Showing papers in "American Journal of Physical Medicine & Rehabilitation in 2001"
TL;DR: Constraint-induced movement therapy produced significant functional improvement and resulted in plasticity as demonstrated by functional MRI.
Abstract: Levy CE, Nichols DS, Schmalbrock PM, Keller P, Chakeres DW: Functional MRI evidence of cortical reorganization in upper-limb stroke hemiparesis treated with constraint-induced movement therapy. Am J Phys Med Rehabil 2001;80:4–12.ObjectiveThe purpose of this pilot study was to test constraint
309 citations
TL;DR: Although almost all persons living with trauma-related amputations use prosthetic devices, the majority are not satisfied with prosthetic comfort and Phantom pain and residual limb skin problems are also common afflictions in this population.
Abstract: Dillingham TR, Pezzin LE, MacKenzie EJ, Burgess AR: Use and satisfaction with prosthetic devices among persons with trauma-related amputations: a long-term outcome study. Am J Phys Med Rehabil 2001;80:563–571.ObjectiveTo document and examine the use, satisfaction, and problems with prosthetic device
309 citations
TL;DR: Resistance training can produce functional improvements in gait and may, therefore, be useful as part of a physical rehabilitation and/or health maintenance program for patients with Parkinson’s disease.
Abstract: Scandalis TA, Bosak A, Berliner JC, Helman LL, Wells MR: Resistance training and gait function in patients with Parkinson’s disease. Am J Phys Med Rehabil 2001;80:38–43.ObjectiveTo determine whether patients with Parkinson’s disease who are enrolled in a resistance training program can gain
234 citations
TL;DR: Logistic regression analysis indicated that for female athletes, the percentage difference between the right and left hip extensors was predictive of whether treatment for LBP was required over the ensuing year, adding validity to the concept of hip muscle imbalance being associated with LBP occurrence in female athletes.
Abstract: Nadler SF, Malanga GA, Feinberg JH, Prybicien M, Stitik TP, DePrince M: Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: a prospective study. Am J Phys Med Rehabil 2001;80:572–577.ObjectiveTo assess whether athletes with strength imbalance of the hip
221 citations
TL;DR: Findings reinforce the convergent construct validity of the manual muscle test and dynamometry measurements but challenge the discriminant construct validate of manual muscle testing.
Abstract: ObjectiveTo compare manual muscle test with hand-held dynamometer measurements of knee extension strength. A secondary analysis of measurements (n = 256 knees) from 128 acute rehabilitation patients was performed.DesignKnee extensor muscle testing was conducted according to the technique of
180 citations
TL;DR: It was concluded that resistance training had a positive effect on bone mineral density at the lumbar spine of all women and at the femur and radius sites for postmenopausal women.
Abstract: The purpose of this study was to use meta-analysis to examine the effects of resistance training on bone mineral density at the femur, lumbar spine, and radius in pre- and postmenopausal women. Resistance training had a positive effect on bone mineral density at the lumbar spine of all women and at the femur and radius sites for postmenopausal women. It was concluded that resistance training has a positive effect on bone mineral density in women.
173 citations
TL;DR: Impaired cognition, weakness, and visual-perceptual deficits were the most common problems in this study population, and the benefits of comprehensive and interdisciplinary rehabilitation for patients with primary as well as metastatic brain tumors are supported.
Abstract: Objective To report and discuss common neurologic problems in adults with brain tumors admitted for inpatient rehabilitation at an acute rehabilitation center. Design Retrospective, descriptive, case series of 51 consecutive adult patients (65% male), with a variety of tumor types (31.3% glioblastoma, 25.5% meningioma, and 25.5% metastatic). Outcome measures were the functional status as measured by the FIM scores, the length of rehabilitation stay, and discharge dispositions. Results The most common deficit was impaired cognition (80%), followed by weakness (78%), visual-perceptual deficit (53%), sensory loss (38%), and bowel and bladder dysfunction (37%). Less common problems, in decreasing incidence, were cranial nerve palsy, dysarthria, dysphagia, aphasia, ataxia, and diplopia. Thirty-eight (74.5%) patients had three or more concurrent neurologic deficits, and 20 (39.2%) patients had five or more deficits. Concurrent deficits among patients with hemi- and tetraparesis involved cognition (n = 29 patients), visual-perceptual function, sensation, cranial nerve palsy, and neurogenic bowel/bladder. The average admission FIM score of 67.2 increased to 87.1 at the time of discharge, with similar gains between patients with primary brain tumor and metastatic disease. Thirty-five patients were discharged home, seven to a nursing home, and one to hospice care; there were eight acute transfers. Conclusions Impaired cognition, weakness, and visual-perceptual deficits were the most common problems in this study population. Our study supports the benefits of comprehensive and interdisciplinary rehabilitation for patients with primary as well as metastatic brain tumors.
171 citations
TL;DR: The authors review the literature related to the return to work for persons with traumatic brain injuries, including back to work outcomes, factors influencing return toWork, and vocational programs that enhance employment, including a supported employment approach.
Abstract: Individuals with traumatic brain injuries experience an array of physical, cognitive, and emotional changes that often make return to preinjury employment unlikely and locating new employment difficult. The authors review the literature related to the return to work for persons with traumatic brain injuries. This includes return to work outcomes, factors influencing return to work, and vocational programs that enhance employment, including a supported employment approach. Guidelines for professionals engaged in supported employment practices are also provided.
168 citations
TL;DR: Dry needling of the myofascial trigger spot is effective in diminishing SEA if local twitch responses are elicited, and the local twitch response elicitation seems to be the primary inhibitory factor on SEA during dry needling.
Abstract: Chen JT, Chung KC, Hou CR, Kuan CR, Chen SM, Hong CZ: Inhibitory effect of dry needling on the spontaneous electrical activity recorded from myofascial trigger spots of rabbit skeletal muscle. Am J Phys Med Rehabil 2000;80:729 –735. Objective: Dry needling of myofascial trigger points can relieve myofascial pain if local twitch responses are elicited during needling. Spontaneous electrical activity (SEA) recorded from an active locus in a myofascial trigger point region has been used to assess the myofascial trigger point sensitivity. This study was to investigate the effect of dry needling on SEA. Design: Nine adult New Zealand rabbits were studied. Dry needling with rapid insertion into multiple sites within the myofascial trigger spot region was performed to the biceps femoris muscle to elicit sufficient local twitch responses. Very slow needle insertion with minimal local twitch response elicitation was conducted to the other biceps femoris muscle for the control study. SEA was recorded from 15 different active loci of the myofascial trigger spot before and immediately after treatment for both sides. The raw data of 1-sec SEA were rectified and integrated to calculate the average integrated value of SEA. Results: Seven of nine rabbits demonstrated significantly lower normalized average integrated value of SEA in the treatment side compared with the control side (P 0.05). The results of two-way analysis of variance show that the mean of the normalized average integrated value of SEA in the treatment group (0.565 0.113) is significantly (P 0.05) lower than that of the control (0.983 0.121). Conclusions: Dry needling of the myofascial trigger spot is effective in diminishing SEA if local twitch responses are elicited. The local twitch response elicitation, other than trauma effects of needling, seems to be the primary inhibitory factor on SEA during dry needling.
163 citations
TL;DR: Neuromuscular electrical stimulation of thigh muscles in patients with refractory heart failure is effective in increasing muscle strength and bulk and positively affects the perception of quality of life and activities of daily living.
Abstract: Quittan M, Wiesinger GF, Sturm B, Puig S, Mayr W, Sochor A, Paternostro T, Resch KL, Pacher R, Fialka-Moser V: Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart failure: a single-blind, randomized, controlled trial. Am J Phys Med Rehabil 2
163 citations
TL;DR: Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.
Abstract: Objectives: To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined. Design: A controlled, prospective study of trunk muscle strengths of patients with chronic low-back pain and the short-term impact of exercise on strength. The study group consisted of 25 female patients who had been experiencing low-back pain for at least 3 mo, and the control group included 20 age-matched women without known low-back trouble. The Davenport Index was used to calculate the body mass indexes of all subjects. The Oswestry Disability Questionnaire was used to assess pain in the study group. Full flexion and extension ranges of motion were measured, then isokinetic measurements of trunk muscles were performed at 60-, 120-, and 180-degrees/sec velocities. Isometric measurements were also recorded for both flexors and extensors at a 60-degree angle. Results: Increased body mass index and decreased trunk muscle strength were found to be directly associated with chronic low-back pain (P < 0.05). After a 15-day standard trunk strengthening exercise program in the patient group, trunk muscle strength was found to be increased (P < 0.05). Conclusions: Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.
TL;DR: It is substantiated that the frequent use of these alternative propulsion mechanisms may help prevent some of the secondary impairments that are seen among today’s wheelchair-user population.
Abstract: An estimated 90% of all wheelchairs are hand-rim propelled, a physically straining form of ambulation that can lead to repetitive strain injuries in the arms and, eventually, to secondary impairments and disability. Further disability in wheelchair-dependent individuals can lead to a sedentary lifestyle and thereby create a greater risk for cardiovascular problems. Studies on lever-propelled and crank-propelled wheelchairs have shown that these propulsion mechanisms are less straining and more efficient than hand-rim-propelled wheelchairs. This article reviews these studies and substantiates that the frequent use of these alternative propulsion mechanisms may help prevent some of the secondary impairments that are seen among today's wheelchair-user population.
TL;DR: Age- and gender-related differences in Vo may partially explain the impairments in Muscle function that occur with aging and the greater impairment in muscle function observed in OW compared with that observed in OM.
Abstract: Krivickas LS, Suh D, Wilkins J, Hughes VA, Roubenoff R, Frontera WR: Age- and gender-related differences in maximum shortening velocity of skeletal muscle fibers. Am J Phys Med Rehabil 2001:80:447–455.ObjectiveTo determine age- and gender-related differences in maximum unloaded shortening velocity (
TL;DR: This cross-sectional study showed that physiologic reduction of muscle strength, which began early in life, later stopped and that muscle strength even improved, despite the aging process, and initiating strengthening exercises at any age is encouraged to prevent the impact of several age-related musculoskeletal challenges.
Abstract: Sinaki M, Nwaogwugwu NC, Phillips BE, Mokri M: Effect of gender, age, and anthropometry on axial and appendicular muscle strength. Am J Phys Med Rehabil 2001;80:330–338.ObjectiveTo assess age and gender differences in muscle strength.DesignThe strength of back extensors, upper limbs (grip),
TL;DR: Though the two groups did not differ in self-reported social integration, dependent individuals may have greater difficulty creating new social relationships, and independent individuals reported better overall physical health than dependent individuals.
Abstract: Hicken BL, Putzke JD, Richards JS: Bladder management and quality of life after spinal cord injury. Am J Phys Med Rehabil 2001;80:916–922ObjectiveThis study examines the quality of life among individuals with spinal cord injury requiring assistance for bowel and bladder management vs. those with ind
TL;DR: Perturbations in below-knee amputee gait affected the hip muscle powers on the amputated side in all three planes, although the hip frontal plane balance was modified in the sound limb.
Abstract: Sadeghi H, Allard P, Duhaime M: Muscle power compensatory mechanisms in below-knee amputee gait. Am J Phys Med Rehabil 2001;80:25-32. Objective: This three-dimensional and bilateral gait study on five below-knee amputees was undertaken to demonstrate the following: (1) how hip muscle powers can compensate for the lack of ankle function on the amputated side; and (2) how these compensatory mechanisms can influence muscle power activities in the sound limb. Design: Gait data were assessed by an eight-camera high-speed video system synchronized to two force plates. The three-dimensional mechanical muscle powers were calculated at the joints of the lower limbs. Significant differences between each limb were determined using the Student's t test for paired data with P < 0.05. Results: In the absence of ankle plantar flexor power, hip extensors and flexors as well as hip external rotators became the major power generators, whereas hip abductors and adductors and knee extensors muscle powers became the main source of absorption. For the sound limb, increased hip extensor activity was observed, accompanied by less hip abduction-adduction activity. Conclusions: Perturbations in below-knee amputee gait affected the hip muscle powers on the amputated side in all three planes, although the hip frontal plane balance was modified in the sound limb.
