ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A goal of many physiatric interventions is to improve biomechanical walking efficiency. Thus, a tool that helps assess this efficiency, independent of cardiac, pulmonary, psychologic, or other nonbiomechanical factors, would be useful. Currently used methods to measure efficiency, including comfortable walking speed, are not specific to biomechanical variables. A potential tool, the biomechanical efficiency quotient (BEQ), which uses three variables-average stride length, vertical displacement of the trunk during walking, and sacral height during standing-is proposed and preliminarily tested. This quotient is based on Saunders, Inman, and Eberhart's theories and on a prior study in able-bodied subjects. The BEQ was computed in 20 consecutive patients with neurologically based gait disability referred for gait laboratory evaluation who subjectively reported that one or two ankle-foot-orthoses (AFOs) reduced the effort necessary to walk. The quotient was calculated with and without the AFO(s) by dividing the average vertical displacement of the sacrum, which was measured with an optoelectronic system, and by a predicted displacement, which was based on the patient's sacral height and average stride length. The mean BEQ with the AFO(s) (6.3 ± 4.4) was significantly less than the mean BEQ without the AFO(s) (9.7 ± 7.1);P= 0.005. Furthermore, the BEQ was less with the AFO(s) compared with trials without the AFO(s) in all subjects. Percent change in BEQ with the AFO(s) (26.8 ± 19.6) correlated with percent change in comfortable walking velocity (24.8 ± 31.8),r= 0.73,P< 0.001, across all subjects. The BEQ may be useful in specifically assessing the effect on biomechanical efficiency of physiatric interventions, despite variable nonbiomechanical factors. An instrument to measure vertical trunk displacement during walking outside of the gait laboratory would be extremely useful for further necessary longitudinal studies.

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study compared the Functional Independence Measure (FIM) scores of traumatic (n= 12) and vascular (n= 12) unilateral lower limb amputees at admission and discharge from a rehabilitation facility. FIM scores that were measured were amputation FIM subscores and total FIM scores. Comorbidity indexes were developed to weight the stump condition and comorbidities seen in both groups. The vascular group was significantly (P< 0.01) older and had significantly (P< 0.01) greater stump comorbidity, but there was no significant difference with respect to length of stay, medical comorbidity score, and amputation and total FIM scores both at admission and discharge between the two groups. Medical comorbidity was significantly (P< 0.05) correlated with amputation and total FIM scores at discharge for traumatic amputees withr= -0.64 andr= -0.66, respectively. Stump comorbidity was significantly (P< 0.05) correlated with total FIM at discharge withr= -0.64 for vascular amputees. Medical comorbidity was a good predictor of discharge FIM scores for traumatic amputees, whereas stump comorbidity predicted discharge FIM scores for vascular amputees, although not as well. In conclusion, inpatient traumatic amputees may be younger than vascular amputees, but traumatic amputees may not necessarily be healthier or do better functionally at discharge than vascular amputees.

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Fine wire (FW) intramuscular electrodes and spectral analysis have not previously been used to quantify metabolic muscle fatigue in deep muscles not accessible with surface electrodes. This study compares initial median frequency (IMF) and decline in median frequency with fatigue (SLOPE) using surface and FW electrodes. Eighteen men performed isometric biceps contractions for 100 s. Electromyographic signals were collected using FW and surface electrodes. The recordings of SLOPE was greater with FW (-0.44v-0.23%IMF/s) and IMF was higher (195v69 Hz). Intrasession reliability for slope was better with FW electrode (intraclass correlation coefficient (ICC) = 0.74;P< 0.0001) than with the surface electrode (ICC = 0.43;P= 0.006), but intersession reliability was best with the surface electrode (ICC = 0.50;P= 0.03). Spectral analysis using FW electrodes provides earlier detection of muscle fatigue and can be used in deep muscles, but the reliability must be improved before clinical application.

