摘要:

Gabis L, Shklar B, Geva D: Immediate influence of transcranial electrostimulation on pain and &bgr;-endorphin blood levels: An active placebo-controlled study.Am J Phys Med Rehabil2003;82:81–85.BackgroundStimulation of the antinociceptive system by noninvasive electrical current from electrodes placed on the head is a renewed method of pain relief.MethodsWe conducted a randomized, double-blind, placebo-controlled study on 20 chronic back pain patients. They were treated with either transcranial electrostimulation (TCES) or an active placebo device. Pain level and serum &bgr;-endorphin levels were measured before and after treatment.Results&bgr;-Endorphin level increased in seven of the ten patients from the treatment group and did not change in eight of ten patients from control group (P= 0.057 between groups). Pain level decreased in eight treated patients and seven control patients (significant decrease for each group, no significant difference between groups).ConclusionsTranscranial electrostimulation is a nonpharmacologic method of pain relief accompanied or mediated by &bgr;-endorphin release. The comparable degree of the initial clinical response emphasizes the powerful placebo effect on reported pain not mediated by endorphin release. This preliminary study shows that noninvasive electrical stimulation is a safe treatment with a positive effect on &bgr;-endorphin blood levels.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Paternostro-Sluga T, Keilani M, Posch M, Fialka-Moser V: Factors that influence the duration of splint wear in peripheral nerve lesions.Am J Phys Med Rehabil2003;82:86–95.ObjectiveTo assess the weekly frequency and overall duration of wear for splints used to treat peripheral nerve lesions and factors that possibly influence splint wear.DesignA total of 78 patients (23 women, 55 men) who had been treated with a hand splint for peripheral nerve palsy were interviewed by telephone, based on a preformulated questionnaire. The duration of wear, reasons for terminating use, the effect of the splint, the patients’ assessment of splint treatment, the patients’ instruction, and the patients’ level of education were recorded. Survival analysis for the entire period of wear and logistic regressions to determine factors that influence splint wear were performed. Comparison of effect scores between lesions in the dominantvs.those in the nondominant hand were carried out with attest.ResultsThe median duration of wear was 6 mo for daytime and 4 mo for nighttime splints. Daytime splints were worn by 85% and nighttime splints by 84% of patients for 5–7 days per week. The reported effect of the splint was the only significant factor that influenced the frequency of wear. The splint was reported to be significantly more effective in the dominant hand than in the nondominant hand. Numerically, radial nerve lesions and cock-up wrist splints were most common.ConclusionRegular splint wear was registered in the majority of patients and was positively influenced by a good effect of the splint, which was reported to be better in the dominant hand.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Han TR, Chung SG, Shin HI: Gait patterns of transtibial amputee patients walking indoors barefoot.Am J Phys Med Rehabil2003;82:96–100.ObjectiveTo evaluate the gait patterns of lower limb amputee patients walking with and without shoes and to identify differences in barefoot gait patterns when using different prosthetic feet.DesignOptoelectronic three-dimensional motion analysis of gait was performed on six transtibial amputees using a solid ankle cushion heel foot and a single-axis foot, both with and without shoes.ResultsGait abnormalities were observed during barefoot walking when the solid ankle cushion heel foot was used. These included knee joint hyperextension of 9.9 ± 2.0 degrees and the loss of ankle plantar flexion in the early stance phase. When the single-axis foot was used, knee flexion thrust declined from 9.9 ± 3.7 degrees to 7.2 ± 3.8 degrees and ankle plantar flexion decreased from 9.9 ± 2.8 degrees to 7.0 ± 2.1 degrees during the early stance phase.ConclusionsIn transtibial amputees, significant gait abnormalities were observed during barefoot walking using the solid ankle cushion heel foot. These gait patterns improved, however, with use of a single-axis prosthetic foot, which permits a further plantar flexion after the initial contact.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Gillet C, Duboy J, Barbier F, Armand S, Jeddi R, Lepoutre FX, Allard P: Contribution of accelerated body masses to able-bodied gait.Am J Phys Med Rehabil2003;82:101–109.ObjectiveThe objectives of this study were to demonstrate that data from a video-based system could be used to estimate the net effect of the external forces during gait, to determine the contribution of the trunk and upper and lower limbs using their accelerated body masses, and to test the hypothesis that the thigh mainly assumed lower limb propulsion during able-bodied locomotion.MethodsThe gait of 16 able-bodied subjects was assessed using an eight-camera video-based system and two force plates. The right limb was the leading limb, and there were two trials per subject. Although data from all the body segments were used to answer the first two objectives, only right limb information was used to address the third objective.ResultsPearson’s coefficients of correlation and root mean square errors were calculated to determine the difference between the curves obtained from the sum of the external forces and that of the accelerated masses. These were >0.85, and the mean root mean square error was <4 N. Analyses of variance were performed on the peak forces developed by the trunk and