ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTA recent investigation of the effects of the antidepressants desipramine and trazodone on behavioral recovery in brain-injured animals suggested that antidepressants, which act to increase noradrenergic activity in the brain, may facilitate the rate of recovery, whereas those that act to increase serotonergic (5-HT) activity may hinder recovery and reinstate deficits in recovered animals. The present study was designed to evaluate these findings further by assessing the effect of a single intraperitoneal injection of fluoxetine (a relatively pure 5-HT reuptake blocker), amitriptyline (a mixed 5-HT and noradreneregic reuptake blocker with α1-adrenergic receptor blocking activity) or a single intraventricular infusion of 5-HT on recovery of beam-walking ability in animals with a unilateral sensorimotor cortex injury. None of the drugs significantly affected the rate of recovery. Although fluoxetine was ineffective in reinstating the motor deficit in recovered animals, amitriptyline reinstated the deficit in a dose-dependent fashion. Infusion of 5-HT resulted in an extremely transient reinstatement of the deficit, which was largely attributable to its short-term sedative properties. These results suggest that 5-HT may be less involved in functional recovery than previously thought. They also add further support to previous findings that indicate that drugs which act to antagonize α1-adrenergic activity (e.g., phenoxybenzamine) may interfere with motor recovery after sensorimotor cortex injury. An appreciation of the potential impact of certain antidepressants on functional recovery in brain-injured patients appears warranted.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTThe value of routine chest roentgenograms has come under increasing scrutiny in the medical literature. In this retrospective study we investigated the value of routine chest radiographs obtained on admission to a rehabilitation unit after an acute spinal cord injury. The charts of all patients admitted for rehabilitation after a traumatic spinal cord injury during a 1-year period were reviewed and 79 patients fulfilled criteria for inclusion into the study. Of the 79 patients, 12 had findings on routine admission films, 9 of which were felt to be significant (11.4%). All 9 patients with abnormal admission films had experienced cardiopulmonary complications during their acute hospitalization (P< 0.001). Fourteen patients with normal chest roentgenograms on admission had repeat films performed during their rehabilitation stay, 4 of which were abnormal. All 4 had experienced cardiopulmonary complications during their acute hospitalizations (P< 0.01). Our findings would support the selective use of admission chest roentgenograms in spinal cord-injured patients with clinical indications or a history of cardiopulmonary complications during their acute care stay.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTThis study tested differences in functional independence status, level of psychologic distress and extent of handicap experienced after discharge from inpatient rehabilitation among a group of 125 outpatients with spinal cord injury (SCI) sponsored by one of three types of rehabilitation insurance payors: catastrophic (Michigan Automobile No-Fault and Workers' Disability Compensation), Medicaid and third-party privates. Outcome measures included the functional independence measure, the brief symptom inventory and the Craig handicap assessment reporting technique. Insurance data was obtained via medical chart reviews and interviews that were conducted either face-to-face or by telephone, using the benefits coverage inventory. No differences in terms of post discharge functional independence across subjects sponsored by the three payors was found when controlling for neurologic status. However, SCI subjects sponsored by different payors reported receiving different amounts of benefits. Subjects also differed on the extent of psychologic distress experienced after discharge and the extent of their handicaps. SCI subjects sponsored by Medicaid reported receiving fewer benefits, being more distressed and experiencing greater handicap in comparison to others. Third-party privately sponsored subjects, conversely, experienced less handicap and distress than did the study's other subjects.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTTranscranial magnetic stimulation (TMS) of human cortex during voluntary muscle contraction produces a transient period of inhibition (i.e., silent period, SP) in the electromyographic (EMG) activity. The duration of the SP in relation to the level of muscle force (10%, 50% and 100% of maximum voluntary contraction) as well as possible cumulative effects of sequential TMS on the SP were studied. Methodologic problems were encountered in defining the SP and thus the duration of both an absolute (complete EMG silence) and relative (return of uninterrupted EMG activity) SP was measured. In all subjects, shortening of the SP duration occurred in relation to an increase in force when the criterion for absolute SP was used. Conversely, the relative SP duration suggested a trend toward prolongation with increasing force of contraction. No cumulative effects of TMS were observed on the absolute SP duration, whereas two subjects showed a cumulative effect of TMS on the relative SP. We conclude that the effect of muscle force and sequential TMS on the SP duration is dependent on the methods used to measure the SP. It is therefore essential to agree on methodology before SP measurements are clinically useful.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTThe community integration questionnaire (CIQ) was designed to assess home integration, social integration and productive activity in persons with acquired brain injury. The instrument consists of 15 items and can be completed by self report or with the assistance of a family member or caregiver familiar with the person's health status and social activities. Previous research has demonstrated adequate test-retest reliability and internal consistency. This study was designed to examine further, the psychometric characteristics of the CIQ and begin the process of establishing the instrument's validity. The CIQ was administered to 341 persons with traumatic brain injury (TBI) and 210 persons without TBI or any other apparent disabilities. The results indicate that the total scores are normally distributed for both persons with and without TBI. A statistically significant difference (P< 0.01) was found between subjects with TBI and those without TBI for all three subscales of the CIQ and for total scores. Data analysis also revealed that the total CIQ scores statistically differentiated among subjects with TBI living in three different settings: (1) living independently; (2) living in a supported community situation and (3) living in an institution. Intercorrelations among the three subscales (home, social and productivity) demonstrated that the CIQ provides unique information in the assessment of community integration for persons with TBI. Areas of future research necessary to expand the research and program evaluation usefulness of the CIQ are identified.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTThe effect of the occupational environment on fibromyalgic patients has not been well studied. Individuals (321) from across the United States completed a questionnaire regarding effects of their current and past occupations on their fibromyalgia. Occupations with a high percentage of responders were general office workers (20%), health care providers (14%) and educators (11%). Of the respondents, 8% were unemployed. Activities reported to aggravate the symptoms of fibromyalgia were computer or typing (37%), prolonged sitting (37%), prolonged standing and walking (27%), stress (21%), heavy lifting and bending (19%) and repeated moving and lifting (18%). Activities that did not appear to exacerbate the symptoms of fibromyalgia included walking (19%), variable light sedentary work (15%), teaching (8%), light desk work (6%) and phone work (6%). Patients with fibromyalgia report that they do not tolerate prolonged, repetitive activities, maintaining any one position for sustained periods of time and jobs with high stress. Light sedentary occupations that allow varied tasks and changing positions appear to be tolerated the best.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTDiscriminant function analysis can be useful when applied to multiple nerve conduction parameters for diabetic and nondiabetic subjects to reveal the essential dimension along which key neuropathic differences occur between these groups. In this study, 19 electrophysiologic parameters were used in a stepwise discriminant function analysis to reveal a highly significant dimension of inter-group differences between 67 diabetic and 75 normal adult Japanese-American males. The classification functions thereby derived are more sensitive and specific than those reported previously for this population. Furthermore, when 72 additional subjects with impaired glucose tolerance were examined, they showed considerable overlap with the normal and separation from the diabetic groups, respectively. Their intermediate position between normal and diabetics in the key discriminant dimension indicates that essential neuropathic change is, at most, incipient in this latter group.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ABSTRACTAdventitious bursae are known to occur from repeated friction and pressure but rarely have been reported in adult amputees. Four cases of adventitious bursae are described, which were noted during the course of a follow-up study of below knee amputees. Two bursae resolved with modification of the socket or refabrication. One developed bursitis and drainage and a fourth persisted in a patient with systemic lupus erythematosus

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID