bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of oxygenator membranes on blood: a comparison of two oxygenators in open-heart surgery
Authors: Noora Joseph , Lamy Andre , Smith Kelly M , Kent Rosanne , Batt Dianne , Fedoryshyn John , Wang Xiaoyin 
Published: November 2003

Open-heart surgery (OHS) requires cardiopulmonary bypass (CPB) in most patients. Membrane oxygenators are a critical component of the CPB system. Despite advancements in CPB technology, injury to blood components during CPB still occurs and may result in complications after surgery. The purpose of the present study was to evaluate the performance of the Medtronic Affinity NT® with Trillium coating and the Cobe Optima XP® oxygenators and compare their influence on blood components. Two hundred and fifty-six male and female patients scheduled for urgent or elective cardiac surgery with CPB were randomly assigned to either the Affinity NT or the Optima XP oxygenators. Outcomes included platelets, hemoglobin, leukocyte counts, and O2 transfer, measured preoperatively and at 15, 45 and 75 min of CPB time. Blood loss was measured at six and 12 hours postoperatively. A modified intention-to-treat analysis was conducted. The two groups were similar for age, sex, height, weight, body surface area, and blood components at baseline. There were no differences between the Affinity NT and Optima XP for any outcome measure, although a significant change with time was seen in platelets, hemoglobin, hematocrit and leukocytes, as well as O2transfer for both groups ( p <0.001). The Affinity NT oxygenator had a significantly lower difference in pressure across the membrane ( p <0.001) compared with the Optima XP. In conclusion, the two oxygenators performed similarly with respect to their impact on blood components, O2transfer, and blood loss postoperatively during OHS with CPB. The Affinity NT had the smaller transmembrane pressure drop of the two.
Expanding the role of perfusionists in the era of new treatment options for cardiovascular disease
Authors: Sistino Joseph J 
Published: November 2003

Treatment for cardiovascular disease has dramatically changed the surgical patient population over the past 10 years. Advances in medical management and interventional cardiovascular procedures have delayed surgery in many adults, and the surgical pool has begun to decrease despite an aging population. This affects perfusionists in terms of new psychological and technical challenges, and has serious consequences and implications for the future of the profession. This study will review the changing patterns of diagnosis and treatment of cardiovascular disease in the USA over the past 10 years by examining the annual surgical procedure rates and correlating them with the number of practicing perfusionists and new student graduates. The purpose of this review is to project the future employment opportunities for perfusionists. The second part of the paper will look at the alternative roles perfusionists have expanded into as a result of changes in the treatment of cardiovascular disease. The results of an e-mail survey of perfusionists will be presented to identify new applications of perfusion technology.
Evaluation of cervical range of motion and isometric neck muscle strength: reliability and validity
Authors: Chiu Thomas Tai Wing , Lo Sing Kai 
Published: November 2003

Objective: To examine the test–retest reliability and construct validity of cervical active range of motion and isometric neck muscle strength as measured by the Multi Cervical Rehabilitation Unit (Hanoun Medical Inc., Ontario). Design: A cross-sectional study. Setting: Institutional practice. Subjects: Twenty-one patients with neck pain and 25 healthy volunteers. Methods: After a trial-run session, active range of motion (AROM) was measured in the subsequent two sessions, with 2–3 days in between. During each session, three measurements were taken for each direction (flexion, extension, lateral flexions and rotations). The measurement of isometric strength was after a 15-minute break following completion of the measurement of AROM. Three measurements were made for each of the six directions (flexion, extension, lateral flexions, protraction and retraction). The software of the Multi Cervical Rehabilitation Unit automatically recorded and calculated the maximum AROM and isometric strength. Results: There was a good to high level of reliability in the measurement of AROM for both groups of subjects, with intraclass correlation coefficients (ICCs) ranging from 0.81 to 0.96. Results also demonstrated very good to excellent reliability in isometric strength measurement (ICCs ranged from 0.92 to 0.99). Moreover, there was a significant difference in isometric neck muscle strength ( p = 0.001) and in AROM ( p = 0.034) between the two groups. Conclusions: The Multi Cervical Rehabilitation Unit was found to be reliable and valid for testing the cervical active range of motion and isometric neck muscle strength for both normal and patient subjects.
Setting priorities for a discharge plan for stroke patients entering nursing home care
Authors: Sackley Cath , Pound Kate 
Published: November 2003

Objective: To agree priorities for the structure and content of the discharge process for stroke patients entering nursing home care. Design: A formal priority-setting exercise using the Nominal Group Technique. Participants: A panel of 12 members of a multidisciplinary team from a hospital and community setting with experience in the management of stroke patients on a daily basis. Results: Agreement was good and improved during the process (Kendall coefficient of concordance ‘ W’ increased from 0.48 to 0.58 for physical care needs, 0.45 to 0.75 for care needs and 0.56 to 0.72 for the discharge process). The priorities for discharge were: 1) Plans need to be co-ordinated by one person 2) Clear written information on medication should be provided 3) Clear written information on nutritional needs should be provided. Conclusion: Agreement was reached by a panel of clinicians on an evidencebased discharge plan for stroke patients entering nursing home care.
Systematic review of conservative interventions for subacute low back pain
Authors: Pengel Heloise M , Maher Chris G , Refshauge Kathryn M 
Published: November 2003

Objective: To evaluate the effect of conservative interventions on clinically relevant outcome measures for patients with subacute low back pain. This is particularly important because effective treatment for subacute low back pain will prevent the transition to chronic low back pain, a condition that is largely responsible for the high health care costs of low back pain. Design: Systematic review of randomized controlled trials. Main outcome measures: Methodological quality of each trial was assessed. Effect sizes and 95% confidence intervals were calculated for pain and disability and risk ratios for return to work. Results: Thirteen trials were located, evaluating the following interventions: manipulation, back school, exercise, advice, transcutaneous electrical nerve stimulation (TENS), hydrotherapy, massage, corset, cognitive behavioural treatment and co-ordination of primary health care. Most studies were of low quality and did not show a statistically significant effect of intervention. For the strict duration of low back pain (six weeks to three months), no evidence of high internal validity was found but when other methodological criteria were considered, evidence was found for the efficacy of advice. Furthermore, there is evidence that when a broader view is taken of the duration of subacute low back pain (seven days to six months), other treatments (e.g. manipulation, exercise, TENS) may be effective. Conclusions: Our review identified a major gap in the evidence for interventions that are currently recommended in clinical practice guidelines for the treatment of subacute low back pain. Lack of a uniform definition of subacute low back pain further limited current evidence.
The effects of patellar taping on pain and neuromuscular performance in subjects with patellofemoral pain syndrome
Authors: Ng Gabriel YF , Cheng Jenny MF 
Published: November 2003

Objective: To examine the immediate effects of patellar taping on pain and relative activity of vastus medialis obliquus to vastus lateralis in subjects with patellofemoral pain and patellofemoral joint malalignment. Design: Pre-and post-treatment design, with order of testing determined randomly. Setting: Outpatient physiotherapy department. Subjects: Fifteen subjects with patellofemoral joint pain and malalignment. Interventions: With and without patellar taping with a standard force of application. Main outcome measures: Pain and surface EMG activity ratio of vastus medialis obliquus to vastus lateralis during single-legged semi-squat with 20% of extra body weight loading. Results: There was a significant decrease in anterior knee pain ( p < 0.001) and vastus medialis obliquus to vastus lateralis activity ratio ( p = 0.05) during single-legged standing after patellar taping. Conclusions: Patellar taping can reduce pain in people with patellofemoral pain syndrome and patellofemoral malalignment but it decreases the relative activity of vastus medialis obliquus to vastus lateralis. Such a decrease in relative activity of vastus medialis obliquus after taping implies that it may not be suitable to combine patellar taping with vastus medialis obliquus facilitative exercise training.
Reliability and validity of the Cantonese version of the Test of Everyday Attention among normal Hong Kong Chinese: a preliminary report
Authors: Chan Raymond CK , Hoosain Rumjahn , Lee Tatia MC 
Published: November 2003

Objective: To validate the translated Cantonese version of an ecologically valid clinical test of attention – the Test of Everyday Attention (TEA). Design: A cross-sectional study was conducted on a sample of 49 healthy participants with a mean age of 25.9 years in the Hong Kong Chinese setting. Outcome measures: These included the Color Trails Test, Stroop Colour-Word Test, Symbol Digit Modalities Test, Word Fluency Test, Design Fluency Test, Digits Backward Span Test and Modified Six Elements Test. In addition, the Cognitive Failures Questionnaire and Dysexecutive Questionnaires were also administered to the participants. Results: The TEA was found to have a good range of test–retest reliability. The convergent validity of the instrument was established by correlation of the TEA with various measurements of attention, whereas the divergent validity was demonstrated by the insignificant correlation with tests of other cognitive functioning. Factor analysis of the TEA subtests replicated the major factor structure of the original version. Conclusion: The present study indicates that the translated TEA represents a culturally appropriate tool for measuring everyday life attention performance among the healthy Hong Kong Chinese.
Is stair negotiation measured appropriately in functional assessment scales?
Authors: van Iersel Marianne B , Rikkert Marcel GM Olde , Mulley Graham P 
Published: November 2003

Background: A decline in mobility may result in problems with the negotiation of stairs, which can potentially be hazardous. In practice, stair negotiation is an important aspect of daily living and therefore needs to be assessed carefully. Methods: We conducted a systematic literature review to identify the way functional assessment scales assess stair negotiation. We evaluated whether stair negotiation could be assessed in a valid and reliable way with these scales. Results: Forty-three of the 92 identified scales have an item on stair negotiation. In these scales, the definition of ‘negotiation of stairs’ varies, as does the definition of independence. Important aspects such as safety on stairs are missing from all scales. In contrast to older scales, newer scales consist of items that have been tested for validity and reliability. In none of the scales was the stair negotiation item tested separately for validity. Only two scales examined test–retest reliability and only one measured inter-observer agreement. Discussion: In current functional assessment scales stair negotiation is measured with great heterogeneity and insufficient validity. In patients and in studies in which assessment of stair negotiation ability is a key part of functional assessment, an improved, well-validated scale is needed. This scale should include not only the subject's physical ability to negotiate stairs, but also safety and change in ability over time.
Intensive, time-series measurement of upper limb recovery in the subacute phase following stroke
Authors: Goodwin Nicola , Sunderland Alan 
Published: November 2003

Objectives: To discover if intensive monitoring of wrist extension would produce consistent recovery curves during the subacute period, and whether any impact of additional physiotherapy could be detected. We also investigated improved approaches to statistical analysis in single-case experiments. Design: A randomized multiple-baseline experiment with very frequent assessment. Setting: Stroke rehabilitation unit. Subjects: Four patients with some active wrist movement less than seven weeks after stroke. Interventions: Wrist extension was measured twice daily with an electrogoniometer for 3–4 weeks. Additional upper limb physiotherapy (15 minutes, twice per day) commenced after a randomly determined period. Main outcome measures: Speed and range of wrist movement. Results: A logarithmic function was fitted to the data to produce recovery curves. In all cases, active range and maximum velocity of wrist extension rose gradually over time. Mean variability in range was <5%, but with occasional outliers. Range of passive movement decreased in two cases in association with pain and increased tone. There were no large improvements coinciding with additional physiotherapy but autoregression analysis indicated statistically significant changes in three cases. A randomization test confirmed an increase in active range associated with additional physiotherapy. Conclusions: Intensive electrogoniometry provided a detailed recovery pattern for each of these patients. The data were surprisingly consistent over time, showing that it is feasible to use a time-series approach to investigate subacute recovery. Changes associated with additional physiotherapy were observed on some measures, demonstrating the potential of this approach for exploratory evaluation of interventions.
A systematic review of exercise trials post stroke
Authors: Meek C , Pollock A , Potter J , Langhorne P 
Published: November 2003

Objective: To perform a systematic review of exercise trials post stroke. Design: A systematic review of controlled clinical trials. Search strategy: MEDLINE, EMBASE, CINAHL, Amed, Sports Discus, Cochrane controlled trials register and PEDro were searched for relevant trials. Inclusion criteria: Studies – randomized or quasi-randomized controlled clinical trials. Participants – Adults of any age with a clinical diagnosis of stroke. Interventions – Any cardiovascular exercise intervention aimed at improving cardiovascular fitness and/or function. Outcomes: Impairment: gait speed, strength, endurance, balance, flexibility, tonus and exercise capacity. Disability: global dependency, functional independence. Extended activities of daily living. Quality of life. Death. Data collection and analysis: Two independent reviewers categorized selected trials, documented the methodological quality and extracted the relevant data. Comparisons of cardiovascular exercise interventions versus no cardiovascular intervention were made. Statistical comparisons were carried out using a random effects model to calculate standardized mean differences. Results: We identified three eligible trials. Small numbers and heterogeneous outcomes limited the analyses and comparisons. Based on the limited data available, we found that cardiovascular exercise post stroke was no better than no exercise with respect to disability, impairment, extended activities of daily living, quality of life and death. Conclusion: Insufficient evidence was identified to establish if cardiovascular exercise has a positive effect on disability, impairment, extended activities of daily living, quality of life and case fatality post stroke.
Treating sensory impairments in the post-stroke upper limb with intermittent pneumatic compression. Results of a preliminary trial
Authors: Cambier D C , De Corte E , Danneels L A , Witvrouw E E 
Published: November 2003

Objective: To evaluate the efficacy of intermittent pneumatic compression (IPC) in treating sensory impairments in the hemiplegic upper limb in stroke patients. Design: Twenty-three stroke patients were enrolled in a randomized, controlled preliminary trial that compared the application of intermittent pneumatic compression with a passive treatment strategy. Setting: Four Belgian day centers for treatment of neurological disabilities. Four acute and rehabilitation care wards specialized in neurological treatment. Subjects: Twenty-three stroke patients. Interventions: The experimental group ( n = 11) received standard physiotherapy combined with intermittent pneumatic compression treatment (10 cycles of 3 minutes with a peak of 40 mmHg) for their hemiplegic upper limb. The control group ( n = 12) received supplementary to their conventional physiotherapy a placebo treatment, namely sham short-wave therapy on the hemiplegic shoulder for 30 minutes. Main outcome measures: Sensory impairments were clinically assessed at three occasions over a period of four weeks using the Nottingham Sensory Assessment scale. Results: Both groups improved in somatosensation over time, but the experimental group improved more than the control group ( p = 0.036) or 81.1% improvement versus 30.9%. Conclusions: The use of intermittent pneumatic compression in the rehabilitation of stroke patients may be of clinical importance for the restoration of sensory function.
Effects of multisensory stimulation in people with Huntington's disease: a randomized controlled pilot study
Authors: Leng Tanya R , Woodward Melanie J , Stokes Maria J , Swan Anthony V , Wareing Lesley-Ann , Baker Roger 
Published: November 2003

Objective: To investigate whether behavioural, motor and physiological responses of individuals with Huntington's disease (HD) to a controlled multisensory environment (MSE) are effective as a therapeutic (sustained effects) or leisure (immediate effects) activity. Design: Pilot study – a randomized, controlled, two-group design. Setting: Specialist residential unit for people with mid-late stage HD. Subjects: Twelve patients with HD (one subject from each group dropped out during the study after week 8 due to medical complications). Interventions: Patients attended eight, 30-minute sessions over a four-week period, of multisensory stimulation (MSE, treatment group) or relaxation activities (control group). Main outcome measures: Between-group comparisons for changes between assessment sessions for two behavioural assessments: Rehabilitation Evaluation – Hall and Baker (REHAB), Behaviour and Mood Disturbance Scale (BMD); a motor assessment: the dyskinesia section of the St Hans Rating Scale (SHRS); physiological measures: blood pressure, heart rate and respiratory rate. Secondary measures during intervention sessions included behavioural assessment using the Interact. Results: There were no significant differences found between the groups for any main outcome measures made between sessions. The MSE group showed some positive effects within-sessions, with the Interact showing significant between-group differences in immediate effects on mood ( p = 0.028). There was also a significantly different change over time for within-session changes in stimulation levels ( p = 0.0002) and mood ( p = 0.0001) between the groups. No physiological effects were observed in relation to sessions in either group. Two MSE subjects underwent changes in medication during the study period.
Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4–8 years
Authors: Blundell S W , Shepherd R B , Dean C M , Adams R D , Cahill B M 
Published: November 2003

