ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTThe vertical displacement of the sacrum during walking is proposed as an estimation of the overall biomechanical performance of walking, independent of cardiopulmonary factors. Vertical sacral displacement during walking was measured using an optoelectronic motion analysis system in 10 normal volunteers at variable speeds. Oxygen consumption was simultaneously measured. The actual vertical displacement of the sacrum, when correlated with body weight, reliably predicted oxygen consumption (r2= 0.91). The relationship between vertical sacral displacement and oxygen consumption persisted when controlling for the variables, velocity, square of velocity, cadence or stride length, each known to co-vary with cardiopulmonary performance. A mathematic model designed to predict the vertical displacement of the sacrum, based on sacral height and average stride length, was tested. The actual vertical sacral displacement correlated with predicted displacement (r= 0.94). Unilateral immobilization of each subject's knee resulted in a greater average vertical sacral displacement during gait than predicted. Comparing measured with predicted vertical sacral displacement may provide a clinically useful and specific overallassessment of biomechanical gait performance.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTThis study examined the comparability of estimates of functional status elicited through a telephone interview and a face-to-face interview. The Barthel Index, a commonly used measure to assess activities of daily living, was administered over the telephone and then again in the home to 366 individuals, up to 5 yr after their discharge from a rehabilitation hospital. One-half of the telephone interviews were performed by health professionals and the other half by trained lay interviewers; all of the home interviews were performed by health professionals. Proxy-respondents provided information for those unable to respond for themselves. The percent agreement between the scores on the telephone and on the home interview was always greater than 90%; the intraclass correlation coefficient for the telephone/home comparison was 0.89. Responses between the modes of interview were more consistent when provided by self-respondents than when provided by proxies. The telephone assessment worked well in identifying those who did not have functional disabilities; all individuals who scored 100 on the home interview, scored 95 or better on the telephone. When differences arose, they were always in those considered to have moderate to severe impairment and were most often (23 of 29 times) in the direction of higher scores, indicative of less disability, on the telephone. The results of this study suggest that, with the exception of a small subgroup of patients, functional status can be elicited reliably over the telephone by both lay persons and health professionals.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTCardiorespiratory function and exercise tolerance appear very limited in persons with rheumatoid arthritis (RA). Many studies have demonstrated that aerobic exercise training is beneficial to prevent physical deconditioning without inducing adverse effects on an individual's joints and general health. The present study was conducted to demonstrate that a dance-based exercise program is a safe and efficient activity to improve physical fitness and psychological state in persons with RA. A group of 19 persons (mean age, 49.3 ± 13 yr) participated in a 12-wk exercise program (twice weekly), whereas 10 persons (mean age, 49.4 ± 12 yr) served as controls. Health status, use of medication, joint pain and swelling, physical fitness, activity of daily living and psychological state were assessed at baseline, after the 12-wk training program and 6 mo after the end of the program. Exercise training induced a mean improvement of 13% in aerobic power, with the highest values reaching 40%. No significant changes were observed in joint status, even though the count of painful joints tended to decrease in the exercise group. Positive changes in depression, anxiety, fatigue and tension were observed after the 12-wk exercise program. These findings provide some evidences in favor of aerobic exercise in individuals with RA. Furthermore, it is of primary interest to note that a weight-bearing activity with limited ground impacts do not provoke short-term adverse effects on joint status. Further studies, however, are required to determine the long-term effect of weight-bearing exercise on the health status of individuals with RA.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTThis study sought to evaluate the timing of burn-associated polyneuropathy (BAPN) and its relationship to burn severity or size. Seventeen burned subjects were studied 1 wk after thermal burns. Eleven subjects remained in the study to complete 6-wk follow-up studies. Nerve conduction studies were done on at least three nerves in two unburned limbs; results were numerically summarized by calculatingZscores for each parameter. A compositeZscore, termedZtotal, measured global nerve function. One week postburn, motor and sensory distal latencies were prolonged (meanZ, −0.72 and −0.85, respectively), motor conduction velocities slowed (meanZ, −1.31) and sensory nerve action potentials reduced in amplitude (meanZ, −0.66). Associations ofZtotalscores with total burn surface area and depth were not statistically significant. Those with severe neuropathy had higher levels of c-reactive protein (Spearman correlation, −0.624;P= 0.0129). There were no significant changes inZscores at 6 wk. We conclude that BAPN is common after thermal injury, and the electrophysiologic manifestations of BAPN are present within the first week. Thermal injuries may induce an inflammatory cascade that results in alterations of nerve function.