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Periodic Limb Movement

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3081. Effect of Ropinirole on Spinal Cord Reflexes and Restless Legs Syndrome

disturbances. Ropinirole affects chemical messengers thought to be involved in spinal cord function and in modulating RLS symptoms. Healthy normal volunteers and patients with RLS between 18 and 80 years of age may be eligible for this study. Patients must have mild to moderate RLS and periodic limb movements. All candidates will be screened with a medical history, physical and neurological evaluations, electromyogram (see below), polysomnogram (see below), electrocardiogram (ECG), and blood and urine (...) provided by: National Institutes of Health Clinical Center (CC) Study Details Study Description Go to Brief Summary: This study will examine the effects of the drug Ropinirole on spinal cord reflexes and on symptoms of restless legs syndrome (RLS). Patients with RLS have uncomfortable sensations in the legs, usually in the evening or early part of the night. Most patients also have periodic involuntary leg movements. The condition tends to worsen over time, resulting in severe discomfort and sleep

2003 Clinical Trials

3082. Improving Arm Mobility and Use After Stroke

by constraining movement in the less impaired limb for most waking hours over a 2 week period. The constraint is a taped splint in which the hand rests to prevent limb use but enable protective responses. A micro-switch within the splint will permit monitoring of contact time (wearing). Each weekday for 2 weeks, patients come to the clinic/laboratory for specific task training. Evaluations in laboratory and actual use tests are made prior to treatment, 2 weeks later, and at 4 month intervals thereafter (...) . This study examines the effectiveness of CI therapy for improving arm motion after stroke. Condition or disease Intervention/treatment Phase Cerebrovascular Accident Procedure: Constraint-induced movement therapy Phase 3 Detailed Description: Profoundly impaired motor dysfunction is a major consequence of stroke. As a result, a large number of the more than 700,000 people in America sustaining a stroke each year have limitations in motor ability and compromised quality of life. Therapeutic interventions

2003 Clinical Trials

3083. Reconstruction for chronic dysfunction of ileoanal pouches. Full Text available with Trip Pro

Reconstruction for chronic dysfunction of ileoanal pouches. A retrospective review was performed to determine the results after surgical reconstruction for chronic dysfunction of ileal pouch-anal procedures for ulcerative colitis and familial colonic polyposis at a university medical center.During the 20-year period from 1978 to 1998, 601 patients underwent colectomy and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis, familial colonic polyposis, or Hirschsprung's disease. A J pouch (...) was used for 351 patients, a lateral pouch for 221, an S pouch for 6, and a straight pull-through for 23. Acute complications after pouch construction have been detailed in previous publications and are not included in this study. Chronic pouch stasis with diarrhea, frequency, urgency, and soiling gradually became more severe in 164 patients (27.3%), associated with pouch enlargement, an elongated efferent limb, and obstruction to pouch outflow, largely related to the pouch configuration used during

1999 Annals of Surgery

3084. Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Healt Full Text available with Trip Pro

according to level of evidence.A high value was placed on avoidance of cardiovascular morbidity and premature death caused by untreated hypertension.Physical activity of moderate intensity involving rhythmic movements with the lower limbs for 50-60 minutes, 3 or 4 times per week, reduces blood pressure and appears to be more effective than vigorous exercise. Harm is uncommon and is generally restricted to the musculoskeletal injuries that may occur with any repetitive activity. Injury occurs more often (...) . Because of insufficient evidence, no economic outcomes were considered.A MEDLINE search was conducted for the period 1966-1997 with the terms exercise, exertion, physical activity, hypertension and blood pressure. Both reports of trials and review articles were obtained. Other relevant evidence was obtained from the reference lists of these articles, from the personal files of the authors and through contacts with experts. The articles were reviewed, classified according to study design and graded

1999 CMAJ: Canadian Medical Association Journal

3085. Medications for the Treatment of Sleep Disorders: An Overview Full Text available with Trip Pro

, including amphetamines, may be used to induce daytime alertness. Parasomnias include disorders of arousal and of REM sleep. Chronic medical illnesses can become symptomatic during specific sleep stages. Many medications affect sleep stages and can thus cause sleep disorders or exacerbate the effect of chronic illnesses on sleep. Conversely, medications may be used therapeutically for specific sleep disorders. For example, restless legs syndrome and periodic limb movement disorder may be treated (...) Medications for the Treatment of Sleep Disorders: An Overview Sleep disorders can be divided into those producing insomnia, those causing daytime sleepiness, and those disrupting sleep. Transient insomnia is extremely common, afflicting up to 80% of the population. Chronic insomnia affects 15% of the population. Benzodiazepines are frequently used to treat insomnia; however, there may be a withdrawal syndrome with rapid eye movement (REM) rebound. Two newer benzodiazepine-like agents, zolpidem

2001 Primary Care Companion to the Journal of Clinical Psychiatry

3086. Diagnosis and treatment of sleep disorders: a brief review for clinicians Full Text available with Trip Pro

circadian rhythm disorders are described in conjunction with interventions, including chronotherapy and light therapy. The diagnosis and treatment of restless legs syndrome/periodic limb movement disorder is addressed. Attention is focused on obstructive sleep apnea and upper airway resistance syndrome, and their treatment. The constellation of symptoms and findings in narcolepsy are reviewed together with diagnostic testing and therapy, Parasomnias, including sleep terrors, somnambulism, and rapid eye (...) movement (REM) behavior sleep disorders are described, together with associated laboratory testing results and treatment.

2003 Dialogues in Clinical Neuroscience

3087. Treatment of Cortical Myoclonus With Repetitive Transcranial Magnetic Stimulation

on patients participating in the study. The 10 day period will be broken into 5 days of active repetitive magnetic stimulation and 5 days of placebo "ineffective" stimulation. At the end of the 10 day period, if the results show that rTMS was beneficial, patients may undergo an additional 5 days of active rTMS. Condition or disease Intervention/treatment Phase Movement Disorder Myoclonus Nervous System Disease Device: Magstim Super Rapid Stimulator Phase 1 Detailed Description: Repetitive transcranial (...) and Stroke (NINDS) Information provided by: National Institutes of Health Clinical Center (CC) Study Details Study Description Go to Brief Summary: Myoclonus is a condition related to epilepsy of involuntary twitching or jerking of the limbs. The purpose of this study is to determine if stimulation of the brain with magnetic pulses can decrease myoclonus. Researchers believe that this may be possible because in studies on normal volunteers, magnetic stimulation made areas of the brain difficult

1999 Clinical Trials

3088. Tactile/kinesthetic stimulation effects on preterm neonates. (Abstract)

of the limbs for three, 15-minute periods per day for a 10 days. The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic (...) Tactile/kinesthetic stimulation effects on preterm neonates. Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements

1986 Pediatrics Controlled trial quality: uncertain

3089. A controlled study of additional sr-L-dopa in L-dopa-responsive restless legs syndrome with late-night symptoms. (Abstract)

A controlled study of additional sr-L-dopa in L-dopa-responsive restless legs syndrome with late-night symptoms. To investigate whether a combination treatment of regular-release levodopa (rr-L-dopa) and sustained-release levodopa (sr-L-dopa) compared with monotherapy of rr-L-dopa improves sleep quality and reduces periodic limb movements (PLM) in patients with restless legs syndrome (RLS) and problems with maintaining sleep.Reappearance of RLS symptoms during the second half of the night while (...) being treated with rr-L-dopa is a common problem in the treatment of sleep disturbances caused by RLS.A randomized, controlled, double-blind crossover trial was undertaken. Eligible patients fulfilled the diagnostic criteria of the International RLS Study Group, and met an actigraphically confirmed higher number of PLM per hour time in bed (PLM index) during the second half compared with the first half of the night under treatment with rr-L-dopa. During the crossover periods the patients received

1999 Neurology Controlled trial quality: uncertain

3090. Effects of bromocriptine in human narcolepsy. (Abstract)

, or psychomotor performance was observed during bromocriptine administration. Periodic limb movements in sleep (PLMS) were significantly reduced during bromocriptine condition. These results suggest that D2 receptors are unlikely to play a major role in the physiopathology of human narcolepsy, and support the hypothesis that dopaminergic mechanisms are involved in PLMS.

1993 Clinical neuropharmacology Controlled trial quality: uncertain

3091. Successful treatment of the idiopathic restless legs syndrome in a randomized double-blind trial of oxycodone versus placebo. (Abstract)

of commercial preparation), there was a statistically significant reduction in the number of periodic limb movements in sleep [(PLMS)/hour sleep (p < 0.004)] and in the number of arousals/hour sleep (p < 0.009) on drugs as compared to baseline or placebo. A statistically significant improvement was also noted in sleep efficiency (p < 0.006) and 10 of the 11 patients preferred oxycodone over placebo. We conclude that oxycodone is an effective treatment for RLS and PLMS.

1993 Sleep Controlled trial quality: uncertain

3092. Effects of creatine monohydrate ingestion in sedentary and weight-trained older adults. (Abstract)

programme. The strength training programme consisted of three sets of eight repetitions at 80% of one-repetition maximum, for leg press, leg extension and chest press, 3 days a week. The 52-day supplementation programme consisted of 20 g of creatine monohydrate (or glucose) and 8 g of glucose per day for the initial 5 days followed by 3 g of creatine monohydrate (or glucose), and 2 g of glucose per day. Prior to and after the training and supplementation periods, body mass, body fat, lower limb muscular (...) volume, 1-, 12-repetitions maxima and isometric intermittent endurance tests for leg press, leg extension and chest press were determined. In all groups, no significant changes in anthropometric parameters were observed. For all movements, the increases in 1- and 12-repetitions maxima were greater (P < 0.02) in trained than control subjects. No significant interactions (supplementation/training/time) were observed for the 1-, 12-repetitions maxima, and the isometric intermittent endurance, whatever

1998 Acta physiologica Scandinavica Controlled trial quality: uncertain

3093. Postoperative epidural fentanyl infusion--is the addition of 0.1% bupivacaine of benefit? Full Text available with Trip Pro

) bupivacaine. After an initial 50 micrograms bolus of fentanyl, infusion rate was adjusted according to need between 2 and 10 ml/hr for 48 hours. The two groups (n = 40) were similar with regard to age, weight and preoperative status. Analgesia both at rest and with movement were significantly better in group FB (P < 0.0001) during the first 24 hours postoperatively, the greatest difference occurring in the 4 to 16 hour period. There was no significant difference between groups from 24 to 48 hours (...) postoperatively. Fentanyl utilisation was significantly lower in group FB (median 41 versus 53 micrograms/hr, P < 0.001), although clinically the fentanyl dose-sparing effect of bupivacaine was small and did not reduce opioid-induced side-effects. There was no significant difference between groups with respect to side-effects or lower limb weakness, although fewer patients in group FB could be mobilised on the morning of the first postoperative day (P < 0.01). Nevertheless, all study patients were ambulant

1994 Anaesthesia and intensive care Controlled trial quality: predicted high

3094. Response of neonates to vibroacoustic stimulation. (Abstract)

of limb movements. Heart rate increased by 19.5 +/- 9.7 beats/min (mean +/- SD) for a mean duration of 21.4 +/- 11.9 seconds. The five newborns with severe neurologic deficits did not show any response to vibroacoustic stimulation, and auditory brainstem evoked responses were also absent. We conclude that this technique may be useful as a screening procedure in the evaluation of the neurologic integrity of newborn infants. (...) Response of neonates to vibroacoustic stimulation. The response to vibroacoustic stimulation was evaluated in 30 healthy full-term newborns and in five newborns with severe neurologic deficits. The stimulus was applied during a period of quite sleep and a subsequent period of quiet sleep served as the control. All 30 healthy newborns reacted by changing from a state of quite sleep to an active sleep state as determined by heart rate acceleration, irregular respiration, and the appearance

1993 American journal of perinatology Controlled trial quality: uncertain

3095. Motor signs of wakefulness during general anaesthesia with propofol, isoflurane and flunitrazepam/fentanyl and midlatency auditory evoked potentials. (Abstract)

every 20 to 30 s (group 3). Heart rate and arterial pressure were recorded continuously. Purposeful movements of the limbs, eye-opening or other movements as well as coughing were documented as motor signs of intra-operative wakefulness. Auditory evoked potentials were recorded in the awake state, after induction and during maintenance of general anaesthesia. Motor signs of intra-operative wakefulness occurred statistically significantly more often in the patients of the flunitrazepam/fentanyl group (...) than in those of the propofol and isoflurane group. There was no correlation between wakefulness and cardiocirculatory parameters. In the awake patients midlatency auditory evoked potentials had high peak to peak amplitudes and a periodic waveform.(ABSTRACT TRUNCATED AT 250 WORDS)

