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Neurodynamic project

Neurodynamic project. Hvidovre Hospital 7. October 2010 PT, MHSc , PhD student Jakob Lorentzen Department of Physiotherapy, Hvidovre Hospital, Department of Neurorehabilitation TBI UNIT, Copenhagen University Hospital, Glostrup . Baggrund ND.

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Neurodynamic project

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  1. Neurodynamicproject Hvidovre Hospital 7. October 2010 PT, MHSc, PhD student Jakob Lorentzen Department of Physiotherapy, Hvidovre Hospital, Department of Neurorehabilitation TBI UNIT, Copenhagen University Hospital, Glostrup.

  2. Baggrund ND • The lack of mobility of the peripheral nerves in relation to the surrounding structures (so called “mechanical stresses”) is suggested (Shacklock, 1995) to be caused by variations in blood flow, axonal transport and impulse traffic. • The primary treatment objective for ND is thus to ´restore the natural movement of the neural tissue and surrounding mechanical tissue’ and thereby’ reduce the intrinsic pressure on the neural tissue to regain natural physiological function’ (Butler, 2000; Shacklock, 1995).

  3. Oftenusedtreatment in physiotherapy. • BUT – noevidence for it’sefficacy

  4. Formål • In this study we investigate the effect of ND in relation to change in muscle tone and ROM by a hand-held device in traumatic brain injury (TBI) patients with spasticity defined as “velocity-dependent increase in tonic stretch reflexes to phasic stretch, in the absence of voluntary activity” (Lance, 1980).

  5. Method • 10 TBI patients withspasticity in kneeflexors • Design: Blinded(single) , randomized, controlled, cross over design • Intervention: single session treatment ND / RPM • Three raters (twoblinded and one non blinded to the intervention)

  6. Outcome • Objectivemeasures: • Hand-held dynamometer • Subjectivemeasures? • ModifiedAshworth Score (MAS) • Range of motion (ROM) (R1 og R2) • Change in muscle tone (VAS)

  7. Objectivestiffnessmeasurements

  8. MAS - blindet

  9. MAS – ikke blindet

  10. ROM (R1 og R2)

  11. Subjectively perceivedreduction in tone

  12. Conclusion Thanks for your attention!-and to the co-authors: Dorte Nielsen, Susanne Baagøe, Karl Holm, Michael J Grey, Jens B Nielsen ND seems not to be effective in reducing spasticity when evaluated objectively, but may increase ROM in the knee flexors with the same effect as random passive movements.

  13. MAS reliabilitet

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