Patomecánica práctica de la mano afecta por enfermedades neurológicas
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The document discusses pathomechanics and practical hand therapy for neurological diseases. It covers topics like hand posture and tonus modification, muscle imbalance that is reductible or leads to deformity, motor control deficits, instability, and intrinsic and extrinsic patterns. Treatment involves advice from a neurologic team, ergonomic aids, stabilization splints to promote function, mobilization techniques to mold soft tissue, protective splints, and mobilization splints.
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The document discusses neuropathic pain, specifically trigeminal neuralgia. It defines trigeminal neuralgia as paroxysmal attacks of intense, sharp, superficial pain affecting one or more divisions of the trigeminal nerve. The pain is often triggered by innocuous stimuli like tooth brushing or talking. Trigeminal neuralgia is mostly idiopathic, but can occasionally be caused by underlying conditions like multiple sclerosis or tumors. The most widely accepted theory is that trigeminal neuralgia is caused by vascular compression of the trigeminal nerve root, which results in demyelination and hyperexcitability of nerve fibers.
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*Sorry for inconvenience cause as I left out the part of:
-how to differentiate from other structure involved.
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This document discusses the physiology of pain. It covers topics such as the definition of pain, the dual nature of fast and slow pain, pain stimuli and the nerve pathways that carry pain signals to the brain. It also discusses the brain areas involved in pain perception, pain modulatory pathways, and the neurochemicals involved in pain pathways. The gate control theory of pain and theories on referred pain are also summarized.
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neurodynamic-testing-and-neural-mobilization.pdf
This document discusses neurodynamic testing and neural mobilization. It begins by outlining the objectives of determining neurodynamic restrictions, evaluating neurodynamics through testing, and selecting neural mobilizations based on test findings. It then reviews neural anatomy, neurodynamics, types of neural injury, and examples of common neurodynamic tests. The document concludes by summarizing evidence that neural mobilization can reduce pain, improve flexibility and range of motion, and enhance performance.
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Craniosacral therapy was developed in the late 19th century by William Garner Sutherland who believed that the bones of the skull were capable of subtle movement, in contrast to accepted anatomical views. John Upledger later expanded on Sutherland's work in the 1970s. Craniosacral therapy involves gentle palpation to detect and manipulate the cranial bones and release restrictions in the craniosacral system to support health and healing. While some research studies show promise for reducing migraine symptoms, the subtle and variable nature of craniosacral therapy makes it difficult to study and research results are mixed.
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The document discusses neuropathic pain, specifically trigeminal neuralgia. It defines trigeminal neuralgia as paroxysmal attacks of intense, sharp, superficial pain affecting one or more divisions of the trigeminal nerve. The pain is often triggered by innocuous stimuli like tooth brushing or talking. Trigeminal neuralgia is mostly idiopathic, but can occasionally be caused by underlying conditions like multiple sclerosis or tumors. The most widely accepted theory is that trigeminal neuralgia is caused by vascular compression of the trigeminal nerve root, which results in demyelination and hyperexcitability of nerve fibers.
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*Sorry for inconvenience cause as I left out the part of:
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- Lateral flexion and its effects of increasing tension on the convex side and reducing tension on the concave side.
- Various mechanical interface and neural dysfunctions that can occur.
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Trigger points are commonly seen in patients with myofascial pain which is responsible for localized
pain in the affected muscles as well as referred pain patterns. Correct needle placement in a
myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point
injection to help reduce or relieve myofascial pain
Office based ultrasound-guided injection techniques for musculoskeletal
disorders have been described in the literature with regard to tendon, bursa, cystic, and
joint pathologies. For the interventionalist, utilizing ultrasound yields multiple advantages technically
and practically, including observation of needle placement in real-time, ability to perform
dynamic studies, the possibility of diagnosing musculoskeletal pathologies, avoidance of radiation
exposure, reduced overall cost, and portability of equipment within the office setting.
Pain pathway theories of pain
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Pain management
An unpleasant emotional experience usually initiated by noxious stimulus and transmitted over a specialized neural network to CNS where it is interpreted as such.
1. Exteroceptors: arising from receptors from skin & mucosa. sensed at conscious level
E.g. Merkel corpuscles : Tactile receptors.
Free Nerve ending :Perceive superficial pain.
2. Proprioceptors : From musculoskeletal structures.
The presence , positions & movement of body. below conscious levels.
E.g. 1) Muscle spindles : Skeletal muscle fibers. Mechanoreceptors.
2) Free nerve ending : Perceive deep somatic pain & other sensations.
3. Interoceptors : From viscera of body below conscious level.
E.g. Pacinian corpuscles : perception of touch-pressure.
Free nerve ending : Perceive visceral pain & other sensations.
Spasticity management
This document discusses spasticity management. It defines spasticity as a hypertonic motor disorder caused by injury to the corticospinal pathways. Signs of upper motor neuron syndrome include hyperactive stretch reflexes and involuntary flexor/extensor spasms. Spasticity is assessed using measures like the modified Ashworth scale and is treated using a multidisciplinary approach including oral medications, injections, surgery, and physiotherapy. Treatment aims to reduce spasticity and improve function and range of motion.
Physiology of pain
This document discusses the physiology of pain, including:
1. Nociception involves transduction, transmission, perception, and modulation of pain signals. Nociceptors detect damaging stimuli and neurotransmitters like substance P transmit signals.
2. The gate control theory proposes that small nerve fibers carry pain signals through a "gate" in the spinal cord that can be opened or closed by large fiber input.
3. Responses to pain have both physiological and psychological aspects, with the sympathetic nervous system initially activating a fight-or-flight response.
Myofascial release
This document provides information about myofascial pain syndrome (MPS) and myofascial trigger points. It discusses the characteristics of trigger points, including focal tenderness, reproduction of pain on palpation, muscle hardening, referred pain, and limited range of motion. The document also outlines various activating mechanisms for trigger points, characteristics of myofascial release therapy, conditions it can help treat, its proposed mechanisms of action including phase transition and resonance, and two anecdotal examples of its effectiveness in reducing pain and facilitating healing.
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an overview of muscle pain disorder which regularly create some discomfort for patient to live a normal life as well as to the doctor regarding diagnosis of the problem.
Myofascial pain syndrome
Myofascial pain syndrome is characterized by painful muscle trigger points that cause pain in the affected muscle and potentially other referred pain in distant areas. Trigger points form due to muscle injury or overuse and maintain a contracted knot within the muscle via a positive feedback loop. Examination involves identifying a taut band within the muscle and locating the most tender point, which may elicit a local twitch response when pressed. Diagnosis is based on identifying a trigger point and reproducing the patient's pain. Treatment involves education, medications, and non-pharmacological therapies like exercise, massage, and dry needling of trigger points.
Neurodynamics
This document discusses various neurodynamic mobilization techniques used to assess and treat neural tension. It begins by defining neurodynamics and describing principles of neural mobilization including applying gentle oscillatory movements when tension is detected. Several upper and lower extremity neural tension tests are then described in detail, including the upper limb neurodynamic test for the median, radial and ulnar nerves, the straight leg raise for the sciatic nerve, slump-sitting maneuver, prone knee bend for the femoral nerve. Precautions for each technique are provided. The document concludes by briefly defining carpal tunnel syndrome.
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The document discusses various types of muscle tone abnormalities including hypertonia, hypotonia, spasticity, rigidity, dystonia, and their clinical presentations and assessments. Spasticity is characterized by velocity-dependent resistance to stretch and may result in contractures and functional limitations. Rigidity differs from spasticity in being independent of movement velocity. Various assessments of tone are discussed including observation of posture and movement, palpation of muscles, passive range of motion testing, scales like the Modified Ashworth Scale, and reflex testing.
Tone Management
This document discusses muscle tone, including its physiology, characteristics of normal and abnormal tone, and approaches to managing tone issues. Muscle tone refers to a continuous low-level contraction that keeps muscles firm and ready to respond. It is important for posture, balance, and movement. Abnormal tone can include hypotonia (low tone) or hypertonia (high tone), and has various causes. Managing tone issues depends on whether it is low or high, and may involve positioning, stretching, splinting or other techniques. The Modified Ashworth Scale is used to assess levels of high muscle tone.
The Gate Theory of Pain
The Gate Theory of Pain proposes that large diameter sensory fibers inhibit the transmission of pain signals from small diameter fibers in the spinal cord. This creates a "gate" that can be opened or closed by the relative activity of large and small fibers. The theory helped explain phenomena like pain relief from transcutaneous electrical nerve stimulation and windup in spinal cord neurons. It contributed to our understanding of nociception and the role of the substantia gelatinosa in modulating pain signaling from the skin.
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This document discusses cognitive therapeutic exercises and the neurocognitive instruments of exercise. It describes several cognitive tools used in exercise, including cognitive problems, perceptual hypotheses, motor imagery, and verification/comparison. These tools activate the central nervous system and lead to movement reorganization through anticipatory motor learning processes. The cognitive activation helps organize the CNS based on the patient's profile, highlighting the need for neurocognitive instruments to facilitate learning through anticipation.
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Myofascial Pain Syndrome is a musculoskeletal disorder characterized by hyperirritable palpable nodules in muscle fibers called myofascial trigger points. It is underdiagnosed and causes pain, stiffness, and referred pain. Symptoms can be acute or chronic and include tender points, restricted motion, and weakness. Management involves identifying perpetuating factors, manual therapies, medications, and treating underlying causes through methods like dry needling or acupuncture.
Myofacial Release Therapy(MFR).
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
Neurodynamics
The document discusses neuropathodynamics and neuromobilization techniques. It covers:
- Flexion and extension of the spine and their effects on neural tissues, producing tension and sliding.
- Lateral flexion and its effects of increasing tension on the convex side and reducing tension on the concave side.
- Various mechanical interface and neural dysfunctions that can occur.
- Objectives, clinical tests, and techniques used in neuromobilization to restore normal neuromechanical function.
- Contraindications for neuromobilization include acute injuries or infections of the nervous system.
- Different levels of neurodynamic testing based on symptoms and neurological status.
mpds-myofacial pain dysfunction syndrome
This document provides information about Myofascial Pain Dysfunction Syndrome (MPDS). It begins by defining MPDS as a group of muscle disorders characterized by diffuse facial pain and limited mouth opening. The etiology involves various contributing factors like muscle hyperfunction, bruxism, internal joint problems, injuries, and stress. The pathogenesis is that these etiological factors lead to micro- or macro-trauma to the musculoskeletal system, causing muscle spasm and a buildup of chemical pain mediators that lower the pain threshold. Management includes patient education, muscle relaxation techniques, medications, physiotherapy modalities, stress management, bruxism appliances, and in some cases surgery.
Neural mobilization
Neural mobilization one of the advanced tecnique in treating neural stiffness and movement restriction.
Tone
Spasticity, rigidity, hypotonia, dystonia, decerebrate rigidity, and decorticate rigidity are abnormal tones that can occur. Examination of tone includes initial observation, passive and active motion testing using scales like the Modified Ashworth Scale. Typical patterns of spasticity in upper and lower limbs are described for upper motor neuron lesions.
Trigger point injection
Trigger points are commonly seen in patients with myofascial pain which is responsible for localized
pain in the affected muscles as well as referred pain patterns. Correct needle placement in a
myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point
injection to help reduce or relieve myofascial pain
Office based ultrasound-guided injection techniques for musculoskeletal
disorders have been described in the literature with regard to tendon, bursa, cystic, and
joint pathologies. For the interventionalist, utilizing ultrasound yields multiple advantages technically
and practically, including observation of needle placement in real-time, ability to perform
dynamic studies, the possibility of diagnosing musculoskeletal pathologies, avoidance of radiation
exposure, reduced overall cost, and portability of equipment within the office setting.
Pain pathway theories of pain
Pain pathway gate control theory
Pain management
An unpleasant emotional experience usually initiated by noxious stimulus and transmitted over a specialized neural network to CNS where it is interpreted as such.
1. Exteroceptors: arising from receptors from skin & mucosa. sensed at conscious level
E.g. Merkel corpuscles : Tactile receptors.
Free Nerve ending :Perceive superficial pain.
2. Proprioceptors : From musculoskeletal structures.
The presence , positions & movement of body. below conscious levels.
E.g. 1) Muscle spindles : Skeletal muscle fibers. Mechanoreceptors.
2) Free nerve ending : Perceive deep somatic pain & other sensations.
3. Interoceptors : From viscera of body below conscious level.
E.g. Pacinian corpuscles : perception of touch-pressure.
Free nerve ending : Perceive visceral pain & other sensations.
