bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shoulder Dysfunction Assessment: Self-report and Impaired Scapular Movements
Authors: Lin Jiu-jenq , Hanten William P , Olson Sharon L , Roddey Toni S , Soto-quijano David A , Lim Hyun K , Sherwood Arthur M 
Published: February 2017

AbstractBackground and Purpose. Shoulder dysfunction is common in various patient populations. This investigation was performed to assess shoulder dysfunction with self-report and performance-based functional measures. Subjects. Fifty men (25 with shoulder dysfunction and 25 without shoulder dysfunction) participated in this study. Methods. Self-report functional disabilities were assessed with the Flexilevel Scale of Shoulder Function (FLEX-SF), and electromagnetic tracking sensors were used to monitor 3-dimensional scapular movements during 4 functional tasks. Results. Relative to the control group, the group with shoulder dysfunction showed significant alterations in scapular movements (averages of 6.9° less posterior tipping, 5.7° less upward rotation, and 2.3 cm more elevation). Scapular kinematics correlated significantly (r) with the Self-report FLEX-SF measure during functional tasks (posterior tipping=.454 to .712, upward rotation=.296 and .317, and elevation=−.310). Discussion and Conclusion. Functional disabilities were identified with self-report and performance-based functional measures. The inadequate scapular posterior tipping and scapular upward rotation as well as the excessive elevation may have implications in planning intervention strategies for people with shoulder dysfunction.
Shoulder Function and 3-Dimensional Scapular Kinematics in People With and Without Shoulder Impingement Syndrome
Authors: McClure Philip W , Michener Lori A , Karduna Andrew R 
Published: February 2017

AbstractBackground and Purpose. Several factors such as posture, muscle force, range of motion, and scapular dysfunction are commonly believed to contribute to shoulder impingement. The purpose of this study was to compare 3-dimensional scapular kinematics, shoulder range of motion, shoulder muscle force, and posture in subjects with and without primary shoulder impingement syndrome. Subjects. Forty-five subjects with impingement syndrome were recruited and compared with 45 subjects without known pathology or impairments matched by age, sex, and hand dominance. Methods. Shoulder motion and thoracic spine posture were measured goniometrically, and force was measured with a dynamometer. An electromagnetic motion analysis system was used to capture shoulder kinematics during active elevation in both the sagittal and scapular planes as well as during external rotation with the arm at 90 degrees of elevation in the frontal plane. Results. The impingement group demonstrated slightly greater scapular upward rotation and clavicular elevation during flexion and slightly greater scapular posterior tilt and clavicular retraction during scapular-plane elevation compared with the control group. The impingement group demonstrated less range of motion and force in all directions compared with the control group. There were no differences in resting posture between the groups. Discussion and Conclusion. The kinematic differences found in subjects with impingement may represent scapulothoracic compensatory strategies for glenohumeral weakness or motion loss. The decreased range of motion and force found in subjects with impingement support rehabilitation approaches that focus on strengthening and restoring flexibility.
Reliability and Validity of Data for 2 Newly Developed Shuttle Run Tests in Children With Cerebral Palsy
Authors: Verschuren Olaf , Takken Tim , Ketelaar Marjolijn , Gorter Jan Willem , Helders Paul JM 
Published: February 2017

Abstract
Background and Purpose. The purpose of this study was to examine the reliability and validity of data obtained with 2 newly developed shuttle run tests (SRT-I and SRT-II) to measure aerobic power in children with cerebral palsy (CP) who were classified at level I or II on the Gross Motor Function Classification System (GMFCS). The SRT-I was developed for children at GMFCS level I, and the SRT-II was developed for children at GMFCS level II. Subjects. Twenty-five children and adolescents with CP (10 female, 15 male; mean age=11.9 years, SD=2.9), classified at GMFCS level I (n=14) or level II (n=11), participated in the study. Methods. To assess test-retest reliability of data for the 10-m shuttle run tests, the subjects performed the same test within 2 weeks. To examine validity, the shuttle run tests were compared with a GMFCS level–based treadmill test designed to measure peak oxygen uptake. Results. Statistical analyses revealed test-retest reliability for exercise time (number of levels completed) (intraclass correlation coefficients of .97 for the SRT-I and .99 for the SRT-II) and reliability for peak heart rate attained during the final level (intraclass correlation coefficients of .87 for the SRT-I and .94 for the SRT-II). High correlations were found for the relationship between data for both shuttle run tests and data for the treadmill test (r=.96 for both). Discussion and Conclusion. The results suggest that both 10-m shuttle run tests yield reliable and valid data. Moreover, the shuttle run tests have advantages over a treadmill test for children with CP who are able to walk and run (GMFCS level I or II). [Verschuren O, Takken T, Ketelaar M, et al. Reliability and validity of data for 2 newly developed shuttle run tests in children with cerebral palsy. Phys Ther. 2006;86:1107–1117.]
Ultrasound Produced by a Conventional Therapeutic Ultrasound Unit Accelerates Fracture Repair
Authors: Warden Stuart J , Fuchs Robyn K , Kessler Chris K , Avin Keith G , Cardinal Ryan E , Stewart Rena L 
Published: February 2017

Abstract
Background and Purpose. A recent novel application of ultrasound therapy is the treatment of bone fractures. The aim of this study was to investigate the effect on fracture repair of ultrasound produced by a conventional therapeutic ultrasound unit as used by physical therapists. Subjects and Methods. Bilateral midshaft femur fractures were created in 30 adult male Long-Evans rats. Ultrasound therapy was commenced on the first day after fracture and introduced 5 days a week for 20 minutes a day. Each animal was treated unilaterally with active ultrasound and contralaterally with inactive ultrasound. Active ultrasound involved a 2-millisecond burst of 1.0-MHz sine waves repeating at 100 Hz. The spatially averaged, temporally averaged intensity was set at 0.1 W/cm2. Animals were killed at 25 and 40 days after fracture induction, and the fractures were assessed for bone mass and strength. Results. There were no differences between fractures treated with active ultrasound and fractures treated with inactive ultrasound at 25 days. However, at 40 days, active ultrasound-treated fractures had 16.9% greater bone mineral content at the fracture site than inactive ultrasound-treated fractures. This change resulted in a 25.8% increase in bone size, as opposed to an increase in bone density, and contributed to active ultrasound-treated fractures having 81.3% greater mechanical strength than inactive ultrasound-treated fractures. Discussion and Conclusion. These data indicate that ultrasound produced by a conventional therapeutic ultrasound unit as traditionally used by physical therapists may be used to facilitate fracture repair. However, careful interpretation of this controlled laboratory study is warranted until its findings are confirmed by clinical trials. [Warden SJ, Fuchs RK, Kessler CK, et al. Ultrasound produced by a conventional therapeutic ultrasound unit accelerates fracture repair. Phys Ther. 2006;86:1118–1127.]
Twice-Weekly Complete Decongestive Physical Therapy in the Management of Secondary Lymphedema of the Lower Extremities
Authors: Holtgrefe Karen M 
Published: February 2017

Abstract
Background and Purpose. This case report describes the physical therapist examination, evaluation, and intervention for a patient with bilateral lower-extremity lymphedema who received complete decongestive physical therapy 2 days per week instead of the recommended daily frequency. Case Description. The patient was a 55-year-old woman who developed bilateral lower-extremity grade II lymphedema 3 years after surgery and radiation for cervical cancer. She had impairments in hip and knee flexion range of motion and functional limitations in transfers, gait, and activities of daily living. Intervention. A twice-weekly intervention program was implemented consisting of education in skin care, manual lymph techniques, compression, and exercise. Outcomes. Outcomes related to the lymphedema were measured using the sum of the circumference of each limb. At discharge, the patient had reductions in lymphedema of 9% for the left lower extremity and 10% for the right lower extremity. Her hip flexion range of motion increased from 95 degrees to 110 degrees, and her knee flexion range of motion increased from 95 degrees to 130 degrees. She had resumed all premorbid activities and was independent in self-management. Discussion. Twice-weekly management of lymphedema using a program of skin care, manual lymph techniques, compression, and exercise was followed by reduction of the impairments and functional limitations in a patient with bilateral lower-extremity lymphedema.
Reprint—AACVPR/ACCF/AHA 2010 Update: Performance Measures on Cardiac Rehabilitation for Referral to Cardiac Rehabilitation/Secondary Prevention Services
Authors: Thomas Randal J. , King Marjorie , Lui Karen , Oldridge Neil , Piña Ileana L. , Spertus John , Masoudi Frederick A. , DeLong Elizabeth , Erwin John P. , Goff David C. , Grady Kathleen , Green Lee A. , Heidenreich Paul A. , Jenkins Kathy J. , Loth Ann R. , Peterson Eric D. , Shahian David M. 
Published: February 2017

Endorsed by the American College of Chest Physicians, the American College of Sports Medicine, the American Physical Therapy Association, the Canadian Association of Cardiac Rehabilitation, the European Association for Cardiovascular Prevention and Rehabilitation, the Inter-American Heart Foundation, the National Association of Clinical Nurse Specialists, the Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons.
This document was approved by the American College of Cardiology Foundation Executive Committee in April 2010, by the American Heart Association Science Advisory and Coordinating Committee in April 2010, and by the AACVPR Document Oversight Committee and Board of Directors in June 2010.
The American College of Cardiology Foundation requests that this document be cited as follows: Thomas RJ, King M, Lui K, Oldridge N, Piña IL, Spertus J. AACVPR/ACC/AHA 2010 update: performance measures on cardiac rehabilitation for referral to cardiac rehabilitation/secondary prevention services. J Am Coll Cardiol 2010;56:1159–1167.
This article is copublished in Circulation and the Journal of Cadiopulmonary Rehabilitation and Prevention.
Copyright ©2010 by the American Association of Cardiovascular and Pulmonary Rehabilitation, American College of Cardiology Foundation, and American Heart Association, Inc. Published by Elsevier Inc.
CPT™ contained in the online data supplement is ©2009 American Medical Association.
Snoring: Is It in the Ear of the Beholder?
Authors: Hoffstein V. , Mateika S. , Anderson D. 
Published: February 2017

Summary:
Complaint of snoring, which is usually voiced by a patient's bedpartner, frequently leads to investigations in the sleep laboratory that are designed to assess snoring objectively and determine whether it is a symptom of sleep apnea. How well this subjective complaint of the listener is confirmed by the objective measurement of snoring is not known. Consequently, we designed a study i) to test the validity of self-perception of snoring and ii) to compare subjective perception of snoring by the sleep technologist with objective measurement of its frequency and loudness. We studied 613 unselected patients referred to our sleep clinic because of snoring and suspicion of sleep apnea. They all had nocturnal polysomnography that included measurements of snoring, expressed as the number of snores per hour of sleep [snoring index (SI)] and mean (dBmean) and maximum (dBmax) nocturnal sound intensity. Following the sleep study, the technologist (and patient) independently rated a patient's snoring as none, mild, moderate or severe. Kruskall-Wallis test, Spearman rank correlations and Cohen's kappa statistics were used to compare the groups, examine the correlations between subjective and objective measurements, and check the agreement between them. We found that i) most patients who snore (471 of 613) were unaware of this behavior; ii) snoring index increased progressively from the “none” group (median SI = 26) to the “severe” group (median SI = 755), with a significant but moderate correlation between the technologist's impression and SI (r = 0.68, p < 0.0005) and poor correlation between the technologist's impression and dBmean (r = 0.34, p < 0.0005); and iii) most of those patients who claim to be able to judge the severity of their snoring have a different perception of it than the listener, with poor agreement between patient's and technologist's subjective impression (Cohen's kappa = 0.22, 95% confidence limits: 0.14−0.33). We conclude that to a large extent snoring is “in the ear of the beholder”, showing only moderate correlation with objective measurement.
Relationship of Slow and Rapid EEG Components of CAP to ASDA Arousals in Normal Sleep
Authors: Parrino Liborio , Smerieri Arianna , Rossi Mariano , Giovanni Mario 
Published: February 2017

Summary/Abstract:

Study Objectives:
Besides arousals (according to the ASDA definition), sleep contains also K-complexes and delta bursts which, in spite of their sleep-like features, are endowed with activating effects on autonomic functions. The link between phasic delta activities and enhancement of vegetative functions indicates the possibility of physiological activation without sleep disruption (i.e., arousal without awakening). A functional connection seems to include slow (K-complexes and delta bursts) and rapid (arousals) EEG events within the comprehensive term of activating complexes. CAP (cyclic alternating pattern) is the spontaneous EEG rhythm that ties both slow and rapid activating complexes together during NREM sleep. The present study aims at exploring the relationship between arousals and CAP components in a selected sample of healthy sleepers.

Design:
Polysomnographic analysis according to the scoring rules for sleep stages and arousals. CAP analysis included also tabulation of subtypes A1 (slow EEG activating complexes), A2 and A3 (activating complexes with fast EEG components).

Setting:
40 sleep-lab accomplished recordings.

Participants:
Healthy subjects belonging to a wide age range (38 ± 20 yrs.).

Interventions:
N/A

Measurement and Results:
Of all the arousals occurring in NREM sleep, 87% were inserted within CAP. Subtypes A2 and A3 of CAP corresponded strikingly with arousals (r=0.843 ; p&lt;0.0001), while no statistical relationship emerged when arousals were matched with subtypes A1 of CAP. Subtypes A1 instead correlated positively with the percentages of deep sleep (r=0.366; p&lt;0.02).

Conclusions:
The CAP subtype classification encompasses both the process of sleep maintenance (subtypes A1) and sleep fragmentation (subtypes A2 and A3), and provides a periodicity dimension to the activating events of NREM sleep.
Self-Reported Nap Behavior and Polysomnography at Home in Midlife Women with and without Insomnia
Authors: Johnston Sandra K. , Landis Carol A. , Lentz Martha J. , Shaver Joan L.F. 
Published: February 2017

Abstract

Study Objectives:
To describe self-reported nap behavior and relationships among nap history, nap behavior during the study, indicators of subjective and objective insomnia, and self-reported daytime sleepiness from data previously obtained in a week-long field study of sleep in midlife women with and without insomnia.

Design:
Descriptive/comparative secondary analysis.

Setting:
Individual homes of the participants.

Participants:
Midlife women (mean age 46±4 years) with self-reported insomnia (n=101) and women with adequate sleep (n=30).

Interventions:
N/A

Measurements and Results:
Sleep patterns were assessed by polysomnography (PSG), daily diaries, and a sleep history form. Although all women were requested not to nap, 47% of the women reported nap behavior during the study. Strong relationships were observed between a history of daytime naps and nap behavior (c2=25.63, p≤.001), and a history of feeling sleepy or struggling to stay awake during the daytime (i.e., sleepiness) and nap behavior (c2=18.05, p≤.001) during the study. There was also a modest significant (p≤.05) correlation (r=. 25) between tiredness and nap duration during the study. There were no statistical differences in sleep variables between the napping and non-napping groups. In the napping group, there were no differences between women with sleep efficiency &lt; 85% (objective insomnia) and those with sleep efficiency&gt;85%.

Conclusions:
Habitual nap behavior may be indicative of daytime sleepiness in women with insomnia, but it is not necessarily related to subjective or objective measures of insomnia. Women who routinely nap may be unable to refrain from napping during the daytime in long-term research studies.
Feasibility of Using Unattended Polysomnography in Children for Research—Report of the Tucson Children's Assessment of Sleep Apnea Study (TuCASA)
Authors: Goodwin James L. , Enright Paul L. , Kaemingk Kris L. , Rosen Gerald M. , Morgan Wayne J. , Fregosi Ralph F. , Quan Stuart F. 
Published: February 2017

Abstract

Study Objectives:
The Tucson Children's Assessment of Sleep Apnea study (TuCASA) is designed to investigate the prevalence and correlates of objectively measured sleep-disordered breathing in pre-adolescent children. This paper documents the methods and feasibility of attaining quality unattended polysomnograms in the first 162 TuCASA children recruited.

Design:
A prospective cohort study projected to enroll 500 children between 5 and 12 years of age who will undergo unattended polysomnography, neurocognitive evaluation, and physiological and anatomical measurements thought to be associated with sleep-disordered breathing. Setting: Children are recruited through the Tucson Unified School District. Polysomnograms and anthropometric measurements are completed in the child's home.

Participants:
Of the 157 children enrolled in TuCASA, there were 100 children (64%) between 5–8 years old and 57 children (36%) between the ages of 9 to 12. There were 74 (47%) Hispanic children, and 68 (43%) female participants.

Interventions:
N/A

Measurements & Results:
Technically acceptable studies were obtained in 157 children (97%). The initial pass rate was 91%, which improved to 97% when 9 children who failed on the first night of recording completed a second study which was acceptable. In 152 studies (97%), greater than 5 hours of interpretable respiratory, electroencephalographic, and oximetry signals were obtained. The poorest signal quality was obtained from the chin electromyogram and from the combination thermister/nasal cannula. Parents reported that 54% of children slept as well as, or better than usual, while 40% reported that their child slept somewhat worse than usual. Only 6% were observed to sleep much worse than usual. Night-to-night variability in key polysomnographic parameters (n=10) showed a high degree of reproducibility on 2 different nights of study using identical protocols in the same child. In 5 children, polysomnograms done in the home were comparable to those recorded in a sleep laboratory.

Conclusions:
The high quality of data collected in TuCASA demonstrates that multi-channel polysomnography data can be successfully obtained in children aged 5–12 years in an unattended setting under a research protocol.
Indoor Exposure to Natural Bright Light Prevents Afternoon Sleepiness
Authors: Kaida Kosuke , Takahashi Masaya , Haratani Takashi , Otsuka Yasumasa , Fukasawa Kenji , Nakata Akinori 
Published: February 2017

Abstract

Study Objectives:
The present study examined the effects of indoor exposure to natural bright light on afternoon sleepiness.

Design:
Participants took part in 3 experimental conditions: (1) a natural bright light condition in which they carried out performance and arousal tests sitting near a window (3260.0 ± 1812.43 lux) from 12:40 PM to 1:10 PM, (2) a nap condition in which they were provided a nap opportunity for 20 minutes from 12:45 PM, and (3) a control condition in which they performed the tests in less than 100 lux surroundings from 12:40 PM to 1:10 PM. Before and after each treatment, the same series of tests were administered.

Setting:
A temperature- and light-controlled sleep laboratory.

Participants:
Sixteen healthy female paid volunteers aged 33 to 43 (38.1 ± 2.68) years.

Interventions:
Indoor natural bright light and a short nap.

Measurements and Results:
Arousal levels were measured by the Psychomotor Vigilance Task, Alpha Attenuation Test, Karolinska Drowsiness Test, and Karolinska Sleepiness Scale. The tests were repeated every 30 minutes from 11:00 AM to 4:10 PM. Ambient light intensity was maintained at less than 100 lux, except during natural bright light exposure. Short-term exposure to natural bright light significantly improved afternoon arousal levels, as measured by the Karolinska Drowsiness Test and Alpha Attenuation Test, the effects of which continued for at least 60 minutes (1:10–2:10 PM). However, no significant differences were observed between conditions for Psychomotor Vigilance Test performance.

Conclusions:
Brief indoor exposure to natural bright light may decrease afternoon sleepiness. This technique of light could be used in work settings in which napping is not permitted.

Citation:
Kaida K; Takahashi M; Haratani T et al. Indoor exposure to natural bright light prevents afternoon sleepiness.
Defining Insomnia: Quantitative Criteria for Insomnia Severity and Frequency
Authors: Lineberger Margaret D. , Carney Colleen E. , Edinger Jack D. , Means Melanie K. 
Published: February 2017

Abstract

Study Objective:
Recent efforts have been made to develop quantitative frequency, duration, and severity criteria for insomnia. The current study was conducted to test a range of frequency and severity criteria sets for discriminating primary insomnia sufferers from normal sleepers.

Participants:
Seventy-two adults with primary insomnia and 88 agematched normal sleepers.

Methods:
Participants completed 14 consecutive nights of sleep logs to monitor their home sleep patterns. Receiver-operator characteristic curve analyses were used to compare a range of severity and frequency criteria sets for discriminating the insomnia and normal-sleeper groups. In addition, sensitivity and specificity tests were conducted for a range of waketime severity cutoffs based on 2-week mean sleep-log data.

Results:
Receiver-operator characteristic curve analyses showed that no 1 combination of severity and frequency criteria maximized sensitivity and specificity. Rather, the optimal frequency cutoff decreased as the severity criterion increased. Analyses of mean sleep-log data showed that an average sleep-onset latency or middle-of-the-night wake time (ie, time awake between sleep onset and final morning awakening) cutoff of 20 minutes or longer over 2 weeks of sleep-log monitoring appeared to best maximize sensitivity (94.4%) and specificity (79.6%) for insomnia classification.

Conclusions:
The optimal quantitative insomnia criteria found herein differ from those previously proposed. Nonetheless, results suggest that quantitative criteria derived from sleep-log data may be useful for classification of primary insomnia.

Citation:
Lineberger MD; Carney CE; Edinger JD et al. Defining insomnia: quantitative criteria for insomnia severity and frequency.