bluuebunny/crossref_metadata_2025_split huggingface dataset:
Return to work after major trauma
Authors: Holtslag Herman R , Post Marcel W , van der Werken Chris , Lindeman Eline 
Published: July 2007

Objective : To quantify the prevalence of return to work after major trauma, and to investigate the determinants of postinjury work status. Design : Prospective cohort study. Setting : University Medical Centre Utrecht, a level 1 trauma centre in the Netherlands. Method : All severely injured (ISS > 16) adult (age = 16 +) trauma survivors admitted from January 1999 to December 2000 who were full-time employed at the time of the injury were selected for follow-up (n = 214). Response rate was 93%. Outcome was assessed at a mean of 15 months (SD = 1.5) after injury. Multivariate logistic regression analyses identified determinants at hospital discharge and at follow-up. Results : Following injury 58.4% of the patients (n = 125) were able to return to full-time employment, 21.5% had a part-time job, and 20.1% did not return to work. Univariate analysis yielded the following significant determinants of postinjury work status: age, comorbidity, injury severity score, brain injury, spinal cord injury, length of stay in an intensive care unit, hospital stay, discharge destination, percentage of permanent impairment (according to the fourth American Medical Association guide (AMA)), limitations in activities of daily living and cognitive complaints. Logistic regression analyses (23% explained variance) identified spinal cord injury, duration of hospital stay, discharge destination and age as determinants of return to work at hospital discharge. At follow-up, determinants of return to work included AMA, activities of daily living, cognitive complaints and being discharged home (51% explained variance). Conclusions : Around 60% of the patients returned to their pre-injury work status after major trauma. The return to work rate was only partly explained by disability at follow-up. Independent determinants of return to work differ with the time of assessment.
Drop-out predictors in cardiac rehabilitation programmes and the impact of sex differences among coronary heart disease patients in an Iranian sample: a cohort study
Authors: Sarrafzadegan Nizal , Rabiei Katayoun , Shirani Shahin , Kabir Ali , Mohammadifard Noushin , Roohafza Hamidreza 
Published: July 2007

Objective : To determine whether patients who subsequently drop out of a structured cardiac rehabilitation programme could be prospectively distinguished from those who remain in the programme based upon their initial baseline characteristics. Design : A cohort study. Setting : A referral rehabilitation department in a cardiovascular research and training institute. Subjects : One thousand one hundred and fifteen coronary heart disease patients including patients with ischaemic heart disease, and those undergoing bypass surgery or percutaneous coronary interventions. Interventions : Demographic characteristics, coronary heart disease risk factors, ejection fraction, functional capacity and laboratory tests were considered at baseline. Main measures : Patients who completed all 24 sessions of the cardiac rehabilitation programme were compared with drop-out cases who did not. Results : Four hundred and ninety-nine patients (44.8%) completed the whole cardiac rehabilitation programme. Women (adjusted odds ratio (AOR) 1.817, P < 0.001), older patients (AOR 1.015, P = 0.047), patients with lower risk of coronary heart disease (AOR 1.573, P = 0.008) or lower body mass index (BMI) (AOR 0.945, P = 0.001) and higher waist-to-hip ratio (AOR 12.871, P = 0.009) and those who were non-smokers (AOR 1.779, P = 0.001) were significantly more likely to complete cardiac rehabilitation. Conclusions : Developing interventions to address special needs of young, obese, smoker male patients who have a lower waist-to-hip ratio and higher clinical risk may be important, especially in attempts to retain this high-risk group in cardiac rehabilitation therapy.
Early physiotherapy after injection of botulinum toxin increases the beneficial effects on spasticity in patients with multiple sclerosis
Authors: Giovannelli M. , Borriello G. , Castri P. , Prosperini L. , Pozzilli C. 
Published: July 2007

Objective : To determine whether additional physiotherapy increases botulinum toxin type A effects in reducing spasticity in patients with multiple sclerosis. Design : A single-blind, randomized, controlled pilot trial with a 12-week study period. Subjects : Thirty-eight patients with progressive multiple sclerosis affected by focal spasticity and who were observed at the Multiple Sclerosis Centre operating in the S. Andrea Hospital in Rome. Interventions : For intervention all patients received botulinum toxin type A; the treatment group also received additional physiotherapy to optimize management through passive or active exercise and stretching regimens. Main measures : To measure objective and subjective level of spasticity, patients were assessed at baseline, 2, 4 and 12 weeks post treatment by Modified Ashworth Scale and visual analogue scale. Results : When compared with the control group, we found a significant decrease of spasticity by Modified Ashworth Scale (P < 0.01 by t-test) in the treatment group at week 2 (2.73 versus 3.22), week 4 (2.64 versus 3.33) and week 12 (2.68 versus 3.33). The mean (%) difference in Modified Ashworth Scale score between baseline and the end of follow-up was —0.95 (26.1) in the treatment group and —0.28 (7.7) in the control group (P < 0.01). The combined treatment proved also to be more effective by visual analogue scale (P < 0.01) at week 4 (6.95 versus 5.50) and at week 12 (7.86 versus 6.56) but not at week 2 (5.18 versus 5.50; P = 0.41). Conclusions : Our data suggest that physiotherapy in combination with botulinum toxin type A injection can improve overall response to botulinum toxin.
Agreement between clinical and electromyographic assessments during the course of peripheric facial paralysis
Authors: On Arzu Yagiz , Yaltirik Hurrem Pelin , Kirazli Yesim 
Published: July 2007

Objective : To examine the agreement between clinical and electromyographic assessments during the course of facial paralysis, in order to determine whether electromyography adds more information to the clinical examination in determining voluntary and synkinetic movement. Design : Serial clinical and electromyographic assessments were performed. Settings : Physical Medicine and Rehabilitation Department of a university hospital. Subjects : Thirty patients with acute complete idiopathic facial paralysis were included. Main measures : Voluntary and synkinetic movements of the orbicularis oculi and orbicularis oris muscles were graded by Facial Grading System and by needle electromyography at three weeks, and two, three and six months after the onset of paralysis. Weighted kappa ( κ) statistics were performed to measure the agreement between clinical and electromyographic assessments. Results : Agreement between assessments yielded an overall κ value of 0.87 for the orbicularis oculi and 0.59 for the orbicularis oris in identifying voluntary movement. electromyography revealed no voluntary movement in the orbicularis oculi, in 65% of the patients in whom slight movement was considered by clinical assessment. In identifying synkinetic movements, an overall κ value was 0.70 for the orbicularis oculi and 0.85 for the orbicularis oris. Electromyography demonstrated many cases of slight synkinesis that were missed through visual inspection in both muscles. Conclusions : Clinical evaluation provides sufficient information about recovery in voluntary movement in the orbicularis oris, whereas, in the orbicularis oculi, electromyography adds to the clinical evaluation in determining the extent of paralysis.
Randomized controlled study of the antinociceptive effect of ultrasound on trigger point sensitivity: novel applications in myofascial therapy?
Authors: Srbely John Z. , Dickey James P. 
Published: July 2007

Objective : To investigate whether therapeutic ultrasound modulates the pain sensitivity of myofascial trigger points. Design : Repeated measures, single-blinded randomized controlled trial of ultrasound treatment of trigger points. Setting : Outpatient injury rehabilitation clinic. Subjects : Forty-four patients (22 males, 22 females) with trigger points identified within the trapezius muscle. Interventions : Five-minute therapeutic intensity of ultrasound versus 5-min low-intensity application of ultrasound to a trapezius myofascial trigger point locus. Main measures : Pain pressure threshold readings were measured at the trapezius trigger point site before and after exposure to the ultrasound intervention. Results : Pain pressure threshold scores increased an average of 44.4 (14.2)% after therapeutic exposure to ultrasound (pre-ultrasound test 35.4 (8.5) N, post-ultrasound test 51.1 (12.8) N). No significant difference in pain pressure threshold scores was observed with low-intensity ultrasound exposures (pre-ultrasound 36.1 (6.1) N, post-ultrasound 36.6 (4.8) N). Conclusions : Therapeutic exposures to ultrasound reduce short-term trigger point sensitivity. Ultrasound may be a useful clinical tool for the treatment and management of trigger points and myofascial pain syndromes.
Overestimation of stability limits leads to a high frequency of falls in patients with Parkinson's disease
Authors: Kamata Noriyuki , Matsuo Yoshimi , Yoneda Toshihiko , Shinohara Hideki , Inoue Satoru , Abe Kazuo 
Published: July 2007

Objectives : To test a hypothesis that patients with Parkinson's disease may not notice discrepancies between their perceived and actual stability limits and cannot keep their centre of gravity within the stability region. Settings : Outpatients with neurological disorders in rehabilitation service. Subjects : Twenty-one patients with Parkinson's disease (11 men, 10 women; mean duration 5.9 ± 3.9 years) and age- and sex-matched healthy volunteers were recruited. Methods : Each subject's right arm length was subtracted from the distance between the right acromion and the perceived reachable boundary. This was called `perceived reach'. The figure given by subtracting the right arm length from the maximum forward reach length measured by the Functional Reach Test was named `actual reach', and is an index of actual stability limits in each subject. The difference between actual and perceived stability limits (DAP) is given by actual reach minus perceived reach. The motor score of the Unified Parkinson's Disease Rating Scale were used to evaluate disease severity. Results : The mean DAP for the Parkinson's disease group was negative ( —1.8 ± 5.7 cm) and significantly different from that of controls (3.3 ± 9.2 cm) (P < 0.05). In Parkinson's disease, DAP was significantly correlated with the Unified Parkinson's Disease Rating Scale score (correlation coefficient = —0.39, P < 0.05). Conclusions : These results indicated that patients with Parkinson's disease overestimated their stability limits, which may result in falls. In addition, the results demonstrate that patients with Parkinson's disease develop overestimation of stability limits in parallel with their disease progression.
Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke: a systematic review
Authors: Pollock Alex , Baer Gillian , Langhorne Peter , Pomeroy Valerie 
Published: July 2007

Objectives : To determine whether there is a difference in global dependency and functional independence in patients with stroke associated with different approaches to physiotherapy treatment. Data sources : We searched the Cochrane Stroke Group Trials Register (last searched May 2005), Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1980 to May 2005) and CINAHL (1982 to May 2005). We contacted experts and researchers with an interest in stroke rehabilitation. Review methods : Inclusion criteria were: (a) randomized or quasi-randomized controlled trials; (b) adults with a clinical diagnosis of stroke; (c) physiotherapy treatment approaches aimed at promoting postural control and lower limb function; (d) measures of disability, motor impairment or participation. Two independent reviewers categorized identified trials according to the inclusion/exclusion criteria, documented the methodological quality and extracted the data. Results : Twenty trials (1087 patients) were included in the review. Comparisons included: neurophysiological approach versus other approach; motor learning approach versus other approach; mixed approach versus other approach for the outcomes of global dependency and functional independence. A mixed approach was significantly more effective than no treatment control at improving functional independence (standardized mean difference (SMD) 0.94, 95% confidence interval (CI) 0.08 to 1.80). There were no significant differences found for any other comparisons. Conclusions : Physiotherapy intervention, using a `mix' of components from different `approaches' is more effective than no treatment control in attaining functional independence following stroke. There is insufficient evidence to conclude that any one physiotherapy `approach' is more effective in promoting recovery of disability than any other approach.
A national survey of occupational therapy students' and physiotherapy students' attitudes to disabled people
Authors: Stachura Kay , Garven Frances 
Published: July 2007

Objective : To investigate the possible influence of curricular and non-curricular activities on the attitudes of occupational therapy and physiotherapy students towards disabled people at the beginning and end of their pre-registration education. Design : A cross-sectional survey. Setting : United Kingdom. Participants : Two thousand two hundred and ninety-nine students. Main outcome measures : Interaction with Disabled Persons' Scale. Results : Occupational therapy and physiotherapy programmes attract different types of student. Occupational therapy students' attitudes to disabled people were significantly more positive than those of physiotherapy students at the beginning (P < 0.0001) and end (P < 0.0001) of their respective programmes. Students with disabled family members (P < 0.0001) and informal social contact with disabled people (P < 0.0001) had significantly more positive attitudes than those without such contact, and such students tend to choose occupational therapy as a career. Work experience with disabled people did not significantly influence the attitudes towards disabled people of occupational therapy students at the end of their programme (P = 0.187) but did for all other students. A significantly higher proportion of occupational therapy students undertake extracurricular employment and socialize with disabled people than their physiotherapy counterparts. Conclusion : Physiotherapy students hold less positive attitudes to disabled people than occupational therapy students at both the beginning and end of their pre-registration education. Physiotherapy educators need to give greater credit for work experience with disabled people and to ensure the provision of appropriate disability training to counteract possible overemphasis on physical impairments in the curricula.
The reliability of the Movement Assessment Battery for Children for preschool children with mild to moderate motor impairment
Authors: Van Waelvelde Hilde , Peersman Wim , Lenoir Matthieu , Smits Engelsman Bouwien CM 
Published: July 2007

Objectives : To provide further evidence of the test—retest reliability and agreement of the Movement Assessment Battery for Children (M-ABC), a standardized motor test used for identification and evaluation of children with mild to moderate motor impairment. Both the stability of total test scores and classification according to specified cut-off points were examined. Design and setting : Children were tested on the M-ABC, three times with an interval of three weeks between each assessment. Participants : Thirty-three 4- and 5-year-old children with poor motor performance, 24 boys and 9 girls. Results : A systematic practice effect between three consecutive testing sessions was shown. This was significant for the total score and two of the three subscores. Test—retest reliability of the total test score yielded an intraclass correlation coefficient (ICC) of 0.88. The total impairment score ranged between 0 and 40. The standard error of measurement (SEM) of this score was 2.4, resulting in a least detectable difference of 6.6 (with alpha set at 5%). The agreement over three testing sessions ( κ) was 0.72. Conclusions : The total impairment score of the M-ABC is a reliable measure for identification of mild to moderate motor impairment in young children. Repeated testing on the M-ABC at intervals of three weeks results in a systematic measurement error and is not recommended. The SEM is substantial. Follow-up of preschool children with the M-ABC as a single outcome measure is not appropriate.
Clinical tools to measure trunk performance after stroke: a systematic review of the literature
Authors: Verheyden Geert , Nieuwboer Alice , Van de Winckel Ann , De Weerdt Willy 
Published: July 2007

Objective : To give a systematic review of clinical measurement scales used to assess trunk performance after stroke. Data sources : The databases CINAHL, Cochrane, Pedro and PubMed were searched with the terms `sitting balance' plus `stroke' and `trunk' plus `stroke' mentioned in the title or abstract. Databases were searched from inception to January 2006. Review methods : All articles were selected which reported or included a clinical measure of trunk performance used in an adult stroke population. Reference lists were searched as secondary sources of articles. Results : A total of 458 articles resulted from the database search. Thirty-two articles were eligible for inclusion. Earlier studies mentioned ordinal single items or a combination of items which are part of a larger scale used to assess sitting balance as a derived measure of trunk performance. Three clinical tools were available which specifically evaluated trunk performance after stroke; the Trunk Control Test and two Trunk Impairment Scales. Conclusion : Ordinal single items or subscales of existing larger scales lack a systematic evaluation of psychometric characteristics. Both Trunk Impairment Scales have been extensively examined. A comparative study assessing psychometric properties of the Trunk Control Test and two Trunk Impairment Scales could determine which should be the measure of choice when assessing trunk performance after stroke.
One question as a screening instrument for depression in people with multiple sclerosis
Authors: Vahter L. , Kreegipuu M. , Talvik T. , Gross-Paju K. 
Published: July 2007

Objective : To evaluate how effectively one question `Are you depressed?' works as a screening tool for depression in people with multiple sclerosis. Design : The results from a single question were compared with formal clinical diagnosis and the classification from a standard questionnaire. Setting : Estonian Multiple Sclerosis Centre, from October 2001 to April 2002. Subjects : One hundred and thirty-four consecutive inpatients with multiple sclerosis. Intervention : During two weeks of inpatient stay the mood disorder was analysed. On the basis of clinical interview and Beck Depression Inventory the diagnosis of depression was confirmed. Main measures : Beck Depression Inventory and structured clinical interview. Results : Fifty-seven per cent (77/134) of people with multiple sclerosis answered `Yes' to the question `Are you depressed?'. The diagnosis of depression was confirmed in 94% (72/77) of people with multiple sclerosis and not confirmed in 6% (5/77). Hence, the screening test sensitivity was 91%. Forty-three per cent (57/134) answered `No'; 70% (40/57) did not have depression. In this case the sensitivity was 54%. In this group 30% (17/57) were actually depressed according to tests and clinical impression. The age, sex, duration of disease, cognitive abilities and physical disability did not influence consistency of the answers with test results and clinical opinion. Conclusions : One-question interview is a useful tool for screening for depression in people with multiple sclerosis as it confirms existing depression (sensitivity 91%), but the results should be treated with caution if the person denies mood problems.
Stroke patients and long-term training: is it worthwhile? A randomized comparison of two different training strategies after rehabilitation
Authors: Langhammer Birgitta , Lindmark Birgitta , Stanghelle Johan K. 
Published: July 2007

Objective : To find out if there were any differences in improvement and maintenance of motor function, activity of daily living and grip strength between patients with first-ever stroke receiving two different strategies of physical exercise during the first year after stroke. Design : A longitudinal randomized controlled stratified trial. Setting : Rehabilitation institutions, community, patients' homes and nursing homes. Subjects : Seventy-five male and female first-time-ever stroke patients: 35 in an intensive exercise group and 40 in a regular exercise group. Intervention : The intensive exercise group received physiotherapy with focus on intensive exercises in four periods during the first year after stroke. The regular exercise group patients were followed up according to their subjective needs during the corresponding year. Main outcome measures : Motor Assessment Scale, Barthel Index of Activities of Daily Living, and grip strength. Results : Both groups improved significantly up to six months when function stabilized. The groups did not differ significantly on any test occasions. The difference of improvement from admission to discharge was significant in favour of the intensive exercise group, in the Motor Assessment Scale total score (intensive exercise group 7.5; regular exercise group 1.7, P = 0.01), and in the Barthel Index of Activities of Daily Living total score (17.4 versus 8.9, P = 0.04). Conclusion : Motor function, activities of daily living functions and grip strength improved initially and were maintained during the first year after stroke in all patients irrespective of exercise regime. This indicates the importance of motivation for regular exercise in the first year following stroke, achieved by regular check-ups.