共查询到20条相似文献,搜索用时 31 毫秒
1.
James S. Krause Rickey Carter Yusheng Zhai Karla Reed 《Archives of physical medicine and rehabilitation》2009,90(4):628-633
Krause JS, Carter R, Zhai Y, Reed K. Psychologic factors and risk of mortality after spinal cord injury.
Objective
To identify the association of 2 distinct psychologic constructs, personality and purpose in life (PIL), with risk of early mortality among persons with spinal cord injury (SCI).Design
Prospective cohort study with health data collected in late 1997 and early 1998 and mortality status ascertained in December 2005.Setting
A large rehabilitation hospital in the southeastern United States.Participants
Adults (N=1386) with traumatic SCI, at least 1 year postinjury.Interventions
Not applicable.Main Outcome Measures
We first evaluated the significance of a single psychologic predictor (a total of 6 scales) while controlling for biographic and injury predictors using Cox proportional hazards modeling and subsequently built a comprehensive model based on an optimal group of psychologic variables.Results
There were a total of 224 (16.2%) observed deaths in the full sample. The total number of deaths was reduced to 164 in the final statistical model (of 1128 participants) because of missing data. All 6 psychologic factors were statistically significant in the model that was adjusted for biographic and injury factors, whereas only 3 psychologic factors were retained in the final comprehensive model, including 2 personality scales (Impulsive Sensation Seeking, Neuroticism-Anxiety) and the PIL scale. The final comprehensive model only modestly improved the overall prediction of survival compared with the model with only biographic and injury variables, because the pseudo-R2 increased from 0.121 to 0.129, and the concordance increased from 0.730 to 0.747.Conclusions
The results affirm the importance of psychologic factors in relation to survival after SCI. 相似文献2.
3.
Hanneke Bouwsema Corry K. van der Sluis Raoul M. Bongers 《Archives of physical medicine and rehabilitation》2010,91(9):1442-1446
Bouwsema H, van der Sluis CK, Bongers RM. Learning to control opening and closing a myoelectric hand.
Objective
To compare 3 different types of myoelectric signal training.Design
A cohort analytic study.Setting
University laboratory.Participants
Able-bodied right-handed participants (N=34) randomly assigned to 1 of 3 groups.Interventions
Participants trained hand opening and closing on 3 consecutive days. One group trained with a virtual myoelectric hand presented on a computer screen, 1 group trained with an isolated prosthetic hand, and 1 group trained with a prosthetic simulator. One half of the participants trained with their dominant side, and the other half trained with their nondominant side. Before and after the training period, a test was administered to determine the improvement in skill. Participants were asked to open and close the hand on 3 different velocities at command.Main Outcome Measures
Peak velocity, mean velocity, and number of peaks in the myoelectric signal of hand opening and closing.Results
No differences were found for the different types of training; all participants learned to control the myoelectric hand. However, differences in learning abilities were revealed. After learning, a subgroup of the participants could produce clearly distinct myoelectric signals, which resulted in the ability to open and close the hand at 3 different speeds, whereas others could not produce distinct myoelectric signals.Conclusions
Acquired control of a myoelectric hand is irrespective of the type of training. Prosthetic users may differ in learning capacity; this should be taken into account when choosing the appropriate type of control for each patient. 相似文献4.
5.
Desantana JM Santana-Filho VJ Sluka KA 《Archives of physical medicine and rehabilitation》2008,89(4):754-760
DeSantana JM, Santana-Filho VJ, Sluka KA. Modulation between high- and low-frequency transcutaneous electric nerve stimulation delays the development of analgesic tolerance in arthritic rats.
Objective
To investigate whether repeated administration of modulating frequency transcutaneous electric nerve stimulation (TENS) prevents development of analgesic tolerance.Design
Knee joint inflammation (3% carrageenan and kaolin) was induced in rats. Either mixed or alternating frequency was administered daily (20min) for 2 weeks to the inflamed knee under light halothane anesthesia (1%-2%).Setting
Laboratory.Animals
Adult male Sprague-Dawley rats (N=36).Intervention
Mixed- (4Hz and 100Hz) or alternating- (4Hz on 1 day; 100Hz on the next day) frequency TENS at sensory intensity and 100μs pulse duration.Main Outcome Measures
Paw and joint withdrawal thresholds to mechanical stimuli were assessed before induction of inflammation, and before and after daily application of TENS.Results
The reduced paw and joint withdrawal thresholds that occur 24 hours after the induction of inflammation were significantly reversed by the first administration of TENS when compared with sham treatment or to the condition before TENS treatment, which was observed through day 9. By the tenth day, repeated daily administration of either mixed- or alternating-frequency TENS did not reverse the decreased paw and joint withdrawal thresholds.Conclusions
These data suggest that repeated administration of modulating frequency TENS leads to a development of opioid tolerance. However, this tolerance effect is delayed by approximately 5 days compared with administration of low- or high-frequency TENS independently. Clinically, we can infer that a treatment schedule of repeated daily TENS administration will result in a tolerance effect. Moreover, modulating low and high frequency TENS seems to produce a better analgesic effect and tolerance is slower to develop. 相似文献6.
Bradley G. Impink Michael L. Boninger Heather Walker Jennifer L. Collinger Christian Niyonkuru 《Archives of physical medicine and rehabilitation》2009,90(9):1489-1494
Impink BG, Boninger ML, Walker H, Collinger JL, Niyonkuru C. Ultrasonographic median nerve changes after a wheelchair sporting event.
Objectives
To investigate the acute median nerve response to intense wheelchair propulsion by using ultrasonography and to examine the relationship between carpal tunnel syndrome (CTS) signs and symptoms and the acute median nerve response.Design
Case series.Setting
Research room at the National Veterans Wheelchair Games.Participants
Manual wheelchair users (N=28) competing in wheelchair basketball.Intervention
Ultrasound images collected before and after a wheelchair basketball game.Main Outcome Measures
Median nerve cross-sectional area, flattening ratio, and swelling ratio and changes in these after activity. Comparison of median nerve characteristics and patient characteristics between participants with and without positive physical examination findings and with and without symptoms of CTS.Results
Significant changes in median nerve ultrasound characteristics were noted after activity. The group as a whole showed a significant decrease in cross-sectional area at the radius of 4.05% (P=.023). Participants with positive physical examinations showed significantly different (P=.029) and opposite changes in swelling ratio compared with the normal group. Subjects with CTS symptoms had a significantly (P=.022) greater duration of wheelchair use (17.1y) compared with the asymptomatic participants (9y).Conclusions
Manual wheelchair propulsion induces acute changes in median nerve characteristics that can be visualized by using ultrasound. Studying the acute median nerve response may be useful for optimizing various interventions, such as wheelchair set up or propulsion training, to decrease both acute and chronic median nerve damage and the likelihood of developing CTS. 相似文献7.
Ogawa H Oshita H Ishimaru D Yamada K Shimizu T Koyama Y Akaike A Hori H 《Archives of physical medicine and rehabilitation》2008,89(2):329-332
Ogawa H, Oshita H, Ishimaru D, Yamada K, Shimizu T, Koyama Y, Akaike A, Hori H. Analysis of muscle atrophy after hip fracture in the elderly.
Objectives
To examine the relationship between muscle atrophy, ambulatory ability, and fracture type, and to make a specific rehabilitation regimen for each fracture type.Design
Observational study.Setting
Public hospital.Participants
Consecutive patients (N=53) with hip fracture (mean age, 83.6y) who underwent operative treatment.Interventions
Not applicable.Main Outcome Measures
The ambulatory ability score and the cross-sectional areas of lower-limb muscles as measured on computed tomography scans.Results
Muscle atrophy was not related to fracture type. Although the mean ambulatory ability score decreased significantly from 4.5±0.3 points prior to injury to 3.0±0.6 points 1 month postadmission, the degree of muscle atrophy was not associated with the decrease in ambulatory ability.Conclusions
It seems likely that other factors are more important than muscle atrophy and fracture type in determining recovery after surgical repair of a fracture and that there is no need for rehabilitation regimens based on fracture types. 相似文献8.
Sophie Mitra Patricia A. Findley Usha Sambamoorthi 《Archives of physical medicine and rehabilitation》2009,90(9):1532-1540
Mitra S, Findley PA, Sambamoorthi U. Health care expenditures of living with a disability: total expenditures, out-of-pocket expenses, and burden, 1996 to 2004.
Objective
To estimate the health care expenditures associated with a disability and their recent trends.Design
Retrospective analysis of survey data.Setting
Not applicable.Participants
Data from multiple years (1996-2004) of the Medical Expenditure Panel Survey (MEPS) for a nationally representative sample of civilian, noninstitutionalized U.S. population.Interventions
Not applicable.Main Outcome Measures
Health care expenditures consisted of total health care expenditures, total out-of-pocket (OOP) spending, and burden (the ratio of OOP to family income). All the analyses accounted for the complex survey design of the MEPS.Results
Between 1996 and 2004, 6% to 9% of persons in the working-age group (21-61y) were identified as having a disability. Persons with disabilities consistently had higher total health expenditures, OOP spending, and burden compared with their counterparts without disabilities. In 2004, the average total expenditures were estimated at $10,508 for persons with disabilities and at $2256 for those without disabilities. In a multiple regression framework, persons with disabilities were consistently found to have higher expenditures, OOP spending, and burden between 1996 and 2004. Although expenditures, OOP spending, and burden increased over time, after controlling for demographic, socioeconomic, and health status, these 3 health care costs were not found to change disproportionately for persons with disability.Conclusions
During the 1996 to 2004 period, persons with disabilities were consistently found to have significantly higher health expenditures, OOP spending, and burden compared with their counterparts without disabilities, which may adversely affect their health and standard of living. 相似文献9.
Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.
Objective
To determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R).Design
Analysis of interrater and test-retest reliability, internal consistency, concurrent validity, and diagnostic accuracy.Setting
Acute inpatient brain injury rehabilitation hospital.Participants
Convenience sample of 80 patients with severe acquired brain injury admitted to an inpatient Coma Intervention Program with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS).Interventions
Not applicable.Main outcome measures
The CRS-R, the JFK Coma Recovery Scale (CRS), and the Disability Rating Scale (DRS).Results
Interrater and test-retest reliability were high for CRS-R total scores. Subscale analysis showed moderate to high interrater and test-retest agreement although systematic differences in scoring were noted on the visual and oromotor/verbal subscales. CRS-R total scores correlated significantly with total scores on the CRS and DRS indicating acceptable concurrent validity. The CRS-R was able to distinguish 10 patients in an MCS who were otherwise misclassified as in a VS by the DRS.Conclusions
The CRS-R can be administered reliably by trained examiners and repeated measurements yield stable estimates of patient status. CRS-R subscale scores demonstrated good agreement across raters and ratings but should be used cautiously because some scores were underrepresented in the current study. The CRS-R appears capable of differentiating patients in an MCS from those in a VS. 相似文献10.
11.
van Gaal BG Schoonhoven L Mintjes JA Borm GF Koopmans RT van Achterberg T 《International journal of nursing studies》2011,48(9):1049-1057
Background
Patient care guidelines are usually implemented one at a time, yet patients are at risk for multiple, often preventable, adverse events simultaneously.Objective
The SAFE or SORRY? programme targeted three adverse events (pressure ulcers, urinary tract infections and falls) and was successful in reducing the incidence of these events. This article explores the process of change and describes the effect on the preventive care given.Design
Separate data on preventive care were collected along the cluster randomised trial, which was conducted between September 2006 and November 2008.Settings
Ten hospital wards and ten nursing home wards.Participants
We monitored nursing care given to adult patients with an expected length of stay of at least five days.Methods
The SAFE or SORRY? programme consisted of the essential recommendations of guidelines for pressure ulcers, urinary tract infections and falls. A multifaceted implementation strategy was used to implement this multiple guidelines programme. Data on preventive care given to patients were collected in line with these guidelines and the difference between the intervention and the usual care group at follow-up was analysed.Results
The study showed no overall difference in preventive pressure ulcer measures between the intervention and the usual care group in hospitals (estimate = 6%, CI: −7-19) and nursing homes (estimate = 4%, CI: −5-13). For urinary tract infections, even statistically significantly fewer hospital patients at risk received preventive care (estimate = 19%, CI: 17-21). For falls in hospitals and nursing homes, no more patients at risk received preventive care.Conclusion
Though the SAFE OR SORRY? programme effectively reduced the number of adverse events, an increase in preventive care given to patients at risk was not demonstrated. These results seem to emphasise the difficulties in measuring the compliance to guidelines. More research is needed to explore the possibilities for measuring the implementation of multiple guidelines using process indicators. 相似文献12.
Sumiko Shiba Hiroyuki Okawa Hiroyasu Uenishi Yumi Koike Katuya Yamauchi Ko Asayama Taro Nakamura Fumihiro Tajima 《Archives of physical medicine and rehabilitation》2010,91(8):1262-1266
Shiba S, Okawa H, Uenishi H, Koike Y, Yamauchi K, Asayama K, Nakamura T, Tajima F. Longitudinal changes in physical capacity over 20 years in athletes with spinal cord injury.
Objective
To investigate the longitudinal changes in physical capacity over 20 years in athletes with spinal cord injury (SCI).Design
Longitudinal study (20-y follow-up).Setting
Laboratory setting.Participants
Persons with SCI (N=7).Interventions
Not applicable.Main Outcome Measures
Maximum oxygen consumption V?o2max) measured in 1986-1988 and in 2006.Results
Subjects with SCI maintained stable V?o2max in 2006. Six of the 7 continued various wheelchair sports activities, while 1 person quit sports activities 1 year after the baseline study. The latter person showed reduced V?o2max by 53%, while 2 persons who continued strenuous wheelchair sports activities showed increased V?o2max by 43% and 45% after 20 years.Conclusion
The results indicated that physical capacity reflected the level of sports activity in subjects with SCI who maintained sports activities. 相似文献13.
Age-related differences in Tai Chi gait kinematics and leg muscle electromyography: a pilot study 总被引:1,自引:0,他引:1
Wu G 《Archives of physical medicine and rehabilitation》2008,89(2):351-357
Wu G. Age-related differences in Tai Chi gait kinematics and leg muscle electromyography: a pilot study.
Objective
To compare the biomechanic features of Tai Chi gait by elders with those by young adults, and with those of normative gait.Design
Cross-sectional study.Setting
Laboratory-based testing.Participants
Young (n=6; 3 women) and old (n=6; 5 women) Tai Chi practitioners.Intervention
All subjects had practiced Tai Chi for at least 4 months.Main Outcome Measures
Spatial, temporal, and leg muscle electromyography during Tai Chi gait and normative gait.Results
The primary age-related differences in Tai Chi gait were during single stance, with elders having significantly shorter single-stance time (−50%), less lateral displacement (-30%), knee flexion (-42%), hip flexion (-39%), activation time in the tibialis anterior (-13%), soleus (-39%), and tensor fascia lata (TFL) (-21%), activation magnitude in the tibialis anterior (-39%), and coactivation time of the tibialis anterior and soleus (-47%). Compared with normative gait, elders during Tai Chi gait had significantly larger knee (139%) and hip (66%) flexions, longer duration (90%-170%) and higher magnitude (200%-400%) of the tibialis anterior, rectus femoris, and TFL muscle activities, and longer duration of coactivation of most leg muscle pairs (130%-380%).Conclusions
The elders practice Tai Chi gait in higher posture than younger subjects. The Tai Chi gait poses significantly higher challenges to elder’s balance and muscular system than does their normative gait. 相似文献14.
Sally D. Lark Sowjanya Pasupuleti MSc 《Archives of physical medicine and rehabilitation》2009,90(3):470-474
Lark SD, Pasupuleti S. Validity of a functional dynamic walking test for the elderly.
Objective
To determine the validity of a safe, quick, and simple method of measuring dynamic balance in the elderly during gait called the parallel walk test.Design
Control study.Setting
Outpatient clinic, community.Participants
Twenty-seven elderly fallers (age 82±6y) registered at a falls clinic and 34 elderly nonfallers (age 76±7y) were recruited to this study based on Mini Mental State Examination and Barthel Index scores.Interventions
Subjects were timed as they walked 6m between 2 parallel lines on the floor at 3 different widths (20, 30.5, 38cm) in their own footwear. They were scored for foot placement on the line (1 point) or outside the lines (2 points). Participants also performed a timed 6-m tandem walk test, a 30-second tandem stance, and a 30-second parallel stance.Main Outcome Measures
Scores and time to complete the parallel walk test and tandem walk test along with the time of standing for tandem and parallel stance. Validity coefficients were calculated for the sensitivity and specificity of the parallel walk test.Results
All subjects completed the parallel walk test, but few attempted and completed the tandem walk test. The fallers had significantly greater scores at 20 and 30.5cm and took significantly longer to complete the 6m at all widths. The 20-cm width was most discriminatory. The parallel walk test showed a significant correlation with the tandem stance.Conclusions
All subjects attempted and completed the parallel walk test but not the tandem walk test. The time to completion and scoring accurately measures dynamic balance during gait in elderly fallers. The parallel walk test could be a useful tool in the clinical setting for assessing balance in gait pre- and postintervention. 相似文献15.
Feys P Helsen WF Liu X Lavrysen A Nuttin B Ketelaer P 《Archives of physical medicine and rehabilitation》2004,85(6):1031-1033
Feys P, Helsen WF, Liu X, Lavrysen A, Nuttin B, Ketelaer P. Effects of vision and arm position on amplitude of arm postural tremor in patients with multiple sclerosis. Arch Phys Med Rehabil 2004;85:1031-3.
Objectives
To quantify the effects of vision and arm position on arm postural tremor, comparisons were made between flexed and extended arm positions performed with the eyes open and closed.Design
Case-control study.Setting
National multiple sclerosis (MS) center in Belgium.Participants
Sixteen patients (32 arms) with MS who had intention tremor and 16 healthy controls (32 arms).Interventions
Not applicable.Main outcome measure
The amplitude of postural tremor was assessed by a magnetic position sensor attached to the index finger.Results
The amplitude of postural tremor was not influenced by changes in visual condition or different arm positions. Both healthy controls and MS patients made more directional changes in the flexed, compared with the extended arm position.Conclusions
The amplitude of the arm postural tremor in MS is independent of vision and arm position. Selecting 1 arm position is sufficient to assess postural tremor amplitude. 相似文献16.
Celnik P Hummel F Harris-Love M Wolk R Cohen LG 《Archives of physical medicine and rehabilitation》2007,88(11):1369-1376
Celnik P, Hummel F, Harris-Love M, Wolk R, Cohen LG. Somatosensory stimulation enhances the effects of training functional hand tasks in patients with chronic stroke.
Objective
To test the hypothesis that somatosensory stimulation would enhance the effects of training functional hand tasks immediately after practice and 1 day later in chronic subcortical stroke patients.Design
Single-blinded and randomized, crossover study.Setting
Human research laboratory.Participants
Nine chronic subcortical stroke patients.Interventions
Three separate sessions of motor training preceded by (1) synchronous peripheral nerve stimulation (PNS), (2) no stimulation, or (3) asynchronous PNS.Main Outcome Measures
Time to complete the Jebsen-Taylor Hand Function Test (JTHFT time) and corticomotor excitability tested with transcranial magnetic stimulation.Results
After familiarization practice, during which all patients reached a performance plateau, training under the effects of PNS reduced JTHFT time by 10% beyond the post-familiarization plateau. This behavioral gain was accompanied by a specific reduction in GABAergically mediated intracortical inhibition in the motor cortex. These findings were not observed after similar practice under the influence of no stimulation or asynchronous PNS sessions.Conclusions
Somatosensory stimulation may enhance the training of functional hand tasks in patients with chronic stroke, possibly through modulation of intracortical GABAergic pathways. 相似文献17.
Magali Fourny Anne-Sophie Lucas Loïc Belle Guillaume Debaty Pierre Casez Hélène Bouvaist Patrice François Gérald Vanzetto José Labarère 《The American journal of emergency medicine》2011,29(1):37-42
Objectives
Current guidelines recommend utilization of prehospital emergency medical services (EMSs) by patients with ST-elevation myocardial infarction (STEMI). The aims of this study were to estimate the percentage of inappropriate initial dispatcher decisions and determine their impact on delays in reperfusion therapy for EMS users with STEMI.Methods
As part of a prospective regional registry of patients with STEMI, we analyzed the original data for 245 patients who called a university hospital-affiliated EMS call center in France. The primary study outcome was time to reperfusion therapy calculated from the documented date and time of the first patient call.Results
The initial EMS dispatcher's decision was appropriate (ie, dispatching a mobile intensive care unit staffed by an emergency or critical care physician) for 171 (70%) patients and inappropriate for 74 (30%) patients. Inappropriate decisions included referring the patient to a family physician (n = 59), providing medical advice (n = 9), and dispatching an ambulance (n = 6). Inappropriate initial decisions resulted in increased median time to reperfusion for 140 patients receiving fibrinolysis (95 vs 53 minutes; P < .001) and 91 patients undergoing primary percutaneous coronary intervention (170 vs 107 minutes; P < .001). In-hospital mortality was not different between the 2 study groups (6.8% vs 9.9%; P = .42).Conclusion
The initial dispatcher's decision is inappropriate for 30% of EMS users with STEMI and results in substantial delays in time to reperfusion therapy. Accuracy of telephone triage should be improved for patients who activate EMSs in response to symptoms suggestive of acute coronary syndrome. 相似文献18.
Ortqvist M Gutierrez-Farewik EM Farewik M Jansson A Bartonek A Broström E 《Archives of physical medicine and rehabilitation》2007,88(9):1164-1170
Örtqvist M, Gutierrez-Farewik EM, Farewik M, Jansson A, Bartonek Å, Broström E. Reliability of a new instrument for measuring plantarflexor muscle strength.
Objectives
To test the reliability of a new muscle strength testing instrument (the Strength Measuring Chair [SMC]) designed to quantify isometric strength in the lower extremities, and to determine the agreement between the SMC and an isokinetic dynamometer (Biodex).Design
Isometric strength tests were performed in plantarflexors with 2 different knee positions (60°, 30°). Measurements were taken at 3 different sessions.Setting
Strength testing laboratory.Participants
Twenty-three able-bodied adults and 15 able-bodied children.Interventions
Not applicable.Main Outcome Measure
Isometric plantarflexor strength.Results
The reliability of isometric strength measurements of plantarflexors taken in the SMC was excellent for both the adult and children groups (intraclass correlation coefficient range, .84−.87). A Bland-Altman 95% limit of agreement test showed no systematic variation in 3 of the 4 SMC test observations; systematic variation was only observed in the adult group at a knee position of 30°. There was no systematic difference in the adult group between the SMC and the isokinetic dynamometer, but there was a systematic variation in the children’s group.Conclusions
The SMC reliably measured isometric plantarflexor strength in the tested populations. 相似文献19.
Alex R. Ward Wendy Lee Hung Chuen BSc 《Archives of physical medicine and rehabilitation》2009,90(9):1619-1627
Ward AR, Lee Hung Chuen WL. Lowering of sensory, motor, and pain-tolerance thresholds with burst duration using kilohertz-frequency alternating current electric stimulation: part II.
Objective
To determine the optimum burst duration for discrimination between sensory, motor, and pain tolerance thresholds using 20-Hz bursts of kilohertz-frequency sinusoidal alternating current (AC) applied transcutaneously to human participants.Design
A within-subject, repeated-measures trial.Setting
A research laboratory.Participants
Healthy young adults (N=20).Interventions
Bursts of AC electric stimulation at frequencies of 1 and 4kHz. The burst frequency was 20Hz. Burst durations ranged from 250 microseconds (for 1 cycle of 4-kHz AC) and 1 millisecond (for 1 cycle of 1-kHz AC) to 50 milliseconds (continuous AC).Main Outcome Measures
Measurement of sensory, motor, and pain-tolerance thresholds.Results
Thresholds decreased to a minimum with increasing burst duration. The minimum threshold identified the utilization time over which summation of subthreshold stimuli occurs. Utilization times were different for sensory (∼20ms), motor (∼30ms), and pain (>50ms) and were much higher than found in a previous study that used a higher burst frequency (50Hz). As with the previous study, relative thresholds were found to vary with burst duration. Despite the very different utilization times, maximum separation between sensory, motor, and pain thresholds was found to occur with bursts in the range of 1 to 4 milliseconds, the same range found in the previous study.Conclusions
Our conclusions concur with those reported previously and support the contention that short-duration kilohertz-frequency AC bursts (1-4ms) have a more useful role in rehabilitation than the long-duration kilohertz-frequency bursts that characterize Russian and interferential currents. 相似文献20.
Nash MS Koppens D van Haaren M Sherman AL Lippiatt JP Lewis JE 《Archives of physical medicine and rehabilitation》2008,89(11):2080-2085
Nash MS, Koppens D, van Haaren M, Sherman AL, Lippiatt JP, Lewis JE. Power-assisted wheels ease energy costs and perceptual responses to wheelchair propulsion in persons with shoulder pain and spinal cord injury.