bluuebunny/crossref_metadata_2025_split huggingface dataset:
No benefit from D-amphetamine when added to physiotherapy after stroke: a randomized, placebo-controlled study
Authors: Treig Thomas , Werner Cordula , Sachse Martin , Hesse Stefan 
Published: August 2003

Objective: To assess the effect of D-amphetamine on the recovery of activities of daily living and motor functions after stroke, Design: Randomized, placebo-controlled study, Setting: Inpatient rehabilitation centre, Subjects: Twenty-four stroke survivors after a first ischaemic supratentorial stroke within six weeks before study onset, severely to moderately affected, with a Barthel Index (0–100) ranging from 25 to 50, no severe concomitant internal, neurological or psychiatric diseases, and participating in a comprehensive rehabilitation programme of 10–12 weeks, Interventions: Ten sessions with 10 mg D-amphetamine (or placebo) every fourth day totalling 100 mg in a time period of 36 days combined with physical therapy according to the neurodevelopmental concept within 60 minutes after drug intake. Main outcome measures: Barthel Index (0–100) served as the primary outcome measure and the Rivermead Motor Assessment Score with its three sections (gross function, leg and trunk, and arm) as the secondary outcome measure, assessed at days 0, 20, 36, 90, 180 and 360. Results: The two groups did not differ with respect to clinical data and outcome measures at study onset. All patients improved significantly except for arm function over the intervention period and up to day 90 after study onset. The comparison between groups did not reveal any difference at any time; amphetamine-treated patients did not show any increase in motor function or ADL compared with the control group. Conclusions: The placebo-controlled study failed to show any effect of D-amphetamine on stroke recovery compared with control. The small number of patients, the timing and content of physical therapy were limiting factors of the present study. Further trials are warranted.
Effects of perceptual learning exercises on standing balance using a hardness discrimination task in hemiplegic patients following stroke: a randomized controlled pilot trial
Authors: Morioka Shu , Yagi Fumio 
Published: August 2003

Objective: To investigate the effect of perceptual learning exercises for hardness discrimination by the soles on standing balance in stroke patients with hemiplegia. Subjects: Twenty-eight subjects were randomly assigned to an experimental or a control group and participated in a rehabilitation programme. Intervention: The experimental group received perceptual learning exercises on hardness discrimination using three different levels of hardness of a rubber sponge for 10 days. Main measures: Length, enveloped area and rectangular area of the parameter of postural sway were measured by a stabilometer on entry into the study and after 10 days. Results: Twenty-six subjects completed the study. Data indicate that more parameters indicating postural sway were significantly decreased in the experimental group than in the control group. Also, there was a significant difference between the groups in change scores (pre-exercise minus postexercise) of length and enveloped area. Conclusion: The plantar perception exercise used as a method in this study is considered to be effective as a supplemental exercise for standing balance. The possibility of clinical application using the hardness discrimination task with rubber as a balance exercise is therefore suggested.
A study on additional early physiotherapy after stroke and factors affecting functional recovery
Authors: Fang Yannan , Chen Xiaohua , Li Hua , Lin Jianwen , Huang Ruxun , Zeng insheng 
Published: August 2003

Objective: To investigate whether additional early physiotherapy after stroke improved functional recovery in stroke patients. Design: A prospective, randomized, controlled study. Setting: One stroke ward and an acute stroke unit in a large teaching hospital, southern China. Subjects: Patients with first-onset stroke consecutively admitted to the stroke centre. Interventions: One group ( n = 78) received additional early physiotherapy (AEP) for 45 minutes, five days a week for four weeks starting within the first week since stroke onset; the routine therapy (RT) group ( n = 78) received no professional rehabilitation therapy. Main outcome measures: Glasgow Coma Scale, Mini-Mental State Examination, Fugl-Meyer Assessment of Motor Recovery, Clinical Neurological Deficit Scale and Modified Barthel Index (MBI). Results: Patients from the AEP group had a high drop-out rate ( n = 28), but those remaining made relatively better functional recovery at 30 days than those from the RT group if measured by MBI. Multiple linear regression analysis revealed that cognitive disturbance, aphasia, double incontinence, site of lesion and sensory impairment might affect functional recovery after stroke. Conclusions: Additional early physiotherapy might improve independence of patients after stroke but failed to show benefit in other aspects in our study. Cognitive disturbance, aphasia, double incontinence, site of lesion as well as sensory impairment might affect functional outcome after stroke.
Effects of thermal therapy in improving the passive range of knee motion: comparison of cold and superficial heat applications
Authors: Lin Y H 
Published: August 2003

Objective: To assess the effect of applying a hot pack followed by a cold pack (COLD) on the passive range of knee flexion in subjects with restricted knee motion, specifically comparing this treatment to the application of a hot pack (HEAT) alone. Design: Seventy-one subjects were randomized into two groups to conduct a clinical randomized before–after trial. Interventions: Each subject received either (1) cold pack or (2) hot pack during passive knee joint stretching. Main outcome measure: Goniometry was used to measure the passive knee flexion at the baseline (KROM1), before (KROM2) and after (KROM3) applications of a hot pack with/without a cold pack. Results: Repeated ANOVA measurements revealed a marked increase in the passive range of knee flexion in the two study groups ( p < 0.001). Moreover, the paired t-test displayed statistical increments of knee flexion across the different measurement phases, except for the treatment phase without the cold pack. The range of knee flexion following the treatment with the application of a cold pack significantly exceeded that after treatment without a cold pack. Conclusion: Cold pack application had a limited but significant effect during mechanical stretching for restricted knee motion.
The effects of exercise and exercise-related changes in blood nitric oxide level on migraine headache
Authors: Narin S Osün , Pinar L , Erbas D , Oztürk V , Idiman F 
Published: August 2003

Objective: To observe the effects of moderate aerobic exercise on migraine headache, to assess exercise-related changes in blood nitric oxide (NO) levels, and to examine the impact of such changes on migraine attacks. Design: Controlled clinical trial. Setting: School of Physical Therapy and Rehabilitation. Subjects: Forty women with general migraine attending the Neurology Department of the Faculty of Medicine Faculty of Dokuz Eylül University. Intervention: Patients were assigned alternately into two groups: exercise group undertaking 1 hour aerobic exercise three times weekly, and a control group. Main outcome measures: Patients were assessed before and after treatment using three clinical scales – visual analogue scale for headache, Pain Disability Index and Quality of Life Scale – and chemiluminescence analysis for plasma nitric oxide. Results: After the eight-week therapy period, patient complaints concerning the intensity, frequency and duration of pain had decreased significantly in both groups; however, visual analogue scale scoring showed better pain relief in the exercised group than in the controls (from 8.8 ± 1.7 to 4.0 ± 1.4 and from 8.5 ± 0.8 to 7.0 ± 0.9 respectively). Quality of life measures also revealed better migraine relief in the exercised women than in those who received medical treatment only. Blood NO rose significantly from pre to post-therapy in the exercised group, but the change was not significant in the control group. Conclusion: The study showed that regular long-term aerobic exercise reduced migraine pain severity, frequency and duration possibly due to increased nitric oxide production.
The effectiveness of intensive group exercise on patients with ankylosing spondylitis
Authors: Analay Yildiz , Ozcan Emel , Karan Ayse , Diracoglu Demirhan , Aydin Resa 
Published: August 2003

Objective: To compare, in patients with ankylosing spondylitis (AS), the effectiveness on pain, functional and psychological status of an intensive group exercise programme under the supervision of a physiotherapist and a home physiotherapy programme. Design: Fifty-one patients with AS were randomly allocated into study and control groups. The study was designed as a prospective, double-blind study. Setting: Outpatient department, Istanbul Medical Faculty. Subjects: Patients who consulted with complaints of pain, morning stiffness and restricted range of movement with a confirmed diagnosis of ankylosing spondylitis. Interventions: Before exercise, both groups were given an education programme about AS. For group I patients an intensive exercise programme was organized under the supervision of a physiotherapist for six weeks. Group II patients had to practise exercises individually at home. Main outcome measures: Both groups were evaluated and compared for pain, functional and psychological status before treatment, at the end of treatment and three months after treatment using a visual analogue scale (VAS) for pain, Beck Depression Scale and Bath Ankylosing Spondylitis Functional Index (BASFI). Results: Six patients withdrew, four from group I. Results from the remaining 45 showed more positive changes in the patients undertaking group exercise at six weeks and three months after treatment. Values showed a statistical significant difference in favour of group I. Conclusion: Group exercise in hospital may be more effective than home-based exercises at reducing impairment associated with ankylosing spondylitis.
The effectiveness of two psychomotor therapy programmes on physical fitness and physical self-concept in nonpsychotic psychiatric patients: a randomized controlled trial
Authors: Knapen J , Van de Vliet P , Van Coppenolle H , David A , Peuskens J , Knapen K , Pieters G 
Published: August 2003

Objective: To compare the changes in cardiorespiratory and muscular fitness, and the changes in physical self-concept after participation in one of two psychomotor therapy programmes in a sample group of psychiatric patients. To study the relationship between the changes in physical fitness and the changes in physical self-concept. Design: Randomized controlled parallel-group trial with repeated measures. Setting: Three treatment units of a university psychiatric hospital in Belgium. Subjects: One hundred and ninety-nine patients with severe symptoms of depression and/or anxiety, and/or personality disorders. Interventions: A general programme of psychomotor therapy, consisting of different forms of physical exercises and relaxation training, and a personalized psychomotor fitness programme, consisting of aerobic and resistance training. These programmes were followed three times a week for a period of 16 weeks. Outcome measures: The maximum dynamic strength, the strength endurance, physical work capacity at 60% and 80% of the estimated maximal heart rate reserve, and the physical self-concept by means of the Dutch version of the Physical Self-Perception Profile. Results: After eight weeks, both groups exhibited an improvement in muscular fitness (both p-values <0.0001), but only the psychomotor fitness group had improved in cardiorespiratory fitness ( p < 0.01). After 16 weeks, the patients in the general programme of psychomotor therapy had not increased in cardiorespiratory fitness. At the end of the 16-week programmes, both groups showed a more positive physical self-concept ( p from 0.01 to <0.0001). However, these improvements were not related to the progress in physical fitness. Conclusions: The main difference in the effectiveness of the two programmes was the increase in cardiorespiratory fitness in the psychomotor fitness group. The gains in fitness did not play an essential role in the enhancement of physical self-concept.
Motor-evoked potentials are facilitated during perceptual identification of hand position in healthy subjects and stroke patients
Authors: Lackner Eva , Hummelsheim Horst 
Published: August 2003

Objective: To delineate the facilitatory and/or inhibitory influence of relevant and irrelevant sensory afferent information to the motor cortex. The study is based on the assumption that sensorimotor coupling is crucial for motor learning and recovery. Design: The interaction of a standard transcranial magnetic stimulus (TMS) with the facilitatory and/or inhibitory influence that proprioceptive afferent information exerts on the motor cortex was investigated. Setting: A neurological rehabilitation hospital. Subjects: Sixteen healthy subjects and 14 stroke patients. Main outcome measures: Amplitudes and latencies of motor-evoked potentials (MEPs) recorded from the extensor carpi radialis muscle. The influence of a sensory discrimination task was compared with the influence of a sensory input irrelevant for the task and to a verbal memory task. Recordings were taken after the hand had been moved passively in one of four different positions. Results: In the first trial, TMS was applied without any demand on the subjects. In the second trial, subjects were asked to identify the respective hand position and in the third trial a noun presented at a respective hand position had to be memorized and reproduced after TMS. The sensory discrimination task exerted by far the most prominent facilitatory effect on MEP amplitudes and latencies. An unspecific, albeit reproducible influence on MEP amplitudes was observed when a noun presented at a respective hand position had to be remembered. Conclusions: Using a neurophysiological approach the study demonstrates that a sensory discrimination task based on relevant afferent information to motor centres of the brain forms a prominent facilitatory intervention for those muscle groups that are involved in the task. This holds true for healthy subjects and for hemiparetic stroke patients.
Further evidence for the agreement between patients with stroke and their proxies on the Frenchay Activities Index
Authors: Tooth Leigh R , McKenna Kryss T , Smith Melinda 
Published: August 2003

Objective: To determine item, subscale and total score agreement on the Frenchay Activities Index (FAI) between stroke patients and proxies six months after discharge from rehabilitation. Design: Prospective study design. Setting/subjects: Fifty patient–proxy pairs, interviewed separately, in the patient's residence. Main outcome measures: Modified FAI using 13 items. Individual FAI items, subscales and total score agreement as measured by weighted kappa and intraclass correlation coefficients (ICC). Results: Excellent agreement was found for the total FAI (ICC 0.87, 95% confidence interval (CI) 0.78–0.93), and domestic (ICC 0.85, 95% CI 0.73–0.91) and outdoor (ICC 0.87, 95% CI 0.78–0.95) subscales, with moderate agreement found for the work/leisure subscale (ICC 0.63, 95% CI 0.34–0.78). For the individual FAI items, good, moderate, fair and poor agreement was found for five, three, four and one item, respectively. The best agreement was for objective items of preparing meals, washing-up, washing clothes, shopping and driving. The poorest agreement was for participation in hobbies, social outings and heavy housework. Scoring biases associated with patient or proxy demographic characteristics were found. Female proxies, and those who were spouses, scored patients lower on domestic activities; male patients, and those who were younger, scored themselves higher on outdoor activities and higher patient FIM scores were positively correlated with higher FAI scores. Conclusions: While total and subscale agreement on the FAI was high, individual item agreement varied. Proxy scores should be used with caution due to bias.
Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap
Authors: Desrosiers Johanne , Malouin Francine , Bourbonnais Daniel , Richards Carol L , Rochette Annie , Bravo Gina 
Published: August 2003

Objectives: (1) To examine the relationships between measures of impairment and disability for the arm and leg with a measure of handicap and (2) to identify the impairment or disability most strongly related to handicap situations. Design: Prospective cohort study. Setting: Intensive functional rehabilitation unit and community. Patients: One hundred and two persons who had a stroke. Main outcome measures: Arm and leg impairments and disabilities were evaluated with reliable and valid tests at discharge from rehabilitation. Six months later, handicap situations were evaluated with the Assessments of Life Habits (LIFE-H). Results: Arm and leg impairments and disabilities are correlated with handicap situations. Disability of the leg is more strongly associated with handicap than arm disability. Arm and leg disabilities are not statistically more strongly related to handicap than arm and leg impairments. Conclusions: The high correlations found between handicap situations and the impairment and disability measures of the leg provide new information that support the importance of mobility to promote integration after stroke.
A fluidity scale for evaluating the motor strategy of the rise-to-walk task after stroke
Authors: Malouin Francine , McFadyen Bradford , Dion Lise , Richards Carol L 
Published: August 2003

Objective: (1) To develop an ordinal scale (content validity) for assessing ‘uidity of the rise-to-walk task (RTW); (2) to examine the concurrent validity of the ‘uidity scale; (3) to study the inter-rater reliability of the scale. Design: A group of physical therapists participated in the scale development (content validity); a cross-sectional design was used to study the agreement between the ‘uidity scale and the ‘uidity index (criterion measure) obtained with the instrumented method (concurrent validity) and to examine the inter-rater reliability of the scale. Setting: Rehabilitation centre. Subjects: Nineteen persons with a chronic stroke and 19 age and gender-matched healthy subjects. Main outcome measures: For the validation study: the ‘uidity index (FI) and the scores from the ‘uidity scale; for the inter-rater reliability study: duration of the RTW task and ‘uidity scores. Results: The FI values did not overlap across categories of the scale and the relationship between FI values and the ‘uidity scores was 0.99. The weighted kappa (kw) indicated a substantial level of agreement between the new raters (kw = 0.78) and between the new raters and the expert rater (kw = 0.71). Corresponding mean intraclass correlation coefficients for the RTW duration were 0.95. Conclusion: These results indicate that the descriptors of the scale provided a gradation of ‘uidity comparable to the gold standard measure (FI) and that trained clinicians can use the ‘uidity scale with a substantial level of reliability. The RTW task is a simple clinical tool for assessing mobility and motor strategies (locomotor co-ordination) in patients presenting varying degrees of motor recovery after stroke.
Pain in a Swedish spinal cord injury population
Authors: Budh Cecilia Norrbrink , Lund Iréne , Ertzgaard Per , Holtz Anders , Hultling Claes , Levi Richard , Werhagen Lars , Lundeberg Thomas 
Published: August 2003

Objective: To describe pain and associated variables in a prevalence group of persons with a sustained spinal cord injury (SCI) in the Swedish capital and its surroundings. Setting: Spinalis SCI Unit (outpatient clinic), Stockholm, Sweden. Design: Assessment over a 12-month period in a yearly health control. Subjects: Four hundred and fifty-six SCI patients. Results: Two hundred and ninety-one out of 456 SCI patients (63.7%) suffered from pain, and in 45.7% of these it was classified as being neurogenic. Aching pain was the most used descriptor (38.5%). The onset of pain was commonly within three months (73.5%). In 70.4% of patients pain occurred below the level of the lesion. Most patients identified pain as coming from one (55.0%) or two (28.2%) body regions. Rating of the general pain intensity on a visual analogue scale (VAS) was 46 out of 100 and rating of the worst pain intensity was 78 out of 100. Ninety-four out of 276 patients (32.3%) considered that their quality of life was significantly affected by pain. Conclusion: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.
Stability and compatibility of 5-fluorouracil infusions in the Braun Easypump®
Authors: Roberts Sarah , Sewell Graham J 
Published: August 2003

Objective. The aim of this study was to determine the stability and compatibility of `high strength’ (50 mg/mL) and `normal strength’ (25 mg/mL) 5-fluorouracil (5-FU); the latter prepared from 50 mg/mL 5-FU in either 0.9% sodium chloride or 5% glucose diluents and filled into the Braun Easy-pumpÒ (also known as the Homepump Fresenius). Studies were conducted under storage (48C or 258C) and in-use (318C) conditions. Methods. In the first study, the stability of 5-FU 50 mg/mL (undiluted) was determined in the EasypumpÒ at 258C and 318C over time intervals of 0, 1, 3, 5, 7, 14 and 21 days. In the second study, the stability of 25 mg/mL 5-FU diluted in 5% glucose and 0.9% sodium chloride for injection in the EasypumpÒ was determined after incubation at 48C for 0, 7 and 14 days and at 258C and 318C for 0, 1, 3, 5, 7, 14 and 21 days. For each time/temperature interval, the infusions were monitored for precipitation, colour change, pH, moisture loss, subvisual particulate levels (selected intervals) and chemical stability to assess for compatibility with the device. Results. No significant changes in physical or chemical stability occurred in diluted solutions (25 mg/mL) over 14 days at 48C or 21 days at 258C and 318C or in the undiluted solutions (50 mg/mL) over 21 days at 258C and 318C, and 5-FU demonstrated suitable stability in the test devices.
Is pegfilgrastim appropriate for the treatment of established febrile neutropenia?
Authors: Stanford Brad L , Zondor Stacey D , Cobos Everardo 
Published: August 2003

Objective. To report a case where both pegfilgrastim and filgrastim were considered in the treatment of febrile neutropenia in a hospitalized patient and assess the most cost-effective option. Case summary. A 77-year-old white female was diagnosed with squamous cell carcinoma of the anus and adjuvant chemotherapy was ordered. She subsequently developed Grade 4 neutropenia, a wound infection and her Eastern Cooperative Oncology Group (ECOG) performance status declined to 4. Antibiotics were started and growth factor therapy was considered as part of her treatment. Filgrastim 480 g subcutaneously every day was chosen and her absolute neutrophil count (ANC) recovered after seven days of therapy. Discussion. This case illustrates the potential cost benefits of using filgrastim over pegfilgrastim in hospitalized patients. The choice of filgrastim in our patient resulted in only seven days of filgrastim therapy at a cost of $2205.70. A 6 mg dose of pegfilgrastim is priced similarly to 10 days of filgrastim 480 g, therefore a cost savings of $744.01 was realized in our patient. Conclusions. Filgrastim is the most appropriate growth factor for the treatment of established high-risk febrile neutropenia given that the ANC can be monitored on a daily basis and therapy can be discontinued upon recovery.