bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of standardized outcome measures in rehabilitation centres in the UK
Authors: Skinner Aneetha , Turner-Stokes Lynne 
Published: August 2006

Aim: To identify the standardized outcome measures currently used in routine clinical practice in rehabilitation centres in the UK. Design: Cross-sectional survey by postal questionnaire. Participants: All UK consultant members of the British Society of Rehabilitation Medicine (BSRM) ( n = 180). Results: A total of 108 (60%) responses were received, representing 83 different rehabilitation services. Of these, 71 (86%) collected at least one standardized measure. The Barthel Index and the UK Functional Independence Measure and/or Functional Assessment Measure (FIM9 ± FAM) were the most popular global outcome measures: 83% of units measured one or other of these. The Northwick Park Dependency Scale (NPDS) and Care Needs Assessment (NPCNA) ( n = 21, 28%) were used for the more dependent patients. Depression and pain scores were more commonly used than general health measures. Sixty (72%) units routinely assessed outcome through the achievement of set goals, but only four transformed data to a goal attainment scale. Outcome measure scores were routinely reported in discharge summaries by 72% of units. Conclusions: The survey demonstrated quite widespread use of outcome assessments in routine clinical rehabilitation within the UK, with an encouraging level of common measurement in some areas of practice. The results have been used to update the BSRM ‘basket of recommended measures’.
Perceived pain and satisfaction with medical rehabilitation after hospital discharge
Authors: Bergés Ivonne-Marie , Ottenbacher Kenneth J , Smith Pamela M , Smith David 
Published: August 2006

Objective: To examine the association between pain and satisfaction with medical rehabilitation in patients with hip or knee replacement approximately 90 days after discharge from inpatient medical rehabilitation. Design: A cross-sectional design. Participants: The sample included 2507 patients with hip or knee replacement using information from the IT Health Track medical outcome database. Main outcome measure: Satisfaction with medical rehabilitation. Results: The average age was 70.2 years, 66.5% were female, and 88.5% were non-Hispanic white. Pain scores were significantly and inversely associated with satisfaction with medical rehabilitation after adjustment for possible confounding factors. In patients with hip replacement each one-point increase in pain score was associated with a 10% decreased odds ratio (OR) of being satisfied with medical rehabilitation (OR 0.90, 95% confidence interval (CI) 0.84, 0.96). In patients with knee replacement, each one-point increase in pain score was associated with a 9% decreased odds ratio (OR 0.91, 95% CI 0.87, 0.96) of being satisfied with medical rehabilitation. Conclusion: Our data indicate that postoperative pain from hip or knee replacement is associated with reduced satisfaction with medical rehabilitation. Better postoperative pain control may improve a patient's level of satisfaction.
Contracture preventive positioning of the hemiplegic arm in subacute stroke patients: a pilot randomized controlled trial
Authors: de Jong L D , Nieuwboer A , Aufdemkampe G 
Published: August 2006

Objective: To investigate the effectiveness of a contracture preventive positioning procedure for the hemiplegic arm in subacute stroke patients in addition to conventional physio and occupational therapy. Design: A single-blind pilot randomized controlled trial. Setting: Inpatient neurological units from three rehabilitation centres in the Netherlands. Subjects: Nineteen subacute stroke patients (minus two drop-outs) with a severe motor deficit of the arm. Interventions: All subjects underwent conventional rehabilitation care. Nine subjects additionally received a positioning procedure for two 30-min sessions a day, five days a week, for five weeks. Main measures: Passive range of motion of five arm movements using a hydrogoniometer and resistance to passive movement at the elbow using the Ashworth Scale. Secondary outcome measures were pain at the end range of passive motions, the arm section of the Fugl-Meyer Assessment and Barthel Index scores for ADL-independence. Outcome measures were taken after five weeks and additional measurements after 10 weeks by two assessors blinded to group allocation. Results: Comparison of the experimental ( n = 9) with the control subjects ( n = 8) after five weeks showed that additional positioning significantly slowed down development of shoulder abduction contracture ( P = 0.042, −5.3 degrees versus −23 degrees). No other differences were found between the groups. Conclusions: Applying a contracture preventive positioning procedure for the hemiplegic arm slowed down the development of shoulder abduction contracture. Positioning did not show significant additional value on other outcome measures. Since the sample size was small, results of this study need future verification.
Relations between social support, appraisal and coping and both positive and negative outcomes for children of a parent with multiple sclerosis and comparisons with children of healthy parents
Authors: Pakenham Kenneth I , Bursnall Samantha 
Published: August 2006

Objective: To examine adjustment in children of a parent with multiple sclerosis within a stress and coping framework and compare them with those who have ‘healthy’ parents.Subjects: A total of 193 participants between 10 and 25 years completed questionnaires; 48 youngsters who had a parent with multiple sclerosis and 145 youngsters who reported that they did not have a parent with an illness or disability.Method: A questionnaire survey methodology was used. Variable sets included caregiving context (e.g. additional parental illness, family responsibilities, parental functional impairment, choice in helping), social support (network size, satisfaction), stress appraisal, coping (problem solving, seeking support, acceptance, wishful thinking, denial), and positive (life satisfaction, positive affect, benefits) and negative (distress, health) adjustment outcomes.Results: Caregiving context variables significantly correlated with poorer adjustment in children of a parent with multiple sclerosis included additional parental illness, higher family responsibilities, parental functional impairment and unpredictability of the parent's multiple sclerosis, and less choice in helping. As predicted, better adjustment in children of a parent with multiple sclerosis was related to higher levels of social support, lower stress appraisals, greater reliance on approach coping strategies (problem solving, seeking support and acceptance) and less reliance on avoidant coping (wishful thinking and denial). Compared with children of ‘healthy’ parents, children of a parent with multiple sclerosis reported greater family responsibilities, less reliance on problem solving and seeking social support coping, higher somatization and lower life satisfaction and positive affect.Conclusions: Findings delineate the key impacts of young caregiving and support a stress and coping model of adjustment in children of a parent with multiple sclerosis.
Reliability and sensitivity to change of measurement instruments used in a traumatic brain injury population
Authors: van Baalen B , Odding E , van Woensel M PC , van Kessel M A , Roebroeck M E , Stam H J 
Published: August 2006

Objective: To compile a minimum data set for the follow-up of traumatic brain injury patients from discharge from hospital to one year post injury to assess functioning and participation in the physical, cognitive and psychosocial domains, and in quality of life. Design: Repeated questionnaire interviews by two observers to establish interobserver reliability of the measurement instruments at discharge and at one year post injury, as well as their sensitivity to change over time in traumatic brain injury patients. Setting: Department of neurosurgery of an academic hospital, department of a rehabilitation centre, and at the patients' homes in the Netherlands. Subjects: The study at discharge included 25 patients aged 18-50 years with a moderate to severe traumatic brain injury (Glasgow Coma Scale score 3-14), whereas the one year post injury study included 14 patients aged 19-51 years. Main (outcome) measures: Physical domain: Barthel Index (BI), Functional Independence Measurement (FIM), Glasgow Outcome Scale (GOS), GOS Extended (GOSE). Cognitive domain: Disability Rating Scale (DRS), Functional Assessment Measurement (FAM), Levels of Cognitive Functioning Scale (LCFS), Neurobehavioural Rating Scale (NRS). Psychosocial domain: Community Integration Questionnaire (CIQ), Employability Rating Scale (ERS), Frenchay Activity Index (FAI), Multi Health Locus of Control (MHLC), Rehabilitation Activities Profile (RAP), Social Support List (SSL), Supervision Rating Scale (SRS), Wimbledon Self Reporting Rating Scale (WSRS). Quality of life: Coop/Wonca Charts (Coop), Rand SF-36 (Rand-36), Sickness Impact Profile-68 (SIP-68). Results: At both discharge and at one year post injury, in the physical domainthe FIM showed excellent squared weighted kappa (SWK ranging from 0.75 to 0.80), and intraclass correlation coefficient (ICC ranging from 0.75 to 0.92), and a relatively small standard error of measurement (SEM 3.22) and smallest detectable difference (SDD 8.92). In the cognitive domain the FAM and the NRS showed excellent SWK, and ICC, and a relatively small SEM and SDD. In the psychosocial domainthe FAI showed excellent SWK (0.89), and ICC (0.87), and a relatively small SEM (2.64) and SDD (7.31). For quality of life, at both discharge and at one year post injury the SIP-68 and the Coop showed excellent SWK (0.87), and ICC (0.89), and a relatively small SEM (3.79) and SDD (10.51). At both time points SWK and ICC ranged from 0.80 to 0.89, SEM ranged from 1.47 to 1.98, and the SDD was 4.07. Conclusions: An example of a reliable minimum data set that is also able to detect changes over time is: the FIM, the FAM and the Coop for the early stages in recovery, extended with the NRS, the FAI, and the SIP-68 later in recovery, thereby covering all relevant domains after traumatic brain injury.
The effect of botulinum toxin type A injection into the gastrocnemius muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy
Authors: Park Eun Sook , Park Chang Il , Chang Hyun Chung , Park Chan Woo , Lee Don Shin 
Published: August 2006

