共查询到20条相似文献,搜索用时 31 毫秒
1.
Erica N. Johnson 《Archives of physical medicine and rehabilitation》2010,91(7):1140-1142
Johnson EN, Thomas JS. Effect of hamstring flexibility on hip and lumbar spine joint excursions during forward-reaching tasks in participants with and without low back pain.
Objective
To examine the correlation between hamstring flexibility and hip and lumbar spine joint excursions during standardized reaching and forward-bending tasks.Design
Retrospective analysis of data obtained during 2 previous prospective studies that examined kinematics and kinetics during forward-reaching tasks in participants with and without low back pain (LBP).Setting
The 2 previous studies were conducted in the Motor Control Lab at Ohio University and the Orthopaedic Ergonomics Laboratory at The Ohio State University.Participants
Data from a total of 122 subjects from 2 previous studies: study 1: 86 subjects recovered from an episode of acute LBP (recovered) and study 2 (A.I. McCallum, unpublished data): 18 chronic LBP subjects and 18 healthy-matched controls (healthy).Interventions
Not applicable.Main Outcome Measure
Correlation values between hamstring flexibility as measured by straight leg raise (SLR) and amount of hip and lumbar spine joint excursions used during standardized reaching and forward-bending tasks.Results
No significant correlation was found between hamstring flexibility and hip and lumbar joint excursions during forward-bending tasks in the LBP or recovered groups. The SLR had a significant negative correlation with lumbar spine excursions during reaching tasks to a low target in the healthy group (right SLR: P=.011, left SLR: P=.004).Conclusions
Hamstring flexibility is not strongly related to the amount of lumbar flexion used to perform forward-reaching tasks in participants who have chronic LBP or who have recovered from LBP. More research needs to be conducted to examine the influence of hamstring flexibility on observed movement patterns to further evaluate the efficacy of flexibility training in the rehabilitation of patients with LBP. 相似文献2.
Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement.
Objective
To determine differences in strength and range of motion (ROM) between participants who exhibit medial knee displacement (MKD) during a squat that is corrected by a heel lift and those who do not.Design
Case control.Setting
Sports medicine research laboratory.Participants
Thirty-seven healthy subjects (control, 19; MKD, 18) with no lower-extremity injury in the past 6 months volunteered to participate.Interventions
Not applicable.Main Outcome Measures
Peak force was measured in newtons using a hand-held dynamometer and passive ROM was measured in degrees with a goniometer. Separate multivariate analyses of variance were used to determine differences in strength and ROM between groups. Post hoc testing was used to elucidate differences between groups.Results
The MKD group had the following: greater hip external rotation strength (P=.03), increased hip extension strength (P=.01), less plantarflexion strength (P=.007), and increased hip external rotation ROM (P=.008).Conclusions
The MKD group exhibited tight and weak ankle musculature. Interventions focusing on improving strength and ROM of the ankle may improve kinematics during a squat. 相似文献3.
James S. Krause Karla S. Reed John J. McArdle 《Archives of physical medicine and rehabilitation》2010,91(8):1218-1224
Krause JS, Reed KS, McArdle JJ. Factor structure and predictive validity of somatic and nonsomatic symptoms from the Patient Health Questionnaire-9: a longitudinal study after spinal cord injury.
Objective
To investigate the factor structure and predictive validity of somatic and nonsomatic depressive symptoms over the first 2.5 years after spinal cord injury (SCI) using the Patient Health Questionnaire-9 (PHQ-9).Design
Somatic and nonsomatic symptoms were assessed at baseline during inpatient hospitalization (average of 50 days after onset) and during 2 follow-ups (average of 498 and 874 days after onset).Setting
Data were collected at a specialty hospital in the Southeastern United States and analyzed at a medical university. We performed time-lag regression between inpatient baseline and follow-up somatic and nonsomatic latent factors of the PHQ-9.Participants
Adults with traumatic SCI (N=584) entered the study during inpatient rehabilitation.Interventions
Not applicable.Main Outcome Measure
PHQ-9, a 9-item measure of depressive symptoms.Results
The inpatient baseline nonsomatic latent factor was significantly predictive of the nonsomatic (r=.40; P=.000) and somatic latent factors at the second follow-up (r=.29; P=.006), whereas the somatic factor at inpatient baseline did not significantly predict either factor. In contrast, when regressing latent factors between the 2 follow-ups, the nonsomatic factor predicted only the nonsomatic factor (r=.66; P=.002), and the somatic factor predicted only future somatic symptoms (r=.66; P=.000). In addition, the factor structure was not stable over time. Item analysis verified the instability of somatic items between inpatient baseline and follow-up and also indicated that self-harm at inpatient baseline was highly predictive of future self-harm.Conclusions
Nonsomatic symptoms are better predictors of future depressive symptoms when first assessed during inpatient rehabilitation, whereas somatic symptoms become stable predictors only after inpatient rehabilitation. Self-harm (suicidal ideation) is the most stable symptom over time. Clinicians should routinely assess for suicidal ideation and use nonsomatic symptoms when performing assessments during inpatient rehabilitation. 相似文献4.
Adam T. Hirsh Aaron P. Turner Dawn M. Ehde Jodie K. Haselkorn 《Archives of physical medicine and rehabilitation》2009,90(4):646-651
Hirsh AT, Turner AP, Ehde DM, Haselkorn JK. Prevalence and impact of pain in multiple sclerosis: physical and psychologic contributors.
Objective
To characterize the prevalence and impact of pain in veterans with multiple sclerosis (MS) and to assess their association with demographic, biologic, and psychologic variables.Design
Cross-sectional cohort study linking computerized medical record information to mailed survey data.Setting
Veterans Health Administration (VHA).Participants
Sixty-four percent (2994/4685) of veterans with MS who received services in VHA and also returned survey questionnaires.Interventions
Not applicable.Main Outcome Measures
Items assessing pain intensity, pain interference, and physical and mental health functioning.Results
Ninety-two percent of participants reported bodily pain within the prior 4 weeks, with 69% of the total sample indicating pain of moderate or higher intensity. Eighty-five percent indicated that pain caused functional interference during the past 4 weeks, with 71% of the total sample reporting pain-related interference that was moderate or greater. No significant sex or race differences emerged for the pain indices. A significant but modest relationship between increasing age and pain interference emerged (r=.05, P<.01); however, age was not significantly related to pain intensity. Multivariate regression analyses identified pain intensity (β=.73), physical health functioning (β=-.07), and mental health functioning (β=-.13) variables as significant, unique contributors to the prediction of pain interference. The interaction of pain intensity and physical functioning was also significant but of minimal effect size (β=-.03).Conclusions
Pain is highly prevalent and causes substantial interference in the lives of veterans with MS. The functional impact of pain in veterans with MS is influenced by pain intensity, physical health, and emotional functioning. Clinical practice should take each of these domains into consideration and reflect a biopsychosocial conceptualization. 相似文献5.
Angela S. Lee Jacek Cholewicki N. Peter Reeves Bohdanna T. Zazulak Lawrence W. Mysliwiec 《Archives of physical medicine and rehabilitation》2010,91(9):1327-1331
Lee AS, Cholewicki J, Reeves NP, Zazulak BT, Mysliwiec LW. Comparison of trunk proprioception between patients with low back pain and healthy controls.
Objective
To determine whether proprioceptive impairments exist in patients with low back pain (LBP). We hypothesized that patients with LBP would exhibit larger trunk proprioception errors than healthy controls.Design
Case-control study.Setting
University laboratory.Participants
24 patients with nonspecific LBP and 24 age-matched healthy controls.Interventions
Not applicable.Main Outcome Measures
We measured trunk proprioception in all 3 anatomical planes using motion perception threshold, active repositioning, and passive repositioning tests.Results
LBP patients had significantly greater motion perception threshold than controls (P<.001) (1.3±0.9° vs 0.8±0.6°). Furthermore, all subjects had the largest motion perception threshold in the transverse plane (P<.001) (1.2±0.7° vs 1.0±0.8° for all other planes averaged). There was no significant difference between LBP and healthy control groups in the repositioning tasks. Errors in the active repositioning test were significantly smaller than in the passive repositioning test (P=.032) (1.9±1.2° vs 2.3±1.4°).Conclusions
These findings suggest that impairments in proprioception may be detected in patients with LBP when assessed with a motion perception threshold measure. 相似文献6.
Trevor A. Lentz Zach Sutton Scott Greenberg Mark D. Bishop 《Archives of physical medicine and rehabilitation》2010,91(4):557-561
Lentz TA, Sutton Z, Greenberg S, Bishop MD. Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology.
Objective
To determine the unique influence of pain-related fear of movement on foot and ankle disability, after accounting for pain, demographic, and physical impairment variables.Design
Cross-sectional study using retrospective chart review.Setting
Outpatient rehabilitation clinic.Participants
Referred sample of subjects with foot- and ankle-related disability (N=85, 40 men; mean age, 33y; range, 16-77y).Interventions
Not applicable.Main Outcome Measures
Lower Extremity Functional Scale (LEFS), Shortened Tampa Scale of Kinesiophobia (TSK-11).Results
Hierarchical regression analysis determined the proportions of explained variance in disability (LEFS). Demographic variables were entered into the model first, followed by pain intensity and range-of-motion (ROM) deficit, and finally, TSK-11. Demographics collectively contributed 9% (P=.015) of the variance in disability scores. Pain intensity and overall ROM deficit contributed an additional 11% (P<.001) of the variance, and TSK-11 scores contributed an additional 14% (P<.001). In the overall model, age (β=−.29, P=.004), chronicity of symptoms (β=.23, P=.024), ROM deficit (β=−.28, P=.003), and TSK-11 (β=−.41, P<.001) explained 34% of the variance in the LEFS score (P<.001).Conclusions
Age, chronicity of symptoms, ROM deficit, and TSK-11 scores all significantly contributed to baseline foot and ankle self-reported disability. Pain-related fear of movement was the strongest single contributor to disability in this group of patients. 相似文献7.
Jeffrey J. Hebert Shane L. Koppenhaver John S. Magel Julie M. Fritz 《Archives of physical medicine and rehabilitation》2010,91(1):78-85
Hebert JJ, Koppenhaver SL, Magel JS, Fritz JM. The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a cross-sectional study.
Objective
To examine the relationship between prognostic factors for clinical success with a stabilization exercise program and lumbar multifidus (LM) and transversus abdominis (TrA) muscle activation assessed using rehabilitative ultrasound imaging (RUSI).Design
Cross-sectional study.Setting
Outpatient physical therapy clinic.Participants
Volunteers with current low back pain (N=40).Intervention
Not applicable.Main Outcome Measures
We examined the relationship between prognostic factors associated with clinical success with a stabilization exercise program (positive prone instability test, age <40y, aberrant movements, straight leg raise >91°, presence of lumbar hypermobility) and degree of TrA and LM muscle activation assessed by RUSI.Results
Significant univariate relationships were identified between LM muscle activation and the number of prognostic factors present (Pearson correlation coefficient [r] =−.558, P=.001), as well as the individual factors of a positive prone instability test (point biserial correlation coefficient [rpbis]=.376, P=.018) and segmental hypermobility (rpbis=.358, P=.025). The multivariate analyses indicated that after controlling for other variables, the addition of the variable “number of prognostic factors present” resulted in a significant increase in R2 (P=.006). No significant univariate or multivariate relationships were observed between the prognostic factors and TrA muscle activation.Conclusions
Decreased LM muscle activation, but not TrA muscle activation, is associated with the presence of factors predictive of clinical success with a stabilization exercise program. Our findings provide researchers and clinicians with evidence regarding the construct validity of the prognostic factors examined in this study, as well as the potential clinical importance of the LM muscle as a target for stabilization exercises. 相似文献8.
Rotsalai Kanlayanaphotporn Adit Chiradejnant Roongtiwa Vachalathiti 《Archives of physical medicine and rehabilitation》2009,90(2):187-192
Kanlayanaphotporn R, Chiradejnant A, Vachalathiti R. The immediate effects of mobilization technique on pain and range of motion in patients presenting with unilateral neck pain: a randomized controlled trial.
Objective
To determine the immediate effects on both pain and active range of motion (ROM) of the unilateral posteroanterior (PA) mobilization technique on the painful side in mechanical neck pain patients presenting with unilateral symptoms.Design
Triple-blind, randomized controlled trial.Setting
Outpatient physical therapy, institutional clinic.Participants
Patients (N=60), 2 physical therapists, and 1 assessor involved in this study.Interventions
The patients were randomly allocated into either preferred or random mobilization group by using an opaque concealed envelope. The first therapist performed the screening, assessing, prescribing the spinal level(s), and the grade of mobilization. The second therapist performed the mobilization treatment according to their allocated group stated in an envelope. The assessor who was blind to the group allocation conducted the measurements of pain and active cervical ROM.Main Outcome Measures
Pain intensity, active cervical ROM, and global perceived effect were measured at baseline and 5 minutes posttreatment.Results
After mobilization, there were no apparent differences in pain and active cervical ROM between groups. However, within-group changes showed significant decreases in neck pain at rest and pain on most painful movement (P<0.001) with a significant increase in active cervical ROM after mobilization on most painful movement (P=0.002).Conclusions
The results of this study did not provide support for the preference of the unilateral PA mobilization on the painful side to the random mobilization. 相似文献9.
Mark A. Slater Anne L. Weickgenant Melanie A. Greenberg Dennis R. Wahlgren Rebecca A. Williams Christian Carter Thomas L. Patterson Igor Grant Steven R. Garfin John S. Webster J. Hampton Atkinson 《Archives of physical medicine and rehabilitation》2009,90(4):545-552
Slater MA, Weickgenant AL, Greenberg MA, Wahlgren DR, Williams RA, Carter C, Patterson TL, Grant I, Garfin SR, Webster JS, Atkinson JH. Preventing progression to chronicity in first onset, subacute low back pain: an exploratory study.
Objectives
To evaluate the effects of a behavioral medicine intervention, relative to an attention control, in preventing chronic pain and disability in patients with first-onset, subacute low back pain (LBP) with limitations in work-role function.Design
A 2-group, experimental design with randomization to behavioral medicine or attention control groups.Setting
Orthopedic clinic at a Naval Medical Center.Participants
Sixty-seven participants with first-onset LBP of 6 to 10 weeks of duration and impairment in work function, of whom 50 completed all 4 therapy sessions and follow-up 6 months after pain onset.Intervention
Four 1-hour individual treatment sessions of either behavioral medicine, focused on back function and pain education, self-management training, graded activity increases, fear reduction, and pain belief change; or attention control condition, focused on empathy, support, and reassurance.Main Outcome Measures
The primary outcome was proportion of participants classified as recovered, according to pre-established clinical cutoffs on standardized measures, signifying absence of chronic pain and disability at 6 months after pain onset. Secondary analyses were conducted on pain, disability, health status, and functional work category. Intervention credibility and pain belief manipulation checks were also evaluated.Results
Chi square analyses comparing proportions recovered at 6 months after pain onset for behavioral medicine and attention control participants found relative rates of 52% versus 31% in the modified intent-to-treat sample (P=.09) and 54% versus 23% for those completing all 4 sessions and 6-month follow-up (P=.02). At 12 months, 79% of recovered and 68% of chronic pain participants still met criteria for their respective groups (P<.0001). Recovered participants also had higher rates of functional work status recovery at 12 months (recovered: 96% full duty and 4% light duty; chronic pain: 61% full duty, 18% light duty, and 21% medical discharge, respectively; P=.03).Conclusions
Early intervention using a behavioral medicine rehabilitation approach may enhance recovery and reduce chronic pain and disability in patients with first-onset, subacute LBP. Effects are stronger for participants attending all 4 sessions and the follow-up assessment. 相似文献10.
Mira Meeus Jo Nijs Jessica Van Oosterwijck Veerle Van Alsenoy Steven Truijen 《Archives of physical medicine and rehabilitation》2010,91(8):1153-1159
Meeus M, Nijs J, Van Oosterwijck J, Van Alsenoy V, Truijen S. Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial.
Objective
To examine whether pain physiology education was capable of changing pain cognitions and pain thresholds in patients with chronic fatigue syndrome (CFS) and chronic widespread pain.Design
Double-blind randomized controlled trial.Setting
Specialized chronic fatigue clinic in university hospital.Participants
A random sample of patients (N=48) with CFS patients (8 men, 40 women) experiencing chronic pain, randomly allocated to the control group (n=24) or experimental group (n=24). Two women in the experimental group did not complete the study because of practical issues (lack of time and restricted mobility).Interventions
One individual pain physiology education session (experimental) or 1 pacing and self-management education session (control).Main Outcome Measures
Algometry, the Neurophysiology of Pain Test, and questionnaires evaluating pain cognitions—the Pain Coping Inventory, the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia-version CFS—were completed immediately before and immediately after the intervention.Results
After the intervention, the experimental group demonstrated a significantly better understanding of the neurophysiology of pain (P<.001) and a reduction of the Pain Catastrophizing Scale subscale “ruminating” (P=.009) compared with controls. For these variables, moderate to large Cohen d effect sizes were revealed (.79-2.53).Conclusions
A 30-minute educational session on pain physiology imparts a better understanding of pain and brings about less rumination in the short term. Pain physiology education can be an important therapeutic modality in the approach of patients with CFS and chronic pain, given the clinical relevance of inappropriate pain cognitions. 相似文献11.
12.
Miller M Wong WK Wu J Cavenett S Daniels L Crotty M 《Archives of physical medicine and rehabilitation》2008,89(10):2031-2033
Miller M, Wong WK, Wu J, Cavenett S, Daniels L, Crotty M. Upper-arm anthropometry: an alternative indicator of nutritional health to body mass index in unilateral lower-extremity amputees?
Objective
To evaluate the utility of body mass index (BMI) and corrected-arm-muscle area (CAMA) as measures of nutritional health for lower-limb amputees attending prosthetics clinics.Design
Cross-sectional study.Setting
Prosthetics clinic in Australia.Participants
Unilateral lower-extremity amputees (N=58; age range, 21-91y; 37 transtibial, 21 transfemoral) attending a regional prosthetics clinic between May and November 2003.Interventions
Not applicable.Main Outcome Measures
Weight (without prosthesis), corrected and uncorrected for the amputated limb was used with height estimated from knee height to calculate corrected BMI (cBMI) and uncorrected BMI (uBMI). CAMA was calculated using the mean of triplicate mid-upper-arm circumference (MUAC) and triceps skinfold thickness (TST) measurements. The Mini Nutritional Assessment (MNA) and Assessment of Quality of Life were administered according to recommended protocols. The Pearson correlation was used to determine the strength and significance of associations between variables, and bivariate regression analyses were performed to determine whether an association existed between the nutritional variables (BMI, CAMA, MNA) and quality of life (QOL).Results
There were no statistically significant differences in the measures of nutritional health according to site (transtibial, transfemoral) of amputation. MUAC, TST, and CAMA all showed moderate to high positive correlations (r range, .541−.782) with both cBMI and uBMI. The strength of the relationship between the MNA and cBMI/uBMI was weaker (r=.383, r=.380, respectively) but remained positive and statistically significant (P=.003). QOL was not associated with cBMI or uBMI but was related to CAMA (β=−.132; P=.030) and MNA (β=−.561; P=.017).Conclusions
For persons with unilateral lower-extremity amputation, measurement of upper-arm anthropometry may be a more useful indicator of nutritional health and its consequences than BMI. 相似文献13.
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14.
Elizabeth L. Proud Meg E. Morris 《Archives of physical medicine and rehabilitation》2010,91(5):794-799
Proud EL, Morris ME. Skilled hand dexterity in Parkinson's disease: effects of adding a concurrent task.
Objective
To compare the performance of people with Parkinson's disease (PD) and unimpaired participants on a timed dexterity task and to examine the effects of adding a secondary task.Design
A repeated measures analysis of performance for the 2 groups under unitask and dual-task conditions.Setting
All tests were conducted in a human movement laboratory.Participants
People with idiopathic PD (n=22) and age-matched and sex-matched comparisons (n=22) volunteered for the study.Interventions
Not applicable, although a verbal-cognitive secondary task was used.Main Outcome Measures
The number of pegs placed in the Purdue Pegboard in 30 seconds, the number of correct verbal responses for the secondary task, scores on the Manual Ability Measure-16 test of hand function and, for the group with PD, ratings on the Unified Parkinson's Disease Rating Scale.Results
For the pegboard task, people with PD had reduced dexterity (t=−5.289; P<.001) compared with the unimpaired group. When the secondary task was added, both groups placed fewer pegs (F1,42=.652; P=.42). There were no differences between groups in scores for the subtraction task performed alone, but when this activity was carried out with the Purdue Pegboard Test, the number of correct responses declined only in the PD group (F1,42=4.90; P=.032).Conclusions
Manual dexterity was compromised in this group of people with mild-moderate PD when compared with an unimpaired group. When the concurrent verbal-cognitive task was added, dual-task interference occurred in both groups but to a greater extent in people with PD. 相似文献15.
Gustavo J. Almeida Carolyn A. Schroeder BS Alexandra B. Gil PT MS G. Kelley Fitzgerald PT PhD Sara R. Piva PT PhD 《Archives of physical medicine and rehabilitation》2010,91(6):932-938
Almeida GJ, Schroeder CA, Gil AB, Fitzgerald GK, Piva SR. Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty.
Objective
(1) To determine the interrater reliability and measurement error of an 11-step stair ascend/descend test (STTotal-11) and stair up (ascend) test (STUp-11); (2) to seek evidence for the STTotal-11 and STUp-11 as valid measures of physical function by determining if they relate to measures of physical function and do not relate to measures not of physical function; and (3) to explore if the STTotal-11 and STUp-11 scores relate to lower-extremity muscle weakness and knee range of motion (ROM) in subjects with total knee arthroplasty (TKA).Design
Cross-sectional study.Setting
Academic center.Participants
Subjects (N=43, 30 women; mean age, 68±8y) with unilateral TKA.Interventions
Not applicable.Main Outcome Measures
STTotal-11 and STUp-11 were performed twice, and scores were compared with scores on 4 lower extremity performance-based tasks, 2 patient-reported questionnaires of physical function, 3 psychologic factors, knee ROM, and strength of quadriceps, hip extensors, and abductors.Results
Intraclass correlation coefficient was .94 for both the STTotal-11 and STUp-11, standard error of measurements were 1.14 seconds and .82 seconds, and minimum detectable change associated with 90% confidence interval was 2.6 seconds and 1.9 seconds, respectively. Correlations between stair tests and performance-based measures and knee and hip muscle strength ranged from Pearson correlation coefficient (r)=.40 to .78. STTotal-11 and STUp-11 had a small correlation with one of the patient-reported measures of physical function. Stair tests were not associated with psychologic factors and knee extension ROM and were associated with knee flexion ROM.Conclusions
STTotal-11 and STUp-11 have good interrater reliability and minimum detectable changes adequate for clinical use. The pattern of associations supports the validity of the stair tests in TKA. 相似文献16.
Objectives
It has been proposed that neurodynamic examination can assist differential diagnosis of upper/mid lumbar nerve root compression; however, the diagnostic validity of many of these tests has yet to be established. This pilot study aimed to establish the diagnostic validity of the slump knee bend neurodynamic test for upper/mid lumbar nerve root compression in subjects with suspected lumbosacral radicular pain.Design
Two independent examiners performed the slump knee bend test on subjects with radicular leg pain. Inter-tester reliability was calculated using the kappa coefficient. Slump knee bend test results were compared with magnetic resonance imaging findings, and diagnostic accuracy measures were calculated including sensitivity, specificity, predictive values and likelihood ratios.Setting
Orthopaedic spinal clinic, secondary care.Participants
Sixteen patients with radicular leg pain.Results
All four subjects with mid lumbar nerve root compression on magnetic resonance imaging were correctly identified with the slump knee bend test; however, it was falsely positive in two individuals without the condition. Inter-tester reliability for the slump knee bend test using the kappa coefficient was 0.71 (95% confidence interval 0.33 to 1.0). Diagnostic validity calculations for the slump knee bend test (95% confidence intervals) were: sensitivity, 100% (40 to 100%); specificity, 83% (52 to 98%); positive predictive value, 67% (22 to 96%); negative predictive value, 100% (69 to 100%); positive likelihood ratio, 6.0 (1.58 to 19.4); and negative likelihood ratio, 0 (0 to 0.6).Conclusions
Results indicate good inter-tester reliability and suggest that the slump knee bend test has potential to be a useful clinical test for identifying patients with mid lumbar nerve root compression. Further investigation is needed on larger numbers of patients to confirm these findings. 相似文献17.
18.
Lin S-I, Lin R-M, Huang L-W. Disability in patients with degenerative lumbar spinal stenosis.
Objective
To determine factors associated with disability in patients with degenerative lumbar spinal stenosis.Design
One-group cross-sectional study.Setting
University hospital.Participants
One hundred eight patients with degenerative lumbar spinal stenosis.Interventions
Not applicable.Main Outcome Measures
Oswestry Disability Index and 4 categories of factors, including patient demographics (age, sex, number of comorbidities, medications), symptom-related factors (intensity, location, onset duration, neurogenic claudication), body structure and function as described in the International Classification of Functioning, Disability and Health model (muscle strength, vibration sense, spine flexibility), and stenotic condition (type and number of spinal segments involved).Results
Patients with symptoms in both back and leg reported greater disability than those with symptoms only in the leg or back (P=.008). Greater disability correlated significantly with greater symptom intensity (r=.385, P<.001) and higher vibration threshold (r=.236, P=.014). While controlling the variance in patient demographics in the regression analysis, vibration sense and symptom location each added 10% of the variance in disability, and symptom intensity and strength each added 5%, with a total of 44% variance explained (P=.044).Conclusions
Symptom intensity and location, vibration sense, and muscle strength were identified as significant factors and, together with patient demographics, accounted for 44% of the variance explained in disability. Further investigations are needed to determine if causal relationships exist between these factors and disability. 相似文献19.
Shih-Tzu Huang Marion Good Jaclene A. Zauszniewski 《International journal of nursing studies》2010,47(11):1354-1362
Objectives
To examine effects of sedative music on cancer pain.Design
A randomized controlled trial.Settings
Two large medical centers in Kaoshiung City, in southern Taiwan.Participants
126 hospitalized persons with cancer pain.Methods
Participants were randomly assigned to an experimental (n = 62) or a control group (n = 64), with computerized minimization, stratifying on gender, pain, and hospital unit. Music choices included folk songs, Buddhist hymns (Taiwanese music), plus harp, and piano (American). The experimental group listened to music for 30 min; the control group rested in bed. Sensation and distress of pain were rated on 100 mm VAS before and after the 30-min test.Results
Using MANCOVA, there was significantly less posttest pain in the music versus the control group, p < .001. Effect sizes were large, Cohen's d = .64, sensation, d = .70, distress, indicating that music was very helpful for pain. Thirty minutes of music provided 50% relief in 42% of the music group compared to 8% of the controls. The number needed to treat (NNT) to find one with 50% sensation relief was three patients. More patients chose Taiwanese music (71%) than American music (29%), but both were liked and effective.Conclusions
Offering a choice of familiar, culturally appropriate music was a key element of the intervention. Findings extend the Good and Moore theory (1996) to cancer pain. Soft music was safe, effective, and liked by participants. It provided greater relief of cancer pain than analgesics alone. Thus nurses should offer calming, familiar music to supplement analgesic medication for persons with cancer pain. 相似文献20.
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.