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1.
Pamela E. Houghton Karen E. Campbell Christine H. Fraser Connie Harris David H. Keast Patrick J. Potter Keith C. Hayes M. Gail Woodbury 《Archives of physical medicine and rehabilitation》2010,91(5):669-678
Houghton PE, Campbell KE, Fraser CH, Harris C, Keast DH, Potter PJ, Hayes KC, Woodbury MG. Electrical stimulation therapy increases rate of healing of pressure ulcers in community-dwelling people with spinal cord injury.
Objective
To investigate whether electric stimulation therapy (EST) administered as part of a community-based, interdisciplinary wound care program accelerates healing of pressure ulcers in people with spinal cord injury (SCI).Design
Single-blind, parallel-group, randomized, controlled, clinical trial.Setting
Community-based home care setting, Ontario, Canada.Participants
Adults (N=34; mean age ± SD, 51±14y) with SCI and stage II to IV pressure ulcers.Interventions
Subjects were stratified based on wound severity and duration and randomly assigned to receive either a customized, community-based standard wound care (SWC) program that included pressure management or the wound care program plus high-voltage pulsed current applied to the wound bed (EST+SWC).Main Outcome Measures
Wound healing measured by reduction in wound size and improvement in wound appearance at 3 months of treatment with EST+SWC or SWC.Results
The percentage decrease in wound surface area (WSA) at the end of the intervention period was significantly greater in the EST+SWC group (mean ± SD, 70±25%) than in the SWC group (36±61%; P=.048). The proportion of stage III, IV, or X pressure ulcers improving by at least 50% WSA was significantly greater in the EST+SWC group than in the SWC group (P=.02). Wound appearance assessed using the photographic wound assessment tool was improved in wounds treated with EST+SWC but not SWC alone.Conclusions
These results demonstrate that EST can stimulate healing of pressure ulcers of people with SCI. EST can be incorporated successfully into an interdisciplinary wound care program in the community. 相似文献2.
Jan YK Brienza DM Geyer MJ Karg P 《Archives of physical medicine and rehabilitation》2008,89(1):137-145
Jan Y-K, Brienza DM, Geyer MJ, Karg P. Wavelet-based spectrum analysis of sacral skin blood flow response to alternating pressure.
Objectives
To provide insight into the physiologic mechanisms associated with alternating pressure, using wavelet analysis of skin blood flow (SBF) oscillations, and to determine whether the application of alternating pressure induces myogenic responses, thereby enhancing SBF as compared with constant loading.Design
Repeated-measures design.Setting
University research laboratory.Participants
Healthy, young adults (N=10; 5 men, 5 women; mean age ± standard deviation, 30.0±3.1y).Intervention
Alternating pressure for 20 minutes (four 5-min cycles with either 60mmHg or 3mmHg) and constant loading for 20 minutes at 30mmHg on the skin over the sacrum.Main Outcome Measures
A laser Doppler flowmeter was used to measure sacral SBF response to both alternating pressure and constant loading. Wavelet-based spectrum analysis of SBF oscillations was used to assess underlying physiologic mechanisms including endothelium-related metabolic (.008-.02Hz), neurogenic (.02-.05Hz), and myogenic (.05-.15Hz) controls.Results
Alternating pressure stimulated an increase in sacral SBF of compressed soft tissues as compared with constant loading (P<.01). SBF during the high-pressure phase of 4 alternating pressure cycles showed an increasing trend. An increase in power in metabolic frequency range and a decrease in power in the myogenic frequency range during alternating pressure were observed compared with SBF prior to loading. Power increased in the myogenic frequency range during the low-pressure phase of alternating pressure and decreased during the high-pressure phase.Conclusions
SBF control mechanisms, as assessed by the characteristic frequencies embedded in SBF oscillations, show different responses to 2 loading pressures with the same average pressure but different patterns. Our study suggests that optimization of operating parameters and configurations of alternating pressure support surfaces to compensate for impaired SBF control mechanisms in pathologic populations may be possible using wavelet analysis of blood flow oscillations. 相似文献3.
Chou LW Lee SC Johnston TE Binder-Macleod SA 《Archives of physical medicine and rehabilitation》2008,89(5):856-864
Chou L-W, Lee SC, Johnston TE, Binder-Macleod SA. The effectiveness of progressively increasing stimulation frequency and intensity to maintain paralyzed muscle force during repetitive activation in persons with spinal cord injury.
Objective
To compare the effectiveness of progressively increasing stimulation intensity, progressively increasing frequency, or progressively increasing both frequency and intensity on paralyzed quadriceps femoris muscle force maintenance during repetitive activation.Design
Factorial design with different stimulation protocols as independent variables.Setting
A muscle performance laboratory.Participants
People (N=8) with spinal cord injury (SCI) (age, 14.63±1.77y).Interventions
Not applicable.Main Outcome Measure
Number of contractions when the peak force was 90% or more of a subject's maximal twitch force.Results
The protocol involving progressively increasing stimulation intensity and then frequency generated more successful contractions (189.88±53.33) than progressively increasing the frequency followed by intensity (122.75±26.56 contractions). Regardless of the order, progressively increasing both intensity and frequency generated more successful contractions than progressively increasing intensity (97 contractions) or frequency (62 contractions) alone.Conclusions
Our findings suggest that during repetitive electric activation, progressively increasing both stimulation frequency and intensity can produce more successful contractions than progressively increasing only frequency or intensity. These findings can help researchers and clinicians design more effective stimulation protocols for persons with SCI during functional electric stimulation applications. 相似文献4.
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5.
Madhavan G Goddard AA McLeod KJ 《Archives of physical medicine and rehabilitation》2008,89(9):1788-1794
Madhavan G, Goddard AA, McLeod KJ. Prevalence and etiology of delayed orthostatic hypotension in adult women.
Objective
To evaluate the contributing roles of venous status, microvascular filtration, and calf muscle pump activity in the etiology of delayed orthostatic hypotension (OH).Design
Unblinded within-subjects trial.Setting
Academic clinical research center.Participants
Convenience sample of healthy adult women (N=30) with an age range of 30 to 65 years.Intervention
Plantar micromechanical stimulation applied at a 45-Hz frequency and a 50-μm amplitude for a duration of 30 minutes during upright sitting.Main Outcome Measure
Diastolic blood pressure (DBP).Results
White women (mean age, 51.8±1.3y) were recruited and screened for delayed OH. About one quarter (9/33) of the screened subjects showed delayed OH as determined by a significant decrease in blood pressure after at least 15 minutes of quiet sitting. Air plethysmographic assessment provided no evidence of venous insufficiency (venous filling index, >2.5mL/s; venous volume, >80mL) or excessive microvascular filtration in the affected subjects, whereas activation of the calf muscle pump (CMP) through plantar-based micromechanical stimulation consistently resulted in a significant increase in systolic blood pressure (SBP) (ΔSBP=22.8±3.9mmHg, P=.003) and DBP (ΔDBP=20.9±3.3mmHg, P=.002).Conclusions
About 25% of the adult women studied showed delayed OH during quiet sitting and the proximate cause appears to be neuromuscular in origin, specifically inadequate calf muscle tone, because venous and microvascular filtration status is normative in the delayed OH subpopulation and CMP stimulation reverses the hypotension. 相似文献6.
7.
Tanya Onushko Allison Hyngstrom Brian D. Schmit 《Archives of physical medicine and rehabilitation》2010,91(8):1225-1235
Onushko T, Hyngstrom A, Schmit BD. Effects of multijoint spastic reflexes of the legs during assisted bilateral hip oscillations in human spinal cord injury.
Objective
To investigate the timing and magnitude of muscle activation during an active-assist bilateral hip motor task in human spinal cord injury (SCI).Design
A single test session using a novel robotic system to alternately flex and extend the hips from 40° of hip flexion to 10° of hip extension at 1 of 3 frequencies (.25, .50, .75Hz). Subjects were asked either to actively assist the movements or to remain relaxed during the imposed oscillations.Setting
All data were collected in a research laboratory.Participants
Ten subjects with motor incomplete (American Spinal Injury Association grade C or D) SCI and 10 individuals without neurologic injury participated in this study.Interventions
Not applicable.Main Outcome Measures
Electromyograms and joint torques were recorded from the lower extremities of SCI subjects and compared with electromyograms and joint torque patterns recorded from 10 neurologically healthy individuals completing the same tasks.Results
In trials involving active assistance of the imposed hip oscillations, SCI subjects produced muscle activation patterns that were phased differently from muscle activity of neurologically intact subjects. SCI subjects generated peak torque at the end ranges of movement (ie, 40° hip flexion, 10° extension), whereas control subjects generated the greatest torque midway through the movements. Moreover, the phasing of active-assist hip torque in SCI subjects was similar to the phasing of reflexive hip torques produced during the unassisted condition (ie, SCI subjects instructed to relax), while control subjects produced no reflexive torques during unassisted trials.Conclusions
The differences in the timing of muscle activity during the active-assist task in controls and SCI subjects highlights problems in generating appropriately timed muscle activity during ongoing movements. The similarity in muscle activity patterns for the active-assist and unassisted trials in SCI subjects further suggests that reflex feedback from hip afferents contributes substantially to muscle activation during active-assist movements. These findings demonstrate the disruptions in reflex regulation of movement in people with incomplete SCI and suggest that spastic reflexes might disrupt motor control. 相似文献8.
