Biomedical subjects
Publications and source records attributed to D R McNeal.
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Explore the source record for details and available documents.
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The carry-over effect of gait-synchronized stimulation of the peroneal nerve on voluntary dorsiflexion of the paretic foot was evaluated in hemiplegic patients. The influence of providing audiovisual feedback of performance on voluntary control was also evaluated. Each patient received three test sessions separated at least one week apart. In each session, measurement of isometric torque from voluntary effort was repeated four times: before, and at 0, 30 and 60 minutes after a 20-minute walk period. Session 2 involved both peroneal stimulation during walking and performance feedback during voluntary efforts. Session 1 had stimulation only. Session 3 had feedback only. The results were inconsistent among the patients. Where increase of voluntary dorsiflexion was obtained, it was more a consequence of performance feedback than peroneal stimulation. General problems of using isometric torque produced by voluntary dorsiflexion as a measure of the carry-over effect are discussed.
A study was made of the effectiveness of two dental health education programs in an elementary school in Flint, Michigan. Following stratification by grades, random assignments of students were made by classrooms to either the Toothkeeper group or a "Traditional" group. No control groups were employed. Separate in-service training workshops were attended by the classroom teachers according to the education program to which they had been randomly assigned. An intensive 16-week program was conducted by the classroom teachers following the guidelines of the two programs. Dental examinations which included an assessment of plaque and gingivitis scores were conducted on all participants at baseline, at the end of 16 weeks, and at the conclusion of the school year, some seven months after the initiation of the program. Only minimal reductions in plaque scores were observed with either program and little comparative difference was found in the two programs at the end of the evaluation period. The Toothkeeper group experienced a somewhat greater reduction in plaque scores than the "Traditional" group during the intensive 16-week phase of the study, but these scores worsened from this time to the end of the school year. Gingivitis scores demonstrated more improvement than the reductions in plaque scores would indicate and may be related to the confounding factor of large numbers of children receiving dental treatment, especially prophylaxes during the course of this study. Differences in reductions in gingivitis between the two programs were not meaningful clinically.
The effects of electric stimulation on nerve conduction velocity of the peroneal nerve via surgically implanted electrodes was evaluated in a group of nine hemiplegic patients. After a mean duration of 25 months nerve conduction velocity averaged 47.3 meters/sec in the uninvolved and 46.1 meters/sec in the stimulated (paretic) extremity. In a control group of ten hemiplegic subjects who did not receive stimulation, nerve conduction velocity averaged 43.1 meters/sec in the hemiplegic leg, and 41.3 meters/sec in the uninvolved leg. These differences were not statistically significant. Maximum dorsiflexion strength was increased in all patients following chronic stimulation.
Implant units, manufactured by Medtronic, Inc., have been implanted in 31 patients for treatment of drop-foot. The principal problem encountered in this series was inflammatory reaction. This was observed in seven patients, and was serious enough in five to require removal of the implant. On the positive side, there have been no failures of the implanted equipment for periods of up to 7.3 years, although there is currently a question on one patient. There has also been no documented damage to the nerve from chronic stimulation. Fine wire elctrodes have been implanted intraneurally in a series of animals and in three patients. Preliminary results look encouraging, and this approach seems to hold considerable promise for a new generation of electrode design.
A new recording method for continuous spinal cord monitoring has been developed at Rancho Los Amigo Hospital. Using peripheral nerve stimulation, spinal evoked potentials (SEPs) are recorded from cancellous bone of spinous processes. This neurologically noninvasive technique provides a highly reproducible and consistent signal, unaffected by biologic noise and surgical handling of the spinal column. Moreover, the evoked response is extremely sensitive to changes in functional integrity of the spinal cord. In experimental spinal cord injuries, produced by localized distraction of the spine, changes of the evoked responses were well correlated with the change in spinal cord function.
Pica is a behavior commonly displayed by children, pregnant females, and individuals with mental retardation. A population of institutionalized adults with mental retardation was assessed for pica. Of this population, 10.8% were identified with this behavior. Also, this article discusses aspects of pica and describes how this behavior can affect the mouth.
Implanted units, manufactured by Medtronic, Inc., have been implanted in 31 patients for treatment of drop-foot. The principal problem encountered in this series is inflammatory reaction, which was observed in 7 patients and was serious enough in 5 to require removal. Theree have been no failures of the implanted equipment for periods of up to 7.3 years, although there is currently a question in 1 patient. There has also been no documented damage to the nerve due to chronic stimulation. Fine wire electrodes have been implanted intraneurally in a series of animals and in 3 patients. Preliminary results look encouraging, and this approach seems to hold considerable promise for a new generation of electrode design.