摘要:

McKenzie AL, Nagarajan SS, Roberts TPL, Merzenich MM, Byl NN: Somatosensory representation of the digits and clinical performance in patients with focal hand dystonia.Am J Phys Med Rehabil2003;82:737–749.ObjectiveThe purpose of this study was to incorporate magnetoencephalography and clinical testing to describe differences in somatosensory organization and sensorimotor function of the hand in patients with focal hand dystonia, a target-specific disorder of voluntary movement that interferes with fine motor control during the performance of rapid, repetitive, skilled movements.DesignThis descriptive study included prospective, quasi-experimental comparisons between groups.ResultsPatients with focal hand dystonia demonstrated deficits in physical variables, sensory processing, and motor control when compared with age- and sex-matched controls. They also had altered patterns of firing (amplitude and latency integrated over time) and abnormal somatosensory representations on magnetoencephalography.ConclusionsThese study findings suggest that there are alterations in both somatosensory representation of the digits and clinical performance in patients with focal hand dystonia. Future studies to determine if alterations in the sensorimotor feedback loop contribute to the development of focal hand dystonia are indicated. If so, intervention strategies may need to include specific types of somatosensory retraining as part of the rehabilitation program for patients with focal hand dystonia.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Sancho J, Servera E, Vergara P, Marín J: Mechanical insufflation-exsufflationvs.tracheal suctioning via tracheostomy tubes for patients with amyotrophic lateral sclerosis: A pilot study.Am J Phys Med Rehabil2003;82:750–753.ObjectiveTo compare the effects of mechanical insufflation-exsufflationvs.suctioning via tracheostomy tubes on respiratory variables for six amyotrophic lateral sclerosis patients.DesignIn this prospective crossover study, six consecutive patients with amyotrophic lateral sclerosis who required continuous mechanical ventilation via tracheostomy tubes and developed chest infections underwent measurement of pulse oxyhemoglobin saturation (SpO2), peak inspiratory pressure (PIP), mean airway pressure (Pawm), and work of breathing performed by the ventilator (WOBv) at baseline and 5 and 30 min after tracheal suctioning and 5 min after mechanical insufflation-exsufflation.ResultsThe baseline values were 93.50 ± 2.26% for SpO2in ambient air, 18.50 ± 4.23 cm H2O for PIP, 4.67 ± 1.37 cm H2O for Pawm, and 1.03 ± 0.25 J/liters for WOBv. Only WOBvchanged significantly, decreasing after tracheal suctioning (P< 0.05), whereas all variables improved significantly after mechanical insufflation-exsufflation.ConclusionFor ventilator-dependent patients with amyotrophic lateral sclerosis, mechanical insufflation-exsufflation via a tracheostomy tube with an inflated cuff may be more effective in eliminating airway secretions than conventional tracheal suctioning.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Sagliocco L, Orlandi G, Calabrese R, Pellegrinetti A, Baglini O, Castelli F, Baldinotti F, Sartucci F: Electrodiagnostic evidence of phrenic nerve demyelination in Charcot-Marie-Tooth disease 1A.Am J Phys Med Rehabil2003;82:754–759.ObjectiveTo determine whether neurophysiologic findings correlate to clinical respiratory signs or spirometric abnormalities in patients with hereditary motor and sensory neuropathy type 1 (Charcot-Marie-Tooth disease).DesignA total of 11 patients with hereditary motor and sensory neuropathy type 1A, genetically identified, (age range, 10–58 yr) were included and studied by physical pulmonary examination, chest radiography, respiratory function tests, and bilateral transcutaneous phrenic nerve conduction.ResultsNo patient complained of respiratory symptoms or revealed abnormal spirometric or maximal respiratory pressure data, despite a phrenic nerve conduction significantly slower (P< 0.0001; median conduction time, 18.6 msec; 95th percentile, 31.97 msec) than that recorded in the control group of healthy subjects (median, 6.05 msec; 95th percentile, 8.82 msec); the amplitudes of compound muscle action potentials were not statistically different from the controls.ConclusionsOur study confirms a dramatic phrenic nerve involvement in absence of clinical and laboratory evidence of diaphragmatic weakness; further studies and an adequate follow-up are necessary to discover whether the disease progress might encompass respiratory dysfunction at later stages.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Yanagisawa O, Niitsu M, Yoshioka H, Goto K, Itai Y: Magnetic resonance imaging determination of muscle recruitment variations in dynamic ankle plantar flexion exercise.Am J Phys Med Rehabil2003;82:760–765.ObjectiveThe purpose of this study was to investigate the muscle recruitment variations in the dynamic ankle plantar flexion.DesignA total of 17 subjects participated in this study and performed the ankle plantar flexion exercise. Magnetic resonance T2-weighted images were obtained from the calf before and immediately after exercise to calculate each T2 relaxation time in the medial and lateral gastrocnemius, soleus, tibialis posterior, flexor digitorum/hallucis longus, peroneus longus, and dorsiflexors.ResultsAll the muscles except the dorsiflexors showed significantly increased T2 relaxation time and signal intensity on T2-weighted images after exercise. Above all, both gastrocnemius muscles showed significantly greater postexercise T2 relaxation time than the soleus, tibialis posterior, flexor digitorum/hallucis longus, and dorsiflexors. In addition, the peroneus longus had a tendency to show the greatest T2 relaxation time next to the gastrocnemius, but there was no significant difference between them.ConclusionsThe present study may suggest that the gastrocnemius muscle, especially the medial side, was best recruited in the dynamic ankle plantar flexion exercise. In addition, it is possible that the peroneus longus was most recruited next to the gastrocnemius in this exercise mode.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Mendelsohn ME, Leidl DS, Overend TJ, Petrella RJ: Specificity of functional mobility measures in older adults after hip fracture: A pilot study.Am J Phys Med Rehabil2003;82:766-774.ObjectiveTo determine the relationships between measures of functional mobility (Timed Up and Go [TUG], Self-Paced Walking [SPW], Berg Balance Scale [BBS]) and global functional status (FIM™ instrument), the motor component of the FIM instrument (motor FIM), and the mobility/locomotor-specific FIM component (ML-FIM) in older patients admitted to an inpatient rehabilitation program after hip fracture.DesignThe TUG, SPW, BBS, and FIM instrument were administered within 24 hr after admission and before discharge to 20 patients undergoing inpatient rehabilitation after a hip fracture.ResultsSignificant correlations at admission were found between FIM and TUG scores (r= −0.47;p< 0.05), TUG and motor FIM (r= −0.45;p< 0.05), TUG and ML-FIM (r= −0.58;p< 0.01), FIM and BBS (r= 0.60;p< 0.01), motor FIM and BBS (r= 0.50;p< 0.05), and ML-FIM and BBS (r= 0.45;p< 0.05). At discharge, a significant correlation was found between the motor FIM and SPW (r= −0.49;p< 0.05). Change scores between both the motor FIM and ML-FIM and TUG scores were significantly correlated (r= −0.47,p< 0.05,r= −0.50,p< 0.05, respectively).ConclusionsThe FIM instrument, motor FIM, and ML-FIM may not be specific measures of functional mobility in patients with hip fracture.

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:

Titianova EB, Pitkänen K, Pääkkönen A, Sivenius J, Tarkka IM: Gait characteristics and functional ambulation profile in patients with chronic unilateral stroke.Am J Phys Med Rehabil2003;82:778–786.ObjectiveRecent technical progress in gait analysis has resulted in portable walkways with embedded pressure-sensitive sensors. Often claims are made in connection with new equipment of their straightforward clinical use. The purpose of the present study was to assess whether the functional ambulation profile (FAP), calculated from walkway data, is a sensitive measure in the characterization of dissimilar patients with chronic hemiparesis due to stroke.DesignWe investigated the relationships between FAP and the type of stroke, patients’ functional disability, and spatial and temporal variables of gait obtained with the pressure sensor system walkway. Gait variables and FAP scores were compared in 25 patients with residual hemiparesis due to stroke and in 31 healthy subjects.ResultsA prolonged swing phase in the affected side and a prolonged stance phase in the nonaffected side were found in patients. Footprint pressure data revealed reduced peak pressure of the affected-side metatarsal area in patients, probably reflecting foot paresis. Higher Barthel Index score and lower Rankin Scale score were reflected in FAP scores.ConclusionsThe FAP scores of patients reflected well their characteristic spatio-temporal gait variations; however, the FAP score seemed a reliable measure of gait normality/abnormality only in rather unhurried gait. Thus, it is useful when a single number is needed.

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:

Wagner AK, Boninger ML, Levy C, Chan L, Gater D, Kirby RL: Peer review: Issues in physical medicine and rehabilitation.Am J Phys Med Rehabil2003;82:790–802.Peer review, although the standard for evaluating scientific research, is not without flaws. Peer reviewers have been shown to be inconsistent and to miss major strengths and deficiencies in studies. Both reviewer and author biases, including conflicts of interest and positive outcome publication biases, are frequent topics of study and debate. Additional concerns have been raised regarding inappropriate authorship and adequate reporting of the ethical process involving human and animal experimentation. Despite these issues, a good peer review can provide positive feedback to authors and improve the quality of research reported in medical journals. This article reviews some issues and points of concern regarding the peer-review process, and it suggests guidelines for new (and established) reviewers in the area of physical medicine and rehabilitation. It also provides suggestions for editorial considerations and improvements in the peer-review process for physical medicine and rehabilitation research journals.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Winslow C, Rozovsky J: Effect of spinal cord injury on the respiratory system.Am J Phys Med Rehabil2003;82:803–814.There are >200,000 persons living with a spinal cord injury in the United States, with approximately 10,000 new cases of traumatic injury per year. Advances in the care of these patients have significantly reduced acute and long-term mortality rates, although life expectancy remains decreased. This article will review the alterations in respiratory mechanics resulting from a spinal cord injury and will examine the contribution of respiratory complications to morbidity and mortality associated with various types of spinal cord injury.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID