bluuebunny/crossref_metadata_2025 huggingface dataset:
Adapting the Nottingham Health Profile for use in people with severe physical disabilities
Authors: Post Marcel W M , Gerritsen Johan , van Leusen Natascha D M , Paping Marieke A , Prevo Arie J H
Published: May 2003

Background: The Nottingham Health Profile (NHP) is a well-known quality of life questionnaire. However, wheelchair-bound patients might obtain misleading scores on the scales Physical mobility, Pain and Emotional reactions. We tested three possible adaptations of the Dutch NHP to overcome this problem.

Methods: Respondents were 111 wheelchair-using people (walking ability maximum 5 m) with spinal cord injury, rheumatic diseases and other diagnoses. Adaptation methods were formulation of new questions (Q-NHP), a recoding procedure (R-NHP) and deleting items (D-NHP). Internal consistency, correlations between original and adapted scales and correlations with upper and lower extremity function and social functioning (NHP part II) were computed.

Results: All adapted Pain and Emotional reactions scales were close to the original ones. The original Physical mobility scale proved invalid, resulting in better median scores for those patients who could not walk at all (38.7) than for patients who could walk a bit (50.0). The Q-NHP performed little better than the original one and suffered from greater complexity. The R-NHP showed better internal consistency (0.69 versus 0.49) and construct validity than the D-NHP.

Conclusion: An uncomplicated recoding procedure, scoring five questions about walking problems as ‘yes’ if respondents confirmed the question ‘I cannot walk at all’, improved reliability and validity of the Dutch NHP. Use of this recoding procedure in future research using the NHP is recommended, although its applicability in other language versions has to be proven in future research.
The ‘impact factor’ – an explanation and its application to rehabilitation journals
Authors: Lankhorst Gustaaf J , Franchignoni Franco
Published: May 2003

The impact factor is calculated by dividing the number of times articles from a journal are cited in a core of about 5000 journals by the number of articles published by that journal in the same period of two years. It is used as a measure of a journal's scientific influence, but the assumptions underlying this use are flawed. Although the use of the impact factor is recognized to be invalid, nonetheless it continues, in part because no better agreed measure has yet been developed.
Randomized controlled trial of quadriceps training after proximal femoral fracture
Authors: Mitchell Sarah L , Stott David J , Martin Brendan J , Grant Stanley J
Published: May 2003

Objective: To determine whether systematic progressive high-intensity quadriceps training increases leg extensor power and reduces disability in patients rehabilitating after proximal femoral fracture.

Design: Open parallel group randomized controlled trial comparing the addition of six weeks quadriceps training (40 patients) with standard physiotherapy alone (40 patients). The training group exercised twice weekly, with six sets of 12 repetitions of knee extension (both legs), progressing up to 80% of their one-repetition maximum.

Setting: Orthogeriatric unit, and community follow-up.

Subjects: Eighty patients rehabilitating after proximal femoral fracture.

Main outcome measures: Measurements of leg extensor power (Nottingham Power Rig), functional mobility (elderly mobility score), disability (Barthel Index) and quality of life (Nottingham Health Profile) were made at baseline, after six weeks (at the end of the intervention) and at 16 weeks.

Results: Leg extensor power increased significantly in the quadriceps training group (fractured leg mean improvement at six weeks 157% (standard error 16), nonfractured leg 80% (12)) compared with the control group (63% (11) and 26% (8) respectively, unpaired Student's t-test p = 0.007 and p = 0.01 for between-group comparisons). Significant benefits were maintained at 16 weeks. Quadriceps training resulted in a greater increase in elderly mobility scale score compared with standard rehabilitation (between-group difference of 2.5 (95% CI 1.1,3.8) at week 6 and 1.9 (0.4,3.4) at week 16). Barthel score increased significantly from week 0 to 6 in the quadriceps training group compared with controls (Mann–Whitney U-test p = 0.05). Patients in the quadriceps training group scored significantly better in the energy subscore of the Nottingham Health Profile at the end of follow-up (Mann–Whitney U-test p = 0.0185).

Conclusions: Progressive high-intensity quadriceps training in elderly proximal femoral fracture patients increased leg extensor power and reduced disability. This was accompanied by an increase in energy as measured by the Nottingham Health Profile. This intervention may provide a simple practical way of improving outcome in these patients.
Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness
Authors: Kammerlind Ann-Sofi C , Håkansson Jenny K , Skogsberg Maria C
Published: May 2003

Objective: To evaluate the effect of balance training in group in elderly people with nonperipheral vertigo and unsteadiness.

Design: Randomized controlled study.

Setting: Ear, nose and throat department, University Hospital, Sweden.

Subjects: Twenty-three elderly subjects with nonperipheral vertigo and/or unsteadiness randomized into training group and control group.

Intervention: The training group attended balance training in group twice a week for eight weeks.

Main outcome measures: Timed static balance tests, walking tests and six sensory organization tests on EquiTest dynamic posturography were performed before and after the training period. Besides, the patients estimated their vertigo and unsteadiness on a visual analogue scale (VAS) before and after the training period.

Results: The training group improved significantly in standing on one leg with eyes open, walking forward on a line, walking speed, in three out of six tests on dynamic posturography and estimated less vertigo and unsteadiness measured with VAS. No changes were seen in the control group.

