ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Whyte J, Rose T, Glenn MB, Gutowski W, Wroblewski B, Reger J: Quantification of attention‐related behaviors in individuals with traumatic brain injury: a pilot study.Am J Phys Med Rehabil1994;73:2‐9Clinical disorders of attention are common after traumatic brain injury but objective measures of their nature and severity are lacking. We developed a standardized independent work task to be performed by patients in a controlled, distracting environment. Videotaped records of patient behavior were made and coded in 15‐s intervals for on‐task behavior, presence of distractors and presence of extraneous motor behavior. Interrater reliability was good to excellent across eleven testing sessions involving four patients. This evaluation system revealed clinically important differences in on‐task behavior among the four patients, as well as different levels of distraction in response to external stimuli. It also showed effects of different tasks and repeated sessions. These data indicate that this evaluation system and accompanying coding process are reliable and provide preliminary evidence that they produce clinically valid results.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Joyce BM, Rockwood KJ, Mate‐Kole CC: Use of goal attainment scaling in brain injury in a rehabilitation hospital.Am J Phys Med Rehabil1994;73:10‐14We report a study of the measurement properties of goal attainment (GA) scaling when used in the rehabilitation of brain injury patients. GA scaling is an individualized measurement technique with mathematical properties allowing for calculation of summary scores with a normal distribution. The present study examined 16 inpatients, 13 of whom had suffered a traumatic brain injury. In addition to GA scaling, standardized measures were employed to address issues such as content validity and construct validity. GA scaling change scores correlated highly (r= 0.81) with clinical judgment of efficacy and modestly with standard performance measures. A high level of inter‐rater reliability was found between admission (r= 0.92) and discharge (r= 0.94) scores. GA scaling seems to be a feasible method of evaluating rehabilitation in brain injury patients, with promising measurement properties. The goals set are extremely meaningful to the patient and rehabilitation team, providing valuable feedback throughout the rehabilitation course.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Little JW, Powers RK, Michelson P, Moore D, Robinson LR, Goldstein B: Electrodiagnosis of upper limb weakness in acute quadriplegia.Am J Phys Med Rehabil1994;73:15‐22Clinical and neuropathologic observations after cervical spinal cord injury suggest varying involvement of gray and white matter. The resulting upper limb weakness may reflect varying degrees of upper motoneuron (UMN) and/or lower motoneuron (LMN) involvement. This study uses electrophysiologic measures, including compound muscle action potential (M response) amplitude, root mean square (RMS) of the surface electromyographic activity during voluntary muscle contractions and the firing rate of motor units, to distinguish UMN and LMN weakness in upper extremities after acute quadriplegia.M response amplitude did not correlate with strength; many muscles had large M responses given their strength. These muscles manifest: (1) high M/RMS ratios (ratio of electrically elicited to voluntarily recruited electromyographic activity) and (2) slow firing rates of single motor units during maximal isometric contractions. For muscles with normal M amplitudes, M/RMS ratio correlates inversely with strength. For muscles with normal M/RMS ratios, M amplitude correlates positively with strength. Cluster analysis was used to distinguish UMN, LMN or Mixed types of weakness. Distinguishing these different types of weakness in acute quadriplegia may allow individualized rehabilitation for the type of weakness present.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Wong KN, Hills EC, Strax TE: Rotating stations: an innovative approach to third‐year medical student education in physical medicine and rehabilitation.Am J Phys Med Rehabil1994;73:23‐26Education of medical students is an important component of physical medicine and rehabilitation training programs. A one‐day combined lectures/rotating stations conference was designed to introduce physical medicine and rehabilitation to third year medical students during the academic years 1991 through 1993. Pre‐ and post‐testing allowed objective measurement of student knowledge of physical medicine and rehabilitation. The lectures and rotating stations were evaluated, and the feedback was used to improve subsequent conferences. Preand post‐tests indicated increased student knowledge, and interest in physical medicine and rehabilitation doubled in each class that participated. This instructional method increases third year medical student exposure to physical medicine and rehabilitation in a cost‐effective and efficient manner.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Tate D, Kirsch N, Maynard F, Peterson C, Forchheimer M, Roller A, Hansen N: Coping with the late effects: differences between depressed and nondepressed polio survivors.Am J Phys Med Rehabil1994;73:27‐35This study examined differences between depressed and nondepressed individuals with a history of paralytic poliomyelitis in terms of demographics, health status and coping strategies. The prevalence of distress and depression in this group of 116 polio survivors was determined. Subjects completed the Brief Symptom Inventory, the Coping with Disability Inventory and a questionnaire concerning their polio histories and self‐perceptions of health. Medical assessments were performed by physicians. Only 15.8% of the sample had scores indicating depression and elevated distress. Depressed/distressed polio survivors were more likely to: be living alone, be experiencing further health status deterioration, seek professional help, view their health as poor, report greater pain, be less satisfied with their occupational status and their lives in general and exhibit poorer coping outcome behaviors in relation to their disability. Three factors in coping with the late effects of polio were identified through a factor analysis of the Coping with Disability Inventory: positive self‐acceptance, information seeking/sharing about the disability and social activism. Differences between depressed/distressed and other polio survivors were found across these three factors, with depressed/distressed subjects having significantly lower coping scores. These and other results are discussed.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Catz A, Ron S, Solzi P, Korczyn AD: The vestibulo‐ocular reflex and dysequilibrium after hemispheric stroke.Am J Phys Med Rehabil1994;73:36‐39Patients with hemispheric lesions frequently suffer from equilibrium impairment that may be prolonged and may interfere with rehabilitation. In an effort to clarify whether this phenomenon is related to vestibular dysfunction, we examined the relationship of the horizontal vestibulo‐ocular reflex (VOR) with stability in 15 patients with unilateral hemispheric stroke. The study included electro‐oculographic recording of the VOR while the patients were rotated in a vestibular chair. Stability was scored in accordance with the patients' ability to maintain equilibrium in six graded positions. The findings demonstrated relationship between VOR gain (eye/head displacement) and equilibrium. It is suggested that the “loss of balance” after stroke may be related to an impairment of the corticovestibular modulation of the vestibular function.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

&NA;Bunch WH, Dvonch VM: The “value” of various functional independence scores.Am J Phys Med Rehabil1994;73:40‐43Functional independence measure (FIM) scores are frequently used as if the various sections are of equal importance and as if the interval between each score is equal. We tested this hypothesis by using marketing research techniques to assess the value to rehabilitation nurses and therapists of four of the six sections. Communication was valued more highly than continence, mobility and self care in that order. The interval between the scores is not equal, with difference between a FIM 2 and 3 being greater than between a FIM 5 and 6. However, when the other difficulties such as interexaminer reliability are considered, these score differences are not great. We concluded that for practical purposes FIM scores may be used as if they were of equal interval spacing, and the scores of the various sections may be added together.

ISSN:0894-9115    

出版商:OVID    

年代:1994

数据来源: OVID