共查询到20条相似文献,搜索用时 31 毫秒
1.
Objectives
To compare heart rate responses in the 6-minute walk test and the treadmill exercise test before and after an exercise-based cardiac rehabilitation programme.Design
Prospective cohort study.Setting
Hospital-based cardiac rehabilitation programme in Hong Kong.Participants
Thirty patients (mean age 62.1 ± 8.5 years, 20 males) with stable ischaemic heart disease.Interventions
Eight-week exercise-based cardiac rehabilitation programme involving upper and lower limb aerobic and resistance training.Main outcome measures
Six-minute walk test and treadmill exercise test before and after the exercise programme.Results
Comparing parameters before and after the exercise programme, the peak heart rate in the 6-minute walk test increased (median of 105 beats per minute (bpm), interquartile range 96.8-116.5 versus 110 bpm, interquartile range 100.5-124.5, P = 0.006), while heart rate recovery improved in each 30-second interval of a 2-minute recovery period. The distance covered during the 6-minute walk increased from a mean of 486.3 m (±standard deviation 113.9 m) to 552.5 m (±standard deviation 111.9 m) (P < 0.001). Rating of perceived exertion during the 6-minute walk test decreased from a median of 14 (interquartile range 13-15) to 13 (interquartile range 13-13) (P = 0.001). Heart rate recovery following treadmill exercise testing improved during the 30-second periods from 60 to 90 seconds and from 90 to 120 seconds of recovery. Metabolic equivalents increased during treadmill testing from a median of 7.0 (interquartile range 5.8-8.6) to 8.6 (interquartile range 7-8.6) (P < 0.001).Conclusions
Both treadmill exercise and 6-minute walk tests demonstrated improvements in heart rate recovery and increases in achieved workload following exercise training. This suggests that the 6-minute walk test is a valid tool to assess heart rate recovery following such a programme. 相似文献2.
Background
Walking tests, such as the incremental shuttle walk test (ISWT) and the 6-minute walk test (6MWT), are recommended in the assessment of ambulatory oxygen for patients with chronic obstructive pulmonary disease (COPD). However, there is no evidence that these tests can be used interchangeably.Objectives
To compare the ISWT and the 6MWT in COPD patients in terms of indication for ambulatory oxygen therapy.Design
Crossover design.Setting
Patients attended as outpatients.Participants
Fifty patients with stable COPD (31 males; age 67 years, range 43 to 83 years); mean forced expiratory volume in 1 second 1.2 l [standard deviation (SD) 0.6 l] and 48.6% predicted (SD 23.4%).Intervention
Patients performed both the ISWT and the 6MWT whilst breathing air. Breathlessness (Borg scale), percutaneous arterial oxygen saturation (SpO2) and heart rate were measured before and after both tests.Main outcome measures
Post-test SpO2 and change from baseline.Results
The mean change in saturation was −4.6% (SD 6.2%) and −2.8% (SD 5.3%) after the ISWT and the 6WMT, respectively. Using Bland and Altman plots, the limits of agreement for difference in change in SpO2 (%) between the two tests were wide (−8.1 to 11.6) and clinically relevant. Sixteen patients (32%) and 13 patients (26%) met the criteria for ambulatory oxygen with the ISWT and the 6MWT, respectively (P = 0.32).Conclusions
This study found a wide variation between differences in exercise oxygen desaturation after the ISWT compared with the 6MWT, supporting the premise that these tests should not be used interchangeably in the assessment of ambulatory oxygen for COPD patients. 相似文献3.
Sefton JM Hicks-Little CA Hubbard TJ Clemens MG Yengo CM Koceja DM Cordova ML 《Archives of physical medicine and rehabilitation》2008,89(10):1991-1995
Sefton JM, Hicks-Little CA, Hubbard TJ, Clemens MG, Yengo CM, Koceja DM, Cordova ML. Segmental spinal reflex adaptations associated with chronic ankle instability.
Objective
To further understanding of the role that segmental spinal reflexes play in chronic ankle instability (CAI).Design
A 2 × 2 repeated-measures case-control factorial design. The independent variables were ankle group with 2 levels (healthy, CAI) and stance with 2 levels (single, double legged).Setting
University research laboratory.Participants
Twenty-two participants with CAI and 21 matched healthy controls volunteered.Interventions
Not applicable.Main Outcome Measures
The dependent variables were 2 measures of motoneuron pool excitability: paired reflex depression (PRD) and recurrent inhibition.Results
A 2 × 2 repeated-measures multivariate analysis of variance revealed a significant interaction between group and stance on the linear combination of PRD and recurrent inhibition variables (Wilks λ=.808, F2,40=4.77, P=.014). Follow-up univariate F tests revealed an interaction between group and stance on the PRD (F1,41=9.74, P=.003). Follow-up dependent t tests revealed a significant difference between single- and double-legged PRD in the healthy participants (t20=-3.76, P=.001) with no difference in CAI participants (t21=-0.44, P=.67). Finally, there was a significant difference in recurrent inhibition between healthy (mean, 83.66) and CAI (mean, 90.27) (P=.004).Conclusions
This study revealed that, compared with healthy participants, CAI participants were less able to modulate PRD when going from a double- to a single-legged stance. Additionally, CAI participants showed higher overall levels of recurrent inhibition when compared with healthy matched controls. 相似文献4.
Objectives
Acquired brain injury (ABI) requires an extended recovery time and residual signs may be observed years after discharge. Supervised home-based motor training may present a viable option for continuing treatment of adult patients, but little information is available on home-based treatment in children. This study assessed the feasibility of home practice in children with ABI (1 or more years post-trauma). The efficacy of the programme was also evaluated.Design
A non-randomised, self-control study with control and intervention periods.Setting
Home-based exercise programme.Participants
Nineteen children (mean age 12.5 ± 3.1 years).Interventions
A 4-week daily training programme of step-up and sit-stand-sit exercises.Main outcome measures
Feasibility was assessed by the number of participants who completed the programme. Efficacy was evaluated at different stages using 10-metre walking and 2-minute walking tests, and the balance subitems of the Bruininks-Oseretsky Test of Motor Proficiency. An energy expenditure index was calculated for walking. Performance scores were used to assess balance.Results
Nine participants completed the study. The mean number of training sessions was 22 ± 8 of the 30 sessions originally scheduled. Major differences were noted between the experimental stages. Walking speed, endurance and balance improved significantly during the intervention period.Conclusions
Continuing exercising at home may be a feasible and efficient option for a considerable proportion of ABI children who are compliant with a simple but challenging exercise programme. A randomised controlled trial with a larger sample is now required. 相似文献5.
Fausto Avanzini Giuseppe Marelli Walter Donzelli Loredana Sorbara Enzo Palazzo Laura Bellato Elena Lucia Colombo Maria Carla Roncaglioni Emma Riva Mario De Martini 《European Journal of Cardiovascular Nursing》2009,8(3):182-189
Background
Diabetic patients with acute coronary syndromes (ACS) might benefit from tight glycemic control by means of insulin infusion. Nurse-implemented insulin infusion protocols (IIP) are available but none validated in patients with ACS admitted to a coronary care unit (CCU).Aims
To assess feasibility, effectiveness and safety of a new nurse-managed IIP (Desio Diabetes Diagram, DDD) for intensive glucose control in patients with suspected ACS and known diabetes or blood glucose (BG) > 200 mg/dL.Methods and results
To reach and maintain a target BG level of 100-139 mg/dL we adopted a nomogram based on the percent changes in the insulin infusion rate according to the current BG value and the percent change from previous BG level.Ninety-one consecutive patients (53 men, mean age 69.7 ± 11.2 years) were treated with DDD IIP. Baseline BG was 202.2 ± 86.8 mg/dL. The median time to achieve the target was 3 h (Q1-Q3 2-5 h). Afterwards target BG levels were maintained for 70.4 ± 15.9% of the time. During 5004 h of insulin infusion BG never fell below 40 mg/dL.Conclusions
The nurse-managed DDD IIP was easily implemented in our CCU and permitted strict and safe glycemic control in hyperglycemic patients with ACS. 相似文献6.
Objective
To investigate the hypoalgesic effects of massage on experimental pain.Design
A cross-over intervention study separated by a 24-hour washout period. During each experiment, participants completed five cold-induced pain tests, two before the intervention and three during the intervention. During each test, participants immersed their hand in iced water and reported the first sensation of pain and pain intensity after a further 30 seconds.Setting
Laboratory setting.Participants
A volunteer sample of 30 university staff and students without known pathology, recruited from noticeboard advertisements.Interventions
Participants received massage in one experiment and static touch in the other experiment. Interventions were administered to the ipsilateral arm for 4 minutes immediately before the hand was immersed in iced water.Main outcome measures
Time to pain threshold and the odds of a reduction in pain intensity and an increase in pain relief.Results
A mixed model analysis was used to establish how measures varied, according to baseline, during static touch and during massage. Massage increased the pain threshold by a factor of 1.08 (95% confidence interval 0.99-1.17) compared with static touch, but this failed to reach statistical significance (P = 0.088). Massage was more likely to result in a report of low pain intensity than static touch (odds ratio 0.26, 95% confidence interval 0.10-0.71, P = 0.007). Massage was more likely to result in a state of high pain relief than static touch (odds ratio 7.7, 95% confidence interval 3.0-19.8, P < 0.001).Conclusion
Massage produced hypoalgesic effects on experimental pain in healthy volunteers. 相似文献7.
Mohammad A. Mohseni-Bandpei Jacqueline Critchley Thomas Staunton Barbara Richardson 《Physiotherapy》2006,92(1):34-42
Objectives
To assess the short- and long-term effectiveness of spinal manipulation therapy, and to identify the effect of manipulation on lumbar muscle endurance in patients with chronic low back pain (LBP).Design
A randomised controlled trial comparing manipulation and exercise treatment with ultrasound and exercise treatment.Setting
An outpatient physiotherapy department.Participants
One hundred and twenty patients with chronic LBP were allocated at random into the manipulation/exercise group or the ultrasound/exercise group.Interventions
Both groups were given a programme of exercises. In addition, one group received spinal manipulation therapy and the other group received therapeutic ultrasound.Main outcome measures
Pain intensity, functional disability, lumbar movements and muscle endurance were measured shortly before treatment, at the end of the treatment programme and 6 months after randomisation using surface electromyography.Results
Following treatment, the manipulation/exercise group showed a statistically significant improvement (P = 0.001) in pain intensity [mean 16.4 mm, 95% confidence interval (CI) 6.1-26.8], functional disability (mean 8%, 95% CI 2-13) and spinal mobility (flexion: mean 9.4 mm, 95% CI 5.5-13.4; extension: mean 3.4 mm, 95% CI 1.0-5.8). There was no significant difference (P = 0.068) between the two groups in the median frequency of surface electromyography (multifidus: mean 6.8 Hz, 95% CI 1.24-14.91; iliocostalis: mean 2.4 Hz, 95% CI 2.5-7.1), although a significant difference (P = 0.013) was found in the median frequency slope of surface electromyography in favour of spinal manipulation for multifidus alone (mean 0.3, 95% CI 0.1-0.5). A significant difference was also found between the two groups in favour of the manipulation/exercise group at 6-month follow-up.Conclusions
Although improvements were recorded in both groups, patients receiving manipulation/exercise showed a greater improvement compared with those receiving ultrasound/exercise at both the end of the treatment period and at 6-month follow-up. 相似文献8.
