bluuebunny/crossref_metadata_2025_split huggingface dataset:
Walking training of patients with hemiparesis at an early stage after stroke: a comparison of walking training on a treadmill with body weight support and walking training on the ground
Authors: Nilsson Lena , Carlsson Jane , Danielsson Anna , Fugl-Meyer Axel , Hellström Karin , Kristensen Lena , Sjölund Bengt , Sunnerhagen Katharina Stibrant , Grimby Gunnar 
Published: May 2003

Objective: To compare the effect of walking training on a treadmill with body weight support (BWS) and walking training on the ground at an early stage of rehabilitation in patients with hemiparesis after stroke. Design: Randomized controlled experimental study. Setting: Multicentre design; three departments of rehabilitation medicine. Subjects: Seventy-three consecutive first stroke patients admitted to a rehabilitation clinic were randomized into a treatment group and a control group. Interventions: The treatment group received walking training on a treadmill with BWS for 30 minutes, 5 days a week. The control group received walking training according to the Motor Relearning Programme (MRP) on the ground for 30 minutes 5 days a week, not including treadmill training. During the time in the rehabilitation department (about two months), all patients in the study also received professional stroke rehabilitation besides the walking training in the two groups. Main outcome measures: Functional Independence Measure (FIM), walking velocity for 10 m, Functional Ambulation Classification (FAC), Fugl-Meyer Stroke Assessment and Berg's Balance Scale. The assessments were performed at admission, at discharge and at 10-month follow-up. Results: There were no statistically significant differences between the groups at discharge or at the 10-month follow-up with regard to FIM, walking velocity, FAC, Fugl-Meyer Stroke Assessment, and Berg's Balance Scale. Patients in both groups improved in these variables from admission to the 10-month follow-up. Conclusions: Treadmill training with BWS at an early stage of rehabilitation after stroke is a comparable choice to walking training on the ground.
Disability test 10 days after acute stroke to predict early discharge home in patients 65 years and older
Authors: Sommerfeld Disa K , von Arbin Magnus H 
Published: May 2003

Objective: To identify prognostic instruments for the planning of care after acute stroke. Design: Prospective study. Setting: Stroke unit and geriatric rehabilitation unit. Subjects: One hundred and fifteen consecutive acute stroke patients ≥65 years old. Main outcome measures: Univariate and multivariate survival analyses. Length of hospital stay and residential form up to three months after onset. Results: The average length of stay was significantly shorter if age <80 years, male, living with another person, normal sensory ability, Barthel Index (BI) score ≥35 and Rivermead Mobility Index (RMI) score ≥4, assessed 10 days after onset. Multivariate analysis, also including BI subtests, showed that RMI score ≥4, which corresponds to the ability to rise from a chair in less than 15 seconds and remain erect for 15 seconds with or without aid, 10 days after onset, had the greatest impact on early discharge home after acute stroke, together with normal bladder function (BI subtest six), normal sensory ability and living with another person. Conclusion: The best predictor of early discharge home, 10 days after stroke onset, was the ability to rise from a chair with or without aid. This simple and quickly conducted test requires no special equipment and in the present study had a very high predictive value.
Can brain-injured patients participate in an aerobic exercise programme during early inpatient rehabilitation?
Authors: Jackson Diana , Turner-Stokes Lynne , Culpan Jane , Bateman Andrew , Scott Oona , Powell Jane , Greenwood Richard 
Published: May 2003

Objective: We investigated the capacity of brain-injured patients to participate in an aerobic exercise programme early after injury. Design: Retrospective analysis of exercise achievements in patients participating in a randomized controlled trial. Setting and subjects: Ninety patients participated in an exercise training programme on a cycle ergometer at four inpatient neurological rehabilitation units for younger patients. At intake, impairments and function were rated on: Motricity Index, Ashworth Scale, Berg Balance Scale, Barthel Index and Functional Independence Measure. Interventions: Patients cycled for up to 30 minutes three times weekly for 24–36 sessions over 12 weeks. Main outcome measures: Exercise performance was measured by: (a) number of sessions to achieve a cycling time of 30 minutes, (b) overall mean cycling time per session over 24 sessions and (c) mean time per session cycling at >60% of age predicted maximum heart rate (HR max) over 24 sessions. Results: Fifty-five patients completed 24 sessions. Thirty-five withdrew, largely for logistic reasons, before completing training; they were significantly less disabled than the 55 who remained. Forty-four of the 55 patients trained for an average of at least 20 minutes per session, 18 training at >60% HR max for this time. There were no differences in performance on the three exercise parameters between two groups of patients with baseline Barthel scores of ≤12 and ≥13. Conclusions: Brain-injured patients with a range of disabilities have the capacity to participate in an exercise programme during early inpatient rehabilitation, though some may take longer to achieve adequate intensity of aerobic exercise.
Cognitive deficits following stroke in the basal ganglia
Authors: Hochstenbach Jacqueline , van Spaendonck Karel PM , Cools Alexander R , Horstink Martin WIM , Mulder Theo 
Published: May 2003

Objective: To examine the effect of a stroke in the basal ganglia on cognitive functioning. Design: As part of a larger prospective study on the neuropsychological and psychosocial consequences of stroke, 12 patients with a stroke confined to the basal ganglia were examined. Setting: The patients were assessed in one of the three participating hospitals. Subjects: The results of 12 patients with a stroke in the basal ganglia (mean age 55 years), were compared to 24 controls (mean age 54.3 years). Main outcome measures: Different aspects of memory, attention and concentration, visuospatial and visuoconstructive functions, language and arithmetic were assessed using neuropsychological tests. Results: The data show a significant abnormality in cognitive functioning on all cognitive domains. Conclusions: The results stress the notion that subcortical damage may lead to substantial neuropsychological disorders and have clear implications for neurological rehabilitation.
Predictive factors for the outcome of a multidisciplinary pain rehabilitation programme on sick-leave and life satisfaction in patients with whiplash trauma and other myofascial pain: a follow-up study
Authors: Heikkilä Hannu , Heikkilä Eva , Eisemann Martin 
Published: May 2003

Objective: To evaluate the effects of a multidisciplinary rehabilitation programme on sick-leave, coping resources and life satisfaction in whiplash patients and other pain patients. Subjects: Forty patients suffering from symptoms after whiplash trauma and 33 patients with musculoskeletal pain in the neck or back were recruited for this study. Ninety-seven consecutive patients admitted to the Department of Neurosurgery with cervical pain, cervical disc herniation or symptomatic spondylosis served as a control group. Results: Decreased coping resources and poorer life satisfaction were observed for whiplash subjects at the beginning of the rehabilitation programme compared to the control group from the Department of Neurosurgery. After the rehabilitation period 49% of the patients had improved their coping resources totalling to 63% after 2 years. At that follow-up 46% of patients had increased their life satisfaction. Furthermore, the group with whiplash injury showed a significant increase in sick absenteeism whereas the group without whiplash trauma had decreased their sick-leave. Eighty-eight per cent of the subjects could be correctly classified according to their vocational outcome by means of discriminant function. The elapse of time since working, low life satisfaction, lack of increase in coping resources during the rehabilitation programme, ethnic origin of the patient and living in the countryside predicted poor vocational outcome. Conclusion: Our results suggest variables from the social environment and coping resources as useful predictors for treatment outcome.
Environmental control systems – an audit of existing provision in three inner London districts
Authors: Novak S A 
Published: May 2003

Objective: To undertake an audit of existing environmental control system (ECS) provision to see what lessons could be applied to developing a new model of service. Design: Structured interviews and assessments making use of questionnaires and algorithms. Subjects: Users of environmental control systems in the inner London boroughs of Lambeth, Southwark and Lewisham (population 720 000) supplied with equipment prior to April 1996 out of National Health Service funds. Setting: All users were assessed and interviewed in their own homes. Results: In all, 29 users of ECSs were surveyed. Six users were found to have systems either so outdated or poorly planned as to be nearly useless. Seven users were felt not to justify an ECS and many systems were felt to be over specified, leading to wastage of equipment. Many medical and nonmedical needs, not directly related to the users' ECSs, were identified. Conclusions: While the recommendations of the British Society of Rehabilitation Medicine special interest group on ECS are welcomed, it is thought that these do not go far enough. In particular the role of the environmental control assessor needs to extend to participation in the case conference where the exact equipment requirements of the prescribed ECS is agreed, and thereafter to include responsibility for ensuring regular review of users. In such a model of service the current single payment for a one-off assessment is felt to be inappropriate.
The treatment of lateral epicondylitis by iontophoresis of sodium salicylate and sodium diclofenac
Authors: Demirtaş R Nesrin , Öner Cengiz 
Published: May 2003

Objective: To investigate the effectiveness of sodium diclofenac and sodium salicylate applied by topical iontophoresis and to compare them in the treatment of lateral epicondylitis. Subjects: Forty patients with lateral epicondylitis were randomized into two groups of 20 patients who were matched for age and sex. Interventions: The patients in one group were treated by iontophoresis of sodium diclofenac and the other group were treated by iontophoresis of sodium salicylate. Then infrared treatment was applied to patients in both groups. Main outcome measures: Pain scores obtained before and after treatment were compared. Results: Pain produced by pressure on the lateral epicondyle, on resisting wrist extension, during function and spontaneous pain at rest significantly decreased in both groups after treatment ( p <0.001). When pain scores obtained after treatment were compared, greater decrease was observed in the pain produced on resisting wrist extension ( p <0.01) and by pressure on the lateral epicondyle ( p <0.05) in the group treated with sodium diclofenac than in the group treated with sodium salicylate. Conclusions: The results suggest some benefits from the process of iontophoresis and the use of infrared in the treatment of lateral epicondylitis and indicate that iontophoresis of sodium diclofenac is more effective than that of sodium salicylate.
Medical opinions, beliefs and prescription of orthopaedic footwear: a survey of Dutch orthopaedists and rehabilitation practitioners
Authors: Boer H , Seydel E R 
Published: May 2003

Objectives: To get insight into medical opinions about the use of orthopaedic footwear and the medical and social factors related to the prescription of orthopaedic footwear by orthopaedists and rehabilitation practitioners. Methods: In this study 85 orthopaedists and 96 rehabilitation practitioners filled out a questionnaire measuring perceived desirability of prescribing orthopaedic footwear in specific medical conditions, the perceived advantages of orthopaedic footwear, the perceived disadvantages of orthopaedic footwear, the attitude to orthopaedic footwear and satisfaction with the co-operation with the pedorthist. Clinicians were asked to estimate their referral rate of orthopaedic footwear. Results: Orthopaedists and rehabilitation practitioners agree that the prescription of orthopaedic footwear should be considered in the case of rheumatoid arthritis, amputation of the foot and diabetic foot and not be considered in the case of sprain and back pain. In the case of hallux valgi, dermatological problems and clavus (severe corn) a reticent prescription policy seems to be the optimal choice. In the other medical conditions studied no unequivocal prescription policy could be derived. Respondents who prescribed orthopaedic footwear more than the median (more than 50 prescriptions per year) were more often rehabilitation practitioner, perceived more advantages of prescription footwear, perceived less disadvantages of prescription footwear and were more satisfied about the co-operation with the pedorthist. Conclusion: In some medical conditions orthopaedists and rehabilitation practitioners agree about the optimal use of orthopaedic footwear. In some other medical conditions orthopaedists and rehabilitation practitioners are divided about the use of orthopaedic footwear. Reported rate of prescription was not related to desirability of prescription, but was related to beliefs such as perceived advantages, perceived disadvantages and satisfaction with co-operation with the pedorthist, underlining the importance of cognitive factors in prescription style.
Intra-articular triamcinolone acetonide injection in patients with capsulitis of the shoulder: a comparative study of two dose regimens
Authors: de Jong B A , Dahmen R , Hogeweg J A , Marti R K 
Published: May 2003

Background and purpose: Although corticosteroid injections have been reported to be effective in capsulitis of the shoulder, the optimal dose has not been established. The purpose of this study was to compare relief of symptoms following a lower dose with that following a higher dose of triamcinolone acetonide given intra-articularly. Subjects: Thirty-two patients were given low dose suspension; 25 patients were given high dose suspension. Method: Randomized, double-blind clinical trial. Each patient was given a course of three injections. Pain, sleep disturbance, functional impairment and passive range of motion (ROM) were assessed at intake and at one, three and six weeks after the initial injection. Data were analysed by independent sample t-tests and nonparametric Mann–Whitney U-tests. Results: The group which received the 40 mg dose showed significantly greater improvement than the group receiving the 10 mg dose. Conclusions: The study shows that in the treatment of frozen shoulder greater symptom relief is obtained with a dose of 40 mg triamcinolone acetonide intra-articularly than with a dose of 10 mg. The effect on pain and sleep disturbance was more marked than on ROM. Intra-articular injections with triamcinolone acetonide appear to be an effective method to obtain symptom relief for patients with painful capsulitis of the shoulder.
Techniques for measurement and assessment of mobility in rehabilitation: a theoretical approach
Authors: Bussmann J BJ , Stam H J 
Published: May 2003

Objective: Mobility is an important construct in rehabilitation; many instruments have emerged which measure or assess (aspects of) mobility. In the selection or development of an appropriate technique, knowledge about the fundamentals of rehabilitation medicine is needed, as well as about essential characteristics of techniques and fundamental differences between them. The aim of this paper is to classify, assess and discuss current techniques which are or can be used to measure aspects of mobility. Design: Eight techniques (physical science techniques, clinimetry, observation, diaries, questionnaires, actigraphy, physiological techniques and activity monitors) are classified, assessed and discussed, based on the level of outcome measures, the aspect of mobility they measure, and methodological and practical criteria. Results and conclusions: Rehabilitation medicine has a particular need for instruments that enable measurement of outcome measures on the level of activity and role fulfilment. Techniques differ in the type and number of mobility aspects they measure. Furthermore, important differences exist based on methodological and practical criteria. One optimal technique does not exist: the choice of a technique always depends on a complexity of factors, such as clinical problem, research questions, the mobility aspect of interest, required methodological strength, costs and availability.
An evaluation of current risk assessment scales for decubitus ulcer in general inpatients and wheelchair users
Authors: Anthony Denis , Barnes Joanne , Unsworth Jim 
Published: May 2003

Objectives: To study the components of two risk assessment scales for decubitus ulcer risk, Waterlow and Braden, and of the Chailey score for the same purpose. Design: Experimental study of patients at risk of developing decubitus ulcers. Setting: The West Midlands and Yorkshire. Subjects: One hundred and fifty wheelchair users from the West Midlands and 9022 patients from a District General Hospital in York, the latter consisting of all admissions to the hospital in a four-month period. Interventions: Braden, Chailey scores (wheelchair users) and Waterlow scores (all subjects) measured. Main outcome measures: Development of a pressure sore, receiver operating characteristic (ROC) curves. Results: Waterlow outperformed Braden for classification of wheelchair patients with respect to decubitus ulcer. The Chailey score performed randomly in this group. The sensitivity and specificity as seen in ROC curves was different for Waterlow scores for wheelchair users and general patients, the latter being much better classified. Only three items out of 11 in the Waterlow score appeared to have any classification ability in the wheelchair group. Conclusions: Risk indicators used for general patients are probably poorly suited for wheelchair users. There is a need for large-scale predictive studies of wheelchair users and other groups to allow regression analysis of the subscales of risk indicators. From the provisional data of this study it appears that splitting patients by gender and into full and part-time wheelchair users classifies almost as well the much more complicated risk assessment tools currently available.
Electromyographic biofeedback for gait training after stroke
Authors: Bradley Lesley , Hart Barry B , Mandana Suniti , Flowers Kenneth , Riches Mary , Sanderson Peter 
Published: May 2003

Objective: To examine the effects of electromyographic (EMG) biofeedback training on the recovery of gait in the acute phase post stroke. Design: Patients were randomly assigned to EMG biofeedback or control groups. They received treatment three times a week for six weeks. All patients were assessed prior to treatment, after 18 treatment sessions, and at three months follow-up. Setting: The study was carried out at Scunthorpe General Hospital in North Lincolnshire. The subjects were acute stroke patients who had been admitted on to the medical and elderly wards. Interventions: The EMG biofeedback group were treated using EMG as an adjunct to physiotherapy. The patients were encouraged to facilitate or inhibit abnormal muscle tone via auditory or visual signals transmitted from electrodes placed over the appropriate muscles. The control group were treated using the same techniques, electrodes were used with this group of patients, but the EMG machine was turned off and faced away from the patient and the therapist to control the placebo effect. Outcome measures: A large battery of outcome measures was used for physical and psychological assessment. The physical measures consisted of active movement, muscle tone, sensation, proprioception, mobility and activities of daily living (ADL). The psychological measures included orientation, memory, spatial performance, language and IQ. Results: Twenty-one patients were included in the study. Scores were combined into four groups: mild EMG, severe EMG, mild control and severe control. Results showed that there was an improvement in physical scores for active movement, mobility and ADL over time, but there was no significant difference between the EMG and control groups. Scores on the psychological tests were within normal limits, and there was no difference in performance between the EMG and control groups. Conclusions: This study showed no significant differences in the rate of improvement after stroke between the two groups. Although EMG biofeed-back was used as an adjunct to physiotherapy and represented clinical practice, the results provide little evidence to support the clinical significance of using EMG biofeedback to improve gait in the acute phase after stroke.
More than a sympathetic ear? A report on the first year of a writer in residence in a unit for young, physically disabled people
Authors: Chesson Rosemary , Moir Eileen , Tavendale Alison 
Published: May 2003

Objective: To describe a writer in residence scheme and report the views of patients and staff. Design: Qualitative study including interviews with patients, a questionnaire survey of staff, and dialogue with the writer. Setting: A unit for young people with physical disability. Subjects: A convenience sample of patients admitted to the unit and members of the multidisciplinary rehabilitation team. Intervention: A writer in residence working 15 hours per week in the unit. Results: A small number of patients worked regularly with the writer and this led to the publication of a play, short stories and poems. Patients described wide ranging benefits including improvements in mood state. Staff regarded the writer in residence scheme as enhancing their treatment and care and thought it helpful in addressing their own psychological needs. The writer saw herself as a catalyst ‘for the creativity of others'. Conclusion: Such schemes have an important role to play in rehabilitation settings.