Anthony F. DiMarco Krzysztof E. Kowalski Robert T. Geertman Dana R. Hromyak 《Archives of physical medicine and rehabilitation》2009,90(5):717-725
DiMarco AF, Kowalski KE, Geertman RT, Hromyak DR. Lower thoracic spinal cord stimulation to restore cough in patients with spinal cord injury: results of a National Institutes of Health-sponsored clinical trial. Part I: methodology and effectiveness of expiratory muscle activation.
Objective
Evaluation of the capacity of lower thoracic spinal cord stimulation (SCS) to activate the expiratory muscles and generate large airway pressures and high peak airflows characteristic of cough, in subjects with tetraplegia.Design
Clinical trial.Setting
Inpatient hospital setting for electrode insertion; outpatient setting for measurement of respiratory pressures; home setting for application of SCS.Participants
Subjects (N=9; 8 men, 1 woman) with cervical spinal cord injury and weak cough.Interventions
A fully implantable electrical stimulation system was surgically placed in each subject. Partial hemilaminectomies were made to place single-disk electrodes in the epidural space at the T9, T11, and L1 spinal levels. A radiofrequency receiver was placed in a subcutaneous pocket over the anterior portion of the chest wall. Electrode wires were tunneled subcutaneously and connected to the receiver. Stimulation was applied by activating a small portable external stimulus controller box powered by a rechargeable battery to each electrode lead alone and in combination.Main Outcome Measures
Peak airflow and airway pressure generation achieved with SCS.Results
Supramaximal SCS resulted in high peak airflow rates and large airway pressures during stimulation at each electrode lead. Maximum peak airflow rates and airway pressures were achieved with combined stimulation of any 2 leads. At total lung capacity, mean maximum peak airflow rates and airway pressure generation were 8.6±1.8 (mean ± SE) L/s and 137±30 cmH2O (mean ± SE), respectively.Conclusions
Lower thoracic SCS results in near maximum activation of the expiratory muscles and the generation of high peak airflow rates and positive airway pressures in the range of those observed with maximum cough efforts in healthy persons. 相似文献9.
Jan YK Jones MA Rabadi MH Foreman RD Thiessen A 《Archives of physical medicine and rehabilitation》2010,91(11):1758-1764
Jan Y-K, Jones MA, Rabadi MH, Foreman RD, Thiessen A. Effect of wheelchair tilt-in-space and recline angles on skin perfusion over the ischial tuberosity in people with spinal cord injury.
Objective
To investigate the efficacy of wheelchair tilt-in-space and recline on enhancing skin perfusion over the ischial tuberosity in wheelchair users with spinal cord injury (SCI).Design
Repeated-measures, intervention, and outcomes-measure design.Setting
A university research laboratory.Participants
Wheelchair users with SCI (N=11; 9 men, 2 women; mean ± SD age, 37.7±14.2y; body mass index, 24.7±2.6kg/m2; duration of injury, 8.1±7.5y).Interventions
Protocols (N=6) of various wheelchair tilt-in-space and recline angles were randomly assigned to participants. Each protocol consisted of a 5-minute sitting-induced ischemic period and a 5-minute wheelchair tilt-in-space and recline pressure-relieving period. Participants sat in a position without tilt or recline for 5 minutes and then sat in 1 of 6 wheelchair tilted and reclined positions, including (1) 15° tilt-in-space and 100° recline, (2) 25° tilt-in-space and 100° recline, (3) 35° tilt-in-space and 100° recline, (4) 15° tilt-in-space and 120° recline, (5) 25° tilt-in-space and 120° recline, and (6) 35° tilt-in-space and 120° recline. A 5-minute washout period (at 35° tilt-in-space and 120° recline) was allowed between protocols.Main Outcome Measures
Laser Doppler flowmetry was used to measure skin perfusion over the ischial tuberosity in response to changes in body positions caused by performing wheelchair tilt-in-space and recline. Skin perfusion response to wheelchair tilt-in-space and recline was normalized to skin perfusion of the upright seated position (no tilt/recline).Results
Combined with 100° recline, wheelchair tilt-in-space at 35° resulted in a significant increase in skin perfusion compared with the upright seated position (no tilt/recline; P<.05), whereas there was no significant increase in skin perfusion at 15° and 25° tilt-in-space (not significant). Combined with 120° recline, wheelchair tilt-in-space at 15°, 25°, and 35° showed a significant increase in skin perfusion compared with the upright seated position (P<.05).Conclusions
Our results indicate that wheelchair tilt-in-space should be at least 35° for enhancing skin perfusion over the ischial tuberosity when combined with recline at 100° and should be at least 25° when combined with recline at 120°. Although smaller angles of wheelchair tilt-in-space and recline are preferred by wheelchair users for functional purposes, wheelchair tilt-in-space less than 25° and recline less than 100° may not be sufficient for effective pressure reduction for enhancing skin perfusion over the ischial tuberosity in people with SCI. 相似文献10.
Noonan VK Kopec JA Zhang H Dvorak MF 《Archives of physical medicine and rehabilitation》2008,89(6):1074-1082
Noonan VK, Kopec JA, Zhang H, Dvorak MF. Impact of associated conditions resulting from spinal cord injury on health status and quality of life in people with traumatic central cord syndrome.
Objective
To determine the effect of associated spinal cord injury (SCI) conditions on the health status and quality of life (QOL) in people with traumatic central cord syndrome.Design
Cross-sectional design.Setting
Community-based.Participants
Subjects (N=70) with traumatic central cord syndrome who were a minimum of 2 years postinjury.Interventions
Not applicable.Main Outcome Measures
Presence of associated SCI conditions (neuropathic pain, spasticity, bowel, bladder, and/or sexual dysfunction, decreased motor function); health status (36-Item Short-Form Health Survey [SF-36], symptom satisfaction); and QOL.Results
The SF-36 physical component score (PCS) was lower in subjects who reported problems with bowel, bladder, and/or sexual function (−6.9; 95% confidence interval [CI], −11.6 to −2.2). The PCS was decreased in subjects with a lower motor score and this relationship was negatively affected by spasticity and being less educated. The SF-36 mental component score was negatively affected by neuropathic pain and a lower motor score. Neuropathic pain and a lower motor score were both associated with subjects being dissatisfied with their symptoms. Subjects who had a higher motor score were more likely to have a higher QOL (odds ratio, 1.7; 95% CI, 1.1 to 2.7).Conclusions
The associated SCI conditions bowel, bladder, and/or sexual dysfunction, neuropathic pain, decreased motor function, and spasticity negatively affect the health status of persons with traumatic central cord syndrome. Diminished motor recovery was the only associated SCI condition to impact QOL. By developing a conceptual model and adjusting for confounders, an estimate for each associated SCI condition's effect on patient outcomes was obtained. Our results indicate the importance of treating or ameliorating associated SCI conditions in order to maximize physical and mental functioning. 相似文献11.
Elvia Battaglia Alessandro Fulgenzi Maria Elena Ferrero 《Archives of physical medicine and rehabilitation》2009,90(6):913-918
Battaglia E, Fulgenzi A, Ferrero ME. Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease.
Objective
To examine the rationale of the combined use of a new expiratory device in association with a previously assessed inspiratory device in improving 3 indicators of the respiratory muscle strength, for example, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and dyspnea grade.Design
Randomized trial.Setting
Home-based pulmonary rehabilitation.Participants
Adults (N=32; mean age, 68y).Main Outcome Measure
We instructed 32 patients with mild to very severe COPD to use the devices, and randomized them in a 1:1 ratio: they were assigned to the sham training control group (16 patients who trained at a load not able to improve MIP and MEP) or to the training group (16 patients). The patients trained at home twice daily for 15 minutes, 7 days a week, for 12 months. MIP and MEP as well as dyspnea perception were evaluated at 1, 6, and 12 months from the beginning of the training. The impact of additional work of breathing was measured at baseline and after the use of the expiratory device.Results
The patients who performed the respiratory training showed significant and progressive improvements of MIP (81±4 at 12 months vs 57±7 as basal values expressed in cm H2O; P<.05) and MEP (97±2 at 12 months vs 62±4 as basal values; P<.05) at the end of the training. In addition, they showed a significant reduction of dyspnea perception (1.18±0.29 vs 2.93±0.32 as basal values; P<.05) at the end of the training.Conclusions
This study suggests that home exercise with the combined use of our expiratory and inspiratory devices leads to a significant improvement of respiratory muscle function in patients with mild to very severe COPD. 相似文献12.
