ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

To understand better how career choices are made by physiatrists, a 16-item, 7-page questionnaire was sent to all 1994 graduating physical medicine and rehabilitation (PM&R) resident physicians in the United States. Of the 343 senior residents, 202 completed the questionnaire for a response rate of 59%. The questionnaire focused on the following areas: timing of the decision to enter PM&R; and how the medical school curriculum, certain groups of people, and certain specific factors influenced their choices. There were 130 factors modeled after the American Association of Medical Colleges (AAMC) annual medical student questionnaire that the recipients were asked to grade on a numerical scale: 1 = unimportant to 5 = very important. Of the graduating residents, 60.1 % (119/198) made the decision to enter PM&R in their 3rd or 4th yr of medical school, 13.1% (26/198) in the first 2 yr, and 11.1% (22/198) after starting another residency. The five factors ranked most important in the decision were (mean rank score): sufficient time/flexibility for family obligations (4.60); opportunity to make a difference in peoples lives (4.57); interest in helping people (4.55); types of patient problems encountered (4.50); and consistency with personality (4.49). We also obtained the AAMC's 1993 annual data on medical students choosing PM&R. Their top five factors were the same as those listed by the graduating residents, but in a slightly different rank order. Profiles have also been derived on those graduating PM&R residents who chose an academic career (n= 68)vnonacademic (n= 133) and fellowship (n= 34)vnonfellowship (n= 163).

