Guest Editorial: Rehabilitation Research: Changing Focus From Outputs to Outcomes.
Guest Editorial: Rehabilitation research: Changing focus from outputs to outcomes.
Filed under: Rehab Centers
J Rehabil Res Dev. 2012 Dec; 49(9): vii-viii
Jahrami H, Hubail S
In vivo trial results of a novel ultrasonic cough stimulator.
Filed under: Rehab Centers
J Rehabil Res Dev. 2012 Dec; 49(9): 1421-30
Nitz JC, Perrier J, Cook P
The aims of these double-blind in-vivo trials of a prototype ultrasonic cough stimulator (CoughStim™) were to establish (1) whether ultrasound (US) stimulation can be safely used to stimulate a cough, (2) the most efficient US frequency and power parameters to reliably stimulate a cough, (3) whether single- or dual-sided stimulation is more effective, and (4) whether a cough can be stimulated in adults unable to cough on demand. Fifteen nondisabled volunteers (18-59 yr) and seven volunteers unable to cough on demand (85-102 yr) were recruited. Stimulation was applied to the neck unilaterally at eight frequencies and two power levels and bilaterally at two frequencies and three power levels. Vital signs were monitored during testing with no adverse responses. CoughStim stimulated a cough in all nondisabled subjects, 80% of subjects at 0.58 MHz and 9 W unilaterally and 75% of subjects at 0.58 MHz and 6 W bilaterally. Of the subjects unable to cough, 71 percent responded to bilateral stimuli (0.54 MHz and 6 W) with a strong cough. The CoughStim regularly and safely produced a moderately strong cough response in subjects with or without ability to cough and produced this effect without causing undue discomfort.
HubMed – rehab
Regional cortical and trabecular bone loss after spinal cord injury.
Filed under: Rehab Centers
J Rehabil Res Dev. 2012 Dec; 49(9): 1365-76
Dudley-Javoroski S, Shields RK
Spinal cord injury (SCI) triggers rapid loss of trabecular bone mineral density (BMD) in bone epiphyses and a loss of cortical cross-sectional area (CSA) in bone diaphyses, increasing fracture risk for people with SCI. The purpose of this study was to measure trabecular BMD and cortical CSA loss at several previously unexamined lower-limb sites (4% fibula, 12% femur, 86% tibia, cortical) in individuals with SCI. Using peripheral quantitative computed tomography, we scanned 13 participants with SCI longitudinally and 16 on one occasion; 21 participants without SCI served as controls. In the first year post-SCI, 15% to 35% of BMD was lost at the distal femur, proximal tibia, and distal fibula. Bone loss at the distal fibula accelerated between 1 and 2 years post-SCI. BMD at these sites reached a steady state value of ~50% of the non-SCI value 4 years post-SCI. At the tibia diaphysis, cortical CSA decline was slower, eventually reaching 65% of the non-SCI value. Because of the extensive loss of bone observed at these sites, careful consideration needs to be given to the dose of musculoskeletal stress delivered during rehabilitation interventions like standing, muscle electrical stimulation, and aggressive stretching of spastic muscles.
HubMed – rehab
Akathisia-rare cause of psychomotor agitation in patients with traumatic brain injury: Case report and review of literature.
Filed under: Rehab Centers
J Rehabil Res Dev. 2012 Dec; 49(9): 1349-54
Wielenga-Boiten JE, Ribbers GM
Akathisia is reported to be one of the most common and disabling side effects of antipsychotics and other drugs. Akathisia is also a rare cause of psychomotor agitation in patients with traumatic brain injury (TBI). In this clinical note, we describe a case report of akathisia in a 34-year-old woman with TBI; review earlier case studies on akathisia in TBI; and discuss the differential diagnosis and its pathophysiology, treatment, and prognosis.
HubMed – rehab
Determining skill level in myoelectric prosthesis use with multiple outcome measures.
Filed under: Rehab Centers
J Rehabil Res Dev. 2012 Dec; 49(9): 1331-48
Bouwsema H, Kyberd PJ, Hill W, van der Sluis CK, Bongers RM
To obtain more insight into how the skill level of an upper-limb myoelectric prosthesis user is composed, the current study aimed to (1) portray prosthetic handling at different levels of description, (2) relate results of the clinical level to kinematic measures, and (3) identify specific parameters in these measures that characterize the skill level of a prosthesis user. Six experienced transradial myoelectric prosthesis users performed a clinical test (Southampton Hand Assessment Procedure [SHAP]) and two grasping tasks. Kinematic measures were end point kinematics, joint angles, grasp force control, and gaze behavior. The results of the clinical and kinematic measures were in broad agreement with each other. Participants who scored higher on the SHAP showed overall better performance on the kinematic measures. They had smaller movement times, had better grip force control, and needed less visual attention on the hand. The results showed that time was a key parameter in prosthesis use and should be one of the main focus aspects of rehabilitation. The insights from this study are useful in rehabilitation practice because they allow therapists to specifically focus on certain parameters that may result in a higher level of skill for the prosthesis user.
HubMed – rehab
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