bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple sclerosis in Stockholm County. A pilot study exploring the feasibility of assessment of impairment, disability and handicap by home visits
Authors: Einarsson U , Gottberg K , Fredrikson S , Bergendal G , von Koch L , Holmqvist L Widén 
Published: November 2003

Objective: A pilot study performed within Stockholm County to evaluate the feasibility of collecting data using a comprehensive evaluation package administered in the home environment to assess impairment, disability and handicap in order to explore the consequences of multiple sclerosis (MS). Design: Home visits to 26 purposefully selected MS patients with different levels of disability, in both ordinary and sheltered living. The comprehensive evaluation package included: biographical data, Mini-Mental State Examination, Free Recall and Recognition of 12 Random Words Test, Symbol Digit Modalities Test, Beck Depression Index, Lindmark Motor Capacity Assessment, time to walk 10 metres, Nine-hole Peg Test, Barthel ADL Index, Katz Extended ADL Index, Frenchay Activities Index, Sickness Impact Profile and frequency of falls and injurious falls. Results: This pilot study demonstrates that the proposed methods can be used to evaluate MS patients differing in levels of disability and forms of living. The data collection method, based on home visits, was well accepted by the patients, their spouses and salaried personal assistants and could be performed within 2–21/2 hours. Conclusions: The evaluation package used in this pilot study is suitable for use in population-based studies and it should provide comprehensive information on the impact and consequences of MS on patients, and should contribute to the identification of areas in which the provision of rehabilitation and health care services needs to be improved.
Co-ordination of patient care in inpatient rehabilitation
Authors: Pryor Julie 
Published: November 2003

Objective: To evaluate the effectiveness of a new patient care co-coordinator position in an inpatient rehabilitation setting. Design: Pre and post test using a 42-item staff survey. Setting: One inpatient rehabilitation service in rural New South Wales, Australia. Subjects: Members of the multidisciplinary team. Intervention: A new patient care co-coordinator position. Outcome measures: Comparison of trends in staff responses to pre and post test surveys. Findings: The post test survey demonstrated an overall increase in the reported frequency of desirable rehabilitation practices and increased staff satisfaction with those practices. Conclusions: A patient care co-coordinator may contribute to improving the processes and practices of inpatient rehabilitation and staff satisfaction.
The effect of a perceptual cognitive task on exercise performance: the dual-task condition after brain injury
Authors: Dawes Helen , Cockburn Janet , Roach N K , Wade Derick T , Bateman Andrew , Scott Oona 
Published: November 2003

Objective: To examine the effect of additional cognitive demand on cycling performance in individuals with acquired brain injury (ABI). Design: Prospective observational study. Setting: Rivermead Rehabilitation Centre. Participants: Ten individuals with ABI (7 men, 3 women) (traumatic brain injury 7, tumour 1, stroke 2) and 10 healthy controls (6 men, 4 women). Intervention: Individuals were asked to maintain a set cadence during a three-stage incremental cycling test in both single-task (no additional task) and dual-task (whilst performing an additional cognitive task) conditions. Results: The ABI group showed a slight slowing in cadence in stages 1 and 3 of the graded exercise test from the single-to the dual-task condition, although this was not significant ( p £ 0.05). The control group showed no slowing of cadence at any incremental stage. When directly comparing the ABI with the control group, the change in cadence observed in dual-task conditions was only significantly different in stage 3 ( p £ 0.05). Conclusions: Clinicians should be aware of the possibility that giving additional cognitive tasks (such as monitoring exercise intensity) while individuals with acquired brain injury are performing exercises may detrimentally affect performance. The effect may be more marked when the individuals are performing exercise at higher intensities.
Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease
Authors: Yohannes Abebaw M , Connolly Martin J 
Published: November 2003

Objective: We hypothesized that early ambulation with a gutter frame (GF) in elderly patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) may reduce physical disability and allow earlier discharge. Design: Blinded, randomized parallel groups trial. Subjects: One hundred and ten consecutive AECOPD inpatients. Interventions: Participants were recruited two days post admission and randomly allocated to four groups: GF with supplemental oxygen (GFSO), GF with supplemental air (GFSA), rollator with supplemental air (RSA) and rollator with supplemental oxygen (RSO) (air/oxygen was double-blinded to patients and investigators). Patients exercised three times daily (maximum of 15 minutes per session) with a physiotherapist or nurse. Outcome measures: Physical disability measured by Barthel Index and perceived respiratory effort by Borg Scale. Results: After intervention no significant difference was observed between the four groups in length of hospital stay ( F = 0.78; p = 0.50), changes in mean Barthel score ( F = 2.08; p = 0.11) and Borg score ( F = 0.35; p = 0.79). However, improvement in Barthel score (mean 1.22 combined gutter frame group air/oxygen) was greater than the combined rollator group (mean 0.55; p = 0.003). Baseline Barthel score and nurses’ assessment of compliance were associated with improvement in Barthel score ( p < 0.0001 and p < 0.002). Barthel score was predicted by use of gutter frame ( F = 6.17; p = 0.01), not by use of rollator. Use of air/oxygen group was not related to improvement in Barthel score. Conclusion: Short-term exercise therapy with gutter frame after AECOPD admission reduces physical disability in older patients but does not affect length of hospital stay. Use of supplemental oxygen during exercise has no additional benefits.
Long-term outcome of sports injuries: results after inpatient treatment
Authors: Dekker R , van der Sluis C K , Groothoff J W , Eisma W H , Duis H J ten 
Published: November 2003

Objective: To investigate whether sports injuries result in long-term disabilities and handicaps and to establish variables with a prognostic value for the occurrence of these long-term consequences. Materials and methods: All patients older than 17 years of age and admitted to the University Hospital Groningen because of a sports injury were entered in the study. By filling in a questionnaire 1–4 years after the injury an inventory was made of the long-term consequences. Main outcome measures: Absenteeism from work and sports, experienced disabilities or handicaps and the Sickness Impact Profile 68 (SIP68). Results: Out of 306 patients 229 (75%) returned a completed questionnaire. Sixty-seven per cent of the working population had been unfit for work up to one year, whereas 4% still had not resumed work. Absenteeism from sports was also considerable; nearly half of the population did not participate in sports for more than a year. Furthermore, 32% of the patients still experienced disability or handicap following the injury. This finding is in agreement with the results of the SIP68 (odds ratio 6.8; confidence interval (95% CI): 3.51–13.08). Two prognostic variables could be distinguished: ‘gender’ and ‘type of sport’. Long-term consequences occur more often in women ( p < 0.03) and with playing outdoor soccer, horse riding or skiing ( p < 0.01). Conclusions: Sports injuries can lead to long-term disabilities and handicaps. The variables ‘gender’ and ‘type of sport’ were of prognostic significance.
The use of a new overlay mattress in patients with chronic pain: impact on sleep and self-reported pain
Authors: Price P , Rees-Mathews S , Tebble N , Camilleri J 
Published: November 2003

Objective: To evaluate the use of an air flotation mattress overlay in patients with chronic pain. Design: Four-week prospective AB design. Setting: The mattress overlay was used in a community setting. Subjects: Adult patients attending an outpatients clinic in a department of rheumatology, with chronic pain plus sleep problems, or pain sufficient to disturb sleep. Interventions: An inexpensive low-pressure inflatable mattress overlay (ReposeTM), which is readily portable and has no electrical supply, was introduced to the patients. They were encouraged to use the support surface every night. Main outcome measures: The primary outcome was measured by self-reported changes in sleep quantity and frequency of sleep disturbance. Secondary outcomes were self-reported changes in pain and use of analgesia, verified by medical notes. Results: Nineteen female patients (mean age 61 years) completed the study. At baseline, mean length of sleep time was 3.8 h, with mean of 4.9 interruptions of mean 25.3 min: week 4, mean sleep time = 6.4 h, with a mean of 2.3 interruptions for mean 14.2 min (all measures p < 0.001). At baseline, median pain during the day was 6 and at night-time was 7; by week 4 a reduction in pain was reported both for the day (median = 5) and the night (median = 5) (both p < 0.001). Thirteen patients reported a reduction in the use of analgesia during the study. Conclusions: In this pilot study of a new mattress overlay, statistically significant improvements in sleep and pain were noted over a four-week period.
Do psychological measures predict the ability of lower limb amputees to learn to use a prosthesis?
Authors: Larner Stuart , van Ross Ernest , Hale Carolyn 
Published: November 2003

Objective: Can psychological tests predict whether, on admission to a rehabilitation ward post amputation, a lower limb amputee will learn to use a prosthesis during the ensuing inpatient rehabilitation programme? Design: A one-sample design in which psychological variables, and transfemoral/transtibial amputation site were tested as predictors of outcome. Setting: An inpatient rehabilitation unit in the UK offering prosthetic provision. Subjects: Forty-three consecutive patients with peripheral vascular disease (mean age 66.35 years, standard deviation 14.99) who had received an amputation on average 19 days previously on a surgical ward and were transferred to the unit for rehabilitation including assessment for prosthetic provision. Main outcome measure: Whether the patient learnt to use a prosthesis independently during the stay on the rehabilitation unit. Results: During their stay in the rehabilitation unit (mean length of stay = 42 days), 31 patients learnt to use a prosthesis and 12 did not. A forward stepwise logistic regression revealed that the Kendrick Object Learning Test score on admission correctly predicted outcome in 70% of cases. The predictive power rose to 81% correct when the amputation site (transfemoral or transtibial) was included amongst the predictors. Anxiety, depression and recovery locus of control scores were not significant predictors of functional prosthetic use in this study. Conclusion: A simple test of learning ability and the amputation site can help to predict the patient's ability to learn to use a prosthesis following amputation and is recommended as part of the assessment process.
Variability in the measurement of uptime in children: a preliminary study
Authors: Eldridge B , McCoy A , Galea M , Wolfe R , Graham H K 
Published: November 2003

Objective: To examine variability in ‘uptime’ (the amount of time spent in the upright position). Design: An observational study. Setting: The community (i.e., homes and schools in the Melbourne metropolitan area). Subjects: Normal children between 8 and 15 years of age (18 girls and 8 boys). Equipment: An ‘uptimer’, a lightweight, battery-operated remote monitor, was used to record uptime. Procedure: Each child in the study wore the uptimer continuously over a 24-hour period, which included a typical day at school, on four separate occasions, one week apart. Results: The variability in repeated measures of uptime in the same child (standard deviation 0.8 hours in 24 hours) was lower than the variability between the children (standard deviation 1.1 hours in 24 hours). We estimate that a single uptime measurement has reliability given by an ICC of 0.65 (95% confidence interval 0.49–0.82), which is calculated by dividing the between-child variability by the total variability (within-child and between-child variability). There were no systematic differences in mean uptime between occasions of measurement. Conclusion: As an estimate of the time that a child spends in the upright position, a single 24-hour period of measurement of uptime may vary considerably from one occasion to the next. However, this within-child variability is less than the variability between children. In large-scale field studies a one-off measurement of uptime may be acceptable, but in small rehabilitation studies uptime should be measured on at least three occasions.
Life goals of people with disabilities due to neurological disorders
Authors: Nair K P Sivaraman , Wade Derick T 
Published: November 2003

Objective: To identify the life goals of people with long-term neurological disabilities and to correlate them with measures of disability. Design: Cross-sectional descriptive study. Setting: Centre for continuing disability management Subjects: Patients with static or progressive neurological disorders. Interventions: Survey using questionnaires and disability scales. Measures: Life goals were identified with a life goals questionnaire. Subjects were also assessed using the Barthel Index, Rivermead Extended Activities of Daily Living Index, Rivermead Mobility Index, Short Orientation Memory Concentration test and Hospital Anxiety and Depression Scale. Results: Ninety-three subjects participated in the study. The frequency with which goals were chosen as extremely important was: family 64; personal care 59; residential arrangements 58; partner 53; social contacts 30; financial status 29; leisure 26; religion 22; and work 19. Positive correlation was noted between stated importance of: personal care and independence in ADL; work and independence; partner and cognitive ability; religion and age; and financial status and anxiety. There was negative correlation between grades of personal care and depression, work and age, residential arrangements and RMI, and social contact and anxiety and depression. Depressed patients rated fewer goals as being of extreme importance. Conclusions: People with disabilities attach great significance to relationships and personal care. Grades of life goals correlated with measures of disability, cognition and emotion.
Good inter-rater reliability of the Frenchay Activities Index in stroke patients
Authors: Post Marcel WM , Witte Luc P de 
Published: November 2003

Objective: To assess inter-rater reliability of the Frenchay Activities Index (FAI) when used by occupational therapists in stroke patients. Design: Independent administration of the FAI by occupational therapists in 45 stroke outpatients. Setting: Outpatient departments of two Dutch rehabilitation centres. Statistics: Agreement between pairs of raters was assessed at item level using weighted Kappa and the percentage absolute agreement and for the total score using intra-class correlations (ICC), Bland–Altman plots and computation of the smallest real difference (SMR). Results: ICC of the total score was good (0.90; 95% confidence interval (95% CI): 0.82–0.94). The Bland–Altman plot did not reveal relationships between agreement and height of scores. Reliability at item level was good (kappa >0.60) in 11 out of 15 items. The item ‘gainful work’ showed high agreement but a low kappa due to an extremely skewed score distribution. Reliability was insufficient in three items: ‘local shopping’, ‘social occasions’ and ‘actively pursuing hobby’. Clarification of scoring instructions of these items might further improve the inter-rater reliability of the FAI. Conclusion: The FAI is a reliable instrument to measure outcomes of outpatient rehabilitation in patients with stroke.
Relative contribution of footwear to the efficacy of ankle-foot orthoses
Authors: Churchill Andrew JG , Halligan Peter W , Wade Derick T 
Published: November 2003

Objective: To examine the relative effects of footwear and an ankle-foot orthosis (AFO) on hemiplegic gait. Design: A case series with three contrasting conditions: walking without footwear, with footwear alone, and with footwear and an AFO. Spatio-temporal parameters reflecting walking performance were analysed using an analysis of variance (ANOVA). Patients: Five patients with hemiplegia and reduced mobility following stroke. Setting: A specialist rehabilitation centre. Intervention: Wearing either footwear alone, or footwear with an AFO. Measures: Video recordings of gait were subjected to a kinematic analysis to determine spatio-temporal parameters. Results: Stride length was increased by an average of 5 cm when wearing footwear. An additional 5-cm increase was also observed when wearing an AFO. Swing velocity was also affected by the manipulation. Conclusions: The appropriate comparative baseline for assessing the efficacy of an AFO is subjects walking with existing footwear and not barefoot.
The Mobility Scale for Acute Stroke Patients: concurrent validity
Authors: Simondson J A , Goldie P , Greenwood K M 
Published: November 2003

Objective: A new scale, the Mobility Scale for Acute Stroke Patients (MSAS), was developed to specifically discriminate between the lower levels of mobility found in acute stroke patients in the first two weeks post onset. The aim of this study was to investigate the concurrent validity of this new scale with other established scales. Main outcome measures: Concurrent validity was assessed with respect to four other well-validated measures: Motor Assessment Scale (MAS), Functional Ambulation Classification system (FAC), Functional Independence Measure (FIM), and Barthel Index (BI). The measures selected for comparison contained items similar to those in the MSAS. Subjects: From a total of 539 patients who were admitted over a two-year period with a primary diagnosis of stroke, 106 satisfied the criteria for inclusion in this study. Results: The MSAS was found to have a high level of concurrent validity ( r > 0.80) when the total score was correlated with the total scores of the MAS, FAC, FIM (mobility and ADL) and BI. A high level of association was found between the nonbed mobility items (sit to stand, stand and walk) of the MSAS and the mobility items (toileting, transfers, walk and stairs) of the FIM and BI. There was a weaker association between the MSAS items and the ADL items (activities of daily living) of the BI and FIM. Conclusion: A new scale designed specifically for acute stroke patients was found to have a high degree of concurrent validity when compared with four other scales containing similar items.
A comparison of knee kinematic characteristics of stroke patients and age-matched healthy volunteers
Authors: Richards J D , Pramanik A , Sykesand L , Pomeroy V M 
Published: November 2003

Objective: To investigate which knee kinematic characteristics show the greatest differences between stroke patients with minimal residual disability and age-matched healthy volunteers as a first step towards the development of a sensitive, objective measure of performance of movement for use in the clinical setting. Design: A comparative study. Setting: A movement analysis laboratory. Subjects: Ten patients between 6 and 12 months post stroke aged between 65 and 74 years and 10 age-matched healthy volunteers. All patients had made a good recovery and were able to complete all of the functional tasks. Interventions: Each subject had re‘ective markers placed on anatomical landmarks and was filmed performing three movement tasks: sit-to-stand, walking, and step on block. Main outcome measures: Knee kinematic characteristics involving timing, joint angle and angular velocity at key points during each task. Results: Significant differences were found between patients and volunteers for only some of the timing and joint angle characteristics but for all angular velocity characteristics for which the mean differences ranged from 31.85 degrees/s for sit-to-stand ( p = 0.013) to 82.5 degrees/s ( p = 0.014) for the swing phase of gait. Conclusions: These preliminary findings suggest that angular velocity of the knee during functional tasks might have potential as a sensitive, objective measure of performance of movement after stroke for patients with minimal residual disability.
Musical motor feedback (MMF) in walking hemiparetic stroke patients: randomized trials of gait improvement
Authors: Schauer Michael , Mauritz Karl-Heinz 
Published: November 2003

Objective: To demonstrate the effect of rhythmical auditory stimulation in a musical context for gait therapy in hemiparetic stroke patients, when the stimulation is played back measure by measure initiated by the patient's heel strikes (musical motor feedback). Does this type of musical feedback improve walking more than a less specific gait therapy? Design: The randomized controlled trial considered 23 registered stroke patients. Two groups were created by randomization: the control group received 15 sessions of conventional gait therapy and the test group received 15 therapy sessions with musical motor feedback. Setting: Inpatient rehabilitation hospital. Subjects: Median post-stroke interval was 44 days and the patients were able to walk without technical aids with a speed of approximately 0.71 m/s. Main outcome measures: Gait velocity, step duration, gait symmetry, stride length and foot rollover path length (heel-on–toe-off distance). Result: The test group showed more mean improvement than the control group: stride length increased by 18% versus 0%, symmetry deviation decreased by 58% versus 20%, walking speed increased by 27% versus 4% and rollover path length increased by 28% versus 11%. Conclusion: Musical motor feedback improves the stroke patient's walk in selected parameters more than conventional gait therapy. A fixed memory in the patient's mind about the song and its timing may stimulate the improvement of gait even without the presence of an external pacemaker.
The effect of early aerobic training on independence six months post stroke
Authors: Katz-Leurer Michal , Carmeli Eli , Shochina Mara 
Published: November 2003

Objective: To investigate whether early aerobic training has a beneficial effect on stroke patients' independence in daily and social activities six months after the event. Design: Randomized clinical trial. Setting: Rehabilitation unit. Subjects: Ninety-two patients after a first stroke. Interventions: Forty-six patients participated in an eight-week programme of aerobic training, using a leg cycle ergometer. Main outcome measures: Frenchay Activities Index (FAI) measured twice, at entry to programme (pre-event score) and six months after the onset of the event. Results: Despite the significant improvement of study group patients' functional abilities immediately after the intervention compared with controls, no significant difference was found in FAI mean score between groups six months post event. An interaction effect was noted between event severity, intervention and FAI total score. Mean FAI score declined significantly less in the less severely impaired study group patients. Conclusions: Early, moderately intense aerobic training has no direct impact on independence in daily and social activities as measured by FAI total score six months after a stroke.