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1.
Chae J Wolf-Johnson T Govil H 《Archives of physical medicine and rehabilitation》2007,88(12):179-1693
Chae J, Wolf-Johnson T, Govil H. Subacromial corticosteroid injection for poststroke shoulder pain: a retrospective chart review.
Objective
To assess the effectiveness of subacromial corticosteroid injections for the treatment of poststroke shoulder pain.Design
Retrospective chart review.Setting
Ambulatory setting, university-affiliated hospital.Participants
People (N=60) with stroke-associated hemiparesis and pain in the involved shoulder.Interventions
Electronic medical records of stroke survivors with shoulder pain in the hemiparetic limb treated with a subacromial corticosteroid injection by a practitioner between January 1, 2005, and June 30, 2007, were reviewed. Patients who had a documented preinjection pain score on the day of injection by using a 0 to 10 numeric rating scale and a postinjection pain score within 16 weeks of injection were included.Main Outcome Measures
Pre- and postinjection scores were compared by using the paired t test. Treatment success was defined as a minimum of 2-point absolute or 30% relative pain reduction. Linear and logistic regression analyses were used to identify predictors of pain reduction and treatment success, respectively.Results
Patients experienced an absolute pain reduction of 2.6±3.7 (95% confidence interval, 1.7–3.6; P<.001) and a relative pain reduction of 32.9%±53.6%. Fifty-three percent experienced the minimum 2-point absolute pain reduction, whereas 45% experienced the minimum 30% relative pain reduction. Linear regression analyses identified the preinjection pain score as a predictor of absolute pain reduction and concomitant outpatient occupational or physical therapy as a predictor of both absolute and relative pain reduction. No other factors were predictive of pain reduction or treatment success.Conclusions
Subacromial corticosteroid injection is associated with a significant reduction in poststroke shoulder pain. However, controlled trials are needed to show a cause-and-effect relationship and rule out spontaneous recovery, placebo effect, and other confounds. 相似文献2.
Bürge E Kupper D Finckh A Ryerson S Schnider A Leemann B 《Archives of physical medicine and rehabilitation》2008,89(10):1857-1862
Bürge E, Kupper D, Finckh A, Ryerson S, Schnider A, Leemann B. Neutral functional realignment orthosis prevents hand pain in patients with subacute stroke: a randomized trial.
Objective
To quantify the preventive effect of a neutral functional realignment orthosis on pain, mobility, and edema of the hand in subacute hemiparetic poststroke patients with severe motor deficits.Design
Randomized trial.Setting
Rehabilitation center.Participants
Poststroke patients (N=30) with subacute hemiparesis and severe deficits of the upper limb were enrolled. Fifteen patients were randomized to a standard rehabilitation program without orthosis and 15 patients received an experimental orthosis in addition to their standard rehabilitation program.Intervention
The orthosis group wore the neutral functional realignment orthosis for at least 6 hours daily.Main Outcome Measures
Hand pain at rest (visual analog scale), wrist range of motion (Fugl-Meyer Assessment subscale), and edema of hand and wrist (circumferences). Outcome measures were assessed at time of randomization and after 13 weeks between groups.Results
At baseline, 2 patients in each group complained about a painful hand. After 13 weeks, 8 subjects in the control group and 1 subject in the orthosis group complained of hand pain (P=.004). Mobility and edema evolved similarly in both groups.Conclusions
Neutral functional realignment orthoses have a preventive effect on poststroke hand pain, but not on mobility and edema in the subacute phase of recovery. 相似文献3.
4.
Stefania Fatone Steven A. Gard Bryan S. Malas 《Archives of physical medicine and rehabilitation》2009,90(5):810-818
Fatone S, Gard SA, Malas BS. Effect of ankle-foot orthosis alignment and foot-plate length on the gait of adults with poststroke hemiplegia.
Objective
To investigate the effect of ankle-foot orthosis (AFO) alignment and foot-plate length on sagittal plane knee kinematics and kinetics during gait in adults with poststroke hemiplegia.Design
Repeated measures, quasi-experimental study.Setting
Motion analysis laboratory.Participants
Volunteer sample of adults with poststroke hemiplegia (n=16) and able-bodied adults (n=12) of similar age.Interventions
Subjects with hemiplegia were measured walking with standardized footwear in 4 conditions: (1) no AFO (shoes only); (2) articulated AFO with 90° plantar flexion stop and full-length foot-plate-conventionally aligned AFO (CAFO); (3) the same AFO realigned with the tibia vertical in the shoe-heel-height compensated AFO (HHCAFO); and (4) the same AFO (tibia vertical) with ¾ length foot-plate-¾ AFO. Gait of able-bodied control subjects was measured on a single occasion to provide a normal reference.Main Outcome Measures
Sagittal plane ankle and knee kinematics and kinetics.Results
In adults with hemiplegia, walking speed was unaffected by the different conditions (P=.095). Compared with the no AFO condition, all AFOs decreased plantar flexion at initial contact and mid-swing (P<.001) and changed the peak knee moment in early stance from flexor to extensor (P<.000). Both AFOs with full-length foot-plates significantly increased the peak stance phase plantar flexor moment compared with no AFO and resulted in a peak knee extensor moment in early stance that was significantly greater than control subjects, whereas the AFO with three-quarter length foot-plate resulted in ankle dorsiflexion during stance and swing that was significantly less than control subjects.Conclusions
These findings suggest that when an articulated AFO is to be used, a full-length foot-plate in conjunction with a plantar flexion stop may be considered to improve early stance knee moments for people with poststroke hemiplegia. 相似文献5.
Stephen May Ken Chance-Larsen Chris Littlewood Dave Lomas Mahmoud Saad 《Physiotherapy》2010,96(3):179-613
Background
Shoulder pain is a common clinical problem, and numerous tests are used to diagnose structural pathology.Objectives
To systematically review the reliability of physical examination procedures used in the clinical examination of patients with shoulder pain.Data sources
MEDLINE, PEDro, AMED, PsychInfo, Cochrane Library (2009) and CINAHL were searched from the earliest record on the database to June 2009.Study eligibility criteria
Reliability studies that included any patients with shoulder pain were analysed for their quality and reliability results.Study appraisal and synthesis methods
Pre-established criteria were used to judge the quality of the studies (high quality >60% methods score) and satisfactory levels of reliability (kappa or intraclass correlation coefficient ≥0.85, sensitivity analysis 0.70). A qualitative synthesis was performed based on levels of evidence.Results
Thirty-six studies were included with a mean methods score of 57%. Seventeen studies were deemed to be of high quality; high-quality studies were less likely to meet the pre-agreed level of reliability. The majority of studies indicated poor reliability for all procedures investigated.Limitations
Overall, the evidence regarding reliability was contradictory.Conclusions and implications
There is no consistent evidence that any examination procedure used in shoulder assessments has acceptable levels of reliability. Alternate methods of classification which are reliable should be used to classify patients with shoulder problems. 相似文献6.
Pedro Belón-Perez Antonio Ignacio Cuesta-Vargas 《Journal of manipulative and physiological therapeutics》2018,41(7):589-595
Objectives
The purpose of this study was to evaluate the immediate effect of thoracic spine manipulation upon active flexion and abduction mobility of the shoulder, spine temperature, and the size of the subacromial space as measured by ultrasound in 3 positions (internal, neutral, and external rotation) of the glenohumeral joint in patients who have undergone surgery because of subacromial impingement.Methods
Quasi-experimental, prospective, short-term effect study with consecutively sampled participants. Thirty-two patients had undergone subacromial decompression together with supraspinatus tendon suture. The following variables were studied: age, sex, dominant shoulder, presurgery evolution time, working status, surface temperature of dorsal segment with limited mobility, premanipulation functional assessment using the Spanish version of the Upper Limb Functional Index Scale, goniometric range of motion measurement at glenohumeral joint before and after manipulation, and ultrasound measurement of subacromial space before and after manipulation.Results
Significant differences and small effect size were found in measurements for flexion and abduction movements after thoracic spine manipulation (P > .001; ES > 0.2) and subacromial space measurements in neutral rotation and external rotation (P > .001), but without clinical relevance effect size (<0.2).Conclusions
Active shoulder flexion and abduction mobility increase after manipulation of thoracic spine in patients who have undergone surgery for rotator cuff suture. Subacromial space increases significantly with shoulder in neutral and external rotation position after manipulation. No differences were found regarding surface temperature of manipulated area. 相似文献7.
Sandra L. Hubbard Winkler Diane C. Cowper Ripley Samuel Wu Dean M. Reker Bruce Vogel Shirley G. Fitzgerald William C. Mann Helen Hoenig 《Archives of physical medicine and rehabilitation》2010,91(3):369-377
Hubbard Winkler SL, Cowper Ripley DC, Wu S, Reker DM, Vogel B, Fitzgerald SG, Mann WC, Hoenig H. Demographic and clinical variation in Veterans Health Administration provision of assistive technology devices to veterans poststroke.
Objectives
To examine variation in provision of assistive technology (AT) devices and the extent to which such variation may be explained by patient characteristics or Veterans Health Administration (VHA) administrative region.Design
Retrospective population-based study.Setting
VHA.Participants
Veterans poststroke in fiscal years 2001 and 2002 (N=12,046).Interventions
Not applicable.Main Outcome Measure
Provision of 8 categories of AT devices.Results
There was considerable regional variation in provision of AT. For example, differences across administrative regions in the VHA ranged from 5.1 to 28.1 standard manual wheelchairs per 100 veterans poststroke. Using logistic regression, with only demographic variables as predictors of standard manual wheelchair provision, the c statistic was .62, and the pseudo R2 was 2.5%. Adding disease severity increased the c statistic to .67 and the pseudo R2 to 6.2%, and adding Veteran Integrated Network System further increased the c statistic to .72 and pseudo R2 to 9.8%.Conclusions
Our research showed significant variation in the provision of AT devices to veterans poststroke, and it showed that patient characteristics accounted for only 6.2% of the variation. VHA administrative region and disability severity accounted for equivalent amounts of the variation. Our findings suggest the need for improvements in the process for providing AT and/or provider education concerning device provision. 相似文献8.
Brose SW Boninger ML Fullerton B McCann T Collinger JL Impink BG Dyson-Hudson TA 《Archives of physical medicine and rehabilitation》2008,89(11):2086-2093
Brose SW, Boninger ML, Fullerton B, McCann T, Collinger JL, Impink BG, Dyson-Hudson TA. Shoulder ultrasound abnormalities, physical examination findings, and pain in manual wheelchair users with spinal cord injury.
Objectives
To investigate the presence of ultrasound (US) abnormalities in manual wheelchair users with spinal cord injury (SCI) using a quantitative Ultrasound Shoulder Pathology Rating Scale (USPRS). To investigate physical examination (PE) findings using a quantitative Physical Examination of the Shoulder Scale (PESS), and to obtain data about pain and other subject characteristics such as age, years with SCI, and weight.Design
Case series.Setting
National Veterans' Wheelchair Games 2005 and 2006.Participants
Volunteer sample of manual wheelchair users with SCI participating in the National Veterans' Wheelchair Games.Interventions
Not applicable.Main Outcome Measures
Presence of relationships between US findings, PE findings, pain, and subject characteristics.Results
The USPRS correlated with age, duration of SCI, and weight (all P<.01), and showed a positive trend with the total Wheelchair User's Shoulder Pain Index (WUSPI) score (r=.258, P=.073). Several US findings related to presence of PE findings for specific structures. The PESS score correlated with the WUSPI (r=.679, P<.001) and duration of SCI (P<.05). The presence of untreated shoulder pain that curtailed activity was noted in 24.5% of subjects, and this was related to increased WUSPI scores (P=.002).Conclusions
PE and US abnormalities are common in manual wheelchair users with SCI. The USPRS and PESS demonstrated evidence for external validity and hold promise as research tools. Untreated shoulder pain is common in manual wheelchair users with SCI, and further investigation of this pain is indicated. 相似文献9.
Chueh-Hung Wu Yi-Chiang Wang Hsing-Kuo Wang Wen-Shiang Chen Tyng-Guey Wang 《Archives of physical medicine and rehabilitation》2010,91(2):278-282
Wu C-H, Wang Y-C, Wang H-K, Chen W-S, Wang T-G. Evaluating displacement of the coracoacromial ligament in painful shoulders of overhead athletes through dynamic ultrasonographic examination.
Objective
To evaluate displacement of the coracoacromial ligament (CAL), using dynamic ultrasonography (US), for detecting instability-related impingement caused by overhead activities.Design
Between-group survey.Setting
Department of Physical Medicine and Rehabilitation in a tertiary care center.Participants
Volunteer high school volleyball players with unilateral shoulder pain (n=10) and volunteer asymptomatic high school volleyball players with identical training activities as control subjects (n=16).Interventions
Not applicable.Main Outcome Measure
The displacement of the CAL was measured during throwing simulation using dynamic US. Both shoulders of all subjects were evaluated.Results
During throwing simulation, the displacement of the CAL in the painful shoulders of overhead athletes increased significantly greater than the displacement in the asymptomatic shoulder (3.0±0.7mm and 2.2±0.4mm, respectively; P=.017). No difference was identified between the displacements of the CALs of bilateral shoulders of the control group subjects.Conclusions
Dynamic US, by measuring the displacement of the CAL during simulation of throwing, may be helpful in detecting abnormal humeral head upward migration in overhead athletes. 相似文献10.
11.
Ballout S Noureddine S Huijer HA Kanazi G 《Journal of pain and symptom management》2011,42(1):147-154
Context
Pain is a common complaint in oncology patients, and success in its treatment requires accurate assessment. Thus, assessment tools that are practical, culturally sensitive, and psychometrically sound are needed.Objectives
The purpose of this study was to evaluate the psychometric properties and cultural sensitivity of the Arabic Brief Pain Inventory (BPI) in a Lebanese sample of cancer patients. The BPI measures the location and severity of pain; pain relief from treatment; and the pain’s interference with life.Methods
The BPI was translated into Arabic. Its cultural sensitivity was evaluated by a panel of experts. This instrument and a visual analogue scale for pain were administered to a convenience sample of 75 adult oncology patients receiving pain treatment.Results
The experts’ ratings indicated that the tool was culturally sensitive. The majority of the patient sample (88%) was married, male (78.7%), older than 46 years (56%), and with at least a secondary education (84%). The mean pain intensity rating was 5.3 ± 1.7, with interference ratings of 5.3 ± 2.0 to 7.0 ± 2.5. Most patients (78.4%) reported more than 50% pain relief with treatment. Cronbach alpha coefficients were 0.82 and 0.92 for the severity and interference items, respectively. Factor analysis yielded two factors, replicating the severity and interference dimensions. Correlations between the severity and interference items ranged between 0.25 and 0.57 (P < 0.05).Conclusion
The findings support the validity, reliability, and cultural sensitivity of the Arabic BPI in Lebanese oncology patients. This tool can be used to assess pain and improve its management in this population. 相似文献12.
Taeyou Jung DoKyeong Lee Charalambos Charalambous Konstantinos Vrongistinos 《Archives of physical medicine and rehabilitation》2010,91(1):129-136
Jung T, Lee D, Charalambous C, Vrongistinos K. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke.
Objective
To investigate how the application of additional weights to the affected leg influences gait patterns of people poststroke during aquatic treadmill walking.Design
Comparative gait analysis.Setting
University-based aquatic therapy center.Participants
Community-dwelling volunteers (n=22) with chronic hemiparesis caused by stroke.Interventions
Not applicable.Main Outcome Measures
Spatiotemporal and kinematic gait parameters.Results
The use of an ankle weight showed an increase in the stance phase percentage of gait cycle (3%, P=.015) when compared with no weight. However, the difference was not significant after a Bonferroni adjustment was applied for a more stringent statistical analysis. No significant differences were found in cadence and stride length. The use of an ankle weight showed a significant decrease of the peak hip flexion (7.9%, P=.001) of the affected limb as compared with no weight condition. This decrease was marked as the reduction of unwanted limb flotation because people poststroke typically show excessive hip flexion of the paretic leg in the late swing phase followed by fluctuating hip movements during aquatic treadmill walking. The frontal and transverse plane hip motions did not show any significant differences but displayed a trend of a decrease in the peak hip abduction during the swing phase with additional weights. The use of additional weight did not alter sagittal plane kinematics of the knee and ankle joints.Conclusions
The use of applied weight on the affected limb can reduce unwanted limb flotation on the paretic side during aquatic treadmill walking. It can also assist the stance stability by increasing the stance phase percentage closer to 60% of gait cycle. Both findings can contribute to the development of more efficient motor patterns in gait training for people poststroke. The use of a cuff weight does not seem to reduce the limb circumduction during aquatic treadmill walking. 相似文献13.
Liu J Drutz C Kumar R McVicar L Weinberger R Brooks D Salbach NM 《Archives of physical medicine and rehabilitation》2008,89(9):1686-1692
Liu J, Drutz C, Kumar R, McVicar L, Weinberger R, Brooks D, Salbach NM. Use of the six-minute walk test poststroke: is there a practice effect?
Objectives
To determine whether a practice effect occurs across 2 trials of the six-minute walk test (6MWT) among community-dwelling people within 1 year poststroke and to identify characteristics distinguishing people who show a practice effect from those who do not.Design
Secondary analysis of scores on 2 trials of the 6MWT administered approximately 30 minutes apart at baseline in a randomized controlled trial.Setting
General community.Participants
People (N=91) living in the community with a residual walking deficit within the first year of a first or recurrent stroke.Interventions
Not applicable.Main Outcome Measure
Distance walked on the 6MWT.Results
Mean 6MWT scores ± SD for trials 1 and 2 were 196±119m and 197±126m, respectively (n=83). The mean difference in 6MWT performance across trials was 0±35m (95% confidence interval [CI], -7 to 8m). The Pearson correlation coefficient between 6MWT distances was .96 (P<.001), and the intraclass correlation coefficient was .98 (95% CI, .97-.99). The Bland-Altman plot showed no clear pattern. Participants whose improvement was equal to or greater than the minimal detectable change of 29m between trials (14%) did not significantly differ from those in the rest of the study sample; however, they tended to be younger (P=.05) and more likely to have a mild or moderate gait deficit (P=.06).Conclusions
Findings do not support a practice effect across 2 trials of the 6MWT in individuals within 1 year poststroke. Thus, a practice walk does not appear necessary. Further research is recommended to evaluate the influence of young age, acute stroke, and mild-to-moderate gait deficit on practice effects. 相似文献14.
Lisa Lighthall-Haubert Philip S. Requejo PhD Sara J. Mulroy PhD Craig J. Newsam DPT Ernest Bontrager MS JoAnne K. Gronley DPT Jacquelin Perry MD 《Archives of physical medicine and rehabilitation》2009,90(11):1904-1915
Lighthall-Haubert L, Requejo PS, Mulroy SJ, Newsam CJ, Bontrager E, Gronley JK, Perry J. Comparison of shoulder muscle electromyographic activity during standard manual wheelchair and push-rim activated power assisted wheelchair propulsion in persons with complete tetraplegia.
Objectives
To compare spatio-temporal propulsion characteristics and shoulder muscle electromyographic activity in persons with cervical spinal cord injury propelling a standard pushrim wheelchair (WC) and a commercially available pushrim-activated power assisted wheelchair (PAPAW) design on a stationary ergometer.Design
Repeated measures.Setting
Motion analysis laboratory within a rehabilitation hospital.Participants
Men (N=14) with complete (American Spinal Injury Association grade A or B) tetraplegia (C6=5; C7=9).Intervention
Participants propelled a standard pushrim WC and PAPAW during 3 propulsion conditions: self-selected free and fast and simulated 4% or 8% graded resistance propulsion.Main Outcome Measures
Median speed, cycle length, cadence, median and peak electromyographic activity intensity, and duration of electromyographic activity in pectoralis major, anterior deltoid, supraspinatus, and infraspinatus muscles were compared between standard pushrim WC and PAPAW propulsion.Results
A significant (P<.05) decrease in electromyographic activity intensity and duration of pectoralis major, anterior deltoid, and infraspinatus muscles and significantly reduced intensity and push phase duration of supraspinatus electromyographic activity at faster speeds and with increased resistance were seen during PAPAW propulsion.Conclusions
For participants with complete tetraplegia, push phase shoulder muscle activity was decreased in the PAPAW compared with standard pushrim WC, indicating a reduction in demands when propelling a PAPAW. 相似文献15.
Objective
To compare the incidence of treatment-related complications, including lymphoedema, after two programmes of shoulder mobilisation in women with invasive breast cancer when surgical treatment included axillary lymph node dissection.Design
Randomised controlled trial.Setting
Two secondary care National Health Service trusts.Participants
One hundred and sixteen women (mean age 57 years, standard deviation 13.1 years) recruited from November 2003 to March 2006 (58 intervention group, 58 control group). Seven patients (6%) did not complete the study.Intervention
Arm exercises and shoulder movement restricted to below shoulder level for the first 7 days after surgery. Controls commenced an exercise programme that incorporated exercises above shoulder level within 48 hours.Outcome measures
All outcomes were recorded at baseline (pre-operatively) and at 1 year. The primary outcome was incidence of lymphoedema, defined by a limb volume difference of 200 ml or more compared with the contralateral arm. This outcome was measured using volume displacement. Secondary outcome measures included volume differences between the two limbs measured by actual volume displacement difference, wound drainage volumes, range of shoulder movement (manual goniometer), grip strength (hand-held dynamometer) and health-related quality of life (Shoulder Disability Questionnaire, Functional Assessment of Cancer Therapy - Breast).Results
All statistical tests were two-sided. Data were analysed using intention-to-treat principles. The incidence of lymphoedema (200 ml or more) increased significantly in women who had undertaken a programme of early full shoulder mobilisation. Twenty-two women (19%) developed lymphoedema (200 ml or more) in their first postoperative year. There were significantly more women with lymphoedema in the early full shoulder mobilisation group (n = 16) compared with the delayed full shoulder mobilisation group (n = 6). The relative risk of developing lymphoedema after early mobilisation was 2.7 (95% confidence interval 1.1 to 6.3; P = 0.031). Limb volume differences were significantly higher in the early mobilisation group. This was apparent in differences in limb volume displacement (P = 0.004) and percentage difference between the two limbs (P = 0.007). There were no statistically significant differences in shoulder movement, grip strength or self-evaluated outcomes between the two groups at 1 year.Conclusion
A programme of exercise that delays full shoulder mobilisation for 1 week is recommended after axillary node dissection for invasive breast cancer. 相似文献16.
17.
Objective
To investigate the effectiveness of a physiotherapy programme in patients with subacromial impingement syndrome.Design
Prospective randomised study.Setting
Orthopaedic department in a district general hospital.Participants
Eighty-five patients who had been listed for surgery for subacromial impingement syndrome.Interventions
Patients were allocated at random into one of two groups. One group containing 45 patients received physiotherapy while the other group containing 40 patients acted as controls.Outcome measures
All patients entering the study underwent Constant score evaluation prior to being allocated to a group. This was repeated at 6 months, prior to surgical intervention.Results
Seventy-three patients were able to complete the study. In the physiotherapy group, 11 patients no longer required surgery (26%). In this group, all patients improved their Constant score by a mean of 20 (range 4-45). In the control group, all patients required surgery. The mean improvement in the Constant score for the 31 control patients available for review was 0.65 (range −16 to 14).Conclusion
All patients in this study improved with physiotherapy. Physiotherapy should be thought of as a first-line management for patients with subacromial impingement syndrome. 相似文献18.
Objectives
To determine inter-rater agreement on diagnostic category using the Mechanical Diagnosis and Therapy (MDT) classification system for neck pain. If the diagnostic category was derangement syndrome, inter-rater agreement on the subcategory and the directional preference of treatment was also determined.Design
Clinicians viewed videotaped MDT examinations of 20 patients with neck pain and rated the MDT diagnosis independently for each patient. If the diagnostic category was derangement syndrome, the subcategory and directional preference of treatment were also rated.Setting
Private physical therapy outpatient clinics and a university clinical laboratory.Participants
Fifty-four clinicians trained in MDT for neck pain from the USA and Canada, and 20 adult patients with neck pain.Main outcome measures
Inter-rater agreement for MDT diagnosis, derangement subcategory and directional preference of treatment was determined using Kappa and percentage agreement.Results
Overall, agreement was of moderate clinical significance for diagnosis [κ = 0.55, P < 0.001, confidence intervals (CI) 0.52 to 0.58, 67%], derangement subcategory (κ = 0.47, CI 0.44 to 0.50, P < 0.001; 63%) and directional preference of treatment (κ = 0.46, CI 0.43 to 0.49, P < 0.05; 70%).Conclusions
Clinicians trained in MDT for neck pain demonstrate moderate agreement when classifying the diagnostic category and treatment for neck pain. 相似文献19.
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.
Objective
Test effects of pushrim-activated power-assisted wheelchairs (PAPAWs) on the energetics and perceptual responses to steady-state and intensity-graded wheelchair propulsion in persons with paraplegia and tetraplegia having chronic shoulder pain.Design
Test, retest with a control condition.Setting
Academic medical center.Participants
Subjects (N=18) aged 19 to 70 years with chronic, motor-complete paraplegia and tetraplegia having confirmed shoulder pain.Interventions
Study participants underwent testing on 4 randomized nonconsecutive days during either 6 minutes of steady-state or 12 minutes of intensity-graded wheelchair propulsion on stationary rollers. Participants used their own manual wheelchair and either their customary wheels or power-assist wheels attached with an axle bracket.Main Outcome Measures
Oxygen consumption (V?o2, L/min), distance (m), energy cost (L/m), and ratings of perceived exertion (RPE; Borg Categorical 6-20 Scale) were measured during propulsion.Results
Significant main effects of testing were observed for V?o2, heart rate, and RPE in both subject groups. Distances propelled were significantly increased in both groups across both tests and in each of their 2-minute exercise stages.Conclusions
Use of PAPAWs by persons with paraplegia and tetraplegia having shoulder pain significantly lowers energy cost responses and perceived exertion compared with manual wheelchair propulsion while significantly increasing the distanced propelled. 相似文献20.
Serge S. Colson Michaël Benchortane Véronique Tanant Jean-Paul Faghan Manuela Fournier-Mehouas Charles Benaïm Claude Desnuelle Sabrina Sacconi 《Archives of physical medicine and rehabilitation》2010,91(5):697-101
Colson SS, Benchortane M, Tanant V, Faghan J-P, Fournier-Mehouas M, Benaïm C, Desnuelle C, Sacconi S. Neuromuscular electrical stimulation training: a safe and effective treatment for facioscapulohumeral muscular dystrophy patients.