Traumatic spinal cord lesions have a worldwide high morbidity and mortality, and in many developed countries the problem has received special attention, based on epidemiological studies. In Brazil these studies have been restricted to institutional data. In 1988 a survey conducted by the Integrated System of Traumatology and Orthopaedics, covering 36 public hospitals from 7 Brazilian capitals, revealed a point prevalence of 8.6% (108 patients) with spinal cord injury, aged from 6-56 years; 81% were men. The most frequent causes were traffic accidents (42%), firearms (27%) and falling from heights (15%). The main complications were pressure ulcers (54%) and urinary infections (32%).
Further research in brain control and improvement of myoelectric prosthesis will lead to a more holistic approach in the development of a man-machine complex.
The purpose of this study was to verify whether brain activation could be used to modulate the movements of an artificial limb. This approach was begun 20 years ago with the fitting of prostheses immediately following lower-limb amputations. We studied 9 unilateral amputees and 9 control participants using functional MRI, electroneuromyography, gait laboratory, and neuropsychological assessments. The results demonstrated that brain activation is analogous when participants in the control group are asked to mentally move a foot, compared with amputees who are asked to move a nonexistent foot. The brain has not been damaged and maintains its areas of command. This can be applied in rehabilitation.
SUMMARY A retrospective study was performed of 272 patients with spasticity to determine criteria for the prognosis for ambulation based on the ages at which children with cerebral palsy attain important gross motor milestones. The variables analysed were age at last clinical assessment, clinical type of cerebral palsy and ages at attainment of gross motor milestones. Achievement of head balance before nine months was an important parameter for good prognosis for walking and, after 20 months of age, an indicator for poor prognosis. Sitting by 24 months indicated a favourable outcome, and motor control of crawling at 30 months of age was a predictor for good prognosis. Based on these data, a chart for walking prognosis in children with cerebral palsy is presented. RÉSUMÉ Pronostic de marche dans l'IMC: analyse rétrospective de 22 ans Une étude rétrospective a été réalisée chez 272 patients spastiques pour déterminer les critères de pronostic pour la marche, basés sur l'âge auquel les enfants IMC franchissent les étapes de la motricité globale. Les variables analysées étaient l'âge à la dernière évaluation clinique, le type clinique d'IMC et les âges où apparaissaient les repères de la motricité générale. La bonne tenue de tête avant l'âge de neuf mois apparut un paramètre de bon pronostic pour la marche et, après 20 mois, un facteur de mauvais pronistic. S'asseoir à 24 mois indiquait un devenir favorable et un bon contrôle du ramper à 30 mois était une indication de bon pronostic. En s'appuyant sur ces données, un tableau de pronostic de marche chez les enfants IMC est prèsenté. ZUSAMMENFASSUNG Prognose für das Laufen bei Cerebralparese: eine retrospektive Analyse über 22 Jahre Bei 272 spastischen Patienten wurde eine retrospektive Untersuchung durchgeführt, um Kriterien, basierend auf den Alterstufen, in denen Kinder mit Cerebralparese wichtige großmotorische Meilensteine erreichen, herauszufinden, die eine Prognose für das Laufenlernen zulassen. Die anälysierten Variablen waren Alter bei der letzten klinischen Untersuchung, klinische Form der Cerebralparese und Altersstufen, in denen großmotorische Meilensteine erreicht wurden. Kopfkontrolle vor dem neunten Monat war ein wichtiger Parameter für eine gute Prognose für das Laufen und nach dem 20sten Monat ein Indikator für eine schlechte Prognose. Sitzen bis zum 24sten Monat zeigte einen günstigen Outcome an und motorische Kontrolle beim Krabbeln mit 30 Monaten war ein Parameter fiir eine gute Prognose. Basierend auf diesen Daten wird eine Prognosetabelle für das Laufenlernen bei Kindern mit Cerebralparese vorgestellt. RESUMEN Pronóstico de la marcha en la parálisis cerebral: análisis retrospectivo de 22 años Se llevó a cabo un estudio retrospectivo de 272 espásticos para determinar los criterios para establecer el pronóstico de la ambulatión, basado en las edades en que los niños con parálisis cerebral alcanzaban los hitos motores más importantes. Las variables analizadas eran la edad de la última evaluatión clinica, el tipo de parálisis cerebral y las edades de ...
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