Lorraine S. Evangelista Erin Sackett Kathleen Dracup 《European Journal of Cardiovascular Nursing》2009,8(3):169-173
Background
Although evidence exists to support the presence of pain in advanced stages of heart failure (HF), the pain experience in the early phases of this progressive disease is poorly documented, and therefore, poorly understood. The current study was conducted to: 1) examine the prevalence of pain in cohort of patients with chronic HF (New York Heart Association class I-IV); and 2) determine the relationship between pain and QOL.Methods and results
Data were obtained from 300 patients (mean age 54.2 ± 12.7 years; 72% male; 65% Caucasians; time since HF diagnosis 4.6 ± 4.8 years). Two-thirds of the patients (67%) reported some degree of pain; the prevalence of pain increased as functional class worsened (p < .009). Differences in QOL outcomes for patients experiencing pain vs. no pain were statistically significant for physical and overall QOL. Pain accounted for 20% of the variance in QOL (p < .001) even after adjusting for age, gender, and functional class.Conclusions
Our findings suggest pain is present in a majority of patients with HF. Given the potential deleterious effects of untreated pain on QOL in patients with HF, it is important that healthcare providers assess patients for this often-unrecognized symptom. 相似文献9.
Objective
To compare the analgesic efficacy of interferential therapy (IFT) and transcutaneous electrical nerve stimulation (TENS) using an experimental cold pain model.Design
Randomised controlled trial with repeated measures design.Setting
University research laboratory.Participants
Twenty healthy subjects.Interventions
IFT and TENS applied to each subject on different days.Main outcome measures
Cold pain threshold (time), intensity and unpleasantness (visual analogue scales).Results
The mean cold pain threshold with a TENS intervention was higher than that with IFT. A training effect was evident as subjects’ responses become more consistent with repeated exposure to stimulation and the testing procedure. Using data from the second testing sessions, the differences in pain threshold between IFT and TENS for the two during-intervention (T3 and T4) measures were statistically significant (T3 difference in the means 5.9 seconds, 99% confidence interval 3.1 to 8.7 seconds; T4 difference in the means 6.6 seconds, 99% confidence interval 3.8 to 9.4 seconds). No significant differences were identified in pain intensity and unpleasantness ratings.Conclusions
TENS is more effective than IFT at increasing cold pain thresholds in healthy subjects, and this effect increases with repeated exposures. Future trials should include a familiarisation session prior to testing to increase the consistency of subjects’ responses. The clinical implications of these effects need investigation. 相似文献10.
Tricia J. Hubbard Charlie Hicks-Little Mitchell Cordova 《Archives of physical medicine and rehabilitation》2009,90(7):1136-1726
Hubbard TJ, Hicks-Little C, Cordova M. Mechanical and sensorimotor implications with ankle osteoarthritis.
Objective
To understand the mechanical and sensorimotor adaptations that may occur with ankle osteoarthritis (OA).Design
Case-control.Setting
Biodynamics research laboratory.Participants
Subjects with ankle OA (n=8; 4 males, 4 females) were matched to healthy controls (n=8; 4 males, 4 females).Interventions
Not applicable.Main Outcome Measures
Mechanical joint stability was assessed with an instrumented ankle arthrometer. Static balance was measured using a force platform during a double-legged stance. Isometric ankle/foot complex strength in the sagittal and frontal plane was assessed with a handheld dynamometer. Last, subjective level of function was assessed using the foot and ankle disability index.Results
There were significant group × side interactions for anterior displacement, inversion rotation, eversion rotation, ankle isometric strength, and the foot and ankle disability index (P<.05). The affected ankle of the OA group demonstrated significantly more mechanical stiffness, more impairments in ankle/foot isometric strength, and less subjective level of function than the matched controls. Additionally, the ankle OA group exhibited significantly more center of pressure displacement, total velocity, and medial-lateral velocity (P<.05).Conclusions
These limitations observed in joint laxity, postural control, muscle strength, and perceived function provide evidence that patients with ankle OA display a number of characteristics that affect joint stability and overall function. These identified impairments necessitate the need for rehabilitation and exercise programs to be developed to help improve joint stability and function in patients with ankle OA. 相似文献11.
Tricia J. Hubbard Charlie Hicks-Little Mitchell Cordova 《Archives of physical medicine and rehabilitation》2010,91(1):73-77
Hubbard TJ, Hicks-Little C, Cordova M. Changes in ankle mechanical stability in those with knee osteoarthritis.
Objective
To examine ankle joint mechanical stability in patients who had mild to moderate knee osteoarthritis (OA).Design
Case control study.Setting
Biodynamics research laboratory.Participants
Subjects with knee OA (n=15; 5 men and 10 women; mean age ± SD, 60.3±10.2y; mean mass ± SD, 93.9±18.3kg; mean height ± SD, 167.23±9.5cm) were matched to healthy controls (n=15; 5 men and 10 women; mean age ± SD, 59.6±12.6y; mean mass ± SD, 83.5±19.2kg; mean height ± SD, 169.7±12.6cm).Interventions
Not applicable.Main Outcome Measures
Mechanical ankle-subtalar joint stability was assessed with an instrumented arthrometer where ankle-subtalar joint motion for anterior/posterior displacement and inversion/eversion rotation was measured. Separate 2 × 2 mixed model analyses of variance were performed.Results
Significant group × side interactions were observed for anterior and posterior displacement (P<.05) where patients with knee OA had significantly less anterior and posterior ankle displacement compared with the control group, as well as compared with their unaffected extremity. Additionally, patients with knee OA had significantly (P<.05) less inversion/eversion rotation than their respective controls.Conclusions
These data suggest that altered ankle joint mechanics may be the result of deviations in ankle joint alignment secondary to the structural changes at the knee. Compensatory changes in ankle joint mechanics must also be considered when addressing lower extremity functional deficits in patients with knee OA. 相似文献12.
Kluding PM, Santos M. Effects of ankle joint mobilizations in adults poststroke: a pilot study.
Objective
To compare the effect of 2 interventions on ankle mobility, ankle kinematics, and weight-bearing symmetry during functional activities in subjects with hemiparesis after a stroke.Design
Randomized trial.Setting
Academic medical center.Participants
A convenience sample of 16 subjects with hemiparesis after stroke (mean age, 55.2y; mean time since stroke, 21.4mo).Intervention
Subjects received 8 sessions over 4 weeks of either functional task practice combined with ankle joint mobilizations, or functional task practice only.Main Outcome Measures
Changes in ankle range of motion (ROM) (not blinded), ankle kinematics during sit-to-stand (STS) and gait, and lower-extremity weight-bearing symmetry during STS and static standing.Results
The combined intervention group gained 5.7°±3.1° in passive ankle ROM compared with 0.2°±2.6° in the functional practice only group (95% confidence interval [CI], 2.5-8.6; P<.01). No significant changes in ankle kinematics or weight bearing during static standing were noted in either group. The functional practice group decreased differences in weight bearing during STS by 9.5%±6.47%, whereas the combined intervention group increased this difference by 3.37%±5.29% (95% CI, 3.26-19.46; P=.01).Conclusions
The increase in ankle motion did not improve joint kinematics and may have prevented improvement in weight-bearing symmetry. 相似文献13.
Keun Bae Lee Young Hoon Park Eun Kyoo Song Taek Rim Yoon Kwang Ik Jung 《Archives of physical medicine and rehabilitation》2010,91(4):519-522
Lee KB, Park YH, Song EK, Yoon TR, Jung KI. Static and dynamic postural balance after successful mobile-bearing total ankle arthroplasty.
Objective
To investigate static and dynamic postural balance after successful total ankle arthroplasty by using dynamic posturography.Design
A controlled trial study.Setting
A national university orthopedic and rehabilitation hospital.Participants
Patients (n=30, 21 men, 9 women; mean age, 58y) and age- and sex-matched healthy controls (n=30).Interventions
Thirty patients who underwent unilateral total ankle arthroplasty with a cementless mobile-bearing ankle prosthesis and 30 age- and sex-matched healthy control subjects were included.Main Outcome Measures
Using computerized dynamic posturography, sensory (sensory organization test [SOT]), and motor (limit of stability [LOS], rhythmic weight shift [RWS], and weight bearing) impairment assessments were performed at an average of 15 months after total ankle arthroplasty.Results
In the SOT, results of the SOT-2 test reflecting mainly proprioception showed no significant difference between patients and controls, but patients demonstrated significantly lower scores for SOT-4, -5, and -6 as a measure of dynamic postural balance and required more hip movement to maintain balance. In the motor-control tests, patients showed significantly lower measures in indices of LOS test except the mean reaction time and the forward/backward directional control and on-axis velocity of the RWS test. Weight bearing was observed asymmetrically in patients.Conclusions
Patients had a higher degree of dynamic postural imbalance and relied less on ankle strategy to maintain balance than controls. Also, patients showed the deficit of motor control ability as compared with age- and sex-matched healthy controls. 相似文献14.
Objective
To investigate the effect of spectators on the performance of a physiotherapy exercise.Design
Observational study.Setting
Research laboratory, Trinity College Dublin.Participants
Forty adult volunteer subjects (36 females, four males). As there were only four males, these were excluded from the analysis.Interventions
Subjects were observed and timed while performing single leg stance in two conditions 48 hours apart; once with the investigator present (investigator condition) and once with the investigator and three spectators present (spectator condition).Main outcome measure
Duration of single leg stance in seconds.Results
The mean duration of single leg stance, for females, under the investigator condition was 173 seconds [95% confidence interval (CI) 131 to 214], while that of the spectator condition was 168 seconds (95%CI 128 to 208). The mean difference between the two conditions was 5 seconds (95%CI −21 to 31). This was not statistically significant using a paired t-test (P = 0.686).Conclusions
Female performance of a straightforward exercise such as single leg stance was not affected by the presence of three spectators. 相似文献15.
Are patients who refer themselves to physiotherapy different from those referred by GPs? Results of a national trial 总被引:3,自引:3,他引:0
Lesley K. Holdsworth Valerie S. Webster Angus K. McFadyen The Scottish Physiotherapy Self Referral Study Group 《Physiotherapy》2006,92(1):26-33
Objectives
To establish if there are differences in the profile of patients who refer themselves to physiotherapy compared with patients referred by or at the suggestion of their general practitioner (GP) in a range of primary care settings.Design of study
Quasi-experimental.Setting
Twenty-nine general practices throughout Scotland.Participants
Three thousand and ten patients (>16 years of age) and 100 physiotherapists.Method
Self-referral was introduced in each site. The demographic and clinical data relating to all referrals collated over a full year were compared by referral group (self-referrals, GP-suggested referrals and GP referrals).Results
There was no relationship between gender or age group and referral group, but other differences in the profile were found. The groups differed in terms of their presenting condition and its severity (P = 0.027). Greater proportions of patients who referred at the suggestion of their GP and patients who self-referred presented with low back and neck conditions (54% versus 43%, P < 0.001). Self-referrers reported having their symptoms for less than 14 days to a greater extent than the other groups (14% versus 9% and 10%, P = 0.011). Non-preferential treatment waiting time to physiotherapy also differed, with 44% of patients who self-referred being seen within 2 weeks of referral compared with 36% of patients who referred at the suggestion of their GP (P < 0.001). Self-referrers were absent from work in lower proportions (20% versus 28% and 28%, P = 0.048) and were absent for half the mean time (2.5 days versus 6 days). They also completed their treatment in greater proportions (76% versus 69% and 72%, P = 0.002). Although all groups experienced the same mean number of physiotherapy contacts (n = 4), patients who referred at the suggestion of their GP had a proportionally lower contact rate with 65% having four or less contacts compared with 55% of patients who self-referred and 51% of patients referred by their GP (P < 0.001). There was no difference in the outcome determined by physiotherapists or patients.Conclusions
Patients who refer to physiotherapy at the suggestion of their GP and patients who self-refer appear to have a different profile from patients who are referred by their GP. 相似文献16.
Joshua H. You Susan Saliba Ethan Saliba 《Archives of physical medicine and rehabilitation》2009,90(1):102-108
You JH, Saliba S, Saliba E. Use of a combination of ankle pressure and SENSERite system to treat older adults with impaired ankle proprioception: a single-blind experimental study.
Objective
To investigate the effects of a combination of visual biofeedback and ankle pressure on ankle position sense in elderly adults with and without impaired ankle joint position sense (JPS).Design
Independent 2 × 3 factorial design with an experimenter-blind study.Setting
University motion laboratory.Participants
Older adults (N=40) were recruited from local community centers. Among them, 21 elderly subjects had relatively normative score, whereas 19 subjects had impaired ankle position sense.Intervention
Both the normative and impaired elderly subjects underwent either ankle JPS visual feedback training alone or a combination of ankle JPS visual feedback training and circumferential ankle pressure for one 30-minute training session.Main Outcome Measures
The outcome measures included ankle JPS errors measured in absolute constant error (ACE) and variable error (VE) during standing at pretest, posttest, and 1-week follow-up test. A separate repeated measures analyses of variance was performed to evaluate the differential training effects on ACE and VE, respectively. The Pearson chi-square test and Bonferroni test were performed. Significance was assigned at P less than .05 for all analyses.Results
Regardless of intervention conditions, older adults with and without ankle position sense impairment showed immediate treatment benefits, which relatively remained stable even at the follow-up test. These effects were reflected in significant improvements of JPS accuracy and consistency (P<.05).Conclusions
Our findings may suggest that both interventions were equally effective in increasing ankle JPS accuracy and consistency in older adults with and without impairments, and therapeutic effects lasted for a week, reflecting long-term effect. 相似文献17.
Martin Švehlík Ernst B. Zwick Gerhardt Steinwender Wolfgang E. Linhart Petra Schwingenschuh Petra Katschnig Erwin Ott Christian Enzinger 《Archives of physical medicine and rehabilitation》2009,90(11):1880-1886
Švehlík M, Zwick EB, Steinwender G, Linhart WE, Schwingenschuh P, Katschnig P, Ott E, Enzinger C. Gait analysis in patients with Parkinson's disease off dopaminergic therapy.
Objective
To compare time-distance, kinematic, and kinetic gait parameters in patients with idiopathic Parkinson's disease (PD) off dopaminergic therapy with a group of healthy control subjects.Design
A group-comparison study.Setting
Gait analysis laboratory.Participants
Patients with PD (n=20) and healthy age-matched controls (n=20).Interventions
Not applicable.Main Outcome Measures
Time-distance, kinematic, and kinetic gait variables.Results
PD patients walked slower with shorter stride-length, comparable cadence, and longer double support times. Kinematics showed a reduction of the range of motion in the hip, knee, and ankle joints. Maximum hip extension and the ankle plantar flexion were significantly reduced. Kinetic gait parameters showed reduced push-off ankle power and lift-off hip power generation. Strong correlations between these important body advancement mechanisms and the walking velocity were observed.Conclusions
In addition to previously described dysfunctional kinematics, abnormal kinetic parameters play an important role in the characterization of gait in PD patients off therapy. Hence, these parameters could be used to document treatment effects of parkinsonian gait disorders. 相似文献18.
William Johnson Noël Cameron Stuart Emsley Pauline Raynor John Wright 《International journal of nursing studies》2009,46(3):310-316
Background
Reliable data on child growth is a prerequisite for monitoring and improving child health. Despite the extensive resources invested in recording anthropometry, there has been little research into the reliability of these data. If these measurements are unreliable growth may be misreported, and health problems may go undetected.Objectives
To assess the reliability of routine infant growth data, following anthropometric training of health workers responsible for collecting these data, in Bradford, UK. To determine whether being observed by an external administrator influenced reliability.Design
A test-retest design was used.Participants
All health workers (n = 192) responsible for growth monitoring in Bradford were included in the study, of which 36.5% (n = 70) had complete data.Methods
Following training in basic anthropometry all health workers were asked to complete a test-retest study, using infants aged 0-2 years. Health workers took two recordings of weight, length, head circumference, and abdominal circumferences on five infants. A peer health worker recorded a third set of measurements on each infant. Twenty-two individuals were selected to be observed by an external administrator during data collection. Technical error of measurements (TEMs) were produced to assess intra-observer and inter-observer reliability. Differences between groups were tested to determine whether external observation influences reliability.Results
None of the TEMs were excessively large, and coefficients of reliability ranged from 0.96 to 1.00. All intra-observer and inter-observer TEMs for the observed group were larger than those for the non-observed group. For example, the observed group’s intra-observer TEMs for weight, length, abdominal circumference, and head circumference (46.18 g, 0.60 cm, 0.65 cm, 0.47 cm) were larger than the non-observed group’s TEMS (9.14 g, 0.35 cm, 0.34 cm, 0.19 cm). TEMs for weight, abdominal circumference, and head circumference were significantly larger for the observed group, compared to the non-observed group (p < 0.001). Inter-observer TEMs for length were also significantly larger for the observed group (p = 0.031), whilst intra-observer TEMs for length were not significantly different between the two groups (p = 0.137).Conclusions
Following training in anthropometry health workers in Bradford can, in general, reliably measure child growth. TEMs were comparable to data from other research studies and all coefficients of reliability were indicative of good quality control. Reliability measurement provides a method of quality assurance for routine data monitoring. If commissioners of health services are to be informed by these data then some form of reliability assessment should be considered, and if employed external observation is recommended to improve validity. 相似文献19.
Objectives
This study investigated the efficacy of a rehabilitation technique for the treatment of chronic fatigue syndrome that was developed by a physiotherapist. Data collected retrospectively from a pilot study indicated that patients benefited from this multiconvergent approach, so further assessments were warranted.Design
Treatment efficacy was assessed by comparing the primary and secondary outcome measures of patients attending multiconvergent therapy (MCT) with those of patients attending relaxation therapy and a group of non-intervention controls.Setting
The active treatment took place at a clinic within the physiotherapy outpatient unit. Relaxation therapy and all assessments were conducted at the psychology unit.Participants
Thirty-five participants, fitting the Centers for Disease Control and Prevention criteria for chronic fatigue syndrome, were recruited from two outpatient clinics and an existing patient panel.Intervention
Patients were assigned to either MCT (n = 12) or relaxation therapy (n = 14). Nine participants who received general medical care were used as a comparison group.Main outcome measures
The Karnofsky performance scale was used as the primary outcome measure of function. Secondary outcome measures assessing overall improvement in patient condition, fatigue and disability levels were also administered.Results
A significant percentage of the patients attending the MCT sessions showed improvement in the primary outcome score used to measure the success of the treatment (MCT = 83%, relaxation = 21%, controls = 0; P < 0.001). A significant percentage of this group also reported improvement in their overall condition (MCT = 92%, relaxation = 64%, controls = 22%; P < 0.001), lower fatigue levels (MCT = 83%, relaxation = 57%, controls = 11%; P < 0.001) and lower levels of disability (MCT = 75%, relaxation = 43%, controls = 11%; P = 0.032) immediately post-therapy. In addition, these improvements were maintained at 6-month follow-up.Conclusions
Outcomes from this small preliminary study were encouraging. The multiconvergent approach produced significant improvements for standardised primary and secondary outcome measures. Further research is required to examine the efficacy of this approach over time, and its effectiveness on a larger scale within the primary healthcare setting using additional therapists trained in the technique. 相似文献20.