Spasticity management
This document discusses spasticity management. It defines spasticity as a hypertonic motor disorder caused by injury to the corticospinal pathways. Signs of upper motor neuron syndrome include hyperactive stretch reflexes and involuntary flexor/extensor spasms. Spasticity is assessed using measures like the modified Ashworth scale and is treated using a multidisciplinary approach including oral medications, injections, surgery, and physiotherapy. Treatment aims to reduce spasticity and improve function and range of motion.
Physiology of pain
This document discusses the physiology of pain, including:
1. Nociception involves transduction, transmission, perception, and modulation of pain signals. Nociceptors detect damaging stimuli and neurotransmitters like substance P transmit signals.
2. The gate control theory proposes that small nerve fibers carry pain signals through a "gate" in the spinal cord that can be opened or closed by large fiber input.
3. Responses to pain have both physiological and psychological aspects, with the sympathetic nervous system initially activating a fight-or-flight response.
Myofascial release
This document provides information about myofascial pain syndrome (MPS) and myofascial trigger points. It discusses the characteristics of trigger points, including focal tenderness, reproduction of pain on palpation, muscle hardening, referred pain, and limited range of motion. The document also outlines various activating mechanisms for trigger points, characteristics of myofascial release therapy, conditions it can help treat, its proposed mechanisms of action including phase transition and resonance, and two anecdotal examples of its effectiveness in reducing pain and facilitating healing.
Myofascial pain dysfunction syndrome/ dental regular courses
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Myofacial pain dysfunction syndrome anindya
an overview of muscle pain disorder which regularly create some discomfort for patient to live a normal life as well as to the doctor regarding diagnosis of the problem.
Myofascial pain syndrome
Myofascial pain syndrome is characterized by painful muscle trigger points that cause pain in the affected muscle and potentially other referred pain in distant areas. Trigger points form due to muscle injury or overuse and maintain a contracted knot within the muscle via a positive feedback loop. Examination involves identifying a taut band within the muscle and locating the most tender point, which may elicit a local twitch response when pressed. Diagnosis is based on identifying a trigger point and reproducing the patient's pain. Treatment involves education, medications, and non-pharmacological therapies like exercise, massage, and dry needling of trigger points.
Neurodynamics
This document discusses various neurodynamic mobilization techniques used to assess and treat neural tension. It begins by defining neurodynamics and describing principles of neural mobilization including applying gentle oscillatory movements when tension is detected. Several upper and lower extremity neural tension tests are then described in detail, including the upper limb neurodynamic test for the median, radial and ulnar nerves, the straight leg raise for the sciatic nerve, slump-sitting maneuver, prone knee bend for the femoral nerve. Precautions for each technique are provided. The document concludes by briefly defining carpal tunnel syndrome.
Muscle tone and Deep tendon reflex assessment
The document discusses various types of muscle tone abnormalities including hypertonia, hypotonia, spasticity, rigidity, dystonia, and their clinical presentations and assessments. Spasticity is characterized by velocity-dependent resistance to stretch and may result in contractures and functional limitations. Rigidity differs from spasticity in being independent of movement velocity. Various assessments of tone are discussed including observation of posture and movement, palpation of muscles, passive range of motion testing, scales like the Modified Ashworth Scale, and reflex testing.
Tone Management
This document discusses muscle tone, including its physiology, characteristics of normal and abnormal tone, and approaches to managing tone issues. Muscle tone refers to a continuous low-level contraction that keeps muscles firm and ready to respond. It is important for posture, balance, and movement. Abnormal tone can include hypotonia (low tone) or hypertonia (high tone), and has various causes. Managing tone issues depends on whether it is low or high, and may involve positioning, stretching, splinting or other techniques. The Modified Ashworth Scale is used to assess levels of high muscle tone.
The Gate Theory of Pain
The Gate Theory of Pain proposes that large diameter sensory fibers inhibit the transmission of pain signals from small diameter fibers in the spinal cord. This creates a "gate" that can be opened or closed by the relative activity of large and small fibers. The theory helped explain phenomena like pain relief from transcutaneous electrical nerve stimulation and windup in spinal cord neurons. It contributed to our understanding of nociception and the role of the substantia gelatinosa in modulating pain signaling from the skin.
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This document discusses cognitive therapeutic exercises and the neurocognitive instruments of exercise. It describes several cognitive tools used in exercise, including cognitive problems, perceptual hypotheses, motor imagery, and verification/comparison. These tools activate the central nervous system and lead to movement reorganization through anticipatory motor learning processes. The cognitive activation helps organize the CNS based on the patient's profile, highlighting the need for neurocognitive instruments to facilitate learning through anticipation.
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This document discusses the clinical utility and myths surrounding neuromuscular bandages (NB) in children. While there is an absence of randomized controlled trials or systematic reviews on NB, the document raises several questions and considerations. It notes differences in children's skin and tensions compared to adults. Real effects of NB are difficult to measure and it is unclear if NB could influence hand configuration. The document compares NB to other materials and lists advantages of NB, such as versatility, ease of use, child acceptance and cost. It proposes NB, dynamic splints and daytime orthoses could be combined based on individual needs. Several open questions are posed about long-term effects and costs versus gains of continued NB use. The document concludes by
Cortical control of hand function
This document discusses cortical control of hand function from childhood to adulthood. Grasping an object requires the coordination of sensory, cognitive, and motor skills that develop in children. Reaching and grasping are cortical phenomena involving independent finger movement guided by sensory information and visual transformation of object characteristics into adequate hand configurations. Somatosensory feedback is essential for learning new movements, and key moments in motor development should be considered when understanding, treating, and evaluating children with disabilities.
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This document discusses dynamic stability of the wrist and motor control. It defines terms like kinetic stability and kinematic stability. It notes that structural instability does not define the therapeutic approach and that stability alone does not equal better function. The aim is adequate wrist function through conscious control of movements. It discusses hierarchies of functions and motor control, with cognition and recognition playing a role. Assessment involves analyzing wrist function in tasks and detecting abnormal movement patterns. Proprioception and enhancing active wrist control are important rehabilitation goals. Control must be assessed in relation to adjacent joints and movement directions. A gradual training approach is advocated with challenge over time.
La rehabilitacin de la mano en el pos tquirúrgico del paciente espástico
The document discusses postoperative rehabilitation for spastic hands. It covers:
1. Postoperative rehabilitation starts with preoperative evaluation and aims to integrate gained function into daily life.
2. The outcome depends on the surgeon defining a realistic rehabilitation goal that can likely be achieved.
3. Understanding the patient's individual situation and the development of their cerebral palsy is important.
Thinking about the evidence of new therapeutic approaches (supposed the most ...
This document discusses approaches to rehabilitating the hand function of children with hemiparesis. It notes that children naturally learn to use their unaffected side more for tasks. Factors affecting hand use include sensory issues, slow movements, weak grip, and spasticity over time. Early intervention should use a family-centered, functional approach with evidence-based protocols. Emerging therapies focus on task-oriented and bimanual training using games and virtual reality. While modified constraint-induced movement therapy and bimanual intensive therapy show improvements, studies note limited generalization and need for review of protocols. A combined approach may be most effective.
Neurological physiotherapy treatment for tremor
This document presents a case study of a patient with ataxia and intentional tremor in their right hand. It describes the patient's objective measurements on tests like the Fugl-Meyer scale. The treatment plan focused on improving proximal stability, coordination, and perception through techniques like activating the right scapular muscles, bimanual coordination exercises, and CHOR contact responses. After treatment, the patient showed improved scores on objective tests and gained the ability to fill a glass of water without spilling, their main functional goal.
Lateral Epicondylalgia. What do we know about the pain mechanisms?
This document discusses the pain mechanisms involved in lateral epicondylalgia (LE), commonly known as tennis elbow. It outlines that LE pain occurs at the lateral epicondyle due to overuse and microtrauma of the wrist extensor tendons. The mechanisms of pain in LE are multifactorial, involving degeneration of the tendon collagen, changes in the pain system through peripheral and central sensitization, and motor impairments including reduced grip strength. Trigger points in the forearm muscles can also perpetuate LE pain through referred pain patterns and central sensitization processes. While the pain initially occurs at the lateral epicondyle, motor impairments and trigger points may help maintain the chronic pain state in LE.
Aspectos psicosociales del dolor en miembro superior
Revisión de distintos aspectos psicosociales y su relación con síndromes de dolor en el miembro superior
Síndrome de Dolor Regional Complejo
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Diagnostic Differences about Complex Regional Pain Syndrome
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Dolor neuropático interpretación neurocognitiva
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Ponencia sobre la calidad de la información sobre terapia de mano encontrada en internet
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Quality of the information found on the net about hand therapy
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