Objective: To determine the effects of intensive task-specific strength training on lower limb strength and functional performance in children with cerebral palsy. Design: A nonrandomized ABA trial. Setting: Sydney school. Subjects: Eight children with cerebral palsy, aged 4–8 years, seven with diagnosis of spastic diplegia, one of spastic/ataxic quadriplegia. Intervention: Four weeks of after-school exercise class, conducted for one hour twice weekly as group circuit training. Each work station was set up for intensive repetitive practice of an exercise. Children moved between stations, practising functionally based exercises including treadmill walking, step-ups, sit-to-stands and leg presses. Main outcome measures: Baseline test obtained two weeks before training, a pre-test immediately before and a post-test following training, with follow-up eight weeks later. Lower limb muscle strength was tested by dynamometry and Lateral Step-up Test; functional performance by Motor Assessment Scale (Sit-to-Stand), minimum chair height test, timed 10-m test, and 2-minute walk test. Results: Isometric strength improved pre- to post-training by a mean of 47% (SD 16) and functional strength, on Lateral Step-up Test, by 150% (SD 15). Children walked faster over 10 m, with longer strides, improvements of 22% and 38% respectively. Sit-to-stand performance had improved, with a reduction of seat height from 27 (SD 15) to 17 (SD 11) cm. Eight weeks following cessation of training all improvements had been maintained. Conclusions: A short programme of task-specific strengthening exercise and training for children with cerebral palsy, run as a group circuit class, resulted in improved strength and functional performance that was maintained over time.
Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature
Authors: Meijer R , Ihnenfeldt D S , de Groot I JM , van Limbeek J , Vermeulen M , de Haan R J 
Published: November 2003

Objective: To identify evidence-based prognostic factors in the subacute phase after stroke for activities of daily living (ADL) and ambulation at six months to one year after stroke. Design: Systematic literature search designed in accordance with the Cochrane Collaboration criteria with the following data sources: (1) MEDLINE, EMBASE, CINAHL, Current Contents, Cochrane Database of Systematic Reviews, Psyclit, and Sociological Abstracts. (2) Reference lists, personal archives, and consultation of experts. (3) Guidelines. Methods: Inclusion criteria were: (1) cohort studies of patients with an ischaemic or haemorrhagic stroke; (2) inception cohort with assessment of prognostic factors within the first two weeks after stroke; (3) outcome measures for ADL and ambulation; and (4) a follow-up of six months to one year. Internal, statistical and external validity of the studies were assessed using a checklist with 11 methodological criteria in accordance with the recommendations of the Cochrane Collaboration. Results: From 1027 potentially relevant studies 26 studies involving a total of 7850 patients met the inclusion criteria. Incontinence for urine is the only prognostic factor identified in three studies with a level A (i.e., a good level of scientific evidence according to the methodological score). The following factors were found in one level A study: initial ADL disability and ambulation, high age, severe paresis or paralysis, impaired swallowing, ideomotor apraxia, ideational apraxia, and visuospatial construction problems; as well as factors relating to complications of an ischaemic stroke, such as extraparenchymal bleeding, cerebral oedema and size of intraparenchymal haemorrhage. Conclusions: The present evidence concerning possible predictors in the subacute stage of stroke has insufficient quality to make an evidence-based prediction of ADL and ambulation after stroke because only one prognostic factor was demonstrated in at least two level A studies, our cut-off for sufficient scientific evidence.