In many cases of neuromuscular disorders the physician is faced with a complete lack of therapeutic approaches. This helplessness places the doctor in a position of conflict between his desire to help and his awareness that there is no treatment. In this situation it is tempting to indiscriminately use any procedure that avoids an admission of medical helplessness while satisfying the patient's demand for treatment. Electrical interventions are often used to avoid this situation. Due to the random use of therapeutic approaches it is not known what really happens. Presumptions and biased empirical observations have led to the exten sive use of different forms of electrical stimulation regimes in neuromuscular diseases. Due to this unsatisfactory situation it is necessary to know more about appropriate methods that are being used in particular disorders. The search for a better understanding of nerve-muscle interaction has shown that certain activity patterns can influence muscle. These experi mental results provide a rational basis for a possible therapeutic use of electrical stimulation of nerve and muscle. Previously most research has been conducted in normal tissue, and little is known regarding the re sponses of diseased muscle. In an interdisciplinary approach to this, it is our intention to present the current knowledge about basic principles of electrical stimulation in normal muscle. Before electrical stimulation can be accepted as a therapeutic tool, we felt it necessary to summarize the effects of activity in normal and diseased muscle and nerve.
The third edition of this popular textbook - formerly Physical Management in Neurological Rehabilitation and now renamed Physical Management for Neurological Conditions - maintains its scientific and research base with extensive use of references and case studies. It is the only book for physiotherapists that offers a comprehensive overview of the basic principles of neurological rehabilitation, specific neurological / neuromuscular conditions and the related physiotherapy treatment approaches used. Important areas which feature throughout are discussed in relation to the different neurological conditions and include: a non-prescriptive, multidisciplinary, problem-solving approach to patient management involvement of the patient and carer in goal-setting and decision-making (client-centred practice) use of outcome measures to evaluate the effects of treatment in everyday practice use of case studies to illustrate clinical practice scientific evidence of treatment effectiveness Additional specialist editor – Dr Emma Stack Refined content but with the inclusion of 4 brand new chapters: an introductory chapter on rehabilitation in practice one on respiratory management and two covering self management and falls under the section entitled Skill Acquisition and Learning 11 new expert contributors join the reduced contributor team of 31
The introduction of the operating microscope as a surgical tool revolutionized the treatment of peripheral nerve lesions. A new era thus began in the early 1960s, which led to a substantial improvement in the management of nerve lesions. The results of nerve grafting techniques have demonstrated that, independent of the length of the defect, lesions can be successfully bridged. The free tissue transplants with microvascular anastomosis have also opened new, rewarding possibilities for peripheral nerve reconstruction procedures, facilitating the achievement not only of satisfactory anatomical but also of satisfactory fUhctional results. In order to evaluate the state of the art and reflect retrospectively on 25 years of microneurosurgical treatment of peripheral nerves, numerous outstanding scientists and clinicosurgical physicians were invited to Hanover in order to exchange their viewpoints and experiences. An active und fruitful discussion resulted which dealt with the many aspects of anatomy, pathology, clinical and neuro physiology, diagnosis, and with the surgery and physiotherapy which constitute modern-day peripheral nerve lesion treatment. The excit ing ongoing experimental and clinical activities have led us to support the wish and idea to publish the scientific exchange which took place during the Hanover symposium. I truly believe that the articles presented in this book cover so many interesting subjects concerned with peripheral nerve lesions that the book will serve the interested and dedicated physician involved with such cases as a reference work for the basics and also provide him with the therapeutic guidelines to assist him in his daily work.
Pelvic Floor Re-education encompasses a variety of techniques for increasing the strength of, and control over, the pelvic floor muscles. These techniques are now emerging as an effective and viable alternative to surgery in the treatment of urinary incontinence and related conditions. This volume presents a reasoned, scientific approach to the use of pelvic floor re-education. Starting with the latest theories on anatomy, pathophysiology and possible causes of pelvic floor damage, the text then describes the importance of pelvic floor evaluation in determining the type of treatment required. A number of re-education techniques are assessed including isolated muscle exercise, vaginal cones, biofeedback control and electrical stimulation. Recent research work is also reviewed which allows the reader to evaluate the different modalities advocated in the management of pelvic floor dysfunction.
In the literature, there are various investigations assessing the effectiveness of the use of neuromuscular electrical stimulation (NMES) in diverse patient populations diagnosed with dysphagia. To date there is not an extensive amount of literature on the use of NMES in individuals diagnosed with Parkinson's disease (PD). From the literature that is available few researchers utilized surface electromyography (sEMG) as an outcome measure. The purpose of this case study is to evaluate the efficacy of neuromuscular electrical stimulation (NMES) paired with active swallowing and traditional therapy, to assess if the intervention will results in greater muscle firing as measured by surface electromyography (sEMG) when compared to traditional swallowing therapy in isolation. The primary principle underlying the use of NMES dictates that electrical stimulation can enhance muscle functioning during active swallowing, therefore this modality was paired with effortful swallowing and resistance-based exercises. The treatment, in the A-B-A single-subject design, was intensive both from an exercise physiology and session frequency standpoint. The outcome revealed improvement in sEMG firing during the intervention phase which remained during withdrawal. Additionally, quality of life measurement, via the SWAL-QOL, improved. Treatment effects were generalized across both participants. The results support the use of NMES in conjunction with active swallowing to improve dysphagia and quality of life in individuals with Parkinson's disease.
