ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Accurate, noninvasive testing for deep venous thrombosis (DVT) by conventional methods is often not possible in the rehabilitation patient. Lower extremity amputation, a cast or bandage, or skin problems present obstacles to standard diagnostic methods. This report describes the use of duplex ultrasound (US) scanning for noninvasive diagnosis of DVT in a seventy-year-old man with a below-knee amputation, on whom Doppler and plethysmography examinations could not be performed. As experience is gained with this technique, the use of venography for diagnosis of DVT becomes more difficult to rationalize.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Stroke patients undergoing physical rehabilitation were monitored daily to determine the length of time needed to recover independent function. Of the 93 patients admitted, there were 45 who could not attain the sitting position independently, 75 who could not walk independently and 75 who could not negotiate the stairs independently. By discharge, 25 of 45 patients (55.6%) were able to attain sitting from supine independently, 35 of 75 patients (46.7%) achieved the ability to walk independently but only 25 of 75 patients (33.3%) learned to negotiate stairs independently. The time from admission to achievement of independent function and the time from onset of stroke to achievement of independent function was modeled in relation to explanatory variables: age, sex, side of lesion, comorbidity, the presence of depression and the extent of impairment in perception, cognition, auditory comprehension and verbal expression. Four variables were found to influence recovery time: age influenced the rate of recovery of walking and stair climbing; perceptual impairment influenced the rate of achieving independent sitting and stair climbing; and depression and comprehension influenced walking.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The use of noninvasive alternatives to tracheostomy for ventilatory support have been described in the patient management of various neuromuscular disorders. The use of these techniques for patients with traumatic high level quadriplegia, however, is hampered by the resort to tracheostomy in the acute hospital setting. Twenty traumatic high level quadriplegic patients on intermittent positive pressure ventilation (IPPV) via tracheostomy with little or no ability for unassisted breathing were converted to noninvasive ventilatory support methods and had their tracheostomy sites closed. Four additional patients were ventilated by noninvasive methods without tracheostomy. These methods included the use of body ventilators and the noninvasive intermittent positive airway pressure alternatives of IPPV via the mouth, nose, or custom acrylic strapless oral-nasal interface (SONI). Overnight end-tidal pCO2studies and monitoring of oxyhemoglobin saturation (SaO2) were used to adjust ventilator volumes and to document effective ventilation during sleep. No significant complications have resulted from the use of these methods over a period of 45 patient-years. Elimination of the tracheostomy permitted significant free time by glossopharyngeal breathing for four patients, two of whom had no measurable vital capacity. We conclude that noninvasive ventilatory support alternatives can be effective and deserve further study in this patient population.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The authors review the principle of proportional myoelectric control, in which the motor voltage of a prosthetic hand varies in direct proportion to the EMG signal, giving the amputee control over speed and force of grip. This type of myoelectric control is contrasted with digital myoelectric control, in which the system is fully on or off, giving the amputee no control over speed of hand opening and closing, and the grip force is increased only by increasing the time of the sustained EMG signal. A survey was conducted of 33 patients wearing the proportional myoelectric hand. Patients rated quickness of opening and closing; control over speed and force; effort required to open and close; and comfort, convenience, and cosmesis of the hand; as well as giving it an overall rating in comparison with their previous terminal device. The ratings were made on a 5- level scale, so that they could be quantified. Patient responses were grouped according to previous experience with a terminal device type: group A: digital myoelectric hand; group B: body-powered terminal device; group C: no terminal device. Differences in group means were compared using Student's ftest. Previous digital hand wearers gave significantly higher ratings to the proportionally controlled hand overall, especially for its quickness, control of speed and force, and the effort required to open and close the hand. Former body-powered terminal device wearers rated the proportionally controlled hand significantly better on control over speed and force and on cosmesis. Amputees with no previous terminal device had no basis for comparison but gave the proportionally controlled hand high ratings on control over speed and force, effort for opening and closing, and cosmesis. The former digital hand wearers rated the proportionally controlled hand significantly lower on convenience. This reflected early problems with battery life and reliability. Of the three groups of patients, the former digital hand wearers were most impressed with the proportionally controlled hand, and gave it the highest overall ratings.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This study was designed to investigate the effects of a new product of counterirritant, Eucalyptamint, on the cutaneous circulation and on skin and muscle temperatures. Ten normal subjects (six males and four females, with an average age of 34±6 yr) were involved in this study. Eucalyptamint was applied to the anterior forearm skin of one side, and placebo was applied to the contralateral forearm. The subjective feelings, cutaneous blood flow, and skin temperature were measured before and periodically (5-min intervals) after the application of the compound. Muscle temperature was measured before and 30 min after the application of the Eucalyptamint. There was no significant effect on the subjective sensation. However, there were statistically significant (P< 0.05) increases in cutaneous blood flow (up to 4 times base-line) and skin temperatures (up to 0.8° C higher than base-line) after the application of Eucalyptamint with the effects lasting up to 45 min after the application. The muscle temperature was also increased (0.4°C) significantly (P< 0.05) 30 min after application of the Eucalyptamint. There were no significant changes in the placebo application. The results of this study suggested that the new product of counterirritant, Eucalyptamint, produced significant physiologic responses that may be beneficial for pain relief and/or useful to athletes as a passive form of warm-up.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This study was designed to elucidate the role of different muscles of the posterior compartment of the lower leg in the generation of the surface-recorded H-reflex. H-reflexes were evoked through percutaneous stimulation of the posterior tibial nerve and recorded concurrently, using monopolar electrodes from the soleus (SOL), medial and lateral gastrocnemii (MG and LG), tibialis posterior (TP), flexor digitorum longus (FDL), and flexor hallucis longus (FHL). There were significant (P< 0.01) differences in the amplitudes, latencies, and modified H:M ratios of the responses recorded from the different muscles. The SOL modified H:M ratios were consistently the highest (x= 1.02), while the H:M ratios for MG (x= 0.34) and LG (x= 0.37) were consistently the lowest. Latencies of H-reflexes obtained from proximal recording sites (x= 29.2 ms) were significantly shorter than those from the most distal site (x= 31.5 ms). These results establish the contribution made by various deep and superficial muscles to the conventionally recorded H-reflex and help explain the differences in H-reflex amplitudes and latencies when recordings are made from different sites.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

There are basic principles and techniques of measurement that are relevant across biomedical disciplines. The purpose of this article is to explain some of the most important of these for medical rehabilitation, to illustrate how to use them to choose assessment instruments and to describe the nature of measurement in medical rehabilitation by examples in brain injury rehabilitation. Reliability is basic to any scientific measure. Validity, the ultimate criterion, is closely associated with the purpose of the measure. Content validity, criterion validity and construct validity are explained. Sensitivity to rehabilitative interventions and significance in patients' real lives (ecological validity) are emphasized. Measures of functional outcomes (disability) may show improvement after rehabilitation even when impairment measures do not. An extensive but selected list of measures of coma, global status, disabilities, communicative and cognitive impairments, and handicaps is presented, and their main uses are illustrated. Examples illustrate how to choose measures to study comprehensive program-level outcomes, to study learning-based interventions and to develop a general purpose database. Although there are many measures of activities of daily living and mobility, little published evidence of reliability and validity could be found even for some wellknown scales. Ecologically valid and sensitive outcome measures are especially needed. Studies of the clinical utility of measures were also scarce. Many of these gaps can be spanned by clinical researchers with limited resources. Physical medicine and rehabilitation will benefit from formal studies of the reliabilities and validities of both its old and its new measurement instruments and by increased sophistication in choice of measures.

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1991

数据来源: OVID