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1.
Tracy U. Nguyen-Oghalai Kenneth J. Ottenbacher Yong-fang Kuo Helen Wu Michael Grecula Karl Eschbach James S. Goodwin 《Archives of physical medicine and rehabilitation》2009,90(4):560-563
Nguyen-Oghalai TU, Ottenbacher KJ, Kuo Y-F, Wu H, Grecula M, Eschbach K, Goodwin JS. Disparities in utilization of outpatient rehabilitative care following hip fracture hospitalization with respect to race and ethnicity.
Objective
To compare the prevalence of discharge home to self-care after hip fracture hospitalization among the elderly in 3 racial groups: whites, Hispanics, and blacks.Design
Secondary data analysis.Setting
US hospitals.Participants
Patients (N=34,203) aged 65 and older with Medicare insurance discharged after hip fracture hospitalization between 2001 and 2005.Interventions
Not applicable.Main Outcome Measure
Discharge home to self-care.Results
Bivariate analyses showed higher rates of discharge home to self-care among minorities, 16.4% for Hispanics, 8.7% for blacks, and 5.9% for whites. Hispanics had 3-fold higher odds of being discharged home to self-care, and blacks had about 50% higher odds of being discharged home to self-care after adjusting for age, sex, Klabunde's comorbidity index, income, year of admission, type of hip fracture, surgical stabilization procedure, and length of hospital stay.Conclusions
The higher rate of discharge home to self-care among minorities underscores the risk of suboptimal outpatient rehabilitative care among minorities with hip fracture. 相似文献2.
Correlation between vestibular function and hip fracture following falls in the elderly: a case-controlled study 总被引:1,自引:0,他引:1
Objective
To examine vestibular function following falls in the elderly.Design
A case-controlled study to compare vestibular function in elderly people with hip fractures and elderly people with no prior hip fractures.Participants
One hundred and sixty-nine people aged 65 years or older took part in the study. Study Group A consisted of 84 hospitalised volunteers who had received hip surgery due to a fall and who were undergoing rehabilitation. Control Group B consisted of 85 volunteers from retirement homes with no prior history of hip fracture.Intervention
All participants underwent four clinical tests to determine their level of vestibular functioning in order to allow comparison between the groups. Three methods were used to test the vestibulo-ocular reflex (VOR), and one method was used to test benign paroxysmal positional vertigo.Results
Thirty-eight percent of the participants in Study Group A and 11% of the participants in Control Group B demonstrated a positive visual acuity test (P < 0.001). The odds ratio suggests that the participants of Study Group A were 4.83 [95% confidence interval (CI) 2.1 to 11.0] times more likely to present a positive static and dynamic visual acuity test than the participants of Control Group B, and 3.12 (95% CI 1.62 to 6.02) times more likely to have a positive head impulse test. There were no differences in the head shaking nystagmus test or the Dix-Hallpike test between groups, and no association between the side of the fracture and the side of the vestibular impairment.Conclusions
Study Group A exhibited greater VOR impairment than Control Group B. Therefore, impairment of this reflex may be considered as a risk factor for falls. 相似文献3.
Barbic S, Brouwer B. Test position and hip strength in healthy adults and people with chronic stroke.
Objective
To determine if peak torques generated by the hip flexors and extensors are dependent on test position in healthy adults and in people with chronic stroke.Design
Cross-sectional study.Setting
Motor performance laboratory.Participants
Volunteers were 10 young (20.7±1.5y), 10 older adults (62.1±7y), and 10 stroke survivors (60.6±10y) who were an average of 5 years poststroke.Interventions
Not applicable.Main Outcome Measures
Isokinetic (60°/s) peak concentric hip flexor and extensor torques (in Nm/kg) generated in supine and standing positions.Results
Peak flexor torques measured in standing were generally higher than in supine (P=.018); a pattern evident in all groups, but significant only in stroke. An interaction between test position and group for hip extensor strength (P=.016) reflected 2 distinct patterns in which torques were highest in standing among the young subjects and highest in supine after stroke.Conclusions
Isokinetic hip flexor and extensor strength measured in standing and supine are comparable in young and older healthy people. In chronic stroke, the test position may over or underestimate maximum peak torque depending on the muscle group tested, particularly on the side ipsilateral to the lesion. These findings may have implications for predicting functional ability from strength measurements. 相似文献4.
Objectives
Acquired brain injury (ABI) requires an extended recovery time and residual signs may be observed years after discharge. Supervised home-based motor training may present a viable option for continuing treatment of adult patients, but little information is available on home-based treatment in children. This study assessed the feasibility of home practice in children with ABI (1 or more years post-trauma). The efficacy of the programme was also evaluated.Design
A non-randomised, self-control study with control and intervention periods.Setting
Home-based exercise programme.Participants
Nineteen children (mean age 12.5 ± 3.1 years).Interventions
A 4-week daily training programme of step-up and sit-stand-sit exercises.Main outcome measures
Feasibility was assessed by the number of participants who completed the programme. Efficacy was evaluated at different stages using 10-metre walking and 2-minute walking tests, and the balance subitems of the Bruininks-Oseretsky Test of Motor Proficiency. An energy expenditure index was calculated for walking. Performance scores were used to assess balance.Results
Nine participants completed the study. The mean number of training sessions was 22 ± 8 of the 30 sessions originally scheduled. Major differences were noted between the experimental stages. Walking speed, endurance and balance improved significantly during the intervention period.Conclusions
Continuing exercising at home may be a feasible and efficient option for a considerable proportion of ABI children who are compliant with a simple but challenging exercise programme. A randomised controlled trial with a larger sample is now required. 相似文献5.
Objective
To identify the current management of osteoarthritis of the hip by physiotherapists in private practice and acute hospital settings in the Republic of Ireland.Design
Cross-sectional postal questionnaire survey.Participants
Physiotherapists in 35 acute hospitals (n = 150) and a random selection of physiotherapists in private practice (n = 172) in the Republic of Ireland were surveyed.Results
A valid response rate of 65% (n = 210) was achieved. The most common intervention used by therapists was exercise therapy (210/210, 100%), followed by education (207/210, 99%), manual therapy (202/210, 96%), thermal agents (154/210, 73%) and electrotherapy (130/210, 62%). Hydrotherapy and acupuncture were used by 29% (61/210) and 18% (38/210) of respondents, respectively. Statistical differences in these interventions between public and private settings existed only for thermal agents (P = 0.001) and acupuncture (P = 0.002). A total of 84% (177/210) of those surveyed used outcome measures, most commonly pain severity scales (163/210, 78%). Osteoarthritis-specific questionnaires (33/210, 16%) and quality of life (16/210, 8%) measures were used less frequently.Conclusions
The importance of exercise therapy, education and manual therapy in the management of osteoarthritis of the hip was demonstrated. There was little difference overall in the physiotherapy management of osteoarthritis of the hip between public and private settings. The use of these interventions compared to known scientific evidence is discussed. Although there was high usage of outcome measures, hip osteoarthritis-specific outcomes and quality of life measures were not commonly used. This survey identified interventions most commonly used in clinical practice including exercise, education and manual therapy, and highlights a need for further research to evaluate the effectiveness of such interventions. 相似文献6.
Julie Nantel Nicolas Termoz Pascal-André Vendittoli Martin Lavigne François Prince 《Archives of physical medicine and rehabilitation》2009,90(3):463-469
Nantel J, Termoz N, Vendittoli P-A, Lavigne M, Prince F. Gait patterns after total hip arthroplasty and surface replacement arthroplasty.
Objective
To compare gait patterns in patients with total hip arthroplasty (THA) and surface hip arthroplasty.Design
Observational study.Setting
Outpatient biomechanical laboratory.Participants
Two groups of 10 surface hip arthroplasty and THA patients and 10 control subjects participated in the study (N=30). The patients were volunteers recruited from a larger randomized study.Interventions
Not applicable.Main Outcomes Measures
Gait patterns, hip abductor muscle strength, clinical outcomes, and radiographic analyses were compared between groups.Results
In the sagittal plane, the THA group showed a larger flexor moment and larger mechanical work in H2S and K3S power bursts compared with surface hip arthroplasty and control subjects. In the frontal plane, both THA and surface hip arthroplasty patients had smaller hip abductor muscles energy generation (H3F) than the control group. No difference was found for the hip abductor muscles strength.Conclusions
In the THA group, the larger energy absorption in H2S and K3S would be a cost-effective mechanical adaptation to increase stability. The surface hip arthroplasty characteristics could allow the return to a more normative gait pattern compared with THA. The modification in the frontal plane in surface hip arthroplasty and THA would be related to the hip abductor muscles strength. 相似文献7.
Objectives
To explore whether compliance with a prescribed home exercise program in elderly people with knee and/or hip osteoarthritis was influenced by mode of exercise instruction.Design
Participants were randomised to one of three groups who received different modes of exercise instruction. Exercise performance was assessed at baseline and after 4 weeks and 8 weeks of home exercises.Setting
Eighteen physiotherapy clinics in rural Victoria, Australia.Participants
One hundred and fifteen males and females (mean age 70.5 years) with osteoarthritis of the knees and/or hips.Interventions
Participants were randomised to receive verbal instructions on a home exercise program in addition to: (i) a home exercise brochure; (ii) a brochure together with an audiotape; or (iii) a brochure together with a videotape.Main outcome measures
The Correctness of Exercise Performance scale and exercise log-sheets.Results
Compliance with the home exercise program was good for all modes of exercise instruction where between 79% and 91% of exercises were performed correctly. Once provided with verbal instructions together with illustrated brochures, the provision of additional videotapes or audiotapes did not further enhance outcome.Conclusions
Older people with osteoarthritis who received face-to-face instructions and a brochure on how to perform and comply with an 8-week home exercise program did not show additional benefits from other modes of instruction.Key messages
- •
- Brochures can be as effective as additional audiotapes or videotapes to enhance correctness of exercise performance in older people with osteoarthritis of the knees and/or hips when given together with verbal instructions.
- •
- Audiotapes and videotapes may provide additional cues to maintain correctness of performance of exercises that are difficult to perform.
8.
D.J. Beard J. Palan J.G. Andrew J. Nolan D.W. Murray EPOS Study Group 《Physiotherapy》2008,94(2):91-96
Objectives
The clinical importance of a leg length discrepancy (LLD) following total hip arthroplasty (THA) remains controversial. This study was undertaken to determine the effects of LLD on clinical outcomes at up to 3 years follow-up.Design and setting
Prospective, multicentre study.Participants
Nine hundred and eighty-seven cases of primary THA, categorised into two main groups: the NoLLD group (LLD of less than 10 mm) and the LLD group (LLD of 10 mm or more).Main outcome measures
The primary outcome measure was the change in Oxford Hip Score (ΔOHS) at up to 3 years follow-up. Secondary outcome measures were length of operating time and hospital stay, and revision and dislocation rates. Potential predisposing factors for LLD, including body mass index, age and type of anaesthesia employed, were examined.Results
At 3 years, the LLD group had a significantly worse ΔOHS [22.0; 95% confidence interval (CI) 20.5 to 23.5] compared with the NoLLD group (23.8; 95% CI 23.1 to 24.5) (P = 0.034). There were no significant differences in revision (P = 0.389) or dislocation (P = 0.220) rates between the two groups. Use of an epidural was associated with a decreased incidence of developing an LLD of 10 mm (P = 0.004).Conclusion
A postoperative LLD of 10 mm or more leads to poorer functional outcomes. Further studies are needed to assess the impact of an LLD on clinical outcomes in the longer term. 相似文献9.
Sze PC Cheung WH Lam PS Lo HS Leung KS Chan T 《Archives of physical medicine and rehabilitation》2008,89(7):1329-1334
Sze P-C, Cheung W-H, Lam P-S, Lo HS-D, Leung K-S, Chan T. The efficacy of a multidisciplinary falls prevention clinic with an extended step-down community program.
Objective
To investigate the efficacy of a falls prevention clinic and a community step-down program in reducing the number of falls among community-dwelling elderly at high risk of fall.Design
Prospective cohort.Setting
Community.Participants
Community-dwelling elderly (N=200) were screened for risk of fall; 60 were identified as being at high risk and were referred to the intervention program.Intervention
Twelve sessions of a once-a-week falls prevention clinic, including fall evaluation, balance training, home hazard management program, and medical referrals, were provided in the first 3 months. The community step-down program, including falls prevention education, a weekly exercise class, and 2 home visitations, was provided in the following 9 months.Main Outcome Measures
Fall rate, injurious fall, and its associated medical consultation were recorded during the intervention period and the year before intervention. Balance tests included the Berg Balance Scale (BBS), Sensory Organization Test, and limits of stability test; fear of falling, as evaluated using the Activities-specific Balance Confidence (ABC) scale, was measured at baseline and after the training in the falls prevention clinic.Results
Significant reductions in fall rate (74%), injurious falls (43%), and fall-associated medical consultation (47%) were noted. Significant improvement in balance scores (BBS, P<.001; endpoint excursion in limits of stability test, P=.004) and fear of falling (ABC scale, P=.001) was shown.Conclusions
The programs in the falls prevention clinic were effective in reducing the number of falls and injurious falls. The community step-down programs were crucial in maintaining the intervention effects of the falls prevention clinic. 相似文献10.
Morten T. Kristensen Charlotte Ekdahl Henrik Kehlet Thomas Bandholm 《Archives of physical medicine and rehabilitation》2010,91(6):885-889
Kristensen MT, Ekdahl C, Kehlet H, Bandholm T. How many trials are needed to achieve performance stability of the Timed Up & Go test in patients with hip fracture?
Objective
To examine the number of trials needed to achieve performance stability of the Timed Up & Go (TUG) test using a standardized walking aid in patients with hip fracture who are allowed full weight bearing (FWB).Design
Prospective methodologic study.Setting
An acute 14-bed orthopedic hip fracture unit.Participants
Patients (N=122; 89 women, 33 men) with hip fracture with a median age (25%-75%, quartiles) of 80 (67-85) years performed the TUG on hospital discharge to their own home (n=115) or further inpatient rehabilitation (n=7).Interventions
Not applicable.Main Outcome Measures
After a demonstration by a physical therapist how to perform the TUG with a standardized walking aid (a 4-wheeled rollator), the patients performed 6 timed TUG trials with up to 1-minute seated rest intervals. The participants were given a few minutes to familiarize with the rollator before commencing the timed trials. Repeated-measures analysis of variance (ANOVA) with Bonferroni corrections were used to examine the number of trials needed to ensure statistically stable TUG scores.Results
A total of 106 (87%) patients performed all 6 TUG trials, while 120 patients performed a minimum of 3 timed trials. Repeated-measures ANOVAs of both groups showed that TUG scores improved significantly (P≤.007) up to and including the third TUG trial.Conclusions
These results suggest that the original TUG manual, described as 1 practice trial followed by 1 timed trial, needs modification when used in patients with hip fracture who are allowed FWB. The best (fastest) of 3 timed TUG trials performed with a standardized walking aid is recommended. 相似文献11.
Objective
The purpose of this work was to design and evaluate an information leaflet for new patients attending a physiotherapy outpatient department. This formed part of a wider agenda of improving the patients’ experience and increasing adherence to the Chartered Society of Physiotherapy's core standards.Design
A needs analysis was undertaken with existing patients to determine the content of the new leaflet. This was then tested for readability, reviewed by physiotherapy staff and evaluated by patients via a questionnaire.Setting
The musculoskeletal outpatient physiotherapy department at Southampton General Hospital.Participants
Patients referred to the outpatient physiotherapy service, plus all clinical and support staff employed in the musculoskeletal outpatient team.Main outcome measures
Numerical Rating Scale and Gunning's Fog Index.Results
Thirty-seven of 50 patients completed the needs analysis (74%), generating 42 ideas for the leaflet content. The definitive leaflet addressed one core standard and 16 specific criteria, and had a readability of grade 8.3, which is below the recommended maximum limit of grade 9 for health education leaflets. Using an 11-point Numerical Rating Scale, where 0 = of no benefit and 10 = extremely helpful, the mean rating for the leaflet from 29 of 100 patients was 8.6.Conclusions
This work has produced a patient information leaflet for physiotherapy outpatients, a copy of which is freely available (electronically) from the author. The leaflet forms part of an ongoing commitment to improving the patients’ experience. 相似文献12.
Objective
The incremental shuttle walking test (ISWT) is widely used to assess patients with chronic obstructive pulmonary disease. We hypothesised that it would be an appropriate tool to assess patients with coronary heart disease following coronary artery bypass grafts. We therefore explored the reproducibility, validity and sensitivity of the ISWT following rehabilitation.Design
Participants completed three ISWTs and an incremental treadmill test over 7 days. Eleven patients repeated the ISWT following rehabilitation.Setting
Cardiac rehabilitation department.Participants
Thirty-nine patients, 34 of whom were male, with a mean age of 61.2 years (S.D. 8.5), 6-8 weeks after coronary artery bypass graft surgery.Main outcome measures
Maximum oxygen uptake (O2 peak, ml/min/kg) and ISWT.Results
Mean (S.D.) distances for the three ISWTs were 448 m (137.8), 487 m (147.6) and 481 m (138.2). There was no statistically significant difference between the three ISWTs. The mean difference between Tests 1 and 2 was 42.8 m (95% confidence interval 59.1-26.5 m) compared with 1.7 m (95% confidence interval −1.86-5.29) between Tests 2 and 3. The mean O2 peak was 21.0 (S.D. 4.5) ml/min/kg. There was a significant relationship between the results for the three ISWTs and O2 peak (r = 0.79, r = 0.86 and r = 0.87 for Tests 1-3, respectively). Following rehabilitation, there was a significant increase in the distance walked; the mean difference between the second ISWT and the post-rehabilitation ISWT was 81.8 m (95% confidence interval 53.2-110.4, P < 0.001).Conclusions
The ISWT correlates well with O2 peak and is a reliable measure of cardiorespiratory fitness in this population after one practice walk. 相似文献13.
Objective
To investigate the hypoalgesic effects of massage on experimental pain.Design
A cross-over intervention study separated by a 24-hour washout period. During each experiment, participants completed five cold-induced pain tests, two before the intervention and three during the intervention. During each test, participants immersed their hand in iced water and reported the first sensation of pain and pain intensity after a further 30 seconds.Setting
Laboratory setting.Participants
A volunteer sample of 30 university staff and students without known pathology, recruited from noticeboard advertisements.Interventions
Participants received massage in one experiment and static touch in the other experiment. Interventions were administered to the ipsilateral arm for 4 minutes immediately before the hand was immersed in iced water.Main outcome measures
Time to pain threshold and the odds of a reduction in pain intensity and an increase in pain relief.Results
A mixed model analysis was used to establish how measures varied, according to baseline, during static touch and during massage. Massage increased the pain threshold by a factor of 1.08 (95% confidence interval 0.99-1.17) compared with static touch, but this failed to reach statistical significance (P = 0.088). Massage was more likely to result in a report of low pain intensity than static touch (odds ratio 0.26, 95% confidence interval 0.10-0.71, P = 0.007). Massage was more likely to result in a state of high pain relief than static touch (odds ratio 7.7, 95% confidence interval 3.0-19.8, P < 0.001).Conclusion
Massage produced hypoalgesic effects on experimental pain in healthy volunteers. 相似文献14.
Objectives
This study investigated the efficacy of a rehabilitation technique for the treatment of chronic fatigue syndrome that was developed by a physiotherapist. Data collected retrospectively from a pilot study indicated that patients benefited from this multiconvergent approach, so further assessments were warranted.Design
Treatment efficacy was assessed by comparing the primary and secondary outcome measures of patients attending multiconvergent therapy (MCT) with those of patients attending relaxation therapy and a group of non-intervention controls.Setting
The active treatment took place at a clinic within the physiotherapy outpatient unit. Relaxation therapy and all assessments were conducted at the psychology unit.Participants
Thirty-five participants, fitting the Centers for Disease Control and Prevention criteria for chronic fatigue syndrome, were recruited from two outpatient clinics and an existing patient panel.Intervention
Patients were assigned to either MCT (n = 12) or relaxation therapy (n = 14). Nine participants who received general medical care were used as a comparison group.Main outcome measures
The Karnofsky performance scale was used as the primary outcome measure of function. Secondary outcome measures assessing overall improvement in patient condition, fatigue and disability levels were also administered.Results
A significant percentage of the patients attending the MCT sessions showed improvement in the primary outcome score used to measure the success of the treatment (MCT = 83%, relaxation = 21%, controls = 0; P < 0.001). A significant percentage of this group also reported improvement in their overall condition (MCT = 92%, relaxation = 64%, controls = 22%; P < 0.001), lower fatigue levels (MCT = 83%, relaxation = 57%, controls = 11%; P < 0.001) and lower levels of disability (MCT = 75%, relaxation = 43%, controls = 11%; P = 0.032) immediately post-therapy. In addition, these improvements were maintained at 6-month follow-up.Conclusions
Outcomes from this small preliminary study were encouraging. The multiconvergent approach produced significant improvements for standardised primary and secondary outcome measures. Further research is required to examine the efficacy of this approach over time, and its effectiveness on a larger scale within the primary healthcare setting using additional therapists trained in the technique. 相似文献15.
Objectives
Outpatient pulmonary rehabilitation relies on the patient completing bouts of unsupervised exercise at home. The aim of this study was to monitor adherence with a home walking programme using activity monitors.Design
The sensitivity and reliability of five activity monitors were initially established at speeds at which patients are advised to walk. Thereafter, 18 patients with established chronic obstructive pulmonary disease attending pulmonary rehabilitation were recruited. All patients were required to wear a small device around their waist for two, 7-day periods during the 7-week course of rehabilitation. During this time, patients also completed a home diary card. Adherence was monitored by frequency, duration and intensity of walks.Setting
Pulmonary Rehabilitation Department, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.Results
The activity monitors were able to clearly discriminate varying walking speeds and were reproducible at each pre-selected speed (P < 0.05). However, between-monitor comparison was not reproducible at the pre-determined speeds. Individually prescribed walking speeds for home training ranged from 1.76 to 4.83 km/hour. As a group, only two patients failed to achieve 100% of total adherence. Adherence for the individual components varied widely.Conclusion
Activity monitor technology appears to be able to discriminate individually prescribed walking speeds that allow home walking programmes to be monitored. 相似文献16.
Belanger HG King-Kallimanis B Nelson AL Schonfeld L Scott SG Vanderploeg RD 《Archives of physical medicine and rehabilitation》2008,89(2):244-250
Belanger HG, King-Kallimanis B, Nelson AL, Schonfeld L, Scott SG, Vanderploeg RD. Characterizing wandering behaviors in persons with traumatic brain injury residing in Veterans Health Administration nursing homes.
Objective
To examine the prevalence and correlates of wandering in persons with traumatic brain injury (TBI) in nursing homes (NHs).Design
Using a cross-sectional design, logistic regression modeling was used to analyze a national database.Setting
One hundred thirty-four NH facilities operated by the Veterans Health Administration.Participants
NH residents (N=625) with TBI as well as a sample (n=164) drawn from a larger dataset of NH residents without TBI using 1:K matching on age.Interventions
Not applicable.Main Outcome Measure
Wandering.Results
Wanderers with and without TBI did not differ significantly overall. The prevalence of wandering among patients with TBI was 14%, compared with 6.5% of the general nursing home population. The results of the multivariate logistic regression suggested that wandering was associated with poor memory, poor decision making, behavior problems, independence in locomotion and ambulation, and dependence in activities of daily living related to basic hygiene.Conclusions
Wandering is relatively common in NH residents with TBI. As expected, it is associated with cognitive, social, and physical impairments. Further research with a larger sample should examine those with comorbid dementia and/or psychiatric diagnoses. 相似文献17.
Willi Horner-Johnson Gloria L. Krahn Rie Suzuki Jana J. Peterson Gale Roid Trevor Hall RRTC Expert Panel on Health Measurement 《Archives of physical medicine and rehabilitation》2010,91(4):570-575
Horner-Johnson W, Krahn GL, Suzuki R, Peterson JJ, Roid G, Hall T, the RRTC Expert Panel on Health Measurement. Differential performance of SF-36 items in healthy adults with and without functional limitations.
Objective
To determine whether Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) items show differential item functioning among healthy adults with various types of functional limitations as compared with a healthy sample with no identified limitations.Design
Survey responses were analyzed by using partial correlations.Setting
General community.Participants
Participants (N=206) included (1) adults with spinal cord injury (SCI), (2) adults who were deaf or hard of hearing, (3) adults who were legally blind, (4) adults with psychiatric or emotional conditions, and (5) adults with no reported functional limitations. Participants were screened to ensure the absence of substantial health problems.Interventions
Not applicable.Main Outcome Measure
SF-36.Results
Partial correlations showed a significant negative correlation, indicating differential item functioning (ie, apparent bias) for people with SCI on all 10 SF-36 Physical Functioning items. For people who were blind, 5 items showed a significant negative correlation. Two items had significant negative correlations for the deaf/hard-of-hearing group. One item showed significant negative performance for people with mental health conditions.Conclusions
Our data indicated a possibility for measurement bias caused by the blending of health and function concepts in the SF-36. 相似文献18.
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19.
Objectives
To compare heart rate responses in the 6-minute walk test and the treadmill exercise test before and after an exercise-based cardiac rehabilitation programme.Design
Prospective cohort study.Setting
Hospital-based cardiac rehabilitation programme in Hong Kong.Participants
Thirty patients (mean age 62.1 ± 8.5 years, 20 males) with stable ischaemic heart disease.Interventions
Eight-week exercise-based cardiac rehabilitation programme involving upper and lower limb aerobic and resistance training.Main outcome measures
Six-minute walk test and treadmill exercise test before and after the exercise programme.Results
Comparing parameters before and after the exercise programme, the peak heart rate in the 6-minute walk test increased (median of 105 beats per minute (bpm), interquartile range 96.8-116.5 versus 110 bpm, interquartile range 100.5-124.5, P = 0.006), while heart rate recovery improved in each 30-second interval of a 2-minute recovery period. The distance covered during the 6-minute walk increased from a mean of 486.3 m (±standard deviation 113.9 m) to 552.5 m (±standard deviation 111.9 m) (P < 0.001). Rating of perceived exertion during the 6-minute walk test decreased from a median of 14 (interquartile range 13-15) to 13 (interquartile range 13-13) (P = 0.001). Heart rate recovery following treadmill exercise testing improved during the 30-second periods from 60 to 90 seconds and from 90 to 120 seconds of recovery. Metabolic equivalents increased during treadmill testing from a median of 7.0 (interquartile range 5.8-8.6) to 8.6 (interquartile range 7-8.6) (P < 0.001).Conclusions
Both treadmill exercise and 6-minute walk tests demonstrated improvements in heart rate recovery and increases in achieved workload following exercise training. This suggests that the 6-minute walk test is a valid tool to assess heart rate recovery following such a programme. 相似文献20.