Displaying publications 1 - 20 of 34 in total

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  1. Karisnan K, Mahzabin T, Bakker AJ, Song Y, Noble PB, Pillow JJ, et al.
    Am J Physiol Regul Integr Comp Physiol, 2018 04 01;314(4):R523-R532.
    PMID: 29212808 DOI: 10.1152/ajpregu.00150.2017
    The preterm diaphragm is functionally immature compared with its term counterpart. In utero inflammation further exacerbates preterm diaphragm dysfunction. We hypothesized that preterm lambs are more vulnerable to in utero inflammation-induced diaphragm dysfunction compared with term lambs. Pregnant ewes received intra-amniotic (IA) injections of saline or 10 mg lipopolysaccharide (LPS) 2 or 7 days before delivery at 121 days (preterm) or ∼145 days (term) of gestation. Diaphragm contractile function was assessed in vitro. Plasma cytokines, diaphragm myosin heavy chain (MHC) isoforms, and oxidative stress were evaluated. Maximum diaphragm force in preterm control lambs was significantly lower (22%) than in term control lambs ( P < 0.001). Despite similar inflammatory cytokine responses to in utero LPS exposure, diaphragm function in preterm and term lambs was affected differentially. In term lambs, maximum force after a 2-day LPS exposure was significantly lower than in controls (by ~20%, P < 0.05). In preterm lambs, maximum forces after 2-day and 7-day LPS exposures were significantly lower than in controls (by ~30%, P < 0.05). Peak twitch force after LPS exposure was significantly lower in preterm than in controls, but not in term lambs. In term lambs, LPS exposure increased the proportion of MHC-I fibers, increased twitch contraction times, and increased fatigue resistance relative to controls. In preterm diaphragm, the cross-sectional area of embryonic MHC fibers was significantly lower after 7-day versus 2-day LPS exposures. We conclude that preterm lambs are more vulnerable to IA LPS-induced diaphragm dysfunction than term lambs. In utero inflammation exacerbates diaphragm dysfunction and may increase susceptibility to postnatal respiratory failure.
    Matched MeSH terms: Muscle Weakness/blood; Muscle Weakness/chemically induced*; Muscle Weakness/physiopathology
  2. Lim JA, Lee ST, Moon J, Jun JS, Kim TJ, Shin YW, et al.
    Ann Neurol, 2019 03;85(3):352-358.
    PMID: 30675918 DOI: 10.1002/ana.25421
    OBJECTIVE: There is no scale for rating the severity of autoimmune encephalitis (AE). In this study, we aimed to develop a novel scale for rating severity in patients with diverse AE syndromes and to verify the reliability and validity of the developed scale.

    METHODS: The key items were generated by a panel of experts and selected according to content validity ratios. The developed scale was initially applied to 50 patients with AE (development cohort) to evaluate its acceptability, reproducibility, internal consistency, and construct validity. Then, the scale was applied to another independent cohort (validation cohort, n = 38).

    RESULTS: A new scale consisting of 9 items (seizure, memory dysfunction, psychiatric symptoms, consciousness, language problems, dyskinesia/dystonia, gait instability and ataxia, brainstem dysfunction, and weakness) was developed. Each item was assigned a value of up to 3 points. The total score could therefore range from 0 to 27. We named the scale the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The new scale showed excellent interobserver (intraclass correlation coefficient [ICC] = 0.97) and intraobserver (ICC = 0.96) reliability for total scores, was highly correlated with modified Rankin scale (r = 0.86, p

    Matched MeSH terms: Muscle Weakness/etiology; Muscle Weakness/physiopathology
  3. Singh DK, Bailey M, Lee R
    BMC Musculoskelet Disord, 2013 Jul 22;14:215.
    PMID: 23875830 DOI: 10.1186/1471-2474-14-215
    BACKGROUND: Muscle morphology, age and gender may be determinants of muscle strength in older adults. However, very few research studies have directly examined such correlation in the ageing spine. The aim of the study was to examine the correlation between lumbar extensor muscle strength, its muscle fibre angles, thoracolumbar curvature, age and gender in the older and younger adults.

    METHODS: Muscle fibre angles of lumbar extensor muscles, thoracolumbar curvature and lumbar extensor muscle strength were examined in 26 young (mean age 27.9, SD 5.2) and 26 older (mean age 72.1, SD 5.9) participants. Pearson's correlation was employed to determine the association among lumbar extensor muscle fibre angle, thoracolumbar curvature, age, gender and lumbar extensor muscle strength. Multiple stepwise linear regression analysis was used to identify significant determinants of lumbar extensor muscle strength.

    RESULTS: The results demonstrated a significant correlation between lumbar extensor muscle strength, muscle fibre angle, age and gender. In the step wise regression analysis, both gender and age were identified as the most robust determinant for lumbar extensor muscle strength in older adults. However, gender was the only determinant of muscle strength in the young.

    CONCLUSION: These results suggest that the decline in the lumbar extensor muscle strength in older adults was more dependent on age when compared to younger adults.

    Matched MeSH terms: Muscle Weakness/physiopathology*
  4. Seng, Wee Cheo, Rosdina Zamrud Ahmad Akbar, Tee, Tat Khoo, Kuo, Zhau Teo, Carwen Siaw, Qin, Jian Low
    MyJurnal
    Inflammatory myopathies (IM) is a rare inflammatory muscle disorder, which can be broadly divided into 5 subgroups. The accurate diagnosis of subtype of IM can be challenging due to a diverse presentation of the disease. On the other hand, skeletal muscle complication is common in patients with systemic lupus erythematosus (SLE) in the form of myalgia or myopathy. Inflammatory myopathy is a rare association of SLE and the diagnosis and treatment can be quite challenging. A 43-year-old lady with underlying systemic lupus erythematosus (SLE), presented with subacute onset progressively worsening muscle weakness involving upper limbs and lower limbs. Neurological examination showed findings consistent with proximal myopathy, with proximal power of 3/5 and distal power of 4/5. She has elevated creatinine kinase, ALT and AST level. Her myositis-specific autoantibodies were positive for anti-Ku antibodies. Her electromyography showed evidence of active myopathy of the upper and lower limb. Here, we would like to report a case of polymyositis in a patient with SLE.
    Matched MeSH terms: Muscle Weakness
  5. Hanizah Ngadiron, Razrim Rahim, Firdaus Hayati, Nornazirah Azizan, Affirul Chairil Ariffin
    MyJurnal
    Hypophosphataemia occurs in an abnormally low serum phosphate level. Three main mechanisms are postulated: decreased intestinal absorption, increased renal excretion, and extracellular shifts to intracellular compartments. It is potentially a fatal disease if not intervene. The management is merely treating the underlying disorder, giving phosphate supplement and requiring close biochemical monitoring. The incidence of symptomatic isolated hypophosphataemia is extremely rare. In this case report, a 33-year-old man presented with three days history of dysphagia, inability to complete sentences and generalized muscle weakness. He developed blurred vision especially upon exposure to bright light. He had a history of single parathyroidectomy for parathyroid adenoma 2 years ago. Physical examinations were unremarkable. Laboratory investigations were normal except for phosphate level of 0.30 mmol/L. Intravenous KH2PO4 with a dosage of 10 mmol was administered in slow bolus in 3 hours. His symptoms resolved slowly after correction. Although isolated hypophosphataemia is rare but need to recognize the symptoms and signs of hypophosphataemia and treat accordingly.
    Matched MeSH terms: Muscle Weakness
  6. Roos A, van der Ven PFM, Alrohaif H, Kölbel H, Heil L, Della Marina A, et al.
    Brain, 2023 Oct 03;146(10):4200-4216.
    PMID: 37163662 DOI: 10.1093/brain/awad152
    Filamin-A-interacting protein 1 (FILIP1) is a structural protein that is involved in neuronal and muscle function and integrity and interacts with FLNa and FLNc. Pathogenic variants in filamin-encoding genes have been linked to neurological disorders (FLNA) and muscle diseases characterized by myofibrillar perturbations (FLNC), but human diseases associated with FILIP1 variants have not yet been described. Here, we report on five patients from four unrelated consanguineous families with homozygous FILIP1 variants (two nonsense and two missense). Functional studies indicated altered stability of the FILIP1 protein carrying the p.[Pro1133Leu] variant. Patients exhibit a broad spectrum of neurological symptoms including brain malformations, neurodevelopmental delay, muscle weakness and pathology and dysmorphic features. Electron and immunofluorescence microscopy on the muscle biopsy derived from the patient harbouring the homozygous p.[Pro1133Leu] missense variant revealed core-like zones of myofibrillar disintegration, autophagic vacuoles and accumulation of FLNc. Proteomic studies on the fibroblasts derived from the same patient showed dysregulation of a variety of proteins including FLNc and alpha-B-crystallin, a finding (confirmed by immunofluorescence) which is in line with the manifestation of symptoms associated with the syndromic phenotype of FILIP1opathy. The combined findings of this study show that the loss of functional FILIP1 leads to a recessive disorder characterized by neurological and muscular manifestations as well as dysmorphic features accompanied by perturbed proteostasis and myopathology.
    Matched MeSH terms: Muscle Weakness
  7. Chan LG, Parashar UD, Lye MS, Ong FG, Zaki SR, Alexander JP, et al.
    Clin Infect Dis, 2000 Sep;31(3):678-83.
    PMID: 11017815
    From April through June 1997, 29 previously healthy children aged <6 years (median, 1.5 years) in Sarawak, Malaysia, died of rapidly progressive cardiorespiratory failure during an outbreak of hand, foot, and mouth disease caused primarily by enterovirus 71 (EV71). The case children were hospitalized after a short illness (median duration, 2 days) that usually included fever (in 100% of case children), oral ulcers (66%), and extremity rashes (62%). The illness rapidly progressed to include seizures (28%), flaccid limb weakness (17%), or cardiopulmonary symptoms (of 24 children, 17 had chest radiographs showing pulmonary edema, and 24 had echocardiograms showing left ventricular dysfunction), resulting in cardiopulmonary arrest soon after hospitalization (median time, 9 h). Cardiac tissue from 10 patients showed normal myocardium, but central nervous system tissue from 5 patients showed inflammatory changes. Brain-stem specimens from 2 patients were available, and both specimens showed extensive neuronal degeneration, inflammation, and necrosis, suggesting that a central nervous system infection was responsible for the disease, with the cardiopulmonary dysfunction being neurogenic in origin. EV71 and possibly an adenovirus, other enteroviruses, or unknown cofactors are likely responsible for this rapidly fatal disease.
    Matched MeSH terms: Muscle Weakness/etiology
  8. Ni H, Htet A
    PMID: 23074376 DOI: 10.3332/ecancer.2012.274
    Myasthenia gravis (MG) is an autoantibody-mediated disorder affecting the neuromuscular junction causing characteristic fatigable muscle weakness. Though it can be associated with tumours of the thymus as well as thyroid disorders, it is rare for both to coexist. The exact prevalence of thyroid carcinoma in MG with thymoma is not known but only about a dozen cases have been reported in the literature. We report a case of a 38-year-old Myanmar lady who presented with weakness and breathlessness due to MG with neck swelling. On examination, she had fatigable proximal muscle weakness and thyroid enlargement with no obvious features of hyperthyroidism. Mediastinal widening and an enlarged thyroid gland were noted on her chest X-ray and chest CT. A subtotal thyroidectomy and thymectomy were done. The histology showed follicular carcinoma of the thyroid and benign thymoma. The majority of the reported cases of thyroid carcinoma in association with MG were papillary carcinoma. Follicular carcinoma thyroid associated with MG has not yet been reported in the literature.
    Matched MeSH terms: Muscle Weakness
  9. Anuar Ithnin, Kong, Dinnee, Venkataraman, Saraswathy
    Int J Public Health Res, 2012;2(2):137-143.
    MyJurnal
    Carpal tunnel syndrome (CTS) is a hand disorder which indicates the presence of symptoms such as pain, numbness, and muscle weakness among the patient. CTS is an occupational related disorder which can occur in any profession. However, it can be prevented and managed. The aims of the research were to determine the prevalence of acquiring CTS among nurses who worked in the wards and occupational risk factors involving the upper limbs during nursing tasks performance. The specific aims were to determine the relationship between the prevalence of acquiring CTS and individual factors (age, gender, race, educational level, duration of work and medical history), relationship between the prevalence of acquiring CTS and occupational risk factors in nursing tasks. Nurses profession was chosen as they are performing multitask involving upper limbs especially the wrist joints. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to determine the level of severity in CTS. Occupational risk factors were assessed by using the Rapid Upper Limb Assessment (RULA). This research was a cross sectional mode which was carried out at a government university medical centre from November through December 2010. Eighty nurses were involved in the research. The respondents were required to fill in the socio-demographic information sheet. Those having CTS were required to fill in the BCTQ. Assessments were performed by observing of the job activity through RULA. The results showed that the prevalence for nurses acquiring CTS is 7.5%. The RULA assessment also indicated that the risk factor was in the highest level with a score of 7. No relationship was shown between the prevalence of CTS and race, gender, educational level and medical history. Significant relationship was indicated by the prevalence of CTS and occupational risk factors. In conclusion, a significant prevalence of CTS related to age of more than 30 years old, Malay races compared to Indian, working experience of more than 10 years and respondents with right hand dominant. Occupational risk factors also indicated among the active nurses. Therefore, it is important for us to modify the work environment, work flow, work methodology and ergonomic factors in order to prevent the nurses from acquiring CTS. Furthermore, education about the condition of CTS should be implemented and reinforced especially among the higher risk nurses.
    Matched MeSH terms: Muscle Weakness
  10. Kwa, Siew Kim, Zainab Abdul Majeed, Tan, Kah Nian
    MyJurnal
    Myasthenia gravis (MG) is a rare autoimmune disorder
    characterised by fluctuating and variable combination
    of muscle weakness and fatigue. Most cases are due to
    T-cell mediated autoantibodies against post-synaptic
    acetylcholine receptors (AChR-Ab), thus preventing
    acetylcholine from binding and signalling skeletal
    muscle to contract.1
    The annual incidence is 7-23 new cases per million.1
    It can occur at any age but with two peaks; an earlyonset
    (20-40 years) female-predominant and a late-onset
    (60-80 years) male-predominant peak. MG is classified
    into ocular and generalised (80%). More than half the
    patients initially present with ptosis and diplopia but half
    will progress to generalised disease with involvement of
    bulbar, limb and respiratory weakness. Those presenting
    as generalised MG can also develop eye signs later.1
    It is important to recognise MG early because it is
    highly treatable. Untreated disease leads to permanent
    weakness.2 Treatment reduces mortality from lifethreatening
    myasthenic crisis.1,3 Misdiagnosis leads to
    potentially harmful interventions and inappropriate
    management.4,5 Diagnosis in late-onset MG is easily
    missed2,3,4,5 because of overlapping symptoms with
    other diseases common in the elderly. We report a case
    of delay and misdiagnosis in an elderly patient with
    co-morbidities. (Copied from article).
    Matched MeSH terms: Muscle Weakness
  11. Vijay, A.P., Tan, A.T.B., Suhaida, A.M., Chan, S.P.
    JUMMEC, 2010;13(1):63-68.
    MyJurnal
    Tumour-induced or oncogenic osteomalacia (OOM) is a rare paraneoplastic syndrome characterized by bone pain and muscle weakness. A biochemical profile consisting of normocalcaemia, hypophosphataemia, phosphaturia, increased serum alkaline phosphatase and inappropriately low serum levels of 1, 25-dihydroxyvitamin-D is diagnostic. OOM is usually caused by an osseous or soft-tissue tumour of mesenchymal origin that secretes phosphaturic substances leading to increased urinary phosphate wasting. These tumours are small and slow growing. The diagnosis continues to be easily missed and when eventually made, localization of the tumour can be difficult. We describe the case of a young man who presented with severe generalized pain associated with muscle weakness. He was extensively investigated and eventually diagnosed to have OOM 3 years after initial presentation. Specialized investigations were necessary to localize the offending tumour.
    Matched MeSH terms: Muscle Weakness
  12. Fatimah Azman, Rose Adzrianee Adnan, Norhafizah Che Abdul Razak, Nazihah Mohd Yunus, Sarina Sulong, Rozita Abdullah, et al.
    MyJurnal
    Muscular dystrophy is a group of diseases that result in progressive muscle weakness and atrophy. Duchenne Muscular Dystrophy (DMD) is classified as dystrophinopathy and is an X-linked recessive disease. It is caused by alterations in the dystrophin gene at Xp21.2 encoding 79 exons [1]. It is characterised by progressive muscle wasting that begins at 3 to 5 years, delay in motor development and eventually wheelchair confinement followed by premature death at about 30 years from cardiac or respiratory complications [2]. Genetic etiology of cases of DMD in Malaysia are still scarcely reported. Here, we report the genetic cause in the case of an 11-year-old Kelantanese Malay boy who has progressive muscle weakness since 5 years old. He has difficulty in getting up from sitting and supine position also in climbing up stairs until 1st floor. He has a strong family history of DMD and musculoskeletal problems. His younger brother was diagnosed with DMD by molecular analysis and his maternal uncle died at the age of 16 with musculoskeletal problems but was never investigated. Physical examination revealed no dysmorphic features, positive Gower sign with absent tounge fasciculation. On neurological examination, tendon reflexes and muscle tone for limbs were normal. Muscle power for bilateral upper limbs were normal, however, bilateral lower limbs showed slight reduction in muscle power with calf hypertrophy.
    Matched MeSH terms: Muscle Weakness
  13. Hejazi SM, Engkasan JP, Qomi MS
    J Back Musculoskelet Rehabil, 2012;25(4):231-4.
    PMID: 23220804 DOI: 10.3233/BMR-2012-0340
    BACKGROUND AND OBJECTIVE: Polymyositis (PM) is an idiopathic inflammatory myopathy manifested by proximal limb muscles weakness, elevated creatinin kinase, electromyography changes, and muscle inflammation in biopsy. We report an instance of intensive rehabilitation therapy in a patient with clinically active polymyositis.
    CASE REPORT: A 19-year-old female patient, diagnosed with 'electromyography and biopsy proven' polymyositis for 5 years, suffered from worsening limbs weakness and dysphagia. In her history, she had upper and lower limbs weakness accompanied by dysphagia which was further complicated by right bronchial aspiration 9 months ago. A four-week trial of intensive training and exercise rehabilitation, concurrently accompanied by medications was prescribed for this patient. At the end of therapy she achieved significant improvement in muscle strength, activities of daily living, and ambulation without any disease exacerbation.
    CONCLUSION: We concluded that short-term intensive training and exercise may lead to improvements in patients with PM, without causing a progress in the disease. Due to the rarity of PM and difficulty of conducting well-controlled studies to examine the risks and benefits of exercise in these patients, further research is necessary to investigate benefits of exercise training in active phase of disease.
