bluuebunny/crossref_metadata_2025 huggingface dataset:
CD39 identifies a specific CD8+T cell population in EGFR-driven lung adenocarcinoma related metastatic pleural effusion.
Authors: Lv Lei-lei , Wang Hong , Zhang Yao , Zhai Jia , Shen Yu , Qu Qiu , Chen Cheng
Published: May 2023

Malignant pleural effusions (MPE) are common in lung cancer, which were
a complex microenvironment containing a plethora of immune and tumor
signals. Gene alterations such as driver gene mutations were considered
to affect the components in the TIME of NSCLC. Here, we demonstrated
that pleural CD39+CD8+T cells were selectively elevated in
firstly-diagnosed lung adenocarcinoma with wild-type EGFR compared to
that in mutant EGFR, while abnormally more represented in MPE with
epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI)
acquired resistance. Analysis showed that pleural CD39+CD8+T cells
display exhausted phenotype and potential cytolytic function, together
with skewed usages of T cell receptor (TCR)-Vβ repertoire in comparison
with CD39-CD8+T cells, which constituted common feature of lung
adenocarcinoma related MPE. Further study revealed TCR-Vβ diversity
tended to be more enhanced in pleural CD39+CD8+T cell from MPE coupled
with EGFR-TKI acquired resistance. Taken together, we have identified a
subset of CD8+T cells expressing CD39 in MPE, whom proposed as the
potential tumor-reactive CD8+T cells, and further provided a new
understanding of dynamic immune composition of EGFR-mutant tumor
microenvironment.
The reliability of parametric methods in the case of rating scales: a simulation study
Authors: Kindermann Harald
Published: May 2023

A recurring question is whether rating scales should be considered
metrically scaled or merely ordinally scaled. This has direct
implications for the permissible statistical procedures for significance
testing. Based on the results of a simulation study, it is shown that
the use of parametric procedures for rating scales has distinct
advantages over the non-parametric alternatives. It is also shown that
the parametric procedures are robust to violations of the assumption of
normality, which only result in a modest loss of power compared with
continuous variables. This loss should be taken into account when
calculating the optimal sample size. The results suggest that sample
sizes about 25% larger should be chosen for discrete rating scales than
for continuous variables.
Catastrophic Health Expenditure for Hospitalization in Urban Kerala: Determinants, Inequality and Policy Implications
Authors: Philip Paul John , Panda Gyana Ranjan
Published: May 2023

This research paper examines the health expenditure incurred by
inpatients in Urban Kerala, a southern province in India known for its
commendable health indicators. Despite its reputation, the state
grapples with a significant burden of Out of Pocket Expenditure (OOPE),
as evidenced by robust nationally representative surveys conducted by
the esteemed ‘National Sample Survey’ (NSS). In this context, the paper
aims to achieve two objectives. Firstly, it brings out the estimates of
out of pocket expenditure and explores the determinants of Catastrophic
Health Expenditure (CHE). Secondly, it investigates the inequality in
the incidence of CHE and factors contributing to it. The study uses
unit-level data of 75th round of the National Sample Survey. Descriptive
statistics, logistic regression, Concentration index, and its
Decomposition are employed in the study. Results indicate that
covariates such as social group, medical institution type, and
consumption expenditure correlate with CHE. Further, the findings reveal
socio-economic inequality in CHE incidence and highlight the significant
contribution of type of medical institution and consumption expenditure
to the total inequality. The present study, by employing a magnifying
lens on pre-existing inequalities, highlights the shortcomings of health
financing in urban areas and calls for a reconsideration of extant
policy design by means of which public money is often siphoned to
private purse through the channels of Public funded health insurance,
which in the first place was intended to curb inequities and financial
catastrophic experiences. The study emphasizes the need for
multisectoral collaborations and changes in design features in order to
address supply-side inefficiencies and moral hazards that can hinder
equitable health finance. The critical role of agile institutions is
highlighted.
Divorce is linked with extra-pair paternity in a monogamous passerine
Authors: Dunning Jamie , Burke Terry , Schroeder Julia
Published: May 2023

The question of why socially monogamous females engage in extra-pair
behaviour is long-standing in evolutionary biology. Recent theoretical
work has moved away from the indirect-benefits hypothesis to explain
female extra-pair behaviours, instead favouring suggestions that they
are the result of pleiotropic effects. That is, a trait under strong
positive selection in either or both sexes are genetically linked to
another, often unrelated, trait. For example, where genes beneficial to
female fecundity (contributing to within-pair solicitation of her social
partner) are linked with extra-pair behaviour (soliciting copulations
from extra-pair males). Here, we test two predictions from this
hypothesis: We test the prediction that female divorce, measured from
the number of social mates within a given year, is linked with (1) the
number of extra-pair males and (2) the proportion of her offspring that
are extra-pair. Our results suggest that females who frequently divorce
social partners are more likely to produce extra-pair offspring than
those who maintain social monogamy. However, by contrast, those females
do not also have a higher proportion of extra-pair offspring. The number
of broods initiated was also positively correlated with extra-pair
males, probably through increased opportunity for extra-pair males to
sire offspring over a longer breeding season. Our results provide an
empirical example of a behavioural trait, beneficial to female
fecundity, that is linked with extra-pair behaviour. These empirical
results support the intrasexual pleiotropy hypothesis as a driver of
female extra-pair behaviour.
The Real Impact Factor of Journal of Rehabilitation Medicine (JRM) and JRM Clinical Communications (JRM-CC)
Authors: Stam Henk , Borg Kristian , Andersson Agneta
Published: May 2023

Missing (Editorial)
Motion analysis in the movements of standing up from and sitting down on a chair. A comparison of normal and hemiparetic subjects and the differences of sex and age among the normals
Authors: Yoshida K Iwakura H
Published: May 2023

With regard to the motions of standing up from and sitting down on a chair, and standing quietly for thirty seconds, forty normal adults (ten young males, ten young females, ten elderly males and ten elderly females) and ten hemiparetics were compared by use of a force plate and an electrogoniometer. The hemiparetics had the following characteristics: (1) A long time was required for stabilization of sway at the center of force (C.O.F.) when standing up. (2) The C. O. F. was located to the back and deviated primarily to the sound leg, and the grade of sway was greatest during quiet standing. (3) Vertical 8 Hz fluctuation in quiet standing was seen in all cases, while in sitting down 3-4 Hz were recorded. (4) The motion time in standing up and sitting down was prolonged. (5) Long periods of initial knee flexion existed just before the knee extension in standing. (6) A broad lateral sway of C. O. F. was recorded in the standing movement. Among the normal groups, the following characteristics were noted: (1) The young stand up more rapidly. (2) The elderly needed more time to stabilize the antero-posterior sway in the standing up motion. (3) The C. O. F. of males was located more anteriorly than that of females. (4) The grade of sway in quiet standing was greater in females than in males. (5) In young males, the standing up time was shorter than the sitting down time, while in young females the situation was reversed.(ABSTRACT TRUNCATED AT 250 WORDS)
A prospective study of low back pain in a general population. III. Medical service--work consequence
Authors: Biering-Sørensen F.
Published: May 2023

Of participants with low back pain (LBP) at some time, about 60% said the pain had led them to consult their general practitioner, about 25% a specialist, and about 15% a chiropractor. About 30% had had an X-ray taken of their lumbar spine. Physiotherapy was the most common treatment given for the LBP. Manipulative therapy was the treatment which most often seemed to satisfy those with LBP although these cases might have been the milder acute attacks of LBP. Of the LBP complainers, 4.5% had been admitted to hospital and 1% operated on because of LBP. Work absence because of LBP occurred by 22.5% of the participants who were gainfully employed at some time. An additional 10% found it necessary to take special care on the job. Change of job or work function because of LBP was accomplished by 6.3%. Among those gainfully employed at the time of the examination, 6.7% had taken days-off within the past year because of LBP, an absence rate which corresponded to about two days per year per person. Previous, particularly recent use of medical services turned out to be a prognostic indicator for LBP in the follow-up year, while none of the work related parameters seemed to be good predictors, which may be because of the uncertainties related to these parameters.
Comparative analysis of MMPI form R and MMPI-168 profiles in low back pain patients
Authors: Harasymiw SJ McKian PM
Published: May 2023

This study investigated the efficacy of MMPI Form R in evaluating chronic low back pain patients. Ninety-seven males and 81 females were administered Form R during a pre-treatment evaluation. Each test was scored for Form R and MMPI-168. Scales Pa and Sc were re-scored following a modified conversion table discussed in the literature, resulting in three scores for Pa and Sc. Correlations were calculated between scales on the two forms plus modified conversions for scales Pa and Sc. Highly significant correlations were found between the two forms of the MMPI, with slightly lower correlations between modified Pa and Sc scales and the same scales on Form R. Although there were statistical differences between MMPI Form R and MMPI-168 profile elevations, these were not considered clinically significant. Because of the high intercorrelations, and the test length it seems possible to consider use of the MMPI-168 in screening chronic pain patients. Other hypotheses exploring sex differences and differential profile elevations were investigated and are discussed.
Discomfort and pain from loaded passive joint structures
Authors: Harms-Ringdahl K Brodin H
Published: May 2023

Sensations of strain and pain from healthy elbow and knee joints kept in an extreme position were reported on Borg's category-ratio scale (4) by 12 male volunteers in an experimental situation. The purpose of the study was to find out whether passive joint structures give sensations of discomfort and pain when moderately loaded for a certain time in an extreme position. Sensations of discomfort and pain were reported every 15th second. The mean values of ratings followed a straight line of increasing values during the first four minutes. Great variations were found between individuals. The elbow joint was six times more sensitive to the loading dose expressed as the product of the moment of force and time than was the knee joint. After the load was removed the provoked sensation slowly decreased. Sometimes the initial after-load rating was higher than the last rating with the load. The results imply that static work postures should also be analyzed with respect to joint position.
Cutaneous vasomotor sensitivity to noradrenalin in spinal and intact man
Authors: Stjernberg L.
Published: May 2023

It has been suggested that the increased pressor response to noradrenalin found in tetraplegic patients is due to absence of blood pressure restraining reflexes. However, it has also been found that below the lesion in such patients cutaneous vessels, which in intact man are not under baroreflex control, show prolonged vasoconstriction after sympathetic neural discharges. This finding might indicate that cutaneous blood vessels display an increased sensitivity to noradrenalin in spinal patients. To investigate this, photoelectric cutaneous pulse plethysmograms were monitored during i. v. noradrenalin infusions in six patients with spinal cord injuries and in six intact subjects. There were no significant differences between the groups in either extent or duration of vasoconstriction. The findings provide no evidence that increased sensitivity to noradrenalin is a factor of importance for the attacks of hypertension in tetraplegic patients.
How many strides are required for the analysis of electromyographic data in gait?
Authors: Arsenault AB , Winter DA , Marteniuk RG , Hayes KC.
Published: May 2023

This study was conducted to obtain information on the number of strides of EMG data needed per subject in a gait study. Ten strides of EMG data were cumulated on eight subjects for each of the soleus, rectus femoris, biceps femoris, vastus medialis and tibialis anterior muscles. The linear envelope of the EMG, normalized in time and amplitude, demonstrated a very high level of stability for a given subject, relative to the variability that was found across subjects. It was concluded that three strides of EMG data per subject provides information as reliable as that obtained from twelve strides.
Intellectual Function Training in adults with acquired brain damage. An occupational therapy method
Authors: Söderback I , Normell LA.
Published: May 2023

An occupational therapy method termed Intellectual Function Training (IFT) is presented for cognitive retraining of patients with brain damage. Comprehensive training material, comprising about 900 pages, is described. The method is used to remediate intellectual dysfunction and to give intellectual stimulation, particularly concerning the following abilities: visual perception ability, spatial ability, verbal ability, numerical ability, memory ability and logical ability. The material is used for systematic individualized, daily treatment over a period of 2-4 months. The way in which the material is used is based on neuropsychological and pedagogical principles. Examples of training tasks and the training procedure are given.
Early mobilizing treatment in lateral ankle sprains. Course and risk factors for chronic painful or function-limiting ankle
Authors: Linde F , Hvass I , Jürgensen U , Madsen F.
Published: May 2023

In a prospective study, 150 patients with lesions of lateral ankle ligaments were treated with early mobilization without any fixation of the ankle. After 8 days, 67% were free from pain on ordinary walking and 81% had resumed work. After 1 month 90% were free from pain and 97% had resumed work. Sport was resumed by 70% of athletes after 1 month and 90% after 3 months. At the 1-year follow-up (n = 137), 18% were not fully recovered and experienced pain (14%) or functional instability (7%) or had not resumed sport at their normal level (7%). However, only 8% found the condition inconvenient. Athletes had an increased risk of residual symptoms (p less than 0. 01) and residual symptoms occurred in 32% of top athletes after 1 year.
Return to work after rehabilitation. The significance of the patient's own prediction
Authors: Sandström J , Esbjörnsson E.
Published: May 2023

A prospective study of patients with chronic low-back pain was made to determine the significance of the patient's own prediction of the outcome of a vocational rehabilitation program. Fifty-two patients were screened, and their work situation determined one and 4 years after the rehabilitation program was started. The patients predicted the outcome correctly in 69%, with a sensitivity of 68% and a specificity of 71%. A statistically significant correlation was found between the patient's prediction and the recommendations given by the rehabilitation unit.
Early activation for acutely ill elderly patients
Authors: Hulter Asberg K.
Published: May 2023

In order to describe both the process and the impact of introducing a program of early activation for acutely admitted elderly patients in medical wards, two populations, one before and the other after the intervention of the program, were followed up. The program was implemented in cooperation with the nursing staff, who were integrated in the rehabilitation work. Population I (219 admissions) was collected in 1981 and Population II (272 admissions) during a corresponding period in 1983. Survival, type of residence and ADL status 5 months after hospital admission were recorded as outcome measures. There were no differences between 1981 and 1983. In 1983 the mean length of stay was 4. 7 days shorter than in 1981. The program cannot be shown to have caused the difference in length of stay. The study shows that such a program of early activation was easy to apply in clinical practice for aged and disabled patients in general medical wards.
A computerized method for clinical gait analysis of floor reaction forces and joint angular motion
Authors: Olsson E , Oberg K , Ribbe T.
Published: May 2023

A method for clinical studies of ground reaction forces during gait is presented. A walkway consisting of two force measuring platforms, each five meter long, allows the recording from several consecutive steps from both feet. Signals from photocells and goniometers have been added and a microcomputer system for on line recording and processing have been developed. The accuracy of the system is tested.
Quantitative analysis of rising from a chair in healthy and hemiparetic subjects.
Authors: Hesse S , Schauer M , Malezic M , Jahnke M , Mauritz KH
Published: May 2023

In 15 healthy and 20 hemiparetic persons we studied standing-up by two force-plates. Phases before and after the seat-off, force distribution and centre of gravity displacement were assessed. The patients rose significantly slower. The force ratios after seat-off differed significantly between the groups (0.88 vs 0.68). Left/right hemiparetic patients put more weight on the affected limb in 18%/11% of the trials before seat-off, with its insufficient use after it mainly in the left patients. At seat-off, projection of the centre of gravity fell within the support area in hemiparetic patients, and 3 cm behind it in healthy subjects. With larger lateral displacement of the centre of gravity in the hemiparetic group, left hemiparetic patients mostly shifted their weight to the non-affected side and right hemiparetic patients to both sides. Weight distribution and mediolateral displacement of the centre of gravity in the left and right hemiparetic patients were considered.
Mesh-glove. 2. Modulation of residual upper limb motor control after stroke with whole-hand electric stimulation.
Authors: Dimitrijevi MM , Soroker N
Published: May 2023

The effects of whole-hand electrical stimulation via a wired mesh-glove upon the residual motor control of the upper extremity are described. Clinical observations were made in 2 patients with nonfunctional upper limbs, 4 and 2 years after stroke, who had been enrolled in the home mesh-glove program for 6 and 4 months, respectively. The stimulation paradigm is novel and the target of stimulation is the hand. Preliminary results indicate beneficial effects such as reduction in muscle hypertonia and facilitation of isolated hand movements
The gait of unilateral transfemoral amputees
Authors: Boonstra Schrama J AM , Fidler V , Eisma WH
Published: May 2023

The aim of this study was to describe the gait of persons with a unilateral transfemoral amputation by means of a questionnaire, gait analysis and measurement of energy expenditure, and to find correlations among the variables studied. The study included 29 transfemoral amputees amputated for other reasons than a chronic vascular disease. The patients were assessed using the following methods: 1) A questionnaire rating the walking distance and walking difficulty in different circumstances. 2) Gait analysis measuring temporal variables and goniometry of hips and knees. 3) Measurement of energy expenditure during sitting and walking. Scores on the questionnaire showed a correlation with socket design, a negative correlation with age and energy expenditure, and a positive correlation with fast speed. The gait of transfemoral amputees was asymmetrical as far as temporal variables were concerned, and for most amputees also for the range of motion of hip and knee. The walking speed of the amputees was lower than that of non-amputees and showed a positive correlation with hip extension-flexion range of motion and a negative correlation with age and stride time. The energy expenditure of the amputees during ambulation was higher than that of non-amputees, and seemed to correlate with residual limb length and the hip abduction-adduction range of motion.
Long-term sickness absence due to musculoskeletal disorders: the necessary intervention of work conditions
Authors: Ekberg K , Wildhagen I
Published: May 2023

To make rehabilitation of musculoskeletal disorders effective it is crucial to identify circumstances that tend to support the persistence of sickness absence. A total of 93 patients with recently developed disorders in the neck and shoulders were followed for one year after rehabilitation, in order to identify factors associated with recovery and chronicity, respectively. Health status was evaluated before rehabilitation and after 12 months in terms of sickness absence, pain ratings and self-rated quality of life, the Sickness Impact Profile. The study group was divided into tertiles based on their number of days of sickness absence during the follow-up period (short: < 25 days, medium: 25-101 days, long: > 101 days). Those with long-term sickness absence perceived higher physical and mental load in their jobs. There was also a higher proportion of persons who were not born in Sweden in this group and on average they had more sick-leave days the preceding year. Other background characteristics and personality ratings were similar between the groups. Long-term sickness absence was associated with worse ratings in quality of life after one year, and pain did not diminish during the follow-up year. Multiple regression analysis indicated that long-term sickness absence was largely associated with work conditions rather than with individual characteristics. Therefore, the results underscore the importance not only of treating the individual with musculoskeletal disorders, but in particular of improving his or her work conditions.
A pilot study of rehabilitation at home after stroke: a health-economic appraisal
Authors: Holmqvist Widén L , Pedro de Cuesta J , Möller G , Holm M , Sidén A
Published: May 2023

This study aimed at describing the health-economic implications and organisational issues of rehabilitation at home in south-west Stockholm of 15 acute stroke patients, mean age 68.2, male:female ratio 9:6, independent in feeding and continent one week after their stroke. Average patient satisfaction with different dimensions of care was 92%. Perceived dysfunction, by means of the Sickness Impact Profile, 3 months after stroke was highest for Recreation-and-Pastime, Home Management and Ambulation. Between 3-12 months after stroke, functional improvement was particularly seen in Home Management, Recreation-and-Pastime and Emotional Behaviour. Three fourths of the patients received help with different ADL tasks from a family caregiver and 1/5 from home service assistants. According to the scores for subjective health of the spouses and time used to help the patient, the burden that the programme put on the patient's family was modest, temporary and in accordance with preferences reported by the elderly in Sweden. The mean duration of hospital stay for patients under rehabilitation at home was 14 days and for a selected comparison group with similar ADL-grade, 27 days. The mean number of therapy sessions at home was 11. Each home visit took 3.2 hours, 60% of which were direct patient time. In the selected comparison group, 1/3 was referred to other departments for rehabilitation and care, and 40% had contacts with day-care and paramedical professionals after discharge from the hospital. During the first year after stroke, the average, direct, per capita cost for rehabilitation at home amounted to SEK 127,730 divided between hospital care (50%), followed by contribution by family caregivers (18%), rehabilitation at home (10%), out-patient visits to physicians and nurses (8.8%), home-help service (7%), auxiliary equipment (2%), medication (1.5%), home adaptation (1%) and transportation service (0.3%). This organisational model of home-based rehabilitation of stroke patients constitutes a feasible, possibly less expensive alternative and complement to current rehabilitation in hospital and primary care, which could be further developed and evaluated.
The multi-dimensionality of the FIM motor items precludes an interval scaling using Rasch analysis
Authors: Dickson HG , Köhler F
Published: May 2023

Rasch analysis scaling is said to produce an interval scale of Functional Independence Measure (FIM) motor function items. Rasch analysis requires that the data to be analysed represent the influence of a single underlying unidimensional variable. A unidimensional interval scale of activities of daily living means that a person who can perform the most difficult item on a scale can also perform the easiest item. For a FIM motor function interval scale, the ability to climb stairs would imply necessarily and ability to eat normally. As this need not be the case, the FIM motor items do not constitute an adequate interval scale. Eating and walking are different activities, and a unidimensional construct linking them is unsatisfactory. A principal components analysis of the admission FIM motor function items of 515 consecutive patients admitted to an inpatient rehabilitation unit revealed that more than one significant factor was necessary to explain the variance in scores. The counter-factual and statistical evidence argues that a unidimensional construct does not underly the FIM motor function items, and the use of Rasch analysis will not lead to a description of interval properties of the FIM motor function items.
The Role of Alcohol Abuse in Working Disability in Patients With Low Back Pain
Authors: Sandström J , Andersson GB , Wallerstedt S
Published: May 2023

The prevalence of alcohol problems was investigated in 50 patients with chronic low back pain, and compared to an age, sex, civil status, and income matched control group. Alcohol abuse was significantly more frequent among the male low back patients. Within the patient group the use of analgesics and sedatives was not related to the degree of alcohol consumption. Alcohol problems were not found to influence the rehabilitation process negatively, probably because the rehabilitation programme was not directed to the back only. Such problems therefore should not discriminate against inclusion in a rehabilitation programme.
Hip Load Moments and Muscular Activity During Lifting
Authors: Németh G , Ekholm J , Arborelius UP
Published: May 2023

The load on the hip joint during lifting was studied. Healthy subjects lifted a 12. 8 kg box from floor to table level with straight and flexed knees in four different ways. The loading moment of force about the bilateral hip axis was calculated by means of a computerized static sagittal plane model. The highest load moment, 124 Nm, occurred initially in the straight knee lift and the compressive joint reaction force was 2. 7 times body-weight. The lowest load moment, 82 Nm, occurred in the flexed knee lift with the burden moved close to the trunk, the compressive force was 3. 2 X bw. The load moment was also discussed in relation to the strength capability. The EMG levels of seven different hip muscles were normalized and expressed as a percentage of the recorded level of each muscle group during an isometric maximum voluntary contraction. The initial activity in the hamstrings was higher in the straight knee lift compared to flexed knees. The gluteus maximus was activated to a moderate level.
Physiotherapy After Fracture of the Proximal End of the Humerus. Comparison Between Two Methods
Authors: Bertoft ES , Lundh I , Ringqvist I
Published: May 2023

Two methods of physiotherapy after fracture of the proximal end of the humerus were compared. The study was designed as a randomized, controlled and single-blind trial. Twenty patients were assigned to two groups 10-12 days after the injury. One group was treated conventionally, the other received instructions in self-training with follow-up control of results. Objective examination and subjective assessment were made at five intervals, up to one year after the injury. The greatest improvement in function was shown in both groups between 3 and 8 weeks. The patients deemed their daily life functions to be normal 8 weeks after the injury. The objective assessment was normal at later stages. No significant differences were found between the two groups in any of the tests. Instruction in self-training with control of results including objective assessments are therefore an adequate method in the rehabilitation of these patients.
A Follow-Up Examination of the Function of the Lower Extremity After Pelvic Tumour Extirpation Including the Acetabular Ring
Authors: Olsson E
Published: May 2023

Gait, hip muscular function and clinical features were analysed in 5 patients with chondrosarcoma of the pelvis operated with removal of the tumour, including the acetabular ring. The lower extremity thus remained intact. The aim of this study was to compare the functional results with those obtained in a previous investigation two years earlier. The same tests were used, but more attention was focussed to the functional part and thus step length, gait velocity, and active range of motion were added. At both examinations none of the patients had pain. All performed surprisingly well as regards work and gait. Clinical and objective findings were, however, less impressive. There was a direct relationship between hip extension strength and weight bearing on the operated leg, gait velocity and maximal walking distance. Moreover, the extension strength was also related to the formation of a new acetabular roof and to the age the individual represented, with preference to the young. Compared with the previous examination, 2 patients had made remarkable progress, 2 were unchanged but still showed good results and one showed less good results.
Skin Blood Flow in an Area at Risk for Pressure Sore
Authors: Ek AC , Lewis DH , Zetterqvist H , Svensson PG
Published: May 2023

The aim of this study was to measure skin blood flow in patients with pressure sore in a long-term care unit. For comparison, measurements were also carried out on in-patients at risk of developing pressure sores and on healthy individuals in the same age groups as the in-patients. Skin blood flow was measured in the morning, using a laser-Doppler flowmeter. Measurements were made over the lateral part of the hip and over the lateral part of the upper arm. Measurements were carried out first at ambient temperature. The flow was then followed as the local skin region was heated to 40 degrees C. The results indicate that in healthy individuals the heat stimulus increased skin blood flow over the lateral part of the hip more than in in-patients in the same age group. Individuals below the age of 60 have a greater response than those over the age of 60. This impairment in the ability of the older in-patients to increase skin blood flow in response to thermal stimulus may be a factor in the development of pressure sores.
Outcome of Patients With a Nailed Hip Fracture Requiring Rehabilitation in a Hospital for Chronic Care
Authors: Snaedal J , Thorngren M , Ceder L , Thorngren KG
Published: May 2023

The rehabilitation outcome of seventy-eight consecutive patients with nailed hip fractures admitted to a hospital for chronic care from an orthopaedic department during 1977 through 1980 was followed for two years. They comprised only 13% of all hip fracture patients, the others being discharged to their own homes or old people's homes. Thirty-four of the admitted patients came originally from their own homes, 23 from old people's homes and the others from hospitals for chronic care. Each had been selected for long-term care by the orthopaedic surgeon and his staff as the likelihood of rehabilitation in his/her original habitat was considered poor. Because of an active rehabilitation at the hospital for chronic care, one-third of the surviving patients were discharged to their own homes or old people's homes within one year after the fracture. Most of these patients came originally from their own homes. Once discharged, the patients did not need to return to the hospital for chronic care.
Intra-abdominal Pressure and Trunk Muscle Activity During Lifting. III. Effect of Abdominal Muscle Training in Chronic Low-Back Patients
Authors: Hemborg B , Moritz U , Hamberg J , Holmström E , Löwing H , Akesson I
Published: May 2023

Isometric training of the abdominal muscles is often recommended in programs of primary or secondary prevention for low-back pain. In this study 20 male workers with 2-18 years' history (average 5 1/2 years) of low-back pain without sciatica went through intense isometric abdominal muscle training for 5 weeks. Before and after training the subjects had trunk flexion and extension strength tests and a series of standardized lifts. The intraabdominal pressure (IAP) and the EMG activity of the oblique abdominal muscles, and of the erector spinae muscle were recorded. It was found that: the strength of the abdominal muscles increased; the increased strength was correlated to an improved recruitment of motor units in the oblique abdominal muscles; the EMG activity of the oblique abdominal muscles when lifting decreased after training, i. e. the acquired ability to recruit more motor units was not made use of; the IAP at lifting was generally not affected. A better knowledge of the mechanisms responsible for the IAP in different situations is needed to support advice on training or other prevention.
Isokinetic Plantar Flexion Endurance. Reliability and Validity of output/excitation Measurements
Authors: Fugl-Meyer AR , Gerdle B , Eriksson BE , Jonsson B
Published: May 2023

The reliability and validity of isokinetic measurement of plantar flexion endurance has been studied by a method previously described by us which utilizes simultaneous measurements of mechanical contractional work (CW) and integrated electromyogram (iEMG). The reliability was gauged by test/re-test with a two year's interval; while validity was assessed by myoelectric power spectrum analyses. The output/input balance (CW/iEMG) remained unchanged for the group as well as inter-individually. Changes in myoelectric power spectrum as function of number of contractions were clearly indicative of fatigue. Under the present conditions fatigue of fast twitch motor units may explain the rapid decreases in output and excitation followed by nearly steady state levels of all registered parameters. As is the case for non-fatigued isokinetic plantar flexions, the motor unit recruitment order appears quite stereotyped during plantar flexion fatigue. The findings of significantly lower mean power spectrum during the first part of each contraction than during the second part may support the size-principle described by Henneman.
Severely Mobility-Disabled People Assess the Quality of Their Lives
Authors: Stensman R
Published: May 2023

Thirty-six severely mobility-disabled subjects aged 24-52 years using a wheelchair and in need of daily assistance and 36 non-handicapped, matched control-subjects were interviewed. They were asked to rank 30 different abilities involving physical and mental functions, interpersonal and social relationships, and to rate their overall quality of life (QOL) on a 0-10 point scale. Among the severely mobility-disabled subjects the mean value of self-reported QOL was 8. 0, which differs only slightly from 8. 3 among the controls. The mean QOL among the disabled showed no significant difference regarding congenital/acquired and progressive/permanent disability. The 'abilities' ranked 1-9 were not directly related to mobility and corresponded among the disabled and non-handicapped. The functions lacked by the severely mobility-disabled persons were rated as less important by the disabled. The undiminished QOL is probably a result of personal adjustment, compensation by medical rehabilitation and society, as well as positive features of the disability.
Leisure Time Physical Activities and the Results of Surgery of Lumbar Disc Herniation
Authors: Alaranta H , Hurme M , Karppi SL
Published: May 2023

The aim of this study was to elucidate the consequences of leisure time physical activities on the one-year results of surgery of lumbar intervertebral disc herniation. Pre- and postoperative leisure time physical activities and severity of occupation handicap were analyzed from 212 patients. Only to a certain degree the findings support the claim that a high preoperative level of physical activities during leisure time is linked with good postoperative results.
Life Conditions of Persons With and Without Low-Back Pain
Authors: Saraste H , Hultman G
Published: May 2023

A comparison of life conditions (such as dwelling, health, leisure-time activities, education, occupation, and work characteristics) was made between age- and sex-stratified groups of persons with and without low-back pain (BP). The primary data were collected from a random, geographically standardized 1:1,000 sample of the Swedish population including 2,872 citizens aged 30-59 years. There were no differences with respect to dwelling, height, weight, habits of physical exercise, other non-occupational activities, and frequency of unemployment. In the group of 50-59 year old persons, the males with BP smoked more than those without. In the same age-group of females, and in the younger male groups there were no differences in smoking habits. Physically heavy, monotonous, and repetitive work was more frequent among the subjects with BP. The relative number of highschool-educated was lower among males--in the youngest age group--with BP. The back-healthy persons evaluated their state of health as better and their need of medical care as less than the persons with BP.
Relative Mechanical Load on Back and Hip Muscles in Standing Position When Handling Materials Manually. A Study of Packing Work
Authors: Svensson OK , Németh G , Ekholm J
Published: May 2023

Muscular load on the back and hip muscles was quantified and compared using a muscular strength utilization ratio (MUR). The MUR was obtained by dividing the total moment about the bilateral joint axis by the counteracting maximum muscular strength at the same joint angle. 72 different postures during simulated packing work were studied, with different combinations of box size, angle, edge height and weight. The MUR was calculated for a large, an average sized and a small man depending on whether they were all either strong, of average strength, or weak, thus giving nine MUR values for each posture. For a weak man, the MUR exceeded 100% in many postures. The largest box at a zero- or 30-degree angle to the horizontal with its upper edge 20 cm below elbow height gave the highest MUR, while the smallest box angled at 90 degrees with the upper edge 10 cm above elbow height gave the lowest. The presented concept of relating joint load to strength is proposed for use in preventive ergonomic counselling and in vocational rehabilitation.
The Effect of Water Exercise Therapy Given to Patients With Rheumatoid Arthritis
Authors: Danneskiold-Samsøe B , Lyngberg K , Risum T , Telling M
Published: May 2023

It is well known that patients suffering from rheumatoid arthritis have a reduced muscular function. The positive effect of physical training on rheumatic patients has been shown. In this study the effect of exercise therapy performed in a heated swimming pool has been evaluated for eight patients in a non-acute stage of rheumatoid arthritis. The median pre-treatment maximal isometric and isokinetic quadriceps strength was 88 Nm (44-146) and 99 Nm (62-149) respectively, which was 61% and 70% of that found in a control group of healthy persons. After 2 months exercise therapy the median maximal isometric and isokinetic quadriceps strength increased by 38% and 16% compared to the pre-treatment value (p less than 0.02 and p less than 0.05). All patients, except one who developed cardiac arrhythmia during the second test, accomplished a submaximal bicycle test (a.m. Astrand). An increase in the aerobic capacity was observed in all patients after the training period.
Treatment of Drop Foot Using an Implantable Peroneal Underknee Stimulator
Authors: Strojnik P , Acimovic R , Vavken E , Simic V , Stanic U
Published: May 2023

An implantable peroneal stimulator has been developed to improve the rehabilitation of the drop foot patients who cannot use or refuse the use of conventionally applied peroneal braces. The small size promotes convenient attachment on the stimulation site after a minor surgical intervention. During the past two years twenty implants have been applied. The influence of different stimulation parameters upon the correction of anomalies during walking has been studied using clinical and computer-supported assessment. Possible noxious effects on the peroneal nerve have been studied by measuring nerve conduction velocity. The stimulator is well accepted by patients. Clinical observations show a significant correction of equinovarus and improved gait.
Prediction of the Effect of Training on the Walking Tolerance in Patients With Intermittent Claudication
Authors: Jonason T , Ringqvist I
Published: May 2023

The possibility of predicting the effect of training on the walking tolerance in intermittent claudication has been studied. After three months of supervised training in 54 patients, the maximal walking distance (MWD) increased by 67% and the painfree walking distance (PFD) by 91%. The analysis of the relation between tested background variables and the effect of training showed covariation only in 14% of the increase in MWD and in 19% of the increase in PFD. The possibility of predicting the effect of training on the walking tolerance in the individual patient with intermittent claudication is limited.
Transcutaneous Electrical Stimulation of the Normal Rabbit Joint
Authors: Weinberger A , Dalith M , Toren A , Volovsky-Toren P , Ben-Bassat M , Giler S , Pinkhas J
Published: May 2023

To determine the effect of transcutaneous electrical stimulation on the rabbit joint, we studied skin and intraarticular temperatures and pressure both before and following the stimulation in nine rabbits. An elevation in skin temperature by a mean of 0.6 degrees C (p less than 0.05) and increase in intraarticular temperature by a mean of 0.8 degrees C (p less than 0.01) was noted following the electrical stimulation. Intraarticular pressure in the stimulated joints has only a trend to increase, but not significantly. In four other rabbits, synovial tissue of the stimulated joint showed blood vessels congestion and interstitial edema. These results suggest that the analgetic effect produced by electrical stimulation on joints may partially involve intraarticular temperature and pressure alterations.
Prosthetic Rehabilitation in Bilateral High Above Elbow Amputation
Authors: Johansen PB , Breitholtz M , Cavrini R , Johansson B , Schmidl H , Thyberg M
Published: May 2023

Rehabilitation in patients with bilateral high above elbow amputation presents a considerable prosthetic problem. A patient with high upper arm amputations after a high-voltage injury is presented. He was successfully fitted with multifunctional myoelectric hand prostheses. The problems in rehabilitation of adult bilateral arm amputees are discussed and the value of fitting these patients with electrically powered prostheses is assessed. The balance between technical and clinical aspects is discussed in relation to patient acceptance. In our case good acceptance and functional benefit was noted. The fact is stressed that the bilateral upper extremity amputee can regain considerable physical function with the fitting of suitable prostheses, even if the limb remnants are short and provide little or no function. An extensive team approach at specialized centres will favour the results.
Effect of Electro-Motor Stimulation on the Power Production of a Maximally Stretched Muscle
Authors: Tachino K , Susaki T , Yamazaki T
Published: May 2023

The effect of electro-motor stimulation (EMS) upon the increase in power production of the tibialis anterior muscle (TA) of healthy individuals in both the maximally stretched (ST group) and shortened (SH group) positions was investigated. The effect of cross-education upon the contralateral muscle was also examined. EMS with a frequency of 50 hertz, a duration of 0.2 miliseconds, and a rectangular wave was applied for ten seconds with a ten-second interval and repeated ten times per day for six weeks. The ST group gained significantly 9.4%, 15.5%, and 16.4% after two, four, and six weeks of stimulation, respectively, while the SH group also showed a significant gain of 5.1%, 8.3%, and 3.0%. When comparing the two groups at the end of the six-week period the ST group's gain was significantly greater. The increase of power production of the unstimulated TA was 5.5%, 8.0%, and 4.3% in the ST group, which was significant at the end of the second and fourth week of stimulation. The SH group, however, registered a non-significant increase of -2.7%, 1.8%, and -1.5%. Comparison between the two groups showed a significant increase in the power production of the unstimulated TA in the ST group commencing the second week.
X-linked Duchenne Muscular Dystrophy. Motor Functions and Prognosis
Authors: H Hinge H , Hein-Sørensen O , Reske-Nielsen E
Published: May 2023

69 patients with x-linked Duchenne Muscular Dystrophy (DMD) were included in a retrospective investigation from 1975-1986. A mean profile of the decline of the motor functions was made by using the median age at which the patients were unable to perform specific motor functions by request. It was found that 81.2% of the personal profiles followed the pattern shown in the mean profile of the disease and that DMD is progressing in a uniform way, but with a different progression rate in every DMD patient. Good correlation between two motor functions made it possible to predict a personal prognosis of the decline of the motor functions in the DMD patient. No correlation between late walkers (later than 18 months) and rapid progression was found.
The Swedish Back School in Chronic Low Back Pain. Part II. Factors Predicting the Outcome
Authors: Hurri H
Published: May 2023

The aim of the study was to analyse the factors predicting the outcome of the Swedish back school and spontaneous recovery in chronic low back pain. The predicting variables describing the treatment group (n = 95) and the control group (n = 93) at the initiation of study included sociodemographic factors, variables related to work, severity of low back pain, and a number of clinical measurements and evaluations. The Oswestry Low Back Pain Disability Questionnaire was used for judging recovery factors. It was found that the best predictor for the outcome of the treatment and for spontaneous recovery was work satisfaction.