Dataset Information

Symptom Locus and Symptom Origin Incongruity in Runner's Dystonia - Case Study of an Elite Female Runner.

ABSTRACT: Objectives: Runner's dystonia is a task-specific dystonia that occurs in the lower limbs and trunk, with diverse symptomatology. We aimed to identify the origin of a dystonic movement abnormality using combined three-dimensional kinematic analysis and electromyographic (EMG) assessment during treadmill running. Participant: A 20-year-old female runner who complained of right-foot collision with the left-leg during right-leg swing-phase, which mimicked right-ankle focal dystonia. Results: Kinematic and EMG assessment of her running motion was performed, which showed a significant drop of the left pelvis during right-leg stance-phase, and a simultaneous increase of right hip adductor muscle activity. This resulted in a pronounced adduction of the entire right lower limb with respect to the pelvis segment. Trajectories of right foot were seen to encroach upon left-leg area. Discussion: These findings suggested that the symptom of this runner was most likely a form of segmental dystonia originating from an impaired control of hip and pelvis, rather than a distal focal ankle dystonia. Conclusion: We conclude that, for individualized symptom assessment, deconstructing the symptom origin from its secondary compensatory movement is crucial for characterizing dystonia. Kinematic and EMG evaluation will therefore be a prerequisite to distinguish symptom origin from secondary compensatory movement.

SUBMITTER: Ogasawara I

PROVIDER: S-EPMC8716826 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Symptom Locus and Symptom Origin Incongruity in Runner's Dystonia - Case Study of an Elite Female Runner.

Ogasawara Issei I Hattori Noriaki N Revankar Gajanan S GS Konda Shoji S Uno Yuki Y Nakano Tomohito T Kajiyama Yuta Y Mochizuki Hideki H Nakata Ken K

Frontiers in human neuroscience 20211216

<b>Objectives:</b> Runner's dystonia is a task-specific dystonia that occurs in the lower limbs and trunk, with diverse symptomatology. We aimed to identify the origin of a dystonic movement abnormality using combined three-dimensional kinematic analysis and electromyographic (EMG) assessment during treadmill running. <b>Participant:</b> A 20-year-old female runner who complained of right-foot collision with the left-leg during right-leg swing-phase, which mimicked right-ankle focal dystonia. <b ...[more]

PMID: 34975442

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Project description:BackgroundTraumatic occipitocervical dislocations (OCDs) are rare and potentially devastating injuries, and delayed diagnosis and management is a well-known risk factor for poor outcomes in high energy trauma. Early surgical stabilization has been shown to improve outcomes and neurologic recovery in these patients. We present a case of incongruent atlanto-occipital (O-C1) joints found on post-operative computed tomography (CT) imaging following C1-C2 fusion. This patient was treated non-operatively in a cervical collar (C-collar) after traction testing revealed no dynamic instability.Case descriptionA 19-year-old male with history of obesity was involved in a high-speed motor vehicle collision (MVC). On arrival, he had elevated troponins but otherwise normal laboratory workup and electrocardiogram (EKG). He remained hypotensive throughout his initial presentation. A reliable neurologic exam could not be obtained due to the patient's intubated and sedated status, however, bulbocavernosus reflex was intact, reflexes were normal and the patient did not demonstrate evidence of spinal or neurogenic shock. CT of the full spine revealed distraction of the C1-C2 articulation without associated fracture, and without clear disruption or distraction of the O-C1 joint. He was taken to the operating room for C1-C2 posterior instrumentation and fusion. Post-operative cervical spine CT revealed further distraction and subluxation of the occipitocervical junction bilaterally, with condyle to C1 interval (CCI) of 4-mm bilaterally, a basion-dens interval (BDI) of 10 mm, and a Power's Ratio of 1.1. The patient was brought back urgently to the operating room for traction testing to rule out OCD. There was no distraction noted on dynamic traction testing, and the patient was treated non-operatively in a C-collar. At 12 weeks post-injury, the patient experienced no neck pain, and flexion/extension radiographs showed no evidence of subluxation or distraction at the O-C1 joints.ConclusionsIncongruity of the O-C1 joint may not be synonymous with instability as previously thought, and in cases of O-C1 incongruity with stable traction testing, non-operative treatment with external immobilization can be considered as a viable treatment option even in the polytraumatized patient.

Project description:Elite competitive sport climbers exhibit a high strength-to-weight ratio and are reported in the literature to be lighter and leaner than their athletic counterparts. Current research regarding nutrition among climbers is sparse but suggests that they may be at high risk for low energy availability and Relative Energy Deficiency in Sport (RED-S). The prevalence of amenorrhea, one of the primary indicators of RED-S, is unknown in this athletic population. The purpose of this study was to determine the prevalence of current (previous 12 months) amenorrhea among elite level competitive sport climbers. Methods An anonymous online survey was distributed via email to 1,500 female climbers registered as competitors within the International Federation of Sport Climbing to assess the prevalence of amenorrhea over the past 12 months. Results A total of 114 female sport climbers answered all survey questions regarding menstrual function and 18 athletes (15.8%) presented with current amenorrhea. The majority of the athletes (72%; n = 82) were categorized with eumenorrhea. An additional 14 athletes (12.3%) provided information that indicated irregular cycles, but answers to all menstrual cycle questions were not congruent to elicit a classification of amenorrhea and these athletes were categorized with a menstrual status of unsure. The average BMI for climbers with eumenorrhea was 20.8 ± 1.8 kg/m2 and 19.9 ± 2.4 kg/m2 for those with amenorrhea. A higher percentage of climbers with amenorrhea revealed they currently struggle with an eating disorder compared to those without amenorrhea (13.5 vs. 22.2%, respectively). Conclusion This study indicates that some female climbers competing at the World Cup level do have menstrual disturbances with relatively normal BMIs and some currently struggle with one or more eating disorders. Even though World Cup competitions use BMI critical margins to screen competitors, this research highlights the need for more medical supervision of competitive elite female sport climbers in order to protect their overall health, including menstrual function. Further research is required to clarify how many climbers suffer from endocrine abnormalities related to RED-S. With more scientific evidence in this area practitioners will be better equipped to educate the athlete and coach with evidence-based nutrition recommendations.

Dataset Information

Symptom Locus and Symptom Origin Incongruity in Runner's Dystonia - Case Study of an Elite Female Runner.

Publications

Symptom Locus and Symptom Origin Incongruity in Runner's Dystonia - Case Study of an Elite Female Runner.

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