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A 45-item survey assessing the need for knowledge and skills in clinical problems commonly encountered in physical medicine and rehabilitation was sent to 300 randomly selected family practitioners in the state of Indiana. The purpose of this survey was to determine the clinical needs self-perception of these physicians to help design a physical medicine and rehabilitation curriculum that would be the most relevant to medical students in light of today's emphasis on primary care. Another purpose of the study was to compare the responses with those of a similar survey done among Ohio general practitioners in 1974. The family physicians gave the highest scores in terms of overall need to those items most frequently encountered in practice, especially musculoskeletal problems. They tended to rank much lower those clinical problems that they typically refer to other specialists for care. This survey and the one in 1974 showed remarkably similar results. Only a few items showed considerable change in their overall rank or need. Carpal tunnel syndrome and prescription of wheelchairs, canes, and assistive devices both rose in importance in this survey. Items that were ranked lower in importance on this survey than in 1974 included juvenile rheumatoid arthritis; the use of modalities, such as ultrasound, diathermy, and paraffin; cardiac rehabilitation; stroke rehabilitation; and chronic lung rehabilitation. Although this self-assessment tool provides pertinent and very useful information regarding curricular needs, it cannot be the only source of information in this regard. The chief drawback of such self-assessment instruments is that they show only what primary care physicians need currently and do not necessarily reflect what will be needed in the future.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Proxy agreement and internal structure of the Craig Handicap Assessment and Reporting Technique are documented, and the measure is compared with the Functional Independence Measure for a sample of stroke survivors. Thirty-eight former rehabilitation patients were assessed at follow-up (average time post-stroke was 6 mo) with the Craig Handicap Assessment, which was also answered separately under proxy instructions by caregivers (relatives or friends) who accompanied patients to the interview. Proxy instructions were for caregivers to answer as if they were the stroke survivor. Proxy agreement for the Craig Handicap total score was good (intraclass correlation was 0.77) and adequate for most of its scales. The physical independence, mobility, and occupation scales were highly intercorrelated, with low intercorrelations for social integration and economic self-sufficiency. Correlation between the handicap and Functional Independence Measure disability scores was around 0.50; when the handicap economic self-sufficiency scale was removed, this increased to 0.70. These findings are discussed within the context of the interrelationships among the educational level of the patients and both measures. With some modification, the Craig Handicap Assessment and Reporting Technique appears to be a useful tool for assessing outcomes in terms of the handicap status of stroke survivors.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ObjectiveTo provide baseline information on the state of pediatric pulmonary rehabilitation, including data regarding diagnosis, age, gender, race, gestational age, disposition, medications, complications, procedures, consultations, pulmonary status, and outcomes.DesignRetrospective review.SettingPediatric pulmonary rehabilitation unit of a pediatric rehabilitation hospital that is free-standing, but that receives most of its referrals from a tertiary care pediatric hospital.PatientsAll patients (70 subjects) who had completed a course of inpatient rehabilitation over the 5-yr life of the hospital.Main Outcome MeasuresDescriptive data were collected in regard to the objectives. In addition, outcome measures were developed for this study. They include measurements of developmental equivalence at admission and discharge and the changes in these scores, both actual and expected.ResultsDescriptive characteristics are listed in the text. Forty-six patients had bronchopulmonary dysplasia (BPD). The success rate of weaning those with BPD who were admitted with a goal of ventilator weaning was 81% (24% for those without BPD). On admission, 36 of those with BPD required three pulmonary aids (O2, continuous positive airway pressure, ventilator, and tracheostomy); at discharge, 28 required three aids. Of those without BPD, 16 required three aids at admission and 14 did so at discharge.ConclusionsBasic descriptive data are provided. The characteristics are similar to those in previous studies, although with a larger sample size and more detail. The outcome measures described cannot be compared with a criterion standard, but do offer a starting point in this underdeveloped field and will assist in future research directions.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The objective of this prospective study was to determine if differences exist between individuals who require an inpatient rehabilitation program after elective hip and knee arthroplasty from those patients who can be discharged directly home. Multiple variables consisting of baseline demographics, social status, insurance status, medical history, pain level, quantitative strength, range of motion, and functional ability were examined. The primary outcome measure was the discharge destination from the orthopedic service and consisted of either a discharge to home or a discharge to an inpatient rehabilitation unit. Of the 162 patients followed, 65 (40%) were discharged to an inpatient rehabilitation unit, whereas 97 were discharged to home. The patients discharged to inpatient rehabilitation tended to live alone, were significantly older (mean difference = 6.3 yr), and had increased comorbid conditions (P< 0.001 for all variables). Patients discharged to a rehabilitation unit reported significantly greater pain levels than those discharged to home (P< 0.001). The attainment of a supervision level of function demonstrated greater differences between groups than the attainment of independent function for all functional measures. A logistic regression model was developed that predicted 76% of the discharges to rehabilitation by the third physical therapy session postsurgery. In conclusion, predictive markers do exist that differentiate individuals who require further inpatient therapy services after joint replacement surgery.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The “empty can test” has been described to isolate supraspinatus muscle activity from the activity of other rotator cuff muscles. The shoulder is positioned in 90° of abduction, with full internal rotation, and 30° of forward flexion and maintained against resistance. The purpose of this study was to determine if the supraspinatus muscle is isolated by the empty can test. Ten normal male subjects were studied (age 25–43/mean 32) with fine-wire electromyography recording from their nondominant arm middle deltoid, supraspinatus, infraspinatus, and teres minor. During the maneuver electromyogram activity was seen not only in the supraspinatus, but also in the infraspinatus and the middle head of the deltoid. Teres minor was inactive throughout the test; however, this is interesting because the teres minor and infraspinatus have previously been described as a functional unit. Our study found that the empty can test does not allow selective activation of the supraspinatus muscle.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Medial femoral cutaneous nerve (MFCN), a sensory branch of the femoral nerve, supplies the skin on the anterior medial aspect of the thigh and knee. A conduction study for this nerve is described. A recording electrode was placed anterior-medially in the thigh and 14 cm distal to the stimulating cathode that was placed immediately lateral to the femoral artery just below the inguinal ligament. Sixty-four nerves of 32 adults with a mean age of 40 yr (range, 21–56) were tested. The latencies to the onset and peak were 2.4 ± 0.2 and 2.9 ± 0.2 ms, respectively. The amplitude of baseline to negative peak was 4.9 ± 1.0 μ-V. The conduction velocity calculated by the distance divided by the onset latency was 60 ± 5 m/s. We conclude that the MFCN is accessible for electrophysiologic evaluation, which may help in diagnosing the MFCN or femoral neuropathy.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Evidence has been accumulating that injuries related to wheelchair use are common and sometimes serious. The object of this study was to evaluate the databases of the Food and Drug Administration (FDA) for insights to the nature and causes of such problems. We analyzed 651 records that were received by the FDA between 1975 and 1993. There were 368 injuries, 21 of which were fatal, affecting 334 wheelchair users. Fractures were the most common (45.5%), with lacerations (22.3%) and contusions/abrasions (20.1%) accounting for most of the remainder. The proportion of incidents related to the use of scooters, powered wheelchairs, and manual wheelchairs were 52.8%, 24.6%, and 22.6%, respectively. Four broad classes of contributing factors, often acting in combination, were implicated: engineering (60.5%), environmental (25.4%), occupant (9.6%), and system (4.6%). Of the tips and falls, those in the forward direction were most common in incidents affecting manual or powered wheelchairs, but the sideways direction was most common in scooters. The FDA database provides a unique perspective on wheelchair safety, with implications for clinicians, users, manufacturers, and regulatory bodies.

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