1994 Anaesthesia Controlled trial quality: uncertain

3096. Randomized, double-blind, placebo-controlled study of clonidine in restless legs syndrome. (Abstract)

minutes) (p = 0.028). There were no significant changes in total sleep time, stage 1 and 2 sleep, sleep efficiency, awakenings, arousals or periodic limb movements in sleep. There was a nonstatistical trend toward and increase in stage 3 and 4 sleep and a decrease in motor activity as measured by actigraphic recordings. Globally, seven out of 10 patients felt clonidine was more effective than placebo. Four patients chose to continue clonidine after the study. Clonidine may be an effective treatment (...) for RLS patients who don't have large numbers of sleep-disrupting periodic limb movements but have delayed sleep onset due to leg sensations and subsequent motor restlessness.

1996 Sleep Controlled trial quality: uncertain

3097. Longitudinal effects of nortriptyline on EEG sleep and the likelihood of recurrence in elderly depressed patients. Full Text available with Trip Pro

and EEG sleep measures and the recurrence of major depression. Our results show that nortriptyline acutely and persistently decreased REM sleep, increased phasic REM activity, decreased sleep apnea, and had no effect on periodic limb movements during sleep. Recurrence on maintenance nortriptyline was associated with lower phasic REM activity during early continuation therapy, but EEG sleep measures did not predict recurrence during placebo maintenance therapy. Patients treated with nortriptyline had

1996 Neuropsychopharmacology Controlled trial quality: uncertain

3098. Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. (Abstract)

sleepwalking and sleep terrors (69); rapid eye movement sleep behavior disorder (52); chronic, severe insomnia (25); and restless legs syndrome/periodic limb movement disorder (24).Complete/substantial control of the sleep disorders was achieved by 146 patients (86%); 8% had adverse effects requiring medication changes; 2% had relapses of alcohol or chemical abuse requiring hospitalization; another 2% at times misused their medications. A total of 136 patients received clonazepam nightly for a mean 3.5 (...) Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. To assess the efficacy, dose stability, safety, and abuse potential of long-term, nightly benzodiazepine treatment of chronic disorders of disrupted nocturnal sleep.During a 12-year period, one author evaluated and treated 170 adult referrals for > or = 6 months with nightly benzodiazepine therapy for longstanding, sleep-disruptive disorders: injurious

1996 The American journal of medicine Controlled trial quality: uncertain

3099. Effect of severity of arm impairment on response to additional physiotherapy early after stroke. (Abstract)

given over a five-week period. The treatment approach reflected current usual British practice. 'Blind' outcome assessment was performed after intervention, and at three and six months after stroke.Rivermead Motor Assessment Arm Scale, Action Research Arm Test.In more severe patients, no benefits of additional treatment were detected. In less severe patients, significant benefits were found in those who completed treatment with the trained assistant. However, a considerable number of patients did (...) not complete the additional treatment. The content of treatment differed between the QPT and APT groups. Treatment of less severe APT patients emphasized repetitive supervised practice of movements and functional tasks. No significant effects of additional treatment were found in terms of shoulder pain or spasticity.Regardless of whether additional physiotherapy was given or not, patients with severe arm impairment improved very little in arm function. Enabling adaptation to loss of arm function may

1999 Clinical rehabilitation Controlled trial quality: uncertain

3100. Rapid onset of action of levodopa in restless legs syndrome: a double-blind, randomized, multicenter, crossover trial. (Abstract)

Rapid onset of action of levodopa in restless legs syndrome: a double-blind, randomized, multicenter, crossover trial. To investigate the efficacy and safety of levodopa plus benserazide in the treatment of restless legs syndrome (RLS), in terms of the frequency of periodic limb movements (PLMs), objective and subjective criteria of sleep, onset of action, and withdrawal effects.A randomized, double-blind, placebo-controlled, multicenter, crossover trial, with two 4-week treatment (...) treatment for a further 4 weeks; the dose could be doubled if required. The average dosages were 159 +/- 31 mg of levodopa and 1.56 +/- 0.29 capsules of placebo.Levodopa/benserazide significantly reduced the number of PLMs per hour (p<0.0001), increased the time in bed without limb movements (p<0.0001), and improved subjective quality of sleep (p=0.0004). The onset of action was rapid after the first dose, and full efficacy was achieved within the first few days of therapy; these improvements

1999 Sleep Controlled trial quality: predicted high

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