ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Sinaki M, Nwaogwugwu NC, Phillips BE, Mokri M: Effect of gender, age, and anthropometry on axial and appendicular muscle strength.Am J Phys Med Rehabil2001;80:330–338.ObjectiveTo assess age and gender differences in muscle strength.DesignThe strength of back extensors, upper limbs (grip), and lower limbs (knee extensors) was measured. Anthropometric measurements and body mass index also were assessed.ResultsGroup comparisons were made for each decade. Back extensor strength (BES) in subjects aged 20 to 89 yr ranged from 93 to 832 N in men and from 71 to 440 N in women. BES peaked in the fourth decade for men and in the fifth decade for women. When the two genders were compared, muscle strength in women was less than that in men at all ages. At different decades, women’s BES ranged from 54% to 76% compared with that of men’s BES. There was a 64% loss of BES in men from the peak in their fourth decade (556 N) to the lowest level in their ninth decade (201 N). Women experienced a 50.4% loss from the peak in their fifth decade (306 N) to the lowest level in their ninth decade (152 N).ConclusionsMen had a greater loss of BES than women with increasing age. In both genders, there was more loss of BES than appendicular muscle strength. Reduction in BES in women coincided with increased body mass index in older age. In women, there was a negative correlation between body weight and level of physical activity, whereas this finding was not evident in men. Background factors related to a higher incidence of back pain, falls, and fractures, especially in women, may be a reduction in muscle strength, along with increasing age and body mass index. This cross-sectional study showed that physiologic reduction of muscle strength, which began early in life, later stopped and that muscle strength even improved, despite the aging process. Therefore, initiating strengthening exercises at any age is encouraged to prevent the impact of several age-related musculoskeletal challenges.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Fichtenberg NL, Putnam SH, Mann NR, Zafonte RD, Millard AE: Insomnia screening in postacute traumatic brain injury: utility and validity of the Pittsburgh Sleep Quality Index.Am J Phys Med Rehabil2001;80:339–345.ObjectiveTo assess insomnia in a rehabilitation population, the authors examined the utility and validity of the Pittsburgh Sleep Quality Index (PSQI). The assessment of insomnia is relevant to the treatment of traumatic brain injury at the postacute level and routine screening for insomnia may be enhanced by the availability of a standardized, conveniently used, self-report sleep questionnaire.DesignThe authors prospectively studied 91 consecutive patients with traumatic brain injury who were admitted to an outpatient neurorehabilitation program. Besides administering the PSQI, Beck Depression Inventory, Epworth Sleepiness Scale, and Multidimensional Pain Inventory, sleep diary and interview data were obtained and used to divide subjects into insomnia and noninsomnia groups according to the criteria established by theDiagnostic and Statistical Manual of Mental Disorders, ed 4.ResultsSensitivity and specificity rates to the clinical diagnosis of insomnia were 93% and 100%, respectively, for a PSQI Global Score of >8, and 83% and 100% for a diagnosis of insomnia based exclusively on PSQI-derived sleep variable data. Sleep diary data provided concurrent validity for PSQI estimates of sleep-onset latency, sleep duration, and sleep efficiency. The Beck Depression Inventory, Epworth Sleepiness Scale, and Multidimensional Pain Inventory established concurrent validity for individual PSQI items pertaining to mood, hypersomnia, and pain disturbance.ConclusionThe PSQI was demonstrated to be a valid and useful screening tool for assessing insomnia among postacute patients with traumatic brain injury.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Mukand JA, Blackinton DD, Crincoli MG, Lee JJ, Santos BB: Incidence of neurologic deficits and rehabilitation of patients with brain tumors.Am J Phys Med Rehabil2001;80:346–350.ObjectiveTo report and discuss common neurologic problems in adults with brain tumors admitted for inpatient rehabilitation at an acute rehabilitation center.DesignRetrospective, descriptive, case series of 51 consecutive adult patients (65% male), with a variety of tumor types (31.3% glioblastoma, 25.5% meningioma, and 25.5% metastatic). Outcome measures were the functional status as measured by the FIM™ scores, the length of rehabilitation stay, and discharge dispositions.ResultsThe most common deficit was impaired cognition (80%), followed by weakness (78%), visual-perceptual deficit (53%), sensory loss (38%), and bowel and bladder dysfunction (37%). Less common problems, in decreasing incidence, were cranial nerve palsy, dysarthria, dysphagia, aphasia, ataxia, and diplopia. Thirty-eight (74.5%) patients had three or more concurrent neurologic deficits, and 20 (39.2%) patients had five or more deficits. Concurrent deficits among patients with hemi- and tetraparesis involved cognition (n= 29 patients), visual-perceptual function, sensation, cranial nerve palsy, and neurogenic bowel/bladder. The average admission FIM score of 67.2 increased to 87.1 at the time of discharge, with similar gains between patients with primary brain tumor and metastatic disease. Thirty-five patients were discharged home, seven to a nursing home, and one to hospice care; there were eight acute transfers.ConclusionsImpaired cognition, weakness, and visual-perceptual deficits were the most common problems in this study population. Our study supports the benefits of comprehensive and interdisciplinary rehabilitation for patients with primary as well as metastatic brain tumors.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Kerschan-Schindl K, Uher E, Grampp S, Kaider A, Ghanem A-H, Fialka-Moser V, Preisinger E: A neuromuscular test battery for osteoporotic women: a pilot study.Am J Phys Med Rehabil2001;80:351–357.ObjectiveTo examine the efficacy of a short neuromuscular test battery in elderly women suffering from osteoporosis in accordance with the World Health Organization criteria, with and without a history of fractures.Reduced bone mass and a high likelihood of falling increase the risk of osteoporotic fractures. There is a need for neuromuscular tests to identify individuals at risk for falls and fractures.DesignThe women were assessed twice. Forty-two women, with a mean age of 70.0 ± 5.1 (SD) yr, completed the first assessment. The number of postmenopausal fractures and the women’s history with regard to agility and falls were assessed. The women performed neuromuscular tests (one-leg stance, tandem walk, and body sway); bone mineral density of the spine and femoral neck were measured. For the follow-up assessment, 13.2 ± 1.3 mo later, 39 women were studied. The same outcome measurements were obtained at both evaluations.ResultsDuring the observation period, five women fell once and one woman fell twice; there were only two vertebral fractures and no nonvertebral fracture. Neuromuscular performance did not change during this observation period. The median changes in bone mineral density between the two assessments were clinically not relevant. A comparison between patients suffering from established osteoporosis and osteoporotic patients without a history of postmenopausal fractures showed that both groups of patients did not differ with respect to age, neuromuscular performance, bone mineral density, and fear of falling.ConclustionThis neuromuscular test battery is a feasible and practical tool because it is brief and economical to perform. However, its efficacy as a predictor of fractures must be tested in additional studies with a long-term follow-up and a larger group of subjects.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

de Visser E, Deckers JAEK, Veth RPH, Schreuder HWB, Mulder T, Duysens J: Deterioration of balance control after limb-saving surgery.Am J Phys Med Rehabil2001;80:358–365.ObjectiveEvaluation of the changes in balance control observed in patients after limb-saving surgery for malignant tumors of the lower limb.DesignCase series.ResultsIn 11 patients who underwent limb-saving surgery and 10 healthy, age-matched controls, displacement of the amplitude of the center of pressure (ACP) and velocity of the center of pressure (VCP) during normal standing and standing on a balance board were registered. Adding such constraints as standing with eyes closed and performing a Stroop task made standing more complex. During normal standing and on the balance board, both groups showed comparable ACP and VCP values. With eyes closed, both patients and controls showed a higher amplitude and velocity in the anterior-posterior direction. In the patient group, the Stroop task affected the ACP (4.5 ± 0.8 mm) compared with normal standing (2.9 ± 0.4 mm) and VCP (18.6 ± 3.0 mm/sec) compared with normal standing (11.9 ± 1.0 mm/sec). During balance board standing, the authors found a difference in the VCP for both groups whose eyes were closed and who performed under dual-task conditions (controls, 23.2 ± 3.3 and 14.9 ± 2.9 mm/sec; patients, 80.1 ± 12.9 and 23.6 ± 3.4 mm/sec).ConclusionsAlthough the patient group showed impressive upright standing after limb-saving surgery, upright standing become more difficult under higher visual and cognitive loads. This finding indicates that the level of postural automatism is not complete in these patients.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Putzke JD, Richards JS, Devivo MJ: Gunshot versus nongunshot spinal cord injury: acute care and rehabilitation outcomes.Am J Phys Med Rehabil2001; 80:366–370.ObjectiveTo examine the impact of gunshot-caused spinal cord injury on acute and rehabilitative care outcome using a case control design.DesignTwo groups (i.e., gunshot-vs.nongunshot-caused spinal cord injury) of 212 individuals were matched case-for-case on age (i.e., within 10 yr), education, gender, race, marital status, primary occupation, impairment level, and Model System region. Outcome measures included length of hospital stay, functional status (FIM™), treatment charges, and home discharge rates.ResultsThe two groups did not differ in the length of stay during acute and rehabilitative care, charges during rehabilitative care, or postrehabilitation discharge placement. Several significant between-group differences in treatment procedures were noted (e.g., prevalence of spinal surgery), which may, in part, account for the higher acute-care charges among those persons with nongunshot-caused spinal cord injury.ConclusionOnce an individual is stabilized and admitted for rehabilitative care, gunshot etiology of spinal cord injury seems largely unrelated to the initial rehabilitation outcome.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Chae J, Knutson J, Hart R, Fang Z-P: Selectivity and sensitivity of intramuscular and transcutaneous electromyography electrodes.Am J Phys Med Rehabil2001;80:374–379.We evaluated the differences in selectivity and sensitivity of intramuscular fine-wire electrodes and transcutaneous electrodes in detecting dynamic electromyography (EMG) signals from extensor digitorum (EDC) and extensor carpi radialis (ECR) muscles during isolated EDC and ECR contractions in two able-bodied subjects. Intramuscular fine-wire electrodes differentiated EDC and ECR EMG activities better than transcutaneous electrodes, and intramuscular fine-wire electrodes recorded higher amplitude signals than transcutaneous electrodes. Data suggest that intramuscular fine-wire electrodes are more selective and sensitive than transcutaneous electrodes in detecting EMG signals from adjacent forearm muscles.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID