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February 1922

FACTORS INHIBITING THE RETURN OF MOTOR FUNCTION FOLLOWING NERVE INJURIES

Arch NeurPsych. 1922;7(2):220-228. doi:10.1001/archneurpsyc.1922.02190080069007

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Abstract

First Stage: Period of Neuraxon Regeneration  1. Determination of neuraxon regeneration2. Muscle degeneration3. Changes in joints and tendons4. Sensory changes5. Physiologic and mechanical factors entailed in suture which influence regeneration and ultimate function

Second Stage: Period of Muscle Regeneration  1. Muscle sense2. Regenerative changes in muscles3. Factors preventing the restoration of voluntary movement4. Reeducation of muscle sense5. Determination of motion6. Substitution movements7. Functional overlays

Third Stage: Period of Muscle Training  1. Factors responsible for defective motor restoration(a) Number of physiologically active motor fibers(b) Misdirected motor fibers(c) Fibrotic muscles(d) Muscle stretching(e) Fibrotic joint changes(f) Limitation of tendon movement2. Reeducation of muscles3. Development of amplitude of motion and strengthThe study of over 1,500 peripheral nerve injuries in which we have been able to keep complete records of the disability—determined by individual muscle reaction

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