ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Bogey R, Cerny K, Mohammed O: Repeatability of wire and surface electrodes in gait.Am J Phys Med Rehabil2003;82:338–344.ObjectiveMuscle forces are not directly measurable without invasive methods (i.e., tendon force transducers). Techniques such as dynamic electromyography are therefore required to obtain insight into the role of muscles during motion. There is controversy about the choice of recording electrode type. Surface electrodes are noninvasive and allow recording over a large area yet may allow intramuscular crosstalk. Indwelling electrodes also have been used in gait analysis. This electrode type is able to analyze the electrical activity of small or deep muscles. Despite the advantages of intramuscular electrodes for some applications, this electrode type is often rejected because of the need for skin penetration and for specialized personnel to acquire the data. The reliability of the wire electromyographic signal has also been questioned. The objective of this study was to determine if there were differences in the test-retest reliability of surfacevs.intramuscular electrodes in gait analysis.DesignSurface and intramuscular electromyographic data were obtained from the soleus muscle in 18 adults with no history of neuromuscular disease as they performed self-selected speed walking. A statistical criterion (variance ratio) was used to measure the reproduction of phasic patterns of muscle activity with both wire and surface electrodes on repeat-day testing of the soleus muscle.ResultsEach electrode type was remarkably consistent. Mean variance ratio values for wire electrodes (mean = 187) were slightly lower than mean surface electromyographic variance ratio values (mean = 199). These differences did not approach statistical significance (P= 0.768).ConclusionsThe study results show that the dynamic electromyographic signal obtained with wire electrodes is, at minimum, as repeatable as surface electromyograms.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Arinci İncel N, Genç H, Erdem HR, Yorgancioglu ZR: Muscle imbalance in hallux valgus: An electromyographic study.Am J Phys Med Rehabil2003;82:345–349.ObjectiveHallux valgus is a very common foot deformity in modern societies. Muscle imbalance in abductor and adductor muscles was cited as a major factor in the production of hallux valgus. Our aim in this study was to evaluate the role of certain muscles in this deformity.DesignTwenty hallux valgus patients and 20 healthy volunteers participated in the study. After thorough physical, neurologic, and radiographic investigations, we performed an electromyographic study to observe the relationship of hallux valgus deformity with the muscles coordinating first metatarsophalangeal joint movements. Voluntary extension, flexion, abduction, and adduction at the hallux with maximum resistance were performed. Firing rates and amplitudes of motor unit potentials of four muscles: musculus abductor hallucis, musculus adductor hallucis, musculus extensor hallucis longus, and musculus flexor hallucis brevis were recorded. Statistical analysis, including Spearman’s correlation analysis and Mann-WhitneyUtests were performed with SPSS 8.0 for Windows.ResultsWe observed that in the hallux valgus group, abduction activity of musculus abductor hallucis was markedly decreased when compared with adduction of musculus adductor hallucis. Motor unit potential amplitude of abductor activity recorded from musculus abductor hallucis was slightly more than half of the activity in flexion.ConclusionMuscle imbalance in abductor and adductor muscles is apparent in hallux valgus deformity, and this imbalance may be the reason or the result of joint deformity.

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:

Tang SFT, Chen CPC, Hong WH, Chen HT, Chu NK, Leong CP: Improvement of gait by using orthotic insoles in patients with heel injury who received reconstructive flap operations.Am J Phys Med Rehabil2003;82:350-356.ObjectiveTo investigate the effect of orthotic insoles in heel injury patients who received reconstructive flap operations.DesignMotion analysis and force platform data were collected in able-bodied subjects and patients with heel injuries during walking without and with the use of the total contact insole. Gait kinetics were collected for the hip, knee, and ankle joints and then compared with Student’sttests.ResultsWalking velocity and step length were decreased (P< 0.014 andP< 0.005) for patients not wearing the total contact insole. The affected limbs had longer double-support duration (14.8% of gait cycle,P< 0.037) and shorter single-support duration (34.5% of gait cycle,P< 0.045). Less hip power generation was noted for the affected limbs during both initial contact and preswing phases, 0.17 ± 0.10 N-m/kg-m and 0.45 ± 0.20 N-m/kg-m, as compared with that of the able-bodied subjects, 0.36 ± 0.08 N-m/kg-m and 0.89 ± 0.22 N-m/kg-m, respectively. Decreased ankle power generation was noted for the affected limbs (1.08 ± 0.38 N-m/kg-m) during preswing phase as compared with the able-bodied subjects (2.24 ± 0.33 N-m/kg-m). After fitting of the total contact insole, the affected limbs recovered to a gait pattern similar to that of the able-bodied subjects (P< 0.05).ConclusionAsymmetry of gait pattern after heel injury resulted in altered gait kinetics. Gait symmetry could be recovered in these patients as the total contact insole provides weight acceptance, shock absorption, and cushioning effect for the reconstructed heels.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Fujiwara T, Liu M, Chino N: Effect of pedaling exercise on the hemiplegic lower limb.Am J Phys Med Rehabil2003;82:357–363.ObjectiveTo assess the effects of pedaling exercise on the muscle activities in hemiparetic lower limbs in patients with stroke.DesignIn this before-and-after trial, 17 nonambulatory patients with chronic hemiparetic stroke were recruited. Using a servo-dynamically controlled ergometer with a trunk support, the patients pedaled at a resistance of 5 N-m at their comfortable speeds. Muscle activities were recorded with surface electrodes from bilateral quadriceps femoris, medial hamstrings, tibialis anterior, and medial gastrocnemius, and integrated electromyograms were used for analysis of muscle activity patterns during the pedaling cycle. Muscle activities during pedaling were compared with those during voluntary knee extension of the affected limb before, immediately after, and 30 min after the pedaling.ResultsWe found phasic muscle activities in the affected limb during pedaling that were antiphasic to the contralateral side. The muscle activities of quadriceps femoris and tibialis anterior increased significantly during pedaling compared with those during voluntary knee extension effort, whereas the muscle activity of medial hamstrings did not change. The postpedaling facilitation of quadriceps and tibialis anterior and the inhibition of gastrocnemius during voluntary knee extension effort lasted at least for 30 min.ConclusionPedaling could facilitate phasic and coordinated muscle activities even in patients with severe hemiparesis, and it is potentially an effective mode of muscle reeducation.

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:

Gregory PC, Kuhlemeier KV: Prevalence of venous thromboembolism in acute hemorrhagic and thromboembolic stroke.Am J Phys Med Rehabil2003;82:364–369.ObjectiveDeep venous thromboembolism (DVT) is an important health issue in the hospitalized geriatric population that leads to increased length of stay, morbidity, and mortality. Patients with hemorrhagic strokes are usually not placed on prophylactic therapy because of the risk of hemorrhagic extension of the stroke. The purpose of this study was to evaluate the prevalence of DVTs in hospitalized patients with hemorrhagicvs.thromboembolic strokes.DesignRetrospective chart review of data obtained from the Maryland Health Services Cost Review Commission data base for 1999 to determine the prevalence of DVTs in both hemorrhagic and thromboembolic stroke patients hospitalized acutely. Multiple logistic regression was performed to evaluate possible risk factors.ResultsThere were 1,926 patients hospitalized with a primary diagnosis of hemorrhagic stroke and 15,599 with thromboembolic stroke. Women in general had more strokes than men did. Older patients were more likely to have strokes as evidenced by the mean ages of 66 and 71 yr for hemorrhagic and thromboembolic strokes, respectively. A total of 37 patients (1.9%) with hemorrhagic strokes had DVTs, whereas 74 patients (0.5%) with thromboembolic strokes had DVTs. Hemorrhagic stroke was an independent risk factor for DVT (odds ratio, 2.60; 95% confidence interval, 1.49–4.55;P= 0.0008).ConclusionsDVT prevalence and risk was higher among patients with hemorrhagic strokes in comparison with patients with thromboembolic strokes.

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:

Addington WR, Stephens RE, Widdicombe JG, Ockey RR, Anderson JW, Miller SP: Electrophysiologic latency to the external obliques of the laryngeal cough expiration reflex in humans.Am J Phys Med Rehabil2003;82:370–373.ObjectiveThe purpose of this study was to trigger the laryngeal cough expiration reflex using inhaled tartaric acid aerosol and to record the latency between the time of initiation of the laryngeal cough expiration reflex component of the laryngeal cough reflex and the onset of electromyographically recorded responses in the external abdominal oblique in humans.DesignFive male subjects were tested in the seated position, and four latencies were recorded for each subject. The latencies were recorded from laryngeal stimulation to an electromyogram in the muscle belly of the left external abdominal oblique. The time line was activated by a microswitch attached to a breath-activated nebulizer. Data were analyzed using SPSS for mean latency and standard deviation.ResultsThe mean (standard deviation) latency to the external abdominal oblique muscle was 17.6 ± 10.6 msec. No adverse events to inhalation were reported.ConclusionsIn humans, nebulized tartaric acid stimulates primarily rapid adapting receptors in the supraglottic larynx rather than C-fiber receptors. This receptor location in humans evolved neurologically to protect the airway during speech and swallowing, making the laryngeal cough expiration reflex an inseparable component of the laryngeal cough reflex, thus making it clinically significant when assessing airway protection.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID