Search PubMed⌕ Search

Biomedical subjects

S L Wolf

Publications and source records attributed to S L Wolf.

At least 55 records · Page 3Linked to original sources
PubMed1993

Compartmentalization of muscles and their motor nuclei: the partitioning hypothesis.

This review article is designed to expose physical therapists to an examination of muscle organization and the implications that this organization has for therapeutic applications. The partitioning hypothesis is based on the fact that an individual muscle is arranged in a more complex array than simply fibers attaching at aponeuroses, tendons, or bones with a single muscle nerve innervation. Neuromuscular compartments, which are distinct subvolumes of a muscle, each innervated by an individual muscle nerve branch and each containing motor unit territories with a unique array of physiological attributes, are described. In addition, the organization of individual muscles into these subunits is paralleled by the organization of their parent motoneurons within the spinal cord. These notions are detailed in a review of data derived from studies performed primarily in cat and rat models. Recent data derived from morphological and anatomical study of human muscles support the existence of similar neuromuscular partitions. These data are complemented by physiological studies, the results from which suggest that partitions may have functional or task-oriented roles; that is, different portions of one muscle may be called into play depending on the task demands of the situation. The importance of these observations for reconsidering how we provide clinical applications, such as neuromuscular stimulation or kinesiological monitoring, is discussed.

Animals↗
PubMed1993

Development of the common data base for the FICSIT trials.

The eight FICSIT (Frailty and Injuries: Cooperative Studies of Intervention Techniques) sites test different intervention strategies in selected target groups of older adults. To compare the relative potential of these interventions to reduce frailty and fall-related injuries, all sites share certain descriptive (risk-adjustment) measures and outcome measures. This article describes the shared measures, which are referred to as the FICSIT Common Data Base (CDB). The description is divided into four sections according to the four FICSIT committees responsible for the CDB: (1) psychosocial health and demographic measures; (2) physical health measures; (3) fall-related measures; and (4) cost and cost-effectiveness measures. Because the structure of the FICSIT trial is unusual, the CDB should expedite secondary analyses of various research questions dealing with frailty and falls.

Accidental Falls↗
PubMed1993

The Atlanta FICSIT study: two exercise interventions to reduce frailty in elders.

This study examines the effect of two different exercise approaches on balance and frailty measures among more than 200 community-dwelling individuals greater than 70 years of age. Exercises are provided for 15 weekly sessions on an individual basis for participants randomly assigned to a Balance Training group. Training consists of center-of-mass feedback displayed on a motor under static conditions, or, in later sessions, as the floor surface is moved, with eyes open or closed. This high technology interface provides instantaneous information about displacement of body weight in space so that balance can be enhanced. An alternative procedure is comparatively simple and requires little expense or space. Tai Chi Quan was originally developed as a martial arts form but has been used for centuries in China as an exercise among elderly citizens. Participants randomly assigned to this intervention meet twice weekly for 15 weeks to learn a condensation of 108 Tai Chi forms into 10 that emphasize movement components often restricted or absent with aging. A third group serves as a control for exercise interventions by meeting weekly for 15 sessions to discuss topics of interest such as memory loss, drug management, and nutrition. All subjects are screened prior to assignment, and a host of physical, behavioral, and functional measures are assessed before and after the intervention as well as 4 months later. Measurements unique to the Atlanta site include: balance with eyes closed, programmed force-distribution changes when stance is perturbed, cardiovascular assessments, WAIS, Affects Balance Scale, and a survey of home environment.

Aged↗
PubMed1992

The relationship of technology assessment and utilization. Electromyographic feedback instrumentation as a model.

Biofeedback instrumentation has been a growing part of physical therapy practice for 20 years, and physical therapists have contributed to researching its efficacy in treating varying conditions. The application of biofeedback to the treatment of stroke was marked by some early difficulties with the quality of the electronics, but sophisticated contemporary equipment can do much more than was originally envisioned. The importance of relating quantified movement-based data to functional measures is projected as a high priority if appropriate reimbursement for physical therapy services with biofeedback is to continue in the future.

Biofeedback, Psychology↗
PubMed1991

Anatomical partitioning of three multiarticular human muscles.

To examine neuromuscular partitioning within human muscles, the innervation patterns and muscle fiber architecture of the flexor carpi radialis (FCR), extensor carpi radialis longus (ECRL) and lateral gastrocnemius (LG) muscles were examined. Consistent patterns of innervation between specimens were found within each of the three muscles. The nerve to the FCR clearly innervates three major architectural divisions of the muscle. The ECRL is innervated by two different muscle nerves. Branches of these nerves innervate at least two distinct anatomical subvolumes. However, the subvolumes of the ECRL defined by muscle architecture are not totally congruent with those defined by the innervation pattern. In the LG, the single muscle nerve branches into two main divisions, and these subsequently divide into branches which supply the three heads. However, each head does not receive a completely private nerve. These results indicate that human muscles are partitioned in a manner roughly similar to the divisions of the same muscles in cats and rats, but with less congruency of architecture and innervation.

Hand↗
PubMed1991

Quantitative analysis of surface and percutaneous electromyographic activity in lumbar erector spinae of normal young women.

Bilateral surface and fine-wire electromyographic activity from the erector spinae at the L4-5 interspace was recorded from 10 female subjects during flexion, extension, rotation to right/left, and sidebending to right/left. Fine-wire electrodes demonstrated significant left-right electromyographic differences during terminal flexion. Surface and fine-wire electromyographic recordings demonstrated a symmetric pattern of activity during extension. A symmetric pattern of erector spinae activity was observed during rotation using fine-wire electrodes but not from surface electrodes. Increased electromyographic activity from the contralateral erector spinae was detected by the surface electrodes during sidebending to neutral movements.

Adult↗
PubMed1990

Conditioning of the spinal stretch reflex: implications for rehabilitation.

The purpose of this article is to describe a new technique that can potentially be applied to patients with hyperactive spinal stretch reflexes (SSRs). The progression of clinical research from conditioning of individual muscles or muscle groups (electromyographic biofeedback) to conditioning SSRs is explained. Research data from subhuman primates in addition to the first human experiments are reviewed. Potential applications of SSR conditioning are discussed, as are the issues requiring further delineation and research before the specificity of a training effect can be ascertained.

Animals↗
PubMed1989

Modification of human spinal stretch reflexes: preliminary studies.

Modulation of the human spinal stretch reflex (SSR) may be important in treating hyperactive reflexes or may be a tool to enhance normal performance. Eight of 9 subjects given feedback of biceps brachii SSR amplitude and instructed to increase (uptrain) or decrease (downtrain) this response were able to do so in the appropriate direction. These results imply that, as in non-human primates, SSR amplitude can be modified.

Adult↗
PubMed1989

The relationship of extraneous movements to lumbar paraspinal muscle activity: implications for EMG biofeedback training applications to low back pain patients.

Within recent years clinicians and researchers have applied paraspinal EMG biofeedback procedures during static and dynamic movement retraining of chronic low back pain patients. Most of these applications make use of surface electromyography, an approach complicated by the fact that the erector spinae muscles are deeply situated. This descriptive study reveals that extraneous movements, such as neck flexion and pelvic rotation, can elicit profound activity from percutaneously placed EMG electrodes while little change is seen at the skin surface. The implications of these observations for the use of EMG feedback to remediate low back pain are discussed.

Adult↗
PubMed1989

The influence of cephalostatic ear rods on the positions of the head and neck during postural recordings.

This study examined the effect of cephalostatic ear rods on the positions of the head and neck. The method error was assessed for postural recordings of the head and neck position made with and without ear rods. A photographic angle was correlated with the postural angles on x-ray film. The material compared 33 dental students who were recorded with ear rods in and with ear rods out. Subjects were chosen randomly to repeat the postural recordings. The differences between the mean for each postural variable were subjected to comparative analysis, using Student's t test for paired samples. A significant difference (p less than or equal to 0.05) was found between the means of the inclination of the cervical spine to the true horizontal and the means of the photographic angle. The mean values for the remaining postural variables showed an insignificant but consistent pattern of axial extension of the cervical spine. Cephalostatic ear rods may alter head and neck position during postural recordings. The method error made for recording total head and neck position with ear rods was higher than without ear rods. The difference in the photographic angle was found to have a moderate positive correlation with the difference in the cervical inclination and the total head and neck position. These data suggest that lateral cephalostatics without ear rods may be used to record total head and neck position and the photographic technique may be used as a quick, inexpensive method for the clinician to determine head and neck positional changes before and after treatment.

Adult↗
PubMed1989

Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients.

To test the clinical counterpart of the learned nonuse theory, 25 chronic hemiplegic stroke and head-injured patients with minimal to moderate upper extremity extensor muscle function were required to keep their uninvolved upper extremities within a hand-enclosed sling during waking hours over a 2-week interval. During this forced use period and for 1 year thereafter, changes in force or time-based measures among 21 functional tasks were compared to values at the sixth baseline session, a preintervention time when relearning had plateaued. Significant (P less than 0.05, Friedman's repeated measures followed by Tukey multiple comparison tests) changes were seen in 19 of the 21 tasks with most persisting at the 1-year follow-up. There were no apparent differences between right- and left-sided involvement or between stroke versus head injury clients (Mann-Whitney procedure). Ratings for quality of movement scored from videotapes presented in random order showed no change over time. These data suggest that learned nonuse does occur in select neurological patients and that this behavior can be reversed through application of a forced use paradigm.

Adult↗
PubMed1989

Comparison of motor copy and targeted biofeedback training techniques for restitution of upper extremity function among patients with neurologic disorders.

A total of 30 targeted training electromyographic biofeedback treatments were administered to the hemiplegic upper extremities of 12 chronic stroke and head-injured patients (TT Group). The 30 treatments were divided into three series of 10 treatments each directed to the shoulders; the elbow; and the wrist, fingers, and thumb, respectively. Evaluations for function, active range of motion, and integrated EMG activity were undertaken five times before treatment (baseline measurements), after each series of 10 treatments, and at follow-up intervals for one year. Data from these evaluations were compared with those obtained over an identical time course from 14 chronic stroke and head-injured patients undergoing a motor copy procedure (MC Group) in which the patients matched EMG output viewed on a screen from homologous upper extremity muscles. Both groups showed appropriate significant changes among many independent variables. Changes within the TT Group, however, appeared more treatment-related, whereas changes among the MC Group were latent, occurring more frequently at follow-up evaluations. There were no substantial correlations between EMG activity, active ROM, or function, thus highlighting the continuing difficulty of identifying a causative relationship between physiologic change and enhanced motor capabilities among patients with neurologic disorders. Nonetheless, the results do suggest that both techniques are of clinical benefit, with the motor copy technique offering potential cost-effectiveness because patients can self-train.

Biofeedback, Psychology↗
PubMed1989

Topical anesthetics: effects on the Achilles tendon and H-reflexes. I. Able-bodied subjects.

Achilles tendon reflexes (ATR) and H-reflexes were monitored to determine changes in motor responses after the application of a benzocaine spray or an air spray to normal individuals. There was no change in ATR after application of the spray or the benzocaine, even when the sequence of reflex elicitation was reversed. The only significant change (p less than 0.05) in the H-reflex was an increase in its amplitude from baseline at all posttest times following (1) the placebo application when the H-reflex preceded the ATR (0.264 +/- 0.054V, ten minutes; 0.290 +/- 0.054V, 20 minutes; and 0.322 +/- 0.058V, 30 minutes), and (2) the benzocaine spray when the ATR preceded the H-reflex (0.277 +/- 0.084V, ten minutes; 0.309 +/- 0.152V, 20 minutes; and 0.329 +/- 0.131V, 30 minutes). Within-group comparisons revealed that a significantly greater H-reflex (p less than 0.05) was obtained at 20 and 30 minutes after air spray when H-reflex/ATR test sequence was used, whereas at 30 minutes after application of the benzocaine spray a significantly greater H-reflex was seen using the ATR/H-reflex test sequence. Changes in H-reflex amplitude appear to be as much a function of the reflex testing sequence as whether an air or benzocaine spray is used.

Achilles Tendon↗
PubMed1989

Topical anesthetics: effects on the Achilles tendon and H-reflexes. II. Stroke patients.

This study determined whether the Achilles tendon reflex, H-reflex, and ankle range of motion (ROM) during ambulation undergo significant changes after application of benzocaine spray applied to the triceps surae skin area of eight stroke patients displaying spasticity in ankle plantar flexor muscles. The H-reflex amplitude increased significantly (p less than 0.05) at 30 minutes after both the benzocaine (0.346 +/- 0.101V) and the placebo (air spray, 0.324 +/- 0.078V) when the placebo was given first; however, there was no significant difference between the two interventions. A significant decrease in ankle ROM occurred during midswing at 20 (placebo administered first) and 30 (benzocaine administered first) minutes after the placebo, but this decrease was not significantly greater than the change after the benzocaine. Benzocaine spray did not change motor neuron excitability level or improve the subject's ability to perform a functional task.

Achilles Tendon↗
PubMed1989

Upper extremity joint movement: comparison of two measurement devices.

The Ortho Ranger is a new device available for measurement of joint motion. The purposes of this study were (1) to determine the clinical reliability of the Ortho Ranger compared to the reliability of the standard goniometer and (2) to investigate the correlation between the Ortho Ranger and the goniometer for upper extremity joint movements in healthy adults. Three measurements with each instrument were taken during three different sessions for active shoulder, elbow, and wrist movements. The within-session reliability was higher for the goniometer. The Pearson correlation coefficients suggest a strong relationship between the Ortho Ranger and the goniometer for shoulder internal and external rotation, and a poor relationship for elbow movements. The Ortho Ranger does not provide remarkable advantages in measurement compared to the goniometer.

Adult↗
PubMed1988

Comparison of the reliability of the Orthoranger and the standard goniometer for assessing active lower extremity range of motion.

The purpose of this study were to determine 1) the reliability of the Orthoranger for assessing active lower extremity joint range of motion, 2) specific methods for applying the Orthoranger, and 3) whether a correlation exists between the measurements obtained with the Orthoranger and those obtained with a standard goniometer. Ten men and 10 women, mean ages 28.3 +/- 5.1 and 30.0 +/- 10.1 years, respectively, participated in the study. Random selection was used to determine testing sequences. The Orthoranger and the goniometer were used to measure each joint three times during the five sessions. Results indicated that both instruments were reliable for assessing active lower extremity joint ROM. The goniometer showed greater intraclass correlations and confidence levels for all movements except hip lateral rotation, which demonstrated a higher intraclass correlation for the Orthoranger. In addition, all motions except hip adduction and knee extension demonstrated a positive relationship between instruments. Compared with a manual goniometer, the added costs for purchase and use of the Orthoranger appear to be unnecessary until such time that factors enhancing its inherent reliability are identified.

Adult↗