bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of recovery for lower limb amputation
Authors: Ham Rosalind , de Trafford June , Van de Ven Catherine 
Published: July 2008

Following the identification of functional activities to record the recovery patterns of the amputee, a preliminary survey was carried out over a 12-month period, to monitor these patterns following lower limb amputation. Four hundred and fifty-nine returns were received and the profile of the sample was found to be in line with the UK amputee data. The results show that basic bed activities that is, moving about the bed, moving from the lying to sitting position and being able to sit up unaided, were the easiest activities for the sample to achieve independently and took between one to two weeks. Transferring the upper body and dressing the upper body independently were more difficult and took between three to four weeks to achieve and dressing the lower body took, on average, three to five weeks to master following the amputation. A number of the patients were either transferred or discharged from the site of the operation from the second week postoperatively and were not followed up by the physiotherapists at the acute site. This resulted in the data on the later milestones of recovery, either using an early walking aid or a prosthesis, being less accurate. A further study that takes these facts into account is recommended to conclusively establish the milestones of recovery for this group of disabled patients.
Electrotherapeutic rehabilitation of the quadriceps in elderly osteoarthritic patients: a double blind assessment of patterned neuromuscular stimulation
Authors: Oldham JA , Howe TE , Petterson T. , Smith GP , Tallis RC 
Published: July 2008

Recent studies, in combination with advances in modern electronics, suggest a role for electrotherapy in reversing muscle wasting. However, its effects on human subjects are not always clear-cut. The authors propose that conventional uniform frequency stimulation may deprive the muscle of adaptive information normally encoded in the nonuniform discharge of its motoneuron. This hypothesis was tested in a double blind control trial by stimulating the quadriceps femoris (QF) of elderly subjects with osteoarthritis of the knee. A stimulation pattern replicating that occurring in a normal, fatigued QF motor unit (patterned neuromuscular stimulation) was compared with uniform stimulation of the same mean frequency and random pattern stimulation (created by shuffling the order of the interpulse intervals in the replicated stimulus train). A'sham' stimulation protocol provided an effective placebo. Subjects were assessed at the level of impairment (muscle strength, endurance and cross-sectional area), disability (timed 10-metre walk, timed sit-to-stand) and handicap (part II of the Nottingham Health Profile). Following stimulation, some descriptive improvements in outcome measures were observed in favour of PNMS, particularly in functional tests such as walking speed and sit-to-stand time. No stimulation pattern emerged as being significantly better than another, although statistically significant ( p ≤ 0.05) differences between individual stimulation patterns were observed at a number of assessment weeks.
The effect of shoulder pain on outcome of acute hemiplegia
Authors: Roy CW , Sands Madeleine R , Hill Linda D , Harrison A. , Marshall S. 
Published: July 2008

The aim of this study was to decide whether shoulder pain in stroke is a marker of severity, or an independent predictor of poor outcome. The study was prospective observational in design from consecutive admissions. Acute medical and geriatric wards in three district hospitals provided the setting, and the subjects were 76 patients acutely admitted to hospital with a first stroke. The main outcomes measured were length of stay in hospital, Barthel Index, Frenchay Arm Test, Motricity Index and discharge placement. After controlling for other indicators of stroke severity, shoulder pain on movement was the most important predictor of poor recovery of arm power and function, and an important contributor to length of stay in hospital. Urinary incontinence was the strongest indicator of length of stay and Barthel Index scores. Patients with subluxation and malalignment of the shoulder fared much more poorly than those with normal shoulder alignment. The results concluded that shoulder pain appears to influence outcome of stroke independent of severity. We recommend that this symptom receive careful attention.
An evaluation of exercise regimes for patients with osteoarthritis of the knee: a single-blind randomized controlled trial
Authors: Callaghan MJ , Oldham JA 
Published: July 2008

Osteoarthritis (OA) of the knee is a major public health problem in the United Kingdom and various forms of physiotherapy are used in the treatment of this condition despite the lack of studies evaluating its efficacy. The purpose of this study was to compare the efficacy of two different forms of physiotherapy exercise management with a control group. Twenty-seven patients with OA knee were recruited from routine orthopaedic clinics and were on the waiting-list for physiotherapy. Patients were randomly allocated to three groups. Group 1 ( n = 9) consisted of a control group; Group 2 ( n = 8) consisted of supervised sessions of exercises; Group 3 ( n = 10) consisted of an advice and instruction session plus a functional home exercise regime. Parameters measured were: pain; range of motion; quadriceps strength; knee joint swelling; exercise tolerance. Results were analysed using a Kruskal-Wallis analysis of variance and a Mann-Whitney U-test with the significance level set at p <0.05. The results showed no significant difference ( p >0.05) between any of the outcome measures of the three groups. This study concludes that patients with OA knee can be helped most economically by one session of advice and a functional home exercise regime. This can be done in a group setting under supervision of one physiotherapist.
A regional specialty policy for pressure sores
Authors: Rowe Jed , Barer David 
Published: July 2008

A survey of pressure sores in Mersey's geriatric units revealed almost universal access to high technology equipment but limited availability of specialist skills and knowledge. Many wounds were treated with toxic or inappropriate agents. Consequently a regional specialty policy for pressure sores, incorporating a tissue viability formulary, was introduced. A second audit investigated its effects. The prevalence, grade, ages and anatomical sites affected were very similar in the two studies. Patients receiving a pressure sore risk assessment increased, from 157/170 (92%) to 186/187 (99.5%) ( p <0.0005). Prior to the introduction of the policy 74/272 (27%) pressure sores had an unsuitable cleanser, cavity filler or dressing compared with 51/309 (16%) subsequently ( p <0.005). This regional specialty audit has improved the management of pressure sores in 10 units.
The effect of stump length on the rehabilitation outcome in unilateral below-knee amputees for vascular disease
Authors: Subbarao KV , Bajoria S. 
Published: July 2008

The optimal stump length for prosthetic fitting in a below-knee amputee is considered to be not less than 12.5 cm. However, such long stumps may be associated with delay or failure of wound healing in lower limb amputees for vascular disease. This is often the cause of considerable morbidity, slow progress with rehabilitation, and long hospital stay. In the present study the rehabilitation outcomes in patients with short (10 cm or less) and long (more than 10 cm) stumps who had a unilateral below-knee amputation for peripheral vascular disease were compared. Each group consisted of 25 patients. There was no significant difference in the rehabilitation outcome (as measured by three different assessment scales) between the two groups. It is concluded that relatively short stumps (e.g. 8-10 cm long), which are likely to heal quicker and are associated with less risk of reamputation than long stumps, may be an advantage in this group of patients.
A pilot study to examine the potential impact of professional social work input into a chronic spinal clinic
Authors: Law Christopher SD , Hamlyn Peter J 
Published: July 2008

The potential impact of professional social work input in patients attending a tertiary neurosurgical chronic spinal clinic was assessed over a period of one year. Two hundred and sixty-four patients were booked into the clinic, and 206 attended (78%). Of these, 93 follow-up patients were selected at random and were interviewed (45%). Forty-two (45%) were male and 51 (55%) female. The median age was 50. Advice was found wanting in 35%. At follow-up (6-18 months later), 76% of those receiving it had acted successfully upon the advice given. In addition to identifying the extent of need, a simple scheme to allow easy identification of the most needy group was tested. Lack of employment was the most significant predictor of need, though a larger and more detailed study is required to assess other factors.
The scalability of the Rivermead Motor Assessment in acute stroke patients
Authors: Adams SA , Ashburn A. , Pickering RM , Taylor D. 
Published: July 2008

Objective: To examine the scalability of the Rivermead Motor Assessment with hospitalized acute stroke patients. Design: This was a prospective study of hospitalized stroke patients. Subjects: Fifty-one selected stroke patients, including those over the age of 65, were assessed at one, three and six weeks post-stroke using the Rivermead Motor Assessment. Coefficients of scalability and reproducibility were calculated for each of the three sections of the Rivermead Motor Assessment at each assessment. Results: The items in the gross function and arm sections met scaling criteria at all three assessments which meant that they were in appropriate order of difficulty. There was an overall increase in the proportion of subjects passing each item at successive assessments, suggesting that patients in the study were recovering. The leg and trunk section did not meet scale criteria with these acute stroke patients. Conclusions: We recommend that only the gross function and arm sections should be used as hierarchical scales with selected acute stroke patients. The leg and trunk section should only be used as an assessment checklist.
Relationships between measures of function, strength and walking speed in patients with diabetes and transmetatarsal amputation
Authors: Salsich Gretchen B , Mueller Michael J 
Published: July 2008

Objective: To determine the correlation between strength and functional measures, and the intercorrelation between the functional measures themselves, in a group of subjects with diabetes mellitus (DM) and transmetatarsal amputation (TMA). Design: Correlational study. Setting: The subjects were tested in the Applied Kinesiology Laboratory of the Program in Physical Therapy at Washington University School of Medicine, St Louis, MO, USA. Subjects: Thirty subjects with DM and TMA (mean age 61.7 ± 11.3 years) were studied. Main outcome measures: Function was measured using the Functional Reach Test (FR), the Physical Performance Test (PPT), the Sickness Impact Profile (SIP), and walking speed (WS) for 15.24 m. Strength measurements were taken using a hand-held dynamometer. Results: Highest correlations were found between hip extension strength and PPT: r = 0.69, FR: r = 0.45, and WS: r = 0.76, between knee extension strength and PPT: r = 0.48, and WS: r = 0.51, between hip flexion strength and PPT: r = 0.51, FR: r = 0.47, and WS: r = 0.59, between knee flexion strength and PPT: r = 0.57, and WS: r = 0.63, and between dorsiflexion strength and PPT: r = 0.49, and WS: r = 0.63. The following intercorrelations between functional measures were significant; PPT and FR: r = 0.66, PPT and SIP: r = -0.54, PPT and WS: r = 0.77, FR and WS: r = 0.54, SIP and WS: r = -0.47. Conclusions: The relationship between measures of hip and knee muscle strength and function provides some evidence that rehabilitation should focus on strengthening hip and knee extensors and flexors to improve function. The relationships between walking speed and strength, PPT, FR and SIP suggest that the simple measure of walking speed is a useful functional test in the clinic.
A one year follow-up study on the effects of acupuncture in the treatment of stroke patients in the subacute stage: a randomized, controlled study
Authors: Kjendahl Astrid , Säliström Susanne , Østen Per Egil , Stanghelle Johan Kvalvik , Borchgrevink Christian F 
Published: July 2008

Objective: We recently reported that acupuncture treatment of stroke patients in the subacute stage gave additive therapeutic benefit. The purpose of the present study was to determine, approximately one year after discharge from the rehabilitation hospital, whether the group differences still remained. Design: The patients were randomized into two groups: one acupuncture group and one control group, considering gender and side of hemispheral localization of lesion. With regard to the main parameters the groups were comparable at baseline. Setting: Initially, 45 stroke patients admitted to Sunnaas Rehabilitation Hospital were included in the study: median 40 days post stroke. Subjects: Forty-one of the patients were available one year after the treatment period: 21 patients in the acupuncture group and 20 controls. Intervention: All subjects received an individually adapted, multidisciplinary rehabilitation programme. The acupuncture group received additional treatment with classical acupuncture for 30 min three to four times weekly for six weeks. Main outcome measures: The patients were evaluated at inclusion, after six weeks and approximately 12 months after discharge from the rehabilitation hospital. The Motor Assessment Scale (MAS) for stroke patients, Sunnaas Index of Activity of Daily Living (ADL) and Nottingham Health Profile (NHP) were used. In addition, the social situations of the patients were recorded at one year follow-up. Results: The results show that the acupuncture group improved significantly more than the controls, both during the treatment period of six weeks, and even more during the following year, both according to MAS, ADL, NHP and the social situation. Conclusion: Although the mechanism of the effects is debatable, there seems to be a positive long-term effect of acupuncture given in the subacute stage post stroke.
Pelvic floor rehabilitation is effective in patients with multiple sclerosis
Authors: Vahtera T. , Haaranen M. , Viramo-Koskela AL , Ruutiainen J. 
Published: July 2008

Objective: To determine the effect of pelvic floor muscle exercises combined with electrical stimulation of pelvic floor on lower urinary tract dysfunction in multiple sclerosis (MS) patients with near normal (<100 ml) postvoid residual volumes. Design: Open, controlled, randomized study in two parallel groups. Setting: Rehabilitation centre for MS patients. Subjects: Fifty women and 30 men with definite MS and current symptoms of lower urinary tract dysfunction. Outcome: The muscle activity of the pelvic floor muscles was tested using surface EMG. Subjective urinary symptoms were assessed using a questionnaire. Interventions: Pelvic floor muscles were stimulated using electrical stimulation at six sessions. During and after the final session the patients were taught to exercise their pelvic floor muscles and advised to continue these exercises regularly for at least six months. The control group was not treated. Results: The maximal contraction power and endurance of the pelvic floor muscles increased after six sessions of electrical stimulation with interferential currents. Symptoms of urinary urgency, frequency and incontinence were significantly less frequent in the treated group than in the untreated subjects. Male patients appeared to respond better to the treatment than female patients. Compliance with the pelvic floor exercises was over 60% at the end of a follow-up for six months. Most drop-outs were due to the disappearance of urinary tract symptoms or to severe relapses in MS. Conclusions: The present study indicates that pelvic floor muscle exercises combined with electrical stimulation of the pelvic floor constitute an effective treatment for lower urinary tract dysfunction at least in male patients with MS.
Evaluation of a shortened version of the Abbreviated Mental Test in a series of elderly patients
Authors: Swain David G , Nightingale Peter G 
Published: July 2008

Objective: To determine whether a shortened version of the Abbreviated Mental Test is as effective as the Abbreviated Mental Test (AMT) itself in assessing cognition in elderly patients. Design: A shortened four-item version of the Abbreviated Mental Test (AMT4) was constructed using the following items: (1) Age, (2) Date of birth, (3) Place, and (4) Year, with impaired cognition indicated by an AMT4 score of less than four. Patients were assessed with the AMT. The AMT4 scores were then determined and matched against AMT scores. The performance of all 210 possible four-item combinations derivable from the AMT was assessed and ranked according to predictive efficiency (the percentage of patients whose cognition as judged by the AMT was correctly categorized by each four-item combination). Setting: Inner-city teaching hospital. Subject: Two hundred consecutive elderly patients seen on domiciliary visits, in the clinic or as orthogeriatric referrals. Results: The AMT4 score showed a statistically significant correlation with AMT score (Somers' d statistic 0.90: p < 0.001). The AMT4 had a predictive efficiency of 91 % and ranked 7=/210 possible four-item combinations. Conclusions: The AMT4 may be useful in the initial assessment of cognition in elderly patients, with little loss of accuracy in detecting marked cognitive impairment when compared to the AMT.
The use of standardized outcome measures in rehabilitation centres in the UK
Authors: Turner-Stokes Lynne , Turner-Stokes Tabitha 
Published: July 2008

Objective: To ascertain which standardized instruments are currently most commonly used as outcome measures for rehabilitation in routine clinical practice in the UK. Design: The study used a postal questionnaire which was sent out to members of two major societies of rehabilitation professionals in the UK. Results: Of 182 rehabilitation centres represented by respondents, 140 (77%) collected at least one standardized measure and 42 did not. Principal reasons for not recording measures were lack of time and not knowing what to collect. As had been anticipated, a very wide range of different measures were used by different centres, however some clear favourites emerged including the 10 m Walk, the Motricity Index and the Nine-hole Peg Test. One hundred and twenty-three centres used one or more global disability measure of which the commonest were the Barthel Index or one of its modifications and the Functional Independence Measure (FIM) and/or Functional Assessment Method (FAM). Among units that used handicap or extended activities of daily living (EADL) scales, the Nottingham EADL, the London Handicap Scale and the General Health Questionnaire (GHQ-22 or 12) were most popular. Outside neurorehabilitation, the Harold Wood/Stanmore mobility grades were used by 10/18 amputee rehabilitation centres and the Health Assessment Questionnaire (HAQ) was used by 15/48 units providing musculoskeletal rehabilitation. Conclusions: It is clear that no one measure is suitable in all settings and services, but the most popular measures from this survey may reasonably form the basis for a 'basket of recommended instruments' that may help to guide units wishing to collect outcome data but not knowing which to choose.
Toleration, Pluralism, and Truth
Authors: Roshwald Mordecai 
Published: July 2008

AbstractThis paper deals with three guiding principles of contemporary Western civilization. It explores the compatibility of Toleration, Pluralism and Truth, as well as their application to diverse domains of cultural activity and creation. There is no place for toleration, let alone pluralism, in the realm of logic and mathematics. Scientific conclusions allow diverse degrees of certainty. The realm of monotheistic religions excludes pluralism, but necessitates toleration. The domains of ethics and its related social institutions allow diversity in secondary matters, but essentially should be guided by universally valid principles. In the case of aesthetics, a diversity of taste suggests a virtually unlimited pluralism. Yet, a universal basic principle of aesthetic evaluation is suggested which would greatly reduce tolerable pluralism, although this assertion is made with less confidence than the insistence on basic norms in ethics.
Mathematical Universalism
Authors: Cartier Pierre 
Published: July 2008

AbstractThis paper presents a historical view of the rise of mathematical universalism in modern times. It argues that 20th century mathematical revolution laid the foundations for a new universalism which extended to physics, economics, informatics, and recently biology. It describes the role played by the organization of mathematical work for closer co-operation among scientists on an international scale throughout the century, and stresses the importance of mathematics in the education process.
Scientific Rationality and Cultural Diversity
Authors: Mvé-Ondo Bonaventure 
Published: July 2008

AbstractThis paper examines the dynamics between scientific reason and cultural diversity by: a) analyzing the epistemic structure of ‘universalism' as conceived by science, both theoretically and through its historical determination; and b) focusing on the situation of science in Africa, presenting its limits and challenges. It calls for a coconstruction of science at an international scale, which represents a key factor of development and cultural transmission, in particular, transmission of scientific scholarship.
Identification of FcγRIIa as the ITAM-bearing receptor mediating αIIbβ3 outside-in integrin signaling in human platelets
Authors: Boylan Brian , Gao Cunji , Rathore Vipul , Gill Joan C. , Newman Debra K. , Newman Peter J. 
Published: July 2008

AbstractImmunoreceptor tyrosine-based activation motif (ITAM)–containing proteins have recently been demonstrated in macrophages and neutrophils to be required for cell surface integrins to transmit activation signals into the cell. To identify ITAM-bearing proteins that mediate signaling via the platelet-specific integrin αIIbβ3, fibrinogen binding was induced by (1) allowing platelets to spread directly on immobilized fibrinogen, or (2) activating the PAR1 thrombin receptor on platelets in suspension. Both initiated strong, ligand binding–dependent tyrosine phosphorylation of the ITAM-bearing platelet Fc receptor, FcγRIIa, as well as downstream phosphorylation of the protein tyrosine kinase Syk and activation of phospholipase Cγ2 (PLCγ2). Addition of Fab fragments of an FcγRIIa-specific monoclonal antibody strongly inhibited platelet spreading on immobilized fibrinogen, as well as downstream tyrosine phosphorylation of FcγRIIa, Syk, and PLCγ2, and platelets from a patient whose platelets express reduced levels of FcγRIIa exhibited markedly reduced spreading on immobilized fibrinogen. Finally, fibrinogen binding–induced FcγRIIa phosphorylation did not occur in human platelets expressing a truncated β3 cytoplasmic domain. Taken together, these data suggest that ligand binding to platelet αIIbβ3 induces integrin cytoplasmic domain–dependent phosphorylation of FcγRIIa, which then enlists selected components of the immunoreceptor signaling cascade to transmit amplification signals into the cell.