共查询到20条相似文献,搜索用时 656 毫秒
1.
Purposes
Pulse CO-oximetry (Rad-57; Masimo Corp, Irvine, CA) has been available since 2005. To date, all published clinical studies have focused on clinical reliability and whether the device enhances case finding through screening of various populations. This study examines whether use of pulse CO-oximetry shortens the time to diagnosis and treatment of patients with carbon monoxide (CO) poisoning.Basic Procedures
Data from the joint Undersea and Hyperbaric Medical Society/Centers for Disease Control and Prevention CO poisoning surveillance system from August 2008 to July 2011 were analyzed. Of 1711 cases of CO poisoning treated with hyperbaric oxygen in the United States and reported through the system, 1606 had their initial carboxyhemoglobin (COHb) level measured by laboratory CO-oximetry and 105 by pulse CO-oximetry. Patients were selected from the laboratory CO-oximetry group to match each of the 105 patients evaluated by pulse CO-oximetry in 5 characteristics—age, sex, race/ethnicity, intent of poisoning, and occurrence of loss of consciousness. Measures of timeliness in measurement and management were compared between the 2 groups.Main Findings
Patients with initial COHb measurement by pulse CO-oximetry had significantly shorter time to measurement of COHb, higher average levels of COHb, and shorter time from the end of CO exposure to the initiation of hyperbaric oxygen treatment. On average, patients evaluated by pulse CO-oximetry reached the hyperbaric chamber 1 hour faster than did patients evaluated by laboratory CO-oximetry (P < .01).Principle Conclusions
Pulse CO-oximetry is associated with more rapid diagnosis and initiation of hyperbaric oxygen therapy in CO-poisoned patients compared with laboratory CO-oximetry. The impact on clinical outcome remains to be determined. 相似文献2.
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3.
Objectives
Plasma neopterin is a clinical marker of inflammation. Interferon-γ triggers 7,8-dihydroneopterin and its oxidation product, neopterin, to be released from macrophages. 7,8-dihydroneopterin is a potent antioxidant which can protect macrophages from oxidative damage in vitro. This study examined whether 7,8-dihydroneopterin/neopterin levels reach sufficient concentrations in human pus to provide antioxidant activity and be the source of plasma neopterin.Design and methods
Pus was removed by needle aspiration from 19 patients and examined for total neopterin, protein-bound DOPA, dityrosine, α-tocopherol, lipid oxidation and protein carbonyls.Results
Total neopterin was detected between 50 nM and 1.2 μM, with an average concentration of 0.51 μM. Significant quantities of oxidized proteins and lipids were detected. α-Tocopherol concentrations positively correlate with total neopterin levels.Conclusions
Total neopterin levels found in the pus was up to 100 times higher than that reported in plasma, suggesting plasma neopterin originates from inflammatory sites. The concentration of total neopterin suggests that 7,8-dihydroneopterin could act as an antioxidant during inflammation. 相似文献4.
van Londen A Herwegh M van der Zee CH Daffertshofer A Smit CA Niezen A Janssen TW 《Archives of physical medicine and rehabilitation》2008,89(9):1724-1732
van Londen A, Herwegh M, van der Zee CH, Daffertshofer A, Smit CA, Niezen A, Janssen TW. The effect of surface electric stimulation of the gluteal muscles on the interface pressure in seated people with spinal cord injury.
Objective
To study effects of surface electric stimulation of the gluteal muscles on the interface pressure in seated persons with spinal cord injury (SCI).Design
One session in which alternating and simultaneous surface electric stimulation protocols were applied in random order.Setting
Research laboratory of a rehabilitation center.Participants
Thirteen subjects with SCI.Intervention
Surface electric stimulation of the gluteal muscles.Main Outcome Measures
Interface pressure, maximum pressure, pressure spread, and pressure gradient for the stimulation measurement. Variables were compared using 2-tailed paired t tests.Results
Alternating and simultaneous stimulation protocol caused a significant (P<.01) decrease in interface pressure (-17±12mmHg, -19±14mmHg) and pressure gradient (-12±11mmHg, -14±12mmHg) during stimulation periods compared with rest periods. There was no significant difference in effects between the 2 protocols.Conclusions
Surface electric stimulation of the gluteal muscles in persons with SCI causes a decrease in interface pressure. This might restore blood flow in compressed tissue and help prevent pressure ulcers. 相似文献5.
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6.
Objective
To determine the need for a practice walk for the endurance shuttle walk test (ESWT) following the performance of two incremental shuttle walk tests (ISWTs) - one practice and one test - on the same day.Design
Retrospective data analysis of shuttle walk test measurements. All participants had performed two ISWTs and two ESWTs at a single visit, prior to commencing pulmonary rehabilitation.Setting
Outpatient physiotherapy department of a university hospital.Participants
Forty-four patients (33 males, 11 females) with a primary diagnosis of chronic obstructive pulmonary disease, referred for routine pulmonary rehabilitation.Measurements
Shuttle walk test distance and time, Borg breathlessness score, heart rate and pulsed oxygen saturation.Results
The mean age of the group was 67.6 years [standard deviation (SD) 9.0] and mean forced expiratory volume in 1 second was 37% predicted (SD 13). The mean times walked during ESWTs 1 and 2 were 195 and 207 seconds (SD 115 and 138), respectively. Using the analysis recommended by Bland and Altman, the mean of the individual differences (d) between Tests 1 and 2 was 12 seconds, with limits of agreement from −88 to +112 seconds.Conclusion
A practice endurance shuttle walk is unnecessary following performance of ISWTs on the same day. 相似文献7.
Dale M. Needham Radha Korupolu Jennifer M. Zanni Pranoti Pradhan Elizabeth Colantuoni Jeffrey B. Palmer Roy G. Brower Eddy Fan 《Archives of physical medicine and rehabilitation》2010,91(4):536-542
Needham DM, Korupolu R, Zanni JM, Pradhan P, Colantuoni E, Palmer JB, Brower RG, Fan E. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project.
Objectives
To (1) reduce deep sedation and delirium to permit mobilization, (2) increase the frequency of rehabilitation consultations and treatments to improve patients' functional mobility, and (3) evaluate effects on length of stay.Design
Seven-month prospective before/after quality improvement project.Setting
Sixteen-bed medical intensive care unit (MICU) in academic hospital.Participants
57 patients mechanically ventilated 4 days or longer.Intervention
A multidisciplinary team focused on reducing heavy sedation and increasing MICU staffing to include full-time physical and occupational therapists with new consultation guidelines.Main Outcome Measures
Sedation and delirium status, rehabilitation treatments, functional mobility.Results
Compared with before the quality improvement project, benzodiazepine use decreased markedly (proportion of MICU days that patients received benzodiazepines [50% vs 25%, P=.002]), with lower median daily sedative doses (47 vs 15mg midazolam equivalents [P=.09] and 71 vs 24 mg morphine equivalents [P=.01]). Patients had improved sedation and delirium status (MICU days alert [30% vs 67%, P<.001] and not delirious [21% vs 53%, P=.003]). There were a greater median number of rehabilitation treatments per patient (1 vs 7, P<.001) with a higher level of functional mobility (treatments involving sitting or greater mobility, 56% vs 78%, P=.03). Hospital administrative data demonstrated that across all MICU patients, there was a decrease in intensive care unit and hospital length of stay by 2.1 (95% confidence interval: 0.4-3.8) and 3.1 (0.3-5.9) days, respectively, and a 20% increase in MICU admissions compared with the same period in the prior year.Conclusions
Using a quality improvement process, intensive care unit delirium, physical rehabilitation, and functional mobility were markedly improved and associated with decreased length of stay. 相似文献8.
Context
Intensive palliative care consultations for plan of care may reduce racial differences in end-of-life care.Objectives
To compare cancer patients' hospice referrals and code status changes after inpatient palliative care consultations by patient ethnicity and consultation intensity.Methods
This observational cohort study prospectively recorded data for all adult cancer patients receiving palliative care consultations at the largest teaching hospital in Hawaii from 2005 through 2009. Chi-squared analyses compared hospice referral and code status changes with “Do Not Attempt Resuscitation” by patient characteristics and consultation intensity (more intensive plan of care vs. pain and/or symptom management without plan of care). Multiple logistic regression models analyzed factors associated with hospice referral and code status change.Results
The 1362 consultations generated 454 (33.3%) hospice referrals and 234 (17.2%) code status changes. Controlling for age, gender, Karnofsky score, and preconsultation hospital days, Asian, Pacific Islander, and “other” ethnicities demonstrated increased likelihood of hospice referral vs. whites (adjusted odds ratios [AORs] 1.46-2.34, P < 0.05). Intensive plan-of-care consultations were strongly associated with hospice referral (AOR 3.08, 95% confidence interval [CI] 2.33-4.07, P < 0.0001). Controlling for consultation intensity reduced the association between ethnicity and hospice referral (AORs 1.35-2.06, P = 0.03, “other” ethnicity; P = nonsignificant, Asian and Pacific Islander). Intensive consultations were strongly associated with code status change (AOR 2.96; 95% CI 2.08-4.22, P < 0.0001). Ethnicity was not significantly associated with code status change.Conclusion
Consultation intensity was the strongest predictor of hospice referrals and code status changes and reduced the ethnic variations associated with hospice referral. 相似文献9.
Su PF Gard SA Lipschutz RD Kuiken TA 《Archives of physical medicine and rehabilitation》2008,89(7):1386-1394
Su P-F, Gard SA, Lipschutz RD, Kuiken TA. Differences in gait characteristics between persons with bilateral transtibial amputations, due to peripheral vascular disease and trauma, and able-bodied ambulators.
Objectives
To examine differences in gait characteristics between persons with bilateral transtibial amputations because of trauma and peripheral vascular disease (PVD); and to compare that with data from able-bodied controls that were previously collected and maintained in a laboratory database.Design
Observational study of persons with bilateral transtibial amputations.Setting
A motion analysis laboratory.Participants
Nineteen bilateral transtibial amputees.Intervention
No experimental intervention was performed. To standardize the effect of prosthetic foot type, subjects were fitted with Seattle Lightfoot II feet 2 weeks before quantitative gait analyses.Main Outcome Measures
Temporospatial, kinematic, and kinetic gait data were recorded and analyzed.Results
Results showed that the freely selected walking speeds of subjects with PVD and trauma were 0.69m/s and 1.11m/s, respectively, while that of able-bodied control subjects was 1.20m/s. When data were compared on the basis of freely selected walking speed, numerous differences were found in temporospatial, kinematic, and kinetic parameters between the PVD and trauma groups. However, when data from similar speeds were compared, the temporospatial, kinematic, and kinetic gait data demonstrated no statistically significant differences between the 2 amputee groups. Although not statistically significant, the PVD group displayed increased knee (P=.09) and hip (P=.06) flexion during the swing phase, whereas the trauma group displayed increased pelvic obliquity (P=.06). These actions were believed to represent different strategies to increase swing phase foot clearance. Also, the PVD group exhibited slightly greater hip power (P=.05) before toe-off.Conclusions
Many of the differences observed in the quantitative gait data between the trauma and PVD groups appeared to be directly associated with their freely selected walking speed; the trauma group walked at significantly faster freely selected speeds than the PVD group. When their walking speeds were matched, both amputee groups displayed similar gait characteristics, with the exception that they might use slightly different strategies to increase foot clearance. 相似文献10.
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11.
12.
Elvia Battaglia Alessandro Fulgenzi Maria Elena Ferrero 《Archives of physical medicine and rehabilitation》2009,90(6):913-918
Battaglia E, Fulgenzi A, Ferrero ME. Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease.
Objective
To examine the rationale of the combined use of a new expiratory device in association with a previously assessed inspiratory device in improving 3 indicators of the respiratory muscle strength, for example, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and dyspnea grade.Design
Randomized trial.Setting
Home-based pulmonary rehabilitation.Participants
Adults (N=32; mean age, 68y).Main Outcome Measure
We instructed 32 patients with mild to very severe COPD to use the devices, and randomized them in a 1:1 ratio: they were assigned to the sham training control group (16 patients who trained at a load not able to improve MIP and MEP) or to the training group (16 patients). The patients trained at home twice daily for 15 minutes, 7 days a week, for 12 months. MIP and MEP as well as dyspnea perception were evaluated at 1, 6, and 12 months from the beginning of the training. The impact of additional work of breathing was measured at baseline and after the use of the expiratory device.Results
The patients who performed the respiratory training showed significant and progressive improvements of MIP (81±4 at 12 months vs 57±7 as basal values expressed in cm H2O; P<.05) and MEP (97±2 at 12 months vs 62±4 as basal values; P<.05) at the end of the training. In addition, they showed a significant reduction of dyspnea perception (1.18±0.29 vs 2.93±0.32 as basal values; P<.05) at the end of the training.Conclusions
This study suggests that home exercise with the combined use of our expiratory and inspiratory devices leads to a significant improvement of respiratory muscle function in patients with mild to very severe COPD. 相似文献13.
Employee empowerment, innovative behavior and job productivity of public health nurses: a cross-sectional questionnaire survey 总被引:1,自引:0,他引:1
Background
Employee empowerment is an important organizational issue. Empowered employees with new ideas and innovative attributes may increase their ability to respond more effectively to face extensive changes in current public health care work environments.Objectives
The objective of this study was to investigate the relationships between employee empowerment, innovative behaviors and job productivity of public health nurses (PHNs).Design
This study conducted a cross-sectional research design.Settings and participants
Purposive sampling was conducted from six health bureaus in northern Taiwan. 670 PHNs were approached and 576 valid questionnaires were collected, with a response rate of 85.9%.Methods
Structured questionnaires were used to collect data by post.Results
Meaning and competence subscales of psychological empowerment, information and opportunity subscales of organizational empowerment, and innovative behaviors were the predictors of job productivity, only accounting for 16.4% of the variance. The competence subscale of psychological empowerment made the most contribution to job productivity (β = 0.31). Meaning subscale of psychological empowerment has a negative impact on job productivity.Conclusions
Employee empowerment and innovative behavior of PHNs have little influence on job productivity. Employees with greater competence for delivering public health showed higher self-evaluated job productivity. The negative influences on job productivity possibly caused by conflict meaning on public health among PHNs in current public health policy. It should be an issue in further researches. Public health department should strengthen continuing educations to foster competence of psychological sense of empowerment and innovative behavior to increase job productivity. 相似文献14.
Coster WJ Haley SM Ni P Dumas HM Fragala-Pinkham MA 《Archives of physical medicine and rehabilitation》2008,89(4):622-629
Coster WJ, Haley SM, Ni P, Dumas HM, Fragala-Pinkham MA. Assessing self-care and social function using a computer adaptive testing version of the Pediatric Evaluation of Disability Inventory.
Objective
To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the self-care and social function scales of the Pediatric Evaluation of Disability Inventory compared with the full-length version of these scales.Design
Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study.Setting
Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children’s homes.Participants
Children with disabilities (n=469) and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample).Interventions
Not applicable.Main Outcome Measures
Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length self-care and social function scales; time (in seconds) to complete assessments and respondent ratings of burden.Results
Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (r range, .94-.99). Using computer simulation of retrospective data, discriminant validity, and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared with over 16 minutes to complete the full-length scales.Conclusions
Self-care and social function score estimates from CAT administration are highly comparable with those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time. 相似文献15.
Background
High incidence rates of HIV/AIDS infections among youth draw attention to the need for emphasizing the reduction of risky sexual behavior, a major contributor to the spread of HIV/AIDS. Few researchers have examined the relationship between self-efficacy for HIV/AIDS preventions, depressive symptoms, and adolescent risky sexual behavior. This insufficient understanding limits nurses’ ability to provide effective programs for reducing adolescents’ risky sexual behaviors.Objectives
This study was conducted to investigate the relationships among HIV/AIDS preventive self-efficacy, depressive symptoms, and risky sexual behavior in Taiwanese adolescents.Design
A cross-sectional, correlational study.Settings
Seven vocational high schools located in a metropolitan area in southern Taiwan.Participants
A convenience sample of 16-18-year-old vocational high school Taiwanese adolescents (n = 734) participated in this study.Methods
Several self-administrated questionnaires, including HIV/AIDS Preventive Self-efficacy scale, the Center for Epidemiological Studies-Depression scale, Safe Sex Behavior Questionnaire, and a form for demographic data, were used to collect data.Results
Taiwanese adolescents who had higher HIV/AIDS preventive self-efficacy scores had less overall risky sexual behavior. Adolescents who had less depressive symptoms had higher HIV/AIDS preventive self-efficacy. More depressive symptoms were correlated to more risky sexual behavior.Conclusion
Improving Taiwanese adolescents’ HIV/AIDS preventive self-efficacy could be useful to reduce risky sexual behaviors in this population. Results of this study may assist nurses in understanding factors related to adolescents HIV/AIDS related risky sexual behavior and its’ preventions. However, future longitudinal studies are needed to clarify whether depressive symptoms is a major influential factor that might interfere with the effectiveness of HIV/AIDS prevention programs. 相似文献16.
Tanvi Bhatt 《Archives of physical medicine and rehabilitation》2009,90(1):34-42
Bhatt T, Pai Y-C. Prevention of slip-related backward balance loss: the effect of session intensity and frequency on long-term retention.
Objective
To examine the effects of session intensity (number of slip exposures) and frequency on the retention of acquired adaptation for prevention of backward balance loss after repeated-slip training.Design
A 4-group, randomized, and controlled study.Setting
Biomechanics research laboratory.Participants
Healthy young subjects (N=46; 21 men).Interventions
Twenty-four subjects experienced a high-intensity session of 24 repeated right-side slips; 12 received additional single-slip sessions at a frequency of 1 week, 2 weeks, and 1 month, whereas the rest got no ancillary training. Another 24 subjects received a low-intensity initial session of a single slip; 12 received the same high-frequency ancillary training, whereas the rest got none. All groups were retested with a single slip 4 months after the first session.Main Outcome Measures
The incidence of backward balance loss, gait stability, and limb support.Results
The high-intensity groups, irrespective of ancillary training, displayed similar improvements in all 3 outcome measures. Remarkably, the low-intensity group receiving ancillary training also significantly improved in all measures, with retention comparable to that observed in the other 2 groups. A single-slip exposure without ancillary sessions was insufficient to yield a longer-term effect.Conclusions
Frequent ancillary sessions may be unnecessary for slip-related fall prevention up to 4 months if the initial session intensity is sufficient. Furthermore, the minimum of a single slip may be as effective if the subject is exposed to frequent ancillary sessions. 相似文献17.
Holm Thieme Claudia Ritschel Christian Zange 《Archives of physical medicine and rehabilitation》2009,90(9):1565-1570
Thieme H, Ritschel C, Zange C. Reliability and validity of the Functional Gait Assessment (German version) in subacute stroke patients.
Objective
To investigate validity and reliability of the Functional Gait Assessment (FGA) (German version) as a measure for balance abilities during walking in subacute stroke patients.Design
Cohort study.Setting
Inpatient rehabilitation center.Participants
Ambulatory subjects (N=28) at a maximum of 6 months after stroke participated in this study. One direct observer and 2 video observers rated the FGA.Interventions
Not applicable.Main Outcome Measures
Performance of the FGA was video recorded and directly rated. For testing concurrent validity of the FGA, subjects also completed testing in the Berg Balance Scale, fast walking speed, the Functional Ambulatory Category, the Rivermead Mobility Index, and the Barthel Index. Intrarater reliability, interrater reliability, and concurrent validity of the FGA were analyzed.Results
Intrarater (intraclass correlation coefficient=.97) and interrater reliability (intraclass correlation coefficient=.94) were almost perfect for total scores. Reliability of single items varied between substantial and almost perfect values. Analysis revealed significant correlations between the FGA and other measures of gait and balance functions between Spearman rho values of .71 and .93. The FGA differs significantly between levels of gait ability (Functional Ambulatory Category) (P≤.01).Conclusions
Almost perfect intrarater and interrater reliability for total FGA scores and good concurrent validity were shown in this study. Therefore, the FGA (German version) can be used as a reliable and valid tool to assess functional gait performance of patients in subacute stages after stroke. 相似文献18.
Objectives
Studies of neuroplasticity suggest that repetitious movements optimise changes at brain level, and that this response is optimised if the task is challenging and engaging. The evidence to date on physiotherapy interventions suggests that an increased intensity of therapy provides better outcomes and that exercise-based interventions demonstrate positive treatment effects. Robot-mediated therapy (RMT) is an innovative way of providing these components. This study investigated the effect of RMT on upper extremity function post-stroke.Design
Single case study using an ABC design.Setting
Physiotherapy outpatient department.Participant
A 79-year-old female, 22 months following right cerebrovascular accident.Interventions
Phase A consisted of a series of nine baseline measurements, phase B consisted of nine 30-minute sessions of RMT, and phase C consisted of nine 30-minute sessions of sling suspension.Main outcome measures
Fugl-Meyer Assessment, the Motor Assessment Scale and the Short-Form-36 (SF-36) questionnaire.Results
The rate of recovery during the RMT phase B was greater than that with no treatment (A) and that with sling suspension (C) for the Fugl-Meyer Assessment and the Motor Assessment Scale. Improvement was seen only in those domains addressed by the RMT system. No change in quality of life as measured by the SF-36 was noted.Conclusions
Treatment delivered by this RMT system had a positive effect on the rate of recovery at the level of impairment of body function and at the level of activities. The superiority of RMT over sling suspension is consistent with the theories of neuroplasticity which suggest that repetitious movements must be challenging and meaningful. While these initial results concur with those of previous studies of RMT, further evidence is required before this form of intervention should be incorporated routinely into clinical practice. 相似文献19.
Muzeyyen Uzel MD Nese Colak Oray Basak Bayram Tuncay KumeSedat Yanturali MD 《The American journal of emergency medicine》2014
Introduction
Differential diagnosis of seizure is critical in patients presented to emergency department (ED) with altered mental status or loss of consciousness. Although electroencephalogram is important for the diagnosis of seizures, its use in EDs is limited. The level of ischemia-modified albumin (IMA) increases in conditions of ischemic distress such as acute coronary syndrome, pulmonary embolism, and mesenteric ischemia. No studies exist in literature regarding the increase of IMA levels parallel to increased seizure activity in adults. The aim of the study was to investigate the diagnostic value of IMA in adult patients presented to ED with seizures.Methods
Forty patients presented to ED with seizure, and 40 control patients of similar age and sex as the study group were enrolled in this study. Initial and fourth-hour levels of IMA and albumin were measured. Groups were compared in terms of sociodemographic data and details regarding their seizures as well as initial and fourth-hour levels of IMA.Results
Mean levels of IMA were 61.5 IU/mL and 18.5 IU/mL (P < .001) initially and 56.7 IU/mL and 15.4 IU/mL (P < .001) at the fourth hour; levels were higher in the study group compared with control group. Ischemia-modified albumin/albumin ratios in study and control groups were 1555.3 IU/g and 462.4 IU/g (P < .001) initially and 1431.4 IU/g and 383.6 IU/g (P < .001) at the fourth hour, respectively.Conclusion
Blood IMA level and IMA/albumin ratio significantly increase in adult patients who experienced seizures. Ischemia-modified albumin may be considered as a useful biomarker in the differential diagnosis of seizure. 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.