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1.
Laffont I Guillon B Fermanian C Pouillot S Even-Schneider A Boyer F Ruquet M Aegerter P Dizien O Lofaso F 《Archives of physical medicine and rehabilitation》2008,89(10):1958-1964
Laffont I, Guillon B, Fermanian C, Pouillot S, Even-Schneider A, Boyer F, Ruquet M, Aegerter P, Dizien O, Lofaso F. Evaluation of a stair-climbing power wheelchair in 25 people with tetraplegia.
Objective
To compare the performance of a power wheelchair with stair-climbing capability (TopChair) and a conventional power wheelchair (Storm3).Design
A single-center, open-label study.Setting
A physical medicine and rehabilitation hospital.Participants
Patients (N=25) who required power wheelchairs because of severe impairments affecting the upper and lower limbs.Interventions
Indoor and outdoor driving trials with both devices. Curb-clearing and stair-climbing with TopChair.Main Outcome Measures
Trial duration and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) tool; number of failures during driving trials and ability to climb curbs and stairs.Results
All 25 participants successfully completed the outdoor and indoor trials with both wheelchairs. Although differences in times to trial completion were statistically significant, they were less than 10%. QUEST scores were significantly better with the Storm3 than the TopChair for weight (P=.001), dimension (P=.006), and effectiveness (P=.04). Of the 25 participants, 23 cleared a 20-cm curb without help, and 20 climbed up and down 6 steps. Most participants felt these specific capabilities of the TopChair—for example, curb clearing and stair climbing—were easy to use (22/25 for curb, 21/25 for stairs) and helpful (24/25 and 23/25). A few participants felt insecure (4/25 and 6/25, respectively).Conclusions
The TopChair is a promising mobility device that enables stair and curb climbing and warrants further study. 相似文献2.
van Til JA Renzenbrink GJ Dolan JG Ijzerman MJ 《Archives of physical medicine and rehabilitation》2008,89(3):457-462
van Til JA, Renzenbrink GJ, Dolan JG, IJzerman MJ. The use of the analytic hierarchy process to aid decision making in acquired equinovarus deformity.
Objective
To increase the transparency of decision making about treatment in patients with equinovarus deformity poststroke.Design
The analytic hierarchy process (AHP) was used as a structured methodology to study the subjective rationale behind choice of treatment.Setting
An 8-hour meeting at a centrally located rehabilitation center in The Netherlands, during which a patient video was shown to all participants (using a personal computer and a large screen) and the patient details were provided on paper.Participants
A panel of 10 health professionals from different backgrounds.Interventions
Not applicable.Main Outcome Measures
The performance of the applicable treatments on outcome, impact, comfort, cosmetics, daily effort, and risks and side effects of treatment, as well as the relative importance of criteria in the choice of treatment.Results
According to the model, soft-tissue surgery (.413) ranked first as the preferred treatment, followed by orthopedic footwear (.181), ankle-foot orthosis (.147), surface electrostimulation (.137), and finally implanted electrostimulation (.123). Outcome was the most influential consideration affecting treatment choice (.509), followed by risk and side effects (.194), comfort (.104), daily effort (.098), cosmetics (.065), and impact of treatment (.030).Conclusions
Soft-tissue surgery was judged best on outcome, daily effort, comfortable shoe wear, and cosmetically acceptable result and was thereby preferred as a treatment alternative by the panel in this study. In contrast, orthosis and orthopedic footwear are usually preferred in daily practice. The AHP method was found to be suitable methodology for eliciting subjective opinions and quantitatively comparing treatments in the absence of scientific evidence. 相似文献3.
Background
Although many experimental, epidemiologic, and clinical studies have suggested that aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in reducing and preventing colorectal adenomas, randomized, controlled trials (RCTs) are still being carried out to obtain statistically reliable results.Objective
The aim of this meta-analysis was to review long-term, prospective RCTs investigating the effect of NSAIDs on the relative risk (RR) for developing ≥1 new colorectal polyp or adenoma in a high-risk population.Methods
We conducted a comprehensive search of MEDLINE, PubMed, and other electronic databases (including Inter-Science, Science Direct, Ebsco, Synergy, and Proquest) (key terms: nonsteroidal anti-inflammatory drugs, aspirin, colorectal, and polyps; years: 1974-2004) for English-language articles. Eligible studies were analyzed in terms of demographic data, adverse effects, and effect of NSAIDs on the RRs.Results
Four long-term, prospective RCTs were used in the statistical analysis. A total of 2069 high-risk patients were enrolled; 1880 patients completed the studies, and 1127 were in active-treatment groups (aspirin 81-325 mg/d or sulindac 150-300 mg/d). Our meta-analysis of these studies revealed that the overall RR for developing ≥ 1 new colorectal polyp or adenoma was significantly reduced by using aspirin or other NSAIDs (RR = 0.809; 95% CI, 0.718-0.912).Conclusions
The results of this meta-analysis suggest that regular use of aspirin 81 to 325 mg/d or sulindac 150 to 300 mg/d for ≥1 year was associated with a decrease in the RR for developing ≥ 1 new colorectal polyp or adenoma to 0.80 (95% CI, 0.718-0.912) in patients at high risk. 相似文献4.
Sultan M. Mosleh Alice Kiger Neil Campbell 《European Journal of Cardiovascular Nursing》2009,8(3):161-168
Background
Attendance rates at cardiac rehabilitation remain low with typically fewer than 35% of eligible patients attending. Much of the poor attendance stems from invited patients failing to attend.Aim
To design a theoretically based intervention to improve attendance at cardiac rehabilitation.Methods
Our methods followed recommendations that have been developed from the Medical Research Council (MRC) framework for the design of complex interventions. We conducted three processes that progressed simultaneously: 1) literature review for evidence on epidemiology, behavioural theory, and efficacy of interventions; 2) expert meetings on behavioural theory and to select target points for intervention; and 3) development and theoretical modelling of the intervention.Result
Our final interventions were a theoretically worded invitation letter and leaflet based on the Theory of Planned Behaviour and the Common Sense Model of Illness, designed to: a) motivate patients through professional recommendation; b) provide simple information on the contents of cardiac rehabilitation emphasising ease for participants; c) reassure participants that the programme is tailored to their personal needs in a safe supervised environment; and d) reinforce the benefits of attending cardiac rehabilitation.Conclusion
A theoretically worded letter and leaflet could be an inexpensive intervention to improve attendance at cardiac rehabilitation. The letters and leaflets will now be evaluated in a randomised trial. 相似文献5.
Martin W. Stenekes Jan H. Geertzen Jean-Philippe A. Nicolai Bauke M. De Jong Theo Mulder 《Archives of physical medicine and rehabilitation》2009,90(4):553-15
Stenekes MW, Geertzen JH, Nicolai J-P, De Jong BM, Mulder T. Effects of motor imagery on hand function during immobilization after flexor tendon repair.
Objective
To determine whether motor imagery during the immobilization period after flexor tendon injury results in a faster recovery of central mechanisms of hand function.Design
Randomized controlled trial.Setting
Tertiary referral hospital.Participants
Patients (N=28) after surgical flexor tendon repair were assigned to either an intervention group or a control group.Intervention
Kinesthetic motor imagery of finger flexion movements during the postoperative dynamic splinting period.Main Outcome Measures
The central aspects of hand function were measured with a preparation time test of finger flexion in which subjects pressed buttons as fast as possible following a visual stimulus. Additionally, the following hand function modalities were recorded: Michigan Hand Questionnaire, visual analog scale for hand function, kinematic analysis of drawing, active total motion, and strength.Results
After the immobilization period, the motor imagery group demonstrated significantly less increase of preparation time than the control group (P=.024). There was no significant influence of motor imagery on the other tested hand function (P>.05). All tests except kinematic analysis (P=.570) showed a significant improvement across time after the splinting period (P≤.001).Conclusions
Motor imagery significantly improves central aspects of hand function, namely movement preparation time, while other modalities of hand function appear to be unaffected. 相似文献6.
Sefton JM Hicks-Little CA Hubbard TJ Clemens MG Yengo CM Koceja DM Cordova ML 《Archives of physical medicine and rehabilitation》2008,89(10):1991-1995
Sefton JM, Hicks-Little CA, Hubbard TJ, Clemens MG, Yengo CM, Koceja DM, Cordova ML. Segmental spinal reflex adaptations associated with chronic ankle instability.
Objective
To further understanding of the role that segmental spinal reflexes play in chronic ankle instability (CAI).Design
A 2 × 2 repeated-measures case-control factorial design. The independent variables were ankle group with 2 levels (healthy, CAI) and stance with 2 levels (single, double legged).Setting
University research laboratory.Participants
Twenty-two participants with CAI and 21 matched healthy controls volunteered.Interventions
Not applicable.Main Outcome Measures
The dependent variables were 2 measures of motoneuron pool excitability: paired reflex depression (PRD) and recurrent inhibition.Results
A 2 × 2 repeated-measures multivariate analysis of variance revealed a significant interaction between group and stance on the linear combination of PRD and recurrent inhibition variables (Wilks λ=.808, F2,40=4.77, P=.014). Follow-up univariate F tests revealed an interaction between group and stance on the PRD (F1,41=9.74, P=.003). Follow-up dependent t tests revealed a significant difference between single- and double-legged PRD in the healthy participants (t20=-3.76, P=.001) with no difference in CAI participants (t21=-0.44, P=.67). Finally, there was a significant difference in recurrent inhibition between healthy (mean, 83.66) and CAI (mean, 90.27) (P=.004).Conclusions
This study revealed that, compared with healthy participants, CAI participants were less able to modulate PRD when going from a double- to a single-legged stance. Additionally, CAI participants showed higher overall levels of recurrent inhibition when compared with healthy matched controls. 相似文献7.
Gagnon C Mathieu J Jean S Laberge L Perron M Veillette S Richer L Noreau L 《Archives of physical medicine and rehabilitation》2008,89(7):1246-1255
Gagnon C, Mathieu J, Jean S, Laberge L, Perron M, Veillette S, Richer L, Noreau L. Predictors of disrupted social participation in myotonic dystrophy type 1.
Objective
To identify personal and environmental predictors of the most disrupted participation domains in people with myotonic dystrophy type 1 (DM1).Design
Cross-sectional study.Setting
Outpatient neuromuscular clinic.Participants
Adults (n=200; 121 women), age 18 years or older (mean age, 47y), with a confirmed diagnosis of DM1 were selected from the registry of a neuromuscular clinic (N=416). Fifty-two participants had the mild phenotype and 148 the adult phenotype.Interventions
Not applicable.Main Outcome Measures
Social participation in mobility, housing, employment, and recreation was assessed with the Life Habits Measure. Disrupted participation was based on whether help was needed in performing most life habits because of incapacities or environmental barriers. Environmental factors were assessed by using the Measure of the Quality of the Environment. Personal factors were assessed with standardized instruments including the Berg Balance Scale, the Krupp Fatigue Severity Scale, and manual muscle testing.Results
A large proportion of participants (45%-61%) reported disrupted participation in all 4 domains. Lower-extremity strength (odd ratios [OR], 15.0-5.5; P<.050) and higher fatigue (OR, 6.0-2.6; P<.05) were present in participants with disrupted participation. With regard to environmental factors, family support (OR, 3.6-2.5; P<.05) and public services (OR, 2.8-2.2; P<.05) were perceived as barriers for participants with disrupted participation in most domains.Conclusions
This study identified personal and environmental factors that may influence the trajectory toward disrupted participation in individuals with DM1. Fatigue, strength, family support, and public services were found to be independent predictors of disrupted participation. 相似文献8.
Eamonn Delahunt Angela McGrath Naoise Doran Garrett F. Coughlan 《Archives of physical medicine and rehabilitation》2010,91(9):1383-1389
Delahunt E, McGrath A, Doran N, Coughlan GF. Effect of taping on actual and perceived dynamic postural stability in persons with chronic ankle instability.
Objective
To investigate whether 2 different mechanisms of ankle joint taping ([1] lateral subtalar sling or [2] fibular repositioning) can enhance actual and perceived dynamic postural stability in participants with chronic ankle instability (CAI).Design
Laboratory-based repeated-measures study.Setting
University biomechanics laboratory.Participants
Participants (n=16) with CAI.Interventions
Participants performed the Star Excursion Balance Test (SEBT) under 3 different conditions: (1) no tape, (2) lateral subtalar sling taping and (3) fibular repositioning taping.Main Outcome Measures
Reach distances in the anterior, posteromedial, and posterolateral directions on the SEBT. Participants' perceptions of stability, confidence, and reassurance when performing the SEBT under 2 different taping conditions.Results
Taping did not improve reach distance on the SEBT (P>.05). Feelings of confidence increased for 56% of participants (P=.002) under both tape conditions. Feelings of stability increased for 87.5% of participants (P<.001) using condition 2 (lateral subtalar sling taping) and 75% of participants (P=.001) using condition 3 (fibular repositioning taping). Feelings of reassurance increased for 68.75% of participants (P=.001) using condition 2 (lateral subtalar sling taping) and 50% of participants (P=.005) using condition 3 (fibular repositioning taping).Conclusions
No significant change in dynamic postural stability was observed after application of either taping mechanism; however, participants' perceptions of confidence, stability, and reassurance were significantly improved. Further research is necessary to fully elucidate the exact mechanisms by which taping may help reduce the incidence of repeated injury in subjects with CAI. 相似文献9.
Morse LR Stolzmann K Nguyen HP Jain NB Zayac C Gagnon DR Tun CG Garshick E 《Archives of physical medicine and rehabilitation》2008,89(4):726-731
Morse LR, Stolzmann K, Nguyen HP, Jain NB, Zayac C, Gagnon D, Tun CG, Garshick E. Association between mobility mode and C-reactive protein levels in men with chronic spinal cord injury.
Objective
To assess clinical determinants of systemic inflammation in persons with chronic spinal cord injury (SCI).Design
Cross-sectional survey.Setting
Veterans Affairs medical center.Participants
As part of an epidemiologic study assessing SCI-related health conditions, 63 men with chronic SCI provided a blood sample and information regarding locomotive mode and personal habits.Interventions
Not applicable.Main Outcome Measure
Plasma high-sensitivity C-reactive protein (CRP).Results
The mean ± standard deviation age was 56±14y, and participants were assessed 21±13y after injury. Adjusting for heart disease, hypertension, and body mass index (BMI), the mean CRP in 12 motorized wheelchair users (5.11mg/L) was not significantly greater than 23 participants who used a manual wheelchair (2.19mg/L) (P=.085) but was significantly greater than the 17 who walked with an assistive device (1.41mg/L) (P=.005) and the 12 who walked independently (1.63mg/L) (P=.027). CRP was significantly greater in participants with obesity but was not related to age, smoking, or SCI level and severity. CRP was elevated in participants reporting a urinary tract infection (UTI) or pressure ulcer within a year, but adjustment for this did not account for the elevated CRP in motorized wheelchair users.Conclusions
These results suggest that CRP in chronic SCI is independently related to locomotive mode, BMI, and a history of pressure ulcers and UTI. It is suggested that future studies in SCI investigate whether modifying these factors influence systemic inflammation and cardiovascular health. 相似文献10.
Filiatrault J Gauvin L Richard L Robitaille Y Laforest S Fournier M Corriveau H 《Archives of physical medicine and rehabilitation》2008,89(10):1948-1957
Filiatrault J, Gauvin L, Richard L, Robitaille Y, Laforest S, Fournier M, Corriveau H. Impact of a multifaceted community-based falls prevention program on balance-related psychologic factors.
Objective
To assess the impact of a multifaceted falls prevention program including exercise and educational components on perceived balance and balance confidence among community-dwelling seniors.Design
Quasi-experimental design.Setting
Community-based organizations.Participants
Two hundred community-dwelling adults aged 60 years and over recruited by community-based organizations.Intervention
A 12-week multifaceted falls prevention program including 3 components (a 1-hour group exercise class held twice a week, a 30-minute home exercise module to be performed at least once a week, a 30-minute educational class held once a week).Main Outcome Measures
Perceived balance and balance confidence.Results
Multivariate analysis showed that the program was successful in increasing perceived balance in experimental participants. However, balance confidence was not improved by program participation.Conclusions
A multifaceted community-based falls prevention program that was successful in improving balance performance among community-dwelling seniors also had a positive impact on perceived balance. However, the program did not improve participants' balance confidence. These results suggest that balance confidence has determinants other than balance and that new components and/or modifications of existing components of the program are required to achieve maximal benefits for seniors in terms of physical and psychologic outcomes. 相似文献11.
Altman IM Swick S Parrot D Malec JF 《Archives of physical medicine and rehabilitation》2010,91(11):1697-1704
Altman IM, Swick S, Parrot D, Malec JF. Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged.
Objective
To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR).Design
Retrospective analysis of program evaluation data for treatment completers and noncompleters.Setting
Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities.Participants
Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group).Intervention
PABIR delivered in home and community settings by certified professional staff on an individualized basis.Main Outcome Measures
Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact.Results
Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up.Conclusions
Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up. 相似文献12.
Marita B. de Leon Ned L. Kirsch Ronald F. Maio Cheribeth U. Tan-Schriner Scott R. Millis Shirley Frederiksen Clare L. Tanner M. Lynn Breer 《Archives of physical medicine and rehabilitation》2009,90(6):956-965
de Leon MB, Kirsch NL, Maio RF, Tan-Schriner CU, Millis SR, Frederiksen S, Tanner CL, Breer ML. Baseline predictors of fatigue 1 year after mild head injury.
Objective
To compare reports of fatigue 12 months after minor trauma by participants with mild head injury (MHI) with those with other injury, and identify injury and baseline predictors of fatigue.Design
An inception cohort study of participants with MHI and other nonhead injuries recruited from and interviewed at the emergency department (ED), with a follow-up telephone interview at 12 months.Setting
Level II community hospital ED.Participants
Participants (n=58) with MHI and loss of consciousness (LOC) of 30 minutes or less and/or posttraumatic amnesia (PTA) less than 24 hours, 173 with MHI but no PTA/LOC, and 128 with other mild nonhead injuries. Inclusion criteria: age 18 years or older, within 24 hours of injury, Glasgow Coma Scale score of 13 or higher, and discharge from the ED.Interventions
Not applicable.Main Outcome Measure
Medical Outcomes Study 36-Item Short-Form Health Survey Vitality subscale.Results
Significant predictors of fatigue severity at 12 months were baseline fatigue, having seen a counselor for a mental health issue, medical disability, marital status, and in some stage of litigation. Injury type was not a significant predictor.Conclusions
Fatigue severity 12 months after injury is associated with baseline characteristics and not MHI. Clinicians should be cautious about attributing persisting fatigue to MHI without comprehensive consideration of other possible etiologic factors. 相似文献13.
Objective
To investigate the effect of spectators on the performance of a physiotherapy exercise.Design
Observational study.Setting
Research laboratory, Trinity College Dublin.Participants
Forty adult volunteer subjects (36 females, four males). As there were only four males, these were excluded from the analysis.Interventions
Subjects were observed and timed while performing single leg stance in two conditions 48 hours apart; once with the investigator present (investigator condition) and once with the investigator and three spectators present (spectator condition).Main outcome measure
Duration of single leg stance in seconds.Results
The mean duration of single leg stance, for females, under the investigator condition was 173 seconds [95% confidence interval (CI) 131 to 214], while that of the spectator condition was 168 seconds (95%CI 128 to 208). The mean difference between the two conditions was 5 seconds (95%CI −21 to 31). This was not statistically significant using a paired t-test (P = 0.686).Conclusions
Female performance of a straightforward exercise such as single leg stance was not affected by the presence of three spectators. 相似文献14.
Claire L. Boswell-Ruys Daina L. Sturnieks Lisa A. Harvey Catherine Sherrington James W. Middleton Stephen R. Lord 《Archives of physical medicine and rehabilitation》2009,90(9):1571-1577
Boswell-Ruys CL, Sturnieks DL, Harvey LA, Sherrington C, Middleton JW, Lord SR. Validity and reliability of assessment tools for measuring unsupported sitting in people with a spinal cord injury.
Objectives
To develop simple tests to assess the abilities of people with spinal cord injury (SCI) to sit unsupported and to assess the construct validity and test-retest reliability of these tests.Design
Cross-sectional comparisons, convenience sample.Setting
Biomechanical laboratory.Participants
People (N=30) with SCI between the C6 and the L2 level of 2 months to 37 years duration before assessment. The sample was stratified by impairment level (at T8) and time since injury (1y postinjury).Interventions
Not applicable.Main Outcome Measures
On 2 separate occasions, participants performed tests that measured the distance of upper-body sway and maximal torso leaning, errors made during a coordinated stability task, timed dressing/undressing of the upper body and alternating arm reaching, and percentage change in seated upper body/arm reaching.Results
All tests showed good construct validity in that they distinguished between participants with higher (C6-T7) and lower (T8-L2) level impairments (P<.05) and between participants with acute (≤1y) and chronic (>1y) lesions (P<.05). The tests also showed good to excellent test-retest reliability (intraclass correlation coeffiecient3,1 range, .51-.91).Conclusions
These simple and quick-to-administer tests have both construct validity and test-retest reliability. They would be appropriate for research and clinical purposes to quantify the abilities of people with SCI to sit unsupported. 相似文献15.
Kluding PM, Santos M. Effects of ankle joint mobilizations in adults poststroke: a pilot study.
Objective
To compare the effect of 2 interventions on ankle mobility, ankle kinematics, and weight-bearing symmetry during functional activities in subjects with hemiparesis after a stroke.Design
Randomized trial.Setting
Academic medical center.Participants
A convenience sample of 16 subjects with hemiparesis after stroke (mean age, 55.2y; mean time since stroke, 21.4mo).Intervention
Subjects received 8 sessions over 4 weeks of either functional task practice combined with ankle joint mobilizations, or functional task practice only.Main Outcome Measures
Changes in ankle range of motion (ROM) (not blinded), ankle kinematics during sit-to-stand (STS) and gait, and lower-extremity weight-bearing symmetry during STS and static standing.Results
The combined intervention group gained 5.7°±3.1° in passive ankle ROM compared with 0.2°±2.6° in the functional practice only group (95% confidence interval [CI], 2.5-8.6; P<.01). No significant changes in ankle kinematics or weight bearing during static standing were noted in either group. The functional practice group decreased differences in weight bearing during STS by 9.5%±6.47%, whereas the combined intervention group increased this difference by 3.37%±5.29% (95% CI, 3.26-19.46; P=.01).Conclusions
The increase in ankle motion did not improve joint kinematics and may have prevented improvement in weight-bearing symmetry. 相似文献16.
Ogawa H Oshita H Ishimaru D Yamada K Shimizu T Koyama Y Akaike A Hori H 《Archives of physical medicine and rehabilitation》2008,89(2):329-332
Ogawa H, Oshita H, Ishimaru D, Yamada K, Shimizu T, Koyama Y, Akaike A, Hori H. Analysis of muscle atrophy after hip fracture in the elderly.
Objectives
To examine the relationship between muscle atrophy, ambulatory ability, and fracture type, and to make a specific rehabilitation regimen for each fracture type.Design
Observational study.Setting
Public hospital.Participants
Consecutive patients (N=53) with hip fracture (mean age, 83.6y) who underwent operative treatment.Interventions
Not applicable.Main Outcome Measures
The ambulatory ability score and the cross-sectional areas of lower-limb muscles as measured on computed tomography scans.Results
Muscle atrophy was not related to fracture type. Although the mean ambulatory ability score decreased significantly from 4.5±0.3 points prior to injury to 3.0±0.6 points 1 month postadmission, the degree of muscle atrophy was not associated with the decrease in ambulatory ability.Conclusions
It seems likely that other factors are more important than muscle atrophy and fracture type in determining recovery after surgical repair of a fracture and that there is no need for rehabilitation regimens based on fracture types. 相似文献17.
Shiow-Ru Chang Kuang-Ho Chen Yu-Mei Y. Chao 《International journal of nursing studies》2011,48(4):409-418
Background
The episiotomy rate has declined worldwide but remains high in several countries such as Taiwan. The effects of episiotomy on women's health should be a constant concern. Few data are available on the effect of episiotomy by validated measures.Objective
The present study examined the effect of episiotomy on pain, urinary incontinence, and sexual function up to 3 months postpartum.Design, setting and participants
A prospective follow-up study of 243 women who completed the Taiwanese versions of the Short Form McGill Pain Questionnaire, International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form, Female Sexual Function Index, and a demographic questionnaire after vaginal delivery in a Taiwanese medical center.Methods
Differences between those who did and did not have an episiotomy were tested using ANCOVA, adjusting for age, parity, newborn weight, and vacuum delivery. The reliability and validity of the measuring instruments were assessed using Cronbach's α coefficient and factor analysis.Results
Women who delivered without an episiotomy had significantly lower perineal pain scores at weeks 1, 2 and 6 postpartum compared to women who had an episiotomy (p = 0.0065, 0.0391, 0.0497, respectively). Women in the no-episiotomy group had significantly lower non-localized pain scores at week 2 postpartum compared to women in the episiotomy group (p = 0.0438). The mean urinary incontinence score was significantly higher in the episiotomy group 3 months postpartum (p = 0.0293). No significant difference in sexual function score was found between groups.Conclusions
The results indicate that episiotomy increased pain at weeks 1, 2 and 6 postpartum, and urinary incontinence at 3 months postpartum. Awareness of the relationship between episiotomy and women's health will help health care professionals develop policy and promote the application of restrictive episiotomy. 相似文献18.
Correlation between vestibular function and hip fracture following falls in the elderly: a case-controlled study 总被引:1,自引:0,他引:1
Objective
To examine vestibular function following falls in the elderly.Design
A case-controlled study to compare vestibular function in elderly people with hip fractures and elderly people with no prior hip fractures.Participants
One hundred and sixty-nine people aged 65 years or older took part in the study. Study Group A consisted of 84 hospitalised volunteers who had received hip surgery due to a fall and who were undergoing rehabilitation. Control Group B consisted of 85 volunteers from retirement homes with no prior history of hip fracture.Intervention
All participants underwent four clinical tests to determine their level of vestibular functioning in order to allow comparison between the groups. Three methods were used to test the vestibulo-ocular reflex (VOR), and one method was used to test benign paroxysmal positional vertigo.Results
Thirty-eight percent of the participants in Study Group A and 11% of the participants in Control Group B demonstrated a positive visual acuity test (P < 0.001). The odds ratio suggests that the participants of Study Group A were 4.83 [95% confidence interval (CI) 2.1 to 11.0] times more likely to present a positive static and dynamic visual acuity test than the participants of Control Group B, and 3.12 (95% CI 1.62 to 6.02) times more likely to have a positive head impulse test. There were no differences in the head shaking nystagmus test or the Dix-Hallpike test between groups, and no association between the side of the fracture and the side of the vestibular impairment.Conclusions
Study Group A exhibited greater VOR impairment than Control Group B. Therefore, impairment of this reflex may be considered as a risk factor for falls. 相似文献19.
Shih-Tzu Huang Marion Good Jaclene A. Zauszniewski 《International journal of nursing studies》2010,47(11):1354-1362
Objectives
To examine effects of sedative music on cancer pain.Design
A randomized controlled trial.Settings
Two large medical centers in Kaoshiung City, in southern Taiwan.Participants
126 hospitalized persons with cancer pain.Methods
Participants were randomly assigned to an experimental (n = 62) or a control group (n = 64), with computerized minimization, stratifying on gender, pain, and hospital unit. Music choices included folk songs, Buddhist hymns (Taiwanese music), plus harp, and piano (American). The experimental group listened to music for 30 min; the control group rested in bed. Sensation and distress of pain were rated on 100 mm VAS before and after the 30-min test.Results
Using MANCOVA, there was significantly less posttest pain in the music versus the control group, p < .001. Effect sizes were large, Cohen's d = .64, sensation, d = .70, distress, indicating that music was very helpful for pain. Thirty minutes of music provided 50% relief in 42% of the music group compared to 8% of the controls. The number needed to treat (NNT) to find one with 50% sensation relief was three patients. More patients chose Taiwanese music (71%) than American music (29%), but both were liked and effective.Conclusions
Offering a choice of familiar, culturally appropriate music was a key element of the intervention. Findings extend the Good and Moore theory (1996) to cancer pain. Soft music was safe, effective, and liked by participants. It provided greater relief of cancer pain than analgesics alone. Thus nurses should offer calming, familiar music to supplement analgesic medication for persons with cancer pain. 相似文献20.
Elizabeth L. Proud Meg E. Morris 《Archives of physical medicine and rehabilitation》2010,91(5):794-799
Proud EL, Morris ME. Skilled hand dexterity in Parkinson's disease: effects of adding a concurrent task.