bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of an exercise performance support system for people with lower extremity impairment
Authors: Minor Marian A. , Reid John C. , Griffin Joyce Z. , Patrick Timothy B. , Pittman Cory B. , Cutts James H. 
Published: February 2007

AbstractObjective. To identify innovative strategies to support appropriate, self‐directed exercise that increase physical activity levels of people with arthritis. This article reports on one interactive, multimedia exercise performance support system (PSS) for people with lower extremity impairments in strength or flexibility.Methods. An interdisciplinary team developed the PSS using self‐report of lower extremity musculoskeletal impairments (flexibility and strength) to produce an individualized exercise program with video and print educational materials. Initial evaluation has investigated the validity and reliability of program assessments and recommendations.Results. PSS self‐report and professional assessments were similar, with more impairments indicated by self‐report. PSS exercise recommendations were similar to those made by 3 expert physical therapists using the same exercise data base. Results of PSS impairment assessments were stable over a 1‐week period.Conclusion. PSS exercise recommendations appear to be reliable and a valid reflection of current exercise knowledge in rheumatology. Furthermore, users were able to complete the computer‐based program with minimal assistance and reported it to be enjoyable and informative.
Positive impact of an intervention by arthritis educators on retention of information, confidence, and examination skills of medical students
Authors: Branch Valerie Klusas , Lipsky Peter E. 
Published: February 2007

AbstractObjective. To determine whether an intervention by trained persons with arthritis could have a positive impact on retention of information, confidence, and examination skills of medical students.Methods. Second‐year medical students were introduced to the musculoskeletal examination as part of their Introduction to Clinical Medicine course by viewing a video (n = 93) or were taught the joint examination by a trained arthritis educator after viewing the video (n = 88). Each group was tested before and after the intervention about arthritis information, confidence, and attitude about arthritis and also evaluated for the ability to carry out a musculoskeletal examination.Results. Retention of information and confidence of both groups increased as a result of the intervention. However, students who received the arthritis educator intervention increased their scores significantly in comparison. Musculoskeletal examination skills of the students receiving the arthritis educator intervention were also significantly greater than the control group.Conclusion. An intervention by arthritis educators improved the retention of information, confidence, and examination skills of second‐year medical students significantly compared with the standard educational approach. The impact of the intervention persisted for at least two weeks.
Joint hypermobility in patients with fibromyalgia syndrome
Authors: Acasuso‐Díaz Manuel , Collantes‐Estéez Eduardo 
Published: February 2007

AbstractObjective. To test the hypothesis that joint hyperlaxity can play some role in the pathogenesis of pain in primary fibromyalgia.Methods. A total of 66 women with fibromyalgia (according to the 1990 American College of Rheumatology criteria) and 70 women with other rheumatic diseases were examined for joint laxity based on 5 criteria (The Non‐Dominant Spanish modification). Individuals meeting 4 or 5 criteria were considered to be hyperlax.Results. Joint hyperlaxity was detected in 18 (27.3%) of the patients with fibromyalgia and 8 (11.4%) of those with another rheumatic disorder. The statistical analysis revealed significant differences (p < 0.05) between both groups.Conclusion. The results of this study suggest that joint hypermobility and fibromyalgia are associated. Joint hyperlaxity may play a prominent role in the pathogenesis of pain in fibromyalgia.
A standardized protocol for measurement of range of movement of the shoulder using the Plurimeter‐V inclinometer and assessment of its intrarater and interrater reliability
Authors: Green Sally , Forbes Andrew , Buchbinder Rachelle , Bellamy Nicholas 
Published: February 2007

AbstractObjective. To develop a standardized protocol for measurement of shoulder movements using a gravity inclinometer designed for use in clinical trials, and to assess its intra‐ and interrater reliability in a group of manipulative physiotherapists.Methods. After instruction, 6 manipulative physiotherapists independently assessed 8 movements of the shoulder, including total and glenohumeral flexion (TE GHF), total and glenohumeral abduction (TA, GHA), external rotation in neutral (ERN) and abduction (ERA), internal rotation in abduction (IRA), and hand behind back (HBB), in random order in 6 patients with shoulder pain and stiffness according to a 6 × 6 Latin square design using the standardized protocol. The assessments were then repeated. Analysis of variance was used to partition total variability into components of variance in order to calculate intraclass correlation coefficients (ICCs).Results. The intra‐ and interrater reliability of the different movements varied widely Reliability was higher for TF and TA than for the corresponding glenohumeral movements (e.g., intmrater ICCs: TF = 0.80, GHF = 0.65, TA = 0.75, GHA = 0.62). Intererrater reliability was higher in the second round suggesting a practice effect (e.g., round 1,2 interrater ICCs TF = 0.62, 0.82; TA = 0.62, 0.88; ERN = 0.85, 0.95).Conclusion. The measurement of the active range of TF, TA, ERN, and HBB, measured by manipulative physiotherapists following the standardized protocol, has intra‐ and interrater reliability acceptable for use as an outcome measure in clinical trials assessing interventions for shoulder pain.
A comparison of IgM rheumatoid nephelometry and latex methods: Clinical and laboratory significance
Authors: Wolfe Frederick 
Published: February 2007

AbstractObjectives. To study the comparative performance characteristics of nephelometric and IgM latex rheumatoid factor [RF] with regard to diagnosis, to determine the level of test result that most accurately classifies patients as having rheumatoid arthritis [RA] versus noninflammatory rheumatic disorders, to develop mathematic and graphic conversion tools, and to determine the usefulness of serial nephelometric RF factors test in assessing change in clinical status.Methods. Sera and clinical measurements were obtained from 576 rheumatic disease patients during routine clinic visits and were analyzed by latex and nephelometric methods.Results. Nephelometric and latex methods were highly correlated (0.872) and generally equivalent in their ability to discriminate between RA and noninflammatory conditions. Serial measures of RF were correlated with changes in clinical activity, but were much less effective in this respect than erythrocyte sedimentation rate or C‐reactive protein.Conclusion. Both tests yield equivalent results. Mathematic and graphic models will allow conversion between tests so that clinicians can use either or both methods effectively. RF is modestly correlated with changes in clinical activity and therefore is not a useful measure to follow clinical improvement or worsening.
Effect of satisfaction with one's abilities on positive and negative affect among individuals with recently diagnosed rheumatioid arthritis
Authors: Blalock Susan J. , Orlando Maria , Mutran Elizabeth J. , DeVellis Robert F. , Devellis Brenda M. 
Published: February 2007

AbstractObjective. The purpose of this study was to examine the effect that self‐evaluation processes have on psychologic well‐being among individuals with rheumatoid arthritis (RA).Methods. The study used a longitudinal research design with 4 data collection points. Participants were 227 adults with recently diagnosed RA. Data were collected via mailed questionnaire and telephone interview. Two dimensions of psychologic well‐being were assessed—positive affect and negative affect.Results. We found that, among participants who viewed the abilities being evaluated as very important, greater satisfaction at time 1 was associated with less negative affect at time 2 and time 4. Satisfaction was not associated with positive affect at any of the time points, however.Conclusion. Study findings indicate that dissatisfaction with illness‐related abilities can exacerbate psychologic distress. The findings also highlight the need for research examining the role that positive affect plays in adaptation to RA.
Arthritis health service utilization among the elderly: The role of urban‐rural residence and other utilization factors
Authors: Saag Kenneth G. , Doebbeling Bradley N. , Rohrer James E. , Kolluri Sheela , Mitchell Theresa A. , Wallace Robert B. 
Published: February 2007

