The Experts below are selected from a list of 144 Experts worldwide ranked by ideXlab platform
Alvin A. Freehafer - One of the best experts on this subject based on the ideXlab platform.
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Limb fractures in patients with Spinal cord injury
Archives of physical medicine and rehabilitation, 1995Co-Authors: Alvin A. FreehaferAbstract:Limb fractures that occur late in patients with Spinal Paralysis are considered to be different enough to warrant variations in treatment. In the author's experience, treatment ensures that the functional level is unchanged when healing occurs. Treatment includes use of splints, made of soft materials, that are effective, inexpensive, safe, and allow for good healing. There is motion at the fracture site but, in the author's experience, healing occurs in all fractures except those at the femoral neck. Treatment with soft materials is the least expensive treatment method because it does not require hospitalization, surgery is not recommended, the bone is so soft and pathological that it does not hold firmly with internal fixation, rehabilitation is simplified.
Ursula S. Hofstoetter - One of the best experts on this subject based on the ideXlab platform.
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Spinal Cord Stimulation and Augmentative Control Strategies for Leg Movement after Spinal Paralysis in Humans.
CNS neuroscience & therapeutics, 2016Co-Authors: Karen Minassian, Ursula S. HofstoetterAbstract:Severe Spinal cord injury is a devastating condition, tearing apart long white matter tracts and causing Paralysis and disability of body functions below the lesion. But caudal to most injuries, the majority of neurons forming the distributed proprioSpinal system, the localized gray matter Spinal interneuronal circuitry, and Spinal motoneuron populations are spared. Epidural Spinal cord stimulation can gain access to this neural circuitry. This review focuses on the capability of the human lumbar Spinal cord to generate stereotyped motor output underlying standing and stepping, as well as full weight-bearing standing and rhythmic muscle activation during assisted treadmill stepping in paralyzed individuals in response to Spinal cord stimulation. By enhancing the excitability state of the Spinal circuitry, the stimulation can have an enabling effect upon otherwise "silent" translesional volitional motor control. Strategies for achieving functional movement in patients with severe injuries based on minimal translesional intentional control, task-specific proprioceptive feedback, and next-generation Spinal cord stimulation systems will be reviewed. The role of Spinal cord stimulation can go well beyond the immediate generation of motor output. With recently developed training paradigms, it can become a major rehabilitation approach in Spinal cord injury for augmenting and steering trans- and sublesional plasticity for lasting therapeutic benefits.
Mitchell Batavia - One of the best experts on this subject based on the ideXlab platform.
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Abstract 10: Standing induced via segmental reflex pathways of persons with Spinal Paralysis: a case series.1
Archives of Physical Medicine and Rehabilitation, 2003Co-Authors: John G. Gianutsos, Joan Gold, Michael Hutchinson, Edwin F. Richter, Jung H. Ahn, Mitchell BataviaAbstract:Abstract Setting: Urban hospital. Patients: 12 persons with Paralysis of Spinal origin. Case Description: Reflex standing is induced by means of whole body vibration in persons with Paralysis of Spinal origin. A case series of persons who had Paralysis due to Spinal infection, paraplegia after traumatic injury at the thoracic and lumbar levels, or quadriplegia after cervical trauma. Subjects were 1 year postonset, had stable skeletal systems, and tone in the thighs. Subjects reflexively stood on a vibratory device as muscles contracted and relaxed in response to segmental reflex loops triggered by vibration delivered at amplitudes ranging from 0 to 5.1mm, and frequencies ranging from 0 to 28Hz. Assessment/Results: Standing time with and without vibratory stimulaton; degree of volitional movement in trunk and limbs; and carry-over to voluntary standing and walking. Subjects were able to stand for periods (up to 30min) with vibration and for brief periods (1–3min) after vibration ceased. Some patients recovered the ability to stand and to ambulate. Discussion: Long periods of immobility and loss of sensation can produce skin breakdown with fatal consequences if left untreated. A sedentary life style resulting from a loss of voluntary movement and sensation may aggravate existing dysfunction of the bowel and bladder and lead to constipation and urinary infection, as well as increased vulnerability to pneumonia and respiratory infection. Spinal cord injury increases the vulnerability to chronic conditions such as cardiovascular disease, diabetes, and osteoporosis. Fitness has been improved through treadmill-induced reflex walking in humans for 2 decades. Likewise, the act of standing, be it for brief periods, benefits patients physically and provides a source of emotional, psychologic, and social satisfaction. Conclusion: Vibratory-induced standing represents a promising modality for use in the rehabilitation of persons with motor dysfunction of Spinal origin.
Karen Minassian - One of the best experts on this subject based on the ideXlab platform.
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Spinal Cord Stimulation and Augmentative Control Strategies for Leg Movement after Spinal Paralysis in Humans.
CNS neuroscience & therapeutics, 2016Co-Authors: Karen Minassian, Ursula S. HofstoetterAbstract:Severe Spinal cord injury is a devastating condition, tearing apart long white matter tracts and causing Paralysis and disability of body functions below the lesion. But caudal to most injuries, the majority of neurons forming the distributed proprioSpinal system, the localized gray matter Spinal interneuronal circuitry, and Spinal motoneuron populations are spared. Epidural Spinal cord stimulation can gain access to this neural circuitry. This review focuses on the capability of the human lumbar Spinal cord to generate stereotyped motor output underlying standing and stepping, as well as full weight-bearing standing and rhythmic muscle activation during assisted treadmill stepping in paralyzed individuals in response to Spinal cord stimulation. By enhancing the excitability state of the Spinal circuitry, the stimulation can have an enabling effect upon otherwise "silent" translesional volitional motor control. Strategies for achieving functional movement in patients with severe injuries based on minimal translesional intentional control, task-specific proprioceptive feedback, and next-generation Spinal cord stimulation systems will be reviewed. The role of Spinal cord stimulation can go well beyond the immediate generation of motor output. With recently developed training paradigms, it can become a major rehabilitation approach in Spinal cord injury for augmenting and steering trans- and sublesional plasticity for lasting therapeutic benefits.
Goran Gunther - One of the best experts on this subject based on the ideXlab platform.
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tick borne encephalitis pathogenesis clinical course and long term follow up
Vaccine, 2003Co-Authors: Mats Haglund, Goran GuntherAbstract:The prospective studies available today confirm the experience gained from several retrospective studies that TBE is a disease with a severe acute clinical course and considerable long-term morbidity. A defined post-encephalitic TBE syndrome exists, causing long-lasting morbidity that often affects the quality of life and sometimes also forces the individual to a change in life-style. The sequelae render high costs for individual patients and the society. Three clinical courses may be identified: one with complete recovery within 2 months, occurring in approximately one fourth of patients, one with protracted, mainly cognitive dysfunction, and one with persisting Spinal nerve Paralysis with or without other post-encephalitic symptoms. Up to 46% of patients are left with permanent sequelae at long-time follow-up, the most commonly reported residuals being various cognitive or neuropsychiatric complaints, balance disorders, headache, dysphasia, hearing defects, and Spinal Paralysis. This knowledge enhances the need for continued local epidemiological surveillance of TBE to form a basis for vaccination policies. Even though knowledge of the clinical course of TBE has improved in recent years, there are still several aspects of this disease that warrant further studies. These comprise the clinical picture and prognosis in children, an evaluation of different rehabilitation strategies, and an improved understanding of pathogenic mechanisms to permit the development of antiviral or, maybe more probable, immune modulatory treatment strategies.