James M. Elliott Shaun P. O'Leary Barbara Cagnie Gail Durbridge Lieven Danneels Gwendolen Jull 《Archives of physical medicine and rehabilitation》2010,91(9):1418-1422
Elliott JM, O'Leary SP, Cagnie B, Durbridge G, Danneels L, Jull G. Craniocervical orientation affects muscle activation when exercising the cervical extensors in healthy subjects.
Objective
To evaluate the activity of neck extensor muscles during different extension exercises with muscle functional magnetic resonance imaging (mfMRI).Design
Cross-sectional.Setting
University laboratory.Participants
Healthy subjects (N=11; 7 men, mean age ± SD, 34±5.6y; 4 women, mean age ± SD, 23.3±5.2y; group mean age ± SD, 30.1±7.5y).Intervention
Not applicable.Main Outcome Measures
mfMRI measures of T2 relaxation were made for the multifidus (Mul), the semispinalis cervicis (SCe), the semispinalis capitis (SCa), and the splenius capitis (SpC) at C2-3, C5-6, and C7-T1 in response to 2 head/neck orientations: craniocervical neutral (CCN) and craniocervical extension (CCE). Subjects performed three 1-minute repetitions of each condition at 20% maximum voluntary contraction.Results
Significant shifts were observed in all muscle groups at the C5-6 and C7-T1 levels after both conditions (P=.04) except the SpC muscle at C5-6 with CCN (P=.17). T2 shifts in the SCa were significantly greater in response to CCE than CCN at C2-3 (P=.03) and C5-6 (P=.02). Similarly, CCE resulted in larger shifts than CCN in the Mul/SCe at C7-T1 (P=.003). No segmental differences were observed between exercises for SpC (P=.25).Conclusions
The results of this study provide some preliminary insight into the impact of craniocervical orientation on the differential response of the deep and superficial cervical extensor muscles during the performance of cervical extensor exercises. 相似文献13.
Janssen TW Beltman JM Elich P Koppe PA Konijnenbelt H de Haan A Gerrits KH 《Archives of physical medicine and rehabilitation》2008,89(3):463-469
Janssen TW, Beltman JM, Elich P, Koppe PA, Konijnenbelt H, de Haan A, Gerrits KH. Effects of electric stimulation-assisted cycling training in people with chronic stroke.
Objective
To evaluate whether leg cycling training in subjects with chronic stroke can improve cycling performance, aerobic capacity, muscle strength, and functional performance and to determine if electric stimulation (ES) to the contralateral (paretic) leg during cycling has additional effects over cycling without ES.Design
A randomized controlled trial, with a partial double-blind design.Setting
A rehabilitation center.Participants
Twelve stroke patients (range, 18-70y), more than 5 months poststroke, with lower-extremity hemiparesis.Intervention
Subjects were randomly assigned to groups that performed cycling exercise, one with ES evoking muscle contractions and a control group with ES not evoking muscle contractions. Subjects, blinded for group assignment, trained twice a week for 6 weeks.Main Outcome Measures
Changes in aerobic capacity and maximal power output, functional performance, and lower-limb muscle strength.Results
Aerobic capacity and maximal power output significantly increased by 13.8%±19.1% and 38.1%±19.8%, but muscle strength was not significantly enhanced after training. Functional performance improved (ie, scores on the Berg Balance Scale increased by 6.9%±5.8% (P=.000) and the six-minute walk test improved by 14.5%±14.1% (P=.035). There was no significant effect on the Rivermead Mobility Index (P=.165). Training-induced changes were not significantly different between the 2 groups. Changes in cycling performance and aerobic capacity were not significantly related to changes in functional performance.Conclusions
This study showed that a short cycling training program on a semirecumbent cycle ergometer can markedly improve cycling performance, aerobic capacity, and functional performance of people with chronic stroke. The use of ES had no additional effects in this specific group of subjects with chronic stroke. 相似文献14.
Lynne R. Sheffler Maureen T. Hennessey Jayme S. Knutson John Chae 《Archives of physical medicine and rehabilitation》2009,90(2):362-365
Sheffler LR, Hennessey MT, Knutson JS, Chae J. Neuroprosthetic effect of peroneal nerve stimulation in multiple sclerosis: a preliminary study.
Objective
To determine the neuroprosthetic effect of a peroneal nerve stimulator on tasks of functional ambulation in multiple sclerosis (MS).Design
A single point-in-time assessment of functional ambulation tasks under the conditions of no device and peroneal nerve stimulator.Setting
Outpatient academic medical center.Participants
Participants (N=11) with diagnosis of MS (>6mo), dorsiflexion weakness, and prior usage of an ankle-foot orthosis.Intervention
Surface peroneal nerve stimulator for ambulation.Main Outcome Measures
Timed 25-foot Walk portion of the MS Functional Composite; Floor, Carpet, Up and Go, Obstacle, and Stair components of the Modified Emory Functional Ambulation Profile.Results
Peroneal nerve stimulator-Stair performance was significantly enhanced (P=.05) versus no device, and statistical significance was approached for peroneal nerve stimulator-Obstacles (P=.09) versus no device. There were no significant differences between peroneal nerve stimulator and no device conditions in the remaining outcome measures.Conclusions
The neuroprosthetic effect of the peroneal nerve stimulator is modest relative to no device in the performance of specific functional tasks of ambulation in MS gait. A longitudinal, controlled trial is needed to show effectiveness. 相似文献15.
Objective
To determine the need for a practice walk for the endurance shuttle walk test (ESWT) following the performance of two incremental shuttle walk tests (ISWTs) - one practice and one test - on the same day.Design
Retrospective data analysis of shuttle walk test measurements. All participants had performed two ISWTs and two ESWTs at a single visit, prior to commencing pulmonary rehabilitation.Setting
Outpatient physiotherapy department of a university hospital.Participants
Forty-four patients (33 males, 11 females) with a primary diagnosis of chronic obstructive pulmonary disease, referred for routine pulmonary rehabilitation.Measurements
Shuttle walk test distance and time, Borg breathlessness score, heart rate and pulsed oxygen saturation.Results
The mean age of the group was 67.6 years [standard deviation (SD) 9.0] and mean forced expiratory volume in 1 second was 37% predicted (SD 13). The mean times walked during ESWTs 1 and 2 were 195 and 207 seconds (SD 115 and 138), respectively. Using the analysis recommended by Bland and Altman, the mean of the individual differences (d) between Tests 1 and 2 was 12 seconds, with limits of agreement from −88 to +112 seconds.Conclusion
A practice endurance shuttle walk is unnecessary following performance of ISWTs on the same day. 相似文献16.
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17.
Morse LR Stolzmann K Nguyen HP Jain NB Zayac C Gagnon DR Tun CG Garshick E 《Archives of physical medicine and rehabilitation》2008,89(4):726-731
Morse LR, Stolzmann K, Nguyen HP, Jain NB, Zayac C, Gagnon D, Tun CG, Garshick E. Association between mobility mode and C-reactive protein levels in men with chronic spinal cord injury.
Objective
To assess clinical determinants of systemic inflammation in persons with chronic spinal cord injury (SCI).Design
Cross-sectional survey.Setting
Veterans Affairs medical center.Participants
As part of an epidemiologic study assessing SCI-related health conditions, 63 men with chronic SCI provided a blood sample and information regarding locomotive mode and personal habits.Interventions
Not applicable.Main Outcome Measure
Plasma high-sensitivity C-reactive protein (CRP).Results
The mean ± standard deviation age was 56±14y, and participants were assessed 21±13y after injury. Adjusting for heart disease, hypertension, and body mass index (BMI), the mean CRP in 12 motorized wheelchair users (5.11mg/L) was not significantly greater than 23 participants who used a manual wheelchair (2.19mg/L) (P=.085) but was significantly greater than the 17 who walked with an assistive device (1.41mg/L) (P=.005) and the 12 who walked independently (1.63mg/L) (P=.027). CRP was significantly greater in participants with obesity but was not related to age, smoking, or SCI level and severity. CRP was elevated in participants reporting a urinary tract infection (UTI) or pressure ulcer within a year, but adjustment for this did not account for the elevated CRP in motorized wheelchair users.Conclusions
These results suggest that CRP in chronic SCI is independently related to locomotive mode, BMI, and a history of pressure ulcers and UTI. It is suggested that future studies in SCI investigate whether modifying these factors influence systemic inflammation and cardiovascular health. 相似文献18.