Conclusion: Balance training in elderly people with nonperipheral vertigo and unsteadiness seems to improve both objective and perceived balance.
Factors determining participation in young adults with a physical disability: a pilot study
Authors: Bent N , Jones A , Molloy I , Chamberlain M A , Tennant A
Published: May 2003

Objectives: To evaluate in a pilot study the usefulness of measures of health and psychosocial status for use with young people with physical and complex disability. Also to test empirically a conceptual model of the factors determining key outcomes in young disabled adults, in particular, participation (handicap).

Design: A cross-sectional study involving face-to-face interviews with young adults aged 16–28 years (n = 45) with physical and complex disabilities. A group of nondisabled college students completed the same set of questions to provide normative scores for some psychosocial measures.

Setting: Young people with physical disabilities were recruited from the area of North and North East Lincolnshire, and nondisabled young people from the Leeds area.

Methods: Standardized measures of impairment, disability and handicap, together with various psychosocial scales were incorporated into a structured face-to-face interview. Standardized measures included the Nottingham Health Profile (NHP), the Barthel Index, the London Handicap Scale, Rosenberg's Self-esteem Scale and the Proactive Scale.

Results: Regression analysis showed the most important predictors of participation were energy and pain (NHP), disability (Barthel) and self-efficacy. Most of the health status measures were able to discriminate between disabled and nondisabled young people, but some measures lacked face validity for the ‘nonwalking’ disabled group.

Conclusions: Both health status and psychosocial factors were found to impact on the participation of young people. Impairment and disability however, did not impact adversely on self-ratings of health or quality of life and it is clear from these results that having a disability may limit participation, but is not necessarily synonymous with a poorer quality of life.
Regional variations in stroke care in England, Wales and Northern Ireland: results from the National Sentinel Audit of Stroke
Authors: Rudd Anthony G , Irwin P , Rutledge Z , Lowe D , Wade D T , Pearson M
Published: May 2003

Study objective: To identify the variations between regions in England, Wales and Northern Ireland in the case-mix, organization and process of care for stroke.

Design: Retrospective audit of case notes and service organization.

Setting: Two hundred and ten Trust sites from 197 Trusts in 10 Health Regions in England, Wales and Northern Ireland.

Patients: The 6894 consecutive stroke patients admitted between 1 January and 31 March 1998 (up to 40 per Trust).

Audit tool: The Intercollegiate Stroke Audit.

Results: There are significant differences in stroke care between regions that cannot be explained by known case-mix or clinical variables. The proportion of patients spending more than half their hospital stay in stroke unit care varied between regions from 10% to 27%. Thirty-day mortality in different regions ranged between 21% and 33%. Institutionalization rates for those admitted from home varied between 6% and 19%. Similar variations existed in discharge disability and length of stay.

Conclusions: There were widespread variations in specialist service provision for stroke in different regions. Regional variation in 30-day mortality and in institutionalization after stroke is not explained by clinical factors and therefore may represent different local health care policies and expectations.
Association between amputation, arthritis and osteopenia in British male war veterans with major lower limb amputations
Authors: Kulkarni Jai , Adams Judith , Thomas Elaine , Silman Alan
Published: May 2003

Objectives: To investigate the association between amputation, osteoarthritis and osteopenia in male war veterans with major lower limb amputations. Specific questions were to determine whether lower limb amputees following trauma are at subsequent risk of developing osteoarthritis (OA) and osteoporosis of the hip on both the amputated and nonamputated sides.

Design: Retrospective cohort study in British Male Second World War veterans with major unilateral lower limb amputations.

Subjects: Seventy-five male Second World War veterans with major lower limb amputations known to be alive were invited to participate from a subregional rehabilitation centre. After exclusions, 44 agreed to attend for examination and radiological screening.

Methods: The presence of hip OA was determined from a single anterior posterior pelvic X-ray using two approaches: minimum joint space and the Kellgren and Lawrence (K&L) scoring system. Bone mineral density (BMD) was measured by a dual energy X-ray absorptiometry (DXA) scan and prosthetic rehabilitation outcome measures were recorded.

Results: Twenty-seven (61%) hips on the amputated side and 10 (23%) on the nonamputated side were positive for OA (based on Kellgren and Lawrence grade of >2). Using a minimum joint space threshold of below 2.5 mm, 24 (55%) hips on the amputation side and 8 (18%) on the nonamputated side were also positive for OA. There was a threefold increased risk of OA for those with above-knee compared to a below-knee amputation. By contrast from published general population surveys, only 4 (11%) cases of hip OA would have been expected on both the amputated and nonamputated hips.

There was a significant decrease in femoral neck BMD in the amputated side ( p< 0.0001) and significantly lower BMD in above-knee amputees than in below-knee amputees ( p = 0.0027) as compared to normal age- and sexmatched population.

Conclusion: Male war veterans with unilateral major lower limb amputations develop significantly more osteoarthritis of the hip than expected on both ipsi- and contralateral sides. Amputation was also associated with loss of bone density. Above-knee amputees develop significantly more hip osteoarthritis and osteopenia of greater severity in the amputated side than below-knee amputees
Clinical experience of rehabilitation therapists with chronic diseases: a quantitative approach
Authors: Rijken P M , Dekker J
Published: May 2003

Objectives: To provide an overview of the numbers of patients with selected chronic diseases treated by rehabilitation therapists (physical therapists, occupational therapists, exercise therapists and podiatrists). The study was performed to get quantitative information on the degree to which rehabilitation therapists are experienced in the treatment of chronically ill patients.

Methods: Secondary analyses were performed on several databases containing representative data on patients treated by rehabilitation therapists. Rates per 1000 patients in the populations of these rehabilitation therapists and 90% confidence intervals were computed for patients with the following diagnoses: ischaemic heart diseases, stroke, rheumatoid arthritis, osteoarthritis, osteoporosis, multiple sclerosis, Parkinson's disease, epilepsy, headache syndromes, COPD/asthma, diabetes mellitus and chronic back pain (the size of the latter group could only be assessed in physical therapy in primary care).

Results: The largest group of chronically ill patients treated by physical therapists in primary care are patients with chronic back pain (82 per 1000). Stroke patients are the most common chronically ill patients treated by physical therapists in institutional care (157 per 1000) and by occupational therapists in institutional (358 per 1000) and noninstitutional care (246 per 1000). These therapists also see a variety of other chronically ill patients. Exercise therapists and podiatrists treat less patients with the selected chronic diseases.
Experience of an open referral system for stroke rehabilitation in the community
Authors: Maheswaran Ravi , Davis Sue
Published: May 2003

Objective: To examine referral patterns and characteristics of patients assessed by a community stroke rehabilitation service utilizing an open referral system.

Design: Descriptive study. Setting: Two boroughs in a health district in South London, England.

Subjects: Two hundred and seventy-six patients with stroke assessed by the service in its first 18 months of operation.

Results: Patients were referred from a variety of sources including hospitals (38%), general practitioners (18%), district nurses (10%), social services (9%), self-referrals (8%), community physiotherapists (7%) and family or carers (2%). Referrals from hospital were younger (33% aged under 65 years) while referrals from community health and social services were older (44% aged 75–84 years) (2 = 23, df = 9, p <0.01). Fifty per cent of patients who had self-referred or had been referred by families or carers had longstanding stroke (>1 year), 46% of patients from general practitioners had acute stroke (<4 weeks) and 37% of hospital patients were seen between one and three months post stroke (2 = 50.4, df = 12, p <0.001). There was a marginally significant difference in the prevalence of incontinence and no significant differences in limb weakness, visual impairment and speech impairment.

There were no significant changes in sources of referral between the first and second nine months of the service. There was a significant increase in the percentage of patients with recent stroke seen in the second nine months (2= 22.8, df = 5, p <0.001). In this period, 36% of patients assessed were seen within four weeks of their stroke compared with 15% in the first nine months.

Of patients with stroke, 8.7% were considered to have been inappropriate referrals but they were not significantly associated with any particular source of referral.

Conclusions: Referrals were received from a wide variety of sources with significant differences in age and duration of stroke of patients from different referral sources. The results suggest that an open referral system may make rehabilitation accessible to a broader range of patients with stroke living in the community.
Camptocormia: a case of possible paraneoplastic aetiology
Authors: Zwecker Manuel , Iancu Iulian , Zeilig Gabi , Ohry Avi
Published: May 2003

We present a patient with gradual development of camptocormia, three years before a non-Hodgkin's lymphoma was diagnosed. Lymphomas are known to produce neuromuscular symptoms through several indirect mechanisms. Recent studies regard camptocormia as a primary disease of the paravertebral muscles. To our knowledge this is the first report associating camptocormia with malignancy. The possibility of a paraneoplastic syndrome is discussed.
Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses
Authors: Rankin Gabrielle , Stokes Maria
Published: May 2003

Objective: To provide a practical guide to appropriate statistical analysis of a reliability study using real-time ultrasound for measuring muscle size as an example.

Design: Inter-rater and intra-rater (between-scans and between-days) reliability.

Subjects: Ten normal subjects (five male) aged 22–58 years.

Method: The cross-sectional area (CSA) of the anterior tibial muscle group was measured using real-time ultrasonography.

Main outcome measures: Intraclass correlation coefficients (ICCs) and the 95% confidence interval (CI) for the ICCs, and Bland and Altman method for assessing agreement, which includes calculation of the mean difference between measures ( d), the 95% CI for d, the standard deviation of the differences (SD diff), the 95% limits of agreement and a reliability coefficient.

Results: Inter-rater reliability was high, ICC (3,1) was 0.92 with a 95% CI of 0.72 → 0.98. There was reasonable agreement between measures on the Bland and Altman test, as d was -0.63 cm2, the 95% CI for d was -1.4 → 0.14 cm2, the SDdiff was 1.08 cm2, the 95% limits of agreement -2.73 → 1.53 cm2 and the reliability coefficient was 2.4. Between-scans repeatability was high, ICCs (1,1) were 0.94 and 0.93 with 95% CIs of 0.8 → 0.99 and 0.75 → 0.98, for days 1 and 2 respectively. Measures showed good agreement on the Bland and Altman test: d for day 1 was 0.15 cm2 and for day 2 it was -0.32 cm2, the 95% CIs for d were -0.51 → 0.81 cm2 for day 1 and -0.98 → 0.34 cm2 for day 2; SDdiff was 0.93 cm2 for both days, the 95% limits of agreement were -1.71 → 2.01 cm2 for day 1 and -2.18 → 1.54 cm2for day 2; the reliability coefficient was 1.80 for day 1 and 1.88 for day 2. The between-days ICC (1,2) was 0.92 and the 95% CI 0.69 0.98. The d was -0.98 cm2, the SDdiff was 1.25 cm2 with 95% limits of agreement of -3.48 → 1.52 cm2 and the reliability coefficient 2.8. The 95% CI for d(-1.88 → -0.08 cm2) and the distribution graph showed a bias towards a larger measurement on day 2.

Conclusions: The ICC and Bland and Altman tests are appropriate for analysis of reliability studies of similar design to that described, but neither test alone provides sufficient information and it is recommended that both are used.
Leg extensor power and quadriceps strength: an assessment of repeatability in patients with osteoarthritic knees
Authors: Robertson Sunita , Frost Helen , Doll Helen , J O’Connor John
Published: May 2003

Objective: To assess the repeatability of two muscle function measures – leg extensor power (LEP) and isometric quadriceps force (IQF) – in a population of patients with osteoarthritis of the knee.

Design: Repeat measures of LEP and IQF at 25° and 50° knee flexion were taken within seven days. Both legs were measured and a numerical rating scale was used to assess pain on the two occasions.

Subjects: Patients who were on a waiting list for a primary unilateral knee replacement for osteoarthritis were invited to take part in the study. Setting: The physiotherapy department of a National Health Service Orthopaedic Hospital in Oxford, UK.

Intervention: Subjects were measured using a Kin-Com dynamometer to assess maximum isometric force and a leg extensor power rig to assess maximum single leg explosive power.

Results: Twenty-six patients (mean age: 72 years; SD: 8 years; range: 50–87 years) were included in the study following informed consent. A weak relationship was found between LEP, IQF and pain scores which reached the 5% significance level for the LEP measures only. The level of repeatability for both measures was found to be acceptable.

Conclusion: Both LEP and IQF are recommended as repeatable measures for assessment of muscle function in patients with osteoarthitis of the knee. However, the LEP rig has the added advantage of being quicker, cheaper and simpler to use in the clinical setting.
Outcome of strategy training in stroke patients with apraxia: a phase II study
Authors: van Heugten C M , Dekker J , Deelman B G , van Dijk A J , Stehmann-Saris J C
Published: May 2003

Objective: Evaluation of a therapy programme for stroke patients with apraxia. The programme is based on teaching patients strategies to compensate for the presence of apraxia. This programme was designed for assessment and treatment by occupational therapists.

Design: The outcome was studied in a pre–post test design. Measurements were conducted at baseline and 12 weeks later.

Subjects: Thirty-three stroke patients with apraxia were treated at occupational therapy departments in general hospitals, rehabilitation centres and nursing homes.

Main outcome measures: The following measurements were conducted: an apraxia test, a motor functioning test, observation of activities of daily living (ADL), Barthel Index, and an ADL questionnaire for the therapist and the patient.

Results: The patients showed large improvements in ADL functioning on all measures and small improvements on the apraxia test and the motor functioning test. The effect sizes for the disabilities, ranging from 0.92 to 1.06, were large compared to the effect sizes for apraxia (0.34) and motor functioning (0.19). The significant effect of treatment is also seen when individual improvement and subjective improvement are considered. Measured with the Barthel Index for instance, 71% of the patients improved.

Conclusions: These results suggest that the programme seems to be successful in teaching patients compensatory strategies that enable them to function more independently, despite the lasting presence of apraxia.
Variation in measurements of range of motion: a study in reflex sympathetic dystrophy patients
Authors: Geertzen Jan HB , Dijkstra Pieter U , Stewart Roy E , Groothoff Johan W , Duis Henk Jan Ten , Eisma Willem H
Published: May 2003

Objective: To quantify the amount of variation attributed to different sources of variation in measurement results of upper extremity range of motion, and to estimate the smallest detectable difference (SDD) between measurements in reflex sympathetic dystrophy (RSD) patients.

Design: Two observers each measured in two sessions the range of motion of several upper extremity joints of RSD patients participating in an outcome study.

Setting: Department of Rehabilitation of a university hospital.

Subjects: Twenty-nine upper extremity RSD patients.

Main outcome measures: The range of motion of forward flexion and external rotation of the shoulder, extension, flexion and supination of the elbow, palmar, dorsiflexion and ulnar, radial deviation of the wrist of affected and nonaffected sides, using a two-armed goniometer and an inclinometer. The measurement results were analysed using an analysis of variance according to the generalizability theory.

Results: The results indicate that observer and patient–observer were important sources of variation. The random error was the most important source of variation. Averaged over all ranges of motion the observer contributed 3.9% to the total variation, patient–observer interactions contributed 5.2% and the random error 20.3%. The SDD was smallest for elbow flexion, 7.1° and 9.6° and was largest for external rotation of the shoulder, 24.8° and 28.7°. The SDD was smaller for the nonaffected side as compared to the affected side for the majority of ranges of motion except elbow extension, wrist dorsiflexion, and radial and ulnar deviation.

Conclusion: Clinically, our results indicate that range-of-motion measurements in RSD patients are subject to considerable variation and indicate that results of medical examinations in order to assess disability on the basis of range-of-motion measurements are subject to the same variation.
Functional outcome of patients with spinal cord injury: rehabilitation outcome study
Authors: Schönherr M C , Groothoff J W , Mulder G A , Eisma W H
Published: May 2003

Objective: To increase our knowledge of neurological recovery and functional outcome of patients with spinal cord injuries in order to make more successful rehabilitation programmes based on realistic goals.

Design: Descriptive analysis of data gathered in an information system.

Setting: Rehabilitation centre in The Netherlands with special department for patients with spinal cord injuries.

Subjects: Fifty-five patients with traumatic spinal cord lesions admitted to the rehabilitation centre from 1988 to 1994.

Main outcome measures: The functional improvement was presented in terms of progress in independence in nine daily activity skills. Independence was rated on a four-point scale.

Results: From admission to discharge, lesions in 100% of patients with tetraplegia and 96% of patients with paraplegia remained complete. Significant progress in independence was made in self-care, ambulation and bladder and bowel care. Differences were found in the extent of functional improvement between subgroups of patients with different levels and extent of lesion. Contrary to expectations based on theoretical models, patients with complete paraplegia did not achieve maximal independence in self-care. Independent walking was only attained by patients with incomplete lesions. Regarding outcome of bladder and bowel care, poor results were found, especially the independence in defaecation and toilet transfers.

Conclusions: The results of this study provided more insight into the functional outcome of a group of patients with traumatic spinal cord injury. More research is needed to evaluate the rehabilitation programmes for these patients.
Trunk kinematics in hemiplegic gait and the effect of walking aids
Authors: Tyson Sarah F
Published: May 2003

Objective: To establish baseline measurements of trunk movements during hemiplegic gait, to assess the relationship between trunk movements and walking ability, and to investigate the effect of walking aids on the trunk movements.

Method: Twenty subjects with a chronic hemiplegia from a stroke, who could walk independently, were recruited. Lateral and vertical movements of the pelvis, and symmetry of these movements were measured using CODA (a three-dimensional movement analysis system) as the subjects walked at their own pace without an aid. They were also tested as they walked with a stick and a tripod to assess the effect of different walking aids. Mean values for the trunk movements and symmetry were calculated, Pearson's correlations assessed the relationship between each trunk movement and gait velocity (a measure of overall walking ability), and the influence of the different aids was assessed using a one-way repeated measures ANOVA.

Results: Lateral displacement was large (mean = 9.9 cm, SD 3.9) and orientated to the sound side, vertical displacement was small (mean = 2.45 cm, SD 1.4). The movements showed marked asymmetry which favoured the hemiplegic side in that there was less movement of, or towards this side. There was a significant relationship (at 5% level) between walking ability and lateral movements (r= 0.6), but not vertical movements (r= 0.41). No significant differences were found with the different aids.

Conclusion: These results give baseline values for trunk movements during hemiplegic gait and the relationship between the movements and walking ability. The use of walking aid and the type of walking aid did not affect the subjects' trunk movements or walking ability.
Repeatability of goniometer measurements of the knee in patients wearing an Ilizarov external fixator: a clinic-based study
Authors: Barker K L , Lamb S E , Burns M , Simpson A HRW
Published: May 2003

Objective: To examine the intra-tester and inter-tester reliability of three different methods of measurement of knee range of motion in patients undergoing limb reconstruction with the Ilizarov external fixator.

Design: Twenty-five patients had the passive range of motion of their knee measured by 13 physiotherapists who were experienced in the use of goniometry. The testers were assigned into random pairs, each tester measured three or four patients who were allocated to them using the three different methods. These were: (1) a universal goniometer aligned against anatomical landmarks, (2) a universal goniometer aligned against the Ilizarov frame and (3) a modified universal goniometer.

Setting: Orthopaedic limb reconstruction outpatient clinics.

Subjects: Twenty-five patients undergoing limb reconstruction using an Ilizarov external fixator on both the femur and tibia.

Results: Comparison of the three different goniometry methods showed that using a modified goniometer there was enhanced reliability compared with other methods. This method demonstrated good repeatability for both intra-tester and inter-tester measurements.

Conclusions: When serial measurements of knee range of motion are taken in patients wearing an Ilizarov external fixator the modified model of goniometer should be used.
Screening for mobility disorders by the Mobility Control subscale of the short version of the Sickness Impact Profile
Authors: Jannink-Nijlant J MM , Diederiks J PM , Brouwers M AH , Metsemakers J FM
Published: May 2003

Objective: To test the usefulness of the Mobility Control subscale (MC scale) of the short version of the Sickness Impact Profile (SIP68) as a simple self-administered questionnaire for screening mobility disorders in a population of independent living elderly.

Design: The SIP68-MC scale was compared with the results of one functional test as independent criteria.

Subjects and setting: A group of 81 people of 70 years and older was selected from a potential population of over 200 people. All were independent living elderly persons selected from a general practice.

Interventions: The short version of the Sickness Impact Profile and questions about falling last year were applied. Three functional tests were carried out: walking 10 metres, get up and sit down in a chair five times and a test for standing balance. A trained observer rated all tests.

Results: It is shown that the sensitivity of the MC scale (cut-off point: 1) with the total functional score is 91%, with a relative low specificity (59%). The relationship between the SIP-MC score and falling frequency is significant when there is a falling frequency equal to or more than two times a year. Conclusion: It is concluded that the MC scale is a useful test for screening mobility disorders in the elderly.
Effect of calcitonin on bone and connective tissue metabolism in hemiplegic patients: a two-year prospective study
Authors: Uebelhart Daniel , Hartmann Daniel J , Barbezat Sylva , Mermillod Bernadette , Chantraine Alex
Published: May 2003

Objectives: To test the effects of 200 IU/day of a nasal spray of salmon calcitonin in modulating the increased bone tissue metabolism observed in hemiplegic patients.

Design: A two-year, prospective, randomized, double-blind, placebo-controlled study.

Patients: Thirty-four patients with hemiplegia due to a cerebrovascular accident were included in the study during the first month after onset of hemiplegia after giving their informed consent. All patients followed a suitably planned course of active rehabilitation according to Bobath. They were randomly allocated to either the calcitonin or the placebo group but all of them received a daily oral calcium supplementation of 1000 mg.

Results: Biochemical markers of bone formation, serum total alkaline phosphatase, osteocalcin and type I procollagen did not vary during the two years of follow-up. Cross-linked carboxy-terminal telopeptide of type I collagen, a biochemical marker of bone resorption, was elevated initially after stroke and then decreased significantly (p <0.001), stabilizing as of month 12. Urinary calcium/creatinine and total hydroxyproline/creatinine ratios presented with similar profiles. The serum levels of the type III procollagen, a marker of connective tissue metabolism, were also elevated upon entry and decreased thereafter. No significant difference could be found between the calcitonin-treated and the placebo group for any of the biochemical markers at any time point.

Conclusion: This prospective study demonstrated that biochemical markers of bone and connective tissue metabolism were elevated shortly after the occurrence of stroke and then gradually decreased during the first two years after injury. The daily administration of 200 IU of intranasal calcitonin did not influence the levels of these markers.
Rivermead Mobility Index: a brief review of research to date
Authors: Forlander David A , Bohannon Richard W
Published: May 2003

Objective: To determine the extent of use of the Rivermead Mobility Index (RMI) in published research and document findings relevant to the RMI in that research.

Design: Literature search and document analysis.

Results: Eight research articles in which the RMI was used were found. The RMI was described as reliable, correlated with other published scales, and responsive to changes over time.

Conclusions: The RMI possesses characteristics desirable in a measurement scale. It warrants broader application.
Social reintegration after stroke: the first stages in the development of the Subjective Index of Physical and Social Outcome (SIPSO)
Authors: Trigg Richard , Wood Victorine A , Hewer Richard Langton
Published: May 2003

Objective: To ensure at outset the content validity of a measure (to be developed) of social integration following stroke.

Design: Qualitative study, using in-depth interviews with patients at least six months following stroke.

Setting: Community setting, Bristol, UK.

Subjects: Thirty survivors of stroke, discharged at least six months previously from a neurological rehabilitation unit in a district general hospital.

Results: Patients reported a change, usually for the worse, in their levels of integration following stroke. More specifically they alluded to a decrease in both the quantity and quality of activities, especially with regard to leisure and those activities occurring outside the home. Social interaction was reduced in most patients, in terms of frequency and quality of contact. From the data, six dimensions of change in quality of interaction emerged. Finally, changes in patients' physical and financial environments were reported. Based on the findings, four diagrams were developed, providing a structure for questionnaire development.

Conclusions: The results of this study confirm the findings of previously reported research. An individual's level of social integration can be affected by stroke in a wide variety of areas and along many different dimensions. Data from this study have highlighted the importance of the patient's subjective impression of the quality of both functional and social performance. This has provided the opportunity to develop a questionnaire based on the patient's perspective, rather than that of health professionals.
Adrenocorticotropic Hormone Directly Stimulates Testosterone Production by the Fetal and Neonatal Mouse Testis
Authors: O’Shaughnessy P. J. , Fleming L. M. , Jackson G. , Hochgeschwender U. , Reed P. , Baker P. J.
Published: May 2003

Adult Leydig cell steroidogenesis is dependent on LH but fetal Leydig cells can function independently of gonadotropin stimulation. To identify factors that may be involved in regulation of fetal Leydig cells expressed sequence tag libraries from fetal and adult testes were compared, and fetal-specific genes identified. The ACTH receptor [melanocortin type 2 receptor (Mc2r)] was identified within this fetal-specific group. Subsequent real-time PCR studies confirmed that Mc2r was expressed in the fetal testis at 100-fold higher levels than in the adult testis. Incubation of fetal or neonatal testes with ACTH in vitro stimulated testosterone production more than 10-fold, although ACTH had no effect on testes from animals aged 20 d or older. The steroidogenic response of fetal and neonatal testes to a maximally stimulating dose of human chorionic gonadotropin was similar to the response shown to ACTH. The ED50 for ACTH, measured in isolated fetal and neonatal testicular cells, was 5 × 10−10m and the lowest dose of ACTH eliciting a response was 2 × 10−11m. Circulating ACTH levels in fetal mice were around 8 × 10−11m. Neither α-MSH nor γ-MSH had any effect on androgen production in vitro at any age. Fetal testosterone levels were normal in mice that lack circulating ACTH (proopiomelanocortin-null) indicating that ACTH is not essential for fetal Leydig cell function. Results show that both LH and ACTH can regulate testicular steroidogenesis during fetal development in the mouse and suggest that fetal Leydig cells, but not adult Leydig cells, are sensitive to ACTH stimulation.
Formation of the breaking surface of alumina in laser cutting with a controlled fracture technique
Authors: Tsai C-H , Chen C-J
Published: May 2003

Laser cutting using the controlled fracture technique is based on the thermal breaking principle. The laser beam is applied to the surface of a ceramic substrate; the substrate is then controllably separated along the moving path of the laser beam. The fractography and cutting surface formation are studied in this work. It is found that the breaking surface can be divided into four regions. The first region is the laser evaporation region produced by the heat concentration. The second region is the columnar grain region produced by resolidification of the melted material. The third region is the intergranular fracture region produced by anisotropic thermal expansion. The fourth region is the transgranular fracture region characterized by unstable fractures. These experiments are conducted on alumina ceramics using a CO2 laser. The fracture mechanism is analysed using stress analysis and fractographic observation. The tensile stress generated on the surface due to the laser beam separates the material along its path. The effects of the cutting parameters such as the laser power, cutting speed, laser spot diameter and specimen geometry on the machining quality are obtained from the experimental analysis. It is concluded that the best cutting quality is obtained using a large laser spot size.
Victimization in the school and the workplace: Are there any links?
Authors: Smith Peter K. , Singer Monika , Hoel Helge , Cooper Cary L.
Published: May 2003

We examine whether reported roles in school bullying, and victimization in the workplace, are connected; the influence of victim coping strategies at school; and sex differences. A questionnaire was completed by 5,288 adults from various workplace venues in Great Britain. We analysed two questions on school experiences (participant role; coping strategies if bullied) and questions on workplace bullying (experiences of being bullied). We found a significant relationship between reported roles in school bullying, and experience of workplace victimization. The highest risk of workplace victimization was for those who were both bullies and victims at school (bully/victims), followed by those who were only victims. An analysis of relative risk of workplace bullying, given being a victim at school plus using various coping strategies, revealed an increased risk for the strategies ‘tried to make fun of it’, and ‘did not really cope’. Women were at slightly higher risk of getting bullied at work, but there were no interactions with roles at school, and only one interaction with coping strategies. This is the first study to report an association between school and workplace bullying. Victims at school are more at risk of workplace victimization, but the especial risk for ‘bully/victims’ supports other indications that this particular category of school pupils should be a focus of concern. The findings also suggest that school pupils who consistently cannot cope with bullying, or try to make fun of the bullying, are more at risk for later problems in the workplace. However, associations are modest; many victims of school bullying are not being victimized in later life, and the results also suggest important contextual or environmental effects on risks of victimization.
Kinetics of hydrolysis and alcoholysis of poly(methacryloyl chloride)
Authors: Połowiński St.
Published: April 2003

The kinetics of hydrolysis and alcoholysis of poly(methacryloyl chloride) (PMC) in homogeneous acetone‐water systems has been studied. First order rate constants and activation energies of the reaction were calculated. It was found that the rate constants of hydrolysis and alcoholysis of the side groups in PMC were considerably lower than those in low molecular weight compounds. Higher rate constants were also observed in the case of hydrolysis of poly(acryloyl chloride). The activation energies found were low, which in comparison with other results indicates the effect of polymer flexibility and diffusion processes on the reaction under investigation.
Zum Umsatz des Monomers Hexamethyldisiloxan in siliciumorganisches Schichtmaterial bei der Glimmpolymerisation
Authors: Schulz K.‐D. , Schmidt M.
Published: April 2003

Durch Ausmessen der Profile der Schichtabscheidungsrate entlang der Wand durchströmter langer Entladungsrohre lassen sich deren Abhängigkeiten von den verschiedenen Parametern diskutieren. Speziell die Auswertung des Umsetzungsgrades liefert wichtige Aussagen zum Mechanismus der Glimmpolymerschichtbildung.
Mechanochemically initiated copolymerizations. 5. Characterization of some binary and ternary copolymers obtained mechanochemically by vibratory milling
Authors: Oprea C. V. , Popa M.
Published: April 2003

Vibratory milling proved to be a method of mechanochemical initiation of some copolymerization reactions for binary and ternary systems of vinyl comonomers. Some physico‐chemical properties of the copolymers obtained by this method are presented. The structure of the reaction products was characterized by means of IR and ESR spectroscopy, vapourphase osmometry and elemental analysis.
Potentialuntersuchungen an Polyvinylacetat‐latices. II
Authors: Hergeth W.‐D. , Schmutzler K.
Published: April 2003

Der Einfluß von Initiator‐ und Elektrolytkonzentration auf die Oberflächenladungsdichte von Polyvinylacetat‐Kolloiden wurde untersucht. Auf der Partikeloberfläche konnten nur Sulfatendgruppen nachgewiesen werden. Bei pH > 3 tritt keine spezifische Wasserstoffionenadsorption auf.
Kernspinrelaxationsuntersuchungen zum Einfluß von Verhakungen in Polyethylenschmelzen
Authors: Geschke D. , Pöschel K. , Eckhardt G. , Brauer E.
Published: April 2003

An langkettenverzweigten Polyethylenen niederer Dichte wird untersucht, welchen Einfluß frei bewegliche kleine bzw. bewegliche Teile großer Moleküle auf den Verlauf der transversalen Relaxationsfunktion der Polymerschmelze besitzen.
1H‐NMR‐spektroskopische Untersuchungen zum Glykoleinbau in gesättigten und ungesättigten Polyestern
Authors: Herrmann D. , Kimmer W. , Sauer W.
Published: April 2003

Eine Methode zur quantitativen Bestimmung des Polyglykolgehaltes in Polyestern aus 1H‐NMR‐spektroskopischen Daten wird beschrieben. Durch Einbeziehung der Säurezahl und der Molmasse können weitere Aussagen zum Kettenaufbau des Polyesters, wie Funktionalität, Verhältnis von Säure‐/Glykol‐Kettenenden und mittlere Anzahl Säureund Glykolbausteine im Polyester, gemacht werden.
Anti–GM1 IgG antibodies induce leukocyte effector functions via Fcγ receptors
Authors: van Sorge Nina M. , van den Berg Leonard H. , Geleijns Karin , van Strijp Jos A. , Jacobs Bart C. , van Doorn Pieter A. , Wokke John H. J. , van de Winkel Jan G. J. , Leusen Jeanette H. W. , van der Pol W‐Ludo
Published: April 2003

Guillain–Barré syndrome (GBS) is an immune‐mediated neuropathy, in which leukocytes and humoral components of the immune system proposedly initiate localized inflammation. An important pathogenic role for anti–GM1 ganglioside antibodies has been suggested. Therefore, we evaluated anti‐GM1 IgG antibody‐induced leukocyte effector functions such as degranulation and phagocytosis using serum of 24 GBS patients. Serum without anti‐GM1 antibodies of 9 GBS patients as well as pooled serum from healthy individuals served as controls. Ten out of 15 (67%) of anti‐GM1 IgG positive sera were capable of inducing leukocyte degranulation, and 8 out of 15 (53%) of anti‐GM1 IgG positive sera were capable of inducing phagocytosis of GM1‐coated beads. In all of these sera anti‐GM1 antibody titers were ≥1:800. No leukocyte degranulation or phagocytosis was observed in control sera. Leukocyte activation was completely abrogated in the presence of IgG receptor (FcγR) blocking antibodies, suggesting a crucial role for leukocyte FcγR in GBS pathogenesis. No correlation of antibody titers with the extent of leukocyte activation, or severity of disease was observed. These data document the capacity of anti‐GM1 IgG antibodies to activate leukocyte inflammatory functions, and suggest an important role for anti‐ganglioside IgG antibodies in the pathogenesis of GBS.
Diminished auditory mismatch fields in dyslexic adults
Authors: Renvall Hanna , Hari Riitta
Published: April 2003

Electroencephalographic studies have demonstrated smaller auditory responses to infrequent deviances of speech and nonspeech sounds in dyslexic than normal‐reading subjects. We used a whole‐scalp neuromagnetometer to study selectively reactivity of the auditory cortices to sound deviances in 8 dyslexic and 11 normal‐reading adults. Within a monotonous sequence of 50‐millisecond 1,000Hz binaural tones, tones of 920 and 1,080Hz occurred with 7% probability each. Magnetic mismatch fields, elicited by the stimulus deviances, were diminished in the left hemisphere of the dyslexic subjects. The results indicate deficient change detection in the left auditory cortex of right‐handed dyslexic adults. Ann Neurol 2003
Parkin mutations and susceptibility alleles in late‐onset Parkinson's disease
Authors: Oliveira Sofia A. , Scott William K. , Martin Eden R. , Nance Martha A. , Watts Ray L. , Hubble Jean P. , Koller William C. , Pahwa Rajesh , Stern Matthew B. , Hiner Bradley C. , Ondo William G. , Allen Fred H. , Scott Burton L. , Goetz Christopher G. , Small Gary W. , Mastaglia Frank , Stajich Jeffrey M. , Zhang Fengyu , Booze Michael W. , Winn Michelle P. , Middleton Lefkos T. , Haines Jonathan L. , Pericak‐Vance Margaret A. , Vance Jeffery M.
Published: April 2003

Parkin, an E2‐dependent ubiquitin protein ligase, carries pathogenic mutations in patients with autosomal recessive juvenile parkinsonism, but its role in the late‐onset form of Parkinson's disease (PD) is not firmly established. Previously, we detected linkage of idiopathic PD to the region on chromosome 6 containing the Parkin gene (D6S305, logarithm of odds score, 5.47) in families with at least one subject with age at onset (AAO) younger than 40 years. Mutation analysis of the Parkin gene in the 174 multiplex families from the genomic screen and 133 additional PD families identified mutations in 18% of early‐onset and 2% of late‐onset families (5% of total families screened). The AAO of patients with Parkin mutations ranged from 12 to 71 years. Excluding exon 7 mutations, the mean AAO of patients with Parkin mutations was 31.5 years. However, mutations in exon 7, the first RING finger (Cys253Trp, Arg256Cys, Arg275Trp, and Asp280Asn) were observed primarily in heterozygous PD patients with a much later AAO (mean AAO, 49.2 years) but were not found in controls in this study or several previous reports (920 chromosomes). These findings suggest that mutations in Parkin contribute to the common form of PD and that heterozygous mutations, especially those lying in exon 7, act as susceptibility alleles for late‐onset form of Parkinson disease. Ann Neurol 2003