bluuebunny/crossref_metadata_2025 huggingface dataset:
Correction for gravity in isokinetic dynamometry of knee extensors in below knee amputees
Authors: Van der Leeuw GH , Stam HJ , Van Nieuwenhuyzen JF
Published: August 2024

In isokinetic dynamometry of the knee extensors the influence of gravity on the lower limb is often neglected. The aim of this study was to assess the shape, the quantity and reproducibility of the gravity correction curve (GCC). Eight amputees participated in this study. The GCC was produced on an isokinetic dynamometer (QD) throughout the range of motion on the amputated side with prosthesis and on the non-amputated side. The results were compared with the GCC calculated according to the Cybex data reduction computer procedure. The isokinetic torque registration of the QD is, in a mathematical way, a straight line (Pearson correlation coefficient greater than 0.99). The other GCC is shaped like a cosinus curve. The intra-individual reproducibility is high, the inter-individual variability substantial. An explanation for the difference between the two methods is discussed. For an ideal measurement of the muscular torque, one should not only correct for the effect of gravity but for all factors counteracting the effect of the knee extensors. In that case an individual GCC should be made directly with the dynamometer.
The Swedish back school in chronic low back pain. Part I. Benefits
Authors: Hurri H.
Published: August 2024

The aim of this 12-month follow-up study was to evaluate the effect of the Swedish-type back school in chronic low back pain. 188 subjects completed the study (95 in the treatment group and 93 in the control group). The following were assessed: 1) subjective scores of pain and disability; 2) clinical measurement and evaluation including spinal mobility and strength measurement; 3) number and length of sick-leaves. At 12 months, subjective scores of pain and disability, and mobility of the lumbosacral section of the spine showed differences in the favour of the treatment group. There was no difference, however, in the number or the length of sick-leaves after the back school. It was concluded that patients with chronic or recurrent low back pain may get relief of subjective symptoms of low back pain from the back school. In addition to chronicity, there may be other factors affecting the outcome of treatment.
Isokinetic muscle torque in the dorsiflexors of the ankle in children 6-15 years of age. Normal values and evaluation of the method
Authors: Bäckman E , Oberg B.
Published: August 2024

Isokinetic muscle torque of the dorsiflexors of the ankle was tested in 137 children 6-15 years old. Reference values in different age groups are given for girls and boys separately. Generally, peak torque values increased with age. However, the developed torque/kg bodyweight showed no significant difference in 15-year-old girls compared to 12-year-old girls. For prediction of normal torque the best parameters are age, weight and height. The maximal torque and work values generally increased with increasing weight and height. The prediction was not improved by adding factors like length of the lower leg, calf circumference and length of the foot. In the youngest age groups, the stronger leg, in the highest velocities, was on the dominant side, while in the older groups the strongest leg, at least in slow velocities, was on the non-dominant side. The boys seem to have their most intensive force development between 12 and 15 years while this occurs earlier in girls.
Isokinetic strength, macro EMG and muscle biopsy of paretic foot dorsiflexors in chronic neurogenic paresis
Authors: Tollbäck A , Borg J , Borg K , Knutsson E.
Published: August 2024

Ten ambulatory patients with chronic dorsiflexor paresis due to prior poliomyelitis or lumbar root (LV) lesion and without recent decline of the foot dorsiflexor strength were examined with isokinetic strength measurement, macro EMG and muscle biopsy. Isokinetic strength measurement showed peak torques at 30 degrees/s angular velocity ranging 6-44 Nm and at 240 degrees/s 1-10 Nm. Mean of individual median macro EMG motor unit potential amplitudes was 2020 microV (SD 1040) which was 5-10 times higher than expected values in healthy subjects. Muscle biopsies showed a mean type 1 fibre proportion of 91% (SD 14) and a mean type 1 fibre area of 8561 microns 2 (SD 2773) which was about 2 times larger than those observed in healthy subjects. Peak torque and both motor unit potential amplitude and area were inversely correlated at 30 (p < 0.01 and p < 0.025), 60 (p < 0.025 and p < 0.025) and 120 (p < 0.05 and p < 0.05) degrees/s angular velocity, as were peak torque and type 1 muscle fibre proportion at 30 (p < 0.05) and 60 (p < 0.05) degrees/s angular velocity. Peak torque or macro EMG parameters were not correlated to muscle fibre area. The data suggest that the remaining muscle strength was directly correlated to the degree of collateral sprouting and that about half of it could be attributed to compensatory muscle fibre hypertrophy.
Effect of preoperative physiotherapy in unicompartmental prosthetic knee replacement
Authors: Weidenhielm L , Mattsson E , Broström LA , Wersäll-Robertsson E.
Published: August 2024

The purpose of this study was to analyse the effects of preoperative physiotherapy on pain and function in 39 patients scheduled for unicompartmental prosthetic knee replacement. Nineteen patients were selected at random to receive preoperative physiotherapy. The control group received no preoperative therapy. Evaluations were performed 3 months prior to surgery, immediately before and 3 months after operation. Evaluations included: Clinical assessment, measurements of the knee muscle strength, self-selected walking speed and the oxygen cost of walking. Three months before surgery the patients in both groups had similar types and levels of problems. Before surgery patients who had received physiotherapy showed slight improvements in pain, perceived stability of the knee during walking, and faster self-selected and maximal walking speeds compared to the control group, but were unchanged in muscle strength, ROM, and oxygen cost. Three months after surgery pain was significantly decreased in all patients, however, no significant differences were found between the two groups for any variable except muscle strength. This was unchanged compared to preoperative values for patients of the control group while patients who received preoperative physiotherapy showed a decrease in strength. In summary, this study did not disclose any major benefit from the program of preoperative physiotherapy tested.
Impact of knee extensor strength deficits on stair ascent performance in patients after medial meniscectomy
Authors: Moffet H , Richards CL , Malouin F , Bravo G.
Published: August 2024

After arthroscopic meniscectomy the relationship between the magnitude of knee extensor strength deficits and locomotor performance during stair ascent unloaded and when carrying a 22 kg load has been tested in 31 patients. The specific locomotor adaptations related to large strength deficits were also studied. The results indicate that large deficits were significantly associated to: 1) reduced activation of the knee extensor muscles (vastus medialis and lateralis) during the first double leg support and single leg support phases, and of the hip extensors (medial hamstrings) during the second double leg support of stair ascent, 2) overactivations of the hip extensors (gluteus maximus and medial hamstrings) during single leg support, and 3) longer cycle and step durations and lower cadences. Locomotor abnormalities in movements and muscle activations were generally found in patients with strength deficits greater than 25% while patients with smaller strength deficits (less than 25%) usually could climb stairs with normal performance. These results support the use of knee extensor strength measures to predict locomotor capacities, and also highlight the importance of postoperative knee strength rehabilitation.
A new nasal mask for nocturnal home ventilation in chronic neuromuscular disorders
Authors: Klefbeck B , Remmer L , Weinberg J , Borg J.
Published: August 2024

A new nasal mask for nocturnal, intermittent positive pressure ventilation was used by patients with symptomatic sleep hypoventilation due to chronic neuromuscular disorders. The custom-fabricated mask is cast in visible light curing acrylic from a plaster model. Air is delivered through plastic tubes cast in the mask. The treatment was introduced through close cooperation between a physiotherapist and a technician. Evaluation was performed after 4-34 months' regular use. The mask was well tolerated. All patients reported comfortable sleep and symptom relief. The effectiveness was confirmed by whole-night measurements of oxygen saturation and end-tidal carbon dioxide.
Comparison of the Jamar dynamometer and the Martin vigorimeter for grip strength measurements in a healthy elderly population
Authors: Desrosiers J , Hébert R , Bravo G , Dutil E.
Published: August 2024

Grip strength is considered to be a good indicator of upper limb strength. The Jamar dynamometer and the Martin vigorimeter are two instruments frequently used to assess grip strength in clinical and research settings. The purpose of this study was to compare these instruments for assessing grip strength in 360 people aged 60 to 94 years, randomly selected from the electoral list. Anthropometric data were also collected. Data analyses were done using the maximum value on 3 trials with each instrument. Although the Martin vigorimeter is a pressure measure implying a dynamic movement as opposed to the static strength measure of the Jamar dynamometer, results indicate a very high correlation between the two measures. Grip strength measured by the Jamar dynamometer is even more dependent on hand anthropometry than measurements with the Martin vigorimeter.
A comparison of symptoms between Swedish and American post-polio individuals and assessment of lower limb strength--a four-year cohort study
Authors: Agre JC , Grimby G , Rodriquez AA , Einarsson G , Swiggum ER , Franke TM.
Published: August 2024

A cohort study with initial and 4-year follow-up evaluations was performed in 78 post-polio volunteers aged 34-65 years at the time of enrolment in the study, which was made to compare post-polio individuals living in Sweden and the United States, to determine whether lower limb musculature becomes weaker over time, and to determine whether individuals with complaints of post-polio syndrome, new weakness, fatigue, walking or stair climbing difficulty were weaker or lost more strength over a 4-year interval than those individuals without such complaints. Dynametrically-measured knee extensor and flexor strength and questionnaire data were obtained initially and 4 years later. The two cohorts were fairly similar, though they differed in weight gain. The Americans gained significantly (p < 0.05) more weight than the Swedish subjects. Both groups lost significant (p < 0.05) knee extensor strength (approximately 8%), but the loss was not significantly (p < 0.05) different between the groups. Knee flexor strength did not change significantly (p < 0.05) over time. Subjects acknowledging new strength loss were not significantly (p < 0.05) weaker than those denying strength loss; however, they lost significantly (p < 0.05) more isometric knee extensor strength than the other individuals. Subjects acknowledging new fatigue, walking or stair climbing difficulty were significantly (p < 0.05) weaker in both muscle groups than those without such complaints. Subjects acknowledging post-polio syndrome were significantly (p < 0.05) weaker than those denying this symptom, but the amount of loss of strength over time was not significantly (p < 0.05) different. We conclude that the two cohorts were quite similar. Knee extensor strength decreased during the study interval. Individuals acknowledging post-polio syndrome had weaker knee extensor musculature. Subjects with new fatigue, walking difficulty, or stair climbing difficulty were weaker in both the knee extensors and the knee flexors than the other subjects. Subjects reporting new muscle weakness also had a greater decline in isometric knee extensor strength during the study interval than those without such complaint.
Restoration of gait by combined treadmill training and multichannel electrical stimulation in non-ambulatory hemiparetic patients
Authors: Hesse S , Malezic M , Schaffrin A , Mauritz KH.
Published: August 2024

Functional electrical stimulation and treadmill training with partial body weight support through suspension by a parachute harness were combined for gait restoration in 11 chronic non-ambulatory hemiparetic patients. Individually adjusted multichannel stimulation of the trunk and of upper and lower limb muscles, as well as a motor driven treadmill, induced functional gait within 3 to 6 weeks. The improvement of gait ability was assessed by the Functional Ambulation Category test. Other motor functions were rated by the Rivermead Motor Score. The leg muscle strength, stride length, cadence, gait velocity and gait pattern were recorded. In seven of the patients, we did a single case research A-B-A study that showed that this combined approach had advantages, in regard to gait restoration and walking velocity (p
Otoneurologic and audiologic findings in fibromyalgia
Authors: Rosenhall U , Johansson G , Orndahl G.
Published: August 2024

Patients with fibromyalgia were studied with otoneurological and audiological tests. Altogether 168 patients (141 women) participated. Vertigo/dizziness was reported by 72% of the patients. Sensorineural hearing loss was found in 15% of the cases. Auditory brainstem responses (ABR) and oculomotor tests were applied, and statistical comparisons between patients and controls were performed. Significant differences were found for the absolute latency of wave V and for the I-V and III-V interpeak latencies, indicating brainstem dysfunction. Abnormal ABR recordings were found in 30% of the cases. In the oculomotor study the mean velocity gain for the smooth pursuits and the mean saccadic latency were significantly different between patients and controls. Abnormal saccades were seen in 28% and pathological smooth pursuit eye movements in 58% of the patients. Electronystagmography was pathological in 45% of the cases. The findings indicate that CNS dysfunction frequently occurs in patients with fibromyalgia, although proprioceptive disturbances might also explain some of the abnormalities observed.
A 5-year psycho-medical follow-up study of coronary by-pass artery graft patients
Authors: Líndal E , Hartharson P , Magnússon J , Alfrethsson H.
Published: August 2024

This is a 5-year follow-up study of coronary artery by-pass graft (CABG) patients. Our aim was: To study the development of previously rated psycho-medical aspects, with special reference to depression among the CABG patients. The patients were sent two questionnaires, one of which focused on psycho-medical factors and the other on depression. The average rate of participation was 80%. The most important results were that previously high levels of depression were no longer to be found and that post-operative depression among the CABG patients clearly disappears over time.
Predominance of postural imbalance in left hemiparetic patients
Authors: Rode G , Tiliket C , Boisson D.
Published: August 2024

Postural sway characteristics in a group of 15 left hemiparetic patients were compared with those in a group of 15 right hemiparetic patients using a statokinesimetric platform. The results in the two patient groups were also compared with those derived from a group of 15 age-matched healthy control subjects. Three postural sway parameters were used: the total sway area, the anteroposterior sway and the lateral sway. Hemiparetic patients showed a larger sway area and a lateral displacement of the center of pressure toward the side of the lesion compared to normal subjects. Furthermore, left hemiparetic patients showed greater sway area and lateral displacement compared to right hemiparetic patients. We suggest that the predominance of postural imbalance in left hemiparetic patients could be due to a displacement of postural reference toward the lesion's side.
Factors influencing vocational outcomes following stroke in Taiwan: a medical centre-based study
Authors: Hsieh CL , Lee MH.
Published: August 2024

This study was aimed at identifying the factors relating to return to work for stroke patients of working age in Taiwan, adjusting for confounding factors. A retrospective cohort study was used to test the association between patients' characteristics, such as medical condition at admission and sociodemographic factors, and the degree of return to work after stroke. Two hundred and forty-eight consecutive stroke survivors discharged from the National Taiwan University Hospital participated in the follow-up survey. Variables considered likely to influence return to work were collected from the patients' hospital records. Vocational outcomes were collected via questionnaire. Return to work was classified into four levels: (I) no return to work; (II) limited return to work; (III) partial return to work; and (IV) complete return to work. Of the 248 subjects surveyed, 105 (42.7%) subjects had not returned to work, 32 (12.9%) subjects had returned to work on a limited basis, 43 (17.3%) subjects had partially returned, and 68 (27.4%) subjects had returned to work completely. Cramer's V test and stepwise logistic regression were employed to examine factors influencing return to employment. Maximum weakness and employment institution were identified as the strongest predictors of return to work. In brief, nearly three-quarters of the patients did not resume their usual work roles after stroke. Maximum weakness and employment institution were the strongest predictors of return to work following a stroke in Taiwan.
Peripheral muscle training in patients with clinical signs of heart failure
Authors: Cider A , Tygesson H , Hedberg M , Seligman L , Wennerblom B , Sunnerhagen KS.
Published: August 2024

The aim of the study was to evaluate, in a controlled setting, the effects of a 5-month dynamic peripheral training programme in patients with clinical signs of congestive heart failure with special reference to their anaerobic threshold, muscle function, heart rate variability and quality of life. Twenty-four randomized patients with clinical signs of heart failure in NYHA II-III entered the study. Training resulted in a significant (p = 0.01) change in the anaerobic threshold, the patients' ability to lift weights (p = 0.01) and performance of heel-lift (p = 0.01). The heart rate recorded during the training exercises decreased significantly (p = 0.04). There were no significant differences in peak oxygen uptake, isokinetic and isometric strength, HRV and quality of life except for three items in the control group. The results of this study indicate that peripheral training is beneficial for patients with clinical signs of congestive heart failure.
Prediction of recovery from upper extremity paralysis after stroke by measuring evoked potentials
Authors: Hendricks HT , Hageman G , Van Limbeek J.
Published: August 2024

Paralysis of the upper extremity is a severe motor impairment that can occur after stroke. Prediction of recovery from paralysis is difficult and is primarily based on subjective clinical evaluation. However, the integrity of the sensorimotor system can be assessed objectively and quantitatively by measuring evoked potentials. In this retrospective exploratory study, we evaluated the predictive value of motor and somatosensory evoked potentials for recovery from paralysis of the upper extremity. Motor and somatosensory evoked potentials were recorded in 29 patients who had had their first-ever infarction in the territory of the middle cerebral artery and who exhibited paralysis of the upper extremity. At follow-up, seven patients showed motor recovery. The evoked potential data were dichotomized into present or absent and related to the occurrence of motor recovery. Analysis revealed a significant association between the presence of evoked potentials early after stroke and the observed occurrence of motor recovery. These results suggest strongly that evoked potentials predict the occurrence of motor recovery of upper extremity paralysis in patients suffering from first-ever infarction in the territory of the middle cerebral artery.
Measures of individual and group changes in ordered categorical data: application to the ADL staircase
Authors: Sonn U , Svensson E.
Published: August 2024

The aim was to describe the application of a non-parametric method to a study of changes in activities of daily living (ADL) measured by a 10-level ordinal scale, the Staircase of ADL, in a population of 70-year-old persons followed to the age of 76 (n = 371). The statistical method takes account of the fact that change cannot be defined by differences and can separately measure the level of change for the group and for the individuals. This is demonstrated step by step. Measures of change for the subgroups, men and women, are also given. As a group, there was a systematic increase in ADL dependence between the ages of 70 and 76 years. The individual pattern of change was more dispersed between 73 and 76 years of age. Individual variations in ADL changes with increasing age were small compared to the systematic change for ADL for the subgroups of men and women. The systematic change in ADL follows a pattern with "one step at a time" for women and "many steps at a time" for men. In conclusion, this new statistical method provides a valuable tool for detailed information of individual as well as group changes in longitudinal studies.
Hip stress during lifting with bent and straight knees
Authors: Luepongsak N , Krebs DE , Olsson E , Riley PO , Mann RW.
Published: August 2024

"Correct" body mechanics during lifting are believed to protect the back by employing knee and hip flexion while keeping the back straight. Lower limb joint stress, however, has been largely ignored. We compared hip cartilage contact stress during "leg lifting" with "back lifting" (lifting with bent or straight knees, respectively) in a subject fitted with a pressure instrumented hip endoprosthesis. Synchronized pressure data and whole-body kinematics and kinetics were collected simultaneously while the subject lifted an 11.8 kg mass from the floor to waist level. The highest pressure, 13.7 MPa, occurred during leg lifting at the antero-lateral femoral head transducers opposed at maximum hip flexion by the postero-superior quadrant of acetabular cartilage. In back lifting, the highest pressure, 11.5 MPa occurred in the supero-lateral aspect of the head, which during hip extension was opposed by the posterior quadrant of the acetabulum. Maximum pressures and hip torques occurred simultaneously with peak hip flexion, during the initial lifting of the burden from the floor. Acetabular contact pressures during leg lifting were on average twice as great as during back lifting, and both techniques generate much greater hip stress than gait (typically 4-6 MPa). Degenerative changes in the articular surface of the acetabulum occur primarily on the postero-superior aspect, corresponding to the locations of peak contact pressures in the present in vivo data. Thus leg lifting puts more stress on the postero-superior region, and probably contributes to more hip cartilage degeneration, than does back lifting. We conclude that although leg lifting may mechanically protect the back, it substantially increases hip cartilage stress.
Gait analysis, isokinetic muscle strength measurement in patients with Parkinson's disease
Authors: Pedersen SW , Oberg B , Larsson LE , Lindval B.
Published: August 2024

The aim of this study was to describe motor performance in Parkinson patients in relation to controls. Gait, concentric isometric and eccentric strength in the ankle dorsiflexors were investigated in 25 patients with Parkinson's disease and in 37 control subjects of the same age. In patients concentric torque was significantly lowered but, eccentric torque was significantly lowered in male patients only. Among controls a significant difference in strength was found between sexes. This was not found in the patient group. No correlation between strength tests and clinical ratings was found in the patient group. Patients walked with significantly lower maximum and ordinary velocity, compared with controls. At constant velocity, stride length was shorter, single support had a shorter duration. The duration for heel on to ball on in males was shorter, reflecting the flat foot strike of Parkinson patients. Single support and the duration of heel on to ball on correlated significantly to the clinical ratings in male but not in female patients. In the male group of patients there was a relation between concentric strength on the one hand and gait velocity, stride length and stride frequency on the other. Female patients generally had fewer symptoms and less deviation from their respective controls in the measurements. The comparatively simple neurophysiological tests presented here may be suitable for evaluation of patients with Parkinson's disease.
Neuroaudiological Findings in Chronic Primary Fibromyalgia With Dysesthesia
Authors: Rosenhall U , Johansson G , Orndahl G
Published: August 2024

Thirty-six patients (31 females and 5 males) with "chronic primary fibromyalgia" combined with dysesthesia were studied using neuroaudiological tests. Auditory brainstem response (ABR) was pathological in 11 patients (31%). In six instances the I-V interpeak latency (IPL) was prolonged, in two instances the interaural difference of wave V (IT5) was pathological, and in three instances there was a reduction of the amplitude of wave V. A comparison of the I-V IPLs between the female patient group and a matching control group showed that there was a significant prolongation of this parameter in the patient group. The ABR-findings indicate that a brainstem dysfunction might be present in some patients with fibromyalgia. The results of the impedance audiometric tests were generally normal in the patient group.
Is "handicap" affected by a hospital based rehabilitation programme?
Authors: Roy CW Hunter J
Published: August 2024

"Handicap", categorised according to the ICIDH, and "Disability", measured by the Smith Activities of Daily Living (ADL) Index, were assessed in over 300 patients (suffering from strokes, lower limb amputations, cardiac disorders, low back pain and other diseases) on admission to and after discharge from a hospital based rehabilitation programme. Statistically significant improvements were found in Physical Independence and Mobility Handicaps which correlated with improvements in ADL Self-care (R = 0.58, p less than 0.001) and ADL Mobility (R = 0.53, p less than 0.001) averages. Small but significant improvements were also found in Orientation, Occupation and Social Integration Handicaps but there was no change in Economic Self Sufficiency Handicap. Thus it is possible to use the Handicap categorisations to assess disabled people sequentially during a rehabilitation programme. The problems of data collection, however, are so formidable that its usefulness must be limited.
Gait evaluation in hemiparetic patients using subcutaneous peroneal electrical stimulation
Authors: Kljajić M Malezic M
Published: August 2024

In hemiparetic patients with an implantable peroneal stimulator for correction of drop foot the gait pattern was studied over several years. The gait parameters and M-waves of subcutaneously stimulated muscles were compared with the results obtained before implantation and their variation was observed over time. Of a group of 35 patients with previously implanted electrodes 19 were evaluated. Significant improvements of gait were found although in some cases an excessive eversion of the foot was observed. Nine of these patients had reimplantation because of displacement of the stimulation electrodes after an average time of 3.5 years of proper functioning of the implant. After the reimplantations, similar gait patterns and muscular responses to stimulation were observed as after the initial implantation.
Symmetry of electro- and acoustic myographic activity of the lumbar paraspinal muscles in normal adults
Authors: Wright F Stokes MJ.
Published: August 2024

The symmetry of paraspinal muscle activity was examined in 15 healthy adults (aged 31-60 years). Acoustic myography (AMG), which provides a measure of force, was recorded with electromyography (EMG) to assess electromechanical relationships during contraction. Bilateral recordings of EMG and AMG were made over the paraspinal muscles at the level of the 4th lumbar vertebra during a fatiguing test manoeuvre. Subjects were strapped to a hinged couch in the prone position. When the upper part of the couch was lowered, subjects maintained the upper body (above the anterior, superior iliac spines) unsupported, in the horizontal position for 60 sec. The EMG and AMG signals were full-wave rectified, integrated (IEMG, IAMG) and recorded on an ink-jet oscillograph during the fatigue test. By 60 sec of activity, IEMG had increased (right 122% +/- 8.7; left 125% +/- 11.8; mean +/- 1 SD as a percentage of initial values) while IAMG (reflecting force) remained unaltered (right 99% +/- 8.2; left 100% +/- 5.3). The IAMG:IEMG ratio (reflecting efficiency of activation) thus declined (right 0.81 +/- 0.08; left 0.80 +/- 0.08). The similarly of changes on both sides of the spine have quantified normal symmetry of paraspinal muscle activity and could be used to assess asymmetry in patients with spinal pathology.
Work-related chronic neck impairment. Neck motion analysis in female traverse crane operators
Authors: Alund M Larsson SE
Published: August 2024

Twenty-one female steel industry traverse crane operators with long-term sick-leave (3 (1-8) years) due to chronic neck disability underwent careful analysis of case history, physical status and electrogoniometric three-dimensional recordings of active neck motion. Results were compared with those from working female crane operators having identical work posture and tasks and, further, with a group of working female clerks. The sick-listed crane operators had previous frequent contacts with the primary health care because of complaints from the neck and back. In comparison with the reference groups, the sick-listed crane operators showed tenderness of the trapezius and levator scapulae muscles and a short neck stature in combination with impaired active neck motion range with reduced motion speed. The motion pattern was however unchanged. The findings are consistent with the clinical picture of chronic neck myalgia that persisted despite long-term absence from the previous exposure to high static work load upon the neck-shoulders.
Blood pressure response to detrusor pressure elevation in patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury
Authors: Thyberg M Ertzgaard P
Published: August 2024

In 12 patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury, blood pressure was measured every 30 s during cystometry. Four consecutive cystometries were performed by means of suprapubical catheters and 50 ml/min filling rate. The aim was to improve the methodological basis for cystometrical studies of paroxysmal hypertension and its treatment. In each cystometry there was an elevation of the systolic (20-60 mmHg) and the diastolic (15-55 mmHg) blood pressure. The maximum blood pressure always occurred during the emptying phase and always in close relation to the peak of the detrusor pressure. The amplitude of the blood pressure response varied intraindividually, but did not change in any particular direction during the series of cystometries. Thus, a cystometrical method which stimulates the detrusor in a physiological way is sufficient to give the typical uninhibited blood pressure reaction in most patients with a reflex bladder and a spinal reflex vasomotor function after a high level spinal cord injury. The blood pressure reaction obtained with this method is probably representative for the daily reaction during physiological reflex emptying of the bladder. To describe the maximum blood pressure reaction, it has to be measured during a well defined emptying phase and close to the occurrence of the maximum detrusor pressure. Since repetition of cystometry did not change the blood pressure response, this cystometrical method is useful for evaluation of pharmacological intervention.
Evaluating the outcome of vocational rehabilitation
Authors: Riipinen M , Hurri H , Alaranta H.
Published: August 2024

This paper presents an analysis of studies in which vocational rehabilitation was followed up during the 1980s and early 1990s. Its purpose is to clarify the outcome of vocational rehabilitation as well as the factors predicting that outcome. In these follow-up studies the variables by which the outcome is measured are closely linked with the subjects' employment opportunities, and are basically the same as those applied in earlier follow-up studies. Because of the study designs it is difficult to make any generalizations concerning the results. Little attention has been paid to the evaluation of psychological adaptation in most of these studies. Also, follow-up studies generally have not taken into account the employment situation. Whether those who have had rehabilitation are able to find employment depends essentially on employers' policies towards the handicapped and the disabled.
Reliability of heart rate responses to non-steady-state activities of daily living in men with spinal cord injuries
Authors: Janssen TW , Van Oers CA , Van der Woude LH , Hollander AP.
Published: August 2024

The reliability of heart rate responses to non-steady-state tasks among 37 men with spinal cord injuries (lesion level: C4/5-L5) was examined with a simple heart rate recording device (Sport Tester PE3000). Three identical trials of 6 different transfers and an 8-cm curb ascent were performed on one day (Trial 1 and 2; n = 37) and one week later (Trial 3; n = 12). Pearson's r and intraclass correlations for the highest and the mean heart rate provoked during Trial 1 and 2 ranged from 0.73 to 0.97 for the transfers and from 0.92 to 0.97 for the curb ascent. Correlations were somewhat lower for Trial 1 versus Trial 3. A paired t-test revealed lower heart rate responses to Trial 2 and 3, suggesting a moderate learning effect and/or a reduction in psychological stress. It was concluded that heart rate responses to non-steady-state tasks, as recorded by a Sport Tester PE3000, are reproducible in men with spinal cord injuries.
Flexibility of the use of residual tibial anterior motor units during walking in neuromuscular diseases
Authors: Grimby L Sjöström L.
Published: August 2024

The use of tibial anterior (TA) motor units in lower motoneurone disorders was studied during comfortable walking that was the main function of TA. The findings were compared to those in normal subjects. The loss of TA power was compensated either by increases of recruitment and firing rate of residual TA units or by a change from the normal plantigrade gait pattern to the infantile digitigrade pattern putting less strain on TA. Moderately paralysed subjects usually maintained plantigrade gait by excessive use of residual TA units but tended to change to digitigrade gait on fatigue thus economizing with remaining TA power. Severely paralysed subjects used digitigrade gait but plantigrade gait could be restored by application of a toe using string, i.e. the string might increase the strain on TA instead of decreasing it.
Postocclusive reactive hyperemia and thermal response in the skin microcirculation of subjects with spinal cord injury
Authors: Schubert V Fagrell B.
Published: August 2024

The response of skin blood cell flux (SBF) to locally applied pressure was evaluated by laser Doppler fluxmetry over the sacrum and the gluteus maximus muscle in twenty patients with spinal cord injuries (SCI)-ten with tetraplegia, ten with paraplegia-and ten healthy subjects. The SCI patients were further divided into two subgroups, one with sensation and the other without sensation over the sacrum area. The SBF over the sacrum, without applied pressure, showed somewhat higher values among the patients. The ten paraplegic patients (p less than 0.05) and the subgroup of patients without sensation over the sacrum (p less than 0.05) showed the highest values. Occlusion of the SBF was reached at a lower external skin pressure over the sacrum than over the gluteus maximus muscle in the group with spinal cord injuries (p less than 0.01). During the postocclusive reactive hyperemia we found a much shorter time to peak SBF over the gluteus muscle for the patients compared to the healthy subjects (p less than 0.01). In the subgroup of patients without sensation over the sacrum a prolonged time to peak SBF was found (p less than 0.01) over the sacrum compared to patients with sensation and to healthy subjects. The increase of the SBF during postocclusive hyperemia response was lower over both the sacrum and the gluteus maximus muscle areas in the patients with spinal cord injuries (p less than 0.01).
Assessment of walking before and after unicompartmental knee arthroplasty. A comparison of different methods
Authors: Mattsson E , Olsson E , Broström LA.
Published: August 2024

Walking ability was assessed in twenty patients before and one year after knee replacement with a cemented unicompartmental, Brigham prosthesis (mean age 63.4 years, nine women). All patients had moderate medial gonarthrosis. One year after surgery, knee function, assessed by the BOA score, self-selected and maximal walking speed as well as single limb support of the involved leg were increased. Pain and exertion during walking and oxygen cost of level walking were decreased at all measured speeds. Individual improvement in self-selected walking speed was correlated to improvement in maximal walking speed. Individual decrease of oxygen cost of level walking was correlated to decrease of perceived pain and exertion during walking. For clinical routine purpose clinical assessment, especially of pain, supplemented with measurement of self-selected walking speed were found to be sufficient for assessing effects of treatment such as unicompartmental prosthetic knee replacement.
Pressure pain threshold on upper trapezius and levator scapulae muscles. Repeatability and relation to subjective symptoms in a working population
Authors: Takala EP.
Published: August 2024

The pressure pain threshold for the upper trapezius and levator scapulae muscles was studied in a working population with a mechanical algometer. The lower 95% confidence interval limits of the correlation coefficient describing intraobserver reliability varied from 0.71 to 0.92, measured in 93 men and 70 women. The values describing interobserver reliability varied from 0.68 to 0.79, measured only in men. The day-to-day repeatability was measured in 10 women and it proved to be acceptable. In general, women had lower pain threshold values than men. Low values were related to complaints in the neck and shoulder region. However, the values in the non-symptomatic population displayed wide variation. Though unsuited for use as a primary diagnostic or screening tool, the method shows promise for application in individual follow-up studies as an outcome measure in therapeutic trials.
Comparison of TENS treatments in hemiplegic shoulder pain
Authors: Leandri M , Parodi CI , Corrieri N , Rigardo S.
Published: August 2024

The aim of this paper is to evaluate the effectiveness of high-intensity versus low-intensity transcutaneous electrical nerve stimulation (TENS) and versus placebo for treatment of hemiplegic shoulder pain. Three groups of 20 patients each (A, B, C) were studied. In group A high-intensity TENS was delivered at 3 times the sensory threshold with frequency of 100 Hz; in group B low-intensity TENS was delivered at the sensory threshold with frequency of 100 Hz. Group C received placebo stimulation. The treatment protocol consisted of 12 sessions (4 weeks). Before treatment, at the end of it and one month after, passive range of motion (PROM) for flexion, extension, abduction and external rotation were evaluated. Statistically significant improvements of PROMs were recorded for group A, but not for groups B or C.
Disability and handicap in late poliomyelitis
Authors: Einarsson G , Grimby G.
Published: August 2024

The impact of long-standing polio sequelae in terms of disability and handicap was studied in 41 patients (17 men and 24 women, mean age 54 years). Twenty-nine (71%) of these met the criteria for post-polio syndrome. The Katz' ADL index, the Functional Status Questionnaire (FSQ), selected questions concerning social needs and support and the WHO ICIDH-Classification of handicaps were used. A substantial impact on intermediate (secondary or instrumental) ADL was a consistent finding, most severely affecting the quality of mobility. This emphasizes needs for individual rehabilitation services including transportation, walking and domestic aids.
Two-point discrimination test. A valuable part of hand surgical rehabilitation, e.g. in tetraplegia
Authors: Moberg E.
Published: August 2024

In assessing the prospects for surgical and other kinds of rehabilitation in tetraplegia and stroke patients the two-point discrimination test, correctly performed by experienced examiners, is of great value. Valid and repeatable results depend on exact technique and proper tools. There is a firm correlation between the thresholds of two-point discrimination on the pulps of the fingers and the accuracy of position sense at the metacarpophalangeal and interphalangeal joints. Microneurography has shown that cutaneous receptors have proprioceptive as well as exteroceptive functions. Thus the two-point discrimination test can be used as a measure of proprioceptive function. The results can be expressed numerically. A two-point threshold less than 10 mm on the pulp is a valid measure of useful finger proprioception. It also shows tactile gnosis, necessary for precision sensory grips.
Important predictors of the outcome of physical training in patients with intermittent claudication
Authors: Rosfors S , Arnetz BB , Bygdeman S , Sköldö L , Lahnborg G , Eneroth P.
Published: August 2024

Hemodynamic and endocrine variables have been unsuccessful to predict improvement in walking distance in patients with intermittent claudication following structured training programs. In the present study we evaluated the predictive value of a number of hemodynamic and endocrine parameters. In addition we included information on cognitive factors such as stress and the belief in the structured training and motivation to participate. Twenty-five elderly subjects were studied. Significant improvement in overall walking distance was achieved. The most important explanatory variables of relative improvement in walking distance were belief in training, initial walking distance and number of smoke years. The results support the belief that cognitive factors are of major importance in predicting functional effects of structured training programs for patients with intermittent claudication.
Traumatic brain injury in northern Sweden. Incidence and prevalence of long-standing impairments and disabilities
Authors: Johansson E Rönnkvist M
Published: August 2024

Based on a retrospective survey of hospital admissions and autopsies the incidence of traumatic brain injury (TBI) for the age range 16-60 was found to be 24.9/10,000 in the Umeå district of Northern Sweden. In male youngsters aged 16-19 the incidence was remarkably high in comparison with reports from other parts of the western hemisphere. Self-reports on the prevalence of impairments and disabilities 1 1/2-3 years after the injury were obtained by a mailed questionnaire. Among the subjects with brain concussion 1/3 reported impairments and 1/10 disabilities, most commonly leisure-disability. By factor analysis impairments and disabilities could be logically grouped into three factors. Two of these factors clearly circumscribed combinations of impairments and disabilities, one of them being dominated by instrumental ADL, the other by basic self-care ADL. The third factor incorporated the classic post-concussion triad and memory. Taken together the findings indicate that many subjects with an early diagnosis of brain concussion, hospitalized for only one day, experienced losses in pre-injury functions and abilities. It is therefore suggested that not only radiologically and/or operatively confirmed TBIs but also subjects with brain concussion should be followed after discharge in order to minimize losses in social well-being.
Pulsed ultrasound does not improve healing of venous ulcers
Authors: Lundeberg T , Nordström F , Brodda-Jansen G , Eriksson SV , Kjartansson J , Samuelson UE.
Published: August 2024

A controlled study of the effects of pulsed ultrasound was carried out in conjunction with a standard treatment for healing chronic leg ulcers on 44 patients divided randomly into two groups. All patients received standard treatment (paste impregnated bandage and a self-adhesive elastic bandage) plus placebo-ultrasound or pulsed ultrasound (1:9, 0.5 watt/cm2 at 1 MHz, for 10 min) 3 days a week for 4 weeks, thereafter twice weekly for 4 weeks and once weekly for the following 4 weeks. Percentage healed ulcer area and comparison of percentage healed ulcers were examined after 4, 8 and 12 weeks. There were no significant differences in the proportion of healed ulcers or ulcer area in the pulsed ultrasound group as compared with the placebo group.
Cross-cultural adaptation of the Arabic version of the oral health values scale
Authors: Traina Salema , McNeil Daniel W. , Tantawi Maha El , Arheiam Arheiam
Published: August 2024

Aims: The study aimed to adapt the original English-language oral health values scale (OHVS) to the Arabic culture and to test its psychometric properties.
Methods: The original OHVS was translated into Arabic language and pre-tested using cognitive interviewing. The psychometric properties of Arabic OHVS were examined in a sample comprising 416 Libyan adults aged 18–70 years, recruited from the main public and private dental clinics in Benghazi. The participants’ demographic information, oral health behaviour, perceived oral health, the Arabic version of the OHVS (A-OHVS), dental neglect scale, oral health-related quality of life, oral health literacy, simplified oral hygiene index (OHI-S), and decayed, missing, and filled teeth index (DMFT) were collected. Psychometric properties were tested using content validity, construct validity, discriminating validity, internal consistency, test–retest reliability, and floor as well as ceiling effects were examined.
Results: The Arabic OHVS was successfully and smoothly developed. It showed an acceptable level of equivalence to the original version, The A-OHVS presented an overall Cronbach’s Alpha of 0.74 and the average score was 40.02, ranging between 26 and 54. All hypotheses predefined to test construct validity were confirmed. The bivariate correlation between A-OHVS and other health indicators shows a significant positive correlation between A-OHVS and oral health literacy (p = 0.000). On the other hand, statistically significant negative correlations were observed between A-OHVS and dental neglect and quality of life (p ≤ 0.001) as well as DMFT and OHI-S (p ≤ 0.001). Floor or ceiling effects were not observed.
Conclusions: The A-OHVS was shown to be a valid and reliable tool for assessing oral health values in the Arabic-speaking population.