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1.
Liang HW Wang YH Pan SL Wang TG Huang TS 《Archives of physical medicine and rehabilitation》2007,88(9):1193-1197
Liang H-W, Wang Y-H, Pan S-L, Wang TG, Huang T-S. Asymptomatic median mononeuropathy among men with chronic paraplegia.
Objectives
To compare electrophysiologic abnormalities of the median nerve in asymptomatic paraplegic subjects and able-bodied controls and to examine the influence of personal factors on these parameters.Design
Cross-sectional survey.Setting
University hospital.Participants
Forty-seven men with paraplegia and 36 able-bodied controls underwent nerve conduction studies on both upper limbs. All were free of hand numbness in the past month, diabetic mellitus, or neuromusculoskeletal injuries to the upper limbs.Interventions
Not applicable.Main Outcome Measure
Nerve conduction studies of the bilateral median and ulnar nerves.Results
Although the 2 groups were of comparable age and had a similar body mass index (BMI), the subjects with paraplegia had a significantly higher proportion of asymptomatic median mononeuropathy than the controls (25.5% vs 5.6%, P=.02). The spinal cord injury (SCI) group had a prolonged median distal latency and a slowed digit-wrist sensory nerve conduction velocity. Multivariate general linear model analysis showed that prolonged motor and sensory latencies of the median nerve were associated with the SCI group and with greater BMI.Conclusions
The asymptomatic subjects with paraplegia had a significantly higher frequency of median mononeuropathy than the able-bodied controls. There was also an association between BMI and distal latency of the median nerve. 相似文献2.
van Koppenhagen CF Post MW van der Woude LH de Witte LP van Asbeck FW de Groot S van den Heuvel W Lindeman E 《Archives of physical medicine and rehabilitation》2008,89(9):1733-1740
van Koppenhagen CF, Post MW, van der Woude LH, de Witte LP, van Asbeck FW, de Groot S, van den Heuvel W, Lindeman E. Changes and determinants of life satisfaction after spinal cord injury: a cohort study in The Netherlands.
Objective
To determine the impact of spinal cord injury (SCI) on life satisfaction of persons with SCI 1 year after discharge of inpatient rehabilitation.Design
A cohort study. Life satisfaction before SCI was retrospectively measured at the start of active rehabilitation. One year after discharge from inpatient rehabilitation, current life satisfaction was measured.Setting
Eight rehabilitation centers in The Netherlands.Participants
Persons (N=147) aged 18 to 65 and wheelchair-dependent at least for long distances.Interventions
Not applicable.Main Outcome Measure
The Life Satisfaction Questionnaire.Results
Mean satisfaction with life ± SD as a whole was 5.3±0 before SCI and 4.3±1.3 one year after inpatient rehabilitation. Sexual life, self-care, and vocational situation showed the largest impact of SCI (P<.05), whereas the social relationships domains appeared to be the least affected. Decrease of life satisfaction after SCI was larger when using the retrospective ratings than when using general population scores. Significant determinants of life satisfaction after SCI were high lesion level (β=.31, P<.05), pain (β=.19, P<.05), and secondary impairments (β=.22, P<.05).Conclusions
Life satisfaction decreased in persons with SCI. Level of lesion and suffering secondary impairments or pain were associated with low life satisfaction 1 year after discharge from inpatient rehabilitation. 相似文献3.
Sepideh Pooyania Karen Ethans Tony Szturm Alan Casey Daryl Perry 《Archives of physical medicine and rehabilitation》2010,91(5):703-707
Pooyania S, Ethans K, Szturm T, Casey A, Perry D. A randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury.
Objectives
To determine whether nabilone, a synthetic cannabinoid, alleviates spasticity in people with spinal cord injury (SCI).Design
A double-blind, placebo-controlled crossover study.Setting
Outpatient rehabilitation clinics.Participants
We recruited volunteers (N=12) with SCI and spasticity. One subject, a paraplegic man, dropped out of the study because of an unrelated cause. Eleven subjects completed the study; all subjects were men with an average age of 42.36 years; 6 of them were persons with tetraplegia, and 5 were persons with paraplegia.Interventions
The subjects received either nabilone or placebo during the first 4-week period (0.5mg once a day with option to increase to 0.5mg twice a day), and then outcome measures were assessed. After a 2-week washout, subjects were crossed over to the opposite arm.Main Outcome Measures
The primary outcome was the Ashworth Scale for spasticity in the most involved muscle group, in either the upper or lower extremities, chosen by the subject and clinician. The secondary outcomes included the sum of the Ashworth Scale in 8 muscle groups of each side of the body measured by the clinician; Spasm Frequency Scale and visual analog scale, reported by the subject; Wartenberg Pendulum Test, in order to quantify severity of spasticity; and the Clinician's and Subject's Global Impression of Change.Results
One subject dropped out during the placebo arm because of an unrelated urinary stricture, and 11 subjects completed the study. There was a significant decrease on active treatment for the Ashworth in the most involved muscle (mean difference ± SD, .909±.85; P=.003), as well as the total Ashworth score (P=.001). There was no significant difference in other measures. Side effects were mild and tolerable.Conclusions
Nabilone may be beneficial to reduce spasticity in people with SCI. We recommend a larger trial with a more prolonged treatment period and an option to slowly increase the dosage further. 相似文献4.
Shah JP Danoff JV Desai MJ Parikh S Nakamura LY Phillips TM Gerber LH 《Archives of physical medicine and rehabilitation》2008,89(1):16-23
Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, Gerber LH. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points.
Objectives
To investigate the biochemical milieu of the upper trapezius muscle in subjects with active, latent, or absent myofascial trigger points (MTPs) and to contrast this with that of the noninvolved gastrocnemius muscle.Design
We used a microanalytic technique, including needle insertions at standardized locations in subjects identified as active (having neck pain and MTP), latent (no neck pain but with MTP), or normal (no neck pain, no MTP). We followed a predetermined sampling schedule; first in the trapezius muscle and then in normal gastrocnemius muscle, to measure pH, bradykinin, substance P, calcitonin gene-related peptide, tumor necrosis factor alpha, interleukin 1β (IL-1β), IL-6, IL-8, serotonin, and norepinephrine, using immunocapillary electrophoresis and capillary electrochromatography. Pressure algometry was obtained. We compared analyte concentrations among groups with 2-way repeated-measures analysis of variance.Setting
A biomedical research facility.Participants
Nine healthy volunteer subjects.Interventions
Not applicable.Main Outcome Measures
Preselected analyte concentrations.Results
Within the trapezius muscle, concentrations for all analytes were higher in active subjects than in latent or normal subjects (P<.002); pH was lower (P<.03). At needle insertion, analyte concentrations in the trapezius for the active group were always higher (pH not different) than concentrations in the gastrocnemius muscle. At all times within the gastrocnemius, the active group had higher concentrations of all analytes than did subjects in the latent and normal groups (P<.05); pH was lower (P<.01).Conclusions
We have shown the feasibility of continuous, in vivo recovery of small molecules from soft tissue without harmful effects. Subjects with active MTPs in the trapezius muscle have a biochemical milieu of selected inflammatory mediators, neuropeptides, cytokines, and catecholamines different from subjects with latent or absent MTPs in their trapezius. These concentrations also differ quantitatively from a remote, uninvolved site in the gastrocnemius muscle. The milieu of the gastrocnemius in subjects with active MTPs in the trapezius differs from subjects without active MTPs. 相似文献5.
Hussain R Cevallos ME Darouiche RO Trautner BW 《Archives of physical medicine and rehabilitation》2008,89(2):339-342
Hussain R, Cevallos ME, Darouiche RO, Trautner BW. Gram-negative intravascular catheter-related bacteremia in patients with spinal cord injury.
Objective
To determine whether the prevalence of gram-negative catheter-related bloodstream infection (CRBSI) is higher in patients with spinal cord injury (SCI) than in patients without SCI.Design
Retrospective chart review from August 1998 to August 2006.Setting
A Veterans Affairs medical center, which serves as a tertiary care medical center to over 500 veterans with SCI and is the primary source of health care for veterans in southeast Texas.Participants
All hospitalized patients who had an International Classification of Diseases, Ninth Revision, code for bacteremia associated with their hospital stay.Interventions
Not applicable.Main Outcome Measure
The proportion of CRBSI caused by gram-negative organisms in the SCI patients to the proportion of CRBSI caused by gram-negative organisms in the non-SCI patients.Results
Eight (42%) of 19 episodes of CRBSI in the SCI were caused by a gram-negative organism as compared with 4 (11%) of 36 infections in the non-SCI group (P<.01). Factors associated with having a gram-negative organism rather than a gram-positive organism as the causative agent of CRBSI were SCI, femoral catheter site, prolonged hospitalization, decubitus ulcer, and urinary catheter.Conclusions
In our medical center, patients with SCI who develop CRBSI are more likely to have an infection with a gram-negative organism than are patients without SCI. This knowledge may guide initial empirical therapy of suspected bloodstream infection. 相似文献6.
Alena M. Grabowski 《Archives of physical medicine and rehabilitation》2010,91(6):951-957
Grabowski AM. Metabolic and biomechanical effects of velocity and weight support using a lower-body positive pressure device during walking.
Objectives
To determine how changes in velocity and weight support affect metabolic power and ground reaction forces (GRFs) during walking using a lower-body positive pressure (LBPP) device. To find specific velocity and weight combinations that require similar aerobic demands but different peak GRFs.Design
Repeated measures.Setting
University research laboratory.Participants
Healthy volunteer subjects (N=10).Interventions
Subjects walked 1.00, 1.25, and 1.50m/s on a force-measuring treadmill at normal weight (1.0 body weight [BW]) and at several fractions of BW (.25, .50, .75, .85 BW). The treadmill was enclosed within an LBPP apparatus that supported BW.Main Outcome Measures
Metabolic power, GRFs, and stride kinematics.Results
At faster velocities, peak GRFs and metabolic demands were greater. In contrast, walking at lower fractions of BW attenuated peak GRFs and reduced metabolic demand compared with normal weight walking. Many combinations of velocity and BW resulted in similar aerobic demands, yet walking faster with weight support lowered peak GRFs compared with normal weight walking.Conclusions
Manipulating velocity and weight using an LBPP device during treadmill walking can reduce force yet maintain cardiorespiratory demand. Thus, LBPP treadmill training devices could be highly effective for rehabilitation after orthopedic injury and/or orthopedic procedures. 相似文献7.
Macciocchi S Seel RT Thompson N Byams R Bowman B 《Archives of physical medicine and rehabilitation》2008,89(7):1350-1357
Macciocchi S, Seel RT, Thompson N, Byams R, Bowman B. Spinal cord injury and co-occurring traumatic brain injury: assessment and incidence.
Objectives
To examine prospectively the incidence and severity of co-occurring traumatic brain injury (TBI) in persons with traumatic spinal cord injury (SCI) and to describe a TBI assessment process for SCI rehabilitation professionals.Design
A prospective, cohort design to collect and analyze clinical variables relevant for diagnosing co-occurring TBI.Setting
An urban, single-center National Institute of Disability and Rehabilitation Research Model Spinal Cord Injury System in the Southeastern United States.Participants
People (N=198) who met inclusion criteria and provided consent within an 18-month recruitment window.Interventions
Not applicable.Main Outcome Measure
FIM cognitive scale.Results
Based on participants' presence and duration of posttraumatic amnesia, initial Glasgow Coma Scale total score, and presence of cerebral lesion documented by neuroimaging, 60% of our traumatic SCI sample also sustained a TBI (n=118). Most co-occurring TBIs were mild (34%). Co-occurring mild complicated (10%), moderate (6%), and severe TBI (10%) were less common but still occurred in a significant percentage (26%) of persons with traumatic SCI. Persons with traumatic SCI who were injured in motor vehicle collisions and falls were more likely to sustain a co-occurring TBI. Cervical level traumatic SCI was associated with greater rates of TBI but not more severe injuries. Tree analyses established a practical algorithm for classifying TBI severity associated with traumatic SCI. Analysis of variance established criterion validity for the algorithm's TBI severity classifications.Conclusions
Findings from our prospective study provide strong support that TBI is a common co-occurring injury with traumatic SCI. Incomplete acute care medical record documentation of TBI in the traumatic SCI population remains a considerable issue, and there is a significant need to educate emergency department and acute care personnel on the TBI clinical data needs of acute rehabilitation providers. A systematic algorithm for reviewing acute care medical records can yield valid estimates of TBI severity in the traumatic SCI population. 相似文献8.
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9.
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10.
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11.
Frances M. Weaver Stephen P. Burns Charlesnika T. Evans Lauren M. Rapacki Barry Goldstein Margaret C. Hammond 《Archives of physical medicine and rehabilitation》2009,90(3):517-521
Weaver FM, Burns SP, Evans CT, Rapacki LM, Goldstein B, Hammond MC. Provider perspectives on soldiers with new spinal cord injuries returning from Iraq and Afghanistan.
Objective
The military conflicts in Iraq and Afghanistan have resulted in many soldiers returning with serious combat injuries, including spinal cord injuries (SCIs). The purpose of this study was to query providers regarding any unique problems or needs in a cohort of these soldiers treated in Veterans Health Administration (VHA) SCI Centers.Design
Semistructured questionnaire.Setting
Seventeen VHA SCI Centers.Participants
Thirty-eight providers, including physicians, nurses, therapists, social workers, and psychologists who volunteered to return completed questionnaires.Interventions
Not applicable.Main Outcome Measures
Identification of medical and psychosocial issues, rehabilitation delays, therapy and vocational needs, social support, and discharge planning.Results
Providers identified several injuries and conditions beyond SCI that were experienced by these soldiers including fractures, pressure ulcers, traumatic brain injuries, posttraumatic stress disorder, and resistant infections. Rehabilitation was often delayed because these problems needed to be addressed first. Soldiers' family and friends provide considerable support. Vocational needs include use of technology, especially computers; education; and participation in sports. Although most return to the community after discharge, many soldiers are still active duty, and some return to military base housing.Conclusions
Combat soldiers returning with SCI often have additional medical and psychosocial problems that require appropriate and timely intervention. They have strong support from family and friends and are motivated to integrate back into the community after discharge. 相似文献12.
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13.
Fornusek C, Davis GM. Cardiovascular and metabolic responses during functional electric stimulation cycling at different cadences.
Objective
To determine the influence of pedaling cadence on cardiorespiratory responses and muscle oxygenation during functional electric stimulation (FES) leg cycling.Design
Repeated measures.Setting
Laboratory.Participants
Nine subjects with T4 through T10 spinal cord injury (SCI) (American Spinal Injury Association grade A).Interventions
FES cycling was performed at pedaling cadences of 15, 30, and 50 revolutions per minute (rpm).Main Outcome Measures
At each cadence, heart rate, oxygen uptake, and cardiac output were recorded during 35 minutes of cycling. Near infrared spectroscopy was used to quantify quadriceps muscle oxygenation.Results
All pedaling cadences induced similar elevations in cardiorespiratory metabolism, compared with resting values. Higher average power output was produced at 30rpm (8.2±0.7W, P<.05) and 50rpm (7.9±0.5W, P<.05) compared with 15rpm (6.3±0.6W). Gross mechanical efficiency was significantly higher (P<.05) at 30 and 50rpm than at 15rpm. Quadriceps muscle oxygenation did not differ with pedaling cadences.Conclusions
Cardiorespiratory responses and muscle metabolism adjustments during FES leg cycling were independent of pedal cadence. FES cycling at a cadence of 50rpm may not confer any advantages over 30 or 15rpm for cardiovascular fitness promotion in persons with SCI. 相似文献14.
Leslie R. Morse Antonio A. Lazzari Ricardo Battaglino Kelly L. Stolzmann Kirby R. Matthess David R. Gagnon Samuel A. Davis 《Archives of physical medicine and rehabilitation》2009,90(5):827-1657
Morse LR, Lazzari AA, Battaglino R, Stolzmann KL, Matthess KR, Gagnon DR, Davis SA, Garshick E. Dual energy x-ray absorptiometry of the distal femur may be more reliable than the proximal tibia in spinal cord injury.
Objective
To evaluate the precision of dual energy x-ray absorptiometry scanning at 2 skeletal sites at the knee (proximal femur and distal tibia) in people with SCI.Design
Cross-sectional.Setting
Veterans Affairs Medical Center.Participants
Subjects (N=20) with chronic SCI.Interventions
Not applicable.Main Outcome Measures
Precision as determined by root mean square coefficient of variation (RMS-CV) and root mean square standard deviation (RMS-SD).Results
At the distal femur the root RMS-CV was 3.01% and the RMS-SD was 0.025g/cm2. At the proximal tibia the RMS-CV was 5.91% and the RMS-SD was 0.030g/cm2.Conclusions
Precision at the distal femur is greater than at the proximal tibia and we recommend it as the preferred site for the longitudinal assessment of bone mineral density at the knee in chronic SCI. 相似文献15.
Khaled Mâaref Noël Martinet Constance Grumillier Slaheddine Ghannouchi Jean Marie André Jean Paysant 《Archives of physical medicine and rehabilitation》2010,91(6):919-925
Mâaref K, Martinet N, Grumillier C, Ghannouchi S, André JM, Paysant J. Kinematics in the terminal swing phase of unilateral transfemoral amputees: microprocessor-controlled versus swing-phase control prosthetic knees.
Objectives
To analyze the spatiotemporal parameters in the terminal swing phase of the prosthetic limb in unilateral transfemoral amputees (TFAs) compared with a group of asymptomatic subjects, and to identify a latency period (LP) in the TFA between the full extension of the prosthetic knee and the initial ground contact of the ipsilateral foot. To study the correlation between the LP and the duration of the swing phase. To evaluate the influence of the type of knee, the time since amputation, and the amputation level on the latency period.Design
Three-dimensional gait analysis with an optoelectronic device.Setting
Gait analysis laboratory of a re-education and functional rehabilitation service.Participants
TFA (n=29) and able-bodied (n=15) subjects.Interventions
Not applicable.Main Outcome Measures
Spatiotemporal and kinematics gait parameters.Results
The swing phase and the LP of the prosthetic limb, associated with a consequently longer single-limb stance phase in the intact limb, were significantly longer than those measured in the intact limbs of these subjects, as well as those measured on both lower limbs of the able-bodied subjects (P<.05). There is a positive correlation (P<.05; r2=.58 between the LP and the swing phase on the TFA's prosthetic side. The LP measured in the prosthetic limb of TFA with a swing-phase control prosthetic knee is significantly greater than in those using the microprocessor-controlled prosthetic knee (P<.05).Conclusions
Of negligible duration in able-bodied subjects and in the intact limb of TFA, the LP is significantly greater in the prosthetic limb. It can explain the lengthened swing phase on the prosthetic side of those subjects. The use of a microprocessor-controlled prosthetic knee allows the LP to be reduced. This LP appears to be necessary to insure the stability of the prosthetic knee. We suggest calling this time “confidence time.” 相似文献16.
Iracema Serrat Vergotti Ferrigno Alberto Cliquet Jr Luis Alberto Magna Américo Zoppi Filho 《Archives of physical medicine and rehabilitation》2009,90(7):1152-1158
Ferrigno IS, Cliquet Jr, A, Magna LA, Zoppi Filho A. Electromyography of the upper limbs during computer work: a comparison of 2 wrist orthoses in healthy adults.
Objective
To examine the effect of wrist orthoses on the electromyography activities of the extensor carpi ulnaris, flexor digitorum superficialis, and fibers of the upper trapezius muscles during computer work.Design
A randomized, 3×2 factorial design: orthoses (no orthosis, wearing a custom-made orthosis, wearing a commercial orthosis) and tasks (typing, using the mouse).Setting
Laboratory for biomechanics and rehabilitation.Participants
Healthy university students (N=23), ranging from 18 to 26 years of age.Intervention
Study volunteers performed standardized tasks such as typing and using the mouse while wearing 1 of 2 types of wrist orthoses or no orthosis.Main Outcome Measures
We used surface electromyography and considered 100% maximum voluntary contraction to represent the amplitude of electromyographic activity.Results
We observed a significant increase in the electromyographic activity of the trapezius (P<.05) with the use of orthoses. No significant difference was observed in the activities of the flexor digitorum superficialis or extensor carpi ulnaris in participants who typed with or without orthoses (P>.05). However, when the participants used the mouse, the extensor muscle presented an increase in activity with both orthoses, and the same pattern was observed in the flexor muscle when the volunteers used the custom-made orthosis.Conclusions
Wrist orthoses affected the muscle activities in the upper limbs of healthy adults who were using a computer. Electromyographic activity increased in the trapezius when the subjects used either type of orthosis, and the same pattern was observed in the extensor carpi ulnaris when the subjects used the mouse. The flexor digitorum superficialis presented an increase in activity only when the subjects worked with the mouse and used a custom-made splint. 相似文献17.
Karin H. Gerrits Marijke J. Beltman Peter A. Koppe Hermanna Konijnenbelt Peter D. Elich Arnold de Haan Thomas W. Janssen 《Archives of physical medicine and rehabilitation》2009,90(3):480-487
Gerrits KH, Beltman MJ, Koppe PA, Konijnenbelt H, Elich PD, de Haan A, Janssen TW. Isometric muscle function of knee extensors and the relation with functional performance in patients with stroke.
Objective
(1) To examine the isometric strength, speed, and fatigue resistance of the knee extensors of the paretic limb and nonparetic limb in patients with stroke and compare these with able-bodied subjects. (2) To relate the contractile properties with different indices of functional performance.Design
Case-control study.Setting
Rehabilitation center research laboratory.Participants
Eighteen stroke patients and 10 able-bodied controls.Interventions
Not applicable.Main Outcome Measures
Maximal voluntary torque (MVT), maximal rate of torque development, time to maximal rate of torque development, half relaxation time (½RT), and fatigue index. Scores on the Functional Ambulation Category scale, Berg Balance Scale, and Rivermead Mobility Index as well as distance walked during the six-minute walk test were obtained.Results
MVT of the paretic leg was lower than of the nonparetic leg (P<.05), and both limbs had lower MVT than controls (P<.05). Both the paretic and the nonparetic leg showed longer ½RT compared with controls (P<.05). The fatigue index was reduced in the paretic leg (P<.05) but not in the nonparetic leg compared with controls. MVT and fatigue index of the paretic leg were related to indices of functional performance (r=0.49-0.64; P<.05).Conclusions
Apart from bilateral weakness, knee extensors in patients with stroke showed a lower rate of torque development and relaxation (both paretic and nonparetic leg) and lower fatigue resistance (paretic leg only) than controls, which in part may be a consequence of changes within the muscles. Strength and fatigue resistance relate to functional performance, indicating that these muscle properties should be addressed during rehabilitation. However, future research is needed to elucidate the efficacy of exercise programs. 相似文献18.
19.
Objectives
To consider physiotherapy students’ responses to three illness narratives common in rugby players who have suffered a spinal cord injury (SCI).Design
A narrative vignette was provided to first and third year students reading for a Batchelor of Science degree in physiotherapy.Setting
A university in the West Midlands during a year cohort meeting.Participants
Seventy-seven first year students and 45 third year students took part in the study. All students were attending the university at the time of the study. None of the first year students had completed any clinical placement hours, and all of the third year students had completed the required number of clinical hours for a physiotherapy degree.Main outcome measures
The narrative vignette consisted of nine questions relating to the vignette. Thematic content analysis was applied to the results.Results
The role of experience appeared to influence students’ responses. The third year students’ reactions to each narrative appeared more consistent and unified as a medical voice. This appeared to support their preference for an ideal type of story and patient. Problems with each narrative were identified, although often not critiqued.Conclusions
Students need more time to consider different illness narratives in order to accept and understand them. 相似文献20.
Fan Gao Thomas H. Grant Elliot J. Roth Li-Qun Zhang 《Archives of physical medicine and rehabilitation》2009,90(5):819-2500
Gao F, Grant TH, Roth EJ, Zhang L-Q. Changes in passive mechanical properties of the gastrocnemius muscle at the muscle fascicle and joint levels in stroke survivors.