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1. Monkeys were trained to maintain hand position against a range of constant forces. Short-latency responses to passive wrist extension or flexion, as well as short-latency responses to stretch of a single wrist muscle, were recorded from units in areas 4, 3, 1, and 2. These responses were compared to unit activity during active holding and during active movement. 2. Units related to active holding and to active movement were most common in areas 4 and 2. Three-quarters of these units displayed a specific correlation between their passive and active behaviors. Thus, a unit excited by passive extension was excited during active holding against extension force and excited during an active flexion movement. This behavior is similar to the expected concurrent behavior of muscle stretch receptors. By demonstrating that a significant number of task-related units give qualitatively similar responses to passive extension and passive flexion, the results appear to explain the disagreement among previous studies (5, 9, 36) in regard to area 4 behavior during active and passive movements. 3. Area 4 units responded similarly to passive wrist extension and electromagnetic stretch of a single flexor muscle occurring in the absence of wrist extension, indicating that muscle stretch was important in determining area 4 unit responses to passive movements. 4. The similarity of area 4 behavior to area 2 behavior in active and passive situations, along with the observation that area 2 responses to passive movements occurred several milliseconds earlier than those of area 4, emphasizes the importance of area 2 in motor performance and is consistent with significant area 2 mediation of area 4 responses. 5. Results support the hypothesis of an oligosynaptic transcortical pathway (22, 32, 34), beginning in large part with muscle stretch receptors. Furthermore, the correlation noted between short-latency responses to passive movement and task-related activity suggests that this transcortical pathway not only mediates responses to passive movement but may be responsible, to a significant degree, for task-related activity during undisturbed performance. Thus, active position maintenance and active movement were probably accomplished, at least in part, by increasing and decreasing the influence of this pathway on specific area 4 neurons and thereby producing the patterns of area 4 activity responsible for task performance.

The effect of storage at sub-zero temperatures and subsequent thawing was investigated in dissected muscles, tendons, limbs and spines. Freezing caused a noticeable shortening of muscles which when thawed could easily be elongated; the same effects, though less pronounced, were observed with tendons. During freezing, myotomy or tenotomy led to the development of a striking deformity owing to unopposed shortening of the opposing muscles. After thawing, all frozen specimens containing muscles and joints showed an increased range of passive movements, easily demonstrable by mild tensile forces.

To avoid paraosteoarthropathy no postural changes or passive movements should be done in the first 4 weeks after spinal cord injuries. Physiotherapists who are in charge of treatment of paraplegics should have a fundamental knowledge of spinal cord injuries to prevent such severe complications.

Cerebrospinal fluid (CSF) dynamics in infants and children is still obscure. This paper aims to analyze the characteristics of CSF dynamics in the younger age group and to clarify the changes both in the acute/chronic hydrocephalic status and in the post-shunt condition on the basis of our experience with 118 cases of metrizamide CT cisternography. In order to pursue the CSF passive movements, the exact regional CT numbers were obtained by means of the ROI method in each case at 3, 6, and 24 hours after metrizamide injection. The results revealed that, in the normal CSF dynamics in both the major and minor pathways in children, it took more than 24 hours until the regional metrizamide was completely cleared up.

A method is recommended that facilitates the postmortem assessment of early stages of congenital or experimental paralytic and postural limb deformities, which otherwise are difficult to demonstrate on small specimens. One of the early signs detectable is change in the range of passive movements in the limb, and for its fine and objective assessment it is recommended that limb weight and gravity be used. Any disturbance of the original in vivo shape and position of the extremity during fixation of the postmortem specimen is prevented by suspension and free floating in the fixation fluid.

After induction of an experimental knee joint inflammation, the activity of single Group III and IV afferent units in the medial articular nerve of the cat was recorded at rest and during passive movements. The properties of these units were compared to those sampled from normal knee joints. The proportion of units displaying resting discharges was higher in the inflamed group. The frequency of discharges was also higher. The receptive fields were larger than those in the control units. Passive movements in the normal working range of the joint activated many more units in the inflamed joint than in the control sample. We conclude that joint inflammation sensitizes articular nociceptors to be active not only at rest, but also during normally innocuous joint movements.

Discharges of Purkinje cells (PCs) with simple (SS) and complex spikes (CS) in the c1-zone of lobule Vc of the anterior lobe of the cerebellar cortex were analyzed in the decerebrate cat during a passive movement of the cat forepaw. The CS of the PC responded differentially and/or proportionally to the position of the extremity, amplitude of the movement, velocity and acceleration. Inphase and outphase responses of the climbing fiber (CF) system to sinusoidal movements could depend on the position of the extremity within the operational range. From these results we deduce that peripheral events can be signalled by the CF system. The possible function of the interaction between the two inputs at the PC level is discussed.

Dissection reveals that the ball of the foot contains a connective tissue framework with transverse, vertical, and sagittal fibers, all connecting the skin with the proximal phalanges of the toes. Dorsiflexion of the toes tightens the framework and thereby restricts passive movements of the skin, enabling shear forces to be transferred to the skeleton. An electromechanical oscillator was constructed that applied oscillatory shear forces of constant amplitude (+/- 0.2 N) to the skin and at the same time measured the resulting motions. It was found that the toes should be dorsiflexed by 35--40 degrees to restrict skin mobility to 50 per cent and by 50 degrees to restrict it maximally. The results were compared to actual dorsiflexions of toes during walking. These dorsiflexions were measured on slow motion film and with still pictures with light tracks formed by light emitting diodes. Maximal dorsiflexion during push off was found to be 60 degrees for feet walking without shoes, 45--50 degrees for feet walking in soft shoes, and 25--30 degrees for feet walking in a stiff shoe of the minus-heel type. Dorsiflexion was further found significant for arch support and for the mechanics of the forefoot during push-off.

No abstract available.

As part of the conjugate team associated with the management of spinal cord injuries, the physical therapist (whether he/she be a physiotherapist or an occupational therapist) must be well informed as to the cause of the paralysis with all its pathologic significance and prognosis. In fact, every aspect of the patient’s physical condition must be made clear. It is important that he amalgamate his personal knowledge with sound medical and physiologic grounding so that the application of his science has meaning. During the early stages of management he is responsible for the acute management of respiration, passive movements, the introduction of independent movement to the patient, and subsequently, the reeducation of nonaffected muscles. This management is helped enormously by a clear understanding and appreciation of the patient’s preaccident activities.

Lower limb prostheses produced so far do not replace the function of the musculature, which provides the necessary amount and the proper distribution of energy to the ambulatory mechanism. Provision of external power to lower limb prostheses has been hindered by the fact that the large amount of energy needed at a lower limb necessitates the use of external power sources of unacceptably high mass and volume. Self energized mechanisms offer a promising alternative to the problem. Normally a large part of energy output during locomotion appears at the ankle joint. It seems therefore desirable to develop an above-knee prosthesis featuring active plantar-flexion at the ankle. Energy may be offered by a self energized system. The system, described here, accumulates energy during the passive movements of the knee and ankle joints and stores it for later use at the ankle. Prosthet Orthot Int

1) Experiments were designed to detect how static parameters of natural, passive hand movements are encoded and integrated within the cerebellar cortex. For this purpose unit activity was recorded extracellularly from presumed mossy fibres (MF), presumed granule cells (GrC) and from Purkinje cells (PC) discharging with simple spikes (SS) and complex spikes (CS). With respect to the PC, our interest was focussed primarily on the SS activity. The recordings were performed in the intermediate part of the cerebellar anterior lobe of decerebrate cats. The animal's forepaw was passively moved around the wrist joint by an electronically controlled device. The movements were exactly reproducible so that peristimulus time histograms of the unit activity could be constructed. 2) At the input level (MF) and at the first level of integration within the cerebellar cortex (GrC), patterns with similar discharge characteristics were found. Such patterns could, to a limited extent, also be detected at the cerebellar output (SS of PC). However, in most cases of SS discharge, patterns were found with weak correlation between the tonic activity and static parameters of the movements. 3) Absolute paw position, amplitude, and duration of movements were found to be related over wide ranges to the activities of MF and GrC. Absolute position is directly encoded by tonic discharge during the low or high holding phases. Beside this, units were found without a correlation between the tonic discharge and the position of the nonmoving paw. However, in these units it was sometimes observed that the information about the momentary position or the information about the mean position was sometimes conveyed exclusively during the proceeding upward or downward movement. Thus, information about static parameters was transmitted only at times when a dynamic parameter (such as velocity) occurred. This type of position information encoding is termed “indirect mode of transmission”. 4) A specific relationship between SS unit activity of PC and the absolute position of the forepaw or amplitude of the movement could be found primarily by using multiple ramps instead of single ramp movements. This was observed even if both types of ramp movements had the same velocity, individual amplitude, and tested range. However, on multiple ramp movements the paw generally remained for a shorter period at a specific position level as compared to the single ramp movements. 5) Apart from this timing phenomenon, a late movement response was observed, which results in a specific type of position information encoding on multiple ramp functions. 6) These results indicate that static parameters of a passive limb movement are conveyed via the MF input to the cerebellar cortex. Patterns related to these parameters undergo a change within the MF-, GrC-, Parallel fibre-, PC-system. Different modes of encoding these parameters were observed depending primarily on the neuronal niveau within the cerebellar cortex. Tonic discharge related e.g. to limb position was found at MF and GrC level. Such patterns resemble, at least to a certain extent, those obtained from different peripheral receptors. The high tonic SS activity never showed such a strong relationship to static parameters as observed at the input level; static parameters could be resolved only within relatively short periods of time, especially during the dynamic phases of the movement or during short periods immediately following these phases. This implies that the function of this part of the cerebellum, which is to provide correction signals, should be considered as a more dynamic process characterized by evaluating predominantly information about the momentary ongoing movement.

The purpose of this study was to measure the effects of lifting, placing, and removing different magnitudes of loads on the spinal stress. Eight male volunteers were measured for spinal stress utilizing intra-abdominal pressure (IAP). The loads used in the lifting tasks to different vertical and horizontal levels, varied from 5 kg up to 15 kg and were placed in a random order. The ANOVA analysis revealed significant individual variation (p0.001) both when placing and removing the loads. The effect of increase in load magnitude on the mean peak IAP values was highly significant (p0.001) when both placing and removing the loads. It is suggested that the area of activity falls within the limits of low truncal stress. The low truncal stress limits are large enough for most loading or unloading activities. Such requirements should also apply to physical therapists using passive movements and transfer activities allowing the therapist to carry out the required treatment or transfer within the safe limits of low truncal stress. J Orthop Sports Phys Ther 1987;9(2):70-76.

Prior findings regarded as evidence for proprioceptive feedback as a mediator in interlimb timing can also be interpreted as evidence for motor outflow because they came from research that had subjects make voluntary movements, and such movements allow for both feedback and outflow to operate. The present study was designed to resolve this controversy by determining if these findings could be replicated with passive movements which allow for feedback, but not outflow, to operate. The interlimb timing task studied was one where subjects made the timing response with their right hand while moving their left arm during the 1.5-sec interval to be timed. Three groups of 16 male college students performed 50 trials of the right-hand response with knowledge of results, under one of three left-arm conditions: (a) passive movement, (b) voluntary movement, and (c) no movement. The results indicated that the findings were replicated with passive movements and this was interpreted as support for the involvement of proprioceptive feedback in interlimb timing.

The sensory feedback system of decerebrate, paralyzed cats was studied at different neuronal levels during passive movements of the animals’ forepaw. Information about the static parameters of the movement was primarily found at levels of low integration while responses to dynamic parameters were obtained at all recorded levels. However, at levels with a high degree of convergence information about momentary position was only observed at times, when dynamic parameters were also transmitted. A model is derived, which is characterized by directly processing the dynamic parameters whereas static parameters are linked with different components of the velocity signal. Furthermore the model is expanded to a n-dimensional system with an interactive exertion of the afferent channels. The results of a computer- -simulation of this model are compared with the experimental results.

We found that amiloride and SITS, which are inhibitors of passive movements of Na+ and HCO3- across cell membranes, inhibited but did not abolish the electrical potential difference and net fluid transport across the rabbit corneal endothelium.

1) The present experiments were undertaken to study how information about the parameters of a passive movement is processed at different neuronal levels of the cat cerebellar cortex. The analysis has been performed by recording extracellularly in the intermediate part of the cerebellar anterior lobe from presumed mossy fibres, presumed granule cells, and Purkinje cells with simple spikes and complex spikes. 2) The discharge patterns obtained during passive movements of the cat's forepaw were characterized by components which could be related to dynamic or static parameters of the movement. With respect to the occurrence of dynamic responses, patterns were classified according to a statistically derived measure in three different types. By using the same statistical measure, discharge patterns were additionally classified into two subgroups according to their response components reflecting static parameters. Within the patterns a clearcut relationship between dynamic and static components was observed. The corresponding distributions are shown and discussed. 3) A very interesting result of the classification of cerebellar discharge patterns is that the distribution of the different types depended on the level of integration within the cerebellar cortex. Patterns of the low scale integrated cerebellar input (mossy fibre-system), as well as those of granule cells (the first cerebellar computational niveau), reflected both static and dynamic movement parameters. At the Purkinje cell level (a level with a high degree of convergence) the discharge patterns are characterized predominantly by dynamic responses. 4) The interrelationship between complex- and simple spikes of Purkinje cells was tested by different methods: a) By analyzing the paired values of the mean complex-(CS) and simple spike (SS) discharge probabilities of 110 Purkinje cells a scatter was obtained, indicating an underlying hyperbolic relation (prob(CS) = a/(prob(SS))b). Thus, a high CS discharge probability is accompanied by a low SS probability and vice versa, b) The timelocked complex- and simple spike responses were studied by comparing the similarity of their responses. All combinations of complex- and simple spike patterns were observed, ranging from a sign correct similarity to a mirror image similarity. The distribution of the measure for similarity shows that the mirror image predominated, c) The individual simple spike discharge probability is characterized by a pause evoked by the occurrence of a complex spike event. The simple spike discharge probabilities during an interval preceeding and following a complex spike event were compared. A post climbing pause coefficient was defined as a measure for the effectiveness of the complex spike event. No relationship between these coefficients and the above mentioned measure for similarity was found. Hence, for the Purkinje cell discharging with the simple spikes independent spike generating processes have to be assumed. 5) From these results it can be derived that cerebellar discharge patterns can be classified with respect to responses to static and dynamic parameters of passive limb movements. Based on this classification it appears that the distribution of responses to static and dynamic parameters depends on the computational level within the cerebellar cortex. If both static and dynamic parameters are conveyed by a single unit, a clear relationship between the response components could be observed. However, this effect was independently found at all cerebellar cortical computational levels indicating a functional principle of processing a pair of movement parameters. The interrelation of complex- and simple spike responses to passive movement was further studied. Since transients of complex- and simple spike patterns were observed ranging from two almost identical patterns to mirror image like patterns, it is assumed that under physiological conditions one of the tasks of the climbing fibre system consists of tuning the simple spike discharge according to the peripheral requirements.

A test of kinaesthetic sensitivity to passive movements of the upper limbs was constructed consisting of two tasks: position and movement discrimination, and movement pattern perception and memory. 475 subjects ranging in age from five years to adult were tested and developmental trends were established. The test was found to be a useful tool in measuring the kinaesthetic sensitivity of normal subjects, as well as of intellectually and physically handicapped children. Results for right and left arms did not differ in the test of kinaesthetic perception and memory. Kinaesthetic sensitivity was found to be correlated with everyday motor functions involving fine manual control, as well as with co-ordinated gross body movements.

SAJIKI, N., MORIAI, N. and NAKAMURA, R. Effect of Passive Movements on Reaction Time of the Rectus Femoris in Normal Subjects and Patients with Paraparesis. Tohoku J. exp. Med., 1983, 139 (3), 309-314 -Electromyographic reaction times (EMG-RTs) of the right knee extension were examined in eight normal subjects and eight patients with paraparesis under three conditions; during passive knee flexion (PFLX), passive extension (PEXT) and no passive movements (STAT). EMG-RTs of the three conditions were not significantly different between the normal and the patient group. A two-way analysis of variance (condition×group) showed that the main effect of condition was significant, but that of group and the interaction were not. Both in the normal and the patient group the shortest EMG-RTs of all was obtained in PEXT, followed by that of STAT and PFLX. Effect of passive movements on EMG-RTs in the patients whose position sense of the knee and muscle strength of the knee extension were within normal range did not vary with the abnormality of tactile sense and/or myotatic reflexes. The results indicated that activities of the pyramidal tract neurons in carrying out a movement were directy influenced by kinesthetic information of the moving limb.

Measurements were made of the regulation of the body ionic content, the fluxes of Na, Cl and water and the electrical potential across the intertidal teleost, Pholis gurmellus in 100% (410 mM-Na/1.) and 20% sea water. The rates of the ion flux depended on the method of measurement. The flux of Cl is much below the flux of Na in 100% sea water. In 20% sea water the fluxes of Na and Cl are the same. In 100 % sea water only the Na flux has an exchange-diffusion component. There is no exchange-diffusion component of the flux of either ion in 20 % sea water. The electrical potential across Pholis changes from 18 mV. (inside positive) in 100% sea water to 6 mV (inside negative) in 100% sea water. Comparison with the Nernst potentials indicate that Cl is actively transported in both salinities while Na may possibly be actively transported in 100% sea water. In 20% sea water the permeability to Na decreases to 51 % of the permeability in 100% sea water, while the Cl permeability decreases to 82% and the water permeability remains at the sea-water level. In both salinities the rate of diffusion of Na ions is greater than the rate of diffusion of Cl ions. The osmotic permeability to water is approximately equal to the diffusional permeability to water in both salinities. It is concluded that the passive movements of Na, Cl and water must be independent of each other and not via uncharged, water-filled pores.

Summary 1.Two comparable cases of grease-gun injuries are described, the first treated conservatively and the other by immediate surgery. 2.The long inactivity arising from an apparently trivial injury is stressed. 3.A bayonet incision was found to give an adequate exposure without the formation of a "bow string scar". 4.On removing only I c.c. of grease there was a marked reduction in the tenseness of the finger, with immediate restoration of full passive movements of the interphalangeal joints.

The stimulus-response characteristics of the mechanoreceptors in the posterior capsule of the temporomandibular joint of the cat were examined oscilloscopically during graduated passive movements of isolated joints. Analysis of the resulting afferent action-potential discharges in articular nerves confirmed the presence in the joint capsule of two varieties of mechanoreceptor differing in latency, threshold and adaptation time. The two functional varieties of articular mechanoreceptor response correlated with the two (Type I and Type II) morphological varieties of corpuscular end-organ previously demonstrated histologically in the temporomandibular joint capsule. A rapidly adapting discharge, attributed to the Type II receptors, was evoked only at the onset of joint movement, and then produced transient reflex facilitation of motor units in the prime movers of the joint. A slowly adapting discharge, attributed to the Type I receptors whose graded thresholds provided a continuing (though fluctuating) discharge throughout all joint movements, contributed co-ordinated facilitatory and inhibitory reflex influences to motoneurones innervating the mandibular musculature, as well as contributing to mandibular kinaesthesis.

Single-unit impulses were recorded with semi-microelectrodes from muscular portions of peripheral limb nerves in awake human subjects. Thirteen units were studied. Four of them could not be activated by mechanical peripheral stimuli but they fired steadily during sustained voluntary contractions. They were considered to be either motor fibres or proprioceptor units, having high thresholds to mechanical stimuli. The other nine units were shown to be proprioceptors which had their end organs located in deep structures of the leg or the forearm. They were divided into three groups on the basis of their responses to local mechanical stimuli, passive movements, and voluntary contractions. Possible relations between each group of units and various anatomical types of proprioceptors are discussed. Some of the units had characteristics which suggested that they were muscle spindle afferents. The findings reported in this investigation and in an earlier investigation, dealing with multi-fibre discharges in muscle nerves, indicate that the muscle spindle afferent discharge is increased during voluntary contractions and thus, that the fusimotor system is engaged in voluntary motor acts.

The aim of this paper is to obtain information on the number, nature and location of the barriers to Na movement across the frog skin, and on the size and location of the Na-pool that might be contained between these barriers. On the basis that Na penetrates passively across an outer barrier, and is actively extruded across an inner barrier which is impermeable to passive movements of Na, we expected to detect at least the Na-pool of a single cell layer containing some 10−8 moles per cm2 of epithelium (i.e., in a cell layer 5 μ thick and with 21mm Na). Yet no Na-pool with these characteristics was found. The method employed could have detected a Na-pool at least an order of magnitude smaller than the one expected. It is concluded that either a Na-pool does not exist (except for the Na bound to the mechanisms operating the translocation), or else that the Na-pool is contained between barriers with different characteristics than the ones assumed above. In the first case, Na transportacross the epithelium would consist of a translocation across a single asymmetrical functional “barrier”. In the second case, the experimental results would require that ouabain either directly (by inhibiting an active step) or indirectly (through a mediated decrease of the Na permeability of the outer barrier) prevents Na penetration at the outer border.

The patient, a young woman, had suffered since four years of age from hip-joint disease. She had been under the care of four different surgeons, all excellent men of high standing. While a patient of the third surgeon, she became very impatient to have the apparatus removed. She was wearing at this time some sort of a convalescent splint the exact nature of which I do not know. About five years ago the patient put herself under the care of the fourth surgeon and was immediately told that she should nave discarded all braces ten years before. Since that time she has not only been without any protection to the joint but has had massage and passive movements prescribed. She complained of weakness from the first and during the last four years it has been increasing. The surgeon does not seem to have appreciated the true significance of this subjective

Summary1. Normal rabbits injected with 0.5 ml of duck anti-rabbit kidney serum (DARKS) in the stifle, twice weekly for 6 weeks, developed a delayed monoarthritis starting 2 to 4 months following first intraarticular injection. 2. Control animals injected with a similar dose of normal duck serum (NDS) failed to develop arthritis within a 6 months observation period. 3. The intra-articular injections of either NDS or DARKS produced high serum antibody titers precipitating both, NDS and DARKS prior to development of the arthritis. The titer disappeared as the arthritis developed in rabbits treated with DARKS but persisted in the NDS-treated control animals. 4. When either, DARKS or NDS, was injected into the joint of rabbits previously immunized with NDS, an accelerated arthritis developed within one week. 5. The main clinical symptoms at site of the affected joint consisted of pain, swelling, crepitus, limitation of active and passive movements with subsequent functional impairment. 6. Histologic studies re...

