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1.
Maria T. Schultheis Valerie Weisser Jocelyn Ang Elie Elovic Richard Nead Nicole Sestito Cassandra Fleksher Scott R. Millis 《Archives of physical medicine and rehabilitation》2010,91(3):465-473
Schultheis MT, Weisser V, Ang J, Elovic E, Nead R, Sestito N, Fleksher C, Millis SR. Examining the relationship between cognition and driving performance in multiple sclerosis.
Objective
To identify cognitive predictors of driving performance after multiple sclerosis (MS).Design
Prospective design examining predictive value of cognitive measures on driving performance.Setting
All data were collected in an outpatient research setting and an outpatient driver rehabilitation program.Participants
Participants were community-dwelling persons (N=66) with clinically defined MS (86% relapsing-remitting, 14% progressive) with a mean age of 43.47 years. All were active drivers who met vision requirements established by their respective states, and none required adaptive driving equipment.Intervention
Not applicable.Main Outcome Measures
Participants were administered a comprehensive neuropsychologic assessment and a clinical behind-the-wheel (BTW) driving evaluation. Additional measures of driving performance included history of traffic violations and collisions (since MS onset).Results
Logistic regression indicated that information processing speed (Symbol Digit Modality Test [SDMT]) was the strongest predictor of BTW performance. A logistic regression revealed that the strongest predictors of collision and violation frequency were visuospatial learning and recall (7/24 Spatial Recall Test [SPART 7/24]).Conclusions
These findings indicate that information processing and visuospatial skills are predictive of driving performance among persons with MS. These measures (SDMT and SPART 7/24) may serve as screening methods for identifying the potential impact of cognitive impairment on driving. Furthermore, the findings raise questions regarding the appropriateness of the BTW evaluation to evaluate driving difficulties accurately among individuals with MS. 相似文献2.
Vandervelde L Dispa D Van den Bergh PY Thonnard JL 《Archives of physical medicine and rehabilitation》2008,89(9):1720-1723
Vandervelde L, Dispa D, Van den Bergh PY, Thonnard J-L. A comparison between self-reported and observed activity limitations in adults with neuromuscular disorders.
Objective
To investigate the agreement between the self-reported and examiner-reported difficulties of patients with neuromuscular disorders (NMDs) in performing daily activities at home.Design
A comparison between 2 methods of administering a measurement instrument.Setting
Neuromuscular reference center in a university hospital.Participants
Adult patients (N=57) with diagnosed NMDs living at home.Interventions
Not applicable.Main Outcome Measure
The ACTIVLIM questionnaire.Results
The intraclass correlation coefficient, model 2,1 (ICC2,1), between the measures was very good (ICC2,1=.87), indicating a good agreement between self-perceived and observed measures.Conclusions
The use of ACTIVLIM as a self-reporting questionnaire is a valid method for assessing activity limitations in patients with NMD. 相似文献3.
Marcotte TD Rosenthal TJ Roberts E Lampinen S Scott JC Allen RW Corey-Bloom J 《Archives of physical medicine and rehabilitation》2008,89(9):1753-1758
Marcotte TD, Rosenthal TJ, Roberts E, Lampinen S, Scott JC, Allen RW, Corey-Bloom J. The contribution of cognition and spasticity to driving performance in multiple sclerosis.
Objective
To examine the independent and combined impact of cognitive dysfunction and spasticity on driving tasks involving high cognitive workload and lower-limb mobility in persons with multiple sclerosis (MS).Design
Single-visit cohort study.Setting
Clinical research center.Participants
Participants included 17 drivers with MS and 14 referent controls. The group with MS exhibited a broad range of cognitive functioning and disability. Of the 17 patients with MS, 8 had significant spasticity in the knee used to manipulate the accelerator and brake pedals (based on the Modified Ashworth Scale).Interventions
Not applicable.Main Outcome Measures
A brief neuropsychologic test battery and 2 driving simulations. Simulation 1 required participants to maintain a constant speed and lane position while attending to a secondary task. Simulation 2 required participants to adjust their speed to accelerations and decelerations of a lead car in front of them.Results
Patients with MS showed greater variability in lane position (effect size, g=1.30), greater difficulty in maintaining a constant speed (g=1.25), and less ability to respond to lead car speed changes (g=1.85) compared with controls. Within the MS group, in a multivariate model that included neuropsychologic and spasticity measures, cognitive functioning was the strongest predictor of difficulty in maintaining lane position during the divided attention task and poor response time to lead car speed changes, whereas spasticity was associated with reductions in accuracy of tracking the lead car movements and speed maintenance.Conclusions
In this preliminary study, cognitive and physical impairments associated with MS were related to deficits in specific components of simulated driving. Assessment of these factors may help guide the clinician regarding the types of driving behaviors that would put patients with MS at an increased risk for an automobile crash. 相似文献4.
