ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Dumitru D, Diaz CA, King JC: Prevalence of denervation in paraspinal and foot intrinsic musculature.Am J Phys Med Rehabil2001;80:482–490.ObjectiveThe primary purpose of this investigation was to determine the prevalence of abnormal spontaneous activity (positive sharp waves (PSWs) and fibrillation potentials (FPs)) in selected lumbosacral paraspinal and foot intrinsic muscles in an asymptomatic healthy population.DesignThis was a prospective assessment of 50 individuals without history or physical findings suggestive of peripheral neuromuscular disease whereby a monopolar needle electrode was located in the unilateral L4 and L5 paraspinal as well as abductor hallucis and extensor digitorum brevis muscles. These muscles were extensively evaluated for the presence of PSWs, FPs, and fasciculation potentials.ResultsTen subjects per decade from 20-59 yr and ten subjects from 60-80 yr comprised the 50 participants (28 women), resulting in a mean age of 45 ± 15.9 (range, 20-76) yr. A single individual (prevalence, 2%) demonstrated fibrillation potentials in the extensor digitorum brevis, and FPs and PSWs were detected in two subjects’ (4% prevalence) L4/L5 paraspinal muscles. Ninety-four percent of the subjects had fasciculation potentials in the abductor hallucis, whereas 60% had these waveforms in the extensor digitorum brevis. Only 6% of subjects had fasciculation potentials in the L4 but not L5 paraspinal muscles. All subjects demonstrated both prototypical and “atypical” appearing endplate spikes in all of the muscles examined.ConclusionsWe failed to confirm the previously reported prevalence of FPs and PSWs in both the paraspinal and foot intrinsic musculature. Atypical appearing endplate spikes, however, display configurations similar to FPs and PSWs and were present in all subjects. Failure to pay close attention to the discharge rate and rhythm of endplate spikes can lead to misinterpreting these waveforms as FPs and PSWs. It is likely that the previously reported high prevalence of spontaneous activity in healthy persons resulted from not fully appreciating the similarity between innervated and denervated spontaneous single muscle fiber discharge configurations.

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:

Strakowski JA, Redd DD, Johnson EW, Pease WS: H reflex and F wave latencies to soleus normal values and side-to-side differences.Am J Phys Med Rehabil2001;80:491–493.ObjectiveElectromyographers must reliably differentiate between H reflexes and F waves when recording from the soleus muscle in the evaluation of S1 radiculopathy. The use of F waves in root-level injuries is questioned, whereas H reflexes have shown value in the evaluation of S1 radiculopathy. We studied the relationship between the tibial H reflex and F wave latencies in the limbs of 40 subjects.DesignAfter recording the H wave latency, we changed the gain to 200 &mgr;V/cm and increased the stimulation to supramaximal for ten additional responses without moving the recording or stimulating electrodes. We also calculated the predicted H wave latency with the standard formula. Forty subjects, mean age 32 yr, consented and participated.ResultsThe mean of the average F wave was 1.76 ms longer than the ipsilateral H reflex latency. The mean side-to-side difference of the average F wave was 0.56 ms. The H reflex latency side-to-side difference was 0.36 ms.ConclusionThe findings suggest that the average F wave latencies have a predictive value in the clinical context similar to the H reflex.

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:

Pages I-H, Jahr S, Schaufele MK, Conradi E: Comparative analysis of biofeedback and physical therapy for treatment of urinary stress incontinence in women.Am J Phys Med Rehabil2001;80:494–502.ObjectiveTo compare the effectiveness of an intensive group physical therapy program with individual biofeedback training for female patients with urinary stress incontinence.DesignRandomized study of two therapeutic interventions consisting of a specific physical therapy program (PT) or biofeedback training (BF) daily for 4 wk, followed by a 2-mo, unsupervised home exercise program in both groups in an outpatient clinic of a large university hospital. Forty women, referred by gynecologists for nonoperative treatment of genuine stress incontinence of mild-to-moderate severity, were included. Measurements of daytime/nocturnal urinary frequency and subjective improvement of incontinence were the main outcome measures at initial presentation, after completion of the therapy program, and at follow-up after 3 mo. Standardized examinations of digital contraction strength, speculum tests, and manometric measurements were documented as secondary outcome measures.ResultsIn the PT group, the daytime urination frequency decreased 22% after 4 wk of therapy and 19% after 3 mo (P< 0.05) from baseline. The nocturnal urination frequency was reduced by 66% after 4 wk of therapy and 62% after 3 mo (P< 0.001). In the BF group, the daily urination frequency decreased 10% after 4 wk of therapy and 5% after 3 mo (P> 0.05). The nocturnal urination frequency declined 36% after 4 wk of therapy and 66% after 3 months (P< 0.05). Subjective assessment after 3 mo showed that in the PT group, 28% of patients were free of incontinence episodes, 68% reported improved symptoms (incontinence episodes improved by >50%), and 4% were unchanged. In the BF group, 62% were free of incontinence episodes, and 38% were improved. Results of the digital contraction strength assessments, speculum tests, and manometric measurements showed statistically significant improvement in all variables in both groups after 3 months.ConclusionFour weeks of both intensive group physical therapy or individual biofeedback training followed by an unsupervised home exercise program for 2 mo are effective therapies for female urinary stress incontinence and result in a significantly reduced nocturnal urinary frequency and improved subjective outcome. Only group physical therapy resulted in reduced daytime urinary frequency. BF therapy resulted in a better subjective outcome and higher contraction pressures of the pelvic floor muscles.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Sullivan DH, Wall PT, Bariola JR, Bopp MM, Frost YM: Progressive resistance muscle strength training of hospitalized frail elderly.Am J Phys Med Rehabil2001;80:503–509.ObjectiveTo determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training.DesignMuscle strength (one repetition maximum), functional abilities (sit-to-stand maneuver and 20-sec maximal safe gait speed), and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training. The nonrandomized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home. Participants included 19 recuperating elderly subjects (14 male, 5 female; 13 ambulatory, 6 nonambulatory) >64 yr (mean age, 82.8 ± 7.9 yr).ResultsThe one repetition maximum increased an average of 74% ± 49% (median, 70%; interquartile range, 38%–95%, and an average of 20 ± 13 kg (P= 0.0001). Sit-to-stand maneuver times improved in 15 of 19 cases (79%). Maximum safe gait speeds improved in 10 of 19 cases (53%). Four of the six nonambulatory subjects progressed to ambulatory status. No subject experienced a complication.ConclusionsA carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses. A randomized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages, if any, over routine posthospital care that includes traditional low-intensity physical therapy.

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:

Shavelle RM, Strauss D, Whyte J, Day SM, Yu YL: Long-term causes of death after traumatic brain injury.Am J Phys Med Rehabil2001;80:510–516.ObjectiveTo determine which causes of death are more frequent in persons with traumatic brain injury (TBI), and by how much, compared with the general population. Our focus was the period beginning 1 yr after injury.DesignSubjects were 2320 Californians with long-term mental disability after a TBI at age 10 yr or more, followed up between 1988 and 1997. The units of study were person-years, each linked to the subject’s age, gender, level of ambulation, time since injury, and cause of death (if any) for the specific year. Observed numbers of cause-specific deaths were compared with numbers expected according to general population mortality rates.ResultsMortality was higher between 1.0 and 5.0 yr postinjury than after 5.0 yr and was strongly related to reduced mobility. Death rates were elevated for circulatory diseases, respiratory diseases, choking/suffocation, and seizures, with seizure deaths being relatively frequent, even among the most ambulatory.ConclusionsDeath rates for several causes are elevated in persons with long-term sequelae of TBI. The increased risk of choking/suffocation should be of interest to caregivers. Life expectancy seems to be reduced, even for patients who are fully ambulatory.

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