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Fernández-Tenorio E, Serrano-Muñoz D, Avendaño-Coy J, Gómez-Soriano J. Estimulación eléctrica nerviosa transcutánea como tratamiento de la espasticidad: una revisión sistemática. Neurologia 2019; 34:451-460. [PMID: 27474366 DOI: 10.1016/j.nrl.2016.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022] Open
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Fernández-Tenorio E, Serrano-Muñoz D, Avendaño-Coy J, Gómez-Soriano J. Transcutaneous electrical nerve stimulation for spasticity: A systematic review. Neurología (English Edition) 2019. [DOI: 10.1016/j.nrleng.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Jiménez-Sánchez C, Ortiz-Lucas M, Bravo-Esteban E, Mayoral-del Moral O, Herrero-Gállego P, Gómez-Soriano J. Myotonometry as a measure to detect myofascial trigger points: an inter-rater reliability study. Physiol Meas 2018; 39:115004. [DOI: 10.1088/1361-6579/aae9aa] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Pérez-Nombela S, Barroso F, Torricelli D, de Los Reyes-Guzmán A, Del-Ama AJ, Gómez-Soriano J, Pons JL, Gil-Agudo Á. Modular control of gait after incomplete spinal cord injury: differences between sides. Spinal Cord 2016; 55:79-86. [PMID: 27349606 DOI: 10.1038/sc.2016.99] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/21/2016] [Accepted: 05/24/2016] [Indexed: 01/11/2023]
Abstract
STUDY DESIGN This is an analytical descriptive study. OBJECTIVES The main goal of this study was to compare the modular organization of bilateral lower limb control in incomplete spinal cord injury (iSCI) patients during overground walking, using muscle synergies analysis. The secondary goal was to determine whether the similarity between the patients and control group correlate with clinical indicators of walking performance. SETTING This study was conducted in National Hospital for Spinal Cord Injury (Toledo, Spain). METHODS Eight iSCI patients and eight healthy subjects completed 10 walking trials at matched speed. For each trial, three-dimensional motion analysis and surface electromyography (sEMG) analysis of seven leg muscles from both limbs were performed. Muscle synergies were extracted from sEMG signals using a non-negative matrix factorization algorithm. The optimal number of synergies has been defined as the minimum number needed to obtain variability accounted for (VAF) ⩾90%. RESULTS When compared with healthy references, iSCI patients showed fewer muscle synergies in the most affected side and, in both sides, significant differences in the composition of synergy 2. The degree of similarity of these variables with the healthy reference, together with the composition of synergy 3 of the most affected side, presented significant correlations (P<0.05) with walking performance. CONCLUSION The analysis of muscle synergies shows potential to detect differences between the two sides in patients with iSCI. Specifically, the VAF may constitute a new neurophysiological metric to assess and monitor patients' condition throughout the gait recovery process.
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Affiliation(s)
- S Pérez-Nombela
- Biomechanical and Technical Aids Department, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - F Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain.,Centre ALGORITMI, University of Minho, Azurém, Guimarães, Portugal
| | - D Torricelli
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - A de Los Reyes-Guzmán
- Biomechanical and Technical Aids Department, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - A J Del-Ama
- Biomechanical and Technical Aids Department, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - J Gómez-Soriano
- Sensoriomotor Function Group, National Hospital for Spinal Cord Injury, Toledo, Spain.,Toledo Physiotherapy Research Group (GIFTO). Nursing and Physical Therapy School, Castilla-La Mancha, Toledo, Spain
| | - J L Pons
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - Á Gil-Agudo
- Biomechanical and Technical Aids Department, National Hospital for Spinal Cord Injury, Toledo, Spain
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Suardíaz M, Galan-Arriero I, Avila-Martin G, Estivill-Torrús G, de Fonseca FR, Chun J, Gómez-Soriano J, Bravo-Esteban E, Taylor J. Spinal cord compression injury in lysophosphatidic acid 1 receptor-null mice promotes maladaptive pronociceptive descending control. Eur J Pain 2015; 20:176-85. [PMID: 25820316 DOI: 10.1002/ejp.695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although activation of the lysophosphatidic acid receptor 1 (LPA1) is known to mediate pronociceptive effects in peripheral pain models, the role of this receptor in the modulation of spinal nociception following spinal cord injury (SCI) is unknown. AIM In this study, LPA1 regulation of spinal excitability mediated by supraspinal descending antinociceptive control systems was assessed following SCI in both wild-type (WT) and maLPA1-null receptor mice. METHODS The effect of a T8 spinal compression in WT and maLPA1-null mice was assessed up to 1 month after SCI using histological, immunohistochemical and behavioural techniques analysis including electrophysiological recording of noxious toes-Tibialis Anterior (TA) stimulus-response reflex activity. The effect of a T3 paraspinal transcutaneous electrical conditioning stimulus on TA noxious reflex temporal summation was also assessed. RESULTS Histological analysis demonstrated greater dorsolateral funiculus damage after SCI in maLPA1-null mice, without a change in the stimulus-response function of the TA noxious reflex when compared to WT mice. While T3 conditioning stimulation in the WT group inhibited noxious TA reflex temporal summation after SCI, this stimulus strongly excited TA reflex temporal summation in maLPA1-null mice. The functional switch from descending inhibition to maladaptive facilitation of central excitability of spinal nociception demonstrated in maLPA1-null mice after SCI was unrelated to a general change in reflex activity. CONCLUSIONS These data suggest that the LPA1 receptor is necessary for inhibition of temporal summation of noxious reflex activity, partly mediated via long-tract descending modulatory systems acting at the spinal level.
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Affiliation(s)
- M Suardíaz
- Unidad de Gestión Clínica Intercentros de Neurociencias, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospitales Universitarios Regional de Málaga y Virgen de la Victoria, Málaga, Spain
| | - I Galan-Arriero
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - G Avila-Martin
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - G Estivill-Torrús
- Unidad de Gestión Clínica Intercentros de Neurociencias, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospitales Universitarios Regional de Málaga y Virgen de la Victoria, Málaga, Spain
| | - F R de Fonseca
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospitales Universitarios Regional de Malaga y Virgen de la Victoria, Malaga, Spain
| | - J Chun
- Department of Molecular and Cellular Neuroscience, Dorris Neuroscience Centre The Scripps Research Institute, La Jolla, USA
| | - J Gómez-Soriano
- Grupo de Investigación en Fisioterapia Toledo (GIFTO), E.U.E. Fisioterapia de Toledo, Universidad de Castilla la Mancha, USA
| | - E Bravo-Esteban
- Neurorehabilitation Group, Instituto Cajal, Council for Scientific Research (CSIC), Madrid, Spain
| | - J Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain.,Stoke Mandeville Spinal Research, National Spinal Injuries Centre, Aylesbury, UK
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Bravo-Esteban E, Taylor J, Abián-Vicén J, Albu S, Simón-Martínez C, Torricelli D, Gómez-Soriano J. Impact of specific symptoms of spasticity on voluntary lower limb muscle function, gait and daily activities during subacute and chronic spinal cord injury. NeuroRehabilitation 2014; 33:531-43. [PMID: 24018366 DOI: 10.3233/nre-131000] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although the spasticity syndrome is an important sensorimotor disorder, the impact of grade of lower limb muscle hypertonia, spasm and clonus activity on voluntary muscle function, gait and daily activities has not been systematically analysed during subacute and chronic spinal cord injury (SCI). OBJECTIVE To determine the prevalence of spasticity signs and symptoms during SCI, and to assess their impact on motor function and activities. METHODS A descriptive transverse study of sixty-six subjects with SCI was performed by assessing injury characteristics, spasticity (modified Ashworth scale, Penn scale, SCATS scale) and motor function (lower limb manual muscle scores, WISCI II, spinal cord injury spasticity evaluation tool). RESULTS Most subjects with the spasticity syndrome presented lower limb hypertonia and spasms during both subacute and chronic SCI, interfering with daily life activities. Subjects with incomplete SCI and hypertonia revealed a loss of voluntary flexor muscle activity, while extensors spasms contributed strongly to loss of gait function. The Penn spasms scale no correlated with muscle function or gait. CONCLUSIONS Specific diagnosis of spasm activity during subacute SCI, and its impact on lower limb voluntary muscle activity, gait function and daily activities, is required to develop a more effective neurorehabilitation treatment strategy.
