摘要:

Buschbacher RM: Sural and saphenous 14-cm antidromic sensory nerve conduction studies.Am J Phys Med Rehabil2003;82:421–426.ObjectiveTo create a large database of normal values for the sural and saphenous nerve conduction studies and to compare the results for the two nerves.DesignUsing a 14-cm antidromic technique, data were collected for onset latency, peak latency, onset-to-peak amplitude, peak-to-peak amplitude, area, duration, side-to-side variability, and between-nerve variability. A total of 230 subjects were included in the study.ResultsFor the sural nerve, the upper limits of normal, defined as the 97th percentile of observed values, for onset latency, peak latency, and duration were 3.6, 4.5, and 2.1 msec, respectively. The comparable values for the saphenous nerve were 3.8, 4.4, and 1.9 msec, respectively. The lower limits of normal (third percentile) for sural onset-to-peak amplitude and peak-to-peak amplitude were 4 and 4 &mgr;V. The comparable values for the saphenous study were 2 and 1 &mgr;V. The upper limit of normal difference in onset latency between the two nerves was: saphenous 0.7 msec longer than sural or sural 0.3 msec longer than saphenous. The corresponding values for peak latency were: 0.6 and 0.5 msec.ConclusionNormal ranges are presented for a large database of subjects for the sural and saphenous nerve conduction studies.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Granger CV, Wende K, Brownscheidle CM: Use of the FIM™ instrument in a trial of intramuscular interferon &bgr;-1a for disease progression in relapsing-remitting multiple sclerosis.Am J Phys Med Rehabil2003;82:427–436.ObjectiveThis study is a secondary analysis of results from the Multiple Sclerosis Collaborative Research Group multicenter trial. We investigated the effect of interferon &bgr;-1a on disability in patients with relapsing-remitting multiple sclerosis (MS), using the FIM™ instrument to assess levels of decline in total, motor, and cognitive items.DesignOf the 301 patients enrolled in the trial, 274 subjects with relapsing-remitting multiple sclerosis with baseline FIM and Kurtzke Expanded Disability Status Scale scores were studied in this secondary analysis. Mildly disabled patients were chosen, as indicated by a Kurtzke Expanded Disability Status Scale score of 1.0–3.5. Matched subjects were assigned to receive either interferon &bgr;-1a or placebo. Kurtzke Expanded Disability Status Scale and FIM scores were measured serially every 6 mo. Failure was defined as a 4-point reduction in total FIM score sustained for 6 mo. Analysis was by Kaplan-Meier methodology. The Mann-Whitney test (log rank) compared mean change and Spearman’s rank-correlation test determined correlation.ResultA significant difference in treatment groups was seen, with a FIM score decline of ≥4 points, with placebo subjects demonstrating greater loss of function than subjects treated with interferon &bgr;-1a. There was no statistically significant difference in total, cognitive, or motor activities, with a decline of ≤3 points.ConclusionDisability, as measured by the FIM instrument, was slowed by treatment with interferon &bgr;-1a compared with placebo. The treatment effect determined using the FIM instrument, with its motor and cognitive components, indicates an additional level of response to therapy for mild to moderate multiple sclerosis.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Putzke JD, Richards JS, Ness T, Kezar L: Interrater reliability of the International Association for the Study of Pain and Tunks’ spinal cord injury pain classification schemes.Am J Phys Med Rehabil2003;82:437–440.ObjectiveTo determine the interrater reliability of the International Association for the Study of Pain and Tunks’ spinal cord injury pain classification schemes.MethodsA total of 64 pain sites reported by 29 individuals were classified using International Association for the Study of Pain and Tunks’ classification schemes. Three raters independently categorized each pain site.ResultsIn general, disagreement in pain classification between the three raters was found for about 50–70% of the pain sites. Disagreement between rater pairs (two raters at a time) was somewhat better, ranging from about 20% to 50%. The kappa statistic for interrater agreement was in the marginally acceptable range (i.e., 0.3 to 0.65). Although disagreement tended to be somewhat higher using the Tunks scheme, both classification schemes showed low interrater agreement.ConclusionsConsistent with our previous research using the Donovan spinal cord injury pain classification scheme, considerable variability between raters was demonstrated using the International Association for the Study of Pain and Tunks’ spinal cord injury pain classification schemes.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Fuchs S, Tibesku CO, Frisse D, Laa&bgr; H, Rosenbaum D: Quality of life and gait after unicondylar knee prosthesis are inferior to age-matched control subjects.Am J Phys Med Rehabil2003;82:441–446.ObjectiveEvaluation of quality of life, gait pattern, and muscle activity after implantation of unicondylar sledge prostheses in comparison with control group.DesignA total of 17 patients were examined at an average follow-up of 21.5 mo after implantation of unicondylar sledge prostheses. In addition to clinical evaluation with different scores, our patients underwent three-dimensional gait analysis and surface electromyographic investigation of the lower limb and quality-of-life assessment using the Short Form-36 health questionnaire. The control group consisted of 11 healthy subjects.ResultsStatistical analysis showed significantly lower results for the patient group in the Hospital for Special Surgery score, the Knee Society score, the patella score, and the Visual Analog Scale for pain. In quality of life, significant differences could be found for the following items: physical functioning, role limitation because of physical problems, and bodily pain. Electromyographic activities during gait were significantly lower in the patient group, except for the rectus femoris and the tibialis anterior. Regarding gait analysis, the variables for ground reaction forces and stride length differed significantly, whereas maximum knee extension and flexion did not.ConclusionsUnicondylar knee replacement has failed to restore functional capabilities, quality of life, gait pattern, and muscle activity compared with healthy subjects of the same age. The assumption that unicondylar sledge prostheses preserve normal joint function must be questioned.