AbstractObjective. To compare the impact of urban‐rural residence and other factors on the utilization of any type of arthritis‐related physician care and on rheumatologist utilization.Methods. A population‐based random sample of adults 65 years of age or older with self‐reported arthritis from 10 urban and 12 rural Iowa counties were surveyed by telephone interview. We estimated the arthritis prevalence and health service utilization in this sample and evaluated the effects of predisposing, enabling, and need factors on utilization and satisfaction. Health care utilization was defined as ever having visited specific types of providers for arthritis‐related care.Results. A total of 488 individuals participated: 227 from urban counties and 261 rural respondents. Urban respondents more commonly reported having received a diagnosis of osteoarthritis from their physicians but were less likely to report rheumatoid arthritis. A greater proportion of urban versus rural respondents had utilized any physician for arthritis care (50.7% versus 41.0%, P = 0.032) and had more often seen an orthopedist (18.1% versus 9.6%, P = 0.006) or general internist (18.5% versus 8.8%, P = 0.002). A diagnosis of rheumatoid arthritis, younger age, living with another person, higher income, and further distance from an arthritis provider were significantly associated with prior rheumatologist utilization. The strongest adjusted predictor of any physician visit for arthritis care was whether older adults drove themselves to their provider. For rheumatologist utilization, a diagnosis of rheumatoid arthritis and age were independently associated.Conclusions. The most striking finding was the consistent association of need factors (such as the desire for medical advice), joint swelling, and the presence of a diagnosis of rheumatoid arthritis with physician utilization. We identified significant urban‐rural variations in factors both enabling and predisposing to arthritis care, although urban‐rural status did not appear to independently influence arthritis physician utilization. In a rural state with a relatively small number of rheumatologists, deleterious enabling factors such as greater distance from the doctor and lack of supplemental insurance did not provide significant obstacles to either rheumatologist or generalist utilization.
Interdisciplinary treatment for fibromyalgia syndrome: Clinical and statistical significance
Authors: Turk Dennis C. , Okifuji Akiko , Sinclair J. David , Starz Terence W. 
Published: February 2007

AbstractObjectives.The primary purposes of the study were to: evaluate the treatment efficacy of an outpatient, interdisciplinary treatment program for fibromyalgia syndrome (FMS); examine whether treatment gains would be sustained for 6 months following the treatment; assess whether improvements were clinically significant; and delineate the factors associated with clinically significant improvement in pain severity.Methods.Sixty‐seven FMS patients completed a 4‐week outpatient program consisting of medical, physical, psychologic, and occupational therapies. Six‐month followup data were available for 66% of treated patients.Results.Comparisons between pretreatment and posttreatment measures revealed significant improvements in pain severity, life interference, sense of control, affective distress, depression, perceived physical impairment, fatigue, and anxiety; however, there was no improvement in interpersonal relationships or general activities. Clinically significant improvement in pain severity, using the Reliable Change Index, was obtained by 42% of the sample and was predicted by the pretreatment levels of depression, activity, perceived disability, solicitous responses of significant others, and idiopathic onset. Pretreatment level of pain severity was not a significant predictor of the degree of pain improvement. Comparisons among pretreatment, posttreatment, and 6‐month followup data revealed that the patients maintained treatment gains in pain, life interference, sense of control, affective distress, and depression. However, the quadratic polynomial analysis revealed that relapse occurred in the subjective rating of fatigue.Conclusions.The results suggest that, overall, an outpatient interdisciplinary treatment program was effective in reducing many FMS symptoms. Treatment gains tended to be maintained for at least 6 months. However, there were large individual differences in response to treatment. These results suggest that identification of subgroups of FMS patients and their specific clinical characteristics may be useful for maximizing treatment efficacy.
Using focus groups to understand arthritis patients' perceptions about unconventional therapy
Authors: Rao Jaya K. , Arick Rhonda , Mihaliak Kim , Weinberger Morris 
Published: February 2007

AbstractObjective. To understand arthritis patients' use of unconventional therapies (UT).Methods. Thirty‐three rheumatoid arthritis and osteoarthritis patients followed in university clinics participated in 5 focus groups to discuss: their beliefs about arthritis and UT; UT they have used; reasons for using UT; effectiveness of UT; sources of information on UT; and communication about UT with the physician. Two investigators analyzed focus group transcripts to identify common themes.Results. All patients believed arthritis to be incurable by conventional regimens or UT. Over one‐half had used UT to relieve pain; cost was unimportant. Patients trusted information about UT from family, friends, and others with arthritis, but not supermarket tabloids or television commercials. Most discussed UT use with their physician, primarily to prevent interactions with prescribed treatments. Physicians' reactions ranged from ridicule to giving permission to continue using UT.Conclusions. These results provide an understanding of arthritis patients' motives for using UT and for discussing this behavior with their physician.
The experience of knee arthritis in athletic young and middle‐aged adults: An heuristic study
Authors: Keysor Julie J. , Sparling Joyce W. , Riegger‐Krugh Cheryl 
Published: February 2007

AbstractObjective. To gain a better understanding of the experience of living with tibiofemoral osteoarthritis (OA) as young and middle‐aged adults.Methods. Heuristic qualitative research methods were used. Four informants between the ages of 25 and 45 years diagnosed with tibiofemoral OA were purposively sampled. Informants were white, college educated, middle class, and physically active. Informants were interviewed for 4 hours. Interviews were transcribed verbatim and analyzed according to a van Kaam method modified by Moustakas.Results. Living with tibiofemoral OA involved pain, fear, isolation, helplessness, and loss of function, identity, and perceived control. The informants struggled with adapting to their pathology. Behavior change and activity modification were difficult and seemed to be related to the physical, sociologic, and psychologic aspects of pathology.Conclusions. A biopsychosocial model of chronic pathology was developed that may guide health professionals in treating and developing interventions for younger adults with arthritis.
An examination of individual differences in the relationship between interpersonal stress and disease activity among women with rheumatoid arthritis
Authors: Zautra Alex J. , Hoffman Jeanne M. , Matt Kathleen S. , Yocum David , Potter Phillip T. , Castro William Lesley , Roth Sanford 
Published: February 2007

AbstractObjective. The effects of interpersonal stress on disease activity were examined for married women with rheumatoid arthritis (RA) who differ in the quality of their relationships with their spouses.Methods. Measures of interpersonal events were collected weekly for 12 weeks and related to disease activity through a comparison of clinician ratings and immune markers taken at baseline and during a highly stressful week for 20 RA patients. Individual differences in marital relationship variables and illness characteristics were used to predict group differences in how stress affected disease activity.Results. Significant elevations in total T cell activation (DR + CD3 cells), soluble interleukin‐2 receptor (sIL‐2R), and clinician's global ratings of disease activity were found during a week of significant interpersonal stress. However, women with better spousal relationships did not show increases in disease activity following an episode of interpersonal stress. In addition, patients taking low‐dose prednisone showed greater reactivity to stress than patients not currently using glucocorticoid treatment.Conclusion. The results are consistent with the hypothesis that disease activity in RA increases following increases in interpersonal stress and that women with stronger marital relationships were less vulnerable to those stressors.
Effects of epidural steroid injection on pain due to lumbar spinal stenosis or herniated disks: A prospective study
Authors: Rivest Charles , Katz Jeffrey N. , Ferrante F. Michael , Jamison Robert N. 
Published: February 2007

AbstractObjectives. To describe the extent of pain relief two weeks after an epidural steroid injection in patients with herniated disks and lumbar spinal stenosis, and to identify predictors of changes in pain ratings in each population.Methods. The study design was a prospective evaluation of patients with lumbar spinal stenosis (LSS) and herniated disks (HDs) referred to a hospital‐based pain clinic for an epidural steroid injection (ESI). A complete history, detailed physical examination, comprehensive pain questionnaire, and Brief Symptom Inventory were obtained for all patients. Pain was assessed at baseline and two weeks following a single ESI using a visual analog scale.Results. Two hundred twelve patients (mean age 54 years) were enrolled, and 78 of these provided pain ratings before and two weeks after the injection. LSS patients improved less two weeks following the ESI than HD patients (P = 0.04). Just 38% of LSS patients reported improvement in pain score compared with 61 % of HD patients. In analyses that combined LSS and HD patients, predictors of worse response included a report of health problems and a diagnosis of LSS.Conclusions. LSS patients have worse response to ESIs than HD patients. The poor response to ESI in patients with LSS underscores the need for randomized controlled trials of ESI in this population.
The social environment and health in rheumatoid arthritis: Marital quality predicts individual variability in pain severity
Authors: Waltz Millard , Kriegel Walter , Bosch Paul Van'T Pad 
Published: February 2007

AbstractObjective. To examine prospective relations between a wide array of measures of social functioning and pain, while controlling for disease duration and activity and functional grade.Methods. As part of a larger study on health care utilization, longitudinal data were collected from 136 Dutch and 98 German outpatients on clinical status and pain. Social data included information on sexual handicap, spouse behavior, loneliness, daily emotional support, and the maintenance of pleasurable life domains. Pain severity was assessed at baseline and 12 months later with standard measures of pain and analyzed with hierarchical regressions.Results. Social measures obtained at baseline were consistently associated with pain at followup. Depression was a moderate correlate of pain in the Dutch and German samples. The regressions revealed that patient reports of negative spouse behavior (such as avoidance and critical remarks) and baseline depression predicted worse pain outcome, and this association remained significant in analyses controlling for baseline pain. The level of formal education was a weak correlate of disability, emotional support, and pain. Daily emotional support and social life domains associated with positive affect had an indirect influence on outcome. The absence of strong rather than weak social ties was the component of the loneliness construct linked to pain. These associations between social prognostic factors and pain severity, however, were mediated by psychological functioning at baseline.Conclusion. The social environment was found to operate on the core health outcome, pain severity, via several pathways. Social functioning may be affected by rheumatoid arthritis (RA) progression, but it also appears to form a determinant of future health outcome. Not only the status of being married but also the quality of the relationship in terms of long‐term stress and emotional support may be useful prognostic factors in RA.
Arthritis self‐management program variations: Three studies
Authors: Lorig Kate , González Virginia M. , Laurent Diana D. , Morgan Lisa , Laris B. A. 
Published: February 2007

AbstractObjectives. (1) Determine strengths and weaknesses of the Arthritis Self‐Management Program (ASMP). (2) Compare 3‐ and 6‐week ASMP. (3) Evaluate 1.5‐hour arthritis program.Methods. Study 1: Qualitative methods incorporating incomplete block design. Study 2: Comparison of 3‐ and 6‐week outcomes. Study 3: Pretest/ posttest comparison.Results. Study 1: Pain management, exercise, and sharing ranked as the most useful aspects of the ASMP. Nutrition, medications, and making decisions about nontraditional treatments ranked least useful. Study 2: Six‐week ASMP subjects improved pain, health distress, illness impact, exercise, cognitive pain management, self‐efficacy, and reduced visits to physicians (P < 0.05). Three‐week subjects improved health distress, cognitive pain management, and self‐efficacy (P < 0.05). Study 3: Improved knowledge, self‐efficacy, and pain (P < 0.05).Conclusions. The traditional 6‐week ASMP is more effective than a 3‐week version. A 1.5‐hour community program is effective in increasing knowledge, self‐efficacy, and contact with the Arthritis Foundation.
Recruiting adults with osteoarthritis into an aquatic exercise class: Strategies for a statewide intervention
Authors: Spencer Anna C. , Kinne Susan , Belza Basia L. , Ramsey Scott , Patrikc Donald L. 
Published: February 2007

AbstractObjective. Although research suggests that regular exercise can be helpful in reducing the dysfunction and discomfort of osteoarthritis, promoting exercise among older adults within this population is neither straightforward nor easily accomplished. This article describes the various methods, and their relative success rates, that were employed to recruit older adults throughout the state of Washington into an aquatic exercise program.Methods. Strategies included a recruitment letter distributed to Arthritis Foundation (AF) members in Washington state, local media news coverage, physician referrals, and advertisements in local papers and newsletters.Results. The most successful methods for enrolling participants were through the AF recruitment letters and local television coverage. The AF recruitment letter was the most expensive method of generating responses, while the television coverage was the least expensive.Conclusions. Collaborating with a well‐reputed community‐based organization and capitalizing on available publicity resources are important strategies researchers can use to gain access to a difficult and geographically dispersed population.