ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to determine prospectively the optimal electromyographic screening examination of the lower limb that ensures identification of those lumbosacral radiculopathies that can be electrodiagnostically confirmed, yet minimizes the number of muscles studied.DesignA prospective multicenter study was conducted from May 1996 to September 1997. Patients with suspected lumbosacral radiculopathy referred to participating electrodiagnostic laboratories were recruited and examined by needle electromyography using a standard set of muscles. Patients with electrodiagnostically confirmed lumbosacral radiculopathies were selected for analysis. Various muscle screens were tested against this group of patients with radiculopathies to determine the frequency with which each screen identified the patient with radiculopathy.ResultsThere were 102 patients identified. When paraspinal muscles were one of the screening muscles, four-muscle screens identified 88–97% of the radiculopathies, five-muscle screens identified 94–98%, and six-muscle screens 98–100%. When paraspinal muscles were not part of the screen, identification rates were lower for all screens, and eight distal muscles were necessary to identify about 90% of the radiculopathies.ConclusionsSix-muscle screens with paraspinal muscles yielded consistently high identification rates. Studying additional muscles produced no improvements in identification.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveVenous thrombosis and pulmonary embolisms are major complications associated with acute spinal cord injury. The purpose of this study was to perform a cost analysis on the two pharmacoprophylaxis regimens suggested for deep vein thrombosis prophylaxis in this population.MethodsEfficacy and safety data were obtained from the literature.ResultsResults of the cost analysis demonstrates that adjusted dose unfractionated heparin produces a cost savings over enoxaparin at 30 mg every 12 hr.ConclusionFurther studies are needed to determine the most cost-effective therapy for preventing deep vein thrombi in this population.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThe goal of expanding access to individuals with disabilities to scientific and medical conferences is supported by both the Americans with Disabilities Act and the National Institutes of Health.DesignLive-streaming video broadcast over the internet is widely available, although it has been used only in a limited fashion by the medical community. A consumer-oriented medical and rehabilitation conference concerning the rare disabling disease, fibrodysplasia ossificans progressiva, was broadcast via the world wide web. The address of a web page was announced before the conference to three computer users’ groups that were considered likely to have an interest in the conference. The web page presented a live-streaming video broadcast of the conference. A phone line was installed, thereby allowing viewers to ask questions of the presenters during the question and answer periods.ResultsSixteen users logged in 83 times to view the conference over a 2-day period. Five (23%) of 22 members of a fibrodysplasia ossificans progressiva internet users’ group tuned in from distant places as The Netherlands and Israel.ConclusionsThe internet is a viable tool to expand access to and increase the participation of individuals with disabilities in scientific and medical conferences. This technology should be used routinely in conferences of interest.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThe purpose of this study is to identify predictors of functional outcome after acute stroke inpatient rehabilitation using raw Functional Independence Measure (FIMTM) total scores.DesignMultivariate analysis was performed on data collected retrospectively from stroke rehabilitation patients. Six independent variables were obtained from patients’ medical records.ResultsThe FIM total scores at the time of discharge from the hospital correlated strongly with FIM total scores at the time of admission to the hospital and correlated negatively with age and OAI using the Spearman’s rank correlation method. The FIM total scores at the time of hospital admission were the best predictor of FIM total scores at the time of discharge from the hospital. However, the nature of the stroke, gender, and LOHS did not correlate with FIM total scores at the time of discharge from the hospital.ConclusionsBecause FIM total scores at the time of hospital admission and discharge are highly correlated, FIM total scores at the time of hospital admission can be used to establish a rehabilitation program, to inform the patient and family about the possibility of recovery, and to assess the amount and quality of care given in the home or discharge placement.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo evaluate the reliability and validity of the modified physical performance tests for stroke survivors who live in a community.DesignThe subjects included 40 stroke survivors and 40 apparently healthy independent elderly persons. The physical performance tests for the stroke survivors comprised two physical capacity evaluation tasks that represented physical abilities necessary to perform the main activities of daily living, e.g., standing-up ability (time needed to stand up from bed rest) and walking ability (time needed to walk 10 m).ResultsRegarding the reliability of tests, significant correlations were confirmed between test and retest of physical performance tests with both short and long intervals in individuals after stroke. Regarding the validity of tests, the authors studied the significant correlations between the maximum isometric strength of the quardriceps muscle and the time needed to walk 10 m, centimeters reached while sitting and reaching, and the time needed to stand up from bed rest.ConclusionsThe authors confirmed that there were significant correlations between the instrumental activity of daily living and the time needed to stand up from bed rest, along with the time needed to walk 10 m for the stroke survivors. These physical performance tests are useful guides for evaluating a level of activity of daily living and physical frailty of stroke survivors living in a community.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo determine the prevalence of secondary impairments among individuals with long-standing spinal cord injury in Quebec and the potential relationships between these impairments and several variables.DesignA review of 2200 medical files was conducted to determine the target population; 976 patients were selected randomly and mailed questionnaires. The results were based on 482 individuals with spinal cord injury who returned the completed questionnaire. The questionnaire included 14 subsections, such as sociodemographic, medical, psychosocial, and environmental information. The medical section, including the type and level of lesion and the presence of secondary impairments, was analyzed.ResultsUrinary tract infection, spasticity, and hypotension were the most frequently reported secondary impairments, regardless of the severity of injury. Relationships between the prevalence of secondary impairments and the duration of injury, as well as perceived health status, were observed.ConclusionsThis is the first study to describe secondary impairments after long-standing spinal cord injury in Quebec. Patients with spinal cord injury still present a high prevalence of secondary impairments many years after their rehabilitation, despite preventive education or medical follow-up visits. Further studies are required to determine the specific impact that these impairments have on the patients’ social role and their quality-of-life.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo obtain information from continuous intrathecal baclofen infusion (CIBI) pump centers regarding specific clinical practices and experiences.MethodsA total of 115 centers were surveyed by mail.ResultsForty centers (35%) responded with information about 1002 test doses and 936 pump placements. Patient diagnoses included cerebral palsy, spinal cord injury, traumatic brain injury, and others. The average test dose was 50 &mgr;g. A total of 87% of trials were successful. The most common test dose complications were nausea/vomiting (2.6%) and sedation (2.2%). Pump placement complications included cerebrospinal fluid (CSF) collection (3.3%), constipation (2.9%), headache (2.4%), and CSF leak (2.2%). The most common long-term complications were catheter kink or migration (4%) and infection (1.2%). Improved daily activities including easier diapering, dressing, transfers, orthotic wear and comfort, and sitting tolerance were reported in the majority (>90%) of patients. Mixed results were reported for oral motor function and head, bladder, and bowel control.ConclusionsCIBI is an effective treatment for severe spasticity, with dramatic quality-of-life improvements and a small number of significant complications. Long-term benefits and complications need to be monitored in this complex population.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID