ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Grissom SP, Dunagan L: Improved satisfaction during inpatient rehabilitation after hip and knee arthroplasty: a retrospective analysis.Am J Phys Med Rehabil2001;80:798–803.ObjectiveTo increase patient satisfaction by 25% and decrease length of stay by 1 day while maintaining current levels of functional change.DesignThis trial was performed in a university medical center’s acute inpatient rehabilitation hospital and included 46 consecutive subjects who had a total hip or total knee arthroplasty that required acute inpatient rehabilitation. A common documentation system was adapted for physical therapists in the acute-care hospital and rehabilitation setting. A consistent team of physical therapists and rehabilitation nurses, whose treatment focus was joint-replacement patients, was assembled. An enhanced written and verbal patient information and orientation system was implemented. Satisfaction rate and length of stay were determined, and functional change was calculated by use of the FIM™ instrument.ResultsPatient satisfaction increased from a baseline of 77% to 92%. The decrease in average length of stay was not found to be significantly different. Levels of functional change from admission to discharge decreased and was found to be significant.ConclusionPatient satisfaction can be increased during inpatient rehabilitation after total hip and total knee arthroplasty even while the functional change from admission to discharge decreases. The implementation of a common documentation system, consistent staff, and enhanced patient orientation may be the reason for this increase in satisfaction rate, but is difficult to conclude because of the design of the study.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Lam PL, Ng GYF: Activation of the quadriceps muscle during semisquatting with different hip and knee positions in patients with anterior knee pain.Am J Phys Med Rehabil2001;80:804–808.ObjectiveWe measured the surface electromyographic activities of vastus medialis obliquus and vastus lateralis in 16 subjects with patellofemoral joint pain syndrome.DesignEach subject performed bilateral static knee extension exercises at 60% of his or her maximal voluntary effort under different combinations of hip rotation (30 degrees of medial rotation, neutral, 45 degrees of lateral rotation) and knee flexion (20 and 40 degrees) in a standing position. The ratio of surface-integrated electromyographic signals of vastus medialis obliquus over vastus lateralis was calculated for each of the six conditions. Because of significant interaction of hip rotation and knee flexion in the two-way analysis of variance, data were analyzed separately with pairedttests for the effect of knee positions and one-way repeated measures analysis of variance for hip positions.ResultsAt 20 degrees of knee flexion, there was no significant difference among the three hip positions, whereas at 40 degrees of knee flexion, medial rotation of the hip resulted in significantly higher vastus medialis obliquus over vastus lateralis activity ratio than lateral rotation (P< 0.05).ConclusionsThere was relatively more activation of vastus medialis obliquus than vastus lateralis at 40 degrees of semisquat with the hip medially rotated by 30 degrees. This finding has clinical implications for training the vastus medialis obliquus in patients with patellofemoral joint pain syndrome.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Nadler SF, Feinberg JH, Reisman S, Stitik TP, DePrince ML, Hengehold D, Weingand K: Effect of topical heat on electromyographic power density spectrum in subjects with myofascial pain and normal controls: a pilot study.Am J Phys Med Rehabil2001;80:809–815.ObjectiveTo investigate the influence of superficial heat on the fatigue cascade of the upper trapezius muscle in subjects with myofascial pain and matched normal controls.DesignIn a prospective randomized block crossover pilot study, eight female subjects, ages 20–35 yr, with upper trapezius muscle trigger points and eight matched female control subjects without pain were studied. Subjects performed six 100-sec shoulder shrug contractions to fatigue, with subjects randomly chosen to receive heat during the first three or last three trials. The initial median frequency and the slope of the median frequency decline were calculated from the data.ResultsIn the subjects with pain, the slope of the median frequency was elevated in ambient room temperature as compared with controls. There was no difference in slope of the median frequency under heated conditions. Heat application in controls before fatiguing exercise caused an increase in initial median frequency, whereas exercise before heat treatment resulted in a significantly lower initial median frequency. Subjects with myofascial pain had no significant change in initial median frequency.ConclusionsHeat seems to have a positive effect on muscle function in normal individuals when applied before exercise. Subjects with myofascial pain respond differently to exercise and heat challenge, which suggests a difference in their muscle physiology.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Diamond PT, Julian DM: Practice trends in the management of low hematocrit in the acute rehabilitation setting.Am J Phys Med Rehabil2001;80:816–820.ObjectiveTo examine current clinical practice regarding the management of anemic patients in the acute rehabilitation setting.DesignNinety-four medical directors of inpatient rehabilitation units were surveyed on their use of transfusion thresholds and human recombinant erythropoietin. Factors affecting their clinical decision making were assessed.ResultsThe majority of physicians responded that they recommend red cell transfusion in patients with a hematocrit <25%. When a history of cardiovascular disease and advanced age was present, more physicians were likely to transfuse at higher hematocrit levels. Forty-six percent of physicians reported recommending the use of human recombinant erythropoietin in anemic patients. Only 30% of respondents classified their clinical management of anemia as evidence based.ConclusionsClinical practice guidelines should be developed to aid the rehabilitation medicine specialist in the management of anemic patients in the acute rehabilitation setting. Further study of the relationship between hematocrit level, tolerance for therapeutic exercise, and long-term functional outcome is indicated.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Sadeghi H, Sadeghi S, Allard P, Labelle H, Duhaime M: Lower limb muscle power relationships in bilateral able-bodied gait.Am J Phys Med Rehabil2001;80:821–830.ObjectiveThe purpose of this study was to test the hypothesis that limb propulsion is mainly associated with the interaction of a number of muscle power bursts developed throughout the stance phase and that the control actions are mainly achieved by the contralateral limb through different power-burst interactions. We also hypothesized that the power activities of the propulsion limb would be related to those of the control limb.DesignSixty gait trials of 20 subjects with dominant right hands and right legs were chosen for analysis. Each trial represents a performance of an able-bodied gait. Data were assessed using an eight-camera, high-speed, video-based system synchronized to two force plates. The muscle powers and their related mechanical energies were calculated at each joint and in each plane of the lower limbs by use of an inverse dynamic technique. The Pearson correlation method was used to determine the relationships within each limb by use of the data identified by principal component analysis, whereas a canonical correlation analysis was performed to illustrate the interaction between the limbs.ResultsGait propulsion was an activity initiated by the hip shortly after heel-strike and maintained throughout the stance phase. Control was the main task of the left limb as evidenced by the power absorption bursts at the hip and knee. The left limb power generations were generally secondary to control activities and were possibly involved in adjustments to correct the other limb’s propulsion. Interlimb interaction further emphasized the functional relationship between forward progression and control tasks developed by each limb and highlighted the importance of the frontal and transverse plane actions during gait.ConclusionThese results do not support the hypothesis that the ankle was a major contributor to forward progression.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Hurst CA, Kirby RL, MacLeod DA: Locomotor-respiratory coupling during axillary crutch ambulation.Am J Med Phys Rehabil2001;80:831–838.ObjectiveTo test the hypotheses that locomotor-respiratory coupling occurs in humans using axillary crutches in a swing-through ambulation pattern and that expiration occurs during crutch-stance phase during locomotor-respiratory coupling.DesignEighteen able-bodied persons were trained in one-footed swing-through gait with axillary crutches. Then, as subjects walked at “somewhat hard” speeds (Borg) on a motorized treadmill for 5 min, we recorded signals from a crutch pressure switch and a mouthpiece-mounted thermocouple. Coupling was defined as being present when the onset of inspiration varied by ≤5% with respect to the onset of the crutch gait cycle for a minimum of 10 consecutive gait cycles and when there was no drift on a raster plot of the respiratory phases relative to the onset of the gait cycle.ResultsTen (56%) of the 18 subjects exhibited locomotor-respiratory coupling on 1–4 occasions each, with episodes lasting 11.3–148 sec. In 17 (89%) of the 19 episodes of 1:1 locomotor-respiratory coupling, expiration occurred during the crutch-stance phase of the gait cycle and inspiration occurred during crutch swing.ConclusionsTransient 1:1 locomotor-respiratory coupling occurs in many able-bodied subjects ambulating with axillary crutches and a swing-through gait. Expiration is most often associated with the crutch-stance phase of the gait cycle. This study may have implications for training axillary crutch users.

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, Fang Z-P, Walker M, Pourmehdi S, Knutson J: Intramuscular electromyographically controlled neuromuscular electrical stimulation for ankle dorsiflexion recovery in chronic hemiplegia.Am J Phys Med Rehabil2001;80:842–847.We report three cases of survivors of chronic stroke treated with active repetitive movement training of the paretic ankle dorsiflexors mediated by intramuscular electromyographically controlled neuromuscular electrical stimulation (NMES). These case reports demonstrate the feasibility of using intramuscular electromyographically controlled NMES for facilitating ankle dorsiflexion recovery among survivors chronic stroke with moderate hemiplegia. Relevant issues for clinical implementation and future investigations are reviewed.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Kuczewski M, Fiedler I: Ethical issues in rehabilitation: conceptualizing the next generation of challenges.Am J Phys Med Rehabil2001;80:848–851.

ISSN:0894-9115    

出版商:OVID    

年代:2001

数据来源: OVID