Muscle strength dysfunction

After 3 months of therapy (Table 9-1), serum levels of carnitine, though still lower than the controls, had increased markedly from the pretherapy levels. Muscle carnitine levels also increased but remained well below normal. Despite this, clinical muscle strength and tone were remarkably improved. Carnitine levels in the liver (where carnitine transport is not dependent on OCTN-2) increased more dramatically than those in muscle. Despite the low serum carnitine concentration, urinary carnitine losses were dramatically increased in the patient while on therapy as compared with controls. This reflects the continued dysfunction of the renal OCTN-2 and thus the continued urinary wasting of carnitine. 

Skeletal muscle can also be relaxed by drugs that act in the CNS, the spinal cord, or even in the muscle itself. These spasmolytics reduce excessive muscle tone or spasm in acute muscle injury and CNS dysfunction (e.g., cerebral palsy, MS, stroke), in most cases without loss of muscle strength. 

On examination, the left buttocks was lender to palpation and there were tender points at the mid-pole of the sacrum on the lateral border and one deep to the gluteus maximus, where a lense piriformis could be palpated. There was a unilateral sacral flexion (sacral shear) present on the left. No lumbar somatic dysfunctions were present. There was mild tenderness at the sciatic notch of the ischium. Deep tendon reflexes were normal and muscle strength of the ihigh was normal. There was some pain on internal rotation and adduction of the left hip. 

The patient was treated with osteopathic manipulation to resolve the somatic dysfunctions as well as to increase motion of his right hip in all directions. He was prescribed a series of hip exercises to perform for the purpose of increasing hip motion as well as muscle strength. 

Given the possible relationship between decreases in protein synthesis and ventilator-associated respiratory muscle dysfunction, it would seem plausible that administration of anabolic factors, such as growth hormone, might be beneficial to ventilated patients. Unfortunately, when growth hormone was administered to patients requiring PMV, duration of mechanical ventilation was not decreased nor was muscle strength increased (80). The report that recombinant growth hormone can increase mortality of critically ill patients is a matter of concern (81). 

How does physical exercise alleviate depression One possibility is that it increases the release of endorphins that produce a sense of well-being, sometimes referred to as the runner s high . Another possibility is that it is a placebo effect. But even if it is a placebo effect, consider the differences between exercise and antidepressants in side effects. Side effects of antidepressants include sexual dysfunction, nausea, vomiting, insomnia, drowsiness, seizures, diarrhoea and headaches. Side effects of physical exercise include enhanced libido, better sleep, decreased body fat, improved muscle tone, greater life expectancy, increased strength and endurance and improved cholesterol levels. So if both antidepressants and exercise work by means of the placebo effect, which placebo would you prefer ... 

A diagnosis was made of medial collateral knee ligament sprain, with somatic dysfunction of the knee joint. The patient was treated with osteopathic manipulation to increase the knee motion and rest, NSAlDs, and exercises to maintain the strength of the muscles as well as to maintain joint motion. 

Smith [7] performed a study to examine the effect of an increased vertical dimension of occlusion on isometric deltoid strength in 25 members of a professional football team with a variety of temporomandibular joint dysfunction, stomatognathic muscle and bite abnormalities. He concluded that there was a relationship between the jaws, posture, and... 

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