TL;DR: Death rates for several causes are elevated in persons with long-term sequelae of TBI, and life expectancy seems to be reduced, even for patients who are fully ambulatory.
Abstract: Shavelle RM, Strauss D, Whyte J, Day SM, Yu YL: Long-term causes of death after traumatic brain injury. Am J Phys Med Rehabil 2001;80:510–516.ObjectiveTo determine which causes of death are more frequent in persons with traumatic brain injury (TBI), and by how much, compared with the general populat
TL;DR: These initial findings suggest that fluoroscopically guided therapeutic sacroiliac joint injections are a clinically effective intervention in the treatment of patients with sacroiliarac joint syndrome.
Abstract: Slipman CW, Lipetz JS, Plastaras CT, Jackson HB, Vresilovic EJ, Lenrow DA, Debra L. Braverman DL: Fluoroscopically guided therapeutic sacroiliac joint injections for sacroiliac joint syndrome. Am J Phys Med Rehabil 2001;80:425–432.ObjectiveTo investigate the outcomes resulting from the use of fluoro
TL;DR: There is strong experimental evidence that one source of the endplate noise component is grossly increased release (up to three orders of magnitude) of acetylcholine from the nerve terminal of that neuromuscular junction.
Abstract: The concept that the endplate noise and endplate spike components of motor endplate potentials represent normal endplate potentials seems to be flawed. The morphology of the normal miniature endplate potentials described in the physiology literature is different from the morphology of the noise-like component of endplate potentials. This noise-like component is identified as normal in current electromyographic literature. There is strong experimental evidence that one source of the endplate noise component is grossly increased release (up to three orders of magnitude) of acetylcholine from the nerve terminal of that neuromuscular junction. The spikes can be accounted for by release of additional acetylcholine in response to mechanical stimulation by the electromyographic needle. Other possibilities exist.
TL;DR: It is indicated that patients with nontraumatic SCI can achieve rates of functional gains and community discharge comparable with traumatic SCI, and these findings have important implications for the interdisciplinary rehabilitation process in the overall management and outcome of individuals with nontraneous SCI.
Abstract: Objective: Nontraumatic spinal cord injury (SCI) represents a significant proportion of individuals admitted for SCI rehabilitation; however, there is limited literature regarding their outcomes. As our society continues to age and nontraumatic injuries present with greater frequency, further studies in this area will become increasingly relevant. The objective of this study was to compare outcomes of patients with nontraumatic SCI with those with traumatic SCI after inpatient rehabilitation. Design: A longitudinal study with matched block design was used comparing 86 patients with nontraumatic SCI admitted to a SCI rehabilitation unit and 86 patients with traumatic SCI admitted to regional model SCI centers, controlling for age, neurologic level of injury, and American Spinal Injury Association impairment classification. Main outcome measures included acute and rehabilitation hospital length of stay, FIM scores, FIM change, FIM efficiency, rehabilitation charges, and discharge-to-home rates. Results: Results indicate that when compared with traumatic SCI, patients with nontraumatic SCI had a significantly (P < 0.01) shorter rehabilitation length of stay (22.38 vs. 41.35 days) and lower discharge FIM scores (57.3 vs. 65.6), FIM change (18.6 vs. 31.0), and rehabilitation charges ($25,050 vs. $64,570). No statistical differences were found in acute care length of stay, admission FIM scores, FIM efficiency, and community discharge rates. Conclusions: The findings indicate that patients with nontraumatic SCI can achieve rates of functional gains and community discharge comparable with traumatic SCI. Whereas patients with traumatic SCI achieved greater overall functional improvement, patients with nontraumatic SCI had shorter rehabilitation length of stay and lower rehabilitation charges. These findings have important implications for the interdisciplinary rehabilitation process in the overall management and outcome of individuals with nontraumatic SCI.
TL;DR: Final analysis demonstrated that the remaining 16 items represented a unidimensional construct that, in general, supported the original expected item difficulty hierarchy and provides a basis for setting clinically relevant criteria for interventions.
Abstract: Objective: The objective of this study is to demonstrate how a Rasch analytic approach can be used to create fear of falling measures that remain connected to the meaningful descriptions provided by the instrument items. Design: The University of Illinois at Chicago Fear of Falling Measure was developed using focus groups and consists of 19 common activities designed to represent an increasing level of concern about falling among older adults. Results: Rasch analysis of responses from 106 community dwelling elderly revealed that the two middle rating scale categories (a little worried and moderately worried) were not being used in the expected fashion. After modification of the rating scale, Rasch analysis showed that the three items causing the least worry (get dressed, get on/off toilet, and get in/out of bed) were statistically erratic. Conclusion: Final analysis demonstrated that the remaining 16 items represented a unidimensional construct that, in general, supported the original expected item difficulty hierarchy. Because person and item measures were calibrated on the same linear scale person measures are translatable to item descriptions. This connection provides meaning to the numeric values obtained from the instrument and provides a basis for setting clinically relevant criteria for interventions.
TL;DR: The status of measuring assistive technology outcomes is described, and efforts to develop new measures are critically reviewed, and three as yet unmet challenges are discussed that are faced alike by assistivetechnology outcomes research and by rehabilitation outcomes research in general.
Abstract: This article highlights the special requirements, achievements, and yet unmet challenges of assessing the outcomes of assistive technology services. The current status of this research is considered from the standpoint of developmental stages that seem to characterize many areas of outcomes research. Those stages include exhortation, sober appraisal, infrastructure building, and "getting on with it." The status of measuring assistive technology outcomes is described, and efforts to develop new measures are critically reviewed. Three as yet unmet challenges are discussed that are faced alike by assistive technology outcomes research and by rehabilitation outcomes research in general. They are as follows: (1) operationalizing a multiple-stakeholder approach to outcomes research; (2) formulating adequate treatment theories; and (3) creating shared databases.
TL;DR: A computer-generated virtual reality environment represents a reproducible tool to assess selected cognitive functions and can be used as a supplement to traditional rehabilitation assessment in persons with acquired brain injury.
Abstract: Zhang L, Abreu BC, Masel B, Scheibel RS, Christiansen CH, Huddleston N, Ottenbacher KJ: Virtual reality in the assessment of selected cognitive function after brain injury. Am J Phys Med Rehabil 2001;80:597–604.ObjectiveTo assess selected cognitive functions of persons with traumatic brain injury us
TL;DR: The results of the multivariate analyses support the contention that agitation and cognition are intimately related, with the long-term effects of the former being at least partially driven by the latter.
Abstract: Objective: To determine the role of agitation in the prediction of traumatic brain injury rehabilitation outcomes Design: A longitudinal study of 340 consecutive patients admitted to an acute traumatic brain injury rehabilitation unit was conducted Outcomes under study included rehabilitation length of stay, discharge destination, functional independence at discharge (FIMTM instrument), productivity at 1-yr follow-up, and life satisfaction at 1-yr follow-up (Satisfaction with Life Scale) Results: Univariate analyses suggested that the presence of agitation in rehabilitation is predictive of a longer length of stay and decreased functional independence in the cognitive realm at discharge In addition, individuals who exhibit agitation at any time during rehabilitation are less likely to be discharged to a private residence However, multivariate analyses indicated that cognitive functioning at admission to rehabilitation (FIM cognitive) mediates the relationship between the presence of agitation and length of rehabilitation, as well as between agitation and FIM cognitive at discharge Similar results were found when discharge residence was the dependent variable; however, agitation also contributed some unique variance to the prediction Lower cognitive functioning at admission to rehabilitation was associated with the occurrence of agitation during rehabilitation, longer length of stay, lower cognitive functioning at discharge, and a decreased likelihood that an individual would be discharged to a private residence Conclusions: The results of the multivariate analyses support the contention that agitation and cognition are intimately related, with the long-term effects of the former being at least partially driven by the latter These findings support the importance of systematically monitoring both agitation and cognition when applying interventions to reduce agitation
TL;DR: Cognitiveion evaluation should be taken as a whole to predict functional outcome in patients with postacute stroke, except for the baseline orientation score that seemed more predictive for ambulation.
Abstract: Ozdemir F, Birtane M, Tabatabaei R, Ekuklu G, Kokino S: Cognitive evaluation and functional outcome after stroke. Am J Phys Med Rehabil 2001;80:410–415.ObjectiveTo investigate the initial overall cognitive ability and its components as a predictor of functional improvement and ambulation during reha
TL;DR: There was relatively more activation of vastus medialis obliquus than vastus lateralis at 40 degrees of semisquatting with the hip medially rotated by 30 degrees, which has clinical implications for training the vastus medicalis ob liquus in patients with patellofemoral joint pain syndrome.
Abstract: Lam PL, Ng GYF: Activation of the quadriceps muscle during semisquatting with different hip and knee positions in patients with anterior knee pain. Am J Phys Med Rehabil 2001;80:804–808.ObjectiveWe measured the surface electromyographic activities of vastus medialis obliquus and vastus lateralis in
TL;DR: These findings support the likelihood of multiple mechanisms for reduced knee flexion in swing and suggest that each individual has unique mechanisms associated with this observed gait pattern.
Abstract: Objective: The authors previously suggested that spastic paretic stiff-legged gait, defined as reduced knee flexion in swing associated with upper-motor neuron injury, can be attributed to multiple impairments besides spastic quadriceps activity. This study hypothesizes that subjects with spastic paretic stiff-legged gait have altered kinetics not only about the knee but also about the hip and ankle. Design: Joint kinetic data of 20 subjects with spastic paretic stiff-legged gait caused by stroke were compared with data obtained from 20 able-bodied subjects. Results: Significant reductions in the subject group were found in both peak knee-joint power absorption (0.42 ± 0.34 vs. 0.99 ± 0.27 W/(kg.m.m/sec)) and peak ankle-joint power generation (0.74 ± 0.42 vs. 1.51 ± 0.17 W/(kg.m.m/sec); both P < 0.0001). The authors observed increases in peak external-hip flexion torque in stance, hip-power generation in loading response, knee-extension torque in midstance, ankle-dorsiflexion torque, and ankle-power absorption in stance. There was substantial variability in most torque and power values among subjects, which was significantly greater than that observed in the control subjects. Conclusions: These findings, in conjunction with previous studies, support the likelihood of multiple mechanisms for reduced knee flexion in swing. Alternatively, some of the joint kinetic differences could be compensations for or associated with reduced knee flexion in swing. The substantial variability among subjects implies that despite a similar visual appearance of reduced knee flexion among subjects with a spastic paretic stiff-legged gait pattern, each individual has unique mechanisms associated with this observed gait pattern.
TL;DR: A retrospective cohort design study in which chart review was performed on patients, who presented with radiculopathy and received fluoroscopically guided caudal epidural steroid injections, finding no major complications occurred.
Abstract: Botwin KP, Gruber RD, Bouchlas CG, Torres-Ramos FM, Hanna A, Rittenberg J, Thomas SA: Complications of fluoroscopically guided caudal epidural injections. Am J Phys Med Rehabil 2001;80:416–424.ObjectivesTo assess the incidence of complications of fluoroscopically guided caudal epidural injections.De
TL;DR: Four weeks of both intensive group physical therapy or individual biofeedback training followed by an unsupervised home exercise program for 2 mo are effective therapies for female urinary stress incontinence and result in a significantly reduced nocturnal urinary frequency and improved subjective outcome.
Abstract: Pages I-H, Jahr S, Schaufele MK, Conradi E: Comparative analysis of biofeedback and physical therapy for treatment of urinary stress incontinence in women. Am J Phys Med Rehabil 2001;80:494–502.ObjectiveTo compare the effectiveness of an intensive group physical therapy program with individual biofe
TL;DR: Almost all patients with cognitive impairment were functionally dependent postfracture, with new disabilities frequently occurring in transferring, and patients can be assisted in regaining prefracture function if they are targeted for rehabilitation on the basis of mental status.
Abstract: Cree M, Carriere KC, Soskolne CL, Suarez-Almazor M: Functional dependence after hip fracture. Am J Phys Med Rehabil 2001;80:736–743.Objectives:To identify patients at high risk of functional dependence and examine the progression of disability after a hip fracture.Design:This was a population-based