the upper and lower limbs along each axis. Tukey’s posthoc tests (P< 0.05) revealed that the trunk was the principal contributor of external forces in the frontal and transverse planes, whereas the lower limbs were found to be more important in the plane of progression. Analyses of variance and Tukey’s posthoc tests (P< 0.05) were performed on the peak forces developed by each segment of the right limb. In decreasing order, the thigh, shank, and foot displayed the highest mass-acceleration products in the right limb during gait.ConclusionsA video-based system was able to determine the net effect of the external forces with the summation of the mass-acceleration products during able-bodied gait. The trunk and lower limbs were the dominant body segments responsible for the production of external forces during able-bodied gait, whereas the thighs contributed more to the ground reaction force than the foot and shank for forward progression in able-bodied gait.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Ersoz M, Ergun S: Relationship between knee range of motion and Kellgren-Lawrence radiographic scores in knee osteoarthritis.Am J Phys Med Rehabil2003;82:110–115.ObjectiveTo investigate the relationships between the joint range of motion and Kellgren-Lawrence radiographic scores of knee joint compartments in patients with knee osteoarthritis.DesignForty knees of 20 consecutive bilateral, primary knee osteoarthritis patients were examined in the study. Maximal flexion, extension, and internal and external rotation were assessed using a goniometer. Kellgren-Lawrence radiographic scores were determined for medial tibiofemoral, lateral tibiofemoral, and patellofemoral compartments of the knee joint on lateral, tangential, and standing anteroposterior radiographs.ResultsStatistically significant negative correlations were found between the range of motion and radiographic scores. Specifically, internal rotation was correlated with lateral compartment scores (r= −0.439,P< 0.01), and external rotation and flexion were correlated with medial compartment scores (r= −0.361,P< 0.05;r= 0.338,P< 0.05; respectively). Extension values were correlated with patellofemoral (r= −0.533,P< 0.01), medial (r= −0.456,P< 0.01), and lateral (r= −0.327,P< 0.05) compartment scores.ConclusionsA clear relationship is present between joint range of motion and Kellgren-Lawrence radiographic scores in knee osteoarthritis patients. Examination of the joint range of motion can give information about the compartmental distribution of the disease and help the physician focus on the compartment or compartments involved when performing diagnostic and therapeutic procedures. Evaluation of the compartments of the knee joint in radiographs can be informative about the joint range of motion in knee osteoarthritis.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Kondo I, Hosokawa K, Soma M, Iwata M, Sato Y, Iwasaki M, Roseubaum P: Gross Motor Function Classification System: Preliminary study for Japanese children.Am J Phys Med Rehabil2003;82:116–121.ObjectiveThe purpose of the study was to produce a version of the Gross Motor Function Classification System with the same construct as the original one that would be applicable to Japanese children with cerebral palsy.DesignThe reliability studies were performed twice with a convenience sample (first study, 76 children with cerebral palsy; second study, 225 children with cerebral palsy). The first version of the translated Gross Motor Function Classification System was used in the first reliability study. It was revised based on the findings of the study and used in the second reliability study. Two examiners classified each child’s level of gross motor function independently. We calculated kappas for individual levels and across all levels to study interrater reliability.ResultsThe individual kappa for level V changed from 0.59 in the first reliability study to 0.87 in the second reliability study, whereas the overall kappa changed from 0.64 to 0.66. In the second reliability study, the factors that seemed to affect the reproducibility were the unfamiliar words used in the system, partial agreement of the children’s status, and thinking of future levels.ConclusionsExplanation of words and a note stressing the importance of the introduction part should be added to the system for Japanese clinicians.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Strohschein FJ, Kelly CG, Clarke AG, Westbury CF, Shuaib A, Chan KM: Applicability, validity, and reliability of the Piper Fatigue Scale in postpolio patients.Am J Phys Med Rehabil2003;82:122–129.ObjectiveTo identify a scale that is potentially applicable for measuring the fatigue in postpolio patients and to evaluate its validity and reliability in this population.DesignInterview survey of 64 individuals with postpolio syndrome and 25 healthy controls of similar age range, with retest in a subset of postpolio patients. The sample was recruited from a postpolio support group, a postpolio clinic, and the general community. Subjects completed the Piper Fatigue Scale, the Beck Depression Inventory, and the Chalder Fatigue Questionnaire during the interview.ResultsFace and content validity of the Piper Fatigue Scale was established by a team of experts and by a group of postpolio patients. The postpolio subjects had significantly higher Piper Fatigue Scale scores than the healthy control subjects (P< 0.001), demonstrating extreme groups validity. Convergent validity was shown with a strong positive correlation between Piper Fatigue Scale scores and Chalder Fatigue Questionnaire scores (r= 0.80). Reliability was also demonstrated with the Piper Fatigue Scale’s high internal consistency (alpha = 0.98) and strong test-retest agreement (intraclass correlation coefficient = 0.98).ConclusionsThe Piper Fatigue Scale is a valid and reliable tool for measuring postpolio fatigue. This scale may be useful in other studies of postpolio fatigue, including those gauging the effectiveness of various treatments for this fatigue.