摘要:

Chae J, Labatia I, Yang G: Upper limb motor function in hemiparesis: Concurrent validity of the arm motor ability test.Am J Phys Med Rehabil2003;82:1–8.ObjectiveTo evaluate the concurrent validity of the Arm Motor Ability Test (AMAT) using the Fugl-Meyer Assessment (FMA) as the criterion measure of poststroke upper limb motor impairment.DesignUpper limb motor impairment and arm ability of 30 chronic stroke survivors were assessed with the FMA and AMAT, respectively. Spearman’s correlation coefficients were generated relating the components of FMA and AMAT. Scatterplots were generated to provide qualitative assessments of the relationship between FMA and AMAT. Bar graphs of FMA and AMAT normalized to their maximum scores were generated to compare the levels of motor status measured by each instrument.ResultsAll components of AMAT correlated highly with FMA total (r= 0.92–0.94;P< 0.001). AMAT functional ability and AMAT quality of movement were linearly related with FMA total. However, AMAT time of performance exhibited significant ceiling and floor effects with respect to FMA. Normalized AMAT scores were generally lower than normalized FMA scores (P< 0.001), with the greatest difference in scores observed in subjects with more severe motor impairments.ConclusionThis study demonstrates a high degree of concurrent criterion validity of the AMAT. However, AMAT tends to underestimate the arm motor status of those with more severe motor impairments.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Gregory PC, Fried LP: Why Do Older Adults Decide They Are Having Difficulty with a Task?Am J Phys Med Rehabil2003;82:9–16.ObjectivePrevious studies have identified risk factors for decline in physical function, but they have not examined specific reasons older adults report difficulty with mobility tasks.DesignCommunity-dwelling people (n= 160) aged 59 yr and older in an observational cohort study were questioned to determine the most common cited reasons for self-reported difficulty in task performance.ResultsMobility tasks were most often reported to be difficult (66%). The reasons cited for difficulty in low exercise tolerance tasks were task modification by method (33%) and rate (33%). For high exercise tolerance tasks, reasons cited included having to modify the rate of performing the task (20%) or the method (13%). Among those who reported difficulty with low exercise tolerance mobility tasks, >80% reported modification (odds ratio, 46.4 [95% confidence limits: 9.75, 220.51]) and 32% also report frequency change (odds ratio, 5.9 [95% confidence limits: 2.72, 12.85]) as the reason for perceiving difficulty. For those who reported difficulty performing high exercise tolerance–demanding tasks, >90% reported modification (odds ratio, 5.5 [95% confidence limits: 2.05, 14.88]) and 61% also report frequency changes (odds ratio, 3.9 [95% confidence limits: 1.93, 8.04]).ConclusionThe findings suggest that people are able to cite specific reasons for difficulty with mobility task performance, most commonly related to task modification.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Han BS, Jang SH, Chang Y, Byun WM, Lim SK, Kang DS: Functional magnetic resonance image finding of cortical activation by neuromuscular electrical stimulation on wrist extensor muscles.Am J Phys Med Rehabil2003;82:17–20.ObjectiveTo investigate the effects that neuromuscular electrical stimulation on the wrist extensor muscles have on the cerebral cortex.DesignA functional magnetic resonance imaging study was performed on eight normal volunteers. The activation task was the maximum wrist extension by neuromuscular electrical stimulation, applied through a two-channel electrical stimulator. Monophasic square-wave pulses were used. The activation maps were generated by the thresholdttest maps. The level of primary motor cortex and primary sensory cortex activations was estimated.ResultsAmong the eight subjects, seven showed significant activation on contralateral primary sensorimotor cortex by neuromuscular electrical stimulation on the wrist extensor muscles. In these seven subjects, additional bilateral or contralateral supplementary motor area activations were also observed. The number of activated pixels on the primary sensory cortex was slightly greater than that on the primary motor cortex.ConclusionNeuromuscular electrical stimulation, when applied to the peripheral muscles, seems to have a direct effect on the cerebral cortex.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Wong AMK, Leong CP, Su TY, Yu SW, Tsai WC, Chen CPC: Clinical trial of acupuncture for patients with spinal cord injuries.Am J Phys Med Rehabil2003;82:21–27.ObjectiveTo examine whether electrical acupuncture therapy through adhesive surface electrodes and concomitant auricular acupuncture therapy could improve the neurologic or functional recovery in acute traumatic spinal cord injury patients.DesignA total of 100 acute traumatic spinal cord injury patients with American Spinal Injury Association (ASIA) impairment grading of A and B were recruited into this study. They were randomly divided into the acupuncture and control groups. In the acupuncture group, electrical acupuncture therapy via the adhesive surface electrodes were applied to the bilateral Hou Hsi (SI3) and Shen Mo (B62) acupoints. In auricular acupuncture, four acupoints related to the spinal cord were selected for stimulation at the antihelix, helix, and lower portion of the ear-back areas. Acupuncture therapy was initiated early in the emergency room setting or soon after spinal surgical intervention. Rehabilitation therapy was also provided to the patients during acupuncture therapy. In the control group, only rehabilitation therapy was provided to the patients. Neurologic and functional scores were assessed during the time of admission, hospital discharge, and 1-yr postinjury follow-up.ResultsThere were significant improvements in neurologic (sensory and motor), functional, and FIM™ scores in the acupuncture group compared with the initial admission period when assessed during the time of hospital discharge and the 1-yr postinjury follow-up. A greater percentage of patients in the acupuncture group recovered to a higher ASIA impairment grading.ConclusionThe use of concomitant auricular and electrical acupuncture therapies, when implemented early in acute spinal cord injury, can contribute to significant neurologic and functional recoveries.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Unlu Z, Aslan A, Ozbakkaloglu B, Tunger O, Surucuoglu S: Serologic examinations of hepatitis, cytomegalovirus, and rubella in patients with Bell’s palsy.Am J Phys Med Rehabil2003;82:28–32.ObjectiveThe aim of this retrospective case review was to investigate serologic evidence of cytomegalovirus, rubella virus, and hepatitis A, B, and C viruses in patients with Bell’s palsy.DesignA total of 24 patients with idiopathic facial paralysis, without a history of trauma, any evidence of a tumor on high-resolution computed tomographic imaging, or any otologic disease, and 33 healthy individuals as a control group were included in this study. Facial paralysis of the patient was evaluated with the House-Brackmann grading scale. Specific immunoglobulin G and M titers were determined for cytomegalovirus, rubella, hepatitis A, hepatitis B, and hepatitis C by enzyme-linked immunosorbent assay.ResultsSerologic positivity for hepatitis B was found in 15 of 21 Bell’s palsy patients, compared with 32.1% in the control group. The difference was statistically significant. There was no difference in the prevalence of serologic positivity for cytomegalovirus, hepatitis A, and rubella between the patient and control groups. In one Bell’s palsy patient, serologic evidence of recent cytomegalovirus infection was indicated by changes in antibody titers between samples taken on presentation and on the 16th day. There was no serologic evidence of hepatitis C in either Bell’s palsy patients or the control group.ConclusionThere seems to be an association between hepatitis B and idiopathic facial paralysis. In addition, cytomegalovirus might contribute to the development of Bell’s palsy in some ceases with Bell’s palsy. Further studies are required to confirm these data.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Cintas HL, Siegel KL, Furst GP, Gerber LH: Brief Assessment of Motor Function: Reliability and concurrent validity of the Gross Motor Scale.Am J Phys Med Rehabil2003;82:33–41.ObjectiveThe Brief Assessment of Motor Function (BAMF) is a series of 10-point ordinal scales developed for rapid description of gross motor, fine motor, and oral motor performance. We examined interrater and intrarater reliability and concurrent validity of the BAMF Gross Motor Scale.DesignThis validation study included 48 children (age, 5 mo to 17 yr) with a wide range of gross motor capability. Ten children with varied diagnoses participated in the reliability study. For concurrent validity, the BAMF performance of 38 children with osteogenesis imperfecta was compared with scores on the Peabody Developmental Motor Scales, laboratory gait analysis, and manual muscle testing.ResultsReliability values for intraclass correlations were 0.996 (interrater) and 1.00 (intrarater). Significant relationships were identified between the BAMF and gait speed (r= 0.68,P< 0.0001), stride length (r= 0.71,P< 0.0001), duration of double-limb support (r= −0.40,P< 0.03), number of weak muscles (r= −0.74,P< 0.0001), and the Peabody Developmental Motor Scales (r= 0.95,P< 0.0001). Number of weak muscles was the strongest predictor of BAMF score (R2= 0.5080, F = 24.77,P< 0.0001).ConclusionsThe BAMF demonstrates good reliability for children with a range of diagnoses and acceptable concurrent validity with gross motor development, muscle strength, and formal gait assessment in children with osteogenesis imperfecta.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Chou SW, Wong AMK, Leong CP, Hong WS, Tang FT, Lin TH: Postural control during sit-to-stand and gait in stroke patients.Am J Phys Med Rehabil2003;82:42–47.ObjectiveTo investigate the relationship of sit-to-stand and gait performance in hemiplegic stroke patients.DesignA total of 40 chronic stroke patients with hemiplegia and 22 age-matched healthy subjects were included in this study. Data of a motion analysis system and three force platforms were collected in a rehabilitation unit of a medical center.ResultsLaboratory sit-to-stand measurement and gait analysis were evaluated in both groups via three AMTI (Advanced Mechanical Technology Inc.) force platforms and a Vicon 370 system (six high-resolution cameras and one AMTI force plate), respectively. The sit-to-stand and gait parameters of hemiplegic patients were correlated significantly, especially in rising speed and the maximal vertical force of both legs during rising.ConclusionsHemiplegic stroke patients, who could stand up within 4.5 sec or who had a maximal vertical force difference of less than 30% of body weight between both legs, had better gait performance than the others did.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Bayramoğlu M, Karataş M, Leblebici B, Çetin N, Sözay S, Turhan N: Hemorrhagic transformation in stroke patients.Am J Phys Med Rehabil2003;82:48–52.ObjectiveTo identify the predictors of hemorrhagic transformation in stroke patients and to evaluate the impact of hemorrhagic transformation on rehabilitation outcome.DesignThe records of 203 hemiplegic patients hospitalized for rehabilitation after the acute phase of stroke were retrospectively analyzed. In 121 cases, the first computed tomographic scan and a repeat scan were compared to determine whether hemorrhagic transformation occurred. Correlations between the occurrence of hemorrhagic transformation and use of anticoagulants, antiaggregants, and antiedema drugs were evaluated. Admission and discharge FIM™ and Adapted Patient Evaluation Conference System scores were noted, and functional gain was calculated from these. These data were also analyzed for associations with hemorrhagic transformation.ResultsHemorrhagic transformation was detected in 39 of the 121 cases. There was no significant difference in functional outcome between patients who did and did not show hemorrhagic transformation. Although not statistically significant, the use of antiedema drugs was found to increase the risk of hemorrhagic transformation, whereas the use of anticoagulants and antiaggregants had no influence.ConclusionsHemorrhagic transformation of an ischemic lesion does not affect rehabilitation outcome in stroke survivors. The study results favor the use of anticoagulants and antiaggregants in the acute phase unless these drugs are contraindicated by the patient’s condition. Still, prospective trials are needed to make definite conclusions.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Lew HL, Dikmen S, Slimp J, Temkin N, Lee EH, Newell D, Robinson LR: Use of somatosensory-evoked potentials and cognitive event-related potentials in predicting outcomes of patients with severe traumatic brain injury.Am J Phys Med Rehabil2003;82:53–61.ObjectiveThis study was performed to evaluate the usefulness of somatosensory-evoked potentials (SEPs) and cognitive event-related potentials (ERPs) in predicting functional outcomes of severe traumatic brain injury patients.DesignProspective study of 22 patients with severe traumatic brain injury. Demographic information, Glasgow Coma Scale, and electrophysiologic measurements were recorded. Functional outcomes, as quantified by the Glasgow Outcome Scale–Extended, were obtained.ResultsBilateral absence of median nerve SEP was strongly predictive of the worst functional outcome. The specificity and positive predictive value of absent SEP for predicting death or persistent vegetative state at 6 mo after traumatic brain injury were as high as 100%. If the definition of unfavorable outcome was expanded to include Glasgow Outcome Scale–Extended 1–4, absence of ERP was equivalent to the absence of SEP in specificity and positive predictive value. On the other hand, normal ERPs showed higher sensitivity and negative predictive value for prognosticating the best outcomes compared with normal SEPs. If the definition of favorable outcome was expanded to include Glasgow Outcome Scale–Extended 5–8, ERP was still superior to SEP for prognosticating good outcome. Interestingly, the highest sensitivity and negative predictive value for favorable outcomes were associated with the presence of any discernible waveform.ConclusionsAlthough median nerve SEP continues to make reliable prediction of ominous outcome in severe traumatic brain injury, the addition of the speech-evoked ERPs may be helpful in predicting favorable outcomes. The strength of the latter test seems to complement the weakness of the former.

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2003

数据来源: OVID