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Chin T, Sawamura S, Shiba R, Oyabu H, Nagakura Y, Takase I, Machida K, Nakagawa A: Effect of an Intelligent Prosthesis (IP) on the walking ability of young transfemoral amputees: Comparison of IP users with able-bodied people.Am J Phys Med Rehabil2003;82:447–451.ObjectiveTo make a comparative study of energy expenditure and walking speeds between able-bodied people and young Intelligent Prosthesis (IP) users and to demonstrate the effect of IP on the walking ability of young amputees.DesignThe test subjects were eight young traumatic transfemoral amputees. Fourteen able-bodied persons served as controls. All amputees used an IP, and they had all undergone a prosthetic rehabilitation program for 8 wk. IP users, who had completed the rehabilitation program, were instructed to walk at speeds of 30, 50, 70, 90, and 110 m/min. Measurements of energy expenditure while walking were taken. The most metabolically efficient waking speed was also determined.ResultsOn average, the IP users experienced an oxygen uptake that was 24.1% and 24.2% higher than those for the controls at speeds of 70 and 90 m/min, respectively. It was also determined that the most metabolically efficient walking speed for the IP users was the same as for the controls.ConclusionsThis study showed that young IP users who undergo an adequate prosthetic rehabilitation program can achieve remarkably improved walking performance. Young IP users could walk at the normal speeds of able-bodied people, with only around a 24% increase in energy expenditure

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Cherkassky T, Oksenberg A, Froom P, Ring H: Sleep-related breathing disorders and rehabilitation outcome of stroke patients: A prospective study.Am J Phys Med Rehabil2003;82:452–455.ObjectiveSleep-related breathing disorder (SRBD) is more prevalent in stroke patients than in age- and sex-matched controls, but the relationship between SRBD, functional levels at admission, and subsequent recovery is unclear. We evaluated patients after a first stroke to determine the prevalence of SRBD and the influence of SRBD on the recovery of discharge functional status after a rehabilitation program.DesignIn a prospective study, 30 stroke patients were studied by continuous overnight pulse oximetry during sleep for the presence of desaturation events (fall of arterial saturation of >4% from the baseline). The Respiratory Disturbance Index was defined as number of desaturations per hour of sleep. Functional assessment was done at admission using the FIM™ instrument. The patients were asked about total hours of sleep and the presence or absence of habitual snoring before and after the stroke. The outcome measure at discharge was the FIM score.ResultsOn linear regression, after including the FIM score at admission, in the model, the Respiratory Disturbance Index score was negatively correlated with the FIM gain (coefficient, −0.635 ± 0.27;P= 0.025), and together, the variables explained 20.9% of the total variance (adjustedr2). All patients with an admission FIM score of ≥70 (only mild functional impairment) had a good outcome (FIM score of >100 at discharge). However, only two of six of those with FIM scores of <70 with SRBD (defined as a Respiratory Disturbance Index score of >10) had significant improvement (≥30 points), whereas this occurred in seven of nine of those without SRBD (prevalence ratio, 0.43; 95% confidence interval, 0.13–1.40;P= 0.085)ConclusionsEven after adjusting for the admission functional status, the presence of hypoxic events during sleep predicts a poorer recovery, especially in stroke patients with poor function at admission.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Maeshima S, Ueyoshi A, Osawa A, Ishida K, Kunimoto K, Shimamoto Y, Matsumoto T, Yoshida M: Mobility and muscle strength contralateral to hemiplegia from stroke: Benefit from self-training with family support.Am J Phys Med Rehabil2003;82:456–462.ObjectiveTo determine whether patient exercise with the support of family members maximizes mobility and improves muscle strength in the nonparetic lower limb after stroke.DesignComparison of improvement at 2 wk between conventional exercise sessions and a program also including the participation of family members. Subjects were 60 patients rendered nonambulatory by severe hemiparesis from their first stroke. Of these, 42 had family members participating in their therapy. Lower limb strength was measured on the nonparetic side using an isokinetic machine. Mobility status was assessed using the Rivermead Mobility Index. Patients were evaluated at the first inpatient gym session and again at 1 and 2 wk.ResultsAt the first evaluation, lower limb strength and the Rivermead Mobility Index score did not differ between the two groups. Reevaluations were conducted at 1 and 2 wk after the first evaluation. Patients’ strength and mobility improved more when family members participated.ConclusionFamily participation is an important contributor to stroke rehabilitation.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Ikai T, Kamikubo T, Takehara I, Nishi M, Miyano M: Dynamic postural control in patients with hemiparesis.Am J Phys Med Rehabil2003;82:463–469.ObjectiveDecreased postural stability is a common problem associated with hemiparesis secondary to stroke. The purpose of this study was to evaluate dynamic postural control in patients with hemiparesis and in normal subjects matched for age.DesignQuantitative posturography (EquiTest System) was performed to assess the response of subjects to sudden perturbations. A total of 59 patients with hemiparesis and 98 healthy volunteers were evaluated. All the patients were able to walk inside their house without lower limb orthoses. Both the patients and the healthy volunteers were subjected to forward and backward perturbations while standing on a movable force platform. Balance responses were analyzed in terms of weight symmetry, latency, amplitude (relative response strength), and strength symmetry. They were also subjected to toes-up and toes-down perturbations to evaluate their response to a disruptive balance force.ResultsThe response latency to perturbations was longer and the response strength was weaker on the paretic side of patients with hemiparesis. The dynamic postural control was impaired in patients with hemiparesis as compared with healthy subjects.ConclusionThe results suggest that patients with hemiparesis tend to fall easily and that the risk of falls toward the paretic side is high.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID