velikom utjecaju kroničnih bolesti kao npr. diabetes mellitus, hipertenzija itd. Preventivnim postupcima održavanjem što kvalitetnijeg,
„zdravog“ života od ranog djetinjstva i provođenjem dobre medicinske skrbi
kao i naporima za sprječavanje te ranom dijagnostikom i tretmanom kroničnih
bolesti može se postići uspješno starenje, što u starijoj dobi rezultira pozitivnim
učincima kada funkcijske sposobnosti osobe nadilaze kronološku dob. Jedna
od preventivnih metoda je poticanje tjelesne aktivnosti, kojom se smanjuje
opasnost od padanja, poboljšava ravnoteža i koordinacija pokreta, povećava
mišićna snaga, izdržljivost i aerobni kapacitet, što sve doprinosi zdravlju i
kvaliteti života
Lizosomske bolesti nakupljanja (LBN) su rijetke, multisistemske bolesti kod kojih radi genetičkog manjka ili značajnog sniženja aktivnosti lizosomskih, hidrolitičkih enzima i aktivacijskih i ...transportnih proteina, dolazi do postupnog nakupljanja nerazgrađenih supstrata u lizosomima s posljedičnim oštećenjima i poremećenim funkcijama na razini stanice, okolnog tkiva, organa te naposlijetku i cijelog organizma. Na temelju nakupljenog supstrata razlikuju se mukopolisaharidoze, sfingolipidoze, lipidoze, oligosaharidoze, mukolipidoze, glikogenoze, neuronalne ceroidne lipofuscinoze i poremećaji prijenosa. Liječenje ovih bolesti je multi i interdisciplinarno, kauzalno i simptomatsko (rehabilitacijski i ortopedsko operacijski tretman). Unazad 15-ak godina se razvija kauzalni pristup u terapiji LBN koji obuhvaća: a) zamjenu mutacijom izmjenjenog proteina katalitički aktivnim enzimom (transplantacija koštane srži, enzimska nadomjesna terapija, terapija genima) ili b) smanjenje sinteze supstrata u lizosomima (npr. niskomolekularnim inhibitorima sinteze glukoziltransferaze). Od osobite je važnosti mogućnost kliničke primjene uz dobru terapijsku učinkovitost enzimske nadomjesne terapije (ENT), pripravaka humanih enzima proizvedenih tehnikom rekombinirane DNK. Rano prepoznavanje LBN i postavljanje dijagnoze su preduvjeti za rani početak liječenja čime se osigurava ne samo bolja učinkovitost liječenja nego i početak terapije u fazi kada još nisu nastupila ireverzibilna oštećenja. Muskuloskeletni simptomi (miopatija, kontrakture zglobova, spinalne deformacije) kod LBN spadaju među ranije simptome bolesti, stoga njihovo prepoznavanje u diferencijalnoj dijagnostici ostalih koštanozglobnih bolesti može biti putokaz za rano otkrivanje i liječenje LBN.
Bolovi lumbosakralne kralježnice se klinički manifestiraju: a) slikom križobolje, kao dominantnim simptomom ili sa 2) slikom dominantne boli u nozi, koja je značajnija od križobolje (1). Križobolja ...je simptom čiji su uzroci vrlo raznoliki i brojni, ali u većini slučajeva su vertebralne geneze, a rjeđe su odraz visceralne boli. Kod slike gdje je bol u nozi intenzivnija u usporedbi s lumbalnom boli, iradijacija boli je obično po radikularnoj distribuciji. Radikulopatija označava disfunkciju odnosno kronično oštećenje spinalnih korjenova kao posljedicu prolongirane iritacije ili kompresije, uzrokovane primarno vertebralnom degenerativnom bolesti (diskogeno ili u okviru spinalne stenoze). Iznimno je uzrok nevertebralne geneze, te u oko 1 % slučajeva to mogu biti infekcija, maligni proces ili prijelom. Postoji i niz uzroka pseudoradikularne boli u nogama kao što su lezije perifernih živaca nogu, miofascijalni sindromi, vaskularne bolesti, osteoartitisi zglobova zdjelice i nogu. U diferencijalnoj dijagnostici nužno je misliti i na upalne spondilartropatije. Radi što učinkovitije terapije, nužno je anamnezom i kliničkim fizikalnim pregledom adekvatno usmjeriti dijagnostičku obradu u smislu što boljeg definiranja etiopatogeneze boli a potom, planiranja problemu usmjerene terapije.
IntroductionS-Adenosylhomocysteine hydrolase deficiency (SAHHD) is a rare inherited multisystemic disease with muscle involvement as one of the most prominent and poorly understood features. To get ...better insight into muscle involvement, skeletal muscles were analyzed by magnetic resonance imaging (MRI) and MR spectroscopy (MRS) in three brothers with SAHHD in the different age group. MethodThe study was based on analysis of MRI and MRS of skeletal muscles of the lower and the proximal muscle groups of the upper extremities in three SAHHD patients. ResultsThree siblings presented in early infancy with similar signs and symptoms, including motor developmental delay. All manifested myopathy, more pronounced in the lower extremities and the proximal skeletal muscle groups, and permanently elevated creatine kinase. At the time of MRI and MRS study, the brothers were at the age of 13, 11, and 8 years, respectively. MRI revealed lipid infiltration, and the MRS curve showed an elevated muscle lipid fraction (higher peak of lipid), which increased with age, and was more prominent in the proximal skeletal muscles of the lower extremities. These results were consistent with muscle biopsy findings in two of them, while the third patient had no specific pathological changes in the examined muscle tissue. ConclusionsThese findings demonstrate that an accessible and non-invasive method of MRI and MRS is useful for an insight into the extent of muscle involvement, monitoring disease progression, and response to treatment in SAHHD.
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