bluuebunny/crossref_metadata_2025_split huggingface dataset:
A simple measurement of speed of index finger movement
Authors: Worthington JA , De Souza LH 
Published: July 2008

A simple 10s test to measure the speed of index finger tapping has been developed. The equipment used was simple and portable, being only a pocket calculator and a stop watch. Forty-two control subjects were tested to determine the lower limit of normal for the test using dominant and nondominant hands. Fifty-six patients with multiple sclerosis were also tested and the results showed that 55% were below normal with the dominant hand, and 61 % were below normal with the nondominant hand. It was concluded that the index finger tapping test provides a consistent and simple objective measure for a feature of movement which is quite difficult to assess correctly by eye.
Rehabilitation of a below-knee amputee with a diving limb
Authors: Saadah Esm 
Published: July 2008

The idea of a diving limb was born by the need of one of my patients, who is a below-knee amputee. He is quite an enthusiastic diver and because of his age, he was determined to enjoy his hobby to the full. This patient, like other divers, prefers to use a wet suit for diving because of its availability and its insulation properties, therefore he uses his diving artificial limb outside his diving suit (Figure 1). The new diving artificial limb was designed to fulfil the following criteria: a) It is made from lightweight waterproof material so as not to hinder movement under water;1 b) It remains attached to the amputation stump at different depths; c) It has the correct weight and balance to prevent it from floating or falling off.2
Mental status and occupational therapy outcome in teaching dressing skills to the disabled elderly
Authors: Davies Ann DM , Gargaro Paula , Dodd Adrienne , Smith Christine 
Published: July 2008

Two groups of elderly disabled patients referred to an occupational therapy (OT) department, one of higher and one of impaired cognitive status, defined by the mini-mental state examination (MMS), were assessed before and after one month's OT to see if mental status predicted improvement in dressing skills. The Kuriansky Activities of Daily Living performance test (KPT), the Set test (ST) and a specially designed dressing skills task (DST) were administered before and after treatment. Cognitive status as measured by the MMS and the ST were related to the global measure of activities of daily living (KPT) before treatment but not to the specific dressing skills task. There was no significant relationship between cognitive status and OT outcome either in terms of dressing, KPT performance or discharge. The therapist's prediction of outcome at the initial assessment was accurate. A subsidiary study found that all patients entering the hospital over a six week period, likely to benefit from OT were in fact referred.
Survey of severely head-injured people in the Southampton health district
Authors: Wilkinson Stephen M , Fisher Lorna R , Bromfield Pauline 
Published: July 2008

A survey was conducted to identify the needs of the severely head-injured people (SHI) in the Southampton health district, who were known to the medical or social services. The study identified 62 patients with SH I and of these 48 were assessed. The results were similar to previous reports, showing that this group of relatively young individuals (mean age 36.5 years) had considerable residual disability many years after the original accident (mean duration 8.7 years). Over 50% of the study group had multiple impairment of a physical, cognitive and behavioural nature. Cognitive and behavioural problems presented the greatest difficulties for family and social adjustment. This study identified less than 10% of the predicted number of patients suffering from disability following SHI, suggesting that further prospective studies of outcome of SHI are needed at district level. Moreover, current services were not judged to be providing adequate social and vocational activities even for the minority of patients assessed. It is further suggested that a specialized brain-injury team is needed to monitor patients' early and long term management.
Factor analysis of activities of daily living scores: culturally determined versus vegetative components
Authors: Caradoc-Davies TH , Dixon GS 
Published: July 2008

Certain components of the Wakari activities of daily living (ADL) scale change over a period of rehabilitation. The data from two studies using this tool were reanalysed using factor analysis to define these components. Study 1 assessed the stress among the caregivers of people admitted to a geriatric assessment and rehabilitation unit (A&R unit) from the community, and included 94 selected patients. Study 2 included all patients admitted over a four-month period to the A&R unit, and studied 205 people. Patients were divided into those who were discharged to the community (group 1) and those who were discharged to a rest home or hospital (group 2). Admission and discharge ADL scores were significantly higher in group 2 than group 1. ADL abilities which are required for survival have been called 'vegetative', while those acquired in response to the needs of society have been called 'cultural'. Factor analysis of ADL scores on admission revealed two factorial groupings: nursing time, mobility and dressing were called 'cultural', while feeding and rationality were called 'vegetative'. The factor components of discharge scores were similar in the cultural area (nursing time, mobility and dressing), but the vegetative included rationality, feeding, dressing and continence of both urine and faeces. The cultural components improved during the rehabilitation period; vegetative components did not, apart from feeding in some subjects discharged to the community. We suggest that many elderly patients were unable to improve vegetative abilities due to frailty and cognitive impairment. Combining the studies, 25 subjects with low dependency scores below nine were discharged to rest homes or hospitals, while six of 31 with very high scores of more than 18 were discharged to live with a caregiver. The contribution of admission and discharge ADL scores to decisions about discharge placement is significant, but factors unrelated to patient dependence have a major effect on discharge placement. We suggest that interventions such as education and the development of coping skills should be directed toward the caregiver if one is present, and that more attention be given to interventions dealing with vegetative aspects of the patient's ADL ability.
The design of a functional assessment and gait analysis facility for rehabilitation studies
Authors: Minns RJ , Hogarth S. , Bainbridge A. , Pembroke S. 
Published: July 2008

A general functional assessment and gait facility has been designed for use in all aspects of measurement of handicap. The functional assessment course contains various features to assess the ability of subjects with different handicaps to sit, take off and apply orthotic or prosthetic devices, climb ramps and steps, negotiate corners, and doors with different locking and opening mechanisms. Incorporated in the middle of the walking section of the course is a force plate to assess the mechanical function of orthoses or prostheses by a force vector visualization system. A visual analogue scoring system of the quality of performance of the various tasks encountered on the functional assessment course as well as the freely selected speed and fastest walking in a straight line has been adopted. This visual analogue score is marked after analysing the video record obtained from a mobile colour camera. The doors, ramps and walking area are wide enough to assess wheelchair use. We have adopted a 'gait graph' for the gait analyses using a 10m straight walkway and measuring the temporal parameters at free speed walking and the fastest walking speed. Energy cost is measured using heart rate monitoring by telemetry on the functional assessment course and during gait analysis. It is proposed to use this facility for the assessment and management of lower limb bracing in children, patients undergoing corrective surgery on the lower limb and for wheelchair users.
The Rapid Assessment Clinic for Elders
Authors: Davies Keren , Sangster Graeme , Rowe Jed 
Published: July 2008

An audit of domiciliary visits suggested that many were inappropriate and that patients could be served better by immediate admission or urgent assessment in the day hospital. Consequently, a structured referral system was introduced with an alternative option, the 'Rapid Assessment Clinic for Elders'. This has led to a dramatic fall in home assessments. A reduction was also noted in the number of patients whose admission was delayed by prior assessment, whilst more patients were managed at a single contact. No additional resources were required and the clinic has been well received by patients, hospital staff and general practitioners. We describe the establishment of the service and report the first 21 months' experience.
A national survey of wheelchair users
Authors: Kettle Melvyn , Rowley Corinne , Chamberlain M Anne 
Published: July 2008

In 1990 the Disablement Services Authority commissioned a national survey of wheelchair users in England to determine the user's degree of satisfaction with (a) his/her wheelchair and (b) the service provided by the DSA generally and approved repairers in particular. A total of 3082 wheelchair users (2048 women and 1026 men) participated in the survey (58% response rate), most of whom were between 60 and 90 years of age. Although most users expressed satisfaction with their wheelchairs, an overriding problem was that assessment was generally limited to making sure that the individual 'fitted' his or her wheelchair (although even this was not always achieved). In the main, it was the demands of the social and physical environment in which a wheelchair was to be used that were so often overlooked. Also, a significant minority of people were without adequate information about their wheelchair or instruction on how to use it. Furthermore, just under half of the respondents had not heard of their approved repairer and two-thirds had not heard of their local Disablement Services Centre. The survey concluded, inter alia, that the multidisciplinary approach, in which an occupational therapist and/or physiotherapist takes a pivotal role, which is being developed within many wheelchair centres, needed to become universal.
Minor injury resulting in lower-limb loss in diabetic patients
Authors: Isakov Eli , Sussak Zeev , Eldar Reuben 
Published: July 2008

Objective: to identify diabetic patients who had undergone recent amputation of the lower limb, and in whom a possibly avoidable minor injury to the foot had caused infection and gangrene necessitating surgical intervention. Design: questionnaires, administered to consecutively admitted recent lower-limb amputees, addressing demographic, socio-economic and medical data and containing specific questions on circumstances or events that might have caused a foot lesion that started the infection, gangrene and eventually amputation. Setting: department of orthopaedic rehabilitation in a rehabilitation hospital. Patients: 218 recent, lower-limb amputees - due to occlusive arterial disease, with or without diabetes - admitted for prosthetic rehabilitation during 30 months (January 1989 to June 1991). Results: 56 diabetic and 10 non-diabetic amputees were identified in whom a minor injury had caused the sequence leading to amputation which could have been avoided by adequate attention to the feet and their care. Conclusions: All diabetic individuals need education regarding self-care and attention to the feet, irrespective of their demographic or socio-economic variables and disease severity. The view is expressed that such an education — particularly when linked to the provision of necessary health services - would be able to reduce the risk of amputation in diabetes mellitus considerably.
Fatigue effects of rest intervals during electrical stimulation of the human quadriceps muscle
Authors: Rankin RR , Stokes MJ 
Published: July 2008

Optimal rest intervals required between contractions and treatment sessions to allow recovery from fatigue after electrical stimulation of muscle are not known. In eight volunteers (aged 23-38 years), fatigue of the quadriceps was examined during and after three therapeutic stimulation protocols which were performed one week apart. Protocols consisted of 10 isometric contractions at 30% maximum voluntary force. The contractions lasted 10 seconds each, and were separated by rests of either 10, 50 or 120 seconds. Force responses to stimulation at 20 Hz and 50 Hz (for two seconds each) were used as a test to monitor recovery. All three therapeutic stimulation protocols caused significant fatigue during activity. The shorter the rest interval, the greater the fatigue and hence, less work (i.e. integrated force) completed. Recovery was also influenced by the rest intervals. One hour after activity, force at 20 Hz was approximately 50% of initial values (p < 0.01), increasing to 70-80%at 24-hours, and to 90% at 48-hours. Force at 50 Hz was 68-80% after the first hour, had recovered 24-hours after the 10 second protocol but not the 50 and 120 second protocols, and full recovery had been reached by 48-hours. Persistence of both high and low frequency fatigue after these therapeutic protocols was greater than expected. Studies are required to determine whether stimulation of fatigued muscle produces therapeutic or adverse effects, and to establish the degree of recovery required for these effects.
Increasing patient engagement in rehabilitation activities
Authors: Ellul J. , Watkins C. , Ferguson N. , Barer D. , Rowe J. 
Published: July 2008

Despite evidence that intensive rehabilitation speeds recovery from acute illness, several studies on British rehabilitation units have shown that the time spent by patients in therapeutic activities is low and that levels of 'engagement' are poor. We carried out an observational study of patient activity on four rehabilitation wards for the elderly (51 patients observed at half-hourly intervals between 8 a.m. and 5 p.m. on five successive days). Patients were found to be engaged in therapeutically useful activities at only 17% of the observation points. When time spent in the therapy departments (where activities were not monitored) was excluded the proportion of useful activities fell to 11%. Similar patterns of activity were seen in all patient subgroups. An intervention scheme was therefore devised, whereby an hourly activities programme tailored to the needs of each patient was worked out by therapists and ward staff, to be supervised by nurses. One nurse also organized regular group activities. The intervention programme, which required no extra resources, was instituted on two of the four wards. A repeat survey conducted two months later showed a 55% increase in the proportion of time spent in useful activities on the two intervention wards but no change on the other two wards.
Physiological cost index of walking in able-bodied adolescents and adults
Authors: Nene AV 
Published: July 2008

Fifty-four able-bodied adolescents and 40 adults were assessed in the gait laboratory using an infrared telemetry system. Physiological Cost Index (PCI) of walking ranged from 0.15 beats/metre (b/m) to 0.65 b/m (mean 0.35 b/m, SD 0.09) in adolescents and from 0.2 b/m to 0.55 b/m (mean 0.36 b/m, SD 0.08) in adults. There was no significant difference between median values of PCI in the two study groups. It would appear that the range of PCI values is similar for all age groups. Adult males showed lower PCI than adult females (males 0.31 b/m, SD 0.07 and females 0.4 b/m, SD 0.07; p < 0.001). Quetelet Index of each subject was taken into consideration in order to standardize subjects' body mass and height. There was no correlation between the PCI and the Quetelet Index in either group. Estimation of PCI is a convenient and reliable method to monitor changes in the energy expenditure of walking, is relatively easy and does not require elaborate instrumentation.
Patients' satisfaction with stroke services
Authors: Pound Pandora , Gompertz Patrick , Ebrahim Shah 
Published: July 2008

Patient satisfaction with stroke services is a key aspect of the evaluation of the quality of services but there are no adequate means of assessing satisfaction in this area. A questionnaire derived from in-depth interviews was piloted on two samples. The resulting questionnaire consisted of two sections, one on inpatient services (Hospsat) and the other on services in the community (Homesat). It was sent to 219 patients, who had had a stroke six months previously, along with postal versions of the Barthel ADL index, the Nottingham Extended ADL Scale, the Nottingham Health Profile, the short form of the Geriatric Depression Scale and the Faces Scale. The response rate for the questionnaires was 87%. Test-retest reliability and tests of internal consistency of the satisfaction scales were carried out on a subsample of this population. Convergent and discriminant validity were explored by examining correlations with the above measures. The satisfaction questionnaire had construct validity with significant correla tions between the Barthel ADL Index ( r = 0.39), the Nottingham Extended ADL Scale ( r= 0.38) and the physical mobility subsection of the Nottingham Health Profile ( r= -0.36). Internal consistency was high for both sections (Cronbach's Alpha: Hospsat 0.86; Homesat 0.77). Test-retest reliability was fair; the mean difference for total scores was 0.59 (SD = 2.4) for Hospsat, and 0.32 (SD = 2.1) for Homesat. A high level of dissatisfaction was uncovered. Just under half (48%) of people were dissatisfied with some aspect of the care they received in hospital and over half (53%) were dissatisfied with some aspect of the services they received in the community. The highest rate (54%) of dissatisfaction was with the amount of therapy received. Good patient satisfaction measures are useful since they complement 'objective' outcome measures and may highlight areas in need of evaluation and improvement.
Automatic and voluntary lateral weight shifts in rehabilitation of hemiparetic patients
Authors: Dickstein Ruth , Dvir Zeevi , Ben Jehosua Efrat , Rois Miri , Pillar Thomas 
Published: July 2008

One of the main objectives of exercise therapy for hemiparetic patients is the rehabilitation of their impaired ability to accept and bear bodyweight on the involved lower extremity. The purpose of this study was to compare two types of therapeutic exercises, automatic and voluntary weight shifts, used as treatment for this problem. Thirteen hemiparetic patients and nine age-matched healthy controls participated in the study. Criterion variables were four: (1) body sway; (2) location of the centre of pressure; (3) activation pattern of the gluteus medius and medial gastrocnemius muscles; and (4) magnitude of activation of these two muscles. Each subject was tested three times: (1) during static stance; (2) while standing on a moving platform that imposed automatic lateral weight shifts; and (3) while standing on a stationary base and voluntarily shifting bodyweight from one lower limb to the other. Values of sway and location of the centre of pressure on the mediolateral axis were collected by the Chattecx balance system; magnitude and modulation of the muscular activity in both lower extremities were recorded with surface electromyography. The findings showed significant differences between patients and controls in all four variables. Regarding differences between exercise modes, the main finding pointed to larger sways in voluntary as compared to automatic weight shifts. Presumably, body fixation during automatic perturbations was manifested in a decreased body sway. Stance symmetry and the EMG activation profile of the paretic muscles were not improved by either exercise mode.
Improving social outcome after stroke: an evaluation of the volunteer stroke scheme
Authors: Geddes Joanna ML , Chamberlain M Anne 
Published: July 2008

Data were obtained on all referrals of stroke patients to the speech therapy departments of two adjoining Health Authorities, Leeds West and Leeds East. Only Leeds West had a Volunteer Stroke Scheme (VSS) available. Qualified speech and language therapists in both Health Authorities classified patients as dysphasic and/or dysarthric and identified those they thought likely to benefit from support from the VSS. From these latter patients, three groups were identified: Leeds West patients receiving support from the VSS ( n = 34); Leeds West patients who refused VSS support ( n = 9); and Leeds East patients with no VSS support available ( n = 10). All patients were followed up for one year and changes in Barthel Index, Frenchay Activities Index (FAI) and carers' Hospital Anxiety and Depression scores were recorded. Only those patients who received VSS support demonstrated a statistically significant increase in FAI over the year.
A postal version of the Barthel Index
Authors: Gompertz Patrick , Pound Pandora , Ebrahim Shah 
Published: July 2008

The Barthel Index is the best known and most popular activities of daily living (ADL) scale. Many studies have confirmed its validity and it has been validated for many different methods of administration. These include direct observation, interview of patient carer or nurse and telephone. The aim of this study was to devise and test the reliability of a self-completed postal version of the Barthel Index for use in surveys and outcome studies. The items were changed into multiple choice questions, taking into account the published guidelines and knowledge of common areas of confusion when administering the Barthel by interview. The test retest reliability over two weeks of the resulting questionnaire was evaluated using a consecutive series of 21 patients from a stroke register, who had responded without prompting to a postal survey six months after stroke. All the items had κ statistics indicating at least moderate reliability, the toilet and mobility items being the worst. The mean difference in total scores was -0.5 out of 20, standard deviation 2.1. The 95% limits of agreement were -4.6 to 3.6, corresponding to a change in dependence of up to two ADL items. This study demonstrates that the postal self-report questionnaire version of the Barthel is reliable and practical. Further studies are needed to establish its validity in comparison with interview administration.