Objective: To investigate the benefit of botulinum toxin type A injection into the ankle plantarflexor muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy. Design: Case-control study. Setting: Inpatients in a university-affiliated hospital. Subjects: Forty spastic diplegic children aged from 2 to 6 years (18 children with botulinum toxin type A injection into both gastrocnemius muscles as an experimental group and 14 children without injection as a control group). Main measures: Sit-to-stand transfer task was evaluated using a motion analyser (Vicon 370 MA with six infrared cameras). The tests were performed twice with a two-week interval. The changes in temporal, kinematic and kinetic parameters were investigated in each group. Results: In the control group there were no significant changes in any of the measured parameters between the tests. In the experimental group, total duration (s) of sit-to-stand transfer was shortened after injection (4.359 ± 2.49 to 2.899 ± 1.48, P < 0.05). The maximal angles (degrees) of pelvic and hip joints were reduced (28.889 ± 5.53 to 26.579 ± 3.73 and 90.789 ± 8.69 to 87.239 ± 8.76) and the initial angle of ankle dorsiflexion was increased (4.419 ± 6.16 to 7.089 ± 6.09) after injection (P < 0.05). The maximal moments (Nm/kg) of the hip and knee joints (0.449 ± 0.17 to 0.519 ± 0.21 and 0.139 ± 0.05 to 0.189 ± 0.14) were increased while that of the ankle joint was reduced (0.329 ± 0.09 to 0.289 ± 0.10) after injection (P < 0.05). Only the cases with greater reduction of spasticity showed an improvement on kinematic and kinetic parameters. Conclusion: Botulinum toxin type A injection into spastic ankle plantarflexors led to better accomplishment of sit-to-stand transfer in children with spastic diplegic cerebral palsy.
The effect of exercise of the affected foot in stroke patients-a randomized controlled pilot trial
Authors: Rydwik Elisabeth , Eliasson Sara , Akner Gunnar 
Published: August 2006

Objective: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients. Design: A randomized controlled pilot study. Setting: A research centre. Subjects: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle. Interventions: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period. Main measures: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life. Results: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups. Conclusion: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.
Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score
Authors: Foss Nicolai B , Kristensen Morten T , Kehlet Henrik 
Published: August 2006

Objective: To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients. Design: Prospective, descriptive study. Setting: An orthopaedic hip fracture unit in a university hospital. Patients: Four hundred and twenty-six consecutive hip fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria. Main outcome measure: Admission tests with a new mobility score to assess prefracture functional mobility and a short mental score for cognitive dysfunction were performed. On the first three postoperative days patients were assessed with the cumulated ambulation score consisting of a cumulated assessment of simple ambulation characteristics with a score from 0 to18 (fully mobile). The three assessments were correlated to short-term outcome parameters. Results: The cumulated ambulation score was a highly significant predictor for length of hospitalization, time to discharge status, 30-day mortality and postoperative medical complications (P < 0.001 for all). The cumulated ambulation score was superior in its association with all postoperative outcome parameters to both the New Mobility Score and the mental score. A cumulated ambulation score of ±10 correlated with a 99% survival at one month and 93% discharge to own home. Conclusion: The cumulated ambulation score is a potentially valuable score for early prediction of short-term postoperative outcome after hip fracture surgery.
Comparison of customized versus standard exercises in rehabilitation of shoulder disorders
Authors: Wang S Sharon , Trudelle-Jackson Elaine J 
Published: August 2006

Objective(s): (1) To compare the effectiveness of customized exercises with that of standard exercises for the treatment of patients with shoulder disorders. (2) To determine whether four weeks or eight weeks would be needed to see improvement in outcome measures. Design: A single-blinded randomized clinical trial. Setting: An outpatient physical therapy clinic affiliated with an academic institution. Subjects: Thirty patients with shoulder disorders were tested and treated between February 2003 and December 2004. Interventions: Patients were randomized to a customized or standard exercise group. Each patient first underwent a standardized physical therapy assessment. Based on the results of the assessment, a classification was determined and a classification-specific exercise programme was instructed to the patients in the customized exercise group. The standard exercise group, regardless of classification, received preselected standard exercises. Both groups were followed for eight weeks. Main measures: Shoulder range of motion, strength, pain intensity and function were assessed three times (weeks 0, 4 and 8). Results: There were no significant differences between the customized and standard exercise groups in measures of shoulder range of motion, strength, pain intensity and function after four or eight weeks of exercise. Patients in both groups had significant improvements in shoulder strength, pain intensity and function. Significant improvements occurred at week 8, but not at week 4. Conclusion: The customized shoulder exercises did not provide additional benefit to our shoulder patients than the standard exercises.
Materialist returns: practising cultural geography in and for a more-than-human world
Authors: Whatmore Sarah 
Published: August 2006

This paper surveys the return to materialist concerns in the work of a new generation of cultural geographers informed by their engagements with science and technology studies and performance studies, on the one hand, and by their worldly involvements in the politically charged climate of relations between science and society on the other. It argues that these efforts centre on new ways of approaching the vital nexus between the bio (life) and the geo (earth), or the ‘livingness’ of the world, in a context in which the modality of life is politically and technologically molten. It identifies some of the major innovations in theory, style and application associated with this work and some of the key challenges that it poses for the practice of cultural geography. Thinking is neither a line drawn between subject and object nor a revolving of one around the other. Rather thinking takes place in the relationship of territory and earth... involving a gradual but thorough displacement from text to territory.1
Abrasive Wear of Rolling Bearings by Lubricant Borne Particles
Authors: Nilsson R , Dwyer-Joyce R. S. , Olofsson U 
Published: August 2006

Damage caused by lubricant borne particles in rolling/sliding contacts can severely reduce the operational life of machine elements such as cam mechanisms, roller bearings, gears, and pumps. Lubricant supplies frequently contain such contaminating particles, either generated from within the machinery itself or entrained from the surroundings. The particle can be entrained into a lubricated contact and damage the bearing surfaces. Many such individual abrasive actions can lead to significant change in the surface profile of the rolling elements. In this work, a series of experiments has been carried out to investigate the mechanism of this surface damage and abrasion process when the contaminating particles are small and hard. The tests show, how particles are entrained into the contacts, the form of the scratches they produce, and the resulting surface profile changes. On the basis of these observations, a model of the abrasive wear process has been developed. The prediction of abrasive wear compares qualitatively well with observed form change on the bearing surface.
Soot Wear in Diesel Engines
Authors: Yamaguchi E. S. , Untermann M , Roby S. H. , Ryason P. R. , Yeh S. W. 
Published: August 2006

In response to regulatory requirements, lubricant manufacturers are seeking oils that minimize soot thickening and the accompanying soot wear. Formulation technology is being developed by additive manufacturers to satisfy these requirements. For example, such work is in progress at Chevron Oronite Company LLC, using the Cummins M-11 exhaust gas recirculation (EGR) engine test as a surrogate for the anticipated soot wear test for PC-10. Simultaneously, the authors developed bench tests to screen candidate formulations and reduce costs. A ball-on-disc sliding wear test, using a PCS Instruments MTM® tribometer, has been investigated. Sliding conditions at high pressure are required for soot polishing wear. Conditions that correlate tribometer test results with M-11 engine results at high soot concentrations (∼9 per cent) have been found. Both ball wear and Stribeck curves were determined in these tests. The high-wear oil progresses from mixed lubrication conditions to boundary lubrication at higher sliding speeds than the low-wear oil. X-ray photoelectron spectroscopy experiments were also conducted on the ball wear scars, revealing differences in the chemical constitution of the tribofilms from the two oils.
Analysis of the Behaviour of Rolling Bearings in Contaminated Oil Using Some Condition Monitoring Techniques
Authors: Akagaki T , Nakamura M , Monzen T , Kawabata M 
Published: August 2006

Friction and wear behaviours of rolling bearing in contaminated oil containing white-fused alumina particles were studied. The friction and wear processes were monitored using wear debris analysis, such as ferrography and spectrometric oil analysis program, and vibration analysis. Test bearing was a deep groove ball bearing (6002P5); Wear debris and worn surfaces of the bearing components were observed with a scanning electron microscope (SEM). It was found that the friction coefficient in the contaminated oil became lower by about 0.001 than that in the new oil for the large contaminants. The results of wear debris analysis showed that the large contaminants caused the high wear rate in the bearing. Three types of wear debris were commonly observed: thread-like debris, cutting chip debris, and plate-like debris. On the basis of the SEM observation results of the worn surfaces, wear mechanisms of these wear debris were discussed. The results of vibration analysis showed that the probability density function of vibration waveform was normal distribution in both the new and contaminated oils. In the contaminated oil, it changed depending on the contaminant size and the runtime, i.e. the progress of wear in the bearing. The result of wear debris analysis was related to that of vibration analysis and discussed.
Environmental Improvements in Ship Design by the Use of Scoring Functions
Authors: Winnes H , Ulfvarson A 
Published: August 2006

The introduction of environmental aspects in ship design requires a holistic view of the design process. The designer needs to integrate environmental knowledge with the design process without increasing calendar time for the design work. A design tool that supports trade-off analyses with environmental objectives will be presented in this paper. Interviews with experienced ship designers have been conducted to support the mapping of the ship design process. This has resulted in identification of decision points, where environmental aspects could be addressed, and has shown the possibilities of the aforementioned integration. The aim has been to show a design tool that is able to manage geographical differences in sensitivity, when it comes to environmental effects from a ship. The paper will point out changes in approach to include this tool in the design process. This paper demonstrates so-called scoring functions in-a trade-situation with environmental information. The tool produced keeps a lot of information ready at an early stage in the design process and deals with the issue of changing environmental sensitivity in the ship surroundings. Recommendations are given on further development for the use of environmentally focused scoring functions in ship design.