The effects of temperature, cocaine, anoxia, acetylcholine (ACh), K, Na and Ca on influx and efflux of K in isolated rabbit atria have been studied. Increasing the K concentration in the medium (K0) increases both efflux and influx of K; having a much greater effect on the latter. Both fluxes were estimated to be equal at a K0 of 6.0–6.5 mm. ACh increases both influx and efflux. An increase of K0 hardly modifies the effects of ACh in efflux, but greatly enhances its effect on influx. In the presence of ACh both fluxes were estimated to be equal at a K0 of 4.0–4.5 mm. Studies on the influence of temperature, cocaine and anoxia suggest that at K0's less than 5.4 the two fluxes are passive in nature. At K0's above this, influx appears to have an active component. Evidence is presented which suggest that at low K0's ACh affects only passive movements of K, whereas at higher K0's the agent stimulates active transport. A decrease of Na in the medium to one-fifth depresses efflux and influx about 50% when the Ca concentration is maintained at a normal level. A decrease of Ca blocks the effect of low Na. These findings are interpreted to mean that Ca either increases passive movements of K or determines the degree of coupling between Na and K fluxes.

1. The effect of temperature on passive movements of sodium and potassium through the red cell membrane has been determined in the presence of various monovalent anions.2. Passive sodium and potassium fluxes varied in a complex way with temperature, when the isotonic electrolyte media contained 120 mM thiocyanate or salicylate. Between 0 and 18 degrees C the fluxes decreased with increasing temperature. Above 18 degrees C the rate of permeation increased when temperature was increased.3. The ability of anions to induce an increased sodium influx at 0 degrees C was gradually intensified through the following sequence of anions:HCO(3) (-) < Cl(-) = Br(-) < NO(3) (-) < I(-) << SCN(-) << salicylate.4. It is proposed that the anion induced effects on the cation permeability are secondary to binding of anions to fixed cations in the red cell membrane. The temperature dependence of the cation fluxes is assumed to reflect the binding on anions to fixed charges at temperatures between 0 and 18 degrees C.

A method is described for measuring the amount of sodium confined between an outer membrane, which is passively but specifically permeable to sodium, and an inner membrane where the active transport mechanism is located. The method allows correction for sodium outside the transport pool. Several determinations can be performed on the same skin. Repetitive determinations gave a standard deviation of ± 7 per cent. A single determination can ordinarily be made in less than an hour. Good agreement is found under suitable conditions between the potential difference calculated from the pool and the measured potential difference across the skin. Furthermore, from the disappearance rate of sodium from the pool and the size of the pool the active sodium transport can be calculated under conditions where other methods cannot distinguish between active and passive movements of sodium.

Publisher Summary This chapter discusses the paraplegics and hemiplegics. Patients with paraplegia are unfortunate in that, in most cases, they cannot be cured. Patients with cancer are unfortunate in that, in many cases, they cannot be cured and the patients who have a paraplegia or hemiplegia because of cancer are doubly unfortunate. A majority of the patients who have a hemiplegia because of cancer have a poor prognosis. The main avoidable complication is contractures. There is the greatest tendency to form contractures in the first few weeks after onset and a full range of passive movements twice a day is needed. However, even in those patients where a cure cannot be affected, there is an immense difference between a well-treated and a neglected patient. Not only can the length of survival be improved but the quality of survival greatly enhanced. With continued skilled care, the last months or years can be a happy and rewarding period both for the patient, hospital staff, and the patient's family.

In his classical study Goldscheider 1889 attributed most of the sensations involved in kinaesthesis to the joints. He stated that minute changes of joint position of less than one angular degree is perceived as a movement and not as a set of successive positions. He further stated that for passive movements the minimal perceptible excursion in the knee joint is 0.5–0.7 degrees if the speed reaches 1–2.5 degrees/sec. The limit for perception of willed movements is slightly lower.

We recorded somatosensory evoked fields to passive extensions of the left and right index fingers in eight healthy adults. A new nonmagnetic device was designed to produce calibrated extensions of 19 degrees, with a mean angular velocity of 630 degrees/s. The responses, recorded with a 306-channel neuromagnetometer, were modeled with current dipoles. The earliest activation was in the primary somatosensory cortex, with peaks at 36-58 and 30-82 ms for left and right index finger extensions, respectively. Later signals were observed in the left second somatosensory (SII) cortex in six of eight subjects at 75-175 and 75-155 ms for left- and right-sided extensions, respectively; three subjects showed bilateral SII activation in at least one condition. Our results suggest a predominant role for the human left SII cortex in proprioceptive processing.

The paper characterizes basic dysfunctions and diseases of a human wrist as well as describes the mechanics and pathomorphology of the human hand. The radial-carpal joint was analyzed in terms of his ranges of motion. The results of the analysis, i.e. the number of degrees of freedom for a free hand, are included. The concept of manipulator construction for optimal rehabilitation of the wrist was developed. Expected effects of the exercises, which can be implemented on the designed manipulator, were also described. A comparative analysis of other appliances supporting the rehabilitation of the human upper limb were presented. The main purpose of the designed manipulator was to gain full control of implementation of exercises performed by the patient and to archive and precisely track the progress in the rehabilitation. An important feature of the designed manipulator is its versatility enabling its use for: exercises of both hands (left and right) with the repetitive movements, choose of exercises (active and passive movements), choose of the degree of disability of the patient.

