ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Motor unit action potential (MUAP) measurement parameters are reported to be affected by the type of needle electrode. MUAP amplitude measured with monopolar electrodes has been reported to be up to twice the amplitude recorded with concentric electrodes. We hypothesized that with current technology the difference in recordings from the two needles should be minimal and of little clinical significance. The right extensor digitorum communis muscle was examined in 15 healthy volunteers with first a concentric and then a monopolar needle. The filter band-pass of the electromyograph was 20 Hz to 10 kHz. Four first-recruited MUAPs were isolated by using each electrode. A separate muscle insertion was performed to locate each potential. Amplitudes were maximized. Consecutive MUAPs were averaged and measured. The mean (± SD) values of the measurements were as follows: amplitude: monopolar, 1038 (±369) iiW; concentric, 912 (±315) iiW; duration: monopolar, 10.8 (±2.0) ms; concentric, 9.7 (± 1.7) ms. No statistically or clinically significant differences exist between these measurement values.

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Traditional univariate comparisons of nerve conduction data against standard norms may produce conflicting estimates of the presence or absence of a diabetic neuropathy, depending upon the data obtained and the specific nerves sampled. Alternatively, a multivariate analytic approach, using discriminant functions, provides a useful single measure of the degree of neuropathy determined as a weighted combination of the available data. The weights are derived from the linear discriminant function, which maximizes statistical separation of diabetic and nondiabetic subject groups.In this study, 12 electrophysiologic attributes are used to generate a single discriminant function that clearly separates diabetic from nondiabetic subjects and is interpretable as a neuropathic index. Each individual's index of diabetic neuropathy (I) can be quantified as follows:where Ar is the original electrophysiologic attribute (i=12), a1is the coefficient for each attribute that defines the discriminant function and C is a constant specific for that function.For the first time, the degree of diabetic neuropathy can thus be quantified for purposes of comparison and correlation with other quantifiable clinical/ somatic measures of diabetes. The index allows for a higher percentage of type II diabetic patients to be classified as neuropathic than previously described and enables determination of degree of neuropathy in affected individuals by an interpolative method.

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This presentation will review academic programs and discuss the pros and cons of academic practice. The role of the academic physiatrist in the future and the requirements for improving academic programs will be addressed.Like any other medical specialty, the viability of physical medicine and rehabilitation depends on its acceptance as an academic discipline. In recent years, there has been a number of positive indicators for strenghtening academic physiatry including: increased educational exposure to medical students, increased number of residency programs and percentage filled and increased emphasis on research activities.Academic practice of physiatry should appeal to the individual with the following goals in life: (1) increase involvement in scholarly activities; (2) be on the cutting edge of new techniques and concepts of practice; (3) become a recognized expert in subspecialization areas; (4) vary practice more evenly between direct and indirect patient care activities; (5) work in an intellectually stimulating environment but with some constraint on one's destiny; (6) obtain adequate but not high financial rewards supplemented by a high benefit package; and (7) make a significant impact on the future of physical medicine and rehabilitation at the national level.Because academic physiatry will significantly influence the determination of what is rehabilitation and who will practice it, we must strive to improve the quantity and quality of academic programs. Areas especially needing attention are research and education to establish the scientific basis of the field and to train qualified personnel. To meet these goals, high quality clinical and scholarly programs with subspecialization, an adequate financial base and good marketing program will be necessary.

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Agitated behavior is exhibited in up to 30% of patients recovering from a traumatic brain injury. Past treatment protocols have included proactive behavioral management and major tranquilizers. We now report the use of amitriptyline for control of agitation. For a period of over 2 years, 43 male and 15 female patients with a “recent” severe brain injury were admitted for inpatient rehabilitation and subjected to traditional structured programming for treatment of post-traumatic amnesia (PTA). In 20 patients, 18 men and 2 women, where agitation persisted sufficiently to impede rehabilitation despite initiation of structure, amitriptyline was instituted. These patients were of a comparable age (29.4 years for the agitated group versus 25.6 years for the nonagitated group), but the agitated patients had a lower median Rancho Los Amigos Hospital Level of Cognitive Functioning in a comparison to nonagitated patients (V versus VI). All patients were monitored for cognitive performance by the Orientation Group Monitoring System, and a daily account of frequency, severity and type of agitation was recorded. Within 7 days of initiation of therapy, 12 of 17 patients within PTA had dramatic decrease in agitation (5/5 patients at Rancho IV; 4/8 at Rancho V; 3/4 at Rancho VI). Two of the three patients at Rancho VII had agitation that was unresponsive to amitriptyline. The amitriptyline-responsive patients were maintained on the drug through PTA, and the Orientation Group Monitoring System scale demonstrated no impedance in cognitive recovery. Thus, amitriptyline appears most useful as an adjunct for treatment of nondirected agitation; it also has a role in reducing the severity of the directed agitation that is seen during but not after PTA.

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID