bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial
Authors: Manikandan N. 
Published: July 2007

Objective: To determine the effect of facial neuromuscular re-education over conventional therapeutic measures in improving facial symmetry in patients with Bell's palsy. Design: Randomized controlled trial. Setting: Neurorehabilitation unit. Subjects: Fifty-nine patients diagnosed with Bell's palsy were included in the study after they met the inclusion criteria. Patients were randomly divided into two groups: control (n = 30) and experimental (n = 29). Interventions: Control group patients received conventional therapeutic measures while the facial neuromuscular re-education group patients received techniques that were tailored to each patient in three sessions per day for six days per week for a period of two weeks. Main measures: All the patients were evaluated using a Facial Grading Scale before treatment and after three months. Results: The Facial Grading Scale scores showed significant improvement in both control (mean 32 (range 9.7-54) to 54.5 (42.2-71.7)) and the experimental (33 (18-43.5) to 66 (54-76.7)) group. Facial Grading Scale change scores showed that experimental group (27.5 (20-43.77)) improved significantly more than the control group (16.5 (12.2-24.7)). Analysis of Facial Grading Scale subcomponents did not show statistical significance, except in the movement score (12 (8-16) to 24 (12-18)). Conclusion: Individualized facial neuromuscular re-education is more effective in improving facial symmetry in patients with Bell's palsy than conventional therapeutic measures.
Assessment of arm function in stroke patients: Rivermead Motor Assessment arm section revised with Rasch analysis
Authors: Van de Winckel Ann , Feys Hilde , Lincoln Nadina , De Weerdt Willy 
Published: July 2007

Objective : To investigate the construct validity and unidimensionality of the Rivermead Motor Assessment, arm section, using Rasch analysis which transforms the ordinal scale into an interval scale with hierarchical ordering of items. Setting : Twelve stroke units and rehabilitation centres across Belgium, Germany and Switzerland. Subjects : Two hundred fifty-two stroke patients, average (SD) age of 63.5 (13.22) years. Main measures : Principal component analysis on the Rasch data gave additional information on unidimensionality. Differential item functioning established the stability of items for gender, age, country, hemiplegic side, stroke type, and time since stroke. Results : Four items did not meet the requirements for the Rasch model and were removed. These were `Lying, protract shoulder with arm in elevation', `Pick up tennis ball from table, release on midthigh, return to table, release', `Same exercise with pencil' and `Pick up piece of paper from table. Release five times'. Principal component analysis of the remaining 11 items revealed two dimensions in the scale, `static and dynamic control of movement', and `coordination'. All items were stable among the subgroups of the sample. Conclusion : The Rivermead Motor Assessment, revised arm section meets the required criteria for validity and unidimensionality. It consists of 11 individual items, which yield two subtotals of overall upper limb ability of the patients. It is a valid tool to evaluate upper limb function after stroke.
Differences between patient and proxy reports in the assessment of disability after stroke
Authors: Chen Mei-Hsiang , Hsieh Ching-Lin , Mao Hui-Fen , Huang Sheau-Ling 
Published: July 2007

Objective : To determine whether the assessment of disability level including basic activities of daily living (ADL) and instrumental ADL varies between patients' and proxy respondents' reports, and to explore the factors influencing proxy agreement. Design : Patient—proxy agreement study. Setting : Hospital settings. Subjects : Fifty-two stroke patients with mild or without cognitive impairments and their primary caregivers voluntarily participated in this study. Main measures : The self-administered versions of the Barthel Index and Frenchay Activities Index were completed by the patients and their proxy respondents concurrently, yet separately, to assess the level of disability. Results : The proxy agreement on total scores of the self-administered Barthel Index and self-administered Frenchay Activities Index demonstrated moderate to good agreement (self-administered Barthel Index: intraclass correlation coefficient (ICC) = 0.71; self-administered Frenchay Activities Index: ICC = 0.6). There were no significant differences between patient and proxy reports on self-administered Barthel Index and self-administered Frenchay Activities Index scores (paired t = —0.22, P = 0.83; paired t = 0.88, P = 0.39, respectively). However, limits of agreement of patient and proxy reports on the self-administered Barthel Index and self-administered Frenchay Activities Index were notable. Stepwise regression analysis found no significant variables associated with proxy agreement. Conclusions : These results indicate that it is appropriate for research purposes, but not appropriate for clinical usage, to use proxy reports to measure disability levels in patients with stroke. Furthermore, the two methods should not be used interchangeably to monitor patients because of the wide limits of agreement between patient and proxy reports on the self-administered Barthel Index and self-administered Frenchay Activities Index.
The effects of upper body exercise on the physical capacity of people with a spinal cord injury: a systematic review
Authors: Valent Linda , Dallmeijer Annet , Houdijk Han , Talsma Eelkje , van der Woude Luc 
Published: July 2007

Objective : To describe the effects of upper body training on the physical capacity of people with a spinal cord injury. Data sources : The databases of PubMed, CINAHL, Sport Discus and Cochrane were searched from 1970 to May 2006. Review methods : The keywords `spinal cord injury', `paraplegia', `tetraplegia' and `quadriplegia' were used in combination with `training'. The methodological quality of the included articles (both randomized controlled trials and controlled clinical trials) was assessed with the modified `van Tulder et al.' checklist. Studies were described with respect to population, test design, training protocol and mode of training. The training effects on physical capacity, reflected by peak power output (POpeak) and oxygen uptake (VO2peak), were summarized. Results : Twenty-five studies were included with a mean score of 8.8 out of 17 items on the quality checklist. The methodological quality was quite low, mostly because of the absence of randomized controlled trials. Therefore no meta-analysis was possible. In the 14 articles of acceptable quality the mean (SD) increase in VO 2peak and POpeak, following a period of training, was 17.6 (11.2)% and 26.1 (15.6)%, respectively. Conclusions : Due to the overall low quality of studies it is not possible to draw definitive conclusions on training effects for different lesion groups or training modes. The results of the relatively few studies with an acceptable quality seem to support the view that upper body exercise may increase the physical capacity of people with spinal cord injury. The magnitude of improvement in PO peak and VO2peak, however, varies considerably among studies.
The lived body — experiences from adults with cerebral palsy
Authors: Sandström Karin 
Published: July 2007

Objective : To get a deeper understanding into how adults with cerebral palsy experience living with a disability and how they manage daily life. Design : Interviews with open-ended questions were carried out. They were analysed by one person according to the Empirical Phenomenological Psychological method (EPP). Setting and subjects : Twenty-two community-living adults (35—68 years) with cerebral palsy from five counties in Sweden participated. All had mobility problems and all had cognitive abilities making it possible to carry on a conversation. Results : The varied experiences resulted in themes including (1) perceptions of living with a disability and (2) strategies used for managing the described perceptions. The perceptions were: a dys-appearing body, a not-appearing body, difference, being in-between, normality, restricted autonomy and autonomy. The strategies were: to fight one's way, to plan, to get used to it, to hide and to give one's all. Conclusion : These interviews expressed heterogeneity in lived experiences showing the importance for professionals to meet people with cerebral palsy as individual subjects in relation to functional problems, self-image and autonomy together with seeing the consequences of different coping strategies.
Adaptation process, participation and depression over six months in first-stroke individuals and spouses
Authors: Rochette Annie , Bravo Gina , Desrosiers Johanne , St-Cyr/Tribble Denise , Bourget Annick 
Published: July 2007