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTTo ascertain the patients' perception of the consequences of elbow flexion contractures and better understand the circumstances at their inception, we surveyed 405 spinal muscular atrophy and congenital myopathy patients. Diagrams of various elbow angles and questions concerning the effect of elbow contractures on daily activities were part of the survey. Of 108 completed responses, effectively a 24% response rate, 49 reported elbow flexion contractures. Thirteen of the 49 patients reported first noting them during extended periods of inactivity. Elbow flexion contractures greater than 25° were intractable and were reported to hamper 17% (77 of 410) of specifically considered daily activities for the 49 subjects. Twenty-nine of the 49 (59%) subjects with contractures complained of contracture-associated hindrance of at least one daily function. Perceived contracture-associated difficulties increased significantly as a function of contracture severity. Elbow contractures were perceived to be useful by 12% of the respondents. The correlation between contracture severity and upper limb discomfort was also striking. We conclude that elbow flexion contractures are common and perceived to be associated with disability and discomfort for about one-half of spinal muscular atrophy and congenital myopathy patients.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTSubstance P is thought to be the principle neurotransmitter of nociceptive impulses in type C sensory neurons. Prolonged repeated applications of capsaicin cream depletes the sensory C-fibers of substance P. In an open-labeled prospective pilot study, 23 patients with chronic neck pain (greater than 3 mo) completed the study. Patients applied topical capsaicin (0.025%) cream four times a day to painful areas in the neck and shoulder girdle for a 5-wk treatment period. One patient dropped out because of intolerable burning. Statistically significant improvement was obtained in two primary outcome variables, the visual analog pain scale (P= 0.00013) and the pain relief scale (P= 0.002). Paired f tests failed to show a significant improvement in the McGill Pain Questionnaire. This study demonstrated that topically applied capsaicin cream may decrease subjective neck pain. A double-blind, placebo-controlled trial is needed to confirm this treatment effect.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTMeasuring functional activity for elderly at very low functional levels remains a challenge because many functional instruments have not been standardized in a frail elderly population. The Frail Elderly Functional Assessment questionnaire (FEFA) is a 19-item, interviewer-administered questionnaire designed to assess function in frail elderly at a very low activity level. The purpose of this study was to determine the reliability and validity of this instrument in a frail elderly population. Two groups of subjects over 65 yr old were selected to test the reliability and validity of this questionnaire. Test-retest reliability was determined by correlating the responses of 29 homebound (including nursing home-bound) subjects who answered the questionnaire on two occasions 2 wk apart. To assess the validity of the FEFA, the questionnaire was administered to 23 frail, homebound (including nursing home-bound) elderly subjects who had a Mini-Mental State Examination score of ≥18. Validity was determined by correlating patient responses to direct observations by the investigators of tasks addressed in the questionnaire. Correlation was also determined against the Katz's Activity of Daily Living index, Lawton's Instrumental Activity of Daily Living index, and the Barthel index. The reliability coefficient was 0.82. Correlation between the FEFA questionnaire and direct observation of questionnaire task performance was 0.90. Construct validity against the Katz's Activity of Daily Living, Lawton's Instrumental Activity of Daily Living, and the Barthel index showed correlations of 0.86, 0.67 and 0.91, respectively. Initial data indicate that the FEFA is a valid and reliable instrument that may be useful in assessing function in frail elderly people.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTThe ability to exercise among 20 people with chronic renal failure was assessed on three tests by measuring the distance walked in 6 min, heart rate change from pre-exercise to postexercise and perceived exertion. Test 1 was conducted to minimize practice effects. Ten participants received exercise coaching for 3 mo between Tests 2 and 3, and 10 individuals were in a control group. Distance walked was highly correlated on the three tests; heart rate change and perceived exertion were only slightly less consistent. Three people changed their perceived exertion by more than one point between Tests 2 and 3, and these changes obscured differences between the exercise and control groups. Exclusion of data for those who changed by more than one point equalized perceived exertion changes in the two groups and revealed a significant (P< 0.05) increase in distance in the exercise group (+21.8 m) but not in the control group (+1.5 m). The study demonstrates that, although perceived exertion ratings are intended for use in incremental exercise testing, they are also valuable for assessing consistencyvchange in the effort of individual participants in single-intensity testing, such as a self-paced walk.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ABSTRACTLumbosacral pain is a significant complaint in approximately one-half of all pregnancies. In 15%, the pain can be disabling. Although the mechanical and positional stresses of pregnancy have been cited as the primary source of this discomfort, in approximately 1:10,000 cases a herniated lumbar disc (HNP) can be identified as the proximal cause of pain. A 35-yr-old G4AB3PO patient presenting at 10 wk of pregnancy with severe incapacitating lumbar radiculopathy is described. Magnetic resonance imaging, selected by the patient as a diagnostic option, demonstrated a clinically suspected large midline HNP at the L5-S1 level. In the past, visualizing the presence of a HNP during pregnancy by either computerized axial tomography scan or myelography has exposed the fetus to ionizing radiation. However, magnetic resonance imaging now permits a more detailed evaluation without similar x-ray exposure. To date, no recognized biologic effect of MRI on the developing fetus has been reported. Although the long-term effects of an magnetic resonance imaging on the developing fetus have not been conclusively evaluated, its potential for accurate diagnosis and subsequent patient management, as well as planning the delivery, appears to outweigh any recognized hazard to the developing fetus.

ISSN:0894-9115    

出版商:OVID    

年代:1995

数据来源: OVID