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Affiliation(s)
- E Bravo-Esteban
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain IAI, Consejo Superior de Investigación Cientifíca (CSIC), Arganda del Rey, Spain
| | - J Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - J Abián-Vicén
- Department of Physical Therapy, Universidad Camilo José Cela, Madrid, Spain
| | - S Albu
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - C Simón-Martínez
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - D Torricelli
- IAI, Consejo Superior de Investigación Cientifíca (CSIC), Arganda del Rey, Spain
| | - J Gómez-Soriano
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain Escuela de Enfermería y Fisioterapia, Universidad de Castilla LaMancha, Toledo, Spain
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Bravo Esteban-Herreros E, Taylor J, Simón-Martínez C, Torricelli D, Pons J, Gómez-Soriano J. P255: Evaluation of lower limb voluntary motor recovery with clinical, biomechanical, electromyographic and neurophysiological measures: a longitudinal study during subacute spinal cord injury. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50380-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Albu S, Esteban EB, Avila-Martín G, Arriero IG, Gómez-Soriano J, Martínez CS, Taylor J. Differential endogenous pain modulation in patients with neuropathic pain after spinal cord injury correlates with contact heat evoked potential amplitude. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gómez-Soriano J, Goiriena E, Florensa-Vila J, Gómez-Arguelles JM, Mauderli A, Vierck CJ, Albu S, Simón-Martinez C, Taylor J. Sensory function after cavernous haemangioma: a case report of thermal hypersensitivity at and below an incomplete spinal cord injury. Spinal Cord 2012; 50:711-5. [PMID: 22733175 DOI: 10.1038/sc.2012.69] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Case report of a 42-year-old woman with non-evoked pain diagnosed with a cavernous C7-Th6 spinal haemangioma. OBJECTIVES To assess the effect of intramedullary haemorrhage (IH) on nociception and neuropathic pain (NP) at and below an incomplete spinal cord injury (SCI). SETTING Sensorimotor Function Group, Hospital Nacional de Parapléjicos de Toledo (HNPT). METHODS T2*-susceptibility weighted image (SWI) magnetic resonance imaging (MRI) of spinal haemosiderin and a complete pain history were performed 8 months following initial dysaesthesia complaint. Thermal pain thresholds were assessed with short 1 s stimuli, while evidence for central sensitization was obtained with psychophysical electronic Visual Analogue Scale rating of tonic 10 s 3 °C and 48 °C stimuli, applied at and below the IH. Control data were obtained from 10 healthy volunteers recruited from the HNPT. RESULTS Non-evoked pain was present within the Th6 dermatome and lower legs. T2*-SWI MRI imaging detected extensive haemosiderin-rich IH (C7-Th5/6 spinal level). Cold allodynia was detected below the IH (left L5 dermatome) with short thermal stimuli. Tonic thermal stimuli applied to the Th6, Th10 and C7 dermatomes revealed widespread heat and cold allodynia. CONCLUSION NP was diagnosed following IH, corroborated by an increase in below-level cold pain threshold with at- and below-level cold and heat allodynia. Psychophysical evidence for at- and below-level SCI central sensitization was obtained with tonic thermal stimuli. Early detection of IH could lead to better management of specific NP symptoms, an appreciation of the role of haemorrhage as an aggravating SCI physical factor, and the identification of specific spinal pathophysiological pain mechanisms.
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Affiliation(s)
- J Gómez-Soriano
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
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Gómez-Soriano J, Castellote JM, Pérez-Rizo E, Esclarin A, Taylor JS. Voluntary ankle flexor activity and adaptive coactivation gain is decreased by spasticity during subacute spinal cord injury. Exp Neurol 2010; 224:507-16. [PMID: 20580713 DOI: 10.1016/j.expneurol.2010.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 05/18/2010] [Indexed: 11/24/2022]
Abstract
Although spasticity has been defined as an increase in velocity-dependent stretch reflexes and muscle hypertonia during passive movement, the measurement of flexor muscle paresis may better characterize the negative impact of this syndrome on residual motor function following incomplete spinal cord injury (iSCI). In this longitudinal study Tibialis Anterior (TA) muscle paresis produced by a loss in maximal voluntary contraction during dorsiflexion and ankle flexor muscle coactivation during ramp-and-hold controlled plantarflexion was measured in ten patients during subacute iSCI. Tibialis Anterior activity was measured at approximately two-week intervals between 3-5 months following iSCI in subjects with or without spasticity, characterized by lower-limb muscle hypertonia and/or involuntary spasms. Following iSCI, maximal voluntary contraction ankle flexor activity was lower than that recorded from healthy subjects, and was further attenuated by the presence of spasticity. Furthermore the initially high percentage value of TA coactivation increased at 75% but not at 25% maximal voluntary torque (MVT), reflected by an increase in TA coactivation gain (75%/25% MVT) from 2.5+/-0.4 to 7.5+/-1.9, well above the control level of 2.9+/-0.2. In contrast contraction-dependent TA coactivation gain decreased from 2.4+/-0.3 to 1.4+/-0.1 during spasticity. In conclusion the adaptive increase in TA coactivation gain observed in this pilot study during subacute iSCI was also sensitive to the presence of spasticity. The successful early diagnosis and treatment of spasticity would be expected to further preserve and promote adaptive motor function during subacute iSCI neurorehabilitation.
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Affiliation(s)
- J Gómez-Soriano
- Grupo Funcion Sensitivomotora, Hospital Nacional de Parapléjicos, SESCAM, Finca La Peraleda s/n, 45071 Toledo, Spain
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