    Matched MeSH terms: Muscle Weakness/physiopathology; Muscle Weakness/rehabilitation; Muscle Weakness/therapy
  14. Tan HT, Tan CY, Teong CS, Ratnasingam J, Goh KJ
    J Clin Neurophysiol, 2020 Aug 05.
    PMID: 32773648 DOI: 10.1097/WNP.0000000000000766
    PURPOSE: Thyrotoxic periodic paralysis is characterized by recurrent episodes of reversible, severe proximal muscle weakness associated with hypokalemia and hyperthyroidism. Prolonged exercise test is an easy, noninvasive method of demonstrating abnormal muscle membrane excitability in periodic paralyses. Although abnormal in thyrotoxic periodic paralysis patients, the effects thyroid hormone levels in non-thyrotoxic periodic paralysis thyrotoxicosis patients have not been well studied. The study aims to evaluate thyrotoxicosis patients (regardless of thyrotoxic periodic paralysis history) with prolonged exercise test and correlate it with their thyroid status.

    METHODS: This is a prospective, cross-sectional study of consecutive thyrotoxicosis patients seen at the endocrine clinic of a tertiary medical center. Thyroid status was determined biochemically before prolonged exercise test. Compound muscle action potential (CMAP) amplitudes postexercise were compared against pre-exercise amplitudes and recorded as percentage of mean baseline CMAP amplitude. Comparisons of time-dependent postexercise CMAP amplitudes and mean CMAP amplitude decrement were made between hyperthyroid and nonhyperthyroid groups.

    RESULTS: Seventy-four patients were recruited, 23 (31%) men, 30 (41%) Chinese, and the mean age was 48.5 ± 16.8 years. Of 74 patients, 32 (43%) were hyperthyroid and 42 (57%) were nonhyperthyroid viz. euthyroid and hypothyroid. Time-dependent CMAP amplitudes from 10 to 45 minutes after exercise were significantly lower in hyperthyroid patients compared with nonhyperthyroid patients (P < 0.01). Mean CMAP amplitude decrement postexercise was significantly greater in hyperthyroid than nonhyperthyroid patients (23.4% ± 11.4% vs. 17.3% ± 10.5%; P = 0.02).

    CONCLUSIONS: Compound muscle action potential amplitude declines on prolonged exercise test were significantly greater in hyperthyroid patients compared with nonhyperthyroid patients. Muscle membrane excitability is highly influenced by thyroid hormone level. Thyrotoxic periodic paralysis occurs from increased levels of thyroid hormone activity in susceptible patients.

    Matched MeSH terms: Muscle Weakness
  15. Muthusamy KA, Waran V, Puthucheary SD
    J Clin Neurosci, 2007 Dec;14(12):1213-5.
    PMID: 17964168
    Burkholderia pseudomallei infection of the central nervous system (CNS) is rare with less than 50 cases reported over the last 30 years. The retrospective melioidosis study at University Malaya Medical Centre has documented three cases of CNS melioidosis out of more than 160 cases of melioidosis since 1978. There were two patients with brain abscess and one with spinal epidural abscess. The predisposing factors were: one patient was an aboriginal farmer and the other two were diabetic. Their age ranged from 17 to 45 years. Prominent neurological features were limb weakness, cranial nerve palsy (6th and 7th) and visual disturbance. CT brain scan and MRI spine showed abscess formation, subdural collection, and spinal epidural collection, osteomyelitis of vertebra and occipital bone and also sagital sinus thrombosis. All these patients underwent surgical drainage leading to bacteriological diagnosis as well as appropriate long-term antibiotic therapy. All had good recovery at 6 months after completion of treatment.
    Matched MeSH terms: Muscle Weakness/etiology
  16. Goh KJ, Wong KT, Tan CT
    J Clin Neurosci, 2000 Jul;7(4):334-6.
    PMID: 10938615
    We report two patients with myopathic dropped head syndrome, a rare and interesting neuromuscular syndrome characterised by a predominant weakness of the neck extensor muscles. The first patient, a middle aged Chinese man, presented with progressive weakness of neck extension but his clinical course later stabilised despite a lack of response to corticosteroids. Muscle biopsy revealed a necrotising myopathy with no evidence of inflammation. This patient supports the existence of an idiopathic restricted non-inflammatory myopathy, a so called isolated neck extensor myopathy syndrome which is recognised to pursue a less progressive, more benign course. Our second patient had histopathological evidence for polymyositis; there was a favourable response to steroids. Our cases underscore the fact that there may be a spectrum of pathological processes associated with the myopathic dropped head syndrome ranging from non-inflammatory muscle necrosis to a full blown inflammatory myositis.
    Matched MeSH terms: Muscle Weakness/etiology*; Muscle Weakness/pathology*; Muscle Weakness/physiopathology
  17. Chu ECP, Lo FS, Bhaumik A
    J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
    PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19
    Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.
    Matched MeSH terms: Muscle Weakness
  18. Hameed HK, Wan Hasan WZ, Shafie S, Ahmad SA, Jaafar H, Inche Mat LN
    J Med Eng Technol, 2020 Apr;44(3):139-148.
    PMID: 32396756 DOI: 10.1080/03091902.2020.1753838
    To make robotic hand devices controlled by surface electromyography (sEMG) signals feasible and practical tools for assisting patients with hand impairments, the problems that prevent these devices from being widely used have to be overcome. The most significant problem is the involuntary amplitude variation of the sEMG signals due to the movement of electrodes during forearm motion. Moreover, for patients who have had a stroke or another neurological disease, the muscle activity of the impaired hand is weak and has a low signal-to-noise ratio (SNR). Thus, muscle activity detection methods intended for controlling robotic hand devices should not depend mainly on the amplitude characteristics of the sEMG signal in the detection process, and they need to be more reliable for sEMG signals that have a low SNR. Since amplitude-independent muscle activity detection methods meet these requirements, this paper investigates the performance of such a method on people who have had a stroke in terms of the detection of weak muscle activity and resistance to false alarms caused by the involuntary amplitude variation of sEMG signals; these two parameters are very important for achieving the reliable control of robotic hand devices intended for people with disabilities. A comparison between the performance of an amplitude-independent muscle activity detection algorithm and three amplitude-dependent algorithms was conducted by using sEMG signals recorded from six hemiparesis stroke survivors and from six healthy subjects. The results showed that the amplitude-independent algorithm performed better in terms of detecting weak muscle activity and resisting false alarms.
    Matched MeSH terms: Muscle Weakness/physiopathology*
  19. Lim CC, Lee WL, Leo YS, Lee KE, Chan KP, Ling AE, et al.
    J Neurol Neurosurg Psychiatry, 2003 Jan;74(1):131-3.
    PMID: 12486285
    The Nipah virus is a newly identified paramyxovirus responsible for an outbreak of fatal encephalitis in Malaysia and Singapore. This paper reports the follow up clinical and magnetic resonance imaging findings in 22 affected subjects. Of 13 patients with encephalitis, one died, one was lost to follow up, and seven recovered. Among the four remaining patients, one had residual sixth nerve palsy, another suffered from severe clinical depression, and a third patient had evidence of retinal artery occlusion. One patient with delayed onset Horner syndrome had a single lesion in the cervical spinal cord. The brain magnetic resonance findings were stable or improved in nine patients over 18 months of follow up. Among a second group of nine asymptomatic seropositive abattoir workers, magnetic resonance examination in seven subjects revealed discrete small lesions in the brain; similar to those detected in encephalitis patients. These findings suggest that in addition to encephalitis, the newly discovered Nipah virus affects the spinal cord and the retina. Late clinical and radiological findings can occur in Nipah virus infections as with other paramyxoviruses.
    Matched MeSH terms: Muscle Weakness/epidemiology
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