Objective : To describe changes in the adaptation process (appraisal and coping) in the six months after a first stroke and identify domains of the adaptation process related to participation and depressive symptoms for both affected individuals and spouses. Design : A short-longitudinal study where data of the two groups were collected at three times: in the first two weeks post stroke (T1), at three months (T2) and six months (T3) post stroke. Subjects : Individuals with a first stroke and spouses. Main measures: The Stress Appraisal Measure (SAM) for appraisal, Revised Ways of Coping Questionnaire (RWCQ) for coping strategies, Assessment of Life Habits (LIFE-H) for participation, and Beck Depression Inventory (BDI) for depressive symptoms. Results : Mean (SD) ages of the stroke group (n = 88) and spouse group (n = 47) were 71.8 (10.8) and 69.2 (11.2) years respectively. The Threat, Challenge and Stressfulness scales of the SAM decreased significantly (P < 0.02) from T1 to T3 in both groups whereas perceived uncontrollability of the situation increased significantly (P = 0.003) for spouses in the first six months. RWCQ Rationalisation and Giving control to others scales decreased in the stroke group (P = 0.008 and 0.002 respectively) but not in the spouse group (P = 0.07 and 0.39 respectively). Several components of adaptation at T1 could explain between 18% and 27% of the variance observed in the LIFE-H and BDI at T3. Conclusion : Appraisal and coping strategies change over time. Initial adaptation could partially predict participation level and depressive symptoms six months post stroke for affected individuals as well as spouses.
Enhancement of reaching performance via self-speech in people with Parkinson's disease
Authors: Maitra KK 
Published: July 2007

Objective : To evaluate the effects of self-speech as an internal cue on reaching performance in people with Parkinson's disease. Subjects : Eight people with Parkinson's disease were voluntarily recruited from the upstate New York community. Design and setting : This study was a repeated measure analysis of reaching performance under four randomized counterbalanced vocalization (speech) conditions that include a no vocalization control condition. The study was conducted in a university-based motion analysis laboratory. Participants performed a simple sequential daily reaching performance of reaching for a bottle, grasping and placing it on a simulated cabinet. Under counterbalanced randomized conditions, before each performance, participants either self-vocalized the word `yaah' (self-cue), listened to the word `yaah' vocalized by the experimenter (external cue), imagined vocalizing the word `yaah', or just simply performed the task without any vocalization (control — no vocalization). Main measures : The following dependent kinematic measures were extracted from the movement: total movement time, total movement unit, peak velocities and durations of reaching and placing segments. Results : People with Parkinson's disease took significantly shorter time under self-vocalization conditions (2390.00 (326.63) ms) compared with the other three conditions including control — no vocalization conditions (no_voc, 3015.66 (340.83) ms; ext_voc, 2853.12 (376.44) ms; imaginary-voc, 3000.37 (320.54) ms). Under self-vocalization conditions the movements were also significantly smoother as evidenced by significantly lower numbers of movement units (3.43 (0.41)) compared with the other three conditions (no_voc, 4.47 (0.57); ext_voc, 4.16 (0.51); imaginary-voc, 4.16 (0.55)). Conclusions : Self-vocalization of a positive reinforcing word enabled people with Parkinson's disease to perform a daily upper extremity task faster and more smoothly.
Defining the content of individual physiotherapy and occupational therapy sessions for stroke patients in an inpatient rehabilitation setting. Development, validation and inter-rater reliability of a scoring list
Authors: De Wit L. , Kamsteegt H. , Yadav B. , Verheyden G. , Feys H. , De Weerdt W. 
Published: July 2007

Objective : To develop a valid and reliable scoring list to define the content of individual physiotherapy and occupational therapy sessions for stroke patients in inpatient rehabilitation. Design : A list was developed based on previous lists, neurological textbooks and recorded therapy sessions. Content validity was verified and inter-rater reliability evaluated on videos of treatment sessions. In each of four rehabilitation centres, a researcher recorded and scored five physiotherapy and five occupational therapy sessions. These 40 treatment sessions were also scored by the first author. The scores of the researchers and first author were statistically compared. Settings and subjects : Forty stroke patients in four European rehabilitation centres. Results : The scoring list consists of 49 subcategories, divided into 12 categories: mobilization; selective movements; lying (balance); sitting (balance); standing (balance); sensory and visual perceptual training and cognition; transfers; ambulatory activities; personal activities of daily living; domestic activities of daily living; leisure- and work-related activities; and miscellaneous. Comparing the frequency of occurrence of the categories resulted in intraclass correlation coefficients, indicating high reliability for eight categories, good for one, and fair for two. One category was not observed. Spearman rank correlation coefficients were high to very high for 24 subcategories and moderate for four. Twenty-one subcategories contained too few observations to enable calculation of Spearman rank correlation coefficients. Average point-to-point percentage of agreement in time of the treatment sessions equalled 76.6 ± 16.2%. Conclusions : The list is a valid and reliable tool for describing the content of physiotherapy and occupational therapy for stroke patients.
Sensory re-education after nerve injury of the upper limb: a systematic review
Authors: Oud Tanja , Beelen Anita , Eijffinger Elianne , Nollet Frans 
Published: July 2007

Objective : To systematically review the available evidence for the effectiveness of sensory re-education to improve the sensibility of the hand in patients with a peripheral nerve injury of the upper limb. Data sources : Studies were identified by an electronic search in the databases MEDLINE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), and the database of the Dutch National Institute of Allied Health Professions (Doconline) and by screening the reference lists of relevant articles. Review methods : Two reviewers selected studies that met the following inclusion criteria: all designs except case reports, adults with impaired sensibility of the hand due to a peripheral nerve injury of the upper limb, and sensibility and functional sensibility as outcome measures. The methodological quality of the included studies was independently assessed by two reviewers. A best-evidence synthesis was performed, based on design, methodological quality and significant findings on outcome measures. Results : Seven studies, with sample sizes ranging from 11 to 49, were included in the systematic review and appraised for content. Five of these studies were of poor methodological quality. One uncontrolled study (N = 1 3 ) was considered to be of sufficient methodological quality, and one randomized controlled trial ( N = 49) was of high methodological quality. Best-evidence synthesis showed that there is limited evidence for the effectiveness of sensory re-education, provided by a statistically significant improvement in sensibility found in one high-quality randomized controlled trial. Conclusion : There is a need for further well-defined clinical trials to assess the effectiveness of sensory re-education of patients with impaired sensibility of the hand due to a peripheral nerve injury.
Informal carer activities, carer burden and health status in multiple sclerosis
Authors: Forbes Angus , While Alison , Mathes Lucia 
Published: July 2007

Objective : To explore the contribution of carer characteristics, activities and disease impact to care burden and health in the multiple sclerosis caregiver population.Design : A prospective postal survey (24 months).Setting : The study was conducted in seven treatment centres within England.Subjects : Two hundred and fifty-seven caregivers of people with multiple sclerosis.Measures : Carer activity, the Caregivers Reaction Assessment Scale (CRA), the Short Form General Health Survey (SF-36), version 2, and care-related health problems. The carer data were linked to a comprehensive patient data set which permitted dyadic variables to be created measuring shared health.Results : Carers were engaged in a wide spectrum of physical care activities; lifting was the most frequent, 74% (n = 192). Patient disease impact scores were positively correlated (P < 0.01) with higher carer activity levels (r = 0.66). The carer activity level increased over time (P < 0.001 ) by around 5% with a mean increase of 0.22 (95% confidence interval (CI) 0.12—0.3) in the carer activity summary score (scale 0—4). Disease impact was negatively correlated (P < 0.01) with carer burden r = — 0.44 (CRA composite scale), physical health status r = —0.27 (SF-36 physical component score) and mental health status r = — 0.21 (SF-36 mental component score); and positively correlated with care-related health problems r = 0.44. Hierarchical regression models explaining 39% and 49% of the variance in care burden and health problem respectively showed that disease impact and dyadic health explained most of the variance, with carer activity contributing an additional 2% to 4% of the variance (P < 0.001).Conclusion : The analysis demonstrated that greater disease impact, lower dyadic health, high carer activity and greater carer burden are related to the level of carer-related health problems. The data suggested the need to develop interventions for assessing carers and reducing their activity levels and care burden (objective and subjective).
Effects of exercise and nutrition on postural balance and risk of falling in elderly people with decreased bone mineral density: randomized controlled trial pilot study
Authors: Swanenburg Jaap , de Bruin Eling Douwe , Stauffacher Marguerite , Mulder Theo , Uebelhart Daniel 
Published: July 2007

Objective : To compare the effect of calcium/vitamin D supplements with a combination of calcium/vitamin D supplements and exercise/protein on risk of falling and postural balance. Design : Randomized clinical trial. Setting : University hospital physiotherapy department. Subjects : Twenty-four independently living elderly females aged 65 years and older with osteopenia or osteoporosis and mean total hip T-score (SD) of —1.8 (0.8). Interventions : A three-month programme consisting of exercise/protein including training of muscular strength, co-ordination, balance and endurance. Calcium/ vitamin D was supplemented in all participants for a 12-month period. Outcome measures : Assessment took place prior to and following the months 3, 6, 9 and at the end of the study; primary dependent variables assessed were risk of falling (Berg Balance Test) and postural balance (forceplate). Secondary measures included body composition, strength, activity level, number of falls, bone mineral content, biochemical indices, nutritional status and general health. Results : Significant reductions of risk of falling (repeated measures ANOVA F = 8.90, P = 0.008), an increase in muscular strength (ANOVA F = 3.0, P = 0.03), and an increase in activity level (ANOVA F = 3.38, P = 0.02) were found in the experimental group as compared to the control group. Further on, there was 89% reduction of falls reported in the experimental group (experimental pre/post 8/1 falls; control group pre/post 5/6 falls). Conclusion : This study provides support for our intervention programme aimed at reducing the risk of falling in elderly participants diagnosed with osteopenia or osteoporosis. The data obtained from the pilot study allow the calculation of the actual sample size needed for a larger randomized trial.
Brain injury severity and autonomic dysregulation accurately predict heterotopic ossification in patients with traumatic brain injury
Authors: Hendricks Henk T. , Geurts A.C.H. , van Ginneken Bart C. , Heeren Anita J. , Vos Pieter E. 
Published: July 2007

Objective : To assess brain injury severity, autonomic dysregulation and systemic infection as risk factors for the occurrence of heterotopic ossification in patients with severe traumatic brain injury. Design : Historic cohort study. Setting : Radboud University Medical Centre. Subjects : All consecutively admitted patients with severe traumatic brain injury (admission Glasgow Coma Scale score 8 or less) during the years 2002—2003. Main measures : The development of clinically relevant heterotopic ossification, defined as painful swelling of joints with redness and decreased range of motion, confirmed radiographically. Results : Seventy-six (64%) of the 119 patients survived and were eligible for further follow-up. Nine patients (12%) developed 20 symptomatic heterotopic ossifications, in one or more joints. Patients with heterotopic ossification had sustained more severe brain injuries, compared to the group without heterotopic ossification. The mean coma duration in the heterotopic ossification group was 28.11 days (SD 20.20) versus 7.54 days (SD 7.47) in the patients without heterotopic ossification (P < 0.001). The occurrence of autonomic dysregulation (relative risk (RR) 59.55, 95% confidence interval (CI) 8.39—422.36), diffuse axonal injury (RR 20.68, 95% CI 4.92—86.91), spasticity (RR 16.96, 95% CI 3.96—72.57) and systemic infection (RR 13.12, 95% CI 3.01—57.17) were all associated with an increased risk of developing symptomatic heterotopic ossification. However, only autonomic dysregulation had a high positive (88.9%, 95% CI 51.7—99.7) and negative (98.5%, 95% CI 91.9—99.9) predictive value with regard to heterotopic ossification. Conclusions : The occurrence of autonomic dysregulation may predict the chance of developing heterotopic ossification in patients with severe head injury.