ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We previously described the augmentation of sensory nerve action potential amplitudes after near and remote isometric muscle contraction. In this study, we wished to determine if the sensory cortex was involved in this process. In this prospective, intrinsically controlled study, we studied threshold somatosensory evoked potentials in 12 normal subjects with stimulation of the median nerve at 5.1 Hz. The subjects were tested during the following conditions: baseline, 25%, and 75% maximum isometric abductor digiti minimi contraction for 4 min. Each of these conditions was recorded before, during, and 4 min and 8 min after contraction. Results showed that at 25% contraction, there was a significant temporal increase in N9 amplitude (2.1-2.6 μV;P= 0.05, analysis of variance, repeated measures) and a decrease in N20 amplitude with 75% contraction (1.9-1.6 μV;P= 0.03, analysis of variance, repeated measure). No significant changes were noted in the spinal cord or brainstem recordings. In conclusion, it appears that augmentation of the brachial plexus peripheral nervous system recording occurs concurrently with central inhibitory gating. The possibility of peripheral nervous system adaptability will be discussed.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In-line skating, also known as rollerblading, has become popular as a recreational activity as well as a mode of transportation. Increased participation has been accompanied with a marked rise in major and minor injuries. The objective of this study was to survey active in-line skaters and to describe their demographic features, formal training, protective gear used, and a history of incurred injuries. A questionnaire was distributed to randomly selected in-line skaters in a large public park in New York City. Of the 223 skaters who responded, 128 were male and 95 were female. Ages ranged from 12 to 64 (mean, 29) yr. Some kind of injury was reported by 87 (39%) of the participants. The majority of those injuries occurred when the skaters were beginners (46). Skin abrasions and musculoligamentous injuries were the most common. Only 15 (17.2%) sought medical treatment, and of these, 5 were treated for fractures: 3 at the wrist and 1 each at the ankle and knee. The knee was the most commonly injured part of the body (24.7%), followed by the elbow and wrist. Approximately 5% of all injuries involved the head. Many skaters did not wear helmets or knee pads, even though they owned this equipment. There was a strong preference for wearing wrist pads, either alone or with other protective gear. This suggests that skaters have learned that the wrist is particularly vulnerable to serious injury and should be protected.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Many disorders affect the trigeminal nerve, highlighting the need for electrodiagnostic methods to evaluate this cranial nerve. The purpose of this study was to develop and refine clinical nerve conduction techniques for examining mylohyoid late responses and to establish normative clinical data. Intraoral stimulation of the mylohyoid nerve was performed on normal volunteers using a pediatric stimulator taped to a tongue depressor. Mylohyoid direct and late responses were recorded with surface electrodes over the mylohyoid muscles. Mylohyoid late responses with supraorbital nerve stimulation and blink reflexes were also elicited. Fifty-four subjects, 65% females, with an average age of 39.2 (standard deviation, 13.4) yr, were studied. Direct mylohyoid responses were elicited in all subjects with a mean of 1.8 (standard deviation, 0.3) ms and amplitude of 4.1 (standard deviation, 1.4) mV. Late responses occurred in 94% ipsilaterally at an average latency of 32.4 (standard deviation, 6.5) ms and in 90% contralaterally at 32.4 (standard deviation, 5.6) ms. Two distinct late responses, the second occurring at an average of 72.3 (standard deviation, 12.4) ms with intraoral stimulation were noted in 25% of subjects. Only 11% of subjects had mylohyoid late responses with supraorbital stimulation. Blink (R1) reflexes occurred in 89% (10.9 ms; standard deviation, 0.7 ms), ipsilateral R2 responses in 88% (35.2 ms; standard deviation, 3.4 ms), and contralateral R2 responses in 69% (36.2 ms; standard deviation, 4.0 ms). Mylohyoid late responses are present in most normal subjects. The neuroanatomical pathways mediating these responses require delineation. These nerve conduction techniques may be useful in evaluating patients with suspected trigeminal nerve disorders.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

To evaluate the influence of time on the quality of life of hemiplegic stroke patients living at home, we analyzed a sample of 45 outpatients. The sample was divided into two groups, according to the delay between the discharge time from hospital and the assessment (Group 1, fewer than 6 mo; Group 2, more than 6 mo after discharge). We hypothesized that patients in Group 2 would have a lower level of quality of life than patients in Group 1. Disability was assessed with the Functional Independence Measure, and the quality of life was assessed with the Reintegration to Normal Living Index. Both groups were comparable with regard to demographic and stroke characteristics. There was no statistically significant difference in Functional Independence Measure scores (global and subscales). Reintegration to Normal Living Index-perception of self subscale scores were significantly lower in Group 2. At the item level, quality of life scores were also significantly lower in Group 2 for indoor mobility (Mann-WhitneyUtest;P= 0.001), self-care needs (P= 0.005), personal relationships (P= 0.02), and the handling of life events (P= 0.05). These results confirm our hypothesis and suggest that quality of life may deteriorate in some domains over time, even when the disability level is unchanged, but these results need to be replicated in prospective studies with larger samples of stroke survivors.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In many healthy subjects, sensory thresholds for touch using Semmes-Weinstein monofilaments appear to be higher than the 2.83 filament, which some authors have suggested as a screening instrument. The currently proposed normal values, the interpretation of results, as well as the calibration of the filaments are questioned. A normative study of 20 normal subjects using Semmes-Weinstein monofilaments was undertaken at a pain clinic in a university hospital. The main outcome measures were sensory thresholds (touch) in dermatomes C3 to C8. Per subject, 24 sites were tested and 50 sites in dermatome C5 left of one subject. The threshold distribution patterns were analyzed. The mean threshold expressed in log (10 ×F;withF= force in milligrams) of all sites (n= 480) in normal subjects was 3.10 (95% confidence interval, 2.34-3.86). The mean threshold per subject was 3.10 (range, 2.70-3.50). The mean threshold of 50 sites in dermatome C5 left of one healthy subject was 3.22 (range, 2.42-4.02). In the study contained herein, sensory thresholds in the cervical dermatomes have been shown to be higher than the generally proposed normal values. The cervical dermatomes show thresholds from 0.13 to 8.47 mN. This concurs with other authors. Results depend on the testing method, which in this study was different from previous studies. The testing method must be described accurately. The distribution of thresholds within all tested sites, dermatomes, subjects, or even within one dermatome in one subject are comparable. Individual results have to be related to the mean of the subject to determine abnormality. Calibration of the monofilaments is important. When these terms are met, testing with Semmes-Weinstein monofilaments is an easy, reliable, and relatively inexpensive method of quantitative sensory testing and can be a useful tool in the process of rehabilitation.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Cervical traction is administered by various techniques ranging from supine mechanical motorized cervical traction to seated cervical traction using an over-the-door pulley support with attached weights. Duration of cervical traction can range from a few minutes to 20 to 30 min, once or twice weekly to several times per day. Anecdotal evidence suggests efficacy and safety, but there is no documentation of efficacy of cervical traction beyond short-term pain reduction. Because of a clinical impression that a simplified, inexpensive, over-the-door home cervical traction method of treatment requiring 5 min of cervical traction twice daily was efficacious for both cervical pain and radiculopathic syndromes, we undertook a retrospective study of 58 outpatients treated between 1994 and 1996. Age range was 29 to 84 (mean, 56) yr. Twenty-three males and 35 females were classified as Grade 1 to Grade 3 according to the Quebec Task Force of Whiplash-Associated Disorders Cohort Study. Outcomes were as follows: Grade 1 (mild)-4 of 4 (100%) patients improved; Grade 2 (moderate)-34 of 44 (77%) patients improved (P< 0.01), 5 were unchanged, and 5 felt their symptoms were aggravated by cervical traction; Grade 3 (patients with radiculopathy)-9 of 10 (90%) patients improved (P< 0.01). In a retrospective study, a brief (3-5 min), over-the-door home cervical traction modality provided symptomatic relief in 81% of the patients with mild to moderately severe (Grade 3) cervical spondylosis syndromes. Prospective, randomized assessment of cervical traction for this and other methods is needed.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The purpose of the study contained herein was to investigate the effects of old traditional physiotherapeutic treatments on cerebral autoregulation. Treatment consisted of complete body immersion in cold or warm water baths. Fifteen volunteers were investigated by means of transcranial Doppler sonography and a servo-controlled noninvasive device for blood pressure measuring. One group of 8 volunteers (mean age, 27.2 ± 3.5 yr; gender, 3 females/5 males) was subjected to cold baths of 22°C for 20 min Another group of 7 volunteers (mean age, 52.1 ± 8.5 yr; gender, 4 females/3 males) took hyperthermic baths at rising water temperatures from 36° to 42°C, increased by 1°C every 5 min. Each volunteer in both groups underwent autoregulation tests two to four times before, during, and after the thermic bath. Dynamic autoregulation was measured by the response of cerebral blood flow velocity to a transient decrease of the mean arterial blood pressure, induced by rapid deflation of thigh cuffs. The autoregulation index, i.e., a measure of the speed of change of cerebral autoregulation, was used to quantify the response. Further parameters were core temperature, blood pressure (mm Hg) and CO2et. During hypothermic baths, core temperature decreased by 0.3°C (P= 0.001), measured between preliminary phase and the end of the bath; the autoregulation index decreased significantly (P< 0.05) from 5.3 before the bath to 4.25 during the bath. During hyperthermic baths, the autoregulation index increased from 6.0 to 7.5 and 8.9 (P< 0.001), with an increase of core temperature of 0.4°C. The main cerebral autoregulation system is dependent on changes of core temperature, provoked by hypothermic or hyperthermic whole-body thermostimulus. Application of hyperthermic baths increased the autoregulation index, and hypothermic baths decreased the autoregulation index. Further studies are needed to prove the positive effects of thermo-stimulating water applications on cerebral hemodynamics in patients with cerebral diseases.

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1999

数据来源: OVID