Muaidi QI Nicholson LL Refshauge KM 《Archives of physical medicine and rehabilitation》2008,89(2):371-376
Muaidi QI, Nicholson LL, Refshauge KM. Proprioceptive acuity in active rotation movements in healthy knees.
Objectives
To investigate the ability of asymptomatic participants to discriminate between active knee rotation movements of different magnitude and to determine whether proprioceptive acuity of active knee rotation differs between limbs (dominant and nondominant and right and left).Design
Cross-sectional study.Setting
Laboratory in an Australian university.Participants
Healthy volunteers (N=30) without previous cruciate ligament injury or surgery, previous fracture of the lower limbs, or other lower-limb disorders in the last 3 months.Interventions
Not applicable.Main Outcome Measures
Knee rotation proprioceptive acuity was determined by using our custom-designed device. The measure of proprioceptive acuity used in this study was the just-noticeable difference (JND). Participants actively rotated the knee (internal or external rotation) to 1 of 4 movement blocks and judged the magnitude of the permitted motion. Proprioceptive acuity scores, representing a participant’s ability to detect small differences in magnitude of active knee rotation movements, were then calculated.Results
The means of the JND for proprioceptive acuity of internal rotation (1.37°±.11°) were significantly (P=.04) lower than for external rotation (1.6°±.14°) regardless of side (right, left) or dominance. No significant difference was found between the mean JND for left and right knee rotations (P=.84) or between the mean JND for dominant and nondominant knee rotation (P=.69).Conclusions
Participants perceived smaller differences between active internal rotation movements than external rotation. No significant difference was found between the dominant and nondominant leg or between the left and right leg; therefore, clinicians can establish whether a proprioceptive deficit exists after unilateral injury and can use acuity of the uninjured knee as a normal status for rehabilitation. 相似文献5.
Watanabe S, Amimoto K. Generalization of prism adaptation for wheelchair driving task in patients with unilateral spatial neglect.
Objectives
To verify the efficacy of prism adaptation as a practical means of rehabilitation for subjects with unilateral spatial neglect by conducting goal-directed tasks in the presence of similar visual flankers in the right hemispace using an activity of daily living, namely, wheelchair operation.Design
Prospective cohort study.Setting
Rehabilitation center located in Japan.Participants
Patients with unilateral spatial neglect (N=10).Intervention
Prism adaptation.Main Outcome Measures
A midpoint-directed task in which the subject faces the center of 2 symbols placed in front and moves the wheelchair toward it, and a goal-directed task in which the subject must differentiate a single target from multiple symbols and move the wheelchair toward it.Results
In the midpoint-directed task, there was a significant shift in the reach position bias from +27.7cm prior to prism adaptation to +3.1cm after prism adaptation (P<.01). In the goal-directed task, the time taken to reach the outer left target decreased from 21.2 seconds prior to prism adaptation to 11.8 seconds after prism adaptation, and the difference between placement of the targets was eliminated.Conclusions
Prism adaptation exhibited the potential to generalize the effects on activities of daily living such as driving a wheelchair and to ameliorate unilateral spatial neglect even in the presence of right-hemispace flankers. Prism adaptation is an effective therapeutic modality in rehabilitation because it prevents the appearance of neglect symptoms despite situational or contextual changes. 相似文献6.
Cris Zampieri Richard P. Di Fabio PhD PT 《Archives of physical medicine and rehabilitation》2009,90(2):263-270
Zampieri C, Di Fabio RP. Improvement of gaze control after balance and eye movement training in patients with progressive supranuclear palsy: a quasi-randomized controlled trial.
Objective
One of the main oculomotor findings in progressive supranuclear palsy (PSP) is the inability to saccade downward. In addition, people with PSP have difficulty suppressing fixation, which may contribute to vertical gaze palsy. The objective was to investigate the effectiveness of a rehabilitation intervention tailored to enhance suppression of fixation and gaze shift in participants with PSP.Design
Controlled trial with a quasi-randomized design. Measures occurred at week 1 and 5. Researchers assessing participants were blind to the group assignments.Setting
Movement disorders assessment laboratory.Participants
Nineteen adults with possible or probable PSP who were ambulatory for short distances and had far visual acuity of 20/80 and a Folstein Mini-Mental State score of more than 23.Interventions
Balance training complemented with eye movement and visual awareness exercises was compared with balance training alone.Main Outcome Measures
Gaze control was assessed using a vertical Gaze Fixation Score and a Gaze Error Index.Results
Gaze control after the balance plus eye exercise significantly improved, whereas no significant improvement was observed for the group that received balance training alone.Conclusions
These preliminary findings support the use of balance and eye movement exercises to improve gaze control in PSP. 相似文献7.
Lynnette G. Kay Anita C. Bundy ScD Lindy M. Clemson PhD 《Archives of physical medicine and rehabilitation》2009,90(9):1514-1522
Kay LG, Bundy AC, Clemson LM. Predicting fitness to drive in people with cognitive impairments by using DriveSafe and DriveAware.
Objectives
To examine the psychometric properties of DriveSafe and DriveAware and their predictive validity.Design
Prospective study compared screening tests with criterion standard.Setting
Two driving rehabilitation centers affiliated with a university and a geriatric rehabilitation facility.Participants
Consecutive sample of drivers with functional impairments (n=115) and subgroup of drivers with cognitive impairments (n=96) referred for a driving assessment.Interventions
Not applicable.Main Outcome Measure
Driving performance was measured by a standardized assessment in real traffic.Results
Rasch analysis provided evidence for construct validity and internal reliability of both tests. Tests trichotomized drivers into unsafe, safe, and further testing categories. The optimal lower cutoff identified unsafe drivers with a specificity of 97% (95% confidence interval [CI], 83-100) in the test sample and 96% (95% CI, 80-100) in the validation sample. The optimal upper cutoff identified safe drivers with a sensitivity of 93% (95% CI, 77-99) and 95% (95% CI, 76-100), respectively.Conclusions
By using DriveSafe and DriveAware, drivers with cognitive impairments referred for a driving assessment can be categorized as unsafe, safe, or requiring further testing, with only 50% needing an on-road assessment. Before clinical practice is changed, these findings should be replicated. 相似文献8.
Jacob J. Sosnoff Sunghoon Shin MS Robert W. Motl PhD 《Archives of physical medicine and rehabilitation》2010,91(1):93-99
Sosnoff JJ, Shin S, Motl RW. Multiple sclerosis and postural control: the role of spasticity.
Objectives
To examine the association between spasticity and postural control in subjects with multiple sclerosis (MS).Design
Cross-sectional.Setting
Motor control laboratory.Participants
Subjects with MS (n=16, 2 male) and age and sex-matched subjects (n=16) participated in the investigation. All subjects with MS had Expanded Disability Status Scale scores between 0 and 4.5 and modified Ashworth scale scores between 1 and 3.Interventions
Not applicable.Main Outcome Measures
Postural control was measured with a force platform that quantifies ground reaction forces and moments in mediolateral and anteroposterior directions. Postural control was indexed with anterior-posterior sway range, medial-lateral sway range, 95% elliptical area of the deviations of center of pressure (COP), velocity of COP sway, and the frequency at which 95% of spectral profile was contained. Participants with MS further underwent assessment of the soleus Hoffman reflex (H-reflex) as an index of spasticity.Results
Cluster analysis on H-reflex data identified groups of MS participants with high spasticity (n=7) and low spasticity (n=9). There were no differences in age, duration of MS, and disease severity between MS groups. There were no differences in anterior-posterior sway range between any of the groups. The high spasticity group had greater COP area, velocity, and mediolateral sway compared with the low spasticity and control group, and the low spasticity group had postural control values between the high spasticity and control groups.Conclusions
The pattern of results suggests that spasticity contributes to postural deficits observed in MS. 相似文献9.
Nijs J Roussel N Vermeulen K Souvereyns G 《Archives of physical medicine and rehabilitation》2005,86(7):1349-1355
Nijs J, Roussel N, Vermuelen K, Souvereyns G. Scapular positioning in patients with shoulder pain: a study examining the reliability and clinical importance of 3 clinical tests.