Many actions involve limb movements towards a target. Visual and proprioceptive estimates are available online, and by optimally combining (Ernst and Banks, 2002) both modalities during the movement, the system can increase the precision of the hand estimate. The notion that both sensory modalities are integrated is also motivated by the intuition that we do not consciously perceive any discrepancy between the felt and seen hand’s positions. This coherence as a result of integration does not necessarily imply realignment between the two modalities (Smeets et al., 2006). For example, the two estimates (visual and proprioceptive) might be different without either of them (e.g. proprioception) ever being adjusted after recovering the other (e.g. vision). The implication that the felt and seen positions might be different has a temporal analog. Because the actual feedback from the hand at a given instantaneous position reaches brain areas at different times for proprioception and vision (shorter for proprioception), the corresponding instantaneous unisensory position estimates will be different, with the proprioceptive one being ahead of the visual one. Based on the assumption that the system integrates optimally and online the available evidence from both senses, we introduce a temporal mechanism that explains the reported overestimation of hand positions when vision is occluded for active and passive movements (Gritsenko et al., 2007) without the need to resort to initial feedforward estimates (Wolpert et al., 1995). We set up hypotheses to test the validity of the model, and we contrast simulation-based predictions with empirical data.

SAJIKI, N. and NAKAMURA, R. Motor Time of the Rectus Femoris during Passive Movements. Tohoku J. exp. Med., 1985, 145 (2), 231-232-Motor time (MT) of 10 normal subjects were examined in three conditions: 1) during passive flexion of the knee (PFLX), 2) during passive extension (PEXT), and without passive movement (STAT). Compared to STAT, MTs of PFLX and PEXT were significantly long. MT tended to be shorter, though insignificant statistically, in PFLX than in PEXT. In conclusion, passive movements are influential in changing the physical state of the muscle including both series-elastic and contractile components.

SATO, K., NAKAMURA, R. and NAGASAKI, H. EMG Activities of the Biceps Brachii at Rapid Elbow Flexion during Passive Movements. Tohoku J. exp. Med., 1983, 139 (2), 219-220-Seven normal subjects were asked to flex the left elbow as quickly as possible, responding to a tone stimulus under three conditions: 1) during passive flexion of the elbow, 2) during passive extension and 3) without passive movements. The EMG activities in passive movements reduced significantly during first 60 to 70msec, compared to the condition without passive movements.

This study investigated the effects of passive movement and imitation training with verbal instructions on the learning of a perceptual-motor task and the effects of these training procedures on the children’s behavior when the perceptual-motor associations formed in the initial learning are reversed under adult verbal instructions. The four treatments were passive movements and imitation with and without verbal instructions. The conditions were a two-association (colors-forms) motor-perceptual task and the reversal of the associations by means of verbal instructions. The results indicated that 4-year-olds performed significantly better on both task conditions when training was accompanied by verbal instructions. The results indicated that the development of verbal control of nonverbal behavior may be manipulated and develooed artificially.

EVIDENCE in favour of the concept of servo control of muscle as expressed by Merton1, depended first on an interpretation of the electromyographic silent period resulting from procedures which unload the spindle2. Direct recording of spindle and fusimotor activity has supported the idea in the case of certain reflex limb movements3 and in the respiratory muscles of anaesthetized animals4,5. We have sought to extend consideration to the jaw muscles of the cat by recording from their afferents during reflex movements. The cell bodies of these first order afferents can be located in the mid-brain nucleus of the fifth cranial nerve (mid-n V) with extra-cellular metal microelectrodes, with a minimum of operative interference6. Receptors from jaw closing muscles greatly outnumber those from the openers7,8 and attention is restricted here to spindles and tendon organs in the former. Three other types of receptor are potentially represented and must be eliminated. First, tooth mechano-receptors are plentiful, particularly related to the canine teeth9. They were distinguished by their sensitivity to direct pressure on a tooth or gum with jaw supported. Cells belonging to such receptors occurred commonly in groups, their frequency range was lower than that of spindles and their extra-cellular action potentials were usually larger than those of any other cells. Second, extra-ocular muscle stretch receptors have been stated to have their cell bodies in the mid-n V10 and, because the bony orbit is deficient in the cat, jaw movements might have excited them. Although units were often found to be affected by passive eye movements, however, they were invariably more sensitive to jaw movement. Third, temporo-mandibular joint receptors might be represented in the mid-n V, but in fact no unit has been encountered which could not be ascribed to one of the other groups. Elimination of the above types leaves spindles and tendon organs in the jaw closing muscles. They can be distinguished as follows. The three muscles act in parallel on the jaw, so that twitch contraction in one of them brings about a pause in a spindle located in any of them, if some jaw movement is permitted. A tendon organ in one muscle will also pause during a twitch in either of the others, but will speed during a twitch of its own muscle. A twitch to each muscle in turn can therefore identify and locate a tendon organ or identify a spindle. The spindle must then be located by probing the muscle surface. Another important test for spindles is their sensitivity to small doses of succinyl choline (SCh) injected intra-arterially11. Each unit recorded was first tested as above (save for the SCh) and then its behaviour studied during active jaw movements. In the cat lightly anaesthetized with sodium pentobarbitone, reflex movements could be produced by putting fluid in the mouth, mechanically stimulating the pharynx and by obstructing the airway. Testing with SCh was delayed till after recording active movements.

The Brazelton Scale was administered to 204 high risk infants; 366 tests were given. 88% were

We used electrophysiologic methods in the diagnosis of torsion dystonia and the evaluation of therapy in a 7-year-old child. Electromyographic (EMG) activity patterns in five leg muscles were recorded during specific voluntary and passive movements as well as during gait. We found patterns of coactivation in leg muscles in walking or isolated movements, and a shortening reaction was seen in the tibialis anterior. These findings in combination with clinical observations led to the diagnosis of torsion dystonia and the choice of L-dopa therapy. Beneficial effects of therapy were assessed by the same methods.

In suggesting the subject of disabilities of the hand resulting from loss of joint function I wish to submit a problem for consideration and discussion rather than a report of facts ascertained and results accomplished. To attempt to secure improvement of function in a hand with its joints fixed in flexion or extension has been difficult and often unsuccessful. An important complicating factor in many cases has been injury and fixation of tendons as a result of the original injury or infection. Not uncommonly the inability on the part of the patient to perform active movements and the failure to maintain passive movements have been quite as important factors in contributing to the joint fixation as have the injury or infection. Once joint function has been lost, the problem of restoration has presented so many difficulties that one constantly recurs in his mind to what might have been, and the

For a number of years I have observed a symptom in paralysis agitans that is not recorded in the literature. For the want of a better term, I have ventured to call it the "cog-wheel" resistance of the extremities. This is suggested by the use of such terms as "lead-pipe" and "waxy" flexibility. These terms describe a resistance which is felt where there is impaired motility in passive movements of the extremities. The term "cogwheel" is proposed as in a certain sense descriptive of a jerky or intermittent resistance of the extremities, when the sign is looked for. It is elicited by the examiner grasping the wrist with one hand and steadying the arm with the other, above the elbow. Rapid flexion and extension of the arm is made. Instead of an even movement, without resistance, when there is no involvement of motility, one, two or, perhaps, three slight hindrances

Exercises or movements for medical purposes, medical gymnastics, in other words, have been divided and subdivided to an absurd degree by Ling and his followers. Schreiber gives an example of a German term for what is called the quarternary combination of the standing position, which term contains forty-five letters and nine different words, although it is written in German as a single word. The division, however, into such movements or exercises as passive, duplicated active, and active, is rational and useful. Passive movements are performed upon the patient or individual, his will not coming into play except in submitting. In duplicated active movements, both the operator and the individual treated, take part; the first resisting while the second acts, or the reverse. Sometimes these movements are spoken of as semi-active and semi- passive; in the former, the physician or operator resists; in the latter, the subject resists. Movements of this

All physicians who have seen gonorrheal arthritis know how unsatisfactorily the usual treatment—rest, massage, passive movements, salicylates, etc.—often proves in chronic cases, and how hard to overcome in those cases is the extreme painfulness and the stiffness of the diseased joint. It seems to me worth while, therefore, to call attention to a method of treatment which, so far as I have observed, in this country, has by no means found the notice and practice it deserves. I refer to congestive hyperemia by damming according to Bier, which, as his assistant, I saw him employ. As is generally known, Bier recommended hyperemia by damming at first for tuberculous joint diseases; later he employed it also for other diseases, and in his book, "Hyperœmie als Heilmittel," writes: "Yet much more marked is the effect of hyperemia by damming on that form of gonorrheal joint inflammation which is so extremely painful. In these cases the pain becomes easier in from one-half to one hour after the application of the rubber bandage."

Active movements, as opposed to the passive movements due to heart-beat, begin in embryos of the pigeon of 105 ± 5 hours'incubation. These earliest movements, weak and infrequent, are extensions an...