Arthur L. Watkins

The response of the quadriceps femoris to progressive-resistance exercises in poliomyelitic patients.

The qualitative and quantitative evidence presented supports the hypothesis that, following acute anterior poliomyelitis, the remaining innervated muscles respond to proressive-resistance exercises by an increase in strength and work capacity in much the same manner as normal muscles.

Regeneration in the ulnar, median and radial nerves

T HE probIem of regeneration of injured nerves is deaIt with extensively in the Iiterature, but for the most part concerns itseIf with physiologica experiments on Iaboratory animaIs. From a practica1 point of view, we are concerned Iess with the actua1 physiology of regeneration than with the ways and means of ensuring that norma physioIogica1 regeneration take pIace in a given instance and what may be expected as to prognosis under varying situations. The probIem of ensuring regeneration of nerves has been deaIt with by numerous authors and is we11 understood, aIthough modifications of treatment are stiI1 being originated. The question of prognosis has evoked many instances of persona1 opinion, but for the most part there has been a faiIure to substantiate these with clinical facts. In this report we shaI1 summarize the experiences of the Massachusetts Genera1 HospitaI for the past ten years with injured nerves to the upper extremities, and endeavor to formuIate prognostic guides that may prove of assistance to others. The study of regeneration of nerves has severa inherent difficulties: The duration of time involved makes it aImost impossibIe for one man to foIIow any considerabIe number of patients to an end resuIt and certainly even in an institution such as the Massachusetts Genera1 Hospital, the varying expressions of opinion as to progress found on records become very per

Electromyography in orthopaedics.

exing. Then, too, the determination of the exact time at which regeneration may be said to have begun and at which it has reached an end stage requires arbitrary decisions and may invoIve considerable error. More difficuIt stiI1 is the definition of what exactIy constitutes good and poor resuIts. In the past ten years at the Massachusetts Genera1 HospitaI we have found records of 147 instances of injured nerves of the arm. Of these we have reasonabIy good evidence as to the eventual resuIt in I IO or 75 per cent. The resuIts were obtained in eighty-one patients * From the Hand Clinic of the blassachusetts General HospitaI, Boston.

Progressive resistance exercise : technic and medical application

1. Electromyography has been found useful in studying the pattern of motor activity in normal and paretic muscles, particularly in poliomyelitis and peripheral-nerve injuries. 2. Degrees of spasticity, rigidity, and tremor may be measured semi-quantitatively by this method. 3. Information of diagnostic importance is obtained from patients with progressive muscle atrophy, Parkinsons disease, peripheral-nerve injuries, and hysteria.