Selvaraj Samuelkamaleshkumar Somasundaram Radhika BOT Binu Cherian BPT Aarumugam Elango MA Windsor Winrose BPT Baby T. Suhany PhD M. Henry Prakash MD 《Archives of physical medicine and rehabilitation》2010,91(7):1117-1121
Samuelkamaleshkumar S, Radhika S, Cherian B, Elango A, Winrose W, Suhany BT, Prakash MH. Community reintegration in rehabilitated South Indian persons with spinal cord injury.
Objectives
To explore community reintegration in rehabilitated South Indian persons with spinal cord injury (SCI) and to compare the level of community reintegration based on demographic variables.Design
Survey.Setting
Rehabilitation center of a tertiary care university teaching hospital.Participants
Community-dwelling persons with SCI (N=104).Interventions
Not applicable.Main Outcome Measures
Craig Handicap Assessment and Reporting Technique (CHART).Results
The mean scores for each CHART domain were physical independence 98±5, social Integration 96±11, cognitive independence 92±17, occupation 70±34, mobility 65±18, and economic self sufficiency 53±40. Demographic variables showed no statistically significant difference with any of the CHART domains except for age and mobility, level of education, and social integration.Conclusions
Persons with SCI in rural South India who have completed comprehensive, mostly self-financed, rehabilitation with an emphasis on achieving functional ambulation, family support, and self-employment and who attend a regular annual follow-up show a high level of community reintegration in physical independence, social integration, and cognitive independence. CHART scores in the domains of occupation, mobility, and economic self-sufficiency showed lower levels of community reintegration. 相似文献19.
Deydre S. Teyhen Jared N. Williamson Nathan H. Carlson Sean T. Suttles Shaun J. O'Laughlin Jackie L. Whittaker Stephen L. Goffar John D. Childs 《Archives of physical medicine and rehabilitation》2009,90(5):761-767
Teyhen DS, Williamson JN, Carlson NH, Suttles ST, O'Laughlin SJ, Whittaker JL, Goffar SL, Childs JD. Ultrasound characteristics of the deep abdominal muscles during the active straight leg raise test.
Objective
To determine whether changes in the transversus abdominis (TrA) and internal oblique (IO) muscles, as seen on ultrasound imaging, during the active straight leg raise (ASLR) test differ between subjects with and without unilateral lumbopelvic pain.Design
Cross-sectional, case-control study.Setting
Clinical laboratory.Participants
Subjects (n=15) with unilateral symptoms in the lumbopelvic region and age-matched and sex-matched control subjects (n=15).Interventions
Bilateral measurements of the deep abdominal muscles (TrA and IO) were obtained simultaneously using ultrasound imaging to compare the percent change in muscle thickness from rest with (1) immediately on raising, (2) after a 10-second hold, and (3) within 5 seconds after returning the lower extremity to the plinth.Main Outcome Measure
Percent change in muscle thickness of both muscles from rest to the other 3 time intervals during the ASLR test.Results
The 3-way group × side measured × time and 2-way side measured × time interactions were not significant for either the TrA (P≥.34) or the IO (P≥.14) muscles. The 2-way interaction group × time was significant for both the TrA (P=.003) and the IO (P=.02) muscles. On lifting the lower extremity, the control group demonstrated a 23.7% and 11.2% increase in TrA and IO muscle thickness, respectively, while those with lumbopelvic pain demonstrated a 6.4% and 5.7% increase in TrA and IO muscle thickness, respectively.Conclusions
Although subjects with unilateral lumbopelvic pain demonstrated a smaller increase in muscle thickness, during the ASLR test there appears to be a symmetrical response in both of the deep abdominal muscles regardless of which lower extremity is lifted during the ASLR test or the unilateral nature of the symptoms. This study attests to the potential construct validity of using the ASLR test to assess different motor control strategies of the TrA and IO muscles in subjects with unilateral lumbopelvic pain. 相似文献20.
Jianhuo Wang Xianyou Zheng MD Wei Zhang MD Aimin Chen MD Zhen Xu MD 《Archives of physical medicine and rehabilitation》2009,90(11):1944-1947
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