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The focus of treatment for this subgroup will be i) detailed education in relation to the neurophysiology of pain and maladaptive central processing [ 60, 61]; and b) a functional restoration program to promote graded exercise and increased function [ 62, 63].
The Constant-Murley score is a 100-point functional shoulder assessment tool in which higher scores reflect increased function.
Disorders of inhibitory innervation may be those associated with reduced function or increased function.
Increased function of the nitrergic inhibitory nerves is manifested by transient lower esophageal sphincter relaxation (TLESR) and LES hypotension.
We also knew of studies that suggested that consuming cocoa flavanols increased function in that area of the brain and reversed age-related memory decline.
Without a major breakthrough of this sort, the trend toward miniaturization and increased function is threatened by the physical demands of transistors operating at a nano scale.
As such, the DLPFC is commonly activated in experimental pain studies, and shows abnormally increased function in chronic pain populations.
Increased function of excitatory innervation includes hypertensive peristalsis and hypertensive and hypercontracting LES, and decreased function of excitatory innervation of the smooth muscle includes hypotensive peristalsis, hypotensive LES, and decreased reflex LES contraction.
Increased function of the excitatory nerves may be responsible for hypertensive esophageal peristaltic contractions (nutcracker esophagus) or hypertensive and hypercontracting LES. Figure 1: Pathophysiologic classification of motor disorders of smooth muscle portion of esophagus.
Preliminary findings suggest that dynamic splints increased function of children with CP while static splints decreased muscle activation at wrist and increased compensatory shoulder muscle recruitment.
Our result is at odds with those of randomized trials which have failed to demonstrate increased function following the treatment of pain with opioid analgesics.
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