Objective
To examine the interobserver reliability, internal consistency, and clinical importance of 3 clinical tests for the assessment of scapular positioning in patients with shoulder pain.Design
Prospective repeated-measures design.Setting
Private practices for physical therapy and hospital outpatient physical therapy divisions.Participants
Twenty-nine patients with shoulder pain who were diagnosed by a physician as having a shoulder disorder.Interventions
Not applicable.Main Outcome Measures
Study participants filled in a visual analog scale for pain and the Shoulder Disability Questionnaire. Next, 2 assessors performed the following tests: measurement of the distance between the posterior border of the acromion and the table, measurement of the distance from the medial scapular border to the fourth thoracic spinous processes, and the lateral scapular slide test.Results
The interobserver reliability coefficients were greater than .88 (intraclass correlation coefficients) for the measurement of the distance between the posterior border of the acromion and the table, were greater than .50 for the measurement of the distance from the medial scapular border to the fourth thoracic spinous processes, and were greater than .70 for the lateral scapular slide test. The Cronbach α coefficient for internal consistency for all tests was .88. No associations between the outcome of the tests and self-reported pain severity or disability were found.Conclusions
These data provide evidence favoring the interobserver reliability of 2 of 3 tests for the assessment of scapular positioning in patients with shoulder pain. The clinical importance of the tests’ outcomes, however, is questionable. 相似文献10.
Nicola M. Kayes Philip J. Schluter Kathryn M. McPherson Marta Leete Grant Mawston Denise Taylor 《Archives of physical medicine and rehabilitation》2009,90(4):594-601
Kayes NM, Schluter PJ, McPherson KM, Leete M, Mawston G, Taylor D. Exploring Actical accelerometers as an objective measure of physical activity in people with multiple sclerosis.
Objective
To assess the feasibility, acceptability, and psychometric properties of Actical accelerometers in people with multiple sclerosis (MS).Design
Participants attended 2 testing sessions 7 days apart in which they completed 6 activities ranging in intensity while wearing an Actical accelerometer and Polar heart rate monitor. Perceived exertion was recorded after each activity.Setting
University research center.Participants
People (N=31) with a definite diagnosis of MS were purposefully selected, aiming for diversity in level of reported disability, age, sex, and type of MS.Interventions
Not applicable.Main Outcome Measures
Actical accelerometer, Polar S810i and RS800sd heart rate monitors, Borg rating of perceived exertion, six-minute walk test (6MWT), 30-second chair stand test.Results
Accelerometers had good feasibility and acceptability in people with MS. Test-retest reliability was poor for sedentary and free-living activities, with low to moderate intraclass correlation coefficients (.00-.75), but was better for more vigorous or rhythmic activities (.85-.90). Bland-Altman 95% limits of agreement for average accelerometer counts were wide, ranging from ±16 (newspaper reading) to ±1330 (6MWT). Validity was not established with 95% prediction intervals showing high variability for all activities.Conclusions
The psychometric problems highlighted here suggest Actical accelerometers should be used with caution in people with MS as a measure of physical activity, particularly when measuring comparatively sedentary or free-living activities. 相似文献11.
Pereira MJ Jull GA Treleaven JM 《Archives of physical medicine and rehabilitation》2008,89(6):1097-1102
Pereira MJ, Jull GA, Treleaven JM. Self-reported driving habits in subjects with persistent whiplash-associated disorder: relationship to sensorimotor and psychologic features.
Objectives
To study self-reported driving habits after whiplash injury and to determine any relation among self-reported driving habits, selected sensorimotor impairments, and psychologic features.Design
Repeated-measures, case-controlled.Setting
Tertiary institution.Participants
Subjects (n=30) with chronic whiplash and 30 asymptomatic controls.Interventions
Not applicable.Main Outcome Measures
The Driving Habits Questionnaire (composite driving tasks score), Neck Disability Index (NDI), 28-item General Health Questionnaire (GHQ-28), Impact of Events Scale−Revised (IES-R), Tampa Scale for Kinesiophobia, cervical range of motion, cervical joint position error, and smooth pursuit neck torsion test.Results
Subjects in the whiplash group had equal driving exposure and driving spaces (distances, locations) compared with control subjects but reported significantly more driving difficulty with most driving tasks (P<.01). There were no significant correlations between the composite driving tasks score and any of the sensorimotor impairments, but there were significant and moderate correlations between the composite driving task score and both pain and disability (NDI score, .518) and anxiety (GHQ-28 score, .518; IES-R score, .524).Conclusions
Persons with chronic whiplash have greater self-reported driving difficulty than controls, which appears to relate more to reported levels of pain and disability and psychologic stress than laboratory measures of features of cervical sensorimotor control. 相似文献12.
Spaeth DM Mahajan H Karmarkar A Collins D Cooper RA Boninger ML 《Archives of physical medicine and rehabilitation》2008,89(5):996-1003
Spaeth DM, Mahajan H, Karmarkar A, Collins D, Cooper RA, Boninger ML. Development of a wheelchair virtual driving environment: trials with subjects with traumatic brain injury.
Objective
To develop and test a wheelchair virtual driving environment that can provide quantifiable measures of driving ability, offer driver training, and measure the performance of alternative controls.Design
A virtual driving environment was developed. The wheelchair icon is displayed in a 2-dimensional, bird's eye view and has realistic steering and inertial properties. Eight subjects were recruited to test the virtual driving environment. They were clinically evaluated for range of motion, muscle strength, and visual field function. Driving capacity was assessed by a brief trial with an actual wheelchair. During virtual trials, subjects were seated in a stationary wheelchair; a standard motion sensing joystick (MSJ) was compared with an experimental isometric joystick by using a repeated-measures design.Setting
Subjects made 2 laboratory visits. The first visit included clinical evaluation, tuning the isometric joystick, familiarization with virtual driving environment, and 4 driving tasks. The second visit included 40 trials with each joystick.Participants
Subjects (n=8; 7 men, 1 woman) with a mean age of 22.65±2y and traumatic brain injury, both ambulatory and nonambulatory, were recruited.Interventions
The MSJ used factory settings. A tuning program customized the isometric joystick transfer functions during visit 1. During the second visit, subjects performed 40 trials with each joystick.Main Outcome Measure
The root mean square error (RMSE) was defined as the average deviation from track centerline (in meters) and speed (in m/s).Results
Data analysis from the first 8 subjects showed no statistically significant differences between joysticks. RMSE averaged .12 to .21m; speed averaged .75m/s. For all tasks and joysticks, driving in reverse resulted in a higher RMSE and more virtual collisions than forward driving. RMSE rates were greater in left and right turns than straight and docking tasks.Conclusions
Testing with instrumented real wheelchairs can validate the virtual driving environment and assess whether virtual driving skills transfer to actual driving. 相似文献13.
Aaron P. Turner Daniel R. Kivlahan Jodie K. Haselkorn 《Archives of physical medicine and rehabilitation》2009,90(3):420-428
Turner AP, Kivlahan DR, Haselkorn JK. Exercise and quality of life among people with multiple sclerosis: looking beyond physical functioning to mental health and participation in life.
Objective
To describe the prevalence of exercise in a national sample of veterans with multiple sclerosis (MS) and the association of exercise with quality of life, including physical health, mental health, and participation restriction.Design
Cross-sectional cohort study linking computerized medical records to mailed survey data from 1999.Setting
Veterans Health Administration.Participants
Veterans with MS (N=2995; 86.5% men) who received services in the Veterans Health Administration and returned survey questionnaires.Interventions
Not applicable.Main Outcome Measures
Demographic information, Veteran RAND 36-Item Health Survey (VR-36), self-reported exercise frequency.Results
Among all survey respondents with MS, only 28.6% (95% confidence interval, 26.9-30.2) endorsed any exercise. In adjusted logistic regression, exercise was associated with younger age, more education, living alone, lower levels of bodily pain, and higher body mass index. After adjusting for demographic variables and medical comorbidities, exercise was associated with better physical and mental health. People who exercised reported they had better social functioning and better role functioning (participation in life despite physical and emotional difficulties).Conclusions
Exercise in veterans with MS is uncommon. In the context of chronic illness care, the identification of exercise patterns and promotion of physical activity may represent an important opportunity to improve mental health and quality of life among people with MS. Intervention should address factors associated with lower rates of exercise including age, education, and pain. 相似文献14.
Serge S. Colson Michaël Benchortane Véronique Tanant Jean-Paul Faghan Manuela Fournier-Mehouas Charles Benaïm Claude Desnuelle Sabrina Sacconi 《Archives of physical medicine and rehabilitation》2010,91(5):697-101
Colson SS, Benchortane M, Tanant V, Faghan J-P, Fournier-Mehouas M, Benaïm C, Desnuelle C, Sacconi S. Neuromuscular electrical stimulation training: a safe and effective treatment for facioscapulohumeral muscular dystrophy patients.
Objective
To investigate the feasibility, safety, and effectiveness of neuromuscular electrical stimulation (NMES) strength training in facioscapulohumeral muscular dystrophy (FSHD) patients.Design
Uncontrolled before-after trial.Setting
Neuromuscular disease center in a university hospital and a private-practice physical therapy office.Participants
FSHD patients (N=9; 3 women, 6 men; age 55.2±10.4y) clinically characterized by shoulder girdle and quadriceps femoris muscle weakness.Interventions
Patients underwent 5 months of strength training with NMES bilaterally applied to the deltoideus, trapezius transversalis, vastus lateralis, and vastus medialis muscles for five 20-minute sessions per week.Main Outcome Measures
Plasma creatine kinase (CK) activity; scores for pain and fatigue on visual analog scales (VAS), manual muscle testing (MMT), maximal voluntary isometric contraction (MVIC), 6-minute walking tests (6MWT), and self-reported changes in daily living activities.Results
NMES strength training was well tolerated (CK activity and pain and fatigue scores on VAS were not modified). Most of the muscle functions (shoulder flexion and extension and knee extension) assessed by MMT were significantly increased. MVIC of shoulder flexion and abduction and the 6MWT distance were also improved.Conclusions
In FSHD, NMES strength training appears to be safe with positive effects on muscle function, strength, and capacity for daily activities. 相似文献15.
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16.
Crawford SA Stinson MD Walsh DM Porter-Armstrong AP 《Archives of physical medicine and rehabilitation》2005,86(6):1221-1225
Crawford SA, Stinson MD, Walsh DM, Porter-Armstrong AP. Impact of sitting time on seat-interface pressure and on pressure mapping with multiple sclerosis patients. Arch Phys Med Rehabil 2005;86:1221-5.
Objective
To examine changes in seat-interface pressure with multiple sclerosis (MS) patients.Design
Case series.Setting
Multiple Sclerosis Society’s Resource Centre and community.Participants
Convenience sample of 15 MS wheelchair users and 12 MS non-wheelchair users.Intervention
Interface pressure was measured for 8 minutes using the Force Sensing Array pressure mapping system.Main Outcome Measures
Number of activated sensors, standard deviation, average and maximum pressures.Results
With the wheelchair users, significant decreases were found in the standard deviation and average and maximum pressures during 0 to 2 minutes of sitting (P<.01). Average pressure was the only parameter to show a significant decrease in the non-wheelchair users (P<.01) during 0 to 2 minutes. Significant increases were found in all output parameters during 2 to 4 minutes with both groups (P<.05). Non-wheelchair users showed no significant changes in the output parameters after 4 minutes, but wheelchair users showed significant continued increases in the output parameters from 4 to 8 minutes (P<.05).Conclusions
Because no significant changes in interface pressure occurred after 4 minutes of sitting with the non-wheelchair users, 4 minutes may be a reasonable sitting time before interface pressure is recorded with this group. Significant changes in interface pressure continued up to 8 minutes with the wheelchair users, therefore 8 minutes or beyond may be a reasonable sitting time before recording with this group. 相似文献17.
Yoon JS Hong SJ Kim BJ Kim SJ Kim JM Walker FO Cartwright MS 《Archives of physical medicine and rehabilitation》2008,89(5):887-889
Yoon JS, Hong S-J, Kim B-J, Kim SJ, Kim JM, Walker FO, Cartwright MS. Ulnar nerve and cubital tunnel ultrasound in ulnar neuropathy at the elbow.
Objective
To determine the accuracy of the ultrasonographic measurement of ulnar nerve to cubital tunnel area for diagnosis of ulnar neuropathy at the elbow.Design
Patients with confirmed ulnar neuropathy at the elbow and normative, healthy volunteers were evaluated with high-resolution ultrasound. The cross-sectional areas (CSAs) of the ulnar nerve and cubital tunnel were measured with the elbow extended and flexed, and results from the 2 groups were compared.Setting
Electromyography laboratory and radiology department of a tertiary care center.Participants
Twenty-seven patients with ulnar neuropathy at the elbow and 20 controls.Interventions
Not applicable.Main Outcome Measure
The ratio of ulnar nerve to cubital tunnel CSA with the elbow flexed.Results
The ulnar nerve, with the elbow flexed, was larger in those with ulnar neuropathy at the elbow, and this group also had larger cubital tunnels than did controls. In those with ulnar neuropathy at the elbow, the ratio of the ulnar nerve to cubital tunnel was .31, and in the controls it was .32, which was not significantly different (P=.89).Conclusions
The ratio of ulnar nerve to cubital tunnel did not differentiate those with ulnar neuropathy at the elbow from controls. 相似文献18.
