Motnje gibanja (Slovene)

In the past year the methods for analysis of motor control, muscle strength , muscle tone and gait of patients with spastic paresis due to brain and spinal cord lesions were elaborated. These methods were used in our work consisting of several tasks and representing an extension of research from the previous years. We were interested in pathogenetic factors causing movement disturbances following neurological lesions and in their modifications by various therapeutic procedures. In patients with spastic hemiparesis isokinetic measurements and electromiographic analysis were used to determine the characteristics of the disturbance of motor control (muscle coactivation), muscle weakness and spasticity (muscle hypertonia, increased stretch reflex of a lower threshold, changes of viscoelastic properties). In patients with spastic paraparesis transcutaneous electrical stimulation (TENS) of the sural nerve may induce prolonged suppression of exaggerated flexor reflex in spasticity due to spinal cord injury. Stimulation of the flexor reflex afferents may also facilitate the voluntary flexion movements of spastic and paretic lower limbs. In children with cerebral palsy improvement of gait was observed following injection of botulinum toxin to the spastic plantar flexors of the foot. The abnormally enhanced EMG activity of leg muscles during gait was decreased in some children following injection. The therapeutic effects of botulinum could be potentiated and prolonged by functional electrical stimulation and some other therapeutic procedures. In patients with peripheral peroneal paresis the strenght of the leg muscles was measured on isokinetic movements and gait was analysed with and without an ankle-foot orthosis. In the follow up study it was found that the daily use of ankle-foot orthosis does not depend only on the established correction of the gait and degree of weakness of dorsal flexors of the foot but also on the strength of plantar flexors and some other factors that have not been determined as yet.