bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of transcutaneous electrical nerve stimulation (TENS) on Barthel Activities of Daily Living (ADL) Index score following stroke
Authors: Tekeolu Y'brahim , Adak Burhan , Göksoy Turgut 
Published: May 2003

Objective: To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) and placebo TENS on the level of activities of daily living (ADL) of stroke patients. Setting: A university hospital. Patients: Patients who had had a stroke 30–240 days before entry to a university rehabilitation centre. Design: Controlled design with block randomization and blinded assessment. Intervention: All patients had Todd–Davies exercises. In group 1 ( n = 30) TENS with frequency of 100 Hz was used at an intensity that the patient could tolerate; in group 2 ( n = 30) patients were given placebo TENS. The treatment protocol consisted of 40 sessions (eight weeks). Outcomes: The Barthel Index for daily living activities was used to measure functional changes over time, and the Ashworth Scale was used to measure spasticity in the elbow, knee and ankle. These measurements were made prior to and following the treatment by assessors unaware of the patient's group allocation. Results: There were 30 patients in each group. Patients in group 1 (active TENS) were more disabled at entry to the study. Statistically significant improvements were recorded in all parameters such as feeding, transfer, hygiene, toileting, bathing, walking, climbing stairs, dressing, bowel and bladder care for group 1 ( p<0.001) but only in some items in group 2. The change in total score was significant in both groups but the difference in the change score between the two groups was statistically significant ( p<0.001). Spasticity was reduced in the active treatment group. Conclusion: TENS appears to be an effective adjunct in the regaining of motor functions and improving ADL in hemiplegic patients, but the accidental imbalance in severity of disability at entry makes interpretation uncertain.
Measuring outcome in community-based rehabilitation services for people who have suffered traumatic brain injury: the Community Outcome Scale
Authors: Stilwell Philippa , Stilwell John , Hawley Carol , Davies Carol 
Published: May 2003

Objective: To develop a way of measuring long-term outcomes after traumatic brain injury (TBI) that takes account of individual circumstances. Design: Reports by head-injured people and their families about problems and coping strategies were elicited via semi-structured interviews. Specially designed computer software was used to record problems and strengths and to measure their impact for the individual on four handicap dimensions. Setting: Interviews took place in the respondents' homes. Subjects: Between 1992 and 1997 the services at 10 rehabilitation centres in England were evaluated. Subjects were men and women aged between 16 and 65 who had suffered TBI and who had been referred for treatment to one of the centres under study. Interventions: Head-injured people and their families were interviewed three months, 18 months and in some cases 36 months after recruitment. Main outcome measures: The Hospital Anxiety and Depression Scale (HAD) and the Functional Independence/Assessment Measure (FIM/FAM) were used to validate relevant dimensions of the new scale. Results: A measure of long-term outcome was developed and called the Community Outcome Scale. Relevant dimensions of the scale showed significant correlation with the HAD and with items of the FIM/FAM. Conclusion: The scale captures information which no other instrument does, and merits further validation.
Assault, post-traumatic amnesia and other variables related to outcome following head injury
Authors: Wenden F J , Crawford S , Wade D T , King N S , Moss N EG 
Published: May 2003

Objective: To estimate how many patients who sustain a head injury might benefit from intervention and support each year and to consider whether relationships can be found between demographic data relating to patients' circumstances at the time of head injury, and their outcomes six months later. Design: Data collected on 625 patients through follow-up interviews and assessments by the Oxford Head Injury Service for a randomized controlled trial of intervention conducted in 1993–94. Setting: A mixed rural and urban Health District with a population of approximately 560 000. Patients: Patients were aged between 16 and 65 years and resident in Oxfordshire. They presented over 13 months to accident and emergency departments, or were admitted to hospital. All were diagnosed as having suffered a head injury. Outcome measures: The Rivermead Head Injury Follow Up Questionnaire and the Rivermead Post Concussion Symptoms Questionnaire. Results: Data are given on age, sex, social circumstances, employment, cause of injury, severity of associated injuries, post-traumatic amnesia (PTA), anticonvulsants, postconcussion symptoms and activities of everyday life. Outcome at six months was significantly worse for those who had been assaulted as against all other causes of injury combined ( p = 0.0001); and/or had been admitted to hospital ( p = 0.0001); and/or had sustained more severe additional injuries ( p = 0.04); and/or had experienced any PTA ( p = 0.00001). The minimum incidence of such injuries in those aged 16–65, calculated for Oxfordshire, is 292 per annum (74/100 000 aged 16–65 per year). Conclusions: In the general population 52/100 000 patients per annum will experience more serious head injuries as indicated by hospital admission and/or one or more fractures and/or any length of PTA and/or having been assaulted. This group may benefit from monitoring and support and their needs should be considered when planning services.
The use of one-arm crank ergometry in the prediction of upper body aerobic capacity
Authors: Birkett W A , Edwards D F 
Published: May 2003

Objective: To determine whether a submaximal one-arm cranking test could be used to predict an individual's upper body aerobic capacity. This issue has potential importance for the fitness assessment of individuals with neurological disease or damage who have hemiplegia. Methods: Nine healthy male volunteers (33 ± 2.4 years) and nine female volunteers (27 ± 1.9 years) performed a two-arm maximal, two-arm submaximal test and a one-arm submaximal arm crank ergometry test. Heart rate (HR) was monitored via a three-lead electrocardiogram (ECG) and expired air was analysed every 30 seconds throughout. Prediction of peak oxygen consumption ( V O2peak) was calculated by linear extrapolation to an age-adjusted HRpeak. Results: Heart rate and VO2 were highly correlated in each test, and there were no significant differences between the VO2peak values obtained from maximal cranking and VO2peak predicted from one-and two-arm submaximal tests for males and females. As expected, males were found to have significantly ( p<0.001) higher actual and predicted VO2peak values, indicating that separate regression equations should be used for males and females. Conclusions: Heart rate values obtained during one-arm submaximal cranking have the potential to predict arm cranking VO2peak, and therefore provide an estimation of an individual's aerobic capacity, in addition to those obtained from the more traditional two-arm tests.
A study of the factors which influence the length of hospital stay of stroke patients
Authors: Hakim E A , Bakheit A MO 
Published: May 2003

Objective: To examine the factors which influence the length of hospitalization of stroke patients. Design: Analysis of the relative importance of 10 preselected variables on the length of hospital stay of all patients admitted with a clinical diagnosis of stroke. The data were collected prospectively. Setting: Two teaching hospitals serving the city of Southampton and southwest Hampshire, England (approximate population 450 000). Subjects: Forty-six consecutive stroke patients. Results: Data were complete on 38 patients. The mean and (median) length of hospital stay was 74.9 (80.5) days for men and 74.7 (73.5) for women. The mean age of women in the study sample was higher than that of men (73.2 vs 71.6). Patients who were less than 70 years of age stayed shorter periods in hospital than older subjects. Other factors associated with shorter hospitalization were a stroke type other than total anterior circulation infarct, a Barthel score of 12 or more on admission or at the time of discharge and a frequency of consultants' ward rounds of more than one per week. A delay in the provision of equipment and home adaptations and waiting for placement in a private nursing home were the best predictors of long hospital stays of stroke patients. Conclusions: Early liaison of rehabilitation staff with Social Services in order to secure the quick provision of environmental aids and adaptations or placement in residential care of stroke patients with a poor prognosis for functional recovery would probably reduce the unnecessary hospitalization of these patients.
Predictors of outcome of rehabilitation of elderly stroke patients in a geriatric ward
Authors: Thommessen Bente , Bautz-Holter Erik , Laake Knut 
Published: May 2003

Purpose: To identify predictors of outcome after 12 months in elderly stroke patients rehabilitated in a geriatric ward. Design: Prospective with evaluation in the subacute phase and after 12 months. Setting: Geriatric ward and outpatient clinic. Subjects: All stroke patients admitted from the acute unit to a geriatric ward for rehabilitation during a 16-month period ( n = 171). Main outcome measures: Place of living, mortality and social functioning (Frenchay Activities Index) 12 months following stroke. Results: Age, urinary incontinence and cognitive function were significantly associated with place of living (home versus nursing home) 12 months post stroke in bivariate analyses. However, using multivariate logistic regression analyses, only age ( p = 0.005) and urinary incontinence at baseline ( p = 0.028) remained independent predictors of place of living. Mortality during the first year was significantly predicted by urinary incontinence and gender (men doing worse), whereas the Barthel Activities of Daily Living (ADL) Index sumscore was the only significant independent predictor of social activities. Conclusion: Urinary incontinence at baseline seems to be a most important predictor of outcome 12 months post stroke in geriatric patients. However, with regard to social activities (Frenchay Activities Index), functional impairment in the initial phase as reflected by the Barthel ADL Index supersedes other predictors.
The development of a scale of the Guttman type for the assessment of mobility disability in multiple sclerosis
Authors: De Souza L H 
Published: May 2003

Objective: To develop a valid and reliable scale of the Guttman type for the assessment of mobility disability in multiple sclerosis (MS). Subjects: Sixty-eight subjects with a definite diagnosis of MS participated. They were living in the community and attending as outpatients at a MS unit at a District General Hospital. Thirty had the primary progressive pattern of disease, and 38 had the relapsing–remitting pattern. Methods: Formal assessments used for neurological disability were inspected, and 14 test items of gross motor function were extracted and ordered according to criteria. These were that tests required trunk control and did not require isolated movement at a single limb or body segment, that actions progressed from lying, to sitting, to standing and walking tasks, proceeding from broader to narrower bases of support. All subjects carried out all test items which were scored as ‘pass’ or ‘fail'. Analysis: Data were tested for internal consistency, reliability, inter-item correlation, reproducibility and scalability. On the basis of the results, the items were reordered in rank, and reduced to 11 tests. The 11-item scale was reanalysed. Results: Results showed that the scale had an internal consistency of 0.88 (α coefficient) and a coefficient of reproducibility (CR) of 0.95 and above for both MS subject groups. The coefficient of scalability (CS) for items was 0.78 for primary progressive subjects and 0.74 for the relapsing–remitting group. Reliability ranged from moderate (kappa = 0.49) for one item, to perfect for six items. Conclusion: The scale was demonstrated to be a hierarchical scale of the Guttman type exhibiting homogeneity and good reliability. The high CR indicated that scores may be summed, and the very acceptable levels of CS indicated that the cumulative scores are meaningful within the defined concept of hierarchy used in this study.
Sensitivity of Shah, Vanclay and Cooper's modified Barthel Index
Authors: Hocking Clare , Williams Maynard , Broad Joanna , Baskett Jonathan 
Published: May 2003

Objective: To investigate whether Shah, Vanclay and Cooper's modification of the Barthel Index improved its sensitivity to change. Design: Correlational study. Setting: School of Occupational Therapy at Auckland Institute of Technology, Auckland, New Zealand. Subjects: One hundred subjects requiring rehabilitation following a stroke. Main outcome measures: Change in function which was measured using Shah, Vanclay and Cooper's (1989) modified Barthel Index and walking speed over 10 metres. Results: Five statistical analyses were undertaken, none of which demonstrated clear superiority of one measure over the other. Conclusions: The study did not indicate the modified Barthel Index to be more sensitive to change than the 20-point Barthel Index for this population. The statistical analysis strategies utilized are recommended for similar studies.
A systematic review of the evidence base for lifestyle planning in adults with learning disabilities: implications for other disabled populations
Authors: Rudkin Angharad , Rowe Dermot 
Published: May 2003

Objective: To carry out the first systematic review of the evidence base for lifestyle planning (LP) approaches in adults with learning disability/developmental disorder and to discuss implications for other handicapped/disabled groups. Method: Exhaustive review of relevant electronic databases, supplemented by appropriate hand-searching of journals and correspondence with key researchers. We gathered information from any papers reporting clear outcome measures. Quantitative and qualitative aspects of relevant studies are appraised. Results: There are no randomized controlled trials of lifestyle planning in adults with learning disability/developmental disorder. There was one controlled trial. Five studies, with a total of 108 subjects clearly identified, report on some outcome data. Conclusions: There is surprisingly little evidence to support any form of lifestyle planning or lifestyle planning in general in the learning disability population. No statistically significant findings on positive outcomes with good statistical power exist. Limited data are presented to suggest certain desirable features of some methods of lifestyle planning in terms of process or outcome. However, there may be good ethical reasons for pursuing lifestyle planning with certain patient groups. Suggestions are made as to how further research may add to the evidence base for or against effective outcomes in different forms of lifestyle planning.
Patients' perceptions of the Odstock Dropped Foot Stimulator (ODFS)
Authors: Taylor Paul N , Burridge Jane H , Dunkerley Anna L , Lamb Amanda , Wood Duncan E , Norton Jonathan A , Swain Ian D 
Published: May 2003

Objective: To determine the perceived benefit, pattern and problems of use of the Odstock Dropped Foot Stimulator (ODFS) and the users' opinion of the service provided. Design: Questionnaire sent in a single mailshot to current and past users of the ODFS. Returns were sent anonymously. Setting: Outpatient-based clinical service. Subjects: One hundred and sixty-eight current and 123 past users with diagnoses of stroke (CVA), multiple sclerosis (MS), incomplete spinal cord injury (SCI), traumatic brain injury (TBI) and cerebral palsy (CP). Intervention: Functional electrical stimulation (FES) to correct dropped foot in subjects with an upper motor neuron lesion, using the ODFS. Main outcome measures: Purpose-designed questionnaire. Results:• Return rate 64% current users (mean duration of use 19.5 months) and 43% past users (mean duration of use 10.7 months). • Principal reason cited for using equipment was a reduction in the effort of walking. • Principal reasons identified for discontinuing were an improvement in mobility, electrode positioning difficulties and deteriorating mobility. • There were some problems with reliability of equipment. • Level of service provided was thought to be good. Conclusion: The ODFS was perceived by the users to be of considerable benefit. A comprehensive clinical follow-up service is essential to achieve the maximum continuing benefit from FES-based orthoses.
An open socket technique for through-knee amputations in relation to skin problems of the stump: an explorative study
Authors: Otter N , Postema K , Rijken R AJ , van Limbeek J 
Published: May 2003

Objective: To compare the conventional socket for through-knee amputees with an open socket system for skin problems and other relevant items. Design: All data were collected during three visits to the prosthetic clinic. At the second visit the conventional socket was replaced by the open socket. The use of both socket types was evaluated with a questionnaire and stump inspection. Setting: The subjects were evaluated at the Rehabilitation Centre, St Maartenskliniek, Nijmegen, the Netherlands. Subjects: Twenty subjects with a unilateral through-knee amputation were included and 13 subjects had a trial with the open socket. Results: There is a significant decrease of hyperhydrosis when wearing the open socket, there is no significant decrease in skin irritation or ulcers. The open socket also gives more comfort in sitting position. Conclusion: A further trial is needed in a selected group of prosthesis users among through-knee amputees to establish the long-term acceptance and benefits of the prosthesis with an open socket.
Feasibility study of a novel approach to sore prevention in patients with spinal cord lesions: the computerized dynamic control Matrix 200 system
Authors: Catz A , Philo O , Gilad N , Barel O , Geva T 
Published: May 2003

Objective: To evaluate the feasibility of a computerized mattress system based on a novel concept in sore prevention: continuous monitoring and adjustment of the interface pressure in small segments of contact between the skin and the supporting surface. Design: A preliminary observational study. Setting: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. Subjects: Twelve patients with spinal cord lesions. Interventions: Patients were examined for signs of impending sores after lying on the mattress for up to 4 successive hours. The pressure within each of the mattress's air cells was continuously measured and adjusted. Results: No evidence of redness or excessive perspiration was found in any of the areas considered to be high risk for bed sores. Maximal interface pressure was 22–30 mmHg in most of the examinations. Most of the patients felt comfortable on the mattress and the staff adapted easily to its operation. Conclusions: The system is apparently safe, and at least as efficient as other existing means for preventing sores. In addition, it may allow for increased intervals between bed positionings. We conclude that this approach of pressure control has the potential to improve bed sore prevention in a rehabilitation hospital setting.
Current practice and clinical relevance of somatosensory assessment after stroke
Authors: Winward Charlotte E , Halligan Peter W , Wade Derick T 
Published: May 2003

Objective: To examine the perceived clinical relevance, current practice and knowledge of somatosensory testing in three professional groups involved in the management and rehabilitation of stroke. Design: Structured postal questionnaire sent to therapists and doctors. Subjects: One hundred and eighty occupational therapists from the National Association of Neurological Occupational Therapists (NANOT), 180 physiotherapists from the Association of Chartered Physiotherapists with an Interest in Neurology (ACPIN) and 360 doctors from the Association of British Neurologists (ABN) and the British Geriatrics Society (BSG). Setting: Hospitals and rehabilitation centres in the UK. Results: Replies were obtained from 84 occupational therapists (47%), 98 physiotherapists (55%) and 78 doctors (22%). Sixty-four occupational therapists (77%), 82 physiotherapists (84%) and 66 doctors (87%) indicated that they routinely performed somatosensory assessment as part of their clinical assessment. The two most commonly used measures were proprioception and light touch. Seventy-eight occupational therapists (93%), 88 physiotherapists (90%) and 67 doctors (91%) regarded sensory assessment as clinically significant in determining prognosis after stroke. Conclusions: Despite published reservations concerning its usefulness and reliability, most therapists and doctors routinely assess somatosensory loss after stroke. All three professions agreed that somatosensory testing presented useful information for prognosis. Furthermore, all professional groups believe somatosensory assessment to be clinically relevant.
Betz cells of the primary motor cortex
Authors: Nolan Matthew , Scott Connor , Hof Patrick. R. , Ansorge Olaf 
Published: January 2024

AbstractBetz cells, named in honor of Volodymyr Betz (1834–1894), who described them as “giant pyramids” in the primary motor cortex of primates and other mammalian species, are layer V extratelencephalic projection (ETP) neurons that directly innervate α‐motoneurons of the brainstem and spinal cord. Despite their large volume and circumferential dendritic architecture, to date, no single molecular criterion has been established that unequivocally distinguishes adult Betz cells from other layer V ETP neurons. In primates, transcriptional signatures suggest the presence of at least two ETP neuron clusters that contain mature Betz cells; these are characterized by an abundance of axon guidance and oxidative phosphorylation transcripts. How neurodevelopmental programs drive the distinct positional and morphological features of Betz cells in humans remains unknown. Betz cells display a distinct biphasic firing pattern involving early cessation of firing followed by delayed sustained acceleration in spike frequency and magnitude. Few cell type‐specific transcripts and electrophysiological characteristics are conserved between rodent layer V ETP neurons of the motor cortex and primate Betz cells. This has implications for the modeling of disorders that affect the motor cortex in humans, such as amyotrophic lateral sclerosis (ALS). Perhaps vulnerability to ALS is linked to the evolution of neural networks for fine motor control reflected in the distinct morphomolecular architecture of the human motor cortex, including Betz cells. Here, we discuss histological, molecular, and functional data concerning the position of Betz cells in the emerging taxonomy of neurons across diverse species and their role in neurological disorders.
The intensity of environmental scandals, responsible innovation, and corporate resilience: The moderating role of relational trust
Authors: Xia Cao , Delei Wang 
Published: January 2024

AbstractResearch on the reasons contributing to the heterogeneous effects of environmental scandals on corporate performance remains limited. This study examines the factors of corporate resilience (CR) and employs event system theory to investigate the roles of responsible innovation (RI) and relational trust (RT) in shaping the relationship between environmental scandal intensity (ESI) and CR. We focus on examining the mediating role of RI in the relationship between ESI and CR and consider the moderating effect of RT. Analyzing survey data from 211 Chinese companies, we find that RI significantly mediates the inverted U‐shaped impact of ESI on CR. Moreover, RT regulates this relationship. These findings help extend our knowledge on the practice of CR when a scandal occurs and during its aftermath.