ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Shirado O, Shundo M, Kaneda K, Strax TE: Outdoor winter activities of spinal cord-injured patients: with special reference to outdoor mobility.Am J Phys Med Rehabil1995;74:408—414Two hundred forty-seven patients with spinal cord injuries living in Hokkaido, the northern part of Japan, were mailed a questionnaire relating to winter outdoor activities. One hundred eight patients responded to the questionnaire, 98 males and 10 females, with ages ranging from 30 to 79 (mean, 53.3) yr. Injury levels of patients were: cervical in 23 patients, thoracic and thoracolumbar in 47, and lumbar in 38. All respondents were unable to walk independently because of quadriplegia or paraplegia. Approximately 90 percent of respondents found it necessary to go outside during the winter season. Eighty-five percent were outside during the coldest period. The most common reasons for outdoor activities were shopping and routine doctor's appointments. The main method of ambulating outside was a manual and/or electrically operated wheelchair, sometimes in conjunction with an automobile. However, there were many problems reported in using wheelchairs; for example, wheels and casters were very slippery on the snow and ice, casters were easily buried in the snow, and wheelchair rims were very cold to handle. It was also pointed out that exposure to cold weather induced physical problems such as muscle spasticity, pain, and numbness of lower extremities. This survey revealed that spinal cord-injured patients would benefit from a wheelchair specifically designed for winter conditions.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Rapp NS, Gilroy J, Lerner AM : Role of bacterial infection in exacerbation of multiple sclerosis.Am J Phys Med Rehabil1995;74 :415—418.One hundred consecutive patients admitted to the hospital with a diagnosis of exacerbation of multiple sclerosis were evaluated for an infectious process. All patients received a complete blood count, urinalysis, urine culture with susceptibility studies, blood cultures, and a chest x-ray at the time of admission. A control group of 55 patients carrying the diagnosis of multiple sclerosis but without symptoms of neurologic decline were also studied. Thirty-five percent of patients experiencing exacerbation of their disease were identified as having a significant bacterial infection compared with 11 % in the control group with quiescent disease. These results were significant with aPvalue of <0.001. When presumptive viral and bacterial infections diagnosed before admission were included, almost 50% of patients could have had an exacerbation of their disease in response to an infectious process. Bacterial infection might well play a role in precipitating relapse in multiple sclerosis as well as influencing treatment.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Kingery WS, Park KS, Wu PBI, Date ES: Electromyographic motor Tinel's sign in ulnar mononeuropathies at the elbow.Am J Phys Med Rehabil1995;74:419—426A novel test for localizing ulnar mononeuropathies (UM), the electromyographic (EMG) motor Tinel's sign, has been developed. While recording with a monopolar needle from the abductor digiti minimi, the ulnar nerve is lightly rolled at multiple sites across the elbow, and the test is considered positive if a burst of EMG activity is observed simultaneously with nerve compression. To determine the use of the EMG Tinel's sign, we evaluated 70 control nerves and 50 clinically suspected UMs. The EMG Tinel's sign had a 78% sensitivity and a 79% specificity for suspected UM at the elbow. The clinical Tinel's sign was present in 68% of suspected UM cases, and the combined sensitivity of the EMG and clinical Tinel's sign was 96%. Using nerve conduction study (NCS) values derived from the control nerves, 62% of UM nerves had abnormal NCS/EMG findings, and 28% of UM nerves had NCS/EMG abnormalities that could be localized to the elbow. The development of motor axon mechanosensitivity at the site of nerve injury is a new finding, not previously observed in electrophysiologic studies of animal nerve injury models or reported in the electrodiagnostic literature.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Dickstein R, Pillar T, Abulaffio N: Electromyographic activity of the biceps brachii muscles and elbow flexion during associated reactions in hemiparetic patients.Am J Phys Med Rehabil1995;74:427—431Activity of the biceps brachii muscles and movements of the elbows were studied during associated reactions in hemiparetic patients and in healthy volunteers. Onset time and increase in electromyographic (EMG) activity during associated reactions and onset of elbow flexion and its maximal magnitude were measured. Testing was performed while standing with a footswitch attached to the sole of the nonparetic foot in patients and to the sole of the right foot in controls. Lifting of that foot generated a trigger signal that served to time the dependent variables. Bilateral EMG activity associated with one foot stance appeared in the two upper extremities in both patients and controls. Elbow flexion occurred in the majority of patients bilaterally, whereas in controls it frequently took place on one side only. There was a significant difference between patients and controls in onset of EMG activity and elbow flexion. This difference indicates an earlier preparatory activity to one foot stance in the upper limbs of patients than in healthy controls. The greatest excursion into flexion was measured in the paretic upper extremity of patients; it significantly exceeded both the flexion angle measured in controls and increase in flexion angle on the nonparetic side. Further understanding of the nature of associated reactions seems to be required for their adequate treatment by physical procedures.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Tsuji T, Sonoda S, Domen K, Saitoh E, Liu M, Chino N: ADL structure for stroke patients in Japan based on the Functional Independence Measure.Am J Phys Med Rehabil1995;74:432—438The difficulty patterns of FIM (Functional Independence Measure) in Japan were determined and compared with patterns found in the United States to assess whether FIM can be used for worldwide comparisons of ADL (the activities of daily living). The FIM was measured for 190 stroke patients in several hospitals throughout Japan. The scores at admission and discharge were converted to an interval scale by Rasch analysis. Right and left brain lesion patients were analyzed separately. The FIM items were divided into two groups: motor items and cognitive items to minimize misfit. A degree of misfit was acceptable, except for bowel and bladder management, stairs, bathing, and expression. Motor items, eating, and bowel and bladder management were the easiest; stairs, bathing, and tub/shower transfers were the most difficult. The difficulty patterns of patients with left and right hemisphere lesions were almost identical. Bathing and tub/shower transfer were more difficult for Japanese patients than for those studied in the United States. Concerning the cognitive items, expression was easiest for patients with right hemisphere lesions but most difficult for those with left hemisphere lesions. Social interaction was easier for Japanese patients with left hemisphere lesions than the other patients. The item difficulty patterns in Japan differs slightly from those in the United States because of cultural differences. As countries show different patterns of difficulty, we must be careful when making international comparisons of FIM data converted by Rasch analysis.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Atchison JW, Newman RL, Klim GV: Interest in manual medicine among residents in physical medicine and rehabilitation: the need for increased instruction.Am J Phys Med Rehabil1995;74:439&443Manual medicine is an important part of the practice of physical medicine and rehabilitation (PM&R). Using a two-part questionnaire, we surveyed PM&R residents to determine their level of interest in manual medicine, their attitudes about this type of treatment, and the amount of formal training in manual medicine offered in PM&R residencies. Questionnaires were sent to all 75 PM&R residency training programs. Responses were received from 470 residents (41.6%) of 1126 potential respondents; this represented 55 (73%) of the programs surveyed. Of the 470 respondents, 363 (77.2%) believed that manual medicine should be a part of PM&R, 386 (82.1 %) wanted more training in manual medicine, 389 (82.8%) believed that manual medicine is useful in the treatment of back/neck pain, and 392 (83.4%) would refer patients for manual medicine treatment. However, only 124 (27.3%) were receiving formal instruction in manual medicine during their PM&R residency training. Most of the 305 respondents who had received some exposure to manual medicine had done so through conferences (88.7%) and independent reading 66.9%). The results of this survey of PM&R residents demonstrate both a widespread interest in the use of manual medicine and an unmet desire for more instruction. Educational experiences in manual medicine should be provided so that, as residents become practicing physiatrists, they can either utilize this form of treatment or appropriately refer patients to other practitioners.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Krotenberg R, Stitik T, Johnston MV: Incidence of dislocation following hip arthroplasty for patients in the rehabilitation setting.Am J Phys Med Rehabil1995;74:444—447Dislocation of a hip arthroplasty prosthesis is the most common serious complication after hip replacement. It is especially important in the rehabilitation setting because it is potentially preventable. The purpose of this study was to investigate differences in dislocation rates between rehabilitation and acute hospital settings. A retrospective chart review of total hip and bipolar hemiarthroplasty patients admitted to three rehabilitation hospitals was performed. Dislocation rates among 825 rehabilitation patients who met study eligibility criteria were compared with rates found among 5352 acute care patients reported in the published literature. The rate of hip dislocation among total hip replacement patients in rehabilitation hospitals was not significantly higher than that in acute settings (2.17%v1.27%). Among bipolar hemiarthroplasty patients, however, the dislocation rate was markedly and significantly lower in rehabilitation than in acute settings (0%v1.95%,P<0.01). Possible reasons for these results are discussed. Further research is needed to identify risk factors more precisely for prosthesis dislocation.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID