Posts Tagged multiple sclerosis
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Regain function with Bioness’ innovative solutions designed to help those living with Foot Drop or Hand Paralysis due to conditions such as Stroke, Multiple Sclerosis, Cerebral Palsy, Traumatic Brain Injury, or Incomplete Spinal Cord Injury.
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Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity.
The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients’ quality of life, by affecting their ability to perform normal activities.
This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services.
The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients’ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.
PhysioFunction are recognised as international experts in the use of Functional Electrical Stimulation (FES). We ensure our clients receive the most clinically correct rehabilitation technology suited to their needs.
The L300 Foot Drop System helps to alleviate walking challenges that may result from: Stroke, Traumatic Brain Injury, Incomplete Spinal Cord Injury, Multiple Sclerosis. The L300 system is an advanced functional electrical stimulation system that stimulates the nerves in the lower leg, activating muscles to lift the foot which allows you to walk more naturally.
If you have MS-related foot drop, functional electrical stimulation could significantly improve the way you walk. Learn the pros and cons of FES.
[WEB SITE] ProtectYour Pregnancy: Certain neurologic conditions are treated with drugs that may be dangerous or inappropriate for women of reproductive age. We asked experts about the risks and the alternatives. : Neurology Now
Gorman, Megan Othersen
Brandy Parker-McFadden had always considered herself one of the lucky ones, and by any measure she was. Diagnosed with epilepsy at age 15 after her first convulsive seizure, Parker-McFadden, now 40, has had just three seizures in the 25 years since. “I took my medications faithfully and went on with my life,” she says. “I grew up, I got married, and I had a baby—and then two more. Through it all, my epilepsy was well controlled with medication. From the outside, it was almost as though I didn’t have it.”
This was thanks in large part to valproate, an antiseizure medication prescribed by her neurologist that is often used to treat epilepsy and bipolar disorder and to prevent migraines. So when her neurologist instructed her obstetrician to increase the dosage during her first pregnancy to ensure that the medicine remained at a therapeutic level within her body, Parker-McFadden didn’t question it.
That was 12 years ago, in 2003. Parker’s firstborn, Samuel, is now 11.
“Samuel was born right around the time we got the first information on cognitive risks to babies exposed to valproate in utero,” says Kimford J. Meador, MD, a professor of neurology and neurological sciences at Stanford University Medical Center in California, clinical services director of the Stanford Comprehensive Epilepsy Program, and a Fellow of the American Academy of Neurology (FAAN). “There were hints in the epilepsy pregnancy registries [online databases cataloging the experiences of pregnant women taking epilepsy drugs], but what wasn’t fully known until 2004 is that one in 10 children exposed to valproate in utero will have a major complication—plus a 7- to 10-point drop in IQ. Verbal intelligence, in particular, is affected.”
WEB EXTRA: For more information about pregnacy and epilepsy, visithttp://bit.ly/NN-pregnancy-epilepsy.
As anyone who’s ever recovered from an injury knows, physical therapy can be painful, boring and slow. TED Fellow Cosmin Mihaiu is out to change that with MIRA, software that disguises physical therapy exercises as fun-to-play videogames. Here’s how it works.
Unlikely — fun! — physical therapy. “Traditionally, a patient doing physical therapy at home is, at most, looking in the mirror. There’s no other feedback or encouragement,” says Mihaiu. MIRA, built by his team in Romania and the United Kingdom, changes that. It’s a set of simple, fun-to-play videogames that encourage precise movement while offering audio and visual stimulus and a sense of achievement. By reaching their onscreen goals, patients also do their physical therapy exercises. So a patient recovering from a broken arm might fly a bee to gather pollen — while flexing and extending the arm. Someone recovering from a stroke might navigate a submarine through water to improve the precision of movement in the shoulder.
Off-the-shelf hardware and tailored exercises produce a personal experience. Each of the ten games offers a range of exercises that can be tailored to each patient’s needs; it’s up to the therapist to prescribe which ones to play, and for how long. Mihaiu and his team built software that can be played via a Kinect motion-sensing input device and a PC. Using readily available and relatively cheap hardware is one way they hope to promote adoption by clinics and hospitals — and eventually by patients at home.
BECAUSE PATIENTS KNOW THAT THEIR CLINICIANS CAN SEE WHETHER AND HOW THEY ARE DOING THE PRESCRIBED EXERCISES, THEY’RE MORE LIKELY TO COMPLY.
The inspiration for MIRA: a fall from a tree. When he was seven, Mihaiu fell out of a tree he’d used as a (poor) hiding place. “The doctors encased my arm and torso in a cast, and because I was stuck in that position for six weeks, I could no longer extend my elbow when the cast came off,” he says. A physical therapist prescribed exercises that called for him to flex and extend his elbow 100 times a day. Unsurprisingly, little Cosmin balked at such tedium. But that meant his recovery took far longer than it should have done. Years later, as a computer engineering student at the University of Babeș-Bolyai in Romania, Mihaiu remembered this childhood experience during a brainstorming session for the Microsoft Imagine Cup innovation competition. “We thought, what if we could get people to play their way to recovery?” he recalls. They didn’t win, but the idea stuck, and MIRA — which stands for Medical Interactive Recovery Assistant — was born.
Functional electrical stimulation is an effective treatment strategy for the management of foot drop in various neurologic conditions, as demonstrated in improvements in gait performance, mobility, physiologic cost, perceived walking ability, balance, fall frequency, and quality of life. In this article, we review the current literature on the effects of functional electrical stimulation for foot drop in persons with multiple sclerosis.
[ARTICLE] The Effectiveness of Functional Electrical Stimulation on Walking Speed, Functional Walking Category and Clinically Meaningful Changes for People with Multiple Sclerosis
Objective: To determine the effectiveness of functional electrical stimulation (FES) on foot drop in patients with multiple sclerosis, (MS) using data from standard clinical practice.
Design: Case series with a consecutive sample of FES users collected between 2008 and 2013.
Setting: Specialist FES centre at a District General Hospital
Participants: One hundred and eighty seven (117 females, 70 males, mean number of years since diagnosis 11.7, range of years 1-56, age range 27-80, average age 55 years) patients with MS who have foot drop. One hundred and sixty six were still using FES after 20 weeks with 153 patients completing the follow up measures.
Interventions: FES of the common peroneal nerve (178 unilateral, 9 bilateral FES users).
Outcome Measures: Clinically meaningful changes (i.e. >0.05 ms-1 and >0.1ms-1) and functional walking category derived from 10 metre walking speed.
Results: An increase in walking speed was found to be highly significant (p<.001), both initially where a minimum clinically meaningful change was observed (0.07ms-1) and after 20 weeks with a substantial clinically meaningful change (0.11ms-1). After 20 weeks treatment responders displayed a 27% average improvement in their walking speed. No significant training effect was found. Overall functional walking category was maintained or improved in 95% of treatment responders.
Conclusions: FES of the dorsiflexors is a well-accepted intervention that enables clinically meaningful changes in walking speed leading to preserved or increased functional walking category.
[RESEARCH PAPER] A comparison of the orthotic effect of the Odstock Dropped Foot Stimulator and the Walkaide functional electrical stimulation systems on energy cost and speed of walking in Multiple Sclerosis.
Purpose: Functional electrical stimulation (FES), an assistive device used for foot drop, has been found to improve the speed and energy cost of walking in people with multiple sclerosis (pwMS). This study aims to compare the immediate orthotic effect on walking of two different devices; the Odstock Dropped Foot Stimulator (ODFS) and Walkaide (WA).
Method: Twenty pwMS (10 female, 10 male, mean age 50.4 ± 7.3 years) currently using ODFS were recruited. Participants walked for 5 min around an elliptical 9.5 m course at their preferred walking speed; once with ODFS, once with WA and once without FES on the same day of testing. Gait speed, distance and energy cost were measured.
Results: There was a statistically significant increase in walking speed for the ODFS (p = 0.043) and a near to significant increase for the WA (p = 0.06) in comparison to without FES. There were no differences between the ODFS and WA in terms of either walking speed (p = 0.596) or energy cost (p = 0.205).
Conclusions: This is the first pilot study to compare the effects of two different FES devices on walking. Further research recruiting a larger cohort of FES naive participants is needed.
Implications for Rehabilitation
- Functional electrical stimulation (FES) used for foot drop in multiple sclerosis (MS) is effective in improving the speed of walking.
- The Odstock Dropped Foot Stimulator and the Walkaide have similar orthotic effects on the speed and energy cost of walking in people with MS.
- Further research is urgently needed to compare FES devices, recruiting treatment of naive participants for a fully powered RCT.
via A comparison of the orthotic effect of the Odstock Dropped Foot Stimulator and the Walkaide functional electrical stimulation systems on energy cost and speed of walking in Multiple Sclerosis, Disability and Rehabilitation: Assistive Technology, Informa Healthcare.