Here is some of the information I recently shared in the October newsletter. Each newsletter has a specific focus. This newsletter is focused on foot and ankle conditions. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.
TABLE OF CONTENTS
STUDIES and ARTICLES
1. A study titled The Effect of Toe-grasping Exercises on Balance Ability in Home-based Rehabilitation: A Randomized Controlled Trial by Block randomization, published in Phys Ther Res in Oct 2021 concludes: Toe-Grasping exercises could improve the balance ability of home-based rehabilitation users. This suggests the clinical significance of toe function in rehabilitation programs.
2. A study titled Comparative Effectiveness of Minimally Invasive Nonsurgical Treatments for Plantar Fasciitis: A Network Meta-analysis of 30 Randomized Controlled Trials, published in Pain Physician in Nov 2021 concludes: The miniscalpel-needle treatment should be recommended as the best therapy, followed by Botulinum toxin A in the gastrocnemius. Corticosteroid and platelet-rich plasma are common medications that remain valuable in clinical practice. Peppering technique can be performed after the injection of medication.
3. A study titled Impact of Asthma on Plantar Pressures in a Sample of Adult Patients; A Case-Control Study published in Journal of Personalized Medicine in Nov 2021 concludes: …alterations in static plantar pressures in asthmatic patients compared to healthy individuals. Specifically, the subjects with asthma showed less maximum pressure in the right forefoot and less weight on the left heel, which appear to be associated with the asthma disease.
4. A study titled Evaluation of plantar fasciitis improvement after shock wave therapy in calcaneal spur patients by musculoskeletal ultrasonography published in Egyptian Rheumatology and Rehabilitation in Nov 2021 concludes: Plantar fascia thickness increases significantly in calcaneal spur patients and responds to treatment. Extracorporeal shock wave therapy decreases the thickness of the plantar fascia and improves pain and function significantly
5. A study titled Myofascial Treatment Techniques on the Plantar Surface Influence Functional Performance in the Dorsal Kinetic Chain, published in Journal of Sport Science and Medicine in 2022 concludes: The combination of self- and therapeutic massage techniques on the plantar surface applied in our study might reduce performance in terms of force generation along the superficial fascial back line. Our hypotheses is supported by the fact that the plantar fascia itself was not loaded during the functional performance test and that the opposite effect was observed on the control side. As we applied a combination of different self and therapeutic massage techniques, it should be considered that some techniques, like foam rolling, might have no effect, while others, like stretching, had a negative effect.
6. A study, titled A study to Analyze the effect of Calcaneal Taping Techniques in Plantar fasciitis published in Research Journal of Pharmacy and Technology in 2021 concludes: Ultrasound therapy along with plantar fascia stretching and calcaneal taping technique was found more effective than ultrasound therapy and plantar fascia stretching alone at reducing pain in the heel and increasing functional ability of the foot.
7. A study titled Effects of dry needling and stretching exercise versus stretching exercise only on pain intensity, unction, and sonographic characteristics of plantar fascia in the subjects with plantar fasciitis: a parallel single-blinded randomized controlled trial published in Physiotherapy Theory and Practice in Jan 2022 concludes: There were considerable differences tween the two groups and the experimental group experienced more improvements in the primary outcomes (first step pain) compared to the control group. For secondary outcomes, plantar fascia thickness at insertion significantly decreased, and the echogenicity in the two regions significantly increased in the experiments group.
8. A study titled Effectiveness of the Graston Technique on Pain and General Foot Health in Patients with Chronic Plantar Fasciitis; A Randomized Clinical Trial published in Alternative Therapies in Health and Medicine in Feb 2022 concludes: in the case of general foot health, there was no significant difference between the groups at the end of the fourth week. The use of the Graston technique combined with conventional physical therapy shows significant results compared with conventional physical therapy alone; i.e., Graston therapy speeds up the recovery from heel pain and foot function in patients with chronic plantar fasciitis.
9. A study titled The Effectiveness of Two Types of Night Splints on the Range of Motion of the Ankle Joint, Pain Intensity, and Quality of Life in Patients with Plantar Fasciitis: A Pilot Study with Parallel Groups, published in Rehabilitation Journal 2022 concludes: All three orthoses (tension calf splint, tension plantar fascia splint, heel pad) used in this study significantly reduced pain in people with plantar fasciitis. The results also suggest that a tension calf splint has greater effectiveness in improving pain severity and soft tissue flexibility than a tension fascia splint.
10. A study titled Is Dry Needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis published in Pain Medicine in Mar 2021 concluded: moderate to low evidence suggests a positive effect of TrP dry needling for improving pain intensity and pain-related disability in patients with plantar heel pain of musculoskeletal origin at short- and long-term, respectively.
An article titled Kinematics and Kinetics of Ankle and Foot Complex, published in Conceptual Biomechanics and Kinesiology in Nov 2021 reviews the bones, joints, muscles, tendons, and ligaments of the foot and ankle and summarizes some information about the joints.
Here is some of the information I recently shared in the July newsletter. Each newsletter has a specific focus. This newsletter is focused on chronic pain conditions. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.
TABLE OF CONTENTS
STUDIES and ARTICLES
1. An article titled Aerobic Physical Exercise for Pain Intensity, Aerobic Capacity, and Quality of Life in Patients with Chronic Pain: A Systematic Review and Meta-Analysis published in Journal of Physical Activity and Health in Aug 2021 concludes: Aerobic exercise is a nonpharmacological therapeutic option for treatment (of chronic pain). Also, aerobic capacity and endurance improved when this type of exercise was prescribed, thus resulting in a substantial improvement in the quality of life of people suffering from chronic pain.
2. An article titled Mechanistic Insight into the Effects of Curcumin on Neuroinflammation-Driven Chronic Pain, published in Pharmaceuticals in August 2021, reviews and details the role of curcumin in microglia and astrocytes both in vitro and in vivo and how it improved pain.
3. An article titled Melatonin Moderates the Triangle of Chronic Pain, Sleep Architecture and Immunometabolic Traffic, published in Biomedicines in Aug 2021, details and reviews current literature relevant for the shared pathways of sleep, pain, and immunometabolism and elaborates the impact of melatonin on the crossroad of sleep, chronic pain, and immunometabolism.
4. A review titled Ketamine for the Treatment of Chronic Pain: A Comprehensive Review published in Health Psychology Research in 2021 highlights the use of ketamine for: neuropathic pain, fibromyalgia, complex regional pain syndrome, phantom limb pain, cancer pain, and post-thoracotomy pain syndrome.
5. A study titled Effectiveness of myofascial release on pain, sleep, and quality of life in patients with fibromyalgia syndrome: A systematic review published in Complementary Therapies in Clinical Practice in November 2021 concludes: moderate evidence for the effect of therapist-administered and self-myofascial release in improving pain, sleep subscales, and quality of life against sam and no treatment, respectively, in fibromyalgia syndrome patients
6. A study, titled Effects of Vitamin D on Pain severity, Quality of Life, Depression and Sleep in Patients with Fibromyalgia published in Medicine International Istanbul Hastanesi in 2021 concludes: Vitamin D deficiency may be a factor associated with symptom severity, sleep and wakefulness problems, and physical function in FMS. Therefore, serum 25OHD status should be evaluated in patients with FMS and its importance in treatment management should not be ignored.
7. A study titled The effect of Reflexology in patients with Fibromyalgia, published in Signa Vitae (Anesthesiology Department, Pain and Palliative Care Center Aretaeion Hospital, University of Athens, Athens Greece) in Feb 2020 concludes: Reflexology may be beneficial as add-on treatment in patients with Fibromyalgia who are unable to receive the recommended dosages of their medication (pregabalin).
8. A study titled The effects of acupuncture in fibromyalgia: integrative review published in April 2020 in BrJP Sao Paulo concludes: studies suggest that acupuncture is effective for the treatment of pain in patients with fibromyalgia, with improved quality of life and positive interference in sleep.
9. A study titled Investigation of effectiveness of reformer pilates in individuals with fibromyalgia: a randomized controlled trial published in Reumatlogía Clínical in Feb 2022 concludes: reformer pilates exercises had positive effects on clinical status and muscle strength while home mat pilates exercises had positive effects on the number of painful regions, clinical status, biopsychosocial status and physical component quality of life.
10. An article titled Infrared Radiation in the Management of Musculoskeletal Conditions and Chronic Pain: A Systematic Review published in European Journal of Investigation Health, Psychology and Education in Mar 2022 concludes: based on findings of our review, we noted a decrease in pain levels, decrease in Fibromyalgia Impact Questionnaire scores.
Here is some of the information I recently shared in the July newsletter. Each newsletter has a specific focus. This newsletter is focused on chronic pain. If you would be interested in receiving my newsletters, which include links to the studies as well as special offers and sales coupons, please head over to my contact page and sign up.
TABLE OF CONTENTS
STUDIES and ARTICLES
1. An article titled The influence of sleep disturbances and sleep disorders on pain outcomes among veterans: A systematic scoping review, published in Sleep Medicine Reviews in April 2021 concludes: Sleep disturbances and sleep disorders were associated with worse pain outcomes among veterans with chronic pain. Treatment-induced sleep improvements ameliorated pain outcomes in veterans with sleep disorders and sleep disturbances.
2. An article titled Greater somatosensory afferent with acupuncture increases primary somatosensory connectivity and alleviates Fibromyalgia pain via insular y-aminobutyric acid: A randomized neuroimaging trial published in Arthritis & Rheumatology in December 2020 concludes: Fibromyalgia patients who received electroacupuncture therapy experienced a greater reduction in pain severity compared to patients who received mock laser acupuncture.
3. An article titled Use of cryotherapy for managing chronic pain: An evidence-based narrative, published in Pain and Therapy in Dec 2020, concludes: Both local (ice packs) and non-local (partial and whole body cryotherapy) show promise in reducing chronic pain associated with various chronic diseases including those of rheumatic and degenerative origin. Cryotherapy appears to be a safe therapy in carefully selected patients with only minimal adverse effects reported in the literature.
4. A study titled Effect of underwater exercises on treating postmenopausal Fibromyalgia symptoms, published in European Journal of Molecular & Clinical Medicine in Sept 2020 concludes: underwater exercises are very effective in treating Fibromyalgia postmenopausal symptoms.
5. A study titled Cryotherapy alleviates symptoms in chronic prostatitis/chronic pelvic pain syndrome published in Andrologia in Dec 2020 concludes: cryotherapy could alleviate voiding symptoms, ameliorate pain and improve the quality of life in people with CP/CPPS.
6. A study titled Effect of Hydrotherapy on chronic pain in the lumbar region published in Journal of IMAB in Oct 2020 found: physiotherapy includes hydrotherapy with a water temperature of 36-37 C and magnetotherapy with a duration of 30-35 minutes treatment of the paravertebral muscle in the lumbar region, gluteus and lower limbs for 3 times a week for 1 month resulting in a reduction of the neurological and pain symptoms and the restoration of neurodynamics of n.ischiadicus.
7. A study, titled Serial whole-body cryotherapy in Fibromyalgia is effective and alters cytokine profiles, published in Advances in Rheumatology in January 2021 concludes: Whole body cryotherapy is effective in FM and reduces the burden of disease. The effects of serial WBC are strongest during application and are diminished 3 months after WBC treatment.
8. A study titled Chronic fatigue syndrome: Abnormally fast muscle fiber conduction in the membranes of motor units at low static force load, published in Clinical Neurophysiology in Apr 2021 concludes: in chronic fatigue patients, muscle conduction increases abnormally with force, surface EMG can elicit abnormalities in both Fibromyalgia and chronic fatigue, and the surface EMG abnormalities in Fibromyalgia and chronic fatigue differ.
9. A study titled Efficacy and safety of weekly vitamin D3 in patients with Fibromyalgia: 12-week, double-blind, randomized, controlled placebo trial, published in Clinical Rheumatology in Feb 2021, concludes: there is no evidence of a trend in favor of vitamin D treatment, since we did not observe improvement in the VAS of pain or FIQ.
10. A study titled Comparison of the effectiveness of Prolotherapy and facet joint injection in the treatment of chronic low back pain: a retrospective study, published in Turkiye Klinkeri Journal of Medical Sciences in Jan 2021 concludes: facet joint injection is considered more effective at relieving symptoms of back pain early in the condition, but Prolotherapy provided more benefit, according to long-term VAS scores.
Here is some of the information I recently shared in a December newsletter. Each newsletter has a specific focus. This newsletter is focused on chronic pain and fibromyalgia. If you would be interested in receiving my newsletters, please head over to my contact page and sign up.
TABLE OF CONTENTS
STUDIES and ARTICLES
1. An article, titled Fibromyalgia Linked to Gut Bacteria for First Time published in Neuroscience News & Research in Jun 2019, states: In a paper published today in the journal Pain, a Montreal-based research team has shown, for the first time, that there are alterations in the bacteria in the gastrointestinal tracts of people with fibromyalgia.
2. A study, titled Exploring the relationship between serum magnesium, inflammation, and chronic pain in a Vermont primary care population, published in Current Developments in Nutrition Jun 2020, concludes: For adults seen in primary care, lower serum magnesium levels are associated with chronic pain. This inverse relationship is not explained by random noise, including age and gender. The complex relationship between serum magnesium, C-reactive protein, and pain is complex and requires further exploration.
3. A study titled Comparative study of the effectiveness of a low-pressure hyperbaric oxygen treatment and physical exercise in women with fibromyalgia: randomized clinical trial, published in Therapeutic Advances in Musculoskeletal Disease in 2020 concludes: low-pressure hyperbaric oxygen therapy and physical exercise improve pressure pain threshold, endurance and functional capacity, as well as physical performance. Induced fatigue and perceived pain at rest significantly improved only with low-pressure hyperbaric oxygen therapy.
4. An abstract of a study titled Is aquatic therapy more effective than land-based therapy in reducing pain of women with fibromyalgia? published in Ann Rheum Dis in 2020 concludes: Both physiotherapy interventions showed to be effective in reducing pain in patients with fibromyalgia. However, aquatic therapy was more effective in improving quality of sleep and decreasing pain intensity at six weeks of follow-up than land-based therapy. It seems that the therapeutic effects achieved in post-treatment were maintained for a longer time in the aquatic therapy group. Even so, in order to maintain the benefits obtained with the interventions, continuous physiotherapy treatment seems to be necessary.
5. A study titled Association between low vitamin D levels and the Greater impact of fibromyalgia, published in J Clinical Med Res in 2020 concludes: Fibromyalgia patients did not present higher prevalence of vitamin D deficiency or insufficiency than healthy individuals, although low vitamin D concentrations could indicate more severe disease impacts.
6. A study titled Pressure-induced referred pain as a biomarker of pain sensitivity in fibromyalgia, published in Pain Physician in Jul 2020 concludes: referred pain induced by applying a suprathreshold pressure of 120% Pain Pressure Threshold can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from Fibromyalgia.
7. A study titled Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial, published in Trials in Jul 2020 concludes: manual therapy achieves a faster reduction in pain perception than therapeutic exercise. Therapeutic exercise reduces disability faster than manual therapy.
8. A study titled Hypnotic intervention in people with fibromyalgia: a randomized controlled trial, published in American Journal of Clinical Hypnosis in Aug 2020 concludes: the self-administered audio-recorded hypnotic intervention significantly decreased the intensity and interference of pain and fatigue, as well as the depressive symptomatology.
9. A study title The Impact of a 20-minute animal-assisted activity session on the physiological and emotional states in patients with fibromyalgia, published in Mayo Clinic Proceedings in Nov 2020 showed a decrease in heart rate, an increase in heart rate variability, an increase in well-being survey scores, an increase in salivary oxytocin, and subsequent tympanic membrane temperature changes, suggesting that participants were in a more positive emotional-physiologic state as a result of the session.
10. A study titled Intramuscular Pressure is almost three times higher in fibromyalgia patients: a possible mechanism for understanding the muscle pain and tenderness, published in J Rheum in Dec 2020 concludes; pressure in the trapezius muscle of patients with Fibromyalgia is remarkably elevated and may be an intrinsic feature of FMS that could be monitored as part of the diagnostic evaluation. The burden of the pressure abnormality may help explain the diffuse muscle pain of FMS. Therefore, FMS as a disorder of exclusively central pain processing should be revisited. Therapeutically, the reduction of muscle pressure may change the clinical picture significantly.
What Hurting Looks Like: Photographer Translates Pain Into Visceral Still Life provides visual and verbal descriptions of pain. Originally published on NPR
Here is some of the information I recently shared in my Julynewsletter. Each newsletter has a specific focus. This month is focused on chronic pain information. If you would be interested in receiving my newsletters, please head over to my contact page and sign up.
STUDIES and ARTICLES
I receive a weekly update on anything published anywhere on the internet that includes information about chronic pain and fibromyalgia. I try to glean the best of the information and provide a brief synopsis of the information. If you come across any information that you think would be good to share, please also feel free to pass that information along to: firstname.lastname@example.org
1. An article, titled A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management published in J Can Chiropr Assoc in 2018, provides a wonderful overview and comparison between the two disorders.
2. An article, titled Effects of auricular acupressure on pain and disability in adults with chronic neck pain, published in Applied Nursing Research in Feb 2019 concludes: auricular acupressure can be used for alleviating chronic neck pain and more than 4 weeks of treatment is necessary for alleviating neck disability.
3. An article, titled A qualitative study of the experiences and perceptions of adults with chronic musculoskeletal conditions following a 12-week Pilates exercise program, published in Musculoskeletal Care in Nov 2018, concludes: The Pilates-based exercise program enabled the participants to function better and manage their condition more effectively and independently.
4. A study, titled A study to assess the effectiveness of core muscle stabilization regimen in patients with mechanical low backache, published in International’s Journal of Adapted Physical Education & Yoga in Sept 2018 concludes: Core muscle stabilization regimen is more effective along with back care and ergonomic advice than the spinal extension maneuver alone to reduce pain and to improve functional ability of the lumbar spine in subjects with mechanical low back ache.
5. A study, titled Effect of aerobic exercise in the treatment of myofascial pain: a systematic review, published in Journal of Exercise Rehabilitation in 2018 concludes: Pain pressure thresholds significantly increased in muscle areas of the cervical spine in the water exercise group
6. A study, titled Functional and neurochemical disruptions of brain hub topology in chronic pain, published in Pain in Apr 2019 states: A critical component of brain network architecture is a robust hub structure, wherein hub regions facilitate efficient information integration by occupying highly connected and functionally central roles in the network. Across a wide range of neurological disorders, hub brain regions seem to be disrupted, and the character of this disruption can yield insights into the pathophysiology of these disorders. We applied a brain network–based approach to examine hub topology in fibromyalgia, a chronic pain condition with prominent central nervous system involvement….these findings reveal altered hub topology in fibromyalgia and demonstrate, for the first time to our knowledge, a neurochemical basis for altered hub strength and its relationship to the perception of pain.
7. A study, titled How do Satellite Glial Cells control chronic pain, published in Journal of Anesthesia and Perioperative Medicine, concludes: SGC’s are now recognized players in the pathogenesis of chronic pain through the secretion of neuroactive signaling molecules and controls of nociceptive neurons.
8. A study, titled Evidence for kinesiology taping in management of myofascial pain syndrome: a systematic review and meta-analysis, published in Clinical Rehabilitation in Feb 2019, concludes: kinesiology taping could be recommended to relieve pain intensity and range of motion for patients with myofascial pain syndrome at post-intervention.
9. A study, titled Exposure to cold unmasks potential biomarkers of Fibromyalgia Syndrome reflecting insufficient sympathetic responses to stress, published in The Clinical Journal of Pain in May 2019, concludes: the convergence of the effect of cold on 4 relatively simple measures of thermogenic, cardiovascular, and metabolic activity, each regulated by sympathetic activity, strongly indicate that individuals with FMS have impaired sympathetic responses to stress that are observable and highly significant.
10. A study, titled Fibromyalgia: Increased reactivity of the muscle membrane and a role of central regulation, published in Clinical Neurophysiology in Jan 2019 concludes: …muscle membrane propagation speed increases independently of the force load or amount of muscle activity produced. When adopting a limb position, the patients show an augmented muscle membrane reaction, suggesting deregulation from higher neural centers
Here is some of the information I recently shared in my January newsletter. Each newsletter has a specific focus. This month is focused on chronic pain and fibromyalgia information. If you would be interested in receiving my newsletters, please head over to my contact page and sign up.