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Ishida K, Tani T, Ushida T, Zinchk V, Yamamoto H: Recovery of spinal cord conduction after surgical decompression for cervical spondylotic myelopathy: Serial somatosensory evoked potential studies.Am J Phys Med Rehabil2003;82:130–136.ObjectiveWe tested the utility of scalp-recorded median and tibial somatosensory evoked potentials (SEPs) as a measure of delineating the time course of postoperative recovery from cervical spondylotic myelopathy.DesignWe evaluated serial median and tibial SEP studies for 20 hands and 22 feet in 13 cervical spondylotic myelopathy patients during the first 6 mo postoperatively or longer. Serial sensory assessment of the hands and feet served to evaluate clinical correlation with the SEPs.ResultsThe studies distinguished three recovery patterns of the SEPs based on the time course of the latencies of the N20 component for the median SEP and the P40 component for the tibial SEP. The latency started to decrease by 0.5 msec or more within 2 wk (seven hands and eight feet) or later than 2 wk (six hands and eight feet) postoperatively, or the change did not reach 0.5 msec (seven hands and six feet). In the late recovery group, the SEP improvement began as late as 10 wk postoperatively. Sensory recovery correlated with the SEP change in every group.ConclusionsAn early onset of the SEP recovery predicts a favorable clinical course. The SEP may begin to improve later, and once it occurs, progressive return of function will follow.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Bach JR, Vega J, Majors J, Friedman A: Spinal muscular atrophy type 1 quality of life.Am J Phys Med Rehabil2003;82:137–142.ObjectiveTo compare healthcare professionals’ assessment of the quality of life of spinal muscular atrophy type 1 children with that of the care providers for the children.DesignThe care providers of all 53 surviving spinal muscular atrophy type 1 children managed in one neuromuscular disease clinic were sent Likert-scale surveys of six quality of life issues and ten polar-adjective pairs. The quality of life estimations were compared with those of 67 clinicians and with those of 30 parents considering their unaffected children.ResultsOne hundred care providers from 46 out of the 53 families (87%) responded. Although the clinicians’ mean estimate of the children’s quality of life was 2.85 ± 0.2/10, the care providers’ estimate was 7.81 ± 0.2/10 (P< 0.0001). The care providers also found life with the children to be satisfying (6.0 ± 0.2/7), interesting (6.6 ± 0.1/7), friendly (6.1 ± 0.1/7), enjoyable (6.3 ± 0.1/7), worthwhile (6.7 ± 0.1/7), full (6.6 ± 0.1/7), hopeful (5.9 ± 0.2/7), and rewarding (6.4 ± 0.1/7), and they estimated the children to be happy (8.5 ± 0.2/10) and their lives worth living (9.6 ± 0.1/10). However, 69 of 104 felt that their lives were hard rather than easy, and 56 of 104 reported feeling tied down rather than free. Although the effort they felt for raising the child was high (8.3 ± 0.3 by comparison with 5 for an unaffected child), the burden they felt in doing so was not (5.8 ± 0.3/5). When asked whether they would or would not recommend ventilator use, 31 clinicians (45.5%) indicated they would, 24 (36.4%) would not, and 12 (18.2%) chose not to respond to this question. Care provider responses did not differ significantly from the responses of the parents of unaffected children except for the easy/hard semantic differential (care providers, 3.80 ± 1.75vs.controls, 5.27 ± 1.14,P< 0.001).ConclusionsAlthough there is a widespread perception that spinal muscular atrophy type 1 children have a poor quality of life, this perception is not shared by their care providers.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Di Monaco M, Vallero F, Di Monaco R, Mautino F, Cavanna A: Functional recovery and length of stay after hip fracture in patients with neurologic impairment.Am J Phys Med Rehabil2003;82:143–148.ObjectiveTo evaluate the functional recovery and the length of stay after hip fracture in patients with neurologic impairment.DesignA total of 577 inpatients with hip fracture consecutively admitted to our rehabilitation hospital were included in this retrospective study. A total of 71 of 577 were affected by neurologic impairment caused by stroke with hemiplegia (n= 37), Parkinson’s disease (n= 25), or other diseases (n= 9).ResultsMean Barthel index was significantly lower in the patients with neurologic impairment than in the controls: 10.8 (95% confidence interval, 5.9-15.6;P< 0.001) at admission and 13.1 (95% confidence interval, 5.55–20.65;P< 0.001) at discharge. Multiple regression including eight confounding variables showed that neurologic impairment was negatively associated with the Barthel index. However, the mean increase in Barthel index through the course of rehabilitation was not affected by neurologic impairment. The length of stay was significantly higher in the patients with neurologic impairment, 3.84 days (95% confidence interval, 0.51–7.17;P< 0.05), and multiple regression showed that neurologic impairment was positively associated with the length of stay.ConclusionsAfter hip fracture, the presence of neurologic impairment was associated with lower Barthel index and longer length of stay, but it did not affect the increase in Barthel index due to a course of rehabilitation.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID