摘要:

The purpose of this study is to examine the effects of cortical and subcortical infarcts and lesion laterality on the functional status of stroke survivors. Medical records of 72 stroke survivors admitted to an acute inpatient rehabilitation facility with a single nonhemorrhagic lesion were retrospectively reviewed. Multivariate analysis of variance was used to assess the effects of lesion level and hemisphere on admission and discharge Functional Independence Measure (FIM™) and FIM gain. Admission FIM-Total and its subdimensions exhibited significant overall level (Wilk's λ = 2.5;P= 0.03) and hemisphere-specific (Wilk's λ = 2.3;P= 0.04) effects. Significant interaction between factors was noted only for the communication subdimension. Significant level and hemisphere-specific main effects were noted for admission FIM-Total (P< 0.01 andP= 0.02, respectively). There were significant level-specific main effects for self-care (P= 0.01) and mobility (P= 0.03) and hemisphere and level-specific main effects for communication (P< 0.01 andP< 0.01, respectively) and social cognition (P= 0.02 andP= 0.01, respectively). Discharge FIM-Total and its subdimensions exhibited significant overall level (Wilk's λ = 2.5;P= 0.03) and hemisphere-specific (Wilk's λ = 3.4;P= 0.01) effects. Discharge FIM subdimensions did not exhibit significant interaction between factors. Discharge FIM-Total was significant with respect to lesion level (P= 0.01) but not with respect to hemisphere (P= 0.08). There was a significant level-specific main effect for self-care (P= 0.01) and level and hemisphere-specific main effects for communication (P< 0.01 andP< 0.01, respectively) and social cognition (P= 0.01 andP= 0.01, respectively). FIM gain scores did not exhibit significant level (Wilk's λ = 1.1;P= 0.36) or hemisphere-specific (Wilk's λ = 1.4;P= 0.24) effects. The data suggest that the lesion level and hemisphere are important determinants of the function of nonhemorrhagic stroke survivors during inpatient rehabilitation.

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Shoulder subluxation in hemiplegic patients has been recognized as a difficult problem to manage. In the study contained herein, our aims are to evaluate shoulder subluxation, to clarify if shoulder subluxation causes pain, and to discuss the treatment of shoulder subluxation. The study included 75 hemiplegic patients with shoulder subluxation. Each patient was evaluated for the degree of shoulder pain, motor recovery of the upper limb, and shoulder range of motion. Some indexes for evaluating subluxation were measured with radiographs of the shoulders. Arthrograms of the affected shoulder joint were taken in 23 patients. The following results were found: (1) shoulder pain was significant more frequently in left hemiplegia; (2) vertical disparity was strongly correlated with discrepancy of the descendant ratio; (3) severe inferior subluxation had a tendency to show medial displacement of the humeral head; (4) there were correlations between shoulder pain and shoulder range of motion, especially external rotation; (5) adhesive changes in the arthrograms were seen in most subjects. These results indicate that there is no relation between shoulder subluxation and pain, and adhesive capsulitis is a main cause of shoulder pain. We conclude that correct positioning and shoulder range of motion exercises are advisable in hemiplegic patients with shoulder subluxation.

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This study was performed to compare the effects of direct current with ultrasound on fracture healing. Thirty-two rats were subjected to the experiment. Each rat's right legs were used as the experimental sample, and their left legs were used as the control. Four groups were formed, each consisting of 16 ultrasound, 16 electrostimulation, 16 ultrasound control, and 16 electrostimulation control animals. Fibular osteotome was applied to the rats under anesthesia. In the electrostimulation and electrostimulation control groups, a stainless steel cathode electrode was installed in the fractured side. In the electrostimulation group, 10 μA of direct current for 30 min, using a semi-invasive method, was given one day after fracture, for 15 days. On the control side, the aforementioned protocol was followed but sham treated. The ultrasound group was treated with 0.1 W/cm2ultrasound for 2 min every second day for 6 days after fracture (4 times). Rats were killed on the 7th and 14th days to investigate the macroscopic, radiologic, and histopathologic parameters of fracture healing. There was a difference (P< 0.05) between the electrostimulation and the electrostimulation control groups on the 7th day. There was a difference (P< 0.05) between the ultrasound and ultrasound control groups on the 14th day. After statistical evaluation of the experimental results, it was found that in both the ultrasound and the electrostimulation groups, the fracture healing had been accelerated more so than in the control groups. There was no observed statistical difference between ultrasound and electrostimulation effects.

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The use of a recently released anticonvulsant, gabapentin, in the treatment of spasticity in two patients with multiple sclerosis is reported. Gabapentin was chosen because of its GABA-ergic effect and because previously reported studies have shown that it is well tolerated compared with other GABA-mimetic medication. Satisfactory release of spasticity with significant improvement of functional outcome was noted in both cases. Both patients were first treated with gabapentin for one month at 300 mg per day and then, with no reported side-effects, at 400 mg per day. Before treatment, spasticity (graded with modified Ashworth Scale) in one patient was 3 for left lower and 2 for right lower limbs, and Expanded Disability Status Scale (EDSS) was 7; ambulation was limited to a few steps with a standard walker. After two weeks of treatment, spasticity was 2 and 1 for the left and right lower limbs, respectively. At three-month intervals, spasticity was +1 for left and 1 for right lower limbs, and EDSS was 6; the patient could ambulate 75 to 100 m with a standard walker. In the second patient, spasticity before treatment was 2 for both lower and left upper limbs. EDSS was 5.5, and ambulation was confined to 100 m with a cane. Spasticity improved to +1 in lower and 1 in left upper limbs after two weeks and to 1 and normal after three months. At three months, EDSS was 3 and the patient could ambulate for long distances without an assistive device. We suggest that gabapentin can be used effectively to decrease spasticity without significant side effects in patients with multiple sclerosis.

ISSN:0894-9115    

出版商:OVID    

年代:1998

数据来源: OVID