STUDIES and ARTICLES
I receive a weekly update on anything published anywhere on the internet that includes information about chronic pain problems. I try to glean the best of the information and provide a brief synopsis of the information. If you come across any information that you think would be good to share, please also feel free to pass that information along to: email@example.com
1. An article titled Myofascial Pelvic Pain: Rationale and Treatment published in Current Bladder Dysfunction Reports in Mar 2015, states: Chronic pelvic pain, in its many forms, commonly has a myofascial component that must be considered in the evaluation and treatment of women and men seeking medical care. ..Myofascial pelvic pain can develop as a result of a trigger point within the pelvic floor musculature or from extra-pelvic muscles that can refer into the pelvic region. Identification and appropriate therapeutic management of the myofascial trigger points is paramount to successful treatment of the pain and symptoms associated with chronic pelvic pain.
2. An article titled Chronic, non-visceral abdominal pain, published in Gut: British Medical Journal in 1994 gives a great explanation of an assessment tool known as Carnett’s Sign, which helps determine if abdominal pain is visceral or from the abdominal wall.
3. An article titled Fascia, Proprioception, and Chronic Pain by Dr. Schierling and published on his blog, cites a number of research articles regarding the relationship between fascia and spindle cells, Ruffini and Pacini corpuscles andGolgii organs. Some important points from the article:
“…muscle spindles, the chief proprioceptive cell affecting our muscles, are not in the muscle, but in the fascia surrounding the muscle and its muscle bundles…
“…abundant innervation of the fascia consisting of both free nerve endings and encapsulated receptors, in particular, Ruffini and Pacini corpuscles.”
“ …hypothesis that the fascia plays an important role in proprioception, especially dynamic proprioception…"
“…now recognized that fascial network is one of our richest sensory organs.”
4. A study titled Analgesic effects of transcutaneous electrical nerve stimulation (TENS) in patients with fibromyalgia: a systematic review, published in Ten Primary Jul 2018, concluded: Treatment with TENS is effective for reducing pain in people with fibromyalgia. In addition, the inclusion of TENS in therapeutic exercise programs seems to have a greater effect than practicing therapeutic exercise in isolation.
5. A study titled Effects of vitamin D optimization on quality of life of patients with fibromyalgia: a randomized controlled trial, published in Med J Islam Repub Iran in Apr 2018, concludes: …vitamin D supplementation has significant therapeutic benefits in the management of FMS especially in pain reduction.
6. A study titled Effects of Sleep Fragmentation and Induced Mood on Pain Tolerance and Pain Sensitivity in Young Healthy Adults, published in Front. Psychol Oct 2018 concluded: Experimental research exploring the sleep pain relationship has typically focused on total or partial sleep deprivation, hereby failing to reproduce the more fragmented sleep pattern typically observed in patients with chronic pain…this study suggests that even one night of fragmented sleep has a negative impact on the perception of pain intensity, but not pain tolerance or pain inhibition.
7. A study, titled The effect of cryotherapy on fibromyalgia: a randomized clinical trial carried out in a cryosauna cabin and published in Rheumatology International, Dec 2018, concluded: Whole Body Cryotherapy during 3 weeks appears to produce a beneficial effect compared to no cold treatment in terms of pain and impact of disease in Fibromyalgia.
8. A study titled A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations, published in Advances in Rheumatology Oct 2018 concludes: The main results included reduction in pain, fatigue, number of tender points, depression, and anxiety, with increased functional capacity and quality of life. Current evidence demonstrates that Strength Training is beneficial and can be used to treat Fibromyalgia.
9. A study titled Effects of dance on pain in patients with fibromyalgia: a systematic review and meta-analysis, published in Evid Based Complement Alternat Med in Oct 2018, concludes: dance-based intervention programs can be an effective intervention for people suffering from fibromyalgia, leading to a significant reduction of the level of pain with an effect size the can be considered as large.
10. A study titled Fibromyalgia: Increased reactivity of the muscle membrane and a role of central regulation, published in Clinical Neurophysiology in Jan 2019 concludes: …muscle membrane propagation speed increases independently of the force load or amount of muscle activity produced. When adopting a limb position, the patients show an augmented muscle membrane reaction, suggesting deregulation from higher neural centers.