Feys P Helsen WF Liu X Lavrysen A Nuttin B Ketelaer P 《Archives of physical medicine and rehabilitation》2004,85(6):1031-1033
Feys P, Helsen WF, Liu X, Lavrysen A, Nuttin B, Ketelaer P. Effects of vision and arm position on amplitude of arm postural tremor in patients with multiple sclerosis. Arch Phys Med Rehabil 2004;85:1031-3.
Objectives
To quantify the effects of vision and arm position on arm postural tremor, comparisons were made between flexed and extended arm positions performed with the eyes open and closed.Design
Case-control study.Setting
National multiple sclerosis (MS) center in Belgium.Participants
Sixteen patients (32 arms) with MS who had intention tremor and 16 healthy controls (32 arms).Interventions
Not applicable.Main outcome measure
The amplitude of postural tremor was assessed by a magnetic position sensor attached to the index finger.Results
The amplitude of postural tremor was not influenced by changes in visual condition or different arm positions. Both healthy controls and MS patients made more directional changes in the flexed, compared with the extended arm position.Conclusions
The amplitude of the arm postural tremor in MS is independent of vision and arm position. Selecting 1 arm position is sufficient to assess postural tremor amplitude. 相似文献19.
Aaron P. Turner Eric J. Hawkins Jodie K. Haselkorn Daniel R. Kivlahan 《Archives of physical medicine and rehabilitation》2009,90(5):842-848
Turner AP, Hawkins EJ, Haselkorn JK, Kivlahan DR. Alcohol misuse and multiple sclerosis.
Objective
To describe the prevalence of alcohol misuse and medical advice to reduce drinking in a national sample of veterans with multiple sclerosis (MS).Design
Cross-sectional cohort study linking computerized medical record information to mailed survey data from 2004 through 2006.Setting
Veterans Health Administration (VHA).Participants
Two thousand six hundred fifty-five of 4929 veterans with MS who received services in VHA between 2004 and 2006 and also a survey questionnaire (53.9% response rate).Interventions
Not applicable.Main Outcome Measures
Demographic information, Short-Form 12-Item Health Survey Mental Component Summary and Physical Component Summary, Alcohol Use Disorders Identification Test Consumption questions, and questions assessing depressive symptoms and the receipt of alcohol-related advice from a medical professional.Results
Among all survey respondents with MS, the prevalence of alcohol misuse for the sample was 13.9% (confidence interval [CI], 12.5-15.2), with 11.9% (CI, 10.6-13.2) and 2.0% (CI, 1.4-2.5) of participants scoring in the mild/moderate and severe range of alcohol misuse, respectively. In contrast to community samples there was no difference in prevalence by sex. In multivariate logistic regression, age younger than 60 years (<50y; adjusted odds ratio [AOR]=1.66; CI, 1.17-2.37, and 50-59; AOR=1.64; CI, 1.19-2.27), employment (AOR=1.54; CI, 1.06-2.24) and better physical health (AOR=1.02; CI, 1.01-1.04) were associated with a higher likelihood of alcohol misuse. Among persons who screened positive for alcohol misuse, only 26.2% (CI, 21.5-30.9) reported they had received advice from a medical provider in the past year to decrease or abstain from drinking. Self-report of advice was more likely among those endorsing severe misuse (AOR=3.65; CI, 1.85-7.17) and less likely among those with better mental health (AOR=0.97; CI, 0.94-1.00).Conclusions
Despite the numerous health and social consequences of alcohol misuse, routine screening and intervention for people with MS remain uncommon. Brief screening and advice to reduce or refrain from alcohol use can be accomplished in as little as 5 minutes and can be incorporated into the regular course of medical care. 相似文献20.
Rasch EK Hochberg MC Magder L Magaziner J Altman BM 《Archives of physical medicine and rehabilitation》2008,89(2):210-218
Rasch EK, Hochberg MC, Magder L, Magaziner J, Altman BM. Health of community-dwelling adults with mobility limitations in the United States: prevalent health conditions. Part I.