jueves, 31 de marzo de 2011

Physical Rehabilitation of Paralysed Facial Muscles: Functional and Morphological Correlates


# Paperback: 155 pages
# Publisher: Springer; 1st Edition. edition (March 1, 2011)
# Language: English
# ISBN-10: 3642181198
# ISBN-13: 978-3642181191

Product Description:

Using a combined morpho-functional approach the author recently found that polyinnervation of the neuro-muscular juction (NMJ) is the critical factor for recovery of function after transection and suture of the facial nerve. Since polyinnervation is activity-dependent and can be manipulated, he tried to design a clinically feasible therapy by electrical stimulation or by soft tissue massage. First, electrical stimulation was applied to the transected facial nerve or to paralysed facial muscles. Both procedures did not improve vibrissal motor performance (video-based motion analysis of whisking), failed to diminish polyinnervation and even reduced the number of innervated NMJ to one fifth of normal values. In contrast, gentle stroking of the paralysed vibrissal muscles by hand resulted in full recovery of whisking. Manual stimulation was also effective after hypoglossal-facial anastomosis and after interpositional nerve grafting. The author concludes that manual stimulation is a non-invasive procedure with immediate potential for clinical rehabilitation following facial nerve reconstruction.

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1 comentario:

Arnau dijo...

As with many concepts considered pseudoscientific, there is debate around the nature and quality of evidence supporting applied kinesiology, with proponents claiming support from some published papers and critics noting other research which fails to show efficacy. One review of the literature identified methodological problems with previous AK studies[18]

Studies supporting AK have been published in respect of food allergies and antibodies for those foods,[19] and a blinded study where the response of a calf muscle to an inhibitory reflex technique used in AK was studied using graphical recordings of electromyography and mechanical parameters, finding that with good coordination between the examiner and subject, muscle inhibition was easily recorded.[20]

Other studies have failed to show clinical efficacy. For example, in some studies muscle testing has not been shown to distinguish a test substance from a placebo under double-blind conditions, and the use of applied kinesiology to evaluate nutrient status was not shown to be more effective than random guessing. Some scientific studies have shown that applied kinesiology tests were not reproducible.[21][22][23][24][25] A review of several scientific studies of AK-specific procedures and diagnostic tests concluded that "When AK is disentangled from standard orthopedic muscle testing, the few studies evaluating unique AK procedures either refute or cannot support the validity of AK procedures as diagnostic tests. The evidence to date does not support the use of [manual muscle testing] for the diagnosis of organic disease or pre/subclinical conditions."[26] Another concluded that "There is little or no scientific rationale for these methods. Results are not reproducible when subject to rigorous testing and do not correlate with clinical evidence of allergy."[27] A double-blind study was conducted by the ALTA Foundation for Sports Medicine Research in Santa Monica, California and published in the June 1988 Journal of the American Dietetic Association. The study used 3 experienced AK practitioners and concluded that, "The results of this study indicated that the use of Applied Kinesiology to evaluate nutrient status is no more useful than random guessing."[28]

Some of the studies, research and reviews of applied kinesiology mentioned above are listed at the National Library of Medicine and National Institutes of Health.[23][24][28][29][30][31][32]

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