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Physical exercise is often recommended as a therapeutic tool to combat pre- and postmenopausal loss of bone density. However, the relationship between training dosage (intensity, duration, frequency) and the effect on bone density still is undergoing discussion. Furthermore, the exercise quantification programs are often described so inadequately that they are neither quantitatively nor qualitatively reproducible. The aim of this investigation was to determine whether a clearly defined training of muscle strength, under defined safety aspects, performed only twice weekly, can counteract bone density loss in women with postmenopausal osteopenia. Data from 16 women in the training group (age, 63.6 ± 6.2 yr) and 15 women in the control group (age, 67.4 ± 9.7 yr), of comparable height and weight, were evaluated. Strength training was performed for 6 mo as continually adapted strength training, providing an intensity of about 70% of each test person's one repetition maximum. Bone mineral density of lumbar vertebrae 2 to 4 and the femoral neck was measured by dual-energy x-ray absorptiometry. Maximum performance in watts and parameters of hemodynamics were controlled with a bicycle ergometer test to maximal effort. In addition, metabolic data were assessed. In the lumbar spine and femoral neck, the training group showed no significant changes, whereas the control group demonstrated a significant loss of bone mineral density, especially in the femoral neck (P< 0.05). The strength increase was highly significant in all exercised muscle groups, rising to about 70% above the pretraining status (P< 0.001). Heart rate and blood pressure data indicated a slight economization, and metabolism was not significantly influenced. Based on these findings, we conclude that continually adapted strength training is an effective, safe, reproducible, and adaptable method of therapeutic strength training, following only two exercise sessions per week.

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Spinal cord-injured (SCI) patients are at increased risk for fractures secondary to neurogenic osteoporosis. Earlier research claimed physical conditioning resulted in a decreased incidence or reversal of neurogenic osteoporosis. This study evaluated the effects of functional electrical stimulation-induced lower extremity cycling (FESILEC) on the bone densities of SCI patients using dual-energy x-ray absorptiometry (DEXA). The study consisted of 12 healthy male SCI patients, aged 23 to 46 (x ± SD, 34 ± 6) yr. The patients were post-traumatic, complete, spastic SCI; time postinjury ranged from 2 to 19 (9.7 ± 5.1) yr. Patients participated in a three-phase training program. Phase 1 consisted of quadriceps strengthening. Phase 2 consisted of progressive sequential stimulation of quadriceps, hamstrings, and gluteal muscles, achieving a rhythmical pedaling motion on the REGYS I ergometer. Phase 3a consisted of 30-min FESILEC sessions. DEXAs were done at baseline and at completion of Phase 3a and Phase 3b. Bone densities were done of the lumbar spine levels 2-4 (L2-4), bilateral trochanters (T), Ward's triangles (WT), and femoral necks (FN). Baseline bone density indicated no difference between L2-4 of ambulatory males and SCI males. Baseline values obtained for T, WT, and FN were, respectively, 71, 82, and 79% of ambulatory values. Results after completion of the Phase 3a training program indicated no statistically significant difference compared with baseline values. There was, however, a positive trend in the lumbar spine post-Phase 3a (L2-4,P= 0.056). Eight patients continued the exercise program, using a combination of upper and lower extremity cycling (Phase 3b) for a longer period of time (25 ± 9 wk). DEXAs done after Phase 3b indicated no change relative to baseline data or data post-Phase 3a. In conclusion, although FESILEC did not significantly increase bone density in the hip parameters of chronic SCI patients, a positive trend was observed in the lumbar spine. Further research with acute intervention, such as FESILEC during the first few months post-SCI, is warranted to further evaluate a treatment regimen to prevent or reduce neurogenic osteopenia.

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Posterior interosseous nerve conduction was studied by a new method consisting of two different techniques in 40 controls. The motor latency of the brachioradialis and extensor carpi ulnaris was compared after stimulation of the radial nerve, either at the axilla or above the elbow. The nerve branches of the brachioradialis never cross the radial tunnel, whereas those of the extensor carpi ulnaris always cross the radial tunnel. The recording was performed with a coaxial needle electrode after percutaneous axillary stimulation and with surface electrodes after near-the-nerve elbow stimulation. The mean brachioradialis/extensor carpi ulnaris latency difference was 1.3 ms and represented the posterior interosseous nerve conduction in the radial tunnel. Identical values were obtained with both techniques, but the inter- and intraindividual variability was less marked with the elbow technique. Overall, the right/left comparison provided the best diagnostic data because of a normal range limited to only 0.4 ms after elbow stimulation.

ISSN:0894-9115    

出版商:OVID    

年代:1996

数据来源: OVID