An investigation of neurosurgical alleviation of parkinsonism, chorea, athetosis and dystonia.
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This paper describes the results of a follow-up evaluation of a bracing program for severely athetoid, mentally retarded children. Bracing to improve upper extremity control was started in 1968 and was described in a 1971 AJOT article. The follow-up study was done in order to provide criteria for selecting patients in future bracing programs, to identify the type of motion problems that could be successfully braced, and to determine the bracing configurations most effecive in aiding arm control.
In 9 controls and in 10 athetosic subjects, authors performed a pneumotachographic registering of ventilation under rest conditions for each phase and determined : the phase duration, the delay between the onset of the phase and the moment where the maximal output occurs, the output reached at the first 1/10th of second after phase change. These determinations were performed in 189 cycles in the controls and in 257 cycles in the athetosic subjects. For each cycle, ventilation and frequency reported to one minute were reckoned, and the relation was established between the duration of expiration and inspiration and between the time necessary for the output to reach its maximal level and the phase duration. The hereafter mentioned facts were noted : in the athetosic subjects there exists a tachypnea for normal ventilation figures, a proportional lengthening in the expiration duration with a reduced mean output; in the beginning of the phase, the output gets increased more rapidly and reaches a higher level than in the controls; then a slow and irregular decrease occurs. Inspiration is rapid and regular. The most perturbed expiration is to be found in the athetosic subjects who exhibit the most severe vocal disorders. These expiratory anomalies appear to be bound with a poor thoracic and laryngeal motor controlling during the passive phase of the respiration, whereas the